ResearchPad - original-contribution https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Athlete availability and incidence of overuse injuries over an athletics season in a cohort of elite Swedish athletics athletes - a prospective study]]> https://www.researchpad.co/article/elastic_article_12681 Athletics is a sport with a high incidence of injury, where most injuries are caused by overuse. Research on injury incidence and the occurrence of overuse injuries during a season in athletics is scarce. An athlete availability (unrestricted ability to participate in training or competition) of less than 80% has been linked with athletes being less likely to reach their performance goals. The purpose of this study was to estimate the monthly injury incidence rates, athlete availability, and the overuse injury incidence rate per 1000 athletics-hours of training in a cohort of Swedish elite athletics athletes.MethodsThe cohort consisted of 59 male and female elite athletes competing in either middle or long-distance running, sprint, or jumping events. Injury and training data were collected during one athletics season, from October to the end of August. All injury data were collected by medical professionals. Training data were collected monthly, and consisted of event-specific training diaries covering training sessions, training days, and non-training or non-competition days. Monthly injury incidence rates were based on the number of new injuries per month in relation to the number of exposed (injury-free) athletes.ResultsThe overall injury incidence rate for all athletes was highest in October (22.0%). Monthly injury incidence rate for middle and long-distance runners was highest in October (26.1%), for sprinters in April (19.0%), and for jumpers in October (21.4%). The overall athlete availability was 78.0% for the cohort. Sprinters had the lowest athlete availability (71.4%), followed by jumpers (77.3%), and middle-distance and long-distance runners (82.7%). Female athletes (76.5%) had a lower athlete availability than male athletes (79.7%). The injury incidence rate was 1.81 injuries per 1000 athletics hours of training. Middle and long-distance runners had the highest injury incidence rate (2.38), followed by jumpers (1.62), and sprinters (1.34).ConclusionMonthly injury incidence rates during a season appears to correspond to periods of high training volume (conditioning phases and training camps). The low overall athlete availability (> 80%) indicates that many Swedish elite athletes are less likely to reach their full potential. ]]> <![CDATA[Executive function training in very preterm children: a randomized controlled trial]]> https://www.researchpad.co/article/elastic_article_10724 Objective of the current study was to assess whether game-formatted executive function (EF) training, is effective in improving attention, EF and academic performance in very preterm and/or extremely low birthweight children aged 8–12 years. A multi-center, double-blind, placebo- and waitlist controlled randomized trial (NTR5365) in two academic hospitals in The Netherlands was performed. Eighty-five very preterm children with parent-rated attention problems on the Child Behavior Checklist were randomized to one of three treatment conditions: EF training, placebo training or waitlist condition. EF or placebo training was completed at home (6 weeks, 25 sessions of 30–45 min each). At baseline, 2 weeks after training or being on the waitlist, and five months after first follow-up visit, children underwent assessments of primary outcomes (parent and teacher ratings of attention) and secondary outcomes (parent and teacher ratings of daily-life EF, computerized EF tasks and academic performance). Linear mixed model analyses were performed for all outcome measures. There were no significant differences in improvement over time on parent- and teacher ratings of attention, parent- and teacher ratings of daily-life EF, computerized EF tasks, and academic performance (arithmetic and reading) between the EF training, placebo training and waitlist condition. In conclusion, game-formatted EF training does not improve attention, EF or academic performance in very preterm children with parent-rated attention problems.

