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Individuals with intellectual disabilities often face unique challenges in physical capabilities, making traditional training methods less effective for their specific needs. This study aimed to investigate the effect of combining balance, plyometric, and strength (CBPS) training with sprint training on physical performance in male athletes with intellectual disabilities. Twenty-seven participants were randomly assigned to either a CBPS group or a control group that only maintained their regular sprint training. Participants underwent pre- and posttraining tests, including measures of balance, jumping, agility, and sprinting ability. The results showed that the CBPS group demonstrated significant improvements (p <.05) in one-leg stance, crossover-hop jump, squat jump, countermovement jump, and 10- and 30-m sprint at posttraining compared with pretraining. CBPS training combined with sprinting significantly improves physical performance in male athletes with intellectual disabilities, suggesting implications for tailored training programs to enhance their physical fitness and overall health. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed at evaluating the effect of level of competition and drill typology on loads during the preseason period in male volleyball players. Methods: Internal (percentage of peak heart rate [HR] and summated HR zone) and external (PlayerLoad per minute, total and high accelerations per minute [tACCmin and hACCmin], decelerations per minute [tDECmin and hDECmin], and jumps per minute [tJUMPmin and hJUMPmin]) loads were monitored across a 5-week preseason period in 12 Division 1 (age: 22.5 [3.9] y; stature: 188 [6.2] cm; body mass: 85 [11.6] kg; training experience: 9.4 [4.2] y) and 12 Division 2 (age: 20.7 [2.9] y; stature: 186 [6.2] cm; body mass: 77.8 [9.6] kg; training experience: 5.6 [2.3] y) male volleyball players. Furthermore, differences in load were assessed for each drill typology (warm-up, conditioning, technical, tactical, and integral). Results: No effects (P >.05) of level of competition on the internal (except for summated HR zone, P =.05) and external loads (except for tJUMPmin, P =.002) were found. Differently, drill typologies showed an effect (P <.001) on all the investigated internal- and external-load measures. The main post hoc results revealed higher (P <.05) percentage of peak HR, summated HR zone, PlayerLoad per minute, and tACCmin in warm-up and conditioning drills, while higher (P <.05) hDECmin and hJUMPmin were found in tactical and integral drills. Conclusions: These results suggest that volleyball coaches use warm-up and conditioning drills when aiming at increasing the internal loads, PlayerLoad per minute, and tACCmin, while tactical and integral drills should be preferred to enhance the number of hDECmin and hJUMPmin. [ABSTRACT FROM AUTHOR]

Context: Slideboards are commonly used in exercise programs, but there is limited information about how they affect muscle activities during exercise. We aim to compare the activation levels of quadriceps and hamstring muscles and hip- and knee-flexion angles during lunge and single-leg squat exercises between normal ground and slideboard in physically active individuals. Design: Cross-sectional study. Methods: Thirty healthy individuals (age: 23.83 [2.84] y, body mass index: 21.75 [1.72] kg/m2) were included in the study. Surface electromyography was used to measure vastus medialis, vastus lateralis, biceps femoris, and semitendinosus activation levels during reaching and returning phases of the forward, lateral, and back lunges and squats that were performed on the normal ground and slideboard. Exercises were performed at a slow pace (60 beats/min). Hip- and knee-flexion angles during the exercises were evaluated by using 2-dimensional motion analysis. Repeated measures of analysis of variance were used for statistical analysis. Results: Vastus medialis and vastus lateralis activation levels were greater during reaching and returning phases of the exercises on slideboard compared with normal ground (P <.05). However, semitendinosus and biceps femoris activity were greater only during the returning phase of the forward lunge (P <.001) and the returning phase of the back squat (P =.002, P =.009, respectively). Hip-to-knee flexion ratios were closer to 1 when the forward lunge (P <.001), back lunge (P =.004), and forward squat (P =.001) exercises were performed on a slideboard. Conclusion: In exercise programs that target the quadriceps and hamstring muscles, slideboards can be effectively used in exercise progressions as they can increase muscle activity. Moreover, squat and lunge exercises on slideboard with a slow pace may also be helpful for improving the balance between hip- and knee-flexion angles. [ABSTRACT FROM AUTHOR]

Summary: The clinical data analysis found that, compared with the traditional obesity index, the waist-weight ratio (WWR) has more advantages in predicting abnormal bone mineral density in subjects with type 2 diabetes. WWR may serve as a new predictive indicator for osteoporosis in T2DM patients. Purpose: This study was designed to explore the correlation between obesity-related indices and bone mineral density (BMD) and its influencing factors in type 2 diabetes mellitus (T2DM) patients. Methods: A total of 528 patients with type 2 diabetes were recruited. Glucose tolerance, insulin stimulation, and blood biochemical tests were conducted on all participants. All subjects underwent dual-energy X-ray bone density testing and were grouped based on the bone density results. Results: Compared with those in the normal BMD group, the waist-to-body weight ratio (WWR) and weight-adjusted-waist index (WWI) in the osteopenia and osteoporosis groups were significantly greater, while body mass index (BMI) was significantly lower (P < 0.05). The logistic regression results showed that the WWR, WWI, and BMI were independently correlated with abnormal BMD in T2DM patients (P < 0.05). WWR and the WWI were negatively correlated with the T-value of bone density in various parts of the body, while BMI was positively correlated with the T-value of bone density (P < 0.05). The area under the working characteristic curve (AUC) for T2DM patients with abnormal bone mass predicted by the WWR [0.806, 95% CI = (0.770–0.843), P < 0.001] was greater than that for patients with other obesity indicators, such as the WWI and BMI. Conclusion: We found a positive correlation between the WWR and bone density in T2DM patients. Compared with other obesity indicators, such as BMI and WWI, the WWR has a stronger discriminative ability for T2DM patients with abnormal bone density. Therefore, more attention should be given to the WWR in T2DM patients. [ABSTRACT FROM AUTHOR]

Introduction Studies link hypovitaminosis D to be significantly associated with poor glycemic control, heightened inflammation, and risk of complications. Studies recommend fasting or calorie restriction as a useful measure to achieve diabetic reversal. The present study explores if therapeutic fasting is associated with improvement in the vitamin D levels and other clinical outcomes related to type 2 diabetes mellitus (T2DM). Methods This observational study included 26 T2DM patients exposed to a 10-day medically supervised fasting (≈ 500–1000 Kcal/day) in a complementary medicine facility. Levels of vitamin D, B12, fasting blood sugar (FBS), blood pressure, anthropometric measures, World Health Organization Quality of Life, disease perception (Brief Illness Perception Questionnaire), and self-reported vitality were measured at the baseline and the 10th day. Results Significant improvement in the levels of vitamin D (p = 0.000), B12 (p = 0.03), and reduction in FBS levels (p = 0.001), blood pressure, body mass index, waist and hip circumference (p ≤ 0.05), and improvement in quality of life, vitality, and disease perception (p < 0.001) were observed by the end of 10th day. FBS shared a negative correlation with vitamin D levels (males r = –0.1, females r = –0.48). Conclusion The present findings provide insights into the probable mechanisms by which therapeutic fasting modulates the progression of T2DM. Nevertheless, large-scale randomized controlled trials are warranted to validate the present findings. [ABSTRACT FROM AUTHOR]

Medial unicompartment knee replacement (UKR) is performed for isolated medial compartment osteoarthritis. Understanding the factors influencing functional outcomes helps patient selection and outcomes. We will review the association between pre-operative BMI and patellofemoral articular wear on post operative Oxford Knee Scores at >2 and > 5 years. A retrospective review of a prospectively collected database was performed. Inclusion criteria were medial UKR for medial compartment OA. The exclusion criteria were age <16, revision procedures and lateral UKR's. Data was collected between 26/6/2014 and 25/8/2022. Statistical analysis was performed using SPSS. Significance was given to variables that reached p < 0.05. 159 UKR procedures were identified in 155 patients. 116 procedures carried out on 111 patients had follow up at > 2 years. At 5 years there were 14 patients had OKS recorded. There was no statistical difference in the ICRS grade I&II vs III&IV groups for >2 year or >5 year OKS with p = 0.408 and p = 0.876. For BMI there was a moderately negative correlation on spearman's rank p(df) = -0.339 (CI 95 % −0.538, −0.104) at >2 years, which was statistically significant with p = 0.004. >5 year data didn't reach significance with p = 0.828. BMI maybe an important patient factor in predicting post operative OKS at 2–5 years. This is beneficial to surgeons for patient selection in medial UKR. Patellofemoral wear doesn't appear to impact on post operative functional outcomes. This supports the theory that patient who suffer from patellofemoral wear, as well as medial compartment wear can benefit from UKR, expanding the current indications. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated whether anthropometric measurements and the five times sit-to-stand test could be used to identify dynapenia. The cut-off values of accurate screening tools for identifying dynapenia were also established. Materials and methods: This was a cross-sectional study conducted on individuals ≥ 60 years old (N = 529). All participants underwent handgrip strength measurement, anthropometric measurements and the five times sit-to-stand test. The participants whose handgrip strength was < 28 kg for men and < 18 kg for women were considered to have dynapenia. The association between the recorded variables and dynapenia was determined using logistic regression, and cut-off values were established by performing the Receiver Operating Characteristic curve analysis. Results: The prevalence of dynapenia was 35.42% in men and 25.61% in women. For males, both calf circumference (≤ 35.2 cm) and the five times sit-to-stand test (≥ 14.6 s) could be used as accurate tools for dynapenia. For females, only the five times sit-to-stand test (≥ 11.8 s) had sufficient accuracy to be used as a screening tool for dynapenia. Conclusions: The five times sit-to-stand test was an accurate screening tool for identifying dynapenia. The calf circumference could be only used as a screening tool in males. IMPLICATIONS FOR REHABILITATION: Calf circumference and the five times a sit-to-stand test can be used as accurate screening tools in males with dynapenia. Only the five times sit-to-stand test had sufficient accuracy in females with dynapenia. The optimal cut-off values established for older males and females are only applicable to the Asian population. [ABSTRACT FROM AUTHOR]

