3,201 research outputs found

    Effect of Brief Counseling by Allied Health Professionals on Step Count of People With Peripheral Artery Disease: A Randomized Clinical Trial

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    Importance: It is unclear how to effectively promote walking in people with peripheral artery disease (PAD). Objective: To test whether brief counseling delivered by allied health professionals increases step count in participants with PAD. Design, Setting, and Participants: In this randomized clinical trial, participants with symptomatic PAD were recruited from sites in Australia and randomly allocated 1:1 to the counseling intervention or an attention control. Data were collected from January 2015 to July 2021, and data were analyzed from March to November 2022. Interventions: Two 1-hour face-to-face and two 15-minute telephone counseling sessions designed to increase walking. Main Outcomes and Measures: The primary outcome was the between-group difference in change in daily step count estimated by accelerometer recordings over 7 days at baseline and 4 months, using imputation for missing values. Other outcomes at 4, 12, and 24 months included step count, 6-minute walk distance, and disease-specific and generic measures of health-related quality of life. Risk of major adverse limb events was assessed over 24 months. Results: Of 200 included participants, 144 (72.0%) were male, and the mean (SD) age was 69.2 (9.3) years. The planned sample of 200 participants was allocated to the counseling intervention group (n = 102) or attention control group (n = 98). Overall, 198 (99.0%), 175 (87.5%), 160 (80.0%) and 143 (71.5%) had step count assessed at entry and 4, 12, and 24 months, respectively. There was no significant between-group difference in the primary outcome of change in daily step count over 4 months (mean steps, 415; 95% CI, −62 to 893; P = .07). Participants in the counseling group had significantly greater improvement in the secondary outcome of disease-specific Intermittent Claudication Questionnaire score at 4 months (3.2 points; 95% CI, 0.1-6.4; P = .04) and 12 months (4.3 points; 95% CI, 0.5-8.1; P = .03) but not at 24 months (1.2 points; 95% CI, −3.1 to 5.6; P = .57). Findings were similar for mean PAD Quality of Life Questionnaire component assessing symptoms and limitations in physical functioning (4 months: 1.5 points; 95% CI, 0.3-2.8; P = .02; 12 months: 1.8 points; 95% CI, 0.3-3.3; P = .02; 24 months: 1.3 points; 95% CI. −0.5 to 3.1; P = .16). There was no significant effect of the intervention on change in mean 6-minute walking distance (4 months: 9.3 m; 95% CI, −3.7 to 22.3; P = .16; 12 months: 13.8 m; 95% CI, −4.2 to 31.7; P = .13; 24 months: 1.2 m; 95% CI, −20.0 to 22.5; P = .91). The counseling intervention did not affect the rate of major adverse limb events over 24 months (12 [6.0%] in the intervention group vs 11 [5.5%] in the control group; P > .99). Conclusions and Relevance: This randomized clinical trial found no significant effect of brief counseling on step count in people with PAD. Alternate interventions are needed to enable walking

    Recovery of Lung Function, Dominant Handgrip Strength, and Health-Related Quality of Life in Cardiac Surgical Patients Following Hospital Discharge

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    Purpose: Assessment of recovery in post-cardiac surgical patients is commonly conducted using lung function, dominant handgrip strength (DHGS), and health-related quality of life (HRQoL). The aim of this study was to determine the recovery of lung function, DHGS and HRQoL in cardiac surgical patients at six-weeks and six-months after hospital discharge. Further, this study investigated the association between these parameters and the predictive ability of DHGS for lung function and HRQoL. Methods: This was a prospective observational study that involved 58 cardiac surgical patients who completed lung function, DHGS, and HRQoL assessments pre-operatively, at six-weeks, and six-months after hospital discharge. Lung function was assessed using three different calibrated spirometers, while DHGS was measured using three different calibrated handgrip dynamometers. The Short-Form 36 questionnaire was utilized for HRQoL assessment. Results: At six-weeks after hospital discharge, lung function and DHGS were significantly (pConclusion:Variable changes were identified in lung function, DHGS, and HRQoL in cardiac surgical patients at six-weeks and six-months after hospital discharge. Dominant hand grip strength may have limited or no value in predicting lung function and HRQoL in cardiac surgical patients during the intermediate recovery period

