Significant Between-group Differences Research Articles

A Retrospective Analysis of Southeastern U.S. Police Recruit Health and Fitness From 4 Points in Time Within a 16-Year Period: Implications for Physical Fitness Training.

Gonzales, SM, Orr, RM, Coburn, JW, Hoffmann, MD, Kennedy, K, Dawes, JJ, and Lockie, RG. A retrospective analysis of southeastern U.S. police recruit health and fitness from 4 points in time within a 16-year period: Implications for physical fitness training. J Strength Cond Res 38(6): 1118-1126, 2024-Drawing from the general population for its recruiting needs, police departments often employ academy curricula to improve a recruit's fitness so they can perform occupational tasks. Recently, obesity and physical inactivity have increased in the general population, potentially influencing the health and fitness of incoming recruits. This study involved a retrospective, cross-sectional analysis of health and fitness data of police recruits. Data from 1 police department in southeastern United States were analyzed at 4 specific time points, splitting the recruits into natural immerging groups; 2003 (n = 93), 2006 (n = 137), 2009 (n = 74), and 2019 (n = 242). Health and fitness data for all recruits included age, height, body mass, and body mass index (BMI); systolic and diastolic blood pressure (BP); sit-and-reach; combined grip strength; push-ups and sit-ups completed in 60 seconds; physical ability test time; and 2.4-km run time. Several univariate analyses, with sex and age as covariates (analyses of covariance), and a Bonferroni's post hoc, determined whether there were significant between-group differences. Effect sizes (d) were also calculated. Key results demonstrated that 2019 recruits were heavier than the recruits in 2006 and 2009 (p ≤ 0.032; d = 0.14-0.38); had a greater BMI (p ≤ 0.028; d = 0.24-0.75) and systolic BP (p < 0.001; d = 0.47-0.65), and lesser sit-and-reach distance (p ≤ 0.020; d = 0.26-0.46), than all recruit groups; completed fewer sit-up repetitions than the recruits in 2006 and 2009 (p ≤ 0.025; d = 0.42-0.48); and were slower in the 2.4-km run than the recruits in 2006 (p = 0.009; d = 0.36). Police training staff may need to address lesser health (BMI, BP) and fitness (hamstring flexibility, abdominal endurance, aerobic fitness) in incoming recruits.

Assessing quadriceps strength in patellofemoral pain patients: A study on the reliability and validity of a low-cost strain-gauge for clinical practice.

Patellofemoral pain (PFP) is a common knee complaint affecting diverse populations both acutely and chronically. Quadriceps muscle weakness is one possible aetiology, but current devices for measuring muscle strength (isokinetic dynamometer [ID] and hand-held dynamometers [HHD]) are frequently too expensive (e.g., ID) or lack reliability (e.g., HHD) for practitioners, especially in under-resourced settings. There is a need to evaluate a low-cost device to manage rehabilitation of people with PFP. Isometric quadriceps strength of participants aged 18-35 years (total [n = 33], control group [n = 17] and PFP group [n = 16]) were evaluated on an isokinetic dynamometer and a commercially available strain gauge at baseline and after an 8-week non-standardised intervention. The strain gauge showed high absolute and relative reliability (intraclass correlation coefficient = 0.89-0.99; typical error of measurement = 3.9-10.4%). Clinically meaningful difference scores (12.2-45 Nm) were greater than the typical error of measurement, implying sufficient sensitivity of the strain gauge to measure true changes in isometric quadricep strength. Strong to very strong correlations were evident between the strain gauge and isokinetic dynamometer torque measurements (r = 0.88-0.90, SEE = 0.05-0.07 Nm), but slope values (β = 0.65-0.77) indicated that torque from the strain gauge was lower than that obtained from the isokinetic dynamometer. An average systematic bias of 16.3-28.8 Nm was evident in favour of the isokinetic dynamometer, with no statistically significant between-group differences apparent between baseline and follow-up testing. The present commercially available strain gauge is reliable and sensitive enough to detect clinically meaningful differences in quadriceps strength of both healthy individuals and those with PFP. However, the strain gauge lacks validity and therefore cannot replace isokinetic dynamometry. Given the low cost and excellent reliability, the strain gauge can be a valuable tool to assess quadriceps muscle deficits and track rehabilitation progress in people with PFP.

Effects of a Nonlinear Program on Different Health Parameters in the Elderly.

