The effectiveness of exercise interventions targeting sleep in older adults with cognitive impairment or Alzheimer's disease and related dementias (AD/ADRD): A systematic review and meta-analysis.

Sleep loss is associated with reduced health and quality of life, and increased risk of Alzheimer's disease and related dementias. Up to 66% of persons with Alzheimer's disease and related dementias experience poor sleep, which can predict or accelerate the progression of cognitive decline. Exercise is a widely accessible intervention for poor sleep that can protect against functional and cognitive decline. No previous systematic reviews have investigated the effectiveness of exercise for sleep in older adults with mild cognitive impairment or Alzheimer's disease and related dementias. We systematically reviewed controlled interventional studies of exercise targeting subjectively or objectively (polysomnography/actigraphy) assessed sleep in persons with mild cognitive impairment or Alzheimer's disease and related dementias. We conducted searches in PubMed, Embase, Scopus and Cochrane-Library (n = 6745). Nineteen randomised and one non-randomised controlled interventional trials were included, representing the experiences of 3278 persons with mild cognitive impairment or Alzheimer's disease and related dementias. Ten had low-risk, nine moderate-risk, and one high-risk of bias. Six studies with subjective and eight with objective sleep outcomes were meta-analysed (random-effects model). We found moderate- to high-quality evidence for the beneficial effects of exercise on self-reported and objectively-measured sleep outcomes in persons with mild cognitive impairment or Alzheimer's disease and related dementias. However, no studies examined key potential moderators of these effects, such as sex, napping or medication use. Our results have important implications for clinical practice. Sleep may be one of the most important modifiable risk factors for a range of health conditions, including cognitive decline and the progression of Alzheimer's disease and related dementias. Given our findings, clinicians may consider adding exercise as an effective intervention or adjuvant strategy for improving sleep in older persons with mild cognitive impairment or Alzheimer's disease and related dementias.

Super-resolution mapping in rod photoreceptors identifies rhodopsin trafficking through the inner segment plasma membrane as an essential subcellular pathway.

Photoreceptor cells in the vertebrate retina have a highly compartmentalized morphology for efficient phototransduction and vision. Rhodopsin, the visual pigment in rod photoreceptors, is densely packaged into the rod outer segment sensory cilium and continuously renewed through essential synthesis and trafficking pathways housed in the rod inner segment. Despite the importance of this region for rod health and maintenance, the subcellular organization of rhodopsin and its trafficking regulators in the mammalian rod inner segment remain undefined. We used super-resolution fluorescence microscopy with optimized retinal immunolabeling techniques to perform a single molecule localization analysis of rhodopsin in the inner segments of mouse rods. We found that a significant fraction of rhodopsin molecules was localized at the plasma membrane, at the surface, in an even distribution along the entire length of the inner segment, where markers of transport vesicles also colocalized. Thus, our results collectively establish a model of rhodopsin trafficking through the inner segment plasma membrane as an essential subcellular pathway in mouse rod photoreceptors.

The effects of acute exercise and a nap on heart rate variability and memory in young sedentary adults.

Recent evidence suggests that the autonomic nervous system can contribute to memory consolidation during sleep. Whether fluctuations in cardiac autonomic activity during sleep following physical exercise contribute to the process of memory consolidation has not been studied. We assessed the effects of a non-rapid eye movement (NREM) nap following acute exercise on cardiac autonomic regulation assessed with heart rate variability (HRV) to examine if HRV influences memory processes. Fifty-six (59% female) healthy young adults (23.14 ± 3.74 years) were randomly allocated to either the exercise plus nap (ExNap, n = 27) or nap alone (NoExNap, n = 29) groups. The ExNap group performed a 40-minute moderate-intensity cycling, while the NoExNap group was sedentary prior to learning 45 neutral pictures for a later test. Subsequently, participants underwent a 60-minute NREM nap while measuring EKG, followed by a visual recognition test. Our results indicated that heart rate did not significantly differ between the groups (p = .243), whereas vagally mediated HRV indices were lower in the ExNap group compared to the NoExNap group (p < .05). There were no significant differences in sleep variables between the groups (p > .05). Recognition accuracy was significantly higher in the ExNap group than in the NoExNap group (p = .027). In addition, the recognition accuracy of the ExNap group was negatively associated with vagally mediated HRV (p < .05). Pre-nap acute exercise appears to attenuate parasympathetic activity and to alter the relationship between memory and cardiac autonomic activity.

