Abdominal Muscles Research Articles

Rectus Abdominis Sheath Hematoma Following Cesarean Section: A Case Series

This case series describes two patients who underwent Cesarean section complicated by a rectus abdominis sheath hematoma that did not immediately resolve following exploratory laparotomy. One of the patients required an additional procedure by interventional radiology. Both patients had similar presentations. Both were noted to have symptomatic anemia on postoperative day 1 with an acute drop in hemoglobin. This was accompanied by severe abdominal pain and distension on physical exam. Computerized tomography (CT) abdomen/pelvis demonstrated evidence of active bleeding within the anterior abdominal wall musculature. Due to increasing concern for intrabdominal hemorrhage in the setting of an acute abdominal exam, the decision was made to proceed with an exploratory laparotomy. A substantial amount of blood was evacuated from the abdomen with greater than 1500 cc of estimated blood loss in both cases. A Jackson-Pratt drain was placed and had increased output immediately postoperatively. Both patients received blood products. One developed a consumptive coagulopathy. Interventional Radiology was consulted following exploratory laparotomy to consider intravascular embolization of the inferior epigastric arteries, which was eventually performed in one of the cases. The patients were discharged on hospital day 5 in good condition. Rectus abdominis sheath hematomas are a rare complication that can lead to significant postpartum hemorrhage. Prompt recognition and management is vital to avoid significant morbidity and mortality. Algorithms exist to guide treatment and standardize patient care. Despite using sound clinical judgment in line with existing algorithms, both patients had delayed resolution of their bleeding following initial management, requiring additional intervention.

Multidisciplinary behavioral therapy reduces rumination

AbstractBackgroundBehavioral therapy has proved effective as rumination therapy. Our objective was to treat rumination patients using multidisciplinary behavioral therapy aimed at reducing ≥2 of the rumination score.MethodsAll patients fulfilled Rome IV criteria for rumination and were referred to speech therapy for psychoeducation, diaphragmatic breathing exercises and guided eating, physiotherapy for exercises to relax the thoracic and abdominal muscles, and consultation with the psychologist and the dietitian. Symptoms, depression, anxiety, health‐related quality of life (HRQoL), and functional capacity were evaluated by questionnaires (Rome IV, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), 15D, and World Health Organization Disability Assessment Schedule (WHODAS) 2.0) at baseline and at 6‐month control. Esophageal manometry was performed at 6‐month control.Key ResultsThe study enrolled 11 patients (19–64 years, 10 female). Rumination score: 6.5 (5–8) at baseline, 4.0 (3–5) at the 6‐month control, p = 0.005. BDI/8 (6–13), BAI/15 (8–29) at baseline; BDI/7 (4–8), BAI/15 (7–27) at the 6‐month control, NS. 15D score: 0.800 at baseline, 0.845 at the 6‐month control, NS. WHODAS 2.0 score: 15 (7–33) at baseline, 11 (7–26) at the 6‐month control, NS. Rumination could be evoked in manometry in six of nine (67%) patients at 6‐month control.Conclusions and InferencesBehavioral multidisciplinary therapy significantly reduces the self‐assessed frequency of rumination. These patients have more depression, anxiety and a lower HRQoL compared to the normal population.

Abdominal muscles infiltration analgesia for donor-site pain in autologous ear reconstruction: A randomized controlled clinical trial

