• Vitamin B12 insufficiency induces cholesterol biosynthesis by limiting s-adenosylmethionine and modulating the methylation of SREBF1 and LDLR genes

      Adaikalakoteswari, A; Finer, S; Voyias, P.D; McCarthy, C.M; Vatish, M; Moore, J; Smart-Halajko, M; Bawazeer, N; Al-Daghri, N.M; McTernan, P.G; et al. (BMC, 27/02/2015)
      The dietary supply of methyl donors such as folate, vitamin B12, betaine, methionine, and choline is essential for normal growth, development, and physiological functions through the life course. Both human and animal studies have shown that vitamin B12 deficiency is associated with altered lipid profile and play an important role in the prediction of metabolic risk, however, as of yet, no direct mechanism has been investigated to confirm this.
    • Vitamin B12 deficiency is associated with adverse lipid profile in Europeans and Indians with type 2 diabetes.

      Adaikalakoteswari, A; Jayashri, R; Sukumar, N; Venkataraman, H; Pradeepa, R; Gokulakrishnan, K; Anjana, R.M; McTernan, P.G; Tripathi, G; Patel, V; et al. (BMC, 26/09/2014)
      Metformin, a standard therapy in type 2 diabetes, reduces vitamin B12 levels. Studies linking low vitamin B12 levels and cardiovascular disease are equivocal and suggest improving B12 levels may help in primary prevention. The role of vitamin B12 deficiency on cardiovascular risk factors, especially in type 2 diabetes has not been explored. The aim of this study is to investigate whether vitamin B12 deficiency in type 2 diabetes patients is associated with cardiovascular risk factors in two different ethnic groups in UK and India. Type 2 diabetes patients from two secondary care diabetic centres (Europeans - UK and Indians - India) were studied. Serum vitamin B12, folate and biochemical parameters were measured. The prevalence rates of vitamin B12 deficiency (<191 ng/L) were 27% and 12% in Europeans and Indians, respectively and higher in metformin treated type 2 diabetes patients. In linear regression analysis, after adjusting for all likely confounding factors, vitamin B12 independently associated with triglycerides in both the populations and cholesterol/HDL ratio in Indians. Logistic regression showed type 2 diabetes patients with vitamin B12 deficiency were at significantly higher odds of having coexisting coronary artery disease (CAD) in Europeans with similar but non-significant trend in Indians, after adjusting for all likely confounding factors. The prevalence of vitamin B12 deficiency is common in type 2 diabetes patients and is associated with adverse lipid parameters. Type 2 diabetes management guidelines should include the recommendation for regular testing for B12 levels, especially for those on metformin.
    • PWE-254 Is the macroscopically normal mucosa (MNM) around colorectal cancer really ‘normal’?

      Patel, A; Fang, Y; Moore, J; Williams, N; Tripathi, G; Arasaradnam, R; University of Westminster (BMJ, 22/06/2015)
      Field cancerisation refers to the process whereby cells acquire pro-tumourigenic mutations that predispose to malignant transformation but do not produce morphological change.1Previous colorectal cancer studies have assumed that the macroscopically normal mucosa (MNM) adjacent to a cancer is biologically unaltered. The aim of this study was to determine if the genetic expression profile of the MNM around a cancer or adenoma is different to that found in healthy controls. 15 patients undergoing colonoscopy were recruited over 12 months; 5 healthy controls, 5 with colorectal adenomas and 5 with adenocarcinoma. Two mucosal pinch biopsies were taken in the rectum, right colon and adjacent to polyp or cancer. mRNA was extracted and gene expression was assessed using standard whole genome micro-array analysis. Differentially expressed genes were identified using three methods of analysis: LIMMA (fold change ratio >1.5 and p value <0.05), Robust Regression (RR) (adjusted p value <0.05) and genes that ‘overlap’ when LIMMA (p value <0.001) and RR (adjusted p value <0.1) are used. Functional analysis was performed using DAVID2software to identify important biological processes that were dysregulated. A large number of genes were dysregulated in the MNM adjacent to cancer or adenoma compared with controls (Table 1). Interestingly, the greatest differences were seen between MNM adjacent to cancer and polyp in chromatin organisation, nucleosome processing, nuclear transport and histone assembly. The most significantly upregulated genes consisted of FUT2, CTSA, MUC2 and SDS and downregulated genes consisted of GREM1, SFRP, HIST1H, IL17B and TFF1.
    • Habitual physical activity is associated with circulating irisin in healthy controls but not in subjects with diabetes mellitus type 2

