Publications by authors named "Julien S Baker"

254 Publications

Does exercise affect bone mineral density and content when added to a calorie-restricted diet? A systematic review and meta-analysis of controlled clinical trials.

Osteoporos Int 2021 Oct 13. Epub 2021 Oct 13.

Department of Nutrition, Faculty of Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, PO Code 8915173160 , Yazd, Iran.

The effects of exercise in conjunction with weight-loss diets on bone health are mixed. Our objective was to systematically review and meta-analyze controlled clinical trials in adults investigating the addition of exercise to a weight-loss diet compared with a calorie-matched weight-loss diet without exercise on bone measures. Online databases including PubMed/MEDLINE, EMBASE, ISI (Web of Science), Scopus, and Google Scholar were searched up to April 2021 with no restriction. A random effects model was used to calculate the overall estimates. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Fourteen eligible controlled clinical trials were included in the systematic review. The meta-analysis revealed that, compared to weight-loss diets alone, the addition of exercise did not improve total body bone mineral density (BMD) [weighted mean difference (WMD) = 0.002 g/cm, P = 0.62, n = 8], lumbar BMD (WMD = 0.007 g/cm, P = 0.44, n = 9), total hip BMD (WMD = 0.015 g/cm, P = 0.14, n = 4) and total bone mineral content (BMC) (WMD =  - 11.97 g, P = 0.29, n = 7). Subgroup analysis revealed that resistance exercise in conjunction with hypocaloric diets positively affects total BMD compared to an energy restrictive diet alone (WMD = 0.01 g/cm, P = 0.003, n = 3). Overall, it appears that only resistance exercise beneficially affects total BMD during a calorie-restricted diet in adults. Further well-controlled and long-term clinical trials are still needed to confirm these results. PROSPERO registration number: CRD42020173434.
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http://dx.doi.org/10.1007/s00198-021-06187-9DOI Listing
October 2021

Effects of Fatigue Running on Joint Mechanics in Female Runners: A Prediction Study Based on a Partial Least Squares Algorithm.

Front Bioeng Biotechnol 2021 24;9:746761. Epub 2021 Sep 24.

Faculty of Sports Science, Ningbo University, Ningbo, China.

Joint mechanics are permanently changed using different intensities and running durations. These variations in intensity and duration also influence fatigue during prolonged running. Little is known about the potential interactions between fatigue and joint mechanics in female recreational runners. Thus, the purpose of this study was to describe and examine kinematic and joint mechanical parameters when female recreational runners are subject to fatigue as a result of running. Fifty female recreational runners maintained running on a treadmill to induce fatigue conditions. Joint mechanics, sagittal joint angle, moment, and power were recorded pre- and immediately post fatigue treadmill running. Moderate reductions in absolute positive ankle power, total ankle energy dissipation, dorsiflexion at initial contact, max dorsiflexion angle, and range of motion of the joint ankle were collected after fatigue following prolonged fatigue running. Knee joint mechanics, joint angle, and joint power remained unchanged after prolonged fatigue running. Nevertheless, with the decreased ankle joint work, negative knee power increased. At the hip joint, the extension angle was significantly decreased. The range motion of the hip joint, hip positive work and hip positive power were increased during the post-prolonged fatigue running. This study found no proximal shift in knee joint mechanics in amateur female runners following prolonged fatigue running. The joint work redistribution was associated with running fatigue changes. As for long-distance running, runners should include muscle strength training to avoid the occurrence of running-related injuries.
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http://dx.doi.org/10.3389/fbioe.2021.746761DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8497745PMC
September 2021

The major worldwide stress of healthcare professionals during the first wave of the COVID-19 pandemic - the international COVISTRESS survey.

PLoS One 2021 6;16(10):e0257840. Epub 2021 Oct 6.

Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Clermont-Ferrand, France.

Introduction: The COVID-19 pandemic has initiated an upheaval in society and has been the cause of considerable stress during this period. Healthcare professionals have been on the front line during this health crisis, particularly paramedical staff. The aim of this study was to assess the high level of stress of healthcare workers during the first wave of the pandemic.

Materials And Methods: The COVISTRESS international study is a questionnaire disseminated online collecting demographic and stress-related data over the globe, during the pandemic. Stress levels were evaluated using non-calibrated visual analog scale, from 0 (no stress) to 100 (maximal stress).

Results: Among the 13,537 individuals from 44 countries who completed the survey from January to June 2020, we included 10,051 workers (including 1379 healthcare workers, 631 medical doctors and 748 paramedical staff). The stress levels during the first wave of the pandemic were 57.8 ± 33 in the whole cohort, 65.3 ± 29.1 in medical doctors, and 73.6 ± 27.7 in paramedical staff. Healthcare professionals and especially paramedical staff had the highest levels of stress (p < 0.001 vs non-healthcare workers). Across all occupational categories, women had systematically significantly higher levels of work-related stress than men (p < 0.001). There was a negative correlation between age and stress level (r = -0.098, p < 0.001). Healthcare professionals demonstrated an increased risk of very-high stress levels (>80) compared to other workers (OR = 2.13, 95% CI 1.87-2.41). Paramedical staff risk for very-high levels of stress was higher than doctors' (1.88, 1.50-2.34). The risk of high levels of stress also increased in women (1.83, 1.61-2.09; p < 0.001 vs. men) and in people aged <50 (1.45, 1.26-1.66; p < 0.001 vs. aged >50).

Conclusions: The first wave of the pandemic was a major stressful event for healthcare workers, especially paramedical staff. Among individuals, women were the most at risk while age was a protective factor.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0257840PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8494302PMC
October 2021

Joint Angle, Range of Motion, Force, and Moment Assessment: Responses of the Lower Limb to Ankle Plantarflexion and Dorsiflexion.

Appl Bionics Biomech 2021 18;2021:1232468. Epub 2021 Sep 18.

Faculty of Sports Science, Ningbo University, China.

There is limited research on the biomechanical assessment of the lower limb joints in relation to dynamic movements that occur at the hip, knee, and ankle joints when performing dorsiflexion (DF) and plantarflexion (PF) among males and females. This study investigated the differences in joint angles (including range of motion (ROM)) and forces (including moments) between the left and right limbs at the ankle, knee, and hip joints during dynamic DF and PF movements in both males and females. Using a general linear model employing multivariate analysis in relation to the joint angle, ROM, force, and moment datasets, the results revealed significant main effects for gender, sidedness, phases, and foot position with respect to joint angles. Weak correlations were observed between measured biomechanical variables. These results provide insightful information for clinicians and biomechanists that relate to lower limb exercise interventions and modelling efficacy standpoints.
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http://dx.doi.org/10.1155/2021/1232468DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476262PMC
September 2021

Ground Reaction Force Differences between Bionic Shoes and Neutral Running Shoes in Recreational Male Runners before and after a 5 km Run.

