Lower Body Research Articles

Study on changes in serum irisin level in free-flap transplantation and the correlation of serum irisin level with flap blood flow

Background and aimsThe beneficial effect of myokine irisin on ischemia-reperfusion of skin flaps has been rarely reported in clinical studies. This study was designed to determine whether irisin plays a protective role in flap transplantation and identify the factors affecting serum irisin levels. Materials and methodsWe analyzed the changes in serum irisin levels and flap blood flow before and after surgery in 40 patients who underwent skin-flap transplantation. Factors affecting serum irisin levels were analyzed by metabolic parameter measurements. ResultsPreoperative serum irisin levels were positively correlated with blood flow in the skin flap 7 days post-surgery. The increase in serum irisin levels in the first 3 days after surgery positively correlated with flap blood flow. A longer duration of high-intensity exercise, higher skeletal muscle content, lower body mass index, and waist-to-hip ratio were associated with higher irisin levels. Fasting blood glucose and glycosylated hemoglobin levels showed significant negative correlations with serum irisin levels. Several other indicators, including sex, were not associated with serum irisin levels. ConclusionsSerum irisin levels benefit blood flow recovery during flap transplantation. Better outcomes may be achieved by adjusting the timing and intensity of the exercise and controlling the patient's body size.

Clinical outcomes among patients with mitral valve regurgitation undergoing Impella-supported high-risk PCI

BackgroundMitral valve regurgitation (MR) is associated with worse outcomes in patients undergoing percutaneous coronary intervention (PCI). We sought to evaluate outcomes of Impella-supported high-risk PCI (HRPCI) patients according to MR severity. MethodsPatients from the PROTECT III study undergoing Impella-supported HRPCI were stratified into 4 groups according to MR severity: No or trace MR, mild MR, moderate MR, and severe MR. Immediate PCI-related complications, major adverse cardiovascular and cerebrovascular events (MACCE: all-cause death, myocardial infarction, stroke/transient ischemic attack, and repeat revascularization) at 90 days and death at 1-year were assessed. ResultsFrom March 2017 to March 2020, 631 patients who underwent Impella-supported HRPCI in the PROTECT III study had evaluable MR severity at baseline. Patients with severe MR had lower body mass indices, lower left ventricular ejection fractions (LVEFs), and were more frequently diagnosed with heart failure. The incidence of immediate PCI-related complications was similar between groups. Unadjusted 90-day MACCE and 1-year mortality rates were numerically higher in patients with severe MR compared to the other study groups yet without reaching statistical significance. In multivariable analyses, there was no significant association between the presence of severe MR for 90-day MACCE or 1-year mortality compared with other degrees of MR (adj. HR = 1.71, 95% CI [0.73, 3.98], p = 0.21; adj. HR = 1.79, 95% CI [0.86, 3.74], p = 0.12, respectively). ConclusionsImpella-supported HRPCI patients with moderate or severe MR exhibited a higher prevalence of heart failure, lower LVEF, and longer hospital stays. Patients with severe MR showed numerically higher unadjusted rates of 90-day MACCE and 1-year mortality compared to other groups, however these differences did not reach statistical significance even after adjustment for potential confounders. Clinical trial informationTrial Name: The Global cVAD Study (cVAD)ClinicalTrial.govIdentifier:NCT04136392URL: https://clinicaltrials.gov/ct2/show/NCT04136392?term=cvad&draw=2&rank=2

Real-World Outcomes of a Digital Behavioral Coaching Intervention to Improve Employee Health Status: Retrospective Observational Study.

