Twenty-four-hour physical activity patterns associated with depressive symptoms: a cross-sectional study using big data-machine learning approach.

BACKGROUND: Depression is a global burden with profound personal and economic consequences. Previous studies have reported that the amount of physical activity is associated with depression. However, the relationship between the temporal patterns of physical activity and depressive symptoms is poorly understood. In this exploratory study, we hypothesize that a particular temporal pattern of daily physical activity could be associated with depressive symptoms and might be a better marker than the total amount of physical activity. METHODS: To address the hypothesis, we investigated the association between depressive symptoms and daily dominant activity behaviors based on 24-h temporal patterns of physical activity. We conducted a cross-sectional study on NHANES 2011-2012 data collected from the noninstitutionalized civilian resident population of the United States. The number of participants that had the whole set of physical activity data collected by the accelerometer is 6613. Among 6613 participants, 4242 participants had complete demography and Patient Health Questionnaire-9 (PHQ-9) questionnaire, a tool to quantify depressive symptoms. The association between activity-count behaviors and depressive symptoms was analyzed using multivariable logistic regression to adjust for confounding factors in sequential models. RESULTS: We identified four physical activity-count behaviors based on five physical activity-counting patterns classified by unsupervised machine learning. Regarding PHQ-9 scores, we found that evening dominant behavior was positively associated with depressive symptoms compared to morning dominant behavior as the control group. CONCLUSIONS: Our results might contribute to monitoring and identifying individuals with latent depressive symptoms, emphasizing the importance of nuanced activity patterns and their probability of assessing depressive symptoms effectively.

Association of physiological factors with grip and leg extension strength: tohoku medical megabank community-based cohort study.

BACKGROUND: Upper and lower extremity muscle strength can be used to predict health outcomes. However, the difference between the relation of upper extremity muscle and of lower extremity muscle with physiological factors is unclear. This study aimed to evaluate the association between physiological data and muscle strength, measured using grip and leg extension strength, among Japanese adults. METHODS: We conducted a cross-sectional study of 2,861 men and 6,717 women aged ≥ 20 years living in Miyagi Prefecture, Japan. Grip strength was measured using a dynamometer. Leg extension strength was measured using a hydraulic isokinetic leg press machine. Anthropometry and physiological data, including blood pressure, calcaneal ultrasound bone status, pulmonary function, carotid echography, and blood information, were assessed. We used a general linear model adjusted for age, body composition, and smoking status to evaluate the association between muscle strength and physiological factors. RESULTS: Grip and leg extension strength were positively associated with bone area ratio, vital capacity, forced vital capacity, forced expiratory volume in one second, and estimated glomerular filtration rate, and negatively associated with waist circumference and percentage body fat mass in both the sexes. Diastolic blood pressure was positively associated with grip strength in both the sexes and leg extension strength in men, but not women. High-density lipoprotein cholesterol and red blood cell counts were positively associated with grip and leg extension strength in women, but not men. In both the sexes, pulse rate, total cholesterol, and uric acid were consistently associated with only leg extension strength, but not grip strength. In women, glycated hemoglobin demonstrated negative and positive associations with grip and leg extension strength, respectively. CONCLUSIONS: Grip and leg extension strength demonstrated similar associations with anthropometry, pulmonary function, and estimated glomerular filtration rate, but the associations with the other factors were not always consistent.

Dietary patterns associated with the incidence of hypertension among adult Japanese males: application of machine learning to a cohort study.

