A Biologically Inspired Movement Recognition System with Spiking Neural Networks for Ambient Assisted Living Applications.

This study presents a novel solution for ambient assisted living (AAL) applications that utilizes spiking neural networks (SNNs) and reconfigurable neuromorphic processors. As demographic shifts result in an increased need for eldercare, due to a large elderly population that favors independence, there is a pressing need for efficient solutions. Traditional deep neural networks (DNNs) are typically energy-intensive and computationally demanding. In contrast, this study turns to SNNs, which are more energy-efficient and mimic biological neural processes, offering a viable alternative to DNNs. We propose asynchronous cellular automaton-based neurons (ACANs), which stand out for their hardware-efficient design and ability to reproduce complex neural behaviors. By utilizing the remote supervised method (ReSuMe), this study improves spike train learning efficiency in SNNs. We apply this to movement recognition in an elderly population, using motion capture data. Our results highlight a high classification accuracy of 83.4%, demonstrating the approach's efficacy in precise movement activity classification. This method's significant advantage lies in its potential for real-time, energy-efficient processing in AAL environments. Our findings not only demonstrate SNNs' superiority over conventional DNNs in computational efficiency but also pave the way for practical neuromorphic computing applications in eldercare.

Gait analysis comparison between manual marking, 2D pose estimation algorithms, and 3D marker-based system.

Introduction: Recent advances in Artificial Intelligence (AI) and Computer Vision (CV) have led to automated pose estimation algorithms using simple 2D videos. This has created the potential to perform kinematic measurements without the need for specialized, and often expensive, equipment. Even though there's a growing body of literature on the development and validation of such algorithms for practical use, they haven't been adopted by health professionals. As a result, manual video annotation tools remain pretty common. Part of the reason is that the pose estimation modules can be erratic, producing errors that are difficult to rectify. Because of that, health professionals prefer the use of tried and true methods despite the time and cost savings pose estimation can offer. Methods: In this work, the gait cycle of a sample of the elderly population on a split-belt treadmill is examined. The Openpose (OP) and Mediapipe (MP) AI pose estimation algorithms are compared to joint kinematics from a marker-based 3D motion capture system (Vicon), as well as from a video annotation tool designed for biomechanics (Kinovea). Bland-Altman (B-A) graphs and Statistical Parametric Mapping (SPM) are used to identify regions of statistically significant difference. Results: Results showed that pose estimation can achieve motion tracking comparable to marker-based systems but struggle to identify joints that exhibit small, but crucial motion. Discussion: Joints such as the ankle, can suffer from misidentification of their anatomical landmarks. Manual tools don't have that problem, but the user will introduce a static offset across the measurements. It is proposed that an AI-powered video annotation tool that allows the user to correct errors would bring the benefits of pose estimation to professionals at a low cost.

Theory of Change in Complex Research for Development Programmes: Challenges and Solutions from the Global Challenges Research Fund.

The United Kingdom Research and Innovation (UKRI) Global Challenges Research Fund (GCRF) aimed to address global challenges to achieve the United Nations (UN) Sustainable Development Goals through 12 interdisciplinary research hubs. This research documents key lessons learned around working with Theory of Change (ToC) to guide Monitoring, Evaluation and Learning (MEL) within these complex research for development hubs. Interviews and document reviews were conducted in ten of the research hubs. The results revealed that only one hub invested in an explicit visual system mapping approach, and that funder timelines, budget constraints and issues with capacity and expertise limited the application of these approaches across all hubs. In contrast, many hubs attempted to deal with visual complexity by means of ether constructing multiple, nested ToCs, or a conscious simplification of complexity through reducing their ToC towards a straightforward and uncomplicated chain model or spherical model. While the former approach had some value, most hubs struggled to find capacity to support the full articulation of nested ToCs. In contrast, the latter approach resulted in ToCs which lacked detail or mechanism articulation, but which nevertheless were often 'fit for purpose' in ensuring effective communication and coherence across diverse stakeholders and sub-projects. We conclude that in instances where the reporting, funding and management cycles of complex research for development programmes cannot be adapted to properly support learning-based approaches to ToC development, imposing simplicity in the ToC might be fit for purpose. This might also be preferable to more complex visual approaches that are only partially realised.

