Lower Body Research Articles

Weight gain leads to greater adverse metabolic responses in South Asian compared with white European men: the GlasVEGAS study

South Asians (SAs) develop type 2 diabetes at lower body mass index values than white Europeans (WEs). This basic human experimental study aimed to compare the metabolic consequences of weight gain in SA and WE men without overweight or obesity. Fourteen SAs and 21 WEs had assessments of body composition, metabolic responses to mixed-meal ingestion, cardiorespiratory fitness and physical activity, and a subcutaneous abdominal adipose tissue biopsy, before and after 4–6 weeks of overfeeding to induce 5–7% weight gain. Here we show that body mass index and whole-body adipose tissue volume increases similarly between ethnic groups, but SAs gain less lean tissue. SAs experience a substantially greater decrease in insulin sensitivity compared with WEs (38% versus 7% decrease, P = 0.009), have fewer small (37.1% versus 60.0%, P = 0.003) and more large (26.2% versus 9.1%, P = 0.005) adipocytes at baseline and have a smaller decrease in very small adipocytes with weight gain (−0.1% versus −1.9%, P < 0.0001). Ethnic differences in adipocyte morphology are associated with SA’s greater adverse metabolic changes with weight gain. ClinicalTrials.gov registration: NCT02399423.

The upper limit of thermoneutrality is not indicative of thermotolerance in bats

To assess the vulnerability of birds and mammals to climate change recent studies have used the upper critical limit of thermoneutrality (TUC) as an indicator of thermal tolerance. But, the association between TUC and thermal tolerance is not straightforward and most studies describe TUC based solely on a deviation in metabolism from basal levels, without also considering the onset of evaporative cooling. It was argued recently that certain torpor-using bat species who survived prolonged exposure to high ambient temperatures (i.e. high thermal tolerance) experienced during extreme heat events did so by entering torpor and using facultative heterothermy to thermoconform and save on body water. Assuming that TUC is indicative of thermal tolerance, we expect TUC in torpor-using species to be higher than that of species which are obligate homeotherms, albeit that this distinction is based on confirmation of torpor use at low temperatures. To test this prediction, we performed a phylogenetically informed comparison of bat species known to use torpor (n = 48) and homeothermic (n = 16) bat species using published thermoregulatory datasets to compare the lower critical limit of thermoneutrality (TLC) and TUC in relation to body temperature. The influence of diet, biogeographical region, body mass and basal metabolic rate (BMR) was also considered. Body mass had a positive relationship with BMR, an inverse relationship with TLC and no relationship with TUC. Normothermic body temperature scaled positively with BMR, TLC and TUC. There was no relationship between diet or region and BMR, but both influenced thermal limits. Torpor-using bats had lower body mass and body temperatures than homeothermic bats, but there was no difference in BMR, TLC and TUC between them. Exceptional examples of physiological flexibility were observed in 34 torpor-using species and eight homeothermic species, which included 15 species of bats maintaining BMR-level metabolism at ambient temperatures as high as 40 °C (and corresponding body temperatures ∼39.2 °C). However, we argue that TUC based on metabolism alone is not an appropriate indicator of thermal tolerance as it disregards differences in the ability of animals to tolerate higher levels of hyperthermia, importance of hydration status and capacity for evaporative cooling. Also, the variability in TUC based on diet challenges the idea of evolutionary conservatism and warrants further consideration.

Compensatory reserve index during central hypovolemia and volume loading in healthy young and older hyperthermic adults: A pilot study.

