Associations of Self-Control with Physical Activity, Physical Fitness, and Adiposity in Adolescents

The associations between self-control and objective measures of physical activity, physical fitness, and adiposity are yet to be explored in young people; this is a gap in the literature that the present study aimed to address. The study employed a cross-sectional design. A total of 101 young people participated in the study. Participants completed the Brief Self-Control Scale as a measure of trait self-control. Free-living physical activity was assessed using an ActiGraph GT3X + triaxial accelerometer, which was worn for 7 days. Participants also completed the 15-meter version of the multistage fitness test as a measure of physical fitness. For the assessment of adiposity, three criterion measures were used: body mass index (BMI), sum of skinfolds, and waist circumference. Data were analyzed using the glm function in the open access software R. Higher levels of trait self-control were associated with higher levels of physical fitness (measured by distance run on the multistage fitness test) and lower adiposity (BMI, waist circumference, and sum of skinfolds) in adolescents. There was a tendency for a positive association between self-control and time spent in vigorous physical activity, although this did not reach statistical significance. In a combined model, self-control was also associated with both physical fitness and waist circumference, with these effects independent of each other. These findings suggest that self-control is associated with healthy behaviors and characteristics in adolescents and is thus potentially an attractive target for future interventions aimed at increasing physical activity and physical fitness and reducing adiposity in this population.

Durvalumab Treatment Patterns for Patients with Unresectable Stage III Non-Small Cell Lung Cancer in the Veterans Health Administration (VHA): A Nationwide, Real-World Study

BACKGROUND

Durvalumab is approved for the treatment of adults with unresectable stage III non-small cell lung cancer (NSCLC) post-chemoradiotherapy (CRT). This real-world study describes patient characteristics and durvalumab treatment patterns (number of doses and therapy duration; treatment initiation delays, interruptions, discontinuations, and associated reasons) among VHA-treated patients.

METHODS

This was a retrospective cohort study of adults with unresectable stage III NSCLC receiving durvalumab at the VHA between 1 January 2017 and 30 June 2020. Patient characteristics and treatment patterns were presented descriptively.

RESULTS

A total of 935 patients were included (median age: 69 years; 95% males; 21% Blacks; 46% current smokers; 16% ECOG performance scores ≥ 2; 50% squamous histology). Durvalumab initiation was delayed in 39% of patients (n = 367). Among the 200 patients with recorded reasons, delays were mainly due to physician preference (20%) and CRT toxicity (11%). Overall, patients received a median (interquartile range) of 16 (7-24) doses of durvalumab over 9.0 (2.9-11.8) months. Treatment interruptions were experienced by 19% of patients (n = 180), with toxicity (7.8%) and social reasons (2.6%) being the most cited reasons. Early discontinuation occurred in 59% of patients (n = 551), largely due to disease progression (24.2%) and toxicity (18.2%).

CONCLUSIONS

These real-world analyses corroborate PACIFIC study results in terms of the main reasons for treatment discontinuation in a VHA population with worse prognostic factors, including older age, predominantly male sex, and poorer performance score. One of the main reasons for durvalumab initiation delays, treatment interruptions, or discontinuations was due to toxicities. Patients could benefit from improved strategies to prevent, identify, and manage CRT and durvalumab toxicities timely and effectively.

Effects of a games-based physical education lesson on cognitive function in adolescents

Despite the importance of physical education (PE) lessons for physical activity in adolescents, the acute cognitive responses to PE lessons have not been explored; a gap in the literature that this study addresses. Following familiarisation, 76 (39 female) adolescents (12.2 ± 0.4 y) completed two trials (60 min games-based PE lesson and 60 min academic lesson) separated by 7-d in a counterbalanced, crossover design. Attention, executive function, working memory, and perception were assessed 30 min before, immediately post, and 45 min post-lesson in both trials. Participants were split into high-and low-fit groups based on a gender-specific median split of distance run on the multi-stage fitness test. Furthermore, participants were split into high and low MVPA groups based on a gender-specific median split of MVPA time (time spent >64% HR max) during the PE lesson. Overall, a 60 min games-based PE lesson had no effect on perception, working memory, attention, or executive function in adolescents (all p > 0.05) unless MVPA time is high. The physical activity-cognition relationship was moderated by MVPA, as working memory improved post-PE lesson in adolescents who completed more MVPA during their PE lesson (time*trial*MVPA interaction, p < 0.05, partial η2 = 0.119). Furthermore, high-fit adolescents displayed superior cognitive function than their low-fit counterparts, across all domains of cognitive function (main effect of fitness, all p < 0.05, partial η2 0.014–0.121). This study provides novel evidence that MVPA time moderates the cognitive response to a games-based PE lesson; and emphasises that higher levels of fitness are beneficial for cognitive function in adolescents.

Agreement and equivalence of estimated physical activity behaviours, using ENMO- and counts-based processing methods, for wrist-worn accelerometers in adolescents

The present study examined the agreement and equivalence between two physical activity processing methods. Data were obtained from 161 Hong-Kong adolescents (74 girls, age: 12.6 ± 1.7y). Participants wore an Actigraph GT3XBT on their non-dominant wrist for 7d. Time spent sedentary, and in light-(LPA), moderate-(MPA), vigorous-(VPA), and moderate-to-vigorous physical activity (MVPA) were calculated using different processing methods (proprietary counts and Euclidean Norm Minus One (ENMO)). Intraclass correlation coefficients (ICC) were used to examine absolute agreement (ICC2) and consistency (ICC3), and equivalence was assessed using pairwise equivalence tests. Using ENMO, sedentary time and VPA were higher, whereas all other behaviours were lower (compared to counts processing). Agreement ranged from poor (ICC2:0.42(Sedentary)) to moderate (ICC2:0.86(LPA)) and consistency ranged from moderate (ICC3:0.71(sedentary)) to good (ICC3:0.91(LPA)). Methods were not considered equivalent (all p > 0.05). Due to differences in the wear-time validation of processing methods, a sensitivity analyses (sub-sample with the same valid wear time for both methods (n = 56)), resulted in minimal change. Lack of agreement and equivalence between ENMO and counts processing methods suggests that the processing method significantly affects youth physical activity estimates.