In this paper, we measured B cell function in elderly healthy individuals (EH) and in elderly patients with Type-2 Diabetes Mellitus (T2DM, ET2DM), which are treatment-naive, as compared to healthy young (YH) individuals. Results show a higher serum inflammatory status of elderly versus young individuals, and especially of ET2DM versus EH. This status is associated with a reduced response to the seasonal influenza vaccine and with increased frequencies of the circulating pro-inflammatory B cell subset called Double Negative (DN) B cells. B cells from ET2DM patients are not only more inflammatory but also hyper-metabolic as compared to those from EH controls. The results herein are to our knowledge the first to show that T2DM superimposed on aging further increases systemic and B cell intrinsic inflammation, as well as dysfunctional humoral immunity. Our findings confirm and extend our previously published findings showing that inflammatory B cells are metabolically supported. [ABSTRACT FROM AUTHOR]

Background: UKA is a well-established treatment option for anteromedial osteoarthritis of the knee, resulting in superior functional outcomes but also higher revision rates than TKA. This study aimed to compare the outcomes of UKA, TKA, UKA converted to TKA using identical standard implants and revised TKA to support clinical decision-making. Methods: In this study, we retrospectively examined 116 patients who underwent UKA, 77 patients who received TKA, 28 patients whose UKA was converted to TKA using identical standard implants, and 21 patients who had a one-stage revision of TKA. The mean age at operation was 66.5 years (39–90 years), with a mean BMI of 28.8 kg/m2 (17.4–58.8) and a mean follow-up period of four years (0.9–9.9 years). We assessed various PROMs, including Oxford Knee Score, UCLA score, KSS score, and a modified WOMAC-Score as well as patient satisfaction and ability to resume daily activities, work, and sports. Results: The highest patient satisfaction was seen in the UKA. All scores were significantly higher for UKA than for TKA, converted UKA, and revised TKA. None of the scores showed a significant inferiority of converted UKA to TKA. In the case of revision, two scores showed significantly better results for converted UKA than for revised TKA. Conclusions: Our results indicated that patients initially treated with UKA did not have significantly worse functional outcomes after conversion to TKA, given the use of identical standard implants. This highlights the effectiveness of UKA as a therapeutic option with outcomes superior to those of primary TKA and the importance of a bone-sparing procedure. Conversely, revision TKA is linked to poorer functional outcomes compared to both primary arthroplasties. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this cross-sectional study was to investigate if serum levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) and CC chemokine ligand 17 (CCL17) correlate with disease activity in axial spondyloarthritis (axSpA) and peripheral spondyloarthritis (pSpA) patients. Patients and methods: The cross-sectional study was conducted with 80 individuals (48 females, 32 males; mean age: 47.7±11.5 years) between March 2021 and September 2021. Of the participants, 20 were axSpA, 20 were pSpA, and 20 were active rheumatoid arthritis patients, and the remaining 20 were healthy controls. Age, sex, body mass index, disease duration, comorbid diseases, smoking status, medical treatments, C-reactive protein (CRP) level and human leukocyte antigen B27 (HLA-B27) positivity were recorded. Serum GM-CSF and CCL17 levels were analyzed by ELISA. Ankylosing Spondylitis Disease Activity Score with CRP (ASDAS-CRP) was used to evaluate the disease activity of patients with spondyloarthritis. Functional status of spondyloarthritis patients was evaluated by Bath Ankylosing Spondylitis Functional Index (BASFI). Results: While the serum GM-CSF levels were similar in the axSpA and pSpA groups, they were significantly higher than the healthy control group (p=0.021 and p=0.009, respectively). There was a significant correlation between GM-CSF levels and ASDAS-CRP (r=0.545, p=0.013) and BASFI (r=0.546, p=0.013) in the axSpA group. In active axSpA patients, the cut-off value for GM-CSF was 15.89 pg/mL (sensitivity 50%, specificity 100%). No differences were detected in serum CCL17 levels among the groups. Conclusion: The results suggest that serum GM-CSF levels may be used as a new marker for the evaluation of disease activity in axSpA, and GM-CSF might be a therapeutic target. [ABSTRACT FROM AUTHOR]

Background: Based on theoretical physiology, the ratio of pulmonary artery pulse pressure to mean pulmonary pressure (PP-MPAP), termed proportional pulmonary pulse pressure, provides a measure of coupling between the right ventricle and the pulmonary circulation. This study tested the hypothesis that lower PP-MPAP ratio was associated with left ventricular (LV) distension in patients with cardiogenic shock who underwent extracorporeal life support (ECLS). Methods: This is a retrospective observational single-centre study of 22 patients with cardiogenic shock who underwent ECLS as the primary support modality without and with LV distension and Impella unloading. The relationship between post-support PP-MPAP and 12-hour lactate clearance was also assessed. Results: Of the 22 patients: 10 patients underwent additional Impella unloading due to LV distension (Group 1) and 12 patients on ECLS only without LV distension (Group 2). As predicted by the theoretical model, PP-MPAP on ECLS dropped in Group 1 (pre-Impella) from 0.473 ± 0.067 to 0.372 ± 0.087, p < 0.001; but increased in Group 2 patients without LV distension (0.518 ± 0.070 to 0.549 ± 0.072, p = 0.002). Impella support in Group 1 increased PP-MPAP (0.372 ± 0.087 to 0.615 ± 0.094, p < 0.001). On multiple regression analysis, post-support PP-MPAP was significantly associated with 12-hour lactate clearance. Conclusion: Changes in PP-MPAP is associated hemodynamic response to ECLS and 12-hour lactate clearance. This simple parameter may guide therapeutic optimization in cardiogenic shock and ECLS. [ABSTRACT FROM AUTHOR]

To investigate the release of lipolytic hormones during various high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), and their effects on fat loss. 39 young women categorized as obese (with a body fat percentage (BFP) ≥30%) were randomly allocated to one of the following groups: all-out sprint interval training (SIT, n =10); supramaximal HIIT (HIIT120, 120% VO2peak, n = 10); HIIT (HIIT90, 90% VO2peak, n = 10), or MICT, (60% VO2peak, n = 9) for a twelve-week observation period consisting of 3 to 4 exercise sessions per week. Serum epinephrine (EPI) and growth hormone (GH) were measured during the 1st, 20th, and 44th training sessions. Body weight (BW), body mass index (BMI), whole-body fat mass (FM) and BFP were assessed pre- and post-intervention. Following the 1st and 20th sessions, significant increases in EPI (p < 0.05) were observed post-exercise in HIIT120 and HIIT90, but not in SIT and MICT. In the 44th session, the increased EPI was found in SIT, HIIT120, and HIIT90, but not in MICT (p < 0.05). For the GH, a significant increase was observed post-exercise in all groups in the three sessions. The increased EPI and GH returned to baselines 3 hours post-exercise. After the 12-week intervention, significant reductions in FM and BFP were found in all groups, while reductions in BW and BMI were only found in the SIT and HIIT groups. Greater reductions in FM and BFP, in comparison to MICT, were observed in the SIT and HIIT groups (p < 0.05). 12-week SIT, HIIT120, and HIIT90, in comparison to MICT, were more efficacious in fat reduction in obese women, partly benefiting from the greater release of lipolytic hormones during training sessions. [ABSTRACT FROM AUTHOR]

Background: Changes in the trunk and lower limbs' sagittal movements may cause patellofemoral pain (PFP) because they influence the forces acting on this joint. Objectives: To compare trunk and lower limb sagittal kinematics between women with and without PFP during functional tests and to verify whether sagittal trunk kinematics are correlated with those of the knees and ankles. Methods: A total of 30 women with PFP and 30 asymptomatic women performed single-leg squat (SLS) and step-down (SD) tests and were filmed by a camera in the sagittal plane. The trunk inclination angle, forward knee displacement, and ankle angle were calculated. Results: The PFP group exhibited less trunk flexion (SLS, p =.006; SD, p =.016) and greater forward knee displacement (SLS, p =.001; SD, p =.004) than the asymptomatic group; there was no significant difference in ankle angle (SLS, p =.074; SD, p =.278). Correlation analysis revealed that decreased trunk flexion was associated with increased forward knee displacement (SLS, r = −0.439, p =.000; SD, r = −0.365, p =.004) and ankle dorsiflexion (SLS, r = −0.339, p =.008; SD, r = −0.356, p =.005). Conclusion: Women with PFP present kinematic alterations of the trunk and knee in the sagittal plane during unipodal activities. Furthermore, the trunk and lower limb sagittal movements were interdependent. [ABSTRACT FROM AUTHOR]

