Twenty-four-hour physical activity patterns associated with depressive symptoms: a cross-sectional study using big data-machine learning approach.

BACKGROUND: Depression is a global burden with profound personal and economic consequences. Previous studies have reported that the amount of physical activity is associated with depression. However, the relationship between the temporal patterns of physical activity and depressive symptoms is poorly understood. In this exploratory study, we hypothesize that a particular temporal pattern of daily physical activity could be associated with depressive symptoms and might be a better marker than the total amount of physical activity. METHODS: To address the hypothesis, we investigated the association between depressive symptoms and daily dominant activity behaviors based on 24-h temporal patterns of physical activity. We conducted a cross-sectional study on NHANES 2011-2012 data collected from the noninstitutionalized civilian resident population of the United States. The number of participants that had the whole set of physical activity data collected by the accelerometer is 6613. Among 6613 participants, 4242 participants had complete demography and Patient Health Questionnaire-9 (PHQ-9) questionnaire, a tool to quantify depressive symptoms. The association between activity-count behaviors and depressive symptoms was analyzed using multivariable logistic regression to adjust for confounding factors in sequential models. RESULTS: We identified four physical activity-count behaviors based on five physical activity-counting patterns classified by unsupervised machine learning. Regarding PHQ-9 scores, we found that evening dominant behavior was positively associated with depressive symptoms compared to morning dominant behavior as the control group. CONCLUSIONS: Our results might contribute to monitoring and identifying individuals with latent depressive symptoms, emphasizing the importance of nuanced activity patterns and their probability of assessing depressive symptoms effectively.

Association of physiological factors with grip and leg extension strength: tohoku medical megabank community-based cohort study.

BACKGROUND: Upper and lower extremity muscle strength can be used to predict health outcomes. However, the difference between the relation of upper extremity muscle and of lower extremity muscle with physiological factors is unclear. This study aimed to evaluate the association between physiological data and muscle strength, measured using grip and leg extension strength, among Japanese adults. METHODS: We conducted a cross-sectional study of 2,861 men and 6,717 women aged ≥ 20 years living in Miyagi Prefecture, Japan. Grip strength was measured using a dynamometer. Leg extension strength was measured using a hydraulic isokinetic leg press machine. Anthropometry and physiological data, including blood pressure, calcaneal ultrasound bone status, pulmonary function, carotid echography, and blood information, were assessed. We used a general linear model adjusted for age, body composition, and smoking status to evaluate the association between muscle strength and physiological factors. RESULTS: Grip and leg extension strength were positively associated with bone area ratio, vital capacity, forced vital capacity, forced expiratory volume in one second, and estimated glomerular filtration rate, and negatively associated with waist circumference and percentage body fat mass in both the sexes. Diastolic blood pressure was positively associated with grip strength in both the sexes and leg extension strength in men, but not women. High-density lipoprotein cholesterol and red blood cell counts were positively associated with grip and leg extension strength in women, but not men. In both the sexes, pulse rate, total cholesterol, and uric acid were consistently associated with only leg extension strength, but not grip strength. In women, glycated hemoglobin demonstrated negative and positive associations with grip and leg extension strength, respectively. CONCLUSIONS: Grip and leg extension strength demonstrated similar associations with anthropometry, pulmonary function, and estimated glomerular filtration rate, but the associations with the other factors were not always consistent.

Dietary patterns associated with the incidence of hypertension among adult Japanese males: application of machine learning to a cohort study.

