Low-impact Group Research Articles

Impact of diversified aerobic training approaches for amplifying bone density in young individuals

Various aerobic training approaches have garnered considerable interest in improving bone health in young individuals. This study examines the effects of high-impact and low-impact multi-aerobic training on bone density in healthy young students in an effort to enhance bone health. In this study, the primary objective is to assess the effects of diverse multi-aerobic training regimens on bone density among 20-25 year olds. This study also examines the benefits of integrating high-impact and low-impact exercises for improving bone health. We selected 120 participants (60 men and 60 women) for a 27-week randomized three-by-two experimental design. Three groups of participants were assigned to each exercise group: the high-impact group (HIEG), the low-impact group (LIEG), and the control group (CG). A bone density (BD) measurement was performed before and after the training program using dual-energy X-ray absorptiometry (DXA). The results of an ANCOVA with baseline scores as covariates indicated a significant improvement (P < 0.05) in bone density among participants following the intervention. As compared to CG, both HIEG and LIEG improved bone density significantly (P < 0.05), suggesting multi-aerobic training promotes bone health effectively. It highlights the potential of both HIEG and LIEG in enhancing bone density in young individuals through a 27-week diversified multi-aerobic training program. In order to cultivate and enhance bone density among young individuals, regular multi-aerobic exercise is critical to their lifestyles. This can be used to formulate exercise interventions aimed at boosting bone health in both sexes.

Influence of sport type and gender on bone turnover markers in young athletes

BackgroundExercise is beneficial to bone health. However, little is known about the interaction effect of gender and sport type on bone turnover in young athletes. This study aimed to examine the influence of gender and sports categories (high, medium, and low impact) on bone turnover: reabsorption markers–osteocalcin, calcium, inorganic phosphate (IP), alkaline phosphatase (ALP), and resorption marker–cross-linked N-telopeptides of type 1 collagen (NTx) among a university’s undergraduate athletes.MethodsThe study was an ex-post facto design involving forty-seven purposively recruited gender- and sport-type-matched undergraduate athletes whose demographic characteristics and BMI were obtained. Participants’ 5 mL antecubital blood samples were collected and analysed for serum levels of osteocalcin, calcium, IP, ALP, and NTx using standard laboratory protocols, Bio-Tek spectrometer, and KC4 (3.3) software. Data were analysed using descriptive statistics and two-way ANOVA.ResultsThe study involved 24 females and 23 males (n = 47) aged 22.15 ± 3.35 years with an average BMI of 23.34 ± 4.66. There was no significant gender effect on the biomarkers. However, there was a significant effect of the sports category on IP (F = 4.307, p = 0.020), calcium (F = 6.807, p = 0.003), and ALP serum levels (F = 11.511, p < 0.001). Specifically, mid-impact sports participants had a higher IP than the low-impact group (mean difference [MD] = 0.81 mg/dL, p = 0.036). Low-impact had a higher calcium level than mid-impact (MD = 0.40 mg/dL, p = 0.022) and high-impact (MD = 0.49 mg/dL, p = 0.003). Conversely, low-impact had lower ALP than mid-impact (MD = − 11.13 U/L, p = 0.013) and high-impact (MD = − 17.44 IU/L, p < 0.001).ConclusionModerate to high-impact sports positively affected bone turnover in young athletes. However, gender had no significant impact.

Perceived negative impact of caregiving demands in parents of individuals with autism spectrum disorders from 9 to 25 years of age

