Although stress strongly predicts life satisfaction, the psychosocial mechanisms underlying this association remain unclear. To investigate the possible mediating role of coping, we conducted a ...cross‐sectional study that assessed youths' life stress levels, propensity to engage in three different coping styles (i.e., active coping, internal coping, & withdrawal), and life satisfaction in a probabilistic, two‐stage stratified cluster sample of 1830 high school seniors (986 females; age range: 17–22 years old) from 26 schools in or around the four largest cities in Croatia. We used correlational analyses and structural equation modelling to test the hypothesis that coping mediates the relation between stress and life satisfaction. The tested model was marginally acceptable: χ2 = 1613.85, df = 177, p < 0.001, goodness‐of‐fit‐index = 0.92, Comparative Fit Index = 0.91, Tucker‐Lewis Index = 0.89, root mean square error of approximation = 0.067 (90% CI = 0.064 to 0.070), standardized root mean squared residual = 0.056. As hypothesized, stress was related to life satisfaction directly (βc’ = −0.22, p < 0.01) but also indirectly (βab = −0.05, p < 0.01) by affecting youths' likelihood of engaging in withdrawal behaviours, such as avoiding problems, distracting, or using anger, alcohol, or drugs. The proportion of the total effect mediated by withdrawal was 19.4%. In contrast, neither active nor internal coping were significant mediators. Based on these results, we conclude that preventive and educational programs for enhancing youth mental health may benefit from reducing adolescents' stress levels and stress‐related withdrawal behaviour, and by encouraging youth to use active coping strategies instead.
The aim of the present study was to investigate whether greater splenic emptying or higher skeletal muscle deoxygenation amplitude (determined by near-infrared spectroscopy, NIRS) contributes to ...higher V̇O
max. during supine cycling. We hypothesized that the reduction in splenic volume, and subsequent manipulations of O
delivery by blood ejected from the spleen, would not contribute to higher V̇O
max. during supine cycling, because this transient increase in circulating red blood cells (RBC's) would be insufficient to increase the O
storage capacity in the blood. Rather, O
uptake during supine cycling in healthy subjects is expected to be limited, at least in part, by skeletal muscle bioenergetics. Here, fourteen healthy young individuals completed all study procedures. On three separate days they underwent a medical examination, supine V̇O
max. test, and three step-transitions from 20 W to a moderate-intensity power output equivalent to V̇O
uptake at 90% gas exchange threshold. During these step-transitions, pulmonary V̇O
, NIRS of the vastus lateralis (VL), and cardiovascular responses (via Finapres) were measured continuously. In parallel, minute-by-minute ultrasound measurements of the spleen were performed. Blood samples were taken before and immediately after the step-transition cycling. Mean V̇O
max. was 46.5±6.5 mL·kg·min
. In response to supine step-transition cycling, spleen volume was significantly reduced (by ~38%, p=.001). Both hematocrit and hemoglobin concentration increased by ~4%, after exercise cessation. There was no correlation between: i)spleen volume at rest, ii) changes in spleen volume (%), iii) hematocrit at rest and V̇O
max. However, a linear, near-significant correlation was observed between VL deoxygenation amplitude and V̇O
max. Apparently, individuals with a higher V̇O
max. are capable of greater O
extraction from the superficial knee extensors, whereas in parallel, greater splenic emptying does not correlate with higher V̇O
max, regardless of the subsequent release of erythrocytes. Therefore, it is reasonable to suggest that maximal O
utilization during supine cycling in healthy young men is limited, in part, by skeletal muscle bioenergetics. REFERENCES: Holmström, PK, Karlsson Ö, Lindblom H, McGawley K, & Schagatay, EK. (2021). Enhanced splenic volume and contraction in elite endurance athletes. J Appl Physiol, 131(2), 474-486, DOI: 10.1152/japplphysiol.01066.2020; Zubac, D, Obad, A, Bosnjak, A, Zec, M, Ivancev, V, Valic, Z. (2021). Spleen emptying does not correlate with faster oxygen kinetics during a step-transition supine cycling. Appl Physiol Nutr Metab. Accepted for publication in Jun 24. doi: 10.1139/apnm-2021-0294.2021.
