Effects of High-Intensity Interval Training on the Parameters Related to Physical Fitness and Health of Older Adults: A Systematic Review and Meta-Analysis.

BACKGROUND: As a novel and time-efficient exercise form, high-intensity interval training (HIIT) has shown great potential in improving health-related physical fitness among diverse populations. However, empirical evidence on its efficacy among the elderly has not been well summarized. This systematic review and meta-analysis aimed to determine the effect of HIIT interventions on the parameters related to physical fitness and health of older adults, including resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiorespiratory fitness (CRF), body mass index (BMI), body fat percent (BF%), waist circumference (WC), muscular endurance (ME), muscular strength (MS), muscular power (MP), balance and flexibility, compared to non-exercise and other-exercise (e.g., moderate-intensity continuous training, resistance training) conditions. METHODS: Literature published from January 2000 to May 2023 was collected through extensive searches across eight databases and relevant review papers. Randomized controlled trials (RCTs) featuring a minimum 2-week exercise intervention for older adults (≥ 60 years) were included. The pooled effect size of Hedges'g was estimated using random-effects models in R. Meta-regression was performed for both categorical (health status, duration of training programme, and frequency) and continuous moderators (mean age, male rate, and attrition rate). RESULTS: Forty-four eligible RCTs with 1863 participants (52.1% female; 60.5-81.2 years) were included in the quantitative analysis. Compared to non-exercise condition, HIIT significantly improved resting HR (g = -0.36, 95%CI = [-0.67, -0.05], P = 0.032), SBP (g = -0.29, 95%CI = [-0.54, -0.03], P = 0.008), CRF (g = 0.77, 95%CI = [0.51, 1.04], P < 0.001), BF% (g = -0.26, 95%CI = [-0.41, -0.11], P = 0.006), MS (g = 0.47, 95%CI = [0.23, 0.71], P = 0.004), ME (g = 0.65, 95%CI = [0.10, 1.19], P = 0.036), and balance (e.g., timed-up-and-go) (g = -0.79, 95%CI = [-1.19, -0.40], P = 0.035). Compared to other-exercise condition, HIIT significantly improved resting HR (g = -0.11, 95%CI = [-0.21, -0.01], P = 0.029), SBP (g = -0.14, 95%CI = [-0.28, -0.01], P = 0.038), and CRF (g = 0.23, 95%CI = [0.07, 0.38], P = 0.008). No significant difference was found between HIIT and non-exercise condition for DBP, BMI and WC, as well as between HIIT and other-exercise condition for DBP, BMI, BF%, WC, ME, and balance (all P > 0.05). Meta-regression indicated that mean age moderated the HIIT effect on resting HR (b = -0.02, P = 0.014; HIIT vs. other-exercise condition) and SBP (b = 0.03, P = 0.048; HIIT vs. non-exercise), and attrition rate moderated the effect on CRF (b = 0.03, P = 0.007; HIIT vs. non-exercise). CONCLUSION: This study supports the efficacy of HIIT in improving resting HR, SBP, CRF, BF%, MS, ME and balance among older adults. More empirical evidence is needed to determine the efficacy of HIIT for MP and flexibility in this population. TRIAL REGISTRATION: PROSPERO CRD42022316246.

Antigenic analysis of the influenza B virus hemagglutinin protein.

Influenza B viruses (IBVs) primarily infect humans and are a common cause of respiratory infections in humans. Here, to systematically analyze the antigenicity of the IBVs Hemagglutinin (HA) protein, 31 B/Victoria and 19 B/Yamagata representative circulating strains were selected from Global Initiative of Sharing All Influenza Data (GISAID), and pseudotyped viruses were constructed with the vesicular stomatitis virus system. Guinea pigs were immunized with three doses of vaccines (one dose of DNA vaccines following two doses of pseudotyped virus vaccines) of the seven IBV vaccine strains, and neutralizing antibodies against the pseudotyped viruses were tested. By comparing differences between various vaccine strains, we constructed several pseudotyped viruses that contained various mutations based on vaccine strain BV-21. The vaccine strains showed good neutralization levels against the epidemic virus strains of the same year, with neutralization titers ranging from 370 to 840, while the level of neutralization against viruses prevalent in previous years decreased 1-10-fold. Each of the high-frequency epidemic strains of B/Victoria and B/Yamagata not only induced high neutralizing titers, but also had broadly neutralizing effects against virus strains of different years, with neutralizing titers ranging from 1000 to 7200. R141G, D197N, and R203K were identified as affecting the antigenicity of IBV. In this study, pseudotyped virus system was used to monitor the cross-neutralizing efficacy of high-frequency epidemic strains and vaccine strains recommended by the World Health Organization. Additionally, we identified three mutation sites that can seriously affect the antigenicity of B/Victoria vaccine strains. These mutation sites provide valuable references for the selection and design of a universal IBV vaccine strain in the future.

Efficacy and safety of recombinant human endostatin combined with whole-brain radiation therapy in patients with brain metastases from non-small cell lung cancer.

