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This report evaluates whether health related quality of life (HRQoL) and patient-reported arm morbidity one year after axillary surgery are affected by the omission of axillary lymph node dissection (ALND). The ongoing international non-inferiority SENOMAC trial randomizes clinically node-negative breast cancer patients (T1-T3) with 1–2 sentinel lymph node (SLN) macrometastases to completion ALND or no further axillary surgery. For this analysis, the first 1181 patients enrolled in Sweden and Denmark between March 2015, and June 2019, were eligible. Data extraction from the trial database was on November 2020. This report covers the secondary outcomes of the SENOMAC trial: HRQoL and patient-reported arm morbidity. The EORTC QLQ-C30, EORTC QLQ-BR23 and Lymph-ICF questionnaires were completed in the early postoperative phase and at one-year follow-up. Adjusted one-year mean scores and mean differences between the groups are presented corrected for multiple testing. Overall, 976 questionnaires (501 in the SLN biopsy only group and 475 in the completion ALND group) were analysed, corresponding to a response rate of 82.6%. No significant group differences in overall HRQoL were identified. Participants receiving SLN biopsy only, reported significantly lower symptom scores on the EORTC subscales of pain, arm symptoms and breast symptoms. The Lymph-ICF domain scores of physical function, mental function and mobility activities were significantly in favour of the SLN biopsy only group. One year after surgery, arm morbidity is significantly worse affected by ALND than by SLN biopsy only. The results underline the importance of ongoing attempts to safely de-escalate axillary surgery. The trial was registered at clinicaltrials.gov prior to initiation (https://clinicaltrials.gov/ct2/show/ NCT 02240472). [Display omitted] • Omission of ALND significantly reduces patient-reported arm morbidity. • SLNB versus ALND results in significant less pain and better physical function. • HRQoL is not affected by de-escalated axillary surgery. • Complaints from axillary surgery are evaluated with patient-reported outcomes. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the effects of aquatic training on motor risk factors for falls in older people during the COVID-19 pandemic. A randomized controlled trial was carried out with older people, divided into an aquatic training group (ATG) (n = 24) and a control group (CG) (n = 25). Muscle strength was assessed by the 5-Times Sit-to-Stand Test, mobility by the simple and dual-task Timed Up and Go Test, and postural stability through stabilometric data (force platform). The CG received monthly calls to monitor general health. The ATG carried out training lasting 16 weeks, with two 1-hour sessions per week. Both groups improved muscular strength and cognitive-motor tasks, and they performed a dual task with fewer errors in the secondary task after 16 weeks regardless of the pandemic and COVID-19 diagnosis. There was a significant decrease in the area of center of pressure displacement in the tandem posture with eyes closed in the CG. When analyzing participants who adhered at least 50% to the intervention, the ATG significantly reduced the number of steps on the Timed Up and Go Test performance. Both groups improved muscular strength and cognitive-motor tasks and increased the cognitive task cost. In the CG, there was a significant decrease in the mean amplitude of the anteroposterior center of pressure displacement in the feet together with eyes open. We found that aquatic physical exercise presented positive effects on some potentially modifiable motor risk factors for falls (mobility and muscle strength) regardless of the COVID-19 pandemic and COVID-19 diagnosis, especially among people who adhered to the intervention. [ABSTRACT FROM AUTHOR]

To assess differences in postoperative patient-reported outcome measures (PROMs) and minimal clinically important difference (MCID) attainment following single-level anterior cervical discectomy and fusion based on predominant preoperative pain symptom. Patients undergoing primary, single-level anterior cervical discectomy and fusion were identified. PROMs included visual analog scale (VAS) arm and neck, 12-item short-form physical component summary (SF-12 PCS), Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), and Neck Disability Index, collected preoperatively and postoperatively. Patients were placed in preoperative predominant arm pain (pAP) and preoperative predominant neck pain groups. χ2 test compared demographic and perioperative characteristics, and MCID attainment rates. Student t test evaluated change from preoperative to postoperative PROM values and compared PROMs between groups. There were 110 patients assessed (52 neck pain, 58 arm pain). Patients with preoperative predominant neck pain improved significantly from preoperative to postoperative at 12 weeks to 1 year for PROMIS-PF, 6 months and 1 year for SF-12 PCS, 6 weeks to 1 year for VAS neck, 6 weeks to 6 months for VAS arm, and 6 weeks to 2 years for Neck Disability Index (all P ≤ 0.035). Patients with pAP improved significantly from preoperative to all postoperative time points for PROMIS-PF, 6 months to 2 years for SF-12 PCS, 6 weeks to 1 year for VAS neck, 6 weeks to 1 year for VAS arm, and 6 weeks to 6 months for Neck Disability Index (all P ≤ 0.040). Mean PROMIS-PF was higher at 6 weeks, preoperative VAS neck was lower, and preoperative VAS arm was higher for pAP patients (all P ≤ 0.013). MCID attainment was significantly higher in pAP patients for PROMIS-PF from 6 weeks to 6 months, SF-12 PCS 6 weeks, and VAS arm 12 weeks. Predominant pain symptom demonstrated little effect on perioperative characteristics and postoperative PROMs. Anterior cervical discectomy and fusion candidates will likely experience similar clinically meaningful postoperative improvements in physical function, disability, and pain. [ABSTRACT FROM AUTHOR]

Objectives: Many trials conclude "no clinically meaningful detriment" to health-related quality of life (HRQL) or function between arms, even when notable differential toxicity is observed. Mean change from baseline analyses of function or HRQL can possibly obscure important change in subgroups experiencing symptomatic toxicity. We evaluate the impact of diarrhea, a key treatment arm toxicity, on patient-reported HRQL and functioning in clinical trials submitted to US Food and Drug Administration.Methods: This study used 4 randomized, breast cancer trials (adjuvant to late-line metastatic) as case examples. Diarrhea, physical functioning (PF), and global health status and quality of life (GHS/QoL) from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 were analyzed at baseline and approximately 3 and 6 months.Results: Generally, patients reporting very much diarrhea at months 3 and 6 had worse PF (9-19 points lower) and GHS/QoL (16-19 points lower) than patients reporting no diarrhea regardless of treatment arm. In the change from baseline analysis, patients reporting very much diarrhea also experienced a greater decrease in PF (6-13 points) and GHS/QoL (6-16 points) versus patients reporting no diarrhea in both arms.Conclusions: In trials with moderate to large differences in symptomatic toxicity by arm, reporting "no meaningful difference in functioning and HRQL between arms" based on mean change from baseline analysis is insufficient and may obscure important impacts on subgroups experiencing symptomatic adverse events. Additional exploratory analyses with simple data visualizations evaluating functioning or HRQL in patient subgroups experiencing expected symptomatic toxicities can further inform the safety and tolerability of an investigational agent. [ABSTRACT FROM AUTHOR]

Purpose: Painful bone metastases hamper quality of life (QoL). The aim of this prespecified secondary analysis of the PRESENT trial was to compare change in global QoL, physical functioning, emotional functioning, functional interference, and psychosocial aspects after conventional radiation therapy (cRT) versus stereotactic body RT (SBRT).Methods and Materials: A total of 110 patients were enrolled in the phase 2 randomized controlled VERTICAL trial (NCT02364115) following the "trials within cohorts" design and randomized 1:1 to cRT or SBRT. Patient-reported global QoL, physical functioning, emotional functioning, functional interference, and psychosocial aspects were assessed by the European Organization for Research and Treatment of Cancer QoL Questionnaire (QLQ) Core 15 Palliative Care and QLQ Bone Metastases 22 modules. Changes in QoL domains over time were compared between patients treated with cRT and SBRT using intention-to-treat (ITT) and per-protocol (PP) linear mixed model analysis adjusting for baseline scores. Proportions of patients in the cRT versus SBRT arm reporting a clinically relevant change in QoL within 3 months were compared using a χ2 test.Results: QoL scores had improved over time and were comparable between groups for all domains in both the ITT and PP analyses, except for functional interference and psychological aspects in the ITT. Functional interference scores had improved more after 12 weeks in the cRT arm than in the SBRT arm (25.5 vs 14.1 points, respectively; effect size [ES] = 0.49, P = .04). Psychosocial aspects scores had improved more after 8 weeks in the cRT arm than in the SBRT arm (12.2 vs 7.3; ES = 0.56, P = .04). No clinically relevant differences between groups at 12 weeks in terms of global QoL, physical functioning, emotional functioning, functional interference, and psychosocial aspects were observed.Conclusions: Palliative RT improves QoL. Both SBRT and cRT have a comparable effect on patient-reported QoL outcomes in patients with painful bone metastases. Functional interference and psychological aspects scores improved more in patients treated with cRT versus patients offered SBRT. [ABSTRACT FROM AUTHOR]