BackgroundCostal cartilage donor-site pain is an adverse effect of autologous ear reconstruction. This study aimed to introduce rectus abdominis and external oblique muscle infiltration analgesia (RAM+EOM-IA) for costal cartilage donor-site pain and evaluate its efficacy and safety. MethodsThe study was a randomized controlled clinical trial. Patients were randomized between intermittent RAM+EOM-IA combined with intravenous patient-controlled anesthesia (IPCA) and IPCA alone. Thirty patients were followed in the RAM+EOM-IA combined with the IPCA group and 30 patients in the IPCA alone group. The primary outcome was the numerical rating score (NRS) of pain recorded during 48 h postoperatively. Secondary outcomes included the Barthel index (BI) and rescue analgesic consumption. Sensory block areas were tested using a cold stimulus. ResultsNRS was significantly lower with RAM+EOM-IA combined with IPCA than with IPCA alone at 28 h (P < 0.01), 32 h (P < 0.01), 36 h (P < 0.01), 44 h (P < 0.001), and 48 h (P < 0.01) postoperatively. The number of patients who received rescue analgesics (P < 0.01) and consumption (P < 0.01) was significantly higher for IPCA alone. RAM+EOM-IA improved the BI at 24 h postoperatively (P < 0.001), especially for mobility (P < 0.001), using the stairs (P < 0.001) and toilet use domains (P < 0.001). At 10 and 60 min after RAM+EOM-IA, the total sensory block area in the abdomen had not extended proximally beyond the xiphoid, distally beyond the navel, and beyond midaxillary and midsternal lines on either side. ConclusionRAM+EOM-IA effectively and safely prevented costal cartilage donor-site pain by blocking anterior and lateral cutaneous branches of intercostal nerves from T6 to T10 in microtia patients.

Functional Tests of the Abdominal Wall Muscles in Normal Subjects and in Patients with Diastasis and Oblique Inguinal Hernias in a Pilot Study.

To identify typical patterns of abdominal wall muscle activation in patients with diastasis recti and inguinal hernias compared to controls during the Valsalva maneuver, voluntary coughing, and physical activity. The study included 15 subjects: 5 with diastasis recti, 4 with inguinal hernias, and 6 healthy controls. The functions of rectus abdominis (RA) and external oblique (OE) muscles were measured by surface electromyography (sEMG). Using ultrasound, the thicknesses of the RA, OE, internal oblique (IO), and transversus abdominis (TA) muscles were assessed as well as the echo intensity (EI) of RA and OE. We found a significant effect of the type of abdominal wall pathology on the maximum sEMG amplitude (p = 0.005). There was a reliable trend in maximum sEMG amplitude, with the highest one in diastasis recti and a significantly lower one in inguinal hernias. Duncan's test showed a significant difference in muscle thickness, both on the right and left sides, between patients with diastasis and controls, but only on the left side between patients with diastasis and those with inguinal hernia (p < 0.05). The abdominal wall pathology results in a change in the function and structure of the abdominal muscles, which can be detected using electromyography and ultrasound examination. The presence of diastasis recti is accompanied by an increase in bioelectrical activity and a decrease in thickness.

Functioning of unidirectional ventilation in flying hawkmoths evaluated by pressure and oxygen measurements and X-ray video and tomography.

Flying sphingids generate unidirectional ventilation with an inflow through the anterior thoracic spiracles and an outflow through the posterior thoracic spiracles. This phenomenon was documented by the CO2 emission and tracheal air pressure in split-chamber experiments in preceding studies. In the present study, we evaluated the function of the air pump mechanism by measuring the tracheal pressure and PO2in the air sacs and monitoring the wing beat using photocells. Microelectrodes recorded the abdomen flexing muscles and abdominal transverse muscle septum. The crucial structure was the vertical mesophragma, with longitudinal flight muscles attached anteriorly and large fused metathoracic air sacs posteriorly, continuous to the first abdominal segment. Longitudinal flight muscles and abdomen lifting muscles contracted synchronously, producing positive pressure pulses within the mesothoracic air sacs. In the scutellar air sacs, the PO2with starting full flight was elevated to 18-20 kPa, with a pressure increase of 35-50 Pa. In contrast, in the metathoracic air sacs, the O2 concentration during flight could rise to 10 kPa, then decline to 5±1 kPa. The metathoracic air sacs provided compliance for ventilation by the flight muscles. The initial rise and subsequent decrease of the PO2in these posterior metathoracic air sacs indicated the unidirectional flow path of the air used. Serial X-ray frames of flying Acherontia atropos visualised the cyclic phragma movement and volume changes in the metathoracic air sacs. The results showed that the contracting dorsolongitudinal flight muscles expanded the metathoracic air sacs, acting as a suction pump.

