Investigating the effectiveness and feasibility of exercise on microvascular reactivity and quality of life in systemic sclerosis patients: study protocol for a feasibility study

Background: Raynaud’s phenomenon is one of the first clinical manifestations observed in systemic sclerosis (SSc). This microvasculature disorder affects mostly the digits in over 95% of SSc patients, significantly affecting their healthrelated quality of life (HRQoL) and incurring higher hospital admissions and other healthcare costs. Exercise is known to improve both micro- and macrovascular function – aerobic exercise and resistance training, separately or combined, have been demonstrated to lead to significant vasculo-physiological improvements in conditions that present vasculopathy. However, the effects of a combined exercise programme on microcirculation in SSc patients has yet to be investigated. Therefore, the purpose of this study is to assess the effects of high-intensity interval training (HIIT) combined with circuit resistance training on the microvascular function in the digital area of SSc patients. Methods: This will be a randomised controlled, feasibility trial with two arms, wherein 30 patients with SSc in receipt of medical treatment will be randomly assigned to usual care (medical treatment) or to a 12-week supervised exercise programme. Patients in the exercise group will undertake two, 45-min sessions each week consisting of 30 min HIIT (30 s 100% peak power output/30 s passive recovery) on the arm crank ergometer and 15 min of upper body circuit resistance training. Patients will be assessed before as well as at 3 and 6 months following randomisation. Primary outcomes of the study will be recruitment and retention rate, intervention acceptability and adherence to the exercise programme. Secondary outcomes include the digital area cutaneous microvascular function (laser Doppler fluximetry combined with iontophoresis), physical fitness, functional ability, upper back transcutaneous oxygen tension, body composition and quality of life (EQ-5D-5L). Selected interviews with a subsample of patients will be undertaken to explore their experiences of having Raynaud’s phenomenon and the acceptability of the exercise intervention and study procedures. Discussion: Data from this study will be used to identify the feasibility of a combined exercise programme to be implemented in SSc patients, the acceptability of the intervention and the study design, and to determine the effects of exercise on the microvasculature. Overall, this study will provide sufficient data to inform and support a full multicentre clinical trial

Global maps of the magnetic thickness and magnetization of the Earth’s lithosphere

International audienceWe have constructed global maps of the large-scale magnetic thickness and magnetization of Earth's lithosphere. Deriving such large-scale maps based on lithospheric magnetic field measurements faces the challenge of the masking effect of the core field. In this study, the maps were obtained through analyses in the spectral domain by means of a new regional spatial power spectrum based on the Revised Spherical Cap Harmonic Analysis (R-SCHA) formalism. A series of regional spectral analyses were conducted covering the entire Earth. The R-SCHA surface power spectrum for each region was estimated using the NGDC-720 spherical harmonic (SH) model of the lithospheric magnetic field, which is based on satellite, aeromagnetic, and marine measurements. These observational regional spectra were fitted to a recently proposed statistical expression of the power spectrum of Earth's lithospheric magnetic field, whose free parameters include the thickness and magnetization of the magnetic sources. The resulting global magnetic thickness map is compared to other crustal and magnetic thickness maps based upon different geophysical data. We conclude that the large-scale magnetic thickness of the lithosphere is on average confined to a layer that does not exceed the Moho

Subcycle Quantum Electrodynamics

Besides their stunning physical properties which are unmatched in a classical world, squeezed states of electromagnetic radiation bear advanced application potentials in quantum information systems and precision metrology, including gravitational wave detectors with unprecedented sensitivity. Since the first experiments on such nonclassical light, quantum analysis has been based on homodyning techniques and photon correlation measurements. These methods require a well-defined carrier frequency and photons contained in a quantum state need to be absorbed or amplified. They currently function in the visible to near-infrared and microwave spectral ranges. Quantum nondemolition experiments may be performed at the expense of excess fluctuations in another quadrature. Here we generate mid-infrared time-locked patterns of squeezed vacuum noise. After propagation through free space, the quantum fluctuations of the electric field are studied in the time domain by electro-optic sampling with few-femtosecond laser pulses. We directly compare the local noise amplitude to the level of bare vacuum fluctuations. This nonlinear approach operates off resonance without absorption or amplification of the field that is investigated. Subcycle intervals with noise level significantly below the pure quantum vacuum are found. Enhanced fluctuations in adjacent time segments manifest generation of highly correlated quantum radiation as a consequence of the uncertainty principle. Together with efforts in the far infrared, this work opens a window to the elementary quantum dynamics of light and matter in an energy range at the boundary between vacuum and thermal background conditions.Comment: 19 pages, 4 figure

The effects of upper and lower limb exercise on the microvascular reactivity in limited cutaneous systemic sclerosis patients