PURPOSE: The previous studies that examined the effectiveness of unsupervised machine learning methods versus traditional methods in assessing dietary patterns and their association with incident hypertension showed contradictory results. Consequently, our aim is to explore the correlation between the incidence of hypertension and overall dietary patterns that were extracted using unsupervised machine learning techniques. METHODS: Data were obtained from Japanese male participants enrolled in a prospective cohort study between August 2008 and August 2010. A final dataset of 447 male participants was used for analysis. Dimension reduction using uniform manifold approximation and projection (UMAP) and subsequent K-means clustering was used to derive dietary patterns. In addition, multivariable logistic regression was used to evaluate the association between dietary patterns and the incidence of hypertension. RESULTS: We identified four dietary patterns: 'Low-protein/fiber High-sugar,' 'Dairy/vegetable-based,' 'Meat-based,' and 'Seafood and Alcohol.' Compared with 'Seafood and Alcohol' as a reference, the protective dietary patterns for hypertension were 'Dairy/vegetable-based' (OR 0.39, 95% CI 0.19-0.80, P = 0.013) and the 'Meat-based' (OR 0.37, 95% CI 0.16-0.86, P = 0.022) after adjusting for potential confounding factors, including age, body mass index, smoking, education, physical activity, dyslipidemia, and diabetes. An age-matched sensitivity analysis confirmed this finding. CONCLUSION: This study finds that relative to the 'Seafood and Alcohol' pattern, the 'Dairy/vegetable-based' and 'Meat-based' dietary patterns are associated with a lower risk of hypertension among men.

Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies.

OBJECTIVE: To quantify the associations between muscle-strengthening activities and the risk of non-communicable diseases and mortality in adults independent of aerobic activities. DESIGN: Systematic review and meta-analysis of prospective cohort studies. DATA SOURCES: MEDLINE and Embase were searched from inception to June 2021 and the reference lists of all related articles were reviewed. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Prospective cohort studies that examined the association between muscle-strengthening activities and health outcomes in adults aged ≥18 years without severe health conditions. RESULTS: Sixteen studies met the eligibility criteria. Muscle-strengthening activities were associated with a 10-17% lower risk of all-cause mortality, cardiovascular disease (CVD), total cancer, diabetes and lung cancer. No association was found between muscle-strengthening activities and the risk of some site-specific cancers (colon, kidney, bladder and pancreatic cancers). J-shaped associations with the maximum risk reduction (approximately 10-20%) at approximately 30-60 min/week of muscle-strengthening activities were found for all-cause mortality, CVD and total cancer, whereas an L-shaped association showing a large risk reduction at up to 60 min/week of muscle-strengthening activities was observed for diabetes. Combined muscle-strengthening and aerobic activities (versus none) were associated with a lower risk of all-cause, CVD and total cancer mortality. CONCLUSION: Muscle-strengthening activities were inversely associated with the risk of all-cause mortality and major non-communicable diseases including CVD, total cancer, diabetes and lung cancer; however, the influence of a higher volume of muscle-strengthening activities on all-cause mortality, CVD and total cancer is unclear when considering the observed J-shaped associations. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020219808.

The proton ATPase inhibitor bafilomycin A1 reduces the release of rhinovirus C and cytokines from primary cultures of human nasal epithelial cells.

Rhinovirus species C (RV-C) causes more severe asthma attacks than other rhinovirus species. However, the modulation of RV-C replication by drugs has not been well studied. Primary human nasal epithelial (HNE) cells cultured on filter membranes with air-liquid interface methods were infected with RV-C03, and the levels of RV-C03 RNA collected from the airway surface liquid (ASL) of HNE cells were measured with a SYBR Green assay. Pretreatment of HNE cells with the specific vacuolar H+-ATPase inhibitor bafilomycin A1 reduced the RV-C03 RNA levels in the ASL; inflammatory cytokines, including interleukin (IL)-1ß, IL-6 and IL-8, in the supernatant; the mRNA expression of the RV-C receptor cadherin-related family member 3 (CDHR3) in the cells; and the number of acidic endosomes where RV-B RNA enters the cytoplasm. The levels of RV-C03 RNA in the ASL obtained from HNE cells with the CDHR3 rs6967,330 G/A genotype tended to be higher than those obtained from HNE cells with the G/G genotype. Pretreatment with the Na+/H+ exchanger inhibitor ethyl-isopropyl amiloride or either of the macrolides clarithromycin or EM900 also reduced RV-C03 RNA levels in the ASL and the number of acidic endosomes in HNE cells. In addition, significant levels of RV-A16, RV-B14 and RV-C25 RNA were detected in the ASL, and bafilomycin A1 also decreased the RV-C25 RNA levels. These findings suggest that bafilomycin A1 may reduce the release of RV-Cs and inflammatory cytokines from human airway epithelial cells. RV-Cs may be sensitive to drugs, including bafilomycin A1, that increase endosomal pH, and CDHR3 may mediate virus entry through receptor-mediated endocytosis in human airway epithelial cells.