      Al‐Daghri, N.M; Alokail, M.S; Rahman, S; Amer, O.E; Al‐Attas, O.S; Alfawaz, H; Tripathi, G; Sabico, S.; Chrousos, G.P; McTernan, P.G; et al. (Wiley, 22/05/2015)
      Irisin, a novel myokine, has been shown to increase following vigorous exercise, with studies suggesting that it mediates some of the beneficial effects of exercise. Irisin might play a role in ‘browning’ of white adipocytes, thus increasing energy expenditure. The role of irisin in exercise and energy expenditure in subjects with diabetes mellitus type 2 (DMT2) remains largely unknown. We aimed to investigate the association between circulating irisin and habitual physical activity in subjects with and without DMT2. In this cross‐sectional study, 164 Saudi adults: 81 non‐DMT2 controls [age: (mean ± SD) 51·6 ± 10·9; BMI: 29·6 ± 4·3 kg/m2] and 83 DMT2 subjects [age: 54·3 ± 10·3 year; BMI: 29·4 ± 4·7 kg/m2] were studied. Anthropometric and fasting serum biochemical data were collected. Circulating irisin was measured using an enzyme‐linked immunosorbent assay (ELISA). Frequency intensity time (FIT) index was used to assess the level of habitual physical activity. We observed significantly higher levels of irisin in DMT2 subjects than in controls (P < 0·001). FIT index was positively associated (r = 0·20, P = 0·03) with circulating irisin in controls only. Additionally, irisin levels were significantly higher in tertile 3 (0·75 ± 0·07 μg/mL) than tertile 1 (0·49 ± 0·06 μg/mL) of the FIT index in healthy controls, whilst no such relation with physical activity was observed in DMT2 subjects. This cross‐sectional study has shown a weak association of irisin with physical activity levels in healthy controls but not in DMT2 subjects, suggesting the possibility of discordant regulation in the condition of DMT2.
    • Telmisartan reverses antiretroviral-induced adipocyte toxicity and insulin resistance in vitro

      Pushpakom, S.P; Adaikalakoteswari, A; Owen, A; Back, D.J; Tripathi, G; Kumar, S; McTernan, P; Pirmohamed, M; University of Warwick (Sage, 21/02/2018)
      Antiretroviral therapy in HIV-positive patients leads to insulin resistance which is central to the pathogenesis of various metabolic abnormalities and cardiovascular disease seen in this patient group. We have investigated the dose–response relationship of telmisartan, an antihypertensive, on adipocytes in vitro in order to determine whether it may have metabolic beneficial effects. Using in vitro chronic toxicity models (3T3-F442A murine and primary human adipocytes), we evaluated the effects of different concentrations of telmisartan on adipocyte differentiation and adipogenic gene expression using lipid accumulation assays and real-time polymerase chain reaction, respectively. Adipokine secretion and expression of insulin signalling mediators were evaluated using enzyme-linked immunosorbent assays. Telmisartan partially reversed the deleterious effects of antiretrovirals on adipocyte lipid accumulation, expression of adipogenic regulators (peroxisome proliferator receptor-gamma and lipin 1), adipokine secretion and expression of the insulin signalling mediator pAktSer473. The metabolic effects of telmisartan followed a non-monotonic response with the maximal effect observed at 5 µM in the primary human adipocyte model. Telmisartan has beneficial metabolic effects in adipocytes in vitro, but its potential to reduce antiretroviral-induced cardiometabolic disease in HIV-infected individuals needs to be evaluated in a well-designed adequately powered clinical trial.
    • The effect of the number of interviewers on children’s testimonies