The aim of this research was to evaluate the impact of a nonlinear training program on visceral adipose tissue (VAT) and systolic (SBP) and diastolic (DBP) blood pressure, as well as the response of biochemical parameters such as fasting plasma glucose (FPG), total cholesterol (TC), high-density cholesterol (HDL-C), low-density cholesterol (LDL-C), and triglycerides (TG). The nonlinear periodized program would produce greater improvements in outcomes than the linear periodized training program. Randomized cross-sectional design. Level 3. Older adults with no previous training experience (10 male and 8 female [age, 64 ± 2.1 years; height, 165.12 ± 7.5 cm; body mass, 72.5 ± 11.4 kg; body max index, 26.5 ± 3.2 kg/m2]) were randomized to linear (n = 9, TT) or undulating (n = 9, UT) periodization. After a 3-week familiarization period, all participants performed 3 sessions of resistance training per week; 8 weeks of training were conducted for each group. Dual x-ray absorptiometry was used to measure VAT, and SBP and DBP were measured using an OMRON M3 digital automatic blood pressure monitor. Blood samples were collected between 8:00 a.m. and 9:30 a.m. after 12-hour overnight fasting. Both interventions significantly (P < 0.05) decreased FPG, TC, LDL-C, and TG. A significant decrease in SBP and DBP was observed only in the UT group (P < 0.05). No significant between-group differences in outcomes were observed (P > 0.5). However, the effect size was marginally more pronounced for all outcomes in the UT group. An undulating periodization program was effective in improving VAT, TC, LDL-C, FPG, HDL-C, TG, and blood glucose levels in older adults. Resistance training can be programmed in an undulating or traditional way in older adults based on improvements in health parameters, considering adherence and individual preferences.

Cost-effectiveness analysis of a cardio-oncology rehabilitation framework compared to an exercise intervention for cancer survivors with high cardiovascular risk.

A cardio-oncology rehabilitation model among cancer survivors showed superior results comparing to a community-based exercise intervention. However, questions remain about its cost-effectiveness. To assess the cost-effectiveness of a center-based cardiac rehabilitation (CBCR) program when compared to usual care encompassing a community-based exercise training (CBET), among cancer survivors with high cardiovascular risk. The CORE study was a single-center, prospective, randomized controlled trial; 80 adult cancer survivors with previous exposure to cardiotoxic cancer treatment and/or with previous cardiovascular disease were assigned (1:1 ratio) to an 8-week CBCR or CBET, twice/week. Cost-effectiveness was a pre-specified secondary endpoint. Outcomes included healthcare resource use and costs, quality-adjusted life-years (QALYs) and cost-effectiveness; incremental cost-effectiveness ratio (ICER) was computed from a societal perspective. 75 patients completed the study (CBCR N=38; CBET N=37). The CBCR had significantly higher cost per patient (477.76 ± 39.08€) compared to CBET group (339.32 ± 53.88€), with a significant between-group difference 138.44€ (95% CI, 116.82 to 160.05€, p<0.01). A between-group difference by 0.100 points in QALYs was observed, favouring the CBCR (95% CI, -0.163 to -0.037, p=0.002). When CBCR was compared with CBET, the ICER was €1,383.24 per QALY gained; at a willingness-to-pay threshold of €5,000 per QALY, the probability of CBCR being cost-effective was 99.9% (95% CI, 99.4 to 100.0). The CORE trial shows that a CBCR is a cost-effective intervention in the management of cancer survivors with high cardiovascular risk, reinforcing the potential benefits of this multidisciplinary approach in supportive care of this specific subset of cancer patients.

Effect of sustained decreases in sedentary time and increases in physical activity on liver enzymes and indices in type 2 diabetes

BackgroundCurrent guidelines for nonalcoholic fatty liver disease (NAFLD) recommend high volumes and/or intensities of physical activity (PA), the achievement of which generally requires participation in supervised exercise training programs that however are difficult to implement in routine clinical practice. Conversely, counselling interventions may be more suitable, but result in only modest increases in moderate-to-vigorous-intensity PA (MVPA). This study assessed whether a counseling intervention for increasing PA and decreasing sedentary time (SED-time) is effective in improving NAFLD markers in people with type 2 diabetes.MethodsThree-hundred physically inactive and sedentary patients were randomized 1:1 to receive one-month theoretical and practical counseling once-a-year (intervention group) or standard care (control group) for 3 years. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltranspeptidase (γGT) levels were measured and fatty liver index (FLI), hepatic steatosis index (HSI), and visceral adiposity index (VAI) were calculated. Total PA volume, light-intensity PA (LPA), moderate-to-vigorous-intensity PA (MVPA), and SED-time were objectively measured by an accelerometer.ResultsThroughout the 3-year period, NAFLD markers did not change in the control group, whereas ALT, γGT, FLI, and HSI decreased in the intervention group, with significant between-group differences, despite modest MVPA increases, which however were associated with larger decrements in SED-time and reciprocal increments in LPA. Mean changes in NAFLD markers varied according to quartiles of (and correlated with) changes in MVPA (all markers) and SED-time, LPA, and PA volume (ALT, γGT, and HSI). Mean changes in MVPA or PA volume were independent predictors of changes in NAFLD markers. When included in the models, change in cardiorespiratory fitness and lower body muscle strength were independently associated with some NAFLD markers.ConclusionA behavior change involving all domains of PA lifestyle, even if insufficient to achieve the recommended MVPA target, may provide beneficial effects on NAFLD markers in people with type 2 diabetes.

