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Introduction Physical activity among children and adolescents remains insufficient, despite the substantial efforts made by researchers and policymakers. Identifying and furthering our understanding of potential modifiable determinants of physical activity behaviour (PAB) and sedentary behaviour (SB) is crucial for the development of interventions that promote a shift from SB to PAB. The current protocol details the process through which a series of systematic literature reviews and meta-analyses (MAs) will be conducted to produce a best-evidence statement (BESt) and inform policymakers. The overall aim is to identify modifiable determinants that are associated with changes in PAB and SB in children and adolescents (aged 5-19 years) and to quantify their effect on, or association with, PAB/SB. Methods and analysis A search will be performed in MEDLINE, SportDiscus, Web of Science, PsychINFO and Cochrane Central Register of Controlled Trials. Randomised controlled trials (RCTs) and controlled trials (CTs) that investigate the effect of interventions on PAB/SB and longitudinal studies that investigate the associations between modifiable determinants and PAB/SB at multiple time points will be sought. Risk of bias assessments will be performed using adapted versions of Cochrane's RoB V.2.0 and ROBINS-I tools for RCTs and CTs, respectively, and an adapted version of the National Institute of Health's tool for longitudinal studies. Data will be synthesised narratively and, where possible, MAs will be performed using frequentist and Bayesian statistics. Modifiable determinants will be discussed considering the settings in which they were investigated and the PAB/SB measurement methods used. Ethics and dissemination No ethical approval is needed as no primary data will be collected. The findings will be disseminated in peer-reviewed publications and academic conferences where possible. The BESt will also be shared with policy makers within the DE-PASS consortium in the first instance. Systematic review registration CRD42021282874.
The purpose of this study was to examine the test-retest reliability, and convergent and discriminative validity of a new taekwondo-specific change-of-direction (COD) speed test with striking techniques (TST) in elite taekwondo athletes. Twenty (10 males and 10 females) elite (athletes who compete at national level) and top-elite (athletes who compete at national and international level) taekwondo athletes with an average training background of 8.9 ± 1.3 years of systematic taekwondo training participated in this study. During the two-week test-retest period, various generic performance tests measuring COD speed, balance, speed, and jump performance were carried out during the first week and as a retest during the second week. Three TST trials were conducted with each athlete and the best trial was used for further analyses. The relevant performance measure derived from the TST was the time with striking penalty (TST-TSP). TST-TSP performances amounted to 10.57 ± 1.08 s for males and 11.74 ± 1.34 s for females. The reliability analysis of the TST performance was conducted after logarithmic transformation, in order to address the problem of heteroscedasticity. In both groups, the TST demonstrated a high relative test-retest reliability (intraclass correlation coefficients and 90% compatibility limits were 0.80 and 0.47 to 0.93, respectively). For absolute reliability, the TST’s typical error of measurement (TEM), 90% compatibility limits, and magnitudes were 4.6%, 3.4 to 7.7, for males, and 5.4%, 3.9 to 9.0, for females. The homogeneous sample of taekwondo athletes meant that the TST’s TEM exceeded the usual smallest important change (SIC) with 0.2 effect size in the two groups. The new test showed mostly very large correlations with linear sprint speed (r = 0.71 to 0.85) and dynamic balance (r = −0.71 and −0.74), large correlations with COD speed (r = 0.57 to 0.60) and vertical jump performance (r = −0.50 to −0.65), and moderate correlations with horizontal jump performance (r = −0.34 to −0.45) and static balance (r = −0.39 to −0.44). Top-elite athletes showed better TST performances than elite counterparts. Receiver operating characteristic analysis indicated that the TST effectively discriminated between top-elite and elite taekwondo athletes. In conclusion, the TST is a valid, and sensitive test to evaluate the COD speed with taekwondo specific skills, and reliable when considering ICC and TEM. Although the usefulness of the TST is questioned to detect small performance changes in the present population, the TST can detect moderate changes in taekwondo-specific COD speed.