Exploring the relationship between trunk muscles and lower limb injuries in Australian badminton players

Due to its dynamic nature, lower limb injuries are common in badminton. Overuse injuries of the knee, including tendon related conditions, are the most common. During jumping and landing, force transference and dissipation through the trunk is required, with the trunk muscles playing a vital role. However, the relationship between knee pain and the ability to voluntarily contract the trunk muscles has not yet been explored in badminton players. A cross-sectional study of Australian badminton players was therefore conducted. Players performed a single leg decline squat to identify those with knee pain. Ultrasound imaging was used to image and measure the size of the multifidus and quadratus lumborum, and the ability to contract the abdominal and multifidus muscles. Voluntary contraction of the trunk muscles was conducted with the subjects lying down. Independent samples T-Tests were performed to test for between group differences. Badminton players with knee pain had larger quadratus lumborum muscles and demonstrated a greater change in muscle thickness from the rested to contracted state. While we cannot comment on causation or direction, over co-contraction of trunk muscles has been shown in other studies to be associated with increased ground reaction forces on landing. Motor control training has been successfully used in other conditions to modify trunk muscle recruitment patterns and may therefore potentially represent a useful approach for badminton players.

Alinhamento toraco-lombo-pélvico em adolescentes que frequentam aulas de balé clássico

This study aimed to assess factors associated with altered thoraco-lumbo-pelvic alignment among adolescents who attend classical ballet class. 57 adolescents were distributed into a case group formed by student ballet dancers with altered thoraco-lumbo-pelvic alignment and a control group formed by student ballet dancers with neutral alignment. The adolescents were subjected to an anthropometric and postural evaluation (photographic record of posture in the lateral view analysed using the vector graphics editor software Corel Draw 3), abdominal muscle strength test and questionnaire. The practice of ballet through Royal Academy of Dancing (RAD) method was 10.47 times more likely to be associated with altered thoraco-lumbo-pelvic alignment than the practice through Vaganova method in adolescents, and muscle strengthening was 6.23 times more likely to be associated with altered alignment when controlling for the other study variables. RAD method combined with muscle strengthening was associated with altered thoraco-lumbo-pelvic alignments among adolescents who showed weak or normal abdominal muscle strength, performed another physical activity, danced ballet for five years or less, had a weekly training load over three hours and usually slept in the prone position. The practice of ballet by the RAD method, in addition to the practice of muscle strengthening, was a factor associated with altered thoraco-lumbar-pelvic alignment.

Quality of life and abdominal wall functionality after abdominal wall reconstruction: A prospective single center follow-up study

