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Health Reports May 2024The availability of measures to operationalize allostatic load - the cumulative toll on the body of responding to stressor demands - in population health surveys may...
BACKGROUND
The availability of measures to operationalize allostatic load - the cumulative toll on the body of responding to stressor demands - in population health surveys may differ across years or surveys, hampering analyses on the entire sampled population. Here, impacts of variable selection and calculation method were evaluated to generate an allostatic load index applicable across all cycles of the Canadian Health Measures Survey (CHMS).
METHODS
Data from CHMS cycles 1 to 4 were used to compare allostatic load scores when replacing the most prevalent risk factor, waist-to-hip ratio - available in cycles 1 to 4 but not 5 and 6 - with body mass index (BMI), waist circumference, waist circumference within BMI groups (classified as normal, overweight, or obese), or waist-to-height ratio. Indexes were generated using clinical or sex-specific empirically defined risk thresholds and as count-based or continuous scores. Logistic regression models that included age and sex were used to relate each potential index to socioeconomic indicators (educational attainment, household income).
RESULTS
Of the variables assessed, waist-to-height ratio and waist circumference were closest to waist-to-hip ratio according to an individual's percentile ranking and in classifying "at risk" using either clinical or empirically defined cut-offs. Allostatic load profiles generated using waist-to-height ratios most closely resembled profiles constructed using waist-to-hip ratios. Sex-dependent associations with educational attainment and household income were maintained across constructs whether indexes were count-based or continuous.
INTERPRETATION
Allostatic load profiles and associations with socioeconomic indicators were robust to variable substitution and method of calculation, supporting the use of a harmonized index across survey cycles to assess the cumulative toll on health of stressor exposure.
Topics: Humans; Canada; Male; Female; Allostasis; Health Surveys; Body Mass Index; Adult; Middle Aged; Waist Circumference; Waist-Hip Ratio; Waist-Height Ratio; Risk Factors; Aged; Socioeconomic Factors
PubMed: 38758724
DOI: 10.25318/82-003-x202400500002-eng -
Clinical Case Reports May 2024A patient presented with cardiogenic shock, requiring the implantation of a left ventricular assist device (LVAD), and acute myeloblastic leukemia. This necessitated...
KEY CLINICAL MESSAGE
A patient presented with cardiogenic shock, requiring the implantation of a left ventricular assist device (LVAD), and acute myeloblastic leukemia. This necessitated total body irradiation (TBI) while balancing dose reduction to the LVAD components to avoid potential radiation damage. Here we outline our treatment approach and dose estimates to the LVAD.
ABSTRACT
This case report discusses the delivery of TBI to a patient with an LVAD. This treatment required radiation-dose determinations and consequential reductions for the heart, LVAD, and an external controller connected to the LVAD. The patient was treated using a traditional 16MV anterior posterior (AP)/posterior anterior (PA) technique at a source-to-surface-distance of 515 cm for 400 cGy in two fractions. A 3 cm thick Cerrobend block was placed on the beam spoiler to reduce dose to the heart and LVAD to 150 cGy. The external controller was placed in a 1 cm thick acrylic box to reduce neutron dose and positioned as far from the treatment fields as achievable. In vivo measurements were made using optically stimulated luminescence dosimeters (OSLDs) placed inside the box at distances of 2 cm, 8.5 cm, and 14 cm from the field edge, and on the patient along the central axis and centered behind the LVAD block. Further ion chamber measurements were made using a solid water phantom to more accurately estimate the dose delivered to the LVAD. Neutron dose measurements were also conducted. The total estimated dose to the controller ranged from 135.3 cGy to 91.5 cGy. The LVAD block reduced the surface dose to the patient to 271.6 cGy (68.1%). The block transmission factors of the 3 cm Cerrobend block measured in the phantom were 45% at 1 cm depth and decreased asymptotically to around 30% at 3 cm depth. Applying these transmission factors to the in vivo measurements yielded a dose of 120 cGy to the implanted device. The neutron dose the LVAD region is estimated around 0.46 cGy. Physical limitations of the controller made it impossible to completely avoid dose. Shielding is recommended. The block had limited dose reduction to the surface, due to secondary particles, but appropriately reduced the dose at 3 cm and beyond. More research on LVADs dose limits would be beneficial.
