High PA Research Articles

In silico prediction of the pharmacological potential of new 7-alkyl-8-hydrazine derivatives of 1,3-dimethylxanthine

The development of new drug-like molecules based on 7-R-8-hydrazine derivatives of 1,3-dimethylxanthine is promising in view of the known pharmacological effect of theophylline and functional hydrazine derivatives. In silico methods make it possible to rationalize the synthesis and reduce the number of chemical compounds at the stage of virtual screening by eliminating potentially ineffective molecules. The aim of the work was to carry out а virtual design and predictive evaluation of pharmacological activity of new 7-alkyl-8-hydrazine derivatives of 1,3-dimethylxanthine by in silico methods. Materials and methods. To perform in silico prediction of the pharmacological potential of several new 7-alkyl-8-hydrazine derivatives of 1,3-dimethylxanthine, we used the online services. As 12 model compounds, we chose 12 derivatives of 5-(2-(1,3-dimethyl-2,6-dioxo-2,3,6,7-tetrahydro-1H-purin-8-yl)hydrazine)-5-phenylpentanoic acid with linear and branched alkyl substituents at the 7th position of the basic heterocycle: methyl-, ethyl-, n-propyl-, n-butyl, i-butyl, n-amyl, i-amyl, n-hexyl, n-heptyl, n-octyl, n-nonyl, n-decyl. The use of the freely available web tool SwissADME made it possible to calculate physicochemical parameters and to determine the drug-likeness properties of molecules. And other Internet platforms allowed to predict the spectrum of biological activity of the target compounds. Results. In silico analysis of the pharmacological potential of model compounds was performed. Three biological actions (peripheral vasodilator, kidney function stimulant, lipoprotein lipase inhibitor) with high Pa values are predicted for all derivatives of the series. The ADME parameters of the molecules were evaluated and their potential drug-like properties were determined. Conclusions. It was established that the extension of the alkyl substituent at the 7th position of the basic heterocycle should lead to a deterioration of the ADME parameters of the molecules, potentially reduce their oral bioavailability, but should not radically affect their biological activity profile. Compounds 1–3 and 5 are predicted to be orally bioavailable. They should be characterized by a wide spectrum of biological activity with the highest probability of vasodilator effect on peripheral vessels. In the future, it is advisable to carry out targeted synthesis of hit compounds and thorough in vitro, in vivo studies, and for compounds with violated physicochemical criteria – structural optimization of molecules in order to find a lead compound.

Adaptive Leadership and Burnout in Military Healthcare Workers During a Global Health Pandemic.

Occupational burnout among healthcare workers has continued to climb, impacting workforce well-being, patient safety, and retention of qualified personnel. Burnout in military healthcare workers, who have had the added stress of increased deployments, remains unknown. Although certain leadership styles have been associated with lower rates of burnout, the association between adaptive leadership and burnout in military healthcare has not previously been described. The aim of this study is to examine the role of adaptive leadership in burnout among military healthcare workers following the Coronavirus Disease 2019 (COVID-19) pandemic. A convenience sampling of military healthcare workers employed at a military medical treatment facility between March 2020 and March 2023 was anonymously surveyed using an online link, which included demographics, the Maslach-Burnout Inventory Health Services Survey (MBI-HSS), the Adaptive Leadership with Authority Scale, and the Pandemic Experiences and Perceptions Survey. Data were analyzed for associations. Structural equation modeling (SEM) was performed using MPlus 8.0, which included demographics, all three subscales that contribute to burnout (emotional exhaustion, depersonalization, and personal accomplishment [PA]), adaptive leadership (indicated by a subscale mean), and COVID impact and COVID risk perception. Of the 365 participants analyzed, 88.5% had high emotional exhaustion, and 80.4% had high depersonalization. Burnout was significantly associated with adaptive leadership (r = -0.302, P < .001), COVID impact (r = 0.208, P < .001), and COVID risk perception (r = 0.174, P < .001). A total of 93.0% scored high in at least one subscale of the MBI-HSS (i.e., emotional exhaustion ≥27, depersonalization ≥10, or PA ≤33), although 78 (21.8%) met the complete definition of burnout, because of the overwhelmingly high levels of PA (77.8% reported high PA). In the SEM model, burnout was significantly and negatively predicted by adaptive leadership (b = -0.28, SE = 0.05, Standardized b = -0.31, P < .001). Burnout was also significantly and positively predicted by COVID impact (b = 0.25, SE = 0.09, Standardized b = 0.17, P = .028) and health professions' perception of risk (b = 0.15, SE = 0.07, Standardized b = 0.14, P = .008). Together, this model explained 17% of the total variance in health professions' reported burnout. The findings of burnout in this military healthcare worker population were higher than have previously been described in healthcare workers or other military personnel, and the significant associations between adaptive leadership and burnout suggest the protective role of adaptive leadership in healthcare systems to address burnout. Implementing adaptive leadership training or selecting leaders with more adaptive leadership skills may be beneficial in a health care system where employee burnout is prevalent, especially during periods stressed by adaptive problems. This may be especially important in military healthcare when active duty service obligations preclude attrition in the presence of additional stressors such as deployments and Federal Emergency Management Agency responses. Further research is needed to determine whether this intervention is successful at reducing healthcare burnout.

