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BACKGROUND: Side effects of breast cancer treatment may persist long into survivorship, reducing quality of life (QOL) in patients with breast cancer and survivors. There is growing evidence for the use of digital health technologies, such as mobile apps, to support self-management, decrease symptom burden, and improve QOL in patients with cancer. However, an updated overview of the effects of mobile apps on QOL and well-being in patients with breast cancer and survivors is needed. OBJECTIVE: The aim of this review was to provide an overview of breast cancer-specific, mobile app-driven lifestyle or behavioral interventions in patient care through to survivorship and their impact on QOL and mental well-being. METHODS: A systematic search of PubMed, Scopus, and Web of Science was conducted to identify relevant studies. The inclusion criteria were limited to original studies involving a trial of a mobile app-driven lifestyle or behavioral intervention for patients with breast cancer or survivors and using QOL or well-being measures. The results of the studies that met the inclusion criterion were then synthesized in text and table format. The quality of the evidence was assessed with the Cochrane risk-of-bias tool. RESULTS: A total of 17 studies with the number of participants ranging from 23 to 356 met the inclusion criterion. Of the 17 reviewed studies, 7 (41%) delivered an app-only intervention, and 10 (59%) combined an app with additional supporting materials, such as SMS text messaging, telecoaching, wearables, or printed materials. Among the 17 reviewed studies, 6 (35%) focused on aiding patients with breast cancer during the active treatment phase (excluding ongoing hormone therapy), whereas the remaining 11 (65%) focused on survivorship. The majority of the studies (14/17, 82%) observed some positive effects on QOL or well-being measures. CONCLUSIONS: The results of the review indicate that mobile apps are a promising avenue for improving QOL and well-being in breast cancer care. Positive effects were observed in patients undergoing active treatment in all reviewed studies, but effects were less clear after chemotherapy and in long-term survivors. Although lifestyle and behavioral digital interventions are still being developed, and further research should still be pursued, the available data suggest that current mobile health apps aid patients with breast cancer and survivors.
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Neoplasias da Mama , Aplicativos Móveis , Telemedicina , Envio de Mensagens de Texto , Humanos , Feminino , Neoplasias da Mama/terapia , Qualidade de Vida , Sobreviventes , Telemedicina/métodosRESUMO
The commercial production of lumpfish Cyclopterus lumpus L. is expanding with the increased demand for their use as cleaner fish, to control sea-lice numbers, at marine Atlantic salmon Salmo salar L. aquaculture sites throughout Northern Europe. A new ranavirus has been isolated from lumpfish at multiple locations in the North Atlantic area. First isolated in 2014 in the Faroe Islands, the virus has subsequently been found in lumpfish from Iceland in 2015 and from Scotland and Ireland in 2016. The Icelandic lumpfish ranavirus has been characterized by immunofluorescent antibody test, optimal growth conditions and transmission electron microscopy. Partial sequences of the major capsid protein gene from 12 isolates showed 99.79-100% nt identity between the lumpfish ranaviruses. Complete genome sequencing from three of the isolates and phylogenetic analysis based on the concatenated 26 iridovirus core genes suggest these lumpfish ranavirus isolates form a distinct clade with ranaviruses from cod Gadus morhua L. and turbot Scophthalmus maximus L. isolated in Denmark in 1979 and 1999, respectively. These data suggest that these viruses should be grouped together as a new ranavirus species, European North Atlantic Ranavirus, which encompasses ranaviruses isolated from marine fishes in European North Atlantic waters.
