Sleep duration and perceptions of sleep quality in British Army recruits during basic training - an observational analysis.

Introduction: Sleep is critical to the health, wellbeing and performance of military personnel during basic training. This two-part study evaluated sleep-wake patterns and sleep disturbances in junior soldiers (JS) and infantry recruits in Autumn 2021 (study 1), and non-infantry recruits in spring 2022 (study 2). Methods: During studies 1 and 2, validated wearable technology combined with a sleep diary was used to quantify sleep-wake indices, sleep disturbances and perceptions of sleep quality. Sleep diary data was analysed descriptively. A series of repeated-measures ANOVAs examined differences in objective sleep-wake indices. Correlation analysis determined associations between time in bed (TIB) and total sleep time (TST). Results: Significant (p < 0.05) differences in most sleep-wake indices were observed between weeks of basic training for all cohorts. Strong positive correlations between TIB and TST were observed for each cohort across basic training (r = 0.681 - 0.970, p < 0.001), with longer TST associated with greater TIB. The mean±SD sleep duration (hours and mins [hm]) for JS (06:22 ± 00:27hm), non-infantry (05:41 ± 00:47hm) and infantry (05:46 ± 00:34hm) recruits across basic training was consistently below national recommendations. The mean±SD bed and wake times for JS (bedtime: 23:01 ± 00:32hm; awake: 05:34 ± 00:10hm), non-infantry (bedtime: 23:38 ± 01:09hm; awake: 04:47 ± 00:58hm), and infantry (bedtime: 23:13 ± 00:29hm; awake: 05:38 ± 00:26hm) recruits varied across weeks of basic training, with over 80% reporting "fairly bad" or "very bad" sleep quality and frequent periods of "dozing off" during daytime activity. The most commonly reported sleep disturbing factors identified during basic training involved: late-night military admin (e.g., ironing, boot cleaning, kit set up etc), early morning wake times, extraneous noise, light and hot room temperatures within the primary sleeping environment, bed/mattress discomfort, muscle soreness and feelings of stress and anxiety. Discussion/Conclusion: Our findings contribute to the existing evidence that long-term sleep loss is pervasive during initial military training programmes. The average sleep durations indicate chronic and unrecoverable sleep loss which would be expected to significantly impair physical and cognitive military performance, and increase the risk of injury, illness and attrition rates during basic training. Changes in the design and scheduling of basic training programmes to enable, at the least, minimum sleep recommendations to be met, and to improve sleep hygiene in the primary sleeping environment are warranted.

The Consequences of Anthropomorphic and Teleological Beliefs in a Global Pandemic.

To describe something in terms of its purpose or function is to describe its teleology. Previous studies have found that teleological beliefs are positively related to anthropomorphism, and that anthropomorphism decreases the perceived unpredictability of non-human agents. In the current study, we explore these relationships using the highly salient example of beliefs about the coronavirus pandemic. Results showed that both anthropomorphism and teleology were negatively associated with perceived uncertainty and threat, and positively associated with self-reported behavioural change in response to the pandemic. These findings suggest that highly anthropomorphic and teleological individuals may view coronavirus as agentive and goal-directed. While anthropomorphic and teleological beliefs may facilitate behavioural change in response to the pandemic, we also found that the associated reduction in uncertainty and threat may be detrimental to behavioural change. We discuss the implications of these findings for messaging about global events more broadly.

Pre-sleep protein supplementation does not improve performance, body composition, and recovery in British Army recruits (part 1).

