The role of area deprivation index in health care disruptions among cancer survivors during the SARS-CoV-2 pandemic.

OBJECTIVE: To examine the associations between demographic/medical and geographic factors with follow-up medical care and health-related quality of life (HRQoL) among cancer survivors during the SARS-CoV-2 pandemic. STUDY DESIGN: Cross-sectional survey. METHODS: An online survey was sent to cancer survivors between May 2020 and January 2021, exploring their experience with SARS-CoV-2, follow-up care, and HRQoL. PolicyMap was used to geocode home addresses. Both geographic and demographic/medical factors were examined for their associations with SARS-CoV-2 experience, follow-up care, and HRQoL (FACT-G7). RESULTS: Geographic data were available for 9651 participants. Patients living in the highest area deprivation index (ADI) neighborhoods (most deprived) had higher odds of avoiding in-person general (odds ratio [OR] = 7.20; 95% confidence interval [CI] = 2.79-18.60), cancer (OR = 8.47; 95% CI = 3.73-19.30), and emergency (OR = 14.2; 95% CI = 5.57-36.30) medical care, as well as lower odds of using telemedicine (OR = 0.61; 95% CI = 0.52-0.73) compared to the lowest ADI group. Race/ethnicity was not associated with follow-up care after controlling for ADI. The effect of ADI on HRQoL was generally in the expected direction, with higher ADI being associated with worse HRQoL. CONCLUSIONS: ADI influenced follow-up medical care more than age, race/ethnicity, or health insurance type. Healthcare providers and institutions should focus on decreasing barriers to in-person and telemedicine health care that disproportionally impact those living in more deprived communities, which are exacerbated by health care disruptions like those caused by the SARS-CoV-2 pandemic.

Suppression of a BAHD acyltransferase decreases p-coumaroyl on arabinoxylan and improves biomass digestibility in the model grass Setaria viridis.

Grass cell walls have hydroxycinnamic acids attached to arabinosyl residues of arabinoxylan (AX), and certain BAHD acyltransferases are involved in their addition. In this study, we characterized one of these BAHD genes in the cell wall of the model grass Setaria viridis. RNAi silenced lines of S. viridis (SvBAHD05) presented a decrease of up to 42% of ester-linked p-coumarate (pCA) and 50% of pCA-arabinofuranosyl, across three generations. Biomass from SvBAHD05 silenced plants exhibited up to 32% increase in biomass saccharification after acid pre-treatment, with no change in total lignin. Molecular dynamics simulations suggested that SvBAHD05 is a p-coumaroyl coenzyme A transferase (PAT) mainly involved in the addition of pCA to the arabinofuranosyl residues of AX in Setaria. Thus, our results provide evidence of p-coumaroylation of AX promoted by SvBAHD05 acyltransferase in the cell wall of the model grass S. viridis. Furthermore, SvBAHD05 is a promising biotechnological target to engineer crops for improved biomass digestibility for biofuels, biorefineries and animal feeding.

Investigating charge-up and fragmentation dynamics of oxygen molecules after interaction with strong X-ray free-electron laser pulses.

During the last decade, X-ray free-electron lasers (XFELs) have enabled the study of light-matter interaction under extreme conditions. Atoms which are subject to XFEL radiation are charged by a complex interplay of (several subsequent) photoionization events and electronic decay processes within a few femtoseconds. The interaction with molecules is even more intriguing, since intricate nuclear dynamics occur as the molecules start to dissociate during the charge-up process. Here, we demonstrate that by analyzing photoelectron angular emission distributions and kinetic energy release of charge states of ionic molecular fragments, we can obtain a detailed understanding of the charge-up and fragmentation dynamics. Our novel approach allows for gathering such information without the need of complex ab initio modeling. As an example, we provide a detailed view on the processes happening on a femtosecond time scale in oxygen molecules exposed to intense XFEL pulses.

The relationship between depression symptoms and academic performance among first-year undergraduate students at a South African university: a cross-sectional study.