Int J Environ Res Public Health 2021 Sep 17;18(18). Epub 2021 Sep 17.

Faculty of Sports Science, Ningbo University, Ningbo 315211, China.

Running-related injuries are common among runners. Recent studies in footwear have shown that designs of shoes can potentially affect sports performance and risk of injury. Bionic shoes combine the functions of barefoot running and foot protection and incorporate traditional unstable structures based on bionic science. The purpose of this study was to investigate ground reaction force (GRF) differences for a 5 km run and how bionic shoes affect GRFs. Sixteen male recreational runners volunteered to participate in this study and finished two 5 km running sessions (a neutral shoe session and a bionic shoe session). Two-way repeated-measures ANOVAs were performed to determine the differences in GRFs. In the analysis of the footwear conditions of runners, bionic shoes showed significant decreases in vertical impulse, peak propulsive force, propulsive impulse, and contact time, while the braking impulse and vertical instantaneous loading rate (VILR) increased significantly compared to the neutral shoes. Main effects for a 5 km run were also observed at vertical GRFs and anterior-posterior GRFs. The increases of peak vertical impact force, vertical average loading rate (VALR), VILR, peak braking force and braking impulse were observed in post-5 km running trials and a reduction in peak propulsive force and propulsive impulse. The interaction effects existed in VILR and contact time. The results suggest that bionic shoes may benefit runners with decreasing injury risk during running. The findings of the present study may help to understand the effects of footwear design during prolonged running, thereby providing valuable information for reducing the risk of running injuries.
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http://dx.doi.org/10.3390/ijerph18189787DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8469130PMC
September 2021

An electromyographic assessment pilot study on the reliability of the forearm muscles during multi-planar maximum voluntary contraction grip and wrist articulation in young males.

Technol Health Care 2021 Sep 17. Epub 2021 Sep 17.

Faculty of Sports Science, Ningbo University, Ningbo, Zhejiang, China.

Background: Electromyographic systems are widely used in scientific and clinical practice. The reproducibility and reliability of these measures are crucial when conducting scientific research and collecting experimental data.
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http://dx.doi.org/10.3233/THC-212822DOI Listing
September 2021

Deep learning versus ophthalmologists for screening for glaucoma on fundus examination: A systematic review and meta-analysis.

Clin Exp Ophthalmol 2021 Sep 10. Epub 2021 Sep 10.

Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, Clermont-Ferrand, France.

Background: In this systematic review and meta-analysis, we aimed to compare deep learning versus ophthalmologists in glaucoma diagnosis on fundus examinations.

Method: PubMed, Cochrane, Embase, ClinicalTrials.gov and ScienceDirect databases were searched for studies reporting a comparison between the glaucoma diagnosis performance of deep learning and ophthalmologists on fundus examinations on the same datasets, until 10 December 2020. Studies had to report an area under the receiver operating characteristics (AUC) with SD or enough data to generate one.

Results: We included six studies in our meta-analysis. There was no difference in AUC between ophthalmologists (AUC = 82.0, 95% confidence intervals [CI] 65.4-98.6) and deep learning (97.0, 89.4-104.5). There was also no difference using several pessimistic and optimistic variants of our meta-analysis: the best (82.2, 60.0-104.3) or worst (77.7, 53.1-102.3) ophthalmologists versus the best (97.1, 89.5-104.7) or worst (97.1, 88.5-105.6) deep learning of each study. We did not retrieve any factors influencing those results.

Conclusion: Deep learning had similar performance compared to ophthalmologists in glaucoma diagnosis from fundus examinations. Further studies should evaluate deep learning in clinical situations.
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http://dx.doi.org/10.1111/ceo.14000DOI Listing
September 2021

Establishing a Global Standard for Wearable Devices in Sport and Exercise Medicine: Perspectives from Academic and Industry Stakeholders.

Sports Med 2021 11 1;51(11):2237-2250. Epub 2021 Sep 1.

International Federation of Sports Medicine (FIMS), Lausanne, Switzerland.

Millions of consumer sport and fitness wearables (CSFWs) are used worldwide, and millions of datapoints are generated by each device. Moreover, these numbers are rapidly growing, and they contain a heterogeneity of devices, data types, and contexts for data collection. Companies and consumers would benefit from guiding standards on device quality and data formats. To address this growing need, we convened a virtual panel of industry and academic stakeholders, and this manuscript summarizes the outcomes of the discussion. Our objectives were to identify (1) key facilitators of and barriers to participation by CSFW manufacturers in guiding standards and (2) stakeholder priorities. The venues were the Yale Center for Biomedical Data Science Digital Health Monthly Seminar Series (62 participants) and the New England Chapter of the American College of Sports Medicine Annual Meeting (59 participants). In the discussion, stakeholders outlined both facilitators of (e.g., commercial return on investment in device quality, lucrative research partnerships, and transparent and multilevel evaluation of device quality) and barriers (e.g., competitive advantage conflict, lack of flexibility in previously developed devices) to participation in guiding standards. There was general agreement to adopt Keadle et al.'s standard pathway for testing devices (i.e., benchtop, laboratory, field-based, implementation) without consensus on the prioritization of these steps. Overall, there was enthusiasm not to add prescriptive or regulatory steps, but instead create a networking hub that connects companies to consumers and researchers for flexible guidance navigating the heterogeneity, multi-tiered development, dynamicity, and nebulousness of the CSFW field.
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http://dx.doi.org/10.1007/s40279-021-01543-5DOI Listing
November 2021

Kinematic Comparison on Lower Limb Kicking Action of Fetuses in Different Gestational Weeks: A Pilot Study.

Healthcare (Basel) 2021 Aug 18;9(8). Epub 2021 Aug 18.

Faculty of Sports Science, Ningbo University, Ningbo 315211, China.

The fetal movements during different gestational weeks are essential for normal musculoskeletal development. The kinematic characteristics of fetuses with small differences in gestational weeks may be different and important. Ultrasonographic videos of fetal kicking action and plantarflexion action were collected from three healthy pregnant women (24, 27, and 30 gestational weeks) with normal fetal development. The kinematic characteristics, including angular range and angular velocity, were analyzed. These kinematic parameters were measured using simi motion. The final knee angle was found to decrease with progressive gestational weeks. Compared with 24 w, the knee joint angle at 27 w and 30 w was significantly reduced at the end of a kick-type movement ( < 0.01). Except for the mean angular velocity of the knee joint, there were no significant differences in the other conditions. The value at 30 w for mean angular velocity was significantly higher than that at 24 w ( = 0.02). In the ankle joint, no significant differences were observed between different conditions. Therefore, we can conclude that there was no significant difference in the kinematic characteristics of the ankle joint for small gestational age gaps, but there was a significant difference in the knee joint. As the gestation weeks increase, the range of kicking motion tends to decrease. The reason may be that with the increase of gestational weeks, fetal lower limb musculoskeletal development is gradually enhanced; the slower growth rate indicates that development reaches a peak level in weeks 24 to 30.
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http://dx.doi.org/10.3390/healthcare9081057DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394357PMC
August 2021

Association between Metabolic Syndrome Components and Cardiac Autonomic Modulation among Children and Adolescents: A Systematic Review and Meta-Analysis.