BackgroundCaregivers of autistic individuals often report higher levels of perceived negative impact of caregiving. We know very little about the trajectories of caregivers perceived negative impact related to caregiving demands over time in autism. MethodThe aim of this study was to identify trajectories of perceived negative impact related to parenting of caregivers of autistic individuals and other developmental delays from childhood through emerging adulthood (n = 209). We also explored the factors that predict trajectories of caregiver perceived negative impact including the characteristics of the autistic individuals at age 9 (i.e., social affect, restricted and repetitive behaviors, irritability, hyperactivity, daily living skills and cognitive ability) and caregivers’ race, education, social support, and study site. ResultsLatent class growth modelling yielded three negative impact of caregiving classes: (1) a low impact class that decreased over time (n = 68, 32.54 %), (2) a medium impact class that increased in negative impact during adolescence and decreased in emerging adulthood (n = 98, 46.98 %), and (3) a high impact class that decreased over time (n = 43, 20.57 %). Across all classes, reductions in negative impact of caregiving over time were reported in emerging adulthood, but the high and medium impact groups were still elevated in comparison to the low impact class at the last timepoint. Caregivers of children with less irritability and parent-reported restricted and repetitive behaviors were more likely to belong to the low negative impact group. Caregivers who were African American, had lower educational attainment and those with social support were more likely to belong to the low negative impact group. ConclusionsThese findings highlight the importance of continued support for caregivers of autistic individuals over time. The influence of race and education on levels of caregiver perceived negative impact of caregiving are discussed further.

Stress phenotypes in epilepsy: impact on cognitive functioning and quality of life.

Drug-resistant epilepsy has been proposed as a chronic stress model. Stress can be measured in terms of chronicity (epilepsy duration) and intensity (comorbidities), with depression and anxiety among the most important comorbidities in epilepsy due to its prevalence and its relationship with cognitive functioning and quality of life. This study aims to establish phenotypes according to how patients face a stressful condition (epilepsy) and examine differences in cognition and quality of life depending on these phenotypes. We hypothesize that there will be an interrelationship between epilepsy duration and negative affectivity, and these variables will influence cognition and quality of life. 170 patients (82 men and 88 women) underwent a neuropsychological evaluation in which trait anxiety, depression, attention and executive function, verbal and visual memory, language, emotional recognition, and quality of life were assessed. Hierarchical clustering was performed using z-scores for three variables: trait anxiety; depression; and epilepsy duration. Three clusters were found: vulnerable (high negative affectivity and short duration); resilient (moderate negative affectivity and long duration); and low-impact group (low negative affectivity and short duration). Results show that the vulnerable group had poorer cognitive functioning and quality of life than the other groups. Specifically, the vulnerable group had poorer scores than the low-impact group on verbal memory, visual confrontation naming, and quality of life (except seizure worry). Furthermore, resilient patients had better scores than the low-impact group on cognitive flexibility variables, but lower scores on some quality-of-life subscales (i.e., overall quality of life, emotional well-being, and energy). Finally, the vulnerable group had poorer scores than the resilient group in executive functioning, naming, and quality of life. These results suggest that dealing with stress in patients with epilepsy is related to cognitive performance and quality of life. These findings underline the relevance of considering comorbidities in epilepsy and may be useful for detecting vulnerable or resilient profiles as risk or protective factors for cognitive and quality of life decline.

Assessing Severity of Chronic Obstructive lung disease (COPD) Using CAT score among high altitude residents of Nepal

Introduction: The goal of this study was to see if the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) score was beneficial in determining the severity of COPD patients. It produces a score that reflects the impact of the condition on their health status. GOLD guideline (2013) recommends CAT above other respiratory questionnaires since it is regarded to be a better assessment tool.&#x0D; Methods: Cross-sectional study conducted in Karnali Academy of Health Sciences, Jumla (Nepal) who presented with COPD exacerbation. A validated CAT questionnaire in the local language (Nepali) was employed and completed by the patient, and then the total CAT score was calculated and grouped into four impact levels. Data was evaluated using descriptive statistics (such as percentage and mean) and Pearson’s correlation tests to compare means.&#x0D; Results: Out of 55 patients, 52.7% were females; all 55 had firewood exposure with current smoking history more prevalent in the high-impact group 0.5%. At 3 months, the median number of COPD exacerbations was 2 (range: 0–90) with median CAT score 30 (range: 17–37). Patients were divided into severity groups based on their CAT scores. 47.3% were in the high impact group, whereas none were in the low impact group. The “very high impact” group had a considerably higher median number of exacerbations than the other high impact and medium groups (5 vs. 2 and 0) respectively with p&lt;0.001. In the “very high impact” group, significant use of inhalers in form of salbutamol or long-acting bronchodilators in combination with steroid was seen.&#x0D; Conclusions: CAT is an independent severity score that is higher in frequent exacerbates. The “very high impact” group had a considerably higher median number of exacerbations than the other groups (5 vs. 2 and 0) respectively with a significant p&lt;0.001 value. Thus, useful in monitoring patients health status and treatment.