Dietary protein is crucial for optimising physical training adaptations such as muscular strength and mass, which are key aims for athletic populations, including British Army recruits. New recruits fail to meet the recommended protein intake during basic training (BT), with negligible amounts consumed in the evening. This study assessed the influence of a daily bolus of protein prior to sleep on performance adaptations, body composition and recovery in British Army recruits. 99 men and 23 women [mean ± standard deviation (SD): age: 21.3 ± 3.5 years, height: 174.8 ± 8.4 cm, body mass 75.4 ± 12.2 kg] were randomised into a dietary control (CON), carbohydrate placebo (PLA), moderate (20 g) protein (MOD) or high (60 g) protein (HIGH) supplementation group. Supplements were isocaloric and were consumed on weekday evenings between 2000 and 2100 for 12 weeks during BT. Performance tests (mid-thigh pull, medicine ball throw, 2 km run time, maximal push-up, and maximal vertical jump) and body composition were assessed at the start and end of BT. Dietary intake, energy expenditure, salivary hormones, urinary nitrogen balance, perceived muscle soreness, rating of perceived exertion, mood, and fatigue were assessed at the start, middle and end of BT. Protein supplementation increased protein intake in HIGH (2.16 ± 0.50 g⸱kg-1⸱day-1) and MOD (1.71 ± 0.48 g⸱kg-1⸱day-1) compared to CON (1.17 ± 0.24 g⸱kg-1⸱day-1) and PLA (1.31 ± 0.29 g⸱kg-1⸱day-1; p < 0.001). Despite this, there was no impact of supplementation on mid-thigh pull performance (CON = 7 ± 19%, PLA = 7 ± 19%, MOD = 0 ± 16%, and HIGH = 4 ± 14%; p = 0.554) or any other performance measures (p > 0.05). Fat-free mass changes were also similar between groups (CON = 4 ± 3%, PLA = 4 ± 4%, MOD = 3 ± 3%, HIGH = 5 ± 4%, p = 0.959). There was no impact of protein supplementation on any other body composition or recovery measure. We conclude no benefits of pre-bed protein supplementation to improve performance, body composition and recovery during BT. It is possible the training stimulus was great enough, limiting the impact of protein supplementation. However, the high degree of inter-participant variability suggests an individualised use of protein supplementation should be explored, particularly in those who consume sub-optimal (<1.6 g⸱kg-1⸱day-1) habitual amounts of protein. Clinical trial registration: The study was registered with ClinicalTrials.gov, U.S. national institutes (identifier: NCT05998590).

Pre-sleep protein supplementation does not improve recovery from load carriage in British Army recruits (part 2).

British Army basic training (BT) is physically demanding with new recruits completing multiple bouts of physical activity each day with limited recovery. Load carriage is one of the most physically demanding BT activities and has been shown to induce acute exercise-induced muscle damage (EIMD) and impair muscle function. Protein supplementation can accelerate muscle recovery by attenuating EIMD and muscle function loss. This study investigated the impact of an additional daily bolus of protein prior to sleep throughout training on acute muscle recovery following a load carriage test in British Army recruits. Ninety nine men and 23 women (mean ± SD: age: 21.3 ± 3.5 yrs., height: 174.8 ± 8.4 cm, body mass 75.4 ± 12.2 kg) were randomized to dietary control (CON), carbohydrate placebo (PLA), moderate (20 g; MOD) or high (60 g; HIGH) protein supplementation. Muscle function (maximal jump height), perceived muscle soreness and urinary markers of muscle damage were assessed before (PRE), immediately post (POST), 24-h post (24 h-POST) and 40-h post (40 h-POST) a load carriage test. There was no impact of supplementation on muscle function at POST (p = 0.752) or 40 h-POST (p = 0.989) load carriage but jump height was greater in PLA compared to HIGH at 24 h-POST (p = 0.037). There was no impact of protein supplementation on muscle soreness POST (p = 0.605), 24 h-POST (p = 0.182) or 40 h-POST (p = 0.333). All groups had increased concentrations of urinary myoglobin and 3-methylhistidine, but there was no statistical difference between groups at any timepoint (p > 0.05). We conclude that pre-sleep protein supplementation does not accelerate acute muscle recovery following load carriage in British Army recruits during basic training. The data suggests that consuming additional energy in the form of CHO or protein was beneficial at attenuating EIMD, although it is acknowledged there were no statistical differences between groups. Although EIMD did occur as indicated by elevated urinary muscle damage markers, it is likely that the load carriage test was not arduous enough to reduce muscle function, limiting the impact of protein supplementation. Practically, protein supplementation above protein intakes of 1.2 g⸱kg-1⸱day-1 following load carriage over similar distances (4 km) and carrying similar loads (15-20 kg) does not appear to be warranted.

Eye Movements, Pupil Dilation, and Conflict Detection in Reasoning: Exploring the Evidence for Intuitive Logic.

A controversial claim in recent dual process accounts of reasoning is that intuitive processes not only lead to bias but are also sensitive to the logical status of an argument. The intuitive logic hypothesis draws upon evidence that reasoners take longer and are less confident on belief-logic conflict problems, irrespective of whether they give the correct logical response. In this paper, we examine conflict detection under conditions in which participants are asked to either judge the logical validity or believability of a presented conclusion, accompanied by measures of eye movement and pupil dilation. The findings show an effect of conflict, under both types of instruction, on accuracy, latency, gaze shifts, and pupil dilation. Importantly, these effects extend to conflict trials in which participants give a belief-based response (incorrectly under logic instructions or correctly under belief instructions) demonstrating both behavioral and physiological evidence in support of the logical intuition hypothesis.

