Sedentary Behavior and Obesity in Youth According to Meeting Physical Activity Guidelines: National Health and Nutrition Examination Survey 2003-2006

Background: The purpose of this study was to examine the association between sedentary time and obesity in youth according to meeting physical activity guidelines. Methods: A total of 1991 youth (10-17 years) from the 2003 to 2006 National Health and Nutrition Examination Survey were included in the analysis. Physical activity was categorized into two levels: (1) daily engagement in ≥60 minutes of moderate and vigorous physical activity (MVPA) and (2) <60 minutes per day of MVPA. Sedentary time was categorized into four levels using quartiles. BMI was categorized into two levels using sex-specific BMI for age percentiles from the CDC: (1) obese group: BMI ≥90 percentile and (2) nonobese group: BMI <90 percentile. Results: After adjusting for covariates, among those meeting physical activity guidelines, there was a statistically significant relationship between sedentary time and obesity for Q1 (sedentary time <383.5 min/day) vs. Q4 (sedentary time >523.5 min/day) [odds ratio (OR) = 0.14, 95% confidence interval (CI): 0.02-0.87] and Q2 (sedentary time = 383.5-451.83 min/day) vs. Q4 (sedentary time >523.5 min/day) (OR = 0.16, 95% CI: 0.03-0.99). Among youth not meeting physical activity guidelines, however, sedentary time was not associated with obesity [OR = 0.72 (Q1 vs. Q4), OR = 0.88 (Q2 vs. Q4), OR = 1.08 (Q3 vs. Q4)]. Conclusions: These results indicate that sedentary time is associated with obesity among those meeting physical activity guidelines. However, the relationship between sedentary time and obesity in a low physical activity group is not obvious. Therefore, to confirm the role of low-level physical activity on the relationship between sedentary time and health outcomes, further investigation is required.

Toward Efficient Electrocatalytic Oxygen Evolution: Emerging Opportunities with Metallic Pyrochlore Oxides for Electrocatalysts and Conductive Supports

The design of active and stable electrocatalysts for oxygen evolution reaction is a key enabling step toward efficient utilization of renewable energy. Along with efforts to develop high-performance electrocatalysts for oxygen evolution reaction, pyrochlore oxides have emerged as highly active and stable materials that function as catalysts as well as conductive supports for hybrid catalysts. The compositional flexibility of pyrochlore oxide provides many opportunities to improve electrocatalytic performance by manipulating material structures and properties. In this Outlook, we first discuss the recent advances in developing metallic pyrochlore oxides as oxygen evolution catalysts, along with elucidation of their reaction mechanisms, and then introduce an emerging area of using pyrochlore oxides as conductive supports to design hybrid catalysts to further improve the OER activity. Finally, the remaining challenges and emerging opportunities for pyrochlore oxides as electrocatalysts and conductive supports are discussed.

Motivational signage increases stair usage on a Hispanic serving institution

Objective: Stair climbing is considered a good physical activity. Motivational signage has been successful in promoting stair usage in various settings. This study was to investigate the effects of motivational signage on stair usage in a Hispanic serving institution. Participants: A total of 31,067 pedestrians were observed from February to March 2013. Methods: Stair usage was monitored for 9 h per day each week at phase 1 (baseline), 2 (intervention), and 3 (post-intervention). Results: Overall, participants' stair usage was higher during phase 2 (49.0%) and phase 3 (48.0%), compared with phase 1 (39.7%). The participants during phase 2 and 3 were more likely to use the stairs compared to participants during phase 1, regardless of floor level (3-story or 4-story building), status (student or staff/faculty), and time of day (7:30-10:29, 10:30-13:29, or 13:30-16:30) (p < .001). Conclusion: Motivational signage can effectively encourage more stair usage, and hence promote healthy behavior in a predominantly Hispanic-serving institution.

