Potential association between working memory and physical fitness status: the BRAVE study

Introduction

The World Health Organization launched a global action plan targeted to obtain a 15% relative reduction in the global prevalence of physical inactivity in adolescents by 2030 also promoting school-based PA interventions and programs in school. Active Breaks (ABs) are a school-based intervention consisting of short bursts (5-15 minutes) of Pa led by teachers or peer. Many researches investigated the implementation of ABs into primary school setting as a strategy to reduce sedentary behaviour, improve cognitive and physical function. However, this kind of intervention has not extended to secondary school, especially in Italian context. For this reason we started the BRAVE study to evaluate the potential effect of implementing ABs in secondary school. The study is currently in the administration phase of ABs to adolescents The preliminary analysis aims to underline a potential association between working memory performance (WM) and physical fitness status among secondary school students at baseline.

Methods

In March 2022 we conducted baseline assessment in a secondary school in Valsamoggia (Bologna, Italy). Working memory was evaluated using backward digit span while physical fitness status was assessed using three different fitness test: standing long-jump (SLJ), six minute Cooper Test (6MCT) and Shuttle run test (SR).

Results

A total of n = 125 adolescent, mean age 12.79±0.89, were enrolled in the study. After performing a regression analysis we found that WM is significantly associated only with age of student (b = 0.2, 95%CI 0.25, 0.11 p = 0.02). A trend also emerged between WM performance and SLJ but with no statistically significant differences (b = 0.160, 95%CI 0.03, 0.02, p = 0.09). The 6MCT and HT have no relevant associations with WM score.

Conclusions

These preliminary results suggest that age is associated with cognitive performance but no positive association were found between WM score and physical fitness status excepted for a small trend with SLJ test.

Key messages

• Age is related to WM in adolescent students.

• ABs interventions could represent a valid strategy to encourage movement, improve cognitive and physical fitness performance.

The effect of active breaks on cognitive performance and classroom behaviour: the I-move study

Background

Active Breaks (ABs) intervention involves short bouts of moderate to vigorous physical activity (MVPA) conducted during or between curricular lessons by the appropriately trained teachers. The aim of the Imola Active Breaks Study (I-MOVE study) was to evaluate the effect of an ABs intervention on cognitive function and classroom behaviour in primary school children.

Methods

The study was quasi-experimental, and it involved two groups attending a primary school in Imola (Bologna, Italy). The Active Breaks group (ABsG) performed the I-MOVE protocol consisting in 10 minutes of ABs divided in warm up, tone-up with high intensity interval training and cool-down. This is repeated three times a day for one year and half. The control group (CG) continued with regular lessons. The baseline assessment was conducted in October 2019 and the follow-up in May 2021. Cognitive performance was assessed using working memory test and classroom behaviour was monitored using an “ad hoc questionnaire”.

Results

Working memory performance increased significantly more in the ABsG (change: 1.30±1.17) than in CG (0.96±1.20), p < 0.05. Almost the entire sample of the children wanted to continue with this intervention in the next following year. Children reported improvements in their school-life quality, including feeling better in class (75.40%) and in school (82.50%) when using ABs. Improvements were also reported in children time-on-task behaviours: 52.90% said they work easily in class, 52.90% that they could listen more clearly, 58.80% reported they can stay seated easily, and 59.60% that they learned better and were more focused after ABs.

Conclusions

In conclusion the program has proven to be very effective on the children's cognitive improvement and classroom behaviour. Since the ABs intervention demonstrates these positive effects, its implementation in schools can have a beneficial, sustainable and long-term impact on childhood health.

Key messages

• ABs intervention represents a cost-effective strategy to be implemented in the school settings regardless of the age and sex differences, to make the school a more dynamic environment.

• Despite the pandemic difficulties, the ABs intervention proved to be sustainable, and to have a positive effect on classroom behaviour by improving children’s concentration and attention in class.

