Comparison of the physical activity levels between shift workers and non-shift workers in a large-scale cross-sectional study in Iran.

BACKGROUND: Shift work has been related to adverse health outcomes that can partially be attributed to physical inactivity. However, our knowledge of the influence of shift work on physical activity and sedentary behavior is inconclusive. Therefore, this study aimed to assess physical activity levels among shift and non-shift workers among a sample of Iranian adults. METHODS: Baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort study were used. All participants of RaNCD except those excluded due to unemployment or considerable disability were included in the study. We evaluated participants' physical activity levels using the PERSIAN cohort questionnaire and examined its associations with being a shift worker. RESULTS: A total of 4695 participants with a mean age of 46.1 (SD = 7.74) were included in the study. In total, 1108 (23.6%) participants were shift workers, 1420 (30.2%) had insufficient physical activity levels, and 4283 (91.2%) were male. The prevalence of physical inactivity was significantly lower among shift workers compared to non-shift workers (21% vs. 33.1%, p < 0.001). Multiple backward stepwise binary logistic regression tests indicated that being a shift worker was significantly associated with a lower chance of having insufficient physical activity levels (OR = 0.77, 95% CI = 0.65-0.92, p = 0.003). CONCLUSIONS: The prevalence of insufficient physical activity was higher among non-shift workers than shift workers in our study. By providing the factors associated with insufficient physical activity among the workers in a region of Iran, the current study findings might help policymakers target groups at higher risk of physical activity in Iran and design interventions to improve physical activity, especially among non-shift workers.

The impacts of vorinostat on NADPH oxidase and mitochondrial biogenesis gene expression in the heart of mice model of depression.

The comorbidity of depression and high risk of cardiovascular diseases (CVD) have been reported as major health problems. Our previous study confirmed that fluoxetine (FLX) therapy had a significant influence on brain function but not on the heart in depression. In the present study, suberoyanilide hydroxamic acid (SAHA) was proposed as another therapeutic candidate for treatment of depression comorbid CVD in maternal separation model, following behavioral analyses and gene expression level in the heart. Our data demonstrated that SAHA significantly attenuates the NOX-4 gene expression level in treated mice with SAHA and FLX without significant change in NOX-2 expression level. SAHA decreased the gene expression level of peroxisome proliferator-activated receptor-gamma coactivator (PGC-1α) and nuclear respiratory factors (Nrf2) in heart tissues of maternally separated mice. It supposed that non-effectiveness of FLX on mitochondrial biogenesis and NOX gene expression level in the heart of depressed patient can be related to recurrence of depression. It revealed that SAHA not only reversed the depressive-like behavior similar to our previous data but also recovered the heart mitochondrial function via effect on NOX-2, NOX-4, and mitochondrial biogenesis genes' (PGC-1α, Nrf-2, and peroxisome proliferator-activated receptor-α (PPAR-α)) expression levels. We suggest performing more studies to confirm SAHA as a therapeutic candidate in depression comorbid CVD.

Physical Inactivity and Food Insecurity Are Associated with Social Capital: A Large-Scale Population-Based Study in Tehran.

Background: There are limited studies on food security, physical activity, and social capital in the Iranian population. This study aimed to evaluate the social capital's associations with physical inactivity and food insecurity in a large-scale study in Iran, Urban HEART-2. Methods: This cross-sectional study was conducted in 22 districts of Tehran, the capital of Iran. Residents of Tehran who were 15 years or older were selected by a multi-stage, stratified, and random sampling method. Food insecurity and physical activity were evaluated using Household Food Security Scale and Global Physical Activity Questionnaire, respectively, and their associations with social capital were evaluated. Results: A total of 5030 individuals were included in this study, with 3139 (62.4%) males. The mean age of participants was 44.08 years (SD = 16.33, range = 15-90). Participation in social events (OR = 0.893, 95% CI = 0.819-0.974, P = 0.011), social network (OR = 0.849, 95% CI = 0.786, P < 0.001), and voluntary activities (OR = 0.865, 95% CI = 0.812-0.921, P < 0.001) were all negatively associated with food insecurity. Also, voluntary activities (OR = 0.823, 95% CI = 0.776-0.872, P < 0.001) and participation in the associations activities (OR = 0.665, 95% CI = 0.582-0.759, P < 0.001) were negatively associated with physical inactivity. Conclusion: The prevalence of food insecurity and physical inactivity is relatively high among Tehran residents. As a factor affecting the physical activity and food security, social capital can be targeted in interventions to improve physical activity and food security among Iranians.

