Search Results (166)

Background and aims: Increases in both the prevalence and severity of metabolic dysfunction-associated steatotic liver disease (MASLD) and obesity are closely related. Type 2 diabetes (T2DM) has been associated with metabolic dysfunction-associated steatohepatitis (MASH)-related cirrhosis and hepatocellular carcinoma. Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist approved for the treatment of T2DM and has an important role in weight loss. Also, it may represent a new therapeutic option for the treatment of MASH in obese diabetic patients. The main outcomes were changes from baseline in liver steatosis and fibrosis at week 24. Material and methods: A total of one hundred eighty-seven patients with T2DM were eligible for this prospective study; ninety-five subjects were treated with oral semaglutide, and ninety-two patients were treated with dapagliflozin as an add-on to metformin. All the subjects were evaluated using Vibration Controlled Transient Elastography (VCTE) from June to December 2022. Results: From our cohort, 54% of the patients were females, with a mean age of 59.92 ± 11.89 years and a mean body mass index (BMI) of 29.53 ± 5.33 kg/m². Following a six-month medication period, we observed a substantial reduction in anthropometric measurements, including the BMI, waist circumference (WC), and waist-to-hip ratio (WtHr), in both groups. Regarding HbA1c, a notable decrease was observed in the semaglutide group (p < 0.001) when compared to the dapagliflozin group (p = 0.011). In addition, the liver stiffness measurement (LSM) according to VCTE improved significantly in the semaglutide group participants from 8.07 ± 2.90 kPa at baseline to 6.51 ± 3.09 kPa after medication (p < 0.001). Conclusion: The superior metabolic effects of semaglutide, correlated to dapagliflozin, may contribute to a more efficient decrease in hepatic stress and injury, leading to a substantial enhancement of liver function in T2DM patients. Further investigations conducted over an ideal timeframe are necessary to confirm the evidence presented in this study. Full article

Body dissatisfaction is commonly associated with rhythmic gymnastics (RG) practice, but limited research exists on the prevalence of this issue among recreational level practitioners. This study examines body image dissatisfaction among young girls practicing RG recreationally. A total of 88 girls between six and eleven years of age, who participate in RG as an extracurricular activity, were measured and completed the Stunkard pictogram. To create a control group, 88 girls who did not practice RG were also recruited and matched to the gymnasts by age. Results revealed that the mean body mass index values in both groups were within the normal weight range. The mean score for body dissatisfaction was similar between the two groups, with slightly positive values (RG = 0.94; CG = 1.06). The Mann–Whitney U test showed that there was no significant difference in the ratings of actual body size, ideal body size, and body dissatisfaction between the RG and control groups. These findings suggest that practicing RG at a young age is not associated with body dissatisfaction among girls. Full article

Background: The use of wetting solutions (WSs) during high-volume liposuction is standard; however, the optimal amount of WS and its components and their effect on postoperative complications are unclear. We evaluated the effect of a WS and its components, calculated according to ideal body weight (IBW), on postoperative complications. Methods: High-volume liposuction with a WS containing 0.5 g of lidocaine and 0.5 mg of epinephrine in each liter was performed in 192 patients. Patients who received ≤90 mL/kg of WS were designated as group I and those who received >90 mL/kg of WS as group II. Postoperative complications and adverse events that occurred until discharge were recorded. Results: The mean total amount of epinephrine in the WS was significantly higher for group II (3.5 mg; range, 3.0–4.0 mg) than for group I (2.0 mg; range, 1.8–2.5 mg; p < 0.001), as was the mean total amount of lidocaine (3.5 g [range, 3.5–4.3 g] vs. 2.0 g [range, 1.8–2.5 g], respectively; p < 0.001). No major cardiac or pulmonary complications occurred in either group. Administration of >90 mL/kg of WS increased the median risk of postoperative nausea 5.3-fold (range, 1.8- to 15.6-fold), that of hypertension 4.9-fold (range, 1.1- to 17.7-fold), and that of hypothermia 4.2-fold (range, 1.1- to 18.5-fold). The two groups had similar postoperative pain scores and blood transfusion rates. Conclusions: The risks of postoperative nausea, vomiting, hypothermia, and hypertension may increase in patients who receive >90 mL/kg of WS calculated according to IBW during high-volume liposuction. Full article