      Ferra, Fenia; Blades, Mark; Walsh, Dave; University of Derby; University of Sheffield; De Montfort University (Informa UK Limited, 2021-04-02)
      Many investigative interviews with children who report that they have been victims of crime are carried out by one interviewer. Some interviews, however, may involve more than one interviewer. There has been little research examining the impact upon children’s reports when more than one interviewer (or adult) is present. Over the course of two experimental studies, involving 375 children in total, the effects that the number of adults (present in such interviews) had on children’s recall were investigated. It was found that the number of the adults present during an interview had an effect on the quality and quantity of the information children provided. When children were interviewed by a single interviewer, with no-one else present, the children provided lengthier and more accurate accounts, in comparison to when children were interviewed by an interviewer in the presence of either one or two additional adults. These findings have implications for the conduct of forensic interviews, especially in those countries where several adults are present in forensic interviews.
    • Unethical practices within medical research and publication – An exploratory study.

      Sivasubramaniam, shivadas; Consetino, M; Ribeiro, L; Marino, F; University of Derby; University of Insubria, Via Ravasi, 2, 21100, Varese, VA, Italy (Springer Nature, 2021-04-01)
      The data produced by the scientific community impacts on academia, clinicians, and the general public; therefore, the scientific community and other regulatory bodies have been focussing on ethical codes of conduct. Despite the measures taken by several research councils, unethical research, publishing and/or reviewing behaviours still take place. This exploratory study considers some of the current unethical practices and the reasons behind them and explores the ways to discourage these within research and other professional disciplinary bodies. These interviews/discussions with PhD students, technicians, and academics/principal investigators (PIs) (N=110) were conducted mostly in European higher education institutions including UK, Italy, Ireland, Portugal, Czech Republic and Netherlands. Through collegiate discussions, sharing experiences and by examining previously published/reported information, authors have identified several less reported behaviours. Some of these practices are mainly influenced either by the undue institutional expectations of research esteem or by changes in the journal review process. These malpractices can be divided in two categories relating to (a) methodological malpractices including data management, and (b) those that contravene publishing ethics. The former is mostly related to “committed bias”, by which the author selectively uses the data to suit their own hypothesis, methodological malpractice relates to selection of out-dated protocols that are not suited to the intended work. Although these are usually unintentional, incidences of intentional manipulations have been reported to authors of this study. For example, carrying out investigations without positive (or negative) controls; but including these from a previous study. Other methodological malpractices include unfair repetitions to gain statistical significance, or retrospective ethical approvals. In contrast, the publication related malpractices such as authorship malpractices, ethical clearance irregularities have also been reported. The findings also suggest a globalised approach with clear punitive measures for offenders is needed to tackle this problem.
    • A mixed-methods evaluation of care (cancer and rehabilitation exercise): a physical activity and health intervention, delivered in a community football trust

      Rutherford, Zoe; Zwolinsky, Stephen; Kime, Nicky; Pringle, Andy; University of Queensland; Yorkshire and Harrogate Cancer Alliance; Bradford Institute for Health Research; University of Derby (MDPI, 2021-03-23)
      With increasing cancer survivorship has come an increased necessity to support people living with cancer (PLWC) to have a good quality of life including being physically active. Using mixed methods, the current study aimed to use the RE-AIM evaluation framework (Reach, Effectiveness, Adoption, Implementation and Maintenance) to determine how the football community trust delivered CARE (Cancer and Rehabilitation Exercise) intervention was able to increase participants’ physical activity in order to improve their quality of life and regain physiological and psychological function. Quantitative outcome data were collected at baseline, 3 and 6 months using the Cancer Physical Activity Standard Evaluation Framework questionnaire. Semi-structured focus groups (n = 5) captured participants’ (n = 40) lived experience of the reach, effectiveness, adoption, implementation, and maintenance of CARE. Questionnaire data were analysed using repeated measures ANOVAs and qualitative data were thematically analysed. Following diagnosis, CARE was successful in providing participants with a unique and accessible opportunity to become or restart physically activity, by providing a local, socially supportive, and inclusive environment. This resulted in significant increases in physical activity (F(1.58, 23) = 5.98, p = 0.009), quality of life (QoL) (F(2,36) = 13.12, p = 0.000) and significant reductions in fatigue (F(1.57,31) = 11.19, p = 0.000) over 6 months. Participants also reported becoming more active, recovering physical function, regaining independence, and enhanced psychological well-being as a result of attending CARE. Key design features of CARE were also identified across RE-AIM. CARE, a football community trust delivered physical activity intervention was successful in significantly improving participants’ QoL and in regaining the physical and psychological functioning of people living with cancer. Results suggest that maintaining engagement in CARE for 6 months and beyond can support people to maintain these changes. Engaging in robust evaluations such as this can help organizations to successfully secure future funding for their programs.
    • Investigating the delivery of health improvement interventions through professional football club community trusts-strengths and challenges

