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Background A bone-anchored prosthesis (BAP) eliminates the need for a conventional socket by attaching a prosthesis directly to the user’s skeleton. Currently, limited research addresses changes in gait mechanics post BAP implantation. Objective Examine changes in frontal plane movement patterns after BAP implantation. Methods Participants were individuals with unilateral transfemoral amputation (TFA) enrolled in the US Food and Drug Administration (FDA) Early Feasibility Study examining the Percutaneous Osseointegrated Prosthesis (POP). The participants completed overground gait assessments using their conventional socket and at 6-weeks, 12-weeks, 6-months, and 12-months following POP implantation. Statistical parameter mapping techniques were used in examining changes in frontal plane kinematics over the 12-months and differences with reference values for individuals without limb loss. Results Statistically significant deviations were found pre-implantation compared to reference values for hip and trunk angles during prosthetic limb stance phase, and for pelvis and trunk relative to the pelvis angles during prosthetic limb swing. At 6-weeks post-implantation, only the trunk angle demonstrated a statistically significant reduction in the percent of gait cycle with deviations relative to reference values. At 12-months post-implantation, results revealed frontal plane movements were no longer statistically different across the gait cycle for the trunk angle compared to reference values, and less of the gait cycle was statistically different compared to reference values for all other frontal plane patterns analyzed. No statistically significant within-participant differences were found for frontal plane movement patterns between pre-implantation and 6-weeks or 12-months post-implantation. Conclusions Deviations from reference values displayed prior to device implantation were reduced or eliminated 12-months post-implantation in all frontal plane patterns analyzed, while within-participant changes over the 12-month period did not reach statistical significance. Overall, the results suggest the transition to a BAP aided in normalizing gait patterns in a sample of relatively high functioning individuals with TFA.

Background: A defining clinical characteristics of Parkinson disease is reduced upper-extremity movements. Irregular terrain, the presence of a cross slope, and dual-task conditions have been found to alter the lower-limb gait characteristics of persons with Parkinson disease but there is little information how different environmental and cognitive conditions impact upper-limb kinematics as well as interlimb movement correlation. Research question: Do environmental conditions, such as irregular terrain and the presence of cross slope, as well as dual-task condition impact the upper-extremity kinematics and interlimb movement correlation of persons with Parkinson disease compared to healthy, age-matched controls? Methods: Three-dimensional whole-body gait data were collected for nine participants with mild-to-moderate Parkinson disease and nine healthy age-matched control participants. All participants ambulated on a regular terrain, irregular terrain, with and without cross slope, and under dual and single-task conditions. The primary outcomes were arm swing magnitude, arm swing asymmetry, and normalized cross-correlation between the ipsilateral arms and contralateral legs, which characterized movement correlation. Results: For all conditions, persons with Parkinson disease exhibited reduced arm swing magnitude and greater arm swing asymmetry compared to the healthy controls. All participants increased their arm swing magnitude on the irregular surface and under the dual-task condition. In the healthy group, the arm swing asymmetry was invariant to terrain but declined under the dual-task condition while the persons with Parkinson disease exhibited increased asymmetry on the cross slope, on the irregular terrain, and under the dual-task condition. Interlimb movement correlation decreased on the irregular terrain for the persons with Parkinson disease while the healthy group exhibited decreased interlimb movement correlation on the cross slope as well as under the dual-task condition. Significance: Persons with Parkinson disease were able to increase their arm swing magnitude when their balance was challenged and the most significant threat to their safety as defined by the greatest reduction in the interlimb movement correlation was the irregular terrain.