Emotional impact of compassionate extubation on respiratory therapists and nurses: A pilot study.

BackgroundCompassionate extubation (CE) refers to withdrawing mechanical ventilation and allowing a patient to die peacefully at the end of life. The primary objective of this pilot study was to quantify the emotional impact of CE on Respiratory Therapists (RT) and Registered Nurses (RNs).MethodsThis pilot survey was conducted between March and April 2021 at an academic medical center among RTs and RNs. It included questions on participants’ demographics, work characteristics, and Impact of Events (IES) scale to assess the subjective stress caused by CE. Data were analyzed using descriptive and χ2 statistics.ResultsAmong 20 participants, 18 (90%) were females, 12 (60%) were in the 20–40-year age group, 12 (60%) were RTs, and 8 (40%) RNs. Around 15 (75%) participants worked day shifts with a weekly average of 3–4 shifts, and 14 (70%) performed/observed CE within 1 month before taking this survey. CE performed/observed in a month was ≤2 among 15 (75%) and 3–5 among 4 (20%) participants. Mean total IES score was 16.7 (12.3) among all participants representing 7 (35%) having low, 6 (30%) moderate, and 7 (35%) high emotional impact when performing CE. Risk of developing post-traumatic stress disorder (PTSD) was present in 6 (30%) participants. A significantly higher number of participants in the low impact group were satisfied with the institutional CE process (p = 0.043) than those in the medium/high impact group.ConclusionThis pilot study findings reveal that RTs and RNs experience moderate to high levels of subjective stress when performing CE. One-third of the survey participants were at risk of developing PTSD.

Total Hysterectomy by Low-Impact Laparoscopy to Decrease Opioids Consumption: A Prospective Cohort Study.

Our objective was to evaluate postoperative pain and opioid consumption in patients undergoing hysterectomy by low-impact laparoscopy and compare these parameters with conventional laparoscopy. We conducted a prospective study in two French gynecological surgery departments from May 2017 to January 2018. The primary endpoint was the intensity of postoperative pain evaluated by a validated numeric rating scale (NRS) and opioid consumption in the postoperative recovery unit on Day 0 and Day 1. Thirty-two patients underwent low-impact laparoscopy and 77 had conventional laparoscopy. Most of the patients (90.6%) who underwent low-impact laparoscopy were managed as outpatients. There was a significantly higher consumption of strong opioids in the conventional compared to the low-impact group on both Day 0 and Day 1: 26.0% and 36.4% vs. 3.1% and 12.5%, respectively (p = 0.02 and p < 0.01). Over two-thirds of the patients in the low-impact group did not require opioids postoperatively. Two factors were predictive of lower postoperative opioid consumption: low-impact laparoscopy (OR 1.38, 95%CI 1.13–1.69, p = 0.002) and a mean intraoperative peritoneum below 10 mmHg (OR 1.25, 95%CI 1.03–1.51). Total hysterectomy by low-impact laparoscopy is feasible in an outpatient setting and is associated with a marked decrease in opioid consumption compared to conventional laparoscopy.