Introduction: It has been suggested that inhibin B (InhB), Anti-Müllerian hormone (Müllerian-inhibiting substance, AMH) levels, and 2D/4D finger length ratios are related to sex differences in neurodevelopmental disorders. The aim of this study is to investigate the role of InhB, AMH levels, and 2D/4D finger length ratios in male children with specific learning disorder (SLD). Methods: The study included 38 male children diagnosed with SLD and 38 males of similar ages without SLD as the control group. Tests used in the evaluation were the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version, Specific learning disorder clinical observation battery, Wechsler Intelligence Scale for Children-Revised (WISC-R), and Conners' Parent Rating Scale-Revised: Short Form. Serum AMH, InhB, and Testosterone levels were measured using an enzyme-linked immunosorbent assay. Results: Male children diagnosed with SLD demonstrated significantly higher levels of serum InhB compared to controls (t= 2.59 p=0.009); both groups had similar levels of serum testosterone and AMH. The 2D/4D finger ratios in the SLD group were found to be lower than those in the control group (t= 2.92 p= 0.005). Serum InhB levels were positively correlated with WISC-R verbal scores (p= 0.003). Conclusion: Our findings suggest that serum InhB levels and the 2D/4D ratio, which is an indicator of prenatal testosterone exposure, may play a role in the male predominance of SLD. [ABSTRACT FROM AUTHOR]

This study examined a set of background psychological and other variables of orthorexic (ON) tendency in a sample of young women with special interest in healthy lifestyle. The sample consisted of female young adults (N = 310; aged 18–35 years; mean age = 24.3 years; SD = 4.97 years) who were recruited through social media health sites. Besides Orthorexia Nervosa Questionnaire (ORTO‑15), BMI, regular sporting activity, the following scales were used: Eating Disorder Inventory (EDI, drive for thinness, ineffectiveness and maturity fears); Bergen Social Media Addiction Scale (BSMAS); and The Proactive Coping Inventory. In this sample, 37.7% were at risk for ON. Eating disorder attitudes, regular sporting and social media addiction were the most relevant predictors of orthorexic tendency with drive for thinness being the strongest contributor (β = 0.54, p < 0.001). For young women with a special interest in healthy lifestyle, drive for thinness together with regular sporting, ON tendency may serve as a tool for achieving their goal. Social media addiction and other psychological problems (feeling of ineffectiveness or maturity fears) can also contribute to orthorexic rendency. It would be important to ask for support from qualified health professionals when changing nutritional practices. [ABSTRACT FROM AUTHOR]

Objectives: Our aim was to predict the prevalence of osteopenia and osteoporosis and their associated risk factors among postmenopausal women from Jordan. Methodology: In this cross‐sectional study, a total of 368 postmenopausal women were recruited from King Abdullah University Hospital (KAUH) in the North of Jordan between September 2022 and April 2023. Bone mineral density (BMD) was measured using a dual‐energy X‐ray absorptiometry scan. T‐score was used for osteoporosis diagnosis in accordance with the International Society for Clinical Densitometry (ISCD) guidelines. Data about sociodemographic and lifestyle variables were collected using face‐to‐face interviews. Medical records were used to retrieve participants' BMD information. Predictors of osteoporosis were identified using logistic regression. Results: Prevalence of osteoporosis was 40.5%, while 44.6% of participants were diagnosed with osteopenia. The lumbar spine had the highest frequency of osteoporosis (30.4%), while the left femoral neck had the highest prevalence of osteopenia (46.3%). Postmenopausal women's age (p‐value =.024), and history of chronic diseases (p‐value =.038) were significant factors associated with increased osteoporosis risk. Conclusions: Postmenopausal women from Jordan had high prevalence of osteoporosis and osteopenia. It is therefore necessary to target risk factors leading to osteoporosis and to improve patients' lifestyles through patient education. Healthcare systems should consider early screening approaches for osteoporosis at the age of menopause and thereafter. Supplements of calcium and vitamin D may be routinely considered for this age group depending on their serum levels. [ABSTRACT FROM AUTHOR]

This study investigated the effect of 4 days low energy availability (LEA) on physiological markers and mood states in male endurance runners. Twelve participants (mean (standard deviation); age: 25.8 (3.8) years; fat-free mass (FFM): 52.8 (5.5) kg) completed three 4-day conditions: adequate energy availability (AEA): 45 kcal/kg FFM/day; LEA1: 30 kcal/kg FFM/day; and LEA2: 15 kcal/kg FFM/day, in a randomized order. Participants ran on a treadmill at 65% of V̇O2max until they expended 15 kcal/kg FFM/day of energy. Energy intake was adjusted to achieve the desired energy availability. Pre- and post-measurements of bone turnover, metabolism, testosterone and estradiol (plasma), resting metabolic rate (indirect calorimetry), and mood states (Brunel Mood Scale) were assessed. The results reported a significant decrease in testosterone (condition × time interaction, p = 0.03) occurred on LEA2 (Pre: 23.8 (7.0) nmol/L vs. Post: 20.3 (7.7) nmol/L) compared with AEA (Pre: 22.9 (5.5) nmol/L vs. Post: 23.3 (6.1) nmol/L) or LEA1 (Pre: 23.6 (8.6) nmol/L vs. Post: 20.9 (8.8) nmol/L). Fatigue level significantly increased (condition × time interaction, p = 0.02) in LEA2 (Pre: 3.5 (1.7) vs. Post: 6.5 (2.9)) but did not change in AEA (Pre: 2.8 (1.5) vs. Post: 2.5 (2.7)) or LEA1 (Pre: 2.8(2.4) vs. Post: 2.9 (2.0)). Other measures were unaffected by the interventions. In conclusion, this study suggests that testosterone and fatigue may serve as early indicators of LEA in male runners. However, other physiological markers and mood states appeared largely unaffected, aligning with existing literature indicating minimal disruption of physiological functions during acute LEA in male athletes. Study registration: Australian New Zealand Clinical Trials Registry (Trial No.: 381278). [ABSTRACT FROM AUTHOR]

Background: Aborted bariatric surgeries are an undesirable experience for patients as they are subjected to potential physical harm and emotional distress. A thorough investigation of aborted bariatric surgeries has not been previously reported. This information may allow the discovery of opportunities to mitigate the risk of aborting some bariatric operations. Methods: Data from the Michigan Bariatric Surgery Collaborative, a statewide bariatric surgery registry, were used to identify all aborted primary bariatric operations from June 2006 through January 2023. The reasons for aborting surgery were divided into seven categories. Stepwise logistic regression was performed to identify independent predictors of aborted procedures for potentially modifiable factors. Results: A total of 115,004 patients underwent bariatric surgery with 555 (0.48%) procedures aborted. Of those having an aborted operation the mean age was 52 years and mean BMI was 49.8 with females accounting for 72%. Sleeve gastrectomy had the lowest aborted rate (0.38%) as compared to gastric bypass, adjustable gastric banding, and biliopancreatic diversion (p < 0.0001). The most common aborted surgery reason categories included adhesions and hernias, tumors and anatomic anomalies, and inadequate visualization due to either hepatomegaly or abdominal wall thickness. The most significant (p < 0.0001) independent predictors of aborted surgeries due to hepatomegaly or abdominal wall thickness were BMI ≥ 60 (OR 10.7), BMI 50 to 59 (OR 3.1) and diabetes mellitus (OR 2.7). Preoperative weight loss was a protective factor for aborting surgery due to hepatomegaly or abdominal wall thickness (OR 0.9; p < 0.0001). Conclusions: Aborted surgeries are uncommon and occur in approximately 1 in 200 primary bariatric operations with the lowest rate identified in sleeve gastrectomy. Nearly 20% of operations are aborted due to hepatomegaly or abdominal wall thickness and targeting patients with elevated BMIs and diabetes mellitus for preoperative weight loss might reduce the risk of these types of aborted procedures. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic distal gastrectomy (LDG) has become a common procedure for treating advanced gastric cancer (AGC) in China. However, there is uncertainty regarding its oncological outcomes compared to open distal gastrectomy (ODG). This study aims to compare the 3-year disease-free survival (DFS) rates among patients who underwent surgery for AGC in northern China. Methods: A multicenter, non-inferiority, open-label, parallel, randomized clinical trial was conducted to evaluate patients with AGC who were eligible for distal gastrectomy at five tertiary hospitals in North China. In this trial, patients were randomly assigned preoperatively to receive either LDG or ODG in a 1:1 allocation ratio. The primary endpoint was postoperative morbidity and mortality within 30 days and the secondary endpoint was the 3-year DFS rate. This trial has been registered at ClinicalTrials.gov (Identifier: NCT02464215). Results: A total of 446 patients were randomly allocated to LDG (n = 223) or ODG group (n = 223) between March 2014 and August 2017. After screening, a total of 214 patients underwent the open surgical approach, while 216 patients underwent laparoscopic surgery. The 3-year DFS rate was 85.9% for the LDG group and 84.72% for the ODG group, with no significant statistical difference (Hazard ratio 1.12; 95% CI 0.68–1.84, P = 0.65). Body mass index (BMI) < 25 kg/m2, advanced pathologic T4, and pathologic N2-3 category were confirmed as independent risk factors for DFS in the Cox regression. Conclusions: In comparison to ODG, LDG with D2 lymphadenectomy yielded similar outcomes in terms of 3-year DFS rates among patients diagnosed with AGC. [ABSTRACT FROM AUTHOR]