Synthesis and characterization of thermosensitive hydrogel based on quaternized chitosan for intranasal delivery of insulin.

Nasal administration is a form of systemic administration in which drugs are insufflated through the nasal cavity. Steroids, nicotine replacement, antimigraine drugs, and peptide drugs are examples of the available systematically active drugs as nasal sprays. For diabetic patients who need to use insulin daily, the nasal pathway can be used as an alternative to subcutaneous injection. In this regard, intranasal insulin delivery as a user-friendly and systemic administration has recently attracted more attention. In this study, a novel formulation consists of chitosan, chitosan quaternary ammonium salt (HTCC), and gelatin (Gel) was proposed and examined as a feasible carrier for intranasal insulin administration. First, the optimization of the chitosan-HTCC hydrogel combination has done. Afterward, Gel with various amounts blended with the chitosan-HTCC optimized samples. In the next step, swelling rate, gelation time, degradation, adhesion, and other mechanical, chemical, and biological properties of the hydrogels were studied. Finally, insulin in clinical formulation and dosage was blended with optimized thermosensitive hydrogel and the release procedure of insulin was studied with electrochemiluminescence technique. The optimal formulation (consisted of 2 wt% chitosan, 1 wt% HTCC, and 0.5 wt% Gel) showed low gelation time, uniform pore structure, and the desirable swelling rate, which were resulted in the adequate encapsulation and prolonged release of insulin in 24 H. The optimal samples released 65% of the total amount of insulin in the first 24 H, which is favorable for this study.

Comparison of the effects of the Feldenkrais method versus core stability exercise in the management of chronic low back pain: a randomised control trial.

OBJECTIVE: To investigate the effect of the Feldenkrais method versus core stability exercises on pain, disability, quality of life and interoceptive awareness in patients with chronic non-specific low back pain. DESIGN: A single-blinded, randomised, controlled trial. SETTING: Outpatient, sports medicine clinic of Mazandaran medical university. PARTICIPANTS: Sixty patients with chronic non-specific low back pain randomised equally into the Feldenkrais method versus core stability exercises groups. INTERVENTION: Intervention group received Feldenkrais method consisting of training theoretical content and supervised exercise therapy two sessions per week for five weeks. Control group received educational programme and home-based core stability exercises for five weeks. OUTCOME MEASURES: All patients were examined by World Health Organization's Quality of life Questionnaire, McGill Pain Questionnaire, Oswestry Disability Questionnaire and Multidimensional Assessment of Interoceptive Awareness Questionnaire. All outcomes were measured at baseline and the end of the intervention. RESULTS: There were statistically significant differences between groups for quality of life (P = 0.006, from 45.51 to 60.49), interoceptive awareness (P > 0.001, from 2.74 to 4.06) and disability (P = 0.021, from 27.17 to 14.5) in favour of the Feldenkrais method. McGill pain score significantly decreased in both the Feldenkrais (from 15.33 to 3.63) and control groups (from 13.17 to 4.17), but there were no between-groups differences (P = 0.16). CONCLUSION: Feldenkrais method intervention gave increased benefits in improving quality of life, improving interoceptive awareness and reducing disability index.

Synthesis, characterization, anti-proliferative properties and DNA binding of benzochromene derivatives: Increased Bax/Bcl-2 ratio and caspase-dependent apoptosis in colorectal cancer cell line.