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Doenças dos Peixes/virologia , Ranavirus , Animais , Aquicultura , Proteínas do Capsídeo/genética , Classificação , Dinamarca , Europa (Continente) , Peixes/virologia , Linguados/virologia , Gadus morhua/virologia , Genes Virais , Genoma Viral , Irlanda , Filogenia , Ranavirus/classificação , Ranavirus/genética , Ranavirus/isolamento & purificação , Ranavirus/ultraestrutura , Proteínas Virais/genéticaRESUMO
PURPOSE: Insufficient sleep duration may affect athletic performance and health. Inconsistent sleep pattern also has negative health effects, but studies on athletes' intraindividual sleep variability are scarce. The aim of this research was to compare total sleep time (TST) and variability (TST-variability), wakening after sleep onset, and sleep efficiency, during nights preceding early morning practices with other nights, and to investigate sleep characteristics of nights following a day with early morning only, evening only, or both a morning and an evening session in adolescent swimmers. METHODS: Wrist-worn accelerometers were used to measure 1 week of sleep in 108 swimmers (mean age 16.1 [2.6] y) in Iceland. Adjusted regression analyses and linear mixed models were used to explore associations of training schedules with TST, TST-variability, wakening after sleep onset, and sleep efficiency. RESULTS: Mean TST was 6:32 (h:min) (±39 min) and TST-variability was 63 minutes (±25 min). TST decreased and TST-variability increased with more early morning practices. TST preceding early training was 5:36 and 5:06 in <16- and ≥16-year-olds, respectively, shorter than on nights preceding later or no morning training (P < .001). CONCLUSION: Swimmers have extremely short TST preceding early morning sessions and increased TST-variability with more early morning sessions.
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Condicionamento Físico Humano/métodos , Sono , Natação , Acelerometria , Adolescente , Atletas , Criança , Feminino , Humanos , Islândia , Masculino , Fatores de Tempo , Adulto JovemRESUMO
Fulfilling individual energy and nutrient requirements is of great importance for athletes to support overall health and well-being, training adaptation, recovery and injury prevention. Energy availability is the amount of energy left over and available for bodily functions after the energy expended for training is subtracted from the energy taken in from food. The syndrome of Relative Energy Deficiency in Sport (RED-s) refers to the multifactorial health and performance consequences of low energy availability. Potential physiological implications of RED-s include impaired metabolic rate, hormonal disruptions, menstrual dysfunction, reduced bone health, immunity, protein synthesis, and cardiovascular health. These can have short and long term consequences on health and sport performance. Causes of RED-s range from unintentional (e.g. lack of awareness or difficulties with meeting high energy requirements) to more intentional behaviors and further to clinical eating disorders. RED-s prevalence appears to differ between sports and sport disciplines, with highest risk in endurance, aesthetic and weight-class sports. This article summarizes current knowledge of RED-s implications for health and performance, and highlights the importance of early diagnosis and screening. Research on RED-s in Icelandic athletes is warranted as it could support development of national guidelines, prevention and treatment protocols.
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Atletas , Dieta , Ingestão de Energia , Metabolismo Energético , Valor Nutritivo , Resistência Física , Deficiência Energética Relativa no Esporte , Dieta/efeitos adversos , Humanos , Necessidades Nutricionais , Estado Nutricional , Prevalência , Prognóstico , Deficiência Energética Relativa no Esporte/diagnóstico , Deficiência Energética Relativa no Esporte/epidemiologia , Deficiência Energética Relativa no Esporte/fisiopatologia , Deficiência Energética Relativa no Esporte/terapia , Medição de Risco , Fatores de RiscoRESUMO
A novel 27 kDa ladder-lectin-like protein, showing a multimeric structure under non-reducing conditions, was isolated from halibut serum by binding to N-acetyl glucosamine. Mass-spectrometry analysis did not show significant homology with known proteins. Specific antibodies were produced and used in immunohistochemistry on tissue sections of early halibut ontogeny from 119 until 1050 °d post hatching. A strong positive response was detected in the mucosal cells of the skin, gills and gut, indicating a role in the mucosal immune defence at these sites. Further immunopositivity was detected in liver, myeloma of kidney and the brain at different developmental stages but predominant expression was found in mucosal surfaces at later stages of development tested (1050 °d). It is still uncertain whether this ladder-like lectin forms part of the complement pathway, as a lectin or ficolin, or if it belongs to galectins. A strong detection in mucosal surfaces on skin, gills and gut, show similar patterns of expression as both mucosal lectins and galectins in other fish. Detection in neuronal tissue may indicate putative roles in tissue remodelling of brain and in ongoing neurogenesis in the fish eye.