The compensatory reserve index (CRI), derived from machine learning algorithms from peripherally obtained photoplethysmography signals, provides a non-invasive assessment of cardiovascular stability, that may be useful clinically. Briefly, the CRI device provides a value between 0 and 1, with 1 reflecting full compensable capabilities and 0 reflecting little to no compensable capabilities. However, the CRI algorithm was developed in younger to middle aged adults, such that it is unknown if older age modulates CRI responses to cardiovascular challenges. In young and older subjects, we compared CRI responses to normothermic and hyperthermic progressive lower body negative pressure (LBNP), and volume loading with saline infusion. Eleven younger (20-36 years) and 10 older (61-75 years) healthy participants underwent (1) graded normothermic LBNP up to 30 mmHg, (2) graded hyperthermic (1.5°C increase in blood temperature) LBNP up to 30 mmHg, and (3) infusion of 15 mL/kg saline (volume loading) with hyperthermia maintained. CRI was obtained throughout each procedure. CRI at 30 mmHg LBNP was 0.18 and 0.24 units greater in the older group during normothermic and hyperthermic LBNP, respectively. However, CRI was not different between age groups at any other LBNP stage, nor did CRI change with volume loading regardless of age. In response to passive hyperthermia alone, regression analyses showed that heart rate was the strongest predictor of CRI. Blood temperature, rate pressure product, and stroke volume were also predictive of CRI but to a lesser extent. In conclusion, age attenuates the reduction in CRI during progressive normothermic and hyperthermic LBNP, but only at 30 mmHg. Second, the CRI was unchanged during volume loading in all subjects. Future studies should determine whether the age differences in CRI reflect age differences in LBNP tolerance.

A Two-Part Transformer Network for Controllable Motion Synthesis.

Although part-based motion synthesis networks have been investigated to reduce the complexity of modeling heterogeneous human motions, their computational cost remains prohibitive in interactive applications. To this end, we propose a novel two-part transformer network that aims to achieve high-quality, controllable motion synthesis results in real-time. Our network separates the skeleton into the upper and lower body parts, reducing the expensive cross-part fusion operations, and models the motions of each part separately through two streams of auto-regressive modules formed by multi-head attention layers. However, such a design might not sufficiently capture the correlations between the parts. We thus intentionally let the two parts share the features of the root joint and design a consistency loss to penalize the difference in the estimated root features and motions by these two auto-regressive modules, significantly improving the quality of synthesized motions. After training on our motion dataset, our network can synthesize a wide range of heterogeneous motions, like cartwheels and twists. Experimental and user study results demonstrate that our network is superior to state-of-the-art human motion synthesis networks in the quality of generated motions.

Impact of slit compared with nonslit mesh in laparoscopic groin hernia repairs—A comprehensive propensity score analysis of a cohort of 611 hernias

BackgroundThe slit-mesh technique for laparoscopic groin hernia repair remains controversial. We present the largest cohort of patients to date that have undergone laparoscopic hernia repair with this technique and aim to evaluate the impact of both techniques on postoperative recurrence and other secondary outcomes. MethodsA retrospective, single-institution cohort study of patients who underwent a laparoscopic groin hernia repair over a 5.5-year period was performed. Univariate and multivariate analyses were performed to identify factors associated with recurrence, chronic pain, complications, length of stay, and operative time. A propensity score analysis also was performed. Time to recurrence was then subsequently plotted on a Kaplan-Meier survival analysis. ResultsIn total, 611 laparoscopic groin hernia repairs (nonslit: n = 353; slit: n = 258) were reviewed. Mean follow-up duration was 6.6 months. On the multivariate analysis, body mass index was inversely correlated with recurrence (odds ratio, 0.792; 95% confidence interval, 0.656–0.956), whereas a slit mesh had lower recurrence (odds ratio, 0.228; 95% confidence interval, 0.064–0.809). In the propensity score–adjusted analysis, slit mesh remained significantly associated with reduced recurrence (adjusted odds ratio, 0.251; 95% confidence interval, 0.070–0.900), with no differences in chronic pain (adjusted odds ratio, 1.297; 95% confidence interval, 0.275–6.128) or postoperative complications (adjusted odds ratio, 1.808; 95% confidence interval, 0.429–7.620). Operative time also was reduced in the slit-mesh group (P = .009). ConclusionsThe slit-mesh technique was associated with a reduced likelihood of postoperative recurrence and shorter operative time, with no impact on postoperative chronic pain or complications. A lower body mass index was also correlated with increased likelihood of postoperative recurrence.