Le Fonds de recherche sur les défis mondiaux (GCRF ou Global Challenges Research Fund en anglais) pour la recherche et l'innovation du Royaume-Uni visait à relever les défis mondiaux pour atteindre les objectifs de développement durable des Nations Unies par le biais de 12 centres de recherche interdisciplinaires. Cette étude documente les principales leçons apprises sur l'utilisation de la théorie du changement (TdC) pour guider le suivi, l'évaluation et l'apprentissage (SEA) au sein de ces pôles complexes de recherche pour le développement. Des entretiens et des revues documentaires ont été menés dans dix des 12 pôles de recherche. Les résultats ont révélé qu'un seul pôle a investi dans une approche de cartographie visuelle explicite du système, et que les délais des bailleurs de fonds, les contraintes budgétaires et les problèmes de capacité et d'expertise ont limité l'application de ces approches dans tous les pôles. En revanche, de nombreux pôles ont tenté de gérer la complexité visuelle en construisant de multiples TdC imbriquées, ou une simplification consciente de la complexité en réduisant leur TdC vers un modèle de chaîne simple et pas compliqué ou un modèle sphérique. Bien que la première approche ait une certaine valeur, la plupart des pôles ont eu du mal à trouver les compétences nécessaires pour prendre en charge l'articulation complète des TdC imbriquées. En revanche, cette dernière approche a abouti à des TdC qui manquaient de détails ou d'articulation des mécanismes, mais qui étaient néanmoins souvent « adaptées à l'objectif ¼ pour assurer une communication efficace et la cohérence entre les diverses parties prenantes et sous-projets. En guise de conclusion, nous incluons les cas où les cycles de rapport, de financement et de gestion de programmes complexes de recherche pour le développement ne peuvent pas être adaptés pour appuyer correctement les approches basées sur l'apprentissage pour le développement visuel de la TdC. Dans ces cas-là, il semble être adéquat et préférable en effet d'imposer une TdC simple plutôt que d'utiliser des approches visuellement plus complexes mais qui ne sont que partiellement réalisées.

Correction: High intensity, circuit-type integrated neuromuscular training alters energy balance and reduces body mass and fat in obese women: A 10-month training-detraining randomized controlled trial.

[This corrects the article DOI: 10.1371/journal.pone.0202390.].

Development and validation of a bioelectrical impedance prediction equation estimating fat free mass in Greek - Caucasian adult population.

BACKGROUND AND AIMS: Excessive body fat accumulation is associated with adverse health effects; therefore its accurate and reliable assessment is of great significance. The aim of the study was to develop and validate an easy and applicable equation, based on bioelectrical impedance analysis, estimating fat free mass in Greek general population and compare it with those of the literature. METHODS: Anthropometric and bioelectrical impedance parameters were obtained from 694 Greek adults (429 women and 265 men) so as to develop and validate the equation, using DXA as reference method. The validation and the reliability of the equation were examined with Bland-Altman analysis and Intraclass Correlation Coefficient (ICC). RESULTS: The developed prediction equation was FFM (kg) = 12.299 + (0.164 * Weight (kg)) + (7.287 * Gender (0:female, 1:male)) - (0.116 * Resistance (ohm)/Height (m)2) + (0.365 * Reactance (ohm)/Height (m)2) + (21.570 * Height (m)) (R2 = 0.944, p < 0.0001). Regarding the current population, the current equation presented the lowest bias (-0.069 kg, p = 0.707) and the highest ICC (0.985) compared to those of the literature. CONCLUSION: The current prediction equation was found to be valid and reliable in a representative sample of the Caucasian Greek general population and its utilization for body composition assessment could be an alternative of using labor-intensive, expensive and time-consuming reference methods.

Neurotoxic effects of aluminum are associated with its interference with estrogen receptors signaling.

