Neighbourhood Environments and Lifestyle Behaviours in Adolescents with Type 1 Diabetes.

Early prevention strategies are needed to mitigate the high risk of cardiovascular disease in adolescents with type 1 diabetes (T1D). Residential neighbourhood features can promote healthy lifestyle behaviours and reduce cardiovascular risk, but less is known about their role in lifestyle behaviours in adolescents with T1D, and no studies use comparisons to healthy controls. We examined associations between residential neighbourhood features and lifestyle behaviours in adolescents with T1D and healthy controls. Data from CARDEA, a cross-sectional study of 100 adolescents with T1D (14-18 years) from a paediatric diabetes clinic in Montreal, Canada, and 97 healthy controls, were analysed. Outcomes included physical activity and sedentary behaviour (accelerometry), screen time and sleep duration (questionnaires), and dietary habits (24h recalls). Cluster analysis of selected neighbourhood indicators computed for participants' postal codes resulted in two neighbourhood types: central urban and peri-urban. Central urban neighbourhoods were characterised by very high population density, high active living index, numerous points of interest, higher social deprivation, higher residential mobility, and lower median household income compared to peri-urban neighbourhoods. Associations of neighbourhood type with lifestyle behaviours were estimated with multiple linear regressions and interactions by T1D status were tested. Living in central urban neighbourhoods was associated with greater daily minutes of moderate-to-vigorous physical activity (B = 8.61, 95% CI [1.79, 15.44]) compared to living in peri-urban neighbourhoods. No associations were observed for other lifestyle behaviours, and no statistically significant interactions were found between neighbourhood type and T1D status. Features that characterize central urban built environments appear to promote physical activity in adolescents, regardless of T1D status.

Role of Physical Activity and Sedentary Behaviors on Vascular and Myocardial Structure and Function in Type 1 Diabetes.

OBJECTIVE: To estimate associations between physical activity and sedentary behaviors and early markers of cardiovascular diseases (CVD) in adolescents with and without type 1 diabetes. STUDY DESIGN: Cross-sectional data stem from CARDEA, a study investigating early CVD development in 100 adolescents with type 1 diabetes recruited at Sainte-Justine University Hospital Diabetes Clinic and 97 healthy adolescents without diabetes (14-18 years), in Montréal, Canada. Outcomes included arterial stiffness by pulse-wave velocity, endothelial function (VTI) by flow-mediated dilation test, and cardiac magnetic resonance imaging markers. Moderate-to-vigorous physical activity (MVPA) and sedentary time were estimated by accelerometry and leisure screen time by questionnaire. We estimated multivariable linear regression models stratified by group. RESULTS: In adolescents with type 1 diabetes, 10-minutes daily increase in MVPA was associated with 3.69 g/m (95% CI: -1.16; 8.54) higher left ventricular (LV) mass/height and 1-h increase in device-measured sedentary time with 0.68 mm (0.20; 1.16) higher wall thickness but only in those with glycated hemoglobin ≤7.5%. In healthy adolescents, a 10-minute increase in MVPA was associated with 1.32 g/m (-0.03; 2.66) higher LV mass/height. Every 1-hour increase in sedentary time was associated with -1.82 cm (-3.25; -0.39) lower VTI, -2.99 g/m (-5.03; -0.95) lower LV mass/height, and -0.47 mm (-0.82; -0.12) lower wall thickness. CONCLUSIONS: Being active and limiting sedentary time appears beneficial for cardiac structure and endothelial function in healthy adolescents; however adequate glycemic control combined with higher levels of MVPA may be required for adolescents with type 1 diabetes to overcome the impact of diabetes.

Physiological response during exercise is preserved in children exposed to a suboptimal gestational environment.