The ecological validity of the Yale Food Addiction Scale 2.0 and momentary food addiction symptoms.

This study assessed the ecological validity of the Yale Food Addiction Scale (YFAS 2.0) with ecological momentary assessment (EMA) and explored the internal consistency and convergent validity of a momentary food addiction scale. Adults (N = 49) who met criteria for binge-eating disorder and/or food addiction (age = 34.9 ± 12.1 years; 77.1% cisgender female; 55.1% non-Hispanic White) completed online questionnaires and a 10-day EMA protocol. Analyses examined (a) associations between the YFAS 2.0 and EMA-measured variables corresponding to food addiction criteria, (b) reliability of a momentary food addiction scale (EMA-FA), and (c) concurrent associations between EMA-FA and EMA-measured negative affect, impulsivity, eating expectancies, body satisfaction, consumption of palatable food, and taste response to palatable food. YFAS scores were associated with EMA-reported variables corresponding to food addiction criteria (ps < .045). The multilevel reliability for EMA-FA was adequate (ω = .75-.94). Individuals with higher EMA-FA scores reported greater negative affect, impulsivity, appetite, palatable food consumption, taste response to palatable food, and contrary to expectations, greater body satisfaction (ps < .01). Within-person effects emerged for EMA-FA predicting higher negative affect, impulsivity, likelihood of palatable food consumption, more pleasurable taste responses after consuming palatable foods, yet lower body satisfaction, appetite, and eating expectancies (ps < .01). Results support the ecological validity of the YFAS 2.0, and additional evidence of convergent validity and internal consistency was demonstrated for a momentary food addiction scale. This assessment of the psychometric properties of the YFAS will ultimately further its utility and relevance in the study and diagnosis of food addiction. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Influence of maternal α-lipoic acid supplementation in Sprague Dawley rats on maternal and fetal metabolic health in pregnancies complicated by obesity

The objective of this study was to investigate the influence of α-lipoic acid (LA; R enantiomer) supplementation on maternal and fetal metabolic health in pregnancies complicated by maternal obesity. Forty female Sprague-Dawley rats were randomized to one of four treatment groups (n=10/group) throughout pre-pregnancy (3 weeks) and gestation (20 days): (i) a low calorie control (CON); (ii) a high calorie obesity-inducing diet (HC); (iii) the HC diet with 0.25% LA (HC+LA) or; (iv) the HC diet pair-fed to match the caloric intake of the HC+LA group (HC+PF). On gestation day 20, pregnant rats were placed under anesthesia for collection of maternal/fetal blood and tissues. Compared with the HC group, LA-supplemented mothers demonstrated lower maternal pre-pregnancy and gestational weight gain (GWG), improved glycemic control (lower Homeostatic Model Assessment for Insulin Resistance), and higher cholesterol concentrations in serum [high-density lipoprotein cholesterol (HDL-C) and low-and very-low density lipoprotein cholesterol (LDL/VLDL) fractions] and liver. Male and female fetuses from LA-supplemented mothers exhibited lower body weight, improved insulin sensitivity, and evidence of altered lipid metabolism including lower serum HDL-C, lower serum triglyceride (TG), and increased hepatic TG accumulation. Although maternal LA supplementation showed some benefit for both mothers and fetuses with respect to obesity and glycemic control, concern about the potential longer-term implications of liver cholesterol (mothers) and TG accumulation (fetuses) needs further investigation.

Severe Hypertriglyceridemia in Patients with Type 2 Diabetes Mellitus Participating in the AMD Annals Initiative.