An approach to assess data-less small-scale fisheries: examples from Congo rivers.

Small-scale fisheries (SSF) account for much of the global fish catch, but data to assess them often do not exist, impeding assessments of their historical dynamics and status. Here, we propose an approach to assess 'data-less' SSF using local knowledge to produce data, life history theory to describe their historical multispecies dynamics, and length-based reference points to evaluate stock status. We demonstrate use of this approach in three data-less SSFs of the Congo Basin. Fishers' recalls of past fishing events indicated fish catch declined by 65-80% over the last half-century. Declines in and depletion of many historically important species reduced the diversity of exploited species, making the species composition of the catch more homogenous in recent years. Length-at-catch of 11 of the 12 most important species were below their respective lengths-at-maturity and optimal lengths (obtained from Fishbase) in recent years, indicating overfishing. The most overfished species were large-bodied and found in the Congo mainstem. These results show the approach can suitably assess data-less SSF. Fishers' knowledge produced data at a fraction of the cost and effort of collecting fisheries landings data. Historical and current data on fish catch, length-at-catch, and species diversity can inform management and restoration efforts to curb shifting baselines of these fisheries. Classification of stock status allows prioritizing management efforts. The approach is easy to apply and generates intuitive results, having potential to complement the toolkits of researchers and managers working in SSF and engage stakeholders in decision-making processes. Supplementary Information: The online version contains supplementary material available at 10.1007/s11160-023-09770-x.

Mapping rhodopsin trafficking in rod photoreceptors with quantitative super-resolution microscopy.

Photoreceptor cells in the vertebrate retina have a highly compartmentalized morphology for efficient long-term phototransduction. Rhodopsin, the visual pigment in rod photoreceptors, is densely packaged into the rod outer segment sensory cilium and continuously renewed through essential synthesis and trafficking pathways housed in the rod inner segment. Despite the importance of this region for rod health and maintenance, the subcellular organization of rhodopsin and its trafficking regulators in the mammalian rod inner segment remain undefined. We used super-resolution fluorescence microscopy with optimized retinal immunolabeling techniques to perform a single molecule localization analysis of rhodopsin in the inner segments of mouse rods. We found that a significant fraction of rhodopsin molecules was localized at the plasma membrane in an even distribution along the entire length of the inner segment, where markers of transport vesicles also colocalized. Thus, our results collectively establish a model of rhodopsin trafficking through the inner segment plasma membrane as an essential subcellular pathway in mouse rod photoreceptors.

Acute evening high-intensity interval training may attenuate the detrimental effects of sleep restriction on long-term declarative memory.

Recent evidence shows that a nap and acute exercise synergistically enhanced memory. Additionally, human-based cross-sectional studies and animal experiments suggest that physical exercise may mitigate the cognitive impairments of poor sleep quality and sleep restriction, respectively. We evaluated whether acute exercise may offset sleep restriction's impairment of long-term declarative memory compared to average sleep alone. A total of 92 (82% females) healthy young adults (24.6 ± 4.2 years) were randomly allocated to one of four evening groups: sleep restriction only (S5, 5-6 h/night), average sleep only (S8, 8-9 h/night), high-intensity interval training (HIIT) before restricted sleep (HIITS5), or HIIT before average sleep (HIITS8). Groups either followed a 15-min remote HIIT video or rest period in the evening (7:00 p.m.) prior to encoding 80 face-name pairs. Participants completed an immediate retrieval task in the evening. The next morning a delayed retrieval task was given after their subjectively documented sleep opportunities. Long-term declarative memory performance was assessed with the discriminability index (d') during the recall tasks. While our results showed that the d' of S8 (0.58 ± 1.37) was not significantly different from those of HIITS5 (-0.03 ± 1.64, p = 0.176) and HIITS8 (-0.20 ± 1.28, p = 0.092), there was a difference in d' compared to S5 (-0.35 ± 1.64, p = 0.038) at the delayed retrieval. These results suggest that the acute evening HIIT partially reduced the detrimental effects of sleep restriction on long-term declarative memory.

