Lower Body Research Articles

Complex selection processes on invasive crayfish phenotype at the invasion front of the Zambezi floodplains ecoregion

Abstract Understanding the eco‐evolutionary processes which drive phenotypic variability in non‐native species is crucial to predicting impact and informing spatially explicit management models. Invasive redclaw crayfish, Cherax quadricarinatus, are spreading rapidly through the ecologically and economically important Upper and Middle Zambezi system in south‐central Africa. We tested whether there was an invasion front effect in the Barotse floodplain and disentangle whether these effects were related to environmental filtering, spatial sorting, or density‐dependent processes along a nonlinear 200 km invasion gradient over seasonal hydrological periods. Crayfish spread up‐ and down‐stream indicated an expanding population compared to the former invasion front in 2019, facilitated by both sexes. Wet season detection probability and relative abundance were lower than in the dry season. No signals of environmental filtering were detected as a result of high connectivity of habitats in the wet season. The invasion front population was characterised by lower relative abundance, lower body condition, larger overall body and chelae size, and longer front leg length. There was no effect on sex ratio. This indicated that spatial sorting, density‐dependent processes and predation pressure are acting as selective forces on phenotypic variability across the invasion gradient. Better understanding of the effects of flood regime and trophic interactions on phenotypic variability and dispersal is urgently needed. Population suppression to reduce spatial sorting and conspecific competition could be a viable management option at the invasion front.

Effects of moderate/vigorous activity on 3-year body composition changes in postmenopausal women: a target trial emulation.

Background and Objective Postmenopausal women tend to experience significant changes in body composition, particularly abdominal adipose tissue (AAT) deposition patterns, which are hypothesized to be critical factors influencing future cardiometabolic disease risk. Physical activity has a demonstrable effect on body composition and overall health. However, there is little evidence for how different intensities and durations of physical activity over a sustained period of time influence AAT patterns and other measures of body composition in postmenopausal women. We emulated a target trial of physical activity interventions, including the 2018 Physical Activity Guidelines for Americans recommendations, on 3-year changes in AAT and body composition. Methods We analyzed observational data from 4,451 postmenopausal women aged 50-79 years in the Women's Health Initiative (WHI) to emulate a three-year target trial of adhering to increasing minutes of moderate (at least 15, 30, 75, 150, 300 minutes/week) and vigorous (at least 15, 30, 75, 150 minutes/week) physical activity aligned with the physical activity guidelines. All participants had repeated whole body Dual X-Ray Absorptiometry (DXA) scans with derived abdominal visceral (VAT) and subcutaneous adipose tissue (SAT). The measured differences in average levels of VAT, SAT, and other body composition measures determined at end of follow-up were estimated with the parametric-g formula. Results Over 3 years, interventions of increasing minutes of moderate activity would result in dose-dependent reductions in abdominal VAT, SAT, and overall body fat, and increases in lean soft tissue, with the greatest estimated benefit at the 2018 physical activity guideline recommendation of 150 mins/wk or more. Compared to no intervention, if all participants had adhered to at least 150 mins/wk of moderate physical activity, they would have 16.8 cm2 lower VAT (95% CI -23.1, -10.4), 26.8 cm2 lower SAT (95% CI -36.3, -17.3), 1.3% lower total body fat% (95% CI -1.8, -0.7), 1.2 % higher total lean soft tissue% (95% CI 0.7, 1.8), and 2.6 kg lower total bodyweight (95% CI -3.6, -1.5). We saw similar patterns in our vigorous-intensity activity interventions - if all participants adhered to at least 150 mins/wk, they would have experienced 6.7 cm2 lower VAT (95% CI -17.7, 4.3), 13.3 cm2 lower SAT (95% CI -28.8, 2.1), 1.0 % lower total body fat percent (95% CI -2.0, 0.0 ), % higher total lean soft tissue percent (95% CI) and a 0.9 kg lower total bodyweight (95% CI -2.7, 0.8). Conclusion This hypothetical emulated intervention indicated that postmenopausal women who adhere to physical activity guideline recommendations would experience beneficial changes in abdominal VAT, SAT, and overall body composition over 3 years. The study results underscore the imperative to explore further how physical activity may serve as a potential determinant of body composition.

Non-Alcoholic Fatty Liver Disease Induced by Feeding Medium-Chain Fatty Acids Upregulates Cholesterol and Lipid Homeostatic Genes in Skeletal Muscle of Neonatal Pigs.