OBJECTIVE: This study investigated whether exposure to suboptimal gestational factors (SGFs) alters mechanical efficiency (ME) and substrate oxidation during rest and exercise in children as a mechanism contributing to obesity. METHODS: Data from the Quebec Adiposity and Lifestyle Investigation in Youth cohort were used. Children aged 8 to 10 years performed an incremental maximal cycling test with indirect calorimetry. Their ME was measured during submaximal and maximal effort. The substrate oxidation during rest and submaximal effort was also computed. ME and substrate oxidation results between children exposed to each SGF during pregnancy (gestational diabetes mellitus: n = 68; hypertensive disorders: n = 49; maternal smoking: n = 77) and nonexposed children (n = 370) were compared. RESULTS: No difference was observed for ME during submaximal (F[3,540] = 0.46, p = 0.713) and maximal effort (F[3,545] = 0.86, p = 0.463) between exposed and nonexposed children. The percentage contributions of lipids and carbohydrates did not differ during rest (F[3,545] =1.68, p = 0.169) or submaximal exercise (F[3,544] = 0.31, p = 0.534) between exposed and nonexposed children. CONCLUSIONS: Children exposed to investigated SGFs display a similar physiological response regarding ME and substrate oxidation during rest and exercise compared to nonexposed children. Future studies should confirm these novel results and continue investigating other research avenues to explain the higher risk of obesity in this population.

Effect of physical activity on olfaction acuity: A systematic review.

Olfaction acuity, which includes detection thresholds, discrimination and identification, appears to decline with age, obesity, and various neurological disorders. Knowing that smell influences energy intake, there is a growing interest in protecting this sense. Physical activity could be a key intervention to counteract the loss of olfaction. This systematic review aims to explore the literature on the effect of physical activity on olfaction acuity. The search strategy consisted of using index terms and keywords in MEDLINE, EMBASE, EBM Reviews - Cochrane Central Register of Controlled Trials, CINAHL, SPORTDiscus, and Web of Science search engine. Data from 17 trials involving 10,861 participants showed that physical activity improved olfaction thresholds, discrimination, identification and perceived intensity. Regular practice of physical activity seemed to have better effects on olfaction components than acute exercise. Although this review has clarified the evidence on the effects of physical activity on olfaction, better methodological consistency is needed.

The association between parameters of physical activity and olfactory function-the importance of frequency and moderate intensity.

Introduction: Overall physical activity (PA) has been linked to decreased olfactory dysfunction and could improve olfactory function. Additionally, decreased olfactory function can contribute to reduced overall PA levels, given its association with neurodegenerative disorders. This study aims to examine the relationship between specific PA parameters (duration, frequency, intensity) and olfactory function in adults. Methods: A total of 3,527 participants from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 underwent assessments for weekly PA duration, frequency, and intensity, alongside a smell test (including odors such as chocolate, strawberry, grape, onion, smoke, natural gas, leather, and soap). Correlation analyses and binary logistic regressions using SPSS were used to evaluate associations. Results: The total smell score exhibited small yet significant positive correlations with the duration, frequency, and volume of moderate PA (correlation coefficients ranging between 0.05 and 0.08; all p ≤ 0.05) and frequency of vigorous PA (correlation coefficient of 0.05; p < 0.05). For moderate PA, the duration, frequency, and volume were significantly and positively associated with the ability to correctly detect the smell of grapes while the frequency was significantly and positively associated with the ability to identify smoke and leather odors (odds ratios ranging from 1.01 to 1.07; p < 0.05). For vigorous PA, the frequency of PA was positively associated with the detection of grape smell (odds ratio of 1.05; p < 0.05). Conclusion: Some parameters of an active lifestyle are associated with improved odds of accurately identifying odors by up to 7.4%. Moderate PA duration, frequency, and volume were linked to better olfactory scores, while high-intensity PA had limited associations.

Intensity and Appreciation of Sweet Taste Solutions Are Modulated by High-Intensity Aerobic Exercise in Adolescent Athletic Males.

