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  • 1
    Online Resource
    Online Resource
    Perceptions of Antenatal Exercise in Pregnant Females and the Impact of COVID-19
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 19, No. 17 ( 2022-08-26), p. 10635-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 17 ( 2022-08-26), p. 10635-
    Abstract: Exercise during pregnancy presents many benefits for the mother and baby. Yet, pregnancy is characterised by a decrease in exercise. Studies have reported barriers to antenatal exercise. The coronavirus (COVID-19) pandemic may have further exacerbated barriers to antenatal exercise as pregnant females faced many challenges. Rich, in-depth exploration into pregnant female’s perceived barriers to antenatal exercise during COVID-19 is imperative. Questionnaires reporting physical activity levels were completed by all participants (n = 14). Semi-structured interviews were conducted between November 2020 and May 2021 in the UK. Interviews were analysed using thematic analysis and revealed four main themes: ‘Perceptions of being an active person shaping activity levels in pregnancy’, ‘How do I know what is right? Uncertainty, seeking validation and feeling informed’, ‘Motivators to antenatal exercise’ and ‘A process of adaptations and adjustment’. Findings indicate that the COVID-19 pandemic exacerbated barriers to antenatal exercise and highlight the importance of direct psychosocial support and clear, trustworthy information. Findings also support the fundamental need for better education amongst healthcare professionals regarding antenatal exercise.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph191710635
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 2
    Online Resource
    Online Resource
    The Effect of Water Immersion during Exercise on Cerebral Blood Flow
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Medicine & Science in Sports & Exercise Vol. 47, No. 2 ( 2015-02), p. 299-306
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. 2 ( 2015-02), p. 299-306
    Type of Medium: Online Resource
    ISSN: 0195-9131
    URL: Article
    DOI: 10.1249/MSS.0000000000000422
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 2031167-9
    SSG: 31
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  • 3
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    High-intensity exercise offers no additional benefit to moderate-intensity exercise in reducing liver fat in patients with non-alcoholic fatty liver disease
    BMJ ; 2017
    In:  Evidence Based Medicine Vol. 22, No. 3 ( 2017-06), p. 103-103
    Details
    In: Evidence Based Medicine, BMJ, Vol. 22, No. 3 ( 2017-06), p. 103-103
    Type of Medium: Online Resource
    ISSN: 1356-5524 , 1473-6810
    URL: Article
    DOI: 10.1136/ebmed-2016-110579
    Language: English
    Publisher: BMJ
    Publication Date: 2017
    detail.hit.zdb_id: 2030183-2
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  • 4
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    No evidence of compensatory changes in energy balance, despite reductions in body weight and liver fat, during dapagliflozin treatment in type 2 diabetes mellitus: A randomized, double‐blind, placebo‐controlled, cross‐over trial (ENERGIZE)
    Wiley ; 2023
    In:  Diabetes, Obesity and Metabolism
    Details
    In: Diabetes, Obesity and Metabolism, Wiley
    Abstract: This study assessed the impact of dapagliflozin on food intake, eating behaviour, energy expenditure, magnetic resonance imaging (MRI)‐determined brain response to food cues and body composition in patients with type 2 diabetes mellitus (T2D). Materials and Methods Patients were given dapagliflozin 10 mg once daily in a randomized, double‐blind, placebo‐controlled trial with short‐term (1 week) and long‐term (12 weeks) cross‐over periods. The primary outcome was the difference in test meal food intake between long‐term dapagliflozin and placebo treatment. Secondary outcomes included short‐term differences in test meal food intake, short‐ and long‐term differences in appetite and eating rate, energy expenditure and functional MRI brain activity in relation to food images. We determined differences in glycated haemoglobin, weight, liver fat (by 1 H magnetic resonance spectroscopy) and subcutaneous/visceral adipose tissue volumes (by MRI). Results In total, 52 patients (43% were women) were randomized; with the analysis of 49 patients: median age 58 years, weight 99.1 kg, body mass index 35 kg/m 2 , glycated haemoglobin 49 mmol/mol. Dapagliflozin reduced glycated haemoglobin by 9.7 mmol/mol [95% confidence interval (CI) 3.91‐16.27, p  = .004], and body weight (−2.84 vs. −0.87 kg) versus placebo. There was no short‐ or long‐term difference in test meal food intake between dapagliflozin and placebo [mean difference 5.7 g (95% CI −127.9 to 139.3, p  = .933); 15.8 g (95% CI −147.7 to 116.1, p  = .813), respectively] nor in the rate of eating, energy expenditure, appetite, or brain responses to food cues. Liver fat (median reduction −4.7 vs. 1.95%), but not subcutaneous/visceral adipose tissue, decreased significantly with 12 weeks of dapagliflozin. Conclusions The reduction in body weight and liver fat with dapagliflozin was not associated with compensatory adaptations in food intake or energy expenditure.
