Noble-Gas Difluoride Complexes of MOF4 (M=Mo, W); Syntheses, Structures and Bonding of NgF2 ⋠MOF4 and XeF2 ⋠2MOF4 (Ng=Kr, Xe).

The NgF2 ⋅ MOF4 (Ng=Kr, Xe; M=Mo, W) and XeF2 ⋅ 2MOF4 complexes were synthesized in anhydrous HF (aHF) solvent and melts, respectively. Their single-crystal X-ray diffraction (SCXRD) structures show NgF2 ⋅ MOF4 and XeF2 ⋅ 2MOF4 have Ft -Ng-Fb - - -M arrangements, in which the NgF2 ligands coordinate to MOF4 through Ng-Fb - - -M bridges. The XeF2 ligands of XeF2 ⋅ 2MOF4 also coordinate to F3 OM-Fb '- - -M'OF4 moieties through Xe-Fb - - -M bridges to form Ft -Xe-Fb - - -M(OF3 )-Fb '- - -M'OF4 , where XeF2 coordinates trans to the M=O bond and Fb ' coordinates trans to the M'=O bond. The Ng-Ft , Ng-Fb , and M- - -Fb bond lengths of NgF2 ⋅ nMOF4 are consistent with MOF4 and F3 OM-Fb '- - -M'OF4 fluoride-ion affinity trends: CrOF4

Research on professional organizations: A review of theoretical traditions, themes, methods and locations.

This research note presents an overview of the contemporary "professional organization" research area. We begin with the historical roots and evolution of research into professionals and the organizations in which they work, identifying five theoretical traditions-namely sociology of organization, sociology of the professions, professional organization, professional service firms, and public professionalism. Reviewing recent research in these areas allows us to identify important research phenomena-such as hybridity, institutional work, internationalization, and professional identity-and to understand how the institutional view within the "sociology of the professions" tradition has become a dominant paradigm for this research. This review also reveals the extent to which various occupations, methodological approaches, and academic fields, and locations have assumed positions of importance in recent years. Finally, future directions relevant to sociology researchers are discussed.

Cette note de recherche présente un aperçu du domaine de recherche contemporain sur les " organisations professionnelles ". Nous commençons par les racines historiques et l'évolution de la recherche sur les professionnels et les organisations dans lesquelles ils travaillent, en identifiant cinq traditions théoriques - à savoir la sociologie de l'organisation, la sociologie des professions, l'organisation professionnelle, les entreprises de services professionnels et le professionnalisme public. L'examen des recherches récentes dans ces domaines nous permet d'identifier des phénomènes de recherche importants - tels que l'hybridité, le travail institutionnel, l'internationalisation et l'identité professionnelle - et de comprendre comment la vision institutionnelle au sein de la tradition de la "sociologie des professions" est devenue un paradigme dominant pour cette recherche. Cette revue révèle également dans quelle mesure diverses professions, approches méthodologiques, domaines académiques et lieux ont pris des positions d'importance ces dernières années. Enfin, les orientations futures pertinentes pour les chercheurs en sociologie sont discutées.

Utilization of Healthcare Resources by HIV-Positive Children in the United States: A National Perspective.

