Lower Body Research Articles

Associations Between Pelvis, Trunk, and Shoulder Girdle Muscle Activity; Age; and Scores During the Closed Kinetic Chain Upper Extremity Stability Test in Baseball Pitchers

OBJECTIVE: To evaluate associations between muscle activity, age, and scores on the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST). DESIGN: Quasi-experimental. METHODS: Pelvic, trunk, and shoulder girdle surface electromyography (sEMG) and kinematic data were measured in 21 high school and college male baseball pitchers (17.4 ± 2.0 years, 184.4 ± 5.7 cm, 78.4 ± 14.2 kg) while they performed the CKCUEST. Mean sEMG data were computed while in sole support on the throwing-arm side (TS) as the glove-arm side (GS) was horizontally translating. Correlations and local regressions were used to assess associations and general patterns between mean sEMG data, age, and scores. RESULTS: TS serratus anterior, TS external oblique, GS serratus anterior, and TS gluteus medius had the highest mean sEMG data. Low-to-high significant correlations were found between proximal muscle groups. Correlations with the highest magnitudes in descending order were TS external oblique and TS gluteus maximus, TS external oblique and TS serratus anterior, and GS external oblique and TS gluteus medius. Small significant associations were observed between other muscle groups and age; there were no associations between muscle activity and test performance. CONCLUSION: Associations were observed between mean muscle activity among muscle groups and age but not test outcome. J Orthop Sports Phys Ther 2024;2(4):1-9. Epub 7 June 2024. doi:10.2519/jospt.2024.1023

Maternal low-dose caffeine intake during the perinatal period promotes short- and long-term sex-dependent hormonal and behavior changes in the offspring.

Maternal caffeine crosses the placenta and mammary barriers, reaching the baby and, because his/her caffeine metabolism is immature, our hypothesis is that even a low caffeine intake (250 mg/day), lower than the dose limit recommended by the World Health Organization, can promote caffeine overexposure in the offspring, leading to short- and long-term changes. Pregnant Wistar rats received intragastric caffeine (CAF) (25 mg/Kg/day) or vehicle during the gestation and lactation periods. We evaluated morphometrical, metabolic, hormonal, and behavioral parameters of male and female offspring at different ages. Even a low caffeine intake promoted lower maternal body mass and adiposity, higher plasma cholesterol and lower plasma T3, without changes in plasma corticosterone. Female CAF offspring exhibited lower birth weight, body mass gain and food intake throughout life, and hyperinsulinemia at weaning, while male CAF offspring showed reduced food intake and lower plasma T3 at weaning. At puberty and adulthood, male CAF showed higher preference for palatable food, aversion to caffeine intake and higher locomotor activity, while female CAF only showed lower preference for high fat diet (HFD) and lower anxiety-like behavior. At adulthood, both male and female offspring showed higher plasma T3. Male CAF showed hypertestosteronemia, while female CAF showed hypoinsulinemia without effect on glucose tolerance. A low caffeine intake during the perinatal period affects rat's offspring development, promoting sex-dependent hormonal and behavior changes. Current data suggest the need to review caffeine recommendations during the perinatal period.

Breastfeeding in infancy and cardiovascular disease in middle-aged and older adulthood: a prospective study of 0.36 million UK Biobank participants