3-Amino-1-aryl-1H-benzo[f]chromene-2-carbonitrile derivatives were synthesized from three-component reaction of arylaldehyde, malononitrile and 2-naphthol in the presence of 1, 4-bis(4-ferrocenylbutyl)piperazine as a new catalyst. Cytotoxic potencies of the compounds were tested on HT-29 cells. 3-Amino-1-(4-fluorophenyl)-1H-benzo[f]chromene-2-carbonitrile (4c) was more active among these compounds and was selected for further studies. Apoptosis was investigated by acridine orange/ethidium bromide (AO/EtBr) double staining and flow cytometry. The qRT-PCR was used to analyze the expression of pro- and anti-apoptotic genes. The binding attributes of 4c with calf thymus DNA (ctDNA) was examined using multi-spectroscopic measurements. We found that 4c had potent cytotoxic activity against HT-29 cells with an IC50 value of 60 µM through induction of cell cycle arrest in the sub-G1 phase and apoptosis. RT-PCR analysis demonstrated down-regulation of Bcl-2 expression, while the expression of Bax, caspase-3, -8 and -9 genes was up-regulated in HT-29 cells incubated with 4c compared with control cells. These studies revealed that 4c interacts with DNA through groove binding mode with the intrinsic binding constant (Kb) of 3 × 102 M-1. Thus, 4c is a valuable candidate for further evaluation as a new series of potent chemotherapeutic family in colon cancer treatment.

Evaluating the association between lifetime physical activity and oral squamous cell carcinoma: A case-control study.

PURPOSE: Oral cancers are the 6th most common malignancy worldwide and oral squamous cell carcinoma, comprises over 90% of oral cancers. This study investigates the relationship between physical activity level during the lifetime and oral squamous cell carcinoma risk. METHODS: 100 oral squamous cell carcinoma patients and 200 healthy individuals participated in this case-control study. Physical activity level was evaluated via the Lifetime Physical Activity Questionnaire. The occupational, household, and sports domains of lifetime physical activity were determined. Case and control groups' participants were matched in terms of sex, age, smoking, and alcohol consumption by the Frequency Matching Method. Mann-Whitney U Test was applied to compare physical activity levels between groups. RESULTS: The Body Mass Index was higher among cases compared with controls. The average amounts of lifetime physical activity among cases and controls were approximately identical. However, only a statistically significant difference between time spent on total lifetime physical activities and the oral squamous cell carcinoma risk was discovered. Moreover, there were no statistically significant odds ratios in examining the risk associated with each domain of activities. CONCLUSIONS: The total time spent on lifetime physical activity may decrease the risk of oral squamous cell carcinoma; However, the total level and intensity of lifetime physical activity are not significantly associated with the oral squamous cell carcinoma risk. Further studies are required in this field.

Increasing Burden of Upper-Extremity Fractures in the Middle East and North Africa (MENA): A 30-Year Analysis of the Epidemiology and Causes of Injuries.

BACKGROUND: Upper-extremity fractures (UEFs) account for a large proportion of bone fractures and are costly to both health and the economy. The fracture burden in the Middle East and North Africa (MENA) is influenced by the region's diverse cultural, economic, and political status. This study examined UEF epidemiology and causes across the MENA region and within the 21 MENA countries as categorized by the Global Burden of Disease (GBD) data set. METHODS: On the basis of GBD data, this study evaluated the epidemiology of UEFs from 1990 to 2019. The causes of injuries, incidence, number of years of healthy life lost due to disability (YLD), and their association with the Socio-demographic Index (SDI) were obtained and calculated for males and females in all age groups. RESULTS: From 1990 to 2019, the age-standardized incidence rate (ASIR) of UEFs in the MENA region increased by 2.33%, to 1,086.39 per 100,000 people, and the YLD rate increased 15.69%, to 9.17 per 100,000, opposing the global decreasing trends. Fractures of the radius and/or ulna had the highest ASIR (505.32 per 100,000) of all UEF types in 2019. The clavicle, scapula, and humerus had the highest increasing trend among the fracture sites. In 2019, Saudi Arabia had the highest ASIR of UEFs (2,296.93 per 100,000). Afghanistan had the highest age-standardized YLD rate due to UEFs (19.6 per 100,000) in 2019, with Syria (153.32%) and Iran (37.04%) experiencing the greatest increase and decrease, respectively, from 1990 to 2019. Falling was the leading cause of UEFs, accounting for 45.05% of incidence and 41.19% of YLD overall. CONCLUSIONS: Contrary to global trends, UEFs increased in the MENA region during the study period. Countries with higher fracture incidence and YLD should consider preventive and rehabilitation strategies.

