This longitudinal study aimed at comparing heart rate variability (HRV) in elite athletes identified either in 'fatigue' or in 'no-fatigue' state in 'real life' conditions.
57 elite Nordic-skiers ...were surveyed over 4 years. R-R intervals were recorded supine (SU) and standing (ST). A fatigue state was quoted with a validated questionnaire. A multilevel linear regression model was used to analyze relationships between heart rate (HR) and HRV descriptors total spectral power (TP), power in low (LF) and high frequency (HF) ranges expressed in ms(2) and normalized units (nu) and the status without and with fatigue. The variables not distributed normally were transformed by taking their common logarithm (log10).
172 trials were identified as in a 'fatigue' and 891 as in 'no-fatigue' state. All supine HR and HRV parameters (Beta±SE) were significantly different (P<0.0001) between 'fatigue' and 'no-fatigue': HRSU (+6.27±0.61 bpm), logTPSU (-0.36±0.04), logLFSU (-0.27±0.04), logHFSU (-0.46±0.05), logLF/HFSU (+0.19±0.03), HFSU(nu) (-9.55±1.33). Differences were also significant (P<0.0001) in standing: HRST (+8.83±0.89), logTPST (-0.28±0.03), logLFST (-0.29±0.03), logHFST (-0.32±0.04). Also, intra-individual variance of HRV parameters was larger (P<0.05) in the 'fatigue' state (logTPSU: 0.26 vs. 0.07, logLFSU: 0.28 vs. 0.11, logHFSU: 0.32 vs. 0.08, logTPST: 0.13 vs. 0.07, logLFST: 0.16 vs. 0.07, logHFST: 0.25 vs. 0.14).
HRV was significantly lower in 'fatigue' vs. 'no-fatigue' but accompanied with larger intra-individual variance of HRV parameters in 'fatigue'. The broader intra-individual variance of HRV parameters might encompass different changes from no-fatigue state, possibly reflecting different fatigue-induced alterations of HRV pattern.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Juvenile Idiopathic Arthritis (JIA) is associated with joint inflammation, pain and limited joint mobility, impacting the practice of physical activities. Adapted Physical Activities (APA) are an ...increasingly used method of rehabilitation, but additional studies are needed to define the nature of the most appropriate physical activity for patients with JIA. The "ATHLETIQUE" project aims to evaluate the impact of a program integrating APA sessions with use of a pedometer watch, on disease activity in patients with JIA.
This study will be a randomized, multicenter, open-label, controlled clinical trial with 2 parallel arms. The patients included in this study will be children and adolescents with JIA, aged 6 to 17 years. The experimental group (30 patients) will participate in an APA program for 3 months and will use a pedometer watch for one year. We will evaluate and compare the change in disease activity measurements (primary objective), fatigue, pain, quality of life, level of physical activity, functional capacities, and muscle strength (secondary objectives) after 14, 26 and 50 weeks. The control group (10 patients) will undergo the same evaluations as the experimental group but will not participate in the APA program and will not wear the pedometer watch.
The APA program may help to promote an active lifestyle with regular physical activity, preventing comorbidities and motor disability. Promising results on disease activity, functional capacities and quality of life would enable us to envisage a larger research program with a view to optimizing and assessing APA for children with JIA.
This study will be conducted in the short and medium-term, with one-year follow-up, including 3 months of APA sessions for the experimental group. The sessions proposed during the APA program will mainly be aerobic and bodyweight exercises. Furthermore, in contrast to previous studies on this topic, our study will integrate a novel element, namely the use of a pedometer watch. This watch will help to implement strategies to address motivation. This study aims to improve physical and mental well-being, provide a basis for the design of a larger study, and propose recommendations adapted to children with JIA.
Registered with ClinicalTrials.gov under the number NCT05572424.
Background:
Osteoporosis consists in the reduction of bone mineral density and increased risk of fracture. Age is a risk factor for osteoporosis. Although many treatments are available for ...osteoporosis, there is limited data regarding their efficacy in older people.
Objective:
To evaluate the efficacy of osteoporosis treatments in patients over 75 years old.
Methods:
We reviewed all published studies in MEDLINE, Cochrane and EMBASE including patients over 75 years old, treated by osteoporosis drugs, and focused on vertebral fractures or hip fractures.
Results:
We identified 4,393 records for review; 4,216 were excluded after title/abstract review. After full text review, 19 records were included in the systematic review. Most studies showed a reduction in vertebral fracture with osteoporosis treatments, but non-significant results were observed for hip fractures. Meta-analysis of 10 studies showed that lack of treatment was significantly associated with an increased risk of vertebral fractures at one (OR = 3.67; 95%CI = 2.50–5.38) and 3 years (OR = 2.19; 95%CI = 1.44–3.34), and for hip fractures at one (OR = 2.14; 95%CI = 1.09–4.22) and 3 years (OR = 1.31, 95%CI = 1.12–1.53).
Conclusion:
A reduction in the risk of vertebral fractures with osteoporosis treatments was observed in most of the studies included and meta-analysis showed that lack of treatment was significantly associated with an increased risk of vertebral fractures. Concerning hip fractures, majority of included studies did not show a significant reduction in the occurrence of hip fractures with osteoporotic treatments, but meta-analysis showed an increased risk of hip fractures without osteoporotic treatment. However, most of the data derived from
post hoc
and preplanned analyses or observational studies.