Biology (Basel) 2021 Jul 22;10(8). Epub 2021 Jul 22.

Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong 999077, Hong Kong.

Background: the clustering of metabolic syndrome (MetS) risk factors is becoming more prevalent in children, leading to the development of type 2 diabetes (T2D) and cardiovascular diseases in early adulthood. The impact of MetS risk factors on cardiac autonomic modulation (CAM) or vice versa has been noted to track from childhood to pre-adolescence and adolescence. Understating associations in this age group may help to improve the clinical outcomes of the MetS, even when MetS symptoms are not visible. Potential damage from each individual MetS component and the ability to predict early cardiac damage or upcoming cardiovascular events is very important. Therefore, the present systematic review and meta-analysis investigated the associations between CAM and MetS risk factors individually to verify which of the MetS risk components were significantly correlated with heart rate variability (HRV) indices before or at the onset of the MetS among young people. The purpose of this review was to outline the importance of potentially screening HRV indices in young people even with only one MetS risk factor, as a pre-indicator for early cardiovascular risk stratification.

Methods: cross-sectional studies that examined the relationship of MetS risk factors with HRV indices were searched using four databases including PubMed, the Cochrane clinical trials library, Medline and the Web of Science. Correlation coefficients with 95% confidence intervals (95% CI), and random effects meta-analyses of the association between MetS risk factors with HRV indices were performed.

Results: out of 14 cross-sectional studies and one case-control study, 8 studies (10 data sets) provided association data for the meta-analysis. Our results indicated significant positive correlations for systolic blood pressure (SBP) (correlation coefficient 0.13 (95%CI: 0.06; 0.19), I = 47.26%) and diastolic blood pressure (DBP) (correlation coefficient 0.09 (95%CI: -0.01; 0.18), I = 0%) with a Low Frequency/High Frequency ratio (LF/HF). Significant negative correlations for waist circumference (WC) (correlation coefficient -0.12 (95%CI: -0.19; -0.04), I = 51.50%), Triglycerides (TGs) (correlation coefficient -0.09 (95%CI: -0.15; -0.02), I = 0%) and ≥2 MetS risk factors (correlation coefficient -0.10 (95%CI: -0.16; -0.03), I = 0%); with high frequency (HF) were revealed. Significant positive correlations for high density lipoprotein (HDL) (correlation coefficient 0.08 (95%CI: 0.05; 0.11), I = 0%) and significant negative correlations of ≥2 MetS risk (correlation coefficient -0.04 (95%CI: -0.12; 0.03), I = 0.0%) with low frequency (LF) were revealed. Significant negative correlations for TGs (correlation coefficient -0.09 (95%CI: -0.23; 0.05), I = 2.01%) with a mean square root of the sum of differences between mean time between two successive intervals (rMSSD) and significant positive correlation of HDL (correlation coefficient 0.09 (95%CI: -0.01; 0.19), I = 0.33%) with standard deviation of the time between two successive intervals (SDNN) were also revealed. An Egger's test indicated that there was no obvious publication bias for any of the above relationships except for TGs and rMSSD. The significance level stipulated for the meta-analysis was < 0.05.

Conclusions: lipid profiles (HDL and TGs), WC and BP were associated with CAM in young people up to the age of 19 years. The use of HRV indices to predict future MetS risk, and relationships with individual risk factors including HDL, BP, WC and TGs, were established. Future studies related to young people (up to the age of 19 years) are recommended to explore the associations reported here further.
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http://dx.doi.org/10.3390/biology10080699DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8389259PMC
July 2021

An Investigation of Differences in Lower Extremity Biomechanics During Single-Leg Landing From Height Using Bionic Shoes and Normal Shoes.

Front Bioeng Biotechnol 2021 9;9:679123. Epub 2021 Aug 9.

Faculty of Sports Science, Ningbo University, Ningbo, China.

Bionic shoes utilizing an actual foot shape sole structure can alter lower limb's biomechanics, which may help in the development of specific training or rehabilitation programs. The purpose of this study was to investigate the biomechanical differences in the lower limb during a single-leg landing task using bionic shoes (BS) and normal shoes (NS). Fifteen healthy male subjects participated in this study, sagittal, and frontal plane data were collected during the landing phase (drop landing from 35 cm platform). Our study showed that BS depicted a significantly greater minimum knee flexion angle at initial contact ( = 0.000), a significantly greater minimum (initial contact) hip flexion angle at initial contact ( = 0.009), a significantly smaller sagittal plane total energy dissipation ( = 0.028), a significantly smaller frontal plane total energy dissipation ( = 0.008), a significantly smaller lower limb total energy dissipation ( = 0.017) than NS during the landing phase. SPM analysis revealed that BS depicted a significantly smaller knee joint vertical reaction force during the 13.8-19.8% landing phase ( = 0.01), a significantly smaller anterior tibia shear force during the 14.2-17.5% landing phase ( = 0.024) than NS. BS appears to change lower limb kinematics at initial contact and then readjust the landing strategies for joint work and joint reaction force, thereby reducing the risk of lower limb skeletal muscle injury. BS have great potential for future development and application uses, which may help athletes to reduce lower limb injury risk.
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http://dx.doi.org/10.3389/fbioe.2021.679123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8381337PMC
August 2021

Bayesian structural time series for biomedical sensor data: A flexible modeling framework for evaluating interventions.

PLoS Comput Biol 2021 Aug 23;17(8):e1009303. Epub 2021 Aug 23.

Program in Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, United States of America.