Physical-Layer Security with Irregular Reconfigurable Intelligent Surfaces for 6G Networks.

The goal of 6G is to make far-reaching changes in communication systems with stricter demands, such as high throughput, extremely low latency, stronger security, and ubiquitous connectivity. Several promising techniques, such as reconfigurable intelligent surfaces (RISs), have been introduced to achieve these goals. An RIS is a 2D low-cost array of reflecting elements that can adjust the electromagnetic properties of an incident signal. In this paper, we guarantee secrecy by using an irregular RIS (IRIS). The main idea of an IRIS is to irregularly activate reflecting elements for a given number of RIS elements. In this work, we consider a communication scenario in which, with the aid of an IRIS, a multi-antenna base station establishes a secure link with a legitimate single-antenna user in the presence of a single-antenna eavesdropper. To this end, we formulate a topology-and-precoding optimization problem to maximize the secrecy rate. We then propose a Tabu search-based algorithm to jointly optimize the RIS topology and the precoding design. Finally, we present simulation results to validate the proposed algorithm, which highlights the performance gain of the IRIS in improving secure transmissions compared to an RIS. Our results show that exploiting an IRIS can allow additional spatial diversity to be achieved, resulting in secrecy performance improvement and overcoming the limitations of conventional RIS-assisted systems (e.g., a large number of active elements).

Assessing Public Awareness of the Malaria Vaccine in Sub-Saharan Africa.

BACKGROUND: Malaria infection remains one of the leading causes of death in sub-Saharan Africa. Over the years, several measures have been implemented for the prevention of malaria, including vector control with insecticide-treated nets, indoor residual spraying, and seasonal or traveling prophylactics. In 2021, the World Health Organization (WHO) approved the use of the malaria vaccine in children. We conducted a cross-sectional survey study in three sub-Saharan African countries-Uganda, Ghana, and Nigeria-to assess public awareness of the malaria vaccine among the residents of these countries. METHOD: A cross-sectional, web-based survey was conducted between time January 2022 and April 2022 using Qualtrics® software (Version number: April 2022; Qualtrics, Provo, UT, USA). A total of 3896 responses were analyzed using SAS OnDemand for Academics software. Linear regression model was used to assess the relationship between the demographic characteristics and awareness of the malaria vaccine, using a level of significance (alpha) of 0.05. RESULT: Overall, there was significant association between the level of education and public awareness of the malaria vaccine in each of the countries studied. Gender and place of residence were associated with awareness in Nigeria and Uganda, while younger respondents were more likely to be aware of the malaria vaccine in Ghana. CONCLUSION: Given the negative impact of lack of awareness and knowledge, misinformation and conspiracy theories on immunization programs, public health campaigns preceding the population-wide roll-out of the novel malaria vaccine should target the less-educated, and those residing in more rural areas, while assuring equitable access to the malaria vaccine across sub-Saharan Africa.

The effects of napping on night-time sleep in healthy young adults.