Non-alcoholic fatty liver disease (NAFLD) is a range of disorders characterized by lipid accumulation in hepatocytes. Although this spectrum of disorders is associated with adult obesity, recent evidence suggests that this condition could also occur independently of obesity, even in children. Previously, we reported that pigs fed a formula containing medium-chain fatty acids (MCFAs) developed hepatic steatosis and weighed less than those fed an isocaloric formula containing long-chain fatty acids (LCFAs). Our objective was to determine the association between NAFLD and the skeletal muscle transcriptome in response to energy and lipid intake. Neonatal pigs were fed one of three formulas: a control formula (CONT, n = 6) or one of two isocaloric high-energy formulas containing either long (LCFA, n = 6) or medium (MCFA, n = 6) chain fatty acids. Pigs were fed for 22 d, and tissues were collected. Body weight at 20 and 22 d was greater for LCFA-fed pigs than their CONT or MCFA counterparts (p < 0.005). Longissimus dorsi weight was greater for LCFA compared with MCFA, while CONT was intermediate (p < 0.05). Lean gain and protein deposition were greater for LCFA than for CONT and MCFA groups (p < 0.01). Transcriptomic analysis revealed 36 differentially expressed genes (DEGs) between MCFA and LCFA, 53 DEGs between MCFA and CONT, and 52 DEGs between LCFA and CONT (FDR < 0.2). Feeding formula high in MCFAs resulted in lower body and muscle weights. Transcriptomics data suggest that the reduction in growth was associated with a disruption in cholesterol metabolism in skeletal muscles.

Bone remodeling after revision total hip arthroplasty for large acetabular defects.

Large acetabular bone defects are challenging in hip revision surgery. Clinical assessment is crucial to evaluate modern technologies in surgical reconstruction. We aimed to better understand the bone remodeling that occurs following acetabular reconstruction. Our objectives were: (1) To characterize changes in the shape of the pelvis by studying sequential computed tomography (CT) scans collected immediately and 1-year postoperatively and (2) to identify which part of the pelvis is most susceptible to remodeling. We used the CT scans taken at two timepoints, of 24 patients with acetabular bone defects classified as Paprosky IIIB, treated with three-dimensional (3D)-printed custom-made acetabular implants. Segmented 3D models of the bony pelvis were co-registered using three different techniques. A global co-registration of the full pelvis was conducted, followed by the co-registration of the innominate bone and then ilium only, on the ipsilateral reconstructed side. The relative movements of the ilium, ischium, and pubis were analyzed from visual inspection and using co-registration metrics (root mean square error and intersection over union). No bone remodeling was found in 14/24 patients (58%). The co-registration of the innominate bone indicated bone remodeling in five cases (21%), while the remaining five cases (21%) presented remodeling in the global co-registration but not the innominate bone co-registration, suggestive of changes occurring at the sacroiliac joint. Changes in the pelvic shape were greatest at the pubis and ischium. Bone remodeling may occur in complex cases of Paprosky type IIIB defects, after acetabular reconstruction (occurrence of 21%, 5/24 cases). Surgeons and engineers should consider this when monitoring implant migration.

Impact of the ActTeens Program on physical activity and fitness in adolescents: a cluster randomized controlled trial

BackgroundThe aim of our study was to evaluate the impact of the ActTeens Program on physical activity and health-related physical fitness among adolescents in Brazil.MethodsThe “ActTeens Program” was conducted using a cluster-randomized controlled trial during 24-week school term. The sample consisted of 317 adolescents (52.7% girls; 13.61 ± 0.70 years) from four secondary schools that were randomly assigned to intervention group (N = 169) or control group (N = 148). This school-based physical activity (PA) intervention involved two components: (i) structured physical activity sessions delivered within physical education (PE) and (ii) healthy lifestyle guidance (mHealth). The primary outcome was PA assessed using Physical Activity Questionnaire for Adolescents (PAQ-A); secondary outcomes included muscular (MF) and cardiorespiratory fitness (CRF) assessed using 90-push-up, handgrip dynamometer, standing long jump, and 20 m PACER shuttle run test. Assessments were conducted at baseline, 12- and 24-week. Intervention effects were assessed using linear mixed models (LMM).ResultsFor the primary outcome (PA), no significant group-by-time effects were observed for physical education based-PA (0.3 score; 95%CI: -0.1; 0.6; and − 0.01 score; 95%CI: -0.03; 0.03, at 12-wk and 24-wk respectively) and total PA (-0.02 score; 95%CI: -0.2; 0.2; and − 0.01score; 95%CI: -0.2; 0.2, at 12 and 24 weeks respectively). After 24 weeks, we observed a significant group by time effects for lower body muscular fitness (12.9 cm; 95%CI, 3.2 to 22.2).ConclusionThe implementation of aerobic and muscle-strengthening exercises used in the ActTeens intervention did not lead to improvements in physical activity. The intervention resulted in improved lower body muscular fitness, however, we found no significant differences for upper body muscular and cardiorespiratory fitness.