BackgroundFascial breakdown with the occurrence of an incisional hernia (IH) is an important and challenging complication of any laparotomy. For a long time, the success of the abdominal wall reconstruction (AWR) was measured only from the surgeon’s perspective by defining outcome measures such as wound morbidity and recurrence. The understanding that complete recovery is difficult to assess without considering patients has shifted the paradigm of optimal outcomes to Patient Reported Outcome Measures (PROMS) and Quality of Life (QoL), which are pivotal to evaluate the success and efficacy of AWR.MethodsWe conducted a prospective follow-up study of 91 patients undergoing mesh-augmented abdominal wall reconstruction for primary or recurrent incisional hernia between January 2021 and December 2023. Demographic data, comorbidities, and hernia characteristics were recorded. All patients were evaluated preoperatively by a native abdomino-pelvic CT scan to assess the characteristics of hernia (length, width, surface, and volume of the incisional hernia sac and of peritoneal cavity), the presence of mesh (if previously inserted), and abdominal wall muscles status. All intervention were performed by the same surgical team according to the techniques described by Rives – Stoppa (RS), Ramirez (ACS), and Novitsky (PCS). Abdominal wall function was assessed using trunk raising (TR) and double leg lowering (DLL) measurements performed preoperatively, 1 month, 6 months, and 1 year postoperatively. At the same time, pre- and post-operative quality of life was analysed using the EQ-5D score.ResultsMean age of 59.42 ± 12.28 years and a male/female ratio of 35/56 were recorded, most of them being obese. There were 36 (42%) patients with defects larger than 10 cm. The distribution of the type of surgical intervention was: RS 35 patients, ACS 13 patients, and PCS 43 patients. The mean value of combined score for the preoperative abdominal wall functionality was 4.41 ± 1.67 (2–8) while the mean value of preoperative EQ-5D index was 0.652 ± 0.026 (-0.32–1.00). QoL was poor and very poor for 48% (44) of the patients who recorded index values less than 0.56 (50% percentile). Preoperative EQ-5D index was highly correlated with Combined AWF score (r = 0.620; p < 0.0001) and the correlation was specific (AUC = 0.799; p < 0.0001; asymptotic 95%CI = 0.711–0.923). At 12 months, the AWF score increased to 8.13 ± 2.58 (1–10) and the QoL total score to 0.979 ± 0.007 (0.71–1). Good and very good total scores for QoL were recorded for 47 patients (84%) compared to 33 (36%) in the preoperative evaluation (χ2 with Yates continuity correction for two degrees of liberty = 46.04; p < 0.00001).ConclusionOur results suggest that patients can expect to see a significant overall improvement in all five components of QoL measured with the help of Eq. 5D questionnaire. This improvement is dependent by hernia size, and some individual patient’s factors (diabetes, cardiovascular diseases, and age over 60 years).

Causation between the gut microbiota and inguinal hernia: a two-sample double-sided Mendelian randomization study

Inguinal hernias are the most common type of enterocele and are frequently caused by defects in the abdominal wall muscles in the groin area. Numerous animal models and human studies have shown that the gut microbiota is associated with skeletal muscle aging and loss. However, the causation between the gut microbiota and inguinal hernia remains unclear. To reveal the causal association between the gut microbiota and inguinal hernia, we conducted a two-sample double-sided Mendelian randomization analysis. We used genome-wide association analysis (GWAS) summary statistics of the gut microbiota from the MiBioGen consortium and GWAS statistics of inguinal hernia from the FinnGen R10 database. The causation between the gut microbiota and inguinal hernia was explored through the inverse variance weighted (IVW) method, MR Egger regression method, weighted median method, weighted model method, and simple model method. Sensitivity analysis was used to test whether the Mendelian randomization analysis results were reliable. Reverse Mendelian randomization was used to conduct effect analysis and sensitivity analysis using the entire gut microbiota as the outcome. The IVW results indicated that Verrucomicrobia, Lactobacilliales, Clostridiaceae1, Butyricococcus, Categorybacter, Hungatella, Odoribacter, and Olsenella had a direct negative causation with the gut microbiota. The reverse Mendelian Randomization results showed that Eubacterium brachygroup, Eubacterium eligensgroup, Eubacterium xylanophilumgroup, Coprococcus3, Ruminococcus1, and Senegalimassilia were directly related to inguinal hernia. The bilateral sensitivity analysis revealed no heterogeneity or horizontal pleiotropy. The results confirmed that 8 bacterial traits had a negative causation with inguinal hernia. Reverse MR analysis revealed a positive correlation between inguinal hernia and 6 bacterial traits. Modulating the diversity and components of the gut microbiota is envisaged to contribute to improving the incidence and prognosis of inguinal hernia.