OBJECTIVE: We characterized and estimated the cost of inpatient hospital utilization by US pediatric patients who tested positive for the human immunodeficiency virus (HIV). METHODS: The 2012 Kids' Inpatient Database was analyzed to provide a descriptive assessment of national inpatient hospital utilization. We analyzed a stratified probability sampling of 3.2 million pediatric hospital discharges weighted to 6.7 million national discharges. Descriptive statistics for hospital and patient characteristics were identified and binary variables were analyzed using the Student t test. The Kids' Inpatient Database is the largest available all-payer pediatric (20 years old and younger) inpatient care database in the United States, yielding national estimates of hospital inpatient stays. Children aged 17 years and younger were included in the study and conditions related to pregnancy and delivery. RESULTS: We estimated that 1344 pediatric discharges were associated with an HIV diagnosis, totaling 10,704 inpatient days at a cost of $91 million. Among pediatric patients with HIV, 55% were African American, 20% were white, 15% were Asian/Pacific Islander, 8% were other races (including Hispanics and Native Americans), and 51% were female. Children who were HIV positive were more likely to have longer mean hospital stays, have higher mean hospital charges, be of a higher median age (8 years and older), have Medicaid insurance, come from lower-income families, be treated in urban teaching hospitals, and be more likely to die during hospitalization (P < 0.01 for all). Among non-HIV-related pediatric discharges, 20% occurred in households with a mean annual income >$63,000 compared with only 12% for children who were HIV positive. During hospitalization, at least one procedure was performed in 56.6% of children with HIV compared with 45.65% of hospitalized children without HIV. The most frequently observed diagnoses associated with children infected with HIV were gastrointestinal disorders, mental disorders, and bacterial infections and sepsis. CONCLUSIONS: The results suggest that pediatric patients who were HIV positive were significantly older, from lower-income areas, and members of minority groups. They underwent more procedures during hospitalization, incurred more than twice the total cost, stayed in the hospital twice as long, and had statistically higher in-hospital mortality than children who were HIV negative. As we continue to explore effective and judicious treatment options for patients who are HIV positive, our national estimates of resource utilization can be used to conduct a more detailed examination of current medical practices and specific patterns of diagnoses associated with HIV infection in the US pediatric population.

Depressive Symptoms and All-Cause Mortality in Older American Indians with Type 2 Diabetes Mellitus.

OBJECTIVES: American Indians experience disproportionately high rates of poor mental health and type 2 diabetes mellitus (T2DM). We examined the association between depressive symptoms and all-cause mortality in older American Indians with T2DM. DESIGN: We used the Native Elder Care Study survey data from community-dwelling American Indians aged 55 years or older, linked to data extracted from participants' electronic health records. We focused on those who had an International Classification of Diseases-Ninth Revision diagnosis of T2DM in their electronic health records. SETTING: The study was conducted with a federally-recognized tribe with approximately 16,000 enrolled members, most of whom reside on or near tribally-owned lands that span several rural counties. PARTICIPANTS: Participants were among the Native Elder Care Study participants with a final analytic sample of 222. MEASUREMENTS: We measured depressive symptoms with the Centers for Epidemiologic Studies-Depression (CES-D) scale. We used Cox proportional hazard models to examine the association between depressive symptoms and all-cause mortality in the final analytic sample of 222 subjects. RESULTS: Survival curves revealed that individuals in the third and fourth CES-D scale categories had higher mortality than those in the first and second categories. Mortality risk was significantly higher for participants with CES-D scale scores in the third highest compared with the lowest category (hazard ratio = 2.07; 95% confidence interval = 1.07-4.04), after adjustment for demographic characteristics, health behaviors, obesity, and prevalent T2DM complications. Analyses with the CES-D scale as a continuous variable also showed a positive association with mortality. CONCLUSION: The impact of mental health on older American Indians with T2DM is often overlooked, yet it is vital to clinical and public health practice. Our findings underscore the importance of addressing the mental health needs of this population, particularly because depression in older patients is often undetected or inadequately treated. J Am Geriatr Soc 67:1940-1945, 2019.

Syntheses, Structures, and Bonding of NgF2 ⋠CrOF4 , NgF2 ⋠2CrOF4 (Ng=Kr, Xe), and (CrOF4 )∞.

