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Alzheimer's disease (AD) is a very disabling disease. Pathologically, it is characterized by the presence of amyloid plaques and neurofibrillary tangles in the brain that results in neurodegeneration. Its clinical manifestations include progressive memory impairment, language decline and difficulty in carrying out activities of daily living (ADL). The disease is managed using interventions such as pharmacological interventions and aerobic exercise. Use of aerobic exercise has shown some promises in reducing the risk of developing AD, and improving cognitive function and the ability to carry out both basic and instrumental ADL. Although, the mechanisms through which aerobic exercise improves AD are poorly understood, improvement in vascular function, brain glucose metabolism and cardiorespiratory fitness, increase in antioxidant capacity and haemoglobin level, amelioration of immune-related and inflammatory responses, modulation of concentration of circulating Neurotrophins and peptides and decrease in concentration of tau protein and cortisol level among others seem to be the possible mechanisms. Therefore, understanding these mechanisms is important to help characterize the dose and the nature of the aerobic exercise to be given. In addition, they may also help in finding ways to optimize other interventions such as the pharmacological interventions. However, more quality studies are needed to verify the mechanisms. • Alzheimer's disease (AD) seriously affects cognitive and physical function. • A promising intervention in patients with AD is aerobic exercise. • The exercise modulates disease biomarkers, and improves brain glucose metabolism and vascular function. • It also increases antioxidant capacity and levels of brain-derived neurotrophic factor. • Modulation of those biomarkers helps to slow down progression of the disease. [ABSTRACT FROM AUTHOR]

People's daily movements, as aggregated in spatial units, shape mobility flows that can be modelled by geospatial networks. The structure of these networks both reflects and influences how cities are lived in, perceived and planned. In this study, location tracking data from mobile phones were used to investigate the functional and spatial structures of daily mobility networks and how these networks change as they grow in size. A case study was performed on 81 Spanish functional Urban Areas (FUAs). The results of this study show that the friction of the space and the average length of the aggregate daily mobility are constant and do not depend on the area and demographic size of the FUAs. The average length of the aggregate daily mobility is associated with the increase in complexity that occurs as mobility networks grow, which is reflected in an increase in the number of levels of interaction and the proportion of local flows that integrate adjacent spaces across different scales. The method used provides quantitative indicators that reveal the similarities and differences of daily mobility, as well as the interactions that occur in FUAs according to their size. This information is very useful in urban and mobility planning. • The average length of aggregate daily mobility is identical in all Spanish FUAs. • The mobility networks of the largest FUAs are composed of functional modules. • Modularity is a mechanism for networks to grow without increasing the average length. • Long-distance movements are less numerous and weaker than short-distance movements. • These weak ties make that daily mobility networks function as a spatial unit. [ABSTRACT FROM AUTHOR]

Describe clinicians' perspectives of facilitators and barriers to eliciting physical function goals from patients with multiple chronic conditions pre- and post-surgery. Semi-structured qualitative interviews were conducted with clinicians, recruited from an academic medical center, who treat adult patients with multiple chronic conditions. Purposive sampling ensured multiple provider types were represented. Interviews were conducted in person or via web conference and were audio recorded. Findings were summarized using descriptive qualitative content analysis. Of the 12 participating clinicians, 92% were female and 83% specialized in geriatrics. Clinicians had a mean of 10.7 (min-max: 1–30) years of experience. Key facilitators to goal-setting conversations were sufficient time, familial support, and patient cognitive ability. Barriers included lack of time, lack of training, patient challenges in choosing realistic and specific actionable goals, emotional barriers, and cognitive challenges. Some facilitators and barriers are modifiable, including time, inclusion of family members in the clinical encounter, and clinician training to enable actionable goal setting. These results highlight areas for intervention to facilitate goal elicitation for physical function in clinical care settings. Clinicians should be aware of the barriers impacting eliciting goals. Healthcare organizations could consider providing effective goal elicitation training and tools to facilitate goal setting conversation. • Clinician interviews revealed facilitators and barriers of patient goal-setting • Facilitators included family support, sufficient visit time, and cognitive ability • Barriers included lack of time, inadequate clinician training, and cognitive issues • Many facilitators and barriers to goal-setting are modifiable [ABSTRACT FROM AUTHOR]

Physical unclonable function (PUF) is a promising hardware security primitive that can generate a unique secret key peculiar to each chip by extracting the differences of non-reproducible manufacturing variations for the same implementations. Although there are several types of PUF designs and structures, ring oscillator (RO) PUF is one of the most prominent PUFs due to its straightforward implementation and remarkable performance. However, the traditional RO-PUF does not support large sizes of input/output combinations or challenge-response pairs (CRPs), as it is called in the scope of PUFs. Consequently, RO-PUF is more vulnerable to adversary attacks which can reveal the PUFs' CRPs using a machine learning approach. Increasing the size of RO-PUF's CRPs requires a high increase in the circuit size leading to unacceptable area overhead for lightweight applications. The primary technique used to increase RO-PUF CRPs' size without increasing the size of the required hardware is to develop a configurable ring oscillator (CRO) PUF. In this paper, we propose a configurable logic unit (CLU) that can be utilized to build a low-hardware CRO-PUF. The proposed CLU consists of a 1-XOR gate and a 1-XNOR gate. Building a CRO-PUF using the proposed CLU dramatically increases the CRPs size while minimizing the required hardware. The proposed CRO-PUF achieves excellent evaluation results, with measured uniqueness of 50.1 %, uniformity of 49.45 %, and reliability of 98.33 %. These values are in close proximity to the ideal targets of 50 % for uniqueness and uniformity, and 100 % for reliability [ABSTRACT FROM AUTHOR]

The first goal of this study was to explore associations between functional dependence levels during activities of daily living (eg, functional mobility, eating, and toileting) before COVID-19 and presence of COVID-19 symptoms (eg, fever, dehydration, lethargy, and shortness of breath) during illness. The second goal of this study was to explore associations between presence of specific COVID-19 symptoms and level of functional decline from before to after illness. Retrospective cohort study. A total of 375 residents at a single skilled nursing facility in New York City. Data were extracted from the Minimum Data Set 3.0 and chart reviews. Multiple linear regressions analyzed relationships between baseline functional dependence in eating, functional mobility, and toileting and presence of dehydration, lethargy, shortness of breath, and fever. Ordinal linear regressions analyzed associations between COVID-19 symptom presence and changes in functional dependence from before to after illness. Pre–COVID-19 eating dependence was significantly associated with dehydration during COVID-19. Dehydration during COVID-19 was significantly associated with greater functional declines in functional mobility from before to after illness. Shortness of breath was significantly associated with increased functional declines in eating and functional mobility. Patients with COVID-19 should be monitored for shortness of breath and dehydration, as these symptoms are associated with functional decline. Individuals experiencing functional decline before COVID-19 onset are especially vulnerable to these symptoms. Future research should further explore the relationship between functional status and COVID-19 symptoms. [ABSTRACT FROM AUTHOR]

• The 10-year incidence of dizziness/vertigo was relatively high in older adults. • Age and migraine were independent predictors of incident dizziness/vertigo. • Dizziness/vertigo was associated with reduced quality of life over 10 years. We used a cohort of community-dwelling adults to establish the 10-year incidence and predictors of dizziness/vertigo, and its impacts on health-related quality of life. Of the 1152 participants aged 55 + years who did not have dizziness/vertigo at baseline, 799 and 377 participants were followed up after 5 and 10 years, respectively, and had complete data and so were included in the incidence analysis. Hearing loss was determined as the pure-tone average of audiometric hearing thresholds at 500, 1000, 2000 and 4000 Hz, and any hearing loss was defined as >25 dB hearing level. Tinnitus and migraine were assessed by a positive response to a single question. Audiologists screened participants for reported dizziness using a single question. Quality of life was measured using the Short Form 36-item Health Survey (SF-36). The cumulative 10-year incidence of dizziness/vertigo, vestibular vertigo and non-vestibular vertigo were 39.8 %, 27.1 %, and 11.9 %, respectively. Age and presence of migraine were significant predictors of incident dizziness/vertigo: multivariable-adjusted hazard ratio (HR) 1.03 (95 % confidence interval, CI, 1.01–1.06) and HR 1.63 (95 % CI 1.13–2.35), respectively. A significant decrease in scores for the following SF-36 domains was observed over the 10 years among participants reporting baseline dizziness/vertigo: physical functioning (P -trend ≤ 0.0001), role limitation due to physical problems (P -trend ≤ 0.0001), general health (P -trend = 0.01), and vitality (P -trend = 0.01). Dizziness/vertigo was a frequent and detrimental symptom in this population of community-dwelling adults. Our study highlights the burden imposed by dizziness, as evidenced by a significant prospective association with poorer quality of life. [ABSTRACT FROM AUTHOR]