PURPOSE: The previous studies that examined the effectiveness of unsupervised machine learning methods versus traditional methods in assessing dietary patterns and their association with incident hypertension showed contradictory results. Consequently, our aim is to explore the correlation between the incidence of hypertension and overall dietary patterns that were extracted using unsupervised machine learning techniques. METHODS: Data were obtained from Japanese male participants enrolled in a prospective cohort study between August 2008 and August 2010. A final dataset of 447 male participants was used for analysis. Dimension reduction using uniform manifold approximation and projection (UMAP) and subsequent K-means clustering was used to derive dietary patterns. In addition, multivariable logistic regression was used to evaluate the association between dietary patterns and the incidence of hypertension. RESULTS: We identified four dietary patterns: 'Low-protein/fiber High-sugar,' 'Dairy/vegetable-based,' 'Meat-based,' and 'Seafood and Alcohol.' Compared with 'Seafood and Alcohol' as a reference, the protective dietary patterns for hypertension were 'Dairy/vegetable-based' (OR 0.39, 95% CI 0.19-0.80, P = 0.013) and the 'Meat-based' (OR 0.37, 95% CI 0.16-0.86, P = 0.022) after adjusting for potential confounding factors, including age, body mass index, smoking, education, physical activity, dyslipidemia, and diabetes. An age-matched sensitivity analysis confirmed this finding. CONCLUSION: This study finds that relative to the 'Seafood and Alcohol' pattern, the 'Dairy/vegetable-based' and 'Meat-based' dietary patterns are associated with a lower risk of hypertension among men.

Improving child nutrition in disasters by developing a modeled disaster preparedness nutrition education curriculum.

In contemporary global society, largely because of climate change and other natural and human-induced hazards, disasters are an almost daily occurrence. The nutritional impact of disasters on children results in long-term physical and mental health problems. As children are one of the most vulnerable demographic groups, they must be empowered with disaster preparedness nutrition knowledge, and the skills and motivation to survive, prevent/reduce malnutrition, and maintain good health during disasters. A disaster preparedness nutrition education program (DPNEP) was developed in this study to improve children's nutrition in daily life and during disasters through student-centered education. A consultative approach was used to synthesize the knowledge of a diverse group of four experts in disaster medicine and management, public health, education, and food and nutrition sciences to reach a consensus through discussion. A model DPNEP was developed by targeting grade 4 and 5 students and using interactive teaching methods. This can lead to the implementation of continuous nutrition education to empower children to make healthy food choices in daily life and reduce the risk of disaster-nutrition-related morbidity and mortality. Furthermore, once children acquire the necessary information, they are likely to share this knowledge with their families and communities, thereby enhancing society's resilience.

The aminopeptidase LAP3 suppression accelerates myogenic differentiation via the AKT-TFE3 pathway in C2C12 myoblasts.

Skeletal muscle maintenance depends largely on muscle stem cells (satellite cells) that supply myoblasts required for muscle regeneration and growth. The ubiquitin-proteasome system is the major intracellular protein degradation pathway. We previously reported that proteasome dysfunction in skeletal muscle significantly impairs muscle growth and development. Furthermore, the inhibition of aminopeptidase, a proteolytic enzyme that removes amino acids from the termini of peptides derived from proteasomal proteolysis, impairs the proliferation and differentiation ability of C2C12 myoblasts. However, no evidence has been reported on the role of aminopeptidases with different substrate specificities on myogenesis. In this study, therefore, we investigated whether the knockdown of aminopeptidases in differentiating C2C12 myoblasts affects myogenesis. The knockdown of the X-prolyl aminopeptidase 1, aspartyl aminopeptidase, leucyl-cystinyl aminopeptidase, methionyl aminopeptidase 1, methionyl aminopeptidase 2, puromycine-sensitive aminopeptidase, and arginyl aminopeptidase like 1 gene in C2C12 myoblasts resulted in defective myogenic differentiation. Surprisingly, the knockdown of leucine aminopeptidase 3 (LAP3) in C2C12 myoblasts promoted myogenic differentiation. We also found that suppression of LAP3 expression in C2C12 myoblasts resulted in the inhibition of proteasomal proteolysis, decreased intracellular branched-chain amino acid levels, and enhanced mTORC2-mediated AKT phosphorylation (S473). Furthermore, phosphorylated AKT induced the translocation of TFE3 from the nucleus to the cytoplasm, promoting myogenic differentiation through increased expression of myogenin. Overall, our study highlights the association of aminopeptidases with myogenic differentiation.

Effectiveness of nutrition education in enhancing knowledge and attitude of pupils on choice of school mid-day meal in Ibadan, Nigeria.