Association between physical activity and cardiovascular parameters in 7-year-old children: a Chinese cross-sectional study

IntroductionPhysical activity (PA) is believed to play an important part in many aspects during childhood and adolescence, especially cardiorespiratory fitness and cardiometabolic health. However, whether different levels of PA in daily life influence the structure or function of heart in school-aged children remains unknown. We aimed to investigate the association between PA and cardiovascular parameters in 7-year-old children.MethodsFollow-up data from the Shanghai Prenatal Cohort Study and the Shanghai Birth Cohort was analyzed. Perinatal information including both maternal and offspring datum was recorded. A refined questionnaire was used to evaluate the frequency and duration of children’s PA levels. Blood pressure, echocardiography, and anthropometry assessment were conducted during the follow-up of 7-year-old children.ResultsOverall, high PA level was associated with higher left ventricle posterior wall thickness in diastole (LVPWd, β coefficient: 0.36, 95% CI: 0.12, 0.61), higher left ventricle mass index (LVMI, β = 0.28, 95% CI: 0.07, 0.48), mitral E/a ratio (β = 0.47, 95% CI: 0.22, 0.71) and slower heart rate (β = -0.32, 95% CI: -0.57, -0.07), compared to low PA level. Medium PA level was associated with lower diastolic blood pressure (DBP, β = -0.18, 95% CI: -0.35, -0.01). In subgroup analysis, increased relative wall thickness (RWT) was found in high PA level boys (β = 0.36, 95% CI: 0.05, 0.67), and systolic blood pressure (SBP) showed a significant decrease in high PA level girls (β = -0.42, 95% CI: -0.78, -0.06).ConclusionsThis study suggested non-athlete children having higher PA level were associated with thicker left ventricle (LV) walls and better LV diastolic function, as well as slower heart rate and DBP at the age of 7. Furthermore, disparity in the association between PA level with morphological heart patterns and blood pressure existed in different sex category.

Predictive value of the random forest model based on bioelectrical impedance analysis parameter trajectories for short-term prognosis in stroke patients

BackgroundThe short-term prognosis of stroke patients is mainly influenced by the severity of the primary disease at admission and the trend of disease development during the acute phase (1–7 days after admission).ObjectiveThe aim of this study is to explore the relationship between the bioelectrical impedance analysis (BIA) parameter trajectories during the acute phase of stroke patients and their short-term prognosis, and to investigate the predictive value of the prediction model constructed using BIA parameter trajectories and clinical indicators at admission for short-term prognosis in stroke patients.MethodsA total of 162 stroke patients were prospectively enrolled, and their clinical indicators at admission and BIA parameters during the first 1–7 days of admission were collected. A Group-Based Trajectory Model (GBTM) was employed to identify different subgroups of longitudinal trajectories of BIA parameters during the first 1–7 days of admission in stroke patients. The random forest algorithm was applied to screen BIA parameter trajectories and clinical indicators with predictive value, construct prediction models, and perform model comparisons. The outcome measure was the Modified Rankin Scale (mRS) score at discharge.ResultsPA in BIA parameters can be divided into four separate trajectory groups. The incidence of poor prognosis (mRS: 4–6) at discharge was significantly higher in the “Low PA Rapid Decline Group” (85.0%) than in the “High PA Stable Group “ (33.3%) and in the “Medium PA Slow Decline Group “(29.5%) (all P < 0.05). In-hospital mortality was the highest in the “Low PA Rapid Decline Group” (60%) compared with the remaining trajectory groups (P < 0.05). Compared with the prediction model with only clinical indicators (Model 1), the prediction model with PA trajectories (Model 2) demonstrated higher predictive accuracy and efficacy. The area under the receiver operating characteristic curve (AUC) of Model 2 was 0.909 [95% CI 0.863, 0.956], integrated discrimination improvement index (IDI), 0.035 (P < 0.001), and net reclassification improvement (NRI), 0.175 (P = 0.031).ConclusionPA trajectories during the first 1–7 days of admission are associated with the short-term prognosis of stroke patients. PA trajectories have additional value in predicting the short-term prognosis of stroke patients.