There are few prospective studies in the gynecologic surgical literature that compared patient-reported outcomes between open and minimally invasive hysterectomies within enhanced recovery after surgery pathways. This study aimed to compare prospectively collected perioperative patient-reported symptom burden and interference measures in open compared with minimally invasive hysterectomy cohorts within enhanced recovery after surgery pathways. We compared patient-reported symptom burden and functional interference in 646 patients who underwent a hysterectomy (254 underwent open surgery and 392 underwent minimally invasive surgery) for benign and malignant indications under enhanced recovery after surgery protocols. Outcomes were prospectively measured using the validated MD Anderson Symptom Inventory, which was administered perioperatively up to 8 weeks after surgery. Cohorts were compared using Fisher exact and chi-squared tests, adjusted longitudinal generalized linear mixed modeling, and Kaplan Meier curves to model return to no or mild symptoms. The open cohort had significantly worse preoperative physical functional interference (P =.001). At the time of hospital discharge postoperatively, the open cohort reported significantly higher mean symptom severity scores and more moderate or severe scores for overall (P <.001) and abdominal pain (P <.001), fatigue (P =.001), lack of appetite (P <.001), bloating (P =.041), and constipation (P <.001) when compared with the minimally invasive cohort. The open cohort also had significantly higher interference in physical functioning (score 5.0 vs 2.7; P <.001) than the minimally invasive cohort at the time of discharge with no differences in affective interference between the 2 groups. In mixed modeling analysis of the first 7 postoperative days, both cohorts reported improved symptom burden and functional interference over time with generally slower recovery in the open cohort. From 1 to 8 postoperative weeks, the open cohort had worse mean scores for all evaluated symptoms and interference measures except for pain with urination, although scores indicated mild symptomatic burden and interference in both cohorts. The time to return to no or mild symptoms was significantly longer in the open cohort for overall pain (14 vs 4 days; P <.001), fatigue (8 vs 4 days; P <.001), disturbed sleep (2 vs 2 days; P <.001), and appetite (1.5 vs 1 days; P <.001) but was significantly longer in the minimally invasive cohort for abdominal pain (42 vs 28 days; P <.001) and bloating (42 vs 8 days; P <.001). The median time to return to no or mild functional interference was longer in the open than in the minimally invasive hysterectomy cohort for physical functioning (36 vs 32 days; P <.001) with no difference in compositive affective functioning (5 vs 5 days; P =.07) between the groups. Open hysterectomy was associated with increased symptom burden in the immediate postoperative period and longer time to return to no or mild symptom burden and interference with physical functioning. However, all patient-reported measures improved within days to weeks of both open and minimally invasive surgery and differences were not always clinically significant. [ABSTRACT FROM AUTHOR]

We report important progress in the preparation and development of gas-responsive fluorescent materials with potential as efficient anticancer treatments and fluorescent probes for biomedical imaging. An environmental stimuli-responsive multifunctional material (ESMM) composed of rhodamine 6 G containing a pH-sensitive spirolactam unit and a self-complementary multiple hydrogen-bonded adenine group was successfully synthesized through a simple and efficient two-step synthetic pathway. ESMM has extremely poor water solubility, even in a weakly acidic aqueous environment, but can easily dissolve in common organic solvents. Due to the unique polar heteroaromatic structure of the adenine group that confers chemical reactivity (or responsiveness) with CO 2 , hydrophobic ESMM can rapidly and completely dissolve in water on simple CO 2 bubbling treatment, which is followed by formation of self-assembled spherical-like nanoparticles. The resulting nanoparticles demonstrate unique spontaneous fluorescent characteristics in water and their photophysical properties, surface charge, acid-base characteristics, and self-assembled morphology can be quickly and stably switched on and off by alternating cycles of CO 2 and N 2 bubbling, to thus effectively manipulate their physical performance. Importantly, in vitro cell assays clearly indicated that protonation of the adenine group by CO 2 remarkably enhances the anti-hemolytic properties of ESMM and results in highly potent and selective cytotoxicity against cancer cells at low doses, but not in normal cells. In contrast, pristine ESMM did not exhibit selective cytotoxic effect on normal or cancer cells. Therefore, this newly discovered CO 2 -responsive system may have a great potential to improve the safety and effectiveness of chemotherapeutic drugs. [Display omitted] • Multifunctional adenine-containing rhodamine 6 G (AR) was developed. • AR spontaneously self-assembles into nanoparticles on CO 2 bubbling. • CO 2 -protonated AR has low hemolytic activity towards red blood cells. • CO 2 -treated AR exhibits highly selective cytotoxicity in cancer cells. • This new system holds potential for safer, more efficient chemotherapy. [ABSTRACT FROM AUTHOR]

Exercise-induced fatigue (EF) is a common occurrence during prolonged endurance and excessive exercise and is mainly caused by energy depletion, harmful metabolite accumulation, oxidative stress, and inflammation. EF usually leads to a reduction in initiating or maintaining spontaneous activities and muscle performance and ultimately results in a decrease in the quality of life of people who engage in physical work. Therefore, the interest in investigating EF-targeting agents with minimal side effects and good long-term efficacy has substantially increased. Natural edible and medicinal polysaccharides have shown positive anti-EF effects, but the relevant reviews are rare. This review comprehensively summarizes studies on natural polysaccharides from edible and medicinal sources that can relieve EF and improve physical performance from the past decade, focusing on their sources, monosaccharide compositions, anti-EF effects, and possible molecular mechanisms. Most of these anti-EF polysaccharides are heteropolysaccharides and are mainly composed of glucose, arabinose, galactose, rhamnose, xylose, and mannose. In EF animal models, the polysaccharides exert positive EF-alleviating effects through energy supply, metabolic regulation, antioxidation, anti-inflammation, and gut microbiota remodeling. However, further studies are still needed to clarify the anti-EF effects of these polysaccharides on human beings. In summary, the present review expects to provide scientific data for the future research and development of natural polysaccharide-based anti-EF drugs, dietary supplements, and health-care products for specific fatigue groups. [Display omitted] [ABSTRACT FROM AUTHOR]

Gait and balance impairments affects approximately a quarter of people with multiple sclerosis (pwMS) at onset and increases to almost half by five years. Physical rehabilitation has been recognised as the gold standard method to restore physical function in multiple sclerosis (MS). Emerging evidence in the literature is suggesting that a remote therapy rehabilitation platform (Telerehabilitation) is cost-effective, beneficial, and satisfying for patients and health care practitioners. The overarching aim of this review is to identify and summarise the evidence on the different types of telerehabilitation interventions available to manage gait and balance. This review followed a methodological framework for conducting scoping reviews. PubMed, Science Direct and Web of Science were searched in April 2023 for relevant published literature. The inclusion criteria were peer-reviewed journal articles written in English which included telerehabilitation interventions for pwMS. Search keywords included multiple sclerosis and telerehabilitation. A reviewer screened titles and abstracts and eligible articles were fully reviewed. The included studies were categorised based on the type of intervention. Eight studies were included in this review. The participants (n = 355) had an average age of 48 years (SD = 9.9) with 50% who had relapsing remitting multiple sclerosis who were living with MS for 12 years on average. Study designs included randomised control trials (n = 3), pilot studies and feasibility studies (n = 4). Two types of interventions were identified: Exergaming (n = 5) and Web-Based Physical Therapy (n = 2) of which exergaming appeared to be optimal in improving gait and balance. This scoping review identified and summarised the evidence on telerehabilitation interventions used for gait and balance in MS. The evidence is showing that telerehabilitation could be used as an alternative to conventional rehabilitation methods for improving gait and balance. More robust trials with larger sample sizes are needed to build on the current evidence to enable telerehabilitation to be integrated into care pathways in the future. • Telerehabilitation is changing the landscape of MS rehabilitation. • Digital technology is transforming physical rehabilitation in MS. • Telerehabilitation has potential to co-exist with conventional rehabilitation. • Telerehabilitation may breakdown access barriers for people with MS. [ABSTRACT FROM AUTHOR]

Prostate specific membrane antigen (PSMA) has been the subject of several studies in recent decades as a promising molecular target for prostate cancer (PCa), in fact it is considered an excellent molecular target for both PCa imaging (both for staging and follow-up), by means of PET/CT and for radioligand therapy. Its interesting molecular features have enabled the development of a new diagnostic and therapeutic approach for PCa, called "theranostics." Considering the abundance of PSMA-based probes that have appeared so far in the literature, the present work focuses the attention on radiopharmaceuticals with increasing clinical application, highlighting advantages and disadvantages in terms of different metabolization and excretion processes, pharmacokinetic, binding affinity and variable internalization rate, tumor-to-background ratio, residence times and toxicity profile. [Display omitted] • PSMA investigated as an excellent target for prostate cancer imaging. • DCFPyl, PSMA 1007 and PSMA JK-7 as 18F labeled pharmaceuticals in clinical practice. • Comparison of the physical performance for the radionuclides Ga-68 and F-18. • PSMA radiolabels for imaging and radioligand therapy of prostate cancer. • Aluminium fluoride species with a radiometallic chelating system. [ABSTRACT FROM AUTHOR]

Perception of the full state is an essential technology to support the monitoring, analysis, and design of physical systems, one of whose challenges is to recover global field from sparse observations. Well-known for brilliant approximation ability, deep neural networks have been attractive to data-driven heat and flow field reconstruction studies for practical systems. However, limited by network structure, existing researches mostly learn the reconstruction mapping in finite-dimensional space that usually has poor transferability to the variable resolution of outputs. This paper extends the new paradigm of neural operators and proposes an end-to-end physical field reconstruction method with both excellent performance and mesh transferability named RecFNO. The proposed method aims to learn the mapping from sparse observations to flow and heat fields in infinite-dimensional space, contributing to a more powerful nonlinear fitting capacity and resolution-invariant characteristic. According to different usage scenarios, three types of embeddings are first developed to model the sparse observation inputs: MLP, mask, and Voronoi embedding. The MLP embedding is propitious to more sparse input, while the others benefit from spatial information preservation and perform better with the increase of observation data. Then, stacked Fourier layers are adopted to reconstruct physical field in Fourier space that regularizes the overall recovered field by Fourier modes superposition. Benefiting from the operator in infinite-dimensional space, the proposed method obtains remarkable accuracy and better resolution transferability among meshes. The experiments conducted on fluid mechanics and thermology problems show that the proposed method outperforms existing POD-based and CNN-based methods in most cases and has the capacity to achieve zero-shot super-resolution. • A resolution-invariant temperature and flow field reconstruction method named RecFNO is proposed. • Three types of embeddings for sparse observation are developed. • RecFNO can reconstruct the physical field in function space with excellent performance and resolution transferability. • The validity of the method is confirmed in numerical experiments and practical cases. [ABSTRACT FROM AUTHOR]