Background Context: Physical inactivity has been described as both a cause and a consequence of low back pain (LBP) largely based on self-reported measures of daily activity. A better understanding of the connections between routine physical activity and LBP may improve LBP interventions.Purpose: In this study, we aim to objectively characterize the free-living physical activity of people with low back pain in comparison to healthy controls using accelerometers, and we aim to derive a set of LBP-specific physical activity minutes thresholds that may be used as targets for future physical activity interventions.Study Design: Cross-sectional.Patient Sample: A total of 22 low back pain patients and 155 controls.Outcome Measures: Accelerometry derived physical activity measures.Methods: Twenty-two people with LBP were compared to 155 age and gender-matched healthy controls. All subjects wore an ActiGraph accelerometer on the right hip for 7 consecutive days. Accelerometry-based physical activity features (count-per-minute CPM) were derived using Freedson's intervals and physical performance intervals. A random forest machine learning classifier was trained to classify LBP status using a leave-one-out cross-validation procedure. An interpretation algorithm, the SHapley Additive exPlanations (SHAP) algorithm was subsequently applied to assess the feature importance and to establish LBP-specific physical activity thresholds.Results: The LBP group reported mild to moderate disability (average ODI=18.5). The random forest classifier identified a set of 8 features (digital biomarkers) that achieved 88.1% accuracy for distinguishing LBP from controls. All of the top distinguishing features were related to differences in the sedentary and light activity ranges (<800 CPM), whereas moderate to vigorous physical activity was not discriminative. In addition, we identified and ranked physical activity thresholds that are associated with LBP prediction that can be used in future studies of physical activity interventions for LBP.Conclusions: We describe a set of physical activity features from accelerometry data associated with LBP. All of the discriminating features were derived from the sedentary and light activity range. We also identified specific activity intensity minutes thresholds that distinguished LBP subjects from healthy controls. Future examination on the digital markers and thresholds identified through this work can be used to improve physical activity interventions for LBP treatment and prevention by allowing the development of LBP-specific physical activity guidelines. [ABSTRACT FROM AUTHOR]

Background Context: Preliminary evidence has suggested favorable correlation between National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) assessments and traditional ("legacy") patient reported outcome measures (PROMs) in spine surgery. There has been a significant increase in PROMIS research with regards to spinal conditions.Purpose: The purpose of this systematic review is to provide an assessment of PROMIS Physical Function (PF) measures in this patient population.Study Design/setting: Systematic review.Methods: A systematic search of the PubMed/MEDLINE and Embase databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify published articles that referenced the various PROMIS PF measures. Two authors independently reviewed selected studies. The search returned 1,060 studies, 124 of which were selected for independent review by two authors. Of these, 37 were selected for inclusion. Mixed linear models were performed to assess for differences between legacy PROMs and PROMIS measures.Results: The combined sample size of all included studies yielded 10,296 total patients. Overall, PROMIS Physical Function (PF) measures demonstrated strong correlations with legacy PROMs when evaluating spine patients (weighted Pearson correlation, 0.589, standard error [SE]=0.023; weighted Spearman correlation, 0.702, SE=0.028). PROMIS questionnaires had significantly fewer questions than did legacy PROMs (4.2±0.30 vs. 9.53±0.82, p=.015). In spine studies, the PROMIS PF forms were completed in significantly less time than legacy PROMs (48.1±2.9 vs. 174.7±12.6 seconds, p<.001). The differences for the reliability measures and the floor and ceiling effects were not significant.Conclusions: Patient-Reported Outcomes Measurement Information System PF forms compare favorably with legacy PROMs with regard to correlations, ease of use, and quality criteria in the field of spine surgery. PROMIS PF scores correlate strongly with commonly used legacy PROMs, particularly in spine patients. Patient-Reported Outcomes Measurement Information System PF forms can be administered efficiently and to a broad patient population while remaining highly reliable. [ABSTRACT FROM AUTHOR]

In recent years the focus of healthcare and nutritional science in older adults has shifted from mortality towards physical performance and quality of life. The aim of this review was to summarize observational studies on physical performance in malnourished (MN) or at risk of malnutrition (RMN) older adults compared with well-nourished (WN) older adults. Eligible studies had to report on nutritional status and objectively measured physical performance in older adults (≥60 y). MN or RMN groups had to be compared with a WN group, measured with a validated nutrition screener. Ovid Medline and Web of Science were searched until 13 November, 2020. Study quality was scored using a modified Newcastle–Ottawa Scale (NOS). Results were analyzed by meta-analysis when possible, or narratively reviewed otherwise. Forty-five studies (16,911 participants in total) were included from studies in outpatient clinics (n = 6), nursing homes (n = 3), community-dwelling older adults (n = 20), hospitalized patients (n = 15), or a combination (n = 1). Studies used 11 different screeners of malnutrition, and 8 types of physical performance measures. Meta-analysis showed that compared with MN, WN groups had better hand grip strength (mean difference [MD] = 4.92 kg; 95% CI: 3.43, 6.41; P < 0.001; n = 23), faster gait speed (MD = 0.16 m/s; 95% CI: 0.05, 0.27; P = 0.0033; n = 7), performed faster on timed-up-and-go (MD = –5.94 s; 95% CI: –8.98, –2.89; P < 0.001; n = 8), and scored 1.2 more short physical performance battery points (95% CI: 1.32, 2.73; P < 0.001; n = 6). Results were less pronounced when compared with RMN. Narratively, all studies showed an association for knee extension strength, 6-min walking test, and multicomponent tests, except for the chair stand test. Study limitations include no studies scoring "good" on NOS, lack of confounder adjustment, and high heterogeneity. Overall, evidence from cross-sectional studies indicate an association between malnutrition and worse physical performance in older adults. This study is registered in PROSPERO as CRD42020192893. [ABSTRACT FROM AUTHOR]

• A mixed physical barrier (MPB) was used to control SWI in layered aquifers. • The MPB outperformed the single cut-off wall by up to 55 %. • This barrier system showed its effectiveness in all the layered cases studied. • The MPB proved effective, achieving a SWI reduction of up to 70%. Mixed physical barriers (MPB), which combine a cutoff wall and subsurface dam, were applied in heterogeneous coastal aquifer settings, and their ability to prevent seawater intrusion (SWI) was tested. The performance of MPB was examined in a typical stratified aquifer using laboratory experiments and numerical modelling. The performance of the MPB was compared to that of a single cut-off wall by measuring the percentage of reduction of the intrusion length. SEAWAT was used for validation purposes and to further evaluate the effectiveness of MPB in five additional realistic heterogeneous configurations. Experimental results show that the MPB effectively reduced the saltwater wedge length by up to 71%. The MPB outperformed the single cut-off wall by up to 55 %. Also, numerical results show that the MPB proved to be effective, achieving a SWI length reduction of up to 69% in the scenario regardless of the aquifer layering structures. Comparable performance was observed when the high K layer was confined between two low K layers or when the aquifer presented a monotonically increasing/decreasing K pattern. The findings of this study provide insights into the applicability of the MPB in realistic heterogeneous coastal aquifers. [ABSTRACT FROM AUTHOR]

River recovery is defined as the trajectory of change that a reach takes towards an improved condition. In geomorphic terms, this includes improvement in both the physical structure and function of a river. While there are numerous case studies that track river recovery at the reach scale, there is a lack of work that characterises the patterns of recovery across diverse river types. Here we use ergodic reasoning to quantitatively analyse changes in the assemblage of geomorphic units (GUs) that occur for rivers that are known to be at different stages of geomorphic recovery. We aim to understand how the physical structure of different river types change as recovery occurs. In this study, we adopted a semi-automated method to map GUs using Open Access LiDAR and Sentinel remote sensing imagery. We analyse the assemblage of GUs for 78 river sections that span eight river styles, three valley settings and two bed material textures – sand and gravel. We find that the patterns of river recovery vary for different river styles. Confined and laterally unconfined rivers exhibit linear and non-linear increases in richness, abundance, evenness, and diversity of GUs during recovery. Partly confined rivers show more variable trends for these measures, and channelised fill rivers show decreased diversity. During recovery, sand bed rivers are more susceptible to adjustment than gravel bed rivers. The presence of benches and islands indicates that recovery is underway across most river types. A statistically significant increase in abundance and area of benches and pools, and a decrease in abundance and area of floodplain steps can also be used to indicate that recovery is underway. Additionally, in early stages of recovery, adjustments take place at the unit level. Then as recovery progresses, adjustments tend to occur at the sub-unit level as evidenced by bank-attached bars becoming more compound in structure. Determining the indicator GUs and changes in assemblages to 'look out for' while in the field or on remote sensing images can aid the detection and analysis of river recovery, providing invaluable insight for process-based and recovery-enhancement approaches to river management. [Display omitted] • Patterns of geomorphic recovery vary across different river styles. • Different mixes of metrics can be used to track geomorphic river recovery. • Recovery is not always linear and morphology does not always become more complex. • Changes in assemblages of units and some individual units can detect recovery. [ABSTRACT FROM AUTHOR]