The discrepancies in the effects of napping on sleep quality may be due to differences in methodologies, napping behaviours, and daytime activity levels across studies. We determined whether napping behaviours and daytime activity levels are associated with night-time sleep fragmentation and sleep quality in young adults. A total of 62 healthy adults (mean [SD] age 23.5 [4.2] years) completed screening questionnaires for sleep habits, physical activity, medical and psychological history. Actigraphy was used to record sleep including naps. The fragmentation algorithm (KRA ) was applied to the actigraphic data to measure night-time sleep fragmentation. We classified participants' nap frequency as "non-nappers" (0 naps/8 days), "moderate nappers" (1-2 naps/8 days) or "frequent nappers" (≥3 naps/8 days) naps. Nap duration was defined as "short" (≤60 min) or "long" (>60 min). Naps' proximity to the night sleep episode was defined as "early" (≥7 h) and "late" (<7 h) naps. Outcome variables were night-time KRA and actigraphic sleep variables. Frequent nappers had a significantly higher KRA than moderate nappers (p < 0.01) and non-nappers (p < 0.02). Late naps were associated with poorer measures of night sleep quality versus early naps (all p ≤ 0.02). Nap duration and daytime activity were not associated with significant differences in the outcome variables (all p > 0.05). KRA correlated with sleep duration, sleep efficiency, and awakenings (r = -0.32, -0.32, and 0.53, respectively; all p < 0.05). Frequent napping and late naps may be associated with increased sleep fragmentation and poorer sleep quality, reflected in longer sleep onsets and increased awakenings. These findings have implications for public health sleep hygiene recommendations.

A Landscape Epidemiological Approach for Predicting Chronic Wasting Disease: A Case Study in Virginia, US.

Many infectious diseases in wildlife occur under quantifiable landscape ecological patterns useful in facilitating epidemiological surveillance and management, though little is known about prion diseases. Chronic wasting disease (CWD), a fatal prion disease of the deer family Cervidae, currently affects white-tailed deer (Odocoileus virginianus) populations in the Mid-Atlantic United States (US) and challenges wildlife veterinarians and disease ecologists from its unclear mechanisms and associations within landscapes, particularly in early phases of an outbreak when CWD detections are sparse. We aimed to provide guidance for wildlife disease management by identifying the extent to which CWD-positive cases can be reliably predicted from landscape conditions. Using the CWD outbreak in Virginia, US from 2009 to early 2020 as a case study system, we used diverse algorithms (e.g., principal components analysis, support vector machines, kernel density estimation) and data partitioning methods to quantify remotely sensed landscape conditions associated with CWD cases. We used various model evaluation tools (e.g., AUC ratios, cumulative binomial testing, Jaccard similarity) to assess predictions of disease transmission risk using independent CWD data. We further examined model variation in the context of uncertainty. We provided significant support that vegetation phenology data representing landscape conditions can predict and map CWD transmission risk. Model predictions improved when incorporating inferred home ranges instead of raw hunter-reported coordinates. Different data availability scenarios identified variation among models. By showing that CWD could be predicted and mapped, our project adds to the available tools for understanding the landscape ecology of CWD transmission risk in free-ranging populations and natural conditions. Our modeling framework and use of widely available landscape data foster replicability for other wildlife diseases and study areas.

The effects of evening high-intensity exercise on sleep in healthy adults: A systematic review and meta-analysis.

Moderate-intensity exercise is generally recommended for improving sleep, whereas, high-intensity exercise (HIE) prior to bedtime is often discouraged. We conducted a systematic review and meta-analysis to determine if acute or regular (chronic) HIE performed before bedtime disrupts nighttime sleep of healthy adult, good sleepers compared with a no-exercise control. Six databases (PubMed, EMBASE, Scopus, Web of Science, CENTRAL, and PsycINFO) were searched from inception to 31st May, 2021. Studies were experimental trials published in English language, objectively (polysomnography, actigraphy) and/or subjectively assessed sleep after evening HIE in sedentary and physically fit, good sleepers (aged 18-50 y old). The revised Cochrane risk of bias tool for randomized trials was used to assess risk of bias in the included studies. The random-effects model was used for the meta-analyses. We included 15 acute evening HIE studies in the meta-analysis with a total of 194 participants. Acute evening HIE ending 0.5-4 h before bedtime decreased rapid eye movement sleep (-2.34%; p = 0.002) compared with a no-exercise control. No other significant sleep changes occurred. A regular evening HIE did not disrupt nighttime sleep. Overall, acute evening HIE performed 2-4 h before bedtime does not disrupt nighttime sleep of healthy, young and middle-aged adults. PROSPERO, protocol registration number: CRD42020218299.

Prevalence and lifestyle-associated risk factors of metabolic syndrome among commercial motor vehicle drivers in a metropolitan city in Ghana.