Chronic noncommunicable diseases (NCDs) account for major disability and premature mortality worldwide, with low- and middle-income countries being disproportionately burdened. Given the negative impact of NCDs on employee performance and work productivity, there is a rising need for stakeholders to identify effective workplace solutions that can improve employee health outcomes. As the workplace becomes more dispersed post pandemic, digital behavioral coaching offers a scalable, personalized, and cost-effective method of managing chronic disease risk factors among employees. This study aimed to retrospectively evaluate the impact of a digital behavioral coaching program on year-to-year changes in employee health status in a cohort of Indonesian employees. This retrospective real-world exploratory analysis of secondary health data followed 774 employees of an Indonesian company who completed company-sponsored health screenings between 2021 and 2022 and were given access to Naluri (Naluri Hidup Sdn Bhd), a holistic digital therapeutics platform offering digital behavioral health coaching and self-help tools. Participants were retrospectively classified as those who received active coaching (n=177), passive coaching (n=108), and no coaching (n=489). Linear mixed-effects models were used to evaluate the year-to-year changes in health outcomes across the 3 employee groups, with post hoc analyses evaluating within-group differences between the 2 time points and between-group differences at follow-up. Significant time×group interaction effects were detected for body weight, BMI, hemoglobin A1c, low-density lipoprotein, total cholesterol, and systolic and diastolic blood pressure. Post hoc pairwise comparisons revealed significant improvements in hemoglobin A1c (mean difference [Mdiff]=-0.14, P=.008), high-density lipoprotein (Mdiff=+2.14, P<.001), and total cholesterol (Mdiff=-11.45, P<.001) for employees in the Active Coaching group between 2021 and 2022, with the other 2 groups reporting deteriorations in multiple health outcomes throughout the 2 time points. At follow-up, those who received active coaching between 2021 and 2022 reported significantly lower body weight (P<.001), BMI (P=.001), low-density lipoprotein (P=.045), and total cholesterol (P<.001) than the No Coaching group. This study demonstrates real-world outcomes and implications supporting the use of workplace digital behavioral coaching in improving employee health status. Given the rising burden of NCDs in the Southeast Asian region, our findings underscore the role that workplace digital health interventions can play in preventing and managing chronic disease risk factors.

The influence of lactation on insulin and glucose metabolism, lipid profile, and cytokines in pregnant mares

Glucose metabolism adapts to gestation, resulting in progressive physiological insulin resistance and increased insulin secretion to maintain maternal euglycemia and glucose availability for the developing fetus. These changes can impact mare fertility and maternal and neonatal health. This is the first comparison of body condition, regional adiposity, insulin and glucose dynamics, lipid metabolism, and cytokine production between lactating and non-lactating mares before, during pregnancy, and early postpartum. Twelve pregnancies from 9 broodmares, five nonlactating (NL) and seven lactating (L), were used. Evaluations were performed on the day of ovulation, at 55, 110, 165, 220, 275, and 330 days of gestation (D55, D110, D165, D220, D275, D330) and 21 days postpartum (21pp). Mares in the L group had lower basal insulin and glucose at the beginning of pregnancy, smaller area under the curve of insulin and glucose, and greater insulin sensitivity and glucose tolerance. Resistin was higher in D110 and D165 than in D0, D275, 330 and 21pp, while leptin was higher in D55, and in D110, at D110 it was equal to D0, D220, and D275, but higher than at D330 and D21pp. As for the groups, L presented lower body condition score (BCS), crest neck score (CNS), rump fat thickness (RUM), basal insulin, glucose area under the curve (AUCg), MIRG and higher RISQI, adiponectin and tumor necrosis factor (TNFα). There was no effect over time in non-esterified fatty acids (NEFA) concentrations between the L mares; in the NL, D275 presented higher concentrations than those of D0, D55, and D110, which in turn were equal to the other time points; there were higher concentrations in NL mares than L in samples D165 and D275. In conclusion, a different metabolic profile during pregnancy was detected, and NL mares were closer to the metabolic threshold for the occurrence of metabolic syndrome during pregnancy. Understanding the impacts of these differences on mare's health and their offspring's future is fundamental as most of our recipient mares for embryo transfer are non-lactating. Therefore, we suggest that further studies be performed to evaluate lactation's influence on mares' metabolic parameters.

