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Residents in every state in the United States can lose their driver’s license or car registration because they owe debt to the state. At least eleven million people across the United States suffer these debt-based driving restrictions at any given time. Because Americans overwhelmingly rely on personal automobiles for transportation, states, by controlling access to driver’s licenses and vehicle registrations, use debt policy to control where and how people travel. And because these laws disproportionately affect people of color, primarily Black people, this kind of regulation props up racial segregation in both location and opportunity. This Article’s first contribution is empirical, descriptive, and prescriptive: it catalogs debt-based driving restrictions across multiple categories for all fifty states and the District of Columbia, provides a long overdue analysis of their harms, and proposes corrective legislative action. The driving suspension laws that animate this project are not the first instance where the government has turned to debt policy as a mechanism of racial control. These laws are not an aberration, but rather the latest iteration of a long tradition of government actors using debt policy to expand physical mobility for White people and simultaneously constrict physical mobility for Black people. Tracing this thread across American history provides the basis for this Article’s second contribution—a theoretical one—that expands the traditional view of credit and debt as a mechanism of social and financial mobility to include an analysis of credit and debt as a force that acts on physical mobility. When we expand the lens to include debt policy’s effects on physical mobility, we also see debt policy’s differential effects on White and Black people in the United States. Thus, this Article begins a new conversation about debt and debt policy, one that interrogates debt policy’s racialized effects on physical mobility, freedom, and personhood. [ABSTRACT FROM AUTHOR]

Impaired physical mobility in hemodialysis (HD) patients is considered an important modifiable risk factor of increased all-cause morbidity and mortality. To our knowledge, no study to date has determined the overall burden of limited physical mobility in prevalent HD patients. The aim of this research is to investigate impaired physical mobility and its clinical correlates. We conducted a cross-sectional observational study in all patients of the Centre for Acute and Complicated Dialysis at the University Medical Centre of Ljubljana, where the most complex patients receive HD on average three times per week. The data were collected through interviews based on a prepared questionnaire and medical history review. A total of 205 patients were included in this study (63.9 ± 15.4 years). Sixty percent (122/205) of the patients had little or no physical mobility impairment, and others were categorized with a minor or severe mobility limitation. A minor mobility impairment was found in 21% (43/205) of patients: 10 patients (5%) used a mobility aid in the form of a crutch, 9 patients (4%) were dependent on two crutches or a walker, and 24 patients (12%) were temporarily dependent on the assistance of a third person. Severe mobility limitations were observed in 22% (40/205) of patients, ranging from being confined to bed (19/205, 9%), confined to bed but able to perform some movements (19/205, 9%), and ambulatory but dependent on the assistance of a third person for locomotion (2/205, 1%). The most common causes of the limitation of mobility were neurological (19/40, 47.5%), cardiovascular (9/40, 22.5%), musculoskeletal (8/40, 20%), and other causes (4/40, 10%). A significant, moderate positive correlation was observed between mobility problems and the age of the participants (r = 0.36, p < 0.001), while a significant, small positive correlation was obtained between the mobility problems and C-reactive protein (r = 0.15, p = 0.044). Moreover, mobility problems had a small but significant negative correlation with albumin levels (r = −0.15, p = 0.042). When controlling for age, results yield no significant correlations, and, in regression analysis, only the age (p < 0.001) and male gender (p = 0.007) of the participants were independent predictors of mobility impairment. We conclude that impaired mobility has a high overall prevalence among chronic HD patients. Strategies to prevent and improve mobility limitations are strongly needed. [ABSTRACT FROM AUTHOR]

Abstract Background It is difficult to pinpoint the manner of death in cases of death due to sharp force injuries where injury patterns resemble one another. Other issues that might arise include physical mobility and survival time after injury. Within the scope of this case, a 53-year-old male suicide with findings suggestive of homicide is presented, along with research on the nature of sharp neck injuries, survival time, and movement after injury. Case presentation Thanks to the surveillance camera video that captured a significant portion of the occurrence, it was determined that the incident in the case that was presented, which had two perforations of the larynx, was suicide. At first appearance, this case could be assumed to be homicidal. Due to the injury, the victim could only walk around 300–350 m. The victim had a 4-h average survival time. Conclusions In general terms, the survival time according to the injury sites in the neck can be listed for a person (if the wound sizes are close to each other) as follows: injury causing vagal stimulation < arterial injury with severe blood loss < venous injury with blood loss < airway injury causing aspiration and respiratory failure.

Impaired physical mobility in hemodialysis (HD) patients is considered an important modifiable risk factor of increased all-cause morbidity and mortality. To our knowledge, no study to date has determined the overall burden of limited physical mobility in prevalent HD patients. The aim of this research is to investigate impaired physical mobility and its clinical correlates. We conducted a cross-sectional observational study in all patients of the Centre for Acute and Complicated Dialysis at the University Medical Centre of Ljubljana, where the most complex patients receive HD on average three times per week. The data were collected through interviews based on a prepared questionnaire and medical history review. A total of 205 patients were included in this study (63.9 ± 15.4 years). Sixty percent (122/205) of the patients had little or no physical mobility impairment, and others were categorized with a minor or severe mobility limitation. A minor mobility impairment was found in 21% (43/205) of patients: 10 patients (5%) used a mobility aid in the form of a crutch, 9 patients (4%) were dependent on two crutches or a walker, and 24 patients (12%) were temporarily dependent on the assistance of a third person. Severe mobility limitations were observed in 22% (40/205) of patients, ranging from being confined to bed (19/205, 9%), confined to bed but able to perform some movements (19/205, 9%), and ambulatory but dependent on the assistance of a third person for locomotion (2/205, 1%). The most common causes of the limitation of mobility were neurological (19/40, 47.5%), cardiovascular (9/40, 22.5%), musculoskeletal (8/40, 20%), and other causes (4/40, 10%). A significant, moderate positive correlation was observed between mobility problems and the age of the participants (r = 0.36, p < 0.001), while a significant, small positive correlation was obtained between the mobility problems and C-reactive protein (r = 0.15, p = 0.044). Moreover, mobility problems had a small but significant negative correlation with albumin levels (r = −0.15, p = 0.042). When controlling for age, results yield no significant correlations, and, in regression analysis, only the age (p < 0.001) and male gender (p = 0.007) of the participants were independent predictors of mobility impairment. We conclude that impaired mobility has a high overall prevalence among chronic HD patients. Strategies to prevent and improve mobility limitations are strongly needed.

