Increased Activity Levels Research Articles

Cross-sectional associations between neighbourhood walkability and objective physical activity levels in identical twins

ObjectivesPhysical activity is a cornerstone of chronic disease prevention and treatment, yet most US adults do not perform levels recommended for health. The neighborhood–built environment (BE) may support or hinder...

Population characteristics associated with adherence to prenatal group-based exercise programs

ABSTRACT Community-based supervised group exercise may be an effective option to increase activity levels throughout pregnancy. Previous studies that have explored predictors of low adherence to exercise during pregnancy have not examined group-based settings. We analysed an international cohort of 347 pregnant women who participated in group-based prenatal exercise interventions (from <20 weeks to 34–36 weeks pregnant). Probable adherence predictors informed by previous literature that were assessed included: pre-pregnancy physical activity level and body mass index (BMI) classification, age, number of previous pregnancies, and education level. Adherence was measured by attendance. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated to explore the relationship between the selected predictors and high adherence (≥70%). Post-secondary education level versus only secondary (aOR 5.28; CI 1.67; 16.72) or primary level (aOR 13.82; CI 4.30; 44.45) presented greater likelihood to have high adherence to the exercise intervention than low adherence. Future research and public health initiatives should consider implementing strategies to overcome education-related barriers to improve accessibility to prenatal exercise.

Response to the report published by the UK House of Commons All-Party Parliamentary Group on Chronic Fatigue Syndrome/Myalgic Encephalitis (CFS/ME): implications for cardiometabolic risk.

Chronic Fatigue Syndrome/Myalgic Encephalitis (CFS/ME) is associated with affected individuals being more sedentary and having a reduced breadth of activities with attendant significantly increased cardiovascular and metabolic risk [1]. The recent report by the all-party parliamentary group on ME presents an ambitious vision for ME/CFS which is to be welcomed [2]. It calls for the creation of centres for ME/CFS research excellence and updating medical training on ME/CFS, something which is to be applauded. However, we noted the critical tone in which the biopsychosocial model [3] was discussed. The report states that ‘The biopsychosocial model of the illness has prevented many people with ME from obtaining welfare and health insurance-based benefits.’ Furthermore, it went on to state that ‘despite the scientific evidence showing that ME is a biomedical condition, there is still an inaccurate understanding of ME being perpetuated by small groups within the medical and psychological professions.’ The biopsychosocial model is not a dichotomous model where a medical condition is viewed as ‘all in the mind’ or purely medical. On the contrary, the biopsychosocial model postulates that mind and body are linked, with a complex relationship between the two [4]. The fact that there may be a psychological component does not make the condition any less valid and certainly does not preclude the fact that there may be something medically wrong. For instance, Chu (2020) [5] found that post-transplant depression was associated with significantly worse clinical outcomes in lung transplant recipients, illustrating the important mind-body link. The biopsychosocial model applies just as much to ME/CFS as to the patients whose experiences are reported in this study. In the recently updated National Institute for Health and Care Excellence guidelines for ME/CFS, the treatment options available (based on the best available evidence) are careful energy management and supportive cognitive behavioural therapy (CBT) [6], the latter relating directly to increased activity levels with attendant health benefit. In tertiary NHS referral centres for ME/CFS assessment/treatment, a multidisciplinary team will focus on understanding the specific needs/challenges faced by the individual and will utilise the best evidence available to co-create a management plan with the patient. This approach is guided by the research and as such, would incorporate what may be revealed as evidence for the biological processes that underpin ME/CFS. We do not believe that the answer to improving the lives of those living with ME/CFS is in discouraging the use of the biopsychosocial model. Surely, individuals living with ME/CFS are best served by a holistic biopsychosocial formulation considering all aspects of the reality of living with this very disabling condition. ME/CFS is a complex condition that requires a multi-track not uni-track treatment approach in all aspects of its management. Any intervention that can result in greater activity levels is likely to reduce cardiovascular risk. Acknowledgements All authors contributed equally and substantially to the co-creation and writing of this article. Conflicts of interest There are no conflicts of interest.