BackgroundCardiovascular disease originates in early life. We aimed to investigate the association between breastfeeding in infancy and cardiovascular disease in adult life. MethodsWe followed 364,240 participants from UK Biobank aged 40–73 years from 2006 – 2010 to 2021. Information on breastfeeding in infancy was self-reported by questionnaire. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for the association between breastfeeding and cardiovascular disease in middle-aged and older adulthood. The multivariable Cox models were used by adjusting for the age (used as the time scale), sex, ethnicity, assessment centre, birth weight, multiple birth status, maternal smoking during pregnancy, Townsend deprivation index, smoking status, alcohol drinker status, physical activity, and menopausal status for women. Binary and multinomial multivariable logistic regression models were used to explore the associations of breastfeeding in infancy with cardiovascular disease risk factors including obesity, body composition, metabolic and inflammatory disorders. ResultsDuring a median of 12.6 years of follow-up, we documented 29,796 new cases of cardiovascular disease, including 24,797 coronary heart disease and 6229 stroke. The multivariable adjusted HRs for breastfed versus non-breastfed were 0.94 (95% CI: 0.91, 0.96) for cardiovascular disease, 0.94 (95% CI: 0.91, 0.96) for coronary heart disease, and 0.95 (95% CI: 0.89, 1.01) for stroke. Furthermore, the strength of observed association between breastfeeding and cardiovascular disease seems to decrease with age (P for interaction <0.001), and increase with polygenic risk for cardiovascular disease (P for interaction <0.001). Consistently, breastfeeding in infancy was associated with cardiovascular disease risk factors including lower body mass index 0.92 (95% CI: 0.89, 0.95), body fat percentage 0.85 (95% CI: 0.83, 0.87), android to gynoid fat ratio 0.89 (95% CI: 0.83, 0.96), visceral adipose tissue 0.92 (95% CI: 0.84, 1.01), as well as lower C-reactive protein level 0.95 (95% CI: 0.94, 0.97) and a lower risk of metabolic syndrome 0.89 (95% CI: 0.85, 0.92). ConclusionsBreastfeeding in infancy was associated with a lower risk of cardiovascular disease in middle-aged and older adulthood. Promoting breastfeeding is vital not only for promoting child health, but also for halting the increasing trend of cardiovascular disease in adults.

Regional Phase Angle As An Indicator Of Upper And Lower Body Strength Performance In Youth

Regional Phase Angle As An Indicator Of Upper And Lower Body Strength Performance In Youth

Impact Of Basketball Floor Stiffness On Lower Body Biomechanics During Landing

Impact Of Basketball Floor Stiffness On Lower Body Biomechanics During Landing

A service evaluation of weight management for glycaemic control and remission of type 2 diabetes using traditional food in Nepal (Ho-DIRECT NEPAL): a single-arm trial

Remission of early type 2 diabetes (T2D) is possible; however, diet programmes proven effective are unaffordable in many southeast Asian populations where T2D is more frequent and more aggressive at lower body weight and younger age. We evaluate an entirely food-based service. This study employed a single-arm intervention and follow-up design for intervention evaluation in existing hospital people with T2D of under 5 years known duration. Individuals attending a diabetes clinic in Kathmandu with early T2D (<5 years) aged 30-70 years, BMI ≥23kg/m2, were offered a low-cost nutritionally complete diet-programme, using traditional Nepali foods to provide 8-weeks ∼850kcal/day weight loss induction, and then weight maintenance. The participants received 4-weekly dietetic appointments (30-45min) and verbo-pictorial leaflets using household measures. Glucose-lowering medications (49/70at baseline) were stopped at baseline or soon after. The study was registered as ISRCTN10671396, testing a traditional food-based intervention for weight loss and T2D remission. For 70 individuals (45 female) invited between March 19, 2022 and September 19, 2023, baseline mean (SD) age was 48.6 (9.9) years, bodyweight 74.6 (9.5) kg, BMI 29.7 (3.6) kg/m2, known diabetes duration 2.5 (1.9) years, HbA1c on treatment 8.1 (1.6) %. At 12, 24 and 52 weeks respectively, evaluating n=44, 46, 45, bodyweight was 70.1 (8.5), 69.8 (8.9), 70.0 (8.8) kg, HbA1c 6.8 (0.9), 6.9 (1.5), 7.1 (1.3) %; HbA1c<6.5% was recorded for 46%, 48% and 36% and remission of T2D (HbA1c<6.5% off medication >3 months) in 43%, 39% and 29%. The main reported adherence barriers were fears of weakness, hunger, and inconvenience during travel. Incentives were ease of the diet, reduced doses and costs of medications, and improved appearance. Traditional food-based weight management can valuably improve control, reduce medication needs, and generate remissions of established T2D, but adherence barriers must be overcome to optimise outcomes. All Saints Educational Trust, England.