Decrease in UCP1 by sustained high lipid promotes NK cell necroptosis to exacerbate nonalcoholic liver fibrosis

Uncoupling protein 1 (UCP1) catalyzes the leak of protons across the mitochondrial inner membrane for thermogenesis. Compromised NK cell activity is involved in the occurrence of nonalcoholic liver fibrosis. Here, decreased UCP1 in NK cells was identified in patients with advanced nonalcoholic fatty liver disease. Although no obvious changes were observed in the NK cells of physiologic UCP1−/− mice (8–10 weeks old), impaired NK cell bioactivity was shown in methionine–choline-diet (MCD)-fed UCP1−/− mice and involved in the acerbation of nonalcoholic steatohepatitis (NASH) progress to liver fibrosis. Moreover, UCP1-deficient NK cells were responsible for the aggravation of liver fibrosis, as confirmed in MCD-fed UCP1flox/flox-NCR1cre mice. Acerbation of liver fibrosis was also seen in wild-type mice when their endogenous NK cells were replaced with UCP1−/− NK cells. Transcriptions of mitophagy-associated molecules in UCP1−/− NK cells were enhanced according to RNA-seq. Electron microscopic results showed mitochondrial injuries and autophagic vesicles in MCD-fed NKWT cells, PA-treated NKWT cells, or physiologic NKKO cells. However, the co-existence of UCP1 deficiency and high lipid can synergistically induce NK cell necroptosis via DRP1S616 accompanied with reduced mitophagy. Finally, The UCP1 in NK cells was downregulated when treated by sustained high PA (600 μM) via the PPARγ/ATF2 axis. Thus, persistent high-lipid treatment not only decreases UCP1 expression but also combines with reduced UCP1 to promote NK cell necroptosis, and it is involved in NASH progression to fibrosis.

On the role of the porous support membrane in seawater reverse osmosis membrane synthesis, properties and performance

In this study, we explore the role of the polysulfone (PSU) support membrane skin-layer and whole-body pore morphology on the physical-chemical properties and separation performance of hand-cast polyamide-PSU (PA-PSU) composite seawater reverse osmosis (SWRO) membranes. We tailor the support membrane pore morphology by varying the PSU concentration and the coagulation bath temperature. In order to isolate the impacts of the PSU support, all of the porous supports are coated using identical m-phenylene diamine (MPD) and trimesoyl chloride (TMC) solution compositions, reaction conditions, and post-treatments. As PSU concentration increases, PSU support membrane pore size, surface and body porosity, water permeability, MPD mass uptake (by the PSU support), and PA-PSU composite membrane water permeability decrease, while MPD and TMC conversion, PA film mass and thickness, crosslinking degree (XD), and PA-PSU composite membrane NaCl rejection increase. As PSU support membrane coagulation bath temperature increases, support membrane pore size, surface and body porosity, MPD uptake, PA film mass, thickness and XD, MPD and TMC conversion, and NaCl rejection increase, while composite PA-PSU membrane water and NaCl permeability decrease. Composite membrane permeabilities were 70–90 percent of the (theoretical) unsupported PA film permeabilities due to the high XD and low PA coating film thickness. Composite PA-PSU membrane water/salt permeabilities both correlate most strongly with PA coating film mass/thickness and XD, which in turn correlate most strongly with TMC conversion. The key to increasing water permeability is lower PA film mass/thickness and XD with higher support membrane surface pore size and porosity. In contrast, the key to increasing NaCl rejection is higher PA film mass/thickness and XD with lower support membrane surface pore size and porosity.