Adolescence is a developmental period during which time individuals adopt health behaviors that affect their lifelong health and disease risk. Socioeconomic status, social‐cultural values, and stress ...have all been hypothesized to play a role in this association, but very few studies have examined how these factors interrelate and explain differences in health behaviors in adolescence. To address this issue, we assessed youths' socioeconomic status, social‐cultural values, life stress levels across seven domains, and health behaviors in a national sample of 1,830 high school seniors living in the four largest cities in Croatia. Structural equation modelling examined the extent to which stress mediates the effects of socioeconomic status and social‐cultural values on positive and negative health behaviors. As hypothesized, stress levels significantly mediated associations between youths' socioeconomic status, social‐cultural values, and healthy and unhealthy habits. Additionally, whereas better socioeconomic status predicted less stress, greater social‐cultural value on achieving a “good life” predicted more stress. More stress, in turn, was associated with engaging in fewer healthy behaviors for both males and females, and more unhealthy behaviors for males. Socioeconomic status and social‐cultural values thus appear to influence stress levels, which may in turn affect adolescents' health behaviors and, potentially, their lifespan health.
The aim of this study is to evaluate the diagnostic accuracy of leucine-rich α-2-glycoprotein 1 (LRG1) in saliva as a novel biomarker for acute appendicitis in the pediatric population. From October ...2021 to June 2022, 92 children aged 5 to 17 years who presented with acute abdomen and suspected acute appendicitis were enrolled in this prospective study. The parameters documented included demographic and clinical information, as well as operative and postoperative data. Patients were divided into two groups: those with acute appendicitis who underwent laparoscopic appendectomy (
= 46) and those without appendicitis (
= 46). The total white blood cell (WBC) count, percent of neutrophils, C-reactive protein (CRP) level, and salivary LRG1 were compared between groups. A commercially available enzyme-linked immunosorbent assay (ELISA) LRG kit was used to measure the LRG levels. The median salivary LRG1 level was significantly higher in the group of children with pathohistologically confirmed acute appendicitis compared to the control group: 233.45 ng/mL (IQR 114.9, 531.2) vs. 55.95 ng/mL (IQR 51.5, 117.9),
< 0.001. LRG1 had an overall good receiver-operator characteristic area under the curve of 0.85 (95% CI 0.76-0.92;
< 0.001). The optimal LRG1 cutoff with best separation between acute appendicitis and the controls was >352.6 ng/mL (95% CI from >270.7 to >352.6). Although the specificity was 100% at this cutoff, the sensitivity for identifying appendicitis was 36%. In addition, a significant difference was found between groups in the laboratory values of all inflammatory markers tested: WBC, absolute neutrophil count, and CRP (
< 0.001 for all). Although LRG1 in saliva showed a good AUC parameter and significantly higher values in patients with acute appendicitis compared to the controls, its usefulness in the patient population who present at emergency departments with abdominal pain is debatable. Future studies should focus on investigating its diagnostic potential.
Purpose
The role of splenic emptying in O
2
transport during aerobic exercise still remains a matter of debate. Our study compared the differences in spleen volume changes between aerobically trained ...and untrained individuals during step-transition supine cycling exercise at moderate-intensity. We also examined the relationship between spleen volume changes, erythrocyte release, and O
2
uptake parameters.
Methods
Fourteen healthy men completed all study procedures, including a detailed medical examination, supine maximal O
2
uptake (
V
˙
O
2
max.) test, and three step-transitions from 20 W to a moderate-intensity power output, equivalent to
V
˙
O
2
uptake at 90% gas exchange threshold. During these step-transitions pulmonary
V
˙
O
2
p
, near-infrared spectroscopy of the
vastus lateralis
, and cardiovascular responses were continuously measured. In parallel, minute-by-minute ultrasonic measurements of the spleen were performed. Blood samples were taken before and immediately after step-transition cycling.
