Observability of the Very-High-Energy Emission from GRB 221009A.

The LHAASO Collaboration detected the gamma ray burst GRB 221009A at energies above 500 GeV with a tail extending up to 18 TeV, whose spectral analysis has presently been performed up to 7 TeV for the lower energy instrument LHAASO-WCDA only, with no indication of a cutoff. Soon thereafter, Carpet-2 at Baksan Neutrino Observatory reported the observation of an air shower consistent with being caused by a photon of energy 251 TeV from the same GRB. Given the source redshift z=0.151, the expected attenuation due to the extragalactic background light is very severe so that these detections have proven very hard to explain. In this Letter, we show that the existence of axionlike particles with mass m_{a}≃(10^{-11}-10^{-7}) eV and two-photon coupling g_{aγγ}≃(3-5)×10^{-12} GeV^{-1} strongly reduce the optical depth of TeV photons, thus explaining the observations. Our ALPs meet all available constraints, are consistent with two previous hints at their existence, and are good candidates for cold dark matter. Moreover, we show that Lorentz invariance violation can explain the Carpet-2 result but not the LHAASO observations.

Difference in cardiac remodeling between female athletes and pregnant women: a case control study.

OBJECTIVES: The aim of this study was to detect possible differences in reversible cardiac remodeling occurring in sport training and twin pregnancy. BACKGROUND: cardiac remodeling occurs in athletes and pregnant women due to training and fetal requirements, respectively. These changes could be apparently similar. METHODS: 21 female elite athletes (23.2 ± 5.3 years), 25 women with twin pregnancies (35.4 ± 5.7 years) and 25 healthy competitive female athletes (controls), age-matched with pregnant women (34.9 ± 7.9 years), were enrolled. This latter group was included to minimize the effect of age on cardiac remodeling. All women evaluated through anamnestic collection, physical examination, 12 leads ECG, standard echocardiogram and strain analysis. Sphericity (SI) and apical conicity (ACI) indexes were also calculated. RESULTS: Pregnant women showed higher LA dimension (p < 0.001) compared to both groups of athletes. LV e RV GLS were significantly different in pregnant women compared to female athletes (p = 0.02 and 0.03, respectively). RV GLS was also different between pregnant women and controls (p = 0.02). Pregnant women showed significantly higher S' wave compared to female athletes (p = 0.02) but not controls. Parameters of diastolic function were significantly higher in athletes (p = 0.08 for IVRT and p < 0.001 for E/A,). SI was lower in athletes in both diastole (p = 0.01) and systole (p < 0.001), while ACIs was lower in pregnant women (p = 0.04). CONCLUSIONS: Cardiac remodeling of athletes and pregnant women could be similar at first sight but different in LV shape and in GLS, highlighting a profound difference in longitudinal deformation between athletes and pregnant women. This difference seems not to be related with age. These findings suggest that an initial maternal cardiovascular maladaptation could occur in the third trimester of twin pregnancies.

Integrated total body composition versus Body Mass Index in young athletes.

BACKGROUND: The aim of this study was to assess if the evaluation of Body Mass Index is sufficient to define an overweight index in young athletes, or if a more effective evaluation is preferable in order to examine body fat mass, free-fat mass and hydration status in young athletes. METHODS: Two hundred ninety-nine young athletes between the ages of 8 to 18 have been analyzed in this study. Data from evaluation in body composition of young athletes were studied and subdivided by age, sex and method used. In order to measure body composition in young people, the participants who attend our Department for sport eligibility examination, were evaluated through anthropometric measurements as far as, fat mass, fat-free mass and hydration status are concerned. RESULTS: The statistical differences showed with Body Mass Index and body fat assessment reflect that more accurate evaluation is preferable: the normal-weight with Body Mass Index are 78.0%, overweight 18.7% and obese 3.3% respect to a 75.0%, 14.0% and 11.0% detected with a body fat evaluation (P<0.000); statistical differences have been found also subdividing the group per sex, higher in males (P=0.046) than to females (P<0.000). Bio-impedance data shown a statistical differences in young obese athletes. CONCLUSIONS: The results obtained show clearly that the analysis of the Body Mass Index is not sufficient in young athletes. Therefore, for young athletes a full assessment of body composition would be appropriate to reduce classific-tion errors.