Effect of adiposity and physical fitness on cardiometabolic risk factors in adolescents: A 2-year longitudinal study

Although risk factors for cardiometabolic diseases begin to present in young people, the association between physical fitness and adiposity with traditional and novel risk factors for cardiometabolic diseases across adolescence remains relatively unknown. Following ethical approval, fifty-two adolescents (age 11.6 ± 0.6 years; 32 girls) were recruited for a 2-years longitudinal study. Adiposity was assessed based on sum of skinfolds, waist circumference and body mass index, and physical fitness as distance run on the multi-stage fitness test (MSFT). Risk factors for cardiometabolic diseases (pro- and anti-inflammatory cytokines, plasma insulin, Homeostatic Model Assessment of Insulin Resistance - HOMA-IR, blood pressure) were measured following an overnight fast. Relationships between independent and response variables were analysed using multi-level modelling (final combined models were created using the stepwise backward elimination method). Plasma insulin concentration and HOMA-IR were positively associated with adiposity and inversely associated with distance run on the MSFT (all p < 0.05). The final combined models for plasma insulin concentration and HOMA-IR contained main effects for age, skinfolds and distance run on the MSFT. Levels of the anti-inflammatory cytokine IL-10 were inversely related to the sum of skinfolds (p = 0.046), whereas there was a trend for levels of the pro-inflammatory cytokine TNF-α to be positively related to the sum of skinfolds (p = 0.056). Adiposity and physical fitness are important, independent, determinants of metabolic health in adolescents. Furthermore, adiposity influences levels of pro- and anti-inflammatory cytokines in adolescence, with greater adiposity associated with a poorer inflammatory profile. The present study demonstrates an independent effect of physical fitness on metabolic health longitudinally across adolescence. It is therefore recommended that future work develops therapeutic interventions that reduce adiposity and enhance physical fitness in adolescents, to promote lifelong health.

Effect of 5-weeks participation in The Daily Mile on cognitive function, physical fitness, and body composition in children

The aim of the present study was to determine the effect of 5-weeks participation in The Daily Mile on cognitive function, physical fitness, and adiposity in primary school children. In a quasi-experimental study, one class from each school completed The Daily Mile (n = 44) or acted as a control group (n = 35). Baseline measures included cognitive function tests (Stroop test, Sternberg paradigm, Flanker task), physical fitness (multi-stage fitness test) and body composition (BMI percentile, waist:hip circumference, sum of skinfolds). The intervention group completed 5-weeks of The Daily Mile. Follow-up measurements were completed within 48-h of the last training session. Data were analysed via ANCOVA, examining between group differences at follow-up, controlling for baseline values. Response times on the complex Stroop test were faster at follow-up in the intervention group (Intervention: 1357 ms [1280–1400 ms]; Control: 1463 ms, [1410–1523 ms], d = 0.31, p = 0.048). There was no effect of The Daily Mile on the Sternberg paradigm or Flanker test. Physical fitness was greater at follow-up in the intervention group (Intervention: 880 m, [820–940 m]; Control: 740 m, [680–800 m], d = 0.39, p = 0.002). There was no effect of the intervention on adiposity. In conclusion, five-weeks of The Daily Mile enhanced inhibitory control and physical fitness in children, but did not affect working memory, attention, or adiposity.

Effect of two-weeks of school-based sprint training on physical fitness, risk factors for cardiometabolic diseases and cognitive function in adolescent girls: A randomized controlled pilot trial

Background

School-based physical activity interventions are accessible to most adolescents and could enhance adolescent cardiometabolic health and cognition; yet the feasibility and success of school-based physical activity interventions is understudied.

Methods

Sixteen adolescent girls (age: 11.7 ± 0.3 y; height: 1.58 ± 0.07 m; body mass: 45.5 ± 9.2 kg) were randomized to either an intervention (2-weeks sprint training; n = 8) or control group (continuation of regular physical activity levels; n = 8). Following familiarization, all participants completed baseline measurements including fasted and postprandial capillary blood samples, a battery of cognitive function tests (Stroop Test, Sternberg Paradigm and Flanker Task), and an assessment of physical fitness (20 m sprint and multi-stage fitness test). The intervention group completed 2-weeks progressive sprint training (3 sessions per week: week one 6 × 10 s sprints, week two 8 × 10 s sprints). Follow-up measurements were completed 48 h after the final sprint training session. Data were analyzed via ANCOVA to examine between group differences at follow-up whilst controlling for baseline score.

Results

Accuracy in the intervention group during the three-item Sternberg paradigm was greater when compared with the control group (Intervention: 99.6 ± 1.1%; Control: 97.7 ± 2.2%, p = 0.046). BDNF concentration was also higher in the intervention group at follow-up than control group (Intervention: 39.12 ± 9.88 ng.ml⁻¹; Control: 22.95 ± 9.13 ng.ml⁻¹, p < 0.001). There were no differences at follow-up between the intervention and control group for measures of cardiometabolic health (fasted cytokine concentrations or postprandial glycaemic and insulinaemic responses) or on the Stroop Test or Flanker Task (all p > 0.05). However, the intervention group reported enjoying the sprint training and that they found the sessions valuable.

Conclusion

Two-weeks sprint interval training in a school-setting enhanced working memory and increased concentrations of BDNF in adolescent girls. The intervention was deemed enjoyable and worthwhile by the adolescent girls and thus the longer-term implementation of such an intervention should be examined.

Impact of equal access by race and ethnicity on patients in the Veterans Health Administration (VHA) treated for diffuse large B-cell lymphoma (DLBCL)