Electronic supplementary materialThe online version of this article (10.1007/s00787-020-01561-0) contains supplementary material, which is available to authorized users. ]]>
<![CDATA[Are high school girls’ lacrosse players at increased risk of concussion because they are not allowed to wear the same helmet boys’ lacrosse players are required to wear?]]> https://www.researchpad.co/article/elastic_article_9346 Boys’ lacrosse (LAX), a full contact sport allowing body and stick checking, mandates hard shell helmets with full face masks. Girls’ LAX, which prohibits body checking and whose sphere rule is supposed to prevent stick checking to the head, allows optional flexible headgear with/without integrated eye protection. Whether the required boys’ LAX helmets should also be mandated in girls’ LAX has been debated.MethodsIn this retrospective cohort study we used LAX concussion data from a national high school sports-related injury surveillance study to determine if girls’ LAX players were at increased risk of concussion from stick or ball contact due to differences in helmet regulations by calculating the attributable risk and attributable risk percent (AR%) for concussion resulting from ball or stick impacts.ResultsFrom 2008-09 through 2018–19, boys’ LAX players sustained 614 concussions during 1,318,278 athletic exposures (AEs) (4.66 per 10,000 AEs) and girls’ LAX players sustained 384 concussions during 983,291 AEs (3.91 per 10,000 AEs). For boys, athlete-athlete contact was the most common mechanism of concussion accounting for 66.4% of all concussions, while stick or ball contact accounted for 23.5%. For girls, stick or ball contact accounted for 72.7% of all concussions, while athlete-athlete contact accounted for 19.8%. Concussion rates from stick or ball contact were significantly higher in girls vs. boys (RR = 2.60, 95% CI 2.12–3.18). The attributable risk associated with playing girls’ vs. boys’ LAX for concussion resulting from stick or ball contact was 1.75 concussions per 10,000 AEs (95% CI 1.37–2.12) and the AR% was 61.5% (95% CI 52.9–68.5). An estimated 44.7% of all girls’ LAX concussions could have been prevented if girls’ LAX players wore the helmet mandated in boys’ LAX.ConclusionsGirls’ LAX players who are allowed, but not required, to wear a flexible headgear are at increased risk of concussions from stick or ball impacts compared to boys’ LAX players, who are required to wear a hard shell helmet with full face mask. Additional research is needed to determine if there are any defendable arguments to continue justifying restricting girls’ LAX players access to this effective piece of protective equipment. ]]> <![CDATA[In vitro and in vivo evaluation of a moisture treatment cream containing three critical elements of natural skin moisturization]]> https://www.researchpad.co/article/elastic_article_7086 To evaluate skin barrier and hydration effects of a new rebalancing moisture treatment (TRMT) and to assess efficacy and tolerability in subjects with photodamaged skin.MethodsIn an epidermal skin model, tissues (n = 5/group) were topically treated with 25 µL of TRMT, 25 µL of a market‐leading moisturizer (MLM), or untreated for 60 minutes. Hydration was measured at 0, 15, and 30 minutes. Tissues were harvested for gene expression analysis of markers associated with skin barrier and hydration: Claudin (CLD), Aquaporin (AQP), Hyaluronic Acid Syntheses (HAS), and Hyaluronidase (HYAL). A clinical study evaluated twice‐daily application of TRMT, assessing changes in fine lines/wrinkles, brightness, texture, erythema, and tolerability from baseline through week 8. Hydration was measured using electrical impedance.ResultsTRMT and MLM demonstrated significant increases in hydration vs untreated tissue at each timepoint (P < .005), with greater hydration effects observed for TRMT vs MLM. TRMT‐treated tissues demonstrated greater expression of CLD, AQP, and HA, and reduced expression of HYAL vs untreated and MLM‐treated tissues. Twice‐daily application of TRMT demonstrated significant improvements at 2 weeks in fine lines/wrinkles (P < .001), brightness (P < .0001), texture (P < .0004), and hydration (P < .004). At 8 weeks, statistically significant improvements were achieved in all categories.ConclusionIn an epidermal skin model, TRMT demonstrated significant increases in hydration, greater hydration effects, and expression of key markers associated with skin barrier and hydration vs a MLM. Twice‐daily application of TRMT was well tolerated and resulted in early, significant improvements in hydration and visible improvements in skin brightness, texture, fine lines/wrinkles, and erythema at 8 weeks. ]]> <![CDATA[Novel interpenetrating polymer network provides significant and long‐lasting improvements in hydration to the skin from different body areas]]> https://www.researchpad.co/article/elastic_article_6912 Hydration and moisturization both impact skin quality, directly reflecting its appearance. Signs and onset of dehydration‐related skin aging are region‐specific and require tailored treatment to be effective.AimsTo test the hydrating effects of formulas containing a novel 3‐dimensional 3‐polymer interpenetrating network (3D3P‐IPN) to deliver humectants and actives to specific body sites.MethodsTwo clinical studies were conducted focused on the skin under eyes and body (arms/legs). Healthy women ages 25‐65 (eyes) or 35‐65 (body) with mild to moderate dry and aged skin were enrolled. Study product containing the 3D3P‐IPN and tailored actives was applied twice daily for 8 weeks on the periorbital area and for 4 weeks on the body. Changes in skin attributes were measured by biophysical instrumentation for hydration, dark circles, skin color, elasticity and transepidermal water loss, and by clinical grading and subject self‐assessment.ResultsSignificant improvements in hydration and skin smoothing were demonstrated in both studies. In the periorbital region, actives and humectants delivered by the 3D3P‐IPN also led to significant improvements in dark circles, fine lines/crow's feet, puffiness, restoring radiance, and overall younger‐looking appearance. On the arms and legs, there were significant reductions in crepiness and dullness. The arms and legs also had improvements in tactile and visual skin texture, radiance, and general healthy look. Improvements were immediate and persisted through the end of both studies.ConclusionThe 3D3P‐IPN provides immediate and long‐lasting improvements in skin hydration and overall healthy appearance regardless of the targeted application site. ]]> <![CDATA[Understanding anhedonia: a qualitative study exploring loss of interest and pleasure in adolescent depression]]> https://www.researchpad.co/article/Ndfc06f3d-6d40-4585-bd30-5e4b184993c5