The development of mobile-health technology has the potential to revolutionize personalized medicine. Biomedical sensors (e.g., wearables) can assist with determining treatment plans for individuals, provide quantitative information to healthcare providers, and give objective measurements of health, leading to the goal of precise phenotypic correlates for genotypes. Even though treatments and interventions are becoming more specific and datasets more abundant, measuring the causal impact of health interventions requires careful considerations of complex covariate structures, as well as knowledge of the temporal and spatial properties of the data. Thus, interpreting biomedical sensor data needs to make use of specialized statistical models. Here, we show how the Bayesian structural time series framework, widely used in economics, can be applied to these data. This framework corrects for covariates to provide accurate assessments of the significance of interventions. Furthermore, it allows for a time-dependent confidence interval of impact, which is useful for considering individualized assessments of intervention efficacy. We provide a customized biomedical adaptor tool, MhealthCI, around a specific implementation of the Bayesian structural time series framework that uniformly processes, prepares, and registers diverse biomedical data. We apply the software implementation of MhealthCI to a structured set of examples in biomedicine to showcase the ability of the framework to evaluate interventions with varying levels of data richness and covariate complexity and also compare the performance to other models. Specifically, we show how the framework is able to evaluate an exercise intervention's effect on stabilizing blood glucose in a diabetes dataset. We also provide a future-anticipating illustration from a behavioral dataset showcasing how the framework integrates complex spatial covariates. Overall, we show the robustness of the Bayesian structural time series framework when applied to biomedical sensor data, highlighting its increasing value for current and future datasets.
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http://dx.doi.org/10.1371/journal.pcbi.1009303DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8412351PMC
August 2021

Effects and dose-response relationship of high-intensity interval training on cardiorespiratory fitness in overweight and obese adults: a systematic review and meta-analysis.

J Sports Sci 2021 Aug 17:1-18. Epub 2021 Aug 17.

Department Of Health And Physical Education, The Education University of Hong Kong, Hong Kong, China.

This study aims to quantify the effects of high-intensity interval training (HIIT) on cardiorespiratory fitness (CRF) by considering potential moderators and to characterise dose-response relationships of HIIT variables that could maximise CRF improvements in overweight and obese adults. Following a comprehensive search through four electronic databases, 19 studies met eligibility criteria. Random-effects models were applied to weight all included studies and to compute the weighted mean standardised mean differences (SMD). Meta-analysis showed that HIIT was a highly effective approach for improving CRF in overweight and obese adults (SMD = 1.13). Effects were modified by sex and baseline CRF level. Dose-response relationship analysis provided some preliminary data regarding the training period, training intensity, and session duration. However, it is still not possible to provide accurate recommendations currently. Further studies are still needed to identify the most appropriate training variables to prescribe effective HIIT programmes for improving CRF in overweight and obese adults.
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http://dx.doi.org/10.1080/02640414.2021.1964800DOI Listing
August 2021

Finite element analysis of the lumbar spine in adolescent idiopathic scoliosis subjected to different loads.

Comput Biol Med 2021 09 8;136:104745. Epub 2021 Aug 8.

Faculty of Sports Science, Ningbo University, Ningbo, 315211, China. Electronic address:

Objective: To explore the biomechanical changes of the lumbar spine segment of idiopathic scoliosis under different loads by simulating six kinds of lumbar spine motions based on a three-dimensional finite element (FE) model. Methods According to the plain CT scan data of L1-L5 segment of an AIS patient, a three-dimensional FE model was established to simulate the biomechanics of lumbar scoliosis under different loads. The lumbar model was reconstructed using Mimics20.0, smoothed in Geomagic2013, assembled in Solidworks 2020, with FE analysis performed using Workbench19.0. Results The completed model had a total of 119029 C3D4 solid elements, 223805 nodes, including finely reconstructed tissue structures. In patients with AIS, the range of motion (ROM) is reduced under all loads. Under flexion loads, the vertebral concave stress distribution is greater; under extension lateral bending, and rotation load at the posterior side of the vertebral body, the stress is concentrated in the L3 vertebral arch. The buffering effect of intervertebral disc on the rotational load is the weakest. Different loads of AIS cause corresponding changes in the force and displacement of different positions of the vertebral body or intervertebral discs. Conclusions The change in physiological shape of the lumbar vertebrae limits the ROM of the lumbar vertebrae. The stress showed a trend of local concentration which located in the concave side of the scoliosis. The stress on the lumbar vertebrae comprising the greatest curvature is the most excessive. The stress in the intervertebral disc under the rotating load is greater than that under other kinds of loads, and the intervertebral disc is more likely to be injured because of the rotating load.
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http://dx.doi.org/10.1016/j.compbiomed.2021.104745DOI Listing
September 2021

Tranexamic acid in non-traumatic intracranial bleeding: a systematic review and meta-analysis.

Sci Rep 2021 07 27;11(1):15275. Epub 2021 Jul 27.

CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Occupational and Environmental Medicine, Université Clermont Auvergne, WittyFit, 63000, Clermont-Ferrand, France.

Non-traumatic intracranial bleeding (NTIB), comprising subarachnoid hemorrhage (SAH) and intra-cranial bleeding (ICH) is a significant public health concern. Tranexamic acid (TXA) is a promising treatment with benefits yet to be fully demonstrated. We conducted a systematic review and meta-analysis on the impact of TXA on mortality in NTIB. We searched the PubMed, Cochrane Library, Google Scholar and ScienceDirect databases for studies reporting mortality data following the use of TXA in NTIB for comparisons with a control group. We computed random-effect meta-analysis on estimates of risk and sensitivity analyses. We computed meta-regression to examine the putative effects of the severity of NTIB, sociodemographic data (age, sex), and publication date. Among potentially 10,008 articles, we included 15 studies representing a total of 4883 patients: 2455 receiving TXA and 2428 controls; 1110 died (23%) during the follow-up. The meta-analysis demonstrated a potential of 22% decrease in mortality for patients treated by TXA (RR = 0.78, 95%CI 0.58-0.98, p = 0.002). Meta-regression did not demonstrate any influence of the severity of NTIB, age, sex, length of treatment or date of publication. Sensitivity analyses confirmed benefits of TXA on mortality. TXA appears to be a therapeutic option to reduce non-traumatic intracranial bleeding mortality, particularly in patients with SAH.
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http://dx.doi.org/10.1038/s41598-021-94727-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8316462PMC
July 2021

The Positive Role of Tai Chi in Responding to the COVID-19 Pandemic.

Int J Environ Res Public Health 2021 Jul 13;18(14). Epub 2021 Jul 13.

Faculty of Sports Science, Ningbo University, Ningbo 315211, China.

The ongoing coronavirus 2019 (COVID-19) pandemic has posed a significant threat to both people's physical and mental health. Physical inactivity, sedentary behavior, and negative emotions among the general population have been significantly increased because of COVID-19 home confinement. These are major risk factors associated with higher incidences of morbidity and mortality. Therefore, effective exercise management should be proposed as a prevention strategy to improve both physical and mental health while diminishing the effects of COVID-19. Tai Chi as a low-to-moderate aerobic exercise combines physical and mental training and plays a positive impact on human health. Here we aim to outline the effects of Tai Chi on the immune system, inflammatory responses, pulmonary function, and emotional control. The benefits of Tai Chi practice for individuals coping with COVID-19 are stated here which include immune system promotion, inflammation response reduction, rehabilitation in respiratory diseases, and emotional improvement. This statement has been supported by available clinical, physiological, and biological research. As a result, we hope to introduce Tai Chi as an effective exercise intervention for people coping with COVID-19 and as a beneficial exercise for maintaining an active lifestyle during a pandemic.
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http://dx.doi.org/10.3390/ijerph18147479DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307944PMC
July 2021

Ketogenic diets, physical activity, and body composition: A review.