Nanorectenna spectrally-selective plasmonic hot electron response to visible-light lasers

Active metasurfaces with novel visible and infrared (vis/IR) functionalities represent an exciting, growing area of research. Rectification of vis/IR frequencies would produce needed direct current (DC) with no inherent frequency limitation (e.g. no semiconducting bandgap). However, controlling the materials and functionality of (nano)rectennas for rectifying 100 s of THz to the visible regime is a daunting challenge, because of the small features and simultaneously the need to scale up to large sizes in a scalable platform. An active metasurface of a planar array of nanoscale antennas on top of rectifying vertical diodes is a 'nanorectenna array' or 'microrectenna array' that rectifies very high frequencies in the infrared, or even higher frequencies up to the visible regime. We employ a novel strategy for forming optical nanorectenna arrays using scalable patterning of Au nanowires, demonstrate strong evidence for spectral-selective high-frequency rectification, characteristic of optical antennas. We discover a previously unreported out-of-equilibrium electron energy distribution, i.e. hot electrons arising from plasmonic resonance absorption in an optical antenna characterized by an effective temperature, and how this effect can significantly impact the observed rectification.

Rasch calibration of the 25-item Connor-Davidson Resilience Scale

Rasch modeling was used to examine the 25-item Connor-Davidson Resilience Scale within adults (n = 410) in a weight management program. Rasch analysis assessed model-data fit, item difficulty and person's resilience level, an item-person map to evaluate relative distribution items and persons, and rating scale function. Four misfit items were identified and removed. Item difficulty ranged from 1.25 to 1.19 logits (higher logit values indicate more difficult items). Persons' resilience level had wide distribution (resilience = 2.27 ± 1.56 logits). Item difficulty levels did not adequately assess higher resilience levels. An improved inventory that measures a wider range of resilient behaviors would improve measurement quality.

Systematic Review of the Proposed Associations between Physical Exercise and Creative Thinking

The objective of this study was to evaluate the association between physical exercise and creative thinking. A systematic review approach was employed by searching PubMed, Google Scholar and PsychInfo databases. Among the evaluated 13 studies, 92% indicated a beneficial relationship. However, 77% were vulnerable to moderate-high risk for methodological bias, suggesting adherence to standardized and controlled research initiatives should be promoted. There appears to be weak to modest support for acute, moderate-intensity exercise to benefit creativity. Exercise timing relative to creativity assessment protocols should be addressed and further detailed. Creativity scoring procedures must be refined, and an increased focus on the motivational components of exercise may help guide researchers in measuring creative thoughts and behavior. Broader concluding claims that creativity, in general, is improved or impaired by exercise, is as problematic as sweeping statements that exercise improves or impairs a measure as dynamic as intelligence. Scientific inquiries must specify precisely which outcome characteristics are changing in line with research interventions. This review identifies several fallible linkages between physical activity and creativity. Too few studies were conducted on strong methodological foundations, perpetuating the risk for undermining or inaccurately inflating the potential association between exercise and creative thinking behavior.

[Survey on the quadrivalent influenza vaccine intention and related factors of health care workers in the Pearl River Delta region from 2015 to 2017]

Objective: To analyze the quadrivalent influenza vaccine intention of 718 health care workers (HCWs) in the Pearl River Delta region from 2015 to 2017. Method: In May 2018, 718 HCWs from the department related to the diagnosis and treatment of influenza in 17 hospitals (6 tertiary hospitals, 5 secondary hospitals and 6 primary hospitals) from Guangzhou, Jiangmen, Zhuhai and Dongguan were selected by using stratified sampling method. Questionnaire survey and face-to-face interview were used to collect the information of influenza vaccination, the intention of the quadrivalent influenza vaccine, the acceptance of free and required vaccination policies, and recommendations for increasing influenza vaccination intentions from 2015 to 2017. The multivariate logistic regression was used to analyze factors associated with the vaccination intention. Results: A total of 718 HCWs were surveyed and 147 of them were interviewed face to face. Among them, the vaccination rate of primary hospitals [17.39%(40/230)] was higher than that of other hospitals (χ(2)=15.80, P<0.05). If the vaccine could be free, 84.82% (609/718) of HCWs would like to be vaccinated. The multivariate logistic regression showed that the factors, HCWs who were aged ≥50 years (OR=3.44, 95%CI:1.43-8.28), worked in department of prevention and health care (OR=2.35, 95%CI:1.16-4.75), learned about the quadrivalent influenza vaccine (OR=2.94, 95%CI:2.08-4.18), knowed that HCWs are priority (OR=2.33, 95%CI:1.56-3.48), and had a history of trivalent influenza vaccination from 2015 to 2017 (OR=4.70, 95%CI:3.08-7.15), were associated with the vaccination intention. Conclusion: HCWs in the Pearl River Delta region had weak inclination of getting quadrivalent influenza vaccine. HCWs who were age (≥50 years old), worked in department of prevention and health care, learned about the quadrivalent influenza vaccine, knowed that HCWs are priority, and had a history of trivalent influenza vaccination from 2015 to 2017 were factors positively associated with the vaccination intention.