    Quality attributes of different marinated oven-grilled pork neck meat

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    ABSTRACTWhereas herbs/spices serve as natural preservatives, and thermal processing makes animal meat products edible, combining them should complement each other. Additionally, the application of oven grilling to meat products continues to increase in popularity. However, there is a paucity of relevant published information specific to different marinated oven-grilled pork neck meat. Therefore, the quality attributes of different marinated oven-grilled pork neck meat were investigated, which involved chemical (pH, thiobarbituric acid reactive substance [TBARS], 2,2′-azinobis(3-ethylbenzothiaziline-6-sulfonate) [ABTS], 1,1-diphenyl-2-pierylhydrazy [DPPH], ferric reducing antioxidant power [FRAP]), physical (cooking weight loss, L*a*b* color, and textural cutting force), as well as organoleptic (sensory: flavor, appearance, tenderness, taste, and off-flavor; texture: hardness, chewiness, gumminess, graininess, and greasiness) aspects. In particular, the pork neck meat was procured from a porcine farm in Poland. Different marinated variants comprised constituent 0.5, 1, and 1.5% quantities of cranberry pomace (CP), grape pomace (GP), and Baikal skullcap (BS) that subsequently incorporated either African spice (AS) or industrial marinade/pickle (IM). Results showed decreases in ABTS, DPPH, FRAP, and TBARS in some marinated oven-grilled pork neck meat samples, alongside pH variations by difference that seemingly associated with increasing concentrations of either CP, BS, or GP, which might not always coincide with L*a*b* color trends as AS and IM were incorporated. Despite the many resemblances (p > .05), the sensory aspects fluctuated as textural chewiness, gumminess, and hardness increased in some samples, more evident when incorporating AS compared to IM. Overall, oven-grilling promises to moderate the range values of key quality attributes of different marinated pork neck meat samples in this study

    Walking Training Increases microRNA-126 Expression and Muscle Capillarization in Patients with Peripheral Artery Disease

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    Patients with peripheral artery disease (PAD) have reduced muscle capillary density. Walking training (WT) is recommended for PAD patients. The goal of the study was to verify whether WT promotes angiogenesis in PAD-affected muscle and to investigate the possible role of miRNA-126 and the vascular endothelium growth factor (VEGF) angiogenic pathways on this adaptation. Thirty-two men with PAD were randomly allocated to two groups: WT (n = 16, 2 sessions/week) and control (CO, n = 16). Maximal treadmill tests and gastrocnemius biopsies were performed at baseline and after 12 weeks. Histological and molecular analyses were performed by blinded researchers. Maximal walking capacity increased by 65% with WT. WT increased the gastrocnemius capillary-fiber ratio (WT = 109 ± 13 vs. 164 ± 21 and CO = 100 ± 8 vs. 106 ± 6%, p < 0.001). Muscular expression of miRNA-126 and VEGF increased with WT (WT = 101 ± 13 vs. 130 ± 5 and CO = 100 ± 14 vs. 77 ± 20%, p < 0.001; WT = 103 ± 28 vs. 153 ± 59 and CO = 100 ± 36 vs. 84 ± 41%, p = 0.001, respectively), while expression of PI3KR2 decreased (WT = 97 ± 23 vs. 75 ± 21 and CO = 100 ± 29 vs. 105 ± 39%, p = 0.021). WT promoted angiogenesis in the muscle affected by PAD, and miRNA-126 may have a role in this adaptation by inhibiting PI3KR2, enabling the progression of the VEGF signaling pathway