PURPOSE: Exercise seems to influence taste, but the effect of exercise on specific tastes is still to be elucidated among youths. METHODS: Athlete boys aged 14-16 years were recruited. Participants (n = 19) ages ranged 14.7 (0.7) years, weight 59.6 (7.8) kg, and height of 173.4 (7.9) cm. Distinct taste tests were administered using low and high concentrations of sweet, salty, and bitter solutions before and after a 30-minute aerobic exercise session (70%-90% of estimated maximal heart rate). McNemmar tests, standard paired t tests, Wilcoxon signed-rank tests, and Cohen d effect size tests were used to analyze taste identification, intensity, and appreciation. RESULTS: There were no significant differences in taste identification capacities after exercise. Participants perceived more intense (P = .037) and appreciated better (P = .004) the low-concentration sweet solution after exercise. Taste appreciation was increased for the high-concentration sweet solution (P = .009) after exercise. Effect sizes were moderate (0.516-0.776). Possible effects were noted for the intensity of salty solutions (P = .0501 and .0543). CONCLUSION: Following an exercise session, participants had increased perceived intensity and appreciation of sweet solutions. This adds new insights into how exercise influences taste in youths, a topic less documented compared with adults, suggesting further research into its impact on dietary choices is needed.

Breast tissue imaging atlas using ultra-fast confocal microscopy to identify cancer lesions.

New generation ultra-fast fluorescence confocal microscopy (UFCM) allows to image histological architecture of fresh breast tissue and may be used for ex vivo intraoperative analysis for margin status. The criteria to identify breast tumoral and non-tumoral tissues in UFCM images are still objects of investigation. The objective of the study was to create an atlas of ex vivo UFCM images of breast tissues and breast carcinomas based on the first extensive collection of large field-of-view UFCM breast images. One hundred sixty patients who underwent conserving surgery for breast cancer were included. Their fresh surgical specimens were sliced, stained with acridine orange, and imaged at high resolution with large-field-of-view UFCM. The resulting images were digitally false colored to resemble frozen sections. Each UFCM image was correlated with the corresponding definitive histology. Representative images of normal tissue, inflammation, benign lesions, invasive carcinoma (IC), and ductal carcinoma in situ (DCIS) were collected. A total of 320 large-field images were recorded from 58 IC of no special type, 44 invasive lobular carcinomas, 1 invasive mucinous carcinoma, 47 DCIS, 2 lobular carcinomas in situ, and 8 specimens without cancer. Representative images of the main components of the normal breast and the main types of ICs and DCIS were annotated to establish an UFCM atlas. UFCM enables the imaging of the fresh breast tissue sections. Main morphological criteria defined in traditional histopathology such as tissue architecture and cell features can be applied to describe UFCM images content. The generated atlas of the main normal or tumoral tissue features will support the adoption of this optical technology for the intraoperative examination of breast specimens in clinical practice as it can be used to train physicians on UFCM images and develop artificial intelligence algorithms. Further studies are needed to document rare breast lesions.

Management and outcomes of superficial vein thrombosis: a single-center retrospective study.

Background: Guidelines suggest but cannot recommend the optimal management of superficial vein thrombosis (SVT). Objectives: To identify the prevalence of asymptomatic deep vein thrombosis (DVT) at the time of SVT diagnosis, and to report the treatment and 3-month complications of patients with only SVT more than 3 cm from deep vein junction (or unknown distance). Methods: We performed a single-center retrospective review of patients referred to the Ottawa Hospital thrombosis unit with ultrasound (US)-diagnosed SVT, and followed patients with only SVT for 3 months. Results: Three hundred sixteen patients with SVT were included. Of the 218 patients without DVT symptoms at presentation, 19 (8.7%; 95% CI, 5.7%-13.2%) were found to have asymptomatic concomitant DVT (11 proximal and 8 distal), and 45 (20.6%) had SVT within 3 cm of the saphenofemoral or saphenopopliteal junctions. Among the 192 patients diagnosed with SVT only, we observed 3-month thrombotic complications in 56 (29.2%; 95% CI, 23.2%-36.0%) patients, with a total of 69 events: 11 (5.7%) DVTs, 2 (1.0%) pulmonary embolisms, 37 (19.2%) SVT extensions, and 19 (9.8%) SVT recurrences. Eighty-two percent (9/11) of the 3-month DVT and pulmonary embolism events occurred in patients who initially received conservative management. Therapeutic treatment doses were most effective. Conclusion: At the time of SVT diagnosis, many patients had asymptomatic DVT and SVT near the deep venous system, supporting the systematic use of initial US in patients clinically diagnosed with SVT. The observed differences in 3-month complication rates, according to the treatment provided, highlight the need for large-scale randomized controlled trials to establish optimal management.