• We propose a wind tunnel-based method to comprehensively evaluate the performance of bioaerosol samplers at 2, 8, and 20 km/h. • Performance of bioaerosol samplers was evaluated based on several parameters. • SASS 2300 and BSA-350 are appropriate choices for qualitative analysis and isolation of microorganisms from ambient air. • Polycarbonate and gelatin filters are recommended for long-term sampling and quantitative analyses of bioaerosols without microbial viability requirements. • AGI-30 and BioSampler are suitable for short-term sampling and quantitative analyses of bioaerosols in laboratory environments. Choosing a suitable bioaerosol sampler for atmospheric microbial monitoring has been a challenge to researchers interested in environmental microbiology, especially during a pandemic. However, a comprehensive and integrated evaluation method to fully assess bioaerosol sampler performance is still lacking. Herein, we constructed a customized wind tunnel operated at 2–20 km/h wind speed to systematically and efficiently evaluate the performance of six frequently used samplers, where various aerosols, including Arizona test dust, bacterial spores, gram-positive and gram-negative bacteria, phages, and viruses, were generated. After 10 or 60 min of sampling, the physical and biological sampling efficiency and short or long-term sampling capabilities were determined by performing aerodynamic particle size analysis, live microbial culturing, and a qPCR assay. The results showed that AGI-30 and BioSampler impingers have good physical and biological sampling efficiencies for short-term sampling. However, their ability to capture aerosols at low concentrations is restricted. SASS 2300 and BSA-350 wet-wall cyclones had excellent enrichment ratios and high microbial cultivability in both short-term and long-term sampling; however, they were not suitable for quantitative studies of aerosols. Polycarbonate filter samplers showed outstanding performance in physical and long-term sampling but lacked the ability to maintain microbial activity, which can be improved by gelatin filter samplers. However, limitations remain for some fragile microorganisms, such as E. coli phage PhiX174 and coronavirus GX_P2V. In addition, the effects of wind speed and direction should be considered when sampling particles larger than 4 µm. This study provides an improved strategy and guidance for the characterization and selection of a bioaerosol sampler for better measurement and interpretation of collected ambient bioaerosols. [ABSTRACT FROM AUTHOR]

Research on natural health has identified the potential benefit of outdoor blue spaces for human health and wellbeing. However, the existing evidence has relatively limited attention to the elderly. This study aims to review the available evidence on outdoor blue spaces and health outcomes among older individuals and identify knowledge gaps. In accordance with the PRISMA guidelines, specific keywords were used to search for articles published in English from inception to October 2023. Five databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO) were searched, and 22 studies were identified in this review. We classified articles based on elderly health as general health (e.g., self-reported, perceived health and wellbeing), physical health (e.g., physical activity, physical function index), and mental health and wellbeing (e.g., depression). The findings indicated a positive correlation between outdoor blue space and the health of the elderly. In terms of the characteristics of exposure to outdoor blue spaces, direct contact (e.g., sensory-based) has not been well documented compared to indirect contact (e.g., distance, percentage, region-based). Although encouraging, the available body of evidence is limited and lacks consistency. Future research is needed to provide complementary evidence between outdoor blue spaces and elderly health. • Outdoor blue spaces have the potential to benefit elderly health. • Direct interaction with outdoor blue spaces was understudied in comparison to indirect contact. • For the elderly, the ways to access outdoor blue spaces were distance, percentage, region, and sensory exposure. • Little but important evidence was found on the correlation between outdoor blue spaces and the health of the elderly. [ABSTRACT FROM AUTHOR]

To dispose of the construction spoil (CS) sustainably, using alkali-activated slag (AAS) to solidify CS and prepare solidified construction spoil (SCS) as building materials has great potential. The effects of alkali concentration (Na 2 O%), modulus, binder-soil ratio (B/S), liquid-solid ratio, and sand content on the fluidity, compressive strength, water resistance, and carbon emission factor of SCS were studied via orthogonal experimental methods. It was found that the increasing fluidity was mainly affected by the increasing sand content and liquid-solid ratio, and the increasing compressive strength, water resistance, and carbon emission factor were mainly affected by the increasing Na 2 O% and B/S. Compared with cement, using AAS can reach higher fluidity, compressive strength, and water resistance, and lower carbon emissions of SCS. Finally, considering the influence of sand content on the properties of SCS, the sand washing decisions during the disposal process were reevaluated via life cycle assessment (LCA). Compared to transportation and landfill, preparing SCS with or without washing sand can significantly reduce equivalent carbon emissions, and the latter can result in lower equivalent carbon emissions and better working and physical performance of SCS than the former. From practical engineering considerations, it was suggested that the CS with low sand content doesn't need to wash sand. [ABSTRACT FROM AUTHOR]

Chrome tanning system has been faced with great challenges from potential environmental and human health risks and environmental pressures in the leather industry. The development of chrome-free tanning system towards eco-friendly leather manufacture is the main strategy to solve them from the source. However, appropriate assessments of the physical and environmental properties of a new tanning process remain challenging. In this work, we compared the physical performances and environmental impacts of two nanosilicates-based chrome-free combination tanning systems with conventional chrome tanning system in practical fur leather processing. The objective of this study was to obtain comprehensive insights into the nanosilicates-based chrome-free combination tanning systems from both technical and environmental perspectives. All fur leathers possessed similar and integrated fleece structures, ensuring high glossy and flexibility of final fur leather articles. Tara tannin-Zeolite (TA-ZE) combination tanning system was chosen as the most promising one for manufacturing garment leather articles. The resultant leathers were endowed with favorable physical properties (e.g., tear strength of 15.9 N, elongation at break of 42.3%, shrinkage temperature of 98.6 °C) and no restricted Cr(VI) and free formaldehyde. Life cycle assessment (LCA) results revealed that the TA-ZE combination tanning system exhibited better environmental impacts than other options. The main novelties included the contribution to avoiding the use of high-risk tanning chemicals by presenting a better technical and environmental alternative in the leather processing and the application of LCA to environmentally evaluate the leather processing. We envision these findings can offer comprehensive insights into emergent chrome-free combination tanning systems for designing and rationalizing feasible fur leather processing towards eco-friendly leather manufacture. [Display omitted] • Physical performances and environmental impacts of fur leather manufacture were compared. • TA-ZE tanning system produced the fur leathers with more favorable technical properties. • TA-ZE combination tanning system exhibited better environmental results. • LCA was needed to assure that chrome free tanning alternatives were environmentally better. [ABSTRACT FROM AUTHOR]

• The built-in electric field between the Mn 3 O 4 -MnS enhances the carrier transport. • The core–shell structure enables high mechanical stability. • Mediated pseudo-capacitance is induced by the configuration of Si@Mn 3 O 4 -MnS/C. • The vacancy-enriched Si@Mn 3 O 4 -MnS/C presents excellent cyclability. A configuring vacancy-enriched Mn oxide/sulfide embedded in amorphous carbon layer with highly concentrated vacancies to encapsulate silicon was tentatively explored to overcome the long-term stabilization issues of silicon active center. Our experimental results demonstrate that the configuration of vacancy-enriched Mn 3 O 4 -MnS/carbon hybrid coating layer not only functions as a physical separation layer to prevent silicon from direct contact with electrolytes, but also works as an interesting intermediator to facilitate the structure stabilization and the deep utilization of silicon core center. The surface pseudo-capacitive effect dramatically benefits to the modification of the rate performance of silicon. The synthesized Si@Mn 3 O 4 -MnS/C anode material maintains a high reversible capacity of 830 mAh/g after undergoing 200 charge–discharge cycles at 200 mA g−1 current density. [ABSTRACT FROM AUTHOR]