Loss of Ambulation Due to Calcific Myonecrosis: A Rare but Reversible Complication of Wilson's Disease.

We report two cases of established Wilson's disease (WD) presenting with calcific myonecrosis of the pelvic girdle in association with pelvic fractures. Despite initial improvement with chelation, subacute worsening of ambulation in both led to a consideration of neurologic deterioration on chelation therapy. However, evaluation revealed calcific myonecrosis of the hip joint and adjacent muscles as the cause. Both patients improved with intensive rehabilitation. A review of literature indicates that although osseomuscular complications are reported in WD, calcific myonecrosis is a hitherto unknown entity which, if recognized early, may be reversed, preventing disability and unnecessary change in chelation regimens.

The Effect of Individual Attitude toward Healthy Nutrition on Adherence to a High-UFA and High-Protein Diet: Results of a Randomized Controlled Trial.

502 subjects were randomized to an intervention group (IG; dietary pattern focused on high intake of unsaturated fatty acids (UFA), plant protein and fiber) or control group (CG; dietary recommendation in accordance with the German Society of Nutrition) within a 36-month dietary intervention trial. Sum scores for effectiveness, appreciation and practice of healthy nutrition were assessed using ATHN questionnaire during the trial (n = 344). Linear regression models were used to investigate associations between ATHN and dietary patterns at baseline and at month 12. Retirement, higher education level, age and lower body mass index (BMI) were associated with higher ATHN sum scores. ATHN was similar in CG and IG. Higher baseline intake of polyunsaturated fatty acids (PUFA) and fiber as well as lower intake in saturated fatty acids (SFA) were associated with higher scores in practice in both groups. The intervention resulted in a stronger increase of UFA, protein and fiber in the IG after 12 months, while intake of SFA declined (p < 0.01). Higher scores in appreciation were significantly associated with higher intake of fiber and lower intake of SFA in the CG at month 12, whereas no associations between ATHN and macronutrient intake were observed in the IG after 12 months. While ATHN appeared to play a role in general dietary behavior, ATHN did not affect the success of the specific dietary intervention in the IG at month 12. Thus, the dietary intervention achieved a substantial modification of dietary pattern in the IG and was effective to override the impact of the individual ATHN on dietary behavior.

Obesity Prevention Effects of Avocado (Persea americana) Seed Powder in High-Fat Diet-Induced Obesity in Rats

Avocado seed contains 64% of the phenolic compounds of the whole fruit. This makes avocado seed a potential candidate for the development of treatments for different illnesses, including obesity (the major risk factor for metabolic disorders). The aim of this study was to investigate the effects of avocado seed powder on high-fat diet-induced obesity in rats. Sprague Dawley rats (16 rats) were fed a high-fat diet for 10 weeks. After 10 weeks, the rats were assigned into two groups of eight animals each and were fed either a high-fat diet (HFD; control group) or a high-fat diet containing avocado seed powder (HFD-A; treatment group) for 6 weeks. Animals were weighed weekly, and weekly weight gain was determined. Animals in the treatment (avocado seed) group showed significantly lower body weight gain (7.8 ± 9.63 g) than animals in the control group (33.9 ± 10.84 g) at the end of this study. The treatment group presented with lower triglycerides than the control, with LDL and HDL comparable to the control group. Avocado seed powder showed potential to reduce obesity in rats fed a high-fat diet. Avocado seed can therefore be investigated further as a potential anti-obesity nutraceutical.

Evaluation of developmental milestones and of brain measurements in rats exposed to the pesticide pyriproxyfen in prenatal period.

