Short-term Beneficial Effects Research Articles

Lipid Changes 10-15 Years After Roux-en-Y Gastric Bypass: A Prospective Observational Study.

Several studies have documented a beneficial short-term effect on lipid profile after Roux-en-Y gastric bypass (RYGB), but there is limited data on long-term changes. To describe long-term (> 10years) changes in lipid profile after RYGB and to explore the relationship of lipid changes to changes in weight and baseline and demographic parameters. The BAROBS study is a prospective observational study post RYGB conducted at three different hospitals. Surgical procedures were performed between 2003 and 2009, and the collection of data was in 2018-2020. Data on lipid profile, weight, body mass index (BMI), percentage of total weight loss (%TWL), and pre- and postoperative type II diabetes mellitus (DMII) was collected at baseline, 1-2, 5, and 10years post-surgery and was available for 314 of 546 patients in the study. The mean (SD) follow-up was 11.5(± 1.5) years, with a mean reduction of 11.7% for LDL, 29.7% for TG, and 7.7% for total cholesterol compared to baseline. Except for HDL and total-/HDL-cholesterol-ratio, all lipid variables reached their greatest change after 1-2years with an attenuation of changes at end of study. HDL and total-/HDL-cholesterol-ratio had stable values from 5 to 10years post-surgery. Lipid profile improved more in patients with greater weight loss. There was a 59% reduction in DMII at end of study, and there was a significant relation between preoperative DMII and long-term lipid values. There is an improvement of all lipid parameters after 10years post RYGB related to both the magnitude of weight loss and the presence of DMII.

Trajectories of weight and their impact on cardiac remodeling and function 16 years after bariatric surgery

Abstract Introduction Obesity is a major risk factor for heart failure, particularly heart failure with preserved left ventricular (LV) ejection fraction. Surgical treatment of obesity have significant beneficial short-term effects on weight loss and on cardiac function; its long-term impact on cardiac remodeling and function remains largely unknown. Purpose We examine the long-term effect of bariatric surgery on cardiac remodeling and function in adults with preserved LV ejection fraction. Methods Forty-four individuals with severe obesity [body mass index (BMI) ≥35kg/m2] and preserved LV ejection fraction (≥50%) who underwent bariatric surgery (biliopancreatic diversion with duodenal switch [BPD-DS]) were included. Anthropometric measurements and echocardiography were obtained at baseline, 12 months and 16 years follow-up. Results Mean age of participants (71% female) was 44 ± 8 years and body mass index (BMI) 49.6 ± 6.1 kg/m2. Bariatric surgery led to marked weight reduction and significant improvements in obesity-related metabolic conditions/comorbidities (hypertension, dyslipidemia, type 2 diabetes). Mean percentage of weight loss at 12 months was 37.1 ± 7.0 %. Percentage of weight regain at 16 years averaged 8.9 ± 35.0 %. Bariatric surgery was associated with a significant reduction in indexed LV mass and LV hypertrophy (p <0.01), and improvement in LV diastolic function parameters (p <0.01) at 12 months. In many participants, cardiac remodeling parameters deteriorated at 16 years follow-up compared to the echocardiographic measurements taken at 12 months post-surgery. Prevalence of LV diastolic dysfunction increased at 16 years (81 vs. 38%; p<0.001), even after adjusting for age. Weight regain at 16 years (regaining >10% of weight lost; n=25; 57%) was not found to be associated with a worsening in cardiac remodeling compared to those who maintained weight loss, except for indexed LV mass (-9.3 ± 10.6 vs. -5.5 ± 7.8 g/m2.7; p=0.04) and LV end-diastolic diameter (-5.4 ± 4.0 vs. -3.5 ± 3.3 cm; p=0.01). Conclusion Bariatric surgery (BPD-DS) leads to durable long-term weight loss. Weight regain following bariatric surgery does not appear to have adverse effect on cardiac remodeling and function. Surgical treatment of obesity may be an effective and safe way to prevent clinical cardiac dysfunction and heart failure related to obesity.