Adherence to 2020 ESC recommendations on physical activity in a population with different cardiovascular risk levels: A prospective population-based study from the CoLaus/PsyCoLaus study

IntroductionIn 2020, the European Society of Cardiology (ESC) recommends 150 min of moderate or 75 min of vigorous-intensity PA per week. While general population PA adherence is suboptimal, its status among those with previous ASCVD or high ASCVD risk remains unknown. We aimed to assess objective adherence to ESC PA recommendations using accelerometer-based measurement among these populations. MethodologyWe used data from the Swiss CoLaus|PsyCoLaus cohort study (2014–2016). PA was measured using a 14-day wrist accelerometer. Adherence was defined as > 80 % of recommended PA achievement. Adherence was investigated separately among participants with previous ASCVD and among cardiovascular risk groups (based on the Systematic Coronary Risk Evaluation SCORE-1 and more recent SCORE2) with simple and multivariable logistic regressions. Participants’ characteristics were also evaluated as independent factors after adjustment. ResultsWe studied 1867 participants (median age: 61.2 years, 51.3 % female). ESC PA Adherence reached 55.5 % overall, and 37 % in those with previous ASCVD. Multivariable analysis showed no significant association between previous ASCVD or high cardiovascular risk and PA adherence (Odds ratio adjusted [ORa] 0.9, 95 % Confidence Interval [CI] 0.6–1.4 and ORa 0.7, 95 % CI 0.4–1.2, respectively). Age (≥60 years old), obesity, smoking, chronic renal disease, hypertension, diabetes and benzodiazepine use were significantly associated with lower likelihood of PA adherence in multivariable logistic regression. ConclusionAdherence to ESC PA guidelines, particularly in participants with higher cardiovascular risk, was poor. Since PA adherence was associated with modifiable risk factors (e.g., obesity, smoking, and benzodiazepine use), maintained efforts to implement the ESC recommendations are advised.

Clusters of 24-hour movement behavior and diet and their relationship with health indicators among youth: a systematic review

Movement-related behaviors (physical activity [PA], sedentary behavior [SB], and sleep) and diet interact with each other and play important roles in health indicators in youth. This systematic review aimed to investigate how PA, SB, sleep, and diet cluster in youth by biological sex; and to examine which cluster are associated with health indicators. This study was registered in PROSPERO (number: CRD42018094826). Five electronic databases were assessed. Eligibility criteria allowed studies that included youth (aged 19 years and younger), and only the four behaviors {PA, SB, sleep, and diet (ultra-processed foods [UPF]; fruits and vegetables [FV])} analyzed by applying data-based cluster procedures. From 12,719 articles screened; 23 were included. Of these, four investigated children, and ten identified clusters by biological sex. Sixty-six mixed cluster were identified including, 34 in mixed-sex samples, 10 in boys and 11 in girls. The most frequent clusters in mixed-sex samples were “High SB UPF Low Sleep”, “Low PA High SB Satisfactory Sleep”, and “High PA”. The main difference in profiles according to sex was that girls’ clusters were characterized by high sleep duration, whereas boys’ clusters by high PA. There were a few associations found between cluster types and health indicators, highlighting that youth assigned to cluster types with low PA exhibited higher adiposity. In conclusion, the youth presented a range of clusters of behaviors, typically exhibiting at least one unhealthy behavior. Similar patterns were observed in both sexes with the biggest difference in time of sleep for girls and PA for boys. These findings underscore the importance of intervention strategies targeting multiple behaviors simultaneously to enhance health risk profiles and indicators in children and adolescents.

Physical activity and depressive symptoms during the fifth wave of COVID-19 pandemic: Implication for public policy and administrators.

Depression is a public mental health problem that can progress to suicidal ideation, literature suggests regular physical activity may ameliorate it. The study assessed the link between physical activity and depression symptoms during the fifth wave of the COVID-19 pandemic and the Academic Staff Union (ASU) strike among undergraduates. Four hundred and eighteen undergraduates were recruited and participated in the study. Participants completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and Patient Health Questionnaire-9 (PHQ-9) to measure depression severity. The result on PA showed that about one-third of the participants were inactive, above half were moderately active, while a few achieved high PA levels. Above one-fifth of the participants experienced minimal or no depression while a good percent had mild, moderate, moderately severe, and severe depression. Non-parametric tests between PA total score and depression total score with demographic variables were not significant. Spearman's correlation showed a strong negative relationship between PHQ-9 scores and IPAQ-SF scores. This suggests that a high PA level is associated with lower depression symptoms. The COVID-19 pandemic and the ASU strike experiences resulted in increased depression among undergraduates. The university administration needs to formulate an urgent policy to promote PA among undergraduates and provide treatment for the affected students.