Altered transcriptional levels of autophagy-related genes, induced by oxidative stress in fish Channa punctatus exposed to chromium.

Chromium has been detected in various water bodies as a harmful metallic stressor to aquatic organisms. This study aimed to investigate the mechanism associated with autophagy, oxidative stress, and genotoxicity after chromium (Cr6+) exposure (1/20th of 96h-LC50, 1/10th of 96h-LC50, and 1/5th of 96h-LC50 of Cr6+) of common food fish Channa punctatus. The mRNA levels of autophagy-related genes ATG5, LC3, GABARAP, and mTOR were assessed in the liver and kidney tissue of fish. An upregulation of ATG5, LC3, and GABARAP was observed in both liver and kidney tissue samples, while mTOR showed transcriptional downregulation in both the tissue samples. This depicts autophagic vesicle formation due to stress signals. All the studied oxidative stress markers SOD, CAT, GSH, GR, and GPx showed an increase in the activity level of treated groups in a dose-dependent manner. Particularly, SOD and CAT have shown a significant elevation in activity level. ROS levels in blood cells increased significantly (p < 0.05) in all the treated groups (groups II, III, and IV) in a time-dependent manner as compared to the control (group I). There was a significant induction in MN frequency in all the treated groups. The highest frequency of micronuclei induced by Cr6+ was recorded in group IV after 28days of exposure period. Collectively, it can be concluded that the information about Cr6+-induced oxidative stress-mediated autophagy in vital organs of fish Channa punctatus remains largely obscure hitherto; to fill the aforesaid gap, this study was undertaken, which gives a snapshot for the mechanisms of autophagy induced by Cr6+ in fish. HIGHLIGHTS: • Chronic exposure to Cr6+ induces eco-toxicological manifestations in a fish Channa punctatus. • Altered transcriptional profile of autophagy-related genes suggests autophagic vesicle formation due to stress signals. • Increased activity levels of oxidative stress biomarkers reveal that Cr6+ annihilates antioxidative defense system in fish. • Genotoxicity due to chromium exposure is evident by increased frequency of MN in red blood cells of fish. • The information presented in this study is helpful to get an insight into the mechanism of Cr6+-induced oxidative stress-mediated induction of autophagy in the liver and kidney of Channa punctatus.

52 Functional Outcomes and Return to Sport Following Anterior Cruciate Ligament Reconstruction in Recreational Athletes: A Systematic Review

Abstract Introduction Outcomes of anterior cruciate ligament reconstruction (ACLR) are well reported in athletic populations, however surprisingly little information is available for outcomes in the recreational athletes that make up the majority of cases. The aim was therefore to assess post-operative outcome and return-to-sport in recreational athletes following ACLR. Method A systematic search was conducted in Ovid MEDLINE, CINAHL, AMED and the grey literature according to the PRISMA guidelines. Studies involving a clear definition of recreational athletes who underwent ACLR and recorded postoperative outcomes were included. Publication quality was assessed using Newcastle-Ottawa Scale. Results 107 studies were identified, 19 full-text records reviewed and 13 included, reflecting 1342 patients with an average age of 31.7 (SD 9.8). Mean follow-up was 43.6-months (SD 42.8). Functional activity change was reported in 92% (12/13) papers. Functional outcome was assessed with the Tegner activity score in seven studies, with 43% (3/7) reporting a post-operative improvement. The Lyshom score was used in five, of which, 60% (3/5) showed post-operative improvement, 20% (1/5) showed no difference and 20% (1/5) showed a decrease. 69% (9/13) studies reported return-to-sport, with a mean rate of 55% (S.D. 19.2) at a mean follow-up of 32-months (SD. 34.8). Reported return-to-sports rate increased with length of follow-up. Conclusions Approximately only 50% of recreational athletes increase activity level and return-to-sport following ACLR. There is wide variation in return-to-sports timeframes reported, and the link between return-rate and post-operative timeframe suggests that longer follow-up periods may be required to accurately capture return-to-sport rates in recreational athletes.