      Pringle, Andy; Lozano, Lorena; Zwolinsky, Stephen; University of Derby; West Yorkshire and Harrogate Cancer Alliance; Leeds Beckett University (Elsiever, 2021-03-19)
      This study audits health improvement provision delivered in/by English professional Football Club Community Trusts and reports the strengths and challenges around the implementation of interventions. Multi-methods design: Data were collected through (i) a review of trust websites (n ​= ​72), (ii) an online survey (n ​= ​34/47.2%) and (iii) semi-structured interviews (n ​= ​11/32.3%) with a sub-sample of trust managers. The review of websites confirms all trusts provided physical activity-led interventions. The online survey showed most managers were male (n ​= ​23/67.7%) and white British (n ​= ​30/88.2%). Two thirds held management roles, (n ​= ​23/67.6%) and represented Championship (n ​= ​12/35.2%), League 1 (n ​= ​13/38.2%) and League 2 clubs (n ​= ​9/26.5%). Trusts provided physical activity and most provided diet (n ​= ​31/91.2%) as well as smoking (n ​= ​20/58.8%) and alcohol (n ​= ​19/55.9%) interventions. Weight management, (n ​= ​25/73.5%), mental health interventions (n ​= ​28/82.4%) were offered. Trusts provided male-specific (n ​= ​20/58.8%), with fewer providing female-specific interventions (n ​= ​15/44.1%). Most trusts (n ​= ​30/88.2%) evaluated interventions. 80.8% (n ​= ​21/26) used public health guidance for programme design, 69.2% (n ​= ​18/26) delivery, 57.7% (n ​= ​15/26) needs assessment and 50% (n ​= ​13/26) evaluation. Interviews and qualitative reports identified strengths including, using football, the ‘club brand’, ‘meeting health needs’ and ‘working as a strategic collaboration with partners’. Challenges included ‘short-term funding staffing, mainstreaming, and evaluating interventions’. Football Community Trusts deliver interventions, but challenges were encountered when implementing these programmes.
    • Initiating count down - gamification of academic integrity

      Reza Khan, Zeenath; Dyer, Jarret; Bjelobaba, Sonja; Gomes, Sandra F.; Dlabolová, Dita Henek; Sivasubramaniam, Shivadas; University of Wollongong, Dubai, UAE; College of DuPage, Glen Ellyn, USA; Uppsala University, Uppsala, Sweden; University of Porto, Porto, Portugal; et al. (Springer Nature, 2021-03-18)
      Any problem is a problem until a solution is designed and implemented. This paper reports on a workshop that highlights preliminary work done by the working group on Gamification in the scope of European Network for Academic Integrity (ENAI), which aims to explore the possibility of developing and testing a gamified learning module on academic integrity values. In this paper, the group aims to look at proposing steps we are currently using to develop storyboards of scenarios for the first phase of the project, which were presented at the 6th International Conference Plagiarism Across Europe and Beyond 2020 held virtually in Dubai as a workshop. The study also presents updated findings and scenarios drawn from the workshop conducted and audience feedback, in the following sections that pave the way for the future stages of the gamification process. This serves as a guide to academics and researchers in academic integrity who may wish to study gamification and apply it to develop their own modules for their learning modules.
    • Cardiorespiratory and skeletal muscle damage due to COVID-19: making the urgent case for rehabilitation