Pyriproxyfen is a pesticide used in Brazil to control the Aedes aegypti mosquito, vector of arboviruses like Zika and dengue. However, this pesticide is structurally similar to retinoic acid, a metabolite of vitamin A that regulates neuronal differentiation and hindbrain development during the embryonic period. Due to the similarity between pyriproxyfen and retinoic acid, studies indicate that this pesticide may have cross-reactivity with retinoid receptors. Thus, pregnant exposure to pyriproxyfen could interfere in the nervous system development of the fetal. In this context, the present study evaluated whether prenatal exposure to pyriproxyfen affects neonatal development and brain structure in rats. Wistar rat pups were divided in three experimental groups: (1) negative control (CT-)-offspring of rats that drink potable water during pregnancy; (2) pyriproxyfen (PIR)-offspring of rats exposed to Sumilarv® prenatally, a pesticide that has pyriproxyfen as active ingredient; and (3) positive control (CT+)-offspring of rats exposed to an excess of vitamin A prenatally. Only vitamin A treated-pregnant showed lower weight gain, but gestation length was similar among pregnant that received potable water, water containing vitamin A and water containing Sumilarv. In relation to the offspring, PIR group exhibits a delayed front-limb suspension response but performed early the negative geotaxis reflex. On the other hand, CT+ group exhibited lower body weight in the 1st postnatal day, delayed audio startle response, but performed early the eyelids opening and hindlimb placing response. A reduction in the maximum brain width was observed both in PIR and CT+ groups, but a reduction in the number of neurons in the M1 cortex was showed only in CT+ group. The number of glial cells in this brain area was similar between the three experimental groups studied. Although prenatal exposure to pyriproxyfen did not alter neonatal milestones in the same way as vitamin A in excess, both substances caused a reduction in the maximum width of the brain, suggesting that this pesticide can produce neurotoxic effects during the embryonic period.

Potential Effects of Lifelong Team Handball and Football Training and Nutritional Habits on Bone Health and Body Composition in Elderly Women.

The aim of this study was to evaluate the effects of lifelong team handball/football training on regional bone health and body composition in elderly women. Seventeen elderly women team handball/football players (65.9 ± 5.7 years) and twenty-one untrained age-matched women (controls) (67.7 ± 5.1 years) participated. Whole-body and regional dual-energy X-ray absorptiometry scans of arms, legs, and lower spine (L1-L4) were performed. We observed 8% and 9% higher bone mineral density (BMD) and bone mineral content (BMC), respectively, at the whole-body level and in the legs and 11.5% higher BMC in the legs in team handball/football players compared to untrained age-matched controls (p < 0.05). Higher total and leg lean body mass (p < 0.05), along with lower total body fat percentage (p < 0.05) and higher T- and Z-scores, markers of fragility risk fracture (0.294 ± 1.461 vs. -0.538 ± 1.031; 1.447 ± 1.278 vs. 0.724 ± 0.823, respectively), were also found in team handball/football players compared to controls (p < 0.05). No significant differences in nutritional habits were observed between groups. Our study suggest that the beneficial effects of lifetime handball/football practice on bone preservation in elderly women occur independently from nutritional intake, which emphasize the potential role of team sports in osteoporosis prevention. Future studies should focus on the cofounding factors and causative mechanisms mediated by team sport practice in osteoporosis prevention.

Effect of pollen consumption on development and intraguild predation of two predatory Coccinellidae

Many omnivorous predaceous coccinellids consume both pests like aphids and a range of plant-derived foods including pollen. It is critical to understand how plant-derived food like pollen could affect the fitness and interspecific interactions of predaceous coccinellids. This study investigated the effect of pollen consumption on the development, reproduction and intraguild predation (IGP) of two naturally co-existing aphidophagous ladybirds, Harmonia axyridis and Propylea japonica. Both species were provided with three diets including a moist canola pollen, the aphid Myzus persicae, or moist canola pollen together with aphids. The 1st instar larval of both H. axyridis and P. japonica could not survive and develop to the next larval stage when supplied with water alone. When fed on pollen only, 53 % of the H. axyridis larvae and 25 % of the P. japonica larvae successfully developed to adult. Both species exhibited an elongated development time, shorter larval body length and lower adult body weight than when offered with aphids and the mixed diet. In addition, P. japonica could not reproduce when fed on pollen alone. Interestingly, when pollen was provided as additional food, the overall IGP between larvae of H. axyridis and P. japonica was significantly reduced compared with water control or aphid as food alone. The results of this study indicated that pollen not only supports the survival of H. axyridis and P. japonica when prey is scarce, but also could benefit the co-existence of these species. For future study, it is necessary to investigate how pollinivory could benefit the fitness and biological control potential of H. axyridis and P. japonica under field conditions.