Effects of Accumulated Short Bouts of Exercise on Weight and Obesity Indices in Adults: A Meta-Analysis

OBJECTIVE

To compile and quantify the effectiveness of accumulated short-bout exercise interventions on reducing the obesity indices in adults using meta-analysis.

DATA SOURCE

PubMed, PsycINFO, CINAHL, Cochrane Library, and SportDiscus.

STUDY INCLUSION AND EXCLUSION CRITERIA

(1) Description of a short-bout exercise trial (<30 minutes); (2) obesity indices must be measured pre- and postintervention; and (3) only adults and published in English.

DATA EXTRACTION

Two independent reviewers extracted data and assessed the quality of the studies included. Of 3257 articles retrieved, 18 studies met the inclusion criteria. Based on the Downs and Black checklist, the methodological quality of the included studies was fairly robust.

DATA SYNTHESIS

Pooled effect sizes (ESs) were calculated using a random effects model.

RESULTS

Average intervention length was approximately 16 weeks (ranged from 4 to 72 weeks). All weighted mean ES values for each obesity index measure were non-negative, ranging from small to large (ES = 0.33-0.96) in magnitude. Weighted mean ES for body mass (BM; n = 18; ES = 0.51, 95% confidence interval [CI] = 0.22-0.80), body mass index (BMI; n = 13; ES = 0.61, 95% CI = 0.24-0.97), waist circumference (n = 9; ES = 0.44, 95% CI = 0.15-0.73), body fat percentage (BF%; n = 8; ES = 0.33, 95% CI = 0.09-0.58), skinfold (n = 7; ES = 0.96, 95% CI = 0.39 -1.53), and fat mass (FM; n = 6; ES = 0.55, 95% CI = 0.21-0.90) were statistically significant. Moderator effects of intervention length (weeks) were observed for BM (Q_between [Cochran's Q: a measure of heterogeneity between studies] = 6.83, P < .05); BMI (Q_between = 13.93, P < .05); and FM (Q_between = 10.41, P < .05). Intervention length >10 weeks was more effective than shorter (≤10) intervention period for reducing BM, BMI, and FM.

CONCLUSION

Accumulated short bouts of exercise have a beneficial effect on reducing the obesity indices among adults. The current study can help health researchers and practitioners in designing their intervention programs, which can be applied within schools, clinics, and communities.

Secular trends in the association between obesity and hypertension among adults in the United States, 1999-2014

OBJECTIVE

To examine the secular trends in the association between obesity and hypertension among American adults between 1999 and 2014.

METHODS

Data from the 1999-2014 National Health and Nutrition Examination Survey (eight survey cycles) were used. Obesity was determined from measured body mass index, with hypertension assessed from measured blood pressure and self-reported medication use. Meta-regression was used to examine the linear, quadratic, and cubic trends of the relationship between the observed odds ratio effect sizes (obesity and hypertension) and the NHANES cycles (year) using a random-effects model.

RESULTS

Across the years of 1999 to 2014, there was a significant, positive linear trend (p = .006) in the association between overweight/obesity and hypertension.

CONCLUSION

Our findings suggest that the association between overweight/obesity and hypertension is becoming stronger over time. Continued surveillance of temporal changes associated with obesity and hypertension is necessary to monitor how such changes may underlie changes in the risk for chronic disease.

SIGNIFICANCE OF THE STUDY

This novel study evaluates whether the magnitude of association between obesity and hypertension has changed over the last 15-years.

Sedentary behavior and metabolic syndrome in physically active adults: National Health and Nutrition Examination Survey 2003-2006

OBJECTIVES

The detrimental associations of sedentary behavior (SB) with metabolic syndrome have been shown to be independent of moderate-to-vigorous intensity physical activity (MVPA). Therefore, researchers, in addition to promoting MVPA, are calling attention to the need to reduce SB. However, there has been limited research on the association of SB with metabolic syndrome among those who already meet the PA guidelines. Therefore, the purpose of this study was to examine the relationship between objectively measured SB and metabolic syndrome among those who meet the PA guideline.

METHODS

A total of 1613 adults (>17 years) who met the PA guideline of 150 minutes/week of MVPA from the 2003 to 2006 National Health and Nutrition Examination Survey (NHANES) were included in the analysis. For analytical purposes, four sub-groups of SB were created based on quartiles of SB minutes. Metabolic syndrome was defined according to the ATP III guidelines.

RESULTS

When controlling for covariates, participants in the fourth quartile of SB time (≥539 minutes/day) were more likely to report metabolic syndrome (OR = 3.16; 95% CI: 1.47, 6.80) compared to those in the first quartile of SB time (≤380 minutes/day). Also, participants in the third quartile of SB time (454-539 minutes/day) were more likely to report metabolic syndrome (OR = 2.11; 95% CI: 1.25, 3.56) compared to those in the first quartile of SB time.

CONCLUSION

This finding suggests that, even in those who meet the PA guidelines, detrimental associations with metabolic syndrome are observed with increasing SB time.

[Analysis on epidemiological characteristics of enterovirus 71 cases of hand-foot-mouth disease based on the active monitoring in Guangdong Province in 2011-2015]

Objective: To analyze the hand-foot-mouth disease (HFMD) enterovirus 71 (EV-A71) infection epidemic characteristics of Guangdong Province from 2011 to 2015. Methods: We colleted data on common cases of hand-foot-mouth disease infected with EV-A71 reported from eight sentinel hospitals in Guangdong Province from January 2011 to December 2015, through the "Guangdong Province Acute Infectious Disease Surveillance Information Platform System" , including the age and incidence of cases. Time and etiological data, etc.We also collected data on the number of reported cases of HFMD disease and the number of laboratory-confirmed cases, through the "China Disease Prevention and Control Information System" , including data on common cases of HFMD disease, data on epidemics of severe cases and deaths, and the age, onset time, and pathogens of cases. Learning data, etc.The data from two sources were used to estimate the incidence of HFMD in EV-A71 and describe its distribution characteristics.Chi-square test was used to compare the positive rate of HF-A71 infection in hand-foot-mouth disease and the difference in estimated incidence among different age groups and months. Results: Eight sentinel hospitals from 2011 to 2015 reported a total of 1 855 common cases of EV-A71 infection, of which the highest was in 2014 (31.6%, 605/1 916) and the lowest was in 2015 (6.8%, 134/1 971) (χ(2)=521.85, P<0.001).According to the Disease Surveillance Reporting Information System, 1 772 516 cases of HFMD disease were reported from 2011 to 2015 in Guangdong Province, and 1 902 cases of severe and fatal cases of EV-A71 infection.The composition ratio of EV-A71 infected was 72.6% (1 775/2 444) and 97.0% (127/131) of severe HFMD disease in Guangdong province during 2011-2015.The average annual incidence of HF-A71 infection in all age groups showed a decreasing trend with age (χ(2trend)=990 273.20, P<0.001), and it was the highest in the 1-year-old group, which was 1 697.67/100 000, and the lowest in the 4-year-old group, which was 705.46/100 000. The difference of monthly average incidence of EV-A71 infection in HF-A71 in each month was statistically significant (χ(2)=401.23, P<0.001), the highest in May at 15.51 per 100 000, and the lowest in July at 9.42 per 100 000. Conclusion: EV-A71 infection rate of ordinary HFMD varies in different years. The most severe and death cases of HFMD were EV-A71 infected. 1 year old children were the high-risk group of infected with EV-A71 HFMD. April was the epidemic months of EV-A71 HFMD infection.

[Technical guidelines for seasonal influenza vaccination in China, 2018-2019]

Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and its complications. Currently, China has licensed trivalent (IIV3) and quadrivalent inactivated influenza vaccine (IIV4), including split-virus influenza vaccine and subunit vaccine. In most parts of China, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients need to pay for it. To strengthen the technical guidance for prevention and control of influenza and the operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC), Influenza Vaccine Technical Working Group (TWG), updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)" , based on most recent existing scientific evidences. The main updates include: epidemiology and disease burden of influenza, types of influenza vaccines, northern hemisphere influenza vaccination composition for the 2018-2019 season, and, IIV3 and IIV4 vaccines'major immune responses, durability of immunity, immunogenicity, vaccine efficacy, effectiveness, safety, cost-effectiveness and cost-benefit. The recommendations include: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for any influenza vaccine product for persons who can accept ≥1 licensed, recommended, and appropriate products. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-60 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to pregnant during the influenza season. Children aged 6 months to 8 years old require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in previous influenza season, 1 dose is recommended. People ≥ 9 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. Influenza vaccination should continue to be available for those unable to be vaccinated before the end of October during the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for CDC members who are working on influenza control and prevention, PoVs members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and members of maternity and child care institutions at all levels.