#1821 Baroflex sensitivity and hemodynamic responses during physical and mental tests: a comparative study between HD and PD patients

Abstract Background and Aims Cardiac arrhythmias and sudden death are the leading causes of mortality in end-stage kidney disease (ESKD) and autonomic dysfunction is considered to play a predominant role. This is the first study to compare baroreflex sensitivity (BRS) and hemodynamic responses after mental- and physical-stimulation maneuvers between hemodialysis (HD) and peritoneal (PD) patients. Method 68 ESKD patients (34 HD and 34 PD patients matched for age, sex, and dialysis-vintage) were included. Continuous recordings from Finometer-PRO at rest and during mental-arithmetic, orthostatic, and handgrip-exercise tests were used for calculation of BRS and hemodynamic responses in each individual. Results The two groups were similar in terms of age, sex, dialysis vintage and major comorbidities. BRS during mental (HD 3.59 ± 2.62 vs PD 5.50 ± 9.40 ms/mmHg, p = 0.280) and physical stress tests (orthostatic: HD 3.23 ± 2.42 vs PD 2.07 ± 2.69 ms/mmHg, p = 0.777) was similar between HD and PD patients. During mental test, both groups presented increases in SBP/DBP levels compared to rest (SBP HD: 156.3 ± 27.7 vs 142.7 ± 20.0 mmHg, p &amp;lt; 0.05; PD: 158.0 ± 25.6 vs 143.1 ± 23.6 mmHg, p &amp;lt; 0.05, respectively), but without significant between-group differences (p = 0.853/p = 0.611 respectively for SBP/DBP). Similarly, no significant between-group differences were noted in stroke volume, cardiac output, and total peripheral resistance during the same testing period. The mean SBP levels during the orthostatic test were significantly decreased compared to rest in both groups (HD: 135.4 ± 26.8 vs 142.2 ± 20.1 mmHg; p &amp;lt; 0.05; PD 135.3 ± 21.9 vs 143.1 ± 23.6 mmHg; p &amp;lt; 0.05), but the overall response was not different between-groups (p = 0.937). Similarly, the responses to the other hemodynamic parameters were similar between HD and PD. Finally, the hemodynamic responses during handgrip exercise and recovery were not differed between HD and PD. Conclusion BRS and hemodynamic responses to mental and physical stress tests were similar between HD and PD patients, suggesting that ANS function in ESKD is not affected by dialysis modality.

Timing matters? The effects of two different timing of high protein diets on body composition, muscular performance, and biochemical markers in resistance-trained males

BackgroundIt is unclear whether resistance training in combination with different timing of protein intake might have differential effects on muscle hypertrophy, strength, and performance. Therefore, we compared the effects of 8 weeks of resistance training combined with two different high-protein diet strategies (immediately pre-and after, or 3 h pre and after exercise) in resistance-trained males.MethodsForty resistance-trained males (24 ± 4 years) performed 8 weeks of resistance training combined with 2 g kg−1 d−1 protein. Body composition, muscular performance, and biochemical markers were assessed pre and post-intervention.ResultsNine participants (four from 3 h group and five from the immediate group) withdrew from the study. Therefore, 31 participants completed the study. All measures of skeletal muscle mass, Australian pull-up, and muscle strength, significantly increased post-intervention in both groups (p &amp;lt; 0.05). The biochemical marker urea also significantly increased from pre to post in both groups (p &amp;lt; 0.05). There were no significant between-group differences (p &amp;gt; 0.05).ConclusionHigh-protein diet enhances muscular performance and skeletal muscle mass in resistance-trained males, irrespective of intake time. Consequently, the total daily protein intake appears to be the primary factor in facilitating muscle growth induced by exercise.