Br J Nutr 2021 Jul 12:1-68. Epub 2021 Jul 12.

Department of Biomedical Sciences, University of Padua, Padua, Italy.

Obesity remains a serious relevant public health concern throughout the world despite related countermeasures being well understood (i.e., mainly physical activity and an adjusted diet). Among different nutritional approaches, there is a growing interest in ketogenic diets (KDs) to manipulate body mass (BM) and to enhance fat mass (FM) loss. KDs reduce the daily amount of carbohydrate intake drastically. This results in increased fatty acid utilization, leading to an increase in blood ketone bodies (KBs) (acetoacetate [AcAc], 3-β-hydroxybutyrate [BHB], and acetone), and therefore metabolic ketosis. For many years, nutritional intervention studies have focused on reducing dietary fat with little or conflicting positive results over the long-term. Moreover, current nutritional guidelines for athletes propose carbohydrate-based diets to augment muscular adaptations. This review discusses the physiological basis of KDs and their effects on BM reduction and body composition improvements in sedentary individuals combined with different types of exercise (resistance training [RT] or endurance training [ET]) in individuals with obesity and athletes. Ultimately, we discuss the strengths and the weaknesses of these nutritional interventions together with precautionary measures that should be observed in both individuals with obesity and athletic populations. A literature search from 1921 to April 2021 using MEDLINE, GOOGLE SCHOLAR, PUBMED, WEB OF SCIENCE, SCOPUS, and SPORTDISCUS databases were used to identify relevant studies. In summary, based on the current evidence, KDs are an efficient method to reduce BM and body fat in both individuals with obesity and athletes. However, these positive impacts are mainly because of the appetite suppressive effects of KDs, which can decrease daily calorie intake. Therefore, KDs do not have any superior benefits to non-KDs in BM and body fat loss in individuals with obesity and athletic populations in an isocaloric situation. In sedentary individuals with obesity, it seems that fat-free mass (FFM) changes appear to be as great, if not greater, than decreases following a low-fat diet (LFD). In terms of lean mass, it seems that following a KD can cause FFM loss in resistance-trained individuals. In contrast, the FFM-preserving effects of KDs are more efficient in endurance-trained compared to resistance-trained individuals.
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http://dx.doi.org/10.1017/S0007114521002609DOI Listing
July 2021

Gender Differences in Kinematic Analysis of the Lower Limbs during the Chasse Step in Table Tennis Athletes.

Healthcare (Basel) 2021 Jun 10;9(6). Epub 2021 Jun 10.

Faculty of Sports Science, Ningbo University, Ningbo 315211, China.

The chasse step is one of the most important footwork maneuvers used in table tennis. The purpose of this study was to investigate the lower limb kinematic differences of table tennis athletes of different genders when using the chasse step. The 3D VICON motion analysis system was used to capture related kinematics data. The main finding of this study was that the step times for male athletes (MA) were shorter in the backward phase (BP) and significantly longer in the forward phase (FP) than for female athletes (FA) during the chasse step. Compared with FA, knee external rotation for MA was larger during the BP. MA showed a smaller knee flexion range of motion (ROM) in the BP and larger knee extension ROM in the FP. Moreover, hip flexion and adduction for MA were significantly greater than for FA. In the FP, the internal rotational velocity of the hip joint was significantly greater. MA showed larger hip internal rotation ROM in the FP but smaller hip external rotation ROM in the BP. The differences between genders can help coaches personalize their training programs and improve the performance of both male and female table tennis athletes.
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http://dx.doi.org/10.3390/healthcare9060703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229901PMC
June 2021

An Investigation of Knee Injury Profiles among Iranian Elite Karatekas: Observations from a Cross-Sectional Study.

Int J Environ Res Public Health 2021 06 27;18(13). Epub 2021 Jun 27.

Physiological and Psychosocial Stress, UMR CNRS 6024 LaPSCo, University of Clermont Auvergne, 63000 Clermont-Ferrand, France.

Karate training, despite the many positive health benefits, carries a risk of injury for participants. The current cross-sectional study aimed to investigate knee injury profiles among Iranian elite karatekas. Participants who attended the national team qualifiers, which included 390 male Kumite karatekas (age 24 ± 3 years old and weight 63 ± 12 kg), participated in this study. Information on knee injuries (injury history, type of injury mechanisms, and effects of knee symptoms on the ability to perform daily activities and recreational activities) were obtained using the Knee Outcome Survey (KOS). Using Pearson's correlation coefficient, the study examined the relationships between different variables, including KOS subscales and levels of self-reported knee joint function. Our findings indicated that 287 karatekas (73.6%) experienced knee injuries. The anterior cruciate ligament (ACL) rupture (6.9%), articular cartilage (5.4%), and meniscus damage (3.8%) were the main typology of injury. In addition, there were no differences in knee injuries between the non-dominant and dominant legs. Most injuries occurred during the preparatory period ( = 162, 50%), especially during training periods. The KOS subscales scores (Mean ± Sd) for activities of daily living (ADL) and sports activity (SAS) were, respectively, 89 ± 11 and 91 ± 9. The self-reported scores for both the ADL and SAS subscales were, respectively, 89 ± 11 and 90 ± 10. Pearson coefficients of ADL and SAS subscales with their self-reported score were r = 0.761 ( < 0.0001) and r = 0.782 and ( < 0.0001), respectively. The profile of knee injuries in the current investigation is similar to previous surveys that reported lower extremity injury patterns. The findings of this study could be adopted to inform practice aimed at planning interventions for the reduction and prevention of knee injuries among karatekas.
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http://dx.doi.org/10.3390/ijerph18136888DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296942PMC
June 2021

The Forgotten Health-Care Occupations at Risk of Burnout-A Burnout, Job Demand-Control-Support, and Effort-Reward Imbalance Survey.