Anhedonia (or loss of interest and pleasure) is a core symptom of depression and may predict poor treatment outcome. However, little is known about the subjective experience of anhedonia, and it is rarely targeted in psychological treatment for depression. The aim of this study is to examine how young people experience anhedonia in the context of depression. Semi-structured interviews were conducted with 34 adolescents with a primary diagnosis of depression (N = 12) or elevated depressive symptoms (N = 22). Thematic analysis was used to identify important aspects of adolescents’ experiences. Four main themes were identified: (1) experiencing a loss of joy and a flattening of emotion; (2) struggling with motivation and active engagement; (3) losing a sense of connection and belonging; and (4) questioning sense of self, purpose, and the bigger picture. The results challenge the framing of anhedonia as simply the loss of interest and pleasure. Adolescents reported a range of experiences that mapped closely onto the cluster of negative symptoms associated with schizophrenia and were similar to the sense of ‘apathy’ characteristic in Parkinson’s disease. This highlights the potential benefit of taking a trans-diagnostic approach to understanding and treating reward deficits associated with mental health problems.

Electronic supplementary material

The online version of this article (10.1007/s00787-019-01364-y) contains supplementary material, which is available to authorized users.

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<![CDATA[Dietary intake of total polyphenols and the risk of all-cause and specific-cause mortality in Japanese adults: the Takayama study]]> https://www.researchpad.co/article/N7007b2ab-3abf-4935-a79f-83ba7fe2fc95

Purpose

Several epidemiological studies have demonstrated the health benefits of polyphenols, but the associations between polyphenol intake and mortality including total and major causes of death remain unclear. We investigated the associations between subjects’ total polyphenol intake and their mortality from all causes, cardiovascular disease (CVD), cancer, and other causes of death in a population-based cohort study in Japan.

Methods

A total of 29,079 residents of Takayama City, Japan were analyzed. Their dietary intake was assessed using a validated semi-quantitative food-frequency questionnaire (FFQ) in 1992. Mortality was ascertained over the subsequent 16 years. The dietary polyphenol intake was calculated by matching the subjects’ food consumption data with our original polyphenol content database.

Results

A total of 5339 deaths occurred during the follow-up. After multivariable adjustment, the highest quartile of total polyphenol intake compared with the lowest quartile was significantly associated with a lower risk of all-cause mortality (HR: 0.93, 95% CI: 0.82–0.99, p trend = 0.003). The subjects in the highest quartile showed significantly lower CVD mortality compared to those in the lowest quartile, and among the types of CVD mortality, a strong inverse association was observed for stroke mortality. Inverse associations were also observed for mortality from other causes, specifically digestive disease. The total polyphenol intake was not significantly associated with the risk of cancer mortality.

Conclusions

The results of this prospective study indicate that dietary total polyphenol intake in Japanese is inversely associated with all-cause mortality and mortality from cardiovascular and digestive diseases.

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<![CDATA[Parent–youth conflict as a predictor of depression in adulthood: a 15-year follow-up of a community-based cohort]]> https://www.researchpad.co/article/N848f20d2-4542-4831-b219-0da0efb827cf