      Silva, Rebeca Nunes; Goulart, Cássia da Luz; Oliveira, Murilo Rezende; Tacao, Guilherme Yassuyuki; Back, Guilherme Dionir; Severin, Richard; Faghy, Mark A.; Arena, Ross; Borghi-Silva, Audrey; Federal University of São Carlos, São Carlos, Brazil; et al. (Informa UK Limited, 2021-03-04)
      It has become increasingly evident that COVID-19 contributes to multiorgan pathophysiology. The systemic inflammatory response increases both pro-inflammatory cytokine and chemokine levels, leading to immune dysregulation and increasing the likelihood of incurring cardiac and pulmonary injuries. Longer periods of hospitalization (~20 days) increase susceptibility to ICU-acquired muscle weakness and deconditioning, which decreases muscle function and functional capacity. These conditions affect the quality of life in the post-COVID-19 period and require multi-disciplinary approaches to rehabilitate the cardiopulmonary and musculoskeletal systems of these patients. In this context, this narrative review, which included articles published in the Embase, PEDro and PubMed databases up to December 2020, is focused on discussing the essential role of exercise and rehabilitation health professionals in the COVID-19 recovery process, from hospitalization to hospital discharge, addressing strategies for professionals to mitigate the cardiac and pulmonary impairments associated with hospitalization to home or ambulatory rehabilitation, purposing ways to conduct rehabilitation programs to restore their functional status and quality of life after the infection. In the current environment, these findings further point to the vital role of rehabilitation health professionals in the coming years and the urgent need to develop strategies to assist COVID-19 survivors.
    • Foresee the glory and train better: Narcissism, goal-setting and athlete training

      Zhang, Shuge; Roberts, Ross; Woodman, Tim; Pitkethly, Amanda; English, Cedric; Nightingale, David; University of Derby; Bangor University; Edinburgh Napier University (American Psychological Association, 2021-03)
      Grandiose narcissism may be debilitative to athlete training because the opportunity for self-enhancement that motivates narcissists to strive is normally absent in training environments. However, this view ignores the divergent influences of the self-inflated (reflecting over-confidence) and dominant (reflecting willingness for dominance) facets of grandiose narcissism. We expected that self-inflated narcissism would undermine athlete training, but only when dominant narcissism was low. This is because dominant narcissism may serve as the catalyst that drives those with self-inflated narcissism to train well. We further considered goal-setting as a practical means of alleviating the negative influence of self-inflated narcissism in training. Goal-setting provides athletes with an exciting vision of the future and thus can be an important self-enhancement strategy to engage narcissistic athletes in training. In the present study, 321 athletes completed the Narcissistic Personality Inventory (NPI-40) and the goal-setting subscale in the Test of Performance Strategies-3 (TOPS-3). Coaches of these athletes assessed training behaviors using the Quality of Training Inventory (QTI). Self-inflated narcissism predicted higher levels of (coach-rated) distractibility and poorer quality of preparation only when both dominant narcissism and goal-setting were low (and not when either was high). The findings suggest that dominant narcissism and goal-setting protect against the adverse influences of self-inflated narcissism on athlete training. The work underscores the importance of considering grandiose narcissism as a multidimensional construct and supports goal-setting as a useful self-enhancement strategy.
    • Current activities centered on healthy living and recommendations for the future: a position statement from the HL-PIVOT network

      Arena, Ross; Kaminsky, Leonard A.; Williams, Mark; Sabbahi, Ahmad; Popovic, Dejana; Axtell, Robert; Faghy, Mark; Hills, Andrew P.; Olivares Olivares, Silvia Lizett; Lopez, Mildred; et al. (Elsevier, 2021-02-27)
      We continue to increase our cognizance and recognition of the importance of healthy living (HL) behaviors and HL medicine (HLM) to prevent and treat chronic disease. The continually unfolding events precipitated by the coronavirus disease 2019 (COVID-19) pandemic have further highlighted the importance of HL behaviors, as indicated by the characteristics of those who have been hospitalized and died from this viral infection. There has already been recognition that leading a healthy lifestyle, prior to the COVID-19 pandemic, may have a substantial protective effect in those who become infected with the virus. Now more than ever, HL behaviors and HLM are essential and must be promoted with a renewed vigor across the globe. In response to the rapidly evolving world since the beginning of the COVID-19 pandemic, and the clear need to change lifestyle behaviors to promote human resilience and quality of life, the Healthy Living for Pandemic Event Protection (HL-PIVOT) network was established. The four major areas of focus for the network are: 1) knowledge discovery and dissemination; 2) education; 3) policy; 4) implementation. This HL-PIVOT network position statement provides a current synopsis of the major focus areas of the network, including leading research in the field of HL behaviors and HLM, examples of best practices in education, policy, and implementation, and recommendations for the future.
    • The feasibility and tolerability of using inspiratory muscle training with adults discharged from the hospital with community-acquired pneumonia