Benefits of a light- intensity bout of exercise on attentional networks functioning

The effects of physical exercise on attentional performance have received considerable interest in recent years. Most of previous studies that assessed the effect of an acute bout of exercise on attentional performance have generally been approached by analysing single attentional functions in isolation, thus ignoring the functioning of other attentional functions, which characterizes the real perception-action environmental conditions. Here, we investigated the effect of two different intensities (light vs. vigorous) of acute exercise on attentional performance by using the ANTI-Vea, a behavioral task that simultaneously measures three attentional functions (phasic alertness, orienting, and cognitive control) and the executive and arousal components of vigilance. 30 young (age = 20.93; SD = 1.51 years) physically active participants (21 men and 9 women) completed three experimental sessions: the first one to assess their physical fitness and baseline performance in the ANTI-Vea, and the other two sessions (in counterbalanced order) to assess changes in attentional and vigilance performance after an acute bout of light- intensity vs. vigorous- intensity physical exercise. Beneficial effects on some accuracy scores (i.e., overall higher accuracy in the attentional sub-task and fewer false alarms in the executive vigilance sub-task) were observed in the light- intensity exercise condition compared to baseline and vigorous- intensity. Additionally, the RT score of phasic alertness was increased after the light- intensity exercise in comparison with baseline. The present findings suggest that a bout of acute exercise at light- intensity might induce some short-term beneficial effects on some aspects of attention and vigilance.

Harmonizing the complexities of financial development and fiscal decentralization in highly populated nations for monitoring environmental quality

The increasing challenges posed by global warming underscore the need to examine the contributing factors comprehensively. This study explores the complex interaction that enhances the financial autonomy of local governments (fiscal decentralization), the evolution of financial development, and the dynamics of the environment in China, India, and Pakistan, which are known as highly populated economies. This search fills a vacuum in the research literature by using financial development and fiscal decentralization together to measure the complex interaction by using the broad dataset that spans the years 1979–2019. It significantly advances scientific knowledge by highlighting the frequently disregarded triangle formed by fiscal decentralization, financial development, and environmental quality in emerging nations. Moreover, the study seeks to elucidate how fiscal decentralization affects financial growth and, in turn, the environment. The review acknowledges the possibility of varying results among nations. Strict econometric techniques that consider slope heterogeneity and cross-sectional dependence are used to guarantee the reliability of studies and conclusions. The results show that government money and GDP per capita have beneficial short-term effects on environmental quality. Simultaneously, financial growth positively and negatively impacts several factors, underscoring the complex dynamics at work in these crucial areas. Anticipated outcomes might provide a significant understanding of the fundamental factors influencing environmental quality in developing nations. This research is well-positioned to support the development of evidence-based policies by advising scholars and decision-makers on creating successful climate change mitigation plans.

Long-term treatment outcomes of mindfulness-based cognitive therapy for fatigue in patients with inflammatory bowel disease: Results of a randomized controlled trial

ObjectivesFatigue is prevalent in patients with inflammatory bowel disease (IBD) in remission. Previously, we showed that fatigued IBD patients experienced a significant decrease in fatigue after receiving mindfulness-based cognitive therapy (MBCT). The current study examined to what extent these short-term beneficial effects of MBCT on fatigue were maintained over nine months follow-up, and whether patient characteristics were associated with clinically relevant improvement in fatigue. MethodsA randomized controlled trial, including an MBCT and waiting-list control condition, was performed in fatigued IBD patients in remission. For this study, we analysed long-term outcomes of 108 patients who received MBCT (either directly or after three months waiting). The primary outcome was fatigue, assessed with the Checklist Individual Strenght-20. Secondary outcomes included fatigue interference, depression, anxiety, and quality of life. ResultsThe reduced level of fatigue post-treatment did not change significantly during follow-up (F(2,76) = 1.68, p = 0.19). In total, 29% of patients reported clinically relevant improvement from pre-treatment to nine months follow-up. We found few significant differences in baseline characteristics between those reporting clinically relevant improvement and those not, except that patients who improved were significantly more often unemployed (χ2(1, n = 73) = 4.40, p = 0.04). Secondary outcomes, which did not change significantly during MBCT, also remained stable during follow-up. ConclusionFindings suggest that reductions in IBD-related fatigue after receiving MBCT are sustained over nine months follow-up, with around one-third of patients reporting clinically relevant improvement from pre-treatment to follow-up. Employment status might be related to improvements in fatigue. Future research is needed to confirm these long-term outcomes. PreregistrationClinicalTrials.gov ID: NCT03162575.

