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Background and Purpose: \ud Long periods of daily sedentary time, particularly accumulated in long uninterrupted bouts, are a risk factor for cardiovascular disease. People with stroke are at high risk of recurrent events and prolonged sedentary time may increase this risk. We aimed to explore how people with stroke distribute their periods of sedentary behavior, which factors influence this distribution, and whether sedentary behavior clusters can be distinguished?\ud \ud Methods: \ud This was a secondary analysis of original accelerometry data from adults with stroke living in the community. We conducted data-driven clustering analyses to identify unique accumulation patterns of sedentary time across participants, followed by multinomial logistical regression to determine the association between the clusters, and the total amount of sedentary time, age, gender, body mass index (BMI), walking speed, and wake time.\ud \ud Results: \ud Participants in the highest quartile of total sedentary time accumulated a significantly higher proportion of their sedentary time in prolonged bouts (P < 0.001). Six unique accumulation patterns were identified, all of which were characterized by high sedentary time. Total sedentary time, age, gender, BMI, and walking speed were significantly associated with the probability of a person being in a specific accumulation pattern cluster, P < 0.001 – P = 0.002.\ud \ud Discussion and Conclusions: \ud Although unique accumulation patterns were identified, there is not just one accumulation pattern for high sedentary time. This suggests that interventions to reduce sedentary time must be individually tailored.\ud \ud Video Abstract available for more insight from the authors (see the Video Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A343).

Given the increasing diversity of teachers and students in 21st century classrooms, fairness is a key consideration in classroom adjusted assessment and instructional practices for students with disability. Despite its significance, little research has attempted to explicitly conceptualise fairness for classroom assessment adjusted practices. The purpose of this study is to leverage the multiple perspectives of secondary school students with disability, their teachers, and parents to build a multi-dimensional framework of fairness for assessment adjusted practices. Open-ended survey data were collected from 60 students with disability, 45 teachers, and 58 parents in four states in Australia and were analyzed using qualitative inductive analysis. The findings present a multidimensional framework for assessment adjusted practices that include interactions across elements of assessment practices, socio-emotional environment, overall conceptions of fairness, and contextual barriers and facilitators. The interactions across these elements influence the learning opportunities and academic outcomes for students with disability.

Decades of laboratory research have shown impairments to several body systems after only 4-5 days of strictly controlled consistent low energy availability (LEA); where energy availability (EA) = Energy Intake (EI) - Exercise Energy Expenditure (EEE)/Fat-Free Mass. Meanwhile, cross-sectional reports exist on the interrelatedness of LEA, menstrual dysfunction and impaired bone health in females (the Female Athlete Triad). These findings have demonstrated that LEA is the key underpinning factor behind a broader set of health and performance outcomes, recently termed as Relative Energy Deficiency in Sport (RED-S). There is utmost importance of early screening and diagnosis of RED-S to avoid the development of severe negative health and performance outcomes. However, a significant gap exists between short-term laboratory studies and cross-sectional reports, or clinically field-based situations, of long-term/chronic LEA and no definitive, validated diagnostic tests for RED-S exist. This review aims to highlight methodological challenges related to the assessment of the components of EA equation in the field (e.g. challenges with EI and EEE measures). Due to the uncertainty of these parameters, we propose the use of more chronic "objective" markers of LEA (i.e. blood markers). However, we note that direct extrapolations of laboratory-based outcomes into the field are likely to be problematic due to potentially poor ecological validity and the extreme variability in most athlete's daily EI and EEE. Therefore, we provide a critical appraisal of the scientific literature, highlighting research gaps, and a potential set of leading objective RED-S markers while working in the field.HIGHILIGHTS Direct application of short-term laboratory-based findings in the field is problematic.Calculation of energy availability (EA) in the field is methodologically challenging and prone to errors.The use of several biomarkers may allow the detection of early exposure to low EA in the female athlete.

Abstract Throughout its history the strategy and tactics of contextual behavioral science (CBS) research have had distinctive features as compared to traditional behavioral science approaches. Continued progress in CBS research can be facilitated by greater clarity about how its strategy and tactics can be brought to bear on current challenges. The present white paper is the result of a 2 1/2-year long process designed to foster consensus among representative producers and consumers of CBS research about the best strategic pathway forward. The Task Force agreed that CBS research should be multilevel, process-based, multidimensional, prosocial, and pragmatic, and provided 33 recommendations to the CBS community arranged across these characteristics. In effect, this report provides a detailed research agenda designed to maximize the impact of CBS as a field. Scientists and practitioners are encouraged to mount this ambitious agenda.

© 2020 SAGE Publications. This study compares the individual-level and sample-level predictive utility of a measure of the cultural logics of dignity, honor, and face. University students in 29 samples from 24 nations used a simple measure to rate their perceptions of the interpersonal cultural logic characterizing their local culture. The nomological net of these measures was then explored. Key dependent measures included three different facets of independent versus interdependent self-construal, relevant attitudes and values, reported handling of actual interpersonal conflicts, and responses to normative settings. Multilevel analyses revealed both individual- and sample-level effects but the dignity measure showed more individual-level effects, whereas sample-level effects were relatively more important with the face measure. The implications of this contrast are discussed.