Children's food choices affect their nutritional health, development, and well-being. In Nigeria, school lunch is generally unregulated; the food menu is usually at the discretion of individual vendors forcing pupils to make unsupervised food choices. This study examined the effectiveness of 6-week nutrition education in enhancing pupils' knowledge and attitude on the school mid-day meal choices in Ibadan, Nigeria. A pre-test/post-test, quasi-experimental study was conducted with 100 pupils in 4th and 5th grades in public primary schools. Multistage sampling was used to select the participants. A nutrition education module and a questionnaire were used to collect the data. Frequency counts and t-test were used for statistical analysis. Findings revealed the following dietary pattern: 44 of the pupils preferred junk food (mean 41.5, SD = 12.9), 37 were inclined toward protein-rich food (mean 37.7, SD = 12.5), 32 favored food items dense in carbohydrates (mean 34.4, SD = 9.5), and 11 showed a preference toward food with high vitamins and minerals (mean 28.4, SD = 7.5). Nutrition knowledge (t = 6.4, df = 99, p < .05); (pre-test: X¯ = 20.9 and SD = 1.0; post-test: X¯ = 22.8, SD = 2.8) and attitude toward choice of meal showed statistically significant differences (t = 4.9, df = 99, p < .05; pre-test: X¯ = 13.5 and SD = 6.8; post-test: X¯ = 18.2, SD = 7.2). We recommend that the Ministry of Education should prepare a standard lunch menu for all schools and the school authorities should enforce it through the schools' food vendors.

Lactate promotes neuronal differentiation of SH-SY5Y cells by lactate-responsive gene sets through NDRG3-dependent and -independent manners.

Lactate serves as the major glucose alternative to an energy substrate in the brain. Lactate level is increased in the fetal brain from the middle stage of gestation, indicating the involvement of lactate in brain development and neuronal differentiation. Recent reports show that lactate functions as a signaling molecule to regulate gene expression and protein stability. However, the roles of lactate signaling in neuronal cells remain unknown. Here, we showed that lactate promotes the all stages of neuronal differentiation of SH-SY5Y and Neuro2A, human and mouse neuroblastoma cell lines, characterized by increased neuronal marker expression and the rates of neurites extension. Transcriptomics revealed many lactate-responsive genes sets such as SPARCL1 in SH-SY5Y, Neuro2A, and primary embryonic mouse neuronal cells. The effects of lactate on neuronal function were mainly mediated through monocarboxylate transporters 1 (MCT1). We found that NDRG family member 3 (NDRG3), a lactate-binding protein, was highly expressed and stabilized by lactate treatment during neuronal differentiation. Combinative RNA-seq of SH-SY5Y with lactate treatment and NDRG3 knockdown shows that the promotive effects of lactate on neural differentiation are regulated through NDRG3-dependent and independent manners. Moreover, we identified TEA domain family member 1 (TEAD1) and ETS-related transcription factor 4 (ELF4) are the specific transcription factors that are regulated by both lactate and NDRG3 in neuronal differentiation. TEAD1 and ELF4 differently affect the expression of neuronal marker genes in SH-SY5Y cells. These results highlight the biological roles of extracellular and intracellular lactate as a critical signaling molecule that modifies neuronal differentiation.

Effects of CX3CR1 and CXCR2 antagonists on running-dependent intramuscular neutrophil recruitments and myokine upregulation.