Standard dosages of motor practice in clinical physical rehabilitation are insufficient to optimize motor learning, particularly for older patients who often learn at a slower rate than younger patients. Personalized practice dosing (i.e., practicing a task to or beyond one's plateau in performance) may provide a clinically feasible method for determining a dose of practice that is both standardized and individualized, and may improve motor learning. The purpose of this study was to investigate whether personalized practice dosages [practice to plateau (PtP) and overpractice (OVP)] improve retention and transfer of a motor task, compared to low dose [LD] practice that mimics standard clinical dosages. In this pilot randomized controlled trial (NCT02898701, ClinicalTrials.gov), community-dwelling older adults (n = 41, 25 female, mean age 68.9 years) with a range of balance ability performed a standing serial reaction time task in which they stepped to specific targets. Presented stimuli included random sequences and a blinded repeating sequence. Participants were randomly assigned to one of three groups: LD (n = 15, 6 practice trials equaling 144 steps), PtP (n = 14, practice until reaching an estimated personal plateau in performance), or OVP (n = 12, practice 100% more trials after reaching an estimated plateau in performance). Measures of task-specific learning (i.e., faster speed on retention tests) and transfer of learning were performed after 2–4 days of no practice. Learning of the random sequence was greater for the OVP group compared to the LD group (p = 0.020). The OVP (p = 0.004) and PtP (p = 0.010) groups learned the repeated sequence more than the LD group, although the number of practice trials across groups more strongly predicted learning (p = 0.020) than did group assignment (OVP vs. PtP, p = 0.270). No group effect was observed for transfer, although significant transfer was observed in this study as a whole (p < 0.001). Overall, high and personalized dosages of postural training were well-tolerated by older adults, suggesting that this approach is clinically feasible. Practicing well-beyond standard dosages also improved motor learning. Further research should determine the clinical benefit of this personalized approach, and if one of the personalized approaches (PtP vs. OVP) is more beneficial than the other for older patients.

Robotic exoskeletons can assist humans with walking by providing supplemental torque in proportion to the user's joint torque. Electromyographic (EMG) control algorithms can estimate a user's joint torque directly using real-time EMG recordings from the muscles that generate the torque. However, EMG signals change as a result of supplemental torque from an exoskeleton, resulting in unreliable estimates of the user's joint torque during active exoskeleton assistance. Here, we present an EMG control framework for robotic exoskeletons that provides consistent joint torque predictions across varying levels of assistance. Experiments with three healthy human participants showed that using diverse training data (from different levels of assistance) enables robust torque predictions, and that a convolutional neural network (CNN), but not a Kalman filter (KF), can capture the non-linear transformations in EMG due to exoskeleton assistance. With diverse training, the CNN could reliably predict joint torque from EMG during zero, low, medium, and high levels of exoskeleton assistance [root mean squared error (RMSE) below 0.096 N-m/kg]. In contrast, without diverse training, RMSE of the CNN ranged from 0.106 to 0.144 N-m/kg. RMSE of the KF ranged from 0.137 to 0.182 N-m/kg without diverse training, and did not improve with diverse training. When participant time is limited, training data should emphasize the highest levels of assistance first and utilize at least 35 full gait cycles for the CNN. The results presented here constitute an important step toward adaptive and robust human augmentation via robotic exoskeletons. This work also highlights the non-linear reorganization of locomotor output when using assistive exoskeletons; significant reductions in EMG activity were observed for the soleus and gastrocnemius, and a significant increase in EMG activity was observed for the erector spinae. Control algorithms that can accommodate spatiotemporal changes in muscle activity have broad implications for exoskeleton-based assistance and rehabilitation following neuromuscular injury.

Pelvic floor disorders affect 24% of US women, and elevated intra-abdominal pressure may cause pelvic injury through musculoskeletal strain. Activity restrictions meant to reduce pelvic strain after traumatic events, such as childbirth, have shown little benefit to patients. Reported high variability in abdominal pressure suggests that technique plays a substantial role in pressure generation. Understanding these techniques could inform evidence-based recommendations for protective pelvic care. We hypothesized use of a motion-capture methodology could identify four major contributors to elevated pressure: gravity, acceleration, abdominal muscle contraction, and respiration. Twelve women completed nineteen activities while instrumented for whole body motion capture, abdominal pressure, hip acceleration, and respiration volume. Correlation and partial least squares regression were utilized to determine primary technique factors that increase abdominal pressure. The partial least squares model identified two principal components that explained 59.63% of relative intra-abdominal pressure variability. The first component was primarily loaded by hip acceleration and relative respiration volume, and the second component was primarily loaded by flexion moments of the abdomen and thorax. While reducing abdominal muscle use has been a primary strategy in protective pelvic floor care, the influence of hip acceleration and breathing patterns should be considered with similar importance in future work. [ABSTRACT FROM AUTHOR]