Results
On average,
V
˙
O
2
max. was 10 mL kg min
−1
(
p
= 0.001) higher in trained compared to their aerobically untrained peers. In response to supine step-transition cycling, the splenic volume was significantly reduced, and the largest reduction (~ 106 to 115 mL, ~ 38%,
p
= 0.001) was similar in both aerobically trained and untrained individuals. Erythrocyte concentration and platelet count transiently increased after exercise cessation, with no differences observed between groups. However, the
vastus lateralis
deoxygenation amplitude was 30% (
p
= 0.001) greater in trained compared to untrained individuals. No associations existed between: (i) spleen volumes at rest (ii) spleen volume changes (%), (iii) resting hematocrit and oxygen uptake parameters.
Conclusion
Greater splenic emptying and subsequent erythrocyte release do not lead to a slower
τ
V
˙
O
2
p
, regardless of individual
V
˙
O
2
max. readings.
Background
The aim of this study was to compare inflammatory stress response between laparoscopic percutaneous inguinal ring suturing (PIRS) and open modified Marcy technique for pediatric inguinal ...hernia repair.
Methods
From May 2017 to April 2018, 32 male children with median age of 4.5 years undergoing inguinal hernia repair were included in randomized controlled trial. The patients were divided in two groups, by using random number generator, depending on surgical approach. The blood was tested in three time frames for white blood cells count (WBC), C-reactive protein (CRP), Interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α).
Results
Significant increase in concentration for all inflammatory biomarkers, that occur over time, has been found (
p
< 0.001 for all). Additionally, it was also found that the type of surgery significantly influenced the level of WBC, CRP, and IL-6 with Marcy showing a higher level of inflammatory response (WBC 11.4 ± 3.1 × 10
9
/L; CRP 11.5 mg/L; IL-6 11.0 pg/mL) than the PIRS (WBC 7.6 ± 1.6 × 10
9
/L; CRP 0.8 mg/L; IL-6 2.0 pg/mL) (
p
< 0.001 for all). Similar pattern was also found for TNF-α (Marcy 16.8 pg/mL; PIRS 10.1 pg/mL), but correlation between surgery type and concentration of this biomarker was significant only at the 0.1 level (
p
= 0.055). The mean operation time was significantly shorter (9 ± 2 min) in PIRS group compared to Marcy group (25 ± 7 min) (
p
< 0.001). Significantly lower median of visual analog scale score (VAS) was found in PIRS group (VAS = 2) compared to Marcy group (VAS = 6) (
p
< 0.001).
Conclusions
Use of laparoscopic (PIRS) technique in children shows significantly lower surgical stress in comparison to open hernia repair.
Adropin is a secretory peptide that regulates glucose, lipid, and protein metabolism, which is closely related to obesity, insulin resistance, dyslipidemia, and atherogenesis. The serum adropin level ...is related to sex and depends upon nutritional preferences. This study aims to determine the association between serum adropin levels and body composition parameters in kidney transplant recipients (KTRs), especially emphasizing sex differences. Our case–control study involved 59 KTRs (28 postmenopausal women and 31 men) who were divided into two groups according to sex, and each group of those KTRs was further divided into higher or lower adropin values than the mean value in each sex group. Univariate regression showed a negative association of adropin levels with most anthropometric and body composition parameters in men’s KTRs. Contrary to this, the serum adropin level was negatively associated only with phase angle in postmenopausal female KTRs. Multivariate regression showed that skeletal muscle mass and phase angle were the only negative predictors in women’s KTRs, whereas in men, negative predictors were BMI and body water. These findings imply that adropin could have a different impact on metabolic homeostasis in KTRs regarding sex and could be considered a negative predictor of body composition in KTRs.
Purpose
The present study investigated whether larger splenic emptying augments faster excess post-exercise O
2
consumption (EPOC) following aerobic exercise cessation.