A feasibility trial of prehabilitation before oesophagogastric cancer surgery using a multi-component home-based exercise programme: the ChemoFit study

BackgroundTreatment for locally advanced oesophagogastric adenocarcinoma involves neoadjuvant chemotherapy which has a negative impact on patient fitness. Using ‘prehabilitation’ to increase activity levels and fitness may affect physiology, postoperative outcomes and improve patient wellbeing and quality of life. The aims of the trial were to address the feasibility and acceptability of recruiting participants to a home-based prehabilitation programme and provide data to allow design of future studies.MethodsWe recruited patients to a single-arm feasibility trial of home-based exercise prehabilitation. Eligible patients were aged ≥18years, had operable oesophageal or gastric adenocarcinoma and were receiving neoadjuvant chemotherapy at our tertiary referral hospital. All participants commenced a home-based exercise programme utilising pedometers and step counting to target daily aerobic exercise sessions alongside daily strengthening exercises. A weekly telephone consultation directed the exercise programme and facilitated weekly data collection. The primary (feasibility) outcomes for the trial were (a) recruitment rate, (b) completion rate, (c) engagement with the programme (use of pedometers, recording step counts, telephone consultations) and (d) compliance with exercise sessions, exercise intensity and strengthening exercises.ResultsThere were 42 patients recruited, and the recruitment rate was 72.4% (42/58). 92.3% (36/39) of patients completed the exercise programme. There was 98.7% (IQR 93.2–100.0%) compliance with wearing a pedometer and recording data, and 100.0% (IQR 93.1–100.0%) compliance with a weekly telephone consultation. Exercise sessions and strengthening exercises were completed 70.2% (IQR 53.1–88.9%) and 69.4% (IQR 52.1–84.3%) of the time, respectively. Appropriate exercise intensity was recorded 96% (IQR 85.4–99.4%) of the time. There were no adverse events. Participants were enrolled in the exercise programme for a median of 91 days (IQR 84 to 105 days).ConclusionsThe results of this trial support the feasibility and acceptability of recruiting participants to an appropriately powered randomised controlled trial of prehabilitation.Trial registrationClinicaltrials.gov NCT04194463. Registered on 11th December 2019—retrospectively registered.

Protocol for a collaborative randomised effectiveness trial of lay-delivered versus clinician-delivered behavioural activation in senior centres

IntroductionDepression is common among community-dwelling older adults who make use of senior centre services yet remains undertreated due to a lack of acceptable and available treatments. Emerging evidence suggests that...

How do Complementors React to a Change in Platform Openness? Evidence from YouTube

Openness refers to the degree to which a platform grants users and complementors access to its features and other ecosystem participants. Prior studies highlighted trade-offs between securing a large and diverse set of complementors and protecting the integrity of their offerings, and how this can drive between-platform difference. However, less is known about how incentives and behaviors are affected if a platform's degree of openness changes. We therefore investigate a rule change that significantly increased the eligibility criteria to participate in the YouTube Partner Program, excluding a subset of prior participants, and depriving them from the possibility to monetize their content. Consistent with a deterioration of financial incentives, we find that affected YouTubers exited the platform at higher rates compared to those who are just unaffected. Among those who did not leave the platform, we find increased activity levels after the rule change, suggesting that they strove to regain access to the program. We do not find evidence that affected YouTubers produced more mainstream or high-quality content.

Nonsurgical Management of Distal Radius Fractures in the Elderly: Approaches, Risks and Limitations.

The elderly have conventionally been defined as individuals over the age of 65 and are projected to represent about 21% of the United States (US) population by the year 2030. Distal radius fractures (DRF) in particular are one of the most common fractures among elderly patients and their incidence continues to rise in part due to increased activity levels among the elderly, increased life expectancy, rising rates of obesity, changes to dietary habits, and the prevalence of osteoporosis. Although various treatment options exist for these injuries, nonsurgical treatment of distal radius fractures remains a mainstay among elderly patients with mounting evidence of its non-inferiority to surgical fixation in the literature. Here, we summarize the overall approach to nonsurgical treatment of distal radius fractures in the elderly population while examining its supporting data and highlighting potential risks and limitations to it.