Body flexibility and incident hypertension: The Niigata wellness study.

A high level of physical fitness, especially cardiorespiratory fitness, is associated with lower incidence of hypertension. However, the relationship between flexibility, which is a component of physical fitness, and the incidence of hypertension is unknown. The purpose of this study was to investigate the relationship between flexibility and the incidence of hypertension in a cohort study. A total of 22,972 (14,805 men and 8167 women; median age 49 years) normotensive participants were included in this study. Between April 2001 and March 2002, flexibility (standing forward bending) was measured using a standing trunk flexion meter. The participants were divided into quartiles of flexibility by sex and age group. Hypertension was defined as systolic blood pressure ≥ 140 mm Hg, diastolic blood pressure ≥ 90 mm Hg, or a self-reported history of previously diagnosed hypertension or current medication for hypertension at a health examination between April 2002 and March 2008. Hazard ratios and 95% confidence intervals (95% CI) for the incidence of hypertension were estimated using Cox proportional hazards models after adjusting for age, sex, body mass index, exercise habits, smoking status, and drinking status. During 102,948 person years of follow-up (median 5.6 years), 4235 participants developed hypertension. Compared with the lowest flexibility (quartile 1), hazard ratios and 95% CI were 0.96 (0.88 - 1.04) for quartile 2, 0.94 (0.86 - 1.03) for quartile 3, and 0.83 (0.76 - 0.91) for quartile 4. A high level of flexibility was associated with lower incidence of hypertension, independent of other confounding factors.

Inhibitory effects of glycopyrronium, formoterol, and budesonide on coronavirus HCoV-229E replication and cytokine production by primary cultures of human nasal and tracheal epithelial cells.

BACKGROUND: Coronavirus 229E (HCoV-229E), one of the causes of the common cold, exacerbates chronic obstructive pulmonary disease (COPD) and bronchial asthma. Long-acting muscarinic antagonists and ß2-agonists and inhaled corticosteroids inhibit the exacerbation of COPD and bronchial asthma caused by infection with viruses, including HCoV-229E. However, the effects of these drugs on HCoV-229E replication and infection-induced inflammation in the human airway are unknown. METHODS: Primary human nasal (HNE) and tracheal (HTE) epithelial cell cultures were infected with HCoV-229E. RESULTS: Pretreatment of HNE and HTE cells with glycopyrronium or formoterol decreased viral RNA levels and/or titers, the expression of the HCoV-229E receptor CD13, the number and fluorescence intensity of acidic endosomes where HCoV-229E RNA enters the cytoplasm, and the infection-induced production of cytokines, including IL-6, IL-8, and IFN-ß. Treatment of the cells with the CD13 inhibitor 2'2'-dipyridyl decreased viral titers. Pretreatment of the cells with a combination of three drugs (glycopyrronium, formoterol, and budesonide) exerted additive inhibitory effects on viral titers and cytokine production. Pretreatment of HNE cells with glycopyrronium or formoterol reduced the susceptibility to infection, and pretreatment with the three drugs inhibited activation of nuclear factor-kappa B p50 and p65 proteins. Pretreatment with formoterol increased cAMP levels and treatment with cAMP decreased viral titers, CD13 expression, and the fluorescence intensity of acidic endosomes. CONCLUSIONS: These findings suggest that glycopyrronium, formoterol, and a combination of glycopyrronium, formoterol, and budesonide inhibit HCoV-229E replication partly by inhibiting receptor expression and/or endosomal function and that these drugs modulate infection-induced inflammation in the airway.

Parents' Own Experience of Verbal Abuse Is Associated with their Acceptance of Abuse towards Children from Youth Sports Coaches.