Background: Individuals with transhumeral limb loss have an increased risk of falling, potentially resulting from altered upper-body kinematics during gait. The purpose of this study was to investigate whole-body angular momentum as a measure of movement control, to gain an understanding of how these upper-body kinematics contribute to dynamic balance., Methods: Eight participants with transhumeral limb loss and eight able-bodied control participants completed three gait trials at self-selected speeds. The participants with transhumeral limb loss performed trials with and without their prosthesis. Coefficient of cancellation and whole-body angular momentum about all anatomical axes of rotation were calculated. Means and variance were compared across the conditions over the gait cycle via statistical parametric mapping, and ranges were compared using a one-way ANOVA., Findings: Coefficient of cancellation was decreased between the upper/lower extremities in the transverse plane and between the upper extremities/trunk in the sagittal plane for both transhumeral walking conditions compared to the control group. Whole-body angular momentum was statistically different in the sagittal plane and decreased in the transverse plane when walking with the prosthesis compared to the control group. Walking without the prosthesis resulted in increased variability of whole-body angular momentum., Interpretation: Individuals with transhumeral limb loss had dysregulated whole-body angular momentum compared to the control group. This dysregulation was related to decreased segment-to-segment cancellation from the upper extremities and increased variance throughout the gait cycle. Based on these findings, individuals should be encouraged to wear their transhumeral prosthesis while walking as it may reduce fall risk and fatigue., Competing Interests: Declaration of competing interest Kent N. Bachus reports financial support was provided by US Department of Veterans Affairs. Sarina K. Sinclair reports financial support was provided by US Department of Veterans Affairs. Julia A. Dunn reports financial support was provided by National Science Foundation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Corneal endothelial cells (CECs) are essential for maintaining corneal transparency and hydration through their barrier and pump functions. The COL8A2 gene encodes a component of the extracellular matrix of the cornea, which is crucial for the normal functioning of these cells. Mutations in COL8A2 are linked to corneal dystrophies, emphasizing the gene's importance in corneal health. The purpose of this research is to explore the effects of COL8A2 activation within CECs, to understand its contribution to cellular behavior and health. COL8A2 CRISPR/dCas9 activation system (aCOL8A2) was used to activate the COL8A2. In rats, wound healing and mitochondrial function were assessed after COL8A2 activation. As a result, aCOL8A2 promoted wound healing of rat corneal endothelium by increasing mitochondrial membrane potential. In cultured human CECs, proteomic analysis was performed to screen and identify the differential protein profiles between control and aCOL8A2 cells. Western blot was used to validate the differential proteins from both cells. Mitochondrial function and intracellular distribution were assessed by measuring ATP production and mitochondrial membrane potential. In cultured human CECs, aCOL8A2 increased COL8A2 and phospho-YAP levels. Transendothelial electrical resistance (TEER) was increased and actin cytoskeleton was attenuated by aCOL8A2. Gene ontology analysis revealed that the proteins were mainly involved in the regulation of folate biosynthesis, ECM-receptor interaction, cell differentiation, NADP activity and cytoskeleton. ATP production was increased, mitochondrial membrane potential was polarized and mitochondrial distribution was widespread in the aCOL8A2 group. In conclusion, aCOL8A2 induces a regulatory cascade affecting mitochondrial positioning and efficiency, mediated by alterations in the cytoskeletal architecture and the YAP signaling pathway. This sequence of events serves to bolster the functional capacities of corneal endothelial cells, including their pump and barrier functions, essential for corneal health and transparency., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024. Published by Elsevier B.V.)

Interoception, which refers to sensing, interpreting, and integrating internal bodily signals, has been suggested to be associated with emotion regulation. Previous research has demonstrated individual differences in interoception and its impact on emotion regulation. However, the priming effect of interoception on emotion regulation and the underlying neural mechanisms remain unknown. This study aims to examine how interoception primes different strategies of cognitive reappraisal, using electroencephalography (EEG). Thirty-seven healthy participants completed an interoceptive priming task. We found that interoception increased the amplitudes of the late positive potential (LPP) during both interpretation and detachment strategies. The priming effect of interoception in enhancing LPP amplitudes lasted longer for interpretation than for detachment. A decrease in alpha power during reinterpretation was observed after interoceptive priming, but not during detachment. The results revealed that interoception enhanced attention to bodily signals associated with negative emotions during cognitive reappraisal. Interoception showed distinct effects on different strategies of cognitive reappraisal, with different underlying neural mechanisms. Interoception-based programs may be an effective way to enhance the capacity for cognitive reappraisal., Competing Interests: The authors of this article declare no conflict of interest., (© 2024 The Author(s).)