Preliminary Results of an Exercise Program After Laparoscopic Resective Colorectal Cancer Surgery in Non-Metastatic Adenocarcinoma: A Pilot Study of a Randomized Control Trial.

Performing physical exercise after a colorectal cancer diagnosis is associated with lower mortality related to the tumor itself. In order to improve physical recovery after elective surgery, there are no specific exercise protocols after discharge from the hospital. The purpose of this study is to show the preliminary results of an exercise program after colorectal cancer surgery. Six patients with non-metastatic colorectal adenocarcinoma addressed to respective laparoscopic were randomly assigned to a mixed supervised/home-based exercise program for six months and compared to a control group without exercise. To assess the effectiveness of the program, functional and body composition parameters were evaluated. Three months after surgery, the exercise group increased flexibility (p < 0.01, ES = 0.33), strength of lower limbs (p < 0.01, ES = 0.42) and aerobic capacity (p < 0.01, ES = 0.28). After surgery, the six patients experienced a significant reduction in body mass index (BMI) and free fat mass. More specifically, fat mass reached the lowest values, with a concomitant increase in cell mass after six months (p < 0.01, ES = 0.33). This did not occur in the control group. Colorectal cancer treatment induces a reduction in physical function, particularly during the first six months after treatment. A mixed exercise approach appears promising in countering this process after colorectal cancer surgery.

Evaluation of left ventricular remodelling in young Afro-Caribbean athletes.

BACKGROUND: Cardiac adaptation to intense physical training is determined by many factors including age, gender, body size, load training and ethnicity. Despite the wide availability of ECG analysis, with a higher presence of abnormalities in different races, echocardiographic studies on young Afro-Caribean (AA) and Caucasian athletes (CA) are lacking in literature. We aimed to assess the effect in the secondary LV remodelling of load training in young AA players compared to matched CA players. METHOD: Seventy-seven AA and 53 CA matched soccer players (mean age 17.35 ± 0.50 and 18.25 ± 0.77 y) were enrolled. They were evaluated with echocardiography. A subgroup of 30 AA and 27 CA were followed up for a period of 4 years. The myocardial contractile function was evaluated by speckle-tracking echocardiographic global longitudinal strain (GLS). RESULTS: No significant differences were found in weight and height and in blood pressure response to maximal ergometer test in either group. In AA a higher level of LV remodelling, consisting in higher LV wall thickness, higher interventricular septum (IVS) and posterior wall (PW) thickness were found (IVS: 10.04 ± 0.14 and 9.35 ± 0.10 in AA and CA respectively, p < 0.001. PW: 9.70 ± 0.20 and 9.19 ± 0.10 mm in AA and CA respectively, p < 0.05). Strain data showed no significant differences between the two groups (22.35 ± 0.48 and 23.38 ± 0.69 in AA (n = 27) and CA (n = 25), respectively). At the beginning of the follow-up study AA showed a significantly higher left ventricular remodelling (IVS = 9.29 ± 0.3 and 8.53 ± 0.12 mm in AA and CA respectively, p < 0.002. PW = 9.01 ± 0.2 and 8.40 ± 0.20 in AA and CA respectively, p = 0.1). During the next four years of follow-up we observed a regular parallel increase in LV wall thickness and chamber diameters in both groups, proportionally to the increase in body size and LV mass. (IVS = 10.52 ± 0.17 and 9.03 ± 0.22 mm in AA and CA respectively, p < 0.001. PW: 10.06 ± 0.17 and 8.26 ± 0.19 mm in AA and CA respectively, p < 0.001). CONCLUSION: The study shows that the ventricular remodelling observed in AA appears to be a specific phenotype already present in pre-adolescence. These data also suggest that genetic/ethnic factors play a central role in left ventricular remodelling during the first years of life in elite athletes.

[Phisycal activity and primary prevention: lifestyle analysis in young people]. / Attività fisica e prevenzione primaria: valutazione dello stile di vita nei giovani.