Life cycle assessment (LCA) is a technique widely used to comprehensively characterize the environmental impacts of human activities, and covers a broad range of environmental impact categories. ...Despite the recognized significant impact of environmental noise on public health, mostly because of road traffic, until now noise has not been systematically included in LCA. Research has showed, however, that the addition of the impacts of noise could significantly change the interpretation of LCA results, specifically considering the importance of road transportation in the global economy. This paper proposes a method to calculate characterization factors (CF) for life cycle impact assessment of noise emissions from road traffic on human health. The method builds on up-to-date noise emission and propagation models. It was successfully tested on a demonstrative test bed case, which allowed us to identify the most suitable elementary flows, and draw the spatial variability of the CF and the associated uncertainties. Finally, the case proved that the consideration of noise could double the magnitude of the human health damages due to road transportation, which could significant affect policy decisions.
•Novel method to include noise impacts of road transportation in life cycle assessment.•Relies on noise emission and propagation models.•Significant differences found between factors for day and night on test bed case.•Energy-based approach is recommended rather than distance-based approach.•Inclusion of noise can double the total human health damage of road transportation.
There is growing evidence that environmental noise exposure could increase the risk of atherothrombotic events, including acute myocardial infarction (MI). We analysed the burden of environmental ...noise on atherothrombotic risk in MI patients. From the RICO survey, 879 consecutive MI patients included from 2004 to 2008 and living in an urban unit of > 237,000 inhabitants were analysed. Atherothrombotic risk was calculated using the TRS-2P score. TRS-2P categories were split into low (TRS-2P = 0/1) (40.8%), medium-low (TRS-2P = 2) (25.7%), medium-high (TRS-2P = 3) (21.8%) and high risk (TRS-2P ≥ 4) (11.6%). Noise exposure was associated with atherothrombotic risk, with the L
(OR (95% CI): 1.165 (1.026-1.324)) and L
(OR (95CI): 1.157 (1.031-1.298)), for each 10 dB(A) increase. After adjustment, noise exposure remained a predictor of atherothrombotic risk, with L
(OR (95% CI): 1.162 (1.011-1.337)) and with L
(OR (95% CI): 1.159 (1.019-1.317)). The relationship with transportation L
was significant for men (OR (95% CI): 1.260 (1.078-1.472)) but not for women (OR (95% CI): 0.959 (0.763-1.205)). We found a significant association between residential traffic noise exposure and atherothrombotic risk in men but not in women. These results could have major consequences for secondary prevention.
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•We identified different ozone temporal dynamics that were spatially structured.•Urban, suburban and rural areas described different daily ozone dynamics.•Dynamics complexity was ...decomposed by isolating each determinant’s influence.•Exposure areas could be determined using such an approach.
Ground-level ozone (O3) is one of the most worrisome air pollutants regarding environmental and health impacts. There is a need for a deeper understanding of its spatial and temporal dynamics. Models are needed to provide continuous temporal and spatial coverage in ozone concentration data with a fine resolution. However, the simultaneous influence of each determinant of ozone dynamics, their spatial and temporal variations, and their interaction make the resulting dynamics of O3 concentrations difficult to understand.
This study aimed to i) identify different classes of temporal dynamics of O3 at daily and 9 km2 resolution over a long-term period of 12 years, ii) identify the potential determinants of these dynamics and, iii) explore the spatial distribution of the potential classes of temporal dynamics on a spatial continuum and over about 1000 km2.
Thus, 126 time series of 12-year daily ozone concentrations were classified using dynamic time warping (DTW) and hierarchical clustering (study area centered on Besançon, eastern France). The different temporal dynamics obtained differed on elevation, ozone levels, proportions of urbanized and vegetated surfaces.
We identified different daily ozone temporal dynamics, spatially structured, that overlapped areas called urban, suburban and rural. Urbanization, elevation and vegetation acted as determinants simultaneously. Individually, elevation and vegetated surface were positively correlated with O3 concentrations (r = 0.84 and r = 0.41, respectively), while the proportion of urbanized area was negatively correlated with O3 (r = -0.39). An increasing ozone concentration gradient was observed from urban to rural areas and was reinforced by the elevation gradient. Rural areas were both subject to higher ozone levels (p < 0.001), least monitoring and lower predictability.
We identified main determinants of the temporal dynamics of ozone concentrations. The joint influence of determinants was also synthesized. This study proposed a systematic, and reproducible way to build exposure area mapping.
Patients with acute respiratory distress syndrome received conservative oxygen therapy or liberal oxygen therapy for 7 days. The trial was prematurely stopped because of futility and safety concerns. ...Mortality at day 28 was 34.3% in the conservative-oxygen group and 26.5% in the liberal-oxygen group. Five mesenteric ischemic events occurred, all in the conservative-oxygen group.
Adherence to prescribed medications is a key dimension of healthcare quality. The aim of this large population-based study was to evaluate self-reported medication adherence and to identify factors ...linked with poor adherence in patients with type 2 diabetes in France.
The ENTRED study 2007, a French national survey of people treated for diabetes, was based on a representative sample of patients who claimed reimbursement for oral hypoglycaemic agents and/or insulin at least three times between August 2006 and July 2007, and who were randomly selected from the database of the two main National Health Insurance Systems. Medication adherence was determined using a six-item self-administered questionnaire. A multinomial polychotomous logistic regression model was used to identify factors associated with medication adherence in the 3,637 persons with type 2 diabetes.
Thirty nine percent of patients reported good medication adherence, 49% medium adherence and 12% poor adherence. The factors significantly associated with poor adherence in multivariate analysis were socio-demographic factors: age <45 years, non-European geographical origin, financial difficulties and being professionally active; disease and therapy-related factors: HbA(1c)>8% and existing diabetes complications; and health care-related factors: difficulties for taking medication alone, decision making by the patient only, poor acceptability of medical recommendations, lack of family or social support, need for information on treatment, reporting no confidence in the future, need for medical support and follow-up by a specialist physician.
In a country with a high level of access to healthcare, our study demonstrated a substantial low level of medication adherence in type 2 diabetic patients. Better identification of those with poor adherence and individualised suitable recommendations remain essential for better healthcare management.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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