The effect of mass functionality on laparoscopic adrenalectomy outcomes.

This study aimed to determine the effect of adrenal mass functionality and different hormone subtypes synthesized by the adrenal masses on laparoscopic adrenalectomy (LA) outcomes. The study included 298 patients, 154 of whom were diagnosed with nonfunctional masses. In the functional group, 33, 62, and 59 patients had Conn syndrome, Cushing's syndrome, and pheochromocytoma, respectively. The variables were analyzed between the functional and nonfunctional groups and then compared among functional masses through subgroup analysis. The incidence of diabetes mellitus, hypertension, and obesity, blood loss, and length of hospital stay (LOH) were significantly higher in the functional group than in the nonfunctional group. In the subgroup analysis, patients with pheochromocytoma had significantly lower body mass index but significantly higher mass size, blood loss, and LOH than the other two groups. A positive correlation was found between mass size and blood loss in patients with pheochromocytoma (p ≤ 0.001, r = 0.761). However, no significant difference in complications was found among the groups. In this study, patients with functional adrenal masses had higher comorbidity rates and American Society of Anesthesiologists scores. Moreover, blood loss and LOH were longer on patients with functional adrenal masses who underwent LA. Mass size, blood loss, and LOH in patients with pheochromocytoma were significantly longer than those in patients with other functional adrenal masses. Thus, mass functionality did not increase the complications.

The Effects of a School-Based Physical Activity Program on Physical Fitness in Egyptian Children: A Pilot Study from the DELICIOUS Project.

Ensuring the physical fitness of Egyptian children is of paramount importance to their overall well-being, given the unique socio-cultural and educational barriers they face that may hinder their active participation. As part of the DELICIOUS project, the "Be Fit Program" aims to increase the level of physical fitness among Egyptian school-aged children. This study explores the effectiveness of a structured, six-week physical activity (PA) program in improving various facets of physical fitness in children, including body composition, speed, coordination, muscular strength, and cardiovascular endurance. With the increasing prevalence of sedentary lifestyles, such efforts are imperative to improve overall health outcomes. A cohort of 125 children, aged 8.50 to 12.25 y (mean age 10.19 ± 1.03 y), participated in the study. Their body composition, speed, coordination, strength, and aerobic fitness were assessed before and after the Be Fit Program using the revised International Physical Performance Test Profile. Paired t-tests were used to detect changes between the pre- and post-tests. Following the six-week intervention, statistical analyses revealed significant improvements in coordination and lower body strength (p < 0.01). Aerobic endurance showed marginal improvements, approaching statistical significance (p = 0.06). Conversely, there were no statistically significant changes in body composition, speed, or upper body strength (p > 0.05). The study confirms that tailored, non-competitive physical activities can positively influence specific fitness components in Egyptian children. However, achieving holistic improvements across all targeted fitness domains may require further strategic adjustments or a longer program duration. This pilot study underscores the importance of culturally tailored, school-based PA programs and highlights the continued need for research and program refinement to comprehensively improve children's fitness in the Egyptian context.

Lymphocyte-to-C-reactive protein ratio and score in patients with heart failure: Nutritional status, physical function, and prognosis.