Experiencing conflictual relations with one’s parents while growing up has been linked to onset, recurrence, and worse treatment outcome of adolescent depression. While this suggests that significant problems in the parent–youth relationship make depressive disorders more relentless, it is not clear whether this effect lasts into adulthood. Our aim was to examine if major and minor conflict with parents while growing up predicts depression in adulthood in youth with and without a history of depression. We utilized data from the Uppsala Longitudinal Adolescent Depression Study. This community-based cohort was assessed with structured diagnostic interviews both at age 16–17 and at follow-up 15 years later. The analyses included 382 individuals (227 with a history of child or adolescent depression; 155 peers without such a history). Binary logistic regression was used, adjusting for sex, disruptive behavior disorders, and additional family-related adversities. Among individuals with adolescent depression, major conflict with parents was strongly associated with adult depression (adjusted OR 2.28, 95% CI 1.07–4.87). While major conflict with parents was rare among non-depressed controls, a non-significant association of similar magnitude was still observed. Minor conflict, on the other hand, was not significantly associated with adult depression. Overall, conflict with parents did not predict adult anxiety disorders, substance use, suicidal behavior, somatoform disorders, or psychotic disorders. In conclusion, major parent–youth conflict during upbringing seems to be linked with an increased risk of depression in adulthood. These findings underscore the need to consider contextual/familial factors in the prevention and clinical management of early-life depression.

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<![CDATA[Child mental health and resilience in the context of socioeconomic disadvantage: results from the Born in Bradford cohort study]]> https://www.researchpad.co/article/N469a4a8e-5952-4e73-878a-563718a4b9ef

Socioeconomic disadvantage has been linked to mental health difficulties in children and adolescents, although many children appear to do well despite exposure to financial adversity in childhood. Our study looked at the effects of family financial difficulty on children’s mental health outcomes (n = 636) at 4–5 years in a multi-ethnic UK cohort, the Born in Bradford cohort. We considered potential parent and child variables promoting resilience in this population. Univariate linear regression was used to identify associations between family financial difficulty measured antenatally and child mental health difficulties measured by teacher-rated Strengths and Difficulties (SDQ) scores at 4–5 years. Hierarchical multivariate regression was used to test for potential moderating effects of parent and child factors. Mothers completed the General Health Questionnaire-28, Kessler-6 Questionnaire and questions related to parenting warmth, hostility and confidence. Parent-rated Infant Characteristic Questionnaires and teacher-rated Early Years Foundation Stage scores provided information on child temperament, literacy and physical development as potential moderators. Financial difficulty was associated with worse mental health outcomes in children. High parent warmth, high child literacy scores and physical development scores were all associated with positive child mental health outcomes at 4–5 years. In terms of protective effects, only maternal warmth was found to significantly moderate the relationship between financial difficulty and child mental health difficulties. The current study demonstrates that family financial difficulty is associated with poorer child mental health outcomes in a UK cohort of mothers and their school-aged children. It provides evidence of the positive relationships between warm parenting, child literacy and child physical development with mental health in young children. The study supports the finding that warm parenting moderates the relationship between family financial difficulty and interventions supporting this aspect of parenting may therefore provide particular benefit to children growing up in this context.

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<![CDATA[Effect of tea catechins with caffeine on energy expenditure in middle-aged men and women: a randomized, double-blind, placebo-controlled, crossover trial]]> https://www.researchpad.co/article/N82be4faa-be2f-4b24-ace4-8d1ed58766f8

Purpose

It has been reported that tea catechins increase energy metabolism, but their effect on resting metabolic rate (RMR) remains under debate. This study aimed to examine the effect of repeated intake of tea catechins on energy metabolism in the resting state in middle-aged men and women.

Methods

A total of 30 middle-aged men and women [13 women; age (mean ± SD) 52 ± 4 years; BMI 21.9 ± 2.2 kg/m2] were recruited. A randomized, double-blind, crossover study was conducted using a tea catechin-enriched beverage (611 mg catechins, 88 mg caffeine) and a placebo beverage (0 mg catechins, 81 mg caffeine) as test beverages. After 2 weeks of continuous test beverage intake, fasting RMR and energy expenditure (EE) after the ingestion of test beverage were measured. Measurements of forehead temperature (proxy for core temperature) and skin temperature were also obtained simultaneously.

Results

Among participants who underwent measurements, 26 (10 women; mean age 52 ± 4 years; mean BMI 22.1 ± 2.1 kg/m2) were analyzed. The EE increased significantly after ingestion of the tea catechin beverage compared with the placebo beverage (placebo treatment: 5502 ± 757 kJ/day; catechin treatment: 5598 ± 800 kJ/day; P = 0.041). No between-treatment differences in fasting RMR or the respiratory quotient were detected. In addition, the forehead and skin temperature did not differ significantly between the placebo and catechin treatments.

Conclusion

This study revealed that continuous intake of tea catechins with caffeine for 2 weeks significantly increased EE after ingestion of the tea catechin but not fasting RMR in middle-aged men and women.

Clinical Trial Registry number and website

This trial was registered at www.umin.ac.jp/ctr/ as UMIN000025810 and UMIN000025811.