OBJECTIVES: to assess physical activity and overweight in a young population as factors associated with well-being. DESIGN: cross-sectional study. SETTING AND PARTICIPANTS: data collection was performed in primary and secondary schools of a district located in Florence (Tuscany Region, Central Italy) by a validated questionnaire; 1,776 subjects were enrolled. MAIN OUTCOME MEASURES: physical activity levels and overweight. RESULTS: an overweight or obese condition in 14,4% of the study population was observed. Vigorous physical activity prevailed in normal weight children, while the time spent in a sitting position was higher in overweight subjects. CONCLUSIONS: physical activity levels do not follow the guidelines for youth people. Educational programmes, also at schools, are recommended in order to prevent the risk of developing chronic diseases in adulthood.

New findings on type 2 diabetes in first-generation Chinese migrants settled in Italy: Chinese in Prato (CHIP) cross-sectional survey.

BACKGROUND: Chinese people are one of the fastest growing immigrant populations in Europe, and their health has become a key issue to host nations. Although type 2 diabetes (T2DM) is a big burden among migrant populations, data on Chinese immigrants in Europe are limited. METHODS: A cross-sectional survey was performed in 2014, adopting principles of community-based participatory research to investigate T2DM, diagnosed by the American Diabetes Association fasting criteria, in Chinese first-generation migrants aged 16 to 59 years settled in Prato (Italy). Association with different factors was investigated using logistic regression. RESULTS: Of the 1608 participants, 177 had T2DM (11.0%), 119 being newly diagnosed (7.4%). Among subjects with diabetes, 58 (32.8%) were aware of the disease; among subjects with diabetes aware of their condition, 46 (79%) were treated with glucose lowering drugs. Age-standardized (World Health Organization 2001 population) prevalence of T2DM was 9.6% (95% CI 9.1 to 10.2%), being 12.0% (95% CI 11.0 to 12.9%) in men, and 7.8% (95% CI 7.1 to 8.4%) in women. At adjusted logistic regression, diabetes was associated with hypertension, current smoking, adiposity indices (waist circumference, waist-to-hip ratio, waist-to-height ratio, and body mass index), and high triglycerides. T2DM, adiposity indices, and high triglycerides were not associated with duration of stay in Italy. CONCLUSIONS: The high prevalence of T2DM among first-generation Chinese immigrants in Europe stresses the need for specific health programs for T2DM early diagnosis, treatment, and prevention. There is an urgent need for policies to support this group because current policies will produce major social and economic costs. Copyright © 2016 John Wiley & Sons, Ltd.

Physical Exercise Prescription in Metabolic Chronic Disease.

Metabolic syndrome as a consequence of the association to overweight, hypertension, and diabetes is at high risk of coronary events. Regular physical training has been recently promoted to reduce cardiovascular risks factors, by the improved lifestyle and also by the "anti-inflammatory effectiveness." A positive impact has been shown in case of cancer survived patients either with or without comorbidities and especially in those subjects where the inflammatory process is globally represented. The American College of Sports Medicine (ACSM) guidelines and more recently a new Italian model both support the role of "exercise as therapy" at moderate level of energy expenditure. The importance to establish the individual level of physical exercise, like a drug's dose, has induced authors in investigating this aspect in diverse diseases and in different clinical fields associated to an incorrect lifestyle habits. To reach this goal, a specific research strategy is important to spread the knowledge.

Evaluation of physical activity and dietary behaviors in young athletes: a pilot study.

BACKGROUND: The aim of this study was to evaluate the lifestyle based on the physical activity and eating habits of young athletes. METHODS: In order to measure physical activity and eating habits in young people, 922 young athletes between the ages of 8 to 18 have been analyzed in this study. The participants were all patients come to our Department for sport eligibility evaluation; we have asked them to complete an accurate questionnaire in order to assess their personal physical activity levels and their regular eating habits. Parents were invited to sign a letter explaining the aims of the study and were asked for permission on behalf of their child to take part on the study. RESULTS: The eating habits and the physical activity levels of the young athletes observed, resulted improper. We have noticed that the 13.7% of the participants were overweight and obese, despite their practiced sport activity. Physical activity, without sport activity, resulted inadequate in 38.6% of participants: they did not practice regular physical activity. CONCLUSIONS: The results of the study clearly indicate that higher education is therefore necessary in order to promote a healthy lifestyle in terms of both eating habits and physical activity not only in young people, but also in parents and coaches of teams.