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Background: Racial and ethnic disparities in access to care and outcomes are well-established and are critical issues across several malignancies, including DLBCL. Previous studies from national registry datasets have shown racial disparities in DLBCL disease characteristics, treatment and outcomes. The VHA is an equal access system providing a unique environment to investigate cancer disparities across the disease continuum. Methods: This is a retrospective chart review of 4033 randomly selected patients with an ICD code for lymphoma treated within the VHA between 01/01/2011 and 12/31/2017. Data abstractors collected baseline patient and disease characteristics and treatment responses for those with an initial diagnosis of DLBCL in that time frame. Survival time was determined via electronic health record query on 11/30/2021. Chi-square tests were used to analyze relationship between race and variables of interest. Cox proportional hazards model was used to estimate hazard ratios (HR) for race and controlling factors. Results: 2141 DLBCL patients met our inclusion criteria. 97% were male. Majority were Non-Hispanic Whites (NHW 75%) followed by Non-Hispanic Blacks (NHB 12.5%), Hispanics (H 5.7%) and others (O 6.8%). NHB were diagnosed at younger median age (63 years) when compared to the NHW, H and O (68 years). There was no statistically significant difference in stage at diagnosis, IPI score, cell of origin (COO) and hit status amongst racial subgroups. Outcomes analysis (Table) revealed similar treatment and response rates, median OS, 1- and 2- year survival across all racial subgroups. However, after adjusting for age, IPI, COO, and exposure to agent orange, and including up to 10-years of survival data, H had 36% lower risk of death (HR=0.64, 95% CI 0.44-0.93) than NHW, while NHB and O had similar outcomes to NHW. Conclusions: This large retrospective study is a continuation of our group’s work (Williams et al, 2020) that doubles the cohort size and confirms that when standard of care therapy is given with equal access to care, short-term treatment and survival outcomes are same for all races. Further studies are needed to analyze risk factors associated with differences in long term outcomes.[Table: see text]

Treatment interruptions and discontinuations among patients with stage III unresectable non–small cell lung cancer treated with durvalumab at the Veterans Health Administration

8554

Background: The PD-1/PD-L1 pathway is a mechanism of immune evasion and disruption of this pathway with immune checkpoint inhibitors (ICIs) has shown clinical benefit in multiple malignancies. Based on results from the PACIFIC trial, durvalumab is approved as consolidation therapy in patients (pts) with stage III unresectable non-small cell lung cancer (UR-NSCLC) without progression following concurrent chemoradiotherapy (cCRT). Durvalumab has been used extensively in Veterans Health Administration (VHA) facilities, providing an opportunity to evaluate durvalumab treatment interruptions (TI), treatment discontinuations (TD), and the reasons for these on a national scale. Methods: Patients with stage III UR-NSCLC receiving durvalumab consolidation immunotherapy at the VHA between January 1, 2017 and June 30, 2020 with a minimum follow up for 12 months were included using ICD-10, HCPCS, and J codes and followed from their durvalumab start date through the earliest of last VHA visit, loss to follow up, death, or end of study (excluded if durvalumab therapy was ongoing at the end of the study, because the full treatment course could not be determined). TI were defined as durvalumab infusions separated by >28 days. Reasons for TI and TD are presented descriptively. Durations are reported using medians and interquartile ranges (IQR). Results: 935 pts were included (median age = 69 years; 95% males; 96% current or former smokers; 70% with COPD; histologies [squamous (50%), non-squamous (43%), other/missing (7%)]; and 77% with carboplatin-paclitaxel as their platinum-based CRT). Durvalumab TI were experienced by 19% of pts (median [IQR] number of TI = 1 [1-1], median [IQR] TI duration = 53 days [39-90]). The main reasons for TI were toxicity (8%) and social reasons (3%) (Table). The median duration of treatment (DoT) with durvalumab (TI included) was 9.0 months (IQR 2.9-11.8). Durvalumab TD occurred in 59% of pts. Top reasons for discontinuation across all 935 pts included disease progression (24%) and toxicity (18%) (Table). Conclusions: In this real world analysis of national VHA data, durvalumab DoT was similar to PACIFIC despite having a patient population with worse prognostic factors (e.g. more males, squamous, COPD) with 8% of VHA pts experiencing TI and 18% TD due to toxicity. Patients could benefit from additional efforts to prevent, identify, and manage toxicities in the UR-NSCLC population [Table: see text]

Durvalumab treatment initiation delays in patients with unresectable stage III non–small cell lung cancer treated at Veterans Health Administration facilities

8556

Background: Durvalumab is an FDA-approved immunotherapy for the treatment of adults with UnResectable stage III non-small cell lung cancer (UR-NSCLC) without disease progression following concurrent chemoradiotherapy (CRT). There are limited real-world data regarding Durvalumab treatment initiation delays (TIDs) and reasons for them in the UR-NSCLC population. Methods: Patients with stage III UR-NSCLC receiving consolidation Durvalumab at the Veterans Health Administration (VHA) between January 1, 2017 and June 30, 2020 were selected from the VHA database using ICD-10, HCPCS, and J codes. All had the opportunity to be treated for 12 months and were followed from Durvalumab initiation through the earliest of their last VHA visit, loss to follow up, death, or the study’s end (and excluded if Durvalumab therapy was ongoing at the study’s end). Trained data abstractors determined the occurrence and reasons for TIDs (> 6 weeks from end of CRT to initiation of Durvalumab as in the PACIFIC trial) by chart review. Results: 935 patients were eligible for analysis (median age = 69 years; 95% males; 16% with ECOG performance status >1). TIDs occurred in 39% of the patients (Table). Durvalumab was initiated 61 days (median) from the end of CRT in TID patients vs. 31 days for those without TIDs. There were no significant (α<0.05) differences in age, race, smoking status, histology, or ECOG performance status and no comorbidity differences (except in patients with a history of cerebrovascular accident, for whom TIDs were more likely) between the TID/No-TID patients. Patients without timely post-CRT scans were more likely to have a TID. Of the 367 patients who experienced TIDs, 200 had documented reasons for the delay, consisting of other (not categorized) (28.5%), physician preference (20%), toxicity (11%), patient preference (10.5%), decline in performance status (10%), system issues (9.5%), social reasons (9%), and progression (0.5%). Conclusions: This is one of the largest retrospective cohort studies reporting real-world data in patients with UR-NSCLC receiving Durvalumab. TIDs were associated with increased time to post-CRT scans. This potential issue can be improved with care coordination and involvement of cancer navigators. Additional studies are needed to assess the impact of TIDs on survival outcomes.[Table: see text]

Physical fitness, physical activity and adiposity: associations with risk factors for cardiometabolic disease and cognitive function across adolescence

BACKGROUND

The cross-sectional associations between physical activity, physical fitness and adiposity with risk factors for cardiometabolic disease (particularly novel ones such as inflammatory cytokines) and cognitive function across the period of adolescence are not well understood. Additionally, novel physical activity metrics that summarise activity volume and intensity in a continuous manner have not been investigated in this context. Therefore, this study investigated the cross-sectional associations between physical activity, physical fitness and adiposity with risk factors for cardiometabolic disease and cognitive function. These associations were compared between younger and older adolescents.