    Type of Medium: Online Resource
    ISSN: 1462-8902 , 1463-1326
    URL: Article
    DOI: 10.1111/dom.15257
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2004918-3
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  • 5
    Online Resource
    Online Resource
    Effects of physical activity on vascular function in autoimmune rheumatic diseases: a systematic review and meta-analysis
    Oxford University Press (OUP) ; 2021
    In:  Rheumatology Vol. 60, No. 7 ( 2021-07-01), p. 3107-3120
    Details
    In: Rheumatology, Oxford University Press (OUP), Vol. 60, No. 7 ( 2021-07-01), p. 3107-3120
    Abstract: To summarize existing evidence and quantify the effects of physical activity on vascular function and structure in autoimmune rheumatic diseases (ARDs). Methods Databases were searched (through March 2020) for clinical trials evaluating the effects of physical activity interventions on markers of micro- and macrovascular function and macrovascular structure in ARDs. Studies were combined using random effects meta-analysis, which was conducted using Hedges’ g. Meta-analyses were performed on each of the following outcomes: microvascular function [i.e. skin blood flow or vascular conductance responses to acetylcholine (ACh) or sodium nitropusside (SNP) administration]; macrovascular function [i.e. brachial flow-mediated dilation (FMD%) or brachial responses to glyceryl trinitrate (GTN%); and macrovascular structure [i.e. aortic pulse wave velocity (PWV)] . Results Ten studies (11 trials) with a total of 355 participants were included in this review. Physical activity promoted significant improvements in microvascular [skin blood flow responses to ACh, g = 0.92 (95% CI 0.42, 1.42)] and macrovascular function [FMD%, g = 0.94 (95% CI 0.56, 1.02); GTN%, g = 0.53 (95% CI 0.09, 0.98)]. Conversely, there was no evidence for beneficial effects of physical activity on macrovascular structure [PWV, g = −0.41 (95% CI −1.13, 0.32)] . Conclusions Overall, the available clinical trials demonstrated a beneficial effect of physical activity on markers of micro- and macrovascular function but not on macrovascular structure in patients with ARDs. The broad beneficial impact of physical activity across the vasculature identified in this review support its role as an effective non-pharmacological management strategy for patients with ARDs.
    Type of Medium: Online Resource
    ISSN: 1462-0324 , 1462-0332
    URL: Article
    DOI: 10.1093/rheumatology/keab094
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 1474143-X
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  • 6
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    Relationship Between Endothelial Function and the Eliciting Shear Stress Stimulus in Women: Changes Across the Lifespan Differ to Men
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Journal of the American Heart Association Vol. 8, No. 4 ( 2019-02-19)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 8, No. 4 ( 2019-02-19)
    Abstract: Premenopausal women have a lower incidence of cardiovascular disease, which may partly be due to a protective effect of estrogen on endothelial function. Animal studies suggest that estrogen may also improve the relationship between shear rate ( SR ) and endothelial function. We aimed to explore the relationship between endothelial function (ie, flow‐mediated dilation [ FMD ]) and SR (ie, SR area under the curve [ SRAUC ]) in women versus men, and between pre‐ versus postmenopausal women. Methods and Results Brachial artery FMD and SRAUC were measured in accordance with expert‐consensus guidelines in 932 healthy participants who were stratified into young adults (18‐40 years, 389 men, 144 women) and older adults ( 〉 40 years, 260 men, 139 women). Second, we compared premenopausal (n=173) and postmenopausal women (n=110). There was evidence of a weak correlation between SRAUC and FMD in all groups but older men, although there was variation in strength of outcomes. Further exploration using interaction terms (age‐sex× SRAUC ) in linear regression revealed differential relationships with FMD (young women versus young men [β=−5.8 −4 , P =0.017] and older women [β=−5.9 −4 , P =0.049]). The correlation between SRAUC and FMD in premenopausal women ( r 2 =0.097) was not statistically different from that in postmenopausal women ( r 2 =0.025; Fisher P =0.30). Subgroup analysis using stringent inclusion criteria for health markers (n=505) confirmed a stronger FMD ‐ SRAUC correlation in young women compared with young men and older women. Conclusions Evidence for a stronger relationship between endothelial function and the eliciting SR stimulus is present in young women compared with men. Estrogen may contribute to this finding, but larger healthy cohorts are required for conclusive outcomes.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.118.010994