Evaluation of the Effect of the Pre-Operative Exercise Training on Weight Loss, Quality of Life, and Cardiopulmonary Parameter in Bariatric Metabolic Surgery: A Systematic Review and Meta-Analysis.

The purpose of this study is to assess the impact of pre-surgery exercise training on cardiopulmonary fitness. Ten articles (six RCTs and four non-RCTs) involving 281 individuals were finally included in the synthesis. Regarding the effect on VO2 peak, overall standardized mean differences were 0.71 (95% CI, 0.31 to 1.11, n = 103) with heterogeneity (I2 = 0%, P = 0.49). For 6MWT, overall weighted mean differences (distance in meters) were 31.87 (95% CI, 27.84 to 35.89, n = 100) with heterogeneity (I2 = 0%, P = 0.96). Engaging in pre-bariatric metabolic surgery exercise training might improve anthropometric parameters and cardiopulmonary fitness with no significant changes in components of quality of life. However, considering high levels of heterogeneity, the results should be generalized cautiously.

Effects of aerobic exercise on blood pressure in patients with hypertension: a systematic review and dose-response meta-analysis of randomized trials.

We aimed to evaluate the dose-dependent effects of aerobic exercise on systolic (SBP) and diastolic blood pressure (DBP) and haemodynamic factors in adults with hypertension. PubMed, Scopus, and Web of Science were searched to April 2022 for randomized trials of aerobic exercise in adults with hypertension. We conducted a random-effects meta-analysis to estimate mean differences (MDs) and 95%CIs for each 30 min/week increase in aerobic exercise. The certainty of evidence was rated using the GRADE approach. The analysis of 34 trials with 1787 participants indicated that each 30 min/week aerobic exercise reduced SBP by 1.78 mmHg (95%CI: -2.22 to -1.33; n = 34, GRADE=low), DBP by 1.23 mmHg (95%CI: -1.53 to -0.93; n = 34, GRADE=moderate), resting heart rate (MD = -1.08 bpm, 95%CI: -1.46 to -0.71; n = 23, GRADE=low), and mean arterial pressure (MD = -1.37 mmHg, 95%CI: -1.80 to -0.93; n = 9, GRADE = low). A nonlinear dose-dependent decrement was seen on SBP and DBP, with the greatest decrement at 150 min/week (MD150 min/week = -7.23 mmHg, 95%CI: -9.08 to -5.39 for SBP and -5.58 mmHg, 95%CI: -6.90 to -4.27 for DBP). Aerobic exercise can lead to a large and clinically important reduction in blood pressure in a dose-dependent manner, with the greatest reduction at 150 min/week. The dose-dependent effects of aerobic exercise on systolic and diastolic blood pressure and haemodynamic factors in adults with hypertension.

Characteristics improvement of calcium hydroxide dental cement by hydroxyapatite nanoparticles. Part 1: formulation and microstructure.

Calcium hydroxide cement (CHC), which is a direct pulp-capping material, has been widely used for several decades. In spite of the well-known advantages of CHCs, they have some disadvantages as well, such as high solubility, no inherent adhesive qualities, and low mechanical strength. Previous studies were undertaken to improve these deficiencies by implementing changes to modify the conventional CHCs. The aim of the present research is to demonstrate the potential rectification of the aforementioned deficiencies of the commercially available CHCs by adding hydroxyapatite (HA) nanoparticles without lessening their advantages. Here, the synthesized HA nanoparticles were added into the CHCs in two different portions of 3 and 7 wt%. A scanning electron microscope was used to observe and analyze the microstructure, and X-ray energy dispersive analysis was used to analyze the elemental composition of the new CHCs. In addition, setting time, mechanical strength, pH, calcium (Ca) release, and antibacterial behavior were measured to assess how HA nanoparticles influence the characteristics of CHCs. The results showed that adding 3 wt% HA nanoparticles can optimally improve the mechanical strength of the cement and increase the Ca release rate as a mineralization promoter without reducing the antibacterial behavior.

In vitro safety assessment of alkyl lactate esters in human umbilical vein endothelial cells (HUVECs).