Health emerges from coordinated psychobiological processes powered by mitochondrial energy transformation. But how do mitochondria regulate the multisystem responses that shape resilience and disease risk across the lifespan? The Mitochondrial Stress, Brain Imaging, and Epigenetics (MiSBIE) study was established to address this question and determine how mitochondria influence the interconnected neuroendocrine, immune, metabolic, cardiovascular, cognitive, and emotional systems among individuals spanning the spectrum of mitochondrial energy transformation capacity, including participants with rare mitochondrial DNA (mtDNA) lesions causing mitochondrial diseases (MitoDs). This interdisciplinary effort is expected to generate new insights into the pathophysiology of MitoDs, provide a foundation to develop novel biomarkers of human health, and integrate our fragmented knowledge of bioenergetic, brain-body, and mind-mitochondria processes relevant to medicine and public health., Competing Interests: Declaration of interests The authors have no competing interests to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Repeated stimulus exposure alters the brain's response to the stimulus. We investigated the underlying neural mechanisms by recording functional MRI data from human observers passively viewing 120 presentations of two Gabor patches (each Gabor repeating 60 times). We evaluated support for two prominent models of stimulus repetition, the fatigue model and the sharpening model. Our results uncovered a two-stage learning process in the primary visual cortex. In Stage 1, univariate BOLD activation in V1 decreased over the first twelve repetitions of the stimuli, replicating the well-known effect of repetition suppression. Applying MVPA decoding along with a moving window approach, we found that (1) the decoding accuracy between the two Gabors decreased from above-chance level (∼60% to ∼70%) at the beginning of the stage to chance level at the end of the stage (∼50%). This result, together with the accompanying weight map analysis, suggested that the learning dynamics in Stage 1 were consistent with the predictions of the fatigue model. In Stage 2, univariate BOLD activation for the remaining 48 repetitions of the two stimuli exhibited significant fluctuations but no systematic trend. The MVPA decoding accuracy between the two Gabor patches was at chance level initially and became progressively higher as stimulus repetition continued, rising above and staying above chance level starting at the ∼35th repetition. Thus, results from the second stage supported the notion that sustained and prolonged stimulus repetition prompts sharpened representations. Additional analyses addressed (1) whether the neural patterns within each learning stage remained stable and (2) whether new neural patterns were evoked in Stage 2 relative to Stage 1.