The Imola Active Breaks study: a new strategy in child public health to reduce sedentary

Background

Physical inactivity is worldwide considered one of the biggest public health problems of the 21st century. WHO recommended in children, at least 60 minute of Moderate Vigorous Physical activity (MVPA) per day, but low percentages comply with guidelines. Considering that children spend many hours at school, classroom is the ideal setting to increase their PA. Active Breaks (AB) are a 5-15-minute bouts of PA led by the teachers during academic lessons. The aim of the Imola AB study is to implement a 1-year intervention based on AB (10min/3per-day) in primary school as a new strategy to reduce inactivity. We present the baseline results.

Methods

Quasi-experimental pre-post study in 6-10aged primary school children, in Imola(Italy).We evaluated PA level with Actigraph accelerometers: time (in minutes) spent in MVPA Weekly and Daily (W-MVPA; D-MVPA) and Weekly Sedentary behaviours (W-SB).

Results

We recruited 152 children: N = 110 in Active Breaks experimental group (AB) and N = 42 in control group (CG). Actigraph's analysis showed that 42,5% of children in the ABG vs 31.0% in the CG reach the WHO recommendation (p=ns). We investigated baseline differences between groups using ANOVA dividing children by grade. In 3-4 grades: W-MVPA (AB = 318.3±15.5 vs CG = 310.4±98.0 p = 0.78); D-MVPA (AB = 53.0±20.3 vs CG = 51.8±16.3 p = 0.79);W-SB (AB = 6,687.5±375.3 vs CG = 6,754.7±281.0 p = 0.45). In 1grade: W-MVPA (AB = 376.1±127.9 vs CG = 300.3±120.0 p = 0.02); D-MVPA (AB = 62.7±21.3 vs CG = 50.0±20.0 p = 0.02); W-SB (AB = 6,436.0±496.0 vs CG = 6,373.3 ±1,532.0 p = 0.7).

Conclusions

Only the 39.2% of the total sample met the 60-minute/day of MVPA recommended. We found no significant baseline differences in PA level measured by Actigraph between CG and AB, excepted in 1 grade. The intervention implemented in the Imola AB study could be a good strategy to reduce sedentary in children and reach the WHO recommendation, thus contributing to the aims of the new Global Action Plan on PA 2018-2030.

Key messages

Less than 50% reach the WHO recommendations of PA. AB implemented in the Imola Study could be a public health school-based strategy to reduce sedentary and increase healthy behavior in children. Active breaks (AB) are emerging as a good strategy to increase the PA level, reducing the time in sedentary habits.

A phase I study of PankoMab-GEX, a humanised glyco-optimised monoclonal antibody to a novel tumour-specific MUC1 glycopeptide epitope in patients with advanced carcinomas

BACKGROUND

A phase I open-label dose-escalation study was conducted to define the safety, tolerability, and pharmacokinetics (PK) of PankoMab-GEX, a glyco-optimised humanised IgG1, with high affinity to a novel tumour-specific glycopeptide epitope of MUC1 (TA-MUC1) with excellent preclinical anti-tumour activity.

PATIENTS AND METHODS

Seventy-four patients with advanced TA-MUC1-positive carcinomas received PankoMab-GEX intravenously every 3 (Q3W), 2 (Q2W), or 1 (QW) week in doses of 1-2200 mg in a three-plus-three dose-escalation design until disease progression (NCT01222624).

RESULTS

No maximum tolerated dose was reached. Adverse events were mainly mild-to-moderate infusion-related reactions (IRRs) by the first infusion in 45% of patients. Only one dose-limiting toxicity, a grade III IRR, was observed. PankoMab-GEX exhibited linear PK over all doses. Mean terminal half-life was 189 ± 66 h (Q3W), without dose dependency. A target trough level ≥50 μg/mL was reached after one infusion with doses ≥1700 mg Q3W in 80% of patients. Clinical benefit in 60 evaluable patients included one complete response in a patient with ovarian cancer treated 483 d and confirmed disease stabilisation in 19 patients lasting a median (range) of 23 (10-109) weeks. All but two of the patients with clinical benefit had received a compounded total dose ≥700 mg over a 3-week period, including 8 of 12 (67%) patients with ovarian cancer.

CONCLUSION

PankoMab-GEX is safe, well tolerated, and showed promising anti-tumour activity in advanced disease. A phase IIb study is ongoing evaluating the efficacy of PankoMab-GEX as a maintenance therapy in advanced ovarian cancer.