    BASELINE CARDIORESPIRATORY AS A PREDICTOR OF BP STATUS IN INSUFFICIENTLY ACTIVE ADULTS

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    Zachary S. Leicht1, Nathan R. Weeldreyer1, Marc A. Adams2, Siddhartha S. Angadi, FACSM1. 1University of Virginia, Charlottesville, VA. 2Arizona State University, Phoenix, AZ. Background: Blood pressure and peak oxygen uptake (VO2peak) are strong independent predictors of all-cause and cardiovascular mortality. Individuals with a VO2peak of 8 METs or greater have decreased risk of cardiovascular disease compared to those with a VO2peak less than 8 METs. Increasing physical activity in insufficiently active adults is associated with improvements in both cardiorespiratory fitness (CRF) and blood pressure (BP), however approximately 90% of adults in the United States do not meet current physical activity guidelines. Additionally, the relationship between CRF and the odds of having an elevated blood pressure (SBP ≥ 120 and/or DBP ≥ 80) or hypertension (SBP ≥ 140 and/or DBP ≥ 90) are unknown. Therefore, we determined the odds of having elevated blood pressure or hypertension in individuals stratified based on VO2peak (\u3c 8METS or ≥ 8 METS). Methods: Insufficiently active (as determined by accelerometry) individuals (N=518) underwent blood pressure and anthropometric testing followed by a treadmill-based graded exercise test (modified Balke protocol) with ventilatory gas exchange assessment to determine VO2peak. Only valid VO2peak tests (defined as achieving ≥90% age-predicted heart rate max and RER \u3e 1.05) were used for analyses. Adjusted Logistic Regression examined the role of CRF in whether subjects would have normal (SBP \u3c 120 and DBP \u3c 80) , elevated BP or hypertension. Data are presented as means ± SD or odds ratios with α was set at 0.05. Results: Three hundred and seventy five individuals had BP measured and met the criteria for a valid VO2peak test (age = 44.8 ± 9.1 years; BMI = 32.9 ± 6.6; VO2peak = 24.5 ± 4.8 mL/kg/min; SBP = 121 ± 13; DBP = 81 ± 10 mmHg; Males/Females = 124/251). One-hundred and twenty-seven individuals had normal BP, 164 had elevated BP, and 84 individuals were hypertensive. After adjusting for age and sex, those with a VO2peak less than 8 METs did not have significantly different odds of having elevated BP (OR = 1.3, 95% CI: 0.7 - 2.4, p = 0.33). However, those with a VO2peak less than 8 METs were more likely to be hypertensive compared to individuals with a VO2peak greater than 8 METs (OR = 2.5, 95% CI: 1.2 - 5.2, p = 0.01). Conclusions: Approximately 33.9% of our cohort had a BP that was in the normotensive range, 43.7% had elevated BP, and 22.4% were hypertensive. Importantly, the present study found that low CRF in inactive adults was associated with an increased odds of being hypertensive. This underscores the high CVD burden in this population and the need for targeted interventions to optimize outcomes. Supported by R01CA19891

    Effects of exercise training on heart rate variability in individuals with lower extremity arterial disease and claudication: A systematic review

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    Purpose: To perform a systematic review of studies assessing the effects of regular exercise on heart rate variability (HRV) in individuals with lower extremity arterial disease (LEAD) and symptoms of claudication. Methods: A systematic search in the electronic databases MEDLINE, Embase, and Scielo, was conducted and updated on January 21, 2023. Randomized clinical trials investigating patients with LEAD and IC, assessing ≥ 4 wk of exercise interventions, and reporting at least one HRV measure (e.g., time or frequency domains) at baseline and follow-up were included. Two reviewers independently screened studies for inclusion, performed data extraction, and quality assessment of included studies. Results: Data from 7 trials were included (i.e., 5 walking, 1 resistance, and 1 isometric handgrip training), totaling 327 patients (66% males; range: 61 - 68 yr; ankle brachial index: 0.4 - 0.7). Following exercise training, three studies investigating walking training reported an increase in parasympathetic modulation indices and/or a decrease in sympathetic modulation indices (n = 2) as well as an increase in non-linear indices (n = 1). Conclusion: The current evidence is weak, and larger randomized controlled trials are needed to confirm the efficacy of exercise training in improving HRV. Additionally, the high divergence in the methodology of studies indicated the need for standard tools to improve the quality of HRV measurements in exercise trials. It is recommended to use standard procedures in future trials investigating HRV