Electronic supplementary material

The online version of this article (10.1007/s00394-019-01976-9) contains supplementary material, which is available to authorized users.

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<![CDATA[Associations between long-term adherence to healthy diet and recurrent depressive symptoms in Whitehall II Study]]> https://www.researchpad.co/article/N139b934c-cdc0-4536-85f9-7bec5d275ca3

Purpose

We examined whether long-term adherence to three diet quality scores—the Alternative Healthy Eating Index-2010 (AHEI-2010), Dietary Approach to Stop Hypertension (DASH) and  transformed-Mediterranean Diet Score (tMDS), Alternative Healthy Eating Index-2010 (AHEI-2010) and Dietary Approach to Stop Hypertension (DASH) is associated with the risk of recurrent depressive symptoms.

Methods

Analyses were conducted on a sample of 4949 men and women from the Whitehall II study. Diet scores were calculated using data collected from food frequency questionnaires repeated over 11 years of exposure (1991/1993–2002/2004). Recurrence of depressive symptoms was defined when participants reported at least two episodes of depressive symptoms (assessed by Center for Epidemiologic Studies Depression Scale and use of antidepressants) over the four phases of follow-up (2002/04–2015/16).

Results

After adjustment for potential cofounders, higher scores on AHEI-2010, DASH and tMDS at the end of the exposure period were associated with lower risk of recurrent depressive symptoms over the 13-year follow-up. Repeat measures of dietary history showed that participants who maintained a high AHEI-2010 score over the 11-year exposure period had a 19% (OR 0.81, 95% CI 0.65–1.00) lower odds of recurrent depressive symptoms compared to those who maintained a low AHEI score. Participants whose AHEI-2010 score decreased over time had a 1.34-fold increased odds (95% CI 1.02–1.75) of developing recurrent depressive symptoms compared to those maintaining a high AHEI-2010. No robust associations were observed for long-term tMDS and DASH.

Conclusion

Our findings suggest that long-term adherence to healthy diet defined by Alternative Healthy Eating Index-2010 confers protection against recurrent depressive symptoms.

Electronic supplementary material

The online version of this article (10.1007/s00394-019-01964-z) contains supplementary material, which is available to authorized users.

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<![CDATA[Survival of L. casei DG® (Lactobacillus paracasei CNCMI1572) in the gastrointestinal tract of a healthy paediatric population]]> https://www.researchpad.co/article/N62926d86-8baf-4ca6-9b25-ee83d52bb3ce

Purpose

Ability to survive the digestive process is a major factor in determining the effectiveness of a probiotic. In this study, the ability of the probiotic L. casei DG® (Lactobacillus paracasei CNCMI1572) to survive gastrointestinal transit in healthy children was investigated for the first time.

Methods

Twenty children aged 3–12 years received L. casei DG® as drinkable solution of 1 × 109 colony forming units (CFU), once daily for 7 consecutive days. Recovery in faecal samples was evaluated at baseline and at different time-points during and after administration. Defecation frequency, faeces consistency, digestive function and product safety were also assessed.

Results

Nineteen (95%) of the 20 enrolled children presented viable L. casei DG® cells in their faeces at least once during the study, with a maximum count (mean 4.3 log10 CFU/g ± 2.3) reached between day 4 and 6 from the beginning of consumption. Notably, for 11 (57.9%) of the 19 children with viable cells, L. casei DG® survived in faecal samples up to 3 days after treatment end. Defecation frequency, faeces consistency and digestive function did not change considerably during or after study treatment. Safety of the study product was very good.

Conclusions

This study showed for the first time that L. casei DG® survives the gastrointestinal transit when ingested by children with a paediatric probiotic drinkable solution containing 1 × 109 CFU, and persists in the gut up to 3 days after the end of product intake, demonstrating resistance to gastric juices, hydrolytic enzymes and bile acids.

Electronic supplementary material

The online version of this article (10.1007/s00394-018-1860-5) contains supplementary material, which is available to authorized users.

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<![CDATA[Perspective: cardiovascular disease and the Covid-19 pandemic]]> https://www.researchpad.co/article/N4d975b08-3c62-41bd-ab14-3f8f81f9cccb

We summarize the cardiovascular risks associated with Covid-19 pandemic, discussing the risks for both infected and non-infected patients.