Current diagnostic concepts of somatic symptom disorder (SSD) in DSM-5 and bodily distress disorder (BDD) in ICD-11 require certain psychological criteria, but researchers have called for further specification. Therefore, in a first step, this systematic review and meta-analysis aimed to summarize the current evidence on psychological factors associated with SSD/BDD and/or disorder-relevant clinical outcomes such as symptom severity and impairment. Psychological factors were systematically searched using Pubmed, Cochrane Library and Psycinfo via EBSCO. Studies providing original data in English or German, after 2009 were included. Cross-sectional, cohort and case-control studies investigating at least one psychological factor in individuals with SSD/BDD in the context of disorder-relevant outcomes were included. Forty-three eligible studies (n = 3760 patients) in SSD (none in BDD) provided data on at least one psychological factor, 37 in case-control format, 10 cross-sectional and 5 longitudinal. Meta-analyses of the case-control studies found patients with SSD to be more impaired by depression (SMD = 1.80), anxiety (SMD = 1.55), health anxiety (SMD = 1.31) and alexithymia (SMD = 1.39), compared to healthy controls. Longitudinal results are scarce, mixed, and require refining, individual studies suggest self-concept of bodily weakness, anxiety and depression to be predictive for persistent SSD and physical functioning. This review provides a detailed overview of the current evidence of psychological factors in relation to SSD/BDD. Future studies on SSD and BDD should include under-studied psychological factors, such as negative affect, fear avoidance, or emotion regulation. More longitudinal studies are needed to assess the predictive value of these factors. • Psychological factors related to Somatic Symptom Disorder need clarification. • Depression, anxiety, illness anxiety and alexithymia importance could be confirmed. • Other factors, such as, emotion regulation and avoidance behaviour are understudied. • Longitudinal data is lacking. [ABSTRACT FROM AUTHOR]

The global population as well as the demand for human food is rapidly growing worldwide, which necessitates improvement of efficiency in livestock operations. In this context, environmental factors during fetal and/or neonatal life have been observed to influence normal physical and physiological function of an individual during adulthood, and this phenomenon is called fetal or developmental programming. While numerous studies have reported the impact of maternal factors on development of the female progeny, limited information is available on the potential effects of fetal programming on reproductive function of the male offspring. Therefore, the objective for this review article was to focus on available literature regarding the impact of maternal factors, particularly maternal nutrition, on reproductive system of the male offspring. To this end, we highlighted developmental programming of the male offspring in domestic species (i.e., pig , cow and sheep) as well as laboratory species (i.e., mice and rat) during pregnancy and lactation. In this sense, we pointed out the effects of maternal nutrition on various functions of the male offspring including hypothalamic–pituitary axis, hormonal levels, testicular tissue and semen parameters. • Limited information exists on the effect of maternal nutrition on the male offspring. • Maternal nutrition affects hypothalamus-pituitary axis, hormones, testis and semen. • Colostrum intake and male offspring is an emerging field of research. • Although nutritional requirements and genetic potential have been well documented for livestock species, these figures are not comprehensively defined for the laboratory animals. • The initial stages of development of reproductive organs occur before birth in livestock species; however, part of development of reproductive organs in rodents occurs during lactation. [ABSTRACT FROM AUTHOR]

Ageing is associated with widespread physiological changes prominent within all tissues, including skeletal muscle and the brain, which lead to a decline in physical function. To tackle the growing health and economic burdens associated with an ageing population, the concept of healthy ageing has become a major research priority. Changes in skeletal muscle mitochondrial characteristics have been suggested to make an important contribution to the reductions in skeletal muscle function with age, and age-related changes in mitochondrial content, respiratory function, morphology, and mitochondrial DNA have previously been reported. However, not all studies report changes in mitochondrial characteristics with ageing, and there is increasing evidence to suggest that physical activity (or inactivity) throughout life is a confounding factor when interpreting age-associated changes. Given that physical activity is a potent stimulus for inducing beneficial adaptations to mitochondrial characteristics, delineating the influence of physical activity on the changes in skeletal muscle that occur with age is complicated. This review aims to summarise our current understanding and knowledge gaps regarding age-related changes to mitochondrial characteristics within skeletal muscle, as well as to provide some novel insights into brain mitochondria, and to propose avenues of future research and targeted interventions. Furthermore, where possible, we incorporate discussions of the modifying effects of physical activity, exercise, and training status, to purported age-related changes in mitochondrial characteristics. [ABSTRACT FROM AUTHOR]

The onset of sarcopenia is intimately linked with aging, posing significant implications not only for individual patient quality of life but also for the broader societal healthcare framework. Early and accurate identification of sarcopenia and a comprehensive understanding of its mechanistic underpinnings and therapeutic targets paramount to addressing this condition effectively. This review endeavors to present a cohesive overview of recent advancements in sarcopenia research and diagnosis. We initially delve into the contemporary diagnostic criteria, specifically referencing the European Working Group on Sarcopenia in Older People (EWGSOP) 2 and Asian Working Group on Sarcopenia (AWGS) 2019 benchmarks. Additionally, we elucidate comprehensive assessment techniques for muscle strength, quantity, and physical performance, highlighting tools such as grip strength, chair stand test, dual-energy X-ray Absorptiometry (DEXA), bioelectrical impedance analysis (BIA), gait speed, and short physical performance battery (SPPB), while also discussing their inherent advantages and limitations. Such diagnostic advancements pave the way for early identification and unequivocal diagnosis of sarcopenia. Proceeding further, we provide a deep-dive into sarcopenia's pathogenesis, offering a thorough examination of associated signaling pathways like the Myostatin, AMP-activated protein kinase (AMPK), insulin/IGF-1 Signaling (IIS), and the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathways. Each pathway's role in sarcopenia mediation is detailed, underscoring potential therapeutic target avenues. From a mechanistic perspective, the review also underscores the pivotal role of mitochondrial dysfunction in sarcopenia, emphasizing elements such as mitochondrial oxidative overload, mitochondrial biogenesis, and mitophagy, and highlighting their therapeutic significance. At last, we capture recent strides made in sarcopenia treatment, ranging from nutritional and exercise interventions to potential pharmacological and supplementation strategies. In sum, this review meticulously synthesizes the latest scientific developments in sarcopenia, aiming to enhance diagnostic precision in clinical practice and provide comprehensive insights into refined mechanistic targets and innovative therapeutic interventions, ultimately contributing to optimized patient care and advancements in the field. [Display omitted] [ABSTRACT FROM AUTHOR]

• The study examined the deterioration in FMS and its predictive value for functional disability (FD) progression in Parkinson's disease (PD). • Utilized data from the Taiwan Data Bank of Persons with Disability, assessing FMS (like pen-holding, buttoning, and knotting) and FD through the WHO Disability Assessment Schedule 2.0. • Significant correlations between the decline in FMS and FD. • Deterioration in buttoning ability was notably correlated with overall FD worsening. • Baseline FMS were indicative of future FD progression, particularly in cognition, motility, and life activity areas. Parkinson disease (PD) caused substantially disability. The impairment of fine motor skills (FMSs) is correlated with the severity of functional disability (FD) cross-sectionally in people with PD (PwP). The present study investigated the decline in FMSs and the predictive value of baseline FMSs for the progression of FD. People with moderate-to-advanced PD who received two evaluations within 1–5 years were identified from the Taiwan Data Bank of Persons with Disability database. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to evaluate FD, and FMSs including pen-holding, buttoning, and knotting were assessed. Our study included 2,271 people with moderate-to-advanced PD. We observed annual progression of FD in each domain of the WHODAS 2.0, with no difference between the sexes. The most significant correlation between FD and FMSs was that of decline in buttoning ability and deterioration of summary WHODAS 2.0 scores. Deterioration in FD across all domains of WHODAS 2.0 was associated with at least one FMS. The extent of disability in all three types of FMS at baseline was also correlated with deterioration of motility. Additionally, baseline disability in buttoning was significantly correlated with cognitive decline, and disability in knotting was significantly associated with the progression of FD. FMSs may be reliable markers for further FD, particularly in the areas of cognition, motility, and life activity. Because of the significant FD observed in people with moderate-to-advanced PD, the availability of predictors is essential for applying precautionary measures and providing appropriate treatment. [ABSTRACT FROM AUTHOR]

• Conscious motor processing might disrupt automatic motor control and hamper gait. • External focus training during gait reduces real-time conscious motor processing. • Instruction-specific gait training shortly improves functional balance and gait. This study examined the impact of walking training with different attention focus instructions on real-time conscious motor processing and fall-related rehabilitation outcomes in older adults at risk of falling. A total of 102 community-dwelling older adults (mean age = 75.2 years, SD = 6.8 years) were randomly assigned to three groups: no attention focus walking group (NAFWG), external attention focus walking group (EAFWG), or internal attention focus walking group (IAFWG). All groups underwent 12 training sessions. Assessments were conducted at baseline, post-training, and six months later, measuring real-time conscious motor processing, functional balance and gait, balance ability, functional mobility, walking ability, trait conscious motor processing propensity, fear of falling, and recurrent falls. The EAFWG showed significant reduction on real-time conscious motor processing immediately after training (p = 0.015). No changes were observed for the IAFWG and NAFWG. All groups showed significant improvements in functional balance and gait (p < 0.001) and balance ability (p < 0.001) post-training. Implementing external focus instructions during walking training could be a feasible and beneficial strategy for reducing real-time conscious motor processing, which may improve walking performance and prevent falls in older adults. Further research is needed to examine the sustained benefits of these interventions and determine optimal training dosage for older adults with different risks of falling in fall prevention. [ABSTRACT FROM AUTHOR]