The Difference In Fitness And Lower Body Power Based On Mobility Status In First Responders

The Difference In Fitness And Lower Body Power Based On Mobility Status In First Responders

Effects Of Upper And Lower Body Blood Flow Restriction Training On Subjective Assessments

Effects Of Upper And Lower Body Blood Flow Restriction Training On Subjective Assessments

Force Plate Jump Assessment In The Military: Identifying Lower Body Capabilities During Countermovement Jumps

Force Plate Jump Assessment In The Military: Identifying Lower Body Capabilities During Countermovement Jumps

Canagliflozin can improve cardiac function in HFpEF rats partly by regulating ferroptosis

Objective: To explore the effects of canagliflozin on cardiac function and its regulation of ferroptosis in rats with heart failure with preserved ejection fraction (HFpEF). Methods: Thirty-two 7-week-old Dahl salt-sensitive rats were selected and randomly divided into four groups: the control group (fed with low-salt diet), the HFpEF group (fed with high-salt diet), the canagliflozin 20 group (fed with high-salt diet and 20 mg·kg-1·d-1 canagliflozin), and the canagliflozin 30 group (fed with high-salt diet and 30 mg·kg-1·day-1 canagliflozin). Body weight and blood pressure of the rats in each group were monitored. Metabolic cage tests were conducted at the10th week of the experiment, and echocardiography was performed at the 12th week, after which the rats were killed. Blood and left ventricular samples were collected. HE staining, Masson staining, Prussian blue iron staining, and reactive oxygen species staining were performed to observe the cardiomyocyte size and shape, degree of interstitial fibrosis, iron staining, reactive oxygen species production under optical microscope. The ultrastructure of cardiomyocytes was observed under electron microscope. Western blotting and real-time fluorescent quantitative reverse transcription polymerase chain reaction (RT-qPCR) were used to detect the expression levels of proteins and mRNA related to ferroptosis in left ventricular myocardial tissue of rats in each group. Results: After 1 week of adaptive feeding, all rats survived. Metabolic cage results showed that compared with control group, rats in the HFpEF group, canagliflozin 20 group and canagliflozin 30 group had more food intake, water intake and urine output, and lower body weight (all P<0.05). These changes were more pronounced in canagliflozin 20 group and canagliflozin 30 group than in HFPEF group, and only the body weight at the 12th week showed a statistically significant difference between canagliflozin 20 group and canagliflozin 30 group (P<0.05). The blood pressure of 6th week and 12th week, heart weight and left ventricular corrected mass of 12th week of rats in HFpEF group were higher than those in control group, canagliflozin 20 group and canagliflozin 30 group, while the ratio of early mitral valve peak velocity to late mitral valve peak velocity of 12th week was lower (all P<0.05). HE and Masson staining showed that compared to control group, the myocardial fibers in the left ventricular myocardial tissue of rats in HFpEF group were disordered, with larger cell diameter ((0.032±0.004) mm vs. (0.023±0.003) mm, P<0.05), irregular shape, obvious proliferation of interstitial collagen fibers, and higher collagen volume fraction (0.168±0.028 vs. 0.118±0.013, P<0.05). Compared with HFpEF group, rats in the canagliflozin 20 group and canagliflozin 30 had more orderly arranged myocardial fibers, more regular cardiomyocyte shape, smaller cell diameter, and lower collagen volume fraction (P<0.05). It was observed under electron microscopy that, compared to control group, most of the striated muscles in myocardial tissue of HFpEF group were broken, and the Z line and M line could not be clearly distinguished, some changes such as mitochondrial swelling, membrane thickening, cristae reduction or even disappearance occurred. In the canagliflozin 20 group and canagliflozin 30 group, the arrangement of striated muscles in the myocardial tissue of rats tended to be more regular, and the morphological changes of mitochondria were milder. Prussian blue iron staining results showed that the iron content in myocardial tissue of rats in HFpEF group was higher than that in control group, canagliflozin 20 group and canagliflozin 30 group. Reactive oxygen species staining results showed that the reactive oxygen species content in the myocardial tissue of rats in HFpEF group was higher than that of control group, canagliflozin 20 group and canagliflozin 30 group. Biochemical analysis of myocardial tissue showed that Fe2+ and malondialdehyde content in myocardial tissue of rats in HFpEF group were higher than those in control group, canagliflozin 20 group and canagliflozin 30 group, while glutathione content was lower (all P<0.05). Western blot and RT-qPCR detection results showed that compared to control group, rats in HFpEF group had higher expression levels of transferrin receptor 1 (protein relative expression level: 1.37±0.16 vs. 0.31±0.12), acyl-CoA synthetase long-chain family member 4 (protein relative expression level: 1.31±0.15 vs. 0.63±0.09) protein and mRNA, and lower expression levels of ferritin heavy chain 1 (protein relative expression level: 0.45±0.08 vs. 1.41±0.15) protein and mRNA (all P<0.05). There was no statistically significant difference in these indicators between canagliflozin 20 group and the canagliflozin 30 group (all P>0.05). There was no significant difference in levels of glutathione peroxidase 4 protein and mRNA expression in myocardial tissue of rats in four groups(P>0.05). Conclusion: Canagliflozin improves cardiac function in HFpEF rats by regulating the ferroptosis mechanism.