BACKGROUND: South African universities face a challenge of low throughput rates, with most students failing to complete their studies within the minimum regulatory time. Literature has begun to investigate the contribution of well-being, including mental health, with depression among students being one of the most common mental disorders explored. However, locally relevant research exploring associations between depression and academic performance has been limited. This research hypothesizes that the presence of depression symptoms, when controlling for key socio-demographic factors, has an adverse impact on student academic outcomes and contributes to the delay in the academic progression of students. METHODS: The study used a cross-sectional design. Data were collected in 2019 from first-time, first-year undergraduate students using a self-administered online questionnaire. In total, 1,642 students completed the survey. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depression symptoms. Data on students' academic performance were obtained from institutional records. Bivariate and multivariate regression analyses were used to examine associations between depression symptoms and academic performance. RESULTS: Most participants (76%) successfully progressed (meeting the requirements to proceed to the second year of university study). Of the participants, 10% displayed symptoms of severe depression. The likelihood of progression delay (not meeting the academic requirements to proceed to the second year of university study) increased with the severity of depression symptoms. Moderate depression symptoms nearly doubled the adjusted odds of progression delay (aOR = 1.98, 95% CI: 1.30-3.00, p = 0.001). The likelihood of progression delay was nearly tripled by moderate severe depression symptoms (aOR = 2.70, 95% CI:1.70-4.36, p < 0.001) and severe depression symptoms (aOR = 2.59, 95% CI:1.54-4.36, p < 0.001). The model controlled for field of study, financial aid support as well as sex and race. CONCLUSION: Higher levels of depression symptoms among first-year university students are associated with a greater likelihood of progression delay and may contribute to the low throughput rates currently seen in South African universities. It is important for students, universities and government departments to recognize student mental wellness needs and how these can be met.

Effects of Resistance Training With Machines and Elastic Tubes on Functional Capacity and Muscle Strength in Community-Living Older Women: A Randomized Clinical Trial.

The aim of the present study is to compare the effects of 12 weeks of resistance training with machines and elastic tubes on functional capacity and muscular strength in older women aged 60 years or over. The participants were randomized into two groups: a machine group (n = 23) and an elastic group (n = 20). They performed 12 weeks of progressive resistance training, twice a week, with similar exercises. Outcomes were assessed at three time points: baseline, postintervention, and 8 weeks after the end of the training. A significant intragroup effect was demonstrated for both groups at postintervention on functional tests and muscle strength. For the functional reach test and elbow flexion strength (180°/s), only the machine group demonstrated significant intragroup differences. No differences were observed between groups for any outcome. At the 8-week follow-up, functional capacity outcome values were maintained. The muscle strength outcome values decreased to baseline scores, without differences between groups.

Gut microbiome profiling of a rural and urban South African cohort reveals biomarkers of a population in lifestyle transition.

BACKGROUND: Comparisons of traditional hunter-gatherers and pre-agricultural communities in Africa with urban and suburban Western North American and European cohorts have clearly shown that diet, lifestyle and environment are associated with gut microbiome composition. Yet, little is known about the gut microbiome composition of most communities in the very diverse African continent. South Africa comprises a richly diverse ethnolinguistic population that is experiencing an ongoing epidemiological transition and concurrent spike in the prevalence of obesity, largely attributed to a shift towards more Westernized diets and increasingly inactive lifestyle practices. To characterize the microbiome of African adults living in more mainstream lifestyle settings and investigate associations between the microbiome and obesity, we conducted a pilot study, designed collaboratively with community leaders, in two South African cohorts representative of urban and transitioning rural populations. As the rate of overweight and obesity is particularly high in women, we collected single time-point stool samples from 170 HIV-negative women (51 at Soweto; 119 at Bushbuckridge), performed 16S rRNA gene sequencing on these samples and compared the data to concurrently collected anthropometric data. RESULTS: We found the overall gut microbiome of our cohorts to be reflective of their ongoing epidemiological transition. Specifically, we find that geographical location was more important for sample clustering than lean/obese status and observed a relatively higher abundance of the Melainabacteria, Vampirovibrio, a predatory bacterium, in Bushbuckridge. Also, Prevotella, despite its generally high prevalence in the cohorts, showed an association with obesity. In comparisons with benchmarked datasets representative of non-Western populations, relatively higher abundance values were observed in our dataset for Barnesiella (log2fold change (FC) = 4.5), Alistipes (log2FC = 3.9), Bacteroides (log2FC = 4.2), Parabacteroides (log2FC = 3.1) and Treponema (log2FC = 1.6), with the exception of Prevotella (log2FC = - 4.7). CONCLUSIONS: Altogether, this work identifies putative microbial features associated with host health in a historically understudied community undergoing an epidemiological transition. Furthermore, we note the crucial role of community engagement to the success of a study in an African setting, the importance of more population-specific studies to inform targeted interventions as well as present a basic foundation for future research.