Broilers are particularly sensitive to heat stress, which can impair growth, and lower conversion efficiency and survival rates. Under a climate change scenario, maintaining optimal thermal conditions within broiler houses becomes more complex and energy-intensive. Climate change can worsen air quality issues inside broiler houses by increasing the concentration of harmful gases, and proper mechanical ventilation systems are essential for diluting and removing these gases. The present study aimed to develop and validate a model for the ideal broiler housing strategy by applying the Paraconsistent Annotated Evidential Logic Eτ. A database from four broiler houses in a commercial farm, rearing 157,700 birds from the 1st to the 42nd day of growth, was used in the research. All environmental data were recorded weekly inside the houses, and on day 42, flock mortality, overall feed-to-gain ratio, and body weight were calculated and registered. The Cohen’s Kappa statistics for each environmental parameter classification compared to the paraconsistent classification. Results indicated that temperature shows good agreement, relative humidity shows slight agreement, air velocity presents a good agreement, CO₂ concentration has a slight agreement, and NH₃ concentration is classified by slight agreement. The environmental and productivity variables as a function of the broiler age using the extreme True paraconsistent state indicate the model validation. The paraconsistent analysis presented the ideal scenario for broilers’ growth, maintaining the environmental variables level within a particular threshold and providing greater profit to broiler farmers. Full article

The highly virulent Toxoplasma gondii RH strain is maintained through successive passages in mice, but there is still a lack of studies that refine these procedures from a 3Rs perspective, where humanitarian ideals aim to minimize the stress, pain, or suffering of the animals used in the research without the loss of results. The aim of this study was to establish humane endpoints in Swiss Webster mice inoculated with the T. gondii RH strain. A total of 52 mice were infected with 5 × 10⁶ tachyzoites/mL and monitored for periods of up to 5 days. The parameters body weight; hair condition; higher than normal body temperature; hypothermia; respiratory function; pain; soft stools or diarrhea; bloody diarrhea; tense, nervous, or in distress during handling; and ascites were recorded daily in score tables. The results showed that prominent piloerection, respiratory function, pain parameters, and ascites are important clinical signs to be used as a cut-off point for implementing euthanasia. The application of this refinement method helped to avoid animal suffering and pain without compromising the number of parasites recovered. We therefore suggest adopting these parameters in research protocols that require the maintenance of the T. gondii RH strain in murine models to avoid and reduce animal suffering. Full article

Despite a better understanding of the mechanisms causing cancer cachexia (CC) and development of promising pharmacologic and supportive care interventions, CC persists as an underdiagnosed and undertreated condition. CC contributes to fatigue, poor quality of life, functional impairment, increases treatment related toxicity, and reduces survival. The core elements of CC such as weight loss and poor appetite should be identified early. Currently, addressing contributing conditions (hypothyroidism, hypogonadism, and adrenal insufficiency), managing nutrition impact symptoms leading to decreased oral intake (nausea, constipation, dysgeusia, stomatitis, mucositis, pain, fatigue, depressed mood, or anxiety), and the addition of pharmacologic agents when appropriate (progesterone analog, corticosteroids, and olanzapine) is recommended. In Japan, the clinical practice has changed based on the availability of Anamorelin, a ghrelin receptor agonist that improved lean body mass, weight, and appetite-related quality of life (QoL) compared to a placebo, in phase III trials. Other promising therapeutic agents currently in trials include Espindolol, a non-selective β blocker and a monoclonal antibody to GDF-15. In the future, a single therapeutic agent or perhaps multiple medications targeting the various mechanisms of CC may prove to be an effective strategy. Ideally, these medications should be incorporated into a multimodal interdisciplinary approach that includes exercise and nutrition. Full article

Background: Screening for hydroxychloroquine (HCQ) retinopathy is crucial to detecting early disease. A novel machine-learning-based optical coherence tomography (OCT) biomarker, Ellipsoid Zone (EZ) At-Risk, can quantitatively measure EZ alterations and at-risk areas for progressive EZ loss in a fully automated fashion. The purpose of this analysis was to compare the EZ At-Risk burden in eyes with HCQ toxicity to eyes without toxicity. Methods: IRB-approved image analysis study of 83 subjects on HCQ and 44 age-matched normal subjects. SD-OCT images were reviewed for evidence of HCQ retinopathy. A ML-based, fully automatic measurement of the percentage of the macular area with EZ At-Risk was performed. Results: The mean age for HCQ subjects was 67.1 ± 13.2 years and 64.2 ± 14.3 years for normal subjects. The mean EZ At-Risk macular burden in the “toxic” group (n = 38) was significantly higher (10.7%) compared to the “non-toxic” group (n = 45; 2.2%; p = 0.023) and the “normal” group (1.4%; p = 0.012). Additionally, the amount of EZ At-Risk burden was significantly correlated with the HCQ dose based on the actual (p = 0.016) and ideal body weight (p = 0.033). Conclusions: The novel biomarker EZ-At Risk was significantly higher in subjects with evidence of HCQ retinopathy as well as significantly associated with HCQ dose. This novel biomarker should be further evaluated as a potential screening tool for subjects on HCQ. Full article