In heart failure (HF), inflammation is linked to malnutrition and impaired physical function. In this study, we aimed to assess how novel nutritional-inflammatory markers and lymphocyte-to-C-reactive protein ratio (LCR) and score (LCS) are associated with the nutritional status, physical function, and prognosis of patients with HF. This study was a secondary analysis of the FRAGILE-HF study, a prospective observational study conducted across 15 hospitals in Japan. We included 1212 patients (mean age, 80.2±7.8years; 513 women) hospitalized with HF, who were classified into three groups according to their LCS score: 0 (n=498), 1 (n=533), and 2 (n=181). Baseline data on physical examination, echocardiography, blood test results (including lymphocyte counts and CRP levels), and oral medication usage were collected in a clinically compensated state before discharge. Nutritional status and physical function were evaluated using several indices and tests. The primary outcome of this study was all-cause death within 2years. Univariate and multivariate linear regression analyses were performed to evaluate the associations among the nutritional status, physical function, and LCR/LCS. Patients with an LCS score of 2 were older and had a lower body mass index than those in the other two groups. Multivariate linear regression analysis revealed that lower LCR and higher LCS were independently associated with worse nutritional status, lower handgrip strength, shorter physical performance battery score, and shorter 6-min walk distance. At 2years, all-cause death occurred in 254 patients: 86 (17.6%), 113 (21.5%), and 55 (30.9%) with LCS scores of 0, 1, and 2, respectively (P=0.001). Cox proportional hazards analysis revealed that LCR and LCS were significantly associated with 2-year mortality even after adjusting for the conventional risk model (LCS score, 0 vs. 2: hazard ratio, 1.64; 95% confidence interval [CI]; 1.14-2.35; P=0.007; log-transformed LCR: hazard ratio, 0.88; 95% CI, 0.81-0.95; P=0.002). LCR yielded additional prognostic predictability compared with the conventional risk model (continuous net reclassification improvement, 0.153; 95% CI, 0.007-0.299; P=0.041). LCR and LCS emerge as potential predictors of nutritional status, physical function, and prognosis in older patients with HF.

Factors Affecting Operating Room Scheduling Accuracy for Primary and Revision Total Knee Arthroplasty: A Retrospective Study.

Optimizing operating room (OR) scheduling accuracy is important for improving OR efficiency and maximizing value of total knee arthroplasty (TKA). However, data on factors that may impact TKA OR scheduling accuracy are limited. A retrospective review of 7655 knee arthroplasties (6999 primary TKAs and 656 revision TKAs) performed between January 2020 and May 2023 was conducted. Patient baseline characteristics, surgeon experience (years in practice), as well as actual vs scheduled OR times were collected. Actual OR times that were at least 15% shorter or longer than scheduled OR times were considered to be clinically important. Logistic regression analyses were employed to assess the influence of specific patient and surgeon factors on OR scheduling inaccuracies. Using adjusted odds ratio, patients with primary TKA who had a lower body mass index (P<.001) were independently associated with overestimation of scheduled surgical time. Conversely, younger age (P<.001), afternoon procedure start time (P<.001), surgeons with less than 10 years of experience (P=.037), and higher patient body mass index (P<.001) were associated with underestimation of scheduled surgical time. For revision TKA, female sex (P=.021) and morning procedure start time (P=.038) were associated with overestimation of scheduled surgical time, while surgeons with less than 10 years of experience (P=.014) and patients who underwent spinal/epidural/block anesthesia (P=.038) were associated with underestimation of scheduled surgical time. This study highlights patient, surgeon, and intraoperative variables that impact the accuracy of scheduling for TKA procedures. Health systems should take these variables into consideration when creating OR schedules to fully optimize resources and available space. [Orthopedics. 2024;47(5):313-319.].

Long-term mortality after isolated coronary artery bypass grafting and risk factors for mortality

BackgroundPatients requiring coronary artery bypass grafting (CABG) have multiple co-morbidities which need to be considered in totality when determining surgical risks. The objective of this study is to evaluate short-term and long-term mortality rates of CABG surgery, as well as to identify the most significant risk factors for mortality after isolated CABG.MethodsAll patients with complete dataset who underwent isolated CABG between January 2008 and December 2017 were included. Univariate and multivariate Cox regression was performed to determine the risk factors for all-cause mortality. Classification and regression tree analysis was performed to identify the relative importance of these risk factors.Results3,573 patients were included in the study. Overall mortality rate was 25.7%. In-hospital mortality rate was 1.62% overall. 30-day, 1-year, 5-year, 10-year and 14.5-year mortality rates were 1.46%, 2.94%, 9.89%, 22.79% and 36.30% respectively. Factors associated with death after adjustment for other risk factors were older age, lower body mass index (BMI), hypertension, diabetes mellitus, chronic obstructive pulmonary disease, pre-operative renal failure on dialysis, higher last pre-operative creatinine level, lower estimated glomerular filtration rate (eGFR), heart failure, lower left ventricular ejection fraction and New York Heart Association class II, III and IV. Additionally, female gender and logistic EuroSCORE were associated with death on univariate Cox analysis, but not associated with death after adjustment with multivariate Cox analysis. Using CART analysis, the strongest predictor of mortality was pre-operative eGFR < 46.9, followed by logistic EuroSCORE ≥ 2.4.ConclusionPoorer renal function, quantified by a lower eGFR, is the best predictor of post-CABG mortality. Amongst other risk factors, logistic EuroSCORE, age, diabetes and BMI had a relatively greater impact on mortality. Patients with chronic kidney disease stage 3B and above are at highest risk for mortality. We hope these findings heighten awareness to optimise current medical therapy in preserving renal function upon diagnosis of any atherosclerotic disease and risk factors contributing to coronary artery disease.