The prevalence of mental health issues among UK undergraduate students is growing, and poor diet quality appears to be a risk factor for poor mental health although with limited research in this area. Therefore, the objective of this study was to examine the cross‐sectional associations between diet quality and common mental disorders (CMD) such as depression and anxiety in UK undergraduate students. A cross‐sectional survey consisting of demographic information and validated questionnaires (the Short‐Form Food Frequency Questionnaire [SFFFQ] and the Hospital Anxiety and Depression Scale [HADS]) was conducted to measure diet quality and anxiety and depression in young adults in 44 UK‐based universities. Multiple regression analysis adjusting for confounding factors was used to assess the associations between them. Undergraduate university students (n = 202, 67% female) with a mean age of 20.9 ± 3.6 years and a mean body mass index (n = 170) of 22.6 ± 3.2 kg/m2 took part in the study. Prevalence of anxiety was high, with 40% of the sample having an anxiety score in the severe range (≥12 points) while the prevalence of depression was lower, with 6% of the population having a depression score in the severe range (≥12 points). Diet quality was significantly higher for females than males (p = 0.034) and was poor for 38% of the sample, being more common in males compared to females, although not significantly so (43% and 36%, respectively). Diet quality was inversely associated with anxiety (β = −0.427; p = 0.029) and was more likely to be associated with anxiety in females than males (β = 0.743; p = 0.043). No significant relationship between diet quality and depression was found. Better self‐reported health, father's qualification and smoking status were also associated with less anxiety and depression. This research supports other research suggesting that UK universities should explore whether the implementation of dietary interventions and improving the food environment would be a cost‐effective option to reduce the high prevalence of anxiety among students. [ABSTRACT FROM AUTHOR]

BACKGROUND: Work-related musculoskeletal disorders (WRMSDs) is a multi-factorial disorder in most occupational setting and it has increased significantly in recent years. OBJECTIVE: This study aimed to investigate the relationship between physical, cognitive, and environmental factors of ergonomics with the prevalence of WRMSDs in a car-parts manufacturing industry METHODS: This cross-sectional study was performed among 220 workers in a milling unit of a car parts manufacturing company in 2021-2022. The prevalence of WRMSDs was assessed using the Extended Version of the Nordic Musculoskeletal Questionnaire. Noise exposure was evaluated using dosimetry method. Mental and physical workload were evaluated by the NASA-TLX and key index methods (KIM-MHO and KIM-LHC), respectively. Data analysis was performed using SPSS version 25.0. RESULTS: The subjects' mean age and work experience were 36.3±6.5 and 8.35±6.41 years, respectively. Eighty-five percent of the subjects reported WRMSDs in at least one area of the body. The results of mental workload assessment revealed a high workload mean range (73.23±14.89) in all of the subjects. Mean score of KIM-LHC and KIM-MHO were 738.18±336.42 and 201.86±36.41, respectively with odds ratio of 1.32 for KIM-LHC in creating the WRMSDs. There was a significant relationship between the noise exposure, mental and physical workload and the prevalence of WRMSDs (p-value < 0.05). CONCLUSION: The results of the present study revealed that environmental, physical and cognitive factors can simultaneously be effective in the prevalence of WRMSDs. Therefore, performing effective control measures requires comprehensive attention to physical, environmental, and cognitive ergonomics in the algorithm of ergonomics management in the workplace. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is a chronic gastrointestinal disorder that is most frequently found in Western countries, and the only treatment available today is a lifelong gluten-free diet (GFD). The main aim of the present study is to compare the self-care practices and body mass index (BMI) of adolescents with CD and without CD in different dimensions (physical, psychological, social, and management). The non-probabilistic sample included 236 participants (118 with CD) aged between 12 and 16 years old, who were part of the project "Role of the family in the perception of youth self-care". The data were obtained through the self-administration of the Practice and Management of Youth Self-care questionnaire, while the celiac population also completed the Adherence to a Gluten-Free Diet (GFD) questionnaire. The celiac population analyzed showed significant correlations between the Physical Practices and Management with adherence to a GFD, and between a GFD and Psychological Practices. Differences were observed between the celiac and the non-celiac populations in the dimensions of Physical Practices, Social Practices, and Management. With respect to BMI, age and CD showed a significant influence of a GFD on BMI (p < 0.001). In conclusion, the application of multi-dimensional questionnaires and their relationship with the adherence to a GFD provide valuable information to propose interventions directed to this population. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the demographic-, radiographic-, and surgery-related factors influencing postoperative functional internal rotation (fIR) following reverse total shoulder arthroplasty (RTSA). Methods: In this retrospective cohort study, patients who underwent RTSA between June 2013 and April 2018 at a single institution were assigned to two groups ("IROgood" or "IRObad"). Patients were classified as having good fIR (≥8 points in the Constant–Murley score (CS) and fIR to the twelfth thoracic vertebra or higher) or poor fIR (≤2 points in the CS and fIR to the twelfth thoracic vertebra or lower) after RTSA with a single implant model. The minimum follow-up period was two years. Standardized shoulder-specific scores (Visual Analogue Scale (VAS), Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons Score (ASES), Constant–Murley score (CS)) were used to assess the pre- and postoperative functional status of patients. Postoperative radiographic evaluation included the distalization shoulder angle (DSA), lateralization shoulder angle (LSA), critical shoulder angle (CSA), acromiohumeral distance (AHD), glenoid inclination (GI), medialization of the center of rotation (COR), lateralization of the humerus, and distalization of the greater tuberosity. Additionally, preoperative evaluation included rotator cuff arthropathy according to Hamada, glenoid version, anterior or posterior humeral head subluxation, and fatty infiltration of the rotator cuff according to Goutallier. Univariate analysis of demographic, surgical, radiographic, and implant-associated parameters was performed to identify factors associated with postoperative fIR. The Shapiro–Wilk test assessed the normal distribution of the data. Intergroup comparisons regarding demographic and surgery-related factors were conducted using the Mann–Whitney-U Test. Radiographic changes were compared using chi-square or Fisher's exact tests. The significance level was set at p < 0.05. Results: Of a total of 42 patients, 17 (age: 73.7 ± 5.0 years, follow-up (FU) 38 months [IQR 29.5–57.5]) were included in the "IRObad" group, and 25 (age: 72 ± 6.1 years, FU 47 months [IQR 30.5–65.5]) were included in the "IROgood" group. All patients were treated with the same type of implant (glenosphere size: 36 mm, 14.3%; 39 mm, 38.1%; 42 mm, 47.6%; neck-shaft angle: 135° in 68.0%; 155° in 32.0%) and had comparable indications. Univariate analysis did not reveal any of the investigated demographic, radiographic, or surgery-related parameters as risk factors for poor postoperative fIR (p > 0.05). Conclusion: None of the investigated factors, including implant-associated parameters, influenced postoperative fIR after RTSA in this cohort. [ABSTRACT FROM AUTHOR]

Background & Objective: The role of the mothers is very important in providing care and monitor their children's health in general. Their awareness concerning quality of foods which is needed for each child's developmental stage can effect on nutritional status This Study assess the effect of an nutritional education Program on mother knowledge regarding their children nutritional status. Materials & Methods: Sixty moms were chosen from Al-Ayn Social Care Foundation International in Al-Samawah City and take on using a quasi-experimental design. The researcher used a non-probability "purposive sample" and measured the height and weight for child before calculating the body mass index. Results: The current study found a relationship between moms' educational level and knowledge regard to sociodemographic characteristics with a p-value of .001. However, there were no significant correlations observed between mothers' knowledge in the control group and their age, level of education, occupation, residency, monthly income, and sources of information. Conclusion: Following the interventional program on nutrition-related health, the level of knowledge among the mothers in the study group was enhanced. The study suggested that the nutrition education program should be offered to all moms in order to enhance their understanding and enthusiasm regarding the significance of child nutrition. Additionally, it was advised that their education should be regularly updated. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic imposed social isolation measures, which impacted the child population, especially regarding physical and mental health aspects. Purpose: The aim of this study was to investigate the relationship between sedentary behavior, cardiorespiratory fitness, immunoglobulin -A secretion, and anxiety symptoms in 267 children aged 6–11 years, eutrophic or overweight. Methods: Sedentary behavior was evaluated by the time of exposure to screens. Cardiorespiratory fitness was assessed using the 6-minute run/walk test and immunoglobulin-A by salivary samples. Anxiety symptoms were reported by the SCAS-version for parents. Results: It was observed that after a period of confinement, overweight in children had a negative impact on cardiorespiratory performance and sedentary behavior. Differences were also observed in the concentration and secretion rate of SIgA in the overweight group compared to the normal weight group. Discussion: The return to face-to-face classes brought a high proportion of overweight students, who showed lower aerobic performance. Considering sedentary behavior, all groups presented values greater than 2 hours of daily exposure to screens. Translation to Health Education Practice: Special attention is needed from health professionals and teachers in relation to reducing sedentary behavior and improving cardiorespiratory fitness in schoolchildren. [ABSTRACT FROM AUTHOR]