Physical activity trajectory during pregnancy and associations with maternal fatigue using a growth mixture modeling approach

The purpose of this study was to investigate the associations of physical activity trajectories with maternal fatigue. Pregnant women provided objectively assessed physical activity data by Pregnancy Physical Activity Questionnaire four times. Fatigue scale-14 was used to assess fatigue during pregnancy. Growth mixture modelling characterized physical activity trajectories across pregnancy. The generalized estimating equations was used to analyze the relationship between different physical activity profiles and fatigue in pregnant women. A total of 626 pregnant women were included in analysis in a teaching hospital in Nantong city. Fatigue (total, mental and physical) was not different between two groups based on total energy expenditure of PA (constantly high vs. constantly low). The pregnant women in “constantly high household PA” group had the higher fatigue compared to “constantly low household PA” (P < 0.05) and “constantly medium household PA” (P < 0.05). The pregnant women in “constantly high sport PA” group had lower fatigue compared to “constantly low sport PA” (P < 0.05). Household PA and sport PA were still an independent influencing factor for fatigue after controlling for confounding variables. Specifically, we observed that higher household PA and lower sport PA were associated with higher fatigue during pregnancy.

Improving movement behavior in office workers: effects of two multi-level cluster-RCT interventions on mental health

BackgroundWe have previously reported on the design and efficacy of two cluster-randomized multi-level workplace interventions, attempting to decrease sedentary behavior (SED) or increase moderate to vigorous physical activity (MVPA) among office workers to improve mental health outcomes. The aim of this study was to investigate intervention effects on mental health outcomes, i.e., mental wellbeing, depression or anxiety symptoms, and stress immediately after the 6-month intervention period.MethodsTeams of 263 office workers were cluster-randomized to one of two interventions or a waitlist control group. The PA intervention (iPA) focused on increasing MVPA and the SED intervention (iSED) on reducing SED. Both multi-level interventions targeted individual office workers and their social, physical, and organizational work environment, incorporating counseling based on cognitive behavioral therapy and motivational interviewing. Mental health outcomes were assessed using validated questionnaires before and immediately after the intervention. Intervention effects were analyzed using linear mixed effects models.ResultsParticipants were mostly female and highly educated, with a mean age of 42 years and had favorable levels of mental health at baseline. Mental wellbeing improved for the iSED group (β = 8, 95% CI 1 to 15, p = 0.030) but not for the iPA group (β = 6, 95% CI -1 to 12, p = 0.072) compared to the control group. No effects were found for depression or anxiety symptoms or stress.ConclusionsThe multi-level interventions improved mental wellbeing among this population of office workers, reaching statistical significance in the iSED group. The size of the effect can be regarded meaningful, considering favorable mental health and high PA level at baseline. Thus, workplace interventions that provide support on multiple levels appear to have potential for improving mental wellbeing, but not reducing ill-health variables, among healthy office workers. More research is needed to understand the mechanisms through which such improvements can be achieved and to identify the most effective intervention components.Trial registrationISRCTN92968402 (27 February 2018).

A chromosome-level genome assembly for Onobrychis viciifolia reveals gene copy number gain underlying enhanced proanthocyanidin biosynthesis

Sainfoin (Onobrychis viciifolia), which belongs to subfamily Papilionoideae of Leguminosae, is a vital perennial forage known as “holy hay” due to its high contents of crude proteins and proanthocyanidins (PAs, also called condensed tannins) that have various pharmacological properties in animal feed, such as alleviating rumen tympanic disease in ruminants. In this study, we select an autotetraploid common sainfoin (2n = 4x = 28) and report its high-quality chromosome-level genome assembly with 28 pseudochromosomes and four haplotypes (~1950.14 Mb, contig N50 = 10.91 Mb). The copy numbers of genes involved in PA biosynthesis in sainfoin are significantly greater than those in four selected Fabales species, namely, autotetraploid Medicago sativa and three other diploid species, Lotus japonicus, Medicago truncatula, and Glycine max. Furthermore, gene expansion is confirmed to be the key contributor to the increased expression of these genes and subsequent PA enhancement in sainfoin. Transcriptomic analyses reveal that the expression of genes involved in the PA biosynthesis pathway is significantly increased in the lines with high PA content compared to the lines with medium and low PA content. The sainfoin genome assembly will improve our understanding of leguminous genome evolution and biosynthesis of secondary metabolites in sainfoin.