The purpose of this study was to examine the test-retest reliability, and convergent and discriminative validity of a new taekwondo-specific change-of-direction (COD) speed test with striking techniques (TST) in elite taekwondo athletes. Twenty (10 males and 10 females) elite (athletes who compete at national level) and top-elite (athletes who compete at national and international level) taekwondo athletes with an average training background of 8.9 ± 1.3 years of systematic taekwondo training participated in this study. During the two-week test-retest period, various generic performance tests measuring COD speed, balance, speed, and jump performance were carried out during the first week and as a retest during the second week. Three TST trials were conducted with each athlete and the best trial was used for further analyses. The relevant performance measure derived from the TST was the time with striking penalty (TST-TSP). TST-TSP performances amounted to 10.57 ± 1.08 s for males and 11.74 ± 1.34 s for females. The reliability analysis of the TST performance was conducted after logarithmic transformation, in order to address the problem of heteroscedasticity. In both groups, the TST demonstrated a high relative test-retest reliability (intraclass correlation coefficients and 90% compatibility limits were 0.80 and 0.47 to 0.93, respectively). For absolute reliability, the TST’s typical error of measurement (TEM), 90% compatibility limits, and magnitudes were 4.6%, 3.4 to 7.7, for males, and 5.4%, 3.9 to 9.0, for females. The homogeneous sample of taekwondo athletes meant that the TST’s TEM exceeded the usual smallest important change (SIC) with 0.2 effect size in the two groups. The new test showed mostly very large correlations with linear sprint speed (r = 0.71 to 0.85) and dynamic balance (r = −0.71 and −0.74), large correlations with COD speed (r = 0.57 to 0.60) and vertical jump performance (r = −0.50 to −0.65), and moderate correlations with horizontal jump performance (r = −0.34 to −0.45) and static balance (r = −0.39 to −0.44). Top-elite athletes showed better TST performances than elite counterparts. Receiver operating characteristic analysis indicated that the TST effectively discriminated between top-elite and elite taekwondo athletes. In conclusion, the TST is a valid, and sensitive test to evaluate the COD speed with taekwondo specific skills, and reliable when considering ICC and TEM. Although the usefulness of the TST is questioned to detect small performance changes in the present population, the TST can detect moderate changes in taekwondo-specific COD speed.
Lithium and boron are trace components of magmas, released during exsolution of a gas phase during volcanic activity.
In this study, we determine the diffusivity and isotopic fractionation of Li and B in hydrous silicate melts.
Two glasses were synthesized with the same rhyolitic composition (4.2 wt% water), having different Li and B contents; these were studied in diffusion-couple experiments that were performed using an internally heated pressure vessel, operated at 300 MPa in the temperature range 700-1250 degrees C for durations from 0 s to 24 h. From this we determined activation energies for Li and B diffusion of 57 +/- 4 kJ/mol and 152 +/- 15 kJ/mol with pre-exponential factors of 1.53 x 10(-7) m(2)/s and 3.80 x 10(-8) m(2)/s, respectively.
Lithium isotopic fractionation during diffusion gave beta values between 0.15 and 0.20, whereas B showed no clear isotopic fractionation.
Our Li diffusivities and isotopic fractionation results differ somewhat from earlier published values, but overall confirm that Li diffusivity increases with water content. Our results on B diffusion show that similarly to Li, B mobility increases in the presence of water.
By applying the Eyring relation, we confirm that B diffusivity is limited by viscous flow in silicate melts.
Our results on Li and B diffusion present a new tool for understanding degassing-related processes, offering a potential geospeedometer to measure volcanic ascent rates.
The “HPI Future SOC Lab” is a cooperation of the Hasso Plattner Institute (HPI) and industry partners. Its mission is to enable and promote exchange and interaction between the research community and the industry partners.
The HPI Future SOC Lab provides researchers with free of charge access to a complete infrastructure of state of the art hard and software. This infrastructure includes components, which might be too expensive for an ordinary research environment, such as servers with up to 64 cores and 2 TB main memory. The offerings address researchers particularly from but not limited to the areas of computer science and business information systems. Main areas of research include cloud computing, parallelization, and In-Memory technologies.
This technical report presents results of research projects executed in 2018. Selected projects have presented their results on April 17th and November 14th 2017 at the Future SOC Lab Day events.