Early-stage lung cancer survivors are a growing population. A comprehensive plan to address needs relevant to longer survival (e.g., psychological distress, persistent symptoms, physical function) and clinic capacity is necessary. How to deliver comprehensive survivorship care that meets national standards and results in improved patient outcomes is a challenge. Survivorship clinics staffed by advanced practice providers (APP) are an option to address these needs. In June 2019, Atrium Health Wake Forest Baptist Comprehensive Cancer Center (AHWFB-CCC) opened a dedicated survivorship clinic. Stakeholders from the lung cancer disease-oriented team developed a standard referral pathway for patients to survivorship. A standard workflow was developed in the electronic medical record. Eligible lung cancer survivors were referred to the Lung Cancer Survivorship Clinic for a survivorship orientation visit (SOV) with a lung cancer specific APP. Prior to the SOV, a welcome video, disease-specific questionnaire, and electronic patient reported outcome (ePRO) tools (i.e., PROMIS-29 and Distress Thermometer) were sent to the patients' electronic chart. At the SOV, the ePRO responses and survivorship care plan were reviewed. Patients were offered a post visit survey. A comparison of PROMIS-29 Scores to the United States (US) lung cancer survivor population was performed using a T-test. PROMIS-29 T-score responses based on treatment modality were also compared using T-test. Results: From January 2020 to March 2023, 315 lung cancer patients completed a SOV. Most patients were able to complete the pre-visit questions via the electronic chart. AHWFB-CCC survivors reported improved PROMIS-29 T-Scores compared to the average United States (US) early-stage lung cancer survivor, with meaningfully better scores (≥ 3 pts) in four of the seven health-related domains measured. PROMIS-29 T-Scores did not differ by treatment modality (all p values >0.05). Most patients found the SOV helpful and expressed better understanding of their cancer treatment and side effects after the SOV. Our model of an optimized electronic medical record pathway paired with an APP led survivorship visit is feasible and can address current challenges in providing survivorship care to early-stage lung cancer survivors. Survivors had similar ePROs regardless of treatment modality, indicating their survivorship care could be consolidated. Future evaluation is needed to establish if this care model improves outcomes over subsequent visits, minimizes the effect of health disparities, or enhances care capacity. [ABSTRACT FROM AUTHOR]

Ice slurry ingestion during prolonged exercises may improve performance in hot environments; however, the ideal amount and timing of ingestion are still uncertain. We determined whether ad libitum ice slurry ingestion influences physiological and perceptual variables and half-marathon performance while comparing the effects of the amount and moment of ingestion between ice slurry and water at 37 °C. Ten trained participants (28 ± 2 years; mean and SD) were required to run two half marathons while consuming either ice slurry (-1 °C; Ad-1) or water (37 °C; 37 CE) ad libitum. They then performed two other half marathons where, during one, they were required to ingest an amount of water equivalent to the amount consumed during the Ad-1 trial (Pro37), and in the other, to ingest ice slurry in the amount consumed during the 37 CE trial (Pro-1). During the half marathons, dry-bulb temperature and relative humidity were controlled at 33.1 ± 0.3 °C and 60 ± 3%, respectively. Ad-1 ingestion (349.6 ± 58.5 g) was 45% less than 37 CE ingestion (635.5 ± 135.8 g). Physical performance, heart rate, perceived exertion, body temperatures, and thermal perception were not influenced by the temperature or amount of beverage ingestion. However, a secondary analysis suggested that lower beverage ingestion was associated with improved performance (Ad-1 + Pro37 vs. 37 CE + Pro-1: −4.0 min, Cohen's d = 0.39), with a significant relationship between lower beverage ingestion and faster running time (b = 0.02, t = 4.01, p < 0.001). In conclusion, ice slurry ingestion does not affect performance or physiological or perceptual variables during a half marathon in a hot environment. Preliminary evidence suggests that lower beverage ingestion (ice slurry or warm water) is associated with improved performance compared to higher ingestion. • The current study controlled the temperature of beverages and ingestion behavior. • Ad libitum ice slurry does not improve half-marathon performance in the heat. • Athletes ingested less ice slurry than 37 °C water during the ad libitum trials. • 80% of athletes reported gastric discomfort and headache when ingesting ice slurry. • Half-marathon performance was 3–4% better in trials with lower beverage ingestion. [ABSTRACT FROM AUTHOR]

• Significant benefit for ONB if compared to ICUD was detected only for specific subdomains of QoL questionnaires. • No direct comparison between ICUD/ONB and TMT is available. • These data should be used in clinical practice to empower patients in deciding about local treatment choice. Radical cystectomy (RC) is considered the standard treatment for muscle invasive bladder cancer (MIBC). However, RC is often burdened by significant impact on quality of life (QoL); Continence preserving methods (e.g., continent cutaneous urinary diversion and orthotopic neobladder-ONB), have been proposed as alternatives to improve postoperative QoL. Trimodal therapy (TMT) emerged as alternative to surgery. To assess the impact of these treatments from the patients' perspective, we undertook a systematic review and meta-analysis of literature, focusing on studies reporting QoL data about each of the abovementioned approaches. A systematic review was carried out including all prospective and retrospective studies enrolling patients treated with radical intent for non-metastatic MIBC from 1999 to 2021 (either RC or TMT). All studies included specifically reported QoL for one of the main treatment approaches explored (RC followed by ileal conduit urinary diversion-ICUD, ONB or TMT). Pooled analysis for EORTC QLQ-C30 and BLM-30 questionnaires showed that ONB yielded a significant advantage only for Physical Functioning (pooled mean standardized difference −0.73 SD, p-value 0.019, I 2 = 93 %) and for Emotional Functioning (pooled mean standardized difference −0.16 SD, p-value 0.029, I 2 = 0 %). A trend in favour of higher mean reported values after TMT for Global Health Score, Physical Functioning and Role Functioning was found, if compared to both RC approaches. Significant benefit for ONB if compared to ICUD was detected only for specific subdomains of QoL questionnaires. No direct comparison with TMT is available, but data suggest advantage of this approach when compared to both reconstructive scenarios. [ABSTRACT FROM AUTHOR]

The prognostic significance of obesity in sarcopenic adults is controversial. This systematic review and meta-analysis aimed to investigate the effect of additional obesity on health outcomes in sarcopenia. MEDLINE, EMBASE, Scopus and CENTRAL were systematically searched for studies to compare health outcomes of adults with sarcopenic obesity (SO) to those of sarcopenic non-obese (SNO) adults. We also considered the methods of assessing obesity. Of 15060 records screened, 65 papers were included (100612 participants). Older community-dwelling SO adults had 15% lower mortality risk than the SNO group (hazard ratio, HR: 0.85, 95% confidence interval 0.76, 0.94) even when obesity was assessed by measurement of body composition. Additionally, meta-regression analysis revealed a significant negative linear correlation between the age and the HR of all-cause mortality in SO vs. SNO community-dwelling adults, but not in severely ill patients. Compared with SNO, SO patients presented lower physical performance, higher risk for metabolic syndrome, but similar cognitive function, risk of falls and cardiovascular diseases. Age-related obesity, SO and later fat loss leading to SNO represent consecutive phases of biological aging. Additional obesity could worsen the health state in sarcopenia, but above 65 years SO represents a biologically earlier phase with longer life expectancy than SNO. • Among older adults sarcopenic obesity confers better survival than sarcopenia alone. • The effect of obesity on mortality risk in sarcopenic adults depends on age. • Obesity worsens the physical function and the metabolic syndrome in sarcopenia. • Obesity does not influence the mortality risk in severely ill sarcopenic patients. [ABSTRACT FROM AUTHOR]

Challenging children with Down syndrome to walk fast and with external ankle load has demonstrated acute adjustments, such as increased step length and decreased step width, and improved joint stability. However, it is unknown to what extent these task constraints affect gait stability. Assessing dynamic gait stability through margin-of-stability not only quantifies adjustments related to balance control, but also informs safety considerations. Twenty-four children with and without Down syndrome participated in this study. Subjects walked overground at two speed conditions: self-selected (normal) and as fast as possible (fast); and two ankle load conditions: no load and ankle load of 2% body mass. We assessed margin-of-stability in the anteroposterior and mediolateral directions, separately, at three gait events of toe-off, mid-swing, and heel strike. Children with Down syndrome walked with greater mediolateral margin-of-stability than typically developing children. Children with Down syndrome demonstrated less anteroposterior margin-of-stability than typically developing children only before heel-strike at normal speed but increased anteroposterior margin-of-stability at fast speed. The ankle load increased the mediolateral margin-of-stability in both groups but did not impact the anteroposterior margin-of-stability. In addition, children with Down syndrome took shorter and wider steps for more lateral placement of mediolateral margin-of-stability. Children with Down syndrome were capable of adjusting their margin-of-stability for fast walking and ankle-load conditions. However, children with Down syndrome walked with less mediolateral stability and anteroposterior mobility than typically developing children. Children with Down syndrome overcompensate the mediolateral foot placement to recapture their margin-of-stability and maintain gait stability. • Children with Down syndrome walked with a distinct joint pattern compared to peers. • Increased walking speed improved ankle kinematics, but challenged knee kinematics. • Ankle load improved hip and knee kinematics, but challenged ankle plantarflexion. • Intervention design can consider the manipulation of walking speed and ankle load. [ABSTRACT FROM AUTHOR]

• This is the Editorial of a special issue of " Metabolism " focused on sarcopenia. • Experts in the field reviewed recent progress and the evolution in sarcopenia. • Experts in the field offer their opinion on future research directions in sarcopenia. [ABSTRACT FROM AUTHOR]

Musculoskeletal injuries in elite sports are ones of the most impact issue because their remarkable impact on performance caused by drastic absence of training and competition and a progressive deterioration in physical health, emotional and social athletes' dimensions. Also, the prevalence of epidemiologic research found an incidence of musculoskeletal disorders vary within sports and in elite athletes which is even higher as a consequence of higher demand physical performance. This way, the loss of physical performance due to an sport injury impacts not only the individual economic sphere of the professional but also that ofsports entities, reaching, according to some studies, a loss estimated in the range of 74.7 million pounds. Thus, the purpose of this article is to review and to provide an overview of the most common musculoskeletal injuries in elite sports precipitating factors, clinical presentation, evidence-based diagnostic evaluation, and treatment recommendations with a view to preventing medical conditions or musculoskeletal injuries that may alter performance and general health in the elite athletes. [ABSTRACT FROM AUTHOR]