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Proteínas de Peixes/química , Linguado/imunologia , Lectinas/química , Sequência de Aminoácidos , Animais , Linguado/crescimento & desenvolvimento , Imunidade nas Mucosas , Imuno-Histoquímica , Especificidade de ÓrgãosRESUMO
AIM: The associations between body fat levels and physical activity with academic performance are inconclusive and were explored using longitudinal data. METHODS: We enrolled 134/242 adolescents aged 15, who were studied at the age of nine and agreed to be followed up from April to May 2015 for the Health behaviours of Icelandic youth study. Accelerometers measured physical activity, body mass indexes (BMI) were calculated and dual-energy X-ray absorptiometry scans assessed the participants' body composition at nine and 15. Their language and maths skills were compared to a growth model that estimated the academic performances of children born in 1999. RESULTS: Higher than normal body fat levels between the ages of nine and 15 were negatively associated with maths performance, but the same association was not found for Icelandic language studies. These were Pearson's r = -0.24 (p = 0.01) for BMI and Pearson's r = -0.34 (p = 0.01) for the percentage of body fat. No associations were found with changes in physical activity. CONCLUSION: Children who put on more body fat than normal between the ages of nine and 15 had an increased risk of adverse academic performance that was independent of changes in physical activity.
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Desempenho Acadêmico , Adiposidade , Exercício Físico , Adolescente , Aptidão Cardiorrespiratória , Criança , Feminino , Humanos , Estudos Longitudinais , MasculinoRESUMO
A novel viral haemorrhagic septicaemia virus (VHSV) of genotype IV was isolated from wild lumpfish (Cyclopterus lumpus), brought to a land-based farm in Iceland, to serve as broodfish. Two groups of lumpfish juveniles, kept in tanks in the same facility, got infected. The virus isolated was identified as VHSV by ELISA and real-time RT-PCR. Phylogenetic analysis, based on the glycoprotein (G) gene sequences, may indicate a novel subgroup of VHSV genotype IV. In controlled laboratory exposure studies with this new isolate, there was 3% survival in the I.P. injection challenged group while there was 90% survival in the immersion group. VHSV was not re-isolated from fish challenged by immersion. In a cohabitation trial, lumpfish infected I.P. (shedders) were placed in tanks with naïve lumpfish as well as naïve Atlantic salmon (Salmo salar L.). 10% of the lumpfish shedders and 43%-50% of the cohabiting lumpfish survived after 4 weeks. 80%-92% of the Atlantic salmon survived, but no viral RNA was detected by real-time RT-PCR nor VHSV was isolated from Atlantic salmon. This is the first isolation of a notifiable virus in Iceland and the first report of VHSV of genotype IV in European waters.
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Doenças dos Peixes/virologia , Septicemia Hemorrágica Viral/patologia , Novirhabdovirus/patogenicidade , Perciformes/virologia , Animais , Aquicultura , Surtos de Doenças/veterinária , Doenças dos Peixes/transmissão , Genótipo , Glicoproteínas/genética , Septicemia Hemorrágica Viral/genética , Septicemia Hemorrágica Viral/transmissão , Islândia/epidemiologia , Novirhabdovirus/classificação , Novirhabdovirus/genética , Filogenia , RNA Viral/isolamento & purificação , Salmo salar/virologiaRESUMO
PURPOSE: The underlying goal of the study was to examine gender-specific effects of leisure-time physical activity on the development of symptoms of anxiety. METHODS: The second wave of a prospective cohort survey (HUNT 2) was conducted during 1995-1997 in the county of Nord-Trøndelag, Norway, with a follow-up in 2006-2008 (HUNT 3). The sample consisted of 12,796 women and 11,195 men with an age range of 19-85 years. A binomial model with a log-link function and generalized linear model analysis with gamma distribution was used to assess the association between physical activity and anxiety symptoms (Hospital Anxiety and Depression Scale anxiety subscale, HADS-A). RESULTS: A total of 1,211 (9.5 %) women and 650 (5.8 %) men developed HADS-defined anxiety (≥8 on the HADS-A scale). Men who scored in the middle tertile of the calculated physical activity index developed significantly fewer cases of HADS-defined anxiety compared with men in the lowest tertile (p < 0.05). In the gamma regression analysis for women, having higher scores on the moderate-high physical activity was associated with fewer symptoms of anxiety (p < 0.01). CONCLUSIONS: Women developed almost twice as many cases of HADS-defined anxiety compared to men. Significant associations were found between general leisure-time physical activity and anxiety symptoms among women and men, but the true effect is likely to be different from the observed associations due to several threats to the internal validity in the study.