REVISITING POSITIVE AFFECT: THE ROLE OF AFFECT MEAN LEVELS AND VARIABILITY ON DEPRESSION IN MID AND LATER LIFE

Abstract Recent research suggests that affect dynamics (e.g., variability) combined with mean levels are important predictors of psychological and physical health outcomes. This study explores the joint effect of affect levels and variability on depression across 10 years among middle-aged and older adults. We used the data from the second and third waves of Midlife in the United States (MIDUS) study. During telephone interviews, daily positive (PA) and negative affect (NA) were assessed across eight consecutive evenings. Daily affect mean levels were calculated by averaging daily affect across interview days, and daily affect variability was calculated as the individual’s standard deviation (iSD). Depression status was assessed using the Composite International Diagnostic Interview-Short form at baseline and 10-year follow-up. The final analytic sample includes 1,499 adults aged 55 years old on average (age range = 34-83; 55.7% female; 93% white). Logistic regression analysis was performed to test the interaction effect of daily affect mean levels and variability on depression. We found a significant interaction effect between PA mean levels and variability on depression status at follow-up. For individuals with high PA levels, higher PA variability was associated with higher odds of developing depression, after adjusting for depression and anxiety disorder at baseline. For NA, we only found main effects where higher NA variability was associated with higher odds of depression at follow-up. Findings suggest fragile high PA (i.e., variable high PA) may be a significant predictor of depression, highlighting the need for understanding PA as multidimensional construct.

High late‐life physical activities and reduced progression from MCI to Alzheimer’s dementia

AbstractBackgroundPhysical activity (PA) has been reported to reduce the risk of Alzheimer`s disease (AD) dementia and related cognitive decline. We aimed to investigate the influence of PA on the progression from cognitively normal (CN) status to mild cognitive impairment (MCI) or from MCI to AD dementia in non‐demented older adults.MethodThis study included 194 non‐demented (148 CN and 46 MCI) participants from the Korean Brain Aging Study for Early diagnosis and prediction of Alzheimer’s disease (KBASE), who completed both baseline and 2‐year follow‐up clinical evaluation. At baseline, the participants underwent comprehensive clinical and neuropsychological assessment, multimodal brain imaging including [11C] Pittsburgh Compound B positron emission tomography (PET), [18F] fluorodeoxyglucose PET and MRI, and current PA measured using the Lifetime Total Physical Activity Questionnaire.ResultAfter 2 years, five CN and 22 MCI participants progressed to MCI and AD dementia, respectively. Logistic regression analyses showed that high current PA (above the median value) reduced the risk of the progression from MCI to AD dementia even after controlling age, sex, education, apolipoprotein E e4 positivity, baseline brain amyloid deposition, AD‐signature region glucose metabolism, and AD‐signature region cortical thickness (Bonferroni corrected p‐value = 0.028). In contrast, PA had no effect on the progression from CN to MCI.ConclusionThe findings suggest that a physically active lifestyle in late‐life reduces the risk of conversion to AD dementia in MCI independently of AD‐related brain pathologies.

Abstract 15082: Novel Imaging/Hemodynamic Based Right Ventricular Phenotypes in Patients With Pulmonary Hypertension

Introduction: Right ventricular function and ventricular dynamics associate with outcomes in pulmonary hypertension (PH). Measures of RV strain describe ventricular mechanics but are not included in RV function assessments. This study aimed to develop novel RV imaging-hemodynamic phenotypes using unsupervised machine learning. Methods: Participants with cardiac magnetic resonance (CMR) and right heart catheterization data were identified from The Ohio State University CMR PH registry (n=81). RV areas were segmented from CMR 4-chamber images and used to determine RV free wall (RVFW) and septal strain. K-medoids clustering was used on imaging features, RV hemodynamics, and RV function (Figure A). Correlation analysis was used to reduce collinearity. Significance was measured with Kruskal Wallis and chi-squared tests. A p-value &lt; 0.05 was considered significant. Results: Participants were assigned to three clusters and top contributors to cluster assignment were RVEF, RVFW strain, and Ea. RV phenotypes progress from mild/no RV dysfunction (Cluster 1) to severe RV dysfunction (Cluster 3) (Figure A). Cluster 1 had normal RV function with high RVEF and PA compliance, preserved LVEF, low RVSP, and low Eed. Compared to cluster 1, cluster 2 demonstrates more RV dysfunction with reduced RVEF, stroke volume, and PA compliance with an increase in RVSP but no change in Eed. In addition to more RV dysfunction (decreased RVEF and stroke volume), cluster 3 had increased RA pressure and Eed. In terms of RV strain, (Figure B), cluster 2 had less negative RVFW and septal strain compared to cluster 1. In cluster 3, RV septal strain is similar to cluster 2 but with decreased RVFW strain. Conclusions: Imaging and hemodynamic RV variables contribute to identification of novel RV-centric phenotypes and should be included in phenotyping efforts to better describe altered ventricular dynamics contributing to RV dysfunction in PH.