Objective: This research aimed to study the effects of a physical exercise program on physical mobility in cranial surgery patients. Materials and Methods: The researcher used a quasi-experimental method of surveying 58 patients who had cranial surgery at Siriraj Hospital. The research group was divided into two groups: an experimental group (28 patients) participating in a physical exercise program of patients after cranial surgery, and a control group (30 patients) receiving routine nursing care only. The evaluation of the patients’ physical mobility was performed three days after the surgery. Results: Most patients in the research group had an intracranial tumor (86.2%). One day after the surgery, the experimental group had minor pain at the wound site while the control group had moderate pain. Both groups felt discomfort (64.2%) or had muscle stiffness in the neck and shoulder areas (63.3%). Three days after the surgery, at the end of the program, the body movement function of both groups was reduced compared with the preoperative data. However, the experimental group showed better body movement function scores than the control one as the scores of the former were reduced less than those of the latter at p < 0.05. Conclusion: Nurses who provide health care services to patients after cranial surgery should apply the physical exercise program to promote the recovery of the patients’ physical mobility.

Abstract Background Preventing and responding to gender-based violence (GBV) is both a human rights imperative and a multifaceted economic issue. GBV can also act as a barrier to economic empowerment. The aim of the study was to examine the association between women’s empowerment (physical mobility, decision making and economic resources) and GBV among married youth in India. Methods Community based cross-sectional study was conducted among married youth in the age group of 15–24 years, in two selected districts of Uttar Pradesh and Rajasthan, India. The data was collected from 578 youth. Pre-validated scales were used to assess women’s empowerment indicators (physical mobility, decision making and economic resources). The outcomes assessed were scales on physical and sexual violence. Multivariate regression models examined associations between women’s empowerment, spousal characteristics, socio-economic status and demographics. Results The overall results of the study found that restricted physical mobility had a negative association with sexual violence [AOR: 0.49; CI 0.26–0.92]. Women with no decision-making power had higher odds of physical violence [AOR: 2.12; CI 0.01–4.43] and sexual violence [AOR: 1.96; CI 1.02–3.77]. Having no economic resources had a negative association with sexual violence [AOR: 0.19; CI 0.09–0.39]. Women going through spousal controlling behavior had a higher likelihood of physical [AOR: 3.79; CI 1.75–8.19] and sexual violence [AOR: 4.03; CI 2.09–7.79]. It was also found that married women from rural areas and other ethnic backgrounds had higher odds of physical violence. Conclusion There is a crucial need to work towards women’s empowerment, with progressive gender roles such as greater decision-making, physical mobility and economic resources to reduce GBV. An established method that has worked in various contexts is adopting gender transformative approaches that involve men.

BACKGROUND: Prosthetic rehabilitation decisions depend on estimating a patients mobility potential. However, no validated prediction models of mobility outcomes exist for people with lower-limb amputation (LLA). OBJECTIVES: To develop and test predictions for self-reported mobility after LLA, using the Prosthetic Limb Users Survey of Mobility (PLUS-M). STUDY DESIGN: This is a retrospective cohort analysis. METHODS: Eight hundred thirty-one patient records (1,860 PLUS-M observations) were used to develop and test a neighbors-based prediction model, using previous patient data to predict the 6-month PLUS-M T-score trajectory for a new patient (based on matching characteristics). The prediction model was developed in a training data set (n = 552 patients) and tested in an out-of-sample data set of 279 patients with later visit dates. Prediction performance was assessed using bias, coverage, and precision. Prediction calibration was also assessed. RESULTS: The average prediction bias for the model was 0.01 SDs, average coverage was 0.498 (ideal proportion within the 50% prediction interval = 0.5), and prediction interval was 8.4 PLUS-M T-score points (40% improvement over population-level estimates). Predictions were well calibrated, with the median predicted scores falling within the standard error of the median of observed scores, across all deciles of the data. CONCLUSIONS: This neighbors-based prediction approach allows for accurate estimates of PLUS-M T-score trajectories for people with LLA.

Firefighters work in a dangerous profession with high injury rates. Mobility dysfunction in firefighters may impact performance and contribute to injury. The Functional Movement Screen (FMS) is commonly used to evaluate individuals for mobility dysfunction and compensatory movements. The purpose of this study was to identify if mobility is related to firefighters' occupational task performance. This was a retrospective study assessing 29 career firefighters using FMS and occupational performance task scores. Statistical analyses consisted of a multiple linear regression assessing predictors on occupational task performance, and 21 point-biserial correlations ran to assess the relationship between each individual predictor and occupational task performance. Of the 21 point-biserial correlations, four were found to be significant, indicating a relationship between the FMS and occupational task performance. Inline Lunge L had a negative correlation with occupational task time and was statistically significant (rpb = -0.46, p = 0.012); Inline Lunge R had a negative correlation of moderate strength (rpb = -0.583, p = 0.001), Inline Lunge Combined had a negative correlation of moderate strength (rpb = -0.523, p = 0.004), and Shoulder Mobility L had a negative correlation of moderate strength (rpb = -0.445, p = 0.016). This study determined that the Inline Lunge component of the FMS may be a key element in occupational task performance. [ABSTRACT FROM AUTHOR]

Systematic literature review and meta-analysis were conducted to integrate and analyze intervention studies dealing with the effects of information and communications technology- (ICT-) based interventions on the physical mobility of older adults in the community. The PubMed/MEDLINE, Embase, CINAHL, and Cochrane CENTRAL databases were searched for studies published from January 2000 to December 2022. We used the Risk of Bias 2 (RoB 2) tool to evaluate the quality of the randomized controlled studies in the systematic review. The meta-analysis was performed using a random-effects model. The model was used to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for both effect measures. I2 tests were used to measure the presence of heterogeneity. Thirty-seven randomized controlled trials were included (2,419 intervention participants), of which 23 were included in the meta-analysis. ICT interventions significantly improved Timed Up and Go (TUG) as a marker of physical mobility variable in older adults (SMD = −0.33, 95% CI: −0.57 to −0.10, p=0.005, I2 = 74.7%). A sensitivity analysis was performed on subgroups, and interventions were found to be effective in improving TUG in the exergame group (SMD = −0.40, 95% CI: −0.72 to −0.08, p