INTRODUCTION: commercial motor vehicle drivers are at risk of metabolic syndrome (MetS) due to the nature of their work as they tend to go to work early, work for more hours, have irregular dietary habits and patterns, have little sleep and live sedentary lifestyle. The study sought to determine the prevalence and lifestyle-related risk factors of MetS among commercial taxi drivers around Kwame Nkrumah University of Science and Technology (KNUST) campus, in the Kumasi metropolis, Ghana. METHODS: a cross-sectional survey was conducted among 100 commercial taxi drivers in 3 selected taxi ranks around KNUST campus. Fasting blood lipid and fasting blood glucose levels, blood pressure and anthropometric characteristics were determined using WHO and NCEP-ATP III criteria. Lifestyle-related risk factors of MetS were assessed using a semi-structured questionnaire and dietary pattern was assessed using food frequency questionnaire. Bivariate analysis and linear correlation were used to determine the relationship between lifestyle practices and MetS. RESULTS: the prevalence of diabetes, high blood pressure, dyslipidemia, overweight and obesity were 12%, 63%, 40%, 32% and 13% respectively. The prevalence of MetS was 5% according to NCEP-ATP III (2005) criteria. The lifestyle behaviours of the drivers were, alcohol intake, irregular dietary pattern, long working hours, lack of exercise and tiredness due to driving. Tobacco use (R = 0.405, p = 0.041) and time of supper (R = 0.931, p = 0.047) were related with MetS among the participants. CONCLUSION: though prevalence of MetS (5%) was low among the drivers, the need for intervention to promote positive lifestyle change and curb the high prevalence of overweight/obesity, diabetes, high blood pressure and dyslipidemia is necessary to improve the health of the drivers and the safety of passengers.

The Influence of Forests on Freshwater Fish in the Tropics: A Systematic Review.

Tropical forests influence freshwater fish through multiple pathways, only some of which are well documented. We systematically reviewed the literature to assess the current state of knowledge on forests and freshwater fish in the tropics. The existing evidence is mostly concentrated in the neotropics. The majority of studies provided evidence that fish diversity was higher where there was more forest cover; this was related to the greater heterogeneity of resources in forested environments that could support a wider range of species. Studies quantifying fish abundance (or biomass) showed mixed relationships with forest cover, depending on species-specific habitat preferences. We identify the key challenges limiting our current understanding of the forest-fish nexus and provide recommendations for future research to address these knowledge gaps. A clear understanding of the functional pathways in forest-freshwater ecosystems can improve evidence-based policy development concerned with deforestation, biodiversity conservation, and food insecurity in the tropics.

Improvements in Objectively Measured Activity Behaviors Do Not Correlate With Improvements in Patient-Reported Outcome Measures Following Total Knee Arthroplasty.

BACKGROUND: Activity monitors have added a new dimension to our ability to objectively measure physical activity in patients undergoing total knee arthroplasty (TKA). The aim of the study is to assess whether changes in the time spent sitting, standing, and stepping were associated with changes in patient-reported outcome measures (PROMs) before and after TKA. METHODS: Valid activPAL data (>3 days) and PROMs were obtained from 49 men and women (mean [SD] age, 62.8 [8.6] years; body mass index, 33.8 [7.1] kg/m2) who underwent primary TKA, before and at 6 weeks or 6 months after surgery. Patient-reported symptoms of pain, stiffness, and knee function were obtained using the Knee injury and Osteoarthritis Outcome Score and Oxford Knee Score questionnaires. RESULTS: Mean (SD) Knee injury and Osteoarthritis Outcome Score (80.1 [16.3] to 41.6 [6.5], P < .001) and Oxford Knee Score (12.0 [9.8] to 17.7 [22.8], P < .001) scores improved 6 months after TKA. Walking time (mean [95% confidence interval]; min/d) increased from before (79 [67-91]) to 6 months after TKA (101 [88-114], P = .006). Standing time (318 [276-360] to 321 [291-352], P = .782) and sitting time (545 [491-599] to 509.0 [459.7-558.3], P = .285) did not change from before to 6 months after TKA. Participants took more steps (2559 [2128-2991] to 3515 [2983-4048] steps/day, P = .001) and accumulated more steps (31 [30-34] to 34 [33-35] steps/min, P < .001) after TKA compared to before. There were no associations between changes in activity behaviors and changes in PROMs (P > .05). CONCLUSION: Despite improvements in self-reported knee pain and functional ability, these changes do not correlate with improvements in objectively measured light-intensity and sedentary activity behaviors.

