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Effects of Exercise Duration and Intensity on Maximal Exercise Capacity Over 6 Months in Coronary Heart Disease and Type 2 Diabetes—A Secondary Analysis of the LeIKD Trial
No full textABSTRACT Exercise training is recommended in coronary heart disease (CHD) and type 2 diabetes (T2DM) patients alike; however, uncertainty remains on the influence of exercise intensity and duration in older patients with both entities. To address this, we performed a secondary analysis including 201 patients (67.9 ± 8.2 years; 84.1% men) from the LeIKD trial (NCT038359), which introduced 6 months of home‐based telemedicine‐supported exercise intervention in patients with CHD and T2DM. We assessed the relationships between exercise duration and intensity with change in peak oxygen uptake (V̇O 2 peak) (simple and multiple regression analyses, α = 0.05). V̇O 2 peak increased by 0.42 mL/kg/min per hour of endurance exercise/week (95% CI: 0.17–0.66, p = 0.001). Exercise intensity was not significantly associated with the change in V̇O 2 peak ( p = 0.10). In a subgroup of patients with high adherence (≥ 66.7% of prescribed total duration and meeting prescribed exercise duration in ≥ 50% of weeks of intervention), a 10% increase in exercise intensity (mean % heart rate reserve (HRR)) was associated with an increase in V̇O 2 peak of 0.26 mL/kg/min (95% CI: 0.00–0.52; p = 0.05). Longer training duration within the initial 2 weeks of intervention was significantly associated with high adherence over 6 months (increased likelihood per 10 min/week: OR of 1.09 [95% CI: 1.05–1.14], p < 0.001). Therefore, exercise duration but not intensity influences changes in V̇O 2 peak during exercise intervention in a high‐risk population of older patients with CHD and T2DM. In patients with high adherence to exercise duration, higher exercise intensity led to an additional increase in V̇O 2 peak. Training duration within the first 2 weeks was an important predictor of long‐term adherence. Trial Registration: https://www.clinicaltrials.gov : Identifier: NCT038359Gemeinsame Bundesausschuss https://doi.org/10.13039/50110001484
Productivity-driven decoupling of microbial carbon use efficiency and respiration across global soils
No full textDespite extensive research on soil microbial carbon (C) use efficiency (CUE), its linkage to actual soil C storage remains ambiguous. A key uncertainty is that CUE estimates from short-term labeling incubations assume a linear negative relationship with respiration rates, overlooking nonlinear interactions and long-term microbial acclimation. Here, we use a stoichiometry-based approach to estimate CUE (CUE ST ), which links soil resource availability to microbial demand and captures microbial adaptability under resource constraints. We synthesized 1094 paired observations of CUE ST and heterotrophic respiration rate ( R h ) across natural ecosystems and found a nonlinear relationship between them governed by ecosystem productivity. In low-productivity arid and cold regions, CUE ST declined with increasing R h , whereas in productive tropical and temperate regions, CUE ST stabilized at a low level (0.27 ± 0.11) as R h exceeded 340 ± 10.8 grams of C per square meter per year. This shift reflects microbial trade-offs between C assimilation and stoichiometric homeostasis, revealing a decoupling of microbial growth from respiration that limits the capacity of productive ecosystems to store additional soil C.Resource-dependent microbial adaptability decouples microbial growth from respiration and limits soil carbon storage.Despite extensive research on soil microbial carbon (C) use efficiency (CUE), its linkage to actual soil C storage remains ambiguous. A key uncertainty is that CUE estimates from short-term labeling incubations assume a linear negative relationship with respiration rates, overlooking nonlinear interactions and long-term microbial acclimation. Here, we use a stoichiometry-based approach to estimate CUE (CUE ST ), which links soil resource availability to microbial demand and captures microbial adaptability under resource constraints. We synthesized 1094 paired observations of CUE ST and heterotrophic respiration rate ( R h ) across natural ecosystems and found a nonlinear relationship between them governed by ecosystem productivity. In low-productivity arid and cold regions, CUE ST declined with increasing R h , whereas in productive tropical and temperate regions, CUE ST stabilized at a low level (0.27 ± 0.11) as R h exceeded 340 ± 10.8 grams of C per square meter per year. This shift reflects microbial trade-offs between C assimilation and stoichiometric homeostasis, revealing a decoupling of microbial growth from respiration that limits the capacity of productive ecosystems to store additional soil C.Resource-dependent microbial adaptability decouples microbial growth from respiration and limits soil carbon storage
CBCT-based Online Adaptive Radiotherapy for Prostate Cancer: Dosimetrical Aspects and Comparison to Non-Adaptive Conventional IGRT
No full textIntroduction Daily anatomical variations in prostate cancer radiotherapy, particularly due to pelvic organ motion and filling, can compromise target coverage and increase exposure to organs at risk (OARs). Conventional image-guided radiotherapy (IGRT) uses fixed safety margins and daily couch corrections to account for these variations, potentially leading to overtreatment of healthy tissue or insufficient tumor coverage. Online adaptive radiotherapy (oART), based on cone-beam computed tomography (CBCT), enables daily plan adaptation to the patient's anatomy, offering improved precision, enhanced target coverage, and better OAR sparing. This retrospective study compares oART to conventional IGRT in prostate cancer treatment. Methods A total of 153 treatment fractions from six consecutive prostate cancer patients treated with oART on a Varian Ethos system were analyzed. For each fraction, three plans were evaluated: the scheduled plan (initial plan recalculated on daily CBCT), the adapted plan (reoptimized based on daily anatomy), and the verification plan (applied