Physical Capacity Research Articles

The Impact of Aging and Biological Sex on Diaphragm Hyperemia and Blood Flow Distribution

INTRODUCTION: Age-related respiratory muscle dysfunction (i.e., the diaphragm) diminishes physical capacity and increases the susceptibility to respiratory failure. The diaphragm dysfunction associated with old age is characterized by decreased diaphragm muscle mass and strength, and increased fatiguability. While inadequate perfusion and diminished microvascular function are well recognized to play a central role in age-related peripheral skeletal muscle dysfunction, the impact of aging on diaphragm hyperemia and blood flow distribution, and whether sex differences exist, has not been investigated. METHODS: Young (Y; 4-6 months) and Old (O; 22-24 months) Fischer 344 rats (n=34) were divided into four groups: 1) Young female (YF; n=8), 2) Young male (YM; n=8), 3) Old female (OF; n=9), and 4) Old male (OM; n=9). Fluorescent microspheres were used to assess bulk and regional diaphragm blood flow at rest and during electrically-induced 1Hz contractions. RESULTS: There were no age-related or sex differences in quiescent diaphragm blood flow (BF) or vascular conductance (VC) ( P>0.05). Age-related differences during 1Hz contractions: The increase in total diaphragm BF was significantly lower in OM (98 ± 11 ml/min/100g) compared to YM (141 ± 7 ml/min/100g; p<0.05). Total and regional diaphragm BF was not different in F rats ( P>0.05); however, medial costal diaphragm VC was decreased in OF (1.2 ± 0.1 ml/mmHg/min/100g) compared to YF (1.8 ± 0.2 ml/mmHg/min/100g; p<0.05). Sex differences during 1Hz contractions: Total diaphragm BF and VC were similar in YF and YM ( P > 0.05). While both ventral and medial costal diaphragm BF responses were not different between YF and YM, dorsal costal diaphragm BF was higher in YF (144 ± 27 ml/min/100g) versus YM (84 ± 11 ml/min/100g; p<0.05). Total and regional (ventral, medial, and dorsal costal) diaphragm BF was significantly higher in OF compared to OM ( p<0.05). CONCLUSION: These data demonstrate that aging impaired the ability of the diaphragm to augment BF in response to contractile activity in M rats and decreased medial costal diaphragm VC during contractions in F rats with no significant effect on diaphragmatic hyperemia. In regards to sex differences, these data suggest that both YF and OF may have a greater regional recruitment of the diaphragm compared to YM and OM. The data herein provide a putative mechanism for age-related diaphragm contractile dysfunction and future studies are needed to investigate the impact of aging and biological sex on diaphragm vascular function. National Institute of Aging 1R15AG078060, Ruth L. Kirschstein National Research Service Awards from the National Heart, Lung, and Blood Institute 1F31HL167618-01 and 1F31HL170643-01, and Sustained Momentum for Investigators with Laboratories Established (SMILE) Grants at Kansas State University. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Effects of Myocardial Infarction-induced Heart Failure on Diaphragm Arteriolar Vasorelaxation