Aluminum compounds have been observed in various brain regions, and their accumulation has been associated with many neurodegenerative disorders. Neurotoxic effects of aluminum are attributed to reactive oxygen species generation, induction of apoptosis and inflammatory reactions activation. Metalloestrogen activity of aluminum has also been linked to breast cancer progression and metastasis. In this study, taking into account the anti-apoptotic and anti-oxidant activities of estrogens in neuronal cells, which are mediated by estrogen receptors, the possible estrogenic activity of aluminum in SH-SY5Y neuroblastoma cells was studied. Our results showed that aluminum in the form of aluminum chlorohydrate (ACH) exhibited no effect on estrogen receptors transcriptional activation, and differential effect on estrogen receptor alpha (ERα) and estrogen receptor beta (ERß) protein levels. ACH caused reduction in ERß protein levels, and increase in its mitochondrial localization. ACH-induced reduction in ERß protein level may be linked, at least in part, to the ACH-induced increase in ERα protein level. This statement is based on our observations showing aluminum-induced reduction in the E2-induced increase in ERα S118 phosphorylation, in MCF-7 and SH-SH5Y cells. Phosphorylation at S118 residue is known to be associated with inhibition of the ubiquitin-induced proteolytic degradation of ERα, leading to its accumulation. Since it is known that ERα negatively regulate ERß expression, increase in ERα, may contribute to reduction in ERß levels and subsequent weakening of its anti-apoptotic and anti-oxidant activity, justified by the observed reduction in procaspase 9, mitochondrial cytochrome c, Bcl-2, Bcl-xL and mitochondrial thioredoxin protein level, as well as by the increase in proapoptotic BAX level, in ACH treated SH-SY5Y cells. In addition, increase in mitochondrial ERß localization may also trigger mitochondrial metabolism, suppress biosynthetic process of gluconeogenesis, as indicated by the observed reduction in the phosphoenolpyruvate carboxykinase protein level, and eventually lead to increase in reactive oxygen species (ROS) generation, known to be implicated in aluminum induced neurodegeneration. This statement was verified by the observed ACH-induced increase in ERß mitochondrial localization, induction of the mitochondrial membrane depolarization and increase in ROS production, in neuronal-like differentiated SH-SY5Y cells.

Assessment of the Effectiveness of a Computerised Decision-Support Tool for Health Professionals for the Prevention and Treatment of Childhood Obesity. Results from a Randomised Controlled Trial.

We examined the effectiveness of a computerised decision-support tool (DST), designed for paediatric healthcare professionals, as a means to tackle childhood obesity. A randomised controlled trial was conducted with 65 families of 6⁻12-year old overweight or obese children. Paediatricians, paediatric endocrinologists and a dietitian in two children's hospitals implemented the intervention. The intervention group (IG) received personalised meal plans and lifestyle optimisation recommendations via the DST, while families in the control group (CG) received general recommendations. After three months of intervention, the IG had a significant change in dietary fibre and sucrose intake by 4.1 and -4.6 g/day, respectively. In addition, the IG significantly reduced consumption of sweets (i.e., chocolates and cakes) and salty snacks (i.e., potato chips) by -0.1 and -0.3 portions/day, respectively. Furthermore, the CG had a significant increase of body weight and waist circumference by 1.4 kg and 2.1 cm, respectively, while Body Mass Index (BMI) decreased only in the IG by -0.4 kg/m². However, the aforementioned findings did not differ significantly between study groups. In conclusion, these findings indicate the dynamics of the DST in supporting paediatric healthcare professionals to improve the effectiveness of care in modifying obesity-related behaviours. Further research is needed to confirm these findings.

High intensity, circuit-type integrated neuromuscular training alters energy balance and reduces body mass and fat in obese women: A 10-month training-detraining randomized controlled trial.

This randomized controlled trial examined body mass, body composition, energy balance and performance responses of previously sedentary overweight/obese women to a circuit-type integrated neuromuscular training program with alternative modalities. Forty-nine healthy overweight or class I obese females (36.4±4.4 yrs) were randomly assigned to either a control (N = 21), training (N = 14) or training-detraining (N = 14) group. In weeks 1-20, the training groups trained three times/week using 10-12 whole-body exercises of progressively increased intensity/volume, organized in timed interval circuit form. In weeks 21-40, the training group continued training whereas the training-detraining group not. Heart rate, perceived exertion, blood lactate, exertion, oxygen consumption and excess post-exercise oxygen consumption were measured for one session/phase/person and exercise energy expenditure was calculated. Energy intake, habitual physical activity, resting metabolic rate, body composition, body mass, strength and maximal oxygen consumption were measured at baseline, mid-intervention and post-intervention. A two-way repeated measures ANOVA was used to determine differences between three time points and three groups. In C, VO2max declined (p<0.013) and body fat (p<0.008), waist (p<0.059) and hip (p<0.012) circumferences increased after 40 weeks compared to baseline. Training reduced body mass (6%, p<0.001), body fat (~5.5%, p<0.001) and increased fat-free mass (1.2-3.4%, p<0.05), strength (27.2%, p<0.001) and endurance (26.8%, p<0.001) after a 10-month implementation period using a metabolic overload of only 5-12 metabolic equivalents of task-hours per week. Training induced a long-term negative energy balance during an exercise and a non-exercise day due to an elevation of resting metabolic rate (6%-10%, p<0.05) and exercise-related energy expenditure. Training had an 8% and 94% attrition and attendance rates, respectively. Training-induced gains were attenuated but not lost following a 5-month detraining. A 10-month implementation of a high-intensity interval type training program elicited both endurance and musculoskeletal gains and resulted in a long-term negative energy balance that induced a progressive and sustained reduction of body and fat mass. TRIAL REGISTRATION: ClinicalTrials.gov NCT03134781.