A Systematic Review of Lower Limb Strength Tests Used in Elite Basketball

Background: Basketball players rely on their lower limb strength for speed and agility. Therefore, it is important for strength and conditioning coaches to seek methods to assess and develop lower limb strength. Objectives: This study aimed to identify tests and variables used to assess lower body strength among elite basketball players and to provide normative values for the commonly used strength tests. Methods: A review of PubMed, MEDLINE, Scopus, and SPORTDiscus was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The risk of bias was assessed using the Joanna Briggs Institute cross-sectional and cohort checklists. Results: Among the twelve reviewed studies, seven strength tests and five outcome variables were used. The most frequently used lower limb strength tests were the back squat (nine studies) and isometric mid-thigh pull (IMTP) (three studies), both reporting one repetition maximum (1RM) and peak force metrics. The most frequently used lower limb strength test was the back squat among males and IMTP among females. Conclusions: Among elite basketball players, the back squat 1RM is the most used lower limb strength test. However, across studies, a large variability was evidenced, which suggests that lower limb testing procedures are heterogeneous in this population.

Skin heating during simulated hemorrhage lowers arterial blood pressure but not tolerance following exercise in a cold environment.

Skin heating helps avoid hypothermia in trauma victims but may influence systolic (SBP) and mean arterial blood pressures (MAP) helping guide resuscitation. We examined the effect of skin heating upon tolerance and arterial blood pressure during lower body negative pressure (LBNP) across four trials. Nine participants completed 15 exercise intervals (60 sec 88% PPO and 60 sec 10% PPO) in a cold environment (0°C, 70% RH) lowering mean skin temperature (Tsk) before undergoing LBNP to pre syncope where Tsk remained low (Cold Trial: 27.6 ± 1.1°C) or was increased via water perfused suit sixty seconds into LBNP to 32.3 ± 0.7°C (Normothermic Trial), 34.8 ± 0.4°C (Warm Trial) or 36.1 ± 0.8°C (Hot Trial). Tsk was different between trials (P = 0.001). Core temperature was not different between trials, increasing with exercise (36.9 ± 0.3°C to: 37.9 ± 0.4°C) and remaining elevated during LBNP (37.7 ± 0.4°C). During LBNP, MAP was greatest in the Cold (88 ± 7 mmHg) and relatively lowered in Normothermic (83 ± 5mmHg), Warm (82 ± 5mmHg) and Hot Trials (79 ± 7mmHg, all P ≤ 0.017 vs. Cold). SBP was greatest in Cold (111 ± 9mmHg) and Normothermic trials (110 ± 10mmHg) and relatively lowered in Warm (105 ± 7mmHg) and Hot trials (103 ± 11mmHg, both P ≤ 0.037). LBNP tolerance was not different between trials (P = 0.746). Following exercise in a cold environment, skin heating during simulated hemorrhage lowers arterial blood pressures and has implications for prehospital care of trauma victims.