      Pick, H.J.; Faghy, Mark; Creswell, G; Ashton, D; Bolton, C.E.; McKeever, T; Shen Lim, W; Bewick, T; Nottingham University Hospital NHS Trust; University of Derby; et al. (Via Medica, 2021-02-17)
      Patients experience substantial morbidity following discharge from hospital and during recovery from communi-ty-acquired pneumonia (CAP). Inspiratory muscle training (IMT) has demonstrated improved functional capacity and reduced patient-reported symptoms. To date the safety and tolerability of these methods have not been determined in CAP patients recovering following hospitalization. Accordingly, this study aimed to assess the safety and tolerability of IMT in adults discharged from hospital with CAP. Participants received an IMT device (POWERbreathe KHP2) and completed 9-weeks IMT training with weekly follow-up. Frequency (twice daily) and load (50% PImax) were fixed throughout, but training volume increased incre-mentally (2-week habituation phase, 7-week training phase). Primary outcomes of interest included IMT safety and tolerability. Twenty-two participants were recruited; 16 were male, mean age 55.2 years (range 27.9–77.3). From 1183 possible training days, side effects were reported on 15 occasions by 10 individual participants. All reported side-effects were assessed as grade 1 and did not prevent further training. Participant-reported IMT acceptability was 99.4%. Inspiratory muscle training is safe and tolerable in patients following hospitalisation for CAP. Patient satisfaction with IMT is high and it is viewed by patients as being helpful in their recovery. Distinguishing CAP-related symptoms and device-related side effects is challenging. Symptom prevalence declined during follow-up with concurrent improvements in spirometry observed. Further research is required to determine the efficacy of IMT interventions following CAP and other acute respiratory infections.
    • Creating a compassionate world: addressing the conflicts between sharing and caring versus controlling and holding evolved strategies

      Gilbert, Paul; University of Derby (Frontiers Media SA, 2021-02-10)
      For thousands of years, various spiritual traditions and social activists have appealed to humans to adopt compassionate ways of living to address the suffering of life. Yet, along with our potential for compassion and self-sacrifice, the last few thousand years of wars, slavery, tortures, and holocausts have shown humans can be extraordinarily selfish, callous, vicious, and cruel. While there has been considerable engagement with these issues, particularly in the area of moral psychology and ethics, this paper explores an evolutionary analysis relating to evolved resource-regulation strategies that can be called “care and share” versus “control and hold.” Control and hold are typical of primates that operate through intimidatory social hierarchies. Care and share are less common in non-human primates, but evolved radically in humans during our hunter-gatherer stage when our ancestors lived in relatively interdependent, small, mobile groups. In these groups, individualistic, self-focus, and self-promoting control and hold strategies (trying to secure and accumulate more than others) were shunned and shamed. These caring and sharing hunter-gatherer lifestyles also created the social contexts for the evolution of new forms of childcare and complex human competencies for language, reasoning, planning, empathy, and self-awareness. As a result of our new ‘intelligence’, our ancestors developed agriculture that reduced mobility, increased group size, resource availability and storage, and resource competition. These re-introduced competing for, rather than sharing of, resources and advantaged those who now pursue (often aggressively) control and hold strategies. Many of our most typical forms of oppressive and anti-compassionate behavior are the result of these strategies. Rather than (just) thinking about individuals competing with one another, we can also consider these different resource regulation strategies as competing within populations shaping psychophysiological patterns; both wealth and poverty change the brain. One of the challenges to creating a more compassionate society is to find ways to create the social and economic conditions that regulate control and hold strategies and promote care and share. No easy task.
    • The need for exercise sciences and an integrated response to COVID-19: A position statement from the international HL-PIVOT network