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2653953-6
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  • 7
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    Changes in Energy Balance during Dapagliflozin Therapy in Type 2 Diabetes—The Energize Study
    American Diabetes Association ; 2018
    In:  Diabetes Vol. 67, No. Supplement_1 ( 2018-07-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 67, No. Supplement_1 ( 2018-07-01)
    Abstract: Weight loss during SGLT2i therapy is less than predicted from urinary glucose loss. Modelling suggests a 10-15% compensatory increase in energy intake. We compared effects of 12 weeks’ dapagliflozin 10mg od vs. placebo on food intake in a double-blind, placebo-controlled study with short (1 week) and long-term (12 week) crossover periods. Food intake was measured during test meals at baseline, pre and post each crossover using the Sussex Ingestion Pattern Monitor, continuously recording intake during the meal; primary outcome was the difference after 12 weeks’ treatment. 52 patients with T2DM treated with diet or oral agents were recruited (45 completed;43% female). Median age 60y, weight 98.4 kg, BMI 34, HbA1c 59.5 mmol/mol. Analysis used a linear mixed model with the random effect as study subject and fixed effects of sex, visit, study arm and arm:visit interaction. Dapagliflozin use was associated with a reduction in HbA1c -9.73mmol/mol (95% CI 3.91, 16.27; p=0.004), and body weight (-2.84 vs. -0.87 kg) vs. placebo. There was no difference in test meal food intake between dapagliflozin and placebo at 12 weeks median difference, 2.63g (95% CI,-31.65,36.9); p=0.659 or at other time points. Dapagliflozin was not associated with a compensatory increase in food intake. Disclosure S. Rajeev: None. C.A. Roberts: None. D.J. Cuthbertson: None. V.S. Sprung: None. E. Brown: Research Support; Self; AstraZeneca. J.C. Halford: Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S. J.A. Harrold: None. G.J. Kemp: None. A. Stancak: None. J.P. Wilding: Other Relationship; Self; Astellas, AstraZeneca, Boehringer Ingelheim GmbH, Janssen Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi, Eli Lilly and Company, Orexigen Therapeutics, Inc., Merck & Co., Inc..
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/db18-1163-P
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2018
    detail.hit.zdb_id: 1501252-9
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  • 8
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    Online Resource
    Sympathetic nervous system activation, arterial shear rate, and flow-mediated dilation
    American Physiological Society ; 2014
    In:  Journal of Applied Physiology Vol. 116, No. 10 ( 2014-05-15), p. 1300-1307
    Details
    In: Journal of Applied Physiology, American Physiological Society, Vol. 116, No. 10 ( 2014-05-15), p. 1300-1307
    Abstract: The aim of this study was to examine the contribution of arterial shear to changes in flow-mediated dilation (FMD) during sympathetic nervous system (SNS) activation in healthy humans. Ten healthy men reported to our laboratory four times. Bilateral FMD, shear rate (SR), and catecholamines were examined before/after 10-min of −35-mmHg lower body negative pressure (LBNP 10 ). On day 1, localized forearm heating (LBNP 10 +heat) was applied in one limb to abolish the increase in retrograde SR associated with LBNP. Day 2 involved unilateral cuff inflation to 75 mmHg around one limb to exaggerate the LBNP-induced increase retrograde SR (LBNP 10 +cuff). Tests were repeated on days 3 and 4, using 30-min interventions (i.e., LBNP 30 +heat and LBNP 30 +cuff). LBNP 10 significantly increased epinephrine levels and retrograde SR and decreased FMD (all P 〈 0.05). LBNP 10 +heat prevented the increase in retrograde SR, whereas LBNP 10 +cuff further increased retrograde SR ( P 〈 0.05). Heating prevented the decrease in percent FMD (FMD%) after LBNP 10 (interaction effect, P 〈 0.05), whereas cuffing did not significantly exaggerate the decrease in FMD% (interaction effect, P 〉 0.05). Prolongation of the LBNP stimulus for 30-min normalized retrograde SR, catecholamine levels, and FMD (all P 〉 0.05). Attenuation of retrograde SR during 30 min (LBNP 30 +heat) was associated with increased FMD% (interaction effects, P 〈 0.05), whereas increased retrograde SR (LBNP 30 +cuff) diminished FMD% (interaction effects, P 〈 0.05). These data suggest that LBNP-induced SNS stimulation decreases FMD, at least in part due to the impact of LBNP on arterial shear stress. Prolonged LBNP stimulation was not associated with changes in SR or FMD%. Our data support a role for changes in SR to the impact of SNS stimulation on FMD.