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<![CDATA[Associations between biomechanical and clinical/anthropometrical factors and running-related injuries among recreational runners: a 52-week prospective cohort study]]> https://www.researchpad.co/article/N9f9213ac-3a04-41ef-a3bc-930c117f93e5

Background

The purpose of this exploratory study was to investigate whether runners with certain biomechanical or clinical/anthropometrical characteristics sustain more running-related injuries than runners with other biomechanical or clinical/anthropometrical characteristics.

Methods

The study was designed as a prospective cohort with 52-weeks follow-up. A total of 224 injury-free, recreational runners were recruited from the Gothenburg Half Marathon and tested at baseline. The primary exposure variables were biomechanical and clinical/anthropometrical measures, including strength, lower extremity kinematics, joint range of motion, muscle flexibility, and trigger points. The primary outcome measure was any running-related injury diagnosed by a medical practitioner. Cumulative risk difference was used as measure of association. A shared frailty approach was used with legs as the unit of interest. A total of 448 legs were included in the analyses.

Results

The cumulative injury incidence proportion for legs was 29.0% (95%CI = 24.0%; 34.8%). A few biomechanical and clinical/anthropometrical factors influence the number of running-related injuries sustained in recreational runners. Runners with a late timing of maximal eversion sustained 20.7% (95%CI = 1.3; 40.0) more injuries, and runners with weak abductors in relation to adductors sustained 17.3% (95%CI = 0.8; 33.7) more injuries, compared with the corresponding reference group.

Conclusions

More injuries are likely to occur in runners with late timing of maximal eversion or weak hip abductors in relation to hip adductors.

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<![CDATA[Mechanisms of accidental fall injuries and involved injury factors: a registry-based study]]> https://www.researchpad.co/article/Ne560fd32-8b44-4f60-8de8-d68acdf0bc74

Background

Falls are the leading cause of injury-related morbidity and mortality worldwide, but fall injury circumstances differ by age. We studied the circumstances of accidental fall injuries by age in Shenkursk District, Northwest Russia, using the data from the population-based Shenkursk Injury Registry.

Methods

Data on accidental fall injuries (hereafter: fall injuries) occurring in January 2015–June 2018 were extracted from the Shenkursk Injury Registry (N = 1551) and categorized by age group (0–6, 7–17, 18–59, and 60+ years). The chi-square test and ANOVA were used to compare descriptive injury variables across age groups, and a two-step cluster analysis was performed to identify homogeneous groups of fall injuries by preceding circumstances.

Results

Half of recorded fall injuries in the 0–6 year age group occurred inside dwellings (49%). The largest cluster of falls (64%) mainly included climbing up or down on home furnishings. In the 7–17 year age group, public outdoor residential areas were the most common fall injury site (29%), and the largest cluster of falls (37%) involved physical exercise and sport or play equipment. Homestead lands or areas near a dwelling were the most typical fall injury sites in the age groups 18–59 and 60+ years (31 and 33%, respectively). Most frequently, fall injury circumstances in these groups involved slipping on ice-covered surfaces (32% in 18–59 years, 37% in 60+ years).

Conclusion

The circumstances of fall injuries in the Shenkursk District varied across age groups. This knowledge can be used to guide age-specific preventive strategies in the study area and similar settings.

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<![CDATA[Atrial overexpression of angiotensin-converting enzyme 2 improves the canine rapid atrial pacing-induced structural and electrical remodeling]]> https://www.researchpad.co/article/N7333e186-5865-4679-ae7e-c866926ecf85

The purpose of this study was to investigate whether atrial overexpression of angiotensin-converting enzyme 2 (ACE2) by homogeneous transmural atrial gene transfer can reverse atrial remodeling and its mechanisms in a canine atrial-pacing model. Twenty-eight mongrel dogs were randomly divided into four groups: Sham-operated, AF-control, gene therapy with adenovirus-enhanced green fluorescent protein (Ad-EGFP) and gene therapy with Ad-ACE2 (Ad-ACE2) (n = 7 per subgroup). AF was induced in all dogs except the Sham-operated group by rapid atrial pacing at 450 beats/min for 2 weeks. Ad-EGFP and Ad-ACE2 group then received epicardial gene painting. Three weeks after gene transfer, all animals except the Sham group underwent rapid atrial pacing for another 3 weeks and then invasive electrophysiological, histological and molecular studies. The Ad-ACE2 group showed an increased ACE2 and Angiotensin-(1–7) expression, and decreased Angiotensin II expression in comparison with Ad-EGFP and AF-control group. ACE2 overexpression attenuated rapid atrial pacing-induced increase in activated extracellular signal-regulated kinases and mitogen-activated protein kinases (MAPKs) levels, and decrease in MAPK phosphatase 1(MKP-1) level, resulting in attenuation of atrial fibrosis collagen protein markers and transforming growth factor-β1. Additionally, ACE2 overexpression also modulated the tachypacing-induced up-regulation of connexin 40, down-regulation of connexin 43 and Kv4.2, and significantly decreased the inducibility and duration of AF. ACE2 overexpression could shift the renin–angiotensin system balance towards the protective axis, attenuate cardiac fibrosis remodeling associated with up-regulation of MKP-1 and reduction of MAPKs activities, modulate tachypacing-induced ion channels and connexin remodeling, and subsequently reduce the inducibility and duration of AF.