Background: Patients with cirrhosis often develop hyperdynamic circulation with increased cardiac output, heart rate, and redistribution of the circulating volume with expanded plasma volume (PV). PV determination is part of the evaluation of patients with cirrhosis, but gold-standard methods are invasive, expensive, and time-consuming. Therefore, other estimations of PV would be preferable, and the aim of this study was therefore to study if PV, as assessed by a simplified algorithm based on hematocrit and weight, can replace the gold-standard method. Methods: We included 328 patients with cirrhosis who had their PV assessed by the indicator dilution technique as the gold-standard method (PV_I-125). Actual PV was estimated as PV_a = (1 − hematocrit)·(a + (b·body weight)). Ideal PV was estimated as PV_i = c · body weight, where a, b, and c are constants. Results: PV_I-125, PV_a, and PV_i were 3.99 ± 1.01, 3.09 ± 0.54, and 3.01 ± 0.65 (Mean ± SD), respectively. Although PV_I-125 correlated significantly with PV_a (r = 0.72, p < 0.001), a Bland–Altman plot revealed wide limits of confidence. Conclusions: The use of simplified algorithms does not sufficiently estimate PV and cannot replace the indicator dilution technique. Full article

The purpose of this study was to assess the impact of various concentrations of Bacillus licheniformis-fermented products (BLFP) on the growth and productivity of laying ducks (Anas platyrhynchos) subjected to heat stress during eight weeks of a feeding trial. A total of 150 one-day-old Brown Tsaiya ducks of both sexes were divided into five groups, with each group having three replicates and 10 ducks each for evaluation of growth performance. The treatment groups received dietary supplements of BLFP at levels of 0.1%, 0.2%, and 0.3%, along with a group receiving flavomycin (F) at 5 ppm, all over a 24-week period. The fermentation process in this study utilized a B. licheniformis strain (ATCC 12713) for the production of the spores through solid-state fermentation. The control group was given a basal diet consisting of yellow corn and soybean meal. The results showed that as compared to the flavomycin group, ducks in the 0.3% BLFP group had significantly higher body weights and better feed conversion rates. In addition, during the three weeks, the BLFP group showed higher feed consumption as compared to the control group. The jejunum villi length was significantly increased in the 0.2% BLPF group as compared to the control and flavomycin groups. This study also found that the flavomycin group had a significantly higher egg conversion rate, while the 0.1–0.3% BLFP groups had improved feed intake and the 0.3% group had significantly enhanced egg yolk color. Additionally, the 0.2% BLFP group showed substantial decreases in IL-1$\mathsf{\beta }$, TNF-$\mathsf{\alpha }$, IL-6, and IL-10 levels in the liver as well as an uptick in the tight junction protein Occludin gene expression in the colon when compared to the control group. Furthermore, the expression of the heat shock protein 70 in the gut upregulated in the 0.1% and 0.2% BLFP groups. In conclusion, these observations demonstrate that dietary supplementation of 0.2% BLFP is an ideal concentration to increase gut morphology, alleviate inflammatory response, and promote gut integrity in heat-stressed laying ducks. Full article

The aim of this narrative review is to create a comprehensive, innovative, and pragmatic resource to guide elite fencers and coaches in making strategic nutritional choices to enhance performance and facilitate recovery. The literature review identified only 12 articles specifically addressing the topic of nutrition for fencers. Thus, the recommendations provided in this review derive also from articles dealing with similar sports, such as martial arts, and from investigations with European elite fencers and their coaches. For elite fencers, it is suggested to consume daily 7–11 g/kg of body weight (BW) of carbohydrates and 1.5–2 g/kg of BW of proteins and allocate 25% to 30% of the total energy intake to essential fats, with a specific focus on omega-3 fatty acids. The timing of meals, ideally within one hour after exertion, plays a pivotal role in restoring glycogen reserves and preventing injuries. The intake of leucine, creatine, omega-3, collagen, and vitamins C and D is proposed as a strategy for injury recovery. It is worth acknowledging that even when personalized plans are provided, implementation can be challenging, especially during competitions and training camps. Full article