The noble-gas difluoride adducts, NgF2 ⋅CrOF4 and NgF2 ⋅2CrOF4 (Ng=Kr and Xe), have been synthesized and structurally characterized at low temperatures by Raman spectroscopy and single-crystal X-ray diffraction. The low fluoride ion affinity of CrOF4 renders it incapable of inducing fluoride ion transfer from NgF2 (Ng=Kr and Xe) to form ion-paired salts of the [NgF]+ cations having either the [CrOF5 ]- or [Cr2 O2 F9 ]- anions. The crystal structures show the NgF2 ⋅CrOF4 adducts are comprised of Ft -Ng-Fb - - -Cr(O)F4 structural units in which NgF2 is weakly coordinated to CrOF4 by means of a fluorine bridge, Fb , in which Ng-Fb is elongated relative to the terminal Ng-Ft bond. In contrast with XeF2 ⋅2MOF4 (M=Mo or W) and KrF2 ⋅2MoOF4 , in which the Lewis acidic, F4 (O)M- - -Fb - - -M(O)F3 moiety coordinates to Ng through a single M- - -Fb -Ng bridge, both fluorine ligands of NgF2 coordinate to CrOF4 molecules to form F4 (O)Cr- - -Fb -Ng-Fb - - -Cr(O)F4 adducts in which both Ng-Fb bonds are only marginally elongated relative to the Ng-F bonds of free NgF2 . Quantum-chemical calculations show that the Cr-Fb bonds of NgF2 ⋅CrOF4 and NgF2 ⋅2CrOF4 are predominantly electrostatic with a small degree of covalent character that accounts for their nonlinear Cr- - -Fb -Ng bridge angles and staggered O-Cr- - -Fb -Ng-Ft dihedral angles. The crystal structures and Raman spectra of two CrOF4 polymorphs have also been obtained. Both are comprised of fluorine-bridged chains that are cis- and trans-fluorine-bridged with respect to oxygen.

Food Addiction: A Barrier for Effective Weight Management for Obese Adolescents.

BACKGROUND: Findings from studies of food addiction in adults suggest those with food addiction are less successful in weight-loss interventions. Little is known about food addiction in obesity treatment-seeking adolescents; therefore, the purpose of this study was to explore the prevalence of food addiction and correlates of food addiction symptoms in obese adolescents entering an outpatient, weight management program. METHODS: Obese adolescents (n = 26) were administered the Yale Food Addiction Scale for Children (YFAS-C), measures of appetitive responsiveness, and health-related quality of life (HRQOL) before and following a 12-week, outpatient, behavioral weight management program. Descriptive statistics and correlations between YFAS-C symptoms and study variables were performed and further examined with linear regression. Baseline differences were compared between those meeting criteria for food addiction to those who did not (independent t-tests) and pre-postweight management program changes were examined (paired t-tests). RESULTS: 30.7% met criteria for food addiction and 50% reported ≥3 symptoms. Number of YFAS-C symptoms was correlated with appetitive responsiveness (r = 0.57, p < 0.05) and inversely correlated with all domains of HRQOL (r = 0.47-0.53, p < 0.05). Attrition rate was higher in adolescents with food addiction compared to those without (62.5% vs. 44.4%, p < 0.05). CONCLUSIONS: Adolescents with food addiction or with a higher number of food addiction symptoms may warrant additional resources to support adherence to and retention with a weight management program. Implementing screening measures for food addiction before enrolling in a weight management program may be an effective strategy to identify adolescents who may benefit from adjunct modalities.

Coordination of KrF2 to a Naked Metal Cation, Mg2.

Examples of coordination compounds in which KrF2 functions as a ligand are very rare. In contrast, XeF2 provides a rich coordination chemistry with a variety of main-group and transition metal cations. The reactions of Mg(AsF6 )2 and KrF2 in HF or BrF5 solvent have afforded [Mg(KrF2 )4 (AsF6 )2 ] and [Mg(KrF2 )4 (AsF6 )2 ]⋅2 BrF5 , respectively, the first examples of a metal cation ligated by KrF2 . Their X-ray crystal structures and Raman spectra show that the KrF2 ligands and [AsF6 ]- anions are F-coordinated to a naked Mg2+ cation. Quantum-chemical calculations are consistent with essentially non-covalent ligand-metal bonding. These compounds significantly extend the XeF2 -KrF2 analogy and the limited chemistry of krypton by introducing a new class of coordination compound in which KrF2 functions as a ligand towards a naked metal cation.

Ethnic differences in the consistency and accuracy of perceived exertion.