Muscle contractile activity stimulates intramuscular recruitment of immune cells including neutrophils emerging to serve as a prerequisite for exerting proper muscular performance, although the underlying mechanisms and their contributions to myokine upregulation remain ill-defined. We previously reported that pharmacological inhibition of CX3CR1, a fractalkine receptor, dampens gnawing-dependent neutrophil recruitment into masseter muscles along with compromising their masticatory activity. By using a running exercise model, we herein demonstrated that hindlimb muscles require collaborative actions of both CX3CR1- and CXCR2-mediated signals for achieving neutrophil recruitment, upregulation of myokines including interleukin (IL)-6, enhanced GLUT4 translocation, and adequate endurance capability. Mechanistically, we revealed that a combination of CX3CR1 and CXCR2 antagonists, i.e., AZD8797 and SB2205002, inhibits exercise-inducible ICAM-1 and fractalkine upregulations in the area of the endothelium and muscle-derived CXCL1 upregulation, both of which apparently contribute to the intramuscular neutrophil accumulation in working muscles. Intriguingly, we also observed that 2 h of running results in intramuscular augmentation of innate lymphoid type 2 cells (ILC2s) markers, i.e., Bcl11b mRNA levels and anti-GATA-3-antibody-positive signals, and that these effects are completely abolished by administration of the combination of CX3CR1 and CXCR2 antagonists. Taken together, our findings strongly suggest that the exercise-evoked regional interplay among working myofibers, the adjacent endothelium, and recruited immune cells including neutrophils and possibly ILC2s, mediated through these local factors, plays a key role in the organization of the intramuscular microenvironment supporting the performance of hindlimb muscles during running.NEW & NOTEWORTHY This study provides compelling evidence that running-dependent intramuscular neutrophil recruitment requires both CX3CR1- and CXCR2-mediated signals that prime not only myofiber-derived myokine upregulations but also endothelium ICAM-1 and fractalkine expressions. The results revealed the importance of the exercise-evoked regional interplay among working myofibers, the adjacent endothelium, and recruited immune cells, including neutrophils and possibly ILC2s, which plays a key role in the organization of the intramuscular microenvironment supporting the performance of hindlimb muscles during running.

Little involvement of recycled-amino acids from proteasomal proteolysis in de novo protein synthesis.

Myoblast integrity is essential for skeletal muscle regeneration. Many intracellular proteins are degraded by the proteasome and converted to amino acids by aminopeptidases through the protein degradation pathway. Although we previously reported its importance for myoblast integrity, the involved mechanism remains unclear. In this study, we focused on the reusability of proteolytic products to elucidate the regulatory mechanism of protein synthesis mediated by the proteasome and aminopeptidases. Proteasome inhibition decreased protein synthesis, but recycled-amino acids derived from proteasomal proteolysis were not reused for de novo protein synthesis in C2C12 myoblasts. On the other hand, proteasome and aminopeptidase inhibition decreased intracellular ATP levels in C2C12 myoblasts. Therefore, it was indicated that amino acids produced by these proteolytic systems may be reutilized for ATP production through its metabolism, not for de novo protein synthesis. These findings suggested the proteasome and aminopeptidases are thought to be involved in protein synthesis through intracellular energy production by recycled-amino acid metabolism, thereby maintaining myoblast integrity.

Kakkonto Inhibits Cytokine Production Induced by Rhinovirus Infection in Primary Cultures of Human Nasal Epithelial Cells.

Rhinovirus (RV) is a primary etiologic agent of common cold that can subsequently acutely exacerbate bronchial asthma or chronic obstructive pulmonary disease. Kakkonto (Ge-gen-tang in Chinese), one of the most frequently prescribed traditional Japanese (Kampo) medicines, is used for treating common cold, shoulder stiffness, or inflammatory diseases of the upper body. Previous experimental studies have indicated that kakkonto exerts antiviral and anti-inflammatory effects on the influenza virus and the human respiratory syncytial virus. However, there is a lack of reports investigating the efficacy of kakkonto in RV infection. Hence, the aim of the current study was to investigate the effects of kakkonto on RV infection of human nasal epithelial (HNE) cells. HNE cells obtained via endoscopic sinus surgery were cultured and infected with RV14, with or without kakkonto treatment. The supernatants from the cells were collected, and the RV14 titer and cytokine levels were assessed. Reverse transcription-polymerase chain reaction was performed to determine the amount of viral RNA, while the level of nuclear factor kappa B (NF-κB) subunits in the nucleus was assessed by enzyme-linked immunosorbent assay. Although kakkonto treatment did not reduce RV14 titer or RNA levels, indicating that it did not inhibit RV14 proliferation, it was found to reduce the production of specific pro-inflammatory cytokines, including interleukin (IL)-8, tumor necrosis factor (TNF)-α, and monocyte chemotactic protein-1 (MCP-1). Unlike that observed with the kakkonto extract, none of the crude drugs contained in kakkonto reduced IL-8 level. Furthermore, though kakkonto treatment significantly reduced p50 levels, it did not impact the p65 subunit of NF-κB. These results indicated that kakkonto can inhibit inflammation caused by RV infection and may exert an immunomodulatory effect on HNE cells. This is the first report to elucidate the effects of kakkonto extract on RV infection in primary cultures of HNE cells, providing evidence that kakkonto may act as an effective therapy for RV infection and subsequent airway inflammation.