Ergometer cycling improves the ambulatory function and cardiovascular fitness of stroke patients-a randomized controlled trial.

[Purpose] The aim of this study was to assess the effects of ergometer cycling on the ambulatory function and cardiovascular fitness of patients with stroke in the sub-acute phase. [Participants and Methods] Twenty (20) patients with stroke in the sub-acute phase were randomly allocated to either an ergometer cycling group (n=10) or a control group (n=10). The experimental (ergometer cycling) group performed cycling exercises in addition to conventional physiotherapy for 60 minutes per session, three times per week for 8 weeks. The control group only received conventional physiotherapy for the same duration as the experimental group. Assessments of participants' functional ambulatory category, ambulatory velocity, 6-minute walk test, heart rate and blood pressure were conducted at baseline and at the end of the 8-week intervention. [Results] The means of the ambulatory velocity and distance walked in 6 minutes were significantly higher in the ergometer cycling group than those of the control group at week 8. However, the increase in the FAC score was not significant. The means of heart rate, systolic and diastolic blood pressures significantly decreased in the ergometer cycling group compared to the control group at the end of the 8-week of intervention. [Conclusion] This study demonstrated that ergometer cycling improved the ambulatory function and cardiovascular fitness of patients with stroke in the sub-acute phase.

Light intensity physical activity increases and sedentary behavior decreases following total knee arthroplasty in patients with osteoarthritis.

PURPOSE: To describe objectively measured changes in the volume and pattern of physical activity and sedentary behavior in patients undergoing total knee arthroplasty for osteoarthritis. METHODS: Physical activity and sedentary behavior were measured in patients (13 males, 76 females) with a mean age of 64 years (range 55-80) and end-stage osteoarthritis of the knee, using an accelerometer (ActiGraph GT3X+) for seven consecutive days (24 h/day) prior to, 6 weeks and 6 months after total knee arthroplasty. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), University of California Los Angeles (UCLA) Activity index and range of motion (ROM) were also assessed. RESULTS: Proportion of time spent in sedentary behavior decreased from baseline to 6 months (mean 70.1 vs. 64.0%; p = 0.009) and the interruptions to sedentary behavior improved between baseline and 6 months after total knee arthroplasty (mean 85.0-93.0 breaks/day, p = 0.014). Proportion of time spent in light physical activity increased from baseline to 6 months after total knee arthroplasty (29.0 vs. 34.8%; p = 0.008). There was no change in time spent in moderate to vigorous physical activity after total knee arthroplasty. WOMAC (median 71.0 vs. 4.0, p < 0.001), UCLA (median 2.0 vs. 5.0, p < 0.001) as well as ROM [median (0.0°-90.0°) vs. (0.0°-110°), p < 0.05] scores improved between baseline and 6 months after total knee arthroplasty. CONCLUSION: Clinically, functional improvements in patients following total knee arthroplasty may be assessed by objectively measuring changes in low intensity activity behaviors. The use of accelerometers in this study gives new insights into activity accumulation patterns in a clinical population and highlights their use in determining a behavioral response to an intervention. LEVEL OF EVIDENCE: II.

The effect of home-based low-volume, high-intensity interval training on cardiorespiratory fitness, body composition and cardiometabolic health in women of normal body mass and those with overweight or obesity: protocol for a randomized controlled trial.