Background: Familial chylomicronemia syndrome (FCS) is a rare inherited condition due to lipoprotein lipase deficiency, characterized by hyperchylomicronemia and severe hypertriglyceridemia. Diagnosis is often delayed, thus increasing the risk of acute pancreatitis and hospitalization. Hypertriglyceridemia is a common finding in patients with type 2 diabetes (T2D), who may harbor FCS among the most severe forms. Aim of the Study: We investigated the prevalence and clinical characteristics associated with severe hypertriglyceridemia in a range indicative of FCS, in a large population of subjects with T2D. Methods: Within the large population of the AMD Annals Initiative, patients with T2D with a lipid profile suggestive of FCS [triglycerides >880 mg/dL and/or high-density lipoprotein (HDL)-cholesterol <22 mg/dL or non-HDL-cholesterol ≤70 mg/dL] and their clinical features have been identified. Results: Overall, 8592 patients had triglyceride values >880 mg/dL in a single examination, 613 in two examinations, and 34 in three or more measurements. Patients with high triglyceride levels were mostly male (80%), with a relatively young age (54 years), short duration of diabetes (6.3 years), and elevated hemoglobin A1c (HbA1c) levels (9.4%). By stratifying this group of patients according to the severity of hypertriglyceridemia, more severe hypertriglyceridemia (triglyceride levels ≥2000 mg/dL) was associated with an even younger age (52 vs. 54 years), even higher mean HbA1c values (10.0% vs. 9.4%), and significantly higher HDL-cholesterol levels (37.9 vs. 32.4 mg/dL; P < 0.0001). Patients with persistently elevated triglyceride levels (n = 34), on three measurements, had a younger age; lower body mass index, HbA1c, and HDL-cholesterol levels; more frequent use of fibrates and insulin; and a higher prevalence of major cardiovascular events. Conclusions: Severe hypertriglyceridemia is a frequent condition in outpatients with T2D participating in the AMD Annals Initiative, and it is associated with male sex, young age, short disease duration, and a worse glycemic profile. Among patients with persistent severe hypertriglyceridemia, hidden FCS may be present.

Predictors of Patient-Reported Outcomes After Hyaluronic Acid Injections: Effect of Expectations and Psychological Stress.

Hyaluronic acid (HA) injections are a common nonsurgical treatment of knee osteoarthritis (OA). Patient expectations and psychological stress are believed to affect outcomes after orthopaedic procedures. This was a prospective cohort study seeking to identify factors predictive of greater patient-reported outcomes after HA injections, particularly expectations and psychological stress. 250 patients receiving a series of HA injections for knee OA were enrolled, with 196 being included for analysis. Demographics, surgical history, and preoperative Kellgren-Lawrence severity scores were collected, and patients completed the Knee Osteoarthritis Outcome Score (KOOS) questionnaire, a modified KOOS questionnaire assessing their 6-month postinjection expectations, and the Perceived Stress Scale before the first injection. Outcomes were assessed at 3 weeks and 3 and 6 months after the final injection. KOOS scores improved from preinjection to 6-month follow-up but did not meet patients' expectations or minimal clinically important difference. Expectations correlated with 6-month KOOS pain, activities of daily living, sport, and quality of life subscales (ρ = 0.19 to 0.34), but not the symptom subscale (P = 0.10). Expectations (ρ = 0.31 to 0.37), younger age (ρ = -0.17 to -0.18), and greater perceived stress (ρ = 0.23) correlated with greater improvement from baseline KOOSs. Lower body mass index (ρ = -0.19 to -0.22), male sex (ρ = -0.17), and greater preinjection function (ρ = 0.37 to 0.46) correlated with greater 6-month outcomes. Stress measured on the Perceived Stress Scale did not correlate with 6-month KOOSs (P ≥ 0.27). Lower Kellgren-Lawrence severity score was weakly associated with greater 6-month KOOS activities of daily living and sport scores (ρ = -0.15 to -0.16) and greater improvement in the KOOS symptom score (ρ = -0.15). This study identified that higher expectations, lower body mass index, younger age, male sex, lower radiographic severity, greater preinjection function, and greater perceived stress are associated with greater patient outcomes after HA injection. Physicians should consider these factors when counseling patients with knee OA about viscosupplementation. Prospective Cohort Study (Level of Evidence II).