J Occup Environ Med 2021 Jul;63(7):e416-e425

Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand (Ms Serole, Mr Prunet); Université Clermont Auvergne, University Hospital of Clermont-Ferrand, Public Health, Centre National de la Recherche Scientifique, Sigma Clermont, Institut Pascal (Dr Auclair, Dr Gerbaud); National Research University Higher School of Economics, Moscow, Russia (Dr Charkhabi); Laboratory Epsylon EA4556, Dynamic of Human Abilities & Health Behavior, Montpellier, University Hospital of Montpellier, Occupational and Preventive Medicine, University of Montpellier (Dr Lesage); Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China (Dr Baker); Centre National de la Recherche Scientifique, Laboratoire de Psychologie et NeuroCognition, Université Grenoble Alpes (Dr Mermillod); Institut Universitaire de France, Paris (Dr Mermillod); Centre National de la Recherche Scientifique, Laboratoire de Psychologie Sociale et Cognitive, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Université Clermont Auvergne, WittyFit (Dr Dutheil), Clermont-Ferrand, France; Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia (Dr Dutheil).

Aims: We conducted a cross-sectional study on healthcare workers from the University Hospital in Clermont-Ferrand. They received a self-report questionnaire consisting of the Maslach Burnout Inventory, Job Demand Control Support, Effort-Reward Imbalance model, and questions about ethical conflict in order to investigate on burnout.

Results: We included 1774 workers. Overinvestment was the only factor explaining the increase in emotional exhaustion, depersonalization, and the decrease in personal accomplishment. Taking into account the absence of burnout as a reference, overinvestment multiplied the risk of high burnout by 22.0 (5.10 to 94.7).

Conclusion: Some "forgotten" occupations among healthcare workers are at risk of burnout. Overinvestment was the main factor explaining the increase in the tree dimensions of burnout. Moreover, the two main models of stress at work were highly predictive of burnout.
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http://dx.doi.org/10.1097/JOM.0000000000002235DOI Listing
July 2021

COVID-19 lockdown consequences on body mass index and perceived fragility related to physical activity: A worldwide cohort study.

Health Expect 2021 Jun 9. Epub 2021 Jun 9.

Physiological and Psychosocial Stress, LaPSCo, CNRS, Preventive and Occupational Medicine, WittyFit, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France.

Background: This paper is a follow-up study continuing the COVISTRESS network previous research regarding health-related determinants.

Objective: The aim was to identify the main consequences of COVID-19 lockdown on Body Mass Index and Perceived Fragility, related to Physical Activity (PA), for different categories of populations, worldwide.

Design: The study design included an online survey, during the first wave of COVID-19 lockdown, across different world regions.

Setting And Participants: The research was carried out on 10 121 participants from 67 countries. The recruitment of participants was achieved using snowball sampling techniques via social networks, with no exclusion criteria other than social media access.

Main Outcome Measures: Body Mass Index, Physical Activity, Perceived Fragility and risk of getting infected items were analysed. SPSS software, v20, was used. Significance was set at P < .05.

Results: Body Mass Index significantly increased during lockdown. For youth and young adults (18-35 years), PA decreased by 31.25%, for adults (36-65 years) by 26.05% and for the elderly (over 65 years) by 30.27%. There was a high level of Perceived Fragility and risk of getting infected for female participants and the elderly. Correlations between BMI, Perceived Fragility and PA were identified.

Discussion And Conclusions: The research results extend and confirm evidence that the elderly are more likely to be at risk, by experiencing weight gain, physical inactivity and enhanced Perceived Fragility. As a consequence, populations need to counteract the constraints imposed by the lockdown by being physically active.
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http://dx.doi.org/10.1111/hex.13282DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8239498PMC
June 2021

The Biomechanics of Shoulder Movement with Implications for Shoulder Injury in Table Tennis: A Minireview.

Appl Bionics Biomech 2021 8;2021:9988857. Epub 2021 May 8.

Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong.

A high proportion of shoulder injuries in table tennis players are common, which is both a diagnostic and therapeutic challenge. An understanding of the interaction between biomechanical function of the shoulder and mechanisms of shoulder injuries in table tennis players is necessary to prevent injury and to conduct clinical treatment of the shoulder as soon as possible. The purpose of this minireview was to select the available evidence on the biomechanical characteristics of shoulder movement and potential relationships with various shoulder injuries that are common in table tennis players. Five studies revealed interesting biomechanical characteristics of shoulder movement patterns in table tennis players: large internal rotation torque, an increased torsion-rotation movement, and a greater angular velocity of internal rotation were found. Two studies were noted that were related to specific shoulder injury: glenohumeral internal rotation deficit (GIRD) and impingement syndrome. Unfortunately, it is difficult to draw conclusions on the mechanisms of shoulder injury in table tennis players due to the little evidence available that has investigated shoulder injury mechanisms based on biomechanical characteristics. Future studies should focus on the potential relationship between the biomechanical characteristics of the shoulder and injury prevalence to provide valuable reference data for clinical treatment.
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http://dx.doi.org/10.1155/2021/9988857DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8123990PMC
May 2021

Evaluation of Web-Based and In-Person Methods to Recruit Adults With Type 1 Diabetes for a Mobile Exercise Intervention: Prospective Observational Study.

JMIR Diabetes 2021 Jul 8;6(3):e28309. Epub 2021 Jul 8.

Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.

Background: Our clinical trial of a mobile exercise intervention for adults 18 to 65 years old with type 1 diabetes (T1D) occurred during COVID-19 social distancing restrictions, prompting us to test web-based recruitment methods previously underexplored for this demographic.

Objective: Our objectives for this study were to (1) evaluate the effectiveness and cost of using social media news feed advertisements, a clinic-based approach method, and web-based snowball sampling to reach inadequately active adults with T1D and (2) compare characteristics of enrollees against normative data.

Methods: Participants were recruited between November 2019 and August 2020. In method #1, Facebook and Instagram news feed advertisements ran for five 1-to-8-day windows targeting adults (18 to 64 years old) in the greater New Haven and Hartford, Connecticut, areas with one or more diabetes-related profile interest. If interested, participants completed a webform so that the research team could contact them for eligibility screening. In method #2, patients 18 to 24 years old with T1D were approached in person at clinical visits in November and December 2019. Those who were interested immediately completed eligibility screening. Older patients could not be approached due to clinic restrictions. In method #3, snowball sampling was conducted by physically active individuals with T1D contacting their peers on Facebook and via email for 48 days, with details to contact the research staff to express interest and complete eligibility screening. Other methods referred participants to the study similarly to snowball sampling.