Why buy used clothing during the pandemic? Examining the impact of COVID-19 on consumers’ secondhand fashion consumption motivations

ABSTRACT While many fashion brands and retailers are struggling amidst the shock of the COVID-19 pandemic, consumers’ secondhand fashion consumption (SFC) is accelerating as an alternative to new clothing purchases. Despite the growing importance of the resale market and the impact of the pandemic on consumer behavior, a comprehensive picture of SFC amid the pandemic has yet to be researched. The purpose of this study is to examine how the impact of the pandemic influences the relationships among consumers’ motivations, attitudes, and intentions toward SFC. By applying the theory of reasoned action, consumers’ motivations (e.g., sustainability, social, variety-seeking, fun-seeking, cost-saving dimensions) behind SFC intentions between high vs. low pandemic impact groups are studied. Through the online survey with 467 participants from South Korea, our study demonstrates that consumers are motivated to engage in SFC for different reasons depending on the impact of the pandemic on their daily lives. While cost-saving and social motivations were significant drivers for the high-impact group, the attitudes of the low-impact group were mainly influenced by sustainability and variety-seeking motivations. Study findings and implications are discussed, and future research directions are suggested.

Latent class analysis of COVID-19 experiences, social distancing, and mental health.

Information is needed on the relationship between coronavirus disease (COVID-19) social distancing restrictions and their relationship with mental health. In particular, there is limited investigation into how COVID-related adversities have positively mobilized individuals. We use latent class analysis (LCA) to identify subtypes of positive and negative aspects of the experience of COVID-19 social distancing and the association of these subtypes with mental health. We conduct an online survey of COVID-19 and mental health with 3,183 adults residing in Quebec, Canada, during the first wave of the epidemic. We use LCA to identify subtypes of positive and negative aspects of social distancing. We use logistic and linear regression to estimate the associations between class membership and self-reported impact of COVID-19 on mental health and scores on the Hopkins Symptom Checklist-10 (HSCL-10). We identify five classes of individuals in regards to perceived positives and negatives of social distancing related to COVID-19, named Low Impact, Freedom/Flexibility, Safety, Family/Home, and Hardships. Sociodemographic variables including age, gender, race/ethnicity, and self-reported mental health prior to COVID are associated with class assignment. Latent classes are associated with both outcomes (p < .001). Individuals in the Hardships class have greater odds of reporting a significant impact of COVID-19 on mental health, OR = 2.09, 95% CI = [1.53, 2.86], p < .001, and have higher scores on the HSCL-10, β = .32, 95% CI = [.23, .42], p < .001, than those individuals in the Low Impact group after adjusting for sociodemographic characteristics. Gender, age, and self-reported mental health prior to COVID-19 are independently associated with both outcomes (p < .001). We discuss study implications for public health programming and interventions to promote the mental health of at-risk populations during the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Identifying typologies of quality of life in patients with moderate to severe hand trauma based on patient-reported outcomes.

This study sought to classify the level of quality of life in patients with moderate to severe hand trauma, and explore differences in their potential profile characteristics based on the Patient-Reported Outcomes Measurement Information System (PROMIS). This was a survey research. A convenience sampling method was used to investigate 296 patients with moderate to severe hand trauma. A general information questionnaire (which was used to gather general demographic data and disease-related data) and PROMIS-57 were administered form November 2020 to May 2021. A latent profile analysis and Chi square test were conducted to analyze the data. Based on quality of life, patients with moderate to severe hand trauma were divided into the following 3 groups: (I) Group C1: the psychosocial-pain low-impact group (38.9%); (II) Group C2: the psychosocial-moderate-impact severe-pain group (43.9%); and (III) Group C3: the psychosocial-pain high-impact group (17.2%). There were significant differences in the distribution of age, educational level, marital status, occupation, monthly income, medical insurance type, family role, subsequent financial resources, cause of the injury, satisfaction with the appearance of the hand, degree of the injury, and impact of the injury on daily life among patients in the different groups (P<0.05). The quality of life in patients with moderate to severe hand trauma can be identified to provide precise care.