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Transtornos de Ansiedade/diagnóstico , Ansiedade/diagnóstico , Exercício Físico/psicologia , Atividades de Lazer/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Noruega , Estudos Prospectivos , Fatores Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
Problematic low energy availability (LEA) is the underlying cause of relative energy deficiency in sport (REDs). Male specific etiology, as well as the duration and degree of LEA exposures resulting in REDs remain to be adequately described. The present study aimed to assess occurrences of LEA (energy availability [EA] <25 kcal/kg fat-free mass/day) in male athletes from various sports over 7 days. Associations between number of LEA days, physiological measures, and body image concerns were subsequently evaluated. The athletes recorded their weighed food intakes and training via photo-assisted mobile application. Body composition and resting metabolic rates were measured, and venous blood samples collected for assessments of hormonal and nutrition status. Participants also answered the Low Energy Availability in Males Questionnaire (LEAM-Q), Eating Disorder Examination-Questionnaire Short (EDE-QS), Exercise Addiction Inventory (EAI), and Muscle Dysmorphic Disorder Inventory (MDDI). Of 19 participants, 13 had 0-2, 6 had 3-5, and none had 6-7 LEA days. No associations were found between the number of LEA days with the physiological and body image outcomes, although those with greatest number of LEA days had highest EEE but relatively low dietary intakes. In conclusion, this group displayed considerable day-to-day EA fluctuations but no indication of problematic LEA.
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Atletas , Humanos , Masculino , Adulto , Adulto Jovem , Deficiência Energética Relativa no Esporte , Composição Corporal , Imagem Corporal , Ingestão de Energia , Metabolismo Basal , Esportes/fisiologia , Adolescente , Inquéritos e Questionários , Metabolismo EnergéticoRESUMO
Background: Problematic low energy availability (EA) is the underlying culprit of relative energy deficiency in sport (REDs), and its consequences have been suggested to be exacerbated when accompanied by low carbohydrate (CHO) intakes. Objectives: This study compared dietary intake, nutrition status and occurrence of REDs symptoms in groups of female athletes, displaying different patterns of EA and CHO intake. Methods: Female athletes (n = 41, median age 20.4 years) from various sports weighed and recorded their food intake and training for 7 consecutive days via a photo-assisted mobile application. Participants were divided into four groups based on patterns of EA and CHO intakes: sufficient to optimal EA and sufficient to optimal CHO intake (SEA + SCHO), SEA and low CHO intake (SEA + LCHO), low energy availability and SCHO (LEA + SCHO), and LEA and LCHO (LEA + LCHO). SEA patterns were characterised by EA ≥30 and LEA by EA <30â kcal/kg fat free mass, and SCHO patterns characterised by CHO intake ≥3.0 and LCHO <3.0â g/kg body weight for most of the registered days. Body composition was measured with dual energy x-ray absorptiometry, resting metabolic rate with indirect calorimetry and serum blood samples were collected for evaluation of nutrition status. Behavioural risk factors and self-reported symptoms of REDs were assessed with the Low Energy Availability in Females Questionnaire, Eating Disorder Examination Questionnaire Short (EDE-QS), Exercise Addiction Inventory, and Muscle Dysmorphic Disorder Inventory. Results: In total, 36.6% were categorised as SEA + SCHO, of which 5/16 were ball sport, 7/10 endurance, 1/7 aesthetic, 2/5 weight-class, and 0/3 weight-class athletes. Of LEA + LCHO athletes (19.5% of all), 50% came from ball sports. Aesthetic and endurance athletes reported the greatest training demands, with weekly training hours higher for aesthetic compared to ball sports (13.1 ± 5.7 vs. 6.7 ± 3.4â h, p = 0.012). Two LEA + LCHO and one SEA + LCHO athlete exceeded the EDE-QS cutoff. LEA + LCHO evaluated their sleep and energy levels as worse, and both LEA groups rated their recovery as worse compared to SEA + SCHO. Conclusion: Repeated exposures to LEA and LCHO are associated with a cluster of negative implications in female athletes. In terms of nutrition strategies, sufficient EA and CHO intakes appear to be pivotal in preventing REDs.