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Dolutegravir, an integrase strand inhibitor, has been linked to an increase in body mass index among adults. However, little is known about its effect on adolescents. The study assessed the effect of a dolutegravir-based regimen on adolescents' body weight and emphasized the gender-specific differences in weight gain, if any. This prospective cohort study was conducted among 182 treatment-experienced adolescents living with HIV at a tertiary hospital in Southeast Nigeria. The body mass index measurements were calculated before transitioning to dolutegravir and after six months of being on the dolutegravir regimen. A comparison of the difference in mean body mass index before and after dolutegravir-based therapy was determined using a paired t-test. At the end of the six-month follow-up, there was a significant increase in the respondents' overall body mass index z-score (t = −10.00, p < 0.001). There was a significant increase in the body mass index z-score of both genders (male; t = −7.49, p < 0.001, female; t = −6.91, p < 0.001). The dolutegravir-based therapy (β-coefficient = −0.17, t = − 2.09, p < 0.001) and baseline body mass index z-score (β-coefficient = 0.76, t = 15.86, p < 0.001) were significant predictors of body mass index z-score at six months. In adolescents living with HIV, the transition to dolutegravir is associated with increased body weight. Female adolescents tend to gain more weight compared to males. Therefore, there is a need for regular monitoring of body weight for early detection of obesity and prompt intervention. [ABSTRACT FROM AUTHOR]

Background/objectives: Acute glycemic responses offer important insights into glucose homeostasis although the repeatability of these measurements particularly in Asian populations remains unclear. This research aimed to critically investigate the inconsistencies of the postprandial glycemic profile within individuals, and identify potential variables predicting greater inconsistencies. Subjects/methods: This was a secondary analysis of three randomized controlled trials which fed subjects with glucose (and other carbohydrate-rich foods), and measured postprandial blood glucose at regular intervals. Intra-individual rank-order consistency in the glycemic profile between acute glucose treatments was evaluated and compared against demographic, anthropometric and cardio-metabolic health related indicators to delineate potential confounding variables. Correlations between the incremental area under curve at 120 min (iAUC120 min) for glucose and the carbohydrate-rich foods were further explored. Results: Rank-order consistency was identified to be moderate, with intra-individual inconsistencies marginally lower than inter-individual inconsistencies. Notably, greater inconsistencies within individuals were directly correlated with BMI and fat-mass index (P < 0.01) albeit non-significant for age, ethnicity, and other cardio-metabolic health-related risk indicators. Across the trials, there were positive monotonic correlations between the iAUC120 min for glucose and simple sugars (sucrose, isomaltulose), as well as different varieties of rice (jasmine white, Bapatla brown, Bapatla white; p < 0.05). However, there were a lack of associations between iAUC120 min for glucose with pastas (semolina and wholegrain penne, spaghetti) and mee pok noodles. Conclusion: There are inherent inconsistencies in postprandial glycemic measurements within individuals, particularly among those with higher adiposity. These confounders need to be kept in mind for appropriate and meaningful interpretations of glycemia. [ABSTRACT FROM AUTHOR]

Background: Obesity and sarcopenia are both viewed as pathological body composition issues and indicators of compromised nutritional status. The aim of this study was to evaluate the effects of sarcopenic obesity on short- and long-term clinical outcomes. Methods: The clinical data of patients who underwent radical gastrectomy between 2013 and 2019 were prospectively collected. Sarcopenia is defined by European Working Group on Sarcopenia in Older People (EWGSOP2) and obesity is defined by the body mass index (BMI). To identify the independent predictors of postoperative complications and overall survival, we performed univariate and multivariate logistic and Cox regression analyses. Results: In a total of 508 cases, 372 (73.2%) cases were diagnosed with non-sarcopenia, 112 (22.0%) with non-obese sarcopenia, and 24 (4.7%) with sarcopenic obesity. In the multivariate logistic regression, both of non-obese sarcopenia (OR = 2.305, 95% CI = 1.444–3.679, P < 0.001) and sarcopenic obesity (OR = 2.589, 95% CI = 1.088–6.156, P = 0.031) were independent risk factors for postoperative complications. In the multivariate Cox analysis, only non-obese sarcopenia (HR = 2.614, 95% CI = 1.882–3.631, P < 0.001) was independent risk factor for overall survival. Conclusions: Sarcopenic obesity serves as an independent risk factor for postoperative complications, but not for overall survival. [ABSTRACT FROM AUTHOR]

This study aimed to identify differences among body mass index (BMI) categories of older family caregivers (=60 years) and their care recipients (=65 years). Secondly, this study aimed to examine group differences and factors associated with weight change during a nutrition and oral health intervention. This secondary analysis of a randomized controlled trial (ClinicalTrial.gov (NCT04003493)) involved individually tailored nutritional guidance from a clinical nutritionist and oral health guidance from a dental hygienist. Baseline BMI differences were analyzed, followed by further analyses of group differences and associated factors of weight change over a 6-month period using generalized estimating equations. Among the participants (113 family caregivers and 107 care recipients), 36.3% and 35.1% were overweight (BMI >29 kg/m²), while 18.6% and 21.6% were underweight (BMI <24 kg/m²) at baseline, respectively. For family caregivers differences in BMI categories included age, mid-arm and calf circumferences, and plasma prealbumin concentration. For care recipients differences were observed in medication use, mid-arm and calf circumferences, Mini Nutritional Assessment scores, physical function, and number of teeth. During the 6-month intervention, there were no differences in weight change between intervention and control groups for both caregivers and care recipients. Factors significantly associated (p < 0.05) with weight loss included female sex for both caregivers and care recipients, and frailty for caregivers. Family caregivers' characteristics were not significantly associated with weight change in their care recipients. In conclusion, being overweight is a prevalent among older family caregivers and care recipients. Factors such as age, medication use, physical function, number of teeth, and Mini Nutritional Assessment scores varied across BMI categories. Female sex was associated with weight loss in both older family caregivers and care recipients, and frailty was associated with weight loss in caregivers. However, the characteristics of family caregivers did not explain the weight loss of their care recipients. [ABSTRACT FROM AUTHOR]

Aims: It was conducted to investigate digital gaming addiction among nursing students and the associated factors of such addiction. Methods: The descriptive and relationship-seeking study's universe included 1665 nursing students in three universities' nursing faculties and departments. The sample size was determined to be 774 based on a power analysis with a type I error rate of 0.05, a power of the test of 0.80 (α = 0.05, 1-β = 0.80), and an effect size of d = 0.10. Student Information Form, The Digital Game Addiction Scale (DGAS-7), and the Digital Game Playing Motivation Scale (DGPMS) were used to collect student information. Data analysis was performed using the Mann–Whitney U test, Kruskal–Wallis H test, Spearman correlation, and Binary Logistic Regression Model. Results: It was found that 83.7% of the students were female, and the mean age and BMI were 20.03 ± 1.72 years and 21.98 ± 2.90 kg/m2, respectively. A statistically significant positive correlation was found between the students' Digital Game Addiction Scale and Digital Game Playing Motivation Scale Achievement and Energizing (r = 0.717), Curiosity and Social Acceptance (r = 0.612), and Uncertainty in Game Desire (r = -0.110) sub-dimensions mean scores (p < 0.001). Conclusions: The relationship between nursing students' digital game addiction, game playing motivation, and several individual characteristics affecting digital games was found. The study's results call for further research to focus on developing and testing interventions that could effectively reduce gaming addiction while enhancing positive aspects of digital engagement among nursing students. [ABSTRACT FROM AUTHOR]

Paramedics work under physically and cognitively demanding conditions to provide emergency care. As physical fitness could positively impact the quality of patient care, we investigated within a pilot study whether concurrent training (CT) affects work-related performance parameters in paramedics. At baseline (T1), 16 paramedics performed cardiopulmonary resuscitation whereby resuscitation performance (RP; total resuscitation quality, compressions with correct frequency, and correct ventilation), cognitive performance (CP; reaction time, divided attention, and working memory), and heart rate variability (HRV) were assessed (pre-exertion). Then, participants climbed seven floors carrying 20 kg of gear before completing the same assessments again (post-exertion). The baseline testing was followed by a CT intervention (12 weeks, three sessions/week). After the intervention (T2), the two-stage testing was repeated. We analyzed whether the pre-exertion and post-exertion values, as well as the difference between the pre-exertion and post-exertion values, changed from T1 to T2. Nine paramedics (male: N = 7; age = 26.3 (SD = 8.17) years) took part in the study. The comparison of the pre-exertion values showed significantly better reaction times (p = 0.001) and divided attention (p = 0.02) and a trend toward greater working memory and RP parameters at T2. Regarding the post-exertion values, significant improvements in working memory (p = 0.03) and a trend toward improved reaction time, divided attention, and RP occurred at T2. The difference between the pre- and post-exertion values did not change for any parameter from T1 to T2. HRV decreased significantly from pre- to post-exertion (T1: p = 0.01, T2: p = 0.01). These results indicate that CT is a promising training concept to improve RP and CP in paramedics and should therefore be investigated further to increase patient care quality. [ABSTRACT FROM AUTHOR]