Disparate Habitual Physical Activity and Dietary Intake Profiles of Elderly Men with Low and Elevated Systemic Inflammation.

The development of chronic, low-grade systemic inflammation in the elderly (inflammaging) has been associated with increased incidence of chronic diseases, geriatric syndromes, and functional impairments. The aim of this study was to examine differences in habitual physical activity (PA), dietary intake patterns, and musculoskeletal performance among community-dwelling elderly men with low and elevated systemic inflammation. Nonsarcopenic older men free of chronic diseases were grouped as ‘low’ (LSI: n = 17; 68.2 ± 2.6 years; hs-CRP: <1 mg/L) or ‘elevated’ (ESI: n = 17; 68.7 ± 3.0 years; hs-CRP: >1 mg/L) systemic inflammation according to their serum levels of high-sensitivity CRP (hs-CRP). All participants were assessed for body composition via Dual Emission X-ray Absorptiometry (DEXA), physical performance using the Short Physical Performance Battery (SPPB) and handgrip strength, daily PA using accelerometry, and daily macro- and micronutrient intake. ESI was characterized by a 2-fold greater hs-CRP value than LSI (p < 0.01). The two groups were comparable in terms of body composition, but LSI displayed higher physical performance (p < 0.05), daily PA (step count/day and time at moderate-to-vigorous PA (MVPA) were greater by 30% and 42%, respectively, p < 0.05), and daily intake of the antioxidant vitamins A (6590.7 vs. 4701.8 IU/day, p < 0.05), C (120.0 vs. 77.3 mg/day, p < 0.05), and E (10.0 vs. 7.5 mg/day, p < 0.05) compared to ESI. Moreover, daily intake of vitamin A was inversely correlated with levels of hs-CRP (r = −0.39, p = 0.035). These results provide evidence that elderly men characterized by low levels of systemic inflammation are more physically active, spend more time in MVPA, and receive higher amounts of antioxidant vitamins compared to those with increased systemic inflammation.

Risk factors for fear of falling in elderly patients with severe knee osteoarthritis before and one year after total knee arthroplasty.

PURPOSE: To evaluate the regression of fear of falling (FOF) and identify its risk factors in patients with severe knee osteoarthritis before and one year after total knee arthroplasty (TKA). METHODS: 11 men and 57 women with a mean age of 73 years and a mean body mass index of 30.36 kg/m2 who had severe (grade 3 or 4) knee osteoarthritis and knee pain of ≥1 year were included. Two weeks before and one year after TKA, patients were asked about their FOF status and falls history. Patients were asked to complete the Physical Activity Scale for the Elderly, Short Form 36 (SF-36), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaires. Clinical performance was assessed using the Berg Balance Scale and Timed Up and Go (TUG) test. RESULTS: Of the 68 patients, 56 (82.4%) had FOF preoperatively and 30 (44.1%) had FOF one year after TKA (p<0.001). The strongest predictors for FOF preoperatively were fallers (odds ratio [OR]=9.83, p=0.028), mental component summary (MCS) score of SF-36 (OR=0.88, p=0.024), and TUG (OR=3.4, p=0.013). The strongest predictors for FOF one year postoperatively were fallers (OR=16.51, p=0.041), patients with ≥2 chronic diseases (OR=17.33, p=0.011), physical function score of WOMAC (OR=1.015, p=0.005), and MCS score of SF-36 (OR=0.86, p=0.015). CONCLUSION: TKA positively affected FOF and gradually reduced the FOF rate over a year period after TKA in an elderly population.

The parental role in adolescent screen related sedentary behavior.