Characteristics, Treatment, and Prognosis in Octogenarian and Older Patients With Acute Heart Failure in Japan - Prospective Observational Study on Acute Pharmacotherapy and Prognosis in Management of Acute Heart Failure (POPEYE-AHF Registry).

The number of older people in Japan is increasing more quickly than in other countries; with this aging of society, the number of elderly patients hospitalized for acute heart failure (HF) is also increasing. The treatment and prognosis of acute HF may be changing, but there are insufficient recent data, especially for octogenarian and older patients. This study investigated the characteristics and treatment of acute HF patients in Japan. From 2018 to 2020, 1,146 patients from 7 Tokai area hospitals were followed for at least 1 year. The mean age was 78 years. Compared with patients aged <80 years, those aged ≥80 years were more likely to be female (57.4% vs. 34.2%), have a lower body mass index (22.2 vs. 24.9 kg/m2), and have HF with preserved ejection fraction (43.1% vs. 21.4%), and less likely to have HF with reduced ejection fraction (38.9% vs. 61.7%). During hospitalization, 6.5% died. After discharge, patients faced high risks of rehospitalization for HF and death (27.6 and 14.2 per 100 patient-years, respectively). Notably, prescription rates of HF medications have declined over time for all patients, but especially for those aged ≥80 years. Guideline-directed medical therapy should be provided based on a thorough understanding of an individual's background rather than withheld simply because of clinical inertia due to a patient's advanced age.

The relationship between Geriatric Nutritional Risk Index (GNRI) and in-hospital mortality in critically ill patients with Acute Kidney Injury (AKI)

BackgroundThe role of the geriatric nutritional risk index (GNRI) as a prognostic factor in intensive care unit (ICU) patients with acute kidney injury (AKI) remains uncertain.ObjectivesThe aim of this study was to investigate the impact of the GNRI on mortality outcomes in critically ill patients with AKI.MethodsFor this retrospective study, we included 12,058 patients who were diagnosed with AKI based on ICD-9 codes from the eICU Collaborative Research Database. Based on the values of GNRI, nutrition-related risks were categorized into four groups: major risk (GNRI < 82), moderate risk (82 ≤ GNRI < 92), low risk (92 ≤ GNRI < 98), and no risk (GNRI ≥ 98). Multivariate analysis was used to evaluate the relationship between GNRI and outcomes.ResultsPatients with higher nutrition-related risk tended to be older, female, had lower blood pressure, lower body mass index, and more comorbidities. Multivariate analysis showed GNRI scores were associated with in-hospital mortality. (Major risk vs. No risk: OR, 95% CI: 1.90, 1.54–2.33, P < 0.001, P for trend < 0.001). Moreover, increased nutrition-related risk was negatively associated with the length of hospital stay (Coefficient: -0.033; P < 0.001) and the length of ICU stay (Coefficient: -0.108; P < 0.001). The association between GNRI scores and the risks of in-hospital mortality was consistent in all subgroups.ConclusionsGNRI serves as a significant nutrition assessment tool that is pivotal to predicting the prognosis of critically ill patients with AKI.