BACKGROUND AND PURPOSE: Brain metastasis (BM) is the leading cause of poor prognosis in non-small cell lung cancer (NSCLC) patients. To date, whole-brain radiation therapy (WBRT) is a standard treatment for patients with multiple BMs, while its effectiveness is currently unsatisfactory. This study aimed to investigate the effects of Rh-endostatin combined with WBRT on NSCLC patients with BMs. MATERIALS AND METHODS: A total of 43 patients with BM were randomly divided into two groups. The Rh-endostatin combination group (n = 19) received Rh-endostatin combined with WBRT, and the radiation group (n = 24) received WBRT only. The primary endpoint of the study was progression-free survival (PFS), and the secondary endpoints were intracranial progressionfree survival (iPFS), overall survival (OS), objective response rate (ORR), and changes in the cerebral blood volume (CBV) and cerebral blood flow (CBF). RESULTS: Median PFS (mPFS) was 8.1 months in the Rh-endostatin combination group and 4.9 months in the radiation group (95%CI 0.2612-0.9583, p = 0.0428). Besides, the median iPFS was 11.6 months in the Rh-endostatin combination group and 4.8 months in the radiation group (95%CI 0.2530-0.9504, p = 0.0437). OS was 14.2 months in the Rh-endostatin combination group and 6.4 months in the radiation group (95%CI 0.2508-1.026, p = 0.0688). CBV and CBF in the Rh-endostatin combination group were better improved than that in the radiation group, which indicated that Rh-endostatin might improve local blood supply and microcirculation. CONCLUSION: Rh-endostatin showed better survival and improved cerebral perfusion parameters, which may provide further insights into the application of Rh-endostatin for NSCLC patients with BMs.

Programmed cell death 1 inhibitors with or without concurrent brain radiotherapy for lung cancer patients with brain metastases.

BACKGROUND: Data focusing on the synergistic effect of programmed cell death 1 (PD-1) inhibitors and brain radiotherapy for brain metastases (BMs) in lung cancer is scarce. METHODS: A total of 60 lung cancer patients receiving PD-1 inhibitors with or without brain radiotherapy were identified in this retrospective study. The primary endpoints were intracranial progression-free survival (iPFS), extracranial progression-free survival (PFS), and overall survival (OS) among three groups. RESULTS: Twenty-one patients received PD-1 inhibitors and concurrent brain radiotherapy, 20 patients were treated with PD-1 inhibitors and non-concurrent brain radiotherapy, and the other 19 patients were treated with PD-1 inhibitors alone. Patients in the concurrent group achieved a higher intracranial objective response rate (iORR, 61.1% vs. 29.4% vs. 25.0%) and a higher intracranial disease control rate (iDCR, 83.3% vs. 58.8% vs. 56.3%) compared with those in the non-concurrent group and PD-1 inhibitors alone group. The median iPFS was significantly longer in the concurrent group than the non-concurrent group and the PD-1 inhibitors alone group (9.8, 5.7, and 4.8 months, P=0.039, respectively). The median PFS were 9.2, 5.7 and 4.6 months (P=0.347) in the concurrent group, non-concurrent group and PD-1 inhibitors alone group. And the median OS were not reached, 12.1 and 6.9 months (P=0.206), respectively. Multivariate analysis revealed that the lack of concurrent brain radiotherapy was independently associated with a shorter iPFS. CONCLUSIONS: PD-1 inhibitors with concurrent brain radiotherapy achieved a higher iORR, iDCR, and iPFS in lung cancer patients with treated or newly diagnosed BMs.

Upgrading the school entry vaccination record check strategy to improve varicella vaccination coverage: results from a quasi-experiment study.

BACKGROUND: The school entry vaccination record check strategy (SECS) is an appropriate opportunity to recommend vaccines for students to improve vaccination coverage (VC). However, it is only utilized for providing necessary catch-up vaccination for students who are missing the Expanded Program on Immunization (EPI) vaccines in China. We aimed to address that gap and quantify the relationship between the SECS policy and the increase of coverage in varicella vaccine (VarV). METHODS: We employed a pretest and posttest quasi-experimental design to examine the effect of the upgraded SECS policy on the change of VarV coverage in newly enrolled students in Lu'an, 2019-2020. RESULTS: Eight hundred participants were randomly divided into the control group (C group, 31.8%), the telephone-based intervention group (T group, 31.2%), and the written notification intervention group (W group, 37.0%). Totally, 84 students received VarV during the study period, with a VC of 10.5%. The possibility of vaccination in the T group (RR = 4.9, 95% CI:2.2-10.9) and W group (RR = 5.2, 95% CI:2.4-11.5) was significantly higher than that in the C group (p< .001). CONCLUSIONS: Our study demonstrates that the upgraded SECS produce a positive effect on improving the VC of VarV. This nudge strategy may decrease varicella outbreaks in schools in China, especially in provinces where VarV is not introduced into EPI.

An Update on Physical Activity Research among Children in Hong Kong: A Scoping Review.