The use of reduced DOAC doses in atrial fibrillation patients does not always lead to good anticoagulation levels and avoid adverse events

BackgroundThe MAS study (Blood Advances 2024) showed that a high proportion of Italian AF patients treated with direct oral anticoagulants (DOACs) receive reduced doses. This sub-analysis of MAS data aimed to analyze the effects of reduced (appropriate or not)- or standard-dose use on DOAC activity assessed at baseline and the occurrence of thrombotic or bleeding complications during follow-up. MethodsThe MAS study design, the methods for DOAC measurement, the results, and the adverse events during follow-up, are described in detail elsewhere. ResultsSeven hundred AF patients (42 % of the total 1657) received a reduced dose (considered inappropriate in 140 [20 %]). They were older, more frequently women, with lower body mass index (BMI), hemoglobin levels, and creatinine clearance. They more often had cerebral or cardiovascular diseases, were taking more medications, with higher scores for thrombotic or bleeding risk. Despite the use of low doses, 133 (19.0 %) patients had high standardized C-trough DOAC levels and experienced a high proportion of bleeding events (8.3 % per year). Conversely, some patients (4.7 %) had very low levels, resulting in a high incidence of thrombotic events (6.7 % per year). No difference was detected if the reduced dose was appropriate or not. ConclusionThe unpredictable, highly variable inter-individual anticoagulant effect of DOACs may lead to either too low or too high anticoagulant levels, increasing the risk of thrombotic or bleeding events. This is particularly relevant for patients with high-risk conditions, such as those chosen for reduced-dose treatment. Further studies are needed to investigate this important clinical issue.

The Effects of Resistance Training on Cardiovascular Factors and Anti-Inflammation in Diabetic Rats

Diabetes induces a range of macrovascular and microvascular changes, which lead to significant clinical complications. Although many studies have tried to solve the diabetic problem using drugs, it remains unclear. In this study, we investigated whether resistance exercise affects cardiovascular factors and inflammatory markers in diabetes. The study subjected Otsuka Long-Evans Tokushima Fatty (OLETF) rats, which have genetically induced diabetes mellitus, to a resistance exercise program for 12 weeks and assessed the levels of cardiovascular factors and inflammatory markers using western blotting analysis, ELISA, and immunohistochemistry. During the training period, OLETF + exercise (EX) group exhibited lower body weight and reduced glucose levels when compared with OLETF group. Western blotting analysis, ELISA, and immunohistochemistry revealed that the levels of PAI-1, VACM-1, ICAM-1, E-selectin, TGF-β, CRP, IL-6, and TNF-α were decreased in OLETF + EX group when compared with the OLETF group. Moreover, the anti-inflammatory markers, IL-4 and IL-10, were highly expressed after exercise. Therefore, these results indicate that exercise may influence the regulation of cardiovascular factors and inflammatory markers, as well as help patients with metabolic syndromes regulate inflammation and cardiovascular function.

Evaluation of serum mid-infrared spectroscopy as new prognostic marker for first-line bevacizumab-based chemotherapy in metastatic colorectal cancer

Background and aimsBevacizumab-based chemotherapy is a recommended first-line treatment for metastatic colorectal cancer (mCRC). Robust biomarkers with clinical practice applicability have not been identified for patients with this treatment. We aimed to evaluate the prognostic yield of serum mid-infrared spectroscopy (MIRS) on patients receiving first-line bevacizumab-based chemotherapy for mCRC. MethodsWe conducted an ancillary analysis from a multicentre prospective study (NCT00489697). All baseline serums were screened by attenuated total reflection method. Principal component analysis and unsupervised k-mean partitioning methods were performed blinded to all patients’ data. Endpoints were progression-free survival (PFS) and overall survival (OS). ResultsFrom the 108 included patients, MIRS discriminated two prognostic groups. First group patients had significantly lower body mass index (p = 0.026) and albumin levels (p < 0.001), and higher levels of angiogenic markers, lactate dehydrogenase and carcinoembryonic antigen (p < 0.001). In univariate analysis, their OS and PFS were shorter with respective medians: 17.6 vs 27.9 months (p = 0.02) and 8.7 vs 11.3 months (p = 0.03). In multivariate analysis, PFS was significantly shorter (HR = 1.74, p = 0.025) with a similar trend for OS (HR = 1.69, p = 0.061). ConclusionBy metabolomic fingerprinting, MIRS proves to be a promising prognostic tool for patients receiving first-line bevacizumab-based chemotherapy for mCRC.