The effectiveness of UK protected areas in preventing local extinctions

AbstractProtected areas (PAs) are a core component in global efforts to prevent further declines in biodiversity. We examine whether the United Kingdom's PA portfolio has reduced local extinctions of breeding birds and consider how the characteristics of different PA designations may have affected conservation outcomes. We use breeding bird atlas data to calculate the proportion of species in each 10 × 10‐km grid cell confirmed as breeding in 1988–1991 but not in 2008–2011. We find that the protection offered by PAs is little to no different from that of the wider landscape and, depending on the type of PA, attribute this to PAs being either too small or not managed for biodiversity outcomes. To meet the ambitious new global targets for expanding PA coverage set at the 15th UN Biodiversity Conference, all countries need to monitor and ensure PA effectiveness; high PA coverage does not guarantee that biodiversity is protected.

O.4.1-6 Multidimensional physical activity profiles and changes in physical function and self-reported walking ability among community-dwelling older adults – a 4-year follow-up

Abstract Purpose Physical activity (PA) is multidimensional but often assessed using single metrics. We studied how data-driven PA profiles predict changes in physical functioning and self-reported walking ability over time among older adults. Methods Participants (n = 318) were community-dwelling 75-, 80- and 85-year-olds who wore a thigh-mounted accelerometer for 3-7 days at baseline. PA intensity, fragmentation, absolute and relative PA minutes, sit-to-stand transitions, and gait bout characteristics were used in PA profiling using k-means cluster analysis. Physical function was assessed at baseline and at follow-up 4 years later. Substantial decline in physical function was operationalized as decline of at least 2 points in the Short Physical Performance Battery (SPPB, range 0-12) and at least 0.2 m/s decline in habitual 10-m walking speed. Change in self-reported walking ability during 2 km walk was assessed using a 5-point scale (decline vs. no change/improvement for all). Data were analyzed using logistic regression analysis. Results Three physical activity profiles were identified, and named as Exercisers, Actives and Inactives. Exercisers and Actives accumulated high PA minutes, but Actives engaged in predominantly light intensity PA that was accumulated in shorter bouts. The largest difference was observed in relative PA minutes (minutes exceeding participants’ preferred walking speed). Inactives accumulated the lowest PA minutes, intensity and highest activity fragmentation. During the follow-up period, 32% of participants experienced a substantial decline in walking speed, 24% in SPPB score and 21% in self-reported walking ability. Among women, Exercisers, but not Actives, had lower risk for a substantial decline in walking speed (OR 0.30, 95% CI 0.10-0.95) and SPPB score (0.33, 0.12-0.88) compared to Inactives after adjusting for age, depressive symptoms, comorbidity and baseline walking speed or SPPB score. Among women, Exercisers also had lower risk for decline in self-reported walking ability, but this was explained by differences in health. For men, the differences were not statistically significant. Conclusions Daily PA that is accumulated in longer bouts and at intensity exceeding one’s preferred walking speed may be especially beneficial for the maintenance of physical function with advancing age. Funding Source Academy of Finland, Finnish Ministry of Education &amp; Culture and European Research Council.

Clustering of diet, physical activity and sedentary behaviour and related physical and mental health outcomes: a systematic review

BackgroundPhysical activity (PA), sedentary behaviour (SB) and diet play an important role in the physical and mental health of young people. Understanding how these behaviours cluster, and the impact of clusters on health is important for the development of public health interventions. This review examines the prevalence of clusters of PA, sedentary time, and dietary behaviours, and how clusters relate to physical and mental health indicators among children, adolescents and young adults.MethodsElectronic (PubMed, Web of Science and Scopus) and manual searches were conducted for articles that were (i) observational studies including children, adolescents and/or young adults aged 5–24 years, (ii) examined the 'patterning', ‘clustering’, or ‘co-existence’ of each of PA, dietary behaviour and SB, and (iii) published in English up to and including July 2022. In addition to information on clustering, data on physical and mental health outcomes were extracted where reported. Included studies were assessed using the Cochrane risk of bias for observational studies. A narrative synthesis was conducted due to high heterogeneity. This review was registered with PROSPERO (CRD42021230976).ResultsForty-nine cross-sectional studies and four prospective cohort studies from eighteen countries reporting data from 778,415 individual participants were included. A broad range of clusters (n = 172) were found (healthy, unhealthy, and mixed). Mixed clusters were common (n = 98), and clusters of high diet quality, low PA and high SB were more prevalent in girls, while mixed clusters of high PA, high SB and low diet quality were more prevalent in boys. Unhealthy clusters comprising low moderate to vigorous PA, low consumption of fruits and vegetables, and high screen time were prevalent, particularly in those from lower socioeconomic status families. Compared to those with healthy behavioural clusters, those with unhealthy and mixed clusters had a higher adiposity, higher risk of cardiovascular disease, poorer mental health scores, and lower cardiorespiratory fitness.ConclusionsPA, SB and diet cluster in healthy, unhealthy and mixed patterns in young people that differ across sociodemographic characteristics. Unhealthy clusters are associated with poorer health outcomes. Intervention strategies targeting un-clustering multiple unhealthy behaviours should be developed and evaluated for their impact on health outcomes.