HAPI Fit: An Exercise Intervention to Improve Peak Aerobic Capacity in Young Adults Born Very Preterm.

INTRODUCTION: Individuals born preterm have reduced aerobic capacity, which could be related to impaired organ development. Their capacity to improve aerobic capacity with exercise training could therefore be limited, but this remains unknown. We aimed to test an exercise intervention to improve cardiorespiratory fitness in adults born preterm. METHODS: Twenty-one very preterm and 37 full-term individuals aged 18-33 yr took part in a 14-wk supervised exercise intervention of cardiovascular, resistance, and flexibility training (two group and one individual sessions per week). Adherence and compliance to intervention were recorded. Primary outcome was change in peak oxygen consumption (peak V̇O 2 ) measured before and after the intervention. Within- and between-group differences were estimated using nonparametric tests. RESULTS: Of 219 eligible individuals, 58 were enrolled and 14 participants dropped out over the course of the intervention. Among the 44 who completed the intervention, mean adherence was 82% and 66% for group and individual sessions, respectively. Compliance with training requirement varied between 71% and 100%. There was no difference in adherence between the preterm and full-term groups. Because only one preterm male met the adherence criteria, subsequent analyses were done exclusively on females. Both the term and preterm groups achieved higher peak V̇O 2 after the intervention [term = +4.2 (SD 4.3) mL·min -1 ·kg -1 , P < 0.01; preterm = +4.7 (2.9) mL·min -1 ·kg -1 , P < 0.01]. There was no between-group difference in the response to the intervention ( P = 0.729). CONCLUSIONS: Recruitment and adherence to an exercise intervention are challenging. Results could indicate improvements in cardiorespiratory fitness in young women born preterm after current exercise program. Adaptation of this intervention is needed for wider uptake.

Active time at work following the introduction of a standing and a cycling workstation into worker's office space.

Objectives. Active workstations have been proposed to counteract sedentary behavior at work. This study describes office workers' use of and perceptions toward standing and cycling workstations, and assesses whether the two active workstations were sufficient to break sitting time and replace it with 2-4 h of light activity per workday. Methods. This mixed-method study utilized video recording, semi-structured interviews and a questionnaire. The quantitative data covered time spent sitting, standing and on a cycling workstation. The qualitative data were analyzed based on preferences, barriers and facilitators. Results. Participants (n = 15) used active workstations 125.3 (74.5) min/day and spent 79.0 (63.6) min/day using standing versus 46.3 (47.6) min/day using cycling workstations (p = 0.153, d = 0.58). Following the interviews, the standing workstation was preferred over cycling. The ergonomics of the cycling workstation were not optimal and caused discomfort in use. Seven participants broke their sitting time and accumulated 2+ h of light physical activity per workday. Those participants meeting recommendations were older, had a higher body fat percentage and engaged in less physical activity per week. Conclusion. With a preference for standing workstations, our results showed that 47% of workers used standing and cycling workstations to accumulate 2+ h of active time per day.

Children and chrono-exercise: Timing of physical activity on school and weekend days depends on sex and obesity status.

Recommendations for physical activity (PA) typically focus on frequency, intensity, duration, and type, but timing (chrono-exercise) is also important. The objective of this study is to describe when children are active on school and weekend days and explore PA timing across sex and body mass index (BMI) categories. 359 children (53% male), aged 9.6 (0.9) y, were categorized as normal weight (≥-1 standard deviations (SD) and <1SD; n = 193), overweight (≥1SD and <2SD; n = 80), or obese (≥2SD; n = 86) using WHO BMIz. Moderate-to-vigorous PA (MVPA) was assessed using ActiGraph LS-7164. The results are described as Mean(SD). ANOVA evaluated MVPA across sexes and BMI categories. Normal weight boys were more active than boys with obesity on school (Δ20.33 min; p < 0.001) and weekend days (Δ15.04 min; p < 0.05). On school days, significant differences existed between 9:00 h-11:00 h and 12:00 h-14:00 h (p < 0.017), while on weekends, smaller differences existed throughout the day. Girls' MVPA was similar across BMI categories, on all days (p > 0.05). On school days, 12:00 h-13:00 h represented the most active hour for all participants (~14% total daily MVPA). Peak weekend MVPA was distributed across multiple hours. Differences in MVPA timing emerged on school-days and weekends. Timing may be important when examining the nuances of MVPA in relation to sex and bodyweight in children.