Similar to their Western counterparts, children in Hong Kong generally fail to reach the recommended levels of physical activity (PA). As an ultra-dense metropolis, Hong Kong is different from most Western cities. It is therefore important to update and appraise previous PA research in order to inform future PA promotion for Hong Kong children. Using a scoping review, the current study aimed to evaluate PA research among preschool and school-aged children in Hong Kong aged 3-12 years old who are at a critical development stage. Literature was searched from four English databases: Medline via EBSCOhost, SPORTDiscus, ERIC and PsycINFO via ProQuest; and three Chinese databases: CNKI, CQVIP and WAN-FANG. PA research among Hong Kong children published from 1 January 1997 to the searching date, 31 March 2020 was included. A total of 63 studies were identified, with the majority of studies focused on school-aged children as compared to preschoolers, adopted a cross-sectional design, using self-reported PA measures, and with small to medium sample sizes. We classified eligible studies into five main categories: (a) Health benefits of PA (k = 12). Consistent evidence on the health benefits of skeletal and cardiovascular capacity, quality of life, cognitive function, and sleep quality was revealed. However, inconsistent evidence was found on the benefits of weight-related indicators and academic performance. (b) Patterns of PA (k = 12). There is a general pattern of low levels of PA among Hong Kong children, in particular girls and children with special educational needs. (c) Measures of PA and related constructs (k = 11). The Chinese versions of self-reported measures of PA, PA-related social environment, and PA-related psychological constructs showed acceptable reliabilities and validities. (d) Correlates of PA (k = 18). The correlates of PA include physical environment, social environment, physical factors, psychological factors, and multiple correlates, which is in line with the social-ecological model. (e) Interventions for promoting PA (k = 10). PA interventions among Hong Kong children were conducted for healthy children, children with special educational needs, and children with cancer. Overall, there is a growing volume of PA research among children in Hong Kong in the recent decade. Yet, there is a lack of high-quality research for measuring, understanding, and promoting PA among Hong Kong children. It is highly recommended that future PA research among children should pay more attention on the preschoolers, adopting robust research design (e.g., randomized controlled trials), recruiting large and representative sample, and collecting device-assessed data.

Mindfulness and Smartphone Addiction before Going to Sleep among College Students: The Mediating Roles of Self-Control and Rumination.

This study aims to examine the effects among college students of mindfulness on smartphone addiction before going to bed at night. We examined the mediating roles of self-control and rumination on the mindfulness-smartphone addiction path. Participants (n = 270, 59.3% females, 18-24 years old) completed self-reporting questionnaires measuring mindfulness, self-control, smartphone addiction, and rumination. In addition to the correlation analysis, we adopted a stepwise regression analysis with bootstrapping to test the mediating effects. It was found that mindfulness was inversely related to smartphone addiction before going to sleep. Most importantly, self-control and rumination significantly mediated the effects of mindfulness on smartphone addiction among college students. The findings of this study indicated that mindfulness training is beneficial to improve the ability of self-control and reduce rumination levels, thereby inhibiting the negative impact of smartphone addiction on college students before they go to sleep, and further promoting their sleep health and mental health.

The influence of pemetrexed-based continuous maintenance therapy on survival of locally advanced and metastatic lung adenocarcinoma.

BACKGROUND: Patients may receive delayed maintenance therapy (stopping interval over 21 days) due to multi factors in the real-life setting. This retrospective study aims to collect data of pemetrexed-based continuous maintenance therapy, evaluate the impact of prolonged interval periods on clinical outcomes. METHODS: A total of 168 previously untreated stage IIIB or IV lung adenocarcinoma patients received induction chemotherapy with pemetrexed-platinum (PP) with or without antiangiogenesis inhibitors (bevacizumab or rh-endostatin) every 3 weeks for 4-6 cycles. Among them, 112 patients who did not show progression after induction chemotherapy completion were enrolled. RESULTS: Seventy of the 112 patients received continuous maintenance therapy with pemetrexed with or without antiangiogenesis inhibitors until disease progression; 42 patients did not receive continuous maintenance therapy. Multivariate analysis revealed that only lack of maintenance therapy was independently associated with shorter progression-free survival (PFS) [HR, 4.516 (2.332-8.744), P<0.001]. Brain metastases [HR, 4.263 (1.499-12.127), P=0.007] and lack of maintenance therapy [HR, 4.304 (1.566-11.825), P=0.005] were independent adverse prognostic factors for overall survival (OS). In the maintenance group, most patients delayed continuous maintenance treatment and the median interval between each maintenance therapy cycle was 40 days (range, 21-77 days). The median number of maintenance therapy cycles was 4 (range, 1-26). The best objective response rate (ORR) was higher in the maintenance group than in the non-maintenance group (48.6% and 33.3%). During a median follow-up of 14.6 months, patients in the maintenance group achieved significantly longer PFS (11.5 vs. 6.8 months, P<0.001) and OS (40.1 vs. 18.0 months, P=0.001) compared with those in the non-maintenance group. CONCLUSIONS: Extending maintenance intervals is feasible and continuous maintenance therapy could offer survival benefit in patients who did not show progression after first-line induction treatment for lung adenocarcinoma.