The influence of pain presence on pelvic floor and sexual dysfunctions, and pain intensity-related variables in women using the menstrual cup: A cross-sectional survey

Objective: The aim was to assess the influence of pain during menstrual cup use on pelvic floor and sexual dysfunctions. In addition, we wanted to assess its impact on variables related to pain intensity during menstrual cup use such as insertion, removal, during menstruation, during sexual intercourse or the presence of pelvic pain. Methods: This study was a cross-sectional survey. The study included 566 women who fulfilled the inclusion criteria. Women were categorised into two primary groups: women with no pain and women with pain. Results: Regarding pelvic floor dysfunction, the independent samples t-test showed significant between-group differences ( t(564) = −3.50, mean differences (MD) = −8.86 (−13.8 to −3.89), p &lt; 0.001). With respect to sexual dysfunction, no significant between-group differences were found with the exception of the pain subscale ( t(564) = 2.59, MD = 0.27 (0.48–0.06), p = 0.01. Regarding pain-related variables, we found statistically significant between-groups differences on all analysed variables. Conclusions: In conclusion, the results showed that women who use the menstrual cup and have pain showed worse scores on the pelvic floor dysfunction questionnaire, where it also seems that greater pain intensity was associated with worse questionnaire scores. However, we found no significant differences in sexual dysfunction except for the pain subscale between women who did and did not report pain in menstrual cup use. Finally, women who reported pain from menstrual cup use showed significantly greater pain intensity when inserting and removing the menstrual cup, during menstruation, during sexual intercourse and showed higher levels of pelvic pain although these differences are clinically slight.

Dupilumab for COPD with Blood Eosinophil Evidence of Type 2 Inflammation.

Dupilumab, a fully human monoclonal antibody that blocks the shared receptor component for interleukin-4 and interleukin-13, key and central drivers of type 2 inflammation, has shown efficacy and safety in a phase 3 trial involving patients with chronic obstructive pulmonary disease (COPD) and type 2 inflammation and an elevated risk of exacerbation. Whether the findings would be confirmed in a second phase 3 trial was unclear. In a phase 3, double-blind, randomized trial, we assigned patients with COPD who had a blood eosinophil count of 300 cells per microliter or higher to receive subcutaneous dupilumab (300 mg) or placebo every 2 weeks. The primary end point was the annualized rate of moderate or severe exacerbations. Key secondary end points, analyzed in a hierarchical manner to adjust for multiplicity, included the changes from baseline in the prebronchodilator forced expiratory volume in 1 second (FEV1) at weeks 12 and 52 and in the St. George's Respiratory Questionnaire (SGRQ; scores range from 0 to 100, with lower scores indicating better quality of life) total score at week 52. A total of 935 patients underwent randomization: 470 were assigned to the dupilumab group and 465 to the placebo group. As prespecified, the primary analysis was performed after a positive interim analysis and included all available data for the 935 participants, 721 of whom were included in the analysis at week 52. The annualized rate of moderate or severe exacerbations was 0.86 (95% confidence interval [CI], 0.70 to 1.06) with dupilumab and 1.30 (95% CI, 1.05 to 1.60) with placebo; the rate ratio as compared with placebo was 0.66 (95% CI, 0.54 to 0.82; P<0.001). The prebronchiodilator FEV1 increased from baseline to week 12 with dupilumab (least-squares mean change, 139 ml [95% CI, 105 to 173]) as compared with placebo (least-squares mean change, 57 ml [95% CI, 23 to 91]), with a significant least-squares mean difference at week 12 of 82 ml (P<0.001) and at week 52 of 62 ml (P = 0.02). No significant between-group difference was observed in the change in SGRQ scores from baseline to 52 weeks. The incidence of adverse events was similar in the two groups and consistent with the established profile of dupilumab. In patients with COPD and type 2 inflammation as indicated by elevated blood eosinophil counts, dupilumab was associated with fewer exacerbations and better lung function than placebo. (Funded by Sanofi and Regeneron Pharmaceuticals; NOTUS ClinicalTrials.gov number, NCT04456673.).

Effects of a horizontal speed deceleration training programme on measures of physical fitness in youth male handball players

ABSTRACT This study examined the effects of an 8-week horizontal speed deceleration training (HSDT) programme in combination with regular handball-specific training as compared with handball-specific training only in measures of physical fitness in male youth handball players. Thirty-nine players were randomly assigned to either an HSDT group (n = 18; 15.55 ± 0.24 years) or an active-control group (CG; n = 21; 14.59 ± 0.23 years). The results showed significant and large between-group differences at post-test in countermovement jump, change-of-direction speed, and repeated sprint ability (RSA) (all p < 0.01; d = 2.04 and 1.37, 1.39, 1.53, and 1.53 for the CMJ, 505 CoD, RSAbest, RSAaverage, and RSAtotal performances, respectively). The post-hoc-analysis demonstrated significant and large improvements in all measures of physical fitness in the HSDT group (∆2.49% to 16,25%; d = 1.01 to 1,70; all p < 0,01). The CG, however, failed to reach any significant difference in all measures of physical fitness ((∆0.31% to 1.98%; d = 0.15 to 0.22; p = 0.379; p > 0.05). To summarise, an 8-week in-season HSDT programme alongside regular handball-specific training yielded positive effects on various performance measures including jumping ability, CoD speed, and RSA, when compared to handball-specific training alone. These results highlight the potential benefits of integrating HSDT into the training regimen of youth handball athletes during the competitive season.