Early Lifestyle Determinants of Adiposity Trajectories from Childhood into Late Adolescence.

Objective: The aim of this study was to examine associations of childhood physical activity, sedentary behavior, and dietary intake with adiposity trajectories from childhood to adolescence. Methods: Quebec Adipose and Lifestyle Investigation in Youth (QUALITY) cohort (n = 630) data from 3 time points (8-10, 10-12, and 15-17 years) for 377 Caucasian children with parental obesity were analyzed. Height and weight, physical activity and sedentary behavior (7-day accelerometry), screen time (self-reported), and dietary intake (three 24-hour diet recalls) were measured. Group-based trajectory modeling identified longitudinal trajectories of body-mass index z-scores (zBMIs). Inverse probability of exposure-weighted multinomial logistic regressions examined associations between baseline lifestyles and zBMI trajectory groups. Results: Six trajectory groups were identified: Stable-Low-Normal-Weight (two groups, 5.7% and 33.0%, which were combined), Stable-High-Normal-Weight (24.8%), Stable-Overweight (19.8%), Stable-Obesity (8.8%), and Overweight-Decreasers (7.9%). For every additional portion of fruits and vegetables, the likelihood of being in the group of Overweight-Decreasers increased by 29% (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.09-1.55) compared with the reference group (Stable-Low-Normal-Weight). For every additional hour of sedentary behavior, the likelihood of belonging to the group of Overweight-Decreasers increased 2-fold (OR: 1.99, 95% CI: 1.28-3.21) and Stable-Obesity increased 1.5-fold (OR: 1.56, 95% CI: 1.08-2.23), compared with the reference. Every additional 10 minutes of moderate-to-vigorous physical activity was associated with a lower likelihood of belonging to the Stable-Obesity group (OR: 0.75, 95% CI: 0.61-0.89) and to the group of Overweight-Decreasers (OR: 0.79, 95% CI: 0.64-0.95) compared with the reference. Finally, children were more likely to belong to the Stable-Obesity group with each additional hour/day of screen time (OR: 1.23, 95% CI: 1.01-1.58). Conclusions: Trajectories of zBMIs from childhood to late adolescence were stable, except for one group which decreased from overweight in childhood to normal weight in adolescence. The latter had more favorable baseline dietary intake of fruits and vegetables. ClinicalTrials.org no. NCT03356262.

Effect of odor stimulations on physical activity: A systematic review.

Fewer and fewer people are reaching physical activity recommendations. Therefore, it seems important to make the practice of physical activity more enjoyable to increase the participation rate. Several environmental factors have been studied to see their impact on sports practice, and some studies investigated the effect of odors. This systematic review aims to provide a thorough view of the literature on the effect of different odors on physical activity. The search strategy consisted of using index terms and keywords in MEDLINE, EMBASE, EBM Reviews - Cochrane Central Register of Controlled Trials, CINAHL, SPORTDiscus, and Web of Science search engine. Data from 19 studies that included 458 participants revealed that the odors had different results on strength, cardiovascular, precision, and postural balance tasks depending on the odors' exposition. Among results, an important distinction was made between pleasant and unpleasant odors. Therefore, pleasant odors had better results on physical activity by improving participants' feeling. Even though this review clarified evidence about the effect of odors on physical activity, better methodological consistency is needed across studies such as the odor administration method to produce more meaningful results.

Association between physical activity and taste-The advantage of increased intensity for some but not all individuals.