Electronic supplementary material

The online version of this article (doi:10.1007/s00395-015-0499-0) contains supplementary material, which is available to authorized users.

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<![CDATA[Changes of myocardial gene expression and protein composition in patients with dilated cardiomyopathy after immunoadsorption with subsequent immunoglobulin substitution]]> https://www.researchpad.co/article/Nd06f6db8-6ef5-4376-a17b-25dea798ff3d

Immunoadsorption with subsequent immunoglobulin substitution (IA/IgG) represents a therapeutic approach for patients with dilated cardiomyopathy (DCM). Here, we studied which molecular cardiac alterations are initiated after this treatment. Transcription profiling of endomyocardial biopsies with Affymetrix whole genome arrays was performed on 33 paired samples of DCM patients collected before and 6 months after IA/IgG. Therapy-related effects on myocardial protein levels were analysed by label-free proteome profiling for a subset of 23 DCM patients. Data were analysed regarding therapy-associated differences in gene expression and protein levels by comparing responders (defined by improvement of left ventricular ejection fraction ≥20 % relative and ≥5 % absolute) and non-responders. Responders to IA/IgG showed a decrease in serum N-terminal proBNP levels in comparison with baseline which was accompanied by a decreased expression of heart failure markers, such as angiotensin converting enzyme 2 or periostin. However, despite clinical improvement even in responders, IA/IgG did not trigger general inversion of DCM-associated molecular alterations in myocardial tissue. Transcriptome profiling revealed reduced gene expression for connective tissue growth factor, fibronectin, and collagen type I in responders. In contrast, in non-responders after IA/IgG, fibrosis-associated genes and proteins showed elevated levels, whereas values were reduced or maintained in responders. Thus, improvement of LV function after IA/IgG seems to be related to a reduced gene expression of heart failure markers and pro-fibrotic molecules as well as reduced fibrosis progression.

Electronic supplementary material

The online version of this article (doi:10.1007/s00395-016-0569-y) contains supplementary material, which is available to authorized users.

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<![CDATA[B-vitamins and body composition: integrating observational and experimental evidence from the B-PROOF study]]> https://www.researchpad.co/article/Nf28e6182-dd1b-40ff-ad46-0367254613c3

Purpose

Higher folate and vitamin-B12 have been linked to lower risk of overweight. However, whether this is a causal effect of these B-vitamins on obesity risk remains unclear and evidence in older individuals is scarce. This study aimed to assess the role of B-vitamin supplementation and levels on body composition in older individuals.

Methods

A double-blind, randomized controlled trial in 2919 participants aged ≥ 65 years with elevated homocysteine levels. The intervention comprised a 2-year supplementation with a combination of folic acid (400 µg) and vitamin B12 (500 µg), or with placebo. Serum folate, vitamin-B12, active vitamin-B12 (HoloTC), methylmalonic acid (MMA), and anthropometrics were measured at baseline and after 2 years of follow-up. Dietary intake of folate and vitamin-B12 was measured at baseline in a subsample (n = 603) using a validated food-frequency questionnaire. Fat mass index (FMI) and fat-free mass index (FFMI) were assessed with Dual Energy X-ray absorptiometry (DXA).

Results

Cross-sectional analyses showed that a 1 nmol/L higher serum folate was associated with a 0.021 kg/m2 lower BMI (95% CI − 0.039; − 0.004). Higher HoloTC (per pmol/L log-transformed) was associated with a 0.955 kg/m2 higher FMI (95% CI 0.262; 1.647), and higher MMA (per μgmol/L) was associated with a 1.108 kg/m2 lower FMI (95% CI − 1.899; − 0.316). However, random allocation of B-vitamins did not have a significant effect on changes in BMI, FMI or FFMI during 2 years of intervention.