Introduction: The research deals with a little-studied topic in Estonia: the experiences of women with impaired physical mobility (IPM) during pregnancy, childbirth, and in the postpartum period. Women with IPM, a vulnerable group, have a higher risk of complications and a higher probability of missing out on comprehensive maternity care., Methods: The method of the present research is qualitative. It is a case study of three women with IPM with whom semi-structured interviews were conducted., Results: It was found that women with IPM encountered several obstacles and problems during pregnancy, childbirth, and the postpartum period; despite this, women's experiences with maternity care were mostly positive. Furthermore, there are several areas for improvement to ensure more comprehensive maternity care. Women with IPM need more support and help, and midwives are expected to have additional knowledge regarding the specifics or limitations resulting from mobility impairments., Conclusions: In the future, the topic needs greater attention and improvement in the Estonian context to ensure more comprehensive maternity care for women with IPM. It is important to provide midwives the knowledge and skills to assist women with IPM during pregnancy, childbirth, and the postpartum period., Competing Interests: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2023 Merits M. et al.)

Introdução: a fragilidade é uma síndrome multifatorial de condições biológicas, psicológicas e sociais que predispõe a pessoa idosa a declínio da funcionalidade e maior suscetibilidade à vulnerabilidade. Tal condição pode ser agravada naquelas que apresentam comorbidades, destacando-se as cardiopatias. Objetivo: conhecer a prevalência de fatores relacionados à fragilidade e à mobilidade física, bem como a correlação entre esses indicadores em pessoas idosas em segmento ambulatorial. Casuística e método: estudo transversal com uma abordagem exploratória, descritiva e quantitativa que avaliou um grupo de pessoas idosas com cardiopatias crônicas, de ambos os sexos, com idade ≥60 anos em acompanhamento em um ambulatório de cardiologia. Os participantes foram separados de acordo com a classificação de fragilidade física de Fried e avaliadas a mobilidade física pelo Timed Up and Go (TUG), a força muscular por meio da força de preensão manual (FPM), quantidade muscular dos músculos da panturrilha através da circunferência de panturrilha (CP) e a fragilidade multidimensional com o Índice de Vulnerabilidade Clínico-Funcional (IVCF-20). A prevalência foi investigada por meio de frequência relativa e absoluta e, para as análises de correlação, o teste de Spearman foi utilizado. Resultados: a mediana da idade da amostra foi de 73 anos; 41 (61,2%) eram frágeis, 17 (25,4%) pré-frágeis; e 9 (13,4%) não frágeis. Com relação à mobilidade física, o grupo de frágeis apresento u fraqueza muscular FPM 15,3 kgf (1,6 – 33,3) e maior tempo necessário no TUG 16,3s (8,8 – 50,0). Há evidências de que exista correlação entre o IVCF-20 x TUG (p= chr(38)lt;0,001; r=0,580), além de correlação negativa entre FPM x TUG (p= chr(38)lt;0,001; r= -0,434) e IVCF-20 x FPM (p= chr(38)lt;0,001; r= -0,378). Conclusão: há prevalência de fragilidade física em pessoas idosas cardiopatas em acompanhamento ambulatorial. As medidas de mobilidade se correlacionam entre si

This article adheres to UN guidelines concerning the Decade of Healthy Ageing (2021-2030) which aim to improve the lives of the older population. The objective of this study is to show how social dance with artistic-scenic purposes for a socially vulnerable group of older adults (third and fourth age) contributes to active ageing from social and health perspectives. The sample comes from a social group for the over-60s years and forms part of an artistic-community project in which participant observation has been carried out for five years. To obtain more data from the sample group, an "ad hoc" measurement instrument is developed based on a specific literature review on the topic. The results show that dance, group, and stage performance are a vital driver for members. The analysis shows that individual perspectives are higher than group perspectives. The research provides evidence that social dance groups improve motor expressiveness, stimulate the ability to think, memorize and create, among other aspects.

In this study, we frame learning in the tertiary-level contemporary dance class as a process of developing culturally situated shared patterns of skilled action and attention through dynamic engagement with kinetic experience. Extending existing scholarship on dance learning, we adopt the framework of cultural affordances to understand the developmental relationship between physical and general categories of attention during the learning process. Based on qualitative analysis of student and teacher interviews, we contend that the dance classes were laboratories in which cross-domain mapping (physical and general) was leveraged to develop students' kinetic and attentional skills. Understood in this way, the physical concepts and the general concepts worked in a helical fashion, cycling through dynamic engagement with kinetic experience and the development of attentional awareness, not as pure repetition, but as a progression toward more complex, skilled, and nuanced ways of moving.

Systematic literature review and meta-analysis were conducted to integrate and analyze intervention studies dealing with the effects of information and communications technology- (ICT-) based interventions on the physical mobility of older adults in the community. The PubMed/MEDLINE, Embase, CINAHL, and Cochrane CENTRAL databases were searched for studies published from January 2000 to December 2022. We used the Risk of Bias 2 (RoB 2) tool to evaluate the quality of the randomized controlled studies in the systematic review. The meta-analysis was performed using a random-effects model. The model was used to calculate the standardized mean difference (SMD) and 95% confidence interval (CI) for both effect measures. I tests were used to measure the presence of heterogeneity. Thirty-seven randomized controlled trials were included (2,419 intervention participants), of which 23 were included in the meta-analysis. ICT interventions significantly improved Timed Up and Go (TUG) as a marker of physical mobility variable in older adults (SMD = -0.33, 95% CI: -0.57 to -0.10, 2 tests were used to measure the presence of heterogeneity. Thirty-seven randomized controlled trials were included (2,419 intervention participants), of which 23 were included in the meta-analysis. ICT interventions significantly improved Timed Up and Go (TUG) as a marker of physical mobility variable in older adults (SMD = -0.33, 95% CI: -0.57 to -0.10, p =0.005, I 2  = 74.7%). A sensitivity analysis was performed on subgroups, and interventions were found to be effective in improving TUG in the exergame group (SMD = -0.40, 95% CI: -0.72 to -0.08, p < 0.001, I  = 91.0%) but both groups showed high heterogeneity. A meta-analysis was also performed on Short Physical Performance Battery (SPPB) but statistically significant results were not found (SMD = -0.19, 95% CI: -0.61 to 0.23, 2  = 75.0%) and in the exergame with virtual reality (VR) group (SMD = -0.33, 95% CI: -1.01 to 0.35, p < 0.001, I 2  = 93.5%). However, the number of studies included in the meta-analysis was small and heterogeneity was high, so follow-up studies are needed. This study confirmed that exergames, telecommunication, e-health, information applications, and robots were used as effective ICT-based interventions for improving the physical mobility of older adults. It is necessary to develop and apply more diverse ICT-based interventions that will prevent impairments of mobility and encourage older adults to live more independently, with a higher quality of life, based on extensive research on ICT-based interventions.p =0.375, I 2  = 87.7%). For the Berg Balance Scale (BBS), the post-intervention scores were significantly better than baseline (SMD = 1.52, 95% CI: 0.48 to 2.57, p =0.004, I 2  = 93.5%). However, the number of studies included in the meta-analysis was small and heterogeneity was high, so follow-up studies are needed. This study confirmed that exergames, telecommunication, e-health, information applications, and robots were used as effective ICT-based interventions for improving the physical mobility of older adults. It is necessary to develop and apply more diverse ICT-based interventions that will prevent impairments of mobility and encourage older adults to live more independently, with a higher quality of life, based on extensive research on ICT-based interventions., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Hyori Kim et al.)