Results: In method #1, advertisements were displayed to 11,738 unique viewers and attracted 274 clickers (2.33%); 20 participants from this group (7.3%) volunteered, of whom 8 (40%) were eligible. Costs averaged US $1.20 per click and US $95.88 per eligible volunteer. Men had lower click rates than women (1.71% vs 3.17%; P<.001), but their responsiveness and eligibility rates did not differ. In method #2, we approached 40 patients; 32 of these patients (80%) inquired about the study, of whom 20 (63%) volunteered, and 2 of these volunteers (10%) were eligible. Costs including personnel for in-person approaches averaged US $21.01 per inquirer and US $479.79 per eligible volunteer. In method #3, snowball sampling generated 13 inquirers; 12 of these inquirers (92%) volunteered, of whom 8 (67%) were eligible. Incremental costs to attract inquirers were negligible, and total costs averaged US $20.59 per eligible volunteer. Other methods yielded 7 inquirers; 5 of these inquirers (71%) volunteered, of whom 2 (40%) were eligible. Incremental costs to attract inquirers were negligible, and total costs averaged US $34.94 per eligible volunteer. Demographic overrepresentations emerged in the overall cohort (ie, optimal glycemic control, obesity, and low exercise), among those recruited by news feed advertisements (ie, obesity and older age), and among those recruited by snowball sampling (ie, optimal glycemic control and low exercise).

Conclusions: Web-based advertising and recruitment strategies are a promising means to attract adults with T1D to clinical trials and exercise interventions, with costs comparing favorably to prior trials despite targeting an uncommon condition (ie, T1D) and commitment to an intervention. These strategies should be tailored in future studies to increase access to higher-risk participants.

Trial Registration: ClinicalTrials.gov NCT04204733; https://clinicaltrials.gov/ct2/show/NCT04204733.
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http://dx.doi.org/10.2196/28309DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299346PMC
July 2021

Air pollution in post-COVID-19 world: the final countdown of modern civilization? : Comment on: "COVID-19 and air pollution: the worst is yet to come".

Environ Sci Pollut Res Int 2021 Sep 17;28(33):46079-46081. Epub 2021 May 17.

Université Clermont Auvergne, CNRS, INSERM, GReD, Translational Approach to Epithelial Injury and Repair, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Ophthalmology, F-63000, Clermont-Ferrand, France.

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http://dx.doi.org/10.1007/s11356-021-14433-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8127856PMC
September 2021

COVID-19 Rehabilitation With Herbal Medicine and Cardiorespiratory Exercise: Protocol for a Clinical Study.

JMIR Res Protoc 2021 May 26;10(5):e25556. Epub 2021 May 26.

Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon, Hong Kong.

Background: Recent studies have revealed that many discharged patients with COVID-19 experience ongoing symptoms months later. Rehabilitation interventions can help address the consequences of COVID-19, including medical, physical, cognitive, and psychological problems. To our knowledge, no studies have investigated the effects of rehabilitation following discharge from hospital for patients with COVID-19.

Objective: The specific aims of this project are to investigate the effects of a 12-week exercise program on pulmonary fibrosis in patients recovering from COVID-19. A further aim will be to examine how Chinese herbal medicines as well as the gut microbiome and its metabolites regulate immune function and possibly autoimmune deficiency in the rehabilitation process.

Methods: In this triple-blinded, randomized, parallel-group, controlled clinical trial, we will recruit adult patients with COVID-19 who have been discharged from hospital in Hong Kong and are experiencing impaired lung function and pulmonary function. A total of 172 eligible patients will be randomized into four equal groups: (1) cardiorespiratory exercise plus Chinese herbal medicines group, (2) cardiorespiratory exercise only group, (3) Chinese herbal medicines only group, and (4) waiting list group (in which participants will receive Chinese herbal medicines after 24 weeks). These treatments will be administered for 12 weeks, with a 12-week follow-up period. Primary outcomes include dyspnea, fatigue, lung function, pulmonary function, blood oxygen levels, immune function, blood coagulation, and related blood biochemistry. Measurements will be recorded prior to initiating the above treatments and repeated at the 13th and 25th weeks of the study. The primary analysis is aimed at comparing the outcomes between groups throughout the study period with an α level of .05 (two-tailed).

Results: The trial has been approved by the university ethics committee following the Declaration of Helsinki (approval number: REC/19-20/0504) in 2020. The trial has been recruiting patients. The data collection will be completed in 24 months, from January 1, 2021, to December 31, 2022.

Conclusions: Given that COVID-19 and its sequelae would persist in human populations, important findings from this study would provide valuable insights into the mechanisms and processes of COVID-19 rehabilitation.

Trial Registration: ClinicalTrials.gov NCT04572360; https://clinicaltrials.gov/ct2/show/NCT04572360.

International Registered Report Identifier (irrid): PRR1-10.2196/25556.
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http://dx.doi.org/10.2196/25556DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8158531PMC
May 2021

Cardio-Metabolic Risk Factors in Scottish South Asian and Caucasian Youth.

Int J Environ Res Public Health 2021 04 27;18(9). Epub 2021 Apr 27.

Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong 999077, China.

(1) Background: Scotland has one of the highest rates of obesity in the Western World, it is well established that poor weight profiles, and particularly abdominal obesity, is strongly associated with Type II diabetes and cardiovascular diseases. Whether these associations are apparent in ethnic population groups in Scotland is unclear. The purpose of this study was to examine the associations between different measures of fatness with clustered cardio metabolic risk factors between Scottish South Asian adolescents and Scottish Caucasian adolescents; (2) Methods: A sample of 208 Caucasian adolescents and 52 South Asian adolescents participated in this study. Stature, waist circumference, body mass index, blood pressure, physical activity, and cardiovascular disease (CVD) risk were measured; (3) Results: Significant, partial correlations in the South Asian cohort between body mass index (BMI) and individual risk factors were generally moderate. However, correlations between Waist circumference (WC) and individual risk factors were significant and strong. In the Caucasian cohort, a significant yet weak correlation between WC and total cholesterol (TG) was noted although no other associations were evident for either WC or BMI. Multiple regression analysis revealed that both BMI and WC were positively associated with CCR ( < 0.01) in the South Asian group and with the additional adjustment of either WC or BMI, the independent associations with clustered cardio-metabolic risk (CCR) remained significant ( < 0.005); (4) Conclusions: No positive relationships were found between BMI, WC, and CCR in the Caucasian group. Strong and significant associations between measures of fatness and metabolic risk were evident in Scottish South Asian adolescents.
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http://dx.doi.org/10.3390/ijerph18094667DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8125757PMC
April 2021

Electromyographic Assessment of the Lower Leg Muscles during Concentric and Eccentric Phases of Standing Heel Raise.

Healthcare (Basel) 2021 Apr 14;9(4). Epub 2021 Apr 14.

Advanced Textiles Research Group, School of Art and Design, Nottingham Trent University, Bonington Building, Dryden Street, Nottingham NG1 4GG, UK.