The effect of sex, stature, and limb length on the preferred walk-to-run transition speed.

BACKGROUND: The preferred walk-to-run transition speed (PTS) for healthy adults is approximately 2 m∙s-1, however, PTS is influenced by anthropometric factors. Yet despite known sex differences in anthropometrics, studies have reported no sex differences in PTS. RESEARCH QUESTION: Do stature and limb length affect PTS in the same way for both male and female healthy adults? METHODS: Thirty-seven (19 female) non-injured adults volunteered for this study. Participants completed a walk-to-run transition protocol, where the treadmill speed was increased from 1.2 m∙s-1 to 2.2 m∙s-1, in increments of 0.1 m∙s-1 every two minutes. An independent t-test compared PTS between sexes. Multiple regression analysis determined the effect of sex and stature and sex and limb length on PTS. RESULTS: Female participants transitioned at a lower PTS than male participants (1.8 (0.2) m∙s-1 versus 1.9 (0.1) m∙s-1; p ≤ 0.026). Sex and stature explained 19% of the variance in PTS, while sex and limb length explained 21% of the variance. Including interactions increased the variance explained by 23% and 2% for sex and stature and sex and limb length, respectively. The significant interaction between sex and stature showed PTS was inversely proportional to stature for male participants but directly proportional for female participants. SIGNIFICANCE: These findings suggest that the extent to which stature and limb length influence the preferred transition speed may differ between sexes.

Genetic architecture of a composite beef cattle population.

Composite breeds are widely used in the beef industry. Composites allow producers to combine desirable traits from the progenitor breeds and simplify herd management, without repeated crossbreeding and maintenance of purebreds. In this study, genomic information was used to evaluate the genetic composition and characteristics of a three-breed beef cattle composite. This composite population referred to as Composite Gene Combination (CGC) consisted of 50% Red Angus, 25% Charolais, and 25% Tarentaise. A total of 248 animals were used in this study: CGC (n = 79), Red Angus (n = 61), Charolais (n = 79), and Tarentaise (n = 29). All animals were genotyped with 777k HD panel. Principal component and ADMIXTURE analyses were carried out to evaluate the genetic structure of CGC animals. The ADMIXTURE revealed the proportion of Tarentaise increased to approximately 57%, whereas Charolais decreased to approximately 5% and Red Angus decreased to 38% across generations. To evaluate these changes in the genomic composition across different breeds and in CGC across generations, runs of homozygosity (ROH) were conducted. This analysis showed Red Angus to have the highest total length of ROH segments per animal with a mean of 349.92 Mb and lowest in CGC with a mean of 141.10 Mb. Furthermore, it showed the formation of new haplotypes in CGC around the sixth generation. Selection signatures were evaluated through Fst and HapFlk analyses. Several selection sweeps in CGC were identified especially in chromosomes 5 and 14 which have previously been reported to be associated with coat color and growth traits. The study supports our previous findings that progenitor combinations are not stable over generations and that either direct or natural selection plays a role in modifying the progenitor proportions. Furthermore, the results showed that Tarentaise contributed useful attributes to the composite in a cool semi-arid environment and suggests a re-exploration of this breed's role may be warranted.

Composite breeds are commonly used in the U.S. beef industry since they provide producers with benefits such as breed complementarity and retained heterosis. However, cattle composite genomes are not well characterized. Therefore, in this study, genomic information was used to evaluate the genetic composition and characteristics of a three-breed composite (50% Red Angus, 25% Charolais, and 25% Tarentaise). The analysis showed an increase in the proportion of Tarentaise to approximately 57%, whereas Charolais decreased to approximately 5% and Red Angus decreased to 38%. Furthermore, new genome segments formed around the sixth generation. These changes show that progenitor breed proportions are not stable over generations and that either direct or natural selection plays a role in modifying the proportions. The increase in Tarentaise proportion suggests useful attributes to the composite in a cool semi-arid environment.

Eye tracking and the cognitive reflection test: Evidence for intuitive correct responding and uncertain heuristic responding.