Although studies have shown that transcranial direct-current stimulation (tDCS) can improve physical performance, reduce fatigue, modulate the cardiac autonomic nervous system and increase tolerance to exercise by decreasing the rating of perceived exertion in healthy subjects, athletes, and non-athletes, it has not been examined in patients that have suffered from heart failure (HF). Despite the established benefits of physical exercise, our study investigates whether anodal electrode (a-tDCS) stimulation in the insular cortex, combined with aerobic exercise, enhances physical performance. We aim to assess its impact on inflammatory cytokines, subclinical parameters in cardiopulmonary tests, and quality of life in HFrEF patients compared to sham stimulations. To our knowledge, there are no reports in the literature of studies that have analyzed the effects of a-tDCS applied to the insular area on aerobic performance in patients with HFrEF; thus, our objective is unique and can have a great impact on cardiac rehabilitation. On the other hand, the hypothesis presented here should be approached with caution since there is a lack of clinical trials on this topic. [ABSTRACT FROM AUTHOR]

Health-related quality of life (HRQOL) is an increasingly important outcome in colorectal cancer (CRC) treatment. Established thresholds for clinical importance (TCI) permit an absolute interpretation of HRQOL scores but less emphasis has been placed on whether these can be used in a predictive manner. This study aimed to examine if patients' baseline HRQOL functioning scores, subgrouped based on TCI, would significantly predict HRQOL over time. 211 CRC patients were prospectively followed up from diagnosis to 18 months after surgery. Patients were administered the EORTC Core Quality of Life Questionnaire (EORTC QLQ-C30) at each timepoint. Baseline demographic and clinical data were extracted from electronic medical records. Only the physical and emotional functioning scales of the EORTC QLQ-C30 were utilised with their respective TCIs (score of ≤83 for physical; ≤71 for emotional). Physical functioning was below-threshold for most patients at pre-discharge (81.77 %) and 1-month (56.48 %) before stabilising to baseline proportions by 6-month. For emotional functioning, 22.04 %–30.98 % of patients were below-threshold between baseline to 3-month, stabilising to approximately 14.00 % after 6-month. Baseline TCI subgrouping was significantly associated with change in HRQOL scores over time for both the physical (β = 14.09, 95 % CI: 8.22, 19.97) and emotional (β = 25.66, 95 % CI: 18.79, 32.53) functioning scales (p < 0.01). EORTC QLQ-C30 TCIs can be utilised not just to concretely identify clinically significant impairments in presenting CRC patients, but also as potential predictive tools towards more value-driven delivery of pre- and post-surgical supportive and allied healthcare. [ABSTRACT FROM AUTHOR]

Background To investigate the relationship between 1-year outcome and diastolic dysfunction (DD) and frailty and/or physical performance (PP) in older adults admitted to hospital for acute coronary syndrome (ACS). Methods and results Older (age ≥ 70 years) hospitalized for ACS and receiving coronary artery angiography ± percutaneous coronary intervention were included. Before discharge a complete transthoracic echocardiogram (TTE) was performed with the assessment of DD, following the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging algorithm. Seven different scales of frailty and PP were assessed. The relationship between DD and tests of frailty and PP was investigated, as well as the association with the 1-year occurrence of all-cause death or re-hospitalization. Overall, 329 patients were included in the analysis. Patients were stratified in two groups: DD grade 0–1 versus 2–3. Those with undetermined degree of DD have been excluded by the analysis (n = 106). Mean age of the groups was 77 ± 5 vs 79 ± 6 years, respectively. Scales of frailty and/or PP were significantly poor in patients with DD grade 2–3 compared to the others. After multivariate Cox regression (considering age, female sex, haemoglobin, albumin, clinical presentation, LVEF and SPPB) DD (degree 2–3 vs. 0–1) emerged as an independent predictor of the composite endpoint (HR 1.69, 95%CI 1.04–2.75, p = 0.033). This was mainly driven by 1-year re-hospitalization (HR 2.01, 95%CI 1.22–3.27, p < 0.001). Conclusions In older ACS patients the assessment of DD is related to parameters of frailty and PP and it is an independent predictor of 1-year outcome. • In 2016 a new algorithm for the grading of diastolic disfunction (DD) was released by the ASE/EACVI. • In older patients with ACS from FRASER program, DD is related to frailty and poor physical performance. • DD is an independent predictor of 1-year composite outcome of all-cause death or re-hospitalization. [ABSTRACT FROM AUTHOR]

Purpose: The survival results of the PORTEC-3 trial showed a significant improvement in both overall and failure-free survival with chemoradiation therapy versus pelvic radiation therapy alone. The present analysis was performed to compare long-term adverse events (AE) and health-related quality of life (HRQOL).Methods and Materials: In the study, 660 women with high-risk endometrial cancer were randomly assigned to receive chemoradiation therapy (2 concurrent cycles of cisplatin followed by 4 cycles of carboplatin/paclitaxel) or radiation therapy alone. Toxicity was graded using Common Terminology Criteria for Adverse Events, version 3.0. HRQOL was measured using EORTC QLQ-C30 and CX24/OV28 subscales and compared with normative data. An as-treated analysis was performed.Results: Median follow-up was 74.6 months; 574 (87%) patients were evaluable for HRQOL. At 5 years, grade ≥2 AE were scored for 78 (38%) patients who had received chemoradiation therapy versus 46 (24%) who had received radiation therapy alone (P = .008). Grade 3 AE did not differ significantly between the groups (8% vs 5%, P = .18) at 5 years, and only one new late grade 4 toxicity had been reported. At 3 and 5 years, sensory neuropathy toxicity grade ≥2 persisted after chemoradiation therapy in 6% (vs 0% after radiation therapy, P < .001) and more patients reported significant tingling or numbness at HRQOL (27% vs 8%, P < .001 at 3 years; 24% vs 9%, P = .002 at 5 years). Up to 3 years, more patients who had chemoradiation therapy reported limb weakness (21% vs 5%, P < .001) and lower physical (79 vs 87, P < .001) and role functioning (78 vs 88, P < .001) scores. Both treatment groups reported similar long-term global health/quality of life scores, which were better than those of the normative population.Conclusions: This study shows a long-lasting, clinically relevant, negative impact of chemoradiation therapy on toxicity and HRQOL, most importantly persistent peripheral sensory neuropathy. Physical and role functioning impairments were seen until 3 years. These long-term data are essential for patient information and shared decision-making regarding adjuvant chemotherapy for high-risk endometrial cancer. [ABSTRACT FROM AUTHOR]

Purpose: The effects of thoracic radiation therapy (RT) on physical functioning and quality of life (QoL) are incompletely defined. We determined the associations between thoracic RT dose volume metrics, physical activity, and QoL in patients with cancer.Methods and Materials: Participants with breast cancer, lung cancer, or mediastinal lymphoma treated with radiation with or without chemotherapy were enrolled in a prospective, longitudinal cohort study. Data were collected pre-RT, immediately post-RT, and 5 to 9 months post-RT. At each timepoint, self-reported physical activity was assessed via the Godin-Shephard Leisure-Time Physical Activity Questionnaire, and QoL metrics were assessed via Functional Assessment of Chronic Illness Therapy Fatigue and Dyspnea Scales. Multivariable adjusted linear regression models were stratified by breast cancer alone and lung cancer and lymphoma combined.Results: One hundred thirty participants were included in the study. In breast cancer (n = 80), each 1-Gy increase in mean heart dose was associated with worse Functional Assessment of Chronic Illness Therapy Fatigue scores (-1.0; 95% confidence interval [CI], -1.9 to -0.2; P = .021); similar associations were observed between V5 and fatigue (-2.5; 95% CI, -4.4 to -0.6; P = .010 for each 10% increase in V5). In lung cancer and lymphoma (n = 50), each 10% increase in V5 was associated with decreased physical activity (Godin-Shephard Leisure-Time Physical Activity Questionnaire score -2.3; 95% CI, -4.3 to -0.4; P = .017). Although the associations between baseline levels of physical activity and fatigue and dyspnea were of borderline significance in breast cancer alone (P < .10), increased physical activity over time was associated with improvements in fatigue and dyspnea across all cancer types (P < .05 for all).Conclusions: Higher cardiac RT dose was associated with worse fatigue and physical activity across breast cancer, lung cancer, and mediastinal lymphoma. Longitudinal increases in physical activity were associated with concurrent improvements in QoL measures. Strategies to increase physical activity and decrease cardiac RT dose may improve physical functioning and QoL for patients with cancer. [ABSTRACT FROM AUTHOR]

Aiming at the lack of reliability and uniqueness of the traditional configurable ring oscillator physical unclonable function (RO-PUF) due to the simple configurable path, a configurable RO-PUF is proposed based on the delay characteristics of the ring oscillator. The design scheme redesigned the RO structure, making the configurable path of the RO-PUF more flexible and increasing the number of incentive response pairs (CRPs); At the same time, the introduction of a lightweight SPONGENT hash algorithm in the RO-PUF structure makes the mapping between incentives and responses more complicated, prevents attackers from building model attacks by acquiring CRPs, and enhances RO-PUF security. And then, the design scheme is implemented on Xilinx's Spartan series FPGA chip, and the experimental results are compared and analyzed. The results show that the configurable RO-PUF designed with this scheme has an average reliability of 98.87% and uniqueness of 49.13%. [ABSTRACT FROM AUTHOR]