INTRODUCTION: Taste is a key sensory modulator of energy intake, and while the effects of acute physical activity (PA) on taste have been recently confirmed, its chronic effects remain poorly documented. METHODS: Data were extracted from the NHANES database, including salty and bitter taste tests, moderate PA (MPA) and vigorous PA (VPA) levels, and anthropometric data. Binary logistic regressions were conducted, and odds ratios (ORs) represent the association between physical activity level and successful taste tests. RESULTS: 3,114 participants (51.5% women, mean age 58.5±11.9 years, mean BMI 29.5±7.0 kg/m2) were analyzed. For the tongue tip test, the frequency of VPA was associated with a better score for the bitter and total taste test, while duration of VPA was associated with a better score for the bitter, salty, and total taste test (OR [1.01-1.06], p<0.05). For the whole mouth test, MPA frequency improved the bitter taste score (OR = 1.06, p = 0.01) while VPA frequency and duration were associated with better scores for bitter, salty, and total taste tests (OR [1.01-1.15], p<0.05). These findings were distinctively influenced by weight status and gender, with males and individuals without obesity mainly beneficiating from an active lifestyle. PERSPECTIVES: This study underlines the link between PA, particularly its frequency and intensity, and improved taste preservation. These findings emphasize the potential benefits of regular VPA for optimizing taste perception, although questions remain regarding the advantages for individuals with obesity and the lack of association observed in women who might already have a preserved profile.

Real-World Diagnostic Accuracy of the On-Site Cytopathology Advance Report (OSCAR) Procedure Performed in a Multidisciplinary One-Stop Breast Clinic.

Fine-needle aspiration (FNA) cytology has been widely used for the diagnosis of breast cancer lesions with the objective of differentiating benign from malignant masses. However, the occurrence of unsatisfactory samples and false-negative rates remains a matter of concern. Major improvements have been made thanks to the implementation of rapid on-site evaluation (ROSE) in multidisciplinary and integrated medical settings such as one-stop clinics (OSCs). In these settings, clinical and radiological examinations are combined with a morphological study performed by interventional pathologists. The aim of our study was to assess the diagnostic accuracy of the on-site cytopathology advance report (OSCAR) procedure on breast FNA cytologic samples in our breast OSC during the first three years (April 2004 till March 2007) of its implementation. To this goal, we retrospectively analyzed a series of 1820 breast masses (1740 patients) radiologically classified according to the American College of Radiology (ACR) BI-RADS lexicon (67.6% being either BI-RADS 4 or 5), sampled by FNA and immediately diagnosed by cytomorphology. The clinicoradiological, cytomorphological, and histological characteristics of all consecutive patients were retrieved from the hospital computerized medical records prospectively registered in the central information system. Histopathological analysis and ultrasound (US) follow-up (FU) were the reference diagnostic tests of the study design. In brief, we carried out either a histopathological verification or an 18-month US evaluation when a benign cytology was concordant with the components of the triple test. Overall, histology was available for 1138 masses, whereas 491 masses were analyzed at the 18-month US-FU. FNA specimens were morphologically nondiagnostic in 3.1%, false negatives were observed in 1.5%, and there was only one false positive (0.06%). The breast cancer prevalence was 62%. Diagnostic accuracy measures of the OSCAR procedure with their 95% confidence intervals (95% CI) were the following: sensitivity (Se) = 97.4% (96.19-98.31); specificity (Sp) = 94.98% (92.94-96.56); positive predictive value (PPV) = 96.80% (95.48-97.81); negative predictive value (NPV) = 95.91% (94.02-97.33); positive likelihood ratio (LR+) = 19.39 (13.75-27.32); negative predictive ratio (LR-) = 0.03 (0.02-0.04), and; accuracy = 96.45% (95.42-97.31). The respective positive likelihood ratio (LR+) for each of the four categories of cytopathological diagnoses (with their 95% CI) which are malignant, suspicious, benign, and nondiagnostic were 540 (76-3827); 2.69 (1.8-3.96); 0.03 (0.02-0.04); and 0.37 (0.2-0.66), respectively. In conclusion, our study demonstrates that the OSCAR procedure is a highly reliable diagnostic approach and a perfect test to select patients requiring core-needle biopsy (CNB) when performed by interventional cytopathologists in a multidisciplinary and integrated OSC setting. Besides drastically limiting the rate of nondiagnostic specimens and diagnostic turn-around time, OSCAR is an efficient and powerful first-line diagnostic approach for patient-centered care.

Multidimensional school features associated with physical activity among youth at risk of obesity: an exploratory principal component and generalized estimating equation analysis.