Breast reconstruction is an integral part of breast cancer treatment and offers significant psychosocial benefits for patients undergoing mastectomy as a part of their treatment plan. Autologous breast reconstruction (ABR) utilizes a patient’s own tissue to reconstruct the mastectomy defect, obviating the need for the implantation of a foreign object. As the field of plastic surgery progresses, ABR has become an excellent option for the recreation of a native breast mount. With that said, there are patient populations who present unique challenges when optimizing an aesthetic ABR result. We aim to discuss these challenging groups, including patients with both high and low body mass index (BMI), patients with a history of massive weight loss, patients who require post-mastectomy radiation therapy (PMRT), and patients electing for unilateral procedures where the surgeon attempts to match the reconstructed breast with the native breast. In our discussion, we review the literature recommendations for management as well as our experiences with our own patient cases. Ultimately, we believe this procedure can be performed in a wide variety of patient types and can be offered to those who may not be considered the “ideal” candidate. Full article

Fitness influencers are an emerging profession in recent years. At present, the main research on fitness influencers focuses on their personal traits, professional knowledge and skills, and course content, while there is still a large research gap on the social media marketing strategies of fitness influencers, how they interact with fans, and the reasons for their influence on fans. There is a lack of a comprehensive evaluation framework for fitness influencer research, and there is no clear research on what competencies are required to become a qualified fitness influencer. Therefore, it has become an important issue to establish a comprehensive fitness influencer competency evaluation. In this study, a hybrid model of fitness influencer competency evaluation framework was developed based on government competency standards and expert knowledge using the Multiple Criteria Decision-Making (MCDM) model perspective. This evaluation should expand to include the principles of sustainable development, emphasizing the influencers’ role in advocating for environmental responsibility, social equity, and economic viability within the fitness industry. First, the study developed 21 criteria in six dimensions of fitness influencer competencies through a literature survey and interviews with several experts. The 21 criteria resonate with many of the Sustainable Development Goals (SDGs), including SDG 3 (Good Health and Well-being), SDG 4 (Quality Education), SDG 5 (Gender Equality), SDG 10 (Reduced Inequalities), and SDG 11 (Sustainable Cities and Communities). The Bayesian Best-Worst Method (Bayesian BWM) was used to generate the best group weights for fitness influencer competencies. Then, a modified Technique for Order Preference by Similarity to the Ideal Solution Based on Aspiration Level (modified TOPSIS-AL) was applied to evaluate the performance ranking of major fitness influencers in Taiwan by integrating the concept of the aspiration level. The results of the study revealed that behavioral standards were the most important dimension, emphasizing the need for fitness influencers to establish a comprehensive set of norms for their own behavioral standards. The top five criteria for fitness influencers’ competencies were self-review, punctuality and prudence, creativity, rapport and motivation, and the need to conform to one’s body image. The performance ranking was used to compare the evaluated subjects to the desired level to obtain a basis for improvement. This study effectively identifies key fitness industry competency indicators and refines business performance through the management implications proposed in this study to facilitate the development of the fitness industry. Full article

Dancers are considered aesthetic athletes due to the great emphasis directed towards maintaining svelte figures with the aim of enhancing the aesthetic of performance. Ballerinas are consistently found 10–12% below their ideal body weight and are susceptible to the female athlete triad. Still, while the dietary intake of several sports populations has been extensively studied worldwide, in the dance arts data are limited. The aim of this study was to assess the dietary intake of adult female dancers on a small Mediterranean island. All dance schools in Gozo (n = 7) were invited to participate via email. A 4 day food and beverage diary recorded between Thursday and Sunday was used to assess the dietary intake of eligible students and teachers of dance schools. A self-reported questionnaire was used to assess demographic data and exercise energy expenditure, adapted from the ‘International Physical Activity Questionnaire’. Participants’ energy and macronutrient intakes were compared to the recommended dietary allowances (RDA) using the one sample t-test. The paired samples t-test was used to determine any significant differences in dietary intake between weekdays and the weekend. Of a potential 25 eligible participants, 14 engaged in the study yielding a 56% response rate. The majority of participants were recreational dancers (n = 11). The mean energy intake was 1306 kcal/day with 34.7% derived from fat. The mean carbohydrate and protein intakes were 2.4 g/kg bodyweight and 1.1 g/kg bodyweight, respectively. The mean total energy expenditure was 2034 kcal/day. The daily mean energy, carbohydrate and protein intakes were lower than the RDA, while mean fat intake was higher. There was no evidence of a significant difference in dietary intake between weekdays and the weekend (p = 0.309 carbohydrates, p = 0.596 fat, p = 0.956 protein). Professional dancers failed to meet energy, carbohydrates and protein recommendations for athletic populations, whereas, recreational dancers were likely to consume sufficient energy, carbohydrate and protein intakes. Dietary fat recommendations were met by half of the participants and exceeded by the rest. This study was the first to assess the dietary intake of a dance population in the Maltese Islands. Further research in a larger cohort of local dancers is merited. Full article

In recent years, physical activity levels among youths have declined significantly. This has led to a decline in adherence to physical activity recommendations. In this sense, physical education offers an ideal environment that contributes positively to improving adherence to physical activity recommendations, as it teaches students movement-related skills and knowledge. The objective of the present research was to investigate the relationship between physical activity levels, body composition, fitness in Physical Education, and body dissatisfaction levels, and to analyse sex differences in relation to the study variables. The sample was formed of 1166 participants from the 1st and 2nd secondary compulsory education, of which 642 were boys (age 13.16 ± 0.91), and 524 girls (age 13.08 ± 0.85). The measure of physical activity was the Physical Activity Questionnaire for Adolescents (PAQ-A). Body composition was assessed using weight and height to calculate their body mass index. Cardiorespiratory capacity was assessed using the Course-Navette test in Physical Education lessons. The results showed the relationship between physical activity and body mass index, cardiorespiratory capacity, and body satisfaction. It was also confirmed that higher levels of physical activity were associated with a lower body mass index, improvements in cardiorespiratory fitness, and lower levels of body dissatisfaction to a greater extent in boys than in girls. The study concludes that improvements in the study variables were associated with increased physical activity. In addition, it seems necessary to promote healthy lifestyles in physical education lessons, especially during adolescence, as they could serve as a gateway for the improvement of health-related fitness in future generations. Increasing the amount of physical activity among young people is vital. Therefore, it would be essential to develop intervention programs in physical education classes, especially during adolescence, aimed at promoting and increasing physical activity and its benefits. Full article

There are no ideal non-invasive tests for assessing the severity of liver fibrosis in people with metabolic dysfunction-associated steatotic liver disease (MASLD) and class 3 obesity, where body habitus often makes imaging technically challenging. This study aimed to assess the applicability and diagnostic performance of two-dimensional shear wave elastography (2D-SWE), alongside several serum-based liver fibrosis scoring methods, in individuals with class 3 obesity. A cross-sectional study was conducted in patients aged ≥18 years and with a body mass index (BMI) ≥ 40 kg/m² who were participants in a publicly funded multidisciplinary weight management program in South Western Sydney. The 2D-SWE was performed using the ElastQ Imaging (EQI) procedure with the Phillips EPIQ Elite series ultrasound. An EQI Median value of ≥6.43 kPa was taken as a cutoff score for significant fibrosis, and the scan was considered valid when the liver EQI IQR/Med value was <30%. The Fibrosis-4 (FIB-4) index, AST-to-platelet ratio index (APRI), NAFLD fibrosis score (NFS), and circulating fibroblast activation protein index (FAP index) were calculated from fasting blood samples. The participants (n = 116; 67.2% female) were aged 47.2 ± 12.9 years, with BMI 54.5 ± 11.0 kg/m². EQI Median values were obtained for 97.4% (113/116) of the 2D-SWE scans, and 91.4% (106/116) of the scans were considered valid. The EQI Median values exhibited a moderately positive correlation with the FIB-4 index (r = 0.438; p < 0.001) and a weakly positive correlation with the APRI (r = 0.388; p < 0.001), NFS (r = 0.210; p = 0.036) and FAP index (r = 0.226; p = 0.020). All liver fibrosis scores were positively correlated with one another. Among those referred for a liver biopsy based on the 2D-SWE and serum scores, half (11/22) underwent liver biopsy, and their 2D-SWE scores exhibited 72.7% accuracy (sensitivity: 71.4%; specificity: 75%) in detecting significant fibrosis. Our results show that 2D-SWE is a feasible, non-invasive test to assess liver fibrosis among people with class 3 obesity. Further research is needed to assess how 2D-SWE can be used alongside existing serum-based risk scores to reliably detect significant fibrosis, which would potentially reduce the need for invasive liver biopsy. Full article