Muscle thickness of lateral abdominal muscles in sitting and standing positions during abdominal drawing-in maneuver and abdominal bracing among healthy adults

Background: Spinal stabilization exercises, such as abdominal drawing maneuvers (ADIM) and abdominal bracing (AB), are crucial in alleviating low back pain, especially in functional positions such as sitting and standing. However, few studies have investigated the contraction patterns of the lateral abdominal muscles during ADIM and AB in these daily living positions (i.e., sitting and standing). Objective: The study aimed to investigate the thickness of transverse abdominis (TrA), internal abdominal oblique (IO), and external abdominal oblique (EO) during ADIM and AB between sitting and standing positions. Materials and methods: Twenty-four healthy adults (12 males, 12 females) without low back pain or other orthopedic conditions were assessed in sitting and standing positions while performing ADIM and AB. Real-time ultrasound imaging was used to measure the thickness of the TrA, IO, and EO during the ADIM and AB. Results: Muscle thickness of TrA and IO was significantly greater during ADIM when compared to AB (p&lt;0.05). TrA thickness during AB was significantly greater in sitting than standing (p&lt;0.05), but ADIM showed no difference in both positions. ADIM and AB can produce contraction of the lateral abdominal muscles (LAM) in both sitting and standing positions. Conclusion: ADIM and AB can produce contraction of the LAM in both sitting and standing positions. However, ADIM can activate TrA and IO muscles better than AB. Therefore, clinicians may initially consider using ADIM to teach individuals who need core stability exercises such as low back pain.

Peran Kekuatan Perut dalam Meningkatkan Performa Tolak Peluru pada Atlet

The aim of this research is to determine the role of abdominal strength in improving shot put performance in athletes. This research uses a literature review method by collecting information by looking for relevant references and facts from journals and theses that have been previously researched. The literature is then compared and linked to provide an overview of the topic under study. Qualitative research is used as a type of research. This research explores the role of abdominal muscle strength in improving shot put performance in athletes. Shot put requires the right combination of strength, technique and coordination to achieve optimal results. One key element that is often overlooked is abdominal muscle strength or core strength. This research outlines how abdominal muscle strength contributes to body stability, efficient energy transfer, and optimization of shot put technique. Through literature analysis and research findings, it was concluded that integrated abdominal strength training in athlete training programs can help improve shot put performance by optimizing stability, energy transfer and movement technique. The practical implication is the importance of including abdominal strength training in the training program to achieve maximum performance in shot put and reduce the risk of injury. Further research could explore more deeply the long-term influence of abdominal strength training on the performance of shot put athletes.

Evaluation of Anaesthetic Efficacy of Xylazine-Ketamine-Guaifenesin Combination for Relieving Dystocia in Buffaloes

Background: Dystocia in dairy animals remains major concern causing huge economical losses of farmers. Over the past years, field veterinarian relieves dystocia via maneuvering, fetotomy, modified Schaffers and cesarean methods under local or regional anaesthesia which is always stressful and painful procedure leading to excessive tissue damage. Considering the involved stress and further conception during relieving dystocia under local or regional anaesthesia is always questionable. Hence, the present study was aimed to relieve dystocia in buffalo without stress by improving gentle handling of uterus during cesarean or obstetrical method under the anaesthetic combination of xylazine-ketamine-guaifenesin under field condition. Methods: The present study was undertaken in twelve clinical cases of buffaloes with history of dystocia irrespective of age and breed and they were sedated with xylazine and subjected to obstetrical or cesarean procedure under ketamine and guaifenesin anaesthetic protocol. Result: Twelve buffaloes with average age between 3-8 years and body weight 389.66±19.56 kg reported to hospital and amongst them eight were primiparous. Among maternal dystocia, uterine torsion was most common followed by incomplete cervical dilation whereas in foetal dystocia, malpositioned foetus and emphysematous foetus was reported. Tachycardia and hypothermia were consistent findings in all animals. The alkaline phosphatase, SGPT and SGOT has been increased significantly due to muscular damage. Mean duration of general anaesthesia required for obstetrical and cesarean procedure was 35.00±0.25 min and 132.00±0.18 min, respectively. The present study was concluded that, use of ketamine-Guaifenesin combination premedicated with xylazine hydrochloride produced excellent muscle relaxation during obstetrical and cesarean procedure in buffaloes characterized by loss of abdominal muscle tone, stable respiration and minimal cardiopulmonary changes.