BACKGROUND: Schools may be high-leverage points for the promotion of physical activity (PA), yet little is known about school built and social environments among youth at high risk of obesity. PURPOSE: To characterise school built and social environments that may be salient for PA and to examine associations between school PA environments and PA in youth at risk of obesity. METHODS: Data from youth attending 206 schools (314 youth in 2005-2008, and 129 youth in 2008-2010) within the QUALITY cohort study, a longitudinal investigation of youth at high risk of obesity were used. Features of schools, based on built, policy/programming and social environments were identified using principal components (PC) analysis. Gender-stratified generalized estimating equation (GEE) models were used to explore associations between school features and accelerometer measured mean counts per minute (MCPM), mean daily moderate-to-vigorous physical activity (MVPA) and the odds of meeting MVPA guidelines cross-sectionally and prospectively using 90% confidence intervals. RESULTS: Nine PCs were identified. Associations were observed between PA and 7 of the 9 PCs. The social environment seemed to be particularly important. Social Norms to Promote PA was associated with an increase in girls' baseline MCPM and MVPA. High Willingness to Promote PA was associated with boys' MCPM, MVPA, and odds of meeting MVPA guidelines, at both baseline and follow-up. CONCLUSION: School built and social contexts may be associated with PA cross-sectionally and over time. Further studies are necessary to confirm the direction and magnitude of effects and to establish their relevance to school-based health promotion efforts.

Trajectories of cardiorespiratory fitness from childhood to adolescence: Findings from the QUALITY cohort.

Estimate the shape and number of cardiorespiratory fitness (CRF) trajectories from childhood to adolescence; and verify whether CRF trajectory membership can be predicted by sex, biological maturation, body weight, body composition and physical activity (PA) in childhood. Data from QUALITY were used. Participants attended baseline (8-10 y old, n = 630) and follow-ups 2 years (n = 564) and 7 years (n = 359) after baseline. Group-based trajectory analysis for relative peak oxygen consumption (VO2peak, ml·kg-1·min-1) was performed. A multinomial logistic regression model was used to estimate the associations between baseline predictors and trajectory membership. Mean age of the 454 participants was 9.7 ± 0.9 years at baseline. Three distinct VO2peak trajectories were identified and all tended to decrease. They were labelled according to the starting point and slope. High-Decreasers were mostly boys, had lower body weight and fat-free mass index and higher PA levels at baseline (p < 0.05). Female sex and higher weight were associated with higher odds of being classified in the Low-Decreaser trajectory (OR = 74.03, 95%CI = 27.06-202.54; OR = 1.48, 95%CI = 1.36-1.60). Those with higher PA were less likely to be Low-Decreasers (OR = 0.96, 95%CI = 0.94-0.97). Sex, body weight and PA in childhood are important influencing factors of VO2peak (ml·kg-1·min-1) trajectories across adolescence.

Associations of timing of food intake with energy intake, eating behaviour traits and psychosocial factors in adults with overweight and obesity.

Introduction: Whether a late distribution of food intake impacts obesity through increased energy intake remains uncertain and the behavioural characterization of late eating needs to be further investigated. The first objective of this study was to assess the associations between late eating and body mass index (BMI) and total energy intake (TEI), and whether TEI mediates the association between late eating and BMI. The second objective was to assess the associations between late eating and eating behaviour traits or psychosocial factors and whether eating behaviour traits mediate the association between late eating and TEI. Methods: Baseline data from 301 individuals (56% women, age = 38.7 ± 8.5 years; BMI = 33.2 ± 3.4 kg/m2), who participated in four weight loss studies were used in this cross-sectional study. Total energy intake was assessed using a three-day food record from which the percentage of TEI after 17:00 and after 20:00 was calculated. Eating behaviour traits and psychosocial factors were assessed with questionnaires. Pearson correlations and mediation analyses adjusted for age, sex, underreporting of energy intake, sleep duration and bedtime were performed. Results: Percent TEI after 17:00 and after 20:00 were associated with TEI (r = 0.13, p = 0.03 for both), and TEI mediated the association between percent TEI after 17:00 and BMI (ß = 0.01 ± 0.01, 95% CI: 0.001, 0.02). Percent TEI after 17:00 was associated with disinhibition (r = 0.13, p = 0.03) and percent TEI after 20:00 was associated with susceptibility to hunger (r = 0.13, p = 0.03), stress (r = 0.24, p = 0.002) and anxiety (r = 0.28, p = 0.0004). In women, disinhibition mediated the association between percent TEI after 17:00 and TEI (ß = 3.41 ± 1.43, 95% CI: 0.92, 6.47). Susceptibility to hunger mediated the association between percent TEI after 20:00 and TEI (ß = 0.96 ± 0.59, 95% CI: 0.02, 2.34) in men and women. Conclusion: Late eating is associated with TEI and suboptimal eating behaviours which could contribute to explaining the association between timing of food intake and obesity.