Left ventricular remodeling and the athlete's heart, irrespective of quality load training.

BACKGROUND: Regular physical exercise determines a progressive increase of the cardiac mass known as adaptive hypertrophy. Up to now, two morphological echocardiographic heart patterns of athletes have been described by Morganroth in 1975: predominant augmentation of wall thickness, and major cavity size in chamber dimensions in the case of prevalent static or dynamic components. The aim of the study was to follow up the impact of physical training on heart morphology and function in a group of elite soccer and rugby players for at least five years. METHOD: From January 1993 to December 2015 a group of 250 elite soccer players and 114 rugby players were examined: 78 soccer players and 60 rugby players were followed up for 5 years. They were matched with a control group. RESULTS: LV dimensions and LVMi were significantly higher in the athletes than in the inactive subjects (LVMi : 123.45; LVMi: 81.5 vs 94.36 g/m2 respectively). After the five-year follow up the athletes showed no significant modifications in cardiac dimensions: (LVDd from 52.00 ± mm to 52.90 ± mm; LVSd increased from 31.58 ± mm to 32.33 ± mm; Left Ventricular CMI from 120.77 to 121.45 g/m2;p = NS in soccer; from 50.43 ± mm to 52.22 ± mm; Left Ventricular Systolic diameter increased from 32.51 ± mm to 32.8 ± mm; Left Ventricular Mass index from 81,5 to 87,4 g/m2;p = NS and no significant enhancement of the aortic root diameter was observed (Aortic root: from 27.39 mm to 31.64 mm in soccer players; from 30,68 mm to 30.95 mm). CONCLUSIONS: No significant differences were found among the athletes practicing sports with different workload components, and resistance training. In trained athletes the dimensions of the LV chamber and LVMi are generally within the upper limits of the normal range. After a five-year follow-up, the dimensions of the chambers of the heart remain within the normal range, despite being within the the upper limits. Regular physical exercise induces mild LV hypertrophy which therefore can be considered an adaptive consequence to stress-exercise.

3D Strain helps relating LV function to LV and structure in athletes.

INTRODUCTION: The evaluation of cardiac contraction could benefit from a connection with the underlying helical structure of cardiac fibers in athletes either completely healthy or with minor common cardiopathies like Bicuspid Aortic Valve (BAV). This study aims to exploit the potential role of 3D strain to improve the physiological understanding of LV function and modification due to physical activity as a comparative model. METHODS: Three age-matched groups of young (age 20.3 ± 5.4) individuals are prospectively enrolled: 15 normal healthy subjects, 15 healthy athletes, and 20 athletes with bicuspid aortic valve (BAV). All subjects underwent echocardiographic examination and both 2D and 3D strain analysis. RESULTS: All echo parameters were within the normal range in the three groups. Global values of end-systolic longitudinal and circumferential strain, assesses by either 2D or 3D analysis, were not significantly different. The 3D strain analysis was extended in terms of principal and secondary strain (PS, SS). Global PS was very similar, global SS was significantly higher in athletes and displays a modified time course. The comparative analysis of strain-lines pattern suggests that the enhancement of LV function is achieved by a more synchronous recruitment of both left- and right-handed helical fibers. CONCLUSIONS: 3D strain analysis allows a deeper physiological understanding of LV contraction in different types of athletes. Secondary strain, only available in 3D, identifies increase of performances due to physical activity; this appears to follow from the synergic activation of endocardial and epicardial fibers.

Normative values for heart rate response to exercise in young athletes at 10-18 years old.