Pedestrian hit by a car impacted metal pole: reconstructing the head load.

Fatal head injuries are frequently seen in pedestrians hit by motorized vehicles. In our case, the pedestrian sustained a devastating head injury with skull splitting in the mediosagittal plane. A car collided with a traffic sign causing a bending of the pole. The metal pole hit a man standing close beside it; the man had a head injury severity that is more commonly due to falling objects than due to traffic accidents. Assuming a head mass of 5 kg, simplified calculations yield maximum contact forces of ca. 36 kN exceeding mean parietal fracture forces which are in the order of magnitude of 12.5 kN. The influences of the effective body mass and the horizontal distance between the pole and the pedestrian on maximum contact forces are investigated. High contact forces in our case can be mainly explained by the comparably high impact velocity and by a partial mass transfer of the total car mass to the pole.

The effects of one session of roller massage on recovery from exercise-induced muscle damage: A randomized controlled trial.

BACKGROUND/OBJECTIVE: Roller massage has become a popular intervention in sports settings in order to treat muscle soreness and stiffness, as well as improving post-exercise recovery, although there is limited evidence for these assumptions. Therefore, the purpose of this study was to evaluate the effects of a single session of roller massage, applied with a controlled force after an exercise-induced muscle damage protocol, on muscle recovery. METHODS: A randomized controlled study was performed using a repeated-measures design. Thirty-six young men completed four sets of six eccentric actions of elbow flexors at 90°/s with a 90s rest interval between sets. Participants were randomly assigned into one of three groups: 1) Roller massage (n = 12), 2) Sham (n = 12), and 3) Control (n = 12). Maximal isometric voluntary contraction (MIVC), delayed-onset muscle soreness (DOMS), range of motion (ROM), and muscle thickness were measured at baseline, and at 24, 48, and 72 h post exercise. RESULTS: There was no significant group by time interaction for MIVC (p = 0.090) and ROM (p = 0.416). Also, although there was a significant group by time interaction for muscle thickness (p = 0.028), post hoc test did not find significant difference between groups (p > 0.05). DOMS was recovered at 72 h for roller massage (p < 0.001) and control (p < 0.001) groups, while the Sham group did not recover from DOMS across 72 h (p < 0.001). There was also no significant difference between groups in DOMS at any time (p > 0.05). CONCLUSIONS: A single session of roller massage applied on elbow flexors had no effect on recovery of MIVC, muscle swelling, ROM and DOMS.

Suppression of a single BAHD gene in Setaria viridis causes large, stable decreases in cell wall feruloylation and increases biomass digestibility.