INTRODUCTION: Diaphragm atrophy and contractile dysfunction are prevalent in heart failure (HF), diminishing physical capacity and quality of life. The delivery of blood flow and oxygen necessary to support the metabolic demand of contractions is largely governed by the resistance vasculature (i.e., arterioles) with the endothelium playing a central role in arteriolar vasorelaxation. Adequate perfusion and blood flow distribution, and thus resistance vessel vasodilation, is a major determinate of diaphragm contractile function. While the mechanistic bases of HF-induced diaphragm dysfunction continue to be elucidated, the impact of HF on diaphragm vasomotor control has not been investigated. METHODS: Adult (6 mo) Sprague-Dawley rats (n=7) were divided into two groups: 1) Healthy Control (HC; n=4) and 2) MI-induced heart failure (HF; n=3). First-order arterioles (1A) from the medial costal diaphragm were isolated, cannulated, and pressurized at 90 cmH2O and allowed to equilibrate for 60 min to develop spontaneous tone. Thereafter, endothelium-dependent and -independent vasorelaxation responses to cumulative doses of acetylcholine (ACh; 10−9 to 10−4M) and sodium nitroprusside (SNP; 10−9 to 10−4M) were determined. RESULTS: There were no differences in spontaneous development (%) or maximal diameter (μm) between HC (20 ± 4%; 178 ± 11 μm) and HF (18 ± 2%; 184 ± 29 μm) diaphragm 1As ( P > 0.05). Maximal ACh-mediated relaxation (%) was significantly reduced in HF rats compared to HC rats (52 ± 2 versus 68 ± 5%; P < 0.05). Maximal endothelial-independent vasorelaxation with SNP, was not different between HC and HF rats (71 ± 3 versus 73 ± 1%; P > 0.05). CONCLUSION: The preliminary data herein demonstrate that HF impaired endothelial function and vasomotor function in the medial costal diaphragm resistance vasculature. This suggests that, in HF, there may be a redistribution of blood flow to less effcient regions of the diaphragm (e.g., ventral costal) to sustain contractile function and compensate for the diminished medial costal vasomotor function demonstrated herein. Studies including a larger sample size are warranted to investigate the impact of HF on regional blood flow distribution and resistance vessel function in the diaphragm. Such investigations would yield novel mechanistic insights into HF-induced diaphragm dysfunction. National Institute of Aging 1R15AG078060, Ruth L. Kirschstein National Research Service Awards from the National Heart, Lung, and Blood Institute 1F31HL167618-01, and Sustained Momentum for Investigators with Laboratories Established (SMILE) Grants at Kansas State University. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Association of neuromuscular disjunction with cachexia in patients with gynecological cancers

PurposeThe potential contributions of neuromuscular junction (NMJ) degradation to muscle loss in cancer remain poorly understood. We investigated the biomarkers of NMJ loss to muscle decline in patients with gynecological carcinomas. MethodsWe recruited women with endometrial (n = 37, 56–73 years old) or ovarian (n = 40, 55–72 years old) carcinomas along with age-matched controls (n = 47, 55–71 years old) controls, divided into two subgroups based on the presence of age-associated muscle loss, termed sarcopenia. We measured plasma c-terminal agrin-fragment-32 (CAF22; biomarker of NMJ loss), neurofilament light chain (NF-L; biomarker of neurodegeneration), handgrip strength (HGS), appendicular skeletal muscle mass index (AMMI), and short physical performance battery (SPPB; marker of physical capacity). ResultsPatients with endometrial or ovarian carcinomas exhibits low HGS, AMMI, and SPPB along with higher plasma NF-L levels than in controls (all p < 0.05). We found a modest elevation of plasma CAF22 levels in ovarian but not in endometrial carcinomas. The presence of sarcopenia was associated with further elevation of plasma NF-L but not CAF22 levels. Higher carcinoma stages were associated with higher plasma CAF22 in endometrial carcinoma and higher NF-L levels in both groups of carcinoma patients. ConclusionCollectively, NMJ degradation may have a modest contribution to muscle loss and sarcopenia in gynecological carcinomas. The strategies to counter muscle loss in carcinomas may target intrinsic changes within skeletal muscle independent of NMJ.

Changes in haemoglobin and ferritin levels during basic combat training: relevance for attrition and injury frequency

IntroductionThe primary aim of the present study was to assess interindividual and intraindividual variations in haemoglobin and ferritin concentrations in Swedish recruits over 5 months of basic combat training (BCT)....

ALM/BMI: A Clinically Superior Index for Identifying Skeletal Muscle Dysfunction in Patients With Heart Failure.