Puromycin-sensitive aminopeptidase is required for C2C12 myoblast proliferation and differentiation.

The ubiquitin-proteasome system is a major protein degradation pathway in the cell. Proteasomes produce several peptides that are rapidly degraded to free amino acids by intracellular aminopeptidases. Our previous studies reported that proteolysis via proteasomes and aminopeptidases is required for myoblast proliferation and differentiation. However, the role of intracellular aminopeptidases in myoblast proliferation and differentiation had not been clarified. In this study, we investigated the effects of puromycin-sensitive aminopeptidase (PSA) on C2C12 myoblast proliferation and differentiation by knocking down PSA. Aminopeptidase enzymatic activity was reduced in PSA-knockdown myoblasts. Knockdown of PSA induced impaired cell cycle progression in C2C12 myoblasts and accumulation of cells at the G2/M phase. Additionally, after the induction of myogenic differentiation in PSA-knockdown myoblasts, multinucleated circular-shaped myotubes with impaired cell polarity were frequently identified. Cell division cycle 42 (CDC42) knockdown in myoblasts resulted in a loss of cell polarity and the formation of multinucleated circular-shaped myotubes, which were similar to PSA-knockdown myoblasts. These data suggest that PSA is required for the proliferation of myoblasts in the growth phase and for the determination of cell polarity and elongation of myotubes in the differentiation phase.

Protease Inhibitors: Candidate Drugs to Inhibit Severe Acute Respiratory Syndrome Coronavirus 2 Replication.

The number of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly increased, although the WHO declared a pandemic. However, drugs that function against SARS-CoV-2 have not been established. SARS-CoV-2 has been suggested to bind angiotensin-converting enzyme 2, the receptor of the SARS coronavirus. SARS coronavirus and coronavirus 229E, the cause of the common cold, replicate through cell-surface and endosomal pathways using a protease, the type II transmembrane protease. To examine the effects of protease inhibitors on the replication of coronavirus 229E, we pretreated primary cultures of human nasal epithelial (HNE) cells with camostat or nafamostat, each of which has been used for the treatment of pancreatitis and/or disseminated intravascular coagulation. HNE cells were then infected with coronavirus 229E, and viral titers in the airway surface liquid of the cells were examined. Pretreatment with camostat (0.1-10 µg/mL) or nafamostat (0.01-1 µg/mL) reduced the titers of coronavirus 229E. Furthermore, a significant amount of type II transmembrane protease protein was detected in the airway surface liquid of HNE cells. Additionally, interferons have been reported to have antiviral effects against SARS coronavirus. The additive effects of interferons on the inhibitory effects of other candidate drugs to treat SARS-CoV-2 infection, such as lopinavir, ritonavir and favipiravir, have also been studied. These findings suggest that protease inhibitors of this type may inhibit coronavirus 229E replication in human airway epithelial cells at clinical concentrations. Protease inhibitors, interferons or the combination of these drugs may become candidate drugs to inhibit the replication of SARS-CoV-2.

The impact of intracellular aminopeptidase on C2C12 myoblast proliferation and differentiation.