High-intensity intermittent inspiratory and abdominal muscle combined training in respiratory, swallowing and systemic muscles of healthy adults.

Low-intensity continuous inspiratory muscle training improves its strength. The abdominal muscles are the main expiratory muscles, and their training may improve expiratory muscle strength. Respiratory muscle strength regulates coughing effectiveness, which is critical for pneumonia management. In older people, risk factors for the development of pneumonia were respiratory muscle weakness and swallowing impairment. Currently, the impact of high-intensity intermittent inspiratory and abdominal muscle combined training on the respiratory, swallowing, and systemic muscles is unclear. We aimed to explore the effects of high-intensity inspiratory muscle training combined with or without abdominal muscle training on respiratory muscle strength as well as the strength, mass, and performance of swallowing and systemic muscles. Twenty-eight healthy adults were divided into two groups. Participants performed high-intensity intermittent inspiratory muscle single or its combination with abdominal muscle training for 4 weeks. Respiratory muscle strength, swallowing muscle strength and mass, systemic muscle strength, mass and performance were measured at baseline, Week 2 and Week 4. Both groups showed greater maximal respiratory pressures at Week 2 and Week 4 than baseline. Both groups showed improved tongue pressure and geniohyoid muscle thickness at Week 4. In addition, the combined training group improved body trunk muscle mass, handgrip strength and five-time chair stand test, whereas the single training group did not. This study revealed that high-intensity inspiratory muscle training improved inspiratory muscle strength and swallowing muscle strength and mass. Moreover, inspiratory and abdominal muscle combined training showed an additional benefit of improving systemic muscle strength, mass and performance. UMIN000046724; https://upload.umin.ac.jp/cgi-open-bin/ctr/index.cgi?ctrno=UMIN000046724.

Commercial infant products influence body position and muscle use

The musculoskeletal and motor development of infants is affected by their environment, which varies from being held, lying on a firm flat surface, to seated in various nursery products. Nursery products can alter the body position of infants, particularly the position of the head/neck and trunk, which may inhibit an infant's ability to breathe. With U.S. infants spending an increasing amount of time in seated products, the purpose of this study was to assess muscle activation and body position in four commercial infant products (carrier, bouncer, rocker, and swing) during supine and prone positioning, compared to a firm flat surface. Thirteen healthy infants (age: 4.2 ± 1.4 months; 7 M/6F) were enrolled in this IRB-approved in-vivo biomechanics study. Surface electromyography sensors recorded muscle activity of the erector spinae, cervical paraspinals, quadriceps, and abdominal muscles and retro-reflective markers tracked movements to determine head-neck, trunk, and torso-pelvis flexion/extension in the sagittal plane. While supine, infants exhibited increased head-neck and trunk flexion of up to 21° and 27° above the playmat, respectively, in all seated products. While prone, high abdominal muscle activation compared to the playmat indicates that infants will fatigue faster in seated products. Additionally, the lower muscle activation levels exhibited in younger infants (< 4 months) compared to older infants (≥ 4 months) indicates that younger infants rely on the product design to maintain body position. However, offering infants a variety of environments to move within is important to avoid motor delay, therefore future work should explore how long-term use may impact an infant's development.

Relationship Between the Results of the Landing Error Scoring System and Trunk Muscle Thickness.