Skeletal muscle wasting is critical in patients with heart failure (HF). Whereas prior studies have employed appendicular lean mass (ALM) normalized by height squared to identify low skeletal muscle mass, the potential of ALM normalized to body mass index (ALM/BMI) remains unexplored in patients with HF. In this study, we compared the use of 2 skeletal muscle mass indices in patients with HF to examine their sex-specific correlations with measures of physical capacity, quality of life, and daily physical activity. A total of 111 patients with HF underwent dual x-ray absorptiometry, physical capacity tests, and accelerometry and answered a quality-of-life questionnaire. ALM normalized by height squared and ALM/BMI indices disagreed in classifying low muscle mass (Cohen's κ, -0.008 [95% CI, -0.094 to 0.177]; P=0.93). ALM/BMI correlated well with 6-minute walking distance in women and men (R=0.67 and 0.49; P<0.001), with maximal oxygen uptake in women and men (R=0.41 and 0.48; P<0.05), and with maximal muscle strength in women and men (R=0.54 and 0.43; P<0.01). Inversely, ALM normalized by height squared did not correlate significantly with 6-minute walking distance or maximal oxygen uptake and correlated with maximal muscle strength only in men (R=0.43; P<0.001). Only ALM/BMI allowed for identification of a low-muscle-mass group characterized by poor quality of life (Minnesota Living With Heart Failure Questionnaire score of 33±21 versus 25±16; P=0.027) and less daily time spent in moderate to vigorous physical activity (8 [3-17] versus 15 [9-37] minutes; P<0.001). ALM/BMI was superior for identifying clinically significant muscle dysfunction in both female and male patients with HF.

Health-related quality of life in children and adolescents with Marfan syndrome or related disorders: a controlled cross-sectional study

BackgroundThis cross-sectional controlled study aims to assess health-related quality of life (HRQoL) of children and adolescents with a molecular diagnosis of Marfan syndrome (MFS) or related disorders and to evaluate the factors associated with HRQoL in this population. Sixty-three children with MFS and 124 age- and sex-matched healthy children were recruited. HRQoL was assessed using the Pediatric Quality of Life Inventory (PedsQL™) generic questionnaire. The correlation between HRQoL scores and the different continuous parameters (age, body mass index, disease severity, systemic score, aortic sinus diameter, and aerobic physical capacity) was evaluated using Pearson’s or Spearman’s coefficient. A multiple linear regression analysis was performed on the two health summary self-reported PedsQL™ scores (physical and psychosocial) to identify the factors associated with HRQoL in the MFS group.ResultsExcept for emotional functioning, all other domains of HRQoL (psychosocial and physical health, social and school functions) were significantly lower in children with MFS compared to matched healthy children. In the MFS group, the physical health summary score was significantly lower in female than in male patients (self-report: absolute difference [95%CI] = -8.7 [-17.0; -0.47], P = 0.04; proxy-report: absolute difference [95%CI] = -8.6 [-17.3; 0.02], P = 0.05) and also negatively correlated with the systemic score (self-report: R = -0.24, P = 0.06; proxy-report: R = -0.29, P = 0.03) and with the height Z-score (proxy-report: R = -0.29, P = 0.03). There was no significant difference in the physical health summary scores between the different genetic subgroups. In the subgroup of 27 patients who performed a cardiopulmonary exercise test, self- and proxy-reported physical health summary scores were highly correlated with their aerobic physical capacity assessed by peak oxygen consumption (VO2max) and ventilatory anaerobic threshold (VAT). In the multivariate analysis, the most important independent predictors of decreased physical health were increased height, decreased body mass index, decreased VAT and use of prophylactic therapy.ConclusionsThis study reports an impaired HRQoL in children and adolescents with MFS or related conditions, in comparison with matched healthy children. Educational and rehabilitation programs must be developed and evaluated to improve exercise capacity and HRQoL in these patients.Trial registrationClinicalTrials.gov, NCT03236571. Registered 28 July 2017.

The Relationship between Anxiety Symptoms and Perceived Quality of Life among Caregivers of Children with Autism Spectrum Disorder in the Amazon.