      Arena, Ross; Stoner, Lee; Haraf, Rebecca H.; Josephson, Richard; Hills, Andrew P.; Dixit, Snehil; Popovic, Dejana; Smith, Andy; Myers, Jonathan; Bacon, Simon L.; et al. (Elsevier, 2021-02-04)
      COVID-19 is one of the biggest health crises that the world has seen. Whilst measures to abate transmission and infection are ongoing, there continues to be growing numbers of patients requiring chronic support, which is already putting a strain on health care systems around the world and which may do so for years to come. A legacy of COVID-19 will be a long-term requirement to support patients with dedicated rehabilitation and support services. With many clinical settings characterized by a lack of funding and resources, the need to provide these additional services could overwhelm clinical capacity. This position statement from the Healthy Living for Pandemic Event Protection (HL-PIVOT) Network provides a collaborative blueprint focused on leading research and developing clinical guidelines, bringing together professionals with expertise in clinical services and the exercise sciences to develop the evidence base needed to improve outcomes for patients infected by COVID-19.
    • A Critical Discussion of the Clinical Management of Dietary Supplementation in Children with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder

      Chatzinikolaou, Marios Dimitrios; Apeiranthitou., Vasiliki; University of Derby; University College London (ECronicon Open Access, 2021-01-30)
      Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are both classified as neurodevelopmental disorders, affecting primarily young children and adolescents, stemming from biological/genetic and environmental origins that negatively influence neurobiological structures and leading to gastrointestinal discomforts. More precisely, toxins produced by pathogenic microorganisms’ overgrowth, unnecessary employment of antibiotics, abnormalities in the activity of carbohydrate digestive enzymes and gut’s mucosal lining disruptions result in alterations in children’s neurological functioning. Central nervous system alterations adversely affect brain maturation, social interactions, and cognitive abilities. In this respect, dietary supplementations such as omega-3 and omega-6 long-chain polyunsaturated fatty acids and/or vitamins can be effectuated, potentially increasing the effectiveness of pharmacological medications. However, research findings divulge an unspecified consensus concerning optimal supplementation duration, exact dosages, consistent utilization of outcome measures, adherence to supplements, and their longterm behavioral and health effects. In addition, dietary supplements do not always enable for corrections of children’s micronutrient deficiencies, contributing to excessive intake. Thus, it can be speculated that they cannot be provided solitarily since they depict developmental insensitivities in addressing all nutritional needs of Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder individuals. Accordingly, each individual’s developmental needs and entire dietary patterns should be carefully considered for the elimination of comorbid health conditions. In conjunction with the development and validation of universally accepted dietary plan, this shall allow for the construction of a holistic and multidisciplinary approach to dietary treatment schemes that can fully benefit these populations and are especially adapted to their needs. Future research should further explore gluten/casein-free and other restrictive diets, along with the clarification of effective randomized controlled trials.
    • Supported progressive resistance exercise training to counter the adverse side effects of robot-assisted radical prostatectomy: a randomised controlled trial.