A correlational study between signature, writing abilities and decision-making capacity among people with initial cognitive impairment

BACKGROUND

Some clinical conditions, including dementia, compromise cognitive functions involved in decision-making processes, with repercussions on the ability to subscribe a will. Because of the increasing number of aged people with cognitive impairment there is an acute and growing need for decision-making capacity evidence-based assessment.

AIMS

Our study investigates the relationship between writing abilities and cognitive integrity to see if it is possible to make inferences on decision-making capacity through handwriting analysis. We also investigated the relationship between signature ability and cognitive integrity.

METHODS

Thirty-six participants with diagnosis of MCI and 38 participants with diagnosis of initial dementia were recruited. For each subject we collected two samples of signature-an actual and a previous one-and an extract of spontaneous writing. Furthermore, we administered a neuropsychological battery to investigate cognitive functions involved in decision-making.

RESULTS

We found significant correlations between spontaneous writing indexes and neuropsychological test results. Nonetheless, the index of signature deterioration does not correlate with the level of cognitive decline.

DISCUSSION

Our results suggest that a careful analysis of spontaneous writing can be useful to make inferences on decision-making capacity, whereas great caution should be taken in attributing validity to handwritten signature of subjects with MCI or dementia.

CONCLUSIONS

The analysis of spontaneous writing can be a reliable aid in cases of retrospective evaluation of cognitive integrity. On the other side, the ability to sign is not an index of cognitive integrity.

Abstract P4-07-18: PDGFRbeta-induced miR-9 is up-regulated in triple negative breast cancer

miR-9 has been described as an oncogenic microRNA associated to a metastatic phenotype and able to induce EMT (epithelial-to-mesenchymal transition) through direct targeting of E-cadherin. However, data available concerning the expression and the role of this microRNA in different subgroups of breast cancer are still not exhaustive.

Evaluating miR-9 expression by Real-Time PCR in a series of 92 breast cancer specimens (35 luminal, 36 HER2, 21 triple negative), we found that this microRNA is increasingly higher in HER2 and Triple Negative versus ER positive patients (fold change 3 and 8 respectively).

Moreover, preliminary analysis of miR-9 expression in correlation with bio-pathological features and clinical data also indicates a trend in association with disease progression.

Triple Negative Breast Cancers represent a very aggressive breast cancer subgroup, still lacking specific markers for an effective targeted therapy; we investigated whether miR-9 might play a role in the biology of this tumor subtype. Preliminary data indicate that miR-9 is activated downstream PDGFRbeta, which represents a crucial player in the aggressive phenotype of Triple Negative Breast Cancer.

In summary, here we show that miR-9 is significantly upregulated in triple negative breast cancer in comparison with other breast cancer subgroups and is activated downstream PDGFRbeta.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-07-18.

Abstract P2-12-08: Sorafenib for treatment of breast-cancer related lymphedema

BACKGROUND Lymphedema (LE) is a common complication of breast cancer (BC) treatments conditioning disability that affects quality of life. Decongestive therapy is the most popular treatment but it determines only a transient advantage, while pharmacologic therapy didn't impact on LE. On the basis of clinical observations of LE regression in patients treated with sorafenib with antitumoral intent, we hypothesized that sorafenib could have an anti-LE activity through inhibition of vascular permeability by suppressing VEGFRs.

METHODS We conducted a single-arm, monoistitutional phase II study in BC patients with treatment-acquired LE of the arm. Major or uncontrolled cardiological disease, brain metastasis, history of thromboembolism were exclusion criteria. Concomitant chemo or hormonal therapy was allowed. Pts received sorafenib 200 mg daily for a maximum of 8 weeks. The primary end-point was to evaluate the efficacy of sorafenib as reduction of LE, defined by the percentage reduction (PR) of the difference between the total arm circumference (measured as the sum of the circumference at 12 points) of the affected and the controlateral arm (Starritt, Peterk JA Cancer 2001–10): [(Initial Difference – Final Difference)/Initial Difference] × 100.