Die Debatte um epistemische Ungerechtigkeit verbindet normative Gerechtigkeitstheorien mit erkenntnistheoretischen Theorien und stellt somit die Art von wichtigen Fragen, die in den letzten Jahren sowohl innerhalb als auch außerhalb der Wissenschaft internationale Aufmerksamkeit erfahren haben. Verwiesen sei hier etwa auf soziale Bewegungen wie #MeToo und #BlackLivesMatter zeigen. Theorien der epistemischen Ungerechtigkeit (sowie verwandte Theorien wie Epistemologie des Unwissens, feministische Erkenntnistheorie und Standpunkttheorie) können sowohl epistemische Praktiken analysieren und einen Beitrag zu Gerechtigkeitstheorien und sozialer Epistemologie liefern, als auch zu adäquateren Verständnissen von existierenden Ungerechtigkeiten beitragen. In dem hier vorliegenden Schwerpunkt werden Beiträge zu eben solchen bislang wenig erforschten Ungerechtigkeiten sowie neue Diskussionsbeiträge zur Debatte um epistemische Ungerechtigkeiten geliefert.
Potentially disabled?
(2022)
Ten years ago, I was diagnosed with a rare illness called Myasthenia Gravis. Myasthenia Gravis is a long-term neuromuscular autoimmune disease where antibodies block or destroy specific receptors at the junction between nerve and muscle; hence, nerve impulses fail to trigger muscle contractions. The disease leads to varying degrees of muscle weakness. Currently, I have only minor symptoms, I am not seriously impaired, and I do not suffer from any social disadvantage because of my illness. Yet, my life and my body since my diagnosis feel different than before. In this paper I aim to make this feeling intelligible and propose that it is a state of what I call ‘latent impairment’. Latent impairment is a state of being ‘in between’, different from being actually impaired and also different from being abled-bodied. The theory takes its cues both from social constructionist theories of disability as well as theories of (chronic) illness and their focus on the importance of subjectivity. Furthermore, I suggest that a phenomenological understanding of latent impairment can show possible ways of becoming an ally to the DRM.
The understanding of bidimensional materials dynamics and its electrolyte interface equilibrium, such as graphene oxide (GO), is critical for the development of a capacitive biosensing platform. The interfacial capacitance (C-i) of graphene-based materials may be tuned by experimental conditions such as pH optimization and cation size playing key roles at the enhancement of their capacitive properties allowing their application as novel capacitive biosensors. Here we reported a systematic study of C-i of multilayer GO films in different aqueous electrolytes employing electrochemical impedance spectroscopy for the application in a capacitive detection system. We demonstrated that the presence of ionizable oxygen-containing functional groups within multilayer GO film favors the interactions and the accumulation of cations in the structure of the electrodes enhancing the GO C-i in aqueous solutions, where at pH 7.0 (the best condition) the C-i was 340 mu F mg(-1) at -0.01 V vs Ag/AgCl. We also established that the hydrated cation radius affects the mobility and interaction with GO functional groups and it plays a critical role in the Ci, as demonstrated in the presence of different cations Na+=640 mu F mg(-1), Li+=575 mu F mg(-1) and TMA(+)=477 mu F mg(-1). As a proof-of-concept, the capacitive behaviour of GO was explored as biosensing platform for standard streptavidin-biotin systems. For this system, the C-i varied linearly with the log of the concentration of the targeting analyte in the range from 10 pg mL(-1) to 100 ng mL(-1), showing the promising applicability of capacitive GO based sensors for label-free biosensing.
Outcome-dependent effects of walking speed and age on quantitative and qualitative gait measures
(2022)
Background: Walking speed predicts many clinical outcomes in old age. However, a comprehensive assessment of how walking speed affects accelerometer based quantitative and qualitative gait measures in younger and older adults is lacking. Research question: What is the relationship between walking speed and quantitative and qualitative gait outcomes in younger and older adults? Methods: Younger (n = 27, age: 21.6) and older participants (n = 27, age: 69.5) completed 340 steps on a treadmill at speeds of 0.70 to a maximum of 1.75 m.s(-1). We used generalized additive mixed models to determine the relationship between walking speed and quantitative (stride length, stride time, stride frequency and their variability) and qualitative (stride regularity, stability, smoothness, symmetry, synchronization, predictability) gait measures extracted from trunk accelerations. Results: The type of relationship between walking speed and the majority of gait measures (quantitative and qualitative) was characterized as logarithmic, with more prominent speed-effects at speeds below 1.20 m.s(-1). Changes in quantitative measures included shorter strides, longer stride times, and a lower stride frequency, with more variability at lower speeds independent of age. For qualitative measures, we found a decrease in gait symmetry, stability and regularity in all directions with decreasing speeds, a decrease in gait predictability (Vertical, V, anterior-posterior, AP) and stronger gait synchronization (AP-mediolateral, ML, AP-V), and direction dependent effects of gait smoothness, which decreased in V direction, but increased in AP and ML directions with decreasing speeds. We found outcome-dependent effects of age on the quantitative and qualitative gait measures, with either no differences between age-groups, age-related differences that existed regardless of speed, and age-related differences in the type of relationship with walking speed. Significance: The relationship between walking speed and quantitative and qualitative gait measures, and the effects of age on this relationship, depends on the type of gait measure studied.