BACKGROUND: There is a high prevalence of women in South Africa with overweight and obesity which is associated with an increased risk of cardiometabolic disorders. Perceived barriers such as lack of time and motivation reduce engagement in beneficial activity behaviours for health. High-intensity interval training (HIIT) is a time-efficient and effective way to improve cardiometabolic risk profile regardless of a loss in body mass or change in body composition. This randomized controlled trial aims to determine the effects on cardiorespiratory fitness, body composition and cardiometabolic health and feasibility of a home-based 14-week HIIT program in women with overweight/obesity or normal body mass. METHODS: One hundred and twenty women (18-40 years old) with a body mass index between 20 and 35 kg/m2, will be stratified according to their BMI (normal, BMI 20-24.9 kg/m2; or high BMI ≥25 kg/m2) and randomized into a HIIT exercising group (HIIT) or a non-exercising control group (CON). HIIT participants will perform exercises for 11 min/session six times per week for a period of 14 weeks. The 2 × 4 HIIT protocol will require a work phase of own-body weight exercise lasting 2 minutes (85% VO2peak), repeated four times and separated by a one-minute active rest phase (65% VO2peak). CON participants will be asked to maintain their normal habitual lifestyle. Outcomes of cardiorespiratory fitness, body composition, echocardiography, central blood pressure, arterial stiffness and biomarkers of cardiometabolic health will be measured before and after the 14-week intervention. Every 4 weeks during the intervention, an objective estimation of compliance to the study protocol will be assessed by measuring participant physical activity over 7 days using an Actigraph GT3X accelerometer. DISCUSSION: Supervised laboratory-based HIIT interventions are effective in improving cardiometabolic health. More pragmatic exercise protocols may however show to be successful for mitigating barriers to the engagement in physical activity and exercise resulting in positive benefits to health. Investigation into home-based HIIT regimens are important in women, where globally the rising trend of overweight and obesity overshadows that of men. The results from this study may therefore inform future research on effective exercise prescription for women's health. TRIAL REGISTRATION: Pan African Clinical Trial Registry (www.pactr.org - id no: PACTR201806003434299), 6th June 2018.

Colorectal cancer survival rates in Ghana: A retrospective hospital-based study.

BACKGROUND: Colorectal cancer (CRC) is one of the commonest cancers associated with diverse prognosis times in different parts of the world. Despite medical interventions, the overall clinical outcomes and survival remains very poor for most patients in developing countries. This study therefore investigated the survival rate of colorectal cancer and its prognostic factors among patients at Komfo Anokye Teaching Hospital, Ghana. METHODOLOGY: In this retrospective cohort study, a total of 221 patients diagnosed with CRC from 2009 to 2015 at the Surgical and Oncological units of Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana were employed. The survival graphs were obtained using the Kaplan-Meier method and compared by the Log-rank test. Cox regression analysis was used to assess prognostic factors. All analyses were performed by SPSS version 22. RESULTS: The median survival time was 15 months 95% CI (11.79-18.21). The overall survival rate for CRC over the 5 years period was 16.0%. The survival rates at the 1st, 2nd, 3rd, 4th and 5th years were 64% 95% CI (56.2-71.1), 40% 95% CI (32.2-50.1), 21% 95% CI (11.4-30.6) 16% 95% CI (8.9-26.9) and 16% 95% CI (7.3-24.9). There was a significant difference in the survival rate of colorectal cancer according to the different stages (p = 0.0001). Family history [HR = (3.44), p = 0.029)], Chemotherapy [HR = (0.23), p = <0.0001)], BMI [HR = (1.78), p = 0.017)] and both chemo/radiotherapy (HR = (3.63), p = 0.042)] were the significant social and clinical factors influencing the overall survival. Pathological factors such as TNM tumour stage (p = 0.012), depth of tumour invasion (p = 0.036), lymph node metastasis (p = 0.0001), and distance metastasis (p = 0.001) were significantly associated with overall survival. CONCLUSION: The study has clearly demonstrated that survival rate for CRC patients at KATH, Ghana is very low in a 5 years period. This is influenced by significant number of clinical and pathological prognostic factors. Identification of prognostic factors would be a primary basis for early prediction and treatment of patients with colorectal cancer.

Elevated Proangiogenic Markers are Associated with Vascular Complications within Ghanaian Sickle Cell Disease Patients.

: Sickle cell disease (SCD) is an inherited blood disorder that can result in vasculopathy and end organ damage. Angiogenesis has been implicated as a key contributing factor to vascular mediated tissue injury in SCD. The relative plasma levels of angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), and vascular endothelial growth factor (VEGF) greatly influence angiogenesis. Dysregulation of these growth factors, leading to a pro-angiogenic state in SCD patients, has been documented in the developed world but there is very little data in Africa. There is the need, therefore, for studies in Ghanaian SCD patients. The aim of this study was to assess plasma levels of Ang-1, Ang-2, and VEGF in homozygous (HbSS) SCD patients with or without complications and healthy controls (HbAA) in Ghana. The study was a case-control study involving 544 participants: 396 HbSS SCD patients and 148 HbAA healthy controls. The study was conducted at the Center for Clinical Genetics (Sickle Cell Clinic) and Accra Area Blood Centre for National Blood transfusion at the Korle-Bu Teaching Hospital, Accra, Ghana. The plasma levels of Ang-1, Ang-2, and VEGF of study participants were measured with a double sandwich enzyme-linked immunosorbent assay (ELISA) technique. Complete blood count (CBC) was measured with an autoanalyser. The mean plasma Ang-1, Ang-2, and VEGF were significantly higher in HbSS SCD patients with or without complications than healthy controls (p < 0.001). The Ang-2/Ang-1 ratio was significantly lower in the controls than the HbSS patients (p < 0.001). The Ang-2/Ang-1 ratio was higher in the HbSS patients with leg ulcers as compared with patients with other complications and healthy controls (p < 0.001). There were higher leucocyte counts in HbSS patients than healthy controls. Overall, there was elevated plasma levels of Ang-1, Ang-2, and VEGF in SCD patients. The higher Ang-2/Ang-1 plasma levels in patients with leg ulcers suggests a possible ongoing angiogenesis and response to inflammatory stimuli. The study provides a first report on plasma levels of angiopoietin-1, angiopoietin-2, and vascular endothelial growth factors in homozygous sickle cell disease patients in Ghana.

Effects of packaging and pre-storage treatments on aflatoxin production in peanut storage under controlled conditions.

This study reports on aflatoxin production and peanut (Bailey's variety) quality, for four peanut pre-storage treatments; [(Raw clean (Raw-Cl), Raw inoculated with Aspergillus flavus NRRL 3357 (Raw-Inf), inoculated partially roasted but not-blanched (PRN-blanch); and inoculated partially roasted, blanched with discolored nuts sorted out (PR-blanched)]. All four treated samples were packaged in four different packaging systems [polypropylene woven sacks (PS), hermetic packs (HP), hermetic packs with oxygen absorbers (HPO), and vacuumed hermetic packs (HPV)] and stored under controlled conditions at a temperature of 30 ± 1 °C and water activity of 0.85 ± 0.02, for 14 weeks. Raw-Inf samples in PS had a higher fungal growth with a mean value of 8.01 × 104 CFU/g, compared to the mean values of samples in hermetic packs: 1.07 × 103 CFU/g for HP, 14.55 CFU/g for HPO, and 57.82 CFU/g for HPV. Similarly, the hermetic bags were able to reduce aflatoxin level of the Raw-Inf samples by 50.6% (HP), 63.0% (HPV), and 66.8% (HPO). Partial roasting and blanching in PS also reduced aflatoxin level by about 74.6%. Quality maintenance was the best for peanuts in HPO, recording peroxide value (PV) of 10.16 meq/kg and p-Anisidine (p-Av) of 3.95 meq/kg compared to samples in polypropylene woven sacks which had PV of 19.25 meq/kg and p-Av of 6.48 meq/kg. These results indicate that using zero-oxygen hermetic packaging, instead of the conventional polypropylene woven sacks, helped to suppress aflatoxin production and quality deterioration. Also, partially roasted, blanched and sorted peanuts showed a potential for reducing aflatoxin presence during storage.