Safety assessment requires information on both the chronic and acute effects of chemicals. Chemical materials such as food additives have become one of the most critical and compelling issues in the continuing debate on food safety. Calcium lactate (CL) and Sodium lactate (SL) are approved chemicals used in various products. The present study, in vitro study, was designed to evaluate the cyto-genotoxicity effects of CL and SL on human umbilical vein endothelial cells (HUVECs). The cytotoxicity effect of these additives was determined by MTT and Annexin V-FITC apoptosis assays. Besides, genotoxicity parameters such as morphological change of DNA and DNA fragmentation were studied with DAPI staining and DNA ladder assays, respectively. The results showed that the growth of HUVECs decreased upon treatment with CL at higher concentrations, but SL did not significantly alter HUVECs cell number. Annexin V-FITC apoptosis assays revealed that CL could induce cell death based on necrosis rather than apoptosis. In SL, the early and late apoptosis was not considerable in treated cells. Exposure to CL and SL did not lead to morphological change and DNA fragmentation in the HUVECs cell line. Overall, it is concluded from these results that CL and SL have not been cytotoxic and genotoxic effects in low concentrations in human umbilical vein endothelial cells in vitro.

Association between physical activity and risk of COVID-19 infection or clinical outcomes of the patients with COVID-19: A systematic review and meta-analysis.

Objective: The COVID-19 pandemic has caused serious consequences for global health and economy. The important question is whether the level of physical activity might influence the risk of COVID-19 incidence or clinical outcomes, including the severity or mortality of infected patients. The objective of this systematic review and meta-analysis is to evaluate the association between sufficient physical activity and incidence, hospitalization, severity, recovery, and mortality of COVID-19. Methods: A systematic search of Web of Sciences, PubMed, and Scopus between December 2019 and November 2021 was conducted. Studies were screened based on the inclusion criteria, i.e. observational studies (case-control, prospective or retrospective longitudinal designs, and cross-sectional studies) which have determined the association of physical activity, exercise, sports participation, or sedentary behavior with COVID-19 incidence or outcomes, including mortality, severity, recovery and hospitalization in healthy population or population with any specific comorbidity. Results: Based on eligibility criteria, 27 articles were finally included in the qualitative synthesis. The meta-analysis of five studies evaluating the association of physical activity and COVID-19 mortality showed a weighted OR of OR of 0.61 (CI 95%: 0.50-0.75) with heterogeneity (I2 = 45.8%, P < 0.001) and in seven studies regarding physical activity and COVID-19 hospitalization, weighted OR was 0.541 (CI 95%: 0.491-0.595) with heterogeneity (I2 = 81.7%, P < 0.001). Conclusion: Participating in sufficient physical activity might decrease COVID-19 related COVID-19-related hospitalization and mortality. Developing programs to increase physical activity during the COVID-19 pandemic might be an appropriate health strategy.

Investigating the Relationship between Structural Features of Built Environment and Physical Activity using Geographic Information Systems (GIS).

Background: Built environment determinants of engaging in physical activity are dependent on the properties of societies. This study investigates the relationship between structural variables of the environment using geographic information systems (GIS) and the level of physical activity in 22 districts of Tehran. Methods: This cross-sectional study was based on Urban Health Equity Assessment and Response Tool (Urban HEART-2). Physical activity level was assessed via the Global Physical Activity Questionnaire (GPAQ). The characteristics of the neighborhood environment, including land use, street pattern, population density, and traffic, were determined via ArcGIS software. Walkability index (population density, street pattern, land use) was calculated to assess the effect of the main variables of living environment on physical activity level. Results: Among the built environmental variables, land use was associated with the total physical activity and travel-related physical activity level (r: 0.155, P value: 0.001, and r: 0.122, P value: 0.007, respectively). The walkability index indicated an association with the total physical activity level and travel-related physical activity level (r: 0.126, P value: 0.006, and r: 0.135, P value: 0.001, respectively). Higher levels of the walkability index were associated with an improved level of physical activity (OR: 2.04). Conclusions: Walkability index and land use positively correlate with total physical activity level, and providing action plans that improve walkability index and land use might lead to increased physical activity level.