High pressure and high temperature experiments performed with laser-heated diamond anvil cells (LH-DAC) are being extensively used in geosciences to study matter at conditions prevailing in planetary interiors. Due to the size of the apparatus itself, the samples that are produced are extremely small, on the order of few tens of micrometers. There are several ways to analyze the samples and extract physical, chemical or structural information, using either in situ or ex situ methods. In this paper, we compare two nanoprobe techniques, namely nano-XRF and NanoSIMS, that can be used to analyze recovered samples synthetized in a LH-DAC. With these techniques, it is possible to extract the spatial distribution of chemical elements in the samples. We show the results for several standards and discuss the importance of proper calibration for the acquisition of quantifiable results. We used these two nanoprobe techniques to retrieve elemental ratios of dilute species (few tens of ppm) in quenched experimental molten samples relevant for the formation of the iron-rich core of the Earth. We finally discuss the applications of such probes to constrain the partitioning of trace elements between metal and silicate phases, with a focus on moderately siderophile elements, tungsten and molybdenum.
Integrated Seismic Program (ISP) is a graphical user interface designed to facilitate and provide a user-friendly framework for performing diverse common and advanced tasks in seismological research. ISP is composed of five main modules for earthquake location, time-frequency analysis and advanced signal processing, implementation of array techniques to estimate the slowness vector, seismic moment tensor inversion, and receiver function computation and analysis. In addition, several support tools are available, allowing the user to create an event database, download data from International Federation of Digital Seismograph Networks services, inspect the background noise, and compute synthetic seismograms. ISP is written in Python3, supported by several open-source and/or publicly available tools. Its modular design allows for new features to be added in a collaborative development environment.
This open access book is about Mozambicans and Angolans who migrated in state-sponsored schemes to East Germany in the late 1970s and throughout the 1980s. They went to work and to be trained as a vanguard labor force for the intended African industrial revolutions. While they were there, they contributed their labor power to the East German economy.
This book draws on more than 260 life history interviews and uncovers complex and contradictory experiences and transnational encounters. What emerges is a series of dualities that exist side by side in the memories of the former migrants: the state and the individual, work and consumption, integration and exclusion, loss and gain, and the past in the past and the past in the present and future. By uncovering these dualities, the book explores the lives of African migrants moving between the Third and Second worlds.
Devoted to the memories of worker-trainees, this transnational study comes at a time when historians are uncovering the many varied, complicated, and important connections within the global socialist world.
Groundwater recharge (GWR) is one of the most challenging water fluxes to estimate, as it relies on observed data that are often limited in many developing countries.
This study developed an innovative water budget method using satellite products for estimating the spatially distributed GWR at monthly and annual scales in tropical wet sedimentary regions despite cloudy conditions.
The distinctive features proposed in this study include the capacity to address 1) evapotranspiration estimations in tropical wet regions frequently overlaid by substantial cloud cover; and 2) seasonal root-zone water storage estimations in sedimentary regions prone to monthly variations.
The method also utilises satellite-based information of the precipitation and surface runoff. The GWR was estimated and validated for the hydrologically contrasting years 2016 and 2017 over a tropical wet sedimentary region located in North-eastern Brazil, which has substantial potential for groundwater abstraction.
This study showed that applying a cloud-cleaning procedure based on monthly compositions of biophysical data enables the production of a reasonable proxy for evapotranspiration able to estimate groundwater by the water budget method.
The resulting GWR rates were 219 (2016) and 302 (2017) mm yr(-1), showing good correlations (CC = 0.68 to 0.83) and slight underestimations (PBIAS =-13 to-9%) when compared with the referenced estimates obtained by the water table fluctuation method for 23 monitoring wells. Sensitivity analysis shows that water storage changes account for +19% to-22% of our monthly evaluation.
The satellite-based approach consistently demonstrated that the consideration of cloud-cleaned evapotranspiration and root-zone soil water storage changes are essential for a proper estimation of spatially distributed GWR in tropical wet sedimentary regions because of their weather seasonality and cloudy conditions.