The relationship between anxiety symptoms and perceived quality of life among caregivers of children with autism was verified. To assess perceived quality of life, the Short Form Healthy Survey Item was used; perception of anxiety symptoms was assessed using the Beck Anxiety Inventory. Eighty caregivers of children with autism participated, with 68.7% of caregivers being mothers. Of the total number of caregivers, 68.8% had a severe level of anxiety. Regarding perceived quality of life, they demonstrated greater impairment in limitation due to physical aspects, limitation due to emotional aspects, vitality, and pain. Caregivers with severe anxiety levels had a worse quality of life in the domains of pain (p = 0.012), social aspects (p < 0.001), limitation due to emotional aspects (p = 0.001), and mental health (p < 0.001). However, in the functional capacity domain, caregivers with a moderate level of anxiety had a better physical capacity score (p = 0.001). There was a negative correlation between the general anxiety score and the general physical (p = 0.029) and general emotional components of perceived quality of life (p < 0.001). It was found that caregivers of children with ASD have a high level of anxiety, which is a predictor of the perception of a worse quality of life.

Cardiopulmonary functional capacity in Taiwanese children with atrial septal defects.

Most existing studies measure atrial septal defect (ASD) outcomes based on morbidity rates such as atrial arrhythmias and heart failure rather than the functional assessment of physical capacity postprocedure. Few studies have evaluated cardiopulmonary function in ASD children. This study represents the largest sample population in the current research, encompassing a total of 122 Taiwanese children with ASD who had undergone treatment, to evaluate cardiopulmonary functional capacity through the implementation of cardiopulmonary exercise testing (CPET), and to investigate whether variations in treatment may impact their cardiopulmonary function. This is a retrospective cohort study with the data collected from January 2010 to December 2021. All patients and controls (age-, sex-, and body mass index-matched) underwent CPET and pulmonary function testing. In total, 122 ASD patients (surgically closed ASDs 27, transcatheter-closed ASDs 48, and follow-up unrepaired ASD 47) and 244 healthy controls were recruited. The ASD group exhibited lower peak metabolic equivalent (MET), peak oxygen consumption (VO 2 , p < 0.001), and peak minute ventilation ( p = 0.028) along with MET and VO 2 at the anaerobic threshold (AT) ( p = 0.012) compared to the control group. No statistically significant differences were observed in the pulmonary function test. Among surgically closed, transcatheter closed and unrepaired ASD subgroups, no significant variances were seen in CPET and pulmonary function tests. Taiwanese ASD children exhibited diminished exercise capacity and cardiopulmonary performance compared to their healthy counterparts. Differences among specific ASD treatments in cardiopulmonary tests were non-significant.

Plasma levels of Neurofilament light chain correlate with handgrip strength and sarcopenia in patients with chronic obstructive pulmonary disease

BackgroundAge-associated muscle decline, termed sarcopenia, is a common systemic effect of chronic obstructive pulmonary disease (COPD). Circulating Neurofilament light chain (NfL) levels reflect neuronal degradation and may be relevant to sarcopenia phenotype. However, such an association in COPD patients remains elusive. MethodsWe investigated male, 60–76 years old controls (n = 50) and COPD patients (n = 139) for plasma NfL levels in relation to sarcopenia and physical capacity markers. We measured handgrip strength (HGS), body composition, and short physical performance battery (SPPB) to evaluate sarcopenia and physical capacity. ResultsCOPD patients had higher plasma NfL and lower HGS and SPPB performance than controls. Plasma NfL levels demonstrated negative associations with HGS and gait speed in COPD patients (all p < 0.05). Further, NfL levels were negatively associated with total SPPB scores in controls and patients with advanced COPD (p < 0.05). Plasma NfL also demonstrated an acceptable accuracy in diagnosing sarcopenia in controls (AUC = 0.757, p < 0.05) and COPD (AUC = 0.806, p < 0.05) patients. ConclusionCollectively, plasma NfL may be helpful in evaluating sarcopenia phenotype and physical capacity in geriatric patients with COPD.