The systemic impact of non-surgical treatment of peri-implantitis with or without adjunctive systemic metronidazole: Secondary analysis of a randomized clinical trial.

The aim of this study was to evaluate the systemic effect of non-surgical peri-implantitis treatment (NSPIT) with or without the administration of systemic metronidazole. In this secondary analysis from a previously published clinical trial (NCT03564301), peri-implantitis patients were randomized into two groups: test, receiving NSPIT plus 500 mg of oral systemic metronidazole three times a day for 7 days (n = 10); and control group, receiving NSPIT plus placebo (n = 11). Serum samples were obtained at baseline, 3 and 6 months after therapy to determine levels of inflammatory biomarkers, lipid fractions and complete blood counts. Both treatment modalities produced improvements in clinical and radiographic parameters. After 6 months from NSPIT, a substantial reduction in C-reactive protein (6.9 mg/dL; 95% CI: 3.7 to 9.9, p < .001) and low-density lipoprotein cholesterol (21.8 mg/dL; 95% CI: -6.9 to 50.5, p = .013) as well as a modest increase in neutrophils counts (0.4 × 103/μL; 95% CI: -0.4 to 1.1, p = .010) was observed in the control group while the test group showed a significant reduction of TNF-α (110.1; 95% CI: 38.9 to 181.4, p = .004). NSPIT showed a short-term beneficial systemic effect regardless of adjunctive use of systemic metronidazole.

Removal of the infrapatellar fat pad and associated synovium benefits female guinea pigs in the Dunkin Hartley model of idiopathic osteoarthritis.

Several tissues contribute to the onset and advancement of knee osteoarthritis (OA). One tissue type that is worthy of closer evaluation, particularly in the context of sex, is the infrapatellar fat pad (IFP). We previously demonstrated that removal of the IFP had short-term beneficial effects for a cohort of male Dunkin-Hartley guinea pigs. The present project was designed to elucidate the influence of IFP removal in females of this OA-prone strain. It was hypothesized that resection of the IFP would reduce the development of OA in knees of a rodent model predisposed to the disease. Female guinea pigs (n=16) were acquired at an age of 2.5 months. Surgical removal of the IFP and associated synovium complex (IFP/SC) was executed at 3 months of age. One knee had the IFP/SC resected; a comparable sham surgery was performed on the contralateral knee. All animals were subjected to voluntary enclosure monitoring and dynamic weight-bearing, as well as compulsory treadmill-based gait analysis monthly; baseline data was collected prior to surgery. Guinea pigs were euthanized at 7 months. Knees from eight animals were evaluated via histology, mRNA expression, and immunohistochemistry (IHC); knees from the remaining eight animals were allocated to microcomputed tomography (microCT), biomechanical analyses (whole joint testing and indentation relaxation testing), and atomic absorption spectroscopy (AAS). Fibrous connective tissue (FCT) replaced the IFP/SC. Mobility/gait data indicated that unilateral IFP/SC removal did not affect bilateral hindlimb movement. MicroCT demonstrated that osteophytes were not a significant feature of OA in this sex; however, trabecular thickness (TbTh) in medial femorae decreased in knees containing the FCT. Histopathology scores were predominantly influenced by changes in the lateral tibia, which demonstrated that histologic signs of OA were increased in knees containing the native IFP/SC versus those with the FCT. Similarly, indentation testing demonstrated higher instantaneous and equilibrium moduli in the lateral tibial articular cartilage of control knees with native IFPs. AAS of multiple tissue types associated with the knee revealed that zinc was the major trace element influenced by removal of the IFP/SC. Our data suggest that the IFP/SC is a significant component driving knee OA in female guinea pigs and that resection of this tissue prior to disease has short-term benefits. Specifically, the formation of the FCT in place of the native tissue resulted in decreased cartilage-related OA changes, as demonstrated by reduced Osteoarthritis Research Society International (OARSI) histology scores, as well as changes in transcript, protein, and cartilage indentation analyses. Importantly, this model provides evidence that sex needs to be considered when investigating responses and associated mechanisms seen with this intervention.