Purpose: Accurate height and weight measurement can be challenging in older adults and complicates nutritional status assessment. Other parameters like the neutrophil-to-lymphocyte ratio (NLR) and the lymphocyte count (LC) could be an option to these measurements. We aimed to test these variables as subrogates of body mass index (BMI) or calf-circumference (CC) for malnutrition screening in community-dwelling older adults. Methods: This is a secondary analysis from the Salud, Bienestar y Envejecimiento (SABE) survey from Ecuador (2009). Includes data on demographics, health-related factors, physical assessments, and complete blood count, allowing to calculate NLR and LC to be used as part of the Mini Nutritional Assessment (MNA), instead of the BMI. Consequently, 4 models were included: standard MNA, MNA-CC, MNA-NLR and MNA-LC. Finally, age, sex, and comorbidities were considered as confounding variables. Results: In our analysis of 1,663 subjects, 50.81% were women. Positive correlations with standard MNA were found for MNA-NLR (Estimate = 0.654, p < 0.001) MNA-CC (Estimate = 0.875, p value < 0.001) and MNA-LC (Estimate = 0.679, p < 0.001). Bland-Altman plots showed the smallest bias in MNA-CC. Linear association models revealed varying associations between MNA variants and different parameters, being MNA-NLR strongly associated with all of them (e.g. Estimate = 0.014, p = 0.001 for albumin), except BMI. Conclusion: The newly proposed model classified a greater number of subjects at risk of malnutrition and fewer with normal nutrition compared to the standard MNA. Additionally, it demonstrated a strong correlation and concordance with the standard MNA. This suggests that hematological parameters may offer an accurate alternative and important insights into malnutrition. [ABSTRACT FROM AUTHOR]

Purpose: Esports players' training takes long periods and they sit for a long time during competitions, which increases their risk of obesity and urges them to develop inappropriate eating behaviors. In this study, we aimed to investigate the night-eating syndrome and food addiction in esports players. Methods: This cross-sectional study was conducted with 248 esports players who were members of a university's esports community. The study data were collected using an online questionnaire consisting of the descriptive information form, Night Eating Questionnaire, and Yale Food Addiction Scale. Results: The mean age of the sports players participating in the study was 22.19 ± 5.97 years. Of them, 55.6% had a normal body weight, 13.4% were obese, 54.4% played esports for 3 years or more, 13.3% experienced night eating syndrome, and 21.4% experienced food addiction. While the weekly duration of playing esports and skipping meals were associated with night eating syndrome, the weekly duration of playing esports and smoking were associated with food addiction (p < 0.05). Additionally, although there was no statistically significant difference, the risk of food addiction was 2.12 times higher in those with poor perceived sleep quality. Conclusion: We observed that night eating syndrome was very common in esports players and that these individuals were at risk in terms of food addiction. Since esports has a more sedentary structure than traditional sports, we suggest that esports players should be evaluated in terms of their unhealthy eating behaviors and risk of eating disorders. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic sleeve gastrectomy (LSG) in patients with BMI ≥ 60 presents technical challenges, that might be overcome by robotic surgery, but its effectiveness has not been rigorously evaluated. We compared the 30-day outcomes of LSG and robotic sleeve gastrectomy (RSG) in patients with BMI < 60 versus ≥ 60 and between LSG and RSG in patients with BMI ≥ 60. Methods: Patients aged 18–65 years who underwent sleeve gastrectomy were included using the 2019–2022 MBSAQIP database. We performed a Propensity Score Matching analysis, with 21 preoperative characteristics. We compared 30-day postoperative outcomes for patients with BMI < 60 versus ≥ 60 using either a laparoscopic (Analysis 1) or robotic approach (Analysis 2) and compared LSG versus RSG in patients with BMI ≥ 60 (Analysis 3). Results: 297,250 patients underwent LSG and 81,008 RSG. Propensity-matched¸ outcomes in analysis 1 (13,503 matched cases), showed that patients with BMI ≥ 60 had higher rates of mortality (0.1% vs. 0.0%, p = 0.014), staple line leak (0.3% vs. 0.2%, p = 0.035), postoperative bleeding (0.2% vs 0.1%, p = 0.028), readmissions (3.5% vs. 2.4%, p < 0.001), and interventions (0.7% vs. 0.5%, p = 0.028) when compared to patients with BMI < 60. In analysis 2 (4350 matched cases), patients with BMI ≥ 60 demonstrated longer operative times, length of stay, and higher rates of unplanned ICU when compared to patients with BMI < 60. In analysis 3 (4370 matched cases), patients who underwent RSG had fewer readmissions (2.9% vs. 3.7%, p = 0.037), staple line leaks (0.1% vs. 0.3%, p = 0.029), and postoperative bleeding (0.1% vs. 0.3%, p = 0.045), compared to LSG. Conversely, a longer operative time (92.74 ± 38.65 vs. 71.69 ± 37.45 min, p < 0.001) was reported. Conclusion: LSG patients with BMI ≥ 60 have higher rates of complications compared to patients with a BMI < 60. Moreover, some outcomes may be improved with the robotic approach in patients with BMI ≥ 60. These results underscore the importance of considering a robotic approach in this super super obese population. [ABSTRACT FROM AUTHOR]

Objective To develop the optimal US scanning protocol for the diagnosis of calcium pyrophosphate crystal deposition (CPPD) disease. Methods In this cross-sectional study, consecutive patients with a crystal-proven diagnosis of CPPD disease, and age-, sex-matched disease controls with a negative synovial fluid analysis were prospectively enrolled in two Italian Institutions. Four rheumatologists, blinded to patients' clinical details, performed US examinations using a standardized scanning protocol including 20 joints (shoulders, elbows, wrists, metacarpophalangeal joints from second to fifth fingers, hips, knees, ankles). CPPD was identified as presence/absence, according to the OMERACT definitions. Reduced US scanning protocols were developed by selecting the most informative joints to be imaged by US using the LASSO technique. Patients were randomly divided into training and validation sets. Their diagnostic accuracy was tested comparing the area under the receiver operating characteristic curves. Results The number of participants enrolled was 204: 102 with CPPD disease and 102 disease controls [age, mean (s. d.): 71.3 (12.0) vs 71.1 (13.5) years; female: 62.8% vs 57.8%]. The median number of joints with US evidence of CPPD was 5 [interquartile range (IQR): 4–7] and 0 (IQR: 0–1) in patients with CPPD disease and controls, respectively (P  < 0.01). The detection of CPPD in ≥2 joints using a reduced scanning protocol (bilateral assessment of knees, wrists and hips) showed a sensitivity of 96.7% (95% CI: 82.8, 99.9) and a specificity of 100 (95% CI: 88.8, 100.0) for the diagnosis of CPPD disease and had good feasibility [mean (s. d.): 12.5 (5.3) min]. Conclusion Bilateral US assessment of knees, wrists and hips had excellent accuracy and good feasibility for the diagnosis of CPPD disease. [ABSTRACT FROM AUTHOR]

Comparisons of high-load with low-load resistance training (RT) exercise have demonstrated no differences in postexercise metabolism when volume is matched. This important limitation of matching or equating volume diminishes benefits of the low-load RT protocol. Therefore, the purpose of this study was to determine the effects of acute low-load high volume and high-load low volume RT protocols completed to volitional fatigue on postexercise metabolism. Eleven recreationally active resistance-trained male subjects (24 ± 2 years; BMI: 25.3 ± 1.5 kg⋅m-2) completed 3 experimental sessions: (a) no-exercise control (CTRL); (b) RTat 30% 1 repetition maximum (1RM; 30% 1RM); and (c) RT at 90% 1RM (90% 1RM) with oxygen consumption (...2) measurements 2 hours postexercise. The RT sessions consisted of 3 sets of back squats, bench press, straight-leg deadlift, military press, and bent-over rows to volitional fatigue completed sequentially with 90 seconds of rest between sets and exercises. Changes were considered important if p < 0.100 with a ≥medium effect size. ...o2 1 hour postexercise was elevated following 30% 1RM (25%; p = 0.003, d = 1.40) and 90% 1RM (14%; p = 0.010, d = 1.15) vs. CTRL and remained elevated 2 hours postexercise following 30% 1RM (16%; p = 0.010, d = 1.15) vs. CTRL. Total O2 consumed postexercise increased following 30% 1RM and 90% 1RM (~17%; p < 0.044, d > 0.91) vs. CTRL. Fat oxidation was elevated 1 hour post-exercise following 30% 1RM and 90% 1RM (~155%; p < 0.001, d > 2.97) and remained elevated 2 hours postexercise following 30% 1RM compared with CTRL and 90% 1RM (~69%; p < 0.030, d > 1.03). These data demonstrate beneficial changes to postexercise metabolism following high- and low-load RT sessions, with more prolonged effects following the low-load RT protocol completed to volitional fatigue. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although obstructive sleep apnea (OSA) is common among patients with obesity and linked to cardiovascular disease, there is a lack of studies evaluating the effects of reaching remission from OSA after metabolic and bariatric surgery. STUDY DESIGN: A registry-based nationwide study including patients operated with sleeve gastrectomy or Roux-en-Y gastric bypass from 2007 until 2019 in Sweden. Patients who reached remission of OSA were compared with those who did not reach remission and a propensity score-matched control group of patients without OSA at the time of operation. The main outcome was overall mortality, and secondary outcome was major cardiovascular events (MACEs). RESULTS: In total, 5,892 patients with OSA and 11,552 matched patients without OSA completed a 1-year follow-up and were followed for a median of 6.8 years. Remission of OSA was seen for 4,334 patients (74%). Patients in remission had a lower risk for overall mortality (cumulative incidence 6.0% vs 9.1%; p < 0.001) and MACE (cumulative incidence 3.4% vs 5.8%; p < 0.001) at 10 years after operation compared with those who did not reach remission. The risk was similar to that of the control group without OSA at baseline (cumulative incidence for mortality 6%, p = 0.493, for MACE 3.7%, p = 0.251). CONCLUSIONS: The remission rate of OSA was high after metabolic and bariatric surgery. This was in turn associated with reduced risk for death and MACE compared with patients who did not achieve remission reaching a similar risk seen among patients without OSA at baseline. A diligent follow-up of patients who do not reach remission remains important. [ABSTRACT FROM AUTHOR]