PubMed: 38756618
DOI: 10.1002/ccr3.8868 -
BMC Sports Science, Medicine &... May 2024The performance of swing movement during spikes and serves plays a crucial role in determining the outcomes of volleyball matches. This study aims to explore the effects...
PURPOSE
The performance of swing movement during spikes and serves plays a crucial role in determining the outcomes of volleyball matches. This study aims to explore the effects of the participation of the trunk and lower limbs' involvement on the velocity and power of the swing movement of adolescent male volleyball players, as well as the differences in power and velocity performance of the swing movement among different ages and specific positions.
METHODS
The study involved 22 adolescent male volleyball players, with 11 high school students and 11 middle school students. The Kineo Globus equipment was used to assess the swing movement performance involving different segments, including arm swing movement only involving arm limb participation; upper swing movement involving trunk and arm limb participation; and whole body swing movement involving lower limb, trunk, and arm limb participation. The measured parameters included power and velocity performance levels. Before the test, each subject practiced three movement patterns twice.
RESULTS
The study found that swing movement involving both the trunk and arm limbs had significantly higher average (F = 17.70, p < 0.001) and peak power performance (F = 31.47, p < 0.001), as well as in average (F = 9.14, p = 0.03) and peak velocity performance (F = 23.17, p < 0.001). There were no significant differences in average (F = 17.70; p = 0.46) and peak power (F = 31.47, p = 0.94), as well as in average (F = 9.14, p = 0.99) and peak velocity performance (F = 23.17, p = 0.90) between movements involving the whole body and those involving the trunk and upper limbs. Among different age groups, the swing movement performance of middle school athletes showed significant enhancements in both average (F = 9.20, p < 0.001) and peak power (F = 19.93, p < 0.001), as well as in average (F = 10.75, p < 0.001) and peak velocity (F = 34.35, p < 0.001) when arm swing with trunk involvement was compared to arm swing movement. High school athletes also showed significant improvements in peak velocity (F = 34.35, p < 0.001), peak power (F = 17.31, p < 0.001), and average power (F = 9.41, p < 0.001) during upper swing movements, except for average velocity performance (F = 1.56, p = 0.21), when compared to arm swing movement. The increase rate in average velocity performance of swing movements involving trunk participation was significantly higher in middle school athletes than in high school athletes (p < 0.001). Among athletes in specific positions, Middle Blocker (MB) players exhibited significantly better average power performance in swing movements involving trunk and arm limb participation compared to Outside Hitter (OH) players (p = 0.04). Furthermore, the rate of average (p = 0.01) and peak (p = 0.03) power change during upper swing movements involving lower limb participation was significantly higher among OH players than MB players.
CONCLUSIONS
The involvement of the trunk segment has been observed to significantly improve power and velocity in swing movements during spike and serves among adolescent male volleyball players. This underscores the importance of coordination between the trunk and arm in influencing swing movement performance during spikes and serves. High school athletes demonstrate superior power and velocity in arm swing movements compared to middle school athletes. MB exhibits greater power in upper limb swing movements than OH, although OH players show better coordination between the arm, trunk, and lower limb segments in the swing movement. To enhance swing movement performance in adolescent male volleyball players, particularly focusing on the trunk segment was crucial. Specialized physical training programs should target improving both arm strength and rotational power of the trunk simultaneously. This approach would help in consistently enhancing coordination between the trunk and arms, ultimately leading to optimized force generation during swing movements such as spikes and serves.
PubMed: 38755687
DOI: 10.1186/s13102-024-00898-2 -
PloS One 2024The objective of this research was to conduct a qualitative study among a diverse group of providers to identify their clinical needs, barriers, and adverse safety...
A qualitative exploration of the challenges providers experience during peripartum management of patients with a body mass index ≥ 50 kg/m2 and recommendations for improvement.
BACKGROUND
The objective of this research was to conduct a qualitative study among a diverse group of providers to identify their clinical needs, barriers, and adverse safety events in the peripartum care of people with a body mass index (BMI) ≥ 50 kg/m2.
METHODS
Obstetricians, anesthesiologists, certified nurse midwives, nurse practitioners, and nurses were invited to participate in focus group discussions if they were employed at the hospital for >6 months. Key concepts in the focus group guide included: (1) Discussion of challenging situations, (2) Current peripartum management approaches, (3) Patient and family knowledge and counseling, (4) Design and implementation of a guideline (e.g., checklist or toolkit) for peripartum care. The audiotaped focus groups were transcribed verbatim, uploaded to a qualitative analysis software program, and analyzed using inductive and constant comparative approaches. Emerging themes were summarized along with representative quotes.
RESULTS
Five focus groups of 27 providers were completed in 2023. The themes included staffing (level of experience, nursing-patient ratios, safety concerns), equipment (limitations of transfer mats, need for larger sizes, location for blood pressure cuff, patient embarrassment), titrating oxytocin (lack of guidelines, range of uses), monitoring fetal heart rate and contractions, patient positioning, and communication (lack of patient feedback, need for bias training, need for interdisciplinary relationships). Providers gave examples of items to include in a "BMI cart" and suggestions for a guideline including designated rooms for patients with a BMI ≥ 50 kg/m2, defining nursing ratios and oxytocin titration plans, postpartum incentive spirometer, and touch points with providers (nursing, physicians) at every shift change.
CONCLUSIONS
Providers discussed a range of challenges and described how current approaches to care may negatively affect the peripartum experience and pose threats to safety for patients with a BMI ≥ 50 kg/m2 and their providers. We gathered information on improving equipment and communication among providers.
Topics: Humans; Female; Body Mass Index; Peripartum Period; Pregnancy; Focus Groups; Adult; Qualitative Research; Health Personnel
PubMed: 38753599
DOI: 10.1371/journal.pone.0303497 -
Frontiers in Neurology 2024Knowledge about factors affecting functional disability in patients with non-specific chronic low back pain (NSCLBP) is helpful in guiding treatment, but there has been...
BACKGROUND
Knowledge about factors affecting functional disability in patients with non-specific chronic low back pain (NSCLBP) is helpful in guiding treatment, but there has been little systematic research on this topic. This study aimed to identify independent factors contributing to functional disability in NSCLBP patients especially the impact of sagittal parameters and body postures in work, learning, and daily life.
METHODS
Sociodemographic data, sagittal parameters, Oswestry Disability Index (ODI), Numeric Rating Scale (NRS), and 36-item Short Form Health Survey (SF-36) of NSCLBP patients were collected. Patients were divided into a low-functional disability group (ODI ≤ 20) and a high-functional disability group (ODI > 20), and the ODI was converted to ranked ODI (RODI) accordingly. Sociodemographic data, sagittal parameters, NRS, and SF-36 were compared by univariate analysis between both groups. A correlation analysis of the aforementioned factors with the RODI was conducted. The sociodemographic data and sagittal parameters related to the RODI were analyzed by logistic regression to select potential RODI-associated factors. The level of significance was set at < 0.05.
RESULTS
Age, educational background, daily main posture while working or learning (DMPWL), daily standing time while working or learning (DSTTWL), daily sitting time while resting (DSITR), sacral slope-pelvic tilt (SS-PT), spinosacral angle (SSA), NRS, and SF-36 (except mental health, MH) were different between the two groups ( < 0.05). Correlation analysis showed that they were related to the RODI ( < 0.05). The logistic regression analysis indicated that the regression coefficients of a college degree, postgraduate diploma, DSITR, and SSA were ( = -0.197; = 0.003), ( = -0.211; = 0.006), ( = -0.139; = 0.039), and ( = -0.207; = 0.001), respectively, and the odds ratio (OR) and 95% confidence interval (CI) were 0.489 (0.308; 0.778), 0.299 (0.125; 0.711), 0.875 (0.772; 0.993), and 0.953 (0.925; 0.981), respectively.
CONCLUSION
Educational background, DSITR, and SSA are independent factors affecting functional disability in NSCLBP patients. NSCLBP patients with a lower educational background, shorter DSITR, or smaller SSA should be taken into account in clinical practice and therapeutic choices. Extending sitting time for rest and the avoidance of a forward-leaning standing position are beneficial for reducing functional disability in NSCLBP.