Translation, Cross-Cultural Adaptation, and Validation of the Persian Version of the Lifetime Total Physical Activity Questionnaire.

BACKGROUND: This study aimed to translate and cross-culturally adapt the Lifetime Total Physical Activity Questionnaire (LTPAQ) for use in Persian-speaking countries as well as evaluate its validity and reliability. METHODS: There were 3 stages to this study. First, a forward-backward translation method was used to develop a Persian version of the LTPAQ. In the second stage, the Persian version of the LTPAQ was evaluated for its face validity and content validity. Finally, test-retest reliability and known-group validity were assessed. The LTPAQ has occupational and volunteer activities, including travel to work, exercise and sports, and household activities. Frequency, duration, and estimated metabolic costs of activities with light, moderate, and heavy intensities were used to calculate the metabolic equivalent of each domain during life (in metabolic equivalent-hour/week). Metabolic equivalents of each domain and in total were used to evaluate the reliability and validity of the questionnaire. RESULTS: In total, 60 people (41.7% females) with a mean age of 33.9 (SD = 11.5) years participated in this study. All domains showed excellent test-retest reliability (intraclass correlation coefficient > .9). All items had content validity indexes higher than 0.85. In addition, males had significantly higher physical activity levels than females (P = .022), indicating the known-group validity of the questionnaire. CONCLUSIONS: The LTPAQ was translated into Persian and trans-culturally adapted. This study indicates that the Persian version of the LTPAQ has adequate reliability and validity and can be utilized in future studies to assess physical activity in the Persian population.

The effect of exercise rehabilitation on COVID-19 outcomes: a systematic review of observational and intervention studies.

Purpose: Disturbance to physical and psychological characteristics among COVID-19 survivors are not uncommon complications. In the current systematic review, we aimed to investigate the role of exercise rehabilitation programs, either in acute or post-acute phase, on COVID-19 patients' outcomes. Methods: A systematic search was conducted in November 2021 of Web of Sciences, PubMed-Medline, Google Scholar, and Scopus. Observational and intervention studies on COVID-19-infected patients undergoing a rehabilitation program including any type of exercise were included if they reported physical or psychological factors as outcomes. The Cochrane risk of bias tool for randomized controlled trials and Joanna Briggs Institute (JBI) critical appraisal checklist were used by two independent reviewers. Results: A total number of 469, and 957 patients were included in 9 intervention studies, and 14 observational studies, respectively. Most factors reported by studies as outcomes fell in the categories of exercise capacity, respiratory function, as well as psychological aspects. The reported outcomes in almost all studies, disclosed the overall beneficial role of exercise rehabilitation in improving the outcomes. Conclusion: The current review demonstrated that exercise rehabilitation generally could have a beneficial role in improvement of both physical and psychological related outcomes. As the best onset time, and FITT components are not yet completely clear, further large, well-designed RCTs are suggested to provide details of exercise rehabilitation program.

Translation, Cross-Cultural Adaptation, and Validation of the Persian Version of Thailand Physical Activity Children Survey Questionnaire.

Background: According to the importance of physical activity in the child's physical and mental development and cognitive health, developing a valid, reliable, and comprehensive assessment tool for children's physical activity is mandated. The purpose of this study is the translation, cross-cultural adaptation, and validation of the Persian version of the Thailand Physical Activity Children Survey questionnaire to measure the level of physical activity in children aged between 6-9 years in Iran. Methods: This study consisted of three stages, first, the questionnaire translation into Persian language and modification of the sections according to the Iranian culture, then the evaluation of the questionnaire via a pilot study, and finally, assessing the reliability and validity of the tool. Participants of the pilot study were 250 healthy children, aged 6 to 9 years, meeting eligibility criteria, recruited through a stratified cluster sampling method from schools across Tehran. Results: The Persian version of the questionnaire demonstrated an acceptable content validity (Content Validity Index between 0.88-1). The test-retest reliability reported the Intra-Class Correlation coefficient in the acceptable range in all sections (between 0.71-1). Cronbach's alpha was reported 0.993, which indicated excellent internal consistency. Conclusions: According to the acceptable validity and reliability of the Persian version of the Thailand Physical Activity Children Survey for children aged 6-9 years, it is recommended in research and surveillance studies to determine the level of physical activity of children of that age group in Iran.