Biomarkers and metal content in white seabream (Diplodus sargus) and its relationship with the occurrence of the abnormal tough syndrome

There is still controversy on the cause of the incidence of abnormal tough syndrome (ATS) in some fish species, mainly the white seabream (Diplodus sargus). This work analyses the incidence of the ATS in white seabream in areas with a different extent of heavy metal pollution and its possible relationship with fish health. Muscular cholinesterase (ChE) activities were selected to assess their potential as biomarkers of ATS occurrence. Among the trace elements Zn, Cu, Pb, and As in muscle and Cu in liver were significantly higher in the fish from the most polluted marina location. ATS incidence (33%) was also recorded in this site with individuals showing a significantly lower body condition but ChE activities did not reflect any neurotoxic impact on the fish, neither did detoxification and oxidative stress damage. However, a significant negative association was seen between AChE activity and muscle body burden of Hg, Cu, and Se in fish from the less impacted sites, which suggests a certain neurotoxic modulation by these metals. It also alerts for the consumption of fish from recreational activities that do not follow any regulatory measures.

Evaluating the role of sarcopenia and [18F]FDG PET/CT parameters in prognosis of pancreatic ductal adenocarcinoma

This study investigates the relationship between 18F-fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) metabolic parameters, clinicopathological characteristics, and sarcopenia in patients with pancreatic ductal adenocarcinoma (PDAC) and evaluates their prognostic roles. Material and methodsThe primary tumor's maximum standard uptake (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) values, as well as clinicopathological factors, were evaluated retrospectively. Computed tomography (CT) was used to assess the skeletal muscle index (SMI). Sarcopenia was defined based on SMI calculated at the third lumbar vertebra (L3). SMI cut-off values ​​for sarcopenia were accepted as 44.77 cm2/m2 for men and 32.50 cm2/m2 for women. The primary endpoint was the overall survival (OS). OS data were analyzed by the Kaplan-Meier method and compared using the log-rank test. To identify predictive factors for sarcopenia, multivariable logistic regression was used following univariable logistic regression. Cox proportional hazards regression analyses were used to find predictors of OS. ResultsOf the 86 patients included in the study, 37 (43%) were diagnosed with sarcopenia. Compared with non-sarcopenic patients, sarcopenia was observed in older patients (P=0,028) and patients with lower body mass index (BMI) (p=0,001). Age and BMI independently predicted sarcopenia. Univariate analysis identified sarcopenia, advanced stage, and higher primary tumor TLG as significant predictors of overall survival. Multivariate Cox regression analysis revealed that the advanced tumor stage (p=0.017) and higher TLG (p=0,042) independently predicted OS. The median OS was 9.4 months in non-sarcopenic patients and 5.0 months in sarcopenic patients (p=0,021). ConclusionIn this study cohort, advanced-stage disease and higher primary tumor TLG were identified as independent predictors of OS in patients with PDAC. Additionally, we emphasize the importance of incorporating [18F]FDG PET/CT-derived sarcopenia assessments into the prognostic evaluation and clinical management of PDAC patients. While sarcopenia was associated with shorter OS in univariate analysis, it was not an independent predictor in multivariate analysis.

Joint Damage and Low Lean Body Mass in a Cohort of Peruvian Patients With Rheumatoid Arthritis.