Feruloylation of arabinoxylan (AX) in grass cell walls is a key determinant of recalcitrance to enzyme attack, making it a target for improvement of grass crops, and of interest in grass evolution. Definitive evidence on the genes responsible is lacking so we studied a candidate gene that we identified within the BAHD acyl-CoA transferase family. We used RNA interference (RNAi) silencing of orthologs in the model grasses Setaria viridis (SvBAHD01) and Brachypodium distachyon (BdBAHD01) and determined effects on AX feruloylation. Silencing of SvBAHD01 in Setaria resulted in a c. 60% decrease in AX feruloylation in stems consistently across four generations. Silencing of BdBAHD01 in Brachypodium stems decreased feruloylation much less, possibly due to higher expression of functionally redundant genes. Setaria SvBAHD01 RNAi plants showed: no decrease in total lignin, approximately doubled arabinose acylated by p-coumarate, changes in two-dimensional NMR spectra of unfractionated cell walls consistent with biochemical estimates, no effect on total biomass production and an increase in biomass saccharification efficiency of 40-60%. We provide the first strong evidence for a key role of the BAHD01 gene in AX feruloylation and demonstrate that it is a promising target for improvement of grass crops for biofuel, biorefining and animal nutrition applications.

Two new species and updated checklist of Oxyethira Eaton, 1873 (Trichoptera, Hydroptilidae) from Brazil.

Two new species of Oxyethira Eaton, 1873 are described: Oxyethira cascadanta sp. n. and Oxyethira quadrilobata sp. n. Description and illustrations of the new species are provided based on specimens collected in Parque Nacional da Serra da Canastra, Minas Gerais State, Southeast Brazil. Both species are assigned to the subgenus Loxotrichia but differ from other species mainly in morphology of the subgenital plate, subgenital processes and inferior appendages. Additionally, we provide an updated checklist of the Oxyethira species from Brazil.

[The S2k guideline: Indications for knee endoprosthesis : Evidence and consent-based indications for total knee arthroplasty]. / S2k-Leitlinie: Indikation Knieendoprothese : Evidenz- und konsensbasierte Indikationsstellung in der Knie-Endoprothetik (EKIT-Knie).

Total knee arthroplasty (TKA) is one of the most frequent surgical procedures in orthopaedic surgery. Until now there have not been any standardized indication criteria, which might contribute to the large geographical differences in the frequency of TKA. This guideline aims to consent minimal requirements (main criteria), additional important aspects (minor criteria), as well as relative and absolute contraindications for TKA. The following main criteria have been consented: knee pain, radiological confirmation of osteoarthritis or osteonecrosis, inadequate response to conservative treatment, adverse impact of knee disease on the patient's quality of life and the burden of suffering due to the knee disease. Relative contraindications have been consented as severe general disease with reduced life expectancy and a BMI ≥40; absolute contraindications are an active infection and if the patient is not able to undergo major surgery.

Probiotic bacteria prevent Salmonella - induced suppression of lymphoproliferation in mice by an immunomodulatory mechanism.

BACKGROUND: Salmonella enterica infections often exhibit a form of immune evasion. We previously observed that probiotic bacteria could prevent inhibition of lymphoproliferation and apoptosis responses of T cells associated with S. enterica infections in orally challenged mice. RESULTS: In this study, changes in expression of genes related to lymphocyte activation in mucosa-associated lymphoid tissues (MALT) of mice orally infected with S. enterica with and without treatment with probiotic bacteria were evaluated. Probiotic bacteria increased expression of mRNA for clusters of differentiation antigen 2 (Cd2), protein tyrosine phosphatase receptor type C (Ptprc), and Toll-like receptor 6 (Tlr6) genes related to T and B cell activation in mouse intestinal tissue. The probiotic bacteria were also associated with reduced mRNA expression of a group of genes (RelB, Myd88, Iκκa, Jun, Irak2) related to nuclear factor of kappa light chains enhancer in B cells (NF-κB) signal transduction pathway-regulated cytokine responses. Probiotic bacteria were also associated with reduced mRNA expression of apoptotic genes (Casp2, Casp12, Dad1, Akt1, Bad) that suggest high avidity lymphocyte sparing. Reduced CD2 immunostaining in mesenteric lymph nodes (MLN) was suggestive of reduced lymphocyte activation in probiotic-treated mice. Reduced immunostaining of TLR6 in MALT of probiotic-treated, S. enterica-infected mice suggests that diminished innate immune sensitivity to S. enterica antigens is associated with preventing lymphocyte deletion. CONCLUSIONS: The results of this study are consistent with prevention of S. enterica-induced deletion of lymphocytes by the influence of probiotic bacteria in mucosal lymphoid tissues of mice.