Shell biomechanics suggests an aquatic palaeoecology at the dawn of turtle evolution

The turtle shell is a remarkable structure that has intrigued not only evolutionary biologists but also engineering and material scientists because of its multi-scale complexity and various functions. Although protection is its most apparent role, the carapace and plastron are also related to many physiological functions and their shape influences hydrodynamics and self-righting ability. As such, analysing the functional morphology of the shell could help understanding the ecology of Triassic stem-turtles, which will contribute to the century-long debate on the evolutionary origins of turtles. Here, we used 3D imaging techniques to digitize the shells of two of the earliest stem-turtle taxa, Proganochelys and Proterochersis, and submitted their models to biomechanical and shape analyses. We analysed the strength performance under five predation scenarios and tested the function of two morphological traits found in stem-turtles, the epiplastral processes and an attached pelvic girdle. The latter, also present in the crown-lineage of side-necked turtles, has been suggested to increase load-bearing capacity of the shell or to improve swimming in pleurodires. Our results do not confirm the shell-strengthening hypothesis and, together with the results of our shape analyses, suggest that at least one of the first stem-turtles (Proterochersis) was an aquatic animal.

Standardized bone marrow assessment, risk variables, and survival in dogs with myelodysplastic syndrome and acute myeloid leukemia.

Myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) are heterogeneous neoplasms of hematopoietic stem cells that are challenging to diagnose, differentiate, and prognosticate. Cytogenetic and mutational analyses are useful in humans but unavailable for dogs, where diagnosis and classification still rely largely on hematologic and morphologic assessment. The objectives of this study were to apply a classification scheme to myeloid neoplasms and to assess outcome in relation to predictor variables. Keyword search of a laboratory database, application of sequential exclusion criteria, and consensus from 3 reviewers yielded 70 cases of myeloid neoplasia with hematology results, and cytologic (11), histologic (14), or both (45) types of marrow specimens. Based on blast percentage and morphology, 42 cases were classified as MDS and 28 as AML. Dogs with MDS had significantly lower body weights, hemoglobin concentrations and blood blasts, and higher red blood cell size variability and platelet numbers than dogs with AML. Estimates of median survival using Kaplan-Meier curves for dogs with MDS and AML were 384 and 6 days, respectively (P < .001). The instantaneous risk of death for dogs with MDS was approximately 5× lower than that of dogs with AML. Significant predictor variables of survival were body weight, white blood cell count, platelet count, and percent blood blasts (P < .05). Hazard ratios (HRs) derived from best-fitting Cox regression models were 1.043, 0.998, and 1.061 for increased neutrophils, decreased platelets, and increased blood blasts, respectively. Findings from this study suggest that hematologic and morphologic variables are useful to predict outcomes in myeloid neoplasia.

Social cure model: testing the link between identity centrality and body appreciation in diverse sexual orientation and gender identity groups

BackgroundThe level of experienced sociocultural pressure to have an idealized body can vary depending on a person’s gender identity and sexual orientation. The current study explored whether differences in levels of body appreciation among people with different sexual orientations and gender identities vary because of differing levels of experienced pressure by in-group members and varying levels of experienced hostile behaviors because of their looks or body. Thereby, the study tests the social cure model, according to which high levels of identity centrality are associated with better mental health.MethodsAn online cross-sectional questionnaire study was conducted with 1,587 people (51.3% cisgender women, 39.3% cisgender men, 9.5% non-binary; 52.9% identified as heterosexual, 27.7% identified as bisexual/pansexual, 11.2% identified as gay/lesbian, 8.2% identified as asexual/demi/queer; Mage = 32.9, SD = 12.6) from German-speaking countries. Variables were assessed with German-language versions of the Multidimensional and Multicomponent Measure of Social Identification, Body Appreciation Scale-2, the Perceived Stigmatization Questionnaire, and the Sociocultural Attitudes Towards Appearance Questionnaire-4, revised. A manifest-path model was calculated.ResultsNon-binary persons reported lower levels of body appreciation than did cisgender men and sexual minority persons reported lower levels of body appreciation than did heterosexual persons. Furthermore, sexual minority persons experienced more hostile behaviors directed towards them because of their looks or body than did heterosexual persons. Similarly, non-binary persons experienced more hostile behaviors than did men. Non-binary persons were subjected to lower levels of in-group pressure than were men. Gay/lesbian persons and asexual persons were subjected to lower levels of in-group pressure than were heterosexual persons. More hostile behaviors and stronger in-group pressure were related to lower body appreciation. In cisgender women and men indirect links revealed associations between strong identity centrality and low levels of body appreciation through the mediator of high in-group pressure.ConclusionsData in sexual minority individuals or non-binary persons supported the social cure model, according to which persons can find support and validation for their looks and body from in-group members. In cisgender women and men, strong identification as a woman or man can be related to stronger in-group pressure and in turn to lower body appreciation.