Understanding eastern African paleoclimate is critical for contextualizing early human evolution, adaptation, and dispersal, yet Pleistocene climate of this region and its governing mechanisms remain poorly understood due to the lack of long, orbitally-resolved, terrestrial paleoclimate records. Here we present leaf wax hydrogen isotope records of rainfall from paleolake sediment cores from key time windows that resolve long-term trends, variations, and high-latitude effects on tropical African precipitation. Eastern African rainfall was dominantly controlled by variations in low-latitude summer insolation during most of the early and middle Pleistocene, with little evidence that glacial-interglacial cycles impacted rainfall until the late Pleistocene. We observe the influence of high-latitude-driven climate processes emerging from the last interglacial (Marine Isotope Stage 5) to the present, an interval when glacial-interglacial cycles were strong and insolation forcing was weak. Our results demonstrate a variable response of eastern African rainfall to low-latitude insolation forcing and high-latitude-driven climate change, likely related to the relative strengths of these forcings through time and a threshold in monsoon sensitivity. We observe little difference in mean rainfall between the early, middle, and late Pleistocene, which suggests that orbitally-driven climate variations likely played a more significant role than gradual change in the relationship between early humans and their environment.
Mobilities and lifetimes of photogenerated charge carriers are core properties of photovoltaic materials and can both be characterized by contactless terahertz or microwave measurements. Here, the expertise from fifteen laboratories is combined to quantitatively model the current-voltage characteristics of a solar cell from such measurements. To this end, the impact of measurement conditions, alternate interpretations, and experimental inter-laboratory variations are discussed using a (Cs,FA,MA)Pb(I,Br)(3) halide perovskite thin-film as a case study. At 1 sun equivalent excitation, neither transport nor recombination is significantly affected by exciton formation or trapping. Terahertz, microwave, and photoluminescence transients for the neat material yield consistent effective lifetimes implying a resistance-free JV-curve with a potential power conversion efficiency of 24.6 %. For grainsizes above approximate to 20 nm, intra-grain charge transport is characterized by terahertz sum mobilities of approximate to 32 cm(2) V-1 s(-1). Drift-diffusion simulations indicate that these intra-grain mobilities can slightly reduce the fill factor of perovskite solar cells to 0.82, in accordance with the best-realized devices in the literature. Beyond perovskites, this work can guide a highly predictive characterization of any emerging semiconductor for photovoltaic or photoelectrochemical energy conversion. A best practice for the interpretation of terahertz and microwave measurements on photovoltaic materials is presented.
We present the discovery of a new double-detonation progenitor system consisting of a hot subdwarf B (sdB) binary with a white dwarf companion with a P (orb) = 76.34179(2) minutes orbital period. Spectroscopic observations are consistent with an sdB star during helium core burning residing on the extreme horizontal branch. Chimera light curves are dominated by ellipsoidal deformation of the sdB star and a weak eclipse of the companion white dwarf. Combining spectroscopic and light curve fits, we find a low-mass sdB star, M (sdB) = 0.383 +/- 0.028 M (circle dot) with a massive white dwarf companion, M (WD) = 0.725 +/- 0.026 M (circle dot). From the eclipses we find a blackbody temperature for the white dwarf of 26,800 K resulting in a cooling age of approximate to 25 Myr whereas our MESA model predicts an sdB age of approximate to 170 Myr. We conclude that the sdB formed first through stable mass transfer followed by a common envelope which led to the formation of the white dwarf companion approximate to 25 Myr ago. Using the MESA stellar evolutionary code we find that the sdB star will start mass transfer in approximate to 6 Myr and in approximate to 60 Myr the white dwarf will reach a total mass of 0.92 M (circle dot) with a thick helium layer of 0.17 M (circle dot). This will lead to a detonation that will likely destroy the white dwarf in a peculiar thermonuclear supernova. PTF1 J2238+7430 is only the second confirmed candidate for a double-detonation thermonuclear supernova. Using both systems we estimate that at least approximate to 1% of white dwarf thermonuclear supernovae originate from sdB+WD binaries with thick helium layers, consistent with the small number of observed peculiar thermonuclear explosions.