The Cognitive Reflection Test (CRT) has been used in thousands of studies across several fields of behavioural research. The CRT has fascinated scholars because it commonly elicits incorrect answers despite most respondents possessing the necessary knowledge to reach the correct answer. Traditional interpretations of CRT performance asserted that correct responding was the result of corrective reasoning involving the inhibition and correction of the incorrect response and incorrect responding was an indication of miserly thinking without feelings of uncertainty. Recently, however, these assertions have been challenged. We extend this work by employing novel eye-tracking techniques to examine whether people use corrective cognitive pathways to reach correct solutions, and whether heuristic respondents demonstrate gaze-based signs of uncertainty. Eye movements suggest that correct responding on the CRT is the result of intuitive not corrective cognitive pathways, and that heuristic respondents show signs of gaze-based uncertainty.

Components of the insulin-like growth factor system in in vivo - and in vitro-derived fetuses of cattle, and the association with growth and development.

This experiment was designed to study mechanisms affecting growth of in vivo-derived (IVD) and in vitro-produced (IVP) fetuses of cattle. Day-7 IVD or IVP cattle blastocysts were transferred to recipients, with pregnant females being slaughtered on Days 90 or 180 of gestation or allowed to undergo parturition. Uteri and contents were dissected and physically measured, and maternal and fetal plasma and amniotic and allantoic fluids were collected for IGF-1 and IGF-2 determinations, and IGFBP profile characterization. Transcripts for IGF-1 and IGF-2 mRNA in placental and fetal tissues, and IGF-1r and IGF-2r in placentomes were determined. There was a greater fetal weight in the IVP group, which was associated with greater IGF-1 and IGF-2 concentrations in maternal circulation, and changes in IGFBP profiles within fetal fluids. Day-90 IVP-derived fetuses were longer, had greater organ weights, larger placentomes, less placentome IGF-2r mRNA transcript, and greater maternal IGF-1 and IGF-2 concentrations than controls. On Day 180 and at parturition tissues from IVP-derived fetuses/calves were from larger uteri, with larger placentomes/fetal membranes, fetuses/calves weighed more, had greater fetal hepatic IGF-2 mRNA transcript, had less fetal plasma IGF-1 and greater allantoic IGF-2 concentrations, greater and lesser IGFBP activities in the allantoic and amniotic fluids, respectively, and greater glucose and fructose accumulation in fetal fluids. Components of the IGF system were differentially regulated not only according to the gestation period (Days 90 or 180) and fluid type (maternal or fetal plasma, amniotic or allantoic fluids), but also based on conceptus origin (IVP or IVD) in cattle.

The design stance, intentional stance, and teleological beliefs about biological and nonbiological natural entities.

Teleology involves an appeal to function to explain why things are the way they are. Among scientists and philosophers, teleological explanations are widely accepted for human-made artifacts and biological traits, yet controversial for biological and nonbiological natural entities. Prior research shows a positive relationship between religiosity and acceptance of such controversial teleological explanations. Across three large online studies, we show that the relationship between religiosity and teleological acceptance cannot be explained by acceptance of objectively false explanations. Furthermore, we show that anthropomorphism and a belief in supernatural agents each independently predict teleological acceptance. In contrast, the tendency to inhibit intuitively appealing, yet incorrect responses to simple reasoning problems was associated with lower teleological acceptance. These results provide strong support for an intention-based account of teleology, and further contribute to the existing literature which situates teleological reasoning within a dual-process framework. Several avenues of future research are discussed, including the need to dissociate implicit and explicit measures of teleological belief, and the need for a greater focus on cross-cultural variation in teleological beliefs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Teleology and the intentions of supernatural agents.

Teleological beliefs about the natural world often exist implicitly, and there is a positive relationship between teleological endorsement and belief in supernatural agents. In the current study, participants judged a series of scientifically unwarranted teleological explanations of biological organisms and natural non-living objects, under speeded or un-speeded instructions. After controlling for belief in the existence of supernatural agents, rates of implicit (speeded) and explicit (un-speeded) teleological endorsement were moderated by the belief that supernatural agents intentionally interact with the world. Amongst non-religious individuals, rates of implicit endorsement were significantly higher than explicit endorsement, whereas for highly religious individuals the difference was non-significant. This interaction was driven predominantly by explanations of natural non-living objects. These results are consistent with an intention-based theory of teleology, and help to reconcile the finding of a positive relationship between teleological endorsement and belief in supernatural agents, with the those of an enduring teleological bias.