Fruit peel color is a major factor that influences fruit quality and customers' demand. However, the molecular mechanisms underlying the green fruit peel color trait of Cucurbita pepo L. remain unknown. Two parental lines, RP16 and RP38, were used to study the fruit peel color trait in C. pepo . The parental line RP16 shows white peel color, whereas RP38 exhibits green peel color. 384 F 2 populations were used to identify the inheritance pattern associated with green fruit and white fruit peel in Cucurbita pepo L. 293 F 2 individuals were white, and 91 F 2 individuals were green, resulting in a ratio of 3:1. Hence, white peel is dominant over the green fruit peel trait, and a single recessive green peel gene ( Cpgp ) controls the green fruit peel. The fruit chlorophyll (Chll) content decreases as fruit matures in the RP16 line. In contrast, Chll increases during the fruit growing periods on fruit peels of the RP38 line. The BSA-sequence analysis revealed the Cpgp locus on Chr5, within a 2.3 Mb region. Subsequent fine-mapping analysis, using 699 F 2 plants, narrowed down this region to 23.90 kb on the same chromosome. Within this region, two annotated genes, namely Cp4.1LG05g02070 and Cp4.1LG05g02060 , are present. These genes are predicted to encode a two-component Arabidopsis Pseudo-Response Regulator 2-like protein (APRR2), which may be involved in green pigmentation processes in plants. Consequently, sequence alignment and gene expression analyses at various fruit development stages supported that Cp4.1LG05g02070 may be the primary candidate gene responsible for regulating the green fruit peel color trait in Cucurbita pepo L. This study may provide a basis for further study on the basic mechanisms that control the fruit peel colors in Cucurbita spp ., Supplementary Information: The online version contains supplementary material available at 10.1007/s11032-024-01492-7., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© The Author(s), under exclusive licence to Springer Nature B.V. 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: This study investigates the potential of novel meniscal parameters as predictive factors for incident radiographic knee osteoarthritis (ROA) over a span of four years, as part of the Osteoarthritis Initiative (OAI) study., Objectives: Quantitative measurements of meniscal parameters alteration could serve as predictors of OA's occurrence and progression., Methods and Materials: A nested matched case-control study design was used to select participants from OAI study. Case knees (n = 178) were defined as those with incident ROA (Kellgren Lawrence Grade (KLG) 0 or 1 at baseline (BL), evolving into KLG 2 or above by year 4). Control knees were matched one-to-one by sex, age and radiographic status with case knees. The mean distance from medial-to-lateral meniscal lesions [Mean(MLD)], mean value of tibial plateau width [Mean(TPW)] and the mean of the relative percentage of the medial-to-lateral meniscal lesions distance [Mean(RMLD)] were evaluated through coronal T2-weighted turbo spin echo (TSE) MRI at P-0 (visit when incident ROA was found on radiograph), P-1(one year prior to P-0) and baseline, respectively. Using the imaging data of one patient, the mechanism was investigated by finite element analysis., Results: Participants were on average 60.22 years old, predominantly female (66.7%) and overweight (mean BMI: 28.15). Mean(MLD) and Mean(RMLD) were significantly greater for incident knees compared to no incident knees at baseline, P-1 and P-0. [Mean(MLD), Mean(RMLD); (42.56-49.73) mean ± (7.70-9.52) mm SD vs. (38.14-40.78) mean ± (5.51-7.05)mm SD; (58.61-68.95) mean ± (8.52-11.40) mm SD vs. (52.52-56.35) mean ± (6.53-7.85)mm SD, respectively]. Baseline Mean(MLD) and Mean(RMLD), [Adjusted OR, 95%CI: 1.11(1.07 to 1.16) and 1.13(1.09 to 1.17), respectively], were associated with incident ROA during 4 years, However, Mean(TPW) [Adjusted OR, 95%CI: 0.98(0.94 to 1.02)] was not associated with incident ROA during 4 years. While Mean(TPW) at P-1 and P-0 was not associated with the risk of incident ROA, Mean(MLD) and Mean(RMLD) at P-1 and P-0 were significantly positively associated with the risk of incident ROA., Conclusions: The meniscal parameters alteration could be an important imaging biomarker to predict the occurrence of ROA., (© 2024. The Author(s).)

Electro-hydraulic systems are extensively utilized to generate desired acceleration waveforms to provide a vibration environment for testing the performance and reliability of objects in various industrial applications. However, as electro-hydraulic systems are often affected by some inevitable drawbacks resulted from hydraulic nonlinearities, unwanted dynamic variations and disturbances, the generated acceleration waveform is generally far behind the expectation. In this paper, a convex combined adaptive controller with input shaping technique is proposed for enhancing the transient acceleration waveform replication accuracy of electro-hydraulic systems. The proposed controller is comprised of a three variable controller at the bottom level, an input shaping technique controller at the middle level, and a convex combined adaptive controller at the upper level. The three variable controller is firstly utilized for the establishment of a fundamental closed-loop acceleration control system, and then the input shaping technique controller is constructed by introducing an offline designed inverse prefilter utilizing the multi-innovation recursive least squares algorithm and the zero magnitude error tracking algorithm. The convex combined adaptive controller at the upper level is comprised of two individual adaptive filters with high and low step sizes, which provides the merits of fast convergence rate and high tracking accuracy, and it is further exploited to address for system's dynamic variations, model uncertainties and unexpected perturbations. Comparative experiments of the proposed controller with a manually generated random waveform and a recorded earthquake waveform as the testing inputs are conducted on a typical electro-hydraulic test bench, and the corresponding results demonstrate the feasibility and superiority of the proposed controller in improving the transient acceleration waveform replication performance of electro-hydraulic systems., Competing Interests: Declaration of Competing Interest The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2024 ISA. Published by Elsevier Ltd. All rights reserved.)

Background: OA (osteoarthritis) is a common joint disease characterized by damage to the articular cartilage and affects the entire joint tissue, with its main manifestations being joint pain, stiffness, and limited movement.Currently,we know that OA is a complex process composed of inflammatory and metabolic factors.It is reported that the occurrence and development of OA is related to the change of tryptophan metabolism.Therefore, the study of tryptophan metabolism and OA related genes is hopeful to find a new therapeutic target for OA., Methods: Differentially expressed genes (DEGs) in GSE55235 were gained via differential expression analysis (OA samples vs normal samples). The tryptophan metabolic related DEGs (TMR-DEGs) were obtained by overlapping tryptophan metabolism related genes (TMRGs) and DEGs. Further, biomarkers were screening via Least absolute shrinkage and selection operator (LASSO), naive bayes (NB) and supportvector machine-recursive feature elimination (SVM-RFE) algorithm to establish a diagnostic model. Afterward, Gene Set Enrichment Analysis (GSEA) and drug prediction were performed based on diagnostic biomarkers by multiple software and databases. Eventually, expression level of biomarker public databases was verified using real-time quantitative polymerase chain reaction (RT-qPCR)., Results: Three tryptophan metabolism related biomarkers ( TDO2 , AOX1 and SLC3A2 ) were identified in OA. GSEA analysis demonstrated that biomarkers were associated with the function of 'FoxO signaling pathway', 'spliceosome' and 'ribosome'. There were seven drugs with therapeutic potential on TDO2 and AOX1. Ultimately, compared with normal group, expression of AOX1 and SLC3A2 in OA group remarkable lower., Conclusion: Overall, three tryptophan metabolic related diagnostic biomarkers that associated with OA were obtained, which provided a original direction for the diagnosis and treatment of OA., Competing Interests: Authors declare that they have no competing interests., (© 2024 The Authors. Published by Elsevier B.V.)

Introduction: The complex process of pregnancy and childbirth significantly influences the well-being of both mother and child. Today all pregnant women without medical contraindications are recommended to start or continue regular aerobic and strength training for at least 150 min per week to prevent pregnancy-related diseases and conditions. Urinary incontinence in pregnancy, episiotomy and third- or fourth-degree perineal tear during labor can greatly impact womens' health, quality of life and ability to be physically active. The aim of this study was to examine the efficacy of pelvic floor muscle training (PFMT) during pregnancy in the prevention of urinary incontinence, episiotomy, and third- or fourth-degree perineal tear., Material and Methods: A systematic review and meta-analysis (CRD42022370600) was performed. Only randomized clinical trials published between 2010 and 2023 were included. The following databases were examined: EBSCO (including Academic Search Premier, Education Resources Information Center, MEDLINE, SPORTDiscus and OpenDissertations databases), Clinicaltrials.gov, Web of Science, Scopus, Cochrane Database of Systematic Reviews and Physiotherapy Evidence Database (PEDro). Three meta-analyses to investigate the effect of PFMT exclusively or implemented as a section within a physical activity program during pregnancy on urinary incontinence, episiotomy, and third- or fourth-degree perineal tear were conducted., Results: Thirty studies were analyzed (N = 6691). An effective preventive action of PFMT was found for urinary incontinence (z = 3.46; p < 0.0005; relative risk [RR] = 0.72, 95% confidence interval [CI]: 0.59, 0.87, I 2  = 59%) and third- or fourth-degree perineal tear (z = 2.89; p = 0.004; RR = 0.50, 95% CI: 0.31, 0.80, I 2  = 48%) but not for episiotomy (z = 0.80; p = 0.42; RR = 0.95, 95% CI: 0.85, 1.07, I 2  = 75%)., Conclusions: PFMT during pregnancy proves to be an effective preventive intervention for reducing the risk of urinary incontinence and the occurrence of third- or fourth-degree perineal tears. These findings highlight the importance of incorporating PFMT into antenatal care and training programs to improve maternal well-being and overall childbirth outcomes., (© 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)