BACKGROUND: Adolescents spend an increasing amount of their time engaged in screen using activities. The present study aimed at identifying parental factors associated with screen time among Greek adolescents. METHODS: A sample of 1141 adolescents, as well as their parents, participated in this survey. Adolescents were asked to complete a questionnaire about time spent on screen-viewing behaviors. Respectively, parents completed a questionnaire concerning family predictors. Multiple regression analysis was used to determine correlates of adolescent screen-viewing with family predictors. RESULTS: The mean screen time per weekday was 193 min. Adolescents, whose parents had received up to secondary school education, spend more time in screen-viewing compared with the other groups. Controlling adolescents' gender and age, all the family variables (perceived rules, parental modeling, parents' screen related sedentary behavior, parental concern for screen viewing, support for physical activity, parental education) were statistically significant in predicting adolescent screen time with Perceived Rules recording a higher negative beta value (ß=-0.18, p<0.00). CONCLUSION: Perceived parental screen time rules play a role in the amount of screen time among adolescents. Interventions that focus on parental limit setting development and physical activity support may be effective in decreasing screen time among youth aged 13-15 years.

Home and Neighborhood Environment Predictors of Adolescents' Screen Viewing.

BACKGROUND: Nowadays, the majority of adolescents exceed the AAP guidelines for screen use and this is likely to be a risk factor for obesity. The current study aims at investigating adolescent screen viewing in the context of home and neighborhood environment. METHODS: A sample of 1141 adolescents as well as their parents participated in this survey. Adolescents were asked to complete a questionnaire about time spent on screen viewing behaviors. Respectively, parents completed a questionnaire concerning environmental predictors. RESULTS: Almost two-thirds of the adolescents surveyed spend more than 2 hours per day on screen entertainment, with boys dealing with personal computers (PCs) and electronic games more than girls. The likelihood for an adolescent to exceed 2 hours of screen time is 3.87 times more when he has his meals in front of a TV screen on a daily basis, 1.69 times more when the TV is on, often as not on his return from school and 1.74 times more when there is a PC in the adolescent's bedroom. CONCLUSION: Certain environmental predictors influence adolescents' screen time, as a result, corrective intervention should aim at the family as a whole, as this whole shapes home environment.

Analyzing the History of Falls in Patients with Severe Knee Osteoarthritis.

BACKGROUND: One out of three adults over the age of 65 years and one out of two over the age of 80 falls annually. Fall risk increases for older adults with severe knee osteoarthritis, a matter that should be further researched. The main purpose of this study was to investigate the history of falls including frequency, mechanism and location of falls, activity during falling and injuries sustained from falls examining at the same time their physical status. The secondary purpose was to determine the effect of age, gender, chronic diseases, social environment, pain elsewhere in the body and components of health related quality of life such as pain, stiffness, physical function, and dynamic stability on falls frequency in older adults aged 65 years and older with severe knee osteoarthritis. METHODS: An observational longitudinal study was conducted on 68 patients (11 males and 57 females) scheduled for total knee replacement due to severe knee osteoarthritis (grade 3 or 4) and knee pain lasting at least one year or more. Patients were personally interviewed for fall history and asked to complete self-administered questionnaires, such as the 36-item Short Form Health Survey (SF-36) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and physical performance test was performed. RESULTS: The frequency of falls was 63.2% for the past year. The majority of falls took place during walking (89.23%). The main cause of falling was stumbling (41.54%). There was a high rate of injurious falling (29.3%). The time patients needed to complete the physical performance test implied the presence of disability and frailty. The high rates of fall risk, the high disability levels, and the low quality of life were confirmed by questionnaires and the mobility test. CONCLUSIONS: Patients with severe knee osteoarthritis were at greater risk of falling, as compared to healthy older adults. Pain, stiffness, limited physical ability, reduced muscle strength, all consequences of severe knee osteoarthritis, restricted patient's quality of life and increased the fall risk. Therefore, patients with severe knee osteoarthritis should not postpone having total knee replacement, since it was clear that they would face more complicated matters when combining with fractures other serious injuries and disability.

Lower Levels of Vitamin D Among Bangladeshi Immigrants with Diabetes in Greece Compared to Indigenous Greek Patients with Diabetes.