    Type of Medium: Online Resource
    ISSN: 8750-7587 , 1522-1601
    URL: Article
    DOI: 10.1152/japplphysiol.00110.2014
    RVK:
    WA 15000
    RVK:
    XA 52094
    Language: English
    Publisher: American Physiological Society
    Publication Date: 2014
    detail.hit.zdb_id: 1404365-8
    SSG: 12
    SSG: 31
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  • 9
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    Exercise training and artery function in humans: nonresponse and its relationship to cardiovascular risk factors
    American Physiological Society ; 2014
    In:  Journal of Applied Physiology Vol. 117, No. 4 ( 2014-08-15), p. 345-352
    Details
    In: Journal of Applied Physiology, American Physiological Society, Vol. 117, No. 4 ( 2014-08-15), p. 345-352
    Abstract: The objectives of our study were to examine 1) the proportion of responders and nonresponders to exercise training in terms of vascular function; 2) a priori factors related to exercise training-induced changes in conduit artery function, and 3) the contribution of traditional cardiovascular risk factors to exercise-induced changes in artery function. We pooled data from our laboratories involving 182 subjects who underwent supervised, large-muscle group, endurance-type exercise training interventions with pre-/posttraining measures of flow-mediated dilation (FMD%) to assess artery function. All studies adopted an identical FMD protocol (5-min ischemia, distal cuff inflation), contemporary echo-Doppler methodology, and observer-independent automated analysis. Linear regression analysis was used to identify factors contributing to changes in FMD%. We found that cardiopulmonary fitness improved, and weight, body mass index (BMI), cholesterol, and mean arterial pressure (MAP) decreased after training, while FMD% increased in 76% of subjects ( P 〈 0.001). Training-induced increase in FMD% was predicted by lower body weight (β = −0.212), lower baseline FMD% (β = −0.469), lower training frequency (β = −0.256), and longer training duration (β = 0.367) (combined: P 〈 0.001, r = 0.63). With the exception of a modest correlation with total cholesterol ( r = −0.243, P 〈 0.01), changes in traditional cardiovascular risk factors were not significantly related to changes in FMD% ( P 〉 0.05). In conclusion, we found that, while some subjects do not demonstrate increases following exercise training, improvement in FMD% is present in those with lower pretraining body weight and endothelial function. Moreover, exercise training-induced change in FMD% did not correlate with changes in traditional cardiovascular risk factors, indicating that some cardioprotective effects of exercise training are independent of improvement in risk factors.
    Type of Medium: Online Resource
    ISSN: 8750-7587 , 1522-1601
    URL: Article
    DOI: 10.1152/japplphysiol.00354.2014
    RVK:
    WA 15000
    RVK:
    XA 52094
    Language: English
    Publisher: American Physiological Society
    Publication Date: 2014
    detail.hit.zdb_id: 1404365-8
    SSG: 12
    SSG: 31
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  • 10
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    Dissociation between exercise-induced reduction in liver fat and changes in hepatic and peripheral glucose homoeostasis in obese patients with non-alcoholic fatty liver disease
    Portland Press Ltd. ; 2016
    In:  Clinical Science Vol. 130, No. 2 ( 2016-01-01), p. 93-104
    Details
    In: Clinical Science, Portland Press Ltd., Vol. 130, No. 2 ( 2016-01-01), p. 93-104
    Abstract: Non-alcoholic fatty liver disease (NAFLD) is associated with multi-organ (hepatic, skeletal muscle, adipose tissue) insulin resistance (IR). Exercise is an effective treatment for lowering liver fat but its effect on IR in NAFLD is unknown. We aimed to determine whether supervised exercise in NAFLD would reduce liver fat and improve hepatic and peripheral (skeletal muscle and adipose tissue) insulin sensitivity. Sixty nine NAFLD patients were randomized to 16 weeks exercise supervision (n=38) or counselling (n=31) without dietary modification. All participants underwent MRI/spectroscopy to assess changes in body fat and in liver and skeletal muscle triglyceride, before and following exercise/counselling. To quantify changes in hepatic and peripheral insulin sensitivity, a pre-determined subset (n=12 per group) underwent a two-stage hyperinsulinaemic euglycaemic clamp pre- and post-intervention. Results are shown as mean [95% confidence interval (CI)]. Fifty participants (30 exercise, 20 counselling), 51 years (IQR 40, 56), body mass index (BMI) 31 kg/m2 (IQR 29, 35) with baseline liver fat/water % of 18.8% (IQR 10.7, 34.6) completed the study (12/12 exercise and 7/12 counselling completed the clamp studies). Supervised exercise mediated a greater reduction in liver fat/water percentage than counselling [Δ mean change 4.7% (0.01, 9.4); P & lt;0.05], which correlated with the change in cardiorespiratory fitness (r=–0.34, P=0.0173). With exercise, peripheral insulin sensitivity significantly increased (following high-dose insulin) despite no significant change in hepatic glucose production (HGP; following low-dose insulin); no changes were observed in the control group. Although supervised exercise effectively reduced liver fat, improving peripheral IR in NAFLD, the reduction in liver fat was insufficient to improve hepatic IR.
    Type of Medium: Online Resource
    ISSN: 0143-5221 , 1470-8736
    URL: Article
    DOI: 10.1042/CS20150447
    Language: English
    Publisher: Portland Press Ltd.
    Publication Date: 2016
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