Although research about pregnancy for women with disabilities has increased, their postpartum experience has received little attention. Studies generally focus on parenting, not on the health of the mothers themselves, despite recent studies underscoring the health risks they may face. Thus, our purpose was to examine postpartum health among women with physical disabilities, including how they maintain or improve their health. Semistructured interviews were conducted with eleven new mothers with physically disabling conditions. A qualitative descriptive approach was used to analyze the transcribed interviews and identify themes. Nine women had delivered via cesarean section, and most had mobility impairments. Their average age was 35 years; 91% were college educated and 82% had a partner. Six overarching themes were identified: paying a price to have the baby, focus on the baby, supports—or a lack thereof, feelings of isolation, getting challenges under control/overcoming barriers, and not quite there yet/getting back to health promotion. Despite their resilience in dealing with the challenges of caring for their babies within the context of their disabling conditions (including recovery from complications from the birth experience), these women clearly identified the need for additional resources and supports. They also recognized limitations to their own health that came along with their parenting responsibilities. Health care providers should be more attuned to the postpartum needs of women with physical disabilities, and policies should provide additional supports such as insurance coverage for home visits to help maximize women's health and well-being during this important life transition. [ABSTRACT FROM AUTHOR]

Background: Locomotive syndrome (LS) is a condition of decreased mobility caused by disorders of the locomotive organs. Lumbar spinal stenosis (LSS) is a LS disorder. The Japanese Orthopaedic Association score (JOA score) and the Zurich Claudication Questionnaire (ZCQ) are international evaluation tools for LSS. However, the relationship between LS and JOA score or ZCQ is unknown. This study aimed to clarify the correlations between LS progression and the values/parameters of the JOA score or ZCQ and to determine the critical cutoff point of the JOA score or ZCQ that indicates LS progression.Methods: We recruited preoperative LSS patients (n = 82). Patients' mean age was 73.4 years. The study participants were evaluated using the 25-question Geriatric Locomotive Function Scale (GLFS), JOA score, and ZCQ (which consists of symptom severity and physical function), and the patients' health-related quality of life was assessed using EuroQoL-5 dimension (EQ-5D) utility values and the EuroQoL-visual analog scale (EQ-VAS). We investigated the correlations between the 25-question GLFS and each clinical variable and evaluated the critical cutoff point of each international evaluation tool to detect LS.Results: There was a statistically significant correlation between 25-question GLFS and each clinical evaluation tool. LSS patients with LS showed significantly worse scores in the evaluation tools than LSS patients without LS. Moreover, we found that critical cutoff points of 17.5 on JOA score, 3.1 on ZCQ-symptom, and 2.3 on ZCQ-function could detect LS.Conclusions: A statistically significant correlation exists between the 25-question GLFS and the JOA score or ZCQ. It might be important to perform decompression surgery for LSS patients before they reach the cutoff values of the several clinical evaluation tools to avoid LS progression.Study Design: Clinical prospective case-control study. [ABSTRACT FROM AUTHOR]

Introduction: Emerging technologies show promise for enhanced characterization of Parkinson's Disease (PD) motor manifestations. We evaluated quantitative mobility measures from a wearable device compared to the conventional motor assessment, the Movement Disorders Society-Unified PD Rating Scale part III (motor MDS-UPDRS).Methods: We evaluated 176 PD subjects (mean age 65, 65% male, 66% H&Y stage 2) during routine clinic visits using the motor MDS-UPDRS and a 10-min motor protocol with a body-fixed sensor (DynaPort MT, McRoberts BV), including the 32-ft walk, Timed Up and Go (TUG), and standing posture with eyes closed. Regression models examined 12 quantitative mobility measures for associations with (i) motor MDS-UPDRS, (ii) motor subtype (tremor dominant vs. postural instability/gait difficulty), (iii) Montreal Cognitive Assessment (MoCA), and (iv) physical functioning disability (PROMIS-29). All analyses included age, gender, and disease duration as covariates. Models iii-iv were secondarily adjusted for motor MDS-UPDRS.Results: Quantitative mobility measures from gait, TUG transitions, turning, and posture were significantly associated with motor MDS-UPDRS (7 of 12 measures, p < 0.05) and motor subtype (6 of 12 measures, p < 0.05). Compared with motor MDS-UPDRS, several quantitative mobility measures accounted for a 1.5- or 1.9-fold increased variance in either cognition or physical functioning disability, respectively. Among minimally-impaired subjects in the bottom quartile of motor MDS-UPDRS, including subjects with normal gait exam, the measures captured substantial residual motor heterogeneity.Conclusion: Clinic-based quantitative mobility assessments using a wearable sensor captured features of motor performance beyond those obtained with the motor MDS-UPDRS and may offer enhanced characterization of disease heterogeneity. [ABSTRACT FROM AUTHOR]

With the development of system-on-chip (SoC) chips, more and more design houses are cooperating with each other's. How to achieve benefit sharing and key management for multiple intellectual properties (IPs) has become an emergency problem. This work proposes an orthogonal obfuscation method to protect multiple IPs. The proposed method permits cooperators to control the project using different security keys, protects the patterns with an orthogonal key, and be convenient for the user to manage the key. For reasons of increased security, the proposed method hides the original keys to prevent information leakage. Multi-port Physical Unclonable Function (MPUF) circuit is used as the additional orthogonal key to cluster membership. It protects the IPs from hardware attacks such as brute-force attack, member leakage attack, reverse engineering and so on. The security analyzes results show that the proposed method reduces the key retrieval time by 36.3% over the baseline. The proposed obfuscation methods have been successfully applied to ISCAS′89 benchmark circuits and cryptographic algorithms. Experimental results indicate that the orthogonal obfuscation only increases the area by 3.43% and consumes 2.77% more power than the baseline. • We proposed hardware obfuscation method using an algebraic orthogonal functionality to authenticate for multiple IPs. The orthogonal method permits cooperators to control the project using different security keys, which is different from the key managed by the leader. • The proposed orthogonal obfuscation is not limited to linear algebra, but also IC design. Moreover, the security of the presented method against various attacks is discussed, such as brute-force attack, member leakage attack, reverse engineering and side channel attacks, and so on. • MPUF circuit selects multiple orthogonal vectors as the key of cluster membership. The obfuscation of MPUF allows the user to determine whether the input point is on the orthogonal. [ABSTRACT FROM AUTHOR]

Background: The ability to preoperatively predict which patients will achieve a minimal clinically important difference (MCID) after lumbar spine decompression surgery can help determine the appropriateness and timing of surgery. Patient-Reported Outcome Measurement Information System (PROMIS) scores are an increasingly popular outcome instrument.Purpose: The purpose of this study was to develop algorithms predictive of achieving MCID after primary lumbar decompression surgery.Patient Sample: This was a retrospective study at two academic medical centers and three community medical centers including adult patients 18 years or older undergoing one or two level posterior decompression for lumbar disc herniation or lumbar spinal stenosis between January 1, 2016 and April 1, 2019.Outcome Measures: The primary outcome, MCID, was defined using distribution-based methods as one half the standard deviation of postoperative patient-reported outcomes (PROMIS physical function, pain interference, pain intensity).Methods: Five machine learning algorithms were developed to predict MCID on these surveys and assessed by discrimination, calibration, Brier score, and decision curve analysis. The final model was incorporated into an open access digital application.Results: Overall, 906 patients completed at least one PROMs survey in the 90 days before surgery and at least one PROMs survey in the year after surgery. Attainment of MCID during the study period by PROMIS instrument was 74.3% for physical function, 75.8% for pain interference, and 79.2% for pain intensity. Factors identified for preoperative prediction of MCID attainment on these outcomes included preoperative PROs, percent unemployment in neighborhood of residence, comorbidities, body mass index, private insurance, preoperative opioid use, surgery for disc herniation, and federal poverty level in neighborhood of residence. The discrimination (c-statistic) of the final algorithms for these outcomes was 0.79 for physical function, 0.74 for pain interference, and 0.69 for pain intensity with good calibration. The open access digital application for these algorithms can be found here: https://sorg-apps.shinyapps.io/promis_pld_mcid/ CONCLUSION: Lower preoperative PROMIS scores, fewer comorbidities, and certain sociodemographic factors increase the likelihood of achieving MCID for PROMIS after lumbar spine decompression. [ABSTRACT FROM AUTHOR]

Spasticity is a common movement disorder that arises from trauma or disease affecting the central nervous system. Untreated spasticity can result in limitations in completing activities of daily living, painful limb contractures, and other conditions associated with loss of mobility. In the long-term care setting, this treatable condition is prevalent, yet often unrecognized likely because of a lack of spasticity-trained practitioners. A recently published spasticity referral tool holds promise for addressing the underdiagnosis of spasticity in the long-term care population. The Minimum Data Set (MDS) would be an ideal mechanism for increasing the diagnosis and treatment of spasticity because it is a government-directed comprehensive screening tool that informs care plans for all residents residing in federally funded long-term care facilities. The MDS could easily integrate the published referral assessment to record the presence of spastic postures and muscle rigidity. We propose expanding the MDS to include 3 questions related to spasticity to improve the recognition and treatment of this prevalent and treatable condition. [ABSTRACT FROM AUTHOR]