Multigenerational Effects.

Environmental influences resulting in epigenetic mediation of gene expression can affect multiple generations via direct effect (first generation); direct or maternally mediated effects on the fetus (second generation), or gonadal cell lines of the fetus (third generation) when pregnant animals are exposed to the stimuli; and through generational inheritance. The cumulative effects are rapid changes in phenotypic characteristics of the population when compared with rate of phenotypic change from genetic selection. With extensive data collection, significant potential exists to propagate desired characteristics in the livestock industry through epigenetic pathways.

Developmental and reproductive characteristics of beef heifers classified by number of estrous cycles experienced by start of first breeding.

A retrospective analysis was conducted to evaluate the effect of number of estrous cycles exhibited before breeding on growth and reproductive performance of replacement beef heifers fed ad-libitum or restricted by 20% less than ad-libitum during postweaning development over a 9-yr period. Progesterone concentration in blood samples collected at 9- to 11-d intervals were used to assign heifers into groups by number of estrous cycles exhibited before the start of breeding: 0 (nonpubertal; n = 395), 1 (n = 205), 2 (n = 211), 3 (n = 116), or >3 (n = 249). Heifers (P < 0.01) in the 0 cycle group were born 6 d later than the 1, 2, or 3 cycle groups, which were born 4 d later (P < 0.01) than the >3 cycle group. Weight of heifers at birth decreased (P < 0.05) as the number of cycles increased. Weaning weight and ultrasound measures of loin area and fat thickness over the loin at 1 yr age increased as the number of cycles increased (P < 0.01). Postwean weight gain, hip height at 1 yr age, and weights from the start of breeding through precalving increased with cycle numbers in a quadratic fashion (P < 0.02) and were greater (P < 0.05) in ad-libitum than restricted-fed heifers. Pregnancy rate in the 0 cycle group was lower (84%; P < 0.05) than the 1 (90%) or >3 (94%) estrous cycles groups and tended to differ (P < 0.1) from the 2 (88%) and 3 (89%) estrous cycle groups. Interval from the start of breeding to calving was 3 to 5 d longer (P < 0.05) for the 0 cycle group (300 ± 1 d) than other groups. Proportion of heifers calving in the first 21 d was less (P < 0.05) in the 0 or 1 cycle groups than other groups. Pregnancy rates of 2-yr-old cows (n = 898) were lowest (P < 0.05) for the 0 (73%) and 2 (79%) estrous cycle groups than the 1 (85%), 3 (90%), or >3 (92%) estrous cycle groups. Restricted level of feeding during postweaning development resulted in greater (P < 0.05) proportion of heifers in 0 cycle group and lower (P < 0.05) proportion in >3 cycle group, but reproductive performance was not influenced (P > 0.1) by level of feeding or interaction of feeding and estrous cycle grouping. In summary, date of birth and rate of physical maturation (weight, height, and fat deposition) were associated with timing of puberty. Pregnancy rate was greater in heifers that exhibited estrus before the start of breeding, but did not improve from having more than one estrous cycle. Proportion conceiving early was greater for heifers having two or more cycles before breeding.

Two alternative approaches to access mixed hydride-amido zinc complexes: synthetic, structural and solution implications.

Using bis(amide) Zn(HMDS)2 (HMDS = 1,1,1,3,3,3-hexamethyldisilazide) as a precursor, this study explores the synthesis of N-heterocyclic carbene stabilized mixed amido-hydride zinc complexes using two alternative hydride sources, namely dimethylamine borane (DMAB) and phenylsilane PhSiH3. Hydride-rich zinc cluster Zn4(HMDS)2H6·2IPr () (IPr = 1,3-bis(2,6-di-isopropylphenyl)imidazol-2-ylidene), which can be envisaged as a co-complex of IPr·ZnH2 and (HMDS)ZnH, is obtained when DMAB is employed, with the concomitant formation of heteroleptic bis(amido)borane [HB(NMe2)(HMDS)] and H2 evolution. NMR studies in d8-THF show that although the bulky carbene IPr does not bind to the zinc bis(amide), its presence in the reaction media is required in order to stabilise . Reactions using the slightly less sterically demanding NHC IXy (IXy = 1,3-bis-(2,6-dimethylphenyl)imidazol-2-ylidene) led to the isolation and structural elucidation of the carbene adduct Zn(HMDS)2·IXy (). Contrastingly, mixtures of equimolar amounts of PhSiH3 and the zinc bis(amide) (60 °C, 3 h, hexane) afforded monomeric heteroleptic hydride (HMDS)ZnH·IPr (). NMR studies, including DOSY experiments, revealed that while the integrity of is retained in polar d8-THF solutions, in lower polarity C6D6 it displays a much more complex solution behaviour, being in equilibrium with the homoleptic species ZnH2·IPr, Zn(HMDS)2 and IPr.