dose recalculated on a post-adaptation CBCT). Dose–volume metrics for target volumes and OARs were assessed, and clinical acceptability was evaluated. Interfractional prostate volume changes and treatment times were examined. Results CTV D 98% improved significantly with adaptation (median 97.85% to 98.55%; p < 0.01) and further increased in the verification plan (98.8%; p < 0.01), alongside reduced interquartile ranges. PTV D 98% rose from 90.1% to 97.1% with adaptation and to 96.9% after verification (p < 0.01). Bowel and bladder doses showed dosimetrical advantage. Clinically acceptable plans increased from 24.8% (scheduled) to 98% (adapted) and 85.6% (verification). Scheduled plans were not used clinically. Median prostate volume remained stable despite inter-individual variation. oART required about twice the treatment time of IGRT. Conclusion Although more time-consuming, oART improved target dose coverage and optimized OAR sparing, while simultaneously reducing dose variability for both the target and some OARs compared to IGRT. The plan acceptability improved significantly
Interpretation Biases in Anxiety: A Three-Level Meta-Analysis
No full textInterpretation biases (IBs) play a central role in cognitive models of anxiety disorders and are considered a transdiagnostic feature across anxiety disorders and severity levels. However, the magnitude of this bias in anxiety and modulating factors are largely unknown. In this three-level meta-analysis, we investigated the associations between IBs and symptoms of anxiety. Database searches (PsycINFO, PubMed, ProQuest Dissertations) led to 295 samples with 1,450 contrasts. An overall medium effect size ( g = 0.48, 95% confidence interval = [0.43, 0.52]) was found. Equivalent effect sizes were found for youths and adults and different disorder categories and clinical statuses. Effect sizes were larger for studies using direct measures, verbal stimuli, disorder-specific stimuli, and negative (as opposed to positive) stimuli. Overall, results are consistent with the view that anxiety is associated with IBs across different disorders and severity levels. These findings have implications for cognitive theories of anxiety and clinical interventions.Studienstiftung des Deutschen Volkes https://doi.org/10.13039/501100004350Deutsche Forschungsgemeinschaft https://doi.org/10.13039/501100001659Deutsche Forschungsgemeinschaft https://doi.org/10.13039/50110000165
Persistent structural alteration of the extended limbic system in adolescents with childhood maltreatment
No full textCoral reef aorta: a systematic review and proposal for a novel anatomical classification
No full textGVHD and GRFS in patients with acute myeloid leukemia undergoing allogeneic HCT with treosulfan- versus reduced-intensity busulfan-based conditioning: a subgroup analysis of a randomized phase 3 trial
No full textAcute myeloid leukemia (AML) is the most common indication for allogeneic hematopoietic cell transplantation (alloHCT), yet graft-versus-host disease (GVHD) remains a major post-transplant complication. Conditioning regimens, particularly reduced-intensity approaches, are critical in optimizing outcomes. This subgroup analysis of the phase 3 MC-FludT.14/L trial compared treosulfan-fludarabine with reduced-intensity busulfan-fludarabine in 352 AML patients (aged 31–70) undergoing alloHCT. The primary endpoint was 24-month event-free survival (EFS); secondary endpoints included overall survival (OS), GVHD incidence, relapse/progression, and non-relapse mortality (NRM). Treosulfan compared to busulfan demonstrated superiority: 24-month EFS was 65% vs. 53% (p = 0.01), and OS was 73% vs. 65%. EFS benefits were consistent across AML risk categories and notably higher in patients with hematopoietic cell transplantation comorbidity index >2 (62% vs. 42%, p = 0.02). Treosulfan also showed lower NRM and relapse rates. GVHD outcomes favored treosulfan, with a significantly lower incidence of extensive chronic GVHD at 24 months (15.1% vs. 28.1%, p = 0.01). GVHD-free and relapse-free survival was also improved (53% vs. 40%, p = 0.02). The safety profile was more favorable with treosulfan. These findings support treosulfan-fludarabine as a more effective and safer conditioning regimen than busulfan-fludarabine for AML patients undergoing alloHCT, particularly those at higher risk
Revisiting the Atmosphere of HAT-P-70b with CARMENES High-resolution Transmission Spectroscopy
No full textAbstract Owing to hot and inflated envelopes that facilitate atmospheric studies, ultrahot Jupiters (UHJs) have attracted much attention. Significant progress has been achieved, from enlarging the sample size to broadening the studies to encompass diverse stellar types and ages. Here, we present a transmission spectroscopy study of HAT-P-70b, a UHJ orbiting a young A-type star, through high-resolution observations with CARMENES at the 3.5 m Calar Alto telescope. By using the line-by-line technique, we confirm the previous detections of H α , Na i , and Ca ii , report a new tentative detection of K i , and impose an upper limit on the He triplet absorption. Through cross-correlation analysis, we identify the Ca ii and Fe i absorptions, both blueshifted by approximately 5 km s −1 , indicating a day-to-night side atmospheric wind. Additionally, we find a new tentative detection of K i . We do not see any significant atmospheric molecular signal in the near-infrared data. Putting HAT-P-70b in the context of UHJs from the literature, it turns out that (1) H α absorption is more common on gas giants orbiting stars younger than 1 Gyr, with a relative detection probability of P Age<1 Gyr (H α )/ P Age≥1 Gyr (H α ) ∼ 3; (2) any UHJ is likely to exhibit Fe i absorption if it has Ca ii .MOST ∣ National Natural Science Foundation of ChinaMOST ∣ National Natural Science Foundation of ChinaMEC ∣ Agencia Estatal de InvestigaciónEC ∣ European Regional Development FundEC ∣ European Regional Development FundEC ∣ European Regional Development FundFundación Carmen y Severo Ochoa 100017199Fundación Carmen y Severo Ochoa 100017199Fundación Carmen y Severo Ochoa 100017199EC ∣ European Regional Development Fun