Brain asymmetry reflects left-right hemispheric differentiation, which is a quantitative brain phenotype that develops with age and can vary with psychiatric diagnoses. Previous studies have shown that substance dependence is associated with altered brain structure and function. However, it is unknown whether structural brain asymmetries are different in individuals with substance dependence compared with nondependent participants. Here, a mega-analysis was performed using a collection of 22 structural brain MRI datasets from the ENIGMA Addiction Working Group. Structural asymmetries of cortical and subcortical regions were compared between individuals who were dependent on alcohol, nicotine, cocaine, methamphetamine, or cannabis (n = 1,796) and nondependent participants (n = 996). Substance-general and substance-specific effects on structural asymmetry were examined using separate models. We found that substance dependence was significantly associated with differences in volume asymmetry of the nucleus accumbens (NAcc; less rightward; Cohen's d = 0.15). This effect was driven by differences from controls in individuals with alcohol dependence (less rightward; Cohen's d = 0.10) and nicotine dependence (less rightward; Cohen's d = 0.11). These findings suggest that disrupted structural asymmetry in the NAcc may be a characteristic of substance dependence.

Objective The metabolic master-switch AMP-activated protein kinase (AMPK) mediates insulin-independent glucose uptake in muscle and regulates the metabolic activity of brown and beige adipose tissue (BAT). The regulatory AMPKγ3 isoform is uniquely expressed in skeletal muscle and potentially in BAT. Herein, we investigated the role that AMPKγ3 plays in mediating skeletal muscle glucose uptake and whole-body glucose clearance in response to small-molecule activators that act on AMPK via distinct mechanisms. We also assessed whether γ3 plays a role in adipose thermogenesis and browning. Methods Global AMPKγ3 knockout (KO) mice were generated. A systematic whole-body, tissue, and molecular phenotyping linked to glucose homeostasis was performed in γ3 KO and wild-type (WT) mice. Glucose uptake in glycolytic and oxidative skeletal muscle ex vivo as well as blood glucose clearance in response to small molecule AMPK activators that target the nucleotide-binding domain of the γ subunit (AICAR) and allosteric drug and metabolite (ADaM) site located at the interface of the α and β subunit (991, MK-8722) were assessed. Oxygen consumption, thermography, and molecular phenotyping with a β3-adrenergic receptor agonist (CL-316,243) treatment were performed to assess BAT thermogenesis, characteristics, and function. Results Genetic ablation of γ3 did not affect body weight, body composition, physical activity, and parameters associated with glucose homeostasis under chow or high-fat diet. γ3 deficiency had no effect on fiber-type composition, mitochondrial content and components, or insulin-stimulated glucose uptake in skeletal muscle. Glycolytic muscles in γ3 KO mice showed a partial loss of AMPKα2 activity, which was associated with reduced levels of AMPKα2 and β2 subunit isoforms. Notably, γ3 deficiency resulted in a selective loss of AICAR-, but not MK-8722-induced blood glucose-lowering in vivo and glucose uptake specifically in glycolytic muscle ex vivo. We detected γ3 in BAT and found that it preferentially interacts with α2 and β2. We observed no differences in oxygen consumption, thermogenesis, morphology of BAT and inguinal white adipose tissue (iWAT), or markers of BAT activity between WT and γ3 KO mice. Conclusions These results demonstrate that γ3 plays a key role in mediating AICAR- but not ADaM site binding drug-stimulated blood glucose clearance and glucose uptake specifically in glycolytic skeletal muscle. We also showed that γ3 is dispensable for β3-adrenergic receptor agonist-induced thermogenesis and browning of iWAT. Highlights • Loss of AMPKγ3 reduces glucose uptake in glycolytic skeletal muscle and whole-body glucose clearance with AMP-mimetic drug. • γ3 is not required for muscle glucose uptake and whole-body glucose clearance with ADaM site-targeted allosteric activators. • γ3 is present and forms a trimeric complex with α2 and β2 in brown adipose tissue. • γ3 is dispensable for adipose thermogenesis and browning in response to a β3-adrenergic receptor agonist.