METHODS

Seventy younger (11-12y, 35 girls) and 43 older (14-15y, 27 girls) adolescents volunteered to take part in the study. Physical fitness (multi-stage fitness test, MSFT) and adiposity (waist circumference) were determined, followed 7d later by resting blood pressure, a fasted blood sample (glucose, plasma insulin, IL6, IL10, IL15 and IL-1β concentrations) and a cognitive function test battery. Habitual physical activity was monitored via hip-worn accelerometers over this 7-d period and the average acceleration (activity volume), and intensity gradient (intensity distribution of activity) were determined.

RESULTS

Average acceleration and intensity gradient were negatively associated with mean arterial blood pressure (β = -0.75 mmHg, p = 0.021; β = -10 mmHg, p = 0.006, respectively), and waist circumference was positively associated with IL-6 concentration (β = 0.03%, p = 0.026), with stronger associations observed in older adolescents. Higher physical fitness (MSFT distance) was positively associated with anti-inflammatory IL-15 concentration (β = 0.03%, p = 0.038) and faster response times on the incongruent Stroop task (β = -1.43 ms, p = 0.025), the one-item level of the Sternberg paradigm (β = -0.66 ms, p = 0.026) and the simple (β = 0.43 ms, p = 0.032) and complex (β = -2.43 ms, p = 0.020) levels of the visual search test, but these were not moderated by age group.

CONCLUSIONS

The present study highlights the important role of physical activity (both the volume and intensity distribution) and physical fitness for cardio-metabolic health. Furthermore, the present study highlights the importance of physical fitness for a variety of cognitive function domains in adolescents, irrespective of age.

Comparing ultrastable lasers at 7 × 10-17 fractional frequency instability through a 2220 km optical fibre network

Ultrastable lasers are essential tools in optical frequency metrology enabling unprecedented measurement precision that impacts on fields such as atomic timekeeping, tests of fundamental physics, and geodesy. To characterise an ultrastable laser it needs to be compared with a laser of similar performance, but a suitable system may not be available locally. Here, we report a comparison of two geographically separated lasers, over the longest ever reported metrological optical fibre link network, measuring 2220 km in length, at a state-of-the-art fractional-frequency instability of 7 × 10-17 for averaging times between 30 s and 200 s. The measurements also allow the short-term instability of the complete optical fibre link network to be directly observed without using a loop-back fibre. Based on the characterisation of the noise in the lasers and optical fibre link network over different timescales, we investigate the potential for disseminating ultrastable light to improve the performance of remote optical clocks.

Clinicopathologic differences and mortality among Latinos and non-Latino whites with gastric cancer at a majority-minority cancer center in South Texas

BACKGROUND

Latino patients have a higher incidence of gastric cancer compared to non-Latino white patients nationwide, with greater disparities in South Texas. However, the impact of Latino ethnicity on mortality in gastric cancer is controversial. We evaluated clinicopathological characteristics and survival outcomes in Latino vs. non-Latino white patients at our National Cancer Institute (NCI)-designated cancer center and its affiliated hospital.

METHODS

We conducted a retrospective chart review of Latino and non-Latino white patients diagnosed with gastric cancer who were seen at Mays Cancer Center at the University of Texas Health in San Antonio, Texas, from 2000-2018. Median overall survival (mOS) was estimated from Kaplan-Meier curves and groups were compared with the log-rank test.

RESULTS

A total of 193 patients met inclusion criteria and 65% (n=126) were Latino. Median age for all patients was 61 years. Female patients represented almost 50% of Latinos vs. 36% of non-Latino whites. There were no differences in Eastern Cooperative Oncology Group (ECOG) performance status, primary tumor location, stage, Helicobacter pylori status, HER2 status, or histologic subtype at diagnosis. Median overall survival was 14 months (95% CI: 13-36) for Latinos vs. 33 months (95% CI: 14 to n/a) for non-Latino whites (P=0.36).

CONCLUSIONS

Compared to non-Latino white patients, Latino patients with gastric cancer at a majority-minority cancer center in South Texas did not have significant differences in baseline clinicopathologic features or survival outcomes. Further prospective studies are needed to evaluate epidemiologic, pathogenetic, and molecular differences in gastric cancer in order to identify variables associated with treatment efficacy and survival.

Double disparities in patients with gastric cancer: Clinicopathology and survival of older adults in a Hispanic-rich population

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Background: Gastric cancer incidence increases with advancing age with a median age at diagnosis of 68. However, older adults (age ≥65) are underrepresented in clinical trials. Additionally, Hispanic populations have a higher incidence of gastric cancer compared with non-Hispanic patients and there is evidence that this population has worse outcomes. Given this double disparity in older Hispanic adults, we evaluated the differences in disease characteristics at diagnosis and survival outcomes in older adults compared to younger adults with gastric cancer at our South Texas cancer center serving a predominantly Hispanic population. Methods: We performed a retrospective analysis of patients with a diagnosis of gastric cancer from 2000 – 2018, who had follow-up at Mays Cancer Center, San Antonio, TX. Older patients were defined as ≥65 years and younger patients were defined as <65 years. Median overall survival (mOS) was estimated from Kaplan-Meier curves and groups were compared using the log-rank test. Results: A total of 190 patients met criteria for analysis. Patients were predominantly younger (age <65), with 128 (67.4%) young and 62 (32.6%) older. Most patients were Hispanic (66.4% of younger and 64.5% of older) and male (51.6% of younger and 66.1% of older). The majority of patients had an ECOG performance status of 0-2, including 61.7% and 64.5% (p = 0.55) of younger and older patients, respectively. At baseline, there was no significant difference in location of primary tumor, grade, stage at diagnosis, or histologic classification between younger and older patients (Table). There was also no significant difference between the two groups in H. pylori status, location of metastases, or HER2 status. Of the 109 patients with follow-up for survival, the mOS was 17 months (95% CI: 15-55) for younger patients versus 14 months (95% CI: 13-NR) for older patients (p = 0.19). Conclusions: In this retrospective analysis of predominantly Hispanic patients with gastric cancer, we found that there were no statistically significant differences in clinicopathologic features at diagnosis or in survival between younger versus older adults. Our study was approximately 2/3 Hispanic, a population for which there is a paucity of data, especially in older adults. Given the limited published research available to guide the management of older patients with gastric cancer, including Hispanics, further prospective real-world studies are needed to evaluate toxicity and quality of life in order to improve the care of older adults with gastric cancer. [Table: see text]