The effects of COVID-19 on the Physical Activity and Recreational Screen Time among Chinese children and adolescents

Background/ObjectiveThe lack of Physical Activity (PA) and prolonged Recreational Screen Time (RST) among children and adolescents has been exacerbated during the COVID-19 pandemic, causing this issue to escalate into a crucial public health concern. This study aims to investigate the trends in PA and RST among Chinese children and adolescents from 2019 to 2022, thereby analyzing the short-term and long-term effects of the pandemic on PA and RST among Chinese children and adolescents. MethodsA nationally representative sample of Chinese primary, middle, and high school students was surveyed annually between September and December from 2019 to 2022 using a consistent set of questionnaires. Trends in PA and RST across different school levels, genders, areas (urban/rural), and regions (north/south) were analyzed using Segmented Linear Regression. ResultsFrom 2019 to 2022, the PA and RST of children and adolescents displayed an inverted U-shaped trend, initially increasing and subsequently declining. Specifically, from 2019 to 2021, the PA of children and adolescents significantly increased but dramatically declined from 2021 to 2022. This trend in PA is more pronounced among primary, male, urban, and northern children and adolescent. The RST of children and adolescents increased from 2019 to 2020 but significantly decreased from 2020 to 2022. This trend in RST is more pronounced among primary, urban, and southern children and adolescent. ConclusionsThis research unveils the effects of the pandemic on PA and RST in children and adolescents, suggesting short-term beneficial and long-term adverse effects on PA and short-term adverse and long-term beneficial effects on RST. These findings provide a foundation for formulating policies related to children and adolescents' PA and RST during the pandemic.

Early-life exercise induces immunometabolic epigenetic modification enhancing anti-inflammatory immunity in middle-aged male mice

Exercise is usually regarded to have short-term beneficial effects on immune health. Here we show that early-life regular exercise exerts long-term beneficial effects on inflammatory immunity. Swimming training for 3 months in male mice starting from 1-month-old curbs cytokine response and mitigates sepsis when exposed to lipopolysaccharide challenge, even after an 11-month interval of detraining. Metabolomics analysis of serum and liver identifies pipecolic acid, a non-encoded amino acid, as a pivotal metabolite responding to early-life regular exercise. Importantly, pipecolic acid reduces inflammatory cytokines in bone marrow-derived macrophages and alleviates sepsis via inhibiting mTOR complex 1 signaling. Moreover, early-life exercise increases histone 3 lysine 4 trimethylation at the promoter of Crym in the liver, an enzyme responsible for catalyzing pipecolic acid production. Liver-specific knockdown of Crym in adult mice abolishes this early exercise-induced protective effects. Our findings demonstrate that early-life regular exercise enhances anti-inflammatory immunity during middle-aged phase in male mice via epigenetic immunometabolic modulation, in which hepatic pipecolic acid production has a pivotal function.

Noninvasive Neuromodulation Combined With Rehabilitation Therapy Improves Balance and Gait Speed in Patients With Stroke: A Systematic Review and Network Meta-analysis.

This study aimed to determine repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and cranial nerve noninvasive neuromodulation affect functional balance, gait speed, and walking cadence in stroke patients. We searched PubMed, Embase, Cochrane, and Scopus (June 22, 2022) for randomized controlled trials. Three reviewers independently performed data extraction and assessed the risk of bias. Network and pairwise meta-analyses were performed to assess indirect and direct comparisons. We included 34 studies ( N = 915 patients). Sixty percent had moderate-to-high methodological quality. The meta-analyses showed positive effects of repetitive transcranial magnetic stimulation combined with rehabilitation therapy compared with sham on gait speed, walking cadence, and balance function with weighted mean differences and 95% confidence interval of 0.08 (0.03 to 0.13), 7.16 (3.217 to 11.103), and 3.05 (0.52 to 5.57), respectively. Transcranial direct current stimulation showed improvement on the time up and go test (-0.88 [-1.68 to -0.08]). From the surface under the cumulative ranking analyses, repetitive transcranial magnetic stimulation is the best ranked treatment for gait speed and functional balance improvement compared with transcranial direct current stimulation and sham interventions. There were not enough studies to include cranial nerve noninvasive neuromodulation in the meta-analysis. Walking cadence and speed, functional balance significantly improved after repetitive transcranial magnetic stimulation with short-term effects, which were superior to that of transcranial direct current stimulation and sham treatments. Transcranial direct current stimulation showed short-term beneficial effects on the Time Up and Go test.