To determine the association between radiologic joint damage (JD) and a lower lean body mass (LBM) in rheumatoid arthritis (RA) patients. A cross-sectional study from a single center established RA cohort. JD and appendicular LBM (arms and legs) were measured with the Sharp/van der Heijde (SvdH) score and dual x-ray absorptiometry expressed as kg/m2, respectively. A univariable analysis was used to determine the association between JD an LBM; then, a multivariable regression model was performed to evaluate the persistence of this association, adjusted by age, gender, disease duration, socioeconomic status (by the Graffar method), tobacco use, anticitrullinated protein antibody levels, Disease Activity Score in 28 joints for RA with erythrocyte sedimentation rate, glucocorticoid use (as prednisone equivalent), disease-modifying antirheumatic drug use, body mass index, and disability (by the multidimensional Health Assessment Questionnaire). Two hundred forty-seven patients were included; the average (SD) age was 63.0 (12.8) years, disease duration 20 (15.00) years, the total SvdH was 66 (86.75), and the aLBM was 13.6 (3.82) kg/m2. In the univariable analysis, a lower appendicular LBM was associated with higher SvdH score on the female population, in terms of the total (B = -8.6, p < 0.01), bone erosion (-4.4, p < 0.01), and joint space narrowing (-4.2, p < 0.01) scores; this correlation remained in the multivariable analysis in terms of total SvdH (B = -9.5, p < 0.01), bone erosion (-5.2, p < 0.01), and joint space narrowing (-4.3, p < 0.01). A lower LBM in female patients was associated with more severe JD independently of other variables examined. Strategies aimed at preserving LBM could have a favorable impact on the course of disease.

Investigating the functional effects of the long-term ketogenic diet on pancreatic islets in epileptic rats

Ketogenic Diet is well studied and applied as a treatment in numerous nervous system diseases, such as epilepsy. However, KDs long term effect on the cells and the risk of potential insulin resistance are unclear. In this research, we aim to testify whether the usage of KD on patients with epilepsy would increase the risk of diabetes. In this research we firstly verified the cytotoxicity of the islet B cells which might be stimulated by the abundance of fats in the KD. We used a CCK-8 kit to conduct the experiment and obtained a result of higher IC50 values in the keto conditioned cells, which indicates that cells in keto face a higher cytotoxicity than cells in normal condition. Afterwards, we did both vivo and in vitro experiments on the rats. In the in vitro experiment, the islet cells in a keto-environment showed a higher apoptosis rate. In the in vivo experiment, Enzyme-linked immunosorbent assay (ELISA) was used to detect the insulin level and blood fat in plasma of rats. The result out of ELISA demonstrates a continuously decreasing level of insulin and lower body fat. In addition, oral glucose tolerance test (OGTT) was also used to find the blood sugar in the rats which came out as a result that the glucose metabolism has decreased. Although the experiments exhibit several side effects of KD, it might not be applicable to humans since we only had animal experiment. This research aims to reevaluate the benefits and side effects of application of KD to curing epilepsy.

Examining body appreciation in six countries: The impact of age and sociocultural pressure.

Previous research on body appreciation across the lifespan has produced conflicting results that it increases with age, decreases with age, or is generally stable with an increase in women over 50-years-old. Furthermore, most of the research has been conducted in White, Western populations. Cross-cultural research suggests that both Chinese and African women experience similar sociocultural pressures as White Western women, and that appearance ideals are shifting to resemble a more Western ideal. We cross-sectionally and cross-culturally examined body appreciation across the lifespan, recruiting White Western women (UK, USA, Canada, and Australia), Black Nigerian women, and Chinese women. 1186 women aged 18-80 completed measures of body appreciation, internalisation of thin and athletic ideals, and perceived sociocultural pressure. Body appreciation did not vary with age in women from any country. Nigerian women reported the highest body appreciation, and Western women the lowest. Higher thin/athletic ideal internalisation, and higher perceived sociocultural pressure were significantly associated with lower body appreciation in all countries and age-groups. Overall, our findings indicate that although levels of body appreciation differ drastically between ethnicities and cultures, it is generally stable across age, and shows cross-culturally robust relationships between sociocultural internalisation and pressure.

The impact of preoperative skeletal muscle loss on the completion of S-1 adjuvant chemotherapy for gastric cancer.