The ubiquitin-proteasome pathway is essential for skeletal muscle growth and development. Proteasomes generate oligopeptides in the cytoplasm, and these peptides are considered to be rapidly degraded to amino acids by several intracellular aminopeptidases. However, the role of intracellular aminopeptidases in muscle growth remains unknown. In this study, therefore, we investigated the role of intracellular aminopeptidases in C2C12 myoblast proliferation and differentiation. Inhibition of intracellular aminopeptidases by Bestatin methyl ester (Bes-ME) decreased leucine and alanine aminopeptidase activity, and impaired proliferation and differentiation of C2C12 myoblasts. Furthermore, we observed that the inhibition of intracellular aminopeptidases reduced intracellular levels of amino acid and ATP level, and suppressed the phosphorylation of the mTOR pathway. These results suggested that intracellular aminopeptidases affect C2C12 myoblast proliferation and differentiation via mTOR pathway; however, further studies are required to clarify the role of aminopeptidase in skeletal muscle.

Clarithromycin decreases rhinovirus replication and cytokine production in nasal epithelial cells from subjects with bronchial asthma: effects on IL-6, IL-8 and IL-33.

Rhinoviral infection is associated with an increased risk of asthma attacks. The macrolide clarithromycin decreases cytokine production in nasopharyngeal aspirates from patients with wheezing, but the effects of macrolides on cytokine production in nasal epithelial cells obtained from asthmatic subjects remain unclear. Here, human nasal epithelial cells were infected with type-14 rhinovirus (RV14), a major RV group. Titers and RNA of RV14 and cytokine concentrations, including IL-1ß and IL-6, were higher in the supernatants of the cells obtained from subjects with bronchial asthma (asthmatic group) than in those from the non-asthmatic group. Pretreatment with clarithromycin decreased RV14 titers, viral RNA and cytokine concentrations, and susceptibility to RV14 infection. Pretreatment with clarithromycin also decreased IL-33 production, which was detected after infection. Pretreatment with clarithromycin decreased the expression of intercellular adhesion molecule-1, the receptor for RV14, after infection, the number and fluorescence intensity of the acidic endosomes through which RV RNA enters the cytoplasm, and the activation of nuclear factor kappa-B proteins in nuclear extracts. These findings suggested that RV replication and cytokine production may be enhanced in nasal epithelial cells obtained from subjects with bronchial asthma and may be modulated by clarithromycin.

Parents' Own Experience of Verbal Abuse Is Associated with their Acceptance of Abuse towards Children from Youth Sports Coaches.

Verbal or physical abuse from coaches has negative effects on young athletes, and the parents of athletes also have an influence on the sports environment. It is therefore important to understand parents' attitudes towards abuse against their children from the coaches. This study aimed to elucidate the characteristics of parents who accept the infliction of verbal or physical abuse on their children from coaches of youth sports teams. A cross-sectional study using self-report questionnaires was conducted with parents of young athletes (n = 6,493). Multivariate logistic regression models were used to assess the factors associated with parents' acceptability of verbal or physical abuse against their children. The proportion of parents who were accepting of verbal or physical abuse was 21.5%. Acceptability of verbal or physical abuse was significantly associated with male (odds ratio: 1.67, 95% confidence interval: 1.43-1.95), younger age (1.24, 1.09-1.41), lower educational attainment (1.32, 1.17-1.50), smoking habits (1.42, 1.23-1.63), experience of playing on a team with high levels of competition during their junior or high school days (1.31, 1.15-1.50), and experience of verbal and physical abuse by their own former coaches (3.59, 3.03-4.26 and 1.17, 1.02-1.35). About 58% and 28% of parents had experienced verbal and physical abuse from their own former coaches, and parents who had experienced verbal abuse themselves were most likely to be accepting of verbal or physical abuse towards their children. Educating parents is considered to be important for preventing and eradicating abuse against young athletes.

The characteristics of coaches that verbally and physically abuse young baseball players using a self-reported questionnaire.