Solvent-free synthesis of diacylglycerols via enzymatic glycerolysis between edible oils and glycerol catalyzed by self-made immobilized lipase PS@LXTE-1000

Diglycerol (DAG) is a structural lipid with the functions to lower body fat accumulation and decrease serum triglyceride level. However, the enzymatic synthesis of DAG is limited by the high-efficient and economic lipases. In this paper, the immobilized lipase PS@LXTE-1000 was self-made by immobilizing the Pseudomomas cepacian lipase on to the hydrophobic microporous resin LXTE-1000. The results indicate that LXTE-1000 was a uniform mesoporous sphere with the mean diameter of 400 ​μm, pore size of 14.6 ​nm, pore volume of 0.5 ​cm3/g and surface area of 126.0 ​m2/g, showing superior structural properties for lipase immobilization. Under the optimal reaction conditions with the molar ratio of rapeseed oil to glycerol being 1:1, adding amount of immobilized lipase being 4%, reaction at 50 ​°C, the highest DAG content of 46.7% was achieved in 3 ​h via enzymatic glycerolysis catalyzed by LXTE-1000. After 7 cycles of reuse, the self-made LXTE-1000 could still retain 78.3% of its initial catalytic ability. Besides, LXTE-1000 was observed to facilitate the DAG production via glycerolysis reaction between glycerol with other seven edible oils including corn oil, sesame oil, peony seed oil, rice bran oil, peanut oil, soybean oil and flaxseed oil. Specifically, the glycerolysis reaction with sesame oil, peony seed oil and rice bran oil even led to the DAG content of 52.1%, 53.3% and 51.2%, respectively, Hence, this paper provide a novel strategy to produce high-efficient and economic immobilized lipases, which shows great potential in the green synthesis of functional lipids such as DAG.

TIM-3 on myeloid cells promotes pulmonary inflammation through increased production of galectin-3

T cell immunoglobulin and mucin-containing molecule 3 (TIM-3) exhibits unique, cell type- and context-dependent characteristics and functions. Here, we report that TIM-3 on myeloid cells plays essential roles in modulating lung inflammation. We found that myeloid cell-specific TIM-3 knock-in (FSF-TIM3/LysM-Cre+) mice have lower body weight and shorter lifespan than WT mice. Intriguingly, the lungs of FSF-TIM3/LysM-Cre+ mice display excessive inflammation and features of disease-associated pathology. We further revealed that galectin-3 levels are notably elevated in TIM-3-overexpressing lung-derived myeloid cells. Furthermore, both TIM-3 blockade and GB1107, a galectin-3 inhibitor, ameliorated lung inflammation in FSF-TIM3/LysM-Cre+/− mice. Using an LPS-induced lung inflammation model with myeloid cell-specific TIM-3 knock-out mice, we demonstrated the association of TIM-3 with both lung inflammation and galectin-3. Collectively, our findings suggest that myeloid TIM-3 is an important regulator in the lungs and that modulation of TIM-3 and galectin-3 could offer therapeutic benefits for inflammation-associated lung diseases.

Effectiveness of whey protein supplementation on muscle strength and physical performance of older adults: A systematic review and meta-analysis of randomized clinical trials

BackgroundThe efficacy of whey protein supplement (WPS) in improving muscle strength, physical performance, and body composition in older adults has been widely promoted. However, the results of randomized clinical trials in this regard have been inconsistent. We aimed to determine the impact of WPS, compared to a placebo, during or without training on muscle strength, physical function, and body composition in older adults. MethodsRandomized controlled trials were thoroughly searched using PubMed, EMBASE, the Cochrane Library Database, Scopus databases up to June 2024. The analysis focused on key parameters such as handgrip strength (HS), leg press, knee extension, gait speed (GS), 6-minute walking test (6MWT), Timed-up and go test (TUG), lean body mass (LBM), fat mass (FM), and appendicular skeletal muscle mass (ASM). A pooled effect size was calculated using a random-effects model based on standard mean differences (SMD). ResultsThirty studies involving 2105 participants aged 60 and older met the inclusion criteria. The meta-analysis of 26 RCTs showed no significant positive effect of WPS on HS (n= 11, SMD: 0.18; 95% CI: –0.13, 0.49; I2= 69%), 6MWT (n= 5, SMD: -0.08; 95%CI: -0.31, 0.16; I2= 0%), GS test (n=4, SMD: -0.08; 95%CI: -0.43, 0.28; I2= 36%), TUG test (n=9, SMD: 0.0, 95% CI -0.15, 0.14; I2= 0%), LBM (n=11, SMD: 0.02; 95%CI: -0.13, 0.17; I2= 0%), FM (n=15, SMD: -0.04; 95%CI: -0.18, 0.10; I2= 0%). However, ASM significantly improved after WPS consumption but with high heterogeneity (n= 2, SMD: 0.39; 95%CI: 0.28, 0.51; I2= 69%). In interventions incorporating RE, statistically significant positive effects of WPS on lower body strength were observed (n= 11, SMD: 0.25; 95%CI: 0.05, 0.45; I2= 0%). ConclusionThe present meta-analysis indicates that whey protein supplementation (WPS), when combined with resistance training (RT), can enhance lower body strength but does not seem to have a significant beneficial effect on handgrip strength, physical performance, or body composition. Further large-scale studies are necessary to confirm these findings and elucidate the potential benefits of WPS in this population.