HbA1c changes in a deprived population who followed or not a diabetes self-management programme, organised in a multi-professional primary care practice: a historical cohort study on 207 patients between 2017 and 2019

BackgroundDiabetes self-management (DSM) helps people with diabetes to become actors in their disease. Deprived populations are particularly affected by diabetes and are less likely to have access to these programmes. DSM implementation in primary care, particularly in a multi-professional primary care practice (MPCP), is a valuable strategy to promote care access for these populations. In Rennes (Western France), a DSM programme was designed by a MPCP in a socio-economically deprived area. The study objective was to compare diabetes control in people who followed or not this DSM programme.MethodThe historical cohort of patients who participated in the DSM programme at the MPCP between 2017 and 2019 (n = 69) was compared with patients who did not participate in the programme, matched on sex, age, diabetes type and place of the general practitioner’s practice (n = 138). The primary outcome was glycated haemoglobin (HbA1c) change between 12 months before and 12 months after the DSM programme. Secondary outcomes included modifications in diabetes treatment, body mass index, blood pressure, dyslipidaemia, presence of microalbuminuria, and diabetes retinopathy screening participation.ResultsHbA1c was significantly improved in the exposed group after the programme (p < 0.01). The analysis did not find any significant between-group difference in socio-demographic data, medical history, comorbidities, and treatment adaptation.ConclusionsThese results, consistent with the international literature, promote the development of DSM programmes in primary care settings in deprived areas. The results of this real-life study need to be confirmed on the long-term and in different contexts (rural area, healthcare organisation).

Pamrevlumab for Idiopathic Pulmonary Fibrosis

Current treatments for idiopathic pulmonary fibrosis slow the rate of lung function decline, but may be associated with adverse events that affect medication adherence. In phase 2 trials, pamrevlumab (a fully human monoclonal antibody that binds to and inhibits connective tissue growth factor activity) attenuated the progression of idiopathic pulmonary fibrosis without substantial adverse events. To assess the efficacy and safety of pamrevlumab for patients with idiopathic pulmonary fibrosis. Phase 3 randomized clinical trial including 356 patients aged 40 to 85 years with idiopathic pulmonary fibrosis who were not receiving antifibrotic treatment with nintedanib or pirfenidone at enrollment. Patients were recruited from 117 sites in 9 countries between July 18, 2019, and July 29, 2022; the last follow-up encounter occurred on August 28, 2023. Pamrevlumab (30 mg/kg administered intravenously every 3 weeks; n = 181) or placebo (n = 175) for 48 weeks. The primary outcome was absolute change in forced vital capacity (FVC) from baseline to week 48. There were 5 secondary outcomes (including time to disease progression, which was defined as a decline of ≥10% in predicted FVC or death). The exploratory outcomes included patient-reported symptoms. Adverse events were reported. Among 356 patients (mean age, 70.5 years; 258 [72.5%] were men; 221 [62.1%] were White), 277 (77.8%) completed the trial. There was no significant between-group difference for absolute change in FVC from baseline to week 48 (least-squares mean, -260 mL [95% CI, -350 to -170 mL] in the pamrevlumab group vs -330 mL [95% CI, -430 to -230 mL] in the placebo group; mean between-group difference, 70 mL [95% CI, -60 to 190 mL], P = .29). There were no significant between-group differences in any of the secondary outcomes or in the patient-reported outcomes. In the pamrevlumab group, there were 160 patients (88.4%) with treatment-related adverse events and 51 patients (28.2%) with serious adverse events vs 151 (86.3%) and 60 (34.3%), respectively, in the placebo group. During the study, 23 patients died in each group (12.7% in the pamrevlumab group vs 13.1% in the placebo group). Among patients with idiopathic pulmonary fibrosis treated with pamrevlumab or placebo, there was no statistically significant between-group difference for the primary outcome of absolute change in FVC from baseline to week 48. ClinicalTrials.gov Identifier: NCT03955146.