OBJECTIVES: This study investigated the effect of weight loss and weight regain on accuracy of perceived exertion (APE) in previously overweight African American (AA) and European American (EA) women. METHODS: Formerly overweight women (n = 102, age 20-44 years) completed a weight loss program to achieve BMI < 25 kg/m(2) . Physiological variable of exertion and rating of perceived exertion (RPE, Borg's 6-20 Scale) were recorded during submaximal aerobic exercise prior to, immediately following, and approximately 1 year after weight loss. APE was defined as the composite score of physiological variables (heart rate, ventilation rate, and respiratory exchange ratio) minus RPE. RESULTS: APE was significantly different from the composite score of physiological variables at baseline and at 1-year follow-up for EA women (0.347 ± 0.88 P < 0.05 and 0.53 ± 0.92, P < 0.01, respectively) and at 1-year follow-up for AA (-0.37 ± 1.1, P < 0.01). EA women had lower physiological effort at baseline and 1-year follow-up states (-0.24 ± 0.66 P < 0.05; and, -0.27 ± 0.84 P < 0.05, respectively). AA women had higher physiological effort, at 1-year follow-up state (0.21 ± 0.61, P < 0.01). CONCLUSIONS: Physiologic effort and perceived exertion contributed independently to the racial differences in APE, and APE may be an important trait to evaluate before planning an exercise intervention. Am. J. Hum. Biol. 28:398-404, 2016. © 2015 Wiley Periodicals, Inc.

Can Medication Free, Treatment-Resistant, Depressed Patients Who Initially Respond to TMS Be Maintained Off Medications? A Prospective, 12-Month Multisite Randomized Pilot Study.

BACKGROUND: Repetitive transcranial magnetic stimulation (TMS) is efficacious for acute treatment of resistant major depressive disorder (MDD), but there is little information on maintenance TMS after acute response. OBJECTIVE/HYPOTHESIS: This pilot feasibility study investigated 12-month outcomes comparing two maintenance TMS approaches--a scheduled, single TMS session delivered monthly (SCH) vs. observation only (OBS). METHODS: Antidepressant-free patients with unipolar, non-psychotic, treatment-resistant MDD participated in a randomized, open-label, multisite trial. Patients meeting protocol-defined criteria for improvement after six weeks of acute TMS were randomized to SCH or OBS regimens. TMS reintroduction was available for symptomatic worsening; all patients remained antidepressant-free during the trial. RESULTS: Sixty-seven patients enrolled in the acute phase, and 49 (73%) met randomization criteria. Groups were matched, although more patients in the SCH group had failed ≥ 2 antidepressants (p = .035). There were no significant group differences on any outcome measure. SCH patients had nonsignificantly longer time to first TMS reintroduction, 91 ± 66 days, vs. OBS, 77 ± 52 days; OBS patients were nonsignificantly more likely to need reintroduction (odds ratio = 1.21, 95% CI .38-3.89). Reintroduction lasted 14.3 ± 17.8 days (SCH) and 16.9 ± 18.9 days (OBS); 14/18 (78%) SCH and 17/27 (63%) OBS responded to reintroduction. Sixteen patients (32.7%) completed all 53 weeks of the study. CONCLUSIONS: Maintaining treatment-resistant depressed patients off medications with periodic TMS appears feasible in some cases. There was no statistical advantage of SCH vs. OBS, although SCH was associated with a nonsignificantly longer time to relapse. Those who initially respond to TMS have a strong chance of re-responding if relapse occurs.

Heart Rate and Perceived Exertion in Healthy Weight and Obese Children During a Self-Selected Physical Activity Program.

BACKGROUND: Compared with structured/organized activities, unstructured, self-selected physical activity (PA) may be more appealing for children in particular obese (OB) children. We examined whether both healthy-weight (HW) and OB children would engage in moderate to vigorous intensity PA during an unstructured PA program and compared heart rate (HR) and rate of perceived exertion (RPE) between the children. METHODS: Twenty-one children [9 OB (≥95th BMI percentile, 12 HW (5th - <85th), 8.6 ± 0.8 years; 9 males, 12 females] participated in before-school (7:30 AM to 8:15 AM) PA for 18 weeks, 3 consecutive days/week. Each child wore a Polar E600 HR monitor and was provided a vigorous, age-targeted heart rate (THR) of 70%. RESULTS: Mean HR ≥ vigorous THR for all children in 65.3% of the sessions and exceeded moderate intensity in 100%. Over the 18-weeks, no significant difference was observed in the overall mean HR between the HW (171.4 ± 12.0) and OB (169.3 ± 13.0), however the OB reported significantly lower RPEs than the HW (16.9 ± 2.6 vs. 17.6 ± 1.5, respectively; P < .05). CONCLUSIONS: Both the HW and OB children consistently sustained PA of moderate and vigorous intensity. The current study provides insight regarding the physiological capabilities and perceptual responses of HW and OB children participating in PA programs.

A multisite, naturalistic, observational study of transcranial magnetic stimulation for patients with pharmacoresistant major depressive disorder: durability of benefit over a 1-year follow-up period.

OBJECTIVE: Transcranial magnetic stimulation (TMS) is an effective and safe acute treatment for patients not benefiting from antidepressant pharmacotherapy. Few studies have examined its longer term durability. This study assessed the long-term effectiveness of TMS in naturalistic clinical practice settings following acute treatment. METHOD: Adult patients with a primary diagnosis of unipolar, nonpsychotic major depressive disorder (DSM-IV clinical criteria), who did not benefit from antidepressant medication, received TMS treatment in 42 clinical practices. Two hundred fifty-seven patients completed a course of acute TMS treatment and consented to follow-up over 52 weeks. Assessments were obtained at 3, 6, 9, and 12 months. The study was conducted between March 2010 and August 2012. RESULTS: Compared with pre-TMS baseline, there was a statistically significant reduction in mean total scores on the Clinical Global Impressions-Severity of Illness scale (primary outcome), 9-Item Patient Health Questionnaire, and Inventory of Depressive Symptoms-Self Report (IDS-SR) at the end of acute treatment (all P < .0001), which was sustained throughout follow-up (all P < .0001). The proportion of patients who achieved remission at the conclusion of acute treatment remained similar at conclusion of the long-term follow-up. Among 120 patients who met IDS-SR response or remission criteria at the end of acute treatment, 75 (62.5%) continued to meet response criteria throughout long-term follow-up. After the first month, when the majority of acute TMS tapering was completed, 93 patients (36.2%) received reintroduction of TMS. In this group, the mean (SD) number of TMS treatment days was 16.2 (21.1). CONCLUSIONS: TMS demonstrates a statistically and clinically meaningful durability of acute benefit over 12 months of follow-up. This was observed under a pragmatic regimen of continuation antidepressant medication and access to TMS retreatment for symptom recurrence. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01114477.

Resting energy expenditure and systolic blood pressure relationships in women across 4.5 years.

Recent studies have reported a strong association between blood pressure (BP) and resting energy expenditure (REE). However, it is not known whether this relationship persists over time. Therefore, the authors examined the temporal relationship between REE and systolic BP. In addition, the impact of sympathetic tone and anthropometric variables on this relationship was examined. All testing was performed on healthy, overweight African American and European American women aged 25 to 45 years over 4.5 years in the University of Alabama at Birmingham General Clinical Research Center. Repeated-measures mixed-models revealed REE as a significant determinant of systolic BP (ß=0.0155, P<.0001), independent of catecholamines, leg fat, visceral fat, fat-free mass, fat mass, height, relative skeletal muscle index, and resting heart rate. Observations that REE is predictive of systolic BP across 4.5 years support previous findings that REE may potentially mediate resting BP, independent of anthropometric variables and a marker for sympathetic tone.

Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of quality of life outcome measures in clinical practice.