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Sedentary behavior (SB) or sitting is associated with multiple unfavorable health outcomes. Bone tissue responds to imposed gravitational and muscular strain with there being some evidence suggesting a causal link between SB and poor bone health. However, there are no population-based data on the longitudinal relationship between SB, bone change, and incidence of fragility fractures. This study aimed to examine the associations of sitting/SB (defined as daily sitting time), areal BMD (by DXA), and incident low trauma (fragility) osteoporotic fractures (excluding hands, feet, face, and head). We measured baseline (1995-7) and 10-yr self-reported SB, femoral neck (FN), total hip (TH), and lumbar spine (L1-L4) BMD in 5708 women and 2564 men aged 25 to 80+ yr from the population-based, nationwide, 9-center Canadian Multicentre Osteoporosis Study. Incident 10-yr fragility fracture data were obtained from 4624 participants; >80% of fractures were objectively confirmed by medical records or radiology reports. Vertebral fractures were confirmed by qualitative morphological methods. All analyses were stratified by sex. Multivariable regression models assessed SB-BMD relationships; Cox proportional models were fit for fracture risk. Models were adjusted for age, height, BMI, physical activity, and sex-specific covariates. Women in third/fourth quartiles had lower adjusted FN BMD versus women with the least SB (first quartile); women in the SB third quartile had lower adjusted TH BMD. Men in the SB third quartile had lower adjusted FN BMD than those in SB first quartile. Neither baseline nor stable 10-yr SB was related to BMD change nor to incident fragility fractures. Increased sitting (SB) in this large, population-based cohort was associated with lower baseline FN BMD. Stable SB was not associated with 10-yr BMD loss nor increased fragility fracture. In conclusion, habitual adult SB was not associated with subsequent loss of BMD nor increased risk of fracture.
The number of hours of sitting in a day (often called "sedentary behavior") is currently understood to be "bad for bone health" both because of increased bone loss and a higher risk for fractures. Very few studies in randomly sampled men and women from a whole population have consistently asked about hours of sitting and examined baseline bone density. Fewer still have compared hours of sitting and its changes over 10 yr with changes in bone density and the number of new fractures that occurred. The Canadian Multicentre Osteoporosis Study obtained sitting hours from 5708 women and 2564 men aged 25 to 80+ yr and compared it with the spine, total hip (TH), and femoral neck (FN) bone density values. The average sitting at 7.4 h in men was associated with slightly lower adjusted femoral neck bone density; in women, sitting 6.7 h/d was associated with slightly lower adjusted FN and TH bone density. Ten-year follow-up data (now in about 5000 people) showed no relationship between the slightly longer sitting (an increase of 18% in men and 22% in women) and bone loss or new bone fractures. In this large country-wide population-based study, hours of sitting each day were not associated with 10-yr BMD loss in women or men nor did sitting more associate with new bone fractures. These data are reassuring; women and men who walk regularly and have some moderate-vigorous physical activity each day, despite more sitting, do not seem to be at greater risk for osteoporosis.