The Effect of Computerized Cognitive Training, with and without Exercise, on Cortical Volume and Thickness and Its Association with Gait Speed in Older Adults: A Secondary Analysis of a Randomized Controlled Trial

Background: Slower walking is associated with changes in cortical volume and thickness. Computerized cognitive training (CCT) and exercise improve cortical volume and thickness and thus, may promote gait speed. Slowing of gait is predictive of Alzheimer’s disease. Objective: To examine: 1) the effect of CCT, with or without physical exercise, on cortical volume and thickness and; 2) the association of changes in cortical volume and thickness with changes in gait speed. Methods: A subset of 124 adults (n = 53), aged 65–85 years, enrolled in an 8-week randomized controlled trial and completed T1-weighted MRI and 4-meter walk at baseline and 8 weeks. Participants were randomized to: 1) active control (BAT; n = 19); 2) CCT (n = 17); or 3) CCT preceded by exercise (Ex-CCT; n = 17). Change in cortical volume and thickness were assessed and compared across all groups using Freesurfer. RESULTS: BAT versus CCT increased left rostral middle frontal gyrus volume (p = 0.027) and superior temporal gyrus thickness (p = 0.039). Ex-CCT versus CCT increased left cuneus thickness (p &lt; 0.001) and right post central gyrus thickness (p = 0.005), and volume (p &lt; 0.001). Ex-CCT versus BAT increased left (p = 0.001) and right (p = 0.020) superior parietal gyri thickness. There were no significant between-group differences in gait speed (p &gt; 0.175). Increased left superior parietal volume (p = 0.036, r = 0.340) and thickness (p = 0.002, r = 0.348), right post central volume (p = .017, r = 0.341) and thickness (p = 0.001, r = 0.348), left banks of superior temporal sulcus thickness (p = 0.002, r = 0.356), and left precuneus thickness (p &lt; 0.001, r = 0.346) were associated with increased gait speed. CONCLUSIONS: CCT with physical exercise, but not CCT alone, improves cortical volume and thickness in older adults. These changes may contribute to the maintenance of gait speed in aging.

Electrophysiological and behavioral differences of general and food-specific inhibitory control in people with different levels of intuitive eating

Intuitive eating influences health-related behaviors (including calorie and nutritional intake) that are modulated by inhibitory control, producing implications for physical, mental, and emotional health. However, little is known about the relationship between intuitive eating habits and inhibitory control. Therefore, we tested intuitive eating's influence on measures of general and food-related inhibitory control using behavioral and event-related potentials (N2 and P3 components). We included 40 healthy participants: 23 had a higher level of intuitive eating, and 17 had a lower level. They participated in food-specific go/no-go and general go/no-go tasks for which we recorded electroencephalogram data. As expected, in the food-specific go/no-go task, the P3 component amplitude in the lower intuitive eating group was significantly larger than in the higher intuitive eating group; there were no significant between-group differences in the N2 amplitudes or behavioral measures. Moreover, there were no ERP or behavioral difference between groups in the general go/no-go task. Further research is needed to understand the role of positive eating behaviors in food-specific inhibitory control.

The Effect of Fabry Disease Therapy on Bone Mineral Density.

Fabry disease (FD) is an X-linked lysosomal storage disorder, characterised by the cellular accumulation of globotriaosylceramide due to impaired alpha-galactosidase A enzyme activity. FD may manifest with multisystem pathology, including reduced bone mineral density (BMD). Registry data suggest that the introduction of Fabry-specific therapies (enzyme replacement therapy or chaperone therapy) has led to significant improvements in overall patient outcomes; however, there are limited data on the impact on bone density. The aim of this study was to describe the effect of Fabry-specific therapies on longitudinal changes in bone mineral density (BMD) in FD. We performed a retrospective observational study analysing bone densitometry (DXA) in patients with genetically confirmed FD. Patients were grouped based on the use of Fabry-specific therapies. The between-group longitudinal change in BMD Z-score was analysed using linear mixed effects models. A total of 88 FD patients were analysed (50 untreated; 38 treated). The mean age at first DXA was 38.5 years in the untreated group (84% female) and 43.7 years in the treated group (34% female). There was no significant longitudinal between-group difference in the BMD Z-score at the lumbar spine. However, the Z-score per year at the total hip (β = -0.105, p < 0.001) and femoral neck (β = -0.081, p = 0.001) was significantly lower over time in the treated than the untreated group. This may reflect those receiving therapy having a more severe underlying disease. Nevertheless, this suggests that Fabry-specific therapies do not reverse all disease mechanisms and that the additional management of BMD may be required in this patient population.