Objective: To compare the effects a Mediterranean diet (MedDiet) versus the Irish Healthy Eating Guidelines (HEG) on physical function and quality of life in adults with rheumatoid arthritis (RA) in Ireland. Methods: Forty-four adults with RA were randomised (1:1) to the MedDiet or HEG for 12 weeks. The intervention included three video teleconsultations and two follow-up telephone calls facilitated by a Registered Dietitian (RD). Changes in physical function by Health Assessment Questionnaire- Disability Index (HAQ-DI) and quality of life by Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL) were the primary outcomes measured. Secondary outcomes included changes in dietary adherence, physical activity by Yale Physical Activity survey (YPAS), patient-perceived pain and general health, and anthropometric measures. All measurements were administered at baseline and repeated at 6 and 12 weeks. Results: Forty participants completed the study. Participants were primarily females (87.5%), mean age was 47.5 ± 10.9 years. At the end of the intervention, participants in the MedDiet group reported significantly better physical function (p = 0.006) and quality of life (p = 0.037) compared to HEG group. From baseline to 12 weeks, physical function significantly improved in both diet groups, MedDiet (0.9 ± 0.5 to 0.5 ± 0.4 units, p < 0.001) and HEG (1.4 ± 0.7 to 1.0 ± 0.6 units, p < 0.001). Quality of life also significantly improved in the MedDiet (10.1 ± 7.5 to 4.0 ± 4.7 units, p < 0.001) and HEG group (11.25 ± 7.2 to 7.9 ± 6.4 units, p = 0.048). Physical activity improved significantly in the MedDiet (56.7 ± 28.6 to 70.6 ± 33.5 points, p = 0.01) but not within the HEG group despite similar recommendations. Conclusion: Adhering to the MedDiet and Irish Healthy Eating Guidelines resulted in improvements in RA patient-reported outcomes. The changes observed in both diet groups are likely due to the improvement in overall diet quality irrespective of dietary prescription. Trial registration number: NCT04262505. [ABSTRACT FROM AUTHOR]

Knee osteoarthritis (OA) affects millions worldwide, leading to pain and reduced quality of life. Conventional treatments often fail to provide adequate relief, necessitating new therapeutic approaches. This study evaluated the efficacy and safety of genicular artery embolization (GAE) using permanent microspheres in patients with mild-to-moderate knee OA. In this prospective, single-center study, 17 participants underwent GAE. KOOS (Knee injury and Osteoarthritis Outcome Score), WOMAC (The Western Ontario and McMaster Universities Arthritis Index), and IPAQ (International Physical Activity Questionnaire) scores, along with physical performance tests, medication use, and dual-energy X-ray absorptiometry (DEXA) scans, were assessed at baseline and at multiple follow-up points over six months. The primary endpoint, VAS at six months, showed significant improvement (median reduction from 66 mm to 40 mm, p = 0.0004). All pain and function scores, as well as physical performance tests, improved significantly. No clinically relevant changes in medication use or DEXA parameters were observed after six months. Only minor, self-limiting adverse events occurred. This study indicates that GAE is a promising minimally invasive treatment for knee OA, providing significant pain relief and functional improvement. However, further long-term, randomized trials are needed to confirm these findings and establish optimal patient selection criteria. [ABSTRACT FROM AUTHOR]

Purpose: Congenital aniridia is a serious eye disease characterized by absence of iris to various degrees. The aims of this study were to investigate health‐related quality of life (HRQoL) in adults with aniridia and assess the relationships between HRQoL, psychological status, ocular health and obesity. Methods: Twenty‐nine adults with congenital aniridia (48% male, aged 18–79 years) participated. HRQoL was measured with SF‐36 and the EQ visual analogue scale (VAS). The physical (PCS) and mental (MCS) component summaries of the SF‐36 were calculated with higher scores indicating better HRQoL. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Obesity was assessed with the Patient‐Reported Outcomes in Obesity (PROS). Sociodemographic characteristics, genetic variants and ocular and medical health variables were also analysed. Results: The participants scored significantly lower in the general health domain of the SF‐36 than the general population (65.2 vs. 75.3, p = 0.017). The EQ VAS score was also lower in the aniridia group (64.9 vs. 77.9, p = 0.021). Low PCS score was correlated with presence of ocular pain (p = 0.019), high HADS score (p = 0.017) and high PROS score (p = 0.009). Low MCS score was related to higher educational level (p = 0.038) and high HADS score (p < 0.001). High HADS and PROS scores were both related to low EQ VAS scores. Conclusion: Adults with congenital aniridia scored worse on certain measures of HRQoL than the general population. Poorer HRQoL was associated with increased symptoms of anxiety, depression and obesity and with presence of ocular pain. [ABSTRACT FROM AUTHOR]