BACKGROUND: Transcranial magnetic stimulation (TMS) is an effective and safe therapy for major depressive disorder (MDD). This study assessed quality of life (QOL) and functional status outcomes for depressed patients after an acute course of TMS. METHODS: Forty-two, U.S.-based, clinical TMS practice sites treated 307 outpatients with a primary diagnosis of MDD and persistent symptoms despite prior adequate antidepressant pharmacotherapy. Treatment parameters were based on individual clinical considerations and followed the labeled procedures for use of the approved TMS device. Patient self-reported QOL outcomes included change in the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the EuroQol 5-Dimensions (EQ-5D) ratings from baseline to end of the acute treatment phase. RESULTS: Statistically significant improvement in functional status on a broad range of mental health and physical health domains was observed on the SF-36 following acute TMS treatment. Similarly, statistically significant improvement in patient-reported QOL was observed on all domains of the EQ-5D and on the General Health Perception and Health Index scores. Improvement on these measures was observed across the entire range of baseline depression symptom severity. CONCLUSION: These data confirm that TMS is effective in the acute treatment of MDD in routine clinical practice settings. This symptom benefit is accompanied by statistically and clinically meaningful improvements in patient-reported QOL and functional status outcomes.

[H(OXeF2)n][AsF6] and [FXe(II)(OXe(IV)F2)n][AsF6] (n = 1, 2): examples of xenon(IV) hydroxide fluoride and oxide fluoride cations and the crystal structures of [F3Xe---FH][Sb2F11] and [H5F4][SbF6]·2[F3Xe---FH][Sb2F11].

The xenon(IV) hydroxide fluoride and oxide fluoride salts, [H(OXeF2)n][AsF6] and [FXe(II)(OXe(IV)F2)n][AsF6] (n = 1, 2), have been synthesized as the natural abundance and the (18)O- and (2)H-enriched salts and structurally characterized by low-temperature Raman spectroscopy. Quantum-chemical calculations have been used to arrive at vibrational assignments. The experimental vibrational frequencies and isotopic shift trends are reproduced by the calculated gas-phase frequencies at several levels of theory. The cation chain is limited to one or two OXeF2 subunits, which are oxygen-bridged and strongly ion-paired with the AsF6(-) anion. The reaction of XeOF2·xHF with a superacidic HF/SbF5 solvent mixture yielded crystals of [H5F4][SbF6]·2[XeF3·HF][Sb2F11], [XeF3·HF][Sb2F11], and [XeF3][SbF6]. The XeF3(+) cations of each salt are very similar, displaying T-shaped primary coordination of xenon to three fluorine atoms (AX3E2 VSEPR arrangement) and a secondary contact to the fluorine atom of HF in [H5F4][SbF6]·2[XeF3·HF][Sb2F11] and [XeF3·HF][Sb2F11] or to a fluorine atom of SbF6(-) in [XeF3][SbF6]. The secondary coordination spheres of xenon in [H5F4][SbF6]·2[XeF3·HF][Sb2F11] and [XeF3·HF][Sb2F11] are similar; however, the F3Xe---FH(+) cation of the latter salt is disordered. An additional contact between the XeF3(+) cation and the SbF6(-) anion in [H5F4][SbF6]·2[XeF3·HF][Sb2F11] presumably alters the crystal packing sufficiently to give an ordered F3Xe---FH(+) cation, a rare example in which HF is coordinated to a noble gas. The latter compound also provides the first documentation of the H5F4(+) acidium ion, which forms a zigzag F4-chain terminated by SbF6(-) anions. Enthalpies and Gibbs free energies of reaction obtained from Born-Fajans-Haber thermochemical cycles support the proposed decomposition pathways.

Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of acute treatment outcomes in clinical practice.