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Osteoporose , Fraturas por Osteoporose , Adulto , Feminino , Humanos , Masculino , Densidade Óssea , Canadá/epidemiologia , Colo do Fêmur/diagnóstico por imagem , Vértebras Lombares , Osteoporose/diagnóstico por imagem , Osteoporose/epidemiologia , Fraturas por Osteoporose/epidemiologia , Comportamento Sedentário , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou maisRESUMO
The interaction of hydrogen with the Pt(110)-(1×2) surface is studied using temperature programmed desorption (TPD) measurements and density functional theory (DFT) calculations. The ridges in this surface resemble edges between micro-facets of Pt nano-particle catalysts used for hydrogen evolution (HER) and hydrogen oxidation reactions (HOR). The binding energy and activation energy for desorption are found to depend strongly on hydrogen coverage. At low coverage, the strongest binding sites are found to be the low coordination bridge sites at the edge and this is shown to agree well with the He-atom interaction and work function change which have been reported previously. At higher hydrogen coverage, the higher coordination sites on the micro-facet and in the trough get populated. The simulated TPD spectra based on the DFT results are in close agreement with our experimental spectra and provide microscopic interpretation of the three measured peaks. The lowest temperature peak obtained from the surface with highest hydrogen coverage does not correspond to desorption directly from the weakest binding sites, the trough sites, but is due to desorption from the ridge sites, followed by subsequent, thermally activated rearrangement of the H-adatoms. The reason is low catalytic activity of the Pt-atoms at the trough sites and large reduction in the binding energy at the ridge sites at high coverage. The intermediate temperature peak corresponds to desorption from the micro-facet. The highest temperature peak again corresponds to desorption from the ridge sites, giving rise to a re-entrant mechanism for the thermal desorption.
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PURPOSE: To analyze the association between physical activity (PA), symptoms of depression and anxiety, and personality traits. METHODS: Cross-sectional study from a Norwegian population-based survey conducted in the period 2006-2008. The sample consisted of a total of 38,743 subjects aged ≥ 19 years, 56.1 % women and 43.9 % men. Demographic variables, PA, depression and anxiety (The Hospital Anxiety and Depression Scale), and personality (Eysenck Personality Questionnaire) were assessed by self-reporting measurements. RESULTS: Individuals who reported moderate and high PA had significantly lower scores on depression and anxiety compared with less physically active individuals (p < 0.05). Significantly lower risk of HADS-defined depression and anxiety was associated with frequency, duration, and intensity of activity among women (p < 0.05), and significantly lower risk of HADS-defined depression was associated with frequency, duration, and intensity of activity among men (p < 0.05). There was a significant linear trend between extroversion and levels of PA (p < 0.01) and between neuroticism and PA (p < 0.01). CONCLUSIONS: Subjects reporting regular leisure-time PA were less likely to report symptoms of HADS-defined depression and anxiety. Personality may be an underlying factor in explaining this association.
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Transtornos de Ansiedade/fisiopatologia , Transtorno Depressivo/fisiopatologia , Exercício Físico/psicologia , Inventário de Personalidade , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Psicometria/estatística & dados numéricos , Autoimagem , Inquéritos e QuestionáriosRESUMO
Objectives: Disordered eating and compulsive exercise behaviours are common among athletes and can increase the risk of relative energy deficiency in sport (REDs). Contrarily, the prevalence of muscle dysmorphia and its relationship with REDs are unknown. This cross-sectional study aimed to evaluate associations of all three with REDs symptoms. Methods: Elite and subelite Icelandic athletes (n=83, 67.5% females) answered the Low Energy Availability in Females/Males Questionnaires (LEAF-Q/LEAM-Q), Eating Disorder Examination-Questionnaire Short (EDE-QS), Exercise Addiction Inventory (EAI) and Muscle Dysmorphic Disorder Inventory (MDDI). Body composition was assessed via dual-energy X-ray absorptiometry; resting metabolic rate via indirect calorimetry; and blood samples were drawn for analysis of nutrition and hormonal status. Females were compared based on LEAF-Q total score (≥8 (at risk) vs <8). Simple linear regression was applied to evaluate associations of (a) testosterone with other objective measures and LEAM-Q scores in males; and (b) LEAF-Q/LEAM-Q scores with EDE-QS, EAI and MDDI scores. Results: In total, 8.4% of participants scored above cut-off on EDE-QS, 19.3% on EAI and 13.3% on MDDI. Females with LEAF-Q total score ≥8 had higher median scores on EDE-QS, EAI and MDDI compared with those scoring <8. Testosterone was positively associated with iron and inversely with total iron-binding capacity but was not associated with scoring on any of the administered questionnaires. Conclusion: Drive for muscularity and aesthetic physique may play a role in the complex presentation of REDs. Screening for muscle dysmorphia, in addition to disordered eating and compulsive exercise, could therefore facilitate early detection of REDs.
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BACKGROUND: Patients with atopic dermatitis can experience chronic eczema with pruritus, skin pain, sleep problems, anxiety, and other problems that reduce their quality of life (QoL). Current treatments aim to improve these symptoms and reduce inflammation, but poor treatment adherence and disease understanding are key concerns in the long-term management of atopic dermatitis. Digital therapeutics can help with these and support patients toward a healthier lifestyle to improve their overall QoL. OBJECTIVE: The aim of the study is to test the feasibility of a digital health program tailored for atopic dermatitis through program engagement, retention, and acceptability. METHODS: Adults with atopic dermatitis were recruited in Iceland for a 6-week digital health program delivered through a smartphone app. Key components of the digital program were disease and trigger education; medication reminders; patient-reported outcomes (PROs) on energy levels, stress levels, and quality of sleep (referred to as QoL PROs); atopic dermatitis symptom PROs; guided meditation; and healthy lifestyle coaching. The primary outcome was program feasibility, as assessed by in-app retention and engagement. User satisfaction was assessed by the mHealth (ie, mobile health) App Usability Questionnaire (MAUQ). RESULTS: A total of 21 patients were recruited (17 female, mean age 31 years), 20 (95%) completed the program. On average, users were active in the app 6.5 days per week and completed 8.2 missions per day. The education content, medication reminders, and PROs had high user engagement and retention; all users who were exposed to the QoL PROs (n=17) interacted with these, and 20/21 (95%) users were continuously engaged with the education missions, medication missions, and symptom PROs. Continued engagement with the step counter and mind missions among exposed users was lower (17/21 and 13/20 participants, respectively). Medication reminder and education task completion remained high over time (at least 18/20, 90%), but weekly interactions declined. All assigned users completed atopic dermatitis symptom PROs on weeks 1-5 and only one did not do so on week 6; the reported number and total severity of atopic dermatitis symptoms reduced during the program. Regarding the QoL PROs, 16/17 (94%) and 14/17 (82%) users interacted with these at least 3 times in the first and last week of the program, respectively, and all reported improvements over time. User satisfaction was high with a total score of 6.2/7. CONCLUSIONS: We found high overall engagement and retention in a targeted digital health program among patients with atopic dermatitis, as well as high compliance with missions relating to medication reminders, patient education, and PROs. Symptom number and severity were reduced, and QoL PROs improved over time. We conclude that a digital health program is feasible and may provide added benefits for patients with atopic dermatitis, including the tracking and improvement of atopic dermatitis symptoms.
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Calculations of the desorption of hydrogen from Pt(110)-(1×2), a surface used to model nanoparticle edge sites, show the activation energy varying strongly with hydrogen coverage, from 0.8 to 0.3 eV. The predicted temperature programed desorption spectra agree well with experiments, but the formation of the hydrogen molecules occurs only at two types of sites on the surface even though three peaks are observed. The lowest and highest temperature peaks result from desorption from the same strong binding sites at the ridge, while desorption from the weakest binding trough sites is insignificant.