[English] This study determined if supplementation with pantothenic acid (PA) for 16 weeks could increase skeletal muscle coenzyme A (CoASH) content and exercise performance. Trained male cyclists (n = 14) were matched into control or PA (6 g·day1) groups. At 0, 4, 8, and 16 weeks, subjects performed an incremental time to exhaustion cycle with muscle biopsies taken prior to and following exercise. Prolonged PA supplementation did not change skeletal muscle CoASH and acetyl- CoA contents or exercise performance. Novelty: Supplementation with pantothenic acid for 16 weeks had no effect on skeletal muscle CoASH and acetyl-CoA content or exercise performance in trained male cyclists. [French] Cette étude détermine si une supplémentation en acide pantothénique (« PA ») pendant 16 semaines peut augmenter la teneur en coenzyme A (« CoASH ») du muscle squelettique et la performance à l’exercice. Les cyclistes masculins entraînés (n = 14) sont appariés dans des groupes témoins ou PA (6 g·jour−1). Aux semaines 0, 4, 8 et 16, les sujets effectuent un exercice incrémental de pédalage au cours duquel on mesure la durée jusqu’à épuisement ; des biopsies musculaires sont prélevées avant et après l’exercice. Une supplémentation prolongée en PA ne modifie pas les teneurs en CoASH et en acétyl-CoA du muscle squelettique ni la performance à l’exercice. [Traduit par la Rédaction]

espanolRESUMEN Se ha puesto de manifiesto que muchos tratamientos psicologicos tienen un coste efectivo y son eficaces siempre que se apliquen con fidelidad. La evaluacion de esta y el feedback son caros y exigen mucho tiempo. El aprendizaje automatico se ha utilizado para evaluar la fidelidad al tratamiento, aunque su fiabilidad y capacidad de generalizacion no esten claras. Recopilamos y analizamos todas las aplicaciones de aprendizaje automatico con el fin de evaluar el comportamiento verbal de todos los profesionales de ayuda, con el acento particular en la fidelidad al tratamiento de los terapeutas. Llevamos a cabo busquedas en nueve bases de datos electronicas para enfoques automaticos de codificacion de comportamiento verbal en terapia y contextos semejantes. Llevamos a cabo el cribado, la extraccion y la evaluacion de la calidad por duplicado. Cincuenta y dos estudios cumplian nuestros criterios de inclusion (el 65.3% en psicoterapia). Los metodos de codificacion automatica resultaban mejor que el azar y algunos de ellos mostraban un desempeno casi al nivel humano, que tendia a ser mejor con conjuntos mas grandes de datos, un numero de codigos menor, codigos conceptualmente simples y cuando predecian indices al nivel de sesion que los de tipo declaracion. Escasos estudios cumplian las directrices de buena praxis en aprendizaje automatico. Este presento unos resultados alentadores, sobre todo donde habia conjuntos de datos grandes y anotados y un escaso numero de caracteristicas concretas que codificar, modos expansibles de evaluar la fidelidad y facilitar a los terapeutas un feedback individualizado, rapido y objetivo. EnglishABSTRACT Many psychological treatments have been shown to be cost-effective and efficacious, as long as they are implemented faithfully. Assessing fidelity and providing feedback is expensive and time-consuming. Machine learning has been used to assess treatment fidelity, but the reliability and generalisability is unclear. We collated and critiqued all implementations of machine learning to assess the verbal behaviour of all helping professionals, with particular emphasis on treatment fidelity for therapists. We conducted searches using nine electronic databases for automated approaches of coding verbal behaviour in therapy and similar contexts. We completed screening, extraction, and quality assessment in duplicate. Fifty-two studies met our inclusion criteria (65.3% in psychotherapy). Automated coding methods performed better than chance, and some methods showed near human-level performance; performance tended to be better with larger data sets, a smaller number of codes, conceptually simple codes, and when predicting session-level ratings than utterance-level ones. Few studies adhered to best-practice machine learning guidelines. Machine learning demonstrated promising results, particularly where there are large, annotated datasets and a modest number of concrete features to code. These methods are novel, cost-effective, scalable ways of assessing fidelity and providing therapists with individualised, prompt, and objective feedback.

The AMP-activated protein kinase (AMPK), a central regulator of cellular energy balance and metabolism, binds glycogen via its β subunit. However, the physiological effects of disrupting AMPK-glycogen interactions remain incompletely understood. To chronically disrupt AMPK-glycogen binding, AMPK β double knock-in (DKI) mice were generated with mutations in residues critical for glycogen binding in both the β1 (W100A) and β2 (W98A) subunit isoforms. We examined the effects of this DKI mutation on whole-body substrate utilization, glucose homeostasis, and tissue glycogen dynamics. Body composition, metabolic caging, glucose and insulin tolerance, serum hormone and lipid profiles, and tissue glycogen and protein content were analyzed in chow-fed male DKI and age-matched wild-type (WT) mice. DKI mice displayed increased whole-body fat mass and glucose intolerance associated with reduced fat oxidation relative to WT. DKI mice had reduced liver glycogen content in the fed state concomitant with increased utilization and no repletion of skeletal muscle glycogen in response to fasting and refeeding, respectively, despite similar glycogen-associated protein content relative to WT. DKI liver and skeletal muscle displayed reductions in AMPK protein content versus WT. These findings identify phenotypic effects of the AMPK DKI mutation on whole-body metabolism and tissue AMPK content and glycogen dynamics.