Introduction: Up to 17%-20% of pediatric patients with chronic pain are prescribed opioid pharmacotherapy and face an increased risk of opioid misuse in adulthood. Little is known about the way clinical presentation may influence which children with chronic pain are prescribed opioids. This study examines the associations between child's and caregiver's report of child's pain, physical function, and socioemotional indices with opioid prescriptions in pediatric patients initiating treatment for chronic pain.Methods: Participants were 1,155 pediatric patients (71.26% female, n=823) aged 8-17 years and 1 of their caregivers (89% mothers) who presented for evaluation at a tertiary care pediatric pain clinic. Data were collected from 2015 to 2019 and analyzed in 2020.Results: Binary logistic regression analyses investigated the relative contribution of child's demographic, pain, and Patient-Reported Outcome Measurement Information System measures to opioid prescription status; separate models were conducted for child's and caregiver's report. Across child and caregiver models, findings were that child's age (older), pain duration (longer; child's report only), and increased physical limitations (mobility challenges and pain interference; caregiver's report only) were the most salient clinical correlates of positive opioid status. Contrary to the existing literature on adults with chronic pain, socioemotional indices (anxiety, depression, peer functioning) were nonsignificant.Conclusions: A greater understanding of how clinical presentation may relate to prescribed opioid pharmacotherapy informs the field's conceptualization of the sequelae of opioid use and misuse in the context of pediatric chronic pain. [ABSTRACT FROM AUTHOR]

It is unclear whether the combined effects of exercise and nutrition are better than those of exercise alone or nutrition alone in older adults with sarcopenia. This paper assesses the comparative effects of exercise, nutrition, and the combination of exercise and nutrition on muscle mass, muscle strength, and physical performance in older adults with sarcopenia. In this systematic review and network meta-analysis, 11 electronic databases were searched up to November 2020. Inclusion criteria were: (1) adults aged 65 years and older with sarcopenia; (2) interventions of exercise, nutrition, or the combination of both; (3) the outcomes include at least one of the following: muscle mass, muscle strength (hand grip and knee extension strength), or physical performance (gait speed and dynamic balance); and (4) randomized control trials. For each outcome measurement, a network meta-analysis was conducted to determine the direct and indirect effects of each intervention compared with each of the other interventions. A total of 26 studies were included in the network meta-analysis. Compared with the control group, exercise alone and the combination of exercise and nutrition significantly increased handgrip strength (1.12 kg, 95% CI: 0.12, 2.11; 2.03 kg, 95% CI: 1.10, 2.97) and improved dynamic balance (-1.76 seconds, 95% CI: -2.24, -1.28; -1.02 seconds, 95% CI: -1.64, -0.39). Both exercise alone and the combination of exercise and nutrition have beneficial effects on muscle strength and physical performance in older adults with sarcopenia. [ABSTRACT FROM AUTHOR]

• BMI does not substantially influence sagittal gait kinematics in children with CP. • Children with CP that are overweight spend longer in double support. • Children with CP appear less likely to walk unaided over long distances if overweight. • Challenging functional measures may better assess the impact of obesity on mobility. Obesity causes altered gait patterns in typically developing children, but its effect on gait in children with physical disabilities is largely unknown. This study explores associations between body mass index (BMI), functional mobility and gait in children with cerebral palsy (CP). An observational cross-sectional study was conducted using three-dimensional gait analysis data from 197 children with CP, Gross Motor Functional Classification System (GMFCS) levels I to III. BMI values were categorised using the Centres for Disease Control and Prevention (2000) BMI percentiles, which are specific to age and gender. Regression analyses, with GMFCS level as a covariate, explored associations between BMI category and temporal-spatial, kinematic and functional mobility variables. Analyses included children categorised as healthy weight and overweight/obese only (n = 174), with underweight children excluded (n = 23). 131 children (mean age 10.5 years, SD 3) were categorised as healthy weight and 43 children (mean age 9.6 years, SD 2.5) as overweight or obese. BMI was not associated with most gait variables. Increased double support time, reduced hip extension and increased ankle dorsiflexion were observed in children that were overweight, but most differences were small and of uncertain clinical significance. A lower proportion of overweight children walked independently over 500 m. We found little evidence that BMI has a substantial influence on gait patterns in children with CP but some to suggest it may affect long-distance mobility. Different research strategies are required to improve understanding of relationships between adiposity, strength and function, for effective targeting of interventions to improve mobility. [ABSTRACT FROM AUTHOR]

Objectives: Assessment of patient-reported outcomes (PROs) in oncology is of critical importance because it provides unique information that may also predict clinical outcomes.Methods: We conducted a systematic review of prognostic factor studies to examine the prognostic value of PROs for survival in cancer. A systematic literature search was performed in PubMed for studies published between 2013 and 2018. We considered any study, regardless of the research design, that included at least 1 PRO domain in the final multivariable prognostic model. The protocol (EPIPHANY) was published and registered in the International Prospective Register of Systematic Reviews (CRD42018099160).Results: Eligibility criteria selected 138 studies including 158 127 patients, of which 43 studies were randomized, controlled trials. Overall, 120 (87%) studies reported at least 1 PRO to be statistically significantly prognostic for overall survival. Lung (n = 41, 29.7%) and genitourinary (n = 27, 19.6%) cancers were most commonly investigated. The prognostic value of PROs was investigated in secondary data analyses in 101 (73.2%) studies. The EORTC QLQ-C30 questionnaire was the most frequently used measure, and its physical functioning scale (range 0-100) the most frequent independent prognostic PRO, with a pooled hazard ratio estimate of 0.88 per 10-point increase (95% CI 0.84-0.92).Conclusions: There is convincing evidence that PROs provide independent prognostic information for overall survival across cancer populations and disease stages. Further research is needed to translate current evidence-based data into prognostic tools to aid in clinical decision making. [ABSTRACT FROM AUTHOR]

Background: The 2016 Zero Preventable Deaths report highlighted the need for comprehensive injury data to include long term outcomes such as societal and workforce re-entry. Currently, postinjury quality of life is poorly understood. We hypothesized that routine measurement of patient-reported outcomes is feasible as a part of post-discharge follow-up, and that trauma patients would report that their injury had a detrimental impact on health-related quality of life (HRQoL) after discharge.Methods: After instruction, patients self-administered the PROMIS-29 instrument in our outpatient office (11/2019-4/2020). We surveyed 7 domains: Participation in Social Roles/Activities, Anxiety, Depression, Fatigue, Pain Interference, Physical Function, and Sleep Disturbance. Results are reported as means (SD) and compared to the U.S population by t-score (mean score=50). Higher scores in negatively-worded domains (e.g. "Depression") are worse; vice versa for positively-worded domains (e.g. "Physical Function"). Repeated scores among patients returning for a second visit were analyzed using paired t-tests.Results: 103 patients completed the PROMIS-29. Mean (SD) age was 42.3 (17.3) years, 75% were male, and 42% suffered a penetrating injury. Median length of stay was 3 days and median time from injury to clinic visit was 18 days. Mean scores were worse than population means in every domain. Pain Interference (mean 63.5, 95%CI [61.8-65.3]) and Physical Function (38.0 [36.2-39.8]) were particularly affected. Among patients returning for a second visit (n=10; median time between clinic visits: 17.5 days), there were no significant differences in domain scores over time.Conclusion: Trauma patients are at high risk for poor quality of life outcomes in the short term following injury. Our results highlight the need for early recognition and multidisciplinary treatment following injury. [ABSTRACT FROM AUTHOR]

• Risk stratification of older patients before elective cardiac surgery needs improvement. • Short physical performance battery (SPPB) improves prediction of hospital outcomes. • SPPB should be used systematically to refine prognostic assessment. Risk stratification of cardiac surgery patients is usually based on the Society of Thoracic Surgeons (STS) score, that has limited predictive value in older persons. We aimed assessing whether the Short Physical Performance Battery (SPPB) improves, beyond the STS score, assessment of hospital prognosis in older patients undergoing elective cardiac surgery. All patients aged 75+ years referred for elective cardiac surgery to Careggi University Hospital (Florence, Italy) from April 2013 to March 2017 were evaluated pre-operatively. Participants were classified according to the STS-Predicted Risk Of Mortality (STS-PROM): low (<4%), intermediate (4 to 8%), and high risk (>8%). Primary study outcomes were hospital mortality and STS-defined major morbidity. Length of hospital stay was an additional outcome. Out of 235 participants (females: 46.5%; mean age: 79.6 years), 144 (61.3%) were at low, 67 (28.5%) at intermediate and 24 (10.2%) at high risk, based on the STS-PROM. SPPB (mean±SEM) was 8.8 ± 0.2, 7.0 ± 0.5, and 6.0 ± 0.8 in participants at low, intermediate, and high risk, respectively (p <0.001). The primary outcome occurred in 62 participants (26.4%). In low-risk participants, the SPPB score predicted the primary endpoint (adjusted OR 0.77, 95% CI 0.66–0.89 per each point increase; p <0.001) controlling for STS-Major Morbidity or Operative Mortality (STS-MM) score. This result was not observed in the intermediate-high risk group. SPPB predicts mortality and major morbidity in older patients undergoing elective cardiac surgery, classified as low risk with the STS risk score. The SPPB, applied preoperatively, might improve risk stratification in older patients undergoing elective cardiac surgery. Image, graphical abstract [ABSTRACT FROM AUTHOR]