BACKGROUND: Because the relationship between coaches and athletes is unequal, verbal and physical abuse remains a common problem among sports coaches. We aimed to elucidate the characteristics of baseball coaches who verbally/physically abuse young baseball players. METHODS: A cross-sectional study was conducted on youth sports team coaches in Miyagi prefecture, Japan (n = 380), using a self-reported questionnaire. Multivariate logistic regression models were used for the analyses, evaluating the following variables: sex, age, educational level, smoking habits, years of coaching, level of baseball-playing experience, personal experience with verbal/physical abuse by former coaches, satisfaction with athletes' attitudes, number of athletes on the team, team competition level, awareness of the recommendations of the Japanese Society of Clinical Sports Medicine, limitations in the total pitch count, difficulty in coaching in other positions, number of games per year, and acceptance of former verbal/physical abuse. RESULTS: The prevalence of verbal/physical abuse toward young athletes was 74.5% (n = 283) and 6.6% (n = 25), respectively. Verbal abuse was significantly associated with personal experience of verbal abuse by former coaches (odds ratio [OR]: 2.00, 95% confidence interval [95% CI]: 1.04-3.85), and acceptance of verbal/physical abuse (OR: 2.61, 95% CI: 1.34-5.10). Physical abuse was significantly associated with greater than 10 years of coaching experience (OR: 7.16, 95% CI: 1.36-37.78), personal experience with physical abuse by former coaches (OR: 4.25, 95% CI: 1.23-14.70), and acceptance of verbal/physical abuse (OR: 3.85, 95% CI: 1.51-9.84). CONCLUSIONS: Coaches' experiences with verbal/physical abuse by former coaches negatively affected young athletes. Breaking this cycle is necessary to keep athletes active and interested in playing baseball. LEVEL OF EVIDENCE: Level III.

Knee pain is associated with lower back pain in young baseball players: a cross-sectional study.

PURPOSE: Considerable research has focused on shoulder and elbow injuries among baseball players; however, although lumbar spine and knee injuries are commonly experienced, they are less frequently studied. During common motions in baseball, such as throwing, hitting, and running, energy is transferred from the lower extremities through the lower back to the upper body. Lower extremity pain, as well as lower back pain (LBP), can disrupt the kinematic chain, and it is important to understand the association between lower extremity complaints and LBP. The purpose of this study was to elucidate the association between knee pain and LBP among young baseball players. METHODS: A cross-sectional study was conducted with young baseball players (aged 6-15 years, n = 1,609) using a self-reported questionnaire. Multivariate logistic regression models were used for analyses. Variables considered in the models were sex, age, body mass index, team levels, number of days of training per week, number of hours in practice per day on weekdays and weekend, frequency of participation in games, practice intensity, and player position. RESULTS: The point prevalence of LBP and knee pain was 8.4% and 13.1%, respectively. Knee pain was significantly associated with LBP. Using the absence of knee pain as a reference, the adjusted odds ratio (95% confidence interval) for LBP was 5.83 (3.93-8.65) (p < 0.001) in the presence of knee pain. CONCLUSIONS: Knee pain was associated with LBP among young baseball players. Clinicians should pay attention to knee complaints to prevent and treat LBP among young baseball players. LEVEL OF EVIDENCE: III.

The Ubiquitin-Proteasome System Is Indispensable for the Maintenance of Muscle Stem Cells.

Adult muscle stem cells (satellite cells) are required for adult skeletal muscle regeneration. A proper balance between quiescence, proliferation, and differentiation is essential for the maintenance of the satellite cell pool and their regenerative function. Although the ubiquitin-proteasome is required for most protein degradation in mammalian cells, how its dysfunction affects tissue stem cells remains unclear. Here, we investigated the function of the proteasome in satellite cells using mice lacking the crucial proteasomal component, Rpt3. Ablation of Rpt3 in satellite cells decreased proteasome activity. Proteasome dysfunction in Rpt3-deficient satellite cells impaired their ability to proliferate, survive and differentiate, resulting in defective muscle regeneration. We found that inactivation of proteasomal activity induced proliferation defects and apoptosis in satellite cells. Mechanistically, insufficient proteasomal activity upregulated the p53 pathway, which caused cell-cycle arrest. Our findings delineate a critical function of the proteasome system in maