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Ghotra SS, Cottier Y, Bruguier C, Dominguez A, Monnin P, Sá Dos Reis C. A pilot study to identify suitable MRI protocols for preoperative planning of total hip arthroplasty. Eur J Radiol 2024; 178:111620. [PMID: 39029238 DOI: 10.1016/j.ejrad.2024.111620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 06/15/2024] [Accepted: 07/11/2024] [Indexed: 07/21/2024]
Abstract
PURPOSE The purpose of this study is to identify suitable MRI sequences and evaluate the feasibility and performance of MRI for total hip arthroplasty (THA) preoperative planning. METHOD A multicentric pilot study was conducted to evaluate DP TSE and T1 GRE 3D sequences. High-resolution pelvis, hip, knee and ankle images were acquired. Protocols were optimised to enhance image quality (IQ) and reduce acquisition time to fit clinical practice. The final protocol was validated with 19 healthy volunteers with variable BMIs at 1.5 and 3 Tesla. Visual assessment was performed by five radiographers and radiologists using the ViewDEX software. Visual Grading Analysis (VGA), Intraclass Correlation Coefficient (ICC), Prevalence-adjusted and bias-adjusted kappa (PABAK) and Visual Grading Characteristics (VGC) were performed to analyse data. RESULTS VGA scores indicated that the optimised 3D DP TSE and 3D T1 GRE sequences at 3 T, as well as 3D DP TSE sequence at 1.5 T offer adequate IQ and allow a correct visualisation of the anatomy. Overall ICC analysis was moderate to good reliability at 0.749 (95 % CI 0.69-0.79) and increased from good to excellent at 0.846 (95 % CI 0.72-0.91) for DP at 3 T. PABAK shows fair agreement at 0.25 (95 % CI 0.227-0.273). VGC analysis showed that 3D DP TSE sequences performed statistically better than 3D T1 GRE at 1.5 and 3 T (p-value ≤ 0.05). Furthermore, 3 T sequences showed a statistically better performance compared to 1.5 T (p-value ≤ 0.05). CONCLUSIONS According to the results, 3D DP and T1 MRI sequences can be considered for preoperative planning for THA. Further research is required to emphasize the clinical validation of the results.
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Affiliation(s)
- Switinder Singh Ghotra
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland; Department of Radiology, Hospital of Yverdon-les-Bains (eHnv), 1400 Yverdon-les-Bains, Switzerland.
| | - Yann Cottier
- Centre d'Imagerie Diagnostique de Lausanne, Lausanne 1011, Switzerland
| | - Christine Bruguier
- Department of Diagnostic & Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne 1011, Switzerland; University Center of Legal Medicine Lausanne - Geneva, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne 1011, Switzerland.
| | - Alejandro Dominguez
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland; University Center of Legal Medicine Lausanne - Geneva, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne 1011, Switzerland.
| | - Pascal Monnin
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland.
| | - Cláudia Sá Dos Reis
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland.
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Deka P, Schlegel E, Pathak D, Karve M, Pickford D, DeLuna A, Wyatt G, Buchholz SW. Acceptability of a Portable Exercise Bike in Older Adults With Cardiovascular Diseases. West J Nurs Res 2024:1939459241274869. [PMID: 39180378 DOI: 10.1177/01939459241274869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2024]
Abstract
BACKGROUND Ways to help older adults overcome barriers to performing regular exercise is a challenge to nurses. OBJECTIVE The study evaluated the acceptability of a portable exercise bike for arm/foot pedaling among older patients with cardiovascular diseases (CVDs). METHODS Participants reported their physical activity levels using the International Physical Activity Questionnaire (short form) and thereafter performed two 6-minute-long arm/foot pedal biking sessions using a portable exercise bike. Participants provided qualitative feedback (one open-ended question) on the bike while exercising and completed the quantitative Acceptability Use Questionnaire following the two exercise sessions. RESULTS Twenty-five older adults (52% male and 48% female), with a mean (SD) age of 70 (6.4) years and a body mass index of 30 (7.4), completed the study. Most participants performed moderate to light physical activity at home with a daily mean (SD) sitting/sedentary time of 8 (3.4) hours. The mean scores from the Acceptability Use Questionnaire and the participants' comments alluded to the bike's multitasking utility and acceptability. Three broad themes derived from the qualitative analysis were: (1) the acceptability of the bike with participants who had musculoskeletal problems; (2) the ability to operate and use the bike for aerobic exercise engaging both arms and legs; and (3) the importance of overall utility, ease of use, and cost of the bike. CONCLUSIONS The portable exercise bike was found acceptable in a group of older adults with CVDs. The bike has the potential to be applied in home-based exercise interventions.
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Affiliation(s)
- Pallav Deka
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Emma Schlegel
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Dola Pathak
- Department of Statistics and Probability, Michigan State University, East Lansing, MI, USA
| | | | - Darby Pickford
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Allison DeLuna
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Gwen Wyatt
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Susan W Buchholz
- College of Nursing, Michigan State University, East Lansing, MI, USA
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Feng Z, Chen Y, Guo Y, Lyu J. Deciphering the environmental chemical basis of muscle quality decline by interpretable machine learning models. Am J Clin Nutr 2024; 120:407-418. [PMID: 38825185 DOI: 10.1016/j.ajcnut.2024.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/07/2024] [Accepted: 05/28/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND Sarcopenia is known as a decline in skeletal muscle quality and function that is associated with age. Sarcopenia is linked to diverse health problems, including endocrine-related diseases. Environmental chemicals (ECs), a broad class of chemicals released from industry, may influence muscle quality decline. OBJECTIVES In this work, we aimed to simultaneously elucidate the associations between muscle quality decline and diverse EC exposures based on the data from the 2011-2012 and 2013-2014 survey cycles in the National Health and Nutrition Examination Survey (NHANES) project using machine learning models. METHODS Six machine learning models were trained based on the EC and non-EC exposures from NHANES to distinguish low from normal muscle quality index status. Different machine learning metrics were evaluated for these models. The Shapley additive explanations (SHAP) approach was used to provide explainability for machine learning models. RESULTS Random forest (RF) performed best on the independent testing data set. Based on the testing data set, ECs can independently predict the binary muscle quality status with good performance by RF (area under the receiver operating characteristic curve = 0.793; area under the precision-recall curve = 0.808). The SHAP ranked the importance of ECs for the RF model. As a result, several metals and chemicals in urine, including 3-phenoxybenzoic acid and cobalt, were more associated with the muscle quality decline. CONCLUSIONS Altogether, our analyses suggest that ECs can independently predict muscle quality decline with a good performance by RF, and the SHAP-identified ECs can be closely related to muscle quality decline and sarcopenia. Our analyses may provide valuable insights into ECs that may be the important basis of sarcopenia and endocrine-related diseases in United States populations.
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Affiliation(s)
- Zhen Feng
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China; Joint Centre of Translational Medicine, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang, People's Republic of China; College of Information and Engineering, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Ying'ao Chen
- Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China; Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang, People's Republic of China
| | - Yuxin Guo
- College of Information and Engineering, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Jie Lyu
- Joint Centre of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China; Joint Centre of Translational Medicine, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang, People's Republic of China; Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou, Zhejiang, People's Republic of China.
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Choi S, Nahmias J, Dolich M, Lekawa M, Smith BR, Nguyen N, Grigorian A. Obese adolescents have higher risk for femur fracture after motor vehicle collision. Surg Open Sci 2024; 20:205-209. [PMID: 39156489 PMCID: PMC11327607 DOI: 10.1016/j.sopen.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 07/13/2024] [Accepted: 07/19/2024] [Indexed: 08/20/2024] Open
Abstract
Background Previous reports identified an association between obese adolescents (OAs) and lower extremity (LE) fractures after blunt trauma. However, the type of LE fracture remains unclear. We hypothesized that OAs presenting after motor vehicle collision (MVC) have a higher risk of severe LE fracture and will require a longer length of stay (LOS) and more support services upon discharge, compared to non-OAs. Methods The 2017-2019 Trauma Quality Improvement Program database was queried for adolescents (12-17-years-old) presenting after MVC. The primary outcome was LE fracture. A severe fracture was defined by abbreviated injury scale ≥3. OAs were defined by a body mass index (BMI) ≥30. Results From 22,610 MVCs, 3325 (14.7 %) included OAs. The rate of any LE fracture was higher for OAs (21.6 % vs. 18.8 %, p < 0.001). On subset analysis the only LE fracture at higher risk in OAs was a femur fracture (13 % vs. 9.1 %, p < 0.001). After adjusting for sex and age, the risk for severe LE fracture (OR 1.34, CI 1.18-1.53, p < 0.001) was higher for OAs. OAs with a femur fracture had a longer median LOS (5 vs. 4 days, p = 0.003) and were more likely discharged with additional support services including home-health or inpatient rehabilitation (30.6 % vs. 21.4 %, p < 0.001). Conclusion OAs sustaining MVCs have increased associated risk of femur fractures. OAs are more likely to have a higher-grade LE injury, experience a longer LOS, and require additional support services upon discharge. Future research is needed to determine if early disposition planning with social work assistance can help shorten LOS.
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Affiliation(s)
- Shaelyn Choi
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - Jeffry Nahmias
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - Matthew Dolich
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - Michael Lekawa
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - Brian R. Smith
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - Ninh Nguyen
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - Areg Grigorian
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
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Rai S, Patel S, Chouhan DK, Jain A, Thami T, Dadra A, Dhillon MS. Is There a Need for an Exogenous Activator Along with PRP for Early Knee Osteoarthritis? A Triple-Blinded Randomized Control Trial. Indian J Orthop 2024; 58:905-913. [PMID: 38948365 PMCID: PMC11208341 DOI: 10.1007/s43465-024-01159-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/16/2024] [Indexed: 07/02/2024]
Abstract
Background In addition to other variables associated with PRP injections for Knee Osteoarthritis (OA), some confusion exists about the role of exogenous activators. The current study looks at matched groups getting PRP injections with or without activator (Calcium gluconate) in early knee OA patients. Methods Patients of early OA knee meeting inclusion criteria were randomly divided into 2 groups; Group A (43 patients) received 8 ml PRP injection alone, and Group B (48 patients) received 8 ml PRP along with 2 ml Calcium gluconate as activator. The patients were evaluated at baseline, 6 weeks, 3 months and 6 months for WOMAC Pain and Total WOMAC scores; secondary variables assessed were VAS score and patient satisfaction. Results The baseline characteristics of both groups were comparable. Leucocyte-depleted PRP with 5 times concentration and average absolute platelet numbers of 7.144 billion per knee was injected. Mean Pain WOMAC scores decreased in both groups from baseline (group A-8.68, group B-9.09) to final follow-up (group A-4.67, group B-5.11). Similarly, Mean Total WOMAC scores decreased from baseline (group A-37.81, group B-37.41) to (group A-21, group B-21.36) at the final follow-up in both groups. There was no significant difference between both groups, and both showed similar trends. Similar findings were noted for VAS scores. Patient satisfaction was also not different (group A, 90.69%, group B, 89.58%) at the end of 6 months. Conclusion Our study concluded doubtful role of adding exogenous activator to PRP preparation. Supplementary Information The online version contains supplementary material available at 10.1007/s43465-024-01159-7.
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Affiliation(s)
- Shivam Rai
- Department of Orthopaedics, PGIMER, Chandigarh, India
| | - Sandeep Patel
- Department of Orthopaedics, PGIMER, Chandigarh, India
| | | | - Ashish Jain
- Department of Orthopaedics, PGIMER, Chandigarh, India
| | - Tarkik Thami
- Department of Orthopaedics, PGIMER, Chandigarh, India
| | - Ankit Dadra
- Department of Orthopaedics, PGIMER, Chandigarh, India
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Adouni M, Alkhatib F, Hajji R, Faisal TR. Effects of overweight and obesity on lower limb walking characteristics from joint kinematics to muscle activations. Gait Posture 2024; 113:337-344. [PMID: 39032386 DOI: 10.1016/j.gaitpost.2024.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/16/2024] [Accepted: 06/26/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Obesity is a crucial factor that increases the risk of initiating and advancing knee osteoarthritis. However, it remains unclear how obesity directly impacts the biomechanical experience of the lower limb joints, potentially triggering or exacerbating joint degeneration. This study investigated the interactive effects of BMI augmentation on lower limb kinematics, kinetics, and muscle activations during walking. METHODOLOGY A group of 60 participants underwent a three-dimensional gait analysis. These individuals were categorized into three groups based on their body mass index (BMI): those with a BMI below 25 were classified as having a healthy weight, those with a BMI between 25 and 30 were categorized as overweight, and those with a BMI exceeding 30 were considered obese. This study analyzed the gait of 60 participants categorized by BMI. During walking trials, they recorded ground reaction forces electromyography of leg muscles like the gastrocnemii, hamstrings, and quadriceps. Lower limb joint angles and net moments were also calculated. Statistical mapping identified variations in kinematic, kinetic, and muscle activation patterns across the stance phase between BMI groups. RESULTS The results displayed distinct biomechanical patterns in obese individuals. Notably, there was a significant increase in flexion observed in the hip and knee joints (P < 0.001) during the initial stance phase and an increase in hip and knee adduction angles and moments throughout the entire stance phase (P < 0.001). Additionally, muscle activations underwent significant changes (P < 0.01), with a positive correlation noted with the BMI factor. This correlation was most pronounced during the early stance phase for the quadriceps and hamstring muscles and the late stance phase for the gastrocnemius. CONCLUSION These findings represent a comprehensive picture that contributes to understanding how excess weight and obesity influence joint biomechanics, highlighting the associated risk of joint osteoarthritis.
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Affiliation(s)
- Malek Adouni
- Biomedical and Instrumentation Engineering Program, Abdullah Al Salem University, Khalidiya, Kuwait; Department of Physical Medicine and Rehabilitation, Northwestern University, 345 East Superior Street, Chicago, IL 60611, USA.
| | - Fadi Alkhatib
- Department of Mechanical Engineering, Australian University, P.O. Box 1411, East Mushrif, Kuwait
| | - Raouf Hajji
- Medicine Faculty of Sousse, Department of Internal Medicine, Sidi Bouzid Hospital, University of Sousse, Tunisia
| | - Tanvir R Faisal
- Department of Mechanical Engineering, University of Louisiana at Lafayette, LA 70508, USA
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Wu KA, Helmkamp J, Levin JM, Hurley ET, Goltz DE, Cook CE, Pean CA, Lassiter TE, Boachie-Adjei YD, Anakwenze O, Klifto C. Association between radiographic soft-tissue thickness and increased length of stay, operative time, and infection rate after reverse shoulder arthroplasty. J Shoulder Elbow Surg 2024; 33:1267-1275. [PMID: 38036256 DOI: 10.1016/j.jse.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/11/2023] [Accepted: 10/22/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Reverse shoulder arthroplasty (RSA) is a widely performed surgical procedure to address various shoulder pathologies. Several studies have suggested that radiographic soft-tissue thickness may play a role in predicting complications after orthopedic surgery, but there have been limited studies determining the use of radiographic soft-tissue thickness in RSA. The purpose of this study was to evaluate whether radiographic soft-tissue thickness could predict clinical outcomes after RSA and compare the predictive capabilities against body mass index (BMI). We hypothesized that increased radiographic shoulder soft-tissue thickness would be a strong predictor of operative time, length of stay (LOS), and infection in elective RSA. MATERIAL AND METHODS A retrospective review of patients undergoing RSA at an academic institution was conducted. Preoperative radiographic images were evaluated including measurements of the radius from the humeral head center to the skin (HS), deltoid radius-to-humeral head radius ratio (DHR), deltoid size, and subcutaneous tissue size. Different correlation coefficients were used to analyze various types of relationships, and the strength of these associations was classified based on predefined boundaries. Subsequently, multivariable linear and logistic regressions were performed to determine whether HS, DHR, deltoid size, and subcutaneous tissue size could predict LOS, operative time, or infection while controlling for patient factors. RESULTS HS was the most influential factor in predicting both operative time and LOS after RSA, with strong associations indicated by standardized β coefficients of 0.234 for operative time and 0.432 for LOS. Subcutaneous tissue size, deltoid size, and DHR also showed stronger predictive values than BMI for both outcomes. In terms of prosthetic joint infection, HS, deltoid size, and DHR were significant predictors, with HS demonstrating the highest predictive power (Nagelkerke R2 = 0.44), whereas BMI did not show a statistically significant association with infection. Low event counts resulted in wide confidence intervals for odds ratios in the infection analysis. CONCLUSION Greater shoulder soft-tissue thickness as measured with concentric circles on radiographs is a strong predictor of operative time, LOS, and postoperative infection in elective primary RSA patients.
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Affiliation(s)
- Kevin A Wu
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
| | - Joshua Helmkamp
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Jay M Levin
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Eoghan T Hurley
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Daniel E Goltz
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Chad E Cook
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Christian A Pean
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Tally E Lassiter
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Yaw D Boachie-Adjei
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Oke Anakwenze
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Christopher Klifto
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
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Bonet ML, Ribot J, Sánchez J, Palou A, Picó C. Early Life Programming of Adipose Tissue Remodeling and Browning Capacity by Micronutrients and Bioactive Compounds as a Potential Anti-Obesity Strategy. Cells 2024; 13:870. [PMID: 38786092 PMCID: PMC11120104 DOI: 10.3390/cells13100870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
The early stages of life, especially the period from conception to two years, are crucial for shaping metabolic health and the risk of obesity in adulthood. Adipose tissue (AT) plays a crucial role in regulating energy homeostasis and metabolism, and brown AT (BAT) and the browning of white AT (WAT) are promising targets for combating weight gain. Nutritional factors during prenatal and early postnatal stages can influence the development of AT, affecting the likelihood of obesity later on. This narrative review focuses on the nutritional programming of AT features. Research conducted across various animal models with diverse interventions has provided insights into the effects of specific compounds on AT development and function, influencing the development of crucial structures and neuroendocrine circuits responsible for energy balance. The hormone leptin has been identified as an essential nutrient during lactation for healthy metabolic programming against obesity development in adults. Studies have also highlighted that maternal supplementation with polyunsaturated fatty acids (PUFAs), vitamin A, nicotinamide riboside, and polyphenols during pregnancy and lactation, as well as offspring supplementation with myo-inositol, vitamin A, nicotinamide riboside, and resveratrol during the suckling period, can impact AT features and long-term health outcomes and help understand predisposition to obesity later in life.
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Affiliation(s)
- M. Luisa Bonet
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands, 07122 Palma, Spain; (M.L.B.); (J.S.); (A.P.); (C.P.)
- Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
- Artificial Intelligence Research Institute of the Balearic Islands (IAIB), University of the Balearic Islands, 07122 Palma, Spain
| | - Joan Ribot
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands, 07122 Palma, Spain; (M.L.B.); (J.S.); (A.P.); (C.P.)
- Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
| | - Juana Sánchez
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands, 07122 Palma, Spain; (M.L.B.); (J.S.); (A.P.); (C.P.)
- Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
| | - Andreu Palou
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands, 07122 Palma, Spain; (M.L.B.); (J.S.); (A.P.); (C.P.)
- Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
- Artificial Intelligence Research Institute of the Balearic Islands (IAIB), University of the Balearic Islands, 07122 Palma, Spain
| | - Catalina Picó
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation), University of the Balearic Islands, 07122 Palma, Spain; (M.L.B.); (J.S.); (A.P.); (C.P.)
- Health Research Institute of the Balearic Islands (IdISBa), 07010 Palma, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
- Artificial Intelligence Research Institute of the Balearic Islands (IAIB), University of the Balearic Islands, 07122 Palma, Spain
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Bohler L, Meyer HE, Stigum H, Leirbakk MJ, Cabral D, Wedegren MC, Andersen E, Wieland ML, Madar AA. A controlled weight loss intervention study among women of Somali background in Norway. J Migr Health 2024; 9:100231. [PMID: 38766513 PMCID: PMC11101690 DOI: 10.1016/j.jmh.2024.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/01/2024] [Accepted: 05/02/2024] [Indexed: 05/22/2024] Open
Abstract
Background Women of Somali background in Norway have a high prevalence of overweight and obesity, compared with women in the general Norwegian population. For lifestyle interventions to be applicable for immigrants to Norway, it is important to culturally tailor interventions in collaboration with relevant communities. The primary outcome was a difference in weight change between the intervention and control groups. Methods In this interventional study, Somali women living in one borough of Oslo Municipality in Norway with body mass index (BMI) ≥27.0 kg.m-2 received a co-created, culturally tailored 12-month weight loss intervention consisting of 24 interactive sessions during the first three months, and monthly sessions for the next nine months, compared to a control group. Both groups were measured at baseline and 12 months. Results A total of 169 participants were recruited, and 101 participants completed the follow-up. After multiple imputation, the mean difference in weight change adjusted for baseline weight, age, education, employment, marital status, number of children in the household and length of Norwegian residency was -1.6 kg (95 % CI -3.57, 0.43, p = 0.12) in the intervention compared to the control group. Conclusion This culturally tailored intervention study demonstrated a modest non-significant effect on weight change after 12 months, possibly due to the short intervention duration and COVID-19. Further studies of a longer duration and considering the provision of childcare are needed to understand whether this approach can be transferred to other immigrant groups and genders.Trial registration: The study was registered at clinicaltrials.gov NCT04578067, 2020-09-29.
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Affiliation(s)
- Linn Bohler
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, PO Box 1130 Blindern, 0316 Oslo, Norway
| | - Haakon E. Meyer
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, PO Box 1130 Blindern, 0316 Oslo, Norway
- Norwegian Institute of Public Health, 0213 Oslo, Norway
| | - Hein Stigum
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, PO Box 1130 Blindern, 0316 Oslo, Norway
| | - Maria J. Leirbakk
- Oslo Municipality, District Sagene, Vitaminveien 4, 0485 Oslo, Norway
| | - Danielle Cabral
- Oslo Municipality, District Gamle Oslo, Kolstadgata 1, 0652 Oslo, Norway
| | | | - Eivind Andersen
- Faculty of Humanities, Sports and Educational Science, Department of Sports, Physical Education and Outdoor Studies, University of South-Eastern Norway (USN), Post office box 4, 3199 Borre, Norway
| | - Mark L. Wieland
- Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN 55902, USA
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, Minnesota 55902, USA
| | - Ahmed A. Madar
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, PO Box 1130 Blindern, 0316 Oslo, Norway
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Kessler DA, MacKay JW. Editorial for "Effects of Bariatric Surgery on Knee Articular Cartilage and Osteoarthritis Symptoms-A 12-Month Follow-Up Using T2 Relaxation Time and WOMAC Osteoarthritis Index". J Magn Reson Imaging 2024. [PMID: 38578128 DOI: 10.1002/jmri.29375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 04/06/2024] Open
Affiliation(s)
| | - James W MacKay
- Department of Radiology, University of Cambridge, Cambridge, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
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Gunay Ucurum S, Uzunlar H, Kirmizi M, Altas EU, Ozer Kaya D. Comparative analysis of postural stability and risk of falling and developing disability among overweight and obese women over 40 years. J Bodyw Mov Ther 2024; 38:549-553. [PMID: 38763607 DOI: 10.1016/j.jbmt.2024.03.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 03/05/2024] [Accepted: 03/14/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Increased body mass index (BMI) adversely affects the mechanics of the musculoskeletal system. It is known that obese people have poorer postural stability and mobility-related outcomes compared to normal weight people, but there is limited research comparing overweight and class 1 obese people, two consecutive and prevalent BMI categories. AIMS To compare postural stability, functional mobility, and risk of falling and developing disability between overweight and obese women, and to investigate the relationship of BMI and body weight with the outcomes. METHODS Thirty women with class 1 obesity and 30 overweight women were included. Standing postural stability with eyes-open and eyes-closed and stability limits were assessed using the Prokin system. The Timed Up and Go Test (TUG) was used to assess functional mobility and risk of falling (≥11 s) and developing disability (≥9 s). RESULTS The average center of pressure displacements on the y-axis (COPY) obtained during quiet standing with both eyes-open and eyes-closed were higher in obese women than overweight women (p < 0.05) and the effect sizes were moderate for the results. The COPY values in the eyes-open and eyes-closed conditions were correlated with BMI (r = 0.295 and r = 0.285, p < 0.05). Furthermore, the COPX value in the eyes-open condition and the TUG score were correlated with body weight (r = 0.274 and r = 0.257, p < 0.05). CONCLUSIONS Obese women had poorer static standing stability in the anteroposterior direction than overweight women, while functional mobility and risk of falling and developing disability did not differ. Furthermore, BMI and body weight were related to poorer static standing stability.
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Affiliation(s)
- Sevtap Gunay Ucurum
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
| | - Hilal Uzunlar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey; Department of Sports Management, Faculty of Sports Sciences, Hitit University, Corum, Turkey.
| | - Muge Kirmizi
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
| | - Elif Umay Altas
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bakırcay University, Izmir, Turkey.
| | - Derya Ozer Kaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
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12
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Ma X, Shen J, Wan J. Impact of obesity on outcomes of rotator cuff repair: A systematic review and meta-analysis. PLoS One 2024; 19:e0299125. [PMID: 38478532 PMCID: PMC10936781 DOI: 10.1371/journal.pone.0299125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/05/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND To synthesize the existing evidence on the association between obesity and rotator cuff repair outcomes such as pain, shoulder function, range of motion, and complications. METHODS We searched PubMed, EMBASE, and Scopus databases for relevant observational studies (cohort and case-control) and randomized controlled trials (RCTs). The target population in the included studies comprised adults who had undergone rotator cuff repair procedures. The outcomes of interest were functional outcomes (such as range of motion), pain scores, patient-reported outcome measures, and complication rates (such as re-repair and readmission rates). We applied random-effects models and calculated pooled effect sizes reported as standardized mean differences (SMDs) or relative risks (RRs) with 95% confidence intervals. RESULTS We analysed data from 11 studies. In most, the follow-up periods ranged from 12 to 60 months. Obese individuals experienced greater pain (SMD 0.30; 95% CI, 0.10, 0.50) and lower shoulder function (SMD -0.33; 95% CI, -0.54, -0.12) than other individuals in the long-term post-operative follow-up. Obese individuals also had higher risks of complications (RR 1.48; 95% CI, 1.11, 1.98) and readmission (RR 1.35; 95% CI, 1.27, 1.43), but a similar likelihood of re-repair (RR, 1.27; 95% CI, 0.82, 1.95) than non-obese/normal BMI individuals. While the forward flexion and external rotation functions were comparable, obese individuals displayed less internal rotation function than other individuals (SMD -0.59; 95% CI, -0.87, -0.30). CONCLUSION Obesity was associated with unfavourable outcomes after rotator cuff surgery, including increased pain, reduced shoulder function, high risks of complications, and readmission. These findings emphasize the importance of addressing obesity-related factors to improve post-operative outcomes.
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Affiliation(s)
- Xiaojun Ma
- Department of Sports Medicine, Ningxia Hui Autonomous Region People’s Hospital, Yinchuan City, Ningxia Hui Autonomous Region, China
| | - Jia Shen
- Department of Intensive Care Unit, General Hospital of Ningxia Medical University, Yinchuan City, Ningxia Hui Autonomous Region, China
| | - Jun Wan
- Department of Sports Medicine, Ningxia Hui Autonomous Region People’s Hospital, Yinchuan City, Ningxia Hui Autonomous Region, China
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Patel S, Gahlaut S, Thami T, Chouhan DK, Jain A, Dhillon MS. Comparison of Conventional Dose Versus Superdose Platelet-Rich Plasma for Knee Osteoarthritis: A Prospective, Triple-Blind, Randomized Clinical Trial. Orthop J Sports Med 2024; 12:23259671241227863. [PMID: 38410168 PMCID: PMC10896053 DOI: 10.1177/23259671241227863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 08/18/2023] [Indexed: 02/28/2024] Open
Abstract
Background Confusion persists regarding the ideal dosage of platelet-rich plasma (PRP) injection for knee osteoarthritis (OA). Purpose/Hypothesis The purpose of the study was to compare the efficacy of 2 different single-injection PRP dosages in patients with early knee OA-a conventional 4 mL dose and a superdose of 8 mL. It was hypothesized that 8 mL of PRP would be superior to 4 mL of PRP in this patient population. Study Design Randomized clinical trial; Level of evidence, 1. Methods Patients with early knee OA (Kellgren-Lawrence grades 1 and 2) who met the inclusion criteria were randomly divided into 2 groups: Group A (n = 50 knees) received a 4-mL PRP injection, and group B (n = 49 knees) received an 8-mL PRP injection, both prepared using the same procedure. Patients were evaluated at the baseline, 6 weeks, 3 months, and 6 months using the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the WOMAC-Pain subscale, the visual analog scale for pain, the Knee injury and Osteoarthritis Outcome Score, and patient satisfaction, and results were compared between the groups. Results The baseline characteristics of the 2 groups were comparable (group A: mean age, 51.96 ± 6.93 years; group B: mean age, 49.12 ± 9.8 3 years). Leucocyte-depleted PRP with 3.5 times concentration (final product platelet concentration, 706.74 × 103-μL) was injected. The mean absolute platelet count injected was 2.82 ± 0.0012 billion in group A and 5.65 ± 0.0022 billion in group B. All patient-reported outcome scores improved significantly in both groups from the baseline to the final follow-up (P < .001), with overall trends and results significantly better in group B than in group A (P < .001). Patient satisfaction at the 6-month follow-up was also better in group B (96%) compared with group A (68%). Short (2 to 7 days) self-limiting complications, such as pain and stiffness, occurred more often in group B (P < .001). Conclusion Patients with early knee OA had significantly better improvement in pain and function when treated with an 8-mL injection of PRP compared with a 4-mL injection of PRP. The larger dose of PRP had approximately twice the number of platelets. Registration CTRI/2020/02/023403 (Clinical Trials Registry-India identifier).
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Affiliation(s)
- Sandeep Patel
- Department of Orthopedic Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Shivam Gahlaut
- Department of Orthopedic Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Tarkik Thami
- Department of Orthopedic Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Devendra Kumar Chouhan
- Department of Orthopedic Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Ashish Jain
- Department of Transfusion Medicine, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Mandeep Singh Dhillon
- Department of Orthopedic Surgery, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
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Cialdella-Kam L, Bloedon TK, Stone MS. Body composition as a marker of performance and health in military personnel. Front Sports Act Living 2023; 5:1223254. [PMID: 38169866 PMCID: PMC10759214 DOI: 10.3389/fspor.2023.1223254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Body composition standards are set to ensure operational readiness in active-duty military personnel. To meet body composition standards, some individuals, however, may engage in unhealthy weight control behaviors (i.e., weight cycling and disordered eating). The objectives of this review are to: (1) evaluate the evidence regarding body composition and the associations to physical and military specific performance; (2) discuss body composition and potential health consequences; and (3) examine the evidence of weight cycling and disordered eating behaviors in military personnel for weight control. Methods A systematic search to identify peer-reviewed research articles was conducted in PubMed on 2/20/2023 using Medical Subject Headings (MeSH) including but not limited to "Military Personnel", "Tactical Athlete", "Weight Loss", "Body Composition", and "Weight Cycling". Results A total of 225 research articles were identified. The list was narrowed down to articles from the last 20 years (2003-2023) in military personnel. Only studies in which percent body fat was directly measured were included resulting in 17 research articles for this review. Discussion Evidence-based research is limited on the relationship between body composition and operational readiness. Weight cycling and disordered eating behaviors also has been reported for weight control, yet additional research is needed. Specifically, future research should focus on female service members, racial and ethnic differences, age, and postpartum status and include other service branches (i.e., Air Force and Navy). A comprehensive survey on weight cycling, disordered eating, and weight management would be valuable to determine the prevalence and extent of this issue. This information along with performance data would guide policy makers on the relevance and appropriateness of existing body composition standards.
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Affiliation(s)
- Lynn Cialdella-Kam
- Warfighter Performance Department, Naval Health Research Center, San Diego, CA, United States
| | - Taylor K. Bloedon
- School of Applied Health, Cal Poly Humboldt, Arcata, CA, United States
| | - Michael S. Stone
- Warfighter Performance Department, Naval Health Research Center, San Diego, CA, United States
- Military and Veterans Health Solutions, Leidos, San Diego, CA, United States
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15
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Busebee B, Ghusn W, Cifuentes L, Acosta A. Obesity: A Review of Pathophysiology and Classification. Mayo Clin Proc 2023; 98:1842-1857. [PMID: 37831039 PMCID: PMC10843116 DOI: 10.1016/j.mayocp.2023.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/18/2023] [Accepted: 05/30/2023] [Indexed: 10/14/2023]
Abstract
Obesity is a chronic, multifactorial, and morbid disease. In the United States, 69% of adults are overweight or have obesity, and the global prevalence of obesity is increasing. Obesity is influenced by genetic, neurologic, metabolic, enteric, and behavioral processes. It remains a key modifiable risk factor for many comorbid diseases, including cardiovascular disease, diabetes mellitus, and cancer. Whereas there are recent and significant advances in obesity therapy, including diets, lifestyle modifications, pharmacotherapies, endoscopic procedures, and bariatric surgeries, there is an immense need for a better understanding of the heterogeneity in the pathophysiologic process of obesity and outcomes. Here we review salient pathophysiologic mechanisms underlying the development and morbidity of obesity as well as pathophysiologically based classification systems that inform current obesity management and may inform improved and individualized management in the future.
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Affiliation(s)
| | - Wissam Ghusn
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Lizeth Cifuentes
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Andres Acosta
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN.
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16
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Shen J, Liu J, Liang F, Liu X, Liu X, Fan B, Lv Z, Zhang C. Correlation analysis between body mass index and foot length in Chinese adolescents: a regional study. ERGONOMICS 2023; 66:1845-1853. [PMID: 36607818 DOI: 10.1080/00140139.2023.2166683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
This study aims to analyse the relationship between body mass index and foot length in Chinese adolescents and to provide theoretical guidance for preventing a flat foot in Chinese adolescents. This study recruited 1477 students aged 14-23 years. The participants' height, weight, and body mass index were measured, as well as baseline data, including age, gender and foot length. Differences in foot length (bilateral) and flat foot distribution were statistically significant except for the normal foot and high arch foot distribution based on different body mass index groups. Linear correlation analysis demonstrated that body height, weight and body mass index were positively correlated with bilateral foot length regardless of gender. Body mass index acted as a risk factor for flat foot (bilateral) through disordered multi-classification logistic regression analysis. Body mass index was positively correlated with left and right foot length regardless of gender and acted as a risk factor for a flat foot in Chinese adolescents. Practitioner summary: Significant differences exist in the anthropometric data of various races and ethnic groups. The study was investigated in the form of a cross-sectional study. BMI was positively correlated with bilateral foot length and acted as a risk factor for a flat foot in Chinese adolescents.
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Affiliation(s)
- Jiangtao Shen
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Ji Liu
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Feng Liang
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Xiaohui Liu
- Center for Evidence-Based Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Xibo Liu
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Boyuan Fan
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Zhengang Lv
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Chunhui Zhang
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing, China
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17
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McClure M, Cooke B, Elphingstone J, Schick S, Paul K, Jardaly A, Brabston E, Momaya A, Ponce B. Orthopedic consequences of modern gladiators: a systematic review of lower extremity musculoskeletal issues in retired NFL players. PHYSICIAN SPORTSMED 2023; 51:539-548. [PMID: 36062826 DOI: 10.1080/00913847.2022.2119897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/26/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The stressors that National Football League (NFL) athletes face are well-described and documented with regard to multisystem afflictions and injury prevalence. However, the majority of literature discusses the short-term effects rather than long-term outcomes of playing professional football. The purpose of this study was to characterize the long-term musculoskeletal issues in the retired NFL population. METHODS Publications from CENTRAL, Scopus, Medline, PubMed, Embase, and Google Scholar were searched from database inception to February 2021. A total of 9 cohort studies evaluating lower extremity arthritis in retired NFL athletes were included for review. Two reviewers extracted data from the individual studies, including demographic information (age, body mass index, length of career, position), injury descriptions (location of injury, number of injuries, diagnoses), and procedure (total knee and or hip arthroplasty) frequency. RESULTS Arthritis in retired NFL players was more than twice as prevalent than the general United States male population (95% CI: 2.1-2.3). Ankle osteoarthritis was directly correlated with the number of foot and ankle injuries. Players <50 years of age had a 16.1 and 13.8 times higher risk of undergoing TKA and THA, respectively, when compared to the general population. In older age groups, this trend held with retired NFL players being at least 4.3 and 4.6 times more likely than members of the general population to undergo TKA and THA, respectively. CONCLUSION This review demonstrates that the effects of NFL-related lower extremity injuries extend beyond the players' careers and present a higher risk for early-onset osteoarthritis and overall frequency of undergoing total knee and hip arthroplasty.
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Affiliation(s)
- Mark McClure
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brett Cooke
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joseph Elphingstone
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Samuel Schick
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kyle Paul
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Achraf Jardaly
- The Hughston Clinic, Columbus GA, USA
- The Hughston Foundation, Columbus, GA, USA
| | - Eugene Brabston
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amit Momaya
- Department of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brent Ponce
- The Hughston Clinic, Columbus GA, USA
- The Hughston Foundation, Columbus, GA, USA
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18
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Kutac P, Bunc V, Buzga M, Krajcigr M, Sigmund M. The effect of regular running on body weight and fat tissue of individuals aged 18 to 65. J Physiol Anthropol 2023; 42:28. [PMID: 38037173 PMCID: PMC10690982 DOI: 10.1186/s40101-023-00348-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Age and reduction in performed physical activity cause physiological changes that include an increase in body fat (BF) and visceral fat (VF) during aging. These parameters, together with increased body mass (BM), are some of the risk factors of several noninfectious diseases. However, changes in body composition can be influenced by regular physical activity. Running is a suitable, accessible, and the most effective physical activity cultivating people. The objective of this study is to investigate the effects of long-term, regular PA, specifically recreational running, on changes in body composition among recreational adult runners covering a weekly distance of at least 10 km, compared with inactive adult individuals within the same age bracket. METHODS The study included 1296 runners and inactive individuals (691 male and 605 female), divided into 5 age groups: 18-25, 26-35, 36-45, 46-55, and 56-65 years. Runners are as follows: ran ≥ 10 km/week, and inactive is as follows: did not follow the WHO 2020 physical activity recommendations. The measured parameters included BM, BF, and VF. To check statistical significance, the Mann-Whitney U-test was used. Practical significance was assessed using the effect of size. RESULTS All age groups of runners were selected to include individuals who run at least 10 km per week. In fact, they ran, on average, from 21.6 to 31.4 km per week in relation to age and showed significantly lower values of BM, BMI, BF, and VF (p < 0.05) than inactive individuals. Exceptions included insignificant differences (p > 0.05) in BM and BMI in males in the age category of 18-25 and in females in the age category of 18-25 and 26-35. CONCLUSION The selected runners had to run at least 10 km per week. Their actual average volume was significantly higher (from 21.6 to 31.4 km/week), and the results showed that it could lead to significantly better body composition values. It may lead to significant changes in body mass, body fat, and visceral fat. It may meet the contemporary societal expectations for physical activities that are both achievable and effective at the lowest possible volume.
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Affiliation(s)
- Petr Kutac
- Department of Human Movement Studies, University of Ostrava, Ostrava, 701 03, Czech Republic.
| | - Václav Bunc
- Faculty of Education, Charles University, Praha 6, Praha, 162 52, Czech Republic
| | - Marek Buzga
- Department of Human Movement Studies, University of Ostrava, Ostrava, 701 03, Czech Republic
| | - Miroslav Krajcigr
- Department of Human Movement Studies, University of Ostrava, Ostrava, 701 03, Czech Republic
| | - Martin Sigmund
- Application Centre BALUO, Faculty of Physical Culture, Palacky University, Olomouc, 779 00, Czech Republic
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Stamos J, Stalnaker K, Teegala S, Routh VH, Beck KD. Effects of glucose modulation in lateral hypothalamus on motivated behavior to obtain sucrose in an operant task. Appetite 2023; 189:106621. [PMID: 37311483 DOI: 10.1016/j.appet.2023.106621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/15/2023]
Abstract
Orexin neurons in the Lateral Hypothalamus (LH) play an important role in food seeking behavior. Approximately 60 percent of LH orexin neurons are inhibited by elevated extracellular glucose. It has been shown that elevated LH glucose decreases conditioned place preference for a food associated chamber. However, it has never been shown how modulation of LH extracellular glucose effects a rat's motivation to work for food. In this experiment we used reverse microdialysis to modulate extracellular glucose levels in LH during an operant task. Results from a progressive ratio task demonstrated that 4 mM glucose perfusion significantly decreased the animal's motivation to work for sucrose pellets while not effecting the hedonic value of the pellets. In a second experiment we demonstrated that 4 mM but not 2.5 mM glucose perfusion was sufficient to significantly decrease the number of sucrose pellets earned. Finally, we showed that modulating LH extracellular glucose mid-session from 0.7 mM to 4 mM did not affect behavior. This indicates that once feeding behavior has begun the animal becomes unresponsive to changes in extracellular glucose levels in LH. Taken together these experiments indicate that LH glucose sensing neurons play an important role in motivation to initiate feeding. However, once consumption has begun it is likely that feeding is controlled by brain regions downstream of LH.
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Affiliation(s)
- Joshua Stamos
- Neurobehavioral Research Laboratory, Research Service, Veterans Affairs New Jersey Health Care System, East Orange, NJ, USA
| | - Katherine Stalnaker
- School of Graduate Studies, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Suraj Teegala
- School of Graduate Studies, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Vanessa H Routh
- School of Graduate Studies, Rutgers, The State University of New Jersey, Newark, NJ, USA; Department of Pharmacology, Physiology & Neuroscience, Rutgers - New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Kevin D Beck
- Neurobehavioral Research Laboratory, Research Service, Veterans Affairs New Jersey Health Care System, East Orange, NJ, USA; School of Graduate Studies, Rutgers, The State University of New Jersey, Newark, NJ, USA; Department of Pharmacology, Physiology & Neuroscience, Rutgers - New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA.
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20
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Knapik JJ, Farina EK, Steelman RA, Trone DW, Lieberman HR. The Medical Burden of Obesity and Overweight in the US Military: Association of BMI with Clinically Diagnosed Medical Conditions in United States Military Service Members. J Nutr 2023; 153:2951-2967. [PMID: 37619919 DOI: 10.1016/j.tjnut.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/13/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND A high BMI is associated with various medical conditions, notably type 2 diabetes, cardiovascular disease, and mental health disorders. In the US military, BMI increased linearly between 1975 and 2015. OBJECTIVE This cross-sectional study investigated the associations between BMI and a comprehensive range of clinically diagnosed medical conditions (CDMCs) in US military service members (SMs). METHODS A stratified random sample of SMs (n=26,177) completed an online questionnaire reporting their height, weight, and demographic/lifestyle characteristics. Medical conditions for 6 mo before questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 39 CDMCs covering both broad (largely systemic) and specific medical conditions. BMI was calculated as weight/height2 (kg/m2). The prevalence of CDMCs was compared among normal weight (<25.0 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30 kg/m2) SMs. RESULTS After multivariable adjustment for demographic/lifestyle characteristics, higher BMI was associated with higher odds of a diagnosed medical condition in 30 of 39 CDMCs, with all 30 displaying dose-response relationships. The 5 major CDMCs with the largest odds ratios comparing obese to normal weight were endocrine/nutritional/metabolic diseases (OR=2.67, 95%CI=2.24-3.15), nervous system diseases (odds ratio [OR]=2.59, 95%CI=2.32-2.90), circulatory system diseases (OR=2.56, 95%CI=2.15-3.06), musculoskeletal system diseases (OR=1.92, 95%CI=1.76-2.09), and mental/behavioral disorders (OR=1.69, 95%CI=1.51-1.90). Compared with normal weight SMs, overweight or obese SMs had a higher number of CDMCs (1.8±1.9 vs. 2.0±2.0 and 2.5±2.3, mean ± standard deviation, respectively, P<0.01). CONCLUSIONS In a young, physically active population, higher BMI was associated with a host of medical conditions, even after adjustment for demographic/lifestyle characteristics. The US Department of Defense should improve nutrition education and modify other factors that contribute to overweight and obesity. This study demonstrates that the medical burden of obesity is substantial in overweight and obese SMs.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, MA, United States.
| | - Emily K Farina
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, MA, United States
| | - Ryan A Steelman
- Clinical Public Health and Epidemiology, Defense Centers for Public Health-Aberdeen, MD, United States
| | - Daniel W Trone
- Deployment Health, Naval Health Research Center, CA, United States
| | - Harris R Lieberman
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, MA, United States
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Ameer MA, Abdel-Aziem AA, Abd-Eltawab AE. The impact of anthropometric measures on plantar pressure distribution in male handball players and non-athletes: A cross-sectional study. J Bodyw Mov Ther 2023; 36:55-61. [PMID: 37949600 DOI: 10.1016/j.jbmt.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/05/2023] [Accepted: 06/05/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Increasing body anthropometry brings substantial spinal stress, which influences the spinal curvatures; this in turn may affect the foot plantar pressure distribution. OBJECTIVES This study investigated the impact of body anthropometry on static plantar pressure distribution and their relationship among handball players and non-athletes subjects. METHODS Thirty handball players aged from 21 to 26 years, and thirty age-matched non-athletes subjects aged from 21 to 28 years participated in this study. The spinal lordosis and kyphosis angles, trunk length, pelvic tilting, and pelvic rotation were evaluated using Formetric 4-dimensions and the Pedoscan device was used to assess the plantar pressure distribution. RESULTS The handball players were significantly taller, heavier, and have a long trunk length than non-athletes group (p < 0.05), and a significantly increased thoracic kyphosis, forefeet pressure distribution compared to non-athletes group (p < 0.05). The handball players had a significantly increased forefeet pressure distribution compared to the rearfeet pressure distribution (p < 0.05), a high positive correlation between body height, and both trunk length and kyphosis angle (r = 0.932, 0.665 respectively), and the body height showed a high positive correlation with the forefeet pressure distribution (r = 0.665). There was a high positive correlation between the handball players' thoracic kyphosis and forefeet pressure distribution (r = 0.751). CONCLUSION Increasing the handball players' body height was related to increased thoracic kyphosis and forefeet pressure distribution compared to non-athletes subjects. Additionally, the kyphotic posture of handball players is associated with increasing the total forefeet pressure distribution compared to the total rearfeet pressure distribution.
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Affiliation(s)
- Mariam A Ameer
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Physical Therapy and Health Rehabilitation Department, Faculty of Applied Medical Sciences, Jouf University, Al-Jouf, Saudi Arabia
| | - Amr A Abdel-Aziem
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
| | - Amany E Abd-Eltawab
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Physical Therapy and Health Rehabilitation Department, Faculty of Applied Medical Sciences, Jouf University, Al-Jouf, Saudi Arabia
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22
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Sentandreu-Mañó T, Deka P, Almenar L, Tomás JM, Alguacil-Sancho L, López-Vilella R, Klompstra L, Marques-Sule E. Correlates of musculoskeletal pain and kinesiophobia in older adults with heart failure: A structural equation model. Geriatr Nurs 2023; 53:72-77. [PMID: 37454421 DOI: 10.1016/j.gerinurse.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
The study aimed to study the influence of musculoskeletal pain on kinesiophobia in patients with heart failure. This cross-sectional study recruited 107 heart failure patients aged 73.18±12.68 years (57% men) from an outpatient setting. Participants self-reported pain using the Musculoskeletal System Assessment Inventory and the Cornell Musculoskeletal Discomfort Questionnaire. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia-11. About 62% reported musculoskeletal pain, with knees (16.8%) and lower back (12.%) being the most painful locations. About 31% reported moderate levels and 24% indicated high levels of kinesiophobia. There were positive and significant associations between the indicators of pain and kinesiophobia. Results showed an adequate structural equation model fit to the data with musculoskeletal pain factors explaining 22.09% of the variance in kinesiophobia. Assessment of kinesiophobia in patients with heart failure with musculoskeletal pain is essential to improve self-care and overall quality of life.
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Affiliation(s)
- Trinidad Sentandreu-Mañó
- Department of Physiotherapy, Advanced Research Methods Applied to Quality of Life Promotion (ARMAQoL), University of Valencia, Valencia, Spain
| | - Pallav Deka
- College of Nursing, Michigan State University, East Lansing, MI, USA.
| | - Luis Almenar
- Heart Failure and Transplants Unit, Department of Cardiology, University and Polytechnic Hospital La Fe, Valencia, Spain; CIBERCV, Valencia, Spain; University of Valencia, Valencia, Spain
| | - Jose M Tomás
- Department of Methodology for the Behavioral Sciences, University of Valencia, Valencia, Spain
| | | | - Raquel López-Vilella
- Heart Failure and Transplants Unit, Department of Cardiology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
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23
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Kubota Y, Han Q, Reynoso J, Aoki Y, Masaki N, Obara K, Hamada K, Bouvet M, Tsunoda T, Hoffman RM. Old-age-induced obesity reversed by a methionine-deficient diet or oral administration of recombinant methioninase-producing Escherichia coli in C57BL/6 mice. Aging (Albany NY) 2023; 15:204783. [PMID: 37301544 DOI: 10.18632/aging.204783] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023]
Abstract
Obesity increases with aging. Methionine restriction affects lipid metabolism and can prevent obesity in mice. In the present study we observed C57BL/6 mice to double their body weight from 4 to 48 weeks of age and become obese. We evaluated the efficacy of oral administration of recombinant-methioninase (rMETase)-producing E. coli (E. coli JM109-rMETase) or a methionine-deficient diet to reverse old-age-induced obesity in C57BL/6 mice. Fifteen C57BL/6 male mice aged 12-18 months with old-age-induced obesity were divided into three groups. Group 1 was given a normal diet supplemented with non-recombinant E. coli JM109 cells orally by gavage twice daily; Group 2 was given a normal diet supplemented with recombinant E. coli JM109-rMETase cells by gavage twice daily; and Group 3 was given a methionine-deficient diet without treatment. The administration of E. coli JM109-rMETase or a methionine-deficient diet reduced the blood methionine level and reversed old-age-induced obesity with significant weight loss by 14 days. There was a negative correlation between methionine levels and negative body weight change. Although the degree of efficacy was higher in the methionine-deficient diet group than in the E. coli JM109-rMETase group, the present findings suggested that oral administration of E. coli JM109-rMETase, as well as a methionine-deficient diet, are effective in reversing old-age-induced obesity. In conclusion, the present study provides evidence that restricting methionine by either a low-methionine diet or E. coli JM109-rMETase has clinical potential to treat old-age-induced obesity.
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Affiliation(s)
- Yutaro Kubota
- AntiCancer Inc., San Diego, CA 92111, USA
- Department of Surgery, University of California, San Diego, CA 92111, USA
- Department of Medical Oncology, Division of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | | | | | - Yusuke Aoki
- AntiCancer Inc., San Diego, CA 92111, USA
- Department of Surgery, University of California, San Diego, CA 92111, USA
| | - Noriyuki Masaki
- AntiCancer Inc., San Diego, CA 92111, USA
- Department of Surgery, University of California, San Diego, CA 92111, USA
| | - Koya Obara
- AntiCancer Inc., San Diego, CA 92111, USA
- Department of Surgery, University of California, San Diego, CA 92111, USA
| | - Kazuyuki Hamada
- AntiCancer Inc., San Diego, CA 92111, USA
- Department of Surgery, University of California, San Diego, CA 92111, USA
- Department of Medical Oncology, Division of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Michael Bouvet
- Department of Surgery, University of California, San Diego, CA 92111, USA
| | - Takuya Tsunoda
- Department of Medical Oncology, Division of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Robert M Hoffman
- AntiCancer Inc., San Diego, CA 92111, USA
- Department of Surgery, University of California, San Diego, CA 92111, USA
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24
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Monfrini R, Rossetto G, Scalona E, Galli M, Cimolin V, Lopomo NF. Technological Solutions for Human Movement Analysis in Obese Subjects: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23063175. [PMID: 36991886 PMCID: PMC10059733 DOI: 10.3390/s23063175] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/05/2023] [Accepted: 03/14/2023] [Indexed: 05/27/2023]
Abstract
Obesity has a critical impact on musculoskeletal systems, and excessive weight directly affects the ability of subjects to realize movements. It is important to monitor the activities of obese subjects, their functional limitations, and the overall risks related to specific motor tasks. From this perspective, this systematic review identified and summarized the main technologies specifically used to acquire and quantify movements in scientific studies involving obese subjects. The search for articles was carried out on electronic databases, i.e., PubMed, Scopus, and Web of Science. We included observational studies performed on adult obese subjects whenever reporting quantitative information concerning their movement. The articles must have been written in English, published after 2010, and concerned subjects who were primarily diagnosed with obesity, thus excluding confounding diseases. Marker-based optoelectronic stereophotogrammetric systems resulted to be the most adopted solution for movement analysis focused on obesity; indeed, wearable technologies based on magneto-inertial measurement units (MIMUs) were recently adopted for analyzing obese subjects. Further, these systems are usually integrated with force platforms, so as to have information about the ground reaction forces. However, few studies specifically reported the reliability and limitations of these approaches due to soft tissue artifacts and crosstalk, which turned out to be the most relevant problems to deal with in this context. In this perspective, in spite of their inherent limitations, medical imaging techniques-such as Magnetic Resonance Imaging (MRI) and biplane radiography-should be used to improve the accuracy of biomechanical evaluations in obese people, and to systematically validate less-invasive approaches.
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Affiliation(s)
- Riccardo Monfrini
- Dipartimento di Ingegneria dell’Informazione, Università degli Studi di Brescia, 25123 Brescia, BS, Italy
| | - Gianluca Rossetto
- Dipartimento di Ingegneria dell’Informazione, Università degli Studi di Brescia, 25123 Brescia, BS, Italy
| | - Emilia Scalona
- Dipartimento di Specialità Medico-Chururgiche, Scienze Radiologiche e Sanità Pubblica, Università degli Studi di Brescia, 25123 Brescia, BS, Italy
| | - Manuela Galli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milano, MI, Italy
| | - Veronica Cimolin
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milano, MI, Italy
- Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Piancavallo, 28824 Oggebbio, VB, Italy
| | - Nicola Francesco Lopomo
- Dipartimento di Ingegneria dell’Informazione, Università degli Studi di Brescia, 25123 Brescia, BS, Italy
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25
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Almudhi A, Gabr SA. Associations between glutamic acid decarboxylase antibodies, oxidative stress markers, and cognitive capacity in adolescents who stutter. Saudi J Biol Sci 2023; 30:103580. [PMID: 36844638 PMCID: PMC9943924 DOI: 10.1016/j.sjbs.2023.103580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/04/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
In this study, we amid to evaluate the correlation between the change in the expressed levels of anti-GAD antibodies titers, oxidative stress markers, cytokines markers, and cognitive capacity in adolescents with mild stuttering. Eighty participants (60 male/20 female) with the age range of 10-18 years with moderate stutteringparticipated in this study. To assess the stuttering and cognitive function, stutteringseverity instrument (SSI-4; 4th edit.)and the LOTCA-7 scores assessment were applied respectively in all subjects. In addition, serum GAD antibodies, cytokines like TNF-α, CRP,and IL-6 withtotal antioxidant capacity and nitric oxide as oxidative stress markers were estimated using calorimetry and immunoassay techniques.The results showed that good cognitive capacity was reported in about 56.25 % of the study population (n = 45) with a 117.52 ± 6.3 mean LOTCA-7 score. However, abnormal cognitive function was identified in 43.75 % of the study population (n = 35); they were categorized into moderate (score 62-92, n = 35), and poor (score 31-62; n = 10). There were significant associations between cognitive capacity reported and all biomarkers. The expression of GAD antibodies is significantly associated with the degree of cognitive capacity among students with stuttering. Significant association with the reduction (P = 0.01) in LOTCA-7 score domains, particularly orientation, thinking operations, attention, and concentration among students with variable cognitive capacity compared to controls. In addition, the expressed higher GAD antibodies in students with moderate and poor cognitive capacity showed to be significantly correlated with both elevated concentrations of cytokines; TNF-α, CRP, and IL-6, and the reduction of TAC and nitric oxide (NO) respectively. This study concludes that abnormality of cognitive capacity showed to be associated with higher expression of GAD antibodies, cytokines, and oxidative stress in school students with moderate stuttering.
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Affiliation(s)
- Abdulaziz Almudhi
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia,Speech Language Pathology Unit, King Khalid University, Abha 61481, Saudi Arabia,Corresponding author at: Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.
| | - Sami A. Gabr
- Department of Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura 35511, Egypt
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26
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Batrakoulis A, Jamurtas AZ, Tsimeas P, Poulios A, Perivoliotis K, Syrou N, Papanikolaou K, Draganidis D, Deli CK, Metsios GS, Angelopoulos TJ, Feito Y, Fatouros IG. Hybrid-type, multicomponent interval training upregulates musculoskeletal fitness of adults with overweight and obesity in a volume-dependent manner: A 1-year dose-response randomised controlled trial. Eur J Sport Sci 2023; 23:432-443. [PMID: 34974824 DOI: 10.1080/17461391.2021.2025434] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This study examined the dose-response effects of a 1-year hybrid-type, multicomponent interval training programme (DoIT) on various musculoskeletal fitness parameters in inactive overweight and obese adults in a gym setting. Ninety-seven middle-aged (44.8 ± 5.2 years) individuals with overweight/obesity (31.2 ± 5.7 kg/m2) (66% female) were randomly assigned to the following groups: (i) no-intervention control (CON, n = 29), (ii) DoIT performed once weekly (DoIT-1, n = 24), (iii) DoIT performed twice weekly (DoIT-2, n = 23) and (iv) DoIT performed thrice weekly (DoIT-3, n = 21). DoIT was a time-efficient, intermittent-based, multicomponent exercise protocol using progressive loaded fundamental movement patterns with prescribed work-to-rest intervals (1:3-2:1) in a circuit format (2-3 rounds). Muscular strength, muscular endurance, flexibility, passive range of motion (PRoM), static balance and functional movement screen (FMS®) were assessed at baseline, 6 and 12 months following intervention. At post-training, all exercise groups exhibited superior changes than CON in (i) muscular strength (+13%-38%, p < 0.001); (ii) muscular endurance (+42%-159%, p < 0.001); (iii) flexibility (+12%-42%, p < 0.001); (iv) PRoM (+6%-50%, p = 0.001-0.026); (v) static balance (+61%-163%, p < 0.001); and (vi) FMS (+18%-39%, p < 0.001). Although a single exercise session/week improved musculoskeletal fitness, changes demonstrated a step-wise improvement with two and three sessions/week suggesting a dose-dependent response. The response rate to training was 100% for all exercise groups. These findings suggest that a multicomponent exercise approach incorporating bodyweight drills and resistance-based alternative modes performed under real-world conditions may improve several musculoskeletal fitness indicators in a dose-dependent manner in inactive, middle-aged adults with overweight/obesity.Trial registration: ClinicalTrials.gov identifier: NCT03759951.
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Affiliation(s)
- Alexios Batrakoulis
- University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece
| | - Athanasios Z Jamurtas
- University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece
| | - Panagiotis Tsimeas
- University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece
| | - Athanasios Poulios
- University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece
| | | | - Niki Syrou
- University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece
| | | | - Dimitrios Draganidis
- University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece
| | - Charikleia K Deli
- University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece
| | - Georgios S Metsios
- University of Thessaly, Department of Nutrition and Dietetics, Trikala, Greece
| | - Theodore J Angelopoulos
- University of Vermont, Department of Rehabilitation and Movement Science, Burlington, VT, USA
| | - Yuri Feito
- American College of Sports Medicine, Indianapolis, IN, USA
| | - Ioannis G Fatouros
- University of Thessaly, Department of Physical Education and Sport Science, Trikala, Greece
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27
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Chang X, Chua KY, Ng FL, Wang L, Liu J, Yuan JM, Khor CC, Heng CK, Dorajoo R, Koh WP. Increased BMI and late-life mobility dysfunction; overlap of genetic effects in brain regions. Int J Obes (Lond) 2023; 47:358-364. [PMID: 36788305 DOI: 10.1038/s41366-023-01275-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND How obesity earlier in life impacts upon mobility dysfunctions in late life is not well understood. Pernicious effects of excess weight on the musculoskeletal system and mobility dysfunctions are well-recognized. However, increasingly more data support the link of obesity to overall motor defects that are regulated in the brain. OBJECTIVES To assess the causal relationship between body mass index (BMI) at midlife and performance of the Timed Up-and-Go test (TUG) in late life among a population-based longitudinal cohort of Chinese adults living in Singapore. METHODS We evaluated genetic predispositions for BMI in 8342 participants who were followed up from measurement of BMI at average 53 years, to TUG test (as a functional mobility measure) 20 years later. RESULTS A robust 75.83% of genetically determined BMI effects on late-life TUG scores were mediated through midlife BMI (Pindirect-effect = 9.24 × 10-21). Utilizing Mendelian randomization, we demonstrated a causal effect between BMI and functional mobility in late life (βIVW = 0.180, PIVW = 0.001). Secondary gene enrichment evaluations highlighted down-regulation of genes at BMI risk loci that were correlated with poorer functional mobility in the substantia nigra and amygdala regions as compared to all other tissues. These genes also exhibit differential expression patterns during human brain development. CONCLUSIONS We report a causal effect of obesity on mobility dysfunction. Our findings highlight potential neuronal dysfunctions in regulating predispositions on the causal pathway from obesity to mobility dysfunction.
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Affiliation(s)
- Xuling Chang
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore.,Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore, 119074, Singapore.,Department of Infectious Diseases, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, 3000, VIC, Australia
| | - Kevin Yiqiang Chua
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, 119077, Singapore
| | - Fang Lin Ng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore.,Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore, 119074, Singapore
| | - Ling Wang
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672, Singapore
| | - Jianjun Liu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15232, USA.,Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Chiea-Chuen Khor
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672, Singapore.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 169856, Singapore
| | - Chew-Kiat Heng
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore. .,Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore, 119074, Singapore.
| | - Rajkumar Dorajoo
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, 138672, Singapore. .,Health Systems and Services Research, Duke-NUS Medical School Singapore, Singapore, 169857, Singapore.
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117545, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, 117609, Singapore
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28
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Okonya O, Siddiqui B, George D, Fugate C, Hartwell M, Vassar M. Use of behavioural change taxonomies in systematic reviews and meta-analyses regarding obesity management. Clin Obes 2023; 13:e12574. [PMID: 36515291 DOI: 10.1111/cob.12574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/15/2022] [Accepted: 11/13/2022] [Indexed: 12/15/2022]
Abstract
We investigated the prevalence of behavioural change taxonomies in systematic reviews and meta-analyses related to obesity management. In addition, we analysed the funding sources, author conflicts of interest statements, risk of bias, and favorability of the results in such studies to determine if there was a relationship between methodological quality and taxonomy use. We searched several databases including MEDLINE, Epistemonikos, Cochrane EDSR, Pubmed and Embase for systematic reviews and meta-analyses regarding the behavioural treatment of obesity. Screening and data extraction was performed in a masked, duplicate fashion. We performed statistical analyses to determine any significant association between use of taxonomy and study characteristics. Fifteen (of 186; 8.06%) systematic reviews used a taxonomy-nine used the BCTTv1, three used OXFAB, two used the CALO-RE and one used "Taxonomy of choice architecture techniques." Most interventions that referenced a taxonomy were self-mediated (6/60, 10%). Behavioural change taxonomies were mentioned in 10 (of 87, 11.49%) studies with a public funding source. Of the studies with favourable results, 14 studies (of 181, 7.73%) referred to a taxonomy. We found no statistically significant relationships between use of taxonomy and study characteristics. We found that systematic reviews regarding the management of obesity rarely mention a behavioural change taxonomy. Given the global burden of obesity, it is crucial that behavioural change techniques are reproducible and translatable. We recommend that researchers look further into how taxonomies affect the quality and reproducibility of behavioural interventions in an effort to improve patient outcomes.
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Affiliation(s)
- Ochije Okonya
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Bilal Siddiqui
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - David George
- Department of Pediatrics, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Colony Fugate
- Department of Pediatrics, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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29
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Sharma R, Vaibhav V, Meshram R, Singh B, Khorwal G. A Systematic Review on Quadriceps Angle in Relation to Knee Abnormalities. Cureus 2023; 15:e34355. [PMID: 36874732 PMCID: PMC9974941 DOI: 10.7759/cureus.34355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2023] [Indexed: 01/31/2023] Open
Abstract
Previous studies on the quadriceps (Q) angle and its relation to knee problems have led to conflicting conclusions. In this comprehensive review, we evaluate recent studies on the Q angle and analyze the changes in Q angles. Specifically, we investigate the variation in Q angles when measured under the following conditions: 1) under various measurement techniques; 2) between symptomatic and non-symptomatic groups; 3) between samples of men and women; 4) unilateral versus bilateral Q angles; 5) Q angle in adolescent boys and girls. It is widely believed that Q angles are more significant in symptomatic patients than in asymptomatic individuals or that the right lower leg and left lower limb are equivalent, which is supported by little scientific data. However, research states that young adult females have higher mean Q angles than males.
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Affiliation(s)
- Rahul Sharma
- Anatomy, All India Institute of Medical Sciences, Rishikesh, IND
| | - Vikas Vaibhav
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Rishikesh, IND
| | | | - Brijendra Singh
- Anatomy, All India Institute of Medical Sciences, Rishikesh, IND
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30
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Andersen W, Linge AD, Jensen C. What works? A qualitative study of participants experiences of a traditional lifestyle intervention with a work focus. Int J Qual Stud Health Well-being 2022; 17:2116988. [PMID: 36053211 PMCID: PMC9448365 DOI: 10.1080/17482631.2022.2116988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose Obesity is related to lower labour force participation, increased sickness absence and reduced productivity. The rehabilitation services in Norway have not had much experience introducing a work dimension into lifestyle interventions for persons with obesity. Therefore, this study aimed to evaluate one such type of intervention. Methods This is a qualitative study seeking to gather data on the participants’ experiences. Twenty participants were recruited from two lifestyle interventions. Intervention A, with work focus, included lectures and individual guidance from a work consultant in addition to the lifestyle intervention. Intervention B was a traditional lifestyle intervention. Data were collected by semi-structured interviews held at each stay. Results Seven main themes emerged and one of them pointed towards a confusion of the aim of the intervention, which was viewed as focusing on lifestyle rather than a process focused on work. Otherwise, the results showed that persons with obesity struggle with many of the same inhibiting factors as other groups with reduced work ability. Conclusions The application process might explain the focus on lifestyle change. Communication, guidance and support reduce barriers for lifestyle change, but work is important for general health and social well-being and a work focus may therefore be beneficial in all lifestyle interventions.
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Affiliation(s)
- Wivi Andersen
- The National Advisory Unit on Occupational Rehabilitation, Rauland, Norway
| | - Anita Dyb Linge
- Volda University College, Institute of Social Science, Volda, Norway, and Research and Development Manager, Muritunet Rehabilitation Centre, Norway
| | - Chris Jensen
- The National Advisory Unit on Occupational Rehabilitation, Rauland, Norway
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31
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Rakib A, Kiran S, Mandal M, Singh UP. MicroRNAs: a crossroad that connects obesity to immunity and aging. Immun Ageing 2022; 19:64. [PMID: 36517853 PMCID: PMC9749272 DOI: 10.1186/s12979-022-00320-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
Obesity is characterized by an elevated amount of fat and energy storage in the adipose tissue (AT) and is believed to be the root cause of many metabolic diseases (MDs). Obesity is associated with low-grade chronic inflammation in AT. Like obesity, chronic inflammation and MDs are prevalent in the elderly. The resident immune microenvironment is not only responsible for maintaining AT homeostasis but also plays a crucial role in stemming obesity and related MDs. Mounting evidence suggests that obesity promotes activation in resident T cells and macrophages. Additionally, inflammatory subsets of T cells and macrophages accumulated into the AT in combination with other immune cells maintain low-grade chronic inflammation. microRNAs (miRs) are small non-coding RNAs and a crucial contributing factor in maintaining immune response and obesity in AT. AT resident T cells, macrophages and adipocytes secrete various miRs and communicate with other cells to create a potential effect in metabolic organ crosstalk. AT resident macrophages and T cells-associated miRs have a prominent role in regulating obesity by targeting several signaling pathways. Further, miRs also emerged as important regulators of cellular senescence and aging. To this end, a clear link between miRs and longevity has been demonstrated that implicates their role in regulating lifespan and the aging process. Hence, AT and circulating miRs can be used as diagnostic and therapeutic tools for obesity and related disorders. In this review, we discuss how miRs function as biomarkers and impact obesity, chronic inflammation, and aging.
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Affiliation(s)
- Ahmed Rakib
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN, 38163, USA
| | - Sonia Kiran
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN, 38163, USA
| | - Mousumi Mandal
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN, 38163, USA
| | - Udai P Singh
- Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, 881 Madison Avenue, Memphis, TN, 38163, USA.
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Assessing the relationship between domestic work experience and musculoskeletal health among rural Nigerian women. PLoS One 2022; 17:e0276380. [PMID: 36512538 PMCID: PMC9747006 DOI: 10.1371/journal.pone.0276380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 10/06/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Women performing strenuous domestic tasks (especially those in developing countries) are at risk of experiencing musculoskeletal pain (MSP). Physical, psychosocial, and social conditions of work in rural environments contribute to women's domestic work experiences (DWEs) and the risk of MSP. The impact of DWEs on women's health is especially severe in water-insecure countries like Nigeria. This study examines the relationship between a recently developed measure of DWEs and self-reported pain in the lower back (LBP), neck/shoulder (NSP), and elbow/hand/wrist regions (EHWP) among rural Nigerian women. METHODS Interviewer-administered survey data were collected from 356 women in four rural communities of Ibadan, Nigeria. Binary and ordinal logistic regression models were used to examine the relationship between DWE factor scores, sociodemographic characteristics, and musculoskeletal pain symptoms and severity after controlling for sociodemographic covariates. Effect estimates of association were presented using the odds ratio (OR), and the corresponding 95% confidence interval (CI) at p-value of 0.05. FINDINGS Among 356 participants, the 2-month prevalence of LBP was 58%, NSP was 30%, and EWHP 30%. High DWE scores were significantly associated with higher odds of experiencing and having more severe LBP, NSP, and EHWP. Specifically, the odds of LBP [(OR = 2.88; 95% CI = 1.64-5.11), NSP (OR = 4.58; 95% CI = 2.29-9.40) and EHWP (OR = 1.88; 95% CI = 1.26-3.77)] were significantly higher among women who perceived their domestic work responsibilities as very stressful (i.e., 'high stress appraisal') compared to those with lower stress appraisal scores. Those who were time-pressured and had less autonomy over familial duties (i.e., 'high demand/low control') had significantly higher odds of LBP [(OR = 2.58; 95% CI = 1.64-4.09) and NSP (OR = 1.49; 95% CI = 1.24-2.58)]. Frequently fetching and carrying water over long distances and time (i.e., 'high water sourcing and carriage') was also associated with higher odds of LBP [(OR = 1.31; 95% CI = 1.09-1.79) and NSP (OR = 1.20; 95% CI = 1.08-1.76). CONCLUSION Strenuous and stressful DWEs were associated with MSP among rural Nigerian women. This study provides new evidence on how the physical, social, and psychosocial factors of domestic work can increase women's risk of MSP.
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Loef B, van Oostrom SH, Bosma E, Proper KI. The mediating role of physical activity and sedentary behavior in the association between working from home and musculoskeletal pain during the COVID-19 pandemic. Front Public Health 2022; 10:1072030. [PMID: 36530694 PMCID: PMC9757165 DOI: 10.3389/fpubh.2022.1072030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Working from home during the COVID-19 pandemic has been associated both with physical inactivity and musculoskeletal pain. However, it has not been examined whether physical activity and sedentary behavior are underlying mechanisms in the association between working from home and musculoskeletal pain. Therefore, we examined their mediating role in this association. Methods Data were used from 24 questionnaire rounds of the Lifelines COVID-19 cohort (March 2020-January 2022). Longitudinal information on work situation (location, home, hybrid), physical activity, sedentary behavior, and musculoskeletal pain was collected among 28,586 workers. Analysis of physical activity/sedentary behavior as mediators of the association between working from home and musculoskeletal pain was performed using multilevel structural equation modeling. Results Home workers more often had pain in the upper back [odds ratio (OR) = 1.17, 95%-confidence interval (CI) = 1.02-1.34] and arm, neck, and/or shoulder (ANS) (OR = 1.32, 95%-CI = 1.19-1.47) than location workers. Furthermore, home workers were more often sedentary for >9 h per work day than location workers (OR = 2.82, 95%-CI = 2.56-3.09), and being more sedentary was associated with musculoskeletal pain (upper back: OR = 1.17, 95%-CI = 1.06-1.30; ANS: OR = 1.25, 95%-CI = 1.16-1.34). Corresponding indirect effects were OR = 1.18 (95%-CI = 1.04-1.33) and OR = 1.26 (95%-CI = 1.12-1.35). No indirect effect was found for physical activity. Similar indirect effects were observed for hybrid workers. Conclusion Home and hybrid workers were more likely to have pain in the upper musculoskeletal system during the COVID-19 pandemic than location workers, which was partly mediated by increased sedentary behavior, but not by reduced physical activity. Measures to reduce sedentary time in home workers may contribute to preventing musculoskeletal pain.
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Affiliation(s)
- Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands,*Correspondence: Bette Loef
| | - Sandra H. van Oostrom
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Esmee Bosma
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | | | - Karin I. Proper
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, Netherlands,Department of Public and Occupational Health, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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Sievert LL, Whitcomb BW, Verjee MA, Gerber LM. Limited evidence of a threshold effect for increasing adiposity on risk of symptoms at midlife. Menopause 2022; 29:1381-1387. [PMID: 36166728 DOI: 10.1097/gme.0000000000002074] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess the nature of relationships between increasing body mass index (BMI) and the prevalence of midlife symptoms in a population with high adiposity. METHODS In the cross-sectional Study of Women's Health in Qatar, 841 participants aged 40 to 60 years were recruited from nine primary health centers in Doha. Face-to-face interviews collected demographic, menopause, and symptom information. BMI (kg/m 2 ) was categorized as healthy, overweight, or class I, II, or III obesity. Multivariate logistic regression models were used to examine aches/stiffness in joints, trouble sleeping, shortness of breath, urinary incontinence, and hot flashes with BMI categories. Restricted cubic splines (RCSs) were used to estimate relationships between continuous BMI and each symptom and to conduct formal tests of nonlinearity. RESULTS Mean BMI was 34.3 kg/m 2 (SD, 6.0 kg/m 2 ). Women with class II and III obesity had higher odds of reporting aches/stiffness than women with a healthy BMI, and the odds of reporting urinary incontinence were three times higher among women with class III obesity (odds ratio, 3.08; 95% confidence interval, 1.17-8.14). Using restricted cubic spline models, a significant nonlinear association ( P = 0.002) was observed between aches/stiffness and BMI with an apparent threshold of 38 kg/m 2 . Linear relationships were observed with BMI for urinary incontinence ( P < 0.001 for linear trend) and shortness of breath ( P = 0.005 for linear trend). Trouble sleeping and hot flashes were not associated with BMI. CONCLUSIONS Even at very high levels of BMI, likelihood of urinary incontinence and shortness of breath increases with BMI. In contrast, likelihood of aches/stiffness has a nonlinear relationship with BMI, increasing to a threshold level.
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Affiliation(s)
| | - Brian W Whitcomb
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA
| | | | - Linda M Gerber
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
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Park TJ, Park SY, Cho W, Oh H, Lee HJ, Abd El-Aty AM, Bayram C, Jeong JH, Jung TW. Developmental endothelial locus-1 attenuates palmitate-induced apoptosis in tenocytes through the AMPK/autophagy-mediated suppression of inflammation and endoplasmic reticulum stress. Bone Joint Res 2022; 11:854-861. [PMID: 36458454 PMCID: PMC9792873 DOI: 10.1302/2046-3758.1112.bjr-2022-0077.r2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AIMS Myokine developmental endothelial locus-1 (DEL-1) has been documented to alleviate inflammation and endoplasmic reticulum (ER) stress in various cell types. However, the effects of DEL-1 on inflammation, ER stress, and apoptosis in tenocytes remain unclear. METHODS Human primary tenocytes were cultured in palmitate (400 μM) and palmitate plus DEL-1 (0 to 2 μg/ml) conditions for 24 hours. The expression levels of ER stress markers and cleaved caspase 3, as well as phosphorylated 5' adenosine monophosphate-activated protein kinase (AMPK) and autophagy markers, were assessed by Western blotting. Autophagosome formation was measured by staining with monodansylcadaverine, and apoptosis was determined by cell viability assay and caspase 3 activity assay. RESULTS We found that treatment with DEL-1 suppressed palmitate-induced inflammation, ER stress, and apoptosis in human primary tenocytes. DEL-1 treatment augmented LC3 conversion and p62 degradation as well as AMPK phosphorylation. Moreover, small interfering RNA for AMPK or 3-methyladenine (3-MA), an autophagy inhibitor, abolished the suppressive effects of DEL-1 on inflammation, ER stress, and apoptosis in tenocytes. Similar to DEL-1, 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR), an activator of AMPK, also attenuated palmitate-induced inflammation, ER stress, and apoptosis in tenocytes, which 3-MA reversed. CONCLUSION These results revealed that DEL-1 suppresses inflammation and ER stress, thereby attenuating tenocyte apoptosis through AMPK/autophagy-mediated signalling. Thus, regular exercise or administration of DEL-1 may directly contribute to improving tendinitis exacerbated by obesity and insulin resistance.Cite this article: Bone Joint Res 2022;11(12):854-861.
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Affiliation(s)
- Tae Jun Park
- Department of Pharmacology, College of Medicine, Chung-Ang University, Seoul, South Korea
| | - Seung Yeon Park
- Department of Pharmacology, College of Medicine, Chung-Ang University, Seoul, South Korea,Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, South Korea
| | - Wonjun Cho
- Department of Pharmacology, College of Medicine, Chung-Ang University, Seoul, South Korea
| | - Heeseung Oh
- Department of Pharmacology, College of Medicine, Chung-Ang University, Seoul, South Korea
| | - Hyun Jung Lee
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, South Korea,Department of Anatomy and Cell Biology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - A. M. Abd El-Aty
- Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt,Department of Medical Pharmacology, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Cemil Bayram
- Department of Medical Pharmacology, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Ji Hoon Jeong
- Department of Pharmacology, College of Medicine, Chung-Ang University, Seoul, South Korea,Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, South Korea
| | - Tae Woo Jung
- Department of Pharmacology, College of Medicine, Chung-Ang University, Seoul, South Korea, Tae Woo Jung. E-mail:
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Fu L, Wang Y, Hu YQ. Causal effects of B vitamins and homocysteine on obesity and musculoskeletal diseases: A Mendelian randomization study. Front Nutr 2022; 9:1048122. [PMID: 36505230 PMCID: PMC9731309 DOI: 10.3389/fnut.2022.1048122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/24/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives Although homocysteine (Hcy) increases the risk of cardiovascular diseases, its effects on obesity and musculoskeletal diseases remain unclear. We performed a Mendelian randomization study to estimate the associations between Hcy and B vitamin concentrations and their effects on obesity and musculoskeletal-relevant diseases in the general population. Methods We selected independent single nucleotide polymorphisms of Hcy (n = 44,147), vitamin B12 (n = 45,576), vitamin B6 (n = 1864), and folate (n = 37,465) at the genome-wide significance level as instruments and applied them to the studies of summary-level data for fat and musculoskeletal phenotypes from the UK Biobank study (n = 331,117), the FinnGen consortium (n = 218,792), and other consortia. Two-sample Mendelian randomization (MR) approaches were utilized in this study. The inverse variance weighting (IVW) was adopted as the main analysis. MR-PRESSO, MR-Egger, the weighted median estimate, bidirectional MR, and multivariable MR were performed as sensitivity methods. Results Higher Hcy concentrations were robustly associated with an increased risk of knee osteoarthritis [odds ratio (OR) 1.119; 95% confidence interval (CI) 1.032-1.214; P = 0.007], hospital-diagnosed osteoarthritis (OR 1.178; 95% CI 1.012-1.37; P = 0.034), osteoporosis with pathological fracture (OR 1.597; 95% CI 1.036-2.46; P = 0.034), and soft tissue disorder (OR 1.069; 95% CI 1.001-1.141; P = 0.045) via an inverse variance weighting method and other MR approaches. Higher vitamin B12 levels were robustly associated with decreased body fat percentage and its subtypes (all P < 0.05). Bidirectional analyses showed no reverse causation. Multivariable MR analyses and other sensitivity analyses showed directionally similar results. Conclusions There exist significant causal effects of vitamin B12 in the serum and Hcy in the blood on fat and musculoskeletal diseases, respectively. These findings may have an important insight into the pathogenesis of obesity and musculoskeletal diseases and other possible future therapies.
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Affiliation(s)
- Liwan Fu
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China,*Correspondence: Liwan Fu
| | - Yuquan Wang
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, Institute of Biostatistics, School of Life Sciences, Fudan University, Shanghai, China
| | - Yue-Qing Hu
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, Institute of Biostatistics, School of Life Sciences, Fudan University, Shanghai, China,Shanghai Center for Mathematical Sciences, Fudan University, Shanghai, China,Yue-Qing Hu
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Obesity does not associate with 5-year surgical complications following anatomic total shoulder arthroplasty and reverse total shoulder arthroplasty. J Shoulder Elbow Surg 2022; 32:947-957. [PMID: 36375748 DOI: 10.1016/j.jse.2022.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/29/2022] [Accepted: 10/12/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Although obesity has been shown to increase the risk of short-term medical complications following total shoulder arthroplasty (TSA), evidence is lacking on the influence of obesity on longer-term surgical complications such as revision. The purpose of this study was to assess the association of increasing obesity with 2- and 5-year all-cause revision, periprosthetic joint infection (PJI), aseptic loosening, and manipulation under anesthesia (MUA) among patients undergoing reverse total shoulder arthroplasty (RTSA) or TSA. METHODS Patients who underwent RTSA or TSA with a minimum 5-year follow-up were identified in a national claims database (PearlDiver Technologies). Patients with obesity (body mass index [BMI] ≥30) were compared to patients who are normal or overweight (18.5 ≤ BMI < 30). Those with obesity were further stratified to those with class I or II obesity (30 ≤ BMI < 40) and those with class III obesity (BMI ≥ 40). Outcomes for comparison included all-cause revision, PJI, aseptic loosening, and MUA within 2 or 5 years. These cohorts were compared using univariate and multivariable analysis. RESULTS Patients with obesity had no significant difference in any surgical complication within 2 or 5 years for both those who underwent TSA or RTSA. After stratifying by class I or II obesity and class III obesity, there was still no significant difference in surgical complications with 2 or 5 years for both TSA patients and RTSA patients. DISCUSSION Obesity, when other major comorbidities are controlled for, was not associated with increased risk of long-term surgical complications after shoulder replacement surgery.
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Nygaard NPB, Thomsen GF, Rasmussen J, Skadhauge LR, Gram B. Ergonomic and individual risk factors for musculoskeletal pain in the ageing workforce. BMC Public Health 2022; 22:1975. [PMID: 36303167 PMCID: PMC9615169 DOI: 10.1186/s12889-022-14386-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/10/2022] [Indexed: 11/24/2022] Open
Abstract
Background The present study aimed to investigate the possible association between specific ergonomic and individual risk factors and musculoskeletal pain (MSP) in the back, shoulder, hip and knee region in workers aged 50-65y. Methods The study was a population based cross-sectional survey. The study population comprised citizens born between 1952–1966, living in Esbjerg municipality, Denmark, ultimo 2016 (n = 23,463). A questionnaire was sent electronically or by mail. The analysis included the working population only. A multivariate logistic regression was used for each of the following dependent variables; musculoskeletal pain for the past 3 months in the back, shoulder, hip and knee, where independent variables included ergonomic exposure, age, sex, body mass index (BMI) and leisure time physical activity (LTPA). Results The overall response rate was 58% and the data of individuals at work (n = 9,263) demonstrated several ergonomic exposures with increased odds for pain in specific regions. Exposure to back twisted or bend, squatting or lying on knees and to carrying or lifting were associated with musculoskeletal pain in the back, whereas exposure to back twisted or bend, arms above shoulder and repeated arm movement were associated with pain in the shoulder. Exposure to back twisted or bend, repeated arm movement, squatting or lying on knees and to carrying or lifting were associated with musculoskeletal pain in the hip. Important individual risk factors were also identified. Increasing age was significantly associated with increased pain in the hip but associated with less risk for pain in the back and shoulder. Males had higher odds for pain in the back and knee compared to females but lower odds for pain in the hip. BMI was particularly important for knee pain. The level of LTPA did not have an important association with MSP in any region. Conclusion There is a significant positive association between ergonomic exposures and musculoskeletal pain, which were specific for the back, shoulder, hip and knee. In addition, the data demonstrated a differential association with age, sex and BMI. This needs to be considered for the treatment and classification of musculoskeletal pain and for future preventive initiatives.
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Affiliation(s)
- Niels-Peter Brøchner Nygaard
- Research Unit of Health Science, Hospital of South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark. .,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Gert Frank Thomsen
- Department of Occupational Medicine, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Jesper Rasmussen
- Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lars Rauff Skadhauge
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Occupational Medicine, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Bibi Gram
- Research Unit of Health Science, Hospital of South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Nascimento MDM, Gouveia ÉR, Gouveia BR, Marques A, Campos P, García-Mayor J, Przednowek K, Ihle A. The Mediating Role of Physical Activity and Physical Function in the Association between Body Mass Index and Health-Related Quality of Life: A Population-Based Study with Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113718. [PMID: 36360598 PMCID: PMC9656348 DOI: 10.3390/ijerph192113718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 06/07/2023]
Abstract
This study aimed (1) to investigate the association between body mass index (BMI), physical activity (PA), and physical function (PF) with health-related quality of life (HRQoL), and (2) to examine in-depth whether PA and PF mediate the relationship between BMI and HRQoL in older adults. We investigated 802 individuals (mean age 69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. Harmol and PA were assessed using the SF-36 and Baecke questionnaires, respectively, and PF by the Senior Fitness Test. The prevalence of overweight was 71.3%, 26.5% for normal weight, and 2.1% for underweight. We verified a small correlation between age and sex with BMI, PA, PF, and medium borderline with HRQoL. After adjusting for covariates (i.e., sex, age, comorbidities), the multivariate regression analysis indicated a 93.1% chance of improvement in HRQoL for low BMI, while PA and PF revealed a chance of increasing HRQoL by 91.8% and 60.0%, respectively. According to the serial mediation pathway, PA and PF partially mediated the association between BMI and HRQoL by 32.3% and 81.5%, respectively. The total variance of the model was 90%. It was concluded that BMI can negatively affect HRQoL. On the other hand, PA and PF are able to increase HRQoL levels during the aging process.
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Affiliation(s)
- Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Petrolina 56304-917, PE, Brazil
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
- LARSYS—Laboratory for Robotics and Engineering System, Interactive Technologies Institute, 9020-105 Funchal, Portugal
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
| | - Bruna R. Gouveia
- LARSYS—Laboratory for Robotics and Engineering System, Interactive Technologies Institute, 9020-105 Funchal, Portugal
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Regional Directorate of Health, Secretary of Health of the Autonomous Region of Madeira, 9004-515 Funchal, Portugal
- Saint Joseph of Cluny Higher School of Nursing, 9050-535 Funchal, Portugal
| | - Adilson Marques
- CIPER, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, 1499-002 Cruz Quebrada, Portugal
- Environmental Health Institute (ISAMB), University of Lisbon, 1649-020 Lisbon, Portugal
| | - Pedro Campos
- Department of Informatics Engineering and Interactive Media Design, University of Madeira, 9000-072 Funchal, Portugal
| | - Jesús García-Mayor
- Public Health and Epidemiology Research Group, San Javier Campus, University of Murcia, 30720 San Javier, Spain
| | - Krzysztof Przednowek
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland
| | - Andreas Ihle
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
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Reference equations for the six-minute walking distance in obese Chinese subjects more than 40 years old. Eat Weight Disord 2022; 27:2561-2568. [PMID: 35459986 PMCID: PMC9556423 DOI: 10.1007/s40519-022-01404-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/05/2022] [Indexed: 10/30/2022] Open
Abstract
BACKGROUND Studies have shown that the reference equations for the six-minute walking distance (6MWD), which were mainly derived from healthy, normal-weight people, are not suitable for individuals with obesity. The main purpose of this study was to establish reference equations for the 6MWD in obese Chinese subjects. METHODS In our study, a total of 214 individuals with obesity performed the six-minute walking tests (6MWTs) according to the American thoracic society (ATS) guidelines, and the longer 6MWD was used for further analysis. The reference equations for the 6MWD were developed using stepwise multiple regression analysis. The newly established equations for the 6MWD were compared to the existing prediction equations. RESULTS The mean 6MWD for the cohort was 523 ± 56 m. We found that the reliability of two 6MWTs was good. Age and BMI were identified as independent factors, and explained 31% and 27% of the variance in the 6MWD for the male and female participants, respectively. Thus, the reference equations reported in the previous studies did not accurately predict the 6MWD in our subjects. CONCLUSION Our study was the first to describe the 6MWD in obese Chinese subjects and to propose new predictive equations. These established equations can improve the assessment of the health of obese Chinese patients whose exercise capacity is affected by the disease. LEVEL OF EVIDENCE III, Cohort study.
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Association between Body Weight and Body Mass Index and Patellar Tendinopathy in Elite Basketball and Volleyball Players, a Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10101928. [PMID: 36292375 PMCID: PMC9601617 DOI: 10.3390/healthcare10101928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/04/2022] Open
Abstract
The features of Patellar-Tendinopathy are (1): pain localised to the inferior pole of the patellar; (2): the presence of load-related pain. Body-Weight and Body-Mass-Index, as two easily-measured variables, could potentially aid the prediction of PT. This review aims to establish relationships between Body-Weight and Body-Mass-Index and Patellar-Tendinopathy via synthesising the evidence from prospective-cohort and cross-sectional studies in elite basketball and volleyball players. Seven databases (PubMed, EMBASE, CINAHL, Google Scholar, Health-Management-Information-Consortium, National-Technical-Information-Service, ClinicalTrial.gov) and citation chasing were used to identify English peer-review articles from 2000 to 2022. An adapted version of the Newcastle-Ottawa scale was used for critical appraisal. Two reviewers were involved in literature searching, data extraction, and quality review. Two prospective cohort and five cross-sectional studies met the inclusion criteria, providing 849 subjects (male:female: 436:413). Five studies found BW is associated with PT. Three studies found a relationship between BMI and PT. Six out of seven studies were classified as very good studies. All studies were level IV evidence. The very low certainty evidence suggests an association between BW and PT. There is moderate certainty evidence that BMI is associated with PT. These preliminary findings should be treated cautiously due to the lack of strong evidence.
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Wister A, Li L, Whitmore C, Ferris J, Klasa K, Linkov I. Multimorbidity resilience and health behaviors among older adults: A longitudinal study using the Canadian Longitudinal Study on Aging. Front Public Health 2022; 10:896312. [PMID: 36211713 PMCID: PMC9539554 DOI: 10.3389/fpubh.2022.896312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/01/2022] [Indexed: 01/22/2023] Open
Abstract
Objective There has been a growing interest in examining why some individuals adapt and bounce back from multimorbidity (resilience) better than others. This paper investigates the positive role of protective health behaviors on multimorbidity resilience (MR) among older adults focusing on older persons with two or more concurrent chronic conditions, and separately for three multimorbidity chronic illness clusters. Methods Using Baseline and Follow-up One data from the Comprehensive Cohort of the Canadian Longitudinal Study on Aging, we studied 10,628 participants aged 65 years and older who reported two or more of 27 chronic conditions, and three multimorbidity clusters: Cardiovascular/metabolic, Musculoskeletal, and Mental health. Associations between health behaviors and MR were evaluated using Linear Mixed Models, adjusting for socio-demographic, social/environmental, and illness context social determinants of health. Results Among older adults with two or more illnesses, smoking, satisfaction with sleep, appetite, and skipping meals were associated with MR in the expected direction. Also, obesity (compared to normal weight) and skipping meals showed longitudinal interaction effects with survey wave. Most of the results were replicated for the physical multimorbidity clusters (Cardiovascular/metabolic and Musculoskeletal) compared to the full 2+ multimorbidity analyses; however, for the Mental health cluster, only satisfaction with sleep was supported as a lifestyle predictor of MR. Discussion Several modifiable health behaviors identified in the broader health and aging literature are important in affecting levels of multimorbidity resilience in older age. These factors are important strength-based areas to target. Additionally, several social determinants of health are also supported and parallel research on multimorbidity risk. The effects of lifestyle factors for resilience among older adults is dependent on the type of multimorbidity measured. We conclude that the results have significant public health, program intervention, and clinical implications for healthy aging among persons coping with multimorbidity.
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Affiliation(s)
- Andrew Wister
- Department of Gerontology, Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
| | - Lun Li
- School of Social Work, MacEwan University, Edmonton, AB, Canada
| | - Carly Whitmore
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Jennifer Ferris
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
- BC Observatory for Population and Public Health, BC Centre for Disease Control, Vancouver, BC, Canada
| | - Katarzyna Klasa
- University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Igor Linkov
- United States Army Corps of Engineers, Engineering Research and Development Center, Vicksburg, MS, United States
- Carnegie Mellon University, Pittsburg, PA, United States
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Foster KS, Greenlee TA, Young JL, Janney CF, Rhon DI. How Common is Subsequent Posterior Tibial Tendon Dysfunction or Tarsal Tunnel Syndrome After Ankle Sprain Injury? J Knee Surg 2022; 35:1181-1191. [PMID: 35944572 DOI: 10.1055/s-0042-1751246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Posterior tibial tendon dysfunction (PTTD) and tarsal tunnel syndrome (TTS) are debilitating conditions reported to occur after ankle sprain due to their proximity to the ankle complex. The objective of this study was to investigate the incidence of PTTD and TTS in the 2 years following an ankle sprain and which variables are associated with its onset. In total, 22,966 individuals in the Military Health System diagnosed with ankle sprain between 2010 and 2011 were followed for 2 years. The incidence of PTTD and TTS after ankle sprain was identified. Binary logistic regression was used to identify potential demographic or medical history factors associated with PTTD or TTS. In total, 617 (2.7%) received a PTTD diagnosis and 127 (0.6%) received a TTS diagnosis. Active-duty status (odds ratio [OR] 2.18, 95% confidence interval [CI] 1.70-2.79), increasing age (OR 1.03, 95% CI 1.02-1.04), female sex (OR 1.58, 95% CI 1.28-1.95), and if the sprain location was specified by the diagnosis (versus unspecified location) and did not include a fracture contributed to significantly higher (p < 0.001) risk of developing PTTD. Greater age (OR 1.06, 95% CI 1.03-1.09), female sex (OR 2.73, 95% CI 1.74-4.29), history of metabolic syndrome (OR 1.73, 95% CI 1.03-2.89), and active-duty status (OR 2.28, 95% CI 1.38-3.77) also significantly increased the odds of developing TTS, while sustaining a concurrent ankle fracture with the initial ankle sprain (OR 0.45, 95% CI 0.28-0.70) significantly decreased the odds. PTTD and TTS were not common after ankle sprain. However, they still merit consideration as postinjury sequelae, especially in patients with persistent symptoms. Increasing age, type of sprain, female sex, metabolic syndrome, and active-duty status were all significantly associated with the development of one or both subsequent injuries. This work provides normative data for incidence rates of these subsequent injuries and can help increase awareness of these conditions, leading to improved management of refractory ankle sprain injuries.
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Affiliation(s)
- Kaitlyn S Foster
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, Texas
| | - Tina A Greenlee
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, Texas
| | - Jodi L Young
- Doctor of Science Program in Physical Therapy, Bellin College, Green Bay, Wisconsin
| | - Cory F Janney
- Naval Medical Center San Diego, San Diego, California
| | - Daniel I Rhon
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, Texas.,Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Zhang J, Zou Y, Wang Z, Chen X, Pan J, Yu H, Li E, Zou H. Two-minute walk distance reference equations for middle-aged and elderly Chinese individuals with obesity. PLoS One 2022; 17:e0273550. [PMID: 36001629 PMCID: PMC9401169 DOI: 10.1371/journal.pone.0273550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 08/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background and objective While the six-minute walk test (6MWT) is often used to assess exercise capacity, the less well-known two-minute walk test (2MWT) is more feasible for some patients. In previous studies, we developed reference equations for the two-minute walk distance (2MWD) for healthy Chinese adults. However, our study did not recruit people with obesity, and the reference equations did not apply to participants with a body mass index (BMI) > 30 kg/m2. The main objective of this study was to establish reference equations for the 2MWD among middle-aged and elderly Chinese individuals with obesity. Methods A total of 295 individuals were recruited. The participants underwent two 2MWTs, with the longer of the two 2MWDs used for further analyses. The reference equations for the 2MWD were developed using stepwise multiple regression analysis. The newly established equations for the 2MWD were then compared with the existing equations. Results The mean 2MWD of the participants was 176±20 m. Age and BMI were identified as independent factors that influenced the 2MWD and explained 28% and 32% of the variance in walking distance for the male and female groups, respectively. The reference equations for the 2MWD were as follows: Conclusion This study resulted in the development of reference equations for predicting 2MWD among middle-aged and elderly Chinese people with obesity. These equations will be a clinically valuable tool for evaluating functional capacity, determining prognoses and monitoring treatment in middle-aged and elderly Chinese people with obesity.
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Affiliation(s)
- Jia Zhang
- Department of Medical Inspection, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yingying Zou
- Digestive System Department, The Third Affiliated Hospital of Qiqihar Medical College, Qiqihar, Heilongjiang, China
| | - Zibin Wang
- Obstetrics Department, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaoshu Chen
- Department of Cardiovascular Medicine, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jingye Pan
- Department of General and Intensive Medical Care, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haizhu Yu
- Department of General Practice, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Enci Li
- Nursing Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - He Zou
- Department of Cardiovascular Medicine, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
- * E-mail:
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Serbest K. Effects of weight gaining to lower limb joint moments: a gender-specific sit-to-stand analysis. BIOMED ENG-BIOMED TE 2022; 67:481-489. [PMID: 35977426 DOI: 10.1515/bmt-2022-0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/02/2022] [Indexed: 11/15/2022]
Abstract
The prevalence of obesity, a worldwide health problem, is increasing. Obesity or overweight has significant effects, especially on lower limb biomechanics. Previous studies have investigated the biomechanical effects of weight gain on the knee and hip joints. These studies have been conducted on different individuals with normal weight and overweight. However, no investigation has been carried out between women and men in terms of weight gain. Females usually gain weight in the gluteal-femoral region, whereas males gain weight in the abdominal region. Due to this difference, it is thought that the effects of weight gain should be examined in a gender-specific manner. In this study, a link-segment model of the lower limb was created. Then the sit-to-stand movement was simulated according to female and male-specific weight gain scenarios. According to these results, weight gain in the abdominal region (men-specific) increases the ankle and knee joint moments more than weight gain in the gluteal-femoral region (women-specific). In obese scenarios for males and females, while the ankle and knee joint moment increases, the hip joint moment decreases. These results would be beneficial for considering biomechanical differences caused by gender-specific weight gain in rehabilitation processes and orthotic and prosthetic designs.
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Affiliation(s)
- Kasim Serbest
- Department of Mechatronics Engineering, Sakarya University of Applied Sciences, Serdivan, Sakarya, Turkey
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Oliva F, Marsilio E, Asparago G, Giai Via A, Biz C, Padulo J, Spoliti M, Foti C, Oliva G, Mannarini S, Rossi AA, Ruggieri P, Maffulli N. Achilles Tendon Rupture and Dysmetabolic Diseases: A Multicentric, Epidemiologic Study. J Clin Med 2022; 11:jcm11133698. [PMID: 35806982 PMCID: PMC9267833 DOI: 10.3390/jcm11133698] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction: Achilles tendon ruptures are common. Metabolic disorders, such as diabetes mellitus, hypercholesterolemia, thyroid disorders, and obesity, impair tendons health, leading to Achilles tendinopathy and likely predisposing patients to Achilles tendon ruptures. Materials and methods: Patients who visited the Orthopedic Outpatient Clinics and the Accident and Emergency Departments of five different hospitals in Italy were recruited. Through telephone interviews, we administered a questionnaire to all the patients who had undergone surgical ATR repair, evaluating their past medical history, sport- and work-related activities, drug use, and post-operative rehabilitation outcomes. Results: “Return to work activities/sport” was negatively predicted by the presence of a metabolic disorder (β = −0.451; OR = 0.637) and ‘open’ surgery technique (β = −0.389; OR = 0.678). “Medical complications” were significantly predicted by metabolic disorders (β = 0.600 (0.198); OR = 1.822) and was negatively related to ‘mini-invasive’ surgery (i.e., not ‘open’ nor ‘percutaneous’) (β = −0.621; OR = 0.537). “Immediate weightbearing” and “immediate walking without assistance” were negatively predicted by ‘open’ technique (β = −0.691; OR = 0.501 and β = −0.359 (0.174; OR = 0.698)). Conclusions: Metabolic conditions can strongly affect post-operative outcomes following surgical repair of acute Achilles tendon tears.
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Affiliation(s)
- Francesco Oliva
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (F.O.); (G.A.); (N.M.)
| | - Emanuela Marsilio
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (F.O.); (G.A.); (N.M.)
- Correspondence: ; Tel.: +39-3465115396
| | - Giovanni Asparago
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (F.O.); (G.A.); (N.M.)
| | - Alessio Giai Via
- Department of Orthopaedic Surgery and Traumatology, San Camillo-Forlanini Hospital, 00152 Rome, Italy;
| | - Carlo Biz
- Orthopaedics and Orthopaedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, 35128 Padova, Italy; (C.B.); (P.R.)
| | - Johnny Padulo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy;
| | - Marco Spoliti
- Orthopaedics and Traumatology Unit, Department of Emergency and Acceptance, Azienda Ospedaliera San Camillo-Forlanini, 00152 Rome, Italy;
| | - Calogero Foti
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, 00133 Rome, Italy;
| | - Gabriella Oliva
- Department of Internal Medicine, Ospedale del Mare, ASL1, 80147 Napoli, Italy;
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, 35128 Padova, Italy; (S.M.); (A.A.R.)
- Interdepartmental Center for Family Research, University of Padova, 35128 Padova, Italy
| | - Alessandro Alberto Rossi
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, 35128 Padova, Italy; (S.M.); (A.A.R.)
- Interdepartmental Center for Family Research, University of Padova, 35128 Padova, Italy
| | - Pietro Ruggieri
- Orthopaedics and Orthopaedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, 35128 Padova, Italy; (C.B.); (P.R.)
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (F.O.); (G.A.); (N.M.)
- School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Thornburrow Drive, Stoke on Trent ST4 7QB, UK
- Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, 275 Bancroft Road, London E1 4DG, UK
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Ottesen TD, Amick M, Kapadia A, Ziatyk EQ, Joe JR, Sequist TD, Agarwal-Harding KJ. The Unmet Need for Orthopaedic Services Among American Indian and Alaska Native Communities in the United States. J Bone Joint Surg Am 2022; 104:e47. [PMID: 35104253 DOI: 10.2106/jbjs.21.00512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
ABSTRACT Historic and present-day marginalization has resulted in a high burden of disease and worse health outcomes for American Indian and Alaska Native (AI/AN) communities in the United States. Musculoskeletal disease is the leading cause of disability for the general population in the U.S. today. However, few have examined musculoskeletal disease burden and access to orthopaedic surgical care in the AI/AN communities. A high prevalence of hip dysplasia, arthritis, back pain, and diabetes, and a high incidence of trauma and road traffic-related mortality, suggest a disproportionately high burden of musculoskeletal pathology among the AI/AN communities and a substantial need for orthopaedic surgical services. Unfortunately, AI/AN patients face many barriers to receiving specialty care, including long travel distances and limited transportation to health facilities, inadequate staff and resources at Indian Health Service (IHS)-funded facilities, insufficient funding for referral to specialists outside of the IHS network, and sociocultural barriers that complicate health-system navigation and erode trust between patients and providers. For those who manage to access orthopaedic surgery, AI/AN patients face worse outcomes and more complications than White patients. There is an urgent need for orthopaedic surgeons to participate in improving the availability of quality orthopaedic services for AI/AN patients through training and support of local providers, volunteerism, advocating for a greater investment in the IHS Purchased/Referred Care program, expanding telemedicine capabilities, and supporting community-based participatory research activities.
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Affiliation(s)
- Taylor D Ottesen
- Harvard Global Orthopaedics Collaborative, Boston, Massachusetts
- Massachusetts General Hospital/Harvard Combined Orthopaedic Residency Program, Boston, Massachusetts
| | - Michael Amick
- Harvard Global Orthopaedics Collaborative, Boston, Massachusetts
- Yale University School of Medicine, New Haven, Connecticut
| | - Ami Kapadia
- Harvard Global Orthopaedics Collaborative, Boston, Massachusetts
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elizabeth Q Ziatyk
- Department of Family Medicine, Chinle Comprehensive Healthcare Facility, Chinle, Arizona
| | - Jennie R Joe
- Department of Family and Community Medicine, University of Arizona Health Sciences, Tucson, Arizona
- Native American Research and Training Center, University of Arizona Health Sciences, Tucson, Arizona
| | - Thomas D Sequist
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Healthcare Policy, Harvard Medical School, Boston, Massachusetts
| | - Kiran J Agarwal-Harding
- Harvard Global Orthopaedics Collaborative, Boston, Massachusetts
- Department of Orthopaedic Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY
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Obesity and individual performance: the case of eSports. Int J Obes (Lond) 2022; 46:1518-1526. [PMID: 35585184 DOI: 10.1038/s41366-022-01142-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES The study considers the problem of the inclusion of people with obesity in the context of the growing role of computer-based work. Negative stereotypes about people with obesity still hold even when they are irrelevant in tasks that require little physical activity. SUBJECTS/METHODS Using data from the realm of competitive video gaming (eSports) and image recognition-based metric of body mass index metric derived from artificial intelligence, we examine the individual performance depending on weight. The sample includes 821 players and 127,533 player performance observations. RESULTS For shorter tasks, individuals with normal weight performed better than individuals with obesity. For longer tasks, however, people with Class III (severe) obesity outperformed all others, and their advantage increased with task duration. CONCLUSIONS Our findings shed light on an understanding of how actually body features are related to objective individual performance in a competitive context.
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Copperi F, Kim JD, Diano S. Melanocortin Signaling Connecting Systemic Metabolism With Mood Disorders. Biol Psychiatry 2022; 91:879-887. [PMID: 34344535 PMCID: PMC8643363 DOI: 10.1016/j.biopsych.2021.05.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/11/2021] [Accepted: 05/29/2021] [Indexed: 11/02/2022]
Abstract
Obesity and mood disorders are often overlapping pathologies that are prevalent public health concerns. Many studies have indicated a positive correlation between depression and obesity, although weight loss and decreased appetite are also recognized as features of depression. Accordingly, DSM-5 defines two subtypes of depression associated with changes in feeding: melancholic depression, characterized by anhedonia and associated with decreased feeding and appetite; and atypical depression, characterized by fatigue, sleepiness, hyperphagia, and weight gain. The central nervous system plays a key role in the regulation of feeding and mood, thus suggesting that overlapping neuronal circuits may be involved in their modulation. However, these circuits have yet to be completely characterized. The central melanocortin system, a circuitry characterized by the expression of specific peptides (pro-opiomelanocortins, agouti-related protein, and neuropeptide Y) and their melanocortin receptors, has been shown to be a key player in the regulation of feeding. In addition, the melanocortin system has also been shown to affect anxiety and depressive-like behavior, thus suggesting a possible role of the melanocortin system as a biological substrate linking feeding and depression. However, more studies are needed to fully understand this complex system and its role in regulating metabolic and mood disorders. In this review, we will discuss the current literature on the role of the melanocortin system in human and animal models in feeding and mood regulation, providing evidence of the biological interplay between anxiety, major depressive disorders, appetite, and body weight regulation.
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Affiliation(s)
- Francesca Copperi
- Institute of Human Nutrition, Columbia University Irving Medical Center, New York, NY, 10032
| | - Jung Dae Kim
- Institute of Human Nutrition, Columbia University Irving Medical Center, New York, NY, 10032
| | - Sabrina Diano
- Institute of Human Nutrition, Columbia University Irving Medical Center, New York, New York; Department of Molecular Pharmacology and Therapeutics, Columbia University Irving Medical Center, New York, New York; Department of Physiology and Cellular Biophysics, Columbia University Irving Medical Center, New York, New York.
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Samara O, Jafar H, Hamdan M, Al-Ta'mari A, Rahmeh R, Hourani B, Mandalawi N, Awidi A. Ultrasound-guided intra-articular injection of expanded umbilical cord mesenchymal stem cells in knee osteoarthritis: a safety/efficacy study with MRI data. Regen Med 2022; 17:299-312. [PMID: 35546314 DOI: 10.2217/rme-2021-0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: This study has the primary objective of studying the effect of Wharton jelly mesenchymal stem cells (WJMSCs) in the treatment of knee osteoarthritis. As a secondary end point, we report on the efficacy of such therapy. Patients and methods: 16 patients with advanced Kellgren stage were treated using two doses of expanded WJMSCs given 1 month apart. Patients were followed for 48 months using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and 12 months using magnetic resonance imaging (MRI). Results: Treatment was well tolerated. One patient developed moderate effusion and one superficial phlebitis. We observed functional and pain improvement at 12 and 48 months (p < 0.0001), with statistically significant improvement on MRI scans at 12 months in cartilage loss, osteophytes, bone marrow lesions, effusion and synovitis (p < 0.01), and highly significant improvement in subchondral sclerosis (p < 0.0001). Conclusion: WJMSCs are safe and potentially effective in producing significant improvement in KOOS and MRI scores when administered intra-articularly in knee osteoarthritis cases under ultrasound guidance.
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Affiliation(s)
- Osama Samara
- Department of Radiology & Nuclear Medicine, School of Medicine, University of Jordan, Amman, Jordan.,Department of Radiology, Jordan University Hospital, Amman, Jordan
| | - Hanan Jafar
- Cell Therapy Center, University of Jordan, Amman, Jordan.,Department of Anatomy & Histology, School of Medicine, University of Jordan, Amman Jordan
| | - Mohammad Hamdan
- Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan.,Department of Orthopedic Surgery, Jordan University Hospital, Amman, Jordan
| | - Ahmad Al-Ta'mari
- Cell Therapy Center, University of Jordan, Amman, Jordan.,Department of Internal Medicine, East Tennessee State University, TN, USA
| | - Reem Rahmeh
- Cell Therapy Center, University of Jordan, Amman, Jordan
| | - Bayan Hourani
- Cell Therapy Center, University of Jordan, Amman, Jordan
| | - Noor Mandalawi
- Department of Radiology, Jordan University Hospital, Amman, Jordan
| | - Abdalla Awidi
- Cell Therapy Center, University of Jordan, Amman, Jordan.,Department of Internal Medicine, Hematology-Oncology School of Medicine, University of Jordan, Amman, Jordan.,Department of Hematology-Oncology, Jordan University Hospital, Amman, Jordan
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