Fasting in critical illness: the role of ketonuria — a retrospective observational study

BackgroundMetabolic acidosis is a frequent finding in patients admitted to the intensive care unit (ICU). It can be caused by prolonged fasting due to surgical procedures or by medical conditions that lead to starvation ketoacidosis (SKA). Early recognition and treatment of SKA could prevent several life-threatening complications, improving survival and reducing the ICU length of stay.MethodsWe retrospectively screened all medical records of patients admitted to the ICU (Maggiore Hospital, Bologna, North Italy) from May 2022 to April 2023. We included patients aged 18 years or older who presented ketonuria detected in the urine sample.ResultsWe analyzed 190 patients with ketonuria at ICU admission. Postsurgical patients showed lower levels of albumin and a higher rate of shock compared to medical patients. Ketonuric patients with shock had a lower body mass index (BMI) compared to patients without shock (24 versus 26 kg/m2, respectively). There were no differences within groups regarding mortality and ICU readmission rate. Medical patients had a significantly higher ICU length of stay.ConclusionsThis retrospective observational descriptive study showed that patients with ketonuria, hypoalbuminemia, and low BMI at ICU admission have high risk of hemodynamic instability and shock. Surgical patients compared to medical patients are exposed to a catabolic trigger that could worsen a state of malnutrition and induce anabolic resistance; elective and urgent surgical patients did not differ in terms of risk of shock and mortality, probably due to the activation of this catabolic pathway. Early recognition and treatment of starvation ketoacidosis and perioperative nutritional optimization could reduce incidence of hemodynamic and metabolic complications.

Cool mama: Temperature regulation during high-intensity interval running in pregnant elite and recreational athletes

BackgroundRegular exercise during pregnancy is beneficial, but athletes often exceed the recommended 150 min of moderate-intensity activity, incorporate high-intensity exercises. The upper limit for exercise intensity and duration on fetal and maternal safety remains uncertain. A concern is a maternal core body temperature of >39.0 °C, potentially increase the risk of heat-related fetal malformations and complications during pregnancy. Blood flow redirection for thermoregulation could compromise fetal cardiovascular function, increasing the risk of miscarriage and preterm labor. This study evaluated whether pregnant women (gestational weeks 25–35) were at risk of exceeding a core body temperature of 39.0 °C during high-intensity running. We also investigated effects on skin temperature, fluid loss, and thermal sensation, comparing pregnant athletes to non-pregnant controls. MethodsIn this comparative cross-sectional study, 30 elite and recreational athletes (pregnant n = 15) completed up to five high-intensity treadmill-intervals. Core and skin temperature were continuously measured. Body weight was utilized to calculate the amount of fluid loss. ResultsHighest core body temperature were 38.76 °C and 39.56 °C in one pregnant and non-pregnant participant, respectively. Pregnant participants had lower core body temperatures (mean difference −0.47 °C, p ≤ 0.001) initially and a smaller increase (0.10 °C, p ≤ 0.003) during later intervals compared with the non-pregnant controls. Pregnant participants also showed a greater increase in skin temperature (4.08 ± 0.72 °C vs. 3.25 ± 0.86 °C, p = 0.008) and fluid loss (0.81 ± 0.19 L vs. 0.50 ± 0.12 L, p˂0.001). ConclusionPhysiological changes in pregnancy may enhance thermoregulation, indicating that high-intensity interval runs are unlikely to pose a risk of exceeding a core body temperature of 39 °C for pregnant athletes.