Influencing factors for postpartum depression in women with gestational diabetes mellitus.

It remains undefined about the association between gestational diabetes mellitus (GDM) and postpartum depression (PPD). Hence, a cross-sectional study was conducted to evaluate the association between GDM and PPD among pregnant women and to investigate the influencing factors for PPD. From June 2021 to June 2022, 205 parturients with GDM and 201 without GDM were included in the study as the GDM group and the control group, respectively. The collected data from the general information questionnaire and Self Rating Depression Scale (SDS) were statistically analyzed based on binomial logistic regression analyses and generalized linear mixed models (GLMMs). Age at delivery, gestational age, glycosylated hemoglobin, triglyceride, SDS, and proportions of women who had a history of induced abortion or GDM were significantly different between the GDM group and control group (P<0.05). The incidence of PPD in the GDM group was significantly higher than that in the control group. The neonatal body weight and triglyceride in GDM women with PPD were significantly lower than those in GDM women without PPD (P<0.001). The univariate logistic regression analysis demonstrated that educational age was a protective factor, while glycosylated hemoglobin and GDM were risk factors for PPD. The multiple linear regression analysis revealed that neonatal body weight (OR=-0.904, 95%CI: -1.657 to -0.152, P=0.019) and educational age (OR=-0.166, 95%CI: -0.306 to -0.025, P=0.021) were protective factor, while GDM (OR=1.854, 95%CI: 1.027-2.681, P<0.0001) was a risk factor for PPD. GDM may be associated with PPD. Neonatal body weight and educational age were protective factors for PPD, and GDM was a risk factor for PPD. Therefore, more attention should be paid to the mental health status of women with GDM, especially those with lesser educational age and lower neonatal body weight.

Analysis of human ambulation as a chaotic time-series: with nonlinear dynamics tools.

The aim of the present study is to investigate the complexity and stability of human ambulation and the implications on robotic prostheses control systems. Fourteen healthy individuals participate in two experiments, the first group run at three different speeds. The second group ascended and descended stairs of a five-level building block at a self-selected speed. All participants completed the experiment with seven inertial measurement units wrapped around the lower body segments and waist. The data were analyzed to determine the fractal dimension, spectral entropy, and the Lyapunov exponent (LyE). Two methods were used to calculate the long-term LyE, first LyE calculated using the full size of data sets. And the embedding dimensions were calculated using Average Mutual Information (AMI) and the False Nearest Neighbor (FNN) algorithm was used to find the time delay. Besides, a second approach was developed to find long-term LyE where the time delay was based on the average period of the gait cycle using adaptive event-based window. The average values of spectral entropy are 0.538 and 0.575 for stairs ambulation and running, respectively. The degree of uncertainty and complexity increases with the ambulation speed. The short term LyEs for tibia orientation have the minimum range of variation when it comes to stairs ascent and descent. Using two-way analysis of variance we demonstrated the effect of the ambulation speed and type of ambulation on spectral entropy. Moreover, it was shown that the fractal dimension only changed significantly with ambulation speed.