Background: Extrinsic factors for erosive tooth wear (ETW) have been widely reported, but the intrinsic factors for wear remain unclear. Objectives: The aim of this study was to evaluate the factors associated with the prevalence of ETW in patients with reflux oesophagitis (RO). To prevent severe ETW with RO, factors associated with severity of ETW were also evaluated. Methods: A total of 270 patients with RO were recruited. A modified tooth wear index was used to evaluate the prevalence and severity of ETW. Salivary secretion and buffering capacity were assessed prior to endoscopy. Subjects were asked to complete a medical condition and oral self‐care questionnaire. Univariate and multivariate analyses were employed to identify factors collectively associated with the prevalence and severity of ETW. Results: A total of 212 cases were categorized as patients with ETW (148 with mild ETW and 64 with severe ETW). Multivariate analyses indicated that saliva secretion, severity of RO and proton pump inhibitor (PPI) resistance were associated with the prevalence of ETW, whereas age, BMI and severity of RO were associated with the severity of ETW. The odds ratio of saliva secretion and BMI were less than 1, meaning that higher saliva secretion resulted in a lower prevalence of ETW and lower BMI was associated with severe ETW. Conclusion: Saliva secretion, severity of RO and PPI resistance were associated with the prevalence of ETW, whereas age, BMI and severity of RO were associated with the severity of ETW. Lower saliva secretion and BMI were significant factors for ETW. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to probe the correlation between lung ultrasound score (LUSS) and the arterial oxygen pressure to the inspired oxygen fraction ratio (P/F ratio) in patients with respiratory failure on the first and second days of intensive care unit (ICU) care. Design: This was a prospective, analytic study of LUSS and P/F ratio values below 300 in patients under mechanical ventilation. Setting: We conducted in the ICU of Wahidin Sudirohusodo Hospital Makassar, South Sulawesi, Indonesia, in April 2024. Patients and participants: Patients with respiratory failure on mechanical ventilation. Measurement and results: All patients were examined using GE Logiq V2 ultrasonography and blood gas analysis. Of 52 patients, the mean age was 41.62±15.83 years. Most of the samples were male (61.5%), with the majority having a normal body mass index (BMI). In cases of improvement, there was a significant relationship between the LUSS and the P/F ratio of patients with respiratory failure under mechanical ventilation on the first (r=-0.851, p<0.001) and second day (r=-0.682, p<0.001). In cases of worsening LUSS (n=6), it was found that there was no significant relationship (p>0.05) between the LUSS and the P/F ratio of patients with respiratory failure on mechanical ventilation either on the first or second day. Conclusion: There was a significant correlation between LUSS and P/F ratio on the first and second day in cases of improvement in patients with respiratory failure under mechanical ventilation. [ABSTRACT FROM AUTHOR]

Background: There is ongoing debate around rate versus rhythm control strategies for managing atrial fibrillation (AF), however, much of the data comes from Western cohorts. Kerala‐AF represents the largest prospective AF cohort study from the Indian subcontinent. Objectives: To compare 12‐month outcomes between rate and rhythm control strategies. Methods: Patients aged ≥18 years with non‐transient AF were recruited from 53 hospitals across Kerala. Patients were stratified by rate or rhythm control. The primary outcome was a composite of all‐cause mortality, arterial thromboembolism, acute coronary syndrome or hospitalization due to heart failure or arrhythmia at 12 months. Secondary outcomes included bleeding events and individual components of the primary. Predictors of the composite outcome were analysed by logistic regression. Results: A total of 2901 patients (mean age 64.6 years, 51% female) were included (2464 rate control, 437 rhythm control). Rates of the primary composite outcome did not differ between groups (29.7% vs 30.0%; p =.955), nor did any component of the primary. Bleeding outcomes were also similar (1.6% vs 1.9%; p =.848). Independent predictors of the primary composite outcome were older age (aOR 1.01; p =.013), BMI <18 (aOR 1.51; p =.025), permanent AF (aOR 0.78; p =.010), HFpEF (aOR 1.40; p =.023), HFrEF (aOR 1.39; p =.004), chronic kidney disease (aOR 1.36; p <.001), and prior thromboembolism (aOR 1.31; p =.014). Conclusion: In the Kerala‐AF registry, 12‐month outcomes did not differ between rate and rhythm control cohorts. [ABSTRACT FROM AUTHOR]

This randomized controlled trial was conducted to assess the effectiveness of a family‐based and mobile‐assisted lifestyle intervention in reducing weight gain among school‐age children with overweight and obesity. A total of 164 school‐age children with overweight or obesity and their parents were randomized to the treatment intervention (n = 82) or an attention‐control group (n = 82). The treatment intervention included three face‐to‐face education sessions, augmented by monthly text messages sent to parents on their mobile devices. The primary outcome was child BMI‐for‐age z‐score. Secondary outcomes included child BMI, percent body fat, and actigraphy‐assessed sleep as well as parental sleep quality. Outcomes were assessed at baseline, 3, 6, and 12 months after the intervention, with treatment effects analyzed using general linear models for repeated measures. Our results showed that children in the treatment intervention group had significantly lower BMI‐for‐age z score, BMI, and percent body fat than did those in the control group, with an adjusted mean difference of 0.31 units (95% CI: −0.59 to −0.03; p = 0.03), 1.34 kg/m² (95% CI, −2.42 to −0.26; p = 0.01), and 3.12% (95% CI, −5.93 to −0.30; p = 0.03), respectively. No treatment effects were observed for child and parental sleep. Our findings suggest that family‐based and mobile‐assisted lifestyle intervention results in significant and sustained benefits to enhanced weight management for school‐age children with overweight and obesity. Nurses planning and delivering childhood overweight and obesity treatment interventions should consider a family‐based approach with the assistance of mobile devices. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the workload of a maximal treadmill test (TREAD) and a fire suppression task (BURN) in firefighters and to examine their relationships to fitness as measured by body mass index (BMI), percent body fat (BF%), and peak aerobic capacity (VO2PEAK). The amount of time spent in the heart rate (HR) intensity ranges of 50–59% HRMAX (ZONE1), 60–69% HRMAX (ZONE2), 70–79% HRMAX (ZONE3), 80–89% HRMAX (ZONE4), and ≥90% HRMAX (ZONE5) quantified the workload as the Edward's Training Impulse for TREAD (ETRIMPTREAD) and BURN (ETRIMPBURN). The ETRIMPTREAD was significantly less than ETRIMPBURN. For TREAD, ZONE5 > ZONE2 and ZONE3. For BURN, ZONE4 > ZONE1, ZONE2, and ZONE5 > ZONE1, ZONE2, and ZONE3. A lower BF% and greater VO2PEAK were related to a greater ETRIMPTREAD and unrelated to ETRIMPBURN. For BURN only, a lower BF% and greater VO2PEAK were related to less time in ZONE5. BMI was unrelated to all workload measures. Laboratory-based maximal exercise testing does not adequately reflect the workload of simulated fire suppression and therefore may not be indicative of firefighter readiness to meet job demands. Less-fit firefighters rely on higher cardiovascular intensities to complete the same workload, and practitioners should consider this when selecting strategies to reduce job-associated cardiovascular risk. [ABSTRACT FROM AUTHOR]

BACKGROUND: Firefighter health is of utmost importance both to first responders and the individuals they serve daily. The impact of shift schedule on firefighter health remains poorly understood. OBJECTIVE: The purpose of this study was to examine differences in health and performance outcomes in firefighters across two different shift schedules. METHODS: Firefighter (N = 1995) body composition, muscular strength, endurance, flexibility, and cardiorespiratory endurance were assessed and described. A Mann-Whitney U test was conducted to compare differences between shift schedules (48/96 and 4's and 6's). RESULTS: There was a statistically significant difference in BMI (U = 70115, z=–1.988, p =.047), BF% (U = 67341, z=–2.779, p =.005), and trunk flexion score (U = 81362, z = 1.979, p =.048) favoring the 48/96 shift schedule. CONCLUSION: Firefighters following a 48/96 shift schedule exhibited improved body composition and fitness performance in comparison to peers who followed a 4's and 6's shift schedule. Findings may guide regional firefighter scheduling to optimize health and performance. [ABSTRACT FROM AUTHOR]