The assessment of the chronotropic response during acute physical exertion can allow the discovery of many cardiovascular diseases even at a young age. However, the increase in heart rate (HR) depends on the age and sex of the subject and the modality of the graded exercise test. This study aims to provide sex- and age-related normative values for heart rate performance in young athletes aged 10-18. A retrospective study was carried out on 7896 young athletes (5356 males and 2540 females) aged between 10 and 18 who underwent pre-participation screening to obtain eligibility for competitive sport. First, anthropometric parameters, performance data, and HR are reported. Thus, each age calculated third, tenth, twenty-fifth, fiftieth, seventy-fifth, ninetieth, and ninety-seventh percentiles for the stage-by-stage HR response, according to sex and graded exercise test modality category. Young female athletes of all ages showed lower performance with fewer stages performed on the cycle ergometer and the treadmill. Young male athletes on treadmill and cycle ergometers show lower HR values at submaximal intensities. The treadmill allows a longer duration than the cycle ergometer for males and females. Sex, age, and the specificity of the movement performed must be considered in assessing the chronotropic response in the young population, particularly for those who carry out a training program. In addition, providing reference values of HR response to acute physical exertion may allow for a better functional assessment of the young athletes.HighlightsGrowth and physical training induce continuous changes in the cardiovascular system. However, each young athlete shows individual features. The chronotropic response to incremental load is a common method for assessing health and fitness.Comparing the heart rate data obtained from the incremental effort with the reference percentiles can provide information in a short time in the evaluation of young athletes and the general youth population. Therefore, this methodology is regularly performed in the evaluation of anthropometric growth.In evaluating the chronotropic response to physical exertion, in addition to age and sex, should take the specificity of the movement performed during the test into account.

Normative values and a new predicted model of exercise blood pressure in young athletes.

OBJECTIVES: Assessing the systolic and diastolic blood pressure during acute physical exertion can allow the discovery of many cardiovascular diseases even at a young age. However, this response depends on the age, sex of the subject, and the modality of the graded exercise test. This study aims to provide sex-and age-related normative values of peak and recovery blood pressure performance and to develop a predicted model of systolic and diastolic blood pressure peak in young athletes. DESIGN: Retrospective-study. METHODS: We analyzed 8224 young athletes (5516 males and 2708 females) aged between 8 and 18. Anthropometric and blood pressure parameters related to the effort are reported. Then, according to sex, graded exercise test modality, and age were calculated 1) the fifth, tenth, fiftieth, ninetieth, and ninety-fifth percentiles for the systolic and diastolic blood pressure at peak and after 1 min of recovery and 2) predictive equations of systolic and diastolic blood pressure at the peak. RESULTS: Younger athletes show lower peak blood pressure values, gradually increasing as they age. Males showed higher peak systolic blood pressure values starting at 12-13 years on the cycle ergometer and 10-11 years on the treadmill, while there was no difference in peak diastolic blood pressure values. CONCLUSIONS: Sex, age, and the specificity of the movement performed must be considered in assessing the blood pressure response in the young population. In addition, providing reference values and predictive equations of blood pressure response to acute physical exertion may allow for a better functional assessment of young athletes.

Morphological Characteristics of Elite International Soccer Referees: Somatotype and Bioelectrical Impedance Vector Analysis.

This study aimed to assess the physical characteristics of elite international soccer referees, compare them with other referee populations in the literature, and establish reference tolerance ellipses for the bioelectrical impedance vector analysis (BIVA) point graph. Forty-one elite international soccer referees (age 38.8 ± 3.6 years) participated in the study. The participants underwent body composition assessments, including dual-energy X-ray absorptiometry, BIVA, and somatotype. The Somatotype Attitudinal Distance (SAD), the two-sample Hotelling's T2 test and the Mahalanobis test were used to determine somatotype and bioelectrical vector differences with the literature. The average somatotype of the referees was a balanced mesomorph (2.8, 6.5, 2.8). Elite international referees significantly differed from other samples in the literature (SAD = 2.1, 2.6, 2.9 with respect to Zimbabwean, Brazilian, and South African referees, respectively). The bioelectrical vector was significantly different from the general population (T2 ≤ 76.6; F = 38.8; D = 1.44; p < 0.001) and athletes (T2 ≤ 25.3; F = 12.6; D = 0.8; p < 0.001). Somatotype values and tolerance ellipses from this study may be useful as a reference for developing training programs and improving the selection process of referees in soccer.

Functional strain-line pattern in the human left ventricle.

Analysis of deformations in terms of principal directions appears well suited for biological tissues that present an underlying anatomical structure of fiber arrangement. We applied this concept here to study deformation of the beating heart in vivo analyzing 30 subjects that underwent accurate three-dimensional echocardiographic recording of the left ventricle. Results show that strain develops predominantly along the principal direction with a much smaller transversal strain, indicating an underlying anisotropic, one-dimensional contractile activity. The strain-line pattern closely resembles the helical anatomical structure of the heart muscle. These findings demonstrate that cardiac contraction occurs along spatially variable paths and suggest a potential clinical significance of the principal strain concept for the assessment of mechanical cardiac function. The same concept can help in characterizing the relation between functional and anatomical properties of biological tissues, as well as fiber-reinforced engineered materials.

The effect of exercise training on left ventricular function in young elite athletes.

BACKGROUND: Regular training, in particular endurance exercise, induces structural myocardial adaptation, so-called "athlete's heart". In addition to the 2D standard echo parameters, assessment of myocardial function is currently possible by deformation parameters (strain, rotation and twist). Aim of study is to assess the role of rotation and twist parameters for better characterize the heart performance in trained elite young athletes from different kind of sports. Eventually, verify early on any possible impact due to the regular sport activity not revealed by the standard parameters. METHODS: 50 young athletes (16 cyclists, 17 soccer players, 17 basket players) regularly trained at least three times a week for at least 9 months a year and 10 young controls (mean age 18.5 ± 0.5 years) were evaluated either by to 2D echocardiography or by a Speckle Tracking (ST) multi-layer approach to calculate Left Ventricle (LV) endocardial and epicardial rotation, twist, circumferential strain (CS) and longitudinal strain (LS). Data were compared by ANOVA test. RESULTS: All the found values were within the normal range. Left Ventricle Diastolic Diameter (LVDD 51.7 ± 2.6 mm), Cardiac Mass index (CMi 114.5 ± 18.5 g/m²), epi-CS, epi-LS, epicardial apex rotation and the Endo/Epi twist were significantly higher only in cyclists. In all the groups, a physiological difference of the Endo/Epi basal circumferential strain and twist values have been found. A weak but not significant relationship between the Endo and twist values and LVDD (r² = 0.44, p = .005) and CMi was also reported in cyclists. CONCLUSIONS: Progressive increase of apical LV twist may represent an important component of myocardial remodelling. This aspect is particularly evident in the young cyclists group where the CMi and the LVDD are higher. ST multilayer approach completes the LV performance evaluation in young trained athletes showing values similar to adults.

Lifestyle and resulting body composition in young athletes.

BACKGROUND: Key aspects in a lifestyle analysis are physical activity level and eating habits. An unhealthy lifestyle results in fat mass increase and in a predisposition to non-communicable chronic diseases even in young age. The purpose of this study was to investigate the lifestyle and body composition in young athletes. METHODS: The subjects underwent to an assessment of body composition and they completed two questionnaires, one concerning the level of physical activity and the other regarding eating habits. RESULTS: One hundred fifty-two young athletes (63 females and 89 males) aged 8 to 18 years (13.4±2.5 years, height 159±14 cm) were enrolled in this study. 80.3% of subjects were normal weight (13.4±2.6 years) and 19.7% subjects (13.5±2.5 years) were overweight or obese. Greater sedentary behaviors were found in the overweight or obese participants compared to normal weight (618±125 vs. 523±89 min; P<0.001) and a lower consumption of milk and yoghurt (5.0±3.2 vs. 6.9±4.1 times/week; P=0.031). CONCLUSIONS: Although competitive sports often increase physical activity levels in young people, this activity does not seem to reach the daily recommended amount of physical activity during youth. Therefore, it is necessary to have a comprehensive approach to create a primary prevention strategy from even a young age.

Gender differences in acculturation and cardiovascular disease risk-factor changes among Chinese immigrants in Italy: Evidence from a large population-based cohort.