Exploring the reciprocal relationships between body image flexibility and body fat and muscularity dissatisfaction: An 18-month longitudinal study in Chinese adolescents

Body image flexibility has shown robust negative associations with body dissatisfaction. However, research in this area is confined to cross-sectional studies on adults in Western cultural contexts. Responding to these gaps and the unique cultural nuances and increasing prevalence estimates of body dissatisfaction in China, we examined the bi-directional nature of body image flexibility and body fat and muscularity dissatisfaction in Chinese adolescent boys and girls (N = 1381, 57.3 % girls) at two points over 18 months (Wave [W] 1=baseline, W2=18 months later). We also explored sex differences in longitudinal models. In boys, higher W1 body image flexibility was associated with lower W2 body fat dissatisfaction, and higher W1 body fat dissatisfaction was associated with lower W2 body image flexibility. Null prospective associations between body image flexibility and muscularity dissatisfaction were identified in boys. In girls, higher W1 body fat and muscularity body dissatisfaction were associated with lower W2 body image flexibility. Higher W1 body image flexibility was associated with lower W2 body fat and muscularity dissatisfaction in girls. We found no significant sex differences in the models. Findings advance a multicultural understanding of the temporal and bi-directional links between body image flexibility and body fat and muscularity dissatisfaction in Chinese adolescents.

Possible effects of lumbar stabilization surgery on sagittal alignment, disability and quality of life

BackgroundIn order to restore the individual's health in lumbar stabilization surgeries, it is aimed to bring the sagittal alignment closer to normal values, to eliminate the findings, and thus to increase the quality of life of the individual by reducing the disability level. The aim of this study is to measure the effects of lumbar region stabilization surgeries performed in our clinic on some angular values in the spine, disability and quality of life. Preoperative (preop) and postoperative (postop) radiographs of 30 individuals over the age of 40 who applied to our clinic with various lumbar region complaints and underwent lumbar stabilization surgery between the years 2020–2022 were taken. Lumbar lordosis, pelvic tilt, sacral slope and pelvic inclination angles were measured from the images obtained. The Visual Analog Scale was used to measure the pain of individuals, the Oswestry Disability Index to measure the disability level, and the Nottingham Health Profile questionnaire to measure the quality of life. Preop and postop data were analyzed with the SPSS 23.0 program and p < 0.05 was considered significant.ResultsThe lumbar lordosis angles of individuals who underwent lumbar stabilization surgery approached normal values and the difference between preop–postop lumbar lordosis angle averages was significant (p < 0.05); It was observed that the harmony between the lumbar lordosis and pelvic inclination angles increased, the pain decreased and the difference between preop–postop pain values was significant (p < 0.05), disability levels decreased and quality of life increased.ConclusionsThe decrease in the level of disability and the increase in the quality of life seen in individuals who underwent lumbar stabilization surgery were associated with the decrease in pain; The changes in angular values are considered to be clinically significant.

Financial implications of sarcopenia in colorectal cancer surgery: a cost analysis in an Australian public hospital.

Sarcopenia has a detrimental impact on patient outcomes following colorectal surgery, increasing financial strain on the healthcare system. Given the absence of specific Australian data, this study aimed to measure the cost of sarcopenia in the context of colorectal surgery in an Australian public hospital. A retrospective cost analysis, following CHEERS guidelines, was conducted on major elective colorectal cancer surgical cases at the Royal Adelaide Hospital between 2018 and 2022. The cross-sectional psoas area was measured through computed tomography (CT) imaging at the level of the third lumbar vertebrae, and sarcopenia was determined using gender-specific thresholds. Hospital billing data was used to gather costings (AU$). Out of 271 patients, 57 (21.0%) comprised the sarcopenic group (SG). SG patients were older (74 vs. 69 years, P < 0.001), had a higher American Society of Anaesthesiologists (>II, 71.9% vs. 53.7%, P = 0.014) and a lower median body mass index (24.8 vs. 28.7 kg/m2, P < 0.001). The SG exhibited a greater likelihood of complications (84.2 vs. 68.7%, P = 0.020) and prolonged hospital stay by 1 day (median 7 vs. 6 days, P = 0.027). Despite an increased mean total cost of hospital admission, no statistically significant difference was found (AU$37 712 vs. $34 845, P = 0.296). Multivariate analysis revealed hypoalbuminemia, prolonged operative time, postoperative ileus, return to theatre, Clavien-Dindo grade ≥3 complications, and prolonged stay increased overall cost (P < 0.05). Sarcopenia was not associated with a significantly increased cost of colorectal surgery in our institution. Future studies examining the cost-effectiveness of prehabilitation programmes targeting sarcopenia should be considered.