Body weight loss after surgery for gastric cancer is related to S-1 compliance and it also affects the prognosis. However, it is unclear whether the preoperative skeletal muscle mass affects S-1 completion for gastric cancer. We investigated the impact of preoperative skeletal muscle mass loss on the completion of S-1 adjuvant chemotherapy for gastric cancer. We retrospectively analyzed data from 53 patients who underwent curative gastrectomy followed by adjuvant S-1 monotherapy for pStage II-III gastric cancer between 2012 and 2021 at our hospital. The psoas muscle mass index (PMI) was used as the index for preoperative skeletal muscle mass. Thirty-six patients completed S-1 treatment and 17 discontinued treatment. The patients who completed S-1 treatment had a longer overall survival than those who discontinued treatment (log-rank test, p = 0.043). According to a univariate analysis, the patients in the discontinuation group had a significantly lower preoperative body mass index (< 22.9kg/m2, p = 0.005) and a higher rate of adverse events (grade 2 or higher, p < 0.001) than those in the completion group. According to a multivariate analysis, preoperative PMI (HR 3.563, p = 0.030) was an independent predictive factor for S-1 completion. Preoperative skeletal muscle loss might therefore prevent the completion of adjuvant chemotherapy S-1 in patients with gastric cancer.

A multivariate regression analysis of a comprehensive rehabilitation program and performance improvement in young female volleyball players

Purpose: This study aimed to investigate the efficacy of a comprehensive rehabilitation program tailored for college female volleyball players in India, specifically focusing on its impact on vertical jump performance. Material and Methods: Twenty-seven female college volleyball players participated in the study, undergoing a preseason rehabilitation program comprising various exercises targeting strength, power, stability, agility, and flexibility. Pre- and post-rehabilitation assessments were conducted to evaluate changes in vertical jump height using a Vertec vertical jump measuring device. Statistical analysis included multivariate regression analysis and paired t-tests. Results: The multivariate regression analysis revealed significant positive associations between several rehabilitation components, including squats, depth jumps, and plyometric circuits, and improved vertical jump height (p &lt; 0.01). Paired t-test results indicated a significant increase in vertical jump height post-rehabilitation (p &lt; 0.0001), with a mean difference of 4.863 cm. Strong positive correlations were observed between baseline and post-rehabilitation vertical jump measurements (r = 0.9629). Conclusions: The findings demonstrate the effectiveness of the comprehensive rehabilitation program in enhancing vertical jump performance among college female volleyball players in India. By targeting multiple facets of physical fitness and movement quality, the program facilitated significant improvements in explosive lower body strength and power, essential for volleyball performance. These results underscore the importance of tailored rehabilitation interventions in optimizing athlete capabilities and achieving success on the volleyball court.

Liver fibrosis prediction models in a population of Latina and White women.

Point-of-care tools to assess advanced liver fibrosis, including the NFS, BARD, FIB-4, and APRI, are of major interest due to their noninvasive nature. However, these tools have not been investigated extensively in the Latina population. Given that the highest rate of NAFLD in Latinos and the most severe presentation of non-alcoholic fatty liver disease (NAFLD) is more common in women, we hypothesize that ethnicity may play a role in predicting liver fibrosis, particularly in women. We determined whether ethnicity alone or in association with other parameters can predict the severity of fibrosis in women with NAFLD when included in four tools. We retrospectively included 562 Latina and 133 White Caucasian women with a history of NAFLD. Associations between ethnicity and liver fibrosis severity using the four fibrosis predictor models were studied using backward selection multinomial logistic regression. Latina women compared to White showed lower body mass index (p < 0.001), higher HbA1c (p < 0.001), lower prevalence of bariatric surgery (p < 0.001), lower likelihood to smoke (p = 0.003), and higher prevalence of chronic kidney disease stages 3-5 (p = 0.01). Some clinical variables were associated with fibrosis but not univocally in each tool. We did not find differences in the outcome of the four models when holding all other factors and examining ethnicity alone between Latina and White women. Although we did not include data on liver histology, this is the first study examining the role of ethnicity in predicting the severity of fibrosis using established noninvasive scores and documenting no association between Latina ethnicity and the severity of fibrosis in women with NAFLD.