The Global Prevalence and Associated Factors of Burnout among Emergency Department Healthcare Workers and the Impact of the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

Emergency medicine (EM) settings are very stressful, given the high workload, intense working environment, and prolonged working time. In turn, the rate of burnout and its three domains have been increasingly reported among healthcare workers (HCWs). Therefore, we conducted this meta-analysis to determine the prevalence and risk factors of burnout among EM HCWs. Six databases were searched in February 2023, yielding 29 articles (16,619 EM HCWs) reporting burnout or its three domains (emotional exhaustion "EE", depersonalization "DP", and personal accomplishment "PA"). The primary outcome was the prevalence of burnout and its domains, while secondary outcomes included the risk factors of high burnout, EE, DP, or low PA. Burnout rates were pooled across studies using STATA software. The prevalence was measured using the pooled effect size (ES), and the random-effects model was used when heterogeneity was encountered; otherwise, the fixed-effects model was used. The prevalence of overall burnout was high (43%), with 35% of EM HCWs having a high risk of burnout. Meanwhile, 39%, 43%, and 36% of EM workers reported having high levels of EE and DP and low levels of PA, respectively. Country-specific changes in the rate of burnout were observed. The rate of high burnout, high EE, high DP, and low PA was higher during the COVID-19 pandemic as compared to the pre-pandemic period. The type of profession (nurses, physicians, residents, etc.) played a significant role in modifying the rate of burnout and its domains. However, gender was not a significant determinant of high burnout or its domains among EM workers. Burnout is a prevalent problem in emergency medicine practice, affecting all workers. As residents progress through their training years, their likelihood of experiencing burnout intensifies. Nurses are most affected by this problem, followed by physicians. Country-associated differences in burnout and its domains are evident.

Age differences in hedonic adaptation to societal restrictions? Positive and negative affect trajectories during the first wave of the COVID-19 pandemic in 33 nations.

We examined age group differences in hedonic adaptation trajectories of positive and negative affect (PA/NA) at different arousal levels during the severe societal restrictions that governments implemented to contain the first wave of the COVID-19 pandemic (March to June 2020). Data from 10,509 participants from 33 countries and 12 weekly assessments were used (67% women, aged 18 to 85 +, on average 318 participants per country (SD = 434) and 5.6 assessments (SD = 2.5) per participant). Multilevel models (level 1: assessments, level 2: participants, level 3: countries) were fit to examine trajectories of low to high arousal PA and NA during the phase of tightening societal restrictions, the phase of stable peak restrictions, and the phase of easing restrictions separately. During the entire study period mean levels of PA were lower in emerging and young adults (aged 18-44) than older adults, whereas mean NA levels were higher. During peak societal restrictions, participants reported increasingly more PA, especially high-arousal emotions (d = .36 per month vs. .19 unaroused). NA levels decreased over time, especially high-arousal emotions (d = .35 vs. .14 p/month). These hedonic adaptation trajectories were largely similar across age groups. Nevertheless, up to 30% of the participants increased in NA and up to 6% decreased in PA, against the general trend, demonstrating substantial individual differences in emotional adaptation. Finally, heterogeneity in the effects of time on affect was larger on the individual level than the country level. Emotional recovery trajectories during the first lockdown in the COVID-19 pandemic were virtually similar across age groups in 33 countries, across valence and arousal levels, suggesting age advantages in emotional well-being remain restricted to mean-level differences rather than emotion dynamics. (PsycInfo Database Record (c) 2023 APA, all rights reserved).