      Ashton, Ruth E; Aning, Jonathan J; Tew, Garry A; Robson, Wendy A; Saxton, John M; University of Derby; Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol; University of Northumbria; Freeman Hospital, Newcastle-upon-Tyne (Springer, 2021-01-23)
      To investigate the effects of a supported home-based progressive resistance exercise training (RET) programme on indices of cardiovascular health, muscular strength and health-related quality of life (HR-QoL) in prostate cancer (PCa) patients after treatment with robot-assisted radical prostatectomy (RARP). This study was a single-site, two-arm randomised controlled trial, with 40 participants randomised to either the intervention or control group over a 10-month period. In addition to receiving usual care, the intervention group completed three weekly RET sessions using resistance bands for 6 months. Participants performed 3 sets of 12–15 repetitions for each exercise, targeting each major muscle group. The control group received usual care only. Brachial artery flow-mediated dilatation (FMD) was the primary outcome and assessed at baseline, 3 and 6 months. Secondary outcomes included body weight, body fat, aerobic fitness, strength and blood-borne biomarkers associated with cardiometabolic risk. There was no significant difference between the groups in FMD at 3 or 6 months. However, there were improvements in aerobic exercise capacity (P < 0.01) and upper- (P < 0.01) and lower-limb (P = 0.01) strength in favour of the RET group at 6 months, accompanied by greater weight loss (P = 0.04) and a reduction in body fat (P = 0.02). Improvements in HRQoL were evident in the RET group at 3 and 6 months via the PCa-specific component of the FACT-P questionnaire (both P < 0.01). Five adverse events and one serious adverse event were reported throughout the trial duration. This study demonstrates that home-based RET is an effective and safe mode of exercise that elicits beneficial effects on aerobic exercise capacity, muscular strength and HR-QoL in men who have undergone RARP.
    • UK University staff experience high levels of sedentary behaviour during work and leisure time

      Faghy, Mark A; Roscoe, Clare MP; Pringle, Andy; Duncan, Mike; Buchanan Meharry, John; University of Derby; Coventry University (Taylor and Francis Online, 2021-01-11)
      Reducing sedentary behaviours at work is imperative. Before effective strategies can be developed there is a need to understand profiles of activity within particular roles and organisations. This study aimed to determine activity profiles of staff by job title at a UK University. Three-hundred and seventeen participants completed the short form International Physical Activity Questionnaire to determine physical activity profiles. Fifty-one participants also wore a wrist worn GENEActiv accelerometer for seven days and completed a self-report diary denoting work and leisure hours. Twenty-one per cent of respondents were categorised as inactive and achieved 298 ± 178 metabolic equivalent minutes per week (MET-min/week). Those in administrative roles were most sedentary (501 ± 161 minutes/day). Accelerometer data highlighted that sedentary time was identical between job roles (pooled mean 8746 ± 823 counts) and equated to 84 ± 9% of total time. During working hour’s management, professional and specialist job roles had the highest level of sedentary time (2066 ± 416 counts). Time spent undertaking sedentary activities during working hours contributes to reduced overall activity and can impede productivity, performance, and health. Interventions encouraging regular movement and preventing sedentary behaviours at work are therefore required.
    • The physiological impact of masking is insignificant and should not preclude routine use during daily activities, exercise, and rehabilitation

      Haraf, Rebecca H.; Faghy, Mark; Carlin, Brian; Josephson, Richard A.; University Hospitals Cleveland Medical Center, and Case Western Reserve University, School of Medicine, Cleveland, Ohio; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, Illinois; University of Derby; Sleep Medicine and Lung Health Consultants, Pittsburgh Critical Care Associates, Pittsburgh, Pennsylvania (Ovid Technologies (Wolters Kluwer Health), 2021-01)
      Masking has been employed as a strategy for reducing transmission of a variety of communicable diseases. With the outbreak of SARS-CoV-2, many countries have implemented mandatory public masking. However, the perceived impact of mask use on pulmonary function has been a deterrent to public compliance with recommendations. COVID-19 has shed light on the impact that comorbid cardiac and pulmonary conditions may have on disease severity. This knowledge has led to increased primary and secondary prevention efforts for which exercise and rehabilitation are central. The importance of safe methods of exercise while mitigating risk of viral transmission is paramount to global recovery from the pandemic and prevention of future outbreaks. We constructed a focused literature review of the impact of various masks on pulmonary function at rest and with exercise. This was then incorporated into recommendations for the integration of masks with exercise and rehabilitation in the COVID-19 era. While there is a paucity of evidence, we identified the physiological effects of masking at rest and during exercise to be negligible. The perceived impact appears to be far greater than the measured impact, and increased frequency of mask use leads to a physiological and psychological adaptive response. Masking during daily activities, exercise, and rehabilitation is safe in both healthy individuals and those with underlying cardiopulmonary disease. Rehabilitation participants should be reassured that the benefits of masking during COVID-19 far outweigh the risks, and increased frequency of mask use invokes adaptive responses that make long-term masking tolerable.