BACKGROUND: Few studies have examined the effectiveness of transcranial magnetic stimulation (TMS) in real-world clinical practice settings. METHODS: Forty-two US-based clinical TMS practice sites treated 307 outpatients with Major Depressive Disorder (MDD), and persistent symptoms despite antidepressant pharmacotherapy. Treatment was based on the labeled procedures of the approved TMS device. Assessments were performed at baseline, week 2, at the point of maximal acute benefit, and at week 6 when the acute course extended beyond 6 weeks. The primary outcome was change in the Clinician Global Impressions-Severity of Illness from baseline to end of acute phase. Secondary outcomes were change in continuous and categorical outcomes on self-report depression scales (9-Item Patient Health Questionnaire [PHQ-9], and Inventory of Depressive Symptoms-Self Report [IDS-SR]). RESULTS: Patients had a mean ± SD age of 48.6 ± 14.2 years and 66.8% were female. Patients received an average of 2.5 (± 2.4) antidepressant treatments of adequate dose and duration without satisfactory improvement in this episode. There was a significant change in CGI-S from baseline to end of treatment (-1.9 ± 1.4, P < .0001). Clinician-assessed response rate (CGI-S) was 58.0% and remission rate was 37.1%. Patient-reported response rate ranged from 56.4 to 41.5% and remission rate ranged from 28.7 to 26.5%, (PHQ-9 and IDS-SR, respectively). CONCLUSION: Outcomes demonstrated response and adherence rates similar to research populations. These data indicate that TMS is an effective treatment for those unable to benefit from initial antidepressant medication.

The effect of an unstructured, moderate to vigorous, before-school physical activity program in elementary school children on academics, behavior, and health.

BACKGROUND: Physical inactivity has been deemed a significant, contributing factor to childhood overweight and obesity. In recent years, many school systems removed recess and/or physical education from their curriculum due to growing pressure to increase academic scores. With the vast majority of children's time spent in school, alternative strategies to re-introduce physical activity back into schools are necessary. A creative yet underutilized solution to engage children in physical activity may be in before-school programs. The objective of the proposed study is to examine the effect of an unstructured, moderate to vigorous, before-school physical activity program on academic performance, classroom behavior, emotions, and other health related measures. METHODS/DESIGN: Children in 3rd-5th grade will participate in a before-school (7:30-8:15 a.m.), physical activity program for 12 weeks, 3 days a week. Children will be able to choose their preferred activity and asked to sustain physical activity of moderate to vigorous intensity with individual heart rate monitored during each session. DISCUSSION: The proposed study explores an innovative method of engaging and increasing physical activity in children. The results of this study will provide evidence to support the feasibility of an unstructured, moderate to vigorous, before-school physical activity program in children and provide insight regarding the ideal physical activity intensity and duration necessary to achieve a positive increase in academic performance. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01505244.

Influence of resting energy expenditure on blood pressure is independent of body mass and a marker of sympathetic tone.

Two recent examinations reported a strong association between blood pressure (BP) and resting energy expenditure (REE), independent of body mass and body composition. Both reports postulate that neurohumoral processes that contribute to variation in REE may partly mediate the body mass effect on BP. Therefore, we examined the relationship of REE and BP in 108 asymptomatic women (a) to confirm previous findings in a novel population and (b) to examine the impact of a marker of sympathetic tone on this relationship, as this was indicated as a potentially salient intermediary in previous reports. All testing was performed during a 4-day admission to the General Clinical Research Center. Resting energy expenditure was measured by indirect calorimetry, body composition was determined by dual-energy x-ray absorptiometry, and 24-hour fractionated urinary norepinephrine was determined by high-performance liquid chromatography. Multiple linear regression revealed REE as a significant predictor of systolic BP (ß = 0.30, P = .04), independent of race (ß = 0. 28, P = .01), age (ß = -0.02, P = .80), height (ß = -0.38, P = .08), fat mass (ß = 0.22, P = .20), fat-free mass (ß = 0.08, P = .65), and 24-hour fractionated urinary norepinephrine (ß = 0.06, P = .57); and the same model using diastolic BP as the dependent variable approached significance (ß = 0.24, P = .09). This study affirms previous findings that REE may be a potential mediator in resting BP, independent of many well-cited factors and, additionally, a marker of sympathetic tone.