BACKGROUND: In recent decades, the Chinese presence in Southern Europe has grown rapidly but no data is available on the influence that residing in Mediterranean countries has on Chinese immigrants. In this study, we aim to examine the association between acculturation and cardiovascular risk factors among first-generation Chinese immigrants in Italy. DESIGN: Population-based, cross-sectional study. METHODS: A sample of 2589 Chinese first-generation immigrants (1599 women and 990 men) living in Prato, Italy, underwent blood pressure measurement, blood tests (with measurement of glucose, cholesterol, and triglycerides), and anthropometric measurements. The influence of length of residence (dependent variable) on hypertension, type 2 diabetes, overweight/obesity, and hyperlipidemia (high cholesterol) (independent variables) was investigated with multivariable logistic regression adjusted for age, sex, education and urban/rural home area in China before migration. RESULTS: Mean age of Chinese participants was 47.2 ± 10.7 years and 61.7% were women. Immigrants residing in Italy for ≥20 years were more likely to be hypertensive [odd ratio (OR) 1.84; 95% confidence interval (CI) 1.33 to 2.59], or diabetic (1.91; 1.26 to 2.86) than those residing in Italy for <10 years. Differently, prevalence of hypercholesterolemia (total cholesterol≥240 mg/dl) was lower in immigrants residing in Italy for ≥20 years than in those with <10 years of residence (0.52; 0.32 to 0.83). The association between indicators of acculturation and cardiovascular risk factors appeared to differ by sex. CONCLUSION: Acculturation of Chinese immigrants in Italy was associated with hypertension and type 2 diabetes whereas a favorable effect on hypercholesterolemia was observed.

Dysmenorrhea and Heavy Menstrual Bleeding in Elite Female Athletes: Quality of Life and Perceived Stress.

In female athletes, the incidence of menstrual disorders is variable, and their impact on perceived stress and quality of life (QoL) is poorly known.The aim of the present study was to investigate the menstrual cycle characteristics and disorders in athletes performing different sports, also evaluating perceived stress and QoL according to their menstrual cycle features. A cross-sectional survey was conducted in nulliparous elite athletes of reproductive age, and the study population included 112 cases. Three questionnaires were administered on (1) gynecological health, (2) perceived stress scale (PSS), and (3) short form QoL (SF-12). A group of women not practising regular sport activities (n = 103) was used as control. Data obtained in elite athletes were also analyzed according to the static and dynamic component percentage of practised sports in 3 sub-groups. Athletes had a significantly higher incidence of irregular periods and heavy menstrual bleeding (HMB) (p < 0.01) and a lower incidence of dysmenorrhea (p < 0.01) than controls. Furthermore, athletes had a better physical QoL (53.9 ± 5.9 vs 51.2 ± 6.0) (p < 0.05) but higher PPS level (17.3 ± 4.8 vs 13.8 ± 4.8) and a worse mental QoL (44.9 ± 9.9 vs 47.6 ± 9.0) (p < 0.05) than controls. HMB was associated with lower mental scores (39.7 ± .8.9 vs 45.6 ± 9.9) and higher PSS scores (19.8 ± .3.2 vs 17.0 ± .4.9) than those observed in athletes with normal bleeding. No difference was found in different sports regarding gynecological health, PSS level, and QoL. An increased incidence of HMB should be considered in elite athletes with increased PSS and impaired QoL.

Adjuvant Therapy Reduces Fat Mass Loss during Exercise Prescription in Breast Cancer Survivors.

Improvements in cancer care over the years have increased the numbers of cancer survivors. Therefore, quality of life, fat mass management and physical activity are growing areas of interest in these people. After the surgical removal of a breast cancer, adjuvant therapy remains anyway a common strategy. The aim of this study was to assess how adjuvant therapy can affect the effectiveness of an unsupervised exercise program. Forty-two women were enrolled (52.0 ± 10.1 years). Assessments performed at baseline and after six months of exercise prescription were body composition, health-related quality of life, aerobic capacity by Six-Minute Walk Test, limbs strength by hand grip and chair test and flexibility by sit and reach. Statistical analyses were conducted by ANOVA tests and multiple regression. Improvements in body composition, physical fitness and quality of life (physical functioning, general health, social functioning and mental health items) were found. The percentage change in fat mass has been associated with adjuvant cancer therapy (intercept = -0.016; b = 8.629; p < 0.05). An unsupervised exercise prescription program improves body composition, physical fitness and health-related quality of life in breast cancer survivors. Adjuvant therapy in cancer slows down the effectiveness of an exercise program in the loss of fat mass.