Verbal or physical abuse from coaches has negative effects on young athletes, and the parents of athletes also have an influence on the sports environment. It is therefore important to understand parents' attitudes towards abuse against their children from the coaches. This study aimed to elucidate the characteristics of parents who accept the infliction of verbal or physical abuse on their children from coaches of youth sports teams. A cross-sectional study using self-report questionnaires was conducted with parents of young athletes (n = 6,493). Multivariate logistic regression models were used to assess the factors associated with parents' acceptability of verbal or physical abuse against their children. The proportion of parents who were accepting of verbal or physical abuse was 21.5%. Acceptability of verbal or physical abuse was significantly associated with male (odds ratio: 1.67, 95% confidence interval: 1.43-1.95), younger age (1.24, 1.09-1.41), lower educational attainment (1.32, 1.17-1.50), smoking habits (1.42, 1.23-1.63), experience of playing on a team with high levels of competition during their junior or high school days (1.31, 1.15-1.50), and experience of verbal and physical abuse by their own former coaches (3.59, 3.03-4.26 and 1.17, 1.02-1.35). About 58% and 28% of parents had experienced verbal and physical abuse from their own former coaches, and parents who had experienced verbal abuse themselves were most likely to be accepting of verbal or physical abuse towards their children. Educating parents is considered to be important for preventing and eradicating abuse against young athletes.

The characteristics of coaches that verbally and physically abuse young baseball players using a self-reported questionnaire.

BACKGROUND: Because the relationship between coaches and athletes is unequal, verbal and physical abuse remains a common problem among sports coaches. We aimed to elucidate the characteristics of baseball coaches who verbally/physically abuse young baseball players. METHODS: A cross-sectional study was conducted on youth sports team coaches in Miyagi prefecture, Japan (n = 380), using a self-reported questionnaire. Multivariate logistic regression models were used for the analyses, evaluating the following variables: sex, age, educational level, smoking habits, years of coaching, level of baseball-playing experience, personal experience with verbal/physical abuse by former coaches, satisfaction with athletes' attitudes, number of athletes on the team, team competition level, awareness of the recommendations of the Japanese Society of Clinical Sports Medicine, limitations in the total pitch count, difficulty in coaching in other positions, number of games per year, and acceptance of former verbal/physical abuse. RESULTS: The prevalence of verbal/physical abuse toward young athletes was 74.5% (n = 283) and 6.6% (n = 25), respectively. Verbal abuse was significantly associated with personal experience of verbal abuse by former coaches (odds ratio [OR]: 2.00, 95% confidence interval [95% CI]: 1.04-3.85), and acceptance of verbal/physical abuse (OR: 2.61, 95% CI: 1.34-5.10). Physical abuse was significantly associated with greater than 10 years of coaching experience (OR: 7.16, 95% CI: 1.36-37.78), personal experience with physical abuse by former coaches (OR: 4.25, 95% CI: 1.23-14.70), and acceptance of verbal/physical abuse (OR: 3.85, 95% CI: 1.51-9.84). CONCLUSIONS: Coaches' experiences with verbal/physical abuse by former coaches negatively affected young athletes. Breaking this cycle is necessary to keep athletes active and interested in playing baseball. LEVEL OF EVIDENCE: Level III.

Knee pain is associated with lower back pain in young baseball players: a cross-sectional study.

PURPOSE: Considerable research has focused on shoulder and elbow injuries among baseball players; however, although lumbar spine and knee injuries are commonly experienced, they are less frequently studied. During common motions in baseball, such as throwing, hitting, and running, energy is transferred from the lower extremities through the lower back to the upper body. Lower extremity pain, as well as lower back pain (LBP), can disrupt the kinematic chain, and it is important to understand the association between lower extremity complaints and LBP. The purpose of this study was to elucidate the association between knee pain and LBP among young baseball players. METHODS: A cross-sectional study was conducted with young baseball players (aged 6-15 years, n = 1,609) using a self-reported questionnaire. Multivariate logistic regression models were used for analyses. Variables considered in the models were sex, age, body mass index, team levels, number of days of training per week, number of hours in practice per day on weekdays and weekend, frequency of participation in games, practice intensity, and player position. RESULTS: The point prevalence of LBP and knee pain was 8.4% and 13.1%, respectively. Knee pain was significantly associated with LBP. Using the absence of knee pain as a reference, the adjusted odds ratio (95% confidence interval) for LBP was 5.83 (3.93-8.65) (p < 0.001) in the presence of knee pain. CONCLUSIONS: Knee pain was associated with LBP among young baseball players. Clinicians should pay attention to knee complaints to prevent and treat LBP among young baseball players. LEVEL OF EVIDENCE: III.