Patient height is a predictive factor for good postoperative knee flexion after cruciate-retaining total knee arthroplasty with GRADIUS design.

A gradually reducing radius (GRADIUS) design implant can facilitate a smooth transition from stability through full range of motion in total knee arthroplasty (TKA). Nonetheless, patient-specific factors associated with good knee flexion remain unclear. This study aimed to determine the factors associated with good knee flexion after cruciate-retaining TKA with a GRADIUS prosthesis in an Asian population. This retrospective study included 135 patients that were stratified according to postoperative knee flexion angle (KFA) into Group F (⩾ 120∘; 85 patients [63.2%]) and Group NF (< 120∘; 50 patients [36.8%]). Patients in Group F were taller and had a lower body mass index (BMI) smaller preoperative hipkneeankle angle and better preoperative extension and flexion angle than Group NF patients. The multivariable analysis revealed that patients' height (odds ratio [OR]: 1.07, P= 0.0150), BMI (OR: 0.85, P= 0.0049), and preoperative flexion angle (OR: 1.06, P= 0.0008) predicted good KFA. The ROC curve analysis showed that the cutoff values of a good KFA were height 155.1 cm, BMI 22.1 kg/m2, and preoperative KFA 120∘. Patient height, BMI, and preoperative KFA were independent factors affecting good postoperative KFA in patients of Asian descent who underwent cruciate-retaining TKA with a GRADIUS design.

Using markerless motion capture and musculoskeletal models: An evaluation of joint kinematics.

This study presents a comprehensive comparison between a marker-based motion capture system (MMC) and a video-based motion capture system (VMC) in the context of kinematic analysis using musculoskeletal models. Focusing on joint angles, the study aimed to evaluate the accuracy of VMC as a viable alternative for biomechanical research. Eighteen healthy subjects performed isolated movements with 17 joint degrees of freedom, and their kinematic data were collected using both an MMC and a VMC setup. The kinematic data were entered into the AnyBody Modelling System, which enables the calculation of joint angles. The mean absolute error (MAE) was calculated to quantify the deviations between the two systems. The results showed good agreement between VMC and MMC at several joint angles. In particular, the shoulder, hip and knee joints showed small deviations in kinematics with MAE values of 4.8∘, 6.8∘ and 3.5∘, respectively. However, the study revealed problems in tracking hand and elbow movements, resulting in higher MAE values of 13.7∘ and 27.7∘. Deviations were also higher for head and thoracic movements. Overall, VMC showed promising results for lower body and shoulder kinematics. However, the tracking of the wrist and pelvis still needs to be refined. The research results provide a basis for further investigations that promote the fusion of VMC and musculoskeletal models.

GLP-1R-positive neurons in the lateral septum mediate the anorectic and weight-lowering effects of liraglutide in mice.

Liraglutide, a glucagon-like peptide-1 (GLP-1) analog, is approved for obesity treatment, but the specific neuronal sites that contribute to its therapeutic effects remain elusive. Here, we show that GLP-1 receptor-positive (GLP-1R-positive) neurons in the lateral septum (LSGLP-1R) play a critical role in mediating the anorectic and weight-loss effects of liraglutide. LSGLP-1R neurons were robustly activated by liraglutide, and chemogenetic activation of these neurons dramatically suppressed feeding. Targeted knockdown of GLP-1 receptors within the LS, but not in the hypothalamus, substantially attenuated liraglutide's ability to inhibit feeding and lower body weight. The activity of LSGLP-1R neurons rapidly decreased during naturalistic feeding episodes, while synaptic inactivation of LSGLP-1R neurons diminished the anorexic effects triggered by liraglutide. Together, these findings offer critical insights into the functional role of LSGLP-1R neurons in the physiological regulation of energy homeostasis and delineate their instrumental role in mediating the pharmacological efficacy of liraglutide.