PubMed: 38751880
DOI: 10.3389/fneur.2024.1367400 -
Scientific Reports May 2024Ecological applications of compound-specific stable isotope analysis (CSIA) of amino acids (AAs) include 1) tracking carbon pathways in food webs using essential AA (AA)... (Comparative Study)
Comparative Study
Ecological applications of compound-specific stable isotope analysis (CSIA) of amino acids (AAs) include 1) tracking carbon pathways in food webs using essential AA (AA) δC values, and 2) estimating consumer trophic position (TP) by comparing relative differences of 'trophic' and 'source' AA δN values. Despite the significance of these applications, few studies have examined AA-specific SI patterns among tissues with different AA compositions and metabolism/turnover rates, which could cause differential drawdown of body AA pools and impart tissue-specific isotopic fractionation. To address this knowledge gap, especially in the absence of controlled diet studies examining this issue in captive marine mammals, we used a paired-sample design to compare δC and δN values of 11 AAs in commonly sampled tissues (skin, muscle, and dentine) from wild beluga whales (Delphinapterus leucas). δC of two AAs, glutamic acid/glutamine (Glx, a non-essential AA) and, notably, threonine (an essential AA), differed between skin and muscle. Furthermore, δN of three AAs (alanine, glycine, and proline) differed significantly among the three tissues, with glycine δN differences of approximately 10 ‰ among tissues supporting recent findings it is unsuitable as a source AA. Significant δN differences in AAs such as proline, a trophic AA used as an alternative to Glx in TP estimation, highlight tissue selection as a potential source of error in ecological applications of CSIA-AA. Amino acids that differed among tissues play key roles in metabolic pathways (e.g., ketogenic and gluconeogenic AAs), pointing to potential physiological applications of CSIA-AA in studies of free-ranging animals. These findings underscore the complexity of isotopic dynamics within tissues and emphasize the need for a nuanced approach when applying CSIA-AA in ecological research.
Topics: Animals; Nitrogen Isotopes; Carbon Isotopes; Amino Acids; Beluga Whale; Food Chain; Skin
PubMed: 38750037
DOI: 10.1038/s41598-024-59307-w -
The Journal of the Egyptian Public... May 2024Work-related musculoskeletal disorders (WMSDs) are a significant workplace problem leading to loss of productivity and disability. Administrative workers perform...
BACKGROUND
Work-related musculoskeletal disorders (WMSDs) are a significant workplace problem leading to loss of productivity and disability. Administrative workers perform computer-based tasks for long periods. Consequently, they are at risk of developing musculoskeletal disorders. The objective of this study was to explore the frequency and risk factors of work-related musculoskeletal complaints and their impact on work productivity among administrative employees of Suez Canal University, Egypt.
METHODS
This cross-sectional study was conducted on 300 administrative employees through simple random sampling. Data were collected by an interview questionnaire including sociodemographic, work-related data, ergonomic and psychological risk factors, the Nordic Musculoskeletal Questionnaire (NMQ), and the World Health Organization Health and Work Performance Questionnaire (HPQ).
RESULTS
The frequency of work-related musculoskeletal complaints in at least one anatomical region over the past year was 74.7%. Neck (47.1%), lower back (40.7%), and shoulder (36.3%) were the most reported sites of complaints. Risk factors significantly associated with work-related musculoskeletal complaints were gender, age, physical activity, work experience, workplace stress, sustained body position, awkward posture, and inadequate rest breaks. Logistic regression revealed that older age (OR = 1.039, p = 0.023), being female (OR = 2.175, p = 0.011), and not having adequate rest breaks (OR = 1.979, p = 0.019) were significant predictors for the occurrence of WMSDs. The risk factors of absenteeism include gender, age, marital status, educational level, physical activity, BMI, work experience, and musculoskeletal complaints.
CONCLUSION
Musculoskeletal problems were highly prevalent among administrative employees. Being female and not having adequate rest breaks were significant predictors for the occurrence of WMSDs. Ergonomic interventions and improvement of working conditions are recommended to reduce WMSDs.
PubMed: 38744733
DOI: 10.1186/s42506-024-00156-w -
RSC Advances May 2024Calcium homeostasis imbalance in the body can lead to a variety of chronic diseases. Supplement efficiency is essential. Peptide calcium chelate, a fourth-generation...
Calcium homeostasis imbalance in the body can lead to a variety of chronic diseases. Supplement efficiency is essential. Peptide calcium chelate, a fourth-generation calcium supplement, offers easy absorption and minimal side effects. Its effectiveness relies on peptide's calcium binding capacity. However, research on amino acid sequences in peptides with high calcium binding capacity (HCBC) is limited, affecting the efficient identification of such peptides. This study used soybean peptides (SP), separated and purified by gel chromatography, to obtain HCBC peptide (137.45 μg mg) and normal peptide (≤95.78 μg mg). Mass spectrometry identified the sequences of these peptides, and an analysis of the positional distribution of characteristic amino acids followed. Two HCBC peptides with sequences GGDLVS (271.55 μg mg) and YEGVIL (272.54 μg mg) were discovered. Molecular dynamics showed that when either aspartic acid is located near the N-terminal's middle, or glutamic acid is near the end, or in cases of continuous Asp or Glu, the binding speed, probability, and strength between the peptide and calcium ions are superior compared to those at other locations. The study's goal was to clarify how the positions of characteristic amino acids in peptides affect calcium binding, aiding in developing peptide calcium chelates as a novel calcium supplement.
PubMed: 38741956
DOI: 10.1039/d4ra02916j -
Anaesthesiology Intensive Therapy 2024Although nutritional treatment is an established pillar of multidisciplinary care provided in critical illness, there are many concerns regarding this issue in severe... (Observational Study)
Observational Study
INTRODUCTION
Although nutritional treatment is an established pillar of multidisciplinary care provided in critical illness, there are many concerns regarding this issue in severe COVID-19. This observational, retrospective, multicentre study aimed to analyse the approach to nutritional treatment among selected intensive care units (ICUs) in Poland.
MATERIAL AND METHODS
The medical records of 129 patients hospitalized in five units due to respiratory failure following COVID-19 were analysed in terms of nutritional management on the eighth day of the ICU stay. The Harris-Benedict equation (HB), Mifflin St. Jeor equation (MsJ) and ESPEN formula (20 kcal kg -1 body weight) were used to estimate the energy target for each patient, and two ESPEN formulas determined the protein target (1 g kg -1 body weight and 1.3 g kg -1 body weight).
RESULTS
Evaluation of nutritional therapy was performed in 129 subjects. The fulfilment of caloric requirement considering the HB, MsJ and ESPEN formula was 66%, 66.7% and 62.5%, respectively. Two clinical centres managed to provide 70% or more of daily caloric requirements. According to the ESPEN formula, the implementation of the protein target was 70%; however, one of the investigated units provided a median of 157% of the protein demand. The nutritional management varied in the preferred route of nutrition administration. Neither method nor grade of nutrition supply influenced biochemical parameters on the 8th day of ICU stay.
CONCLUSIONS
Significant differences in nutritional treatment of critically ill COVID-19 patients in Polish ICUs were noted, which underlines the importance of setting up clear guidelines regarding this issue.
Topics: Humans; Retrospective Studies; Critical Illness; COVID-19; Male; Middle Aged; Female; Aged; Intensive Care Units; Energy Intake; Nutritional Support; Poland; Nutritional Requirements; Critical Care
PubMed: 38741446
DOI: 10.5114/ait.2024.138559 -
Cureus Apr 2024ECG interpretation is sometimes difficult due to baseline fluctuations and electrode detachments when placed on the subjects' front side, leading to misinterpretation of...
BACKGROUND
ECG interpretation is sometimes difficult due to baseline fluctuations and electrode detachments when placed on the subjects' front side, leading to misinterpretation of the rhythms and phases of the cardiac cycle. We aimed to compare the differences in the wave amplitudes and respiratory variations between conventional ECG electrode positioning on the front side of patients and an alternative position on the backs of patients.
METHODS
Echocardiography was performed in 85 patients lying in the left lateral position. We attached the red electrode to the right clavicle, the yellow to the left clavicle, and the green to the left lateral abdomen on the front side of the patients; on the back, we attached the electrode to the right clavicle, the right upper posterior iliac spine, and the left upper posterior iliac spine.
RESULTS
The ECG monitor amplitudes were greater on the front side compared to the back side, but the BF-breath values were smaller on the back side (6.0 pixels) compared to the front side (10.5 pixels, p<0.05). The P wave amplitude divided by the BF-breath on the back side was greater than that seen on the front side (2.8 vs. 1.8, p<0.05), whereas the QRS amplitude divided by the BF-breath was 15.0 and 16.3, respectively (p=ns).
CONCLUSION
As an alternative to front-side ECG monitoring, electrodes placed on the back can help avoid misinterpretation of the ECG rhythms and the phases of the cardiac cycle due to respiration during echocardiography.
PubMed: 38738079
DOI: 10.7759/cureus.57967