Background: Aerobic exercise in general and high intensity interval training (HIIT) specifically is known to improve vascular function in a range of clinical conditions. HIIT in particular has demonstrated improvements in clinical outcomes, in conditions that have a strong macroangiopathic component. Nevertheless, the effect of HIIT on microcirculation in systemic sclerosis (SSc) patients is yet to be investigated. Therefore, the purpose of the study was to compare the effects of two HIIT protocols (cycle and arm cranking) on the microcirculation of the digital area in SSc patients. Methods: Thirty four limited cutaneous SSc patients (65.3 ± 11.6 years old) were randomly allocated in three groups (cycling, arm cranking and control group). The exercise groups underwent a twelve-week exercise program twice per week. All patients performed the baseline and post-exercise intervention measurements where physical fitness, functional ability, transcutaneous oxygen tension (ΔtcpO2), body composition and quality of life were assessed. Endothelial-dependent as well as-independent vasodilation were assessed in the middle and index fingers using LDF and incremental doses of acetylcholine (ACh) and sodium nitroprusside (SNP). Cutaneous flux data were expressed as cutaneous vascular conductance (CVC). Results: Peak oxygen uptake increased in both exercise groups (p<0.01, d=1.36). ΔtcpO2 demonstrated an increase in the arm cranking group only, with a large effect, but not found statistically significant,(p=0.59, d=0.93). Endothelial-dependent vasodilation improvement was greater in the arm cranking (p<0.05, d=1.07) in comparison to other groups. Both exercise groups improved life satisfaction (p<0.001) as well as reduced discomfort and pain due to Raynaud's phenomenon (p<0.05). Arm cranking seems to be the preferred mode of exercise for study participants as compared to cycling (p<0.05). No changes were observed in the body composition or the functional ability in both exercise groups. Conclusion: Our results suggest that arm cranking has the potential to improve the microvascular endothelial function in SSc patients. Also notably, our recommended training dose (e.g., a 12-week HIIT program, twice per week), appeared to be sufficient and tolerable for this population. Future research should focus on exploring the feasibility of a combined exercise such as aerobic and resistance training by assessing individual's experience and the quality of life in SSc patients. Trial registration: ClinicalTrials.gov (NCT number): NCT03058887, February 23, 2017, https://clinicaltrials.gov/ct2/show/NCT03058887?term=NCT03058887&rank=1 Key words: High intensity interval training, vascular function, quality of lif

Atmospheric electrification in dusty, reactive gases in the solar system and beyond

Detailed observations of the solar system planets reveal a wide variety of local atmospheric conditions. Astronomical observations have revealed a variety of extrasolar planets none of which resembles any of the solar system planets in full. Instead, the most massive amongst the extrasolar planets, the gas giants, appear very similar to the class of (young) Brown Dwarfs which are amongst the oldest objects in the universe. Despite of this diversity, solar system planets, extrasolar planets and Brown Dwarfs have broadly similar global temperatures between 300K and 2500K. In consequence, clouds of different chemical species form in their atmospheres. While the details of these clouds differ, the fundamental physical processes are the same. Further to this, all these objects were observed to produce radio and X-ray emission. While both kinds of radiation are well studied on Earth and to a lesser extent on the solar system planets, the occurrence of emission that potentially originate from accelerated electrons on Brown Dwarfs, extrasolar planets and protoplanetary disks is not well understood yet. This paper offers an interdisciplinary view on electrification processes and their feedback on their hosting environment in meteorology, volcanology, planetology and research on extrasolar planets and planet formation

Potential therapeutic applications of microbial surface-activecompounds

Numerous investigations of microbial surface-active compounds or biosurfactants over the past two decades have led to the discovery of many interesting physicochemical and biological properties including antimicrobial, anti-biofilm and therapeutic among many other pharmaceutical and medical applications. Microbial control and inhibition strategies involving the use of antibiotics are becoming continually challenged due to the emergence of resistant strains mostly embedded within biofilm formations that are difficult to eradicate. Different aspects of antimicrobial and anti-biofilm control are becoming issues of increasing importance in clinical, hygiene, therapeutic and other applications. Biosurfactants research has resulted in increasing interest into their ability to inhibit microbial activity and disperse microbial biofilms in addition to being mostly nontoxic and stable at extremes conditions. Some biosurfactants are now in use in clinical, food and environmental fields, whilst others remain under investigation and development. The dispersal properties of biosurfactants have been shown to rival that of conventional inhibitory agents against bacterial, fungal and yeast biofilms as well as viral membrane structures. This presents them as potential candidates for future uses in new generations of antimicrobial agents or as adjuvants to other antibiotics and use as preservatives for microbial suppression and eradication strategies

Physical activity - A neat solution to an impending crisis

Childhood obesity is arguably the most significant global public health threat, yet effective strategies to contain or prevent the disease are not available. This review examines the physical activity patterns of children and the role physical activity plays in daily energy expenditure. The prevailing focus on moderate to vigorous activity in childhood means there is limited objective information on either sedentary behaviour or non-exercise activity thermogenesis (NEAT), the energy expended during the activities of daily living. Most strategies targeting the prevention of childhood obesity have focused upon adding moderate to vigorous activity and have not been particularly successful. The low efficacy of more purposeful activity is perhaps not surprising because of the small variance in children's physical activity levels explained by moderate to vigorous activity. Subtle changes in NEAT have in contrast been shown to account for differences in fat-mass gain or resistance in adults. Theoretically, manipulating a child's living environment to enhance NEAT would create a positive gain in TDEE, a gain that could lead to the prevention of excess fat-mass. More careful consideration of the specific aspects of physical activity that are most influential in the maintenance of body weight in childhood is a priority. Appreciating the role NEAT may play in the variation of total daily energy expenditure in children is a future challenge for physical activity research. ©Journal of Sports Science and Medicine (2007).link_to_subscribed_fulltex