Acute mania following COVID-19 in a woman with no past psychiatric history case report

BackgroundThe COVID-19 pandemic that began in late 2019 is caused by infection with the severe acute respiratory syndrome coronavirus-2. Since that time, many neuropsychiatric sequelae including psychosis, neurocognitive disorders, and mood disorders have been observed. The mechanism underlying these effects are currently unknown, however several mechanisms have been proposed.Case presentationA 47-year-old woman with past medical history including hypertension and premenstrual syndrome but no psychiatric history presented to the psychiatric hospital with new onset mania. She had developed symptoms of COVID-19 and was later diagnosed with COVID pneumonia. During quarantine, she reported high levels of stress, grief, and anxiety. Seventeen days into her illness, she developed altered mental status, sleeplessness, elevated mood, talkativeness, and preoccupations. Her spouse was concerned for her safety and contacted emergency medical services who brought her to the psychiatric hospital. She had not slept for five days prior to her arrival and exhibited flight of ideas, talkativeness, and grandiose ideas. She reported a family history of bipolar disorder but no past manic or depressive episodes. She was diagnosed with acute mania and stabilized using antipsychotics, a mood stabilizer, and a short course of a benzodiazepine. Many of her symptoms improved, including her elevated mood, increased activity level, and flight of ideas though she continued to have decreased need for sleep as her benzodiazepine was tapered. She and her partner were agreeable to transitioning to outpatient care after her mood stabilized.ConclusionsThis report emphasizes the link between COVID-19 and neuropsychiatric symptoms. Acute mania has no recognized association with COVID-19, but similar presentations have been reported. The patient’s age and time to onset of psychiatric symptoms is consistent with previous reports. Given the growing body of evidence, this association warrants further investigation. Severe acute respiratory syndrome coronavirus-2 causes systemic inflammation and has been shown to be neurotropic. In addition, patients undergoing quarantine experience anxiety related to the disease in addition to social isolation. Psychiatric practitioners should be aware of these effects and advocate for psychiatric evaluation following COVID-19 infection. Understanding the sequelae of infectious disease is crucial for responding to future pandemics.

Breast Cancer-Stromal Interactions: Adipose-Derived Stromal/Stem Cell Age and Cancer Subtype Mediated Remodeling.

Adipose tissue is characterized as an endocrine organ that acts as a source of hormones and paracrine factors. In diseases such as cancer, endocrine and paracrine signals from adipose tissue contribute to cancer progression. Young individuals with estrogen receptor-alpha positive (ER-α+) breast cancer (BC) have an increased resistance to endocrine therapies, suggesting that alternative estrogen signaling is activated within these cells. Despite this, the effects of stromal age on the endocrine response in BC are not well defined. To identify differences between young and aged ER-α+ breast tumors, RNA sequencing data were obtained from The Cancer Genome Atlas. Analysis revealed enrichment of matrix and paracrine factors in young (≤40 years old) patients compared to aged (≥65 years old) tumor samples. Adipose-derived stromal/stem cells (ASCs) from noncancerous lipoaspirate of young and aged donors were evaluated for alterations in matrix production and paracrine secreted factors to determine if the tumor stroma could alter estrogen signaling. Young and aged ASCs demonstrated comparable proliferation, differentiation, and matrix production, but exhibited differences in the expression levels of inflammatory cytokines (Interferon gamma, interleukin [IL]-8, IL-10, Tumor necrosis factor alpha, IL-2, and IL-6). Conditioned media (CM)-based experiments showed that young ASC donor age elevated endocrine response in ER-α+ BC cell lines. MCF-7 ER-α+ BC cell line treated with secreted factors from young ASCs had enhanced ER-α regulated genes (PGR and SDF-1) compared to MCF-7 cells treated with aged ASC CM. Western blot analysis demonstrated increased activation levels of p-ER ser-167 in the MCF-7 cell line treated with young ASC secreted factors. To determine if ER-α+ BC cells heightened the cytokine release in ASCs, ASCs were stimulated with MCF-7-derived CM. Results demonstrated no change in growth factors or cytokines when treated with the ER-α+ secretome. In contrast to ER-α+ CM, the ER-α negative MDA-MB-231 derived CM demonstrated increased stimulation of pro-inflammatory cytokines in ASCs. While there was no observed change in the release of selected paracrine factors, MCF-7 cells did induce matrix production and a pro-adipogenic lineage commitment. The adipogenesis was evident by increased collagen content through Sirius Red/Fast Green Collagen stain, lipid accumulation evident by Oil Red O stain, and significantly increased expression in PPARγ mRNA expression. The data from this study provide evidence suggesting more of a subtype-dependent than an age-dependent difference in stromal response to BC, suggesting that this signaling is not heightened by reciprocal signals from ER-α+ BC cell lines. These results are important in understanding the mechanisms of estrogen signaling and the dynamic and reciprocal nature of cancer cell-stromal cell crosstalk that can lead to tumor heterogeneity and variance in response to therapy.