Expression times for hsp27 and hsp70 as an indicator of thermal stress during death due to fire.

The expression of heat shock proteins (hsps) increases in cases of hyperthermal cellular stress in order to protect cellular structures. Hsps can be visualized with immunohistochemical staining. We examined 48 cases of death from fire and excessive heat and a control group of 100 deaths without any perimortem thermal stress, measuring both the hsp27 and hsp70 expressions in myocardial, pulmonary, and renal tissues. The results revealed a correlation between hsp expression and survival time. Hsps are expressed rapidly within seconds or minutes after exposure to heat stress. In particular, hsp27 is expressed fast in high levels, whereas hsp70 expression is higher in the pulmonary and renal tissue of long-term survivors. In the myocardial tissue, hsp27 expression dominated in both short- and long-term survival. The expression pattern is strongly dependent on the organ structure and the survival time, which should be considered in future postmortem studies on hsps.

Determining oxidative stability of battery electrolytes: validity of common electrochemical stability window (ESW) data and alternative strategies.

Increasing the operation voltage of electrochemical energy storage devices is a viable measure to realize higher specific energies and energy densities. A sufficient oxidative stability of electrolytes is the predominant requirement for successful high voltage applicability. The common method to investigate oxidative stability of LIB electrolytes is related to determination of the electrochemical stability window (ESW), on e.g. Pt or LiMn2O4 electrodes. However, the transferability of the obtained results to practical systems is questionable for several reasons. In this work, we evaluated the validity of the potentiodynamic based ESW method by comparing the obtained data with the results of galvanostatic based techniques, applied on commercial positive electrodes. We demonstrated that the oxidative stabilities, determined by the two techniques, are in good accordance with each other. However, the investigation of electrolytes being incompatible to Li metal, renders conventional ESW measurements useless when metallic Li is used as counter - and reference electrode in the ESW setup. For this reason, we introduced an alternative setup based on Li4Ti5O12 full cells. On the example of a butyronitrile-based electrolyte, we finally demonstrated that this electrolyte is not only reductively but also oxidatively less stable than common LiPF6/organic carbonate based electrolytes.

Complex interactive effects of water mold, herbicide, and the fungus Batrachochytrium dendrobatidis on Pacific treefrog Hyliola regilla hosts.

Infectious diseases pose a serious threat to global biodiversity. However, their ecological impacts are not independent of environmental conditions. For example, the pathogenic fungus Batrachochytrium dendrobatidis (Bd), which has contributed to population declines and extinctions in many amphibian species, interacts with several environmental factors to influence its hosts, but potential interactions with other pathogens and environmental contaminants are understudied. We examined the combined effects of Bd, a water mold (Achlya sp.), and the herbicide Roundup® Regular (hereafter, Roundup®) on larval Pacific treefrog Hyliola regilla hosts. We employed a 2 wk, fully factorial laboratory experiment with 3 ecologically realistic levels (0, 1, and 2 mg l-1 of active ingredient) of field-formulated Roundup®, 2 Achlya treatments (present and absent), and 2 Bd treatments (present and absent). Our results were consistent with sublethal interactive effects involving all 3 experimental factors. When Roundup® was absent, the proportion of Bd-exposed larvae infected with Bd was elevated in the presence of Achlya, consistent with Achlya acting as a synergistic cofactor that facilitated the establishment of Bd infection. However, this Achlya effect became nonsignificant at 1 mg l-1 of the active ingredient of Roundup® and disappeared at the highest Roundup® concentration. In addition, Roundup® decreased Bd loads among Bd-exposed larvae. Our study suggests complex interactive effects of a water mold and a contaminant on Bd infection in amphibian hosts. Achlya and Roundup® were both correlated with altered patterns of Bd infection, but in different ways, and Roundup® appeared to remove the influence of Achlya on Bd.