A landing error scoring system (LESS) is widely used to evaluate landing maneuvers. Poor landing maneuvers, such as lateral bending of the trunk, are thought to be associated with a risk of lower-extremity injury. However, no studies have examined the association between landing and trunk muscle function, which is associated with a high risk of lower-extremity injury. This study examined whether an association exists between landing movements and a high risk of lower-extremity injury and trunk muscle function. It was hypothesized that athletes with poor activation of deep trunk muscle (transversus abdominis and internal oblique) would have lower LESS scores. Cross-sectional study. The trunk muscle thickness at rest and during the plank was measured using ultrasonography. The percent of change in muscle thickness (during plank/at rest) was calculated. The LESS was measured using the Physimax. Based on the LESS scores, patients were divided into high- (LESS > 6) and low-risk (5 > LESS) groups for lower extremity injury. The relationship between the high-risk group and trunk muscle thickness was examined using a stepwise regression analysis. The high-risk group had significantly lower muscle thicknesses of the transversus abdominis (p=0.02) and transversus abdominis plus internal oblique abdominis (p=0.03) muscles during the plank. Additionally, the high-risk group showed significantly lower percent of change in muscle thickness of the internal oblique (p=0.02) and transversus abdominis plus internal oblique (p=0.01) muscles. Only the percentage of change in the thickness of the internal oblique and transverse abdominal muscles was extracted from the regression as a factor. The findings indicated that athletes with landing movements and a high risk of injury, as determined based on the LESS results, had low trunk muscle function, and a relationship was observed between the change in thickness of transversus abdominis and internal oblique abdominis muscles. 3B.

Nomogram for predicting intolerable postoperative early enteral nutrition following definitive surgery for small intestinal fistula: a cohort study.

This study was designed to develop and validate a nomogram for predicting intolerable early enteral nutrition (EEN) following definitive surgery (DS) for small intestinal fistula. A total of 377 patients, recruited from January 2016 to September 2023, was randomly allocated into development ( n =251) and validation ( n =126) groups in a 2:1 ratio. Risk factors were identified using the nomogram. Its performance was assessed based on calibration, discrimination, and clinical utility, with validation confirming its effectiveness. Of the 377 patients, 87 (23.1%) were intolerant to EEN, including 59 (23.1%) in the development cohort and 28 (22.1%) in the validation cohort ( P =0.84). Four factors were identified as predictive of intolerable EEN: severe abdominal adhesion, deciliter of blood loss during DS, human serum albumin (Alb) input >40g during and within 48h post-DS, and the visceral fat area (VFA)/total abdominal muscle area index (TAMAI) ratio. The model demonstrated excellent discrimination, with a C-index of 0.79 (95% CI: 0.74-0.87, including internal validation) and robust calibration. In the validation cohort, the nomogram showed strong discrimination (C-index=0.77; 95% CI: 0.64-0.87) and solid calibration. Decision curve analysis affirmed the nomogram's clinical utility. This research introduces a nomogram that enables the individualized prediction of intolerable EEN following DS for small intestinal fistula, demonstrating a possible clinical utility.

Effect of Circuit Training and Interval Training on Health Related Physical Fitness of Physical Education Professional Students

Abstract: The purpose of this study was to know the effect of circuit training and interval training on health related physical fitness of physical education professional students. Ninety boys belonging to B.P.Ed class of Govt. College of physical Education, Bhubaneswar age ranging between 22 to 25 years acted as subjects and assigned to three groups (two experimental and one control group) with 30 students each. The two experimental groups were Circuit Training and Interval Training groups. Health related physical fitness parameters such as Abdominal Muscle Strength (Sit Up), Flexibility (Sit and Reach), Cardiovascular Endurance (1 Mile Run), and Body Fat % (Triceps and Sub-Scapular Skin fold) were measured before and after training. All the experimental Groups (Circuit training and Interval training) was administered with the selected exercises, thrice in a week for a duration of 8 weeks under direct supervision of the research scholars. The analysis of data revealed that the three experimental groups, showed significant gains in performance of health related physical fitness after administration of training for duration of 8 weeks. The control group did not show any significant increase in the performance

Dystroglycan-HSPG interactions provide synaptic plasticity and specificity.