[Technical guidelines for seasonal influenza vaccination in China (2018-2019)]

Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) and quadrivalent inactivated influenza vaccine (IIV4), including split-virus influenza vaccine and subunit vaccine. Except for a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients must pay for it. To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccine Technical Working Group (TWG), updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)" . The main updates in this version include: epidemiology, disease burden, types of influenza vaccines, northern hemisphere influenza vaccination composition for the 2018-2019 season, IIV3 and IIV4 immune response, durability of immunity, immunogenicity, vaccine efficacy, effectiveness, safety, cost-effectiveness and cost-benefit. The influenza vaccine TWG provided the recommendations for influenza vaccination for the 2018-2019 influenza season based on existing scientific evidence. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2017-2018 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels.

Experimental effects of exercise on memory function among mild cognitive impairment: systematic review and meta-analysis

OBJECTIVE

The objective of this study was to evaluate the experimental effects of exercise on memory function among adults with mild cognitive impairment (MCI).

METHODS

A systematic review and meta-analysis were employed. Studies were identified using electronic databases, including PubMed, PsychInfo, SPORTDiscus, and Google Scholar. To be eligible for inclusion, studies had to employ an experimental design, be conducted in humans (no animal models) with mild cognitive impairment, include an exercise intervention arm (either acute exercise or chronic training), and measure memory function (any type) as the outcome measure. Comprehensive Meta-Analysis software was used to compute the standardized mean difference effect size (Cohen's d) and 95% CI using a random-effects model.

RESULTS

In total, 11 studies met our criteria, contributing to 20 effect size estimates. Among the 20 effect size estimates, 13 contributed to a short-term memory recall, with 7 contributing to a delayed/long-term memory recall. The overall weighted mean effect size was d = 0.30 (95% CI: 0.16-0.44; P < 0.001), indicating a small to medium effect of exercise on improving memory function. For the moderation analysis, there was no evidence of a moderation effect for recall duration (Q = 0.004, df(1), P = 0.95), as exercise (vs. control) demonstrated both short-term (d = 0.31; 95% CI: 0.14-0.47; P < 0.001) and long-term memory (d = 0.29; 95% CI: 0.06-0.53; P = 0.013) benefits.

CONCLUSION

Current evidence suggests that exercise may help to improve memory function among those with MCI. Safe and progressive forms of exercise should be promoted among MCI patients.

[Epidemiological characteristics of influenza in Guangdong province, during winter of 2017-2018]

Objective: To understand the epidemiological characteristics of influenza in Guangdong province, during the winter of 2017-2018, to provide evidence for response to the diversity of influenza, in different seasonal patterns. Methods: Data on weekly influenza surveillance from January 2016 to April 2018, were collected in Guangdong. Information on patients with Influenza-like illness (ILI), on influenza virus positive rates and on outbreaks during the winter of 2017 to 2018, was analyzed and compared with those in spring of 2016 and summer of 2017. χ(2) test and Fisher exact test were used. Results: In the above said winter, the average percentage of visits for ILI in 28 hospitals where sentinel surveillance program had been set, was 4.99% (157 235/3 149 656), which was above the level of the same period in the previous five years. The positive rates of influenza virus among samples collected from ILI outpatients and hospitalized cases under severe acute respiratory infection (SARI) were 28.33% (2 137/7 543) and 14.93% (256/1 715), with the proportions of B (Yamagata) as 70.43% (1 505/2 137) and 73.05% (187/256) respectively. A total of 257 influenza outbreaks were reported in the winter period, with 82.49% (212/257) occurred in elementary schools. Cases aged 6-14 years occurred in winter and spring appeared of having higher positive rate than those seen in summer (P<0.05) whereas elderly cases aged 60 and above showed higher positive rate in summer than those in winter and spring two seasons (P<0.05). Conclusions: Epidemiological characteristics of influenza appeared in Guangdong province, during the winter from 2017 to 2018, were correlated to Influenza B (Yamagata). Capacity on the implementation of surveillance programs and on the coverage of vaccination should be improved and increased in order to control influenza in different epidemic seasons, in Guangzhou.