Sexual Function of Women with and without Pregnancy-Related Pelvic Girdle Pain and its Relationship with Physical Activity, Kinesiophobia and Body Image: A Cross-Sectional Comparative Study

The aim of this study was to compare the sexual function of women with and without pregnancy-related PGP, and to investigate its relationship with physical activity (PA), kinesiophobia, and body image (BI). Demographic characteristics, sexual function (Pregnancy Sexual Response Inventory), PA (Pregnancy Physical Activity Questionnaire), kinesiophobia (Tampa Kinesiophobia Scale), and BI (Body Image in Pregnancy Scale) of 125 pregnant women were recorded. In the PGP group (n = 46), visual analogue scales were used to assess the pain intensity during resting and sexual activity, and Pelvic Girdle Questionnaire was used to evaluate the activity limitation. Although total sexual function and BI scores of the groups were similar (p > 0.05), dyspareunia during pregnancy and level of kinesiophobia were higher, and energy expenditure during moderate-intensity PA was lower in pregnant women with PGP (p < 0.05). The PGP group had moderate activity limitation and reported increased PGP intensity during sexual activities (p < 0.001). PA level was significantly correlated with sexual desire (r = 0.180), and overall sexual function was correlated with kinesiophobia (r = -0.344) and BI (r = -0.199) during pregnancy (p < 0.05). These findings suggest that pregnant women with PGP are more vulnerable to sexual dysfunctions, and there is a need to develop biopsychosocial framework-oriented management strategies which aim to improve PA level and to eliminate psychological factors such as kinesiophobia and negative BI.Clinical Trial Registration: NCT05990361

COMPARATIVE ANALYSIS OF THE TREATMENT OF PATIENTS WITH DYSPLASTIC AND IDIOPATHIC OSTEOARTHROSIS OF THE HIP JOINT

Hip arthroplasty is a reliable and quick way to relieve the patient of pain, restore movement in the hip joint and improve the function of the affected limb, but the question of how effective this intervention is in dysplastic or idiopathic coxarthrosis requires further study. The objective of the study was to evaluatethe effectiveness of treatment of patients with idiopathic and dysplastic coxarthrosis, and the effect of endoprosthetics on the work of the pelvic muscles. Methods. A comparative analysis of the treatment of 121 patients was conducted, which were divided into two groups — with dysplastic coxarthrosis(63 patients) and with idiopathic coxarthrosis (58 patients). The functional results of the treatment were studied according to the Harris scale, the data of stabilographic studies and the evaluation of the work of the muscles of the pelvic girdle, which are responsible for maintaining the horizontal balanceof the pelvis. Results. In general, the results of endopros thesis were evaluated as good in both groups. At the same time, the average results in the group of patients with idiopathic coxarthrosis are significantly better (t = 2.08; p = 0.001) than in the group of patients with dysplastic coxarthrosis. However, the indicators of the muscles that ensure the horizontal balance of the pelvis, in most cases, remain reduced within 6–8 months after the endoprosthesisoperation. This is evidenced by clinical data and statistical research data. Conclusions. Endoprosthesis of the hip joint is an effective method of coxarthrosis and allows to significantly improve both the patientʼs support and kinematic function and his quality of life. The results of treatment of patients withidiopathic coxarthrosis according to the Harris scoring scale are significantly better than the results of treatment of patients with dysplastic coxarthrosis. But the performance indicators of the muscles of the pelvic girdle, in most cases remain reduced within 6–8 months after endoprosthesis surgery in patientsof both groups.

Ellagic acid mitigates heat-induced testicular detriment in a mouse model

Heat stress has been shown to have a detrimental impact on testicular activity and spermatogenesis. Ellagic acid is a plant-derived organic compound that has a variety of biological functions. Thus, it is believed that ellagic acid may improve heat-stressed testicular dysfunction. There has been no research on the impact of ellagic acid on heat-stressed testicular dysfunction. The mice were divided into 4 groups. The first group was the normal control group (CN), and the second received heat stress (HS) by submerging the lower body for 15 min in a water bath with a thermostatically controlled temperature kept at 43°C (HS), and the third and fourth groups were subjected to heat-stress similar to group two and given two different dosages of ellagic acid (5 mg/kg (EH5) and 50 mg/kg (EH50) for 14 days. Ellagic acid at a dose of 50 mg/kg improved the level of circulating testosterone (increased 3βHSD) and decreases the oxidative stress. The testicular and epididymal architecture along with sperm parameters also showed improvement. Ellagic acid treatment significantly increases the germ cell proliferation (GCNA, BrdU staining) and Bcl2 expression and decreases active caspase 3 expression. Heat stress downregulated the expression of AR, ER-α and ER-β, and treatment with ellagic acid increased the expression of ER-α and ER-β markers in the 50 mg/kg treatment group. Thus, our finding suggests that ellagic acid ameliorates heat-induced testicular impairment through modulating testosterone synthesis, germ cell proliferation, and oxidative stress. These effects could be manifested by regulating androgen and estrogen receptors. However, the two doses showed differential effects of some parameters, which require further investigation.

Early Detection of Renal Complication in Children With Sickle Cell Disease: A Single Center Prospective Study.

This observational cross-sectional study aimed to identify predictors of renal complications in pediatric patients with sickle cell disease (SCD) at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia, over six months from February 2023 to July 2023. The study evaluated microalbuminuria as an early indicator of renal injury and explored its correlations with clinical and laboratory parameters and abdominal ultrasound (US) findings. Included were pediatric patients aged 1 to 14 years with confirmed SCD, excluding those with acute infections or pre-existing renal diseases. Data from 100 patients' electronic medical records were analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States), with a significance set at p ≤ 0.05. The mean age was 7.6 ± 3.3 years, with 51 males and 49 females; 11 were diagnosed with Hb-S-beta thalassemia. Hydroxyurea (HU) compliance was high, with only four non-compliant patients, though all took folic acid. Among 42 tested for albuminuria, all had negative results (<30 mg/g creatinine). A significant association was found between SCD diagnosis and kidney, ureter, and bladder (KUB) US results (p=0.008), with abnormal KUB findings more prevalent in the Hb-S-beta thalassemia group. Patients with abnormal KUB results had significantly lower mean weight (p=0.024). Additionally, Hb-S-beta thalassemia patients had lower mean weight than hemoglobin SS (HGSS) patients (p=0.04). Though not statistically significant, Hb-S-beta thalassemia patients had higher mean systolic blood pressure (p=0.053). Significant associations were identified between SCD diagnosis type and renal US results, with lower body weight emerging as a potential predictor of renal complications. High HU compliance and its impact on renal outcomes warrant further investigation. Routine monitoring of microalbuminuria and KUB US may aid early detection of renal complications in pediatric SCD patients. Further studies with larger sample sizes are recommended to validate these findings and develop comprehensive renal protective strategies.

A Role of Physical Activity in Patients with Systemic Lupus Erythematosus – A Literature Review

Introduction: Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease of unknown cause. Inflammation and immune-mediated damage to multiple organ systems are the hallmarks of this condition. It is capable of affecting virtually every organ of the body, including but not limited to the hematologic, kidney, mucocutaneous, musculoskeletal, and kidney systems. Immunologic abnormalities, specifically the production of numerous antinuclear antibodies Purpose of work: Collect information on the impact of physical exercise and diet on SLE patients and the possibilities of their therapeutic use. Summary: Being active helps patients with SLE maintain a lower body weight, improve their mental state, relieve their fatigue, and increase their general satisfaction. There are some findings that indicate that physical activity is not as important in therapy for patients with SLE as adding exercise to the basic treatment program. Nevertheless, physical activity is beneficial for the overall well-being of individuals, regardless of whether they have SLE or not. Therefore, it is recommended that patients with SLE engage in physical activity, as it has been widely acknowledged to have significant positive health benefits.

