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Objective: The purpose of this systematic review and meta-analysis was to examine the effects of exercise on depression and anxiety in people living with HIV (PLWH), and to evaluate, through subgroup analysis, the effects of exercise type, frequency, supervision by exercise professionals, study quality, and control group conditions on these outcomes. Method: A literature search was conducted through four electronic databases from inception to February 2019. Considered for inclusion were randomized controlled trials (RCTs) investigating exercise interventions and depression or anxiety as outcomes in people living with HIV (>= 18 years of age). Ten studies were included (n = 479 participants, 49.67% females at baseline), and the standardized mean difference (SMD) and heterogeneity were calculated using random-effect models. An additional pre-post meta-analysis was also conducted. Results: A large effect in favor of exercise when compared to controls was found for depression (SMD = -0.84, 95%CI = [-1.57, -0.11], p = 0.02) and anxiety (SMD = -1.23, 95%CI = [-2.42, 0.04], p = -0.04). Subgroup analyses for depression revealed large effects on depression for aerobic exercise only (SMD = -0.96, 95%CI = [-1.63, -0.30], p = 0.004), a frequency of >= 3 exercise sessions per week (SMD = -1.39, 95%CI = [-2.24, -0.54], p < 0.001), professionally supervised exercise (SMD = -1.40, 95%CI = [-2.46, -0.17], p = 0.03]), and high-quality studies (SMD = -1.31, 95%CI = [-2.46, -0.17], p = 0.02). Conclusion: Exercise seems to decrease depressive symptoms and anxiety in PLWH, but other larger and high-quality studies are needed to verify these effects.
Background Small-sided games have been suggested as a viable alternative to conventional endurance training to enhance endurance performance in youth soccer players. This has important implications for long-term athlete development because it suggests that players can increase aerobic endurance through activities that closely resemble their sport of choice. Data Sources The data sources utilised were Google Scholar, PubMed and Microsoft Academic. Study Eligibility Criteria Studies were eligible for inclusion if interventions were carried out in male soccer players (aged < 18years) and compared the effects of small-sided games and conventional endurance training on aerobic endurance performance. We defined small-sided games as modified [soccer] games played on reduced pitch areas, often using adapted rules and involving a smaller number of players than traditional games. We defined conventional endurance training as continuous running or extensive interval training consisting of work durations>3min. Study Appraisal and Synthesis Methods The inverse-variance random-effects model for meta-analyses was used because it allocates a proportionate weight to trials based on the size of their individual standard errors and facilitates analysis whilst accounting for heterogeneity across studies. Effect sizes were represented by the standardised mean difference and presented alongside 95% confidence intervals. Results Seven studies were included in this meta-analysis. Both modes of training were effective in increasing endurance performance. Within-mode effect sizes were both of moderate magnitude [small-sided games: 0.82 (95% confidence interval 0.05, 1.60), Z=2.07 (p=0.04); conventional endurance training: 0.89 (95% confidence interval 0.06, 1.72), Z=2.10 (p=0.04)]. There were only trivial differences [0.04 (95% confidence interval -0.36, 0.43), Z=0.18 (p=0.86)] between the effects on aerobic endurance performance of small-sided games and conventional endurance training. Subgroup analyses showed mostly trivial differences between the training methods across key programming variables such as set duration (>= or < 4 min) and recovery period between sets (>= or< 3min). Programmes that were longer than 8 weeks favoured small-sided games [effect size=0.45 (95% confidence interval -0.12, 1.02), Z=1.54 (p=0.12)], with the opposite being true for conventional endurance training [effect size=-0.33 (95% confidence interval -0.79, 0.14), Z=1.39 (p=0.16)]. Programmes with more than 4 sets per session favoured small-sided games [effect size=0.53 (95% confidence interval -0.52, 1.58), Z=0.98 (p=0.33)] with only a trivial difference between those with 4, or fewer, sets [effect size=-0.13 (95% confidence interval -0.52, 0.26), Z=0.65 (p=0.52)]. Conclusions Small-sided games are as effective as conventional endurance training for increasing aerobic endurance performance in male youth soccer players. This is important for practitioners as it means that small-sided games can allow both endurance and skills training to be carried out simultaneously, thus providing a more efficient training stimulus. Small-sided games offer the same benefits as conventional endurance training with two sessions per week, with4 sets of 4 min of activity, interspersed with recovery periods of 3min, recommended in this population.
Aggression Replacement Training (ART) is a multimodal intervention for chronically aggressive youth. The program has been frequently administered in a variety of samples in the original form or in modified versions. This review examines evaluations of the efficacy of ART on aggressive behavior and secondary outcomes in children and youth, including modifications of ART and evaluations of the original version not covered by earlier reviews. Method: Scholarly databases were searched to identify 10 articles reporting 11 independent studies evaluating the efficacy ART in reducing aggressive behavior and improving anger control, social skills, and moral reasoning in children and youth. Results: The majority of studies found positive effects of ART on aggression and other outcomes related to anger control, social skills, and moral reasoning. However, most studies were based on small samples, and few included a control group to evaluate intervention success. Conclusions: The studies reviewed in this paper tentatively suggest that ART is an efficacious intervention to reduce aggressive behavior and improve anger control, social skills, and moral reasoning in at-risk children and youth. However, this conclusion is qualified by a number of methodological limitations that highlight the need for further, more rigorous evaluation studies.