Responding to COVID‐19: International nonprofits' stakeholder channels, resource pressures and governance responses

The coronavirus disease 2019 (COVID‐19) health crisis imposes severe pressures on nonprofit organizations, which must be resilient to respond effectively to extreme environmental tensions. We combined resource dependence theory with stakeholder theory to frame to what extent nonprofits experienced resource pressures through various stakeholder channels and the nonprofit governance responses. We empirically investigated international medical research and education nonprofits during the COVID‐19 pandemic. Our results indicate resource decreases in nearly all stakeholder channels. In response, nonprofit boards increased activity levels by mainly focusing on adapting organizational offerings and increasing support to the organization. Managerial executives also increased their activity levels, by focusing on safeguarding financial stability, planning and adapting operations to confinement measures.

HGG-56. Spatial mapping of the tumor micro-environment in pediatric glioma

High-grade glioma are the main cause of cancer-related death in children. The highly heterogeneous composition of the tumor cells and their interactions with the tumor micro-environment (TME), contribute substantially to the poor response to treatment and the high levels of morbidity and mortality. Here, we used high-dimensional, multiplexed immunohistochemistry to map the single-cell tissue architecture of 26 pediatric glioma samples covering 8 histologic diagnoses, allowing us to determine the spatial distribution of the various tumoral subtypes and how these interact with their local immune-microenvironment. Overall, this analysis showed that tumor grade anti-correlated with the amount of infiltrating cytotoxic T-lymphocytes (CTLs), which were typically more exhausted in the higher grade tumors. In addition, tumor associated macrophages were primarily infiltrating from the blood and presented an M2-like anti-inflammatory phenotype which became more extended with tumor grade. Using the spatial information, possible cell-cell interactions could be determined. In lower grade glioma, we observed an increased activation level of CTLs that were closely located to neighboring T-helper cells. In pediatric glioblastoma, on the other hand, CTLs, even though they were located close to a T-helper cell, could only minimally be activated, and showed more extended exhaustion when residing further away. Additionally, the activation of the CTLs was associated to the distance to the closest PD-L1 positive macrophage in pilocytic astrocytoma and desmoplastic infantile ganglioglioma. In conclusion, with the use of multiplex immunohistochemistry, we are able to study the tumor and TME of pediatric glioma in depth on a single-cell and spatial level, which allows us to further study the heterogeneous landscape of these tumors.

Notch-dependent and -independent transcription are modulated by tissue movements at gastrulation.