Effect of vaginal progesterone in tocolytic therapy during preterm labor in twin pregnancies: Secondary analysis of a placebo-controlled randomized trial.

AIM: Our aim was to investigate the effect of the prophylactic use of vaginal progesterone on the latency period from the initiation of tocolytic therapy to delivery in twin pregnancies with preterm labor. METHODS: This study was a secondary analysis of a randomized, double-blind, placebo-controlled trial of twin pregnancies in mothers who were exposed to a 200 mg vaginal progesterone ovule or a placebo ovule daily from 18 to 34 weeks gestation. Patients who were administered tocolysis with Atosiban because of preterm labor were included. The latency from tocolysis to delivery, mean gestational age at delivery and the rates of delivery within 48 h and within seven days were compared between progesterone and placebo groups. RESULTS: The analysis included 27 women in the progesterone group and 30 in the placebo group. The baseline characteristics were similar between the groups. Overall, there were no differences in the latency period to delivery (17.54 ± 13.54 days and 21.58 ± 13.52 days; P = 0.289), rates of delivery within 48 h (14.8% and 6.7%; P = 0.40) or within seven days (29.64% and 23.3%; P = 0.76) or mean gestational age at delivery (32.53 ± 3.33 and 34.13 ± 2.87; P = 0.08) between the progesterone and placebo groups, respectively. CONCLUSIONS: Prophylactic use of 200 mg of vaginal progesterone does not influence the latency to delivery in women with twin pregnancies treated with tocolysis because of preterm labor.

QRS Width as a Predictor of Right Ventricular Remodeling After Percutaneous Pulmonary Valve Implantation.

Recent data showed a right ventricular dyssynchrony in patients with tetralogy of Fallot (TOF). Percutaneous pulmonary valve implantation (PPVI) has become an important procedure to treat a pulmonary stenosis and/or regurgitation of the right ventricular outflow tract in these patients. Despite providing good results, there is still a considerable number of nonresponders to PPVI. The authors speculated that electrical dysfunction of the right ventricle plays an underestimated role in the outcome of patients after PPVI. This study aimed to investigate the influence of right ventricular electrical dysfunction, i.e., right bundle branch block (RBBB) on the RV remodeling after PPVI. The study included consecutive patients after correction of TOF with or without RBBB, who had received a PPVI previously at the Heart Center of the University of Leipzig, Germany during the period from 2012 to 2015. 24 patients were included. Patients without RBBB, i.e., with narrow QRS complexes pre-intervention, had significantly better RV function and had smaller right ventricular volumes. Patients with pre-interventionally QRS width below 150 ms showed a post-interventional remodeling of the right ventricle with the decreasing RV volumes (p = 0.001). The parameters of LV function and volume as well as RV ejection fraction remained unaffected by RBBB. The presented data indicate that the QRS width seems to be a valuable parameter in the prediction of right ventricular remodeling after PPVI, as it represents both electrical and mechanical functions of the right ventricle and may serve as an additional parameter for optimal timing of a PPVI.

The truth about the 1st cycle Coulombic efficiency of LiNi1/3Co1/3Mn1/3O2 (NCM) cathodes.

The 1st cycle Coulombic efficiency (CE) of LiNi1/3Co1/3Mn1/3O2 (NCM) at 4.6 V vs. Li/Li(+) has been extensively investigated in NCM/Li half cells. It could be proven that the major part of the observed overall specific capacity loss (in total 36.3 mA h g(-1)) is reversible and induced by kinetic limitations, namely an impeded lithiation reaction during discharge. A measure facilitating the lithiation reaction, i.e. a constant potential (CP) step at the discharge cut-off potential, results in an increase in specific discharge capacity of 22.1 mA h g(-1). This capacity increase during the CP step could be proven as a relithiation process by Li(+) content determination in NCM via an ICP-OES measurement. In addition, a specific capacity loss of approx. 4.2 mA h g(-1) could be determined as an intrinsic reaction to the NCM cathode material at room temperature (RT). In total, less than 10.0 mA h g(-1) (=28% of the overall capacity loss) can be attributed to irreversible reactions, mainly to irreversible structural changes of NCM. Thus, the impact of parasitic reactions, such as oxidative electrolyte decomposition, on the irreversible capacity is negligible and could also be proven by on-line MS. As a consequence, the determination of the amount of extracted Li(+) ("Li(+) extraction ratio") so far has been incorrect and must be calculated by the charge capacity (=delithiation amount) divided by the theoretical capacity. In a NCM/graphite full cell the relithiation amount during the constant voltage (CV) step is smaller than in the half cell, due to irreversible Li(+) loss at graphite.