P1240 Systematic review with meta-analysis: faecal microbiota transplantation as treatment of chronic pouchitis

Abstract Background Pouchitis is inflammation of the ileal pouch-anal anastomosis after proctocolectomy in the surgical treatment of ulcerative colitis. Cohort studies have found evidence that allogenic faecal microbiota transplantation (FMT) can induce short term beneficial effects in patients with chronic pouchitis. Until recently results from randomized controlled trials (RCTs) have been missing. In this systematic review and meta-analysis, we investigated whether FMT treatment was superior to placebo in inducing remission in patients with chronic pouchitis. Methods We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from inception to 15th of November 2023, for RCTs assessing the efficacy of allogenic FMT in the treatment of chronic pouchitis. Autologous FMT or placebo was accepted as control treatment. The primary outcome was the improvement of symptoms as defined by the authors following four weeks. Results The systematic literature search identified a total of three RCTs on the efficacy of FMT in chronic pouchitis comprising 62 patients with 32 patients treated with FMT. Both treatments (FMT and Placebo) and definition of treatment response varied between studies (Table 1). Meta-analysis revealed that FMT was not superior to placebo (risk ratio=0,68;95% CI=(0,47-0,99); p=0.35) in improvement of symptoms four weeks following treatment (Figure 1). Conclusion FMT was not superior to placebo in inducing short-term beneficial effects four weeks after initial treatment in patients with chronic pouchitis. Whether FMT may induce long-term beneficial effects remains to be established.

Brief Virtual Reality Mindfulness is More Effective than Audio Mindfulness and Colouring in Reducing Stress in University Students

ObjectivesAlthough various multi-week mindfulness programs have been introduced for stress reduction over the past decades, there is still little evidence on the effectiveness of short, self-applied interventions. This study aims to compare the effectiveness of virtual reality mindfulness and audio mindfulness, as well as a simple colouring session.MethodSixty-seven participants were initially enrolled, with 64 remaining after exclusions. They were randomly allocated to one of three face-to-face stress management interventions: virtual reality (VR) mindfulness, audio mindfulness or colouring. Before and after the 10-min intervention, questionnaires were administered to assess differences in perceived stress, psychological well-being, and engagement. Heart rate was also measured to indicate physiological stress.ResultsVR mindfulness was the only intervention to significantly increase wellbeing. Both VR and colouring significantly reduced stress, with VR producing the largest reduction in heart rate, though this was not statistically significant when compared to baseline. The three conditions were perceived as highly engaging, with the highest scores corresponding to VR mindfulness and the lowest to audio mindfulness.ConclusionsThis study shows that a single brief session of VR mindfulness can produce short-term beneficial effects in people at high risk of stress, greater than those achieved through colouring and audio mindfulness. This suggests promising direct implications for university mental health services, although future research is needed to explore long-term benefits as well as the relative efficacy of longer interventions.PreregistrationThis study is not preregistered.

Effects of 6 weeks of cryotherapy plus compression therapy after total or unicompartmental knee arthroplasty: protocol for a single-centre, single-blind randomised controlled trial

IntroductionEffective rehabilitation after total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) is often impeded by pain and swelling. Beneficial short-term effects in terms of pain and opioid use after...

Mesenchymal cells support the early retention of primary alveolar type 2 cells on acellular mouse lung scaffolds

ObjectivesTissue engineering approaches via repopulation of acellular biological grafts provide an exciting opportunity to generate lung grafts for transplantation. Alveolar type 2 (AT2) cells are a promising cell source for re-epithelialization. There are however inherent limitations with respect to their survival and growth, thus impeding their usability for tissue engineering applications. This study investigates the use of mesenchymal stromal cells to support primary AT2 cells for recellularization of mouse lung scaffolds. MethodsAT2 cells and bone marrow-derived mesenchymal cells (BMC) were co-delivered to decellularized mouse lung scaffolds. Recellularized lungs were evaluated for cell surface coverage, viability, and differentiation at 1 and 4 days after cell seeding. Recellularization was evaluated via histological analysis and immunofluorescence. ResultsSimultaneous delivery of AT2 and BMC into acellular lung scaffolds resulted in enhanced cell surface coverage and reduced AT2 cell apoptosis in the recellularized scaffolds at Day 1 but not Day 4. AT2 cell number decreased after 4 days in both of AT2 only and codelivery groups suggesting limited expansion potential in the scaffold. After retention in the scaffold, AT2 cells differentiated into Aqp5-expressing cells. ConclusionsOur results indicate that BMC support AT2 cell survival during the initial attachment and engraftment phase of recellularization. While our findings suggest only a short-term beneficial effect of BMC, our study demonstrates that AT2 cells can be delivered and retained in acellular lung scaffolds; thus with preconditioning and supporting cells, may be used for re-epithelialization. Selection and characterization of appropriate cell sources for use in recellularization, will be critical for ultimate clinical application.