Background: Stroke affects long-term physical and cognitive function; many survivors report unmet health needs, such as pain or depression. A hospital-led follow-up service designed to address ongoing health problems may avoid unplanned readmissions and improve quality of life. Methods: This paper outlines the protocol for a registry-based, randomised controlled trial with allocation concealment of participants and outcome assessors. Based on an intention-to-treat analysis, we will evaluate the feasibility, acceptability, potential effectiveness and cost implications of a new tailored, codesigned, hospital-led follow-up service for people within 6–12 months of stroke. Participants (n = 100) from the Australian Stroke Clinical Registry who report extreme health problems on the EuroQol EQ-5D-3L survey between 90 and 180 days after stroke will be randomly assigned (1:1) to intervention (follow-up service) or control (usual care) groups. All participants will be independently assessed at baseline and 12–14-week post-randomisation. Primary outcomes for feasibility are the proportion of participants completing the trial and for intervention participants the proportion that received follow-up services. Acceptability is satisfaction of clinicians and participants involved in the intervention. Secondary outcomes include effectiveness: change in extreme health problems (EQ-5D-3L), unmet needs (Longer-term Unmet Needs questionnaire), unplanned presentations and hospital readmission, functional independence (modified Rankin Scale) and cost implications estimated from self-reported health service utilisation and productivity (e.g. workforce participation). To inform future research or implementation, the design contains a process evaluation including clinical protocol fidelity and an economic evaluation. Discussion: The results of this study will provide improved knowledge of service design and implementation barriers and facilitators and associated costs and resource implications to inform a future fully powered effectiveness trial of the intervention. Trial registration: ACTRN12622001015730pr. Trial sponsor: Florey Institute of Neuroscience and Mental Health, 245 Burgundy Street, Heidelberg, VIC, 3084, PH: +61 3 9035 7032 [ABSTRACT FROM AUTHOR]

This study aimed to investigate the non-linear evolution of position-specific physical and technical performance indicators across different tactical formations in the Chinese Super League (CSL) from the 2015 to the 2021 seasons. Match data were collected from 800 games played in six common formations (3-5-2, 4-3-3, 4-2-3-1, 4-4-2, 3-4-3, and 4-1-4-1). Players were classified into five positions: central defenders (CD; match observations = 2,219), fullbacks (FB; match observations = 2,060), central midfielders (CM; match observations = 2,786), wide midfielders (WM; match observations = 1,587), and forwards (FW; match observations = 1,680). Generalized additive models (GAMs) were constructed to analyze the nonlinear evolution trends in position-specific physical and technical performance across seasons and formations. The results showed that the total distance covered by CDs in the 3-5-2 formation showed a non-linear upward trend from the 2015 to 2021 seasons (R2 = 0.3, p = 0.006); FBs in the 3-4-3, 4-1-4-1, and 3-5-2 formations exhibited non-linear upward trends in number of sprints and sprint distance from the 2015 to 2021 seasons (R2 = 0.189–0.448; P < 0.03, respectively); the high-speed running of FWs in the 4-2-3-1 formation displayed a non-linear decline trend from the 2015 to 2021 seasons (R2 = 0.477; P < 0.001); CMs in the 4-2-3-1 formation demonstrated a non-linear increasing trend in the ball retention percentage (R2 = 0.369; p = 0.001); WMs in the 4-4-2 formation showed a non-linear decreasing trend in ball retention percentage and passes from the 2015 to 2021 seasons (R2 = 0.259–0.29; P = 0.006, respectively). These findings revealed non-linear evolutionary trends in physical and technical performances across positions and formations, providing an in-depth understanding of the changing match demands placed on players during matches. This enables the optimization of training and tactics by developing targeted strategies tailored to meet the specific requirements of different formations and playing positions. [ABSTRACT FROM AUTHOR]

Data describing the three-dimensional structure of physical networks is increasingly available, leading to a surge of interest in network science to explore the relationship between the shape and connectivity of physical networks. We contribute to this effort by standardizing and analyzing 15 data sets from different domains. Each network is made of tube-like objects bound together at junction points, which we treat as nodes, with the connections between them considered as links. We divide these networks into three categories: lattice-like networks, trees, and linked trees. The degree distribution of these physical networks is bounded, with most nodes having degrees one or three. Characterizing the physical properties of links, we show that links have an elongated shape and tend to follow a nearly straight trajectory, while a small fraction of links follow a winding path. These typical node and link properties must be reflected by physical network models. We also measure how confined a link is in space by comparing its trajectory to a randomized null model, showing that links that are central in the abstract network tend to be physically confined by their neighbors. The fact that the shape and connectivity of the physical networks are intertwined highlights that their three-dimensional layout must be taken into account to understand the evolution and function of physical networks. [ABSTRACT FROM AUTHOR]

Instrumenting the six-minute walk test (6MWT) adds information about gait quality and insight into fall risk. Being physically active and preserving multi-directional stepping abilities are also important for fall risk reduction. This analysis investigated the relationship of gait quality during the 6MWT with physical functioning and physical activity. Twenty-one veterans (62.2 ± 6.4 years) completed the four square step test (FSST) multi-directional stepping assessment, a gait speed assessment, health questionnaires, and the accelerometer-instrumented 6MWT. An activity monitor worn at home captured free-living physical activity. Gait measures were not significantly different between minutes of the 6MWT. However, participants with greater increases in stride time (ρ = −0.594, p < 0.01) and stance time (ρ = −0.679, p < 0.01) during the 6MWT reported lower physical functioning. Neither physical activity nor sedentary time were related to 6MWT gait quality. Participants exploring a larger range in stride time variability (ρ = 0.614, p < 0.01) and stance time variability (ρ = 0.498, p < 0.05) during the 6MWT required more time to complete the FSST. Participants needing at least 15 s to complete the FSST meaningfully differed from those completing the FSST more quickly on all gait measures studied. Instrumenting the 6MWT helps detect ranges of gait performance and provides insight into functional limitations missed with uninstrumented administration. Established FSST cut points identify aging adults with poorer gait quality. [ABSTRACT FROM AUTHOR]

Knowledge about a patient's physical fitness can aid in medical decision-making, but objective assessment can be challenging and time-consuming. We aimed to investigate the concordance of self-reported health status and physical functioning with the 6 minute walking distance (6MWD) as objective measure of physical performance. The prospective characteristics and course of heart failure stages A/B and determinants of progression (STAAB) cohort study iteratively follows a representative sample of residents of the city of Würzburg, Germany, aged 30–79 years, without a history of heart failure (HF). The 6MWD was measured in 2752 individuals (aged 58 ± 11 years, 51% women) from a population-based cohort under strictly standardized conditions. Self-reported health status and physical functioning were assessed from items of the short form 36 (SF-36). After the respective classification of self-reported health status and physical functioning into 'good', 'moderate', and 'poor', we determined the association of these categories with 6MWD by applying a generalized linear model adjusted for age and sex. Prevalence of self-reported good/moderate/poor general health and physical functioning was 41/52/7% and 45/48/7%, respectively. Mean 6MWD in the respective categories was 574 ± 70/534 ± 76/510 ± 87 m, and 574 ± 72/534 ± 73/490 ± 82 m, with significant sex-specific differences between all categories (all p < 0.001) as well as significant differences between the respective groups except for the categories 'moderate' and 'poor' health status in men. This cross-sectional analysis revealed a strong association between self-reported health status and physical functioning with the objective assessment of 6MWD, suggesting that physicians can rely on their patients' respective answers. Nevertheless, sex-specific perception and attribution of general health and physical functioning deserve further in-depth investigation. Decision-making based on self-reported health requires prospective evaluation in population-based cohorts as well as adult inpatients. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease due to an autoimmune chronic inflammatory response, yet the etiology is currently not completely understood. It is already known that physical activity plays an essential role in improving quality of life, especially in neuropathological conditions. The study was aimed to investigate the possible benefits of high-intensity interval training (HIIT) in bone and lipid metabolism markers, and neuromotor abilities in MS patients. 130 participants were recruited; 16 subjects with MS met the inclusion criteria and were included in the data analysis. The patients were randomly assigned to two groups: a Control group (CG) (34.88 ± 4.45 yrs) that didn't perform any physical activity and the Exercise group (EG) (36.20 ± 7.80 yrs) that performed HIIT protocol. The training program was conducted remotely by a kinesiologist. It was performed three times a week for 8 weeks. At the beginning (T0) and the end of the study (T1) physical function tests, bone remodelling markers, and lipid markers analyses were performed. After 8 weeks of training the wall squat (s) (T0 = 27.18 ± 4.21; T1 = 41.68 ± 5.38, p ≤ 0.01) and Time Up and Go test (s) (T0 = 7.65 ± 0.43; T1 = 6.34 ± 0.38 p ≤ 0.01) performances improved; lipid markers analysis showed a decrease in Total (mg/dl) (T0 = 187.22 ± 15.73; T1 = 173.44 ± 13.03, p ≤ 0.05) and LDL (mg/dl) (T0 = 108 ± 21.08; T1 = 95.02 ± 17.99, p < 0.05) cholesterol levels. Additionally, the levels of osteocalcin (µg/L), a marker of bone formation increased (T0 = 20.88 ± 4.22; T1 = 23.66 ± 6.24, p < 0.05), 25-OH Vitamin D (µg/L) improved after 8 weeks (T0 = 21.11 ± 7.11; T1 = 27.66 ± 7.59, p < 0.05). HIIT had an effect on lower limb strength and gait control, improved bone formation, and lipid management, in MS patients. [ABSTRACT FROM AUTHOR]

Randomized intra-haemodialysis and home-based exercise trials have demonstrated similar efficacy in improving physical performance, particularly in increasing walking distance. During dialysis sessions, patients can engage in structured, supervised activities such as cycling or resistance exercises, ensuring safety and immediate feedback from healthcare professionals. This structured nature can significantly enhance adherence, making exercise a regular part of the patient's treatment schedule. Home-based exercise offers flexibility and convenience. Patients can incorporate activities like walking, stretching or using resistance bands into their daily lives. This flexibility allows patients to exercise at their own pace and according to their preferences, fostering independence and self-management. By continuing physical activity at home, patients can maintain continuity in their exercise regimen, which is crucial for long-term health benefits. Combining both intra-haemodialysis and home-based exercises has the potential to improve overall adherence to exercise programs. Strategies such as patient education, customized plans, monitoring and feedback, and support systems can help combine these two exercise types. By integrating these two modalities, healthcare providers can create a comprehensive and balanced exercise regimen that enhances adherence, promotes independence and maximizes health benefits for dialysis patients, fostering long-term health and well-being through sustained physical activity. However, this dual approach, which caters to both the need for medical supervision and the desire for personal autonomy, has yet to be tested in randomized trials. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study aimed to find the optimal intervention available to both control blood glucose and improve physical function in the geriatric population with T2DM. Methods and Study Design: A systemic review and network meta-analysis (NMA) was conducted to assess and rank the comparative efficacy of different interventions on glycosylated hemoglobin A1c (HbAc1), fasting blood glucose (FBG), muscle mass, grip strength, gait speed, lower body muscle strength, and dynamic balance. A total of eight databases were searched for eligible randomized controlled trials (RCTs) that the elderly aged more than 60 years or with mean age ≥ 55 years, the minimal duration of the RCT intervention was 6 weeks, and those lacking data about glycemic level and at least one indicator of physical performance were excluded. The Cochrane risk of bias tool was used to assess the bias of each study included. Bayesian NMA was performed as the main results, the Bayesian meta regression and the frequentist NMA as sensitivity analysis. Results: Of the 2266 literature retrieved, 27 RCTs with a total of 2289 older adults were included. Health management provided by health workers exerts beneficial effects that is superior to other interventions at achieving glycemic control, but less marked improvement in physical performance. Exercise combined with cognitive training showed more pronounced improvement in muscle strength, gait speed, and dynamic balance, but ranked behind in decreasing the HbAc1 and FBG. Conclusions: Personalized health management combined with physical and cognitive training might be the optimal intervention to both accomplish glycemic control and improvement of physical performance. Further RCTs are needed to validate and assess the confidence of our results from this NMA. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of comprehensive exercise training on frailty, negative emotions and physical functions of elderly patients with diabetes. Methods: This is a retrospective study. A total of 140 elderly patients with T2DM in The No.2 Hospital of Baoding were selected from December, 2021 to June, 2023 and randomly divided into two groups, with 70 patients in each group. The control group was given routine nursing and routine exercise education, and the study group was additionally given comprehensive exercise training. Tilburg frailty indicator (TFI), emotional status, physical functions, grip strength, fasting blood glucose and patient satisfaction were compared and analyzed between the two groups. Results: Before the intervention, TFI showed no significant differences between the two groups (p>0.05). After the intervention, physical, psychological and social frailty in the study group were significantly lower than those in the control group, with statistically significant differences (p= 0.00). SAS and SDS scores reduced significantly in the study group compared with those in the control group after the intervention, with statistically significant differences (p=0.00). After the intervention, the grip strength was significantly larger while the fasting blood glucose was significantly lower in the study group compared with those in the control group, with statistically significant differences (p=0.00). Patient satisfaction in the study group was higher than in the control group, with a statistically significant difference(p=0.03). Conclusion: Comprehensive exercise training for elderly patients with diabetes is beneficial to improving their frail state, negative emotions, blood glucose levels and physical functions. It has significant clinical application value. [ABSTRACT FROM AUTHOR]