The influence of low-impact dance intervention on bone metabolism, cognition, and function fitness of old women

ABSTRACT This study examined the low-impact dance intervention on the markers of bone metabolism, cognitive function, and functional fitness of postmenopausal women. Senior women were randomized into low-impact dance (LG) or control group (CG). Three dance sessions weekly were scheduled in the LG for 16 weeks. The markers of bone metabolism, bone composition, Stroop test, and functional fitness were assessed at pre- and post-intervention. The marker of bone formation, some of cognitive function and functional fitness were improved in the LG. The low-impact dance intervention benefited the marker of bone formation, parts of cognitive function and functional fitness.

Applying the thresholds for clinical importance for fourteen key domains of the EORTC QLQ-C30: a latent class analysis of cancer survivors.

A person’s quality of life is impacted from the beginning of their oncology experience. One of the most common tools to measure quality of life is the EORTC QLQ-C30. The absolute scores it produces can be difficult to interpret in the clinical setting, and thresholds to help identify those who require intervention have recently been introduced. The aim of this research was to identify heterogeneity of these thresholds for clinical importance using latent class analysis in cancer survivors (those undergoing and those who have completed treatment) attending a hospital in the northwest of Ireland. We identified 3 distinct classes of cancer survivors, using Mplus 6.11: high clinical impact (13.9%), compromised physical function (40.3%) and low clinical impact (45.9%). The compromised physical function group were slightly more likely to be older (OR = 1.042, p < .05, CI = 1.000–1.086), not employed (OR = 8.347, p < .01, CI = 2.092–33.305), have lower PG-SGA scores (OR = .826, p < .001, CI = .755–.904), and not have been diagnosed in the last 2 years (OR = .325, p < .05, CI = .114–.923) compared to the high clinical impact group. The low clinical impact group were more likely to be female (OR = 3.288, p < .05, CI = 1.281–1.073), not employed (OR = 10.129, p < .01, CI = 2.572–39.882), have a lower BMI (OR = .921, p < .05, CI = .853–.994), and lower PG-SGA scores (OR = .656, p < .001, CI = .573–.750) than the high clinical impact group. Functional and symptom issues impact on quality of life, and therefore, identifying those of clinical importance is crucial for developing supportive care strategies.

Clinical Characteristics of COPD Patients According to COPD Assessment Test (CAT) Score Level: Cross-Sectional Study.

PurposeThe chronic obstructive pulmonary disease (COPD) assessment test (CAT) is widely used to assess the impact of COPD symptoms on health status. Whilst the CAT consists of eight different items, details on the distribution of each item are limited. This study aimed to investigate the distribution and clinical implication of each CAT item, stratified by CAT severity group, in stable COPD patients.Patients and MethodsThis was a cross-sectional study at a single referral hospital in South Korea. Spirometry confirmed COPD patients with CAT measured at the first clinical visit were retrospectively identified. Patients were categorized into three groups: low (0 ≤ CAT < 10), medium (10 ≤ CAT < 20), and high (20 ≤ CAT ≤ 40) impact group. For the purpose of this analysis, the first four items (cough, sputum, chest tightness, and dyspnea) and the remaining four items (activities, confidence, sleep and energy) were also grouped as “pulmonary” and “extra-pulmonary”, respectively.ResultsA total of 815 patients were included, and mean (SD) forced expiratory volume in 1 s (FEV1) was 62.8 (17.4) % pred. Among them, 300 patients (36.8%) were in the high impact group and had a greater exacerbation history and lower lung function. The proportion of “extra-pulmonary” items score was greater in patients with higher total CAT scores, with the activity and confidence items showing higher scores.ConclusionIn our study, in addition to dyspnea, activity limitation is a particular problem in individual patients with higher CAT total scores, for which physicians need to pay more attention. Our study suggests that whilst CAT total score captures the overall impact of COPD, each item of the CAT contains potentially useful information in understanding the patient’s symptom burden.

Depression, childhood trauma, and physical activity in older Indigenous Australians.

Indigenous Australians experience higher levels of psychological distress compared to the general population. Physical activity is a culturally acceptable approach, associated with reduction of depressive symptoms. The protective properties of physical activity for depressive symptoms are yet to be evaluated in older Indigenous Australians. A two-phase study design comprised of a qualitative thematic analysis following a quantitative regression and moderation analysis. Firstly, a total of 336 Indigenous Australians aged 60 years and over from five NSW areas participated in assessments on mental health, physical activity participation, and childhood trauma. Secondly, a focus group of seven Indigenous Australians was conducted to evaluate barriers and facilitators to physical activity. Regression and moderation analyses examined links between depression, childhood trauma, and physical activity. Thematic analysis was conducted exploring facilitators and barriers to physical activity following the focus group. Childhood trauma severity and intensity of physical activity predicted depressive symptoms. Physical activity did not affect the strength of the relationship between childhood trauma and depression. Family support and low impact activities facilitated commitment to physical activity. In contrast, poor mental health, trauma, and illness acted as barriers. Physical activity is an appropriate approach for reducing depressive symptoms and integral in maintaining health and quality of life. While situational factors, health problems and trauma impact physical activity, accessing low-impact group activities with social support was identified to help navigate these barriers.

The Impact of SARS-CoV-2 on the Most Common Comorbidities-A Retrospective Study on 814 COVID-19 Deaths in Romania.

Background: The SARS-CoV2 infection has rapidly spread throughout the world, particularly affecting those with underlying conditions.Objective: To assess the impact of SARS-CoV-2 on the most prevalent comorbidities, among people who died of COVID-19 in Romania.Methods: The study comprised 814 deaths caused by COVID-19 between 22nd March and 8th May, 2020 as reported by the Ministry of Health. WHO data regarding deaths of the general population of Romania was used for comparison. The study analyzed the demographics, number and prevalence of comorbidities and calculated the relative risk for each comorbidity.Results: The study sample consisted of 61.4% males and 38.6% females; the mean age was 68.2 y; 90.9% of deaths occurred in people 50+ years. The mean number of pre-existing conditions was 2.73 (SD = 1.521), with 97.4% of the patients having at least one. The most prevalent comorbidities were hypertension (43.1%), diabetes (33.2%), and coronary heart disease (26.0%). The calculated relative risk of death due to COVID-19 was divided into 3 risk categories: high impact comorbidities (RR > 3) included diabetes RR = 6.426 (95% CI, 4.965–8.318), chronic renal disease RR = 4.338 (95% CI, 3.556–5.292) and hypertension RR=3.261 (95% CI, 2.687–3.958). The medium impact (RR = 2–3) group comprised chronic pulmonary disease RR = 2.615 (95% CI, 2.061–3.319) and chronic liver disease RR = 1.577 (95% CI, 1.183–2.104) and the low impact group (RR<2) –coronary heart disease RR = 0.664 (95% CI, 0.581–0.758), cancer RR = 0.515 (95% CI, 0.416–0.637) and stroke RR = 0.468 (95% CI, 0.370–0.593).Conclusion: In the studied sample, SARS-CoV-2 had a greater impact on people with diabetes, chronic renal disease and hypertension and a lesser impact on those with coronary heart disease, cancer and stroke. Therefore, future policies in Romania should focus on shielding people in the high-risk group and prioritizing them for vaccination, whilst encouraging those in the low risk group to continue seeking treatment for their underlying diseases.

Patients With Fibromyalgia Reporting Severe Pain but Low Impact of the Syndrome: Clinical and Pain-Related Cognitive Features.