The vocal repertoire of Tibetan macaques (Macaca thibetana): A quantitative classification.

Vocal repertoires are basic and essential components for describing vocal communication in animals. Studying the entire suite of vocal signals aids investigations on the variation of acoustic structure across social contexts, comparisons on the complexity of communication systems across taxa, and in exploration of the evolutionary origins of species-specific vocalizations. Here, we describe the vocal repertoire of the largest species in the macaque genus, Macaca thibetana. We extracted thirty acoustic parameters from call recordings. Post hoc validation through quantitative analyses of the a priori repertoire classified eleven call types: coo, squawk, squeal, noisy scream, growl, bark, compound squeak, leap coo, weeping, modulated tonal scream, and pant. In comparison to the rest of the genus, Tibetan macaques uttered a wider array of vocalizations in the context of copulations. Previous reports did not include modulated tonal screams and pants during harassment of copulatory dyads. Furthermore, in comparison to the rest of the genus, Tibetan macaque females emit acoustically distinct copulation calls. The vocal repertoire of Tibetan macaques contributes to the literature on the emergence of species-specific calls in the genus Macaca with potential insights from social, reproductive, and ecological comparisons across species. Am. J. Primatol. 78:937-949, 2016. © 2016 Wiley Periodicals, Inc.

Body Composition is Strongly Associated With Cardiorespiratory Fitness in a Large Brazilian Military Firefighter Cohort: The Brazilian Firefighters Study.

Firefighting is associated with high-level physical demands and requires appropriate physical fitness. Considering that obesity has been correlated with decreased cardiorespiratory fitness (CRF) and that the prevalence of obesity may also be elevated within firefighters (FF), we analyzed the association between CRF and body composition (BC) in Brazilian military FF. We assessed 4,237 male FF (18-49 years) who performed a physical fitness test that included BC and CRF. Body composition was assessed by body mass index (BMI), body adiposity index (BAI), body fat percentage (BF%), and waist circumference (WC). CRF was assessed by the 12-minute Cooper test. Comparisons of VO2max between the BC categories were analyzed using the Mann-Whitney test, and the analysis was adjusted for age using the General Linear Model. The Spearman test was used for correlation analysis and the odds ratio (OR) was calculated to assess the odds of the unfit group (≤ 12 metabolic equivalents [METs]) for poor BC. Statistically significant differences were considered when p ≤ 0.05. Considering the BMI categories, 8 volunteers (0.2%) were underweight, 1,306 (30.8%) were normal weight, 2,301 (54.3%) were overweight, and 622 (14.7%) were obese. The VO2max was negatively correlated with age (rs = -0.21), BMI (rs = -0.45), WC (rs = -0.50), and BAI (rs = -0.35) (p < 0.001). Cardiorespiratory fitness was lower in the obese compared with the nonobese for all age categories (-3.8 ml · kg(-1) · min(-1); p < 0.001) and for all BC indices (-4.5 ml · kg(-1) · min(-1); p < 0.001). The OR of the unfit group having poor BC in all indices varied from 2.9 to 8.1 (p < 0.001). Despite the metabolically healthy obesity phenomenon, we found a strong association between CRF and BC irrespective of age and the BC method (BMI, BAI, WC, or BF%). These findings may aid in improving FF training programs with a focus on health and performance.