Beneficial Short-Term Effects of Bariatric Surgery on Nutritional Inflammatory Profile and Metabolic Biomarkers.

Bariatric surgery (BS) has several potential metabolic benefits. However, little is known about its impact on changes in the inflammatory potential of diet and its effect on inflammatory and metabolic markers. This study aimed to assess the short-term beneficial effects of BS on dietary inflammatory potential and inflammatory and metabolic markers. Participants (n = 20) were evaluated 3 months before and after BS. Body mass, body mass index, anthropometric measurements, fat mass, fat-free mass, visceral fat, skeletal muscle mass, basal metabolic rate, serum lipids, HOMA-IR, QUICKI and inflammatory markers, including leptin, adiponectin, adiponectin/leptin ratio and plasminogen activator inhibitor-1 (PAI-1), were evaluated. Diet data were collected using a 3-day diet record and the dietary inflammatory index (DII®) and energy-adjusted dietary inflammatory index (E-DIITM) scores were computed. There was a reduction in DII® (2.56 vs 2.13) and E-DIITM (2.18 vs 0.45) indicating an improvement in inflammatory nutritional profile. Moreover, there were increases in the adiponectin/leptin ratio (0.08 vs 0.21) and QUICKI scores (0.31 vs 0.37), and reductions in leptin (36.66 vs 11.41 ng/ml) and HOMA-IR scores (3.93 vs 1.50). There were also improvements in body composition and anthropometric parameters. BS promotes changes in metabolic profile, inflammatory state and food intake and these modifications appeared to be associated with improvements in diet-related inflammation, an increase in the adiponectin/leptin ratio and a reduction in leptin. These results contribute to knowledge on the contribution bariatric surgery can make to the treatment of obesity and the reduction of related comorbidities.

Short-term beneficial effects of human dental pulp stem cells and their secretome in a rat model of mild ischemic stroke

Although cell therapy has been applied in regenerative medicine for decades, recent years have seen greatly increased attention being given to the use of stem cell-based derivatives such as cell-free secretome. Dental pulp stem cells (DPSCs) are widely available, easily accessible, and have high neuroprotective and angiogenic properties. In addition, DPSC-derived secretome contains a rich mixture of trophic factors. The current investigation evaluated the short-term therapeutic effects of human DPSCs and their secretome in a rat model of mild ischemic stroke.Mild ischemic stroke was induced by 30 min middle cerebral artery occlusion, and hDPSCs or their secretome was administered intra-arterially and intranasally. Neurological function, infarct size, spatial working memory, and relative expression of seven target genes in two categories of neurotrophic and angiogenic factors were assessed three days after stroke. In the short-term, all treatments reduced the severity of neurological and histological deficits caused by ischemic stroke. Moreover, transient middle cerebral artery occlusion led to the striatal and cortical over-expression of BDNF, NT-3, and angiogenin, while NGF and VEGF expression was reduced. Almost all interventions were able to modulate the expression of target genes after stroke. The obtained data revealed that single intra-arterial administration of hDPSCs or their secretome, single intranasal transplantation of hDPSCs, or repeated intranasal administration of hDPSC-derived secretome was able to ameliorate the devastating effects of a mild stroke, at least in the short-term.