• Resistance Training is an Established Strategy to Promote Improvements in Neuromuscular Function. • The Effects of Resistance Training Alone on Cognitive Functioning are Still Under Debate. • Resistance Training Combined with Cognitive Stimulation Improves Lower Limb Muscle Power. • Resistance Training Combined with Cognitive Stimulation Promotes Greater Improvements in Balance than Exercise Alone. Studies examining the effects of dual-task resistance training (RT) on nursing-home residents are still scarce. To add knowledge to this field, the present study compared the effects of 12-week RT and RT plus cognitive task (COG) programs on physical performance and cognitive function in a sample of frail nursing home residents. This is an experimental study that combined data from two studies that examined older adults living in nursing home residences in Brazil. Exercise groups performed a 12-week RT protocol that included four exercises, with 3–4 times (sets) of 8–10 repetitions at 70 %-75 % of 1-repetition maximum (1RM), twice a week. The RT+COG group evoked as many words was possible for specific categories during concentric actions of the squat on the chair (until 90° knee flexion) and seated unilateral knee extension exercises. Global cognitive function and physical performance were evaluated using the Mini-Mental State Examination (MMSE) and Short Physical Performance Battery (SPPB) tests, respectively. After interventions, participants in the RT+COG and RT groups had significantly greater lower-limb muscle strength compared with the control group (CG). Those in the RT+COG group had greater tandem performance in comparison to RT and CG groups. Our findings indicate that RT preserves lower-limb muscle strength in frail nursing home residents, regardless of performance of cognitive tasks. Better balance was exclusively observed in the RT+COG, whereas significant improvements in mobility status were only found in the RT group. The present investigation was based on a small sample of nursing home residents. Larger and more structured studies are necessary to confirm our results. [ABSTRACT FROM AUTHOR]

• Menopause hormone therapy was associated with better performance on gait speed and timed 'up and go'. • No association was found for grip strength, balance, and chair rise. • Associations did not vary according to body mass index, physical activity, or duration of menopause hormone therapy. • The association found in this work may be restricted to women aged over 65 years. • Starting menopause hormone therapy less than 5 years after menopause was associated with better results. To examine the association between menopause hormone therapy (MHT) and physical performance among women from the Canadian Longitudinal Study on Aging. Cross-sectional study of 12,506 postmenopausal Canadian women. Grip strength (kg), gait speed (m/s), timed up and go (s), chair rise (s), and balance (s) were assessed following standard procedures. The association between MHT and physical performance was evaluated using linear regression models adjusted for age, education, study site, smoking, alcohol consumption, body mass index, diabetes, hypertension, and hysterectomy. Sensitivity analyses were conducted according to age at study visit (<65 vs. ≥65 years), body mass index (<25 kg/m2 vs. ≥25 kg/m2), physical activity level (less vs. more active), duration and type of MHT, and time of starting MHT after menopause. Compared with those who never used MHT, prior or current use was associated with better performance on the timed up and go test (β: −0.19; 95%CI: −0.28; −0.11) and faster gait speed (β = 0.01, 95%CI = 0.00; 0.02). No association was found for grip strength, balance, and chair rise. Results did not change by body mass index, physical activity, or duration of MHT use. When stratified by age at study visit, the effect remained significant only in among those aged 65 years or more. Starting MHT <5 years after menopause was associated with better physical performance. MHT was associated with better physical performance in gait speed and timed up and go tests. The cross-sectional design of the study limits causal interpretation. Prospective studies are needed to confirm our results. [ABSTRACT FROM AUTHOR]

During shading conditions, performance of physical relocation techniques for PV formations is more effective than total cross-tied (TCT) type of PV formation. The main purpose of physical relocation technique is to rearrange the physical position of PV modules in TCT formation without changing the electrical connections. Due to relocation of PV modules, the lengths of required wires are increased. So, the appropriate selection of PV formation is also important. In this paper, three different variants of physical relocation techniques are considered for 6×6 size TCT formation. These three variants are named as SuDoKu (SDK), ShapeDoKu (SPDK) and Futoshiki (FS). Moreover, these variants are analyzed on realistic assumptions of shading situations and these shading situations are categorized into eight different cases. Also, the comparative analysis of PV formations is reported in terms of P-V profiles, effects of shadings on individual rows and generation of energy and incomes. Further, from the obtained results of this paper, it is concluded that these variants of physical relocation techniques enhance the output power, energy and income generation in comparison of TCT type of PV formation. The SPDK variant of physical relocation technique is performing better than the other variants. [ABSTRACT FROM AUTHOR]

• Theoretical derivation of super-ellipse model for V-I characteristics. • Super-ellipse model as an approximation of standard implicit model. • Model parameters as an approximate function of physical parameters. • Effects of temperature and solar irradiance on model parameters. • Compared with other explicit models. Recently, it has been shown that the super-ellipse model can be used to represent the voltage-current characteristics of illuminated solar PV modules. Since the model is claimed to be empirical in nature, this paper demonstrates that the super-ellipse model can be derived as a theoretical approximation of the physics-based implicit model of solar PV. Further, the model parameters used in the super-ellipse model can be approximated to the physical parameters of the implicit model of solar PV. Here, it is also shown how the model parameters of the super-ellipse model vary with the ambient temperature and solar irradiance. The super-ellipse model is compared with other explicit models for different solar modules and shows satisfactory results in representing the voltage-current (current–density) curve of the solar PV module. [ABSTRACT FROM AUTHOR]

Interspinous devices (ISDs) and interlaminar devices (ILDs) are marketed as alternatives to conventional surgery for degenerative lumbar conditions; comparisons with decompression alone are limited. The present study reviews the extant literature comparing the cost and effectiveness of ISDs/ILDs with decompression alone. Articles comparing decompression alone with ISD/ILD were identified; outcomes of interest included general and disease-specific patient-reported outcomes, perioperative complications, and total treatment costs. Outcomes were analyzed at <6 weeks, 3 months, 6 months, 1 year, 2 years, and last follow-up. Analyses were performed using random effects modeling. Twenty-nine studies were included in the final analysis. ILD/ISD showed greater leg pain improvement at 3 months (mean difference, −1.43; 95% confidence interval, [−1.78, −1.07]; P < 0.001), 6 months (−0.89; [−1.55, −0.24]; P = 0.008), and 12 months (−0.97; [−1.25, −0.68]; P < 0.001), but not 2 years (P = 0.22) or last follow-up (P = 0.09). Back pain improvement was better after ISD/ILD only at 1 year (−0.87; [−1.62, −0.13]; P = 0.02). Short-Form 36 physical component scores or Zurich Claudication Questionnaire (ZCQ) symptom severity scores did not differ between the groups. ZCQ physical function scores improved more after decompression alone at 6 months (0.35; [0.07, 0.63]; P = 0.01) and 12 months (0.23; [0.00, 0.46]; P = 0.05). Oswestry Disability Index and EuroQoL 5 dimensions scores favored ILD/ISD at all time points except 6 months (P = 0.07). Reoperations (odds ratio, 1.75; [1.23, 2.48]; P = 0.002) and total care costs (standardized mean difference, 1.19; [0.62, 1.77]; P < 0.001) were higher in the ILD/ISD group; complications did not differ significantly between the groups (P = 0.41). Patient-reported outcomes are similar after decompression alone and ILD/ISD; the observed differences do not reach accepted minimum clinically important difference thresholds. ISD/ILDs have higher associated costs and reoperation rates, suggesting current evidence does not support ILD/ISDs as a cost-effective alternative to decompression alone. [ABSTRACT FROM AUTHOR]

[Display omitted] • An ultra-fast humidity sensor based on C 60 -OH/PDDA/SiO 2 composite is proposed. • A human-machine interface based on an ultra-fast humidity sensor is presented for assisting aphasia patients with semantic expressions. • This interface is particularly suitable for aphasic patients with limited physical mobility. Communication between aphasic patients and health care professionals (HCPs) is often difficult, which is even more complex for aphasic patients with limited physical mobility. In this study, we have proposed a C 60 -OH/PDDA/SiO 2 -based humidity sensor with an extremely short response/recovery time (13 ms/30 ms). This is closely related to the electrostatic adsorption of PDDA which effectively alleviates the aggregation of C 60 -OH and the introduction of SiO 2 microspheres which increases the diffusion space of water molecules. The fast response and recovery rates gave the sensor good respiratory monitoring capability, which can be used to develop a human–machine interface (HMI) to assist aphasic patients for semantic expression. In this HMI, aphasia patients can generate different respiratory signals through the ultrafast humidity sensors to express specific semantics (such as thirst, hunger, etc.). In contrast to traditional semantic expression devices, this interface does not require the user to have vocal or physical movement, and therefore is extremely friendly to aphasic patients with limited mobility. [ABSTRACT FROM AUTHOR]

1. Participants will be able to recognize buprenorphine as a safe and effective analgesic for cancer pain in pregnancy 2. Participants will be able to integrate buprenorphine into more facets of clinical practice in treatment of cancer-related pain. There is paucity of literature describing the treatment of cancer associated pain in pregnancy. Buprenorphine is an increasingly recognized analgesic used to treat cancer pain with an established safety profile studied in maternal opioid use disorder (OUD). We present a case demonstrating the safe and efficacious use of buprenorphine for cancer-related pain in a pregnant woman with a pancreatic neoplasm. Opioids often are utilized for the optimization of cancer related pain; however, managing cancer-related pain in pregnancy can present challenges, particularly due to opioid-related risks to the fetus in utero. In addition, there is a paucity of literature with regard to treating cancer related pain in pregnancy. Here we present a case where buprenorphine was successfully used to manage cancer related pain for a pregnant female. We present a case of a 36-year-old G3P2 female diagnosed with metastatic solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas at 27 weeks gestation. She began experiencing severe nociceptive visceral abdominal pain, which impaired her ability to perform activities of daily living and even sleep throughout the night. She was started on very low doses of buprenorphine (partial Suboxone SL films), three times a day with improved pain control, physical functioning and sleep with minimal to no side effects. Labor was induced at 34 weeks secondary to intrauterine growth restriction and oligohydramnios, with APGAR scores 8/8 at birth. Buprenorphine was continued for pain control postpartum at varying doses, compatible with patient's wish to continue to breastfeed with appropriate analgesia. Buprenorphine is becoming increasingly more recognized for its efficacy in treating cancer-related pain. The literature describing buprenorphine for pain management in pregnancy is limited; however, its use in treating opioid use disorder in pregnancy and fetal safety profile is well understood. In presenting this case, we demonstrate the safe and efficacious utility of buprenorphine for cancer-related pain during pregnancy Disease specific management / Pharmacotherapeutics / Pharmacopalliation [ABSTRACT FROM AUTHOR]

• Distinct trajectories exist for physical activity and BMI from middle to older age. • Trajectories in physical activity included an emergent physical activity group. • Stable-high and emergent physical activity groups had better later-life function. • Benefits of physical activity on function existed across different BMI trajectories. We examined the effects of physical activity (PA) and body mass index (BMI) longitudinal patterns (trajectories) on subjective measures of mobility, function, and disability in adults and assessed whether effects of PA trajectories on function varied due to BMI. Group-based trajectory analyses were used to determine patterns of change in PA and BMI using data from the Health and Retirement Study 1931–1941 birth cohort (n = 10,507). Physical function was assessed by Mobility Limitations (0–5 scale) and Large Muscle Function (0–4 scale) Indexes, as well as with score for activities of daily living (ADLs) and instrumental activities of daily living (IADLs), with higher scores being worse. Our analyses estimated four distinct PA trajectories: decreasing, (2) fluctuating, (3) stable high, and (4) emergent (previously low/sedentary with increased PA over the study period). Worse mobility limitations, large muscle function, ADLs, and IADLs were associated with Decreasing and Fluctuating PA groups. Better outcomes were associated with Emergent and Stable High PA groups. The five BMI trajectories were stable normal/overweight, modest decreasing, fluctuating, steep decreasing, and increasing. No significant interaction existed between PA and BMI trajectories for Mobility Limitations (P = 0.577), Large Muscle Function (P = 0.511), ADLs (P = 0.600), and IADLs (P = 0.152). These findings may empower clinicians to promote messages to midlifers that meaningful changes in PA can improve function in older age. [ABSTRACT FROM AUTHOR]

• A nationwide national cohort of 23,941 acute geriatric patients. • DEMMI administered at admission predicts readmission, mortality, and discharge to a sub-acute care facility within a year. • DEMMI had a higher adherence, to testing compared to previously used tests of mobility. To examine the association between the de Morton Mobility Index (DEMMI) score on admission in geriatric patients and readmission and mortality within 30, 180, and 365 days after discharge, and discharge to a post-acute care facility. A nationwide register-based cohort study including 23,941 geriatric in-patients aged ≥65 years admitted to a geriatric ward between 2014 and 2017 and included in the Danish National Database for Geriatrics. The DEMMI score was categorized into four subcategories: very low mobility (DEMMI=0–24), low mobility (DEMMI=27–39), moderately reduced mobility (DEMMI=41–57), and independent mobility (DEMMI=62–100). Patients were followed 30, 180 and 365 days after discharge for readmission and mortality. Their risk of being discharged to a post-acute care facility was examined. Adjusted hazard ratios (HRs) and odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated. HRs for readmission within 30-days were 1.36 (1.24–1.48) for very low mobility, 1.30 (1.20–1.42) for low mobility and 1.17 (1.08–1.28) for moderately reduced compared with independent mobility. Similar results were seen for readmission within 180- and 365-days. For mortality, HR for 30-day mortality ranged from1.93 and 5.66, 180-day mortality between 1.62 and 3.19, and 365-day mortality between 1.54 and 2.81 compared with patients with independent mobility. OR for discharge to a post-acute care facility was 8.76 (7.29–10.53) for lowest compared with the highest DEMMI mobility subcategory. In geriatric in-patients, lower DEMMI scores on hospital admission are associated with increased rates of discharge to a post-acute care facility, and for readmission, and mortality within one year. [Display omitted] [ABSTRACT FROM AUTHOR]

The challenge of ensuring compliant behavior in aerial manipulators during physical interactions is addressed in this study. This work presents a coordinated interactive framework for aerial manipulators, specifically designed to ensure compliant physical interactions during contact with the surroundings. Without the reliance on force sensors, an external force estimator is employed to recognize interaction intentions. The coordinated framework leverages a Model Predictive Control (MPC) planner equipped with adaptive weights, facilitating the coordination of movements for both the quadrotor and manipulator. The adaptive adjustment of weights in the cost function allows for the attainment of diverse interaction behaviors in response to unexpected external forces. Notably, the methodology stands out from current control strategies by incorporating autonomous stiffness adjustment in response to interaction forces, thereby optimizing the delicate balance between safety and precision. The passivity of the system is guaranteed by using a Lyapunov-like function during the physical interaction. The effectiveness of the proposed framework is validated by experiments for the scenario of human operator and aerial manipulator collaborative work. [ABSTRACT FROM AUTHOR]

Active mobility, encompassing walking and cycling for transportation, is a potential solution to health issues arising from inadequate physical activity in modern society. However, the extent of active mobility's impact on individual physical activity levels, and its association with health as mediated by physical activities, is not fully quantified. This study aims to clarify the direct relationship between active mobility usage and individual health, as well as the indirect relationship mediated by physical activity, with a focus on varying levels of physical activity intensity. Utilizing data from the 2017 U.S. National Household Travel Survey (NHTS), we employed Poisson regression to predict active mobility usage based on socio-demographic and household socio-economic characteristics. A Structural Equation Model (SEM) was then used to investigate the direct and indirect effects of active mobility on individual health, mediated by physical activity. We further segmented individuals according to their intensity of physical activity to examine how such effect differs between different levels of physical activity. The study demonstrates that active mobility usage positively correlates with both the amount and intensity of physical activity. The effect of active mobility on individual health includes a direct positive effect (29% for intensity, 67.7% for amount) and an indirect effect mediated by physical activity (71% for intensity, 32.3% for amount). Notably, the mediation effect of active mobility on health is more substantial in the context of vigorous physical activities compared to light or moderate activities. Our findings reveal a significant positive influence of active mobility on individual health, encompassing both direct and indirect effects mediated by physical activities. These results quantitatively underscore the health benefits of active mobility and suggest the importance of promoting active mobility as a strategy to improve public health. • We study the triadic relation between active mobility, physical activity, and health. • Active mobility increases both the amount and intensity of physical activity. • Active mobility has direct, positive effect on individual health. • Active mobility also has indirect effect on health mediated by physical activity. • Vigorous activities have greater mediation effect than light/moderate activities. [ABSTRACT FROM AUTHOR]

Moisture content (MC) is a crucial indicator used for assessing the degree of freeze-drying (FD) of Agaricus bisporus. This study illustrated a novel approach to quickly and visually detect MC in A. bisporus during FD using hyperspectral imaging (HSI) system along with several spectral preprocessing methods and models. The proposed approach employs a support vector machine (SVM) to establish a quantitative function between the physical indicator and the spectra obtained from the acquired hyperspectral images in the full mean spectral range. In the study stability competitive adaptive reweighted sampling (SCARS) was also used to choose key wavelengths most relevant to MC. Multiplicative scattering correction (MSC) was used to improve the precision and robustness of models. Moreover, SCARS-MSC-SVM was selected as the most appropriate model whereby, the values of R C 2 , R C V 2 , R P 2 and RPD were 0.9281, 0.9025, 0.8026, and 2.08, respectively. Furthermore, pseudo-color maps were developed to illustrate color changes, and gradual MC decrease from the edge of the mushroom to the core during the FD process, enabling monitoring of the processing progress. Results demonstrated the potential of HSI to rapidly, accurately, non-destructively, and visually display the MC of A. bisporus during the FD process. • The change in moisture of A. bisporus during freeze drying (FD) was predicted. • The moisture content (MC) of A. bisporus was monitored by hyperspectral imaging. • The SCARS-MSC-SVM model was the best fit for MC prediction of A. bisporus during FD. • The visualization map can directly illustrate the change in MC of A. bisporus during FD. [ABSTRACT FROM AUTHOR]