Conceptualization and development of a questionnaire to determine physical activity barriers.

PURPOSE: Considering the role of physical activity on public health and the high prevalence of physical inactivity worldwide, determining physical activity barriers is critical and will be a road map for future planning. This study aimed to develop a comprehensive questionnaire to determine physical activity barriers. METHODS: By reviewing previous studies, the main domains of the questionnaire were established. A physical activity expert interviewed 20 individuals aged 18 to 65 years. The results were evaluated by an expert panel for a content validity index. Face validity, test-retest reliability, and internal consistency were established on 204 individuals. RESULTS: The content validity index in all items was within the acceptable range (>0.85). Face validity was appropriate, and the misunderstanding index was < 20% in all items. Test-retest reliability in the final questionnaire in all items based on Cohen's kappa was > 0.20, indicating fair agreement. Internal consistency with Cronbach's alpha of 0.63 was within the acceptable range. CONCLUSION: The study revealed that the newly designed survey is valid, accurate, and reliable. The use of this comprehensive tool by policymakers would help them properly identify the perceived barriers, and thus perform better physical activity interventions as promotional health programs.

Aquatic Therapy for improving Lower Limbs Function in Post-stroke Survivors: A Systematic Review with Meta-Analysis.

BACKGROUND: Lower limb disability is common in chronic stroke patients, and aquatic therapy is one of the modalities used for the rehabilitation of these patients. OBJECTIVES: To summarize the evidence of the effects of aquatic therapy on lower limb disability compared to land-based exercises in post-stroke patients. METHODS: MEDLINE, PsycInfo, CENTRAL, SPORTDiscus, PEDro, PsycBITE, and OT Seeker were searched from inception to January 2019. The search included only randomized clinical trials. Two reviewers independently examined the full text and conducted study selection, data extraction, and quality assessment. Data synthesis was applied to summarize information from the included studies. The quantitative analysis incorporated fixed-effect models. RESULTS: Of the 150 studies identified in the initial search, 17 trials (629 participants) satisfied the eligibility criteria. Aquatic therapy improved balance based on the Berg Balance Scale (BBS) (standardized mean difference [SMD], 0.72; 95% confidence interval [CI], 0.50-0.94; I2 = 67%) compared with land-based exercises (control). Also, aquatic therapy had a small positive effect on walking speed (SMD, -0.45; 95% CI {-0.71 - (-0.19)}; I2 = 57%), based on the results of the 10-m walking test, compared to controls. Aquatic therapy had a small positive effect on mobility (based on Timed Up and Go), (SMD, -0.43; 95% CI {-0.7-(- 0.17)}; I2 = 71%) compared to land-based exercise (control). CONCLUSIONS: Aquatic therapy had a more positive effect on walking speed, balance, and mobility than land-based exercises. Further research is needed to confirm the clinical utility of aquatic therapy for patients following stroke in the long term.

COVID-19: insights into virus-receptor interactions.

The recent outbreak of Coronavirus Disease 2019 (COVID-19) calls for rapid mobilization of scientists to probe and explore solutions to this deadly disease. A limited understanding of the high transmissibility of SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) relative to other coronavirus strains guides a deeper investigation into the virus/receptor interactions. The cutting-edge studies in thermodynamic and kinetic properties of interactions such as protein-protein interplays have been reviewed in many modeling and analysis studies. Highlighting the thermodynamic assessments of biological interactions and emphasizing the boosted transmissibility of SARS-CoV-2 despite its high similarity in structure and sequence with other coronavirus strains is an important and highly valuable investigation that can lead scientists to discover analytical and fundamental approaches in studying virus's interactions. Accordingly, we have attempted to describe the crucial factors such as conformational changes and hydrophobicity particularities that influence on thermodynamic potentials in the SARS-COV-2 S-protein adsorption process. Discussing the thermodynamic potentials and the kinetics of the SARS-CoV-2 S-protein in its interaction with the ACE2 receptors of the host cell is a fundamental approach that would be extremely valuable in designing candidate pharmaceutical agents or exploring alternative treatments.