Automatic diagnosis and classification of breast surgical samples with dynamic full-field OCT and machine learning.

Purpose: The adoption of emerging imaging technologies in the medical community is often hampered when they provide a new unfamiliar contrast that requires experience to be interpreted. Dynamic full-field optical coherence tomography (D-FF-OCT) microscopy is such an emerging technique. It provides fast, high-resolution images of excised tissues with a contrast comparable to H&E histology but without any tissue preparation and alteration. Approach: We designed and compared two machine learning approaches to support interpretation of D-FF-OCT images of breast surgical specimens and thus provide tools to facilitate medical adoption. We conducted a pilot study on 51 breast lumpectomy and mastectomy surgical specimens and more than 1000 individual 1.3×1.3 mm2 images and compared with standard H&E histology diagnosis. Results: Using our automatic diagnosis algorithms, we obtained an accuracy above 88% at the image level (1.3×1.3 mm2) and above 96% at the specimen level (above cm2). Conclusions: Altogether, these results demonstrate the high potential of D-FF-OCT coupled to machine learning to provide a rapid, automatic, and accurate histopathology diagnosis with minimal sample alteration.

Breast carcinoma detection in ex vivo fresh human breast surgical specimens using a fast slide-free confocal microscopy scanner: HIBISCUSS project.

BACKGROUND: New generation ultra-fast fluorescence confocal microscopy allows the ex vivo intraoperative analysis of fresh tissue. The High resolution Imaging for Breast carcInoma detection in ex vivo Specimens after breast Conserving sUrgery by hiStolog Scanner (HIBISCUSS) project aimed to develop an online learning program to recognize the main breast tissue features on ultra-fast fluorescence confocal microscopy images and to evaluate the performance of surgeons and pathologists in diagnosing cancerous and non-cancerous breast tissue in ultra-fast fluorescence confocal microscopy images. METHODS: Patients who underwent conservative surgery or mastectomy for breast carcinoma (invasive or in situ lesions) were included. The fresh specimens were stained with a fluorescent dye and imaged using a large field-of-view (20 cm2) ultra-fast fluorescence confocal microscope. RESULTS: One hundred and eighty-one patients were included. The images from 55 patients were annotated to generate learning sheets and images from 126 patients were blindly interpreted by seven surgeons and two pathologists. The time for tissue processing and ultra-fast fluorescence confocal microscopy imaging was between 8 and 10 min. The training program was composed of 110 images divided into nine learning sessions. The final database for blind performance assessment comprised 300 images. The mean duration for one training session and one performance round was 17 and 27 min respectively. The performance of pathologists was almost perfect with 99.6 per cent (standard deviation (s.d.) 5.4 per cent) accuracy. Surgeons' accuracy significantly increased (P = 0.001) from 83 per cent (s.d. 8.4 per cent) in round 1 to 98 per cent (s.d. 4.1 per cent) in round 7 as well as the sensitivity (P = 0.004). Specificity increased without significance from 84 per cent (s.d. 16.7 per cent) in round 1 to 87 per cent (s.d. 16.4 per cent) in round 7 (P = 0.060). CONCLUSION: Pathologists and surgeons showed a short learning curve in differentiating breast cancer from non-cancerous tissue in ultra-fast fluorescence confocal microscopy images. Performance assessment for both specialties supports ultra-fast fluorescence confocal microscopy evaluation for intraoperative management. REGISTRATION NUMBER: NCT04976556 (http://www.clinicaltrials.gov).