Methods
Fifteen healthy ...participants (age 24 ± 4, 47% women) completed 3 laboratory visits at least 48-h apart. After obtaining medical clearance and familiarizing themselves with the test, they performed a ramp-incremental test in the supine position until task failure. At their final visit, they completed three step-transition tests from 20 W to a moderate-intensity power output (PO), equivalent to
V
˙
O
2
at 90% gas exchange threshold, where data on metabolic, cardiovascular, and splenic responses were recorded simultaneously. After step-transition test cessation, EPOC
fast
was recorded, and the first 10 min of the recovery period was used for further analysis. Blood samples were collected before and immediately after the end of exercise.
Results
In response to moderate-intensity supine cycling (
V
˙
O
2
= ~ 2.1 L·min
−1
), a decrease in spleen volume of ~ 35% (
p
= 0.001) was observed, resulting in a transient increase in red cell count of ~ 3–4% (
p
= 0.001) in mixed venous blood. In parallel, mean blood pressure, heart rate, and stroke volume increased by 30–100%, respectively. During recovery, mean τ
V
˙
O
2
was 45 ± 18 s, the amplitude was 2.4 ± 0.5 L·min
−1
, and EPOC
fast
was 1.69 L
·
O
2
. Significant correlations were observed between the percent change in spleen volume and (i) EPOC
fast
(
r
= − 0.657,
p
= 0.008) and (ii) τ
V
˙
O
2
(
r
= − 0.619,
p
= 0.008), but not between the change in spleen volume and (iii)
V
˙
O
2
peak (
r
= 0.435,
p
= 0.105).
Conclusion
Apparently, during supine cycling, individuals with larger spleen emptying tend to have slower
V
˙
O
2
recovery kinetics and a greater EPOC
fast
.
The aim of this study is to assess the diagnostic utility of serum leucine-rich α-2-glycoprotein 1 (LRG1) in pediatric patients with acute abdominal pain, admitted to the emergency surgical unit, in ...order to make a prompt and accurate diagnosis of acute appendicitis.
Pediatric patients older than 5 years of age who presented to the emergency department from 15 October 2021 to 30 June 2022 with acute abdominal pain and suspected acute appendicitis were prospectively recruited in the study. Demographic and clinical data, as well as operative and postoperative data, were recorded. A total of 92 patients were equally distributed into two groups: children with acute appendicitis who underwent laparoscopic appendectomy and non-appendicitis patients, presenting with non-specific abdominal pain. LRG1 levels were determined using a commercially available LRG1 enzyme-linked immunosorbent assay (ELISA) kit. Serum LRG1 levels, as well as other inflammatory markers (white blood cell count (WBC), C-reactive protein (CRP) and absolute neutrophil count) were compared between groups.
The median level of LRG1 in serum was significantly higher in the group of children with pathohistologically confirmed acute appendicitis than in the control group, at 350.3 µg/mL (interquartile range (IQR) 165.2-560.3) and 25.7 µg/mL (IQR 14.7-36.8) (
< 0.001), respectively. Receiver operating characteristic area under the curve for LRG1 from serum was 1.0 (95% CI 0.96-1.00;
< 0.001) and the value of >69.1 µg/mL was found to perfectly separate acute appendicitis cases from controls. Additionally, as expected, each of the examined laboratory inflammatory markers provided a significantly higher values in the acute appendicitis group compared to the control group: WBC 14.6 × 10
/L (IQR 12.7, 18.7) vs. 7.0 × 10
/L (IQR 5.4, 9.0) (
< 0.001), CRP 16.3 mg/dL (IQR 6.9, 50.4) vs. 2.2 mg/dL (IQR 2, 2) (
< 0.001) and absolute neutrophil count 84.6% (IQR 79.5, 89.0) vs. 59.5% (IQR 51.5, 68.6) (
< 0.001).
LRG1 in the serum was found to be a promising novel biomarker, with excellent differentiation of acute appendicitis from non-appendicitis cases in children presenting with non-specific abdominal pain.
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