Physical fitness in adolescent patients with familial Mediterranean fever.

Familial Mediterranean fever (FMF) is the most frequent monogenic auto-inflammatory disease worldwide responsible for episodes of fever, serositis and musculoskeletal symptoms. Inflammatory attacks are responsible for sedentary behavior and FMF patients may be at increased cardiovascular risk. Cardiorespiratory Fitness (CRF) and physical capacities during adolescence are associated with cardiovascular mortality in adulthood. In this study, we aimed to describe the physical fitness of FMF adolescents. A monocentric retrospective study at the Versailles Hospital between January 2020 and June 2023. All FMF patients over 14-year-old who had completed a routine physical test were included. Clinical and physical data including results of the 6-minute walking test, timed unipedal stance test, Ruffier-Dickson index, 30-seconds chair-stand test and sit-and-reach test were extracted from medical records. Results were compared with previously published normative reference values and criterion-referenced standards for healthy subjects. Eighteen FMF patients (12 girls, 6 boys) were included. The median age was 16 years old [14-18]. Clinical history included joint symptoms (n = 11), chest pleuritis (n = 8), and leg pain (n = 11). Estimated VO2max was below the recommended thresholds in 13 patients, which predicts cardiovascular risk. Cardiovascular adaptation was poor in 11 patients. Low VO2max was associated with CRP > 5mg/l on test day and history of joint symptoms. FMF patients displayed altered physical capacities compared to normative values of healthy subjects. History of musculoskeletal pain, systemic inflammation and sedentary behavior may participate in impaired physical abilities and promote cardiovascular diseases in adulthood. Specific exercise programs could benefit patients for disease control and cardiovascular risk reduction.

Cross-sectional interactive associations of physical activity and sedentary behaviour with physical capacity across adulthood.

The way physical activity (PA) and sedentary behaviour (SB) independently and interactively modify the age-related decline in physical capacity remains poorly understood. This cross-sectional study investigated the independent and interactive associations of PA and SB with physical function and performance throughout the adult life course. Data from 499 community-dwelling adults (63% female) aged 20-92years, involved in the INSPIRE Human Translational Cohort, were used in this cross-sectional study. Daily time spent on moderate-to-vigorous PA (MVPA, min/day) and SB (h/day) was measured with activPAL triaxial accelerometers. Physical function and performance were assessed through the measurement of the 4-m usual gait speed (m/s), handgrip strength (kg), lower-limb strength (isokinetic knee extension torque, N·m), estimated lower-limb power (five-time chair-rise test performance, s) and cardiorespiratory fitness (V̇O2max, mL/kg/min). Confounder-adjusted multiple linear and curvilinear regressions were performed to investigate how MVPA, SB and their interactions were associated with the physical outcomes (all square root-transformed except gait speed) throughout the adulthood spectrum. Interaction analyses revealed that the combination of higher levels of MVPA with lower levels of SB favourably reshaped the negative relationship between handgrip strength and age (age2×SB×MVPA: B=-7E-08, SE=3E-08, P<0.05). In addition, higher levels of MVPA were independently associated with an improved age-related profile in gait speed (age2×MVPA: B=3E-06, SE=1E-06, P<0.05), chair-rise performance (age×MVPA: B=-9E-05, SE=4E-05, P<0.05) and V̇O2max (MVPA at 21years: B=3E-02, SE=7E-03, P<0.05; age×MVPA: B=-5E-04, SE=2E-04, P<0.05). Conversely, the detrimental association of age with lower-limb muscle strength (age×SB: B=-1E-04, SE=6E-05, P<0.05) and chair-rise performance (age×SB: B=1E-05, SE=7E-06, P<0.05) was exacerbated with increasing duration of SB, independently of MVPA. Supplementary analyses further revealed that some of these associations were age and sex specific. This cross-sectional study demonstrated that reduced sedentary time and increased activity duration were independently and synergistically associated with an attenuated age-related loss in physical capacity. These findings need to be confirmed with longitudinal data but encourage both adopting an active lifestyle and reducing sedentary time as preventive measures against physical aging.

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The Morphofunctional Condition of Students in Secondary Schools and the Importance of Physical Education in Physical Education Lessons Summary Peculiarities of morphofunctional indices of schoolchildren, studying at the secondary educational institutions with different levels of the organization of physical training, are reflected in the article. We determined an effect of the factor of physical training organization on physical development posture, physical working capacity, strength qualities, functioning of cardio-respiratory system of the children. Key words: health, anthropometric indices, functional indices, children of school age, physical training, risk

Simulated impact of lift car sizes on transport of critical care patients: Informing the design of the New Dunedin Hospital.

The New Dunedin Hospital (NDH) is New Zealand's largest health infrastructure build. Here we describe the use of a simple simulation-based hospital design exercise to inform the appropriate lift car size for critical care intrahospital transfers in the NDH. The intensive care unit (ICU) user group tested a series of entries and exits of simulated complex patient transfers in mocked-up lift cars of three different dimensions. Time taken to enter and exit the lift were recorded, reflecting the relative difficulty of transfer. Qualitative assessments were made of ease and perceived safety of transfer. These simulations demonstrated that recommended standard patient lift cars, often proposed for critical care transfers, could not physically accommodate all complex ICU transfers. A size of 1800 mm wide (W) × 3000 mm deep (D) had the physical capacity to permit all simulated ICU transfers, but with staff and patient risk. As lift car size increased to 2200 mm W × 3300 mm D, the simulation demonstrated reduced transfer times, smoother entry and exit, improved access to the head end of the bed, and reduced risk of disconnection or dislodgement of lines and airway support. The resultant clinical recommendations for the dimensions of a critical care lift car surpass current international health architecture guidelines and may help to inform future updates. The NDH project benefited from an objective assessment of risk, in language familiar to clinicians and healthcare architects. The outcome was an upsizing of the two ICU-capable lifts.

Evaluating Physical Education Courses in Civil Defense and Firefighting Associate Degree Programs in Turkey: Findings and Recommendations

This study aims to evaluate the physical education/sports education courses, content and practices in the curricula of Civil Defense and Firefighting associate degree programs in Turkey. Within the scope of the study, the Bologna course packages of 42 associate degree programs between 2022-2023 were examined in detail using document analysis method. According to the findings, it was determined that 14.3% (6 programs) did not include physical education courses, and 40.5% (17 programs) did not have course content for occupational physical fitness. In addition, 52.3% of the lecturers teaching the course did not have a degree in physical education and sports. The findings reveal important problems considering the requirement of high physical fitness in firefighting profession. The research emphasizes that the deficiencies in the physical education course content should be updated to meet the requirements of the firefighting profession and should be made compulsory. In this context, it is recommended to adopt a special curriculum under the name of "Occupational Physical Fitness" course and it is emphasized that this course should include the objectives of achieving high physical capacity and fitness by focusing on the basic skills of the firefighting profession. The results of the study clearly indicate that civil Defense and firefighting programs should focus on physical fitness-based education to train qualified personnel. Consideration of these recommendations may contribute to the creation of a strong and appropriate educational infrastructure in the firefighting profession.