Background: Maintaining good functional ability is a key component of healthy ageing and a basic requirement for carrying out activities of daily living, staying independent, and delaying admission to a nursing home. Even though women have a higher life expectancy and slower age-related muscle mass loss than men, they often show a higher prevalence of limitations in physical functioning. However, the reasons behind these sex differences are still unclear. Therefore, the aims of this study were to investigate sex differences among older adults regarding physical functioning and to study which factors are explaining these sex differences. Methods: Cross-sectional data from participants of the OUTDOOR ACTIVE study residing in Bremen, Germany, aged 65 to 75 years, were included in the analyses. Physical functioning was assessed via a self-administered questionnaire using the SF-36 10-item Physical Functioning Scale. Social, lifestyle, and health-related factors were also assessed using the questionnaire. Physical activity was measured objectively using wrist-worn accelerometers over seven consecutive days. Descriptive analyses with absolute and relative frequencies, means and standard deviations, as well as T-tests and chi-square tests were carried out. To test for associations between sex, physical functioning, and several individual factors, linear regressions were performed. Results: Data of 2 141 participants (52.1% female) were included in the study. Women and men showed statistically significant differences in physical functioning, with men perceiving fewer limitations than women. On average, women had a physical functioning score of 81.4 ± 19.3 and men 86.7 ± 17.0. Linear regression showed a statistically significant negative association between physical functioning score and sex (β: -0.15, 95% CL: -0.19, -0.10). The association remained statistically significant when adding individual factors to the model. All factors together were only able to explain 51% of the physical functioning-sex association with health indicators and the presence of chronic diseases being the most influential factors. Conclusions: We found sex differences in physical functioning, with older women having more limitations than older men. The results showed that health-related factors and chronic diseases played the biggest roles in the different physical functioning scores of women and men. These findings contribute to future longitudinal, more in-depth research. Trial registration: German Clinical Trials Register DRKS00015117 (Date of registration 17-07-2018). [ABSTRACT FROM AUTHOR]

The aims of this study were to create a composite index to measure the overall players' physical performance in professional soccer matches and analyze the effect of individual playing time and positional differences on this composite index. A total of 830 official matches from LaLiga men's first division and Spanish Copa del Rey were analyzed, which resulted in 24,980 match observations collected from 1138 male players (forwards, n = 286; midfielders, n = 441; defenders, n = 411). The physical performance variables, which represent the locomotor demands, were collected using electronic performance tracking systems. A Partial Least-Squares Structural Equation Model (PLS-SEM) was used to measure performance. The PLS-SEM output had three significant latent components, which explained 95% of the initial variability, that were related to the acceleration-specific performance (component 1), high-intensity running-related variables (component 2), and medium intensity actions variables (component 3). Also, a linear regression analysis was used to explore relationships between playing activity time (hours—X axis) and the composite index (10-point scale—Y axis), in which a strong and positive correlation was observed between individual playing time and the composite index (r = 0.76; p < 0.001; R2 = 0.58). Also, significant positive correlations were observed in forwards (r = 0.85; p < 0.001; R2 = 0.74), midfielders (r = 0.80; p < 0.001; R2 = 0.64), and defenders (r = 0.67; p < 0.001; R2 = 0.45). However, significant differences between playing positions with a small effect size (p < 0.05; eta-squared = 0.01) were found. From a practical perspective, this study may serve as a reference for sports performance practitioners to create a composite index that measures the overall players' physical performance. The instructions to create this index are available in the manuscript. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the potential differences in the match running performance of professional soccer players 5 min. before scoring and conceding a goal in the Polish Ekstraklasa. The sample consisted of 278 matches with 570 goals scored during official matches of the 2022/23 Polish Ekstraklasa season. All data was collected utilising the computerised multiple-camera optical tracking system TRACAB. Total distance covered (TD), standing distance (StD; < 0.72 km h−1), walking distance (WD; 0.73–7.2 km h−1), jogging distance (JG; 7.21–14.4 km h−1), running distance (RD; 14.41–19.8 km h−1), high-speed running distance (HSR; 19.81–25.2 km h−1) and sprinting distance (SprD; > 25.2 km h−1) were analysed in 5-min intervals prior to a goal scored for both teams. The employed linear mixed models showed that all examined match-running performance metrics were higher in teams that scored a goal compared to teams that conceded a goal. Within 5 min before scoring a goal in Polish Ekstraklasa matches, the scoring team produced significantly greater TD (∆ 95%CI 256.8–300.4 m; p = 0.001), WD (∆ 95%CI 52.3–95.8 m; p = 0.001), JG (∆ 95%CI 100.5–144.1 m; p = 0.001) and RD (∆ 95%CI 16.2–59.8 m; p = 0.001) compared to the conceding team, although no differences were found for HSR and SprD. These results demonstrate the enhanced identification potential of key physical performance factors influencing goal scoring in the Polish Ekstraklasa, thereby optimising the training process and improving overall performance. To enhance the effectiveness of soccer training, coaching and performance staff should consider this study's findings, that indicate an increase in the volume of medium- and low-intensity running efforts preceding a goal. [ABSTRACT FROM AUTHOR]