Cells sense and integrate external information from diverse sources that include mechanical cues. Shaping of tissues during development may thus require coordination between mechanical forces from morphogenesis and cell-cell signalling to confer appropriate changes in gene expression. By live-imaging Notch-induced transcription in real time, we have discovered that morphogenetic movements during Drosophila gastrulation bring about an increase in activity-levels of a Notch-responsive enhancer. Mutations that disrupt the timing of gastrulation resulted in concomitant delays in transcription up-regulation that correlated with the start of mesoderm invagination. As a similar gastrulation-induced effect was detected when transcription was elicited by the intracellular domain NICD, it cannot be attributed to forces exerted on Notch receptor activation. A Notch-independent vnd enhancer also exhibited a modest gastrulation-induced activity increase in the same stripe of cells. Together, these observations argue that gastrulation-associated forces act on the nucleus to modulate transcription levels. This regulation was uncoupled when the complex linking the nucleoskeleton and cytoskeleton (LINC) was disrupted, indicating a likely conduit. We propose that the coupling between tissue-level mechanics, arising from gastrulation, and enhancer activity represents a general mechanism for ensuring correct tissue specification during development and that Notch-dependent enhancers are highly sensitive to this regulation.

Glycine Betaine and β-Aminobutyric Acid Mitigate the Detrimental Effects of Heat Stress on Chinese Cabbage (Brassica rapa L. ssp. pekinensis) Seedlings with Improved Photosynthetic Performance and Antioxidant System.

Heat stress is one of the major abiotic factors that limit the growth, development, and productivity of plants. Both glycine betaine (GB) and β-aminobutyric acid (BABA) have received considerable attention due to their roles in stimulating tolerance to diverse abiotic stresses. In order to understand how GB and BABA biostimulants alleviate heat stress in a cool-weather Chinese cabbage (Brassica rapa L. ssp. pekinensis) plant, we investigated the GB- and BABA-primed heat-stressed plants in terms of their morpho-physiological and biochemical traits. Priming with GB (15 mM) and BABA (0.2 mM) was conducted at the third leaf stage by applying foliar sprays daily for 5 days before 5 days of heat stress (45 °C in 16 h light/35 °C in 8 h dark) on Chinese cabbage seedlings. The results indicate that GB and BABA significantly increased chlorophyll content, and the parameters of both gas exchange and chlorophyll fluorescence, of Chinese cabbage under heat stress. Compared with the unprimed heat-stressed control, the dry weights of GB- and BABA-primed plants were significantly increased by 36.36% and 45.45%, respectively. GB and BABA priming also greatly mitigated membrane damage, as indicated by the reduction in malondialdehyde (MDA) and electrolyte leakage through the elevation of proline content, and increased activity levels of superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), and ascorbate peroxidase (APX). Taken together, GB and BABA have great potential to enhance the thermotolerance of Chinese cabbage through higher photosynthesis performance, osmoprotection, and antioxidant enzyme activity.

OA44 Increasing access to rehabilitation for knee and hip osteoarthritis - ESCAPE-pain in leisure/community centres

Abstract Background/Aims Enabling Self-management and Coping with Arthritic Pain using Exercise, ESCAPE-pain, is a rehabilitation programme for people with knee and/or hip osteoarthritis (OA) that reduces pain, improves function and reduces healthcare utilisation. The programme is usually delivered in physiotherapy departments. However, financial and logistical constraints in the NHS limit the number of people who can access the programme. Delivering ESCAPE-pain in community centres would increase accessibility, “reach” and provide better on-going support. We trained exercise professionals to deliver ESCAPE-pain in leisure/community centres, monitored whether it continued to be effective and gathered the experiences of participants, facilitators and organisations delivering the programme. Methods 369 exercise professionals were trained to deliver ESCAPE-pain in 41 leisure and community centres across the UK. Pain, function and quality of life (using Knee or Hip Osteoarthritis Outcome Score, K/HOOS), and self-reported activity levels (minutes/week) were measured before and after the programme. Programme participant's and facilitator/organisation’s experiences were evaluated using semi-structured interviews. Results 1386 participants (998 female) were recruited, mean age 70 years. Before the programme only 24% of participants were “fairly/moderately active” (doing &amp;gt;30 mins activity/week), after the programme 78% were “fairly/moderately active (doing &amp;gt;150mins activity/week). These increased activity levels were maintained for 12 months after completing the programme. Participants enjoyed the programme and reported improvements in their pain (10 K/HOOS points; p &amp;lt; 0.0001), function (9pts; p &amp;lt; 0.0001), QoL (10pts; p &amp;lt; 0.0001), understanding, exercise self-efficacy (their confidence in using exercise to control pain and its impact), mental wellbeing and reduced reliance on healthcare professions, medication and surgery. They were able to walk better, farther, without an aid and returned to former activities, felt better in themselves and “the world was a brighter place”. Most people were planning to continue exercising after completing the programme and had joined classes and taken up activities they enjoyed such as swimming, golf, walking, yoga. The exercise professionals enjoyed getting involved in healthcare interventions and offering people an effective intervention. The 17 partner organisations found the programme increased their portfolio of interventions, forming links with the healthcare sector that they saw as important in the future. Many organisations planned to expand the number of centres running the programme permanently. To create revenue streams that enabled them to sustain delivery of ESCAPE-pain organisations formed collaborations with clinical departments, contracted by CCGs, charged a nominal amount for the programme or membership for the organisation and are expanding the programme to other centres within their organisation. Conclusion ESCAPE-pain can be safely delivered by exercise professionals in leisure/community centres, maintains its clinical effectiveness and nurtures habitual exercise. The community-based programme is capable of helping the large and rapidly increasing number of people with OA. ESCAPE-pain is now being delivered in leisure centres across the UK. Disclosure M.V. Hurley: None. A. Carter: None. H. Sheldon: None. M. Connolly: None.

Arousal, subjective significance and the origin of valence aligned words in the processing of an emotional categorisation task.

An emotional categorisation task allows us to study how emotionality is understood and how emotional factors influence decisions. As emotionality is not only the valence but is also composed of activation (arousal and subjective significance) and the type of process needed to produce emotion (origin), we wanted to test the influence of these emotional factors on with a group of stimuli not differing in valence. We predicted that increasing activation levels should lead to increased classification of stimuli as emotional, with a focus on the late processing stages, when explicit word processing occurs, which on the electrophysiological level corresponds to P300, N450 and LPC components. The behavioural results showed that the emotionality of words increased with increasing levels of arousal and subjective significance. Automatically originated words were assessed as more emotional than reflective ones. The amplitude of the N450 component revealed dissociation for subjective significance and origin effects, showing that these two dimensions ascribe distinct properties of emotionality. Finally, the LPC component was susceptible to all affective dimensions used in manipulation. Our study showed that arousal, subjective significance and origin are dimensions of affect that shape the processing of words’ emotionality, when the values of valence were aligned among the stimuli.

Does Preoperative Activity Level Affect Postoperative Outcomes Following Total Hip Arthroplasty?

BackgroundMany patients electing to undergo total hip arthroplasty (THA) value continuing active lifestyles when considering treatment options. Addressing these concerns requires evaluating the effect of preoperative activity level on patient-reported outcomes and improvement following THA. MethodsThree hundred thirty-five patients (368 hips) who underwent THA with a minimum 6-month (mean 533 ± 271 days) follow-up completed preoperative and postoperative University of California, Los Angeles (UCLA) activity score along with various patient-reported measures of function, pain, and mental state. Preoperative UCLA score divided patients into inactive, mild, and active groups. Analysis of covariance controlling for age, sex, body mass index, surgical approach, implant, bilateral cases, conversions, and follow-up time evaluated differences among groups for postoperative outcomes with subsequent Tukey-Kramer pairwise comparisons. ResultsMildly active patients (73:139 male:female) had better postoperative outcomes than inactive patients (40:70 male:female) for UCLA score, EuroQol Visual Analog Scale (EQVAS), Hip Outcome Score (HOS), 12-item Short-Form (SF-12) Physical, and Visual Analog Pain Scale (average/now/worst) (P values <0.001/<0.001/<0.001/<0.001/0.003/<0.001/<0.001). Active patients (32:14 male:female) had better postoperative outcomes than inactive patients for UCLA score, EQVAS, HOS, SF-12 Physical, and Visual Analog Pain Scale Worst (P values <0.001/0.024/0.001/0.001/0.017). No postoperative outcome differences existed between active and mild patients. Inactive patients displayed greater outcome improvements than mildly active patients for UCLA score, Harris Hip Score, and International Hip Outcome Tool (P values <0.001/<0.001/0.013) and active patients for UCLA score, EQVAS, HOS, International Hip Outcome Tool, and SF-12 Physical (P values <0.001/0.008/0.013/0.022/0.004). ConclusionsInactive patients achieve greater measure improvements following THA. Active patients achieve better absolute outcomes than inactive patients; however, increasing activity levels do not incrementally improve patient-reported outcome measures. Patients similarly improve pain and mental health regardless of activity level.