Conclusions

Although observational data suggested that folate and vitamin B12 status are associated with body composition, random allocation of a supplement with both B-vitamins combined versus placebo did not confirm an effect on BMI or body composition.

Electronic supplementary material

The online version of this article (10.1007/s00394-019-01985-8) contains supplementary material, which is available to authorized users.

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<![CDATA[Diets containing the highest levels of dairy products are associated with greater eutrophication potential but higher nutrient intakes and lower financial cost in the United Kingdom]]> https://www.researchpad.co/article/N02a8d422-5731-4123-89ad-0d5d4f5f625e

Purpose

Previously, the nutritional contribution, environmental and financial costs of dairy products have been examined independently. Our aim was to determine the nutritional adequacy, financial cost and environmental impact of UK diets according to dairy content.

Methods

In this cross-sectional study of adults (19–64 years) from the UK National Diet and Nutrition Survey years 1–4 (n = 1655), dietary intakes assessed from 4-day estimated food diaries were organized into quartiles (Q) total grams of dairy (milk, cheese, yogurt, dairy desserts) and analyzed using ANCOVA controlling for age, sex and energy intake with Bonferroni post hoc test for nutritional adequacy, Alternative Healthy Eating Index (AHEI-2010), environmental impact [greenhouse gas emissions (GHGE), eutrophication and acidification potentials], financial cost, markers of health and cardio-metabolic diseases.

Results

Nutritional adequacy, particularly for protein, calcium and iodine (+ 18 g, + 533 mg, + 95 g, respectively, all P < 0.0001) and AHEI-2010 (P < 0.0001) were significantly higher and systolic BP (− 2 mmHg, P = 0.019) was significantly lower for the higher-dairy diets (Q4, 274–1429 g/day dairy), compared with diets containing lower dairy (Q1, 0–96 g/day dairy). Diets in Q4 had lower financial cost (− 19%, P < 0.0001) and the greatest eutrophication potential, compared with Q1 (+ 29%, P < 0.0001). Yet the environmental (GHGE) and financial costs per unit nutrient (riboflavin, zinc, iodine, magnesium, calcium, potassium) were lower in Q4 than Q1 (all P < 0.0001).

Conclusion

Diets with the highest dairy content had higher nutrient composition, better diet quality, were associated with lower BP and financial cost, but with higher eutrophication potential. Robust environmental data for many of food groups are limited and this needs an urgent addressing.

Trial registration

This trial was registered on clinicaltrials.gov as NCT03407248.

Electronic supplementary material

The online version of this article (10.1007/s00394-019-01949-y) contains supplementary material, which is available to authorized users.

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<![CDATA[Higher protein intake is associated with a lower likelihood of frailty among older women, Kuopio OSTPRE-Fracture Prevention Study]]> https://www.researchpad.co/article/N7fb6d6ca-4b6b-46fc-91d5-66f764a1acfb

Purpose

Nordic nutrition recommendations (2012) suggest protein intake ≥ 1.1 g/kg body weight (BW) to preserve physical function in Nordic older adults. However, no published study has used this cut-off to evaluate the association between protein intake and frailty. This study examined associations between protein intake, and sources of protein intake, with frailty status at the 3-year follow-up.

Methods

Participants were 440 women aged 65─72 years enrolled in the Osteoporosis Risk Factor and Prevention–Fracture Prevention Study. Protein intake g/kg BW and g/d was calculated using a 3-day food record at baseline 2003─4. At the 3-year follow-up (2006─7), frailty phenotype was defined as the presence of three or more, and prefrailty as the presence of one or two, of the Fried criteria: low grip strength adjusted for body mass index, low walking speed, low physical activity, exhaustion was defined using a low life-satisfaction score, and weight loss > 5% of BW. The association between protein intake, animal protein and plant protein, and frailty status was examined by multinomial regression analysis adjusting for demographics, chronic conditions, and total energy intake.

Results

At the 3-year follow-up, 36 women were frail and 206 women were prefrail. Higher protein intake ≥ 1.1 g/kg BW was associated with a lower likelihood of prefrailty (OR = 0.45 and 95% confidence interval (CI) = 0.01–0.73) and frailty (OR = 0.09 and CI = 0.01–0.75) when compared to protein intake < 1.1 g/kg BW at the 3-year follow-up. Women in the higher tertile of animal protein intake, but not plant protein, had a lower prevalence of frailty (P for trend = 0.04).

Conclusions

Protein intake ≥ 1.1 g/kg BW and higher intake of animal protein may be beneficial to prevent the onset of frailty in older women.

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