Multifunctional flexible electronics present tremendous opportunities in the rapidly evolving digital age. One potential avenue to realize this goal is the integration of polyoxometalates (POMs) and ionic liquid-based gels (ILGs), but the challenge of macrophase separation due to poor compatibility, especially caused by repulsion between like-charged units, poses a significant hurdle. Herein, the possibilities of producing diverse and homogenous POMs-containing ionohydrogels by nanoconfining POMs and ionic liquids (ILs) within an elastomer-like polyzwitterionic hydrogel using a simple one-step random copolymerization method, are expanded vastly. The incorporation of polyzwitterions provides a nanoconfined microenvironment and effectively modulates excessive electrostatic interactions in POMs/ILs/H 2 O blending system, facilitating a phase transition from macrophase separation to a submillimeter scale worm-like microphase-separation system. Moreover, combining POMs-reinforced ionohydrogels with a developed integrated self-powered sensing system utilizing strain sensors and Zn-ion hybrid supercapacitors has enabled efficient energy storage and detection of external strain changes with high precision. This work not only provides guidelines for manipulating morphology within phase-separation gelation systems, but also paves the way for developing versatile POMs-based ionohydrogels for state-of-the-art smart flexible electronics., (© 2024 Wiley‐VCH GmbH.)

Background: Stress hyperglycemia, which is associated with poor prognosis in patients with acute myocardial infarction (AMI), can be determined using the stress hyperglycemia ratio (SHR). Impaired left ventricular function and microvascular obstruction (MVO) diagnosed using cardiac magnetic resonance (CMR) have also been proven to be linked to poor prognosis in patients with AMI and aid in risk stratification. However, there have been no studies on the correlation between fasting SHR and left ventricular function and MVO in patients with acute ST-segment elevation myocardial infarction (ASTEMI). Therefore, this study aimed to investigate the additive effect of fasting SHR on left ventricular function and global deformation in patients with ASTEMI and to explore the association between fasting SHR and MVO., Methods: Consecutive patients who underwent CMR at index admission (3-7 days) after primary percutaneous coronary intervention (PPCI) were enrolled in this study. Basic clinical, biochemical, and CMR data were obtained and compared among all patients grouped by fasting SHR tertiles: SHR1: SHR < 0.85; SHR2: 0.85 ≤ SHR < 1.01; and SHR3: SHR ≥ 1.01. Spearman's rho (r) was used to assess the relationship between fasting SHR and left ventricular function, myocardial strain, and the extent of MVO. Multivariable linear regression analysis was performed to evaluate the determinants of left ventricular function and myocardial strain impairment in all patients with AMI. Univariable and multivariable regression analyses were performed to investigate the correlation between fasting SHR and the presence and extent of MVO in patients with AMI and those with AMI and diabetes mellitus (DM)., Results: A total of 357 patients with ASTEMI were enrolled in this study. Left ventricular ejection fraction (LVEF) and left ventricular global function index (LVGFI) were significantly lower in SHR2 and SHR3 than in SHR1. Compared with SHR1 and SHR2 groups, left ventricular strain was lower in SHR3, as evidenced by global radial (GRS), global circumferential (GCS), and global longitudinal (GLS) strains. Fasting SHR were negatively correlated with LVEF, LVGFI, and GRS (r = - 0.252; r = - 0.261; and r = - 0.245; all P<0.001) and positively correlated with GCS (r = 0.221) and GLS (r = 0.249; all P <0.001). Multivariable linear regression analysis showed that fasting SHR was an independent determinant of impaired LVEF, LVGFI, GRS, and GLS. Furthermore, multivariable regression analysis after adjusting for covariates signified that fasting SHR was associated with the presence and extent of MVO in patients with AMI and those with AMI and DM., Conclusion: Fasting SHR in patients with ASTEMI successfully treated using PPCI is independently associated with impaired cardiac function and MVO. In patients with AMI and DM, fasting SHR is an independent determinant of the presence and extent of MVO., (© 2024. The Author(s).)