Only a small number of muscle activation patterns from lower limbs have been reported and simultaneous muscle activation from several lower limb muscles have not yet been investigated. The purpose of this study was to examine any gender differences in surface electromyography (EMG) activity from six recorded lower limb muscles of the dominant limb at baseline (i.e., with the foot placed flat on the floor and in the neutral position), and during concentric and eccentric phases when performing a heel raise task. In total, 10 females and 10 males performed a standing heel raise task comprising of three continuous phases: baseline, unloading (concentric muscle action), and loading (eccentric muscle action) phases. Muscle activation from six muscles (gastrocnemius medialis, gastrocnemius lateralis, soleus, tibialis anterior, peroneus longus, and peroneus brevis) were measured using the Myon 320 EMG System. Root mean squared values of each muscle were calculated for each phase. Descriptive and inferential statistics were incorporated into the study. Statistically significant values were set at 0.05. The results showed no significant differences between baseline, concentric, and eccentric phases with respect to each of the muscles investigated. Except for the gastrocnemius medialis at baseline and concentric phases, no significant differences were observed between genders or contractions. The data suggests that gender does not significantly influence the eccentric phase during the standing heel raise task.
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http://dx.doi.org/10.3390/healthcare9040465DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070905PMC
April 2021

The effects of exercise and low-calorie diets compared with low-calorie diets alone on health: a protocol for systematic reviews and meta-analyses of controlled clinical trials.

Syst Rev 2021 04 20;10(1):120. Epub 2021 Apr 20.

Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background: Exercise and weight loss diets are two independent non-pharmaceutical strategies used to improve several aspects of body composition and health. We plan to systematically review controlled clinical trials investigating weight loss diets alone compared to weight loss diets in conjunction with exercise on energy intake, body weight, body composition, cardiometabolic risk factors, sex hormones, and mental health.

Methods And Analysis: PubMed/MEDLINE, EMBASE, ISI (Web of Science), Scopus, and Google Scholar will be searched to retrieve potential controlled clinical trials investigating the effects of exercise in conjunction with weight loss diets compared with weight loss diets alone on energy intake, body weight and composition (fat mass, fat-free mass), anthropometrics (waist circumference), cardiometabolic markers, sex hormones [testosterone, estradiol, and sex hormone binding globulin (SHBG)], liver and kidney enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), uric acid, blood urea nitrogen (BUN), glomerular filtration rate (GFR), quality of life, and depression in adults. The weighted mean difference (WMD) and its corresponding 95% confidence intervals (CIs) will be derived using random effects model. Several subgroup analyses based on follow-up duration, the health status of the participants, the diet used for weight loss, the exercise protocol, participants' sex, and other possible variables will be conducted to explore possible sources of heterogeneity. Publication bias will be explored by inspecting funnel plots and by conducting asymmetry tests. Overall quality of the evidence will be assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool.

Discussion: We envisage that this systematic review and meta-analysis will provide valuable information regarding the effectiveness of adding exercise to weight loss diets. No primary data is going to be collected; therefore, ethical approval is not required. The resulting manuscripts will be disseminated in peer-reviewed journals and at international and national conferences.

Systematic Review Registration: The study protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO, Registration ID: CRD42020173434 ).
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http://dx.doi.org/10.1186/s13643-021-01669-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8059276PMC
April 2021

Perceived Motivational Climates and Doping Intention in Adolescent Athletes: The Mediating Role of Moral Disengagement and Sportspersonship.

Front Psychol 2021 24;12:611636. Epub 2021 Mar 24.

School of Psychology, Beijing Sport University, Beijing, China.

Doping is an important issue in competitive sports and poses potentially irreversible consequences to athletes. Understanding the psychological process underlying antecedents and doping intention will inform policy and prevention. This study aimed to test the psychosocial mechanisms of doping in adolescent athletes using an integrated model. In this model, we examined the associations of perceived motivational climate (i.e., task-involving and ego-involving), moral variables (i.e., moral disengagement and sportspersonship), and attitudinal variables (i.e., perceived pros/cons of doping and perceived cons of not doping) with doping intention. We further investigated whether the moral variables mediated the relationship between perceived motivational climate and doping intention. A cross-sectional survey was employed in the present study. Six hundred and fifteen Chinese adolescent athletes (mean age = 15.68 ± 1.67 years) completed questionnaires measuring demographic information and the variables mentioned previously. Structural equation modeling showed that the hypothesized model had a good fit and explained 64.1% of the variance in doping intention. Task-involving motivational climate indicated both directly and indirectly negative associations with doping intention via sportspersonship. The ego-involving motivational climate was positively associated with doping intention via moral disengagement. Among perceived pros/cons of doping and perceived cons of not doping, both perceived cons of doping and cons of not doping were positively associated with doping intention with a small effect size. This study confirmed the roles of tasking- and ego-involving motivational climates, moral variables, and attitudinal variables on doping intention. These research findings may provide new insights for the future of intention-based doping prevention programmes.
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http://dx.doi.org/10.3389/fpsyg.2021.611636DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024559PMC
March 2021

Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis.

Front Physiol 2021 26;12:651851. Epub 2021 Mar 26.

China Institute of Sport and Health Science, Beijing Sport University, Beijing, China.

Kinetics, moderators and reference limits for exercise-induced cardiac troponin T (cTnT) elevations are still unclear. A systematic review of published literature was conducted adhering to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Studies reporting high-sensitivity cardiac troponin T (hs-cTnT) concentrations before and after a bout of exercise in athletes were included and analyzed. The final dataset consisted of 62 estimates from 16 bouts in 13 studies of 5-1,002 athletes (1,421 in total). Meta-analysis was performed using general linear mixed modeling and Bayesian inferences about effect magnitudes. Modifying fixed-effect moderators of gender, age, baseline level, exercise duration, intensity and modalities were investigated. Simulation was used to derive 99th percentile with 95% limits of upper reference ranges for hs-cTnT of athletic populations. The mean and upper reference limits of hs-cTnT before exercise were 4.4 and 19 ng.L. Clear increases in hs-cTnT ranging from large to very large (factor changes of 2.1-7.5, 90% compatibility limits, ×/÷1.3) were evident from 0.7 through 25 h, peaking at 2.9 h after the midpoint of a 2.5-h bout of running, when the mean and upper reference limit for hs-cTnT were 33 and 390 ng L. A four-fold increase in exercise duration produced a large clear increase (2.4, ×/÷1.7) in post-exercise hs-cTnT. Rowing exercise demonstrated an extremely large clear reduction (0.1 ×/÷2.4). The kinetics of cTnT elevation following exercise, the positive effect of exercise duration, the impact of exercise modality and 99th upper reference limits for athletic populations were reasonably well defined by this meta-analysis.
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http://dx.doi.org/10.3389/fphys.2021.651851DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033011PMC
March 2021
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