Background/Objectives: Duchenne muscular dystrophy (DMD) is the most prevalent progressive muscular dystrophy, and the guidelines recommend the regular assessment of respiratory muscle function. This study aimed to assess the relationship between maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and sniff nasal inspiratory pressure (SNIP) measurements and upright-supine spirometry parameters in children with DMD, the predictability of upright–supine spirometry in terms of diaphragm involvement, and the impact of nutrition on muscle strength. Methods: This prospective cross-sectional study examined patients with DMD by comparing upright and supine FVC, MIP, MEP, and SNIP measurements. The effects of the ambulatory status, kyphoscoliosis, chest deformity, and low BMI on respiratory parameters were investigated. Results: Forty-four patients were included in the study. The mean patient age was 10.8 ± 2.9 years. Twenty-five patients were ambulatory. A significant decrease in FVC, FEV1, and FEF25–75 values was detected in the supine position in both ambulatory and non-ambulatory patients (p < 0.05). All patients had low MIP, MEP, and SNIP measurements (less than 60 cm H2O). MIP, MEP, and SNIP values were significantly lower in patients with a low BMI than in those without (p < 0.05). Conclusions: To accurately assess respiratory muscle strength, supine FVC should be combined with upright FVC, MIP, MEP, and SNIP measurements. It is crucial to regularly screen patients for nutrition, as this can significantly affect respiratory muscle function during pulmonology follow-up. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity presents a significant public health concern globally, with implications for cardiovascular health and metabolic syndrome. In Portugal, approximately 31.6% of children are affected, highlighting the urgency for intervention strategies. This study aimed to assess the prevalence of overweight and obesity in Portuguese school-aged children, with a focus on sex and age differences. Methods: Anthropometric measurements were conducted on 1564 children aged 6–10 years, including weight, height, and skinfold thickness. Body Mass Index (BMI) and the percentage of body fat were calculated using established methods. Results: The results revealed significant differences in BMI (≤0.001) and body fat percentage (≤0.001) among different BMI categories, with a notable prevalence of overweight and obesity, particularly among boys. A total of 37% of the studied population is overweight or obese, among which 40.1% and 33.9% are boys and girls, respectively. Conclusions: This study highlights statistically significant differences in BMI and body fat percentage for both sexes in different BMI categories. A large proportion of the population is overweight or obese, with a greater prevalence in boys. In short, childhood obesity has a negative impact on body composition and is associated with significant differences in anthropometric parameters, emphasizing the importance of preventative and intervention strategies to address this health problem. [ABSTRACT FROM AUTHOR]

Background: This study aims to analyze the influence of relative age effects, siblings, and digit ratio on the agility of children and adolescents. Methods: The study included 283 children (9.54 ± 1.36 years) and 296 adolescents (14.68 ± 1.36 years) from four different schools. The analyzed variables included anthropometric data, the presence of siblings, relative age effect, and results from the 10 × 5 m shuttle run test. Results: The findings indicated no significant association between agility and either the 2D:4D ratio or the relative age effect in both children and adolescents (p > 0.05). Additionally, having siblings did not have a notable impact on agility. Multiple regression analysis confirmed that relative age did not influence this lack of association (quarter of birth: p = 0.345, β = 0.039; siblings: p = 0.100, β = −0.069). However, boys showed higher performance than girls in the 10 × 5 m shuttle run test, and higher body mass index was related to lower agility. Conclusions: These findings contribute to existing knowledge on the relative effects of age and provide valuable information for physical education teachers on the influence of the 2D:4D ratio and the presence of siblings on the physical fitness of children and adolescents. [ABSTRACT FROM AUTHOR]

Background: Elevated blood pressure, or hypertension, is one of the main health problems among adolescents globally. However, there are limited data on hypertension among adolescents in Sudan. This survey aimed to investigate the prevalence of elevated blood pressure/hypertension and associated factors among adolescents in Gadarif City, Sudan. Methods: A community-based cross-sectional survey was conducted during a three-month period (August to October 2023) in Gadarif City, Eastern Sudan. A face-to-face interview questionnaire was used to collect sociodemographic information. Adolescents' anthropometric (weight and height) measurements were taken, and blood pressure was measured. Multivariate binary and linear regression analyses were performed to analyze the data. Results: A total of 384 adolescents (178 [46.4%] boys and 206 [53.6%] girls) were included in the study. The median (interquartile range, IQR) of the age was 14.0 (12.1–16.1) years, and that of the body mass index (BMI) was 16.9 (15.2–20.0) kg/m2. Thirty-four (8.9%) adolescents had hypertension/elevated blood pressure (≥95th percentile). After adjusting for confounders, multivariable binary regression analysis showed that age (adjusted odds ratio [AOR], 1.20; 95% confidence interval [CI], 1.03–1.42) and BMI (AOR, 1.12; 95% CI, 1.04–1.20) were associated with hypertension. Conclusion: Approximately one in ten adolescents in Eastern Sudan was hypertensive. Adolescents with higher age and BMI were at higher risk for hypertension. Maintaining a healthy BMI during adolescence is recommended to promote adolescents' health. [ABSTRACT FROM AUTHOR]

Context: Induced mental fatigue negatively impacts sport performance and neurocognition. However, it is unclear how induced mental fatigue influences landing biomechanics. The purpose of this study was to examine the influence of mental fatigue on drop landing biomechanics in individuals with and without a concussion history. Design: Crossover design. Methods: Forty-eight (24 per group) recreationally active individuals were matched on age (±3 y), sex, and body mass index (±1 kg/m²). All participants completed an experimental (30-min Stroop task) and control (30-min reading magazines) intervention on separate days separated by a minimum of 24 hours. Drop landings were performed before and after both interventions. Outcomes included peak vertical ground reaction force (vGRF), vertical loading rate (VLR), knee flexion angle, knee abduction angle, external knee flexion moment, external knee abduction moment, and initial ground contact knee flexion and knee abduction angles. Separate 2 (group) x 2 (intervention) between-within analyses of covariance compared drop landing outcomes. Each group's average pre-Stroop and premagazine outcomes were covariates. Results: There was a significant interaction for vGRF (P = .033, ηp²=.097) and VLR (P = .0497, ηp²=.083). The vGRF simple effects were not statistically significantly (P range = .052-.325). However, individuals with a concussion history displayed a medium effect size for greater vGRF post-Stroop compared with their own postmagazine vGRF (mean difference (95% confidence interval [95% CI] = 0.163 (-0.002 to 0.327) bodyweight (BW), p =.052, ηp²=.081. In contrast, the control group displayed a small effect size (mean difference [95% CI] = 0.095 [-0.069 to 0.259] BW, p =.251, ηp²=.029). Individuals with a concussion history displayed greater VLR post-Stroop compared with controls (mean difference [95% CI], 26.29 [6.19 to 46.40] BW/s, P = .012, ηp²=.134) and their own postmagazine values (mean difference [95% CI] = 32.61 [7.80 to 57.42] BW/s, p =.011, ηp²=.135). Conclusion: Mental fatigue leads to greater VLR for individuals with a concussion history. Athletic competition and activities of daily living can increase mental fatigue. Training programs may seek to teach mental fatigue reducing strategies to athletes with a concussion history. [ABSTRACT FROM AUTHOR]

Background: Chronic low-grade inflammation may mediate the relationship between obesity and diabetes, yet clinical research in this area remains scarce. Thus, this study aimed to explore the mediating role of chronic low-grade inflammation in this relationship using the National Health and Nutrition Examination Survey (NHANES). Methods: This study involved 2,482 participants enrolled in the NHANES between 2005 and 2016. Based on the complex sampling survey weights of NHANES, logistic regression models were fitted, adjusting for various covariates to investigate the relationship between BMI, INFLA score, and diabetes. Moreover, weighted quantile sum (WQS) regression models were fitted to analyze the proportional contribution of individual components within the INFLA score. Finally, mediation analysis was conducted to quantitatively assess the magnitude of the mediating effect of the INFLA score on the relationship between BMI and diabetes. Results: After adjusting for all potential confounding factors, a significant positive correlation was noted between INFLA score and diabetes [OR (95% CI), 1.038(1.003–1.075), p = 0.035]. Additionally, a significant positive correlation was observed between the high INFLA group and diabetes compared to the low INFLA group [OR (95% CI), 1.599(1.031–2.481), p = 0.037]. WQS regression models revealed that the proportional contributions of C-reactive protein, white blood cell count, platelet count, and neutrophil-to-lymphocyte ratio (NLR) were 55.5%, 34.8%, 8.46%, and 1.19%, respectively. Finally, the results of the mediation analysis indicated that the indirect effect of the INFLA score accounted for 10.20%. Conclusions: Chronic low-grade inflammation was associated with diabetes and partially mediates the relationship between obesity and diabetes. [ABSTRACT FROM AUTHOR]