Effect of acute football activity and physical fitness on glycaemic and insulinaemic responses in adolescents

The present study examined the metabolic responses to an acute bout of football and the overall and moderating role of physical fitness on these responses, in adolescents. Thirty-six adolescents (16 girls, 20 boys; 12.6±0.5 y) completed two trials (60-min football and 60-min seated rest) separated by 7-d. Capillary blood samples were taken at baseline (60-min prior to exercise/rest), immediately, 30- and 60-min post-exercise and 30-, 60- and 120-min following a standardised lunch (1.5-, 2- and 3-h post-exercise), for the determination of blood glucose and plasma insulin concentrations. The median split of distance covered on the multi-stage fitness test was used to define high- and low-fit groups. Overall plasma insulin tAUC following lunch was lower in high-fit participants compared to low-fit (high-fit: 3784.2±1653.1 pmol·L^-1x120min, low-fit: 6457.3±3290.7 pmol·L^-1x120min; p<0.001), although there was no acute effect of the football session (p>0.05). Football reduced blood glucose concentration 1-h post-exercise compared to control (exercise: 3.8±0.6 mmol·L^-1, rest: 4.6±0.8 mmol·L^-1; p<0.001), but this was similar for the high- and low-fit participants (p>0.05). Blood glucose tAUC was not affected by exercise or physical fitness (p>0.05). These data emphasise the importance of physical fitness for metabolic health in adolescents, as well as the utility of football as a popular form of games-based activity for improving glucose regulation.

Effect of football activity and physical fitness on information processing, inhibitory control and working memory in adolescents

Background

Whilst an acute bout of exercise has been shown to enhance subsequent cognition, including in adolescents, the effects of team games (of which Football is the most popular) has received little attention. Therefore, this study examined: the effect of an acute bout of outdoor Football activity on information processing, inhibitory control, working memory and circulating brain-derived neurotrophic factor (BDNF) in adolescents; the effect of physical fitness on cognition and; the moderating effect of physical fitness on the acute exercise responses.

Methods

Following familiarisation, 36 adolescents (16 girls) took part in two trials (60-min Football and 60-min seated rest) separated by 7-d in a counterbalanced, crossover design. Information processing and inhibitory control (Stroop Test), and working memory (Sternberg Paradigm) were assessed 30-min before exercise/rest and immediately, 45- and 90-min post-exercise/rest. Capillary blood samples were obtained before exercise/rest and up to 120-min post-exercise/rest. The median split of distance covered on the MSFT was used to divide the group into high- and low-fit groups.

Results

Performance on the cognitive function tasks was similar between Football and seated rest (trial*time interactions; all p > .05). However, the high-fit group had overall quicker response times on both levels of the Stroop Task and all three levels of the Sternberg Paradigm (main effect of fitness; all p < .001). Furthermore, the exercise-cognition relationship was moderated by physical fitness, with improvements in working memory response times seen post-exercise, only in the high-fit group (trial*time*fitness interaction, p < .05). Circulating BDNF was unaffected by the Football activity and physical fitness (p > .05).

Conclusion

The present study shows that higher levels of physical fitness are beneficial for cognitive function and provides novel evidence that an ecologically valid, and popular, form of exercise is beneficial for working memory following exercise, in high-fit participants only.

Exploring the perceived medical ethics and law training needs of UK foundation doctors

Foundation doctors (FDs) encounter a wide range of ethical and legal issues during their first two years of work. Despite ethics being a key part of most modern undergraduate curricula, FDs can struggle with the issues they see. This study is based on results from an on-line survey answered by 479 UK FDs regarding their medical law and ethics learning needs, and their undergraduate training in this area. Over two-thirds stated they would wish to receive MEL training as an FD on self-discharge against medical advice (∼71%), sedating patients (∼70%), decision making in emergency medicine (∼67%), and withholding and withdrawing treatment (∼66%). Over half of all respondents want MEL training during their Foundation Programme on DNACPR orders (∼63%), dealing with patients with suicidal intent (∼59%), Mental Health Act (∼55%), Deprivation of Liberty Safeguards (∼54%), and end of life care (∼53%). We therefore propose a minimum curriculum for ethics and law training for FDs based on these topics, as well as cases brought by the FDs themselves.

Interprofessional spanning and building boundaries when supporting potential embryo donors to stem cell research

When patients undergo fertility treatment, it is likely that a surplus of embryos will be created. The existence of these surplus embryos creates responsibilities for the clinics where they are stored and for the people who own them. Since 2001, the owners of the surplus embryos in the UK have the option to donate them to be used in stem cell research (SCR). This development has generated a new population-potential embryo donors to SCR-who have unique support needs as they are neither fertility patients nor donors. However, little is known how lay and professional stakeholders associated with fertility treatment and SCR have conceptualised the support needs of potential embryo donors to SCR or have responded to the additional task once the option became available. In this article, we draw on Gieryn's concept of boundary-work to explore how the emergence of donating embryos to SCR has provided opportunities for embryologists, counsellors, and scientists to shift, adapt, or confirm their roles, knowledge base, and areas of expertise. We present a thematic analysis of 21 in-depth, semi-structured interviews conducted with UK lay and professional stakeholders associated with fertility treatment and SCR. We conclude with reflections on the implications this boundary-work has for those contemplating donating embryos to SCR and the care they receive when making their decision. Such insights are pertinent given the current policy and practice discussions led by the National Donation Strategy Group to improve the care of donors in the UK.

Feshbach enhanced s-wave scattering of fermions: direct observation with optimized absorption imaging

We directly measured the normalized s-wave scattering cross-section of ultracold ⁴⁰K atoms across a magnetic-field Feshbach resonance by colliding pairs of degenerate Fermi gases (DFGs) and imaging the scattered atoms. We extracted the scattered fraction for a range of bias magnetic fields, and measured the resonance location to be B₀ = 20.206(15) mT with width Δ = 1.0(5) mT. To optimize the signal-to-noise ratio of atom number in scattering images, we developed techniques to interpret absorption images in a regime where recoil induced detuning corrections are significant. These imaging techniques are generally applicable to experiments with lighter alkalis that would benefit from maximizing signal-to-noise ratio on atom number counting at the expense of spatial imaging resolution.

Tunable spin-orbit coupling via strong driving in ultracold-atom systems

Spin-orbit coupling is an essential ingredient in topological materials, conventional and quantum-gas-based alike. Engineered spin-orbit coupling in ultracold-atom systems-unique in their experimental control and measurement opportunities-provides a major opportunity to investigate and understand topological phenomena. Here we experimentally demonstrate and theoretically analyze a technique for controlling spin-orbit coupling in a two-component Bose-Einstein condensate using amplitude-modulated Raman coupling.

Typology of Ohio, USA, tree farmers based upon forestry outreach needs

This study differentiated groups of Ohio tree farmers through multivariate clustering of their perceived needs for forest management outreach. Tree farmers were surveyed via a mailed questionnaire. Respondents were asked to rate, on a 1-7 scale, their informational needs for 26 outreach topics, which were reduced to six factors. Based on these factors, three clusters were identified-holistic managers, environmental stewards, and pragmatic tree farmers. Cluster assignment of individuals was dependent upon a tree farmer's age, acreage owned, and number of years enrolled in the American Tree Farm System. Holistic managers showed a greater interest in the outreach topics while pragmatic tree farmers displayed an overall lesser interest. Across clusters, print media and in-person workshops were preferred over emails and webinars for receiving forest management information. In-person workshops should be no more than 1 day events, held on a weekday, during the daytime, at a cost not exceeding $35. Programming related to environmental influences, which included managing for forest insects and diseases, was concluded to have the greater potential to impact clientele among all outreach factors due to the information being applicable across demographics and/or management objectives.

Raman-induced interactions in a single-component Fermi gas near an s-wave Feshbach resonance

Ultracold gases of interacting spin-orbit-coupled fermions are predicted to display exotic phenomena such as topological superfluidity and its associated Majorana fermions. Here, we experimentally demonstrate a route to strongly interacting single-component atomic Fermi gases by combining an s-wave Feshbach resonance (giving strong interactions) and spin-orbit coupling (creating an effective p-wave channel). We identify the Feshbach resonance by its associated atomic loss feature and show that, in agreement with our single-channel scattering model, this feature is preserved and shifted as a function of the spin-orbit-coupling parameters.

Twenty-five years of JEAB: A survey of selected demographic characteristics related to publication trends

Some demographic characteristics related to authorship of research reports in the Journal of the Experimental Analysis of Behavior (JEAB) were analyzed as to affiliation and location (U.S. or foreign) of authors. In addition, the incidence of publications by the members of the editorial board was tallied. The number of different affiliations of JEAB authors has decreased steadily over the past several years with substantially fewer papers deriving from independent laboratories and medical schools. While the number of papers by foreign authors has generally increased over the years there is a recent reduction in their number. These data paint a mixed picture of the "health" status of the experimental analysis of behavior as reflected in its major publication outlet.

Peierls substitution in an engineered lattice potential

Artificial gauge fields open the possibility to realize quantum many-body systems with ultracold atoms, by engineering Hamiltonians usually associated with electronic systems. In the presence of a periodic potential, artificial gauge fields may bring ultracold atoms closer to the quantum Hall regime. Here, we describe a one-dimensional lattice derived purely from effective Zeeman shifts resulting from a combination of Raman coupling and radio-frequency magnetic fields. In this lattice, the tunneling matrix element is generally complex. We control both the amplitude and the phase of this tunneling parameter, experimentally realizing the Peierls substitution for ultracold neutral atoms.

Geometric aspects of particle segregation

Size segregation is a natural occurrence both in everyday life and in industrial processes. Understanding and research of the phenomenon has overwhelmingly been from a mechanistic point of view. This paper demonstrates through simulations that segregation can also be explained and trends predicted geometrically. The algorithm used in this study contains three simple elements: random walks combined with a rebounding probability to encourage particles to settle, plus the non-overlap constraint. It is implemented digitally in a regular lattice grid, to make it easy to deal with arbitrary shapes. It does not explicitly consider any particle interaction forces, and it does not include any rules specifically designed to promote or suppress segregation. Yet particle movement, which occurs within a digitized cubic grid, leads to shaking-induced segregation comparable to that observed in physical tests. The paper details the comparison of shaking-induced particle segregation between a series of computer based simulations and those of physical experiments undertaken in the laboratory. A range of mixtures, comprising nonspherical, arbitrary shaped/sized particles are investigated, having been packed into pseudo-two-dimensional containers. The simulation results suggest that segregation can be adequately explained, from a geometrical point of view, as a result of the relative motion between particles of different sizes and shapes. The geometrical algorithm thus provides a fast and qualitative prediction as to how likely segregation is to occur for any given mixture of arbitrary shapes.

Observation of vortex nucleation in a rotating two-dimensional lattice of Bose-Einstein condensates

We report the observation of vortex nucleation in a rotating optical lattice. A 87Rb Bose-Einstein condensate was loaded into a static two-dimensional lattice and the rotation frequency of the lattice was then increased from zero. We studied how vortex nucleation depended on optical lattice depth and rotation frequency. For deep lattices above the chemical potential of the condensate we observed a linear dependence of the number of vortices created with the rotation frequency, even below the thermodynamic critical frequency required for vortex nucleation. At these lattice depths the system formed an array of Josephson-coupled condensates. The effective magnetic field produced by rotation introduced characteristic relative phases between neighboring condensates, such that vortices were observed upon ramping down the lattice depth and recombining the condensates.

A comparison of direct electron microscopy, virus isolation and a DNA amplification method for the detection of avian infectious laryngotracheitis virus in field material

Seventy-two post-mortem samples of mainly tracheal tissue from commercial chickens from 25 commercial chicken flocks with suspected infectious laryngotracheitis (ILT) were examined for the presence of the virus using direct electron microscopy (EM), virus isolation (VI) in primary chick embryo liver cell culture and a DNA amplification method (polymerase chain reaction; PCR). ILT virus was identified in 22 outbreaks, and in 58 of the 72 specimens. PCR detected virus in 52 of the 72 specimens and VI was positive in 48. In five instances, VI was positive where the other methods were negative and in three, PCR was the only test positive. Direct EM examination detected virus in only 19 of the 58 positive samples and in no case was EM the only method positive. An advantage of PCR was that it could sometimes detect virus in samples that were too heavily contaminated with bacteria for virus to be isolated and on other occasions it was positive for ILT virus when the only virus that could be detected by growth in tissue culture was adenovirus.

Dynamic optical lattices: two-dimensional rotating and accordion lattices for ultracold atoms

We demonstrate a novel experimental arrangement which can rotate a 2D optical lattice at frequencies up to several kilohertz. Ultracold atoms in such a rotating lattice can be used for the direct quantum simulation of strongly correlated systems under large effective magnetic fields, allowing investigation of phenomena such as the fractional quantum Hall effect. Our arrangement also allows the periodicity of a 2D optical lattice to be varied dynamically, producing a 2D accordion lattice.

Pathogenicity of latent infectious laryngotracheitis virus in chickens

Groups of specific pathogen-free chickens were inoculated with the same dose of a field strain of infectious laryngotracheitis virus that had either been isolated from tracheal swabs taken from infected birds during acute phase shedding, or that had been isolated during an episode of virus shedding after a latent period of 12 to 17 weeks. Birds in both groups developed characteristic clinical signs of ILT including difficulty in breathing, rales and sneezing. Thus, ILT virus shed after a latent period is capable of causing disease in susceptible birds similar to that seen in the field.

Further studies on the development of a live attenuated vaccine against turkey rhinotracheitis

Turkey rhinotracheitis (TRT) virus attenuated by passaging in Vero cells was tested at two different passage levels (15 or 25 passages) and two dose levels [10(3) or 10(4) TCID50 (50% tissue culture infectious doses) per bird] to determine the efficacy in protecting turkey poults against experimental challenge with virulent TRT virus. Following administration by the eyedrop route at 10 days of age, all four preparations proved successful in providing protection against clinical disease and establishment of challenge virus in the trachea when challenged with virulent virus 3 weeks later. Twelve-day-old poults given the 25th Vero passage TRT virus at a dose of 10(3.5) TCID50 per bird were protected against experimental challenge with virulent virus for at least 22 weeks post-primary inoculation. The 25th passage virus was tested for safety by administering ten times the dose (10(4.5) TCID50 per bird) used in the previous trial to a group of 10-day-old turkey poults. None of the birds showed any clinical signs during 21 days post-inoculation. Attempts to back-passage the virus from bird to bird were unsuccessful.

Development of a live attenuated vaccine against turkey rhinotracheitis

Three preparations of a strain of turkey rhinotracheitis (TRT) virus were tested for their ability to protect turkey poults against challenge with virulent virus given 3 weeks later. The preparations were as follows: one had been passaged in turkey embryo tracheal organ culture (TOC) 98 times, another had been passaged in primary chick embryo fibroblast (CEF) monolayers 28 times and the third had undergone 17 passages in Vero cell monolayers. Each was administered by the eyedrop route to groups of 21-day-old TRT-seronegative turkey poults. The TOC preparation caused clinical signs consistent with TRT infection, indicating the virus had not been attenuated. The CEF and Vero preparations produced no clinical effects. Following challenge with virulent TRT virus at 21 days post-inoculation, the CEF group developed clinical signs consistent with TRT but the TOC and Vero virus groups showed none. All other parameters correlated with these findings. All groups showed an increase in specific SN and ELISA antibodies following challenge. These results indicated that after relatively few passages in Vero cells, this strain of TRT virus became satisfactorily attenuated and was able to offer protection against clinical disease following experimental challenge. Two of the three virus preparations (TOC and Vero) were also shown to spread from the inoculated birds to uninoculated contact birds, introduced into the groups at 5 days post-inoculation, and they induced protection in these contacts against virulent virus challenge.

Current Strategies for Modulating Lymphangiogenesis Signalling Pathways in Human Disease

The recent discovery that members of the vascular endothelial growth factor (VEGF) family of secreted glycoproteins can mediate lymphatic vessel growth (lymphangiogenesis) via cell surface receptor tyrosine kinases expressed on endothelial cells has opened the way for therapeutic intervention for pathologies involving dysregulated lymphatic vessel function. At least two members of this family, VEGF-C and VEGF-D, have been shown to induce lymphangiogenesis in vivo. Lymphatic vessels and their specific growth factors have been directly implicated in a number of significant human pathologies. In cancer, VEGF-C and VEGF-D appear to correlate with tumor metastasis and poor patient outcome in a range of prevalent human cancers. Experimental studies have demonstrated that expression of the lymphangiogenic growth factors in tumor models induces increased lymphangiogenesis and results in spread of tumor cells via the lymphatics. In contrast, conditions such as lymphedema, where lymphatic vessels fail to clear fluid from interstitial spaces, are opportunities for which the application of growth factors to generate new lymphatic vessels may be a viable therapeutic option. The list of molecules that control lymphangiogenesis is now expanding, allowing more opportunities for the development of drugs with which to manipulate the relevant signalling pathways. Modulating these pathways and other molecules with specificity to the lymphatic endothelium could offer alternative treatments for a number of important clinical conditions.

Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration

OBJECTIVE

To examine (1) the prevalence of depressive disorders in community-dwelling adults with advanced age-related macular degeneration (AMD) and (2) the relationship in this population between depression, visual acuity, the number of comorbid medical conditions, disability caused by vision loss as measured by the National Eye Institute-Vision Function Questionnaire (NEI-VFQ) and the vision-specific Sickness Impact Profile (SIPV), and disability caused by overall health status as measured by the Sickness Impact Profile-68 (SIP).

DESIGN

Analysis of cross-sectional baseline data from a randomized clinical trial.

PARTICIPANTS

Participants were 151 adults aged 60 and older (mean age, 80 years) with advanced macular degeneration whose vision was 20/60 or worse in their better eye.

METHODS

Subjects were interviewed using measures of depression, disability, and chronic medical conditions. Visual acuity was obtained. Nonparametric correlation analyses and linear regression analyses were performed.

MAIN OUTCOME MEASURES

Structured Clinical Interview for DSM-IV (SCID-IV), Geriatric Depression Scale (GDS), NEI-VFQ, SIPV, and SIP.

RESULTS

Of the participants, 32.5% (n = 49) met SCID-IV criteria for depressive disorder, twice the rate observed in previous studies of community-dwelling elderly. Over and above depression (GDS), visual acuity aided in prediction of the level of vision-specific disability (NEI-VFQ and SIPV).

CONCLUSIONS

Depressive disorder is a significant problem for the elderly afflicted with advanced macular degeneration. Further research on psychopharmacologic and psychotherapeutic interventions for depressed AMD patients is warranted to improve depression and enhance functioning. Over and above depression, visual acuity aided in predicting vision-specific disability. Treatment strategies that teach patients to cope with vision loss should be developed and evaluated.

Microbial transformations of steroids--XII. Progesterone hydroxylation profiles are modulated by post-translational modification of an electron transfer protein in Streptomyces roseochromogenes

When Streptomyces roseochromogenes strain 10984 was incubated with exogenous progesterone for 25 h the major monohydroxylated metabolite, 16alpha-hydroxyprogesterone was produced in 3.6 fold excess to the minor metabolite 2beta,16alpha-dihydroxyprogesterone. In a reconstituted system containing highly purified progesterone 16alpha-hydroxylase cytochrome P-450, and electron transfer proteins ferredoxin-like redoxin (roseoredoxin) and redoxin reductase (roseoredoxin reductase), both metabolites were produced but in a 10:1 ratio. When S. roseochromogenes was pre-incubated for 8 h with 0.32 mM progesterone and the purified components of the hydroxylase system incubated as before, the ratio of 16alpha-hydroxyprogesterone to 2beta,16alpha-dihydroxyprogesterone produced decreased to 2.8:1, virtually identical to the ratio in whole cell transformations. Reconstitution assays containing all combinations of hydroxylase proteins purified from progesterone pre-incubated and control cells showed that the roseoredoxin was solely responsible for the observed changes in in vitro metabolite ratios. The fact that the lower 16alpha-hydroxyprogesterone to 2beta,16alpha-dihydroxyprogesterone ratio was also obtained when S. roseochromogenes was exposed to 0.335 mM cycloheximide for 8 h prior to the progesterone pre-incubation, pointed to post-translation modification of the roseoredoxin. Separation of two isoforms of roseoredoxin by isoelectric focusing supported this proposition.

Localization of vascular endothelial growth factor-D in malignant melanoma suggests a role in tumour angiogenesis

Expression of angiogenic and lymphangiogenic factors by tumours may influence the route of metastatic spread. Vascular endothelial growth factor (VEGF) is a regulator of tumour angiogenesis, but studies of the inhibition of solid tumour growth by neutralizing anti-VEGF antibodies indicated that other angiogenic factors may be involved. VEGF-D may be an alternative regulator because like VEGF it is angiogenic and it activates VEGF receptor-2 (VEGFR-2), an endothelial cell receptor which is a key signalling molecule in tumour angiogenesis. This study reports the generation of monoclonal antibodies to the receptor-binding domain of VEGF-D and the use of these antibodies to localize VEGF-D in malignant melanoma. VEGF-D was detected in tumour cells and in vessels adjacent to immunopositive tumour cells, but not in vessels distant from the tumours. These findings are consistent with a model in which VEGF-D, secreted by tumour cells, activates endothelial cell receptors and thereby contributes to the regulation of tumour angiogenesis and possibly lymphangiogenesis. In addition, VEGF-D was detected in the vascular smooth muscle, but not the endothelium, of vessels in adult colon. The endothelium of these vessels was negative for VEGFR-2 and VEGFR-3. As VEGF receptors can be up-regulated on endothelium in response to vessel damage and ischaemia, these findings of a specific localization of VEGF-D in smooth muscle of the blood vessels suggest that VEGF-D produced by vascular smooth muscle could play a role in vascular repair by stimulating the proliferation of endothelial cells.

VEGF-D promotes the metastatic spread of tumor cells via the lymphatics

Metastasis to local lymph nodes via the lymphatic vessels is a common step in the spread of solid tumors. To investigate the molecular mechanisms underlying the spread of cancer by the lymphatics, we examined the ability of vascular endothelial growth factor (VEGF)-D, a ligand for the lymphatic growth factor receptor VEGFR-3/Flt-4, to induce formation of lymphatics in a mouse tumor model. Staining with markers specific for lymphatic endothelium demonstrated that VEGF-D induced the formation of lymphatics within tumors. Moreover, expression of VEGF-D in tumor cells led to spread of the tumor to lymph nodes, whereas expression of VEGF, an angiogenic growth factor which activates VEGFR-2 but not VEGFR-3, did not. VEGF-D also promoted tumor angiogenesis and growth. Lymphatic spread induced by VEGF-D could be blocked with an antibody specific for VEGF-D. This study demonstrates that lymphatics can be established in solid tumors and implicates VEGF family members in determining the route of metastatic spread.

Brief Strategic Family Therapy: twenty-five years of interplay among theory, research and practice in adolescent behavior problems and drug abuse

This article describes a systematic program of research that focuses on Brief Strategic Family Therapy (BSFT) and the adaptations that were developed based on BSFT principles. The culture-specific origins of BSFT are reviewed, as well as its broader applications to the field of family therapy. Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. Programmatic work is described that challenges basic principles of family therapy by expanding BSFT to a One Person modality and a strategic engagement procedure. Both of these novel approaches are intended to add tools to therapists' repertoire in working with difficult-to-engage families. A preview discussion of results is presented from a randomized clinical trial that is an application of an ecosystemic prevention version of BSFT. The implications of the work of the Center for Family Studies are discussed in the context of the broader service system. Ultimately, this article articulates a way of thinking about adolescent problem behavior, its social interactional determinants, and a range of theoretically consistent family-centered strategies that attempt to change social ecological processes that impact adolescent developmental trajectories.

Changes in directed attention and short-term memory in depression

This study examined changes in directed attention and short-term memory in depression using a newly constructed battery of computerized measures. A repeated measures design was used with two sample groups; 25 individuals meeting DSM-IV criteria for Major Depression and a group-matched comparison sample of 27. Both groups were tested at three points in time over a 10-week period. Test-retest reliability of the measures was examined. Profile analysis demonstrated that there were differences between the depressed and comparison groups in both directed attention and short-term memory. Recommendations for specific improvements in the testing battery are discussed. The ability to detect changes in directed attention and short-term memory may have clinical utility in early detection of impending onset of depression or subtle residual symptoms of an acute episode that may impair functioning or signal a relapse.