Spatiotemporal analysis of equine infectious anemia and prediction of risk areas in Europe

Equine Infectious Anemia (EIA) is a vector-borne persistent viral infection in equine animals. The EIA is characterized by recurrent fever, thrombocytopenia, depression, anemia, rapid weight loss, and lower body edema. Control of EIA is achieved through the elimination or isolation of infected animals, resulting in significant economic losses. In recent years, many countries in Europe have experienced outbreaks of EIA, which could potentially develop into a new wave of epidemic and pose a significant threat to the healthy development of the equine industry. This study utilized spatiotemporal analysis techniques and ecological niche modeling to investigate the spatiotemporal distribution characteristics of historical EIA outbreaks and predict risk areas for EIA occurrence in Europe. Spatiotemporal analysis results indicate that from 2005 to 2023, the EIA outbreaks in Europe exhibit five significant spatiotemporal clusters, with hotspots concentrated in southeastern France and northwestern Italy. Ecological niche modeling reveals that western, central, and southern Europe are high-risk areas for EIA outbreaks. Annual mean temperature, annual precipitation, and horse density are important variables that influence the occurrence of EIA. The results of this study can provide decision-makers with valuable insights, helping with EIA monitoring and resource allocation.

Muscle MRI as a biomarker of disease activity and progression in myotonic dystrophy type 1: a longitudinal study

IntroductionMyotonic dystrophy type 1 (DM1) is an autosomal dominant disease characterized by myotonia and progressive muscular weakness and atrophy. The aim of this study was to investigate the usefulness of longitudinal muscle MRI in detecting disease activity and progression in DM1, and to better characterize muscle edema, fat replacement and atrophy overtime.Materials and methodsThis is a prospective, observational, longitudinal study including 25 DM1 patients that performed at least two muscle MRIs. Demographic and genetic characteristics were recorded. Muscular Impairment Rating Scale (MIRS) and MRC score were performed within 3 months from MRIs at baseline (BL) and at follow-up (FU). We analysed 32 muscles of lower body (LB) and 17 muscles of upper body (UB) by T1 and STIR sequences. T1-, STIR- and atrophy scores and their variations were evaluated. Correlations between MRIs’ scores and demographic, clinical and genetic characteristics were analysed.ResultsEighty (80%) of patients showed fat replacement progression at FU. The median T1 score progression (ΔT1-score) was 1.3% per year in LB and 0.5% per year in UB. The rate of fat replacement progression was not homogenous, stratifying patients from non-progressors to fast progressors (> 3% ΔT1-score per year). Half of the STIR-positive muscles at BL showed T1-score progression at FU. Two patients with normal MRI at baseline only showed STIR-positive muscle at FU, marking the disease activity onset. STIR positivity at baseline correlated with fat replacement progression (ΔT1-score; p < 0.0001) and clinical worsening at FU (ΔMRC-score; p < 0.0001). Sixty-five (65%) of patients showed STIR- and fat replacement-independent muscle atrophy progression, more evident in UB.ConclusionsMuscle MRI represents a sensitive biomarker of disease activity, severity, and progression in DM1. STIR alterations precede fat replacement and identify patients with a higher risk of disease progression, while T1-sequences reveal atrophy and fat replacement progression before clinical worsening.

Acute Hormonal and Inflammatory Responses following Lower and Upper Body Resistance Exercises Performed to Volitional Failure.

This study aimed to investigate the effects of a single bench press (BP) vs. leg press (LP) resistance training sessions on testosterone, cortisol, C-reactive protein (CRP) interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) concentrations, and creatine kinase (CK) activity in strength-trained males. Eleven strength-trained males participated in a cross-over randomized trial, undergoing two experimental sessions each consisting of five sets of the BP or the LP exercise to volitional failure with a load corresponding to 50% of one-repetition maximum. Blood samples were taken at baseline (BA), immediately post (POST), and 1 h after the cessation of exercise (POST-1). A significant increase in IL-6 concentration from BA to POST-1 was observed during the LP condition (p = 0.004; effect size [ES] = 0.64). Additionally, a significant main effect of time was found for increasing testosterone concentrations from BA to POST exercise (p = 0.014; ES = 0.25). A significantly lower cortisol concentration at POST-1 compared to POST (p = 0.001; ES = 1.02) was noted in the BP condition. Furthermore, a significantly lower cortisol concentration was found at POST-1 in the BP compared to the LP condition (p = 0.022; ES = 1.3). A significant increase in CK activity was reported from BA to POST (p = 0.024; ES = 0.69) and POST-1 (p = 0.045; ES = 0.55) during the LP condition, and from BA to POST-1 (p = 0.014; ES = 0.96) during the BP condition. No significant differences were found in the CRP (p = 0.659) and TNF-α concentrations (p = 0.487). These results suggest that the amount of muscle mass engaged during the resistance exercise may influence the changes in IL-6 and cortisol concentrations. Larger muscle groups, as engaged in the LP, more likely lead to elevated concentrations of IL-6 myokine.