Relationship between Cardiorespiratory Fitness and Non-High-Density Lipoprotein Cholesterol: A Cohort Study.

AIM: Recent studies have suggested that non-high-density lipoprotein cholesterol (non-HDL-C) may be a good marker of coronary heart disease and cardiovascular disease risk. Therefore, we investigated the relationship between cardiorespiratory fitness (CRF) and non-HDL-C. METHODS: We evaluated CRF and the incidence of high level of non-HDL-C in 4,067 Japanese men without dyslipidemia. The participants were given a submaximal exercise test, a medical examination, and questionnaires on their health habits in 1986. A cycle ergometer was used to measure the CRF and maximal oxygen uptake was estimated. The incidence of a high level of non-HDL -C (≥170 mg/dL) from 1986 to 2006 was ascertained based on the fasting blood levels. A high level of non-HDL-C was found in 1,482 participants during the follow-up. Cox proportional hazard models were used to obtain the hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of a high level of non-HDL-C. RESULTS: Following age adjustment, and using the lowest CRF group (quartile Ⅰ) as reference, the HRs and 95% CIs for quartiles II through IV were: 1.00 (95% CI: 0.87-1.15), 0.87 (95% CI: 0.76-1.00), and 0.70 (95% CI: 0.60-0.81), respectively (P for trend ＜0.001). After additional adjustment for body mass index, systolic blood pressure, smoking, alcohol intake, and family history of dyslipidemia, the HRs and 95% CIs were: 1.05 (95% CI: 0.92-1.21), 0.94 (95% CI: 0.81-1.08), and 0.79 (95% CI: 0.67-0.92), respectively (P for trend=0.001). CONCLUSIONS: These results suggest that there is an inverse relationship between CRF levels and the incidence of a high level of non-HDL-C in Japanese men.

Pneumonia risks in bedridden patients receiving oral care and their screening tool: Malnutrition and urinary tract infection-induced inflammation.

AIM: Pneumonia develops in bedridden patients even when they are receiving oral care. However, the pneumonia risk in bedridden patients remains unclear, and no screening tool has been developed to assess this risk by using daily hospital data. METHODS: We retrospectively examined pneumonia risk factors by analyzing the records of 102 bedridden patients receiving oral care. RESULTS: Body mass index, peripheral blood hemoglobin, and serum concentrations of total protein, albumin, total cholesterol and uric acid in the pneumonia group (n = 51; mean age 73.4 years) were lower than those in the non-pneumonia group (n = 51; mean age 68.1 years). In the univariate analysis, body mass index; leukocytosis; high C-reactive protein; low levels of hemoglobin, total protein and albumin (<3.5 g/dL); and urine bacteria were associated with the development of pneumonia. Furthermore, in the multivariate analysis, low levels of albumin and urine bacteria were independently associated with pneumonia. We developed a bedridden patient pneumonia risk (BPPR) score using these two risk factors to assess pneumonia risk. We applied scores of zero (0) or one (1) according to the absence or presence of the two risk factors and summed the scores in each patient. The proportion of pneumonia patients increased with increasing BPPR score when the patients were divided into three groups - low, moderate and high risk - according to the BPPR score (0, 1 or 2, respectively). CONCLUSIONS: Malnutrition, urinary tract infection-induced inflammation and anemia were associated with pneumonia in bedridden patients. BPPR scoring might be useful for assessing pneumonia risk and managing affected patients. Geriatr Gerontol Int 2018; 18: 714-722.

Youth baseball players with elbow and shoulder pain have both low back and knee pain: a cross-sectional study.