Silicon Physical unclonable functions (PUFs) are regarded as emerging hardware security primitives that can be used for generating secret keys for cryptographic algorithms. Unfortunately, the reliability issues greatly limit the applications of most PUFs since ambient noises and aging issues may alter the output responses of the PUFs. In this paper, a novel error calibration technique (ECT) based on average sampling circuit (ASC) and self-checking circuit (SCC) is proposed for significantly boosting the reliability of PUFs. The primary role of ASC is filtering the ambient noises that may affect the output responses of the PUFs. In contrast, SCC rehabilitates the PUFs once aging issues damage the process mismatches within the PUFs. As shown in the result, a PUF with the proposed ECT is able to achieve a 99% reliability with a 50 Mbps throughput. • Regular PUFs have poor reliability issues due to the effects of ambient noises and aging issues. • Error calibration technique (ECT) is able to the improve the corresponding reliability significantly by filtering critical noises. • An ECT-based PUF offers a high throughput without causing much area overhead. [ABSTRACT FROM AUTHOR]

• Anodal tDCS over M1 reduces pain in people with chronic CHIKV arthralgia. • tDCS may provide functional benefits in chronic CHIKV arthralgia. • tDCS is an easy to use and low-cost intervention that could be used for arthralgia. Chikungunya virus (CHIKV) is a globally prevalent pathogen, with outbreaks occurring in tropical regions. Chronic pain is the main symptom reported and is associated with decreased mobility and disability. Transcranial direct current stimulation (tDCS) is emerging as a new therapeutic tool for chronic arthralgia. To evaluate the effectiveness of 10 consecutive sessions of anodal tDCS on pain (primary outcome) in participants with chronic CHIKV arthralgia. Secondary outcomes included functional status, quality of life, and mood. In this randomized, double-blind, placebo-controlled trial, 30 participants with chronic CHIKV arthralgia were randomly assigned to receive either active (n = 15) or sham (n = 15) tDCS. The active group received 10 consecutive sessions of tDCS over M1 using the C3/Fp2 montage (2 mA for 20 min). Visual analog scale of pain (VAS), health assessment questionnaire (HAQ), short-form 36 health survey (SF-36), pain catastrophizing scale, Hamilton anxiety scale (HAS), timed up and go (TUG) test, lumbar dynamometry, 30-s arm curl and 2-min step test were assessed at baseline, day 10 and at 2 follow-up visits. There was a significant interaction between group and time on pain (p = 0.03; effect size 95 % CI 0.9 (-1.67 to -0.16), with a significant time interaction (p = 0.0001). There was no interaction between time and group for the 2-minute step test (p = 0.18), but the groups differed significantly at day 10 (p = 0.01), first follow-up (p = 0.01) and second follow-up (p = 0.03). HAQ and SF-36 improved but not significantly. There was no significant improvement in mental health, and physical tests. tDCS appears to be a promising intervention for reducing pain in participants with chronic CHIKV arthralgia, although further research is needed to confirm these findings and explore potential long-term benefits. Brazilian Registry of Clinical Trials (ReBEC): RBR-245rh7. [ABSTRACT FROM AUTHOR]

Modern lifestyles have boosted meal-kit subscriptions, yet little is known about how consumers' perceptions of benefits and risks affect their intentions. This study, grounded in prospect theory, aims to uncover the dimensions of perceived benefits and risks associated with meal-kit services. Using a rigorous scale development procedure, five benefits (convenience, environment, price, food quality, and health) and four risks (time-loss/convenience, financial risk, performance risk, and physical risk) were identified. The result of structural equation modeling revealed that convenience, price, and food quality were key benefits influencing consumer attitudes, subsequently impacting purchase intention. Meanwhile, performance and physical risks were identified as significant risk factors. Furthermore, older consumers exhibited greater concern for performance and physical risks than younger consumers. These findings offer practitioners guidelines for developing marketing tools that emphasize meal-kit benefits and strategies to mitigate risks associated with meal-kit delivery. • Convenience, environment, price, food quality, and health are meal kit benefits. • Time-loss, financial risk, performance risk, and physical risk are meal kit risks. • Convenience, price, and food quality impact on meal kit attitudes. • Performance risk and physical risk negatively impact on meal kit attitudes. • Performance/physical risks had stronger impact on older consumers' attitudes.. [ABSTRACT FROM AUTHOR]

The dispersion of hexagonal boron nitride (h-BN) in resin to prepare anti-corrosion coating has only a single physical shielding function, and does not inhibit the electrochemical reaction process, which significantly reduces the durability of anti-corrosion coating. In this paper, polyaniline with anodic passivating function was synthesized on the surface of h-BN by in-situ polymerization, and Ce3+ cation with corrosion inhibition was loaded into polyaniline/h-BN. Thus, a triple functional anti-corrosion filler Ce3+&PANI/h-BN with physical shielding - anode passivation - cathode corrosion inhibition was prepared. The microstructure, crystal form, element distribution, thermal stability and corrosion inhibition ability of the composite filler were characterized. The anti-corrosion, anti-friction and adhesion properties of EP/Ce3+&PANI/h-BN composite coating was investigated. EIS and Tafel test results show that the corrosion inhibition efficiency of Ce3+&PANI/h-BN is 55.5% and 89.67%, respectively. The low-frequency impedance modulus of the composite coating after 40 days of exposure is 13 times that of the pure EP coating, up to 9.79 × 109 ·cm2. The results of salt spray test also show that the barrier ability and anti-corrosion effect of the composite coating are significantly improved compared with the pure EP coating. The wear mass loss of the composite coating is reduced by 43.69% compared with the pure EP coating. This research provides a way to prepare multi-functional, high shielding, wear resistance anti-corrosion fillers to achieve long-term protection of coatings. [Display omitted] • A triple functional anti-corrosion filler was prepared by h-BN, PANI and Ce3+. • The corrosion inhibition capacity of the filler is as high as 55.5%. • Ce3+ ions in the filler are released, inhibiting the cathode reaction. • The triple functional composite coating showed excellent anti-corrosion effect. [ABSTRACT FROM AUTHOR]

Self-healing mechanism of SBS modified bitumen based on dynamic acylhydrazone bonds. [Display omitted] • A self-healing agent with acylhydrazone bond was synthesized. • The introduction of acylhydrazone bonds significantly improved the crack self-healing performance of SBS modified bitumen. • The effect of acylhydrazone self-healing agent on the properties of SBS modified bitumen was investigated. Styrene-butadiene-styrene triblock copolymer (SBS) modified bitumen (SMB) with excellent self-healing performance not only saves resources, but is also important for the sustainable development of pavement and construction industry. In this paper, a self-healing agent (SHA) with acylhydrazone bond was synthesized, and the dynamic acylhydrazone bond was introduced into the SBS molecular chains to prepare the self-healing SMB (SHMB). The structure of SHA was characterized, and the physical properties, chemical structure, microstructure and self-healing performance of the SHMB were investigated. Fourier transform infrared (FTIR) spectra and nuclear magnetic resonance spectra demonstrated that SHA was successfully synthesized. The physical performances of SMB were significantly improved by SHA and its optimal dosage was 0.6 %. FTIR indicated that the dynamic acylhydrazone bond was introduced into the SBS molecular chains, and formed hydrogen bonds in SHMB. The fluorescence microscope showed that SHMB had a denser network structure than SMB. The crack healing observation indicated that the crack healing speed of SHMB was much higher than that of SMB. The break tensile performance recovery showed that the recovery rate of elongation at break (R ε) of SMB and SHMB were 14.38 % and 58.27 % after self-healing at 25℃ for 32 h, and the R ε of SMB and SHMB was elevated to 50.12 % and 92.58 % after self-healing at 40℃ for 4 h, which indicated that the introduction of dynamic acylhydrazone bonds greatly enhanced the self-healing ability of SHMB. [ABSTRACT FROM AUTHOR]

The aim of the study was to develop soybean polysaccharide (SSPS) -carboxylated nanocellulose (CNC) blending films with enhanced mechanical and barrier properties to be used as a tear-free and edible packaging materials. The films were formed by casting method, with CNC as the strengthening unit and glycerol as the plasticizer. The effect of CNC on structural and physical performances of the SSPS-CNC films were studied. SEM indicated that the film will stratify with excess CNC (10 %), but the film remains intact and compact. Incorporation of CNC into SSPS films did not change peak position in the XRD pattern significantly. Hydrogen bonds among SSPS, glycerol and CNC were indicated by the FTIR spectra. The compounding of CNC greatly lessened the light transmittance and hydrophilicity (CA increased from 55.42° to 70.67°), but perfected the barrier (WVP decreased from 3.595 × 10−10 to 2.593 × 10−10 g m−1 s−1 Pa−1) and mechanical properties (TS improved from 0.806 to 1.317 MPa). The results of packaging dehydrated vegetable indicated that the SSPS-8CNC film can effectively inhibit the packaged cabbage absorption water vapor. As a consequence, SSPS film perfected by CNC is hopeful to pack dehydrated vegetables in instant foods. [Display omitted] • The blending of CNC improved the film's mechanical and barrier properties. • The SSPS-CNC blending film possesses a weaker hydrophilicity. • The SSPS-CNC film can be used for packaging dehydrated vegetables in instant foods. [ABSTRACT FROM AUTHOR]

This paper investigates the impacts of weather shocks on athlete performance, focusing on soccer players in the Chinese Soccer Super League over three consecutive seasons from 2014 to 2016. Utilizing daily meteorological data, we construct the temperature and precipitation bin variables to explore the marginal effects on the physical and cognitive performance of soccer players. The empirical findings document a sizeable impact of high temperatures and heavy precipitation on players' performance indicators, including physical performance and cognitive performance. Specifically, relative to conditions with temperatures below 15 °C, the total running distances, the number of passes, and the number of fouls for soccer players significantly decrease by 7.6%, 6.0%, and 23.1%, respectively, when temperatures exceed 30 °C. The results for precipitation bins show that relative to conditions with precipitation below 0.1 mm, the total running distances, the number of passes, and the number of fouls for soccer players significantly decrease by 1.2%, 8.2%, and 4.7%, respectively, when precipitation exceeds 50 mm. Moreover, the heterogeneity analysis reveals that the negative effects of high temperatures and heavy precipitation are more pronounced and significant for older players, for matches performed away from home, and for matches performed in areas with higher temperatures or more precipitation. Evidence of player adaptations suggests that players from regions with higher temperatures or more precipitation perform better in terms of physical and cognitive abilities when playing in areas with lower temperatures or less precipitation compared to players from regions with lower temperatures or less precipitation when they compete in areas with higher temperatures or more precipitation. Finally, policy suggestions are proposed to mitigate the impact of weather shocks on soccer players and to promote the sustainability of the soccer industry. [ABSTRACT FROM AUTHOR]

The concrete industry has been responsible for significant depletion of natural resources and at end-of-life significantly contributes to global waste production. To date experimental studies have typically explored the use of single generation recycled aggregates (RA) in concrete production, however, to move towards a circular economy the concrete industry needs to embrace the use of multi-generation recycled aggregate concrete (MGRAC). In this paper the physical and mechanical performance of 45 concrete mix designs over 4 generations of concrete production is explored. At each generation a series of mixes are conducted at various water to cement ratios (w/c) and with a range of blends of virgin and recycled aggregates from differing generations to capture the impact on material properties. The physical and mechanical properties are quantified for both the aggregates and the concretes at each generation. The results show that the physical properties and some mechanical properties of the concrete and RA decrease with respect to virgin aggregate concrete and virgin aggregate but, implementing a 50% replacement of VA can slow down intergenerational degradation. Furthermore, the blending RA from a range of generations can also slow intergenerational degradation but to a lesser extent. Effective aggregate properties are determined, and direct relationships confirmed indicating potential for informed mix design based on an understanding of a few simple aggregate properties. [ABSTRACT FROM AUTHOR]

The colored and high-saline effluents during the traditional dyeing process poses serious environmental challenge. In our study, an eco-friendly cationic cellulose nano-fiber/chitosan (CCNF/CS) binary versatile auxiliary was designed for the neutral salt-free dyeing and physical enhancement of paper by mixing with pulp simply. Profiting from the rich cationic binding sites of CCNF/CS (Charge density: 3749.67 μmol/g), under near neutral conditions (pH = 6.2), the maximum adsorption capacity of anionic GL (Direct fast turquoise blue GL) on paper with 0.5 % CCNF/CS reached 1865.06 mg/g with a desirable evenness (45.5 % and 92.1 % higher than that of CCNF and NaCl group, respectively), and the dye uptake was up to 97 %. The spontaneous adsorption behavior was aligned with the pseudo-second-order and Langmuir models, with a primary physical mechanism enhanced by chemical forces. The combination of strong electronic attraction, hydrogen bonding, and n-π stacking effects granted CCNF/CS an enhanced proficiency in anionic dye adsorption. In addition, the tensile strength of the resulting paper yarn with 0.5 % CCNF/CS increased to 52.47 MPa under the optimal parameters, deriving from the CCNF/CS-induced inter-fiber cohesion. Overall, our research provided a green promising approach for the innovative neutral salt-free dyeing and mechanical enhancement of paper. [Display omitted] [ABSTRACT FROM AUTHOR]

Participation is defined as frequency (measured by attendance and/or variety or diversity of activities) and involvement (participation experience including engagement, motivation, persistence, social connection and affection) in all life situations, and is seen as an essential condition for the development of the child. Children with myelomeningocele have several functional limitations that can lead to restriction of participation. Improving these children's participation requires knowledge about what factors may influence a child's ability to participate in activities of their choice. To verify whether factors such as age, mobility performance, access to assistive technology equipment and the presence of environmental facilitators are associated with the frequency and involvement of young children with myelomeningocele participation at home, daycare/preschool and in the community. A cross-sectional observational study was carried out with children diagnosed with myelomeningocele, between 6 months and 5 years of age. The dependent variables were Frequency and involvement in participation at home, day care/preschool and in the community, as measured by The Young Children's Participation Environment Measure - YC-PEM. The independent variables were age and access to assistive technology equipment collected through interviews with parents and caregivers, mobility performance measured by the questionnaire: Pediatric Assessment of Disability Inventory – Computerized Adaptive Testing (PEDICAT), and environmental facilitators measured by YC-PEM. Data were analyzed using SPSS version 22.0. To verify the associations between age, mobility performance, access to assistive technology equipment and the presence of environmental facilitators with the frequency and involvement of participation, Spearman's correlation was performed, with a significance level of 5%. Sixty-five children and their families (mean age 27.91 (±17.36) months) participated in the study. The presence of environmental facilitators at home increased the child's involvement at home (r=0.30, p=0.01). In the daycare/preschool setting, a significant positive association was found between age (r=0.50, p<0.0001; r=0.55, p<0.0001), mobility performance (r= 0.35, p=0.003; r=0.37, p=0.002) and the presence of environmental facilitators in daycare/preschool (r=0.95, p<0.0001; r=0.98, p <0.0001), with frequency and involvement, respectively. However, there was a negative association between having access to assistive technology equipment and attendance (r=-0.32, p=0.008) and participation involvement (r=-0.36, p=0.03) in daycare/preschool. In relation to the community environment, factors such as age (r=0.40, p=0.001), mobility performance (r=0.26, p=0.03), and the presence of environmental facilitators (r=0, 35, p=0.003) correlated positively with community engagement. Preliminary results indicated that the presence of environmental facilitators increases the participation involvement of children with myelomeningocele in all environments. Older and more mobile children are more involved in daycare/preschool and in the community. However, having access to assistive technology equipment that facilitates mobility worsens the frequency and involvement of participation in the daycare/preschool environment. These findings highlight the role of the environment for the participation of children with myelomeningocele in different contexts, pointing to the need for more facilitators and environmental changes. [ABSTRACT FROM AUTHOR]

Powered mobility training with modified ride-on cars is an innovative intervention option that aims to improve the body functions and participation of children with severe disabilities. In addition to enabling self-initiated mobility, training can result in learning gains in ride-on car use and attainment of rehabilitation goals. Due to their severe motor and cognitive impairment, children with Congenital Zika Syndrome (CZS) may benefit from interventions with modified powered ride-on cars, as such devices are more cost-effective when compared to motorized wheelchairs. To describe the results of a powered mobility intervention with modified motorized ride-on cars for children with CZS, considering the outcomes of goal attainment and mobility learning. This is a pilot study with 12 weeks of intervention and 4 weeks of follow-up. The intervention was guided by a physiotherapist or occupational therapist and consisted of training sessions with modified ride-on cars, lasting 40 minutes, three times a week, at the Clínica Escola de Fisioterapia da Faculdade de Ciências da Saúde do Trairi (FACISA), in Santa Cruz-RN. The outcomes of interest were mobility learning, assessed using the "Assessment of the Use of Motorized Mobility (ALP)-version 2.0" scale and the attainment of rehabilitation goals, assessed using the Goal Attainment Scaling (GAS). Assessments were performed by previously trained independent examiners at weeks 0, 8, 12 e 16. Four children with CZS participated, two males, aged between 3 and 6 years, three were classified as level V and one as level IV in the Gross Motor Function Classification System (GMFCS). All had moderate to severe intellectual disability, and two associated visual impairment. After the 12 weeks of intervention with powered ride-on cars, changes in mobility learning were observed, with an increment of one or two points in ALP, and clinically significant changes in GAS scores, when compared to week 0, in all participants. The intervention with modified powered ride-on cars was potentially capable of increasing learning in motorized mobility and contributing to the achievement of rehabilitation goals in children with CZS. We suggest the development of clinical trials to explore the effects of the intervention on functional gains and participation of children with CZS. The study presents a fun and low-cost intervention option, through powered mobility training with motorized ride-on cars for children with CZS and severe motor and cognitive impairment, which can be implemented in the child's natural context. In addition, the work contributes to fostering future intervention studies and contributing to evidence-based clinical practice for children with CZS in Brazil. [ABSTRACT FROM AUTHOR]