Fibromyalgia (FM) is a prevalent and highly disabling chronic pain syndrome. However, differences among patients regarding how pain impacts on daily life are remarkable. The main aim of this study was to identify clinical and pain-related cognitive variables characterizing patients reporting high adaptability despite experiencing severe chronic pain. Two hundred and eighty-three Spanish patients with FM with high levels of pain were classified into 2 groups: (1) those reporting low impact of the syndrome, and (2) those with moderate-to-high impact. Perceived stress, anxiety, and depressive symptoms along with pain catastrophizing, psychological inflexibility, and perceived control over pain were evaluated. Differences in sociodemographics, years with FM, past/current major depressive disorder comorbidity, and health-related economic costs (ie, medications, use of medical services, lost productivity due to sick leave) were also assessed. Stepwise logistic regression analyses predicting group membership from clinical variables and pain-related cognitive processes as predictors were performed. Lower stress, anxiety, and depressive symptoms, along with reduced pain catastrophism, psychological inflexibility, and perceived control over pain, were found in the low-impact group. Significant predictors of group membership (low-impact vs. moderate-to-high impact) in regression analyses were "cognitive fusion" (psychological inflexibility), "helplessness" (pain catastrophizing), and depressive symptomatology, together with pain intensity and other FM symptoms. The present study provides further evidence on resilience resources in chronic pain by identifying some variables (ie, reduced depressive symptomatology, pain catastrophizing, and psychological inflexibility) differentially characterizing a profile of patients with FM who are especially able to adapt to high levels of pain.

Association of Increased Serum S100B Levels With High School Football Subconcussive Head Impacts.

Astrocyte-enriched marker, S100B, shows promise for gauging the severity of acute brain trauma, and understanding subconcussive effects will advance its utility in tracking real-time acute brain damage. The aim of the study was to investigate whether serum S100B elevations were associated with frequency and magnitude of subconcussive head impacts in adolescents. This prospective cohort study of 17 high-school football players consisted of the following 12 time points: pre-season baseline, 5 in-season pre-post games, and post-season. A sensor-installed mouthguard recorded the number of head impacts, peak linear (PLA) and peak rotational (PRA) head accelerations from every practice and game. During the 5 games, players wore chest-strap heart-rate monitors to estimate players' excess post-exercise oxygen consumption (EPOC), accounting for physical exertion effects. At each time point, blood samples were obtained and assessed for S100B and creatine kinase levels to account for astrocyte damage/activation and muscle damage, respectively. Using k-means clustering on the impact data, players were categorized into high- or low-impact group. Two players withdrew during the first month of the study. A total of 156 blood samples from 15 players were assessed for S100B and creatine kinase levels and included in the analysis. A median value of 596 head impacts from 15 players were recorded during all practices and games in a season. S100B levels were significantly elevated in all post-game measures compared with the respective pre-game values (median-increase, 0.022 μg/L; interquartile-range, 0.011–0.043 μg/L, p < 0.05 for all games). Greater acute S100B increases were significantly associated with greater impact frequency, sum of PLA and PRA, with negligible contributions from physical exertion and muscle damage effects. The high-impact group exhibited greater increases in serum S100B levels at post-games than the low-impact group (high vs. low, 0.043 ± 0.035 μg/L vs. 0.019 ± 0.017 μg/L, p = 0.002). The degree of acute S100B increases was correlated with subconcussive head impact exposure, suggesting that acute astrocyte damage may be induced in an impact-dependent manner. Acute changes in serum S100B levels may become a useful tool in monitoring real-time brain damage in sports.

Effects of Zumba® and Aquagym on Bone Mass in Inactive Middle-Aged Women.