Predicting low back pain outcome following rehabilitation for low back pain.

BACKGROUND: Psychosocial factors are known to play a key role in determining the progress of back pain patients. However, it is not known whether these factors are applicable to military personnel, who tend to be fitter than the general population. OBJECTIVE: The aim was to identify physical and psychological predictors in a prospective study of the outcome of back pain rehabilitation over 6 months and a longer follow-up time of between 15 and 32 months. METHODS: Two hundred and fifty military personnel reporting for a residential rehabilitation programme completed a battery of physical and psychological tests. The physical tests included 800 m run time and the Biering-Sorensen test. The psychological/psychosocial measures included items on fear avoidance, self efficacy, anxiety and depression and occupational psychosocial factors such as job satisfaction. RESULTS: Self efficacy and 800 m run time predicted self-reported functional ability at 6 months and medical discharge/return to full fitness at 15­32 months. Patients with 800 m run times of more than 3 minutes 31 seconds had a four times greater chance of medical discharge from the Armed forces. CONCLUSIONS: Eight hundred metre run time and self-efficacy were independent predictors of both self-reported functional ability at 6 months and return to full fitness/medical discharge at 15­32 months. Self-efficacy also predicted 40% of the variance in the intensity of back pain and 10% of other non-back pain. Rehabilitation should include greater emphasis on physical fitness and on improving self-efficacy.

Outcomes of surgery for chronic exertional compartment syndrome in a military population.

AIM: To determine the outcome following fasciectomy for chronic exertional compartment syndrome (CECS) in the UK military, and the association between presurgical intramuscular pressure (IMP) and outcome. METHODS: All patients who underwent fasciectomy for anterior CECS were identified between 2007 and 2010. Presurgery and postsurgery military medical grading for leg function was extracted from the medical records system. The Wilcoxon signed-rank test compared grades before and after surgery. Spearman's rank correlation examined the relationship between IMP and outcome. RESULTS: Presurgery and postsurgery grading was available for 63% of patients. These patients had significantly better leg function after surgery (Z=-3.63, p<0.001). Of these, 49% improved by at least one grade, 36% showed no improvement in grading and 15% had a poorer outcome. There were no significant correlations between IMP and outcome. CONCLUSIONS: A large proportion of patients do not return to full fitness following fasciectomy in the military population. This is in line with a recent study in the US military, but conflicts with most civilian reports. The reasons for these differences are not clear. Furthermore, the lack of a relationship between IMP and outcome questions the role of pressure in this condition. These results suggest that the role of postoperative rehabilitation protocols and other conservative options should be explored.

Intramuscular compartment pressure measurement in chronic exertional compartment syndrome: new and improved diagnostic criteria.

BACKGROUND: Patients with chronic exertional compartment syndrome (CECS) have pain during exercise that subsides with rest. Diagnosis is usually confirmed by intramuscular compartment pressure (IMCP) measurement. Controversy exists regarding the accuracy of existing diagnostic criteria. PURPOSE: (1) To compare dynamic IMCP measurement and anthropometric factors between patients with CECS and asymptomatic controls and (2) to establish the diagnostic utility of dynamic IMCP measurement. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: A total of 40 men aged 21 to 40 years were included in the study: 20 with symptoms of CECS of the anterior compartment and 20 asymptomatic controls. Diagnoses other than CECS were excluded with rigorous inclusion criteria and magnetic resonance imaging. The IMCP was measured continuously before, during, and after participants exercised on a treadmill, wearing identical footwear and carrying a 15-kg load. RESULTS: Pain experienced by study subjects increased incrementally as the study progressed (P < .001). Pain levels experienced by the case group during each phase of the exercise were significantly different (P = .021). Subjects had higher IMCP immediately upon standing at rest compared with controls (23.8 mm Hg [controls] vs 35.5 mm Hg [subjects]; P = .006). This relationship persisted throughout the exercise protocol, with the greatest difference corresponding to the period of maximal tolerable pain (68.7 mm Hg [controls] vs 114 mm Hg [subjects]; P < .001). Sensitivity and specificity were consistently higher than the existing criteria with improved diagnostic value (sensitivity = 63%, specificity = 95%; likelihood ratio = 12.5 [95% CI, 3.2-49]). CONCLUSION: Anterior compartment IMCP is elevated immediately upon standing at rest in subjects with CECS. In patients with symptoms consistent with CECS, diagnostic utility of IMCP measurement is improved when measured continuously during exercise. A cutoff of 105 mm Hg in phase 2 provides better diagnostic accuracy than do the Pedowitz criteria of 30 mm Hg and 20 mm Hg at 1 and 5 minutes after exercise, respectively.