Physical detraining is the partial or total interruption of a physical exercise program, and it results in partial or total loss of acquired benefits, generating physiological adaptations in older people. In the context of the social restrictions imposed by the covid-19 pandemic, physical detraining may have resulted in a decline in the functional mobility and mental health of this population. To verify the correlation between functional mobility and mental health of active older people after 18 months of physical detraining due to the covid-19 pandemic. This is a longitudinal study. The participants of the study were older people considered active for practicing a regular multicomponent physical exercise program (MPE) and in a group for at least one year, before being interrupted due to the covid-19 pandemic. The program had a weekly frequency of three times a week, with sessions of 50 minutes each. The physical assessments were carried out in three moments, being T1: before the pandemic (March 2020), T2: after 18 months of the beginning of the pandemic (August 2021) and T3: after 24 months of the pandemic and return to face-to-face activities (February 2022). The functional mobility assessment was done by "Timed Up and Go – TUG" test and it was carried out in the three moments, while the mental health assessment was done using two components: depressive symptoms from the "Geriatric Depression Scale - GDS" and perceived stress by the "Perceived Stress Scale - PSS", being performed only at T2. Statistical analysis was performed using the SPSS 20 software with a significance level of p < 0.05, after verifying the normality of the data, the Friedman test was performed to compare functional mobility and the correlation with mental health was performed using the test of Spearman with delta values ​​between the first 18 months of the pandemic (T2-T1). forty-six older people (74 ± 6.67 age and 87% female) participated in the three moments. There was a significant worsening of functional mobility performance between T1 and T2 (8.29 [7.57-9.38] and 9.34 [8.53-10.96]), reflecting the effect of 18 months of detraining. Regarding the correlation with mental health, a positive correlation was observed with GDS (p=0,015; r=0,414) and PSS (p=0,047; r=0,377). Thus, the longer time spent performing the TUG was associated with a higher presence of depressive symptoms and perceived stress in the 18 months of the pandemic. The pandemic had negative effects on functional mobility that lasted even after 18 months of its beginning, and worst functional mobility was correlated with worsening mental health. With the end of the pandemic, the resumption of physical exercise programs for the older people is important, so that there is a recovery of functional mobility, but it is also necessary that these programs also pay attention to mental health issues in this population. [ABSTRACT FROM AUTHOR]

The International Classification of Functioning, Disability and Health (ICF) is part of the Family of International Classifications of the World Health Organization (WHO) and acts as a tool for describing and organizing information about the functioning and disability of people with and without disabilities, providing a language standard. Marajó is a region with infrastructure peculiarities and disabled people who face very specific and little-known challenges there. Classify the mobility of people with physical disabilities in the Marajó archipelago according to the ICF. Cross-sectional study, with a quantitative approach, referring to the activity profile of physical PCD residents in the municipalities of Marajó. The subjects were selected by convenience through the dissemination of the action in Basic Health Units visited by the group of the "Abrace o Marajó'' Project between August 2021 and January 2022. The participants underwent a structured interview where they answered an adapted checklist, based on the ICF biopsychosocial model, which provides a standardized language. The ICF data used are related to the "activity and participation" domains, with a focus on mobility. The study included 51 physically disabled persons, with a predominance of age between 40 and 59 years (39.22%), men (54.90%), browns/mulattoes (62.75%). Most respondents had mobility problems, with 88.24% having difficulty walking (d450), 84.31% having difficulty lifting and carrying objects (d430), 78.43% having difficulty using transportation (d470), 64.71% using some locomotion device (d465), and 41.18% with impaired fine use of the hands (d440). These data suggest that the mobility deficit combined with the lack of accessibility may be one of the factors that most interfere with the lives of these participants, as it limits and/or restricts their participation in daily activities. Disabled persons residing in Marajó have several limitations and/or restrictions on participation in day-to-day activities related to lack of mobility, the main limitations are those with the highest percentages, that is, walking, lifting, and carrying objects, and using means of transport. In this regard, it is vital to adopt public policies aimed at improving the infrastructure of streets and sidewalks in order to facilitate access for this population, thus promoting an increase in the level of activity and participation. This study can contribute to the visibility of the needs of disabled persons who live in Marajó and the implementation of public policies to assist this population, as well as to understand their main difficulties and what accessibility measures can bring more autonomy. [ABSTRACT FROM AUTHOR]

According to a biopsychosocial approach to health and disability, participation at home and functional skills are important components of the functioning. Therefore, knowledge about interactions between these components allows targeting specific interventions. This study investigated whether participation opportunities (frequency and involvement) for children/adolescents with Down syndrome (DS) in a realistic environment at their own home are associated with the functional skills related to the domains of Daily Activities, Mobility, Social/Cognitive and Responsibility. This was an observational study. Forty-eight children/adolescents with DS participated (mean age: 10.73±3.43; n=27 female). They were evaluated using the Participation and Environment Measure for Children and Youth (PEM-CY) home environment setting (raw frequency and engagement scores) and Pediatric Evaluation of Disability Inventory speedy version (PEDI-CAT-SV) (continuous score). Significant and positive correlations were found between the frequency of participation at home with Daily Activities (ro =.320), Social/Cognitive (ro =.423) and Responsibility (ro =.455). For involvement, significant and positive correlations were found with Daily Activities (ro =.297), Social/Cognitive (ro =.380) and Responsibility (ro =.380). For the PEDI-CAT-SV Mobility , no significant correlation was found. Higher frequency and involvement of participation at home are associated with greater functional skills assessed, except for Mobility. This study provided pioneering insights about the relationships between the level of home participation and functional skills in DS. [ABSTRACT FROM AUTHOR]

The prevalence of obesity has increased substantially in the last decades in the elderly population and, consequently, it has been considered one of the main risk factors for non-communicable diseases in the world. Compared to general obesity, central obesity, which is characterized by excessive accumulation of fat in the abdominal region, has shown a greater association with diabetes and all-cause mortality, in addition to being considered a risk factor for disability in the elderly, regardless of BMI. Some studies suggest that the relationship between central obesity and disability differs according to gender, however, the results are still conflicting. To investigate the association between central obesity and mobility limitation in elderly Brazilians and to assess whether this association was modified by gender. This is a cross-sectional, analytical, and quantitative study that used data from the PNS. This is a household-based survey proposed by the Ministry of Health in partnership with the Brazilian Institute of Geography and Statistics (IBGE). For the present study, those aged 60 years or older were considered (n=11,177). Central obesity was defined when waist circumference (WC) was greater than 84 cm in women and 88 cm in men. Participants reported the degree of difficulty to move, being classified as no difficulty versus some difficulty. Binary logistic regression was used to investigate the association between central obesity and mobility limitation adjusted for sex, age, exercise, chronic diseases, self-reported health, and literacy. P<0.05 and a 95% confidence interval were considered. Women were the majority, representing 55.7% of the sample and the mean age was 66.9 ± 8.07 years. Central obesity was identified in 76.7% of the participants, being more prevalent among older women (60.4%) and 25.9% reported some difficulty with mobility, with a higher prevalence of females (64.8%). Elderly people with central obesity were 1.2 times more likely to have some difficulty with mobility (OR=1.21; 95%CI: 1.08-1.36) compared to elderly people who did not have any difficulty, even after adjusting the covariates. In the analysis stratified by gender, the association between central obesity and mobility limitation was significant among women (OR=1.48; 95%CI: 1.27-1.7; however, it, lost significance among men (OR =0.93;95%CI: 0.78-1.10). The results suggest that elderly women with central obesity are more likely to have some difficulty with mobility compared to men. The high prevalence of central obesity in the Brazilian elderly population, especially in the female public, represents a serious public health problem. Our findings identified a subgroup of the elderly population that is more vulnerable to limited mobility associated with abdominal obesity. Therefore, implementing health actions to prevent or reduce abdominal obesity should be strongly encouraged among elderly women. [ABSTRACT FROM AUTHOR]

Age is possibly the strongest known individual-level socio-demographic determinant of participation in elections. Despite its substantial influence in shaping electoral outcomes, evidence-based understanding of the steep decline in turnout at older ages is scarce. We suggest that time-related proximity to death and the associated decline in cognitive and physical functioning may explain this relationship. With full population data on the participation of the 65+ year-old electorate in the 1999 parliamentary elections in Finland linked to a more than 21-year mortality follow-up, we demonstrate that the remaining lifetime is a more powerful predictor of voting than age, often by an order of magnitude. These results offer a novel theoretical principle into understanding the fundamental age-related decline in electoral participation at older ages: It is not the time from the cradle, but the time to the grave, that counts more. [ABSTRACT FROM AUTHOR]