Getting Into Light Exercise (GENTLE-HF) for Patients With Heart Failure: the Design and Methodology of a Live-Video Group Exercise Study

Newer therapies have increased heart failure (HF) survival rates, but these therapies are rarely curative. The consequence of increased longevity is the likelihood that patients with HF will experience higher symptom burdens over time. Exercise such as cardiac rehabilitation programs can palliate symptom burdens, but numerous barriers prevent exercise participation and adherence. Small pilot studies indicate short-term beneficial effects of gentle forms of exercise such as yoga to address symptom burdens and accommodate comorbidities. Long-term symptom benefit and adherence to yoga are currently unknown. Therefore, a novel a home-based, gentle-stretching intervention that addresses issues of exercise access and adherence is described in this article. The purpose of this article is to describe the background, design and study methodology of the Getting Into Light Exercise for HF (GENTLE-HF) randomized controlled trial. Gentle-HF will test a gentle stretching and education intervention compared to an education control group concerning symptom burden (dyspnea, exercise, activity adherence, depression, and anxiety) and quality of life. As an exploratory aim, we also will determine whether rurality moderates the relationships between exercise participation and symptom burden as a measure of health equity. We designed a randomized controlled trial study (n = 234) with 2 arms: a gentle stretching intervention arm with HF education and an HF education-only control. Participants will be recruited from U.S. cardiology clinics in the mid-Atlantic and the San Francisco Bay areas. This recruitment strategy will include individuals from urban, suburban and rural areas and individuals that have diverse racial and ethnic backgrounds. All participants will be provided with an iPad set up to access HF educational topics, and the intervention arm will have both educational and gentle-stretching class links. Both arms will access the HF health education icons on their iPads weekly; they correspond to the 6 months (26 weeks) of study participation. Symptom burden (dyspnea, fatigue, exercise intolerance, depression, anxiety) and quality of life will be measured at the study's start and completion. Study adherence will be measured by using attendance rates and number of class minutes attended. The GENTLE-HF study is a randomized study that will test the effect of a home-based, video-conference-delivered gentle stretching and HF education intervention designed for patients with HF. The findings will inform whether gentle stretching can decrease symptom burden and potentially provide access to symptom palliation for a diverse population of patients with HF.

Preliminary Study: Short-term Beneficial Effects of Thai Tok Sen Massage on Pain, Pressure Pain Threshold, and Upper Trapezius Muscle Thickness Among People with Shoulder Pain.

Shoulder muscle pain and spasm is the most common problem in people after prolonged working, similar to that resulting from office syndrome. Various medicinal treatments with analgesic drugs, hot packs, therapeutic ultrasound, or deep friction techniques can be clinically applied. Alternatively, traditional Thai massage (TM) with deep compression gentle technique also can help to release that problem. In addition, an traditional Thai treatment with Tok Sen (TS) massage has been generally performed in the Northern part of Thailand without any scientific evidence support. Thus, the aim of this preliminary study was to reveal the scientific value of Tok Sen massage on shoulder muscle pain and upper trapezius muscle thickness among people with shoulder pain. Twenty participants (6 males and 14 females) who suffered from shoulder pain were randomized into TS (n =10, aged 34.2 ± 7.34 yrs) or TM (n=10, aged 32.8 ± 7.24 yrs). Each group received two times 5-10 minutes of treatment, one week apart. At the baseline and after completing two times of each intervention, pain score, pain pressure threshold (PPT), and specific trapezius muscle thickness were evaluated. Before both TM and TS interventions, pain score, PPT, and muscle thickness were not statistically different between groups. After two times of intervention, pain scores significantly reduced in TM (3.1 ± 0.56; p = .02, 2.3 ± 0.48; p < .001), as same as in TS (2.3 ± 0.67; p = .01, 1.3 ± 0.45; p < .001) when compared to baseline. This was the same as the results of PPT in TM (4.02 ± 0.34; p = .012, 4.55 ± 0.42; p = .001) and TS (5.67 ± 0.56; p = .001, 6.8 ± 0.72; p < .001). However, the trapezius muscle thickness reduced significantly after two interventions by TS (10.42 ± 1.04; p = 0.002 & 9.73 ± 0.94 mm, p < .001), but did not change in TM (p > .05). Moreover, when compared between intereventions at the first and second periods, TS showed a significant difference in pain score (p = .01 & p <.001), muscle thickness (p = .008 & p = .001) as well as PPT (p < .001 & p < .001) when compared to TM. Tok Sen massage improves upper trapezius thickness from muscle spasms and reduces pain perception and increases the pressure threshold pain among participants who suffer from shoulder pain similar to that of office syndrome.

Effects of Five Prebiotics on Growth, Antioxidant Capacity, Non-Specific Immunity, Stress Resistance, and Disease Resistance of Juvenile Hybrid Grouper (Epinephelus fuscoguttatus ♀ × Epinephelus lanceolatus ♂).