A comparison of pain levels after the Biering-Sorensen and the modified 20-metre shuttle test in patients with chronic low back pain.

BACKGROUND AND OBJECTIVE: The Biering-Sorensen Test (BST) is a useful and well validated assessment tool in patients with chronic lumbar pain. However there is sometimes concern that it may lead to an unwarranted increase in pain. This study compared pain levels before and after the BST against a currently accepted functional assessment tool- the modified 20-metre shuttle test (MST)- in military patients with chronic low back pain. METHODS: 56 patients with non-specific lumbar pain of more than three months duration were tested on admission and discharge from a three week in-patient rehabilitation programme using the BST and the MST. A questionnaire was used to assess pain levels before and after both tests on admission and discharge from the group. The BST was carried out before the MST, with a time delay of 30-60 minutes. RESULTS: There were significant increases in pain immediately after both the MST and the BST (range of mean increase: 2.2 to 3.2 points, p< 0.001). The mean absolute levels of pain after the BST on admission and discharge were 0.26 and 0.80 more than the levels after the MST. The mean increases were 0.36 and 1.16 more after the BST compared to that after the MST. Pain levels returned to normal within 60 minutes of the BST being completed. CONCLUSION: Using either comparison method, although the initial increases after the BST were slightly more, the amounts were comparable and much less that the minimal clinically important difference in pain which is 1.5.

The functional activity assessment: a validated PROM, unreliable in the hands of clinicians.

OBJECTIVES: To examine the validity of the clinician-assessed version of a military occupational outcome measure (the functional activity assessment; FAA) and to compare the validity with the self-assessed version. METHODS: The relationship between the clinician-assessed FAA and the SF-36 and Physical Workload Questionnaire was examined in 192 service personnel with musculoskeletal injuries. Concurrent validity was checked by comparing actual medical category with the FAA. RESULTS: Clinicians preferentially chose an FAA grade of 2 (56% of all grades). The clinician-assessed FAA was significantly correlated with all measured variables in the expected direction. The performance of the regression models did not fully support construct validity. The discriminative ability of the models was poor. CONCLUSIONS: The clinician-assessed FAA is a less valid measure than its self-assessed counterpart. Use of the patient-reported FAA outcome measure is recommended.

Effect of reduced heifer nutrition during in utero and post-weaning development on glucose and acetate kinetics.

Energetic efficiency was evaluated in composite bred heifers born from dams receiving 1·8 or 1·2 kg/d winter supplementation for approximately 80 d before parturition. Heifers were then developed post-weaning and randomly assigned to heifer development treatments of either control (100 %; ad libitum; n 8/year) or restricted (80 %; fed 80 % of supplementation fed to controls adjusted to a common body weight: n 8/year) in a 2-year study. A glucose tolerance test (GTT) and acetate irreversible loss test (AILT) were administered to heifers at the termination of a 140 d development period when the heifers were approximately 403 d of age and consumed a silage-based diet, and again at 940 d of age when pregnant with their second calf and grazing dormant forage. No differences were measured (P>0·08) for dam winter nutrition or heifer development treatment for baseline serum metabolites or measures in either the GTT or the AILT. However, changes in baseline serum concentrations (P>0·05) were different between metabolic challenges, which occurred at different stages of development. No difference in acetate disappearance (P = 0·18) and half-life (P = 0·66) was measured between the two metabolic challenges. A trend for glucose half-life to be shorter in heifers born from dams receiving in utero winter treatments that supplied 1·2 kg/d of winter supplementation was observed (P = 0·083). Heifers developed with lower total DM intake during a 140 d development period had similar glucose and acetate incorporation rates as ad libitum-fed heifers when evaluated at two different production stages.