Background & aims: Low muscle mass is associated with increased falls, medical complications, length of hospital stay and loss of independence. An increasing number of studies has also shown the association between sarcopenia and health care expenditure. The following narrative review summarizes the current evidence on the economic relevance of low muscle mass (MM) or sarcopenia. Methods: An extensive search of the literature in Medline identified twelve studies in English, which evaluated direct and indirect health care expenditure in patients with low muscle mass or sarcopenia (low MM and strength or mobility). Results: Three studies analysed the cost of age-related loss of MM or strength in large surveys of the general, older population. Six retrospective analyses evaluated perioperative medical costs related to low MM in primarily older patients from different medical areas. One prospective study presented hospital costs related to sarcopenia in patients with gastric cancer. Two studies presented data from general hospital patients. Despite the difference in diagnostic criteria, study population and statistical design, low MM and sarcopenia were consistently identified as predictors of increased health care expenditure in community, perioperative and general hospital settings. Conclusions: Low MM and sarcopenia are prevalent and associated with significantly higher health care costs. Considering the demographic change, which will lead to an increasing number of patients with sarcopenia, every effort should be made to identify and treat patients with sarcopenia. The use of a unified definition and diagnostic criteria would allow a better comparison of data. (C) 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Fungi in aquatic ecosystems
(2019)
Fungi are phylogenetically and functionally diverse ubiquitous components of almost all ecosystems on Earth, including aquatic environments stretching from high montane lakes down to the deep ocean. Aquatic ecosystems, however, remain frequently overlooked as fungal habitats, although fungi potentially hold important roles for organic matter cycling and food web dynamics. Recent methodological improvements have facilitated a greater appreciation of the importance of fungi in many aquatic systems, yet a conceptual framework is still missing. In this Review, we conceptualize the spatiotemporal dimensions, diversity, functions and organismic interactions of fungi in structuring aquatic food webs. We focus on currently unexplored fungal diversity, highlighting poorly understood ecosystems, including emerging artificial aquatic habitats.
The pathophysiological influence of gene-lifestyle interactions on the risk to develop type 2 diabetes (T2D) is currently under intensive research. This systematic review summarizes the evidence for gene-lifestyle interactions regarding T2D incidence. MEDLINE, EMBASE, and Web of Science were systematically searched until 31 January 2019 to identify publication with (a) prospective study design; (b) T2D incidence; (c) gene-diet, gene-physical activity, and gene-weight loss intervention interaction; and (d) population who are healthy or prediabetic. Of 66 eligible publications, 28 reported significant interactions. A variety of different genetic variants and dietary factors were studied. Variants at TCF7L2 were most frequently investigated and showed interactions with fiber and whole grain on T2D incidence. Further gene-diet interactions were reported for, eg, a western dietary pattern with a T2D-GRS, fat and carbohydrate with IRS1 rs2943641, and heme iron with variants of HFE. Physical activity showed interaction with HNF1B, IRS1, PPAR gamma, ADRA2B, SLC2A2, and ABCC8 variants and weight loss interventions with ENPP1, PPAR gamma, ADIPOR2, ADRA2B, TNF alpha, and LIPC variants. However, most findings represent single study findings obtained in European ethnicities. Although some interactions have been reported, their conclusiveness is still low, as most findings were not yet replicated across multiple study populations.
Flood disasters severely impact human subjective well-being (SWB). Nevertheless, few studies have examined the influence of flood events on individual well-being and how such impacts may be limited by flood protection measures. This study estimates the long term impacts on individual subjective well-being of flood experiences, individual subjective flood risk perceptions, and household flood preparedness decisions. These effects are monetised and placed in context through a comparison with impacts of other adverse events on well-being. We collected data from households in flood-prone areas in France. The results indicate that experiencing a flood has a large negative impact on subjective well-being that is incompletely attenuated over time. Moreover, individuals do not need to be directly affected by floods to suffer SWB losses since subjective well-being is lower for those who expect their flood risk to increase or who have seen a neighbour being flooded. Floodplain inhabitants who prepared for flooding by elevating their home have a higher subjective well-being. A monetisation of the aforementioned well-being impacts shows that a flood requires Euro150,000 in immediate compensation to attenuate SWB losses. The decomposition of the monetised impacts of flood experience into tangible losses and intangible effects on SWB shows that intangible effects are about twice as large as the tangible direct monetary flood losses. Investments in flood protection infrastructure may be under funded if the intangible SWB benefits of flood protection are not taken into account.
The short- and long-term thrombogenicity of implant materials is still unpredictable, which is a significant challenge for the treatment of cardiovascular diseases. A knowledge-based approach for implementing biofunctions in materials requires a detailed understanding of the medical device in the biological system. In particular, the interplay between material and blood components/cells as well as standardized and commonly acknowledged in vitro test methods allowing a reproducible categorization of the material thrombogenicity requires further attention. Here, the status of in vitro thrombogenicity testing methods for biomaterials is reviewed, particularly taking in view the preparation of test materials and references, the selection and characterization of donors and blood samples, the prerequisites for reproducible approaches and applied test systems. Recent joint approaches in finding common standards for a reproducible testing are summarized and perspectives for a more disease oriented in vitro thrombogenicity testing are discussed.