    Ingestion of Nylon 11 Polymers by the Mealworm (Tenebrio molitor) Beetle and Subsequent Enrichment of Monomer-Metabolizing Bacteria in Fecal Microbiome

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    Background: Nylon 11 is a synthetic plastic widely used in commercial products such as tubing for automobiles, offshore oilfields, and medical devices. An increasing amount of nylon and other plastic wastes have been released into various environments, posing ecological threats. The biodegradation of bundled nylon polymers has been considered impossible due to their crystalline structures. Methods: Nylon 11 film was created and incubated with adult mealworms. The mass, as well as structures, of nylon 11 films at pre- and post-incubation with beetles were compared. The number of nylon 11 monomer degrading bacteria in feces were determined by culture-dependent approach. The t-test was utilized to examine the statistical significance. Results: We discovered that adult mealworm (Tenebrio molitor) beetle can ingest nylon 11 when stretched thin. The microscopic observation of their feces did not identify the presence of large fragments of nylon 11. The analysis of fecal bacteria revealed that while the total number of culturable bacteria did not change significantly, the number of 11-aminoundecanoic acid-metabolizing bacteria increased by 10,000-fold. Conclusions: Our results suggest that bundled nylon 11 polymers were fragmented into smaller pieces, including monomeric units (11-aminoundecanoic acid) by adult mealworm. The monomers seem to have supported the proliferation of gut microbial communities capable of utilizing 11-aminoundecanoic acid as a carbon and nitrogen source. Our work implies the potential use of the mealworm beetle as a means to fragment nylon polymers for remediation applications

    Editorial: Rising stars in exercise physiology

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    [Extract] Physical exercise has been recognized as essential for human health and evolution for thousands of years, beginning with the ancient cultures. Hippocrates, Plato, Aristotle, and the Roman physician Galen were the earliest recorded and most well-known promoters of the beneficial effects of physical exercise. Since these times, several dedicated laboratories worldwide have been established, with many researchers conducting numerous investigations related to exercise physiology; nevertheless, a cornerstone of all laboratories is the development of new and novel researchers. These talented and emerging researchers have been necessary for our understanding of exercise physiology to have reached where we are today (and where we will be in the future). Given the evolution of exercise physiology, the field has incorporated a range of basic to applied scientific investigations and a range of end-users (e.g., researchers, athletes, coaches, physiologists, and clinical/public health professionals) who will benefit from these new advances in exercise physiology

    Salt-Intake-Related Behavior Varies between Sexes and Is Strongly Associated with Daily Salt Consumption in Obese Patients at High Risk for MASLD

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    Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) imposes a significant burden on Westernized regions. The Western diet, high in salt intake, significantly contributes to disease development. However, there are a lack of data on salt literacy and salt intake among MASLD patients in Germany. Our study aims to analyze daily salt intake and salt-intake-related behavior in MASLD patients. Methods: 234 MASLD patients were prospectively included. Daily salt intake and salt-intake-related behavior were assessed via a food frequency questionnaire (FFQ—DEGS) and a salt questionnaire (SINU). Statistical analyses were performed using SPSS. Results: Mean daily salt intake was higher in men than in women (7.3 ± 5 g/d vs. 5.3 ± 4 g/d; p 6 g/d) and the behavioral salt index (SI) (p < 0.001). Men exhibited higher SI scores compared to women, indicating lower awareness of salt in everyday life. Multivariate analysis identified specific salt-intake-related behaviors impacting daily salt consumption. Conclusions: Our study reveals a strong link between daily salt intake and salt-intake-related behavior, highlighting sex-specific differences in an MASLD cohort. To enhance patient care in high-cardiovascular-risk populations, specific behavioral approaches may be considered, including salt awareness, to improve adherence to lifestyle changes, particularly in male patients
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