Secondary end-points were safety and duration of response (DOR). The study was designed to test the null hypothesis that the PR of edema observed with this therapy was at most 20% versus the alternative hypothesis that the PR obtained by this regimen was ≥40%.

RESULTS From May 2009 to April 2011, 36 BC pts were enrolled. All pts underwent axillary dissection and 29 pts had received adjuvant radiotherapy, but none on the axilla. Median time from primary breast surgery and from occurrence of edema to study enrollement was 65 and 49 months, respectively. All pts are evaluable for efficacy and toxicity. Most common toxicities included grade 1–2 gastralgia (17%), hypertension (17%) and rash (43%); one patient experienced grade 3 hand-foot syndrome. Twenty-five pts completed the planned 8 weeks of therapy, 11 (31%) had early treatment discontinuation after 2 (n = 6), 4 (n = 4) and 6 (n = 1) weeks of treatment due to recurrent grade 2 toxicity or to relapse of disease (n = 1). The median PR of the difference between the two arms was 34% (range, 2–100), 14 pts (39%) experienced a LE reduction ≥40%. Among 25 pts who completed therapy, 12 (48%) achieved a PR ≥40%. The median difference of total circumferences between the LE and controlateral arm was significantly reduced after treatment: 37 cm (range 8–88) vs 25 cm (range 1–62) (p = 0.006). Best response was achieved after a median of 5 weeks of therapy (range 1– 6) and the median DOR was 8 weeks (range 4–15). Reduction of LE was associated with improvement of related symptoms. After discontinuation of study drug 84% pts presented a progressive increase of total circumference of LE arm and returned to values similar to baseline after a median of 7 weeks (range 2–11).

CONCLUSIONS: Low dose of sorafenib has a good toxicity profile and exerts a significant anti-LE activity in BC patients. The early but transient effect observed in this study suggests exploring different schedule of administration. Further studies are warranted in order to obtain a durable benefit in term of reduction of LE and quality of life.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-12-08.

Association of partial AZFc region deletions with spermatogenic impairment and male infertility

BACKGROUND

Complete deletions of the AZFc region in distal Yq are the most frequent molecular genetic cause of severe male infertility. They are caused by intrachromosomal homologous recombination between amplicons--large, nearly identical repeats--and are found in 5-10% of cases of azoospermia and severe oligozoospermia. Homologous recombination may also generate different partial deletions of AZFc, but their contribution to spermatogenic impairment has not been confirmed.

METHODS

In this study we analysed the prevalence and characteristics of different partial AZFc deletions and their association with spermatogenic failure. We studied 337 infertile men with different spermatogenic impairment and 263 normozoospermic fertile men using AZFc specific sequence tagged site markers and DAZ specific single nucleotide variants.

RESULTS

We identified 18 cases of partial AZFc deletions in the infertile group (5.3%) and one case in the control group (0.4%). Seventeen deletions had the "gr/gr" pattern, one the "b2/b3" pattern, and one represented a novel deletion with breakpoints in b3 and b4 amplicons. Partial AZFc deletions were associated with different spermatogenic phenotypes ranging from complete azoospermia to only moderate oligozoospermia.

CONCLUSIONS

Together with published data, our analysis of DAZ gene copy suggested that the contribution of the different deletions to male infertility varies: only partial AZFc deletions removing DAZ1/DAZ2 seem to be associated with spermatogenic impairment, whereas those removing DAZ3/DAZ4 may have no or little effect on fertility. These data show that, beside complete AZFc deletions, specific partial deletions represent a risk factor for male infertility, even if with different effect on spermatogenesis.

Characterization of HSFY, a novel AZFb gene on the Y chromosome with a possible role in human spermatogenesis

HSFY (heat shock transcription factor, Y chromosome) has been mapped in the AZFb region of the Y chromosome, whose deletion results in severe male infertility. HSFY belongs to the heat shock factor family that has been shown to be implicated in spermatogenesis both in animals and humans. We report the characterization of the genomic structure, the number of copies on the Y chromosome and the expression of the gene. By comparison of data obtained from expression analysis and from GenBank cDNA sequences, seven exons were identified. Alternative splicing generates three different transcripts and proteins, each containing an HSF domain typical of HSF proteins. Two identical and functional full-length copies of HSFY map in palindrome P4 of AZFb, whereas four similar sequences mapping in two clusters in palindrome P1 of AZFc and P3 seem to represent pseudogenes. Sequences similar to few HSFY exons are also located in the short arm of chromosomes Y, X and 22. Expression analysis revealed that the three HSFY transcripts are differentially expressed, transcript 1 being present in many tissues including testis and ejaculated sperm, and transcripts 2 and 3 being testis-specific. These data suggest that HSFY could have an important role in human spermatogenesis.

[Dientamoeba fragilis: is it really fragile? Approach to specimen handling and rapid microscopic diagnosis]

Dientamoeba fragilis is a pathogenic protozoan parasite with a world-wide distribution. Interestingly, a resistant cyst stage has not been demonstrated and it is still an unsolved problem how this parasite can survive successfully outside the human host. D. fragilis was found in 2% of approximately 2500 individuals unselected who submitted stools for parasitological examination during 2001 in Padua (Italy). The goal of this study was to detect the protozoan stages and the duration of persistence of this protozoa in faeces stored in different environmental conditions. The trophozoites of D. fragilis were detected up to 60 days after the collection of the faeces stored at 4 degrees C and Giemsa stained. The laboratory detection rate of the organism is greatly enhanced by use of preservative to fix stool specimens immediately after passage. Alternatively, a microscopic observation of the collected stool has to be performed immediately after passage followed by examination of permanently-stained smears. Demonstration of the charateristic "golf-club" and "acanthopodia-like" structures in unstained fixed faecal material by direct microscopy (400x) are suitable for a rapid identification of D. fragilis.

[Alteration of spermatogenesis and Y chromosome microdelations. Analysis of the DAZ gene family]

The Y chromosome has a fundamental role in sex determination and regulation of spermatogenesis. Three regions (designated as AZFa, b, and c) on the long arm of this chromosome exist, deletions of which result in severe damage to spermatogenesis with azoospermia or severe oligozoospermia. Recent progresses in molecular biology and extraordinary development of assisted reproduction techniques contributed to the research on this chromosome and the genes involved in spermatogenesis. About 10-15% of subjects affected by azoospermia or severe oligozoospermia carry a deletion in one or more AZF regions, 60% of which involves AZFc. The genes responsible for the testicular phenotype observed in these subjects are DBY and USP9Y for AZFa, RBMY1 for AZFb, and DAZ for AZFc. In this article, the current knowledge on biology and genetics of the Y chromosome are reported with particular interest to deletions found in infertile subjects. Furthermore, the more recent advances on DAZ gene and its role in spermatogenesis and male infertility are discussed.

Hemispheric specialization in quantification processes

Three experiments were carried out to study hemispheric specialization for subitizing (the rapid enumeration of small patterns) and counting (the serial quantification process based on some formal principles). The experiments consist of numerosity identification of dot patterns presented in one visual field, with a tachistoscopic technique, or eye movements monitored through glasses, and comparison between centrally presented dot patterns and lateralized tachistoscopically presented digits. Our experiments show left visual field advantage in the identification and comparison tasks in the subitizing range, whereas right visual field advantage has been found in the comparison task for the counting range.

Remembering spatial locations: effects of material and intelligence

The aim of the present work was to test some of the criteria for automaticity of spatial-location coding claimed by Hasher and Zacks, particularly individual differences (as intelligence invariance) and effortful encoding strategies. Two groups of subjects, 15 with mental retardation (Down Syndrome, mean chronological age, 20.9 yr.; mean mental age, 11.6 yr.) and 15 normal children (mean age, 11.5 yr.), were administered four kinds of stimuli (pictures, concrete words, nonsense pictures, and abstract words) at one location on a card. Subsequently, subjects were presented the items on the card's centre and were required to place the items in their original locations. Analysis indicated that those with Down Syndrome scored lower than normal children on the four tasks and that stimuli were better or worse remembered according to their characteristics, e.g., their imaginability. Results do not support some of the conditions claimed to be necessary criteria for automaticity in the recall of spatial locations as stated by Hasher and Zacks.