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Theoretical studies of the possibility of forming ammonia electrochemically at ambient temperature and pressure are presented. Density functional theory calculations were used in combination with the computational standard hydrogen electrode to calculate the free energy profile for the reduction of N(2) admolecules and N adatoms on several close-packed and stepped transition metal surfaces in contact with an acidic electrolyte. Trends in the catalytic activity were calculated for a range of transition metal surfaces and applied potentials under the assumption that the activation energy barrier scales with the free energy difference in each elementary step. The most active surfaces, on top of the volcano diagrams, are Mo, Fe, Rh, and Ru, but hydrogen gas formation will be a competing reaction reducing the faradaic efficiency for ammonia production. Since the early transition metal surfaces such as Sc, Y, Ti, and Zr bind N-adatoms more strongly than H-adatoms, a significant production of ammonia compared with hydrogen gas can be expected on those metal electrodes when a bias of -1 V to -1.5 V vs. SHE is applied. Defect-free surfaces of the early transition metals are catalytically more active than their stepped counterparts.
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Local density of states and electric charge in regions defined for individual atoms and molecules using grid based Bader analysis is presented for N(2) and CO(2) adsorbed on a platinum electrode in the presence of an applied electric field. When the density of states is projected onto Bader regions, the partial density of states for the various subregions correctly sums up to the total density of states for the whole system, unlike the commonly used projection onto spheres which results in missing contributions from some regions while others are over counted, depending on the radius chosen. The electrode is represented by a slab with a missing row reconstructed Pt(110)-(1 × 2) surface to model an edge between micro-facets on the surface of a nano-particle catalyst. For both N(2) and CO(2), a certain electric field window leads to adsorption. The binding of N(2) to the electrode is mainly due to polarization of the molecule but for CO(2) hybridization occurs between the molecular states and the states of the Pt electrode.
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Studies of adolescent body image and screen use are mostly limited to girls, and longitudinal data are scarce. We examined cross-sectional and longitudinal associations between these variables in mid-adolescent boys and girls. Data was collected when participants were at age 15 and 17, by questionnaire and objective measurements (n = 152 had complete data). Sex-specific linear regression was used to explore cross-sectional and longitudinal associations of self-reported screen use (total use, and time spent in gaming, TV/DVD/internet-based watching and internet use for communication) and body image, adjusting for vigorous physical activity, symptoms of depression, and body composition. Screen time was negatively associated with body image at both time points, although more strongly at age 15, and for girls only. Gaming and TV/DVD/internet watching was more strongly associated with body image than internet use for communication. Girls with above median screen time at both ages had 14% lower body image score at age 17 than girls with below median screen time at both time points. Our results suggest that screen use is likely to play a role in the development of body dissatisfaction among adolescent females. Limiting screen time may, therefore, help to mitigate body dissatisfaction in adolescent girls.
Assuntos
Imagem Corporal , Tempo de Tela , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários , TelevisãoRESUMO
INTRODUCTION: Improving disease awareness and treatment adherence is key for the long-term management of atopic dermatitis (AD). Digital interventions can support patients in disease self-management and adopting a healthier lifestyle through behavioral modifications. We aimed to test the clinical efficacy of a digital program in patients with AD. METHODS: Adults with mild-to-severe AD were recruited for a 6-week feasibility study. The intervention was delivered through a mobile app and consisted of symptom and trigger education, treatment reminders, lifestyle coaching, and healthy lifestyle support. Here we report the secondary outcomes of intervention efficacy on clinical symptoms, as assessed by Scoring Atopic Dermatitis (SCORAD) and Patient-Oriented Eczema Measure (POEM), on health-related quality of life (HR QoL) as assessed by Dermatology Life Quality Index (DLQI), and changes in behaviors related to disease management as assessed by a six-item questionnaire. RESULTS: Twenty of 21 patients (95.2%) completed the program (81% female, mean age 31.4 years, mean time from diagnosis 26.8 years). Clinical symptoms and patient-reported global severity improved by 44% and 46%, respectively, while HR QoL improved by 41% (p < 0.001 for all measures). Adherence to treatments and preventive measures improved from pre- to post-intervention, including skincare, avoidance of triggers, and disease-related knowledge. A significant interaction was observed between increased treatment adherence and clinical improvement, such that larger clinical improvements were observed in patients with higher treatment adherence. CONCLUSION: Patients with AD are open to and can benefit from a digitally delivered targeted intervention, as demonstrated by significant improvements in treatment adherence and related clinical outcomes.