Whole-body angular momentum (WBAM) represents the cancellations of angular momenta that are produced during a reciprocal gait pattern. WBAM is sensitive to small changes and is used to compare dynamic gait patterns under different walking conditions. Study designs and the normalization techniques used to define WBAM vary and make comparisons between studies difficult. To address this problem, WBAM about each anatomical axis of rotation from a healthy control population during normal gait were investigated within four metrics: 1) range of WBAM, 2) integrated WBAM, 3) statistical parametric mapping (SPM), and 4) principal component analysis (PCA). These data were studied as a function of walking speed and normalization. Normalization techniques included: 1) no normalization, 2) normalization by height, body mass and walking speed, and 3) normalization by height, body mass and a scalar number, gravity×height, that is independent of walking velocity. Significant results were obtained as a function of walking speed regardless of normalization technique. However, the interpretation of significance within each metric was dependent on the normalization technique. Method 3 was the most robust technique as the differences were not altered from the expected relationships within the raw data. Method 2 actually inverted the expected relationship in WBAM amplitude as a function of walking speed, which skewed the results and their interpretation. Overall, SPM and PCA statistical methods provided better insights into differences that may be important. However, depending on the normalization technique used, caution is advised when interpreting significant findings when comparing participants with disparate walking speeds., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Cognitive reappraisal is fundamental to cognitive therapies and everyday emotion regulation. Analyses using Bayes factors and an axiomatic systems identification approach identified four reappraisal-related components encompassing distributed neural activity patterns across two independent functional magnetic resonance imaging (fMRI) studies (n = 182 and n = 176): (1) an anterior prefrontal system selectively involved in cognitive reappraisal; (2) a fronto-parietal-insular system engaged by both reappraisal and emotion generation, demonstrating a general role in appraisal; (3) a largely subcortical system activated during negative emotion generation but unaffected by reappraisal, including amygdala, hypothalamus and periaqueductal gray; and (4) a posterior cortical system of negative emotion-related regions downregulated by reappraisal. These systems covaried with individual differences in reappraisal success and were differentially related to neurotransmitter binding maps, implicating cannabinoid and serotonin systems in reappraisal. These findings challenge 'limbic'-centric models of reappraisal and provide new systems-level targets for assessing and enhancing emotion regulation., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Objective: To explore the diagnostic value of cardiac magnetic resonance feature tracking (CMR-FT) divided left atrial (LA) strain in differentiating constrictive pericarditis (CP) and restrictive cardiomyopathy (RCM)., Methods: Patients with CP (n = 40) and RCM (n = 40), and another 40 normal control group were retrospectively enrolled over a period of 8 years at a tertiary cardiac centre. Left ventricular (LV) and biatrial strain and strain rate (SR) were measured. Atrial strain was used to differentiate between patients with CP and RCM. Then, patients were grouped according to their left ventricular ejection fraction (LVEF), either ≥50% or < 50%. A deeper analysis was done to evaluate the diagnostic value of atrial strain in these subgroups. Receiver operating characteristic curves (ROC) were used to assess the accuracy of myocardial strain based on CMR FT for the differential diagnosis of CP and RCM., Results: LV and LA strain and SR were significantly lower in patients with CP and RCM than those in the normal controls (P < 0.05). LA strain and SR were significantly lower in the RCM group than in the CP group (P < 0.05). In patients with either LVEF≥50% or＜50%, LA strain were lower in the RCM group than in the CP group (P < 0.05). ROC analysis showed that LA stored strain (LA-εs) had a good differential diagnostic value for CP and RCM, with an area under the curve (AUC) of 0.811 and an optimal cutoff value of 6.98%, above this value it tends to develop CP. Further, an excellent differential diagnostic value was found in patients with LVEF＜50%, with an AUC of 0.955., Conclusion: LA strain analysis obtained by CMR-FT provides good differential diagnostic value for distinguishing CP from RCM, especially in patients with LVEF＜50%., Competing Interests: We have reconfirmed that all authors have no conflicts of interest., (© 2024 Published by Elsevier Ltd.)

Recent neuroimaging studies have shown that the visual cortex plays an important role in representing the affective significance of visual input. The origin of these affect-specific visual representations is debated: they are intrinsic to the visual system versus they arise through reentry from frontal emotion processing structures such as the amygdala. We examined this problem by combining convolutional neural network (CNN) models of the human ventral visual cortex pre-trained on ImageNet with two datasets of affective images. Our results show that in all layers of the CNN models, there were artificial neurons that responded consistently and selectively to neutral, pleasant, or unpleasant images and lesioning these neurons by setting their output to zero or enhancing these neurons by increasing their gain led to decreased or increased emotion recognition performance respectively. These results support the idea that the visual system may have the intrinsic ability to represent the affective significance of visual input and suggest that CNNs offer a fruitful platform for testing neuroscientific theories., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2024 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)