Acupuncture for Chronic Radiation-Induced Xerostomia in Head and Neck Cancer

Patients with head and neck cancer who undergo radiotherapy can develop chronic radiation-induced xerostomia. Prior acupuncture studies were single center and rated as having high risk of bias, making it difficult to know the benefits of acupuncture for treating radiation-induced xerostomia. To compare true acupuncture (TA), sham acupuncture (SA), and standard oral hygiene (SOH) for treating radiation-induced xerostomia. A randomized, blinded, 3-arm, placebo-controlled trial was conducted between July 29, 2013, and June 9, 2021. Data analysis was performed from March 9, 2022, through May 17, 2023. Patients reporting grade 2 or 3 radiation-induced xerostomia 12 months or more postradiotherapy for head and neck cancer were recruited from community-based cancer centers across the US that were part of the Wake Forest National Cancer Institute Community Oncology Research Program Research Base. Participants had received bilateral radiotherapy with no history of xerostomia. Participants received SOH and were randomized to TA, SA, or SOH only. Participants in the TA and SA cohorts were treated 2 times per week for 4 weeks. Those experiencing a minor response received another 4 weeks of treatment. Patient-reported outcomes for xerostomia (Xerostomia Questionnaire, primary outcome) and quality of life (Functional Assessment of Cancer Therapy-General) were collected at baseline, 4 (primary time point), 8, 12, and 26 weeks. All analyses were intention to treat. A total of 258 patients (201 men [77.9%]; mean [SD] age, 65.0 [9.16] years), participated from 33 sites across 13 states. Overall, 86 patients were assigned to each study arm. Mean (SD) years from diagnosis was 4.21 (3.74) years, 67.1% (n = 173) had stage IV disease. At week 4, Xerostomia Questionnaire scores revealed significant between-group differences, with lower Xerostomia Questionnaire scores with TA vs SOH (TA: 50.6; SOH: 57.3; difference, -6.67; 95% CI, -11.08 to -2.27; P = .003), and differences between TA and SA (TA: 50.6; SA: 55.0; difference, -4.41; 95% CI, -8.62 to -0.19; P = .04) yet did not reach statistical significance after adjustment for multiple comparisons. There was no significant difference between SA and SOH. Group differences in Functional Assessment of Cancer Therapy-General scores revealed statistically significant group differences at week 4, with higher scores with TA vs SOH (TA: 101.6; SOH: 97.7; difference, 3.91; 95% CI, 1.43-6.38; P = .002) and at week 12, with higher scores with TA vs SA (TA: 102.1; SA: 98.4; difference, 3.64; 95% CI, 1.10-6.18; P = .005) and TA vs SOH (TA: 102.1; SOH: 97.4; difference, 4.61; 95% CI, 1.99-7.23; P = .001). The findings of this trial suggest that TA was more effective in treating chronic radiation-induced xerostomia 1 or more years after the end of radiotherapy than SA or SOH. ClinicalTrials.gov Identifier: NCT02589938.

Effect of Incorporating 1 Avocado per Day Versus Habitual Diet on Vascular Function in Adults With Abdominal Obesity: An Ancillary Study of HAT, a Randomized Controlled Trial.

Abdominal obesity is associated with endothelial dysfunction and poorer vascular health. Avocado consumption improves postprandial endothelial function; however, the longer-term effects remain unclear. It was hypothesized that the daily addition of 1 avocado to a habitual diet for 6 months would improve flow-mediated dilation (FMD) and carotid-femoral pulse wave velocity in individuals with abdominal obesity (waist circumference ≥35 in for women, ≥40 in for men), compared with a habitual diet low in avocados. HAT (Habitual Diet and Avocado Trial) was a multicenter, randomized, controlled, parallel-arm study that investigated the health effects of adding 1 avocado per day to a habitual diet in individuals with abdominal obesity. At the Pennsylvania State University, University Park study center (n=134; age, 50 ± 13 years; women, 78%; body mass index, 32.6 ± 4.8 kg/m2), markers of vascular function were measured, including endothelial function, assessed via brachial artery flow-mediated dilation, and arterial stiffness, assessed via carotid-femoral pulse wave velocity. Between-group differences in 6-month change in flow-mediated dilation and carotid-femoral pulse wave velocity were assessed using independent t tests. Prespecified subgroup analyses were conducted using linear regression. No significant between-group differences in flow-mediated dilation (mean difference=-0.62% [95% CI, -1.70 to 0.46]) or carotid-femoral pulse wave velocity (0.25 m/s [95% CI, -0.13 to 0.63]) were observed. Results of the subgroup analyses were consistent with the primary analyses. Longer-term consumption of 1 avocado per day as part of a habitual diet did not improve measures of vascular function compared with a habitual diet low in avocados in individuals with abdominal obesity. URL: https://www.clinicaltrials.gov; Unique identifier: NCT03528031.

