Critical biomarkers such as cell-free DNA (cfDNA) derived from tumors and circulating tumor cells (CTCs) can be detected and analyzed from a simple blood draw. These analytes are fragile, prone to degradation, and present in extremely low quantities. Therefore, proper preservation of these analytes is necessary to ensure accuracy of test results. Several blood collection tubes are commercially available for cfDNA applications, and selecting the ideal blood collection tube for cfDNA impacts test results, sample collection logistics and costs. However, no comprehensive and systematic evaluation of performance among these tubes is available. This study evaluates five commercial blood collection tubes: LBgard™ Blood Tube (Biomatrica), Streck cfDNA BCT® (Streck), PAXgene Blood ccfDNA Tube (PreAnalytiX), Cell-Free DNA Collection Tube (Roche), and EDTA (BD). Healthy donor blood samples were collected in each tube type and incubated over several days at different temperatures. Total plasma DNA was subsequently isolated, and the yield, fold increase versus time 0 and quality of purified DNA were compared. cfDNA controls were also spiked into blood samples collected in each tube type and measured by droplet digital PCR to determine the mutant allele frequencies over time. Finally, the yield and quality of cfDNA isolated from stage IV colorectal cancer blood collected in LBgard Blood Tube, Streck cfDNA BCT and EDTA were compared. Additionally, the inhibition of hemolysis and CTC stabilization were also assessed. Our results show that LBgard Blood Tube, Streck cfDNA BCT, PAXgene ccfDNA Tube and Cell-Free DNA Collection Tube are superior to EDTA tubes in maintaining cfDNA yield and quality over 7 days at ambient temperature. LBgard Blood Tube out-performs all tested blood tubes in inhibiting genomic DNA release for the longest duration (14 days) and across the widest temperature range (4°C, 25°C and 37°C). LBgard Blood Tube shows equivalent inhibition of genomic DNA release to Streck cfDNA BCT for clinical samples, and both tubes out-perform EDTA blood tubes. LBgard Blood Tube also consistently shows better CTC stabilization and inhibition of hemolysis over Streck cfDNA BCT. This comprehensive and systematic study of blood collection tube performance provides a quantitative and exhaustive assessment of blood sample stability, allowing researchers to make informed decisions based on their sample stabilization needs. Citation Format: Cecille D. Browne, Margrith E. Mattmann, Marc J. Wycoco, Sheila N. Chen, Rajeswari Ravichandran, Joel Desharnais, Laura J. Varela, Jonathan D. Browne, Vasco Liberal, Florence Lee. Comparison of cell-free DNA blood collection tubes [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2758. doi:10.1158/1538-7445.AM2017-2758

The global coronavirus disease 2019 (COVID-19) pandemic has had deleterious effects on our healthcare system. Lockdown measures have decreased the number of patients presenting to the hospital for non-respiratory illnesses, such as strokes. Moreover, there appears to be a racial disparity among those afflicted with the virus. We sought to assess whether this disparity also existed for patients presenting with strokes. Methods The Get with the Guidelines National Stroke Database was reviewed to assess patients presenting with a final diagnosis of ischemic stroke, transient ischemic attack (TIA), subarachnoid hemorrhage (SAH), or spontaneous/nontraumatic intraparenchymal hemorrhage (IPH). The period of February-May 2020 was chosen given the surge of patients affected with the virus and national shutdowns. Data from this same time during 2019 was used as the control population. Our hospital numbers and four additional regions were assessed (California hospitals, Pacific State hospitals, Western Region hospitals, and all hospitals in the United States). Patients were categorized by race (White, Black/African American, Asian, Native American, Hispanic) in each cohort. The primary endpoint of this study is to compare whether there was a significant difference in the proportion of patients in each reported racial category presenting with stroke during the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results A downward trend in total number of patients was noted in all five regional cohorts assessed. A statistically significant increase in the number of Black and Hispanic patients presenting with strokes was noted in California, Pacific hospitals, Western hospitals, and all hospitals in the United States during various months studied comparing 2020 to 2019. A statistically significant increase in the Hispanic population was noted in February and March in all California hospitals (p=0.005 and 0.02, respectively) and Pacific Coast hospitals (p=0.005 and 0.039, respectively). The Western region and all national hospitals noted a significant increase in strokes in the Hispanic population in April (p=0.039 and 0.023, respectively). A statistically significant increase of strokes in the Black population was noted in April in Pacific hospitals,