Physical function is the physical ability to fulfill one's daily roles and responsibilities. Poor physical function is detrimental to health and income-generating activities. Unfortunately, there is a lack of validated methods to measure physical function in adult women in low- and middle-income countries, including Ethiopia, the locus of this study. This study evaluated the feasibility, reliability, and validity of physical tests, including the sit-to-stand (STS) and usual gait speed (UGS) and a context-appropriate instrumental activities of daily living (IADL) survey. The results of the STS were used to calculate a muscle quality index (MQI, STS accounting for body mass and leg length). Feasibility was ascertained qualitatively based on reports from the enumerators on their ability to administer the tests. Reliability was assessed by comparing the results of the tests and questions between each visit using either Cohen's κ or Pearson's ρ. The validity of MQI was assessed using relevant participant characteristics such as age and self-reported disability. The validity of the IADL was assessed using MQI. Study participants comprised 316 women between the ages of 18 and 45 years, living in rural Tigray, Ethiopia, who had previously participated in an impact evaluation of a safety net program. Over a one-week period, participants completed the STS and UGS tests and responded to the IADL survey questions three times. MQI was determined to be a feasible, reliable, and valid physical function test for women in rural, highland Ethiopia. UGS lacked feasibility and reliability; validity was not ascertained. The IADL questions were feasible and reliable, but validity was inconclusive. In rural Ethiopia, the MQI will be a valuable tool to develop interventions for improving physical function, which will have positive impacts on health and quality of life. [ABSTRACT FROM AUTHOR]

This study presents a novel method leveraging surface wave-assisted photonic spin Hall effect (PSHE) to construct physical unclonable functions (PUFs). PUFs exploit inherent physical variations to generate unique Challenge–Response pairs, which are critical for hardware security and arise from manufacturing discrepancies, device characteristics, or timing deviations. We explore PSHE generation-based PUF design, expanding existing design possibilities. With recent applications in precise sensing and computing, PSHE offers promising performance metrics for our proposed PUFs, including an inter-Hamming distance of 47.50% , an average proportion of unique responses of 62.5% , and a Pearson correlation coefficient of − 0.198. The PUF token demonstrates robustness to simulated noise. Additionally, we evaluate security using a machine learning-based attack model, employing a multi-layer perceptron (MLP) regression model with a randomized search method. The average accuracy of successful attack prediction is 9.70% for the selected dataset. Our novel PUF token exhibits high non-linearity due to the PSHE effect, resilience to MLP-based attacks, and sensitivity to process variation. [ABSTRACT FROM AUTHOR]

Physical unclonable functions (PUFs) have emerged as a promising encryption technology, utilizing intrinsic physical identifiers that offer enhanced security and tamper resistance. Multi‐level PUFs boost system complexity, thereby improving system reliability and fault tolerance. However, crosstalk‐free multi‐level PUFs remain a persistent challenge. In this study, a hierarchical PUF system that harnesses the spontaneous phase separation of silk fibroin /PVA blend and the random distribution of silicon‐vacancy diamonds within the blend is presented. The thermodynamic instability of phase separation and inherent unpredictability of diamond dispersion gives rise to intricate random patterns at two distinct scales, enabling time‐efficient hierarchical authentication for cryptographic keys. These patterns are complementary yet independent, inherently resistant to replication and damage thus affording robust security and reliability to the proposed system. Furthermore, customized authentication algorithms are constructed: visual PUFs authentication utilizes neural network combined structural similarity index measure, while spectral PUFs authentication employs Hamming distance and cross‐correlation bit operation. This hierarchical PUF system attains a high recognition rate without interscale crosstalk. Additionally, the coding capacity is exponentially enhanced using M‐ary encoding to reinforce multi‐level encryption. Hierarchical PUFs hold significant potential for immediate application, offering unprecedented data protection and cryptographic key authentication capabilities. [ABSTRACT FROM AUTHOR]

Objectives: The present study examined the agreement and associations of the 5-time sit-to-stand (5STS) test, the countermovement jump test, and lower-limb muscle power equations with a set of physical performance tests in older adults. Methods: Five hundred and thirty-four community-dwelling older adults were recruited for the study. Lower-limb muscle power measures included 5STS, the countermovement jump test, and muscle power equations. Isometric handgrip strength, timed "up-and-go!", the 6 min walking test, one-leg stand, and walking speed at usual and fast paces were used to assess physical performance. Pearson's correlations and Bland–Altman analyses were conducted to examine associations among muscle power measures. Linear and multiple regressions were run to explore associations of 5STS, the countermovement jump test, and muscle power equations with physical performance tests. Results: Weak correlations were observed among lower-limb muscle power measures. Bland–Altman results indicated important differences among the countermovement jump test, 5STS, and muscle power equations. Results of multiple linear regressions indicated that 5STS, the countermovement jump test, and muscle power equations were significantly associated with measures of muscle strength and mobility. However, only 5STS was significantly associated with balance. Conclusions: Our results indicate that the performance on the countermovement jump test and 5STS is weakly correlated with lower-limb muscle power equations. The only exception was the correlation found between the countermovement jump test and relative muscle power, highlighting the importance of accounting for body mass in muscle power evaluations. Muscle power measures were similarly associated with performance on handgrip strength, timed "up-and-go!", and the 6 min walking test. The exclusive association of 5STS with balance suggests that a reassessment of 5STS muscle power equations may be warranted. [ABSTRACT FROM AUTHOR]

Human mobility in an urban area is complicated; the origins, destinations, and transportation modes of each person differ. The quantitative description of urban human mobility has recently attracted the attention of researchers, and it highly related to urban science problems. Herein, combined with physics inspiration, we introduce a revised electric circuit model (RECM) in which moving people are regarded as charged particles and analogical concepts of electromagnetism such as human conductivity and human potential enable us to capture the characteristics of urban human mobility. We introduce the unit system, ensure the uniqueness of the calculation result, and reduce the computation cost of the algorithm to 1/10,000 compared with the original ECM, making the model more universal and easier to use. We compared features including human conductivity and potential between different major cities in Japan to show our improvement of the universality and the application range of the model. Furthermore, based on inspiration of physics, we propose a route generation model (RGM) to simulate a human flow pattern that automatically determines suitable routes between a given origin and destination as a source and sink, respectively. These discoveries are expected to lead to new approaches to the solution of urban science problems. [ABSTRACT FROM AUTHOR]