AIM: Vitamin D deficiency is thought to impair insulin action and glucose metabolism; however, previous studies have not examined ethnic differences. We investigated a cohort of predominantly white Greek Caucasian and Bangladeshi immigrant patients with diabetes mellitus in order assess the association between diabetes mellitus and 25-hydroxyvitamin D [25(OH)VitD]. MATERIALS AND METHODS: A total of 165 patients from Bangladesh and 118 patients from Greece with diabetes were assessed for diabetes and 25(OH)VitD status. RESULTS: The 25(OH)VitD levels of Bangladeshi patients were significantly lower compared to Greek patients (12.42±5.86 ng/ml vs. 23.06±12.36 ng/ml, p<0.001). Only 1.2% of Bangladeshi patients vs. 24.57% of Greek patients had sufficient levels of 25(OH)VitD (≥30 ng/ml) CONCLUSION: The prevalence of vitamin D deficiency is very high amongst patients with diabetes but immigrants are at greater risk. Vitamin D supplementation could be valuable in the prevention or treatment of diabetes.

Epidemiological and clinical study of diabetes in immigrants from Bangladesh in Athens versus Greek patients.

BACKGROUND/AIM: Greece has experienced a large wave of immigration from Bangladesh. The purpose of this study was to determine whether Bangladeshi immigrants with diabetes have poorer preventive follow-up and diabetes self-care compared to Greek patients. PATIENTS AND METHODS: A total of 166 patients from Bangladesh and 123 patients from Greece were recruited. Interviews were conducted, a physical examination followed and blood and urine samples were collected. RESULTS: Patients from Bangladesh had worse glycemic control (A1C=7.74±1.6 vs. 7.55±1.7%; p=0.3), and lower high-density lipoprotein levels (33.99±9.4 vs. 44.05±10.43 mg/dl; p=0.037). They were less likely to regularly take their medication for diabetes mellitus, or to follow dietary recommendations. However, fewer of them smoked, and had a significantly lower body mass index than Greek patients. CONCLUSION: Bangladeshi immigrants are less likely to engage self-care behaviors and have worse glycemic control and less access to medication, laboratory test and healthcare Units.

Pedometer determined physical activity and obesity prevalence of Greek children aged 4-6 years.

BACKGROUND: Pre-school age is important for developing healthy attitudes towards physical activity (PA). However, research on pre-schoolers' pedometer-determined PA is limited. AIM: To describe pre-schoolers' ambulatory activity; investigate step count differences in respect to Body Mass Index (BMI) categories and examine the prevalence of obesity. SUBJECTS AND METHODS: Pre-school aged children (n = 250; 5.5 ± 0.4 years) from Komotini (Greece) wore Omron HJ-720IT-E2 pedometers for 10 consecutive days. Height and weight were measured and BMI was calculated. RESULTS: Three-way repeated measures ANOVAs revealed that children performed more steps on weekdays than during weekends (p < 0.001) and during leisure time than school (p < 0.001). Significant differences appeared between normal and obese children's counts on weekdays (p < 0.001), weekend days (p < 0.05), during school (p < 0.001), after school (p < 0.005) and in weekly steps (p < 0.005). No gender differences were detected. Moreover, according to a sample t-test analysis, children's daily steps were significantly different from the 10,000 steps/day guideline, while obesity prevalence was 15.6%. CONCLUSION: School-based ambulatory activity is lower than after school ambulatory activity, independent of BMI-category and gender, although obese children demonstrated fewer steps. Taking into account the high rate of both the obesity prevalence and children not meeting the 10,000 steps/day guideline, the need for preventive policies becomes obvious.

Diabetic neuropathy: comparison between Bangladeshi immigrants and Greek-born subjects.

The aim of this study was to compare Bangladeshi immigrants with diabetes to native Greeks with diabetes and to distinguish the different risk factors for polyneuropathy (PN) in the two ethnic groups. Subjects were recruited from the outpatient diabetic clinic of a general hospital. A total of 111 Bangladeshi immigrants (97 men and 14 women of mean age 47 years) and 101 native Greeks (82 men and 19 women of mean age 49 years) were included in the study. Sex, mean age, age at diabetes diagnosis, and diabetes duration did not differ between the two groups. PN was diagnosed in 53 (48%) Bangladeshi and in 59 (58%) Greek patients (p = 0.12). Large fiber neuropathy was less prevalent among Bangladeshis (18%) than in Greeks (53%) (p < 0.01). Small fiber neuropathy on the contrary were more frequent in Bangladeshis (18% vs. 7%) (p < 0.02). Regarding the risk factors for PN, Greek patients were taller, with higher BMI, and smoked more cigarettes (p < 0.001). They were also treated with more anti-lipid and antihypertensive agents. The higher percentage of SFN in Bangladeshi was mainly a result of the significantly greater incidence of erectile dysfunction (ED) in their group (68 Bangladeshi vs. 38 Greek men). It is well known that there are many causes of ED aside from SFN which were not evaluated in this study. Thus this conclusion should be taken with caution.

The effect of leg kick on sprint front crawl swimming.

The aim of this study was to examine the influence of leg kick on the pattern, the orientation and the propulsive forces produced by the hand, the efficiency of the arm stroke, the trunk inclination, the inter-arm coordination and the intra-cyclic horizontal velocity variation of the hip in sprint front crawl swimming. Nine female swimmers swam two maximal trials of 25 m front crawl, with and without leg kick. Four camcorders were used to record the underwater movements. Using the legs, the mean swimming velocity increased significantly. On the contrary, the velocity and the orientation of the hand, the magnitude and the direction of the propulsive forces, as well as the Froude efficiency of the arm stroke were not modified. The hip intra-cyclic horizontal velocity variation was also not changed, while the index of coordination decreased significantly. A significant decrease (13%) was also observed in the inclination of the trunk. Thus, the positive effect of leg kick on the swimming speed, besides the obvious direct generation of propulsive forces from the legs, could probably be attributed to the reduction of the body's inclination, while the generation of the propulsive forces and the efficiency of the arm stroke seem not to be significantly affected.

Physical activity is associated with bone geometry of premenarcheal girls in a dose-dependent manner.

OBJECTIVE: To determine the relationship between habitual physical activity (PA) level and peripheral qualitative computed tomography-determined quantitative tibia characteristics of premenarcheal girls. METHODS: Premenarcheal girls matched for age (10-13 years), bone age and maturity level were assigned into: a) low PA group (LPA, n=25), b) moderate PA group (MPA, n=17), and c) high PA group (HPA, n=18). Participants' daily dietary intake, tibia's geometry and serum levels of calcium and vitamin D were assessed. RESULTS: Premenarcheal girls demonstrating HPA exhibited greater pericortical thickness, cross-sectional area (CSA) and bone mineral content (BMC) (p<.001) in cortical bone, greater BMC, volumetric bone density (vBMD) and polar stress strength index (SSIp) in trabecular bone (p<0.001-0.05) and greater total BMC (p<.05) and vBMD (p<.01) when compared to their physically inactive or moderately active counterparts. MPA exhibited greater values of cortical BMC (p<.01) and SSIp (p<.05) than LPA. Partial correlation analysis (adjusted for BMI) revealed modest associations between PA score and bone geometry parameters (r=0.36-0.49, p<.05) at 38% of tibia length. CONCLUSIONS: Habitual PA affects geometry of both cortical and trabecular areas of a long bone of premenarcheal girls in a dose-dependent manner. Specifically, PA increases both the density and size of cortical bone but only the density of trabecular bone during preadolescence. Given the importance of peak bone mass for future fracture risk, high levels of PA during childhood could be a major target for public health interventions aimed at optimising bone health in prepubertal children when the greatest bone gains occur.

The relationship between motor proficiency and pedometer-determined physical activity in young children.

UNLABELLED: The aim of this study was to examine the relationship between motor proficiency and pedometer-determined physical activity in 5-6 year-old children. Participants (n = 232) were randomly recruited and assessed from 30 kindergartens in Northern Greece. Two trained researchers administered the measurements for the assessment of children's motor proficiency by using the BOTMP-SF. Physical activity was assessed by OMRON pedometers. Significant relationships between BOTMP-SF standard score and steps (S), aerobic walking time (AWT) and aerobic steps (AS), (p < .05) were found. When motor proficiency was divided into quartiles to assess the distribution of the relationship between motor proficiency and pedometer-derived variables, significant associations were found for AWT, S and AS (p < .001). Young children with high levels of motor proficiency were more active in contrast to their peers with lower motor proficiency. The findings add to the growing body of literature that considers motor skills/abilities as important elements of physical activity participation. ( ABBREVIATIONS: S-steps per day; AS-aerobic steps per day; AWT-aerobic walking time (minutes·day(-1)); BOTMP-SF-Bruininks-Oseretsky Test of Motor Proficiency-Short Form (standard score)).