To explore the short-term health benefits of five prebiotics on hybrid grouper (Epinephelus fuscoguttatus ♀ × Epinephelus lanceolatus ♂), six experimental groups fed with different diets (basal diet, diet control (CON); basal diet + 0.2% fructooligosaccharide (FOS), diet FOS; basal diet + 0.5% chitosan, diet chitosan (CTS); basal diet + 0.2% mannan-oligosaccharide (MOS), diet MOS; basal diet + 0.1% β-glucan (GLU), Diet GLU; basal diet + 0.05% xylooligosaccharide (XOS), diet XOS) were set up, and a 4-week feeding trial was conducted. MOS and XOS significantly improved the growth of hybrid grouper compared to the CON group (p < 0.05). Antioxidant enzyme assay showed that the activity of glutathione peroxidase (GPx) was significantly enhanced in the MOS group, and the content of malondialdehyde (MDA) in the XOS group was significantly lower than in the CON group (p < 0.05). The catalase (CAT) activities were significantly enhanced in all prebiotic-supplemented groups compared with the CON group (p < 0.05). Non-specific immunity assay showed that the activities of alkaline phosphatase (AKP) and lysozyme (LZM) were significantly increased in all prebiotic-supplemented groups compared with the CON group (p < 0.05). The total protein content in the XOS group was significantly increased (p < 0.05), and the albumin (ALB) activity in the MOS group was more significantly increased than that in the CON group. Histological examination of the intestine revealed that muscle thickness was significantly increased in all prebiotic-supplemented groups compared to the CON group (p < 0.05). Villi length, villi width, muscle thickness all increased significantly in the MOS group (p < 0.05). In addition, the crowding stress and ammonia nitrogen stress experiments revealed that the survival rates of the MOS and XOS groups after stresses were significantly higher than those of the CON group (p < 0.05). Though MOS and XOS exhibited similar anti-stress effects, the antioxidant and non-specific immunity parameters they regulated were not the same, indicating that the specific mechanisms of MOS and XOS's anti-stress effects were probably different. After being challenged with Vibrio harvey, MOS and GLU groups showed significantly higher post-challenge survival rates than the CON group (p < 0.05). These findings indicated that among the five prebiotics, MOS and XOS showed the best overall short-term beneficial effects and could be considered promising short-term feed additives to improve the stress resistance of juvenile hybrid grouper.

Efficacy of aerobic exercise on aerobic capacity in slowly progressive neuromuscular diseases: A systematic review and meta-analysis.

Aerobic exercise aims to improve aerobic capacity. To summarize the evidence on the efficacy of aerobic exercise on aerobic capacity in slowly progressive neuromuscular diseases (NMDs). We searched the electronic databases MEDLINE, EMBASE, SPORTDiscus and Web of Science Conference Proceedings Index for articles published up to June 17, 2021, selecting randomized controlled trials that included adults with slowly progressive NMDs and compared aerobic exercise to no aerobic exercise. The primary outcome was peak oxygen uptake (VO2peak) directly post-intervention. Secondary outcomes included other peak test parameters, submaximal test parameters, long-term outcomes ≥8 weeks post-intervention, adherence and adverse events. Meta-analyses were performed for the primary outcome and for secondary outcomes when reported in more than 2 studies. Risk of bias was assessed with the Cochrane Risk of Bias tool and quality of evidence according to GRADE. Nine studies were included (195 participants with 8 different NMDs). Eight studies were rated at high risk of bias and 1 study was rated at some concerns. Duration of exercise programs ranged from 6 to 26 weeks, with 3 weekly training sessions of 20 to 40min, based on maximal capacity. Meta-analyses revealed short-term moderate beneficial effects of aerobic exercise on VO2peak (standardized mean difference [SMD] 0.55, 95% CI 0.23; 0.86) and peak workload (SMD 0.61, 95% CI 0.24; 0.99). Long-term effects were not assessed. Most training sessions (83-97%) were completed, but time spent in target intensity zones was not reported. Included studies lacked detailed adverse event reporting. There is low-quality evidence that aerobic exercise is safe and leads to moderate improvement of aerobic capacity directly post-intervention in slowly progressive NMDs, but the long-term efficacy remains unclear. Detailed information about the time spent in target intensity zones and adverse events is lacking. CRD42020200083.