Long-Term Bone Mineral Density Changes in Kidney Transplant Recipients Treated with Denosumab: A Retrospective Study with Nonequivalent Control Group.

Data on the effectiveness of denosumab on osteoporosis after kidney transplantation are limited. We investigated the long-term bone mineral density (BMD) changes in kidney transplant recipients (KTRs) treated with denosumab compared to untreated KTRs. We enrolled KTRs treated with denosumab 60mg/6 months for 4years. An untreated group of sex and age-matched KTRs with a 1:1 ratio was included. The primary outcome was BMD changes assessed by Dual-energy X-ray Absorptiometry over 4 years. Data on serum creatinine, alkaline phosphatase (ALP), parathyroid hormone, and 25-hydroxyvitamin D were collected. All patients received oral cholecalciferol and calcium supplementation. 23 denosumab-treated KTRs were enrolled, and 23 untreated KTRs. The median time from transplant to the start of denosumab was 4years (range 0:24). The denosumab group showed a significant increase from baseline in BMD at the lumbar spine (LS) (9.0 ± 10.7%, p < 0.001), and total hip (TH) (3.8 ± 7.9%, p = 0.041). The untreated group showed a significant decrease at all sites (- 3.0 ± 7%, p = 0.041 at the LS; - 6.3 ± 9.2%, p = 0.003 at the TH; - 6.7 ± 9.3%, p = 0.003 at the FN). The between-group differences in percent BMD changes were statistically significant at all sites. Similar results were found for the respective Z-scores. The ALP serum levels significantly decreased from baseline only in the denosumab group, with a significant between-group difference (p = 0.032). No significant differences in serum creatinine, hypocalcaemic events or acute graft rejection rates were observed. Four years of denosumab therapy were associated with increased BMD in KTRs, while untreated KTRs showed significant BMD losses at all sites.

Effects of distal ulnar morphology on symptomatic extensor carpi ulnaris (ECU) subluxation and the clinical outcomes of anatomic ECU subsheath reconstruction: a retrospective observational study

Purpose: This study aimed to evaluate the association between distal ulnar morphology and symptomatic extensor carpi ulnaris (ECU) subluxation and assess the results of anatomic ECU subsheath reconstruction.Methods: To investigate the effects of distal ulnar morphology on symptomatic ECU subluxation, we compared distal ulnar morphology using magnetic resonance imaging among three groups: group 1 (symptomatic ECU subluxation, 12 cases), group 2 (non-symptomatic ECU subluxation, 24 cases), and group 3 (no ECU subluxation, 24 cases). Distal ulnar morphology was evaluated using ulnar variance, ulnar styloid length, and ECU groove depth. Clinical outcomes were evaluated using the Patient-Related Wrist Evaluation (PRWE) score, the Disabilities of the Arm, Shoulder, Hand (DASH) score, grip strength, and the range of motion of the wrist joint.Results: Ulnar variance showed a statistically significant difference between groups 1 and 2, and ECU groove depth showed statistically significant differences between groups 1 and 2 and between groups 2 and 3. Ulnar styloid length showed no statistically significant between-group differences. In patients with symptomatic ECU subluxation, there was a significant increase in the range of motion in supination and grip strength, and a significant decrease in the DASH score (from 40 to 9) and PRWE score (from 48 to 12). Conclusion: Negative ulnar variance was associated with symptomatic ECU subluxation, and shallow ECU groove depth was correlated to asymptomatic ECU subluxation, but unrelated to symptoms. Anatomic ECU tendon sheath reconstruction was identified as an effective surgical method.

Arriba por la Vida Estudio: a randomized controlled trial promoting standing behavior to reduce sitting time among postmenopausal Latinas.

Postmenopausal Hispanic/Latina (N = 254) women with a body mass index (BMI) ≥ 25kg/m2 were randomized to an intervention to reduce sitting time or a comparison condition for 12weeks. The standing intervention group received three in-person health-counseling sessions, one home visit, and up to eight motivational interviewing calls. The heart healthy lifestyle comparison group (C) received an equal number of contact hours to discuss healthy aging. The primary outcome was 12-week change in sitting time measured via thigh-worn activPAL. Group differences in outcomes were analyzed using linear mixed-effects models. Participants had a mean age of 65 (6.5) years, preferred Spanish language (89%), BMI of 32.4 (4.8) kg/m2, and sat for an average of 540 (86) minutes/day. Significant between-group differences were observed in reductions of sitting time across the 12-week period [Mdifference (SE): C - 7.5 (9.1), SI - 71.0 (9.8), p < 0.01]. Results demonstrate that coaching models to reduce sitting are feasible and effective.