This study examined the roles of the laminin and proteoglycan receptor dystroglycan (DG) in extracellular matrix stabilization and cellular mechanosensory processes conveyed through communication between the extracellular matrix (ECM) and cytoskeleton facilitated by DG. Specific functional attributes of HS-proteoglycans (HSPGs) are conveyed through interactions with DG and provide synaptic specificity through diverse interactions with an extensive range of cell attachment and adaptor proteins which convey synaptic plasticity. HSPG-DG interactions are important in phototransduction and neurotransduction and facilitate retinal bipolar-photoreceptor neuronal signaling in vision. Besides synaptic stabilization, HSPG-DG interactions also stabilize basement membranes and the ECM and have specific roles in the assembly and function of the neuromuscular junction. This provides neuromuscular control of muscle systems that control conscious body movement as well as essential autonomic control of diaphragm, intercostal and abdominal muscles and muscle systems in the face, mouth and pharynx which assist in breathing processes. DG is thus a multifunctional cell regulatory glycoprotein receptor and regulates a diverse range of biological and physiological processes throughout the human body. The unique glycosylation of the αDG domain is responsible for its diverse interactions with ECM components in cell-ECM signaling. Cytoskeletal cell regulatory switches assembled by the βDG domain in its role as a nuclear scaffolding protein respond to such ECM cues to regulate cellular behavior and tissue homeostasis thus DG has fascinating and diverse roles in health and disease.

Current state of rumination syndrome.

Rumination syndrome (RS) is an underdiagnosed behavioral disorder of recurrent regurgitation. Regurgitation occurs in RS due to increased gastric pressure achieved by subconscious contraction of the abdominal musculature wall, reversing the pressure gradient between the esophagus and the stomach. RS is mainly diagnosed clinically by the Rome Criteria with symptoms of regurgitation without retching of recently ingested food into the mouth and subsequent spitting or re-mastication. When the diagnosis is unable to be made clinically, supportive testing including fed impedance manometry can be considered. RS occurs worldwide, affecting patients of all ages, races, and genders with a prevalence of 3.1-5.8%. There is significant overlap with RS and disorders of a gut-brain interaction and upright gastroesophageal reflux driven by aerophagia and supragastric belching. There is also an association with mood disorder, fibromyalgia, and eating disorders. RS may be misdiagnosed as a variety of other syndromes including gastroesophageal reflux disease, gastroparesis, achalasia, and bulimia nervosa. Once RS is diagnosed, the mainstay of treatment is diaphragmatic breathing to lower the intragastric pressure and increase the lower esophageal pressure. Diaphragmatic breathing can be supported with biofeedback and cognitive behavioral therapy as well as medication options for more refractory cases. Response to therapy overtime and changes in symptoms overtime can now be tracked with a validated questionnaire.

Role of the pontine respiratory group in the suppression of cough by codeine in cats

Codeine was microinjected into the area of the Kölliker-Fuse nucleus and the adjacent lateral parabrachial nucleus, within the pontine respiratory group in 8 anesthetized cats. Electromyograms (EMGs) of the diaphragm (DIA) and abdominal muscles (ABD), esophageal pressures (EP), and blood pressure were recorded and analyzed during mechanically induced tracheobronchial cough. Unilateral microinjections of 3.3 mM codeine (3 injections, each 37 ± 1.2 nl) had no significant effect on the cough number. However, the amplitudes of the cough ABD EMG, expiratory EP and, to a lesser extent, DIA EMG were significantly reduced. There were no significant changes in the temporal parameters of the cough. Control microinjections of artificial cerebrospinal fluid in 6 cats did not show a significant effect on cough data compared to those after codeine microinjections. Codeine-sensitive neurons in the rostral dorsolateral pons contribute to controlling cough motor output, likely through the central pattern generator of cough.