Background and objectives: Regular exercise may stimulate bone formation and reduce the loss of bone mass in premenopausal women. This study aims to evaluate the effect of high-impact physical activity (Zumba®) and low-impact physical activity (Aquagym) on bone mass in inactive middle-aged women. Materials and methods: Fifty-five healthy inactive women (30–50 years old) were recruited in Spain in 2016 and were randomly allocated into one of three groups: High impact group (HIG: n = 15), low impact group (LIG: n = 12) and control group (CG: n = 28). HIG and LIG were recruited from Madrid and the CG from Toledo. HIG and LIG completed a 12-week intervention program with three 40′ sessions per week of Zumba® or Aquagym; respectively. Dual energy X-ray absorptiometry (DXA) measured bone mineral content (BMC) and areal bone mineral density (aBMD) at total body less head (TBLH), lumbar spine and right hip. Results: Post-intervention adjusted data showed no significant differences in BMC between any of the groups nor in aBMD between HIG and LIG. Interestingly; significant differences for the HIG vs. CG were found in the change in total hip aBMD (1.76% vs. −0.44%), femoral neck aBMD (1.80% vs. −2.71%), and intertrochanter aBMD (2.03% vs. −0.50%). Moreover, significant differences for the LIG vs. CG were also found in the change in femoral neck aBMD (−0.54% vs. −2.71%). Conclusions: The regular practice of Zumba® and Aquagym might reduce the progressive deterioration of bone mass in inactive middle-aged women

Identification of the Transcription Factor Relationships Associated with Androgen Deprivation Therapy Response and Metastatic Progression in Prostate Cancer.

Background: Patients with locally advanced or recurrent prostate cancer typically undergo androgen deprivation therapy (ADT), but the benefits are often short-lived and the responses variable. ADT failure results in castration-resistant prostate cancer (CRPC), which inevitably leads to metastasis. We hypothesized that differences in tumor transcriptional programs may reflect differential responses to ADT and subsequent metastasis. Results: We performed whole transcriptome analysis of 20 patient-matched Pre-ADT biopsies and 20 Post-ADT prostatectomy specimens, and identified two subgroups of patients (high impact and low impact groups) that exhibited distinct transcriptional changes in response to ADT. We found that all patients lost the AR-dependent subtype (PCS2) transcriptional signatures. The high impact group maintained the more aggressive subtype (PCS1) signal, while the low impact group more resembled an AR-suppressed (PCS3) subtype. Computational analyses identified transcription factor coordinated groups (TFCGs) enriched in the high impact group network. Leveraging a large public dataset of over 800 metastatic and primary samples, we identified 33 TFCGs in common between the high impact group and metastatic lesions, including SOX4/FOXA2/GATA4, and a TFCG containing JUN, JUNB, JUND, FOS, FOSB, and FOSL1. The majority of metastatic TFCGs were subsets of larger TFCGs in the high impact group network, suggesting a refinement of critical TFCGs in prostate cancer progression. Conclusions: We have identified TFCGs associated with pronounced initial transcriptional response to ADT, aggressive signatures, and metastasis. Our findings suggest multiple new hypotheses that could lead to novel combination therapies to prevent the development of CRPC following ADT.

Maturation of Lesions Induced by Myocardial Cavitation-Enabled Therapy

Myocardial contrast echocardiography at enhanced therapeutic parameters may be a novel means of tissue reduction therapy, as for hypertrophic cardiomyopathy. Dahl/SS rats were anesthetized and treated with high-amplitude pulsed ultrasound guided by 10-MHz ultrasound images. Contrast microbubbles were infused via the tail vein during intermittent pulse-burst exposure at 4 MPa. A sham group, a low-impact group (group A, 5 cycle pulses with Gaussian modulation and 1:4 trigger for 5 min) and a high-impact group (group B, 10 cycle pulses with 4-ms square modulation and 1:8 trigger for 10 min) were tested. The higher exposure used in group B yielded more substantial injury than the lower exposure in group A. Treated rats in both groups A and B had significant increases in wall thickness measured by echocardiography the next day, which returned to normal by the end of 6 wk. Six weeks after ultrasound exposure, heart tissue samples exhibited tissue fibrosis in Masson's trichrome stained histology. Maturation of lesions involved fibrosis replacement, preserving structural tissue integrity. This study indicates that myocardial injury noted previously progresses into permanent loss of myocardial tissue that may be sufficient for possible hypertrophic cardiomyopathy therapy. More research is needed to define the treatment parameters required for symptomatic relief for hypertrophic cardiomyopathy.