The aim of this study was to investigate the effects of listening to preferred music during a warm up or exercise, on performance during a 6-min all-out exercise test (6-MT) in young adult males. Twenty-five healthy males volunteered to participate in this study. Following a within subject design, participants performed three test conditions (MDT: music during the test; MDW: music during the warm-up; WM: without music) in random order. Outcomes included mean running speed over the 6-min test (MRS6), total distance covered (TDC), heart rate responses (HRpeak, HRmean), blood lactate (3-min after the test), and the rating of perceived exertion (RPE); additionally, feeling scale scores were recorded. Listening to preferred music during running resulted in significant TDC (Delta up arrow 10%, p=0.006, ES=0.80) and MRS6 (Delta up arrow 14%, p=0.012, ES=1.02) improvement during the 6-MT, improvement was also noted for the warm-up with music condition (TDC:Delta up arrow 8%, p=0.028, ES=0.63; MRS6:Delta up arrow 8%, p=0.032, ES=0.61). A similar reverse "J-shaped" pacing profile was detected during the three conditions. Blood lactate was lower in the MDT condition by 8% (p=0.01, ES=1.10), but not the MDW condition, compared to MW. In addition, no statistically significant differences were found between the test sessions for the HR, RPE, and feeling scale scores. In conclusion, listening to music during exercise testing would be more beneficial for optimal TDC and MRS6 performances compared to MDW and WM.
Biochemical markers and wellness status during a congested match play period in elite soccer players
(2022)
Objectives:
To analyze biochemical markers, wellness status, and physical fitness in elite soccer players in relation to changes in training and match exposure during a congested period of match play.
Methods:
Fourteen elite soccer players were evaluated 3 times (T1, T2, and T3) over 12 weeks (T1-T2: 6-wk regular period of match play and T2-T3: 6-wk congested period of match play). Players performed vertical jump tests, repeated shuttle sprint ability test, and the Yo-Yo Intermittent Recovery Test at T1, T2, and T3. Plasma C-reactive protein, creatinine, and creatine kinase were analyzed at T1, T2, and T3. Wellness status was measured daily using the Hopper questionnaire (delayed onset of muscle soreness, stress, fatigue, and sleep quality). Training session rating of perceived exertion was also recorded on a daily basis.
Results:
A significant increase was found in stress, fatigue, delayed onset of muscle soreness scores, and Hopper index during the congested period (between T2 and T3) compared with the regular period (between T1 and T2) (.001 < P < .008, 0.8 < ES < 2.3). Between T2 and T3, significant relationships were found between the percentage variations (Delta%) of C-reactive protein, and Delta% of creatine kinase with the Hopper Index, and the Delta% of fatigue score. In addition, the Delta% of fatigue score and Delta% of delayed onset of muscle soreness score correlated with Delta% Yo-Yo Intermittent Recovery Test and Delta% best of repeated shuttle sprint ability test (.49 < r < P < .01).
Conclusions:
An intensive period of congested match play significantly compromised elite soccer players' physical fitness and wellness status. Elite soccer players' wellness status reflects declines in physical fitness during this period while biochemical changes do not.
INTRODUCTION:
We investigated the impact of changes in lifestyle habits on colorectal cancer (CRC) risk in a multicountry European cohort.
METHODS:
We used baseline and follow-up questionnaire data from the European Prospective Investigation into Cancer cohort to assess changes in lifestyle habits and their associations with CRC development. We calculated a healthy lifestyle index (HLI) score based on smoking status, alcohol consumption, body mass index, and physical activity collected at the 2 time points. HLI ranged from 0 (most unfavorable) to 16 (most favorable). We estimated the association between HLI changes and CRC risk using Cox regression models and reported hazard ratios (HR) with 95% confidence intervals (CI).
RESULTS:
Among 295,865 participants, 2,799 CRC cases were observed over a median of 7.8 years. The median time between questionnaires was 5.7 years. Each unit increase in HLI from the baseline to the follow-up assessment was associated with a statistically significant 3% lower CRC risk. Among participants in the top tertile at baseline (HLI > 11), those in the bottom tertile at follow-up (HLI <= 9) had a higher CRC risk (HR 1.34; 95% CI 1.02-1.75) than those remaining in the top tertile. Among individuals in the bottom tertile at baseline, those in the top tertile at follow-up had a lower risk (HR 0.77; 95% CI 0.59-1.00) than those remaining in the bottom tertile.
DISCUSSION:
Improving adherence to a healthy lifestyle was inversely associated with CRC risk, while worsening adherence was positively associated with CRC risk. These results justify and support recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention.