Criterion-Related Validity of Consumer-Wearable Activity Trackers for Estimating Steps in Primary Schoolchildren under Controlled Conditions: Fit-Person Study.

The purposes were to examine the criterion-related validity of the steps estimated by consumer-wearable activity trackers (wrist-worn activity trackers: Fitbit Ace 2, Garmin Vivofit Jr, and Xiomi Mi Band 5; smartphone applications: Pedometer, Pedometer Pacer Health, and Google Fit/Apple Health) and their comparability in primary schoolchildren under controlled conditions. An initial sample of 66 primary schoolchildren (final sample = 56; 46.4% females), aged 9-12 years old (mean = 10.4 ± 1.0 years), wore three wrist-worn activity trackers (Fitbit Ace 2, Garmin Vivofit Jr 2, and Xiaomi Mi Band 5) on their non-dominant wrist and had three applications in two smartphones (Pedometer, Pedometer Pacer Health, and Google Fit/Apple Health for Android/iOS installed in Samsung Galaxy S20+/iPhone 11 Pro Max) in simulated front trouser pockets. Primary schoolchildren's steps estimated by the consumer-wearable activity trackers and the video-based counting independently by two researchers (gold standard) were recorded while they performed a 200-meter course in slow, normal and brisk pace walking, and running conditions. Results showed that the criterion-related validity of the step scores estimated by the three Samsung applications and the Garmin Vivofit Jr 2 were good-excellent in the four walking/running conditions (e.g., MAPE = 0.6-2.3%; lower 95% CI of the ICC = 0.81-0.99), as well as being comparable. However, the Apple applications, Fitbit Ace 2, and Xiaomi Mi Band 5 showed poor criterion-related validity and comparability on some walking/running conditions (e.g., lower 95% CI of the ICC < 0.70). Although, as in real life primary schoolchildren also place their smartphones in other parts (e.g., schoolbags, hands or even somewhere away from the body), the criterion-related validity of the Garmin Vivofit Jr 2 potentially would be considerably higher than that of the Samsung applications. The findings of the present study highlight the potential of the Garmin Vivofit Jr 2 for monitoring primary schoolchildren's steps under controlled conditions.

Reduction of Chronic Primary Low Back Pain by Spinal Manipulative Therapy is Accompanied by Decreases in Segmental Mechanical Hyperalgesia and Pain Catastrophizing: A Randomized Placebo-controlled Dual-blind Mixed Experimental Trial.

Chronic primary low back pain (CPLBP) refers to low back pain that persists over 3 months, that cannot be explained by another chronic condition, and that is associated with emotional distress and disability. Previous studies have shown that spinal manipulative therapy (SMT) is effective in relieving CPLBP, but the underlying mechanisms remain elusive. This randomized placebo-controlled dual-blind mixed experimental trial (NCT05162924) aimed to investigate the efficacy of SMT to improve CPLBP and its underlying mechanisms. Ninety-eight individuals with CPLBP and 49 controls were recruited. Individuals with CPLBP received SMT (n = 49) or a control intervention (n = 49), 12 times over 4 weeks. The primary outcomes were CPLBP intensity (0-100 on a numerical rating scale) and disability (Oswestry Disability Index). Secondary outcomes included pressure pain thresholds in 4 body regions, pain catastrophizing, Central Sensitization Inventory, depressive symptoms, and anxiety scores. Individuals with CPLBP showed widespread mechanical hyperalgesia (P < .001) and higher scores for all questionnaires (P < .001). SMT reduced pain intensity compared with the control intervention (mean difference: -11.7 [95% confidence interval, -11.0 to -12.5], P = .01), but not disability (P = .5). Similar mild to moderate adverse events were reported in both groups. Mechanical hyperalgesia at the manipulated segment was reduced after SMT compared with the control intervention (P < .05). Pain catastrophizing was reduced after SMT compared with the control intervention (P < .05), but this effect was not significant after accounting for changes in clinical pain. Although the reduction of segmental mechanical hyperalgesia likely contributes to the clinical benefits of SMT, the role of pain catastrophizing remains to be clarified. PERSPECTIVE: This randomized controlled trial found that 12 sessions of SMT yield greater relief of CPLBP than a control intervention. These clinical effects were independent of expectations, and accompanied by an attenuation of hyperalgesia in the targeted segment and a modulation of pain catastrophizing.

Embodied strategies for public speaking anxiety: evaluation of the Corp-Oral program.

Background: Public speaking is an indispensable skill that can profoundly influence success in both professional and personal spheres. Regrettably, managing anxiety during a speech poses a significant challenge for many of the population. This research assessed the impacts of a Corp-Oral program, designed to manage public speaking anxiety in university students, based on, body awareness, embodied message techniques, simulation, embodied visualization, body transformation, and gesture enhancement. Methods: Thirty-six students (61% women; Mage = 20.22, SD = 1.23 years) were randomly assigned to either an experimental group (n = 18), which underwent the Corp-Oral program, or a control group (n = 18). Self-perceived anxiety, heart rate, and electroencephalography were measured in a pre-test and a post-test. Results: The study reveals that the Corp-Oral program significantly (p < 0.005) reduced both physiological responses (heart rate) and self-reported measures of anxiety. The alteration was more noticeable in self-reported anxiety measures (a decrease of 33.217%) than in heart rate (a decrease of 4.659%). During the speech, the experimental group exhibited increased cortical activation in areas related to emotional regulation, consciousness, sensorimotor integration, and movement control. A significant increase in frontal alpha asymmetry was observed for the experimental group in the post-test, but there were no significant variations in the theta/beta ratio. Conclusion: These findings underline the benefit of managing public speaking anxiety not merely by reducing it but by channeling it through embodied strategies. These strategies could lead to greater action awareness that would cushion the physiological effect of the anxiety response and help generate a better self-perception of the anxiety state.

Wild Ungulates Constitute the Basis of the Diet of the Iberian Wolf in a Recently Recolonized Area: Wild Boar and Roe Deer as Key Species for Its Conservation.

The Iberian wolf (Canis lupus signatus) is recolonizing historical distribution areas after decades of absence. As in other human-dominated landscapes, finding a balance to protect this species by favoring recolonization and mitigating human-wildlife conflicts is a challenge. Since wolves are often generalist opportunistic predators, we studied their diet composition in central Spain to evaluate the consumption of domestic ungulates and provide reliable data that could help local authorities to deal with the current wolf-cattle ranchers conflict and coexistence. Diet composition (% prey occurrence, % prey ingested biomass) was analyzed through the identification of prey hairs present in 671 scats collected between 2017 and 2021. The wolves fed more on wild ungulates (82% occurrence) than domestic ones (18%). Wild boar (Sus scrofa, 44% occurrence) and roe deer (Capreolus capreolus, 35%) were the most consumed prey. The wolves positively selected these two species. The wolves' diets varied between seasons, years, and forest regions, but a diet based on wild ungulates predominated over domestic ones. Food niche breadth showed variations depending on seasons and years. Preserving the availability and diversity of wild ungulates may favor reducing livestock attacks and would be an achievable goal that would help to conserve this species and reduce conservation conflicts.

Effect of an activity wristband-based intermittent teaching unit in Physical Education on students' physical activity and its psychological mediators: a cluster-randomized controlled trial. School-fit study.

Objective: The main objective of the present study was to examine the effects of an intermittent teaching unit based on the use of activity wristbands and behavior modification strategies on high school students' perceptions of autonomy support, satisfaction of basic psychological needs, motivation toward Physical Education and physical activity, intention to be physically active, and habitual physical activity levels. Materials and methods: An initial sample of 353 high school students (final sample = 175; 45.7% females; mean age = 13.3 ± 1.2 years) from two public high schools were cluster-randomly assigned into the intermittent (IG, n = 100) and control (CG, n = 75) groups. The IG performed an intermittent teaching unit twice a week for eight weeks. Specifically, the last 15 min of each lesson were used. As the main strategy to promote the practice of regular physical activity, students wore an activity wristband the whole day during the intervention period. Additionally, other behavior modification strategies were also applied (e.g., educational counseling, physical activity goals or reminders). Regarding the CG, during the intervention period (i.e,, the eight weeks that took place the intermittent teaching unit) they also performed two Physical Education sessions, but without using activity wristbands or other behavior modification strategies. Before and after the intervention, as well as at the end of the follow-up period (six weeks), students' physical activity practice mediators and physical activity levels were measured by validated questionnaires. Results: The Multilevel Linear Model results showed that the IG students statistically significantly improved cognitive and procedural autonomy support from pre- to post-intervention (p < 0.05). They also statistically significantly improved autonomy and relatedness basic psychological needs, and autonomous motivation toward physical activity scores from post-intervention to follow-up (p < 0.05). Moreover, the results showed that the IG students statistically significantly improved habitual physical activity scores from pre- to post-intervention, and from post-intervention to follow-up (p < 0.05). Conclusion: The intermittent teaching unit based on the use of activity wristbands and other behavior modification strategies was effective for improving students' autonomy support and habitual physical activity levels, but not the rest of physical activity practice mediators. Clinical trial registration: https://register.clinicaltrials.gov/, ID: NCT05949463.

[Quality of life of Medicine students of the National University of Córdoba, Argentina] / Calidad de vida de estudiantes de la Facultad de Medicina de la Universidad Nacional de Córdoba.

Background: Quality of life (QoL), according to the WHO, includes the perception that a person has about their physical health, level of independence, social relationships, system of values ​​and goals, expectations, standards and concerns. The medical student faces a high level of competitiveness in the course of his academic training with an increase in the workload as he progresses; this causes symptoms such as anxiety, stress, sadness, among others. If these aspects are not treated or are masked, they can turn into depression, generalized anxiety, burnout and even suicide (2). Aim: To describe the QoL of the students of medicina at the National University of Córdoba, considering the complete training cycle divided into two groups from 1 to 3° and from 4 to 5°. Methods: Cross-sectional study, through the Guarani System of the UNC. The WHOQoL-BREF online questionnaire, which uses the Likert scale, was applied to all students. This assesses the global QoL and satisfaction regarding the state of physical and psychological health, interpersonal relationships and environment. p was considered significant <0.05. This work was approved by the Adult CIEIS. Results: 854 responses were obtained, 72% were female, 43% were from another province/country and 63% corresponded to the 1-3° group. Of these, 37% rated their QoL as "fairly good", while 36% of the 4-5th grade group perceived their QoL as "normal" (p:0.0469). The most influential variables correspond to the supply of money for their needs (p:0.0005), sexual satisfaction (p:0.0056) and access to health services (p:0.0042) . Cronbach's alpha was 0.8899. Conclusion: QoL is better perceived in the 1-3 year group and economic supply, sexual satisfaction and access to health services were the main points to take care of in this medicine students.

Introducción: La calidad de vida (CV), según la OMS, comprende la percepción que tiene una persona sobre su salud física, nivel de independencia, relaciones sociales, sistema de valores y metas, expectativas, estándares y preocupaciones (1). El estudiante de medicina se enfrenta con un alto nivel de competitividad en el transcurso de su formación académica con aumento de la carga horaria a medida que avanza; esto origina síntomas como ansiedad, estrés, tristeza, entre otros.  Si tales aspectos no son tratados o son enmascarados pueden transformarse en depresión, ansiedad generalizada, burnout y hasta suicidio (2). Objetivo: Describir la CV de los estudiantes de medicina de la Universidad Nacional de Córdoba, considerando el ciclo completo de formación divididos en dos grupos de 1-3° y 4-5°. Métodos: Estudio transversal, mediante el Sistema Guaraní de la UNC se aplicó el cuestionario online WHOQOL-BREF, que utiliza escala de Likert a todos los alumnos. Este valora la CV global y satisfacción respecto al estado de salud física, psicológica, relaciones interpersonales y entorno. Se consideró significativo una p<0.05. Este trabajo fue aprobado por el CIEIS del Adulto. Resultados: Se obtuvieron 854 respuestas, el 72% fue de género femenino, el 43% es originario de otra provincia/país y el 63% correspondió al grupo de 1-3°. De estos, el 37% calificó su CV como "bastante buena", mientras que el 36% del grupo de 4-5° percibió su CV como "normal" (p:0,0469). Las variables más influyentes corresponden al abastecimiento de dinero para sus necesidades (p:0,0005), satisfacción sexual (p:0,0056) y el acceso a los servicios sanitarios (p:0,0042). El alfa de Cronbach fue 0.8899. Conclusión: La CV es mejor percibida en el grupo de 1-3° año y se destacan el suministro económico, la satisfacción sexual y el acceso a los servicios sanitarios.

Validity of activity wristbands for estimating daily physical activity in primary schoolchildren under free-living conditions: School-Fit study.

Introduction: The use of activity wristbands to monitor and promote schoolchildren's physical activity (PA) is increasingly widespread. However, their validity has not been sufficiently studied, especially among primary schoolchildren. Consequently, the main purpose was to examine the validity of the daily steps and moderate-to-vigorous PA (MVPA) scores estimated by the activity wristbands Fitbit Ace 2, Garmin Vivofit Jr 2, and the Xiaomi Mi Band 5 in primary schoolchildren under free-living conditions. Materials and methods: An initial sample of 67 schoolchildren (final sample = 62; 50% females), aged 9-12 years old (mean = 10.4 ± 1.0 years), participated in the present study. Each participant wore three activity wristbands (Fitbit Ace 2, Garmin Vivofit Jr 2, and Xiaomi Mi Band 5) on his/her non-dominant wrist and a research-grade accelerometer (ActiGraph wGT3X-BT) on his/her hip as the reference standard (number of steps and time in MVPA) during the waking time of one day. Results: Results showed that the validity of the daily step scores estimated by the Garmin Vivofit Jr 2 and Xiaomi Mi Band 5 were good and acceptable (e.g., MAPE = 9.6/11.3%, and lower 95% IC of ICC = 0.87/0.73), respectively, as well as correctly classified schoolchildren as meeting or not meeting the daily 10,000/12,000-step-based recommendations, obtaining excellent/good and good/acceptable results (e.g., Garmin Vivofit Jr 2, k = 0.75/0.62; Xiaomi Mi Band 5, k = 0.73/0.53), respectively. However, the Fitbit Ace 2 did not show an acceptable validity (e.g., daily steps: MAPE = 21.1%, and lower 95% IC of ICC = 0.00; step-based recommendations: k = 0.48/0.36). None of the three activity wristbands showed an adequate validity for estimating daily MVPA (e.g., MAPE = 36.6-90.3%, and lower 95% IC of ICC = 0.00-0.41) and the validity for the MVPA-based recommendation tended to be considerably lower (e.g., k = -0.03-0.54). Conclusions: The activity wristband Garmin Vivofit Jr 2 obtained the best validity for monitoring primary schoolchildren's daily steps, offering a feasible alternative to the research-grade accelerometers. Furthermore, this activity wristband could be used during PA promotion programs to provide accurate feedback to primary schoolchildren to ensure their accomplishment with the PA recommendations.

Validity of the Xiaomi Mi Band 2, 3, 4 and 5 Wristbands for Assessing Physical Activity in 12-to-18-Year-Old Adolescents under Unstructured Free-Living Conditions. Fit-Person Study.

The purpose was to assess the validity of four generations of Xiaomi Mi Band wristbands for the assessment of step count and physical activity (PA) levels among adolescents aged 12-18 years under free-living conditions. One hundred adolescents were invited to participate in the present study. The final sample consisted of 62 high-school students (34 females), aged 12-18 years old (Mage = 14.1 ± 1.6 years), who wore an ActiGraph accelerometer on their hip (PA and step count reference measures) and four activity wristbands (Xiaomi Mi Band 2, 3, 4, and 5) on their non-dominant wrist during the waking time of one day. Results showed that the agreement between daily PA levels (i.e., slow, brisk, and slow-brisk pace walking, total PA and moderate-to-vigorous PA) measured by Xiaomi Mi Band wristbands and the accelerometer were poor (ICC, 95% CI = 0.06-0.78, 0.00-0.92; MAPE = 50.1-150.6%). However, agreement between daily step count measured by the accelerometer and the Xiaomi Mi Band wristbands were between acceptable (MAPE = 12.2-13.6%) to excellent (ICC, 95% CI = 0.94-0.95, 0.90-0.97). Furthermore, the Xiaomi Mi Band wristbands have a good to excellent validity for correctly classifying adolescents as meeting or not meeting the recommended 10,000 steps per day (P = 0.89-0.95, k = 0.71-0.87) and the recommended 60 minutes of moderate-to-vigorous PA per day (P = 0.89-0.94, k = 0.69-0.83). Furthermore, comparability between the four Xiaomi Mi Band generations were poor to excellent (ICC, 95% CI = 0.22-0.99, 0.00-1.00) for the daily PA levels outputs, although it was excellent (ICC, 95% CI = 0.99-1.00, 0.96-1.00; MAPE = 0.0-0.1%) for daily step count. Different models of Xiaomi Mi Band wristbands were comparable and presented good validity for measuring adolescents' step count, and they accurately classified adolescents as meeting or not meeting the PA recommendations under free-living conditions.

Palliative care stay room - designing, testing and evaluating a gamified social intervention to enhance palliative care awareness.

INTRODUCTION: The message of palliative care can be promoted using creative thinking and gamification. It can be an innovative strategy to promote changes in behaviour, promote thinking, and work on skills such as empathy. AIM: Design, test and evaluate a gamified social intervention to enhance palliative care awareness among young university students from non-health background. METHODS: Participatory action research study with mixed methods, Design Thinking and using the Public Engagement strategy. Forty-three undergraduate students participated in a Palliative Care Stay Room and completed the Test of Cognitive and Affective Empathy (TECA) before and after the game. At the end of the game, a ten-minute debriefing was held with the participants, which was concluded with an open conversation. The content analysis was done independently and the sum of the scores of each dimension was compared before and after the activity. FINDINGS: The Stay Room improved the participants' knowledge and new perspectives about palliative care. Before the game, their views focused on the end of life and after the game on their values, highlighting the dedication of the healthcare professionals who do not treat death but the life until death. After de game, participants (N = 43: female = 23; male = 20; x̄ 19.6 years old) presented higher values in perspective adoption (intellectual ability to put oneself in the other's place) p = 0.046 and in emotional understanding (ability to recognize emotional states) p = 0.018, and had high scores on empathic joy (p = 0.08). CONCLUSION: Gamification can be used in teaching and transmitting positive attitudes. Palliative Care and can help young university students to think positively about care issues.

Are Wrist-Worn Activity Trackers and Mobile Applications Valid for Assessing Physical Activity in High School Students? Wearfit Study.

The purpose was to examine the validity of three wrist-worn commercial activity trackers (Samsung Galaxy Watch Active 2, Apple Watch Series 5, and Xiaomi Mi Band 5) and six mobile apps (Pedometer and Pacer for android and iPhone mobiles, Google Fit for android, and Apple Health for iPhone mobiles) for estimating high school students' steps and physical activity (PA) under free-living conditions. A sample of 56 (27 females; mean age = 14.7 years) and 51 (25 females; mean age = 14.0 years) high school students participated in Study 1 and 2, respectively. Study 1: Students performed a 200-meter course in four different conditions while wearing the wearables. Step counting through a video record was used as the golden standard. Study 2: Students wore the three wrist-worn commercial activity trackers during the waking time of one day, considering ActiGraph model wGT3X-BT accelerometers as a standard of reference. Afterward, the agreement between the PA scores measured by the commercial activity trackers and the video (study 1) or accelerometers (study 2) were calculated as follows: Equivalence test, Limits of Agreement (LOA); Mean Absolute Error (MAE); Mean Absolute Percentage Error (MAPE); and Intraclass Correlation Coefficient (ICC). Results showed that all the wearables presented excellent validity for assessing steps in structured free-living conditions (study 1; MAPE < 5%), although their validity was between poor-excellent based on ICC (95% confidence interval) values (ICC = 0.56-1.00). Regarding Study 2, the Xiaomi wristband and the Samsung Watch presented acceptable-excellent (MAPE = 9.4-11.4%; ICC = 0.91-0.97) validity for assessing steps under unstructured free-living conditions (study 2). However, the Apple Watch presented questionable-excellent validity (MAPE = 18.0%; ICC = 0.69-0.95). Regarding moderate-to-vigorous PA (MVPA) and total PA, only the Apple Watch showed low-acceptable validity for MAPE value and questionable-excellent validity for the ICC values for MVPA assessment (MAPE = 22.6; ICC = 0.67-0.93). All wearables checked in this study have shown adequate validity results in order to assess steps in both structured and unstructured free-living conditions for both continuous and dichotomous variables. Moreover, for assessing MVPA, only the Apple Watch reported valid results for compliance or non-compliance with the daily PA recommendations. However, the results showed low validity for total PA and MVPA as continuous variables. In conclusion, depending on the user's/researcher's aim and context, one or another wearable activity tracker could be more adequate, mainly because of its valid measurements and its costs.

Presence of Tumor Necrosis Factor-Alpha in Urine Samples of Patients With Chronic Low Back Pain Undergoing Chiropractic Care: Preliminary Findings From a Prospective Cohort Study.

Background and aims: Low back pain is the leading cause of years lived with disability worldwide. Chiropractors employ different interventions to treat low back pain, including spinal manipulative therapy, although the mechanisms through which chiropractic care improves low back pain are still unclear. Clinical research and animal models suggest that spinal manipulation might modulate plasma levels of inflammatory cytokines, which have been involved in different stages of low back pain. More specifically, serum levels of Tumor Necrosis Factor-alpha (TNF-α) have been found to be elevated in patients with chronic low back pain. We aimed to investigate whether urine from chronic low back pain patients could be an appropriate medium to measure concentrations of TNF-α and to examine possible changes in its levels associated to chiropractic care. Methods: Urine samples were collected from 24 patients with chronic low back pain and TNF-α levels were analyzed by ELISA before and after 4-6 weeks of care compared to a reference value obtained from 5 healthy control subjects, by means of a Welch's t-test. Simultaneously, pain intensity and disability were also evaluated before and after care. Paired t-tests were used to compare mean pre and post urinary concentrations of TNF-α and clinical outcomes. Results: Significantly higher baseline levels of urinary TNF-α were observed in chronic low back pain patients when compared to our reference value (p < 0.001), which were significantly lower after the period of chiropractic treatment (p = 0.03). Moreover, these changes were accompanied by a significant reduction in pain and disability (both p < 0.001). However, levels of urinary TNF-α were not correlated with pain intensity nor disability. Conclusion: These results suggest that urine could be a good milieu to assess TNF-α changes, with potential clinical implications for the management of chronic low back pain.

Effects of Consumer-Wearable Activity Tracker-Based Programs on Objectively Measured Daily Physical Activity and Sedentary Behavior Among School-Aged Children: A Systematic Review and Meta-analysis.

BACKGROUND: The popularity of consumer-wearable activity trackers has led the scientific community to conduct an increasing number of intervention studies integrating them to promote physical activity (PA) and to reduce sedentary behavior (SB) levels among school-aged children. Therefore, the aim of the present study was to estimate the effects of consumer-wearable activity tracker-based programs on daily objectively measured PA and SB among apparently healthy school-aged children, as well as to compare the influence of participants' and programs' characteristics. METHODS: Eligibility criteria were: (1) participants: apparently healthy school-aged children (< 18 years old); (2) intervention: aimed to promote PA and/or to reduce SB incorporating consumer-wearable activity trackers; (3) comparator: baseline measurements and/or a control/traditional group; (4) outcomes: objectively measured daily PA and/or SB levels; (5) study design: pre-experimental, quasi-experimental, and true-experimental trials. Relevant studies were searched from eight databases up to December 2020, as well as from four alternative modes of searching. Based on the Cochrane Risk-of-bias tool 2, the risk of bias was assessed following four domains: (1) randomization process; (2) missing outcome data; (3) measurement of the outcomes; and (4) selection of the reported results. Based on a comprehensive systematic review, meta-analyses of the Cohen's standardized mean difference (d) and 95% confidence interval (CI) with a random-effects model were conducted to estimate the overall effects, as well as the within- and between-study subgroups analyses effects, of the programs on daily total steps, moderate-to-vigorous PA (MVPA), total PA and SB. RESULTS: Forty-four publications (i.e., 45 studies) were included in the systematic review (5,620 unique participants; mean age = 12.85 ± 2.84 years) and 40 publications (i.e., 41 studies) in the meta-analysis. Programs had a mean length of 11.78 ± 13.17 weeks and most used a waist-worn consumer-wearable activity tracker (77.78% waist-worn; 22.22% wrist-worn). Programs characteristics were: goal-setting strategies (64.06%); participants' logbooks (56.25%); counseling sessions (62.50%); reminders (28.13%); motivational strategies (42.19%); and exercise routine (17.19%). Results showed a statistically significant moderate favorable effect on daily total steps (d = 0.612, 95% CI 0.477-0.746), small favorable effect on daily MVPA (d = 0.220, 95% CI 0.134-0.307), trivial favorable effect on daily total PA (d = 0.151, 95% CI 0.038-0.264) and trivial unfavorable effect on daily SB (d = 0.172, 95% CI 0.039-0.305). Subgroups analyses showed a higher effect for daily total steps and daily MVPA levels in females and the physically inactive for daily total steps (p = 0.003-0.044). Programs with educational counseling and/or goal-setting strategies, as well as a greater number of strategies, were more effective for improving children's daily total steps, and wrist-worn activity trackers were more effective than waist-worn trackers for improving their daily MVPA levels (p = 0.001-0.021). CONCLUSIONS: Consumer-wearable activity tracker-based programs seem to be effective in promoting school-aged children's daily total steps and MVPA levels, especially for females and those that are physically inactive. These programs should include specific goal-setting, educational counseling, and wrist-worn trackers as especially effective strategies. However, due to the certainty of evidence being from "low" to "moderate", future well-designed primary research studies about the topic are needed. PROSPERO: CRD42020222363.

High School Students' Accelerometer-Measured Physical Activity and Sedentary Behavior by Motivational Profiles Toward Physical Activity.

Purpose: Based on a Self-Determination Theory with a person-centered approach, the purposes were: (1) to identify motivational profiles toward physical activity (PA) among high school students, and (2) to compare students' accelerometer-measured PA and sedentary behavior (SB) levels between the motivational profiles toward PA. Methods: The present study followed a cross-sectional design. A total of 394 high school students (173 females; final sample = 360 and 198 for the purposes 1 and 2, respectively) aged 12-16 years completed the study. Participants' PA and SB levels were objectively measured by ActiGraph GT3X+ accelerometers (right hip) during seven consecutive days. Later, motivation toward PA was measured by the Behavioral Regulation in Exercise Questionnaire. Results: Based on a two-stage cluster analysis approach, the results identified three clusters: (1) "Self-determined motivational profile toward PA" (65.3%); (2) "Non-self-determined motivational profile toward PA" (23.9%), and (3) "Controlled motivational profile toward PA" (10.8%). The results of the chi-square test showed that a statistically significantly higher percentage of males were represented in cluster 1 (p < .001). The results of the one-way analysis of variance showed that students from cluster 1 had statistically significantly lower levels of SB, and higher levels of light PA, moderate-to-vigorous PA and total PA than those from cluster 2 (p < .05; |d| = 0.40-0.61). Conclusions: In line with the Self-Determination Theory, the students within the self-determined motivational profile had lower SB and higher PA. This preliminary evidence could inform and guide future policy regarding students' PA promotion.

Interdisciplinary discussions on palliative care among university students in Spain: giving voice to the social debate.

BACKGROUND: University students are the future professionals who will influence society. It is thus essential to improve students' understanding of palliative care (PC), especially those in the non-health field, to generate and encourage propitious opinions about PC. This study describes the perceptions of PC among university students from different disciplines. METHOD: Qualitative exploratory study using virtual focus groups (FGs) and design thinking (DT) approach. An intentional sample of students from various disciplines, universities and cities from Spain were selected. Numerous researchers from different fields were involved in the discussion of the final thematic analysis. RESULTS: Four themes and seven subthemes were found: i) Students have an ambiguous understanding about PC; ii) PC is not a common issue for non-health students; ii) Students see PC as an important and necessary field; iii) Students build counter-narratives against PC myths, demonstrating PC brings key benefits into people's lives; iv) PC is a synonym of death. CONCLUSION: Despite the fact that students do not know much about PC, the topic easily arouses reflection and positive discussion. Through the conversations they find positive values and arguments against misunderstand- ing. Students from different disciplines could be the target of innovative educational initia- tives and the social debate on PC.

Immunogenic Amino Acid Motifs and Linear Epitopes of COVID-19 mRNA Vaccines

Reverse vaccinology is an evolving approach for improving vaccine effectiveness and minimizing adverse responses by limiting immunizations to critical epitopes. Towards this goal, we sought to identify immunogenic amino acid motifs and linear epitopes of the SARS-CoV-2 spike protein that elicit IgG in COVID-19 mRNA vaccine recipients. Paired pre/post vaccination samples from N=20 healthy adults, and post-vaccine samples from an additional N=13 individuals were used to immunoprecipitate IgG targets expressed by a bacterial display random peptide library, and preferentially recognized peptides were mapped to the spike primary sequence. The data identify several distinct amino acid motifs recognized by vaccine-induced IgG, a subset of those targeted by IgG from natural infection, which may mimic 3-dimensional conformation (mimotopes). Dominant linear epitopes were identified in the C-terminal domains of the S1 and S2 subunits (aa 558-569, 627-638, and 1148-1159) which have been previously associated with SARS-CoV-2 neutralization in vitro and demonstrate identity to bat coronavirus and SARS-CoV, but limited homology to non-pathogenic human coronavirus. The identified COVID-19 mRNA vaccine epitopes should be considered in the context of variants, immune escape and vaccine and therapy design moving forward.

Effect of a physical education-based fitness intermittent teaching unit on high school students' cardiorespiratory fitness: a cluster-randomized controlled trial.

BACKGROUND: The aim of this study was to compare the effect of the intermittent and traditional physical fitness-based teaching units on cardiorespiratory fitness and physical activity levels in high school students during Physical Education sessions. METHODS: One hundred and three high school students (Mage=13.6±0.7) from six classes, balanced by grade, were cluster-randomly assigned into traditional (TG), intermittent (IG), and control (CG) groups. The TG performed a fitness teaching unit twice a week for nine weeks (35-40 minutes of the main part of each session). The IG worked during the first half of the sessions' main part (18-20 minutes) similarly to the TG, and during the second half they worked on technical-tactical aspects of invasion sports. Students' cardiorespiratory fitness was measured at the beginning and at the end of the teaching unit. Physical activity levels were measured objectively through a heart rate monitor and subjectively by a self-reported scale during Physical Education sessions. RESULTS: Both traditional and intermittent teaching units developed students' cardiorespiratory fitness levels (Δ post-pre-intervention: TG, M∆=19.8, SE=9.4; IG, M∆=16.6, SE=7.7); P<0.01). Additionally, both TG (M=86.2, SE=9.9) and IG (M=90.9, SE=7.6) had higher physical activity levels than the CG (M=76.3, SE=13.5) (P<0.05). However, no differences in physical activity levels were found between the IG and TG (P>0.05). CONCLUSIONS: The intermittent teaching unit allowed the simultaneous development of cardiorespiratory fitness and another curricular objective in the same Physical Education sessions.

V Coloquio Internacional de Psicología del Deporte Público REDDECA. Composición e invarianza factorial de la versión en español del Cuestionario de Clima en el Deporte (S-SCQ) en universitarios deportistas de Chihuahua, México / V Coloquio Internacional de Psicología del Deporte Público REDDECA. Composition and factor invariance of the Spanish version of the Sports Climate Questionnaire (S-SCQ) in university athletes from Chihuahua, Mexico / V Coloquio Internacional de Psicología del Deporte Público REDDECA. Composição e invariância fatorial da versão em espanhol do Climate in Sports Questionnaire (S-SCQ) em atletas universitários de Chihuahua, México

El presente estudio analiza las propiedades psicométricas propuestas por Balaguer, Castillo, Duda y Tomás (2009) para la versión en español del Cuestionario de Clima en el Deporte (S-SCQ) en hombres y mujeres deportistas universitarios. La muestra total fue de 432 universitarios deportistas de Chihuahua, México, 169 mujeres y 263 hombres, con edades comprendidas entre 18-26 años (M = 20.40; DE = 1.89). La estructura factorial del cuestionario se analizó mediante análisis factoriales confirmatorios. Los análisis, muestran que una estructura unifactorial es viable y adecuada tanto para la muestra total como para las poblaciones de hombres y mujeres. La estructura de un solo factor, atendiendo a criterios estadísticos y sustantivos, ha mostrado adecuados indicadores de ajuste de fiabilidad y validez. Además, la estructura factorial, las cargas factoriales y los interceptos se consideran invariantes de acuerdo al género; sin embargo, se encontraron diferencias a favor de los hombres deportistas en cuanto a su percepción sobre el apoyo a su autonomía por parte de su entrenador o entrenadora

The aim of this research was to analyze the psychometric properties proposed by Balaguer et al. (2009) for the spanish version of Sport Climate Questionnaire (S-SCQ) in university athletes mens and women. The total sample has been composed by 432 university athletes, 169 women and 263 mens from Chihuahua, Mexico, with ages from 18-26 years (M = 20.40, SD = 1.89). The factor structure of questionnaire has been analized through the confirmatory factor analysis. This analysis shows that a onefactorial structure is viable and adequate for the total sample and the populations of mens and woman. The one factor structure, according to statistical and substantive criteria, has shown adequate indicators of reliability and validity adjustment. On the other hand, the factorial structure, the factorial loads and the intercepts are considered invariant according to the variable gender; however, differences were found in favor of male athletes in terms of their perception of support for their autonomy on the part of their coaches

O presente estudo analisa as propiedades psicométricas propostas por Balaguer et al. (2009) para a versão espanhola do Sports Climate Questionnaire (S-SCQ). Amostra total foi de 432 universitários atletas de Chihuahua, México, 169 mulheres e 263 homens com idades entre 18-26 anos (M = 20.40; DE = 1.89). A estrutura fatorial foi analisado com anàlises fatorial confirmatòrias. Os analises mostran que uma estrutura unifatorial e factível e adequado para a mostra total e para ambas as populações, homens e mulheres. A estrutura unifatorial, em resposta a criterios estatísticos e materiais tem mostrado indicadores de ajuste adequados de confiabilidade e validade. Além disso a estrutura de fatores, cargas fatoriais e intercepto são considerados invariantes de acordó com o gênero; porém, se encontraram diferenças no grupo de homens atletas em seu percepção de apoiar a seu aotonomia respeito a seu treinador

The value of missing information in severity of illness score development.

OBJECTIVE: We aim to investigate the hypothesis that using information about which variables are missing along with appropriate imputation improves the performance of severity of illness scoring systems used to predict critical patient outcomes. STUDY DESIGN AND SETTING: We quantify the impact of missing and imputed variables on the performance of prediction models used in the development of a sepsis-related severity of illness scoring system. Electronic health records (EHR) data were compiled from Christiana Care Health System (CCHS) on 119,968 adult patients hospitalized between July 2013 and December 2015. Two outcomes of interest were considered for prediction: (1) first transfer to intensive care unit (ICU) and (2) in-hospital mortality. Five different prediction models were employed. Indicators were utilized in these prediction models to identify when variables were missing and imputed. RESULTS: We observed statistically significant gains in prediction performance when moving from models that did not indicate missing information to those that did. Moreover, this increase was higher in models that use summary variables as predictors compared to those that use all variables. CONCLUSION: When developing prediction models using longitudinal EHR data, researchers should explore the incorporation of indicators for missing variables along with appropriate imputation.

Long-term reliability of the telemetric Neurovent-P-tel sensor: in vivo case report.

Intracranial pressure (ICP) measurements are imperative for the proper diagnosis and treatment of several neurological disorders. Telemetric sensors have shown their utility for ICP estimation in short-term monitoring in humans. However, their long-term reliability is uncertain. The authors present the case of a 37-year-old woman diagnosed with benign intracranial hypertension and obesity. The patient underwent gastric bypass surgery for ICP control. In order to monitor ICP before and after bariatric surgery, a Neurovent-P-tel sensor was implanted in the left frontal lobe. After gastric bypass, normal ICP values were recorded, and the patient's visual fields improved. However, the patient experienced incapacitating daily headaches. The authors decided to implant a Codman Microsensor ICP transducer in the right frontal lobe to assess the long-term reliability of the Neurovent-P-tel measurements. A comparison of the recordings at 24 and 48 hours showed good correlation and reliability during long-term monitoring with the Neurovent-P-tel, with minimal zero drift after 11 months of implantation.

Aprendizaje táctico en deportes de invasión en la educación física: influencia del nivel inicial de los estudiantes / Aprendizagem tática em esportes de invasão na educação física: influência do nível inicial de alunos / Tactical learning in invasion sports in physical education: influence of students' baseline level

El aprendizaje táctico objetivo en función del nivel inicial de los estudiantes. 85 estudiantes de 5º y 6º curso de educación primaria realizaron dos unidades didácticas de fútbol sala y baloncesto durante las clases de Educación Física. El grupo de control realizó las unidades didácticas siguiendo un enfoque tradicional técnico-táctico y el grupo experimental siguiendo un enfoque táctico. Los estudiantes del grupo experimental fueron divididos según la habilidad táctica inicial en baja (< P50) y alta (≥ P50). Antes y después de la intervención se evaluó la habilidad táctica objetiva en deportes de invasión. Los resultados mostraron que solo los estudiantes con bajo nivel inicial mejoraron significativamente su habilidad táctica en deportes de invasión tras un programa a corto plazo

O objetivo do presente estudo foi comparar o efeito de um programa de esportes de invasão durante as aulas de Educação Física sobre a aprendizagem tática objetiva em função de no nível inicial de alunos. 85 estudantes de 5º - 6º ano da educação primária fizeram duas unidades didáticas de futsal e basquete durante as aulas de Educação Física. O grupo de controle realizou as unidades didáticas seguindo uma abordagem técnico-tática tradicional e o grupo experimental seguindo uma abordagem tática. Os estudantes do grupo experimental foram divididos de acordo com a habilidade tática inicial em baixa (< P50) e alta (≥ P50). Antes e depois da intervenção, a habilidade tática objetiva em esportes de invasão foi avaliada. Os resultados mostraram que apenas estudantes com baixo nível inicial melhoraram significativamente sua habilidade tática em esportes de invasão após um programa de curto prazo

The purpose of the present study was to compare the effect of an invasion sports program during Physical Education lessons on objective tactical learning according to students' baseline skill level. Eighty-five students from 5th to 6th grade of primary education attended two teaching units of futsal and basketball during Physical Education lessons. The control group performed the teaching units following a traditional technicaltactical approach while the experimental group followed a tactical approach. Students in the experimental group were divided in low (< P50) and high (≥ P50) according to their baseline tactical skills. Objective tactical skills in invasion sports were assessed before and after the intervention. Results showed that only students with low baseline level significantly improved their tactical skills in invasion sports after a short-term program