Bench and pilot scale assessment of 5A molecular sieves for tail gas treatment applications

The modified Claus Process stands out as the predominant method for sulfur recovery within natural gas and crude oil processing facilities. Over the past five decades, in a bid to mitigate the environmental consequences of SO2 emissions, the efficiencies of sulfur recovery units have been enhanced through the integration of tail gas treating units (TGTU). Globally, it is imperative that this sulfur recovery efficiency attains a minimum of 99.95%. This paper delves into both bench- and pilot-scale evaluations of utilizing commercial 5 A molecular sieves to extract H2S from specific tail gas streams, as part of scrutinizing the efficacy of a novel tail gas treatment process, delineated in Patent No. US 10662061 B1 (May 26, 2020). The evaluation revealed that employing a 5 A molecular sieve to remove H2S from dry tail gas treating presents distinct advantages. Notably, the CO2 adsorption capacity on 5 A molecular sieves, being several times that of H2S, did not substantially impair the physical stability and removal capacity of 99.95+% tail gas treating, even after 99 adsorption/desorption cycles. Furthermore, the evaluation demonstrated that extended regeneration at 300°C (as opposed to 250°C) following the 50th and 90th cycles could effectively reinstate the original removal capacity of the 5 A molecular sieves. Additionally, the gas emanating from the 5 A molecular sieve bed could be reused as regeneration gas for the second stage of the patented process. The H2S removal capacity of 5 A molecular sieves from dry tail gas, approximately 1.3 mmol/g, aligns with the reported capacities of other adsorbents, which range from 0.37 to 1.53 mmol/g. Given the cost-effectiveness of 5 A molecular sieves compared to AgY molecular sieves, and based on the evaluation outcomes, it is judicious to conclude that the use of 5 A molecular sieves will be a compelling option for future tail gas treating within sulfur recovery units.

Optimizing physical and technical capacities in basketball through the implementation of coordination training programs and specialized information technologies

Optimizing physical and technical capacities in basketball through the implementation of coordination training programs and specialized information technologies

Effect of a 12-Week Walking Program Monitored by Global Physical Capacity Score (GPCS) on Circulating Cell-Free mtDNA and DNase Activity in Patients with Irritable Bowel Syndrome.

Irritable bowel syndrome (IBS) involves low-grade mucosal inflammation. Among the various approaches capable of managing the symptoms, physical activity is still under investigation. Despite its benefits, it promotes oxidative stress and inflammation. Mitochondria impacts gut disorders by releasing damage-associated molecular patterns, such as cell-free mtDNA (cf-mtDNA), which support inflammation. This study evaluated the effects of a 12-week walking program on the cf-mtDNA and DNase in 26 IBS and 17 non-IBS subjects. Pro- and anti-inflammatory cytokines were evaluated by ELISA. Digital droplet PCR was used to quantify cf-mtDNA; DNase activity was assessed using a single radial enzyme diffusion assay. PCR-RFLP was used to genotype DNASE1 rs1053874 SNP. Significantly lower IL-10 levels were found in IBS than in non-IBS individuals. Exercise reduced cf-mtDNA in non-IBS subjects but not in IBS patients. DNase activity did not correlate with the cf-mtDNA levels in IBS patients post-exercise, indicating imbalanced cf-mtDNA clearance. Different rs1053874 SNP frequencies were not found between groups. The study confirms the positive effects of regular moderate-intensity physical activity in healthy subjects and its role in cf-mtDNA release and clearance. Walking alone might not sufficiently reduce subclinical inflammation in IBS, based on imbalanced pro- and anti-inflammatory molecules. Prolonged programs are necessary to investigate their effects on inflammatory markers in IBS.

Multidimensional frailty connection in older patients with diabetes mellitus

Background and objectivePatients with diabetes mellitus (DM) experience accelerated aging and, thus, a high prevalence of frailty. Our aim is to outline the type of frailty and prefrailty from a multidimensional perspective and the interaction of these dimensions in this scenery. Material and methodsObservational study of patients with DM over 60 years-old. Variables related to nutrition, cognitive and emotional status, physical and instrumental functional capacity and social resources were collected. They were divided into three groups (robust, prefrail and frail) according to the Fried scale. Each of the variables in the groups were compared and a correspondence analysis was carried out to see the influence of some dimensions with others in each stage of frailty. Results188 patients (mean age 72.6 + 7.5) were analysed. Of them, 105 patients had prefrailty and 66 were frail. With the exception of social resources, the rest of the variables had an increasing prevalence depending on the stage of frailty. However, in the correspondence analysis (with 22.9% of variation explained by two dimensions) it was only patients with frailty who were associated with worse functional capacity, cognitive and emotional situation and mild to moderate social incapacity. ConclusionsIn our sample there was a high prevalence of prefrailty, and frailty associated with an increase in the prevalence of other different dimensions except social resources. However, the interaction between these dimensions was only evident in the case of patients with frailty.

Characterising the physical demands of critical tasks across the Royal Australian Air Force.

Militaries have historically utilised generic physical fitness tests to assess physical readiness, but there has been a recent shift to develop physical employment standards (PES) based on actual job demands. The purpose of this investigation was to characterise the physical demands of critical tasks performed by Royal Australian Air Force (RAAF) personnel to inform PES development. Job task analysis were performed for 27 RAAF trades. Criterion tasks were identified through a systematic approach involving workshops and field-observations. The identified tasks were assessed for dominant physical capacity and grouped into movement-based clusters. Psychophysiological measures were collected from personnel performing the tasks. Of 87 criterion tasks, 92% were characterised as manual handling dominant. Across these 87 tasks the principal physical capacities were: muscular strength (59%), muscular endurance (52%) and cardiorespiratory endurance (39%). The most common movement clusters were Lift to Platform (44%) and Lift and Carry (38%). Lift to Platform tasks required lifting to a median height of 1.32 m (1.20 -1.65 m) and a median mass of 25.0 kg (21.0 -28.9 kg) per person. Median carry mass was 25.0 kg (22.4 -36.1 kg) per person and distance was 26.0 m (17.5 -50.0 m). Median task mean 'Vdot;O2, HR and RPE were 1.8 L.min-1 (1.5-2.2 L.min-1), 137 b.min-1 (120-144) and 13 (12-14). The high proportion of manual handling criterion tasks emphasises the importance of these activities and the underlying physical capacities for RAAF personnel. Current fitness assessments are unlikely to predict job task performance.

Association of kidney function with physical performance: the Maastricht study.

Kidney failure has been associated with decreased physical capacity, although evidence regarding the physical performance of individuals with earlier stages of chronic kidney disease (CKD)remains limited. Cross-sectional data were derived from the prospective, population-based Maastricht Study. Multivariate linear regression models were fitted to assess the association of estimated glomerular filtration rate (eGFR) and albuminuria categories with physical performance test outcomes. Overall, 7396 participants were included. Compared to eGFR 60-90ml/min/1.73m2, values < 60ml/min/1.73m2 were associated with significantly shorter 6-min walk distance (β: - 13.04m, 95% confidence intervals-CI - 19.95; - 6.13), worse timed chair rise stand test time (β: 0.91s, 95% CI 0.36; 1.47), lower maximal grip (β: - 0.83kg, 95% CI - 1.50; - 0.15) and elbow flexion (β: - 3.64 Nm, 95% CI - 7.11; - 0.16) strength. Additionally, eGFR > 90ml/min/1.73m2 was linked to significantly shorter 6-min walk distance (β: - 6.13m, 95% CI - 9.44; - 2.82). Urinary albumin excretion > 30mg/24h was associated with shorter 6-min walk distance (β: - 12.48m, 95% CI - 18.28; - 6.68), worse timed chair rise stand test time (β: 0.51s, 95% CI 0.11; 1.06), lower maximal grip (β: - 1.34kg, 95% CI - 1.91; - 0.76) and elbow flexion strength (β: - 3.31Nm, 95% CI - 5.80; - 0.82). Reduced eGFR and higher albuminuria levels were associated with worse physical performance, especially shorter 6-min walk distance and lower muscle strength. The relationship between eGFR and physical function was non-linear, with also high eGFR values being associated with worse performance, especially in the six-minute walk test.