Optimized Flow Cytometry Strategy for Phenotyping Intramuscular Leukocytes: Application to the Evaluation of Myopathological Processes.

Phenotyping intramuscular immune cells is essential for the characterization of dysimmune/inflammatory myopathies (DIM). Flow cytometry (FC) is the most reliable technique for analyzing leukocyte subpopulations and evaluating their activation levels. We developed a purely mechanical protocol for extracting cells from muscle tissue allowing us to preserve cell surface epitopes and determined its applicability to experimental pathology in mice and myopathological diagnosis in human. Skeletal muscle regeneration in mice was associated with a transient enrichment of macrophages (CD11bhighGr-1+), myeloid dendritic cells (CD3-C8+CD11bhigh), CD8+ T cells (CD3+C8+), and NK cells (CD3- CD11bhighNKp46+). In murine models of inherited muscle dystrophies, leukocytes represented 23%-84% of intramuscular mononuclear cells, with a percentage of CD8+ T cells (4%-17%) mirroring that of all CD45+ cells, while MDCs remained a minority. In human 16 samples (DIM: n = 9; nonimmune conditions: n = 7), DIM was associated with intramuscular recruitment of CD8+ T cells, but not CD4+ T cells and NK cells. FC allowed concomitant quantification of HLA-DR, CD25, CD38, and CD57 activation/differentiation biomarkers and showed increased activation levels of CD4+ and CD8+ T cells in DIM. In conclusion, FC is an appropriate method for quantifying intramuscular leukocyte subpopulations and analyzing their activation states.

Totally Excited about Moving Mobility and Exercise (TEAM Me): A Successful Multidisciplinary Exercise Quality Improvement Initiative for Pediatric and Young Adult Oncology and Stem Cell Transplant Inpatients.

Background: Pediatric, adolescent and young adult (PAYA) patients are less active than their healthy counterparts, particularly during inpatient stays. Methods: We conducted a quality improvement initiative to increase activity levels in patients admitted to our pediatric oncology and cellular therapy unit using a Plan-Do-Study-Act (PDSA) model. An interdisciplinary team was assembled to develop an incentive-based inpatient exercise and activity program titled Totally Excited About Moving Mobility and Exercise (TEAM Me). As part of the program, patients were encouraged by their care team to remain active during their inpatient stay. As an additional incentive, patients earned stickers to display on TEAM Me door boards along with tickets that could be exchanged for prizes. Activity was assessed by documentation of physical therapy participation, tests of physical function, and surveys of staff perceptions of patient activity levels, motivations, and barriers. Results: Compared to baseline, patient refusals to participate in physical therapy decreased significantly (24% vs. 2%) (p < 0.02), and staff perceptions of patient motivation to stay active increased from 40% to 70% in the post implementation period. There were no changes in physical function tests. Conclusions: An incentive-based exercise program for young oncology inpatients greatly improved patient activity levels, participation in physical therapy and influenced professional caregivers’ beliefs.