PURPOSE: Serious arm injuries in youth baseball players have been increasing. Though a breakage in the kinetic chain could affect arm injuries, an association between arm injuries and insufficient support of the trunk and lower extremities is not well understood. The purpose of this study was to investigate the association of low back and knee pain with elbow and/or shoulder complaints among youth baseball players. METHODS: A self-administered questionnaire and document informed consent were mailed to youth athletes belonging to the Miyagi Amateur Sports Association. Multiple logistic regression analysis was used to examine the association of low back and knee pain with elbow and/or shoulder pain at the time of the questionnaire. Variables considered in the models were as follows: sex, age, BMI, years of athletic experience, position, team level, the amount of practice, participating day in team practice and game per week, frequency of participation in games, and practice intensity. RESULTS: The final study population was comprised 1582 youth baseball players (aged 6-15 years old, male 95.6 %) who had responded to the questionnaire. A total of 24.8 % (n = 381) had elbow and/or shoulder pain, whereas 8.5 % (n = 130) had low back pain and 13.1 % (n = 201) had knee pain. The prevalence of elbow and/or shoulder pain with concomitant low back and knee pain was 61.2 % (n = 82) and 51.9 % (n = 108) (p < 0.001), respectively. The presence of low back and knee pain was significantly associated with the prevalence of elbow and/or shoulder pain among youth baseball players [adjusted odds ratio (ORs): 4.31, 95 % confidence interval (95 % CI): 2.86-6.51, p < 0.001, and ORs: 2.92, 95 % CI: 2.09-4.09, p < 0.001, respectively]. For other variables, older age (10- and 11-year old: ORs: 1.73, 95 % CI 1.10-2.73, p = 0.018; 12-15 year old: ORs: 1.62, 95 % CI: 1.18-2.58, p = 0.006), pitcher (ORs: 1.46, 95 % CI: 1.10-1.94, p = 0.009), catcher (ORs: 1.69, 95 % CI: 1.24-2.31, p = 0.001,), and practice intensity (ORs: 1.58, 95 % CI: 1.22-2.06, p = 0.001) were significantly associated with elbow and/or shoulder pain. CONCLUSION: Both low back and knee pain were significantly associated with elbow and/or shoulder pain in youth baseball players. Clinicians should check the complaints of the trunk and lower extremities as well as those of the elbow and shoulder for preventing severe injuries in youth baseball players. Level of Evidence III.

Independent and combined relationship of habitual unhealthy eating behaviors with depressive symptoms: A prospective study.

BACKGROUND: Unhealthy eating has been found to be associated with the prevalence of depressive symptoms. However, prospective evidence of the combined effects of unhealthy eating and depressive symptoms has not been reported. This study aimed to elucidate the prospective relationship between habitual unhealthy eating habits and depressive symptoms. METHODS: A 2-year prospective cohort study of 376 Japanese adults aged 24-83 years without depressive symptoms at baseline was conducted. Information about participants' eating behaviors was obtained via a self-administered questionnaire, in which skipping breakfast, eating dinner shortly before bedtime, and snacking after dinner were recorded. Depressive symptoms were assessed using the Japanese version of the Zung Self-rating Depression Scale. RESULTS: The 2-year incidence of depressive symptoms was found to be 23.7% (89/376). Covariate-adjusted multivariate Poisson regression analyses showed that habitual snacking after dinner was significantly associated with the incidence of depressive symptoms (relative risk [RR] 1.77; 95% confidence interval [CI], 1.00-3.14, p = 0.049), whereas no relationship was found between skipping breakfast or eating dinner shortly before bedtime and depressive symptoms. On the other hand, there was an interaction effect of snacking after dinner and dinner before bedtime on depressive symptoms (p for the interaction = 0.044). Participants with more than two unhealthy eating behaviors had a higher incidence of depressive symptoms compared to those with fewer than two unhealthy eating behaviors (RR 1.71; 95% CI, 1.06-2.77, p = 0.028). CONCLUSIONS: This prospective study is the first to reveal the combined relationship between unhealthy eating and the incidence of depressive symptoms.