New Insights into Hepatic and Intestinal Microcirculation and Pulmonary Inflammation in a Model of Septic Shock and Veno-Arterial Extracorporeal Membrane Oxygenation in the Rat.

Despite significant efforts toward improving therapy for septic shock, mortality remains high. Applying veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) in this context remains controversial. Since the cannulation of the femoral artery for V-A ECMO return leads to lower body hyperoxia, this study investigated the impact of V-A ECMO therapy on the intestinal and hepatic microcirculation during septic shock in a rodent model. Thirty male Lewis rats were randomly assigned to receive V-A ECMO therapy with low (60 mL/kg/min) or high (90 mL/kg/min) blood flow or a sham procedure. Hemodynamic data were collected through a pressure-volume catheter in the left ventricle and a catheter in the lateral tail artery. Septic shock was induced by intravenous administration of lipopolysaccharide (1 mg/kg). The rats received lung-protective ventilation during V-A ECMO therapy. The hepatic and intestinal microcirculation was measured by micro-lightguide spectrophotometry after median laparotomy for two hours. Systemic and pulmonary inflammation was detected via enzyme-linked immunosorbent assays (ELISA) of the plasma and bronchoalveolar lavage (BAL), respectively, measuring tumor necrosis factor-alpha (TNF-α), interleukins 6 (IL-6) and 10 (IL-10), and C-X-C motif ligands 2 (CXCL2) and 5 (CXCL5). Oxygen saturation and relative hemoglobin concentration were reduced in the hepatic and intestinal microcirculation during V-A ECMO therapy, independent of the blood flow rate. Further, rats treated with V-A ECMO therapy also presented elevated systolic, diastolic, and mean arterial blood pressure and increased stroke volume, cardiac output, and left ventricular end-diastolic volume. However, left ventricular end-diastolic pressure was only elevated during high-flow V-A ECMO therapy. Blood gas analysis revealed a dilutional anemia during V-A ECMO therapy. ELISA analysis showed an elevated plasma CXCL2 concentration only during high-flow V-A ECMO therapy and elevated BAL CXCL2 and CXCL5 concentrations only during low-flow V-A ECMO therapy. Rats undergoing V-A ECMO therapy exhibited impaired microcirculation of the intestine and liver during septic shock despite increased blood pressure and cardiac output. Increased pulmonary inflammation was detected only during low-flow V-A ECMO therapy in septic shock.

Physiological characteristics predictive of passing military physical employment standard tasks for ground close combat occupations in men and women.

Challenges for some women meeting the physical employment standards (PES) for ground close combat (GCC) roles stem from physical fitness and anthropometric characteristics. The purpose of this study was to identify the modifiable and nonmodifiable characteristics predictive of passing GCC-based PES tasks and determine the modifiable characteristics suitable to overcome nonmodifiable limitations. 107 adults (46 women) underwent multiday testing assessing regional and total lean mass (LM), percent body fat (BF%), aerobic capacity (V̇O2peak), strength, power, and PES performance. Predictors with p-value <0.200 were included in stepwise logistic regression analysis or binary logistic regression when outcomes among sexes were insufficient. Relative and absolute arm LM (OR: 4.617-8.522,p<0.05), leg LM (OR: 2.463, p<0.05), and upper body power (OR: 2.061, p<0.05) predicted medicine ball chest throw success. Relative and absolute arm LM (OR: 3.734-11.694, p<0.05), absolute trunk LM (OR: 2.576, p<0.05), and leg LM (OR: 2.088, p<0.05) predicted casualty drag success. Upper body power (OR: 3.910, p<0.05), absolute trunk LM (OR: 2.387, p<0.05), leg LM (OR: 2.290, p<0.05), and total LM (OR: 1.830, p<0.05) predicted maximum single lift success. Relative and absolute arm LM (OR: 3.488-7.377, p<0.05), leg LM (OR: 1.965, p<0.05), and upper body power (OR: 1.957, p<0.05) predicted water can carry success. %BF (OR: 0.814, p=0.007), V̇O2peak (OR: 1.160, p=0.031), and lower body strength (OR: 1.059, p<0.001) predicted repeated lift and carry success. V̇O2peak (OR: 1.540, p<0.001) predicted 2-km ruck march success. Modifiable characteristics were the strongest predictors for GCC-based PES task success to warrant their improvement for enhancing PES performance for women.