• Natural products promote healthspan in rodent models of physiological ageing. • Oxidative stress is a target of natural products. • Both brain and peripheral tissues benefit from treatment with natural products. • Positive effects of natural products are observed on cognition as well as on physical performance. Over the last decades a decrease in mortality has paved the way for late onset pathologies such as cardiovascular, metabolic or neurodegenerative diseases. This evidence has led many researchers to shift their focus from researching ways to extend lifespan to finding ways to increase the number of years spent in good health; "healthspan" is indeed the emerging concept of such quest for ageing without chronic or disabling diseases and dysfunctions. Regular consumption of natural products might improve healthspan, although the mechanisms of action are still poorly understood. Since preclinical studies aimed to assess the efficacy and safety of these compounds are growing, we performed a systematic review and meta-analysis on the effects of natural products on healthspan in mouse and rat models of physiological ageing. Results indicate that natural compounds show robust effects improving stress resistance and cognitive abilities. These promising data call for further studies investigating the underlying mechanisms in more depth. [ABSTRACT FROM AUTHOR]

• Dance combines aerobic, coordination and cognitive exercise. • Dance is a leisure activity that motivates people and elicits emotions. • Dance improves brain structure and function of older adults. • Dance training has a protective effect on cognition in older adults. Dance is a multidomain activity that combines aerobic, coordination and cognitive exercise. This music-associated physical and cognitive exercise is a leisure activity that motivates people, elicits emotions, and avoids boredom, promoting adherence to practice. Continuing physical activity is of paramount importance, since cognitive benefits tend to disappear or even reverse when training ceases. The question we addressed in this systematic review is what influence dance has on the brain and cognition of healthy middle-aged and older adults. We systematically reviewed the effects of dance on brain and cognition in older adults using MEDLINE, Psyc-Info, PubMed and Scopus databases. After screening 1051 studies, thirty-five met the eligibility inclusion criteria. These studies showed that dance improves brain structure and function as well as physical and cognitive functions. The protective effect of dance training on cognition in older adults, together with the possibility of adapting intensity and style to suit possible physical limitations makes this activity very suitable for older adults. [ABSTRACT FROM AUTHOR]

In this paper, coal-based rotary kiln direct reduction‑hydrogen reduction process was demonstrated to an efficient way to prepare the PMIP. Under the optimum conditions, a superior PMIP with 98.5% iron grade and only 0.31% H 2 -loss can be achieved. Meanwhile, PMIP have the perfect physical properties of 2.45 g/cm3 bulk density, 38 s·50 g−1 flow rate and 6.40 g/cm3 compressibility, which all meet the standard of MHF80·235 (first class goods). Moreover, the enhancing mechanism of PMIP properties was investigated as well, and the results show that the growth of metallic iron grains can obviously reduce the porosity and promote the densification of PMIP structure, which is beneficial for the bulk density and flow rate. This finding can point a new direction to improve the performances, including bulk density and by appropriately extending carbon reduction duration to promote the grain growth and improve the densification of PMIP structure. Unlabelled Image • Coal-based rotary kiln direct reduction process was adopted to prepare PMIP. • The Relationship between structure and performance of PMIP was revealed. • Prolonging the reduction time could improve the physical performance of PMIP. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment has been reported in patients with Major Depressive Disorder (MDD). This study aims to explore the association between lifestyle habits and health-related factors and the presence of cognitive symptoms in MDD patients.Methods: Demographic, clinical, health-related variables and cognitive scores measured with the Cambridge Neuropsychological Test Automated Battery (CANTAB) were compared between 74 patients with current MDD and 68 healthy controls (HC). To test the hypothesis of associated factors to cognitive symptoms, multivariate backward stepwise linear regression models were run.Results: Significant neuropsychological deficits were evident in MDD compared with HC in the global cognitive index (F=8.29; df=1, 140; p=0.005). In the regression analysis performed on MDD and HC, years of schooling (β=-0.11; p=<0.001), job status (β=-0.50; p=0.016), physical activity (β=-0.25; p=0.04) and age at illness onset (β=0.17; p=0.017) were statistically significant factors associated to cognitive impairment. The regression model ran in HC showed that only years of schooling were significant (β=-0.07; p=<0.001) in this group.Limitations: Sample size was relatively small. Everyday cognitive skills were not evaluated.Conclusions: MDD patients have cognitive deficits. These deficits are linked with the years of education, job status, age of onset of the disease and the performance of physical activity. These results support the importance of the implementation of interventions targeting the cognitive reserve and lifestyle habits of MDD patients, in addition to the conventional therapeutic approach focused on symptoms control. [ABSTRACT FROM AUTHOR]

Background: Protein intake greater than the currently recommended amount is suggested to improve physical functioning and well-being in older adults, yet it is likely to increase diet-associated greenhouse gas emissions (GHGEs) if environmental sustainability is not considered.Objectives: We aimed to identify dietary changes needed to increase protein intake while improving diet environmental sustainability in older adults.Methods: Starting from the habitual diet of 1,354 Dutch older adults (aged 56-101 y) from the Longitudinal Aging Study Amsterdam cohort, mathematical diet optimization was used to model high-protein diets with minimized departure from habitual intake in cumulative steps. First, a high-protein diet defined as that providing ≥1.2 g protein · kg body weight-1 · d-1 was developed isocalorically while maintaining or improving nutritional adequacy of the diet. Second, adherence to the Dutch food-based dietary guidelines (FBDG) was imposed. Third, a stepwise 10% GHGE reduction was applied.Results: Achieving a high-protein diet aligned with the FBDG without considering GHGEs required an increase in vegetables, legumes, nuts, whole grains, meat/dairy alternatives, dairy, and eggs and a reduction in total meat (for men only) and discretionary products, but it resulted in a 5% increase in GHGEs in men and 9% increase in women. When a stepwise GHGE reduction was additionally applied, increases in poultry and pork (mainly for women) and decreases in beef/lamb and processed meat were accrued, with total meat staying constant until a 50-60% GHGE reduction. Increases in whole grains, nuts, and meat/dairy alternatives and decreases in discretionary products were needed to lower GHGEs.Conclusions: A high-protein diet aligned with FBDG can be achieved in concert with reductions in GHGEs in Dutch older adults by consuming no more than the recommended 500 g meat per week while replacing beef and lamb and processed meat with poultry and pork and increasing intake of diverse plant-protein sources. [ABSTRACT FROM AUTHOR]

Background Context: Positive psychosocial factors early after surgery, such as resilience and self-efficacy, may be important characteristics for informing individualized postoperative care.Purpose: To examine the association of early postoperative resilience and self-efficacy on 12-month physical function, pain interference, social participation, disability, pain intensity, and physical activity after lumbar spine surgery.Study Design/setting: Pooled secondary analysis of prospectively collected trial data from two academic medical centers.Patient Sample: Two hundred and forty-eight patients who underwent laminectomy with or without fusion for a degenerative lumbar condition.Outcome Measures: Physical function, pain inference, and social participation (ability to participate in social roles and activities) were measured using the Patient Reported Outcomes Measurement Information System. The Oswestry Disability Index, Numeric Rating Scale, and accelerometer activity counts were used to measure disability, pain intensity, and physical activity, respectively.Methods: Participants completed validated outcome questionnaires at 6 weeks (baseline) and 12 months after surgery. Baseline positive psychosocial factors included resilience (Brief Resilience Scale) and self-efficacy (Pain Self-Efficacy Questionnaire). Multivariable linear regression analyses were used to assess the associations between early postoperative psychosocial factors and 12-month outcomes adjusting for age, sex, study site, randomized group, fusion status, fear of movement (Tampa Scale for Kinesiophobia), and outcome score at baseline. This study was funded by Patient-Centered Outcomes Research Institute and Foundation for Physical Therapy Research. There are no conflicts of interest.Results: Resilience at 6 weeks after surgery was associated with 12-month physical function (unstandardized beta=1.85 [95% confidence interval [CI]: 0.29; 3.40]), pain interference (unstandardized beta=-1.80 [95% CI: -3.48; -0.12]), social participation (unstandardized beta=2.69 [95% CI: 0.97; 4.41]), and disability (unstandardized beta=-3.03 [95% CI: -6.04; -0.02]). Self-efficacy was associated with 12-month disability (unstandardized beta=-0.21 [95% CI: -0.37; -0.04].Conclusions: Postoperative resilience and pain self-efficacy were associated with improved 12-month patient-reported outcomes after spine surgery. Future work should consider how early postoperative screening for positive psychosocial characteristics can enhance risk stratification and targeted rehabilitation management in patients undergoing spine surgery. [ABSTRACT FROM AUTHOR]

The primary objective of this study was to determine whether pretransplant physical function is correlated with posttransplantation outcomes. We performed a retrospective study of patients that participated in pretransplantation screening and subsequently underwent lung transplantation. Pretransplant variables of interest included demographics, muscle mass, body composition, physical function, and physical frailty. Correlation tests were performed to assess relationships with significance set at 0.05. Twenty-five patients with a mean age of 57 ± 13 years (68% male) with pretransplant lung allocation score of 45 ± 14 were included. This cohort had a 3-year mortality rate of 32% (n = 8). Pretransplant 4-m gait speed was significantly related to performance on the Short Physical Performance Battery (r = 0.74, P =.02) and distance ambulated on the 6-minute walk test (r = 0.62, P =.07) at hospital discharge. Older age was associated with slower gait speed and worse performance on sit-to-stand testing at hospital discharge (r = −0.76, P =.01 and r = −0.75, P =.01, respectively). Statistically, only diagnosis of cystic fibrosis was associated with 3-year mortality. Our study demonstrates that demographic, clinical, and physical function assessed prior to lung transplantation may be indicators of functional recovery. [ABSTRACT FROM AUTHOR]