Purpose: Wearable biometric monitoring devices (WBMD) show promise as a cutting edge means to improve health and prevent disease through increasing accountability. By regularly providing real-time quantitative data regarding activity, sleep quality, and recovery, users may become more aware of the impact that their lifestyle has on their health. The purpose of this study was to examine the efficacy of a biometric tracking ring on improving sleep quality and increasing physical fitness over a one-year period.Methods: Fifty-six participants received a biometric tracking ring and were placed in one of two groups. One group received a 3-month interactive behavioral modification intervention (INT) that was delivered virtually via a smartphone app with guided text message feedback (GTF). The other received a 3-month non-directive wellness education control (CON). After three months, the INT group was divided into a long-term feedback group (LT-GTF) that continued to receive GTF for another nine months or short-term feedback group (ST-GTF) that stopped receiving GTF. Weight, body composition, and VO2max were assessed at baseline, 3months, and 12months for all participants and additionally at 6 and 9months for the ST-GTF and LT-GTF groups. To establish baseline measurements, sleep and physical activity data were collected daily over a 30-day period. Daily measurements were also conducted throughout the 12-month duration of the study.Results: Over the first 3months, the INT group had significant (p<0.001) improvements in sleep onset latency, daily step count, % time jogging, VO2max, body fat percentage, and heart rate variability (rMSSD HRV) compared to the CON group. Over the next 9months, the LT-GTF group continued to improve significantly (p<0.001) in sleep onset latency, daily step count, % time jogging, VO2max, and rMSSD HRV. The ST-GTF group neither improved nor regressed over the latter 9months except for a small increase in sleep latency.Conclusion: Using a WBMD concomitantly with personalized education, encouragement, and feedback, elicits greater change than using a WBMD alone. Additionally, the improvements achieved from a short duration of personalized coaching are largely maintained with the continued use of a WBMD.

217cases, aerobic--training is poorly tolerated. Thankfully, other modes of exercise training, such as resistance training (RT) have previously been successfully integrated into general rehabilitation programs. However, it is not known whether such exercise modalities are sufficient to enhance cardiopulmonary system function and whether they could be utilized in rehabilitation programs that integrate interventions related to respiration. PURPOSE: To determine the effect of different RT modalities on chest expansion, spirometry, and cardiorespiratory fitness (VO 2max ) in untrained smokers. METHODS: Forty-two untrained male smokers were randomized into either a non-exercising control group (n=15) or a muscle endurance RT group (MERG; n=15) and hypertrophy RT group (HRG; n=15), who trained using their respective one-hour resistance training regimes non-consecutively, thrice weekly. Abdominal and thoracic dimensions and kinematics, spirometry, and VO 2max were assessed pre-and post-test following the eight-week training period. Differences from pre-to post-test were examined using t-tests with alpha levels set at p ≤ 0.05. RESULTS: Hypertrophy type RT improved PIF (from 5.76±2.56 L.sec -1 to 7.46±2.71 L.sec -1 ; p=0.009) and maximum inhalation (from 90.93±4.15 cm to 92.76±4.32 cm; p=0.000). In turn, the muscle endurance type RT only improved VO 2max (from 46.37±7.66 mL.kg -1 .min -1 to 63.62±7.86 mL.kg -1 .min -1 ; p=0.001). CONCLUSIONS: This study suggests that RT can be used to improve abdominal and thoracic dimensions and kinematics, spirometry, and VO 2max in untrained smokers. However, to fully gain the benefits from RT, both hypertrophy and muscle endurance RT should be incorporated into their program design.

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Exergaming, combining elements of video game into the realm of exercise, has recently incorporated immersive virtual reality (IVR) with resistance training. Thirty-two participants (14 females, mean age = 24.3) were randomized to IVR or self-directed control group (SELF) and worked out thrice weekly for 12 weeks (for 36 sessions). The IVR group spent 14 fewer minutes per session (p < 0.001) while reporting the sessions “enjoyable’. Compared to SELF, the IVR group had significantly greater improvement in changes from baseline to post-training in upper-and-lower muscular strength (1-RM) and muscular endurance (85% 1-RM) (14.3 kg vs. 10.0 kg for 1-RM upper, 28.6 kg vs. 22.5 kg for 1-RM lower, 2.6 reps vs. 1.9 reps for 85% 1-RM of upper, 2.7 vs. 2.0 reps for 85% 1-RM of lower, all p < 0.001), peak leg power (1424 vs. 865 W, p < 0.001), body fat% (−3.7% vs. −1.9%, p < 0.001), heart rate variability (4.3 vs. 1.8 ms, p < 0.001), rVO2max (3.28 vs. 0.89 mL/min/kg, p < 0.001) with decreased systolic BP (−0.4 vs. −2.3 mmHg, p < 0.001), and level of perceived exertion during workouts (RPE 14 vs. 16, p < 0.001). With its high-paced and action-filled gaming coupled with superior fitness and cardiometabolic outcomes, this IVR exergaming platform should be considered as another exercise modality for performance and health-related training.

BACKGROUND The intersection of games and exercise has sparked the growth of novel training systems with the potential to promote quality physical activity. Innovations in Immersive Virtual Reality (IVR) have propelled “exergaming” to the forefront of the fitness landscape. Researchers have yet to fully explore the physiological and metabolic efficacy and applications of the immersive environment and interactive programming. OBJECTIVE This study aimed to measure metabolic (i.e., energy expenditure (EE)) and physiological (i.e., heart rate (HR)) demands and subjective fatigue and enjoyment scores during a signature 30-minute IVR adaptive cable resistance exergaming session. METHODS Fourteen healthy, college-aged individuals (7 females) were initially acquainted with the equipment and acclimated to the virtual reality and gameplay dynamics. Participants then completed a signature 30-minute exergaming session using an IVR adaptive cable resistance system (Black Box VR ®) that incorporated chest press, squat, row, lat pulldown, overhead press, and stiff leg deadlift. During the session, a portable metabolic gas exchange analysis system assessed energy expenditure by indirect calorimetry and a chest-worn monitor captured heart rate. Immediately following the session, participants completed questionnaires including the Borg scale for Rating of Perceived Exertion (RPE), the Physical Activity Enjoyment Scale (PACES), and the Simulator Sickness Questionnaire (SSQ). RESULTS EE was greater in males compared to females in terms of kcal/min (P = 0.001), total kcal (P = 0.001), and metabolic equivalents (P = 0.029). Females demonstrated a higher average HR (P = 0.020) and HR as a percentage of theoretical HRmax (P = 0.018). The overall mean metabolic equivalent (MET) during the session was 12.9 (0.5). Men achieved greater volume of total weight lifted during the session (P < 0.001) and with chest press (P = 0.005), overhead press (P = 0.001), stiff-leg deadlift (P = 0.002), and squat (P = 0.015). For the questionnaires, the mean (SD) of RPE, PACES and SSQ was 14 (1), 4.31 (0.36) and 24.04 (24.13), respectively. CONCLUSIONS IVR exergaming with resistance cable training elicits substantial EE and very high physiological demand while attenuating perceived psychological and physical fatigue. Further investigations of IVR utility should explore nuanced muscle recruitment patterns during training and long-term regimen adherence.

It consists of pain perception of a previously amputated limb. The exact pain mechanism is disputed and includes mechanisms involving cerebral, peripheral, and spinal origins. Such controversy limits researchers' and clinicians' ability to develop consistent therapeutics or management. Neuroimaging is an essential tool that can address this problem. This review explores diffusion tensor imaging, functional magnetic resonance imaging, electroencephalography, and magnetoencephalography in the context of PLP. These imaging modalities have distinct mechanisms, implications, applications, and limitations. Diffusion tensor imaging can outline structural changes and has surgical applications. Functional magnetic resonance imaging captures functional changes with spatial resolution and has therapeutic applications. Electroencephalography and magnetoencephalography can identify functional changes with a strong temporal resolution. Each imaging technique provides a unique perspective and they can be used in concert to reveal the true nature of PLP. Furthermore, researchers can utilize the respective strengths of each neuroimaging technique to support the development of innovative therapies. PLP exemplifies how neuroimaging and clinical management are intricately connected. This review can assist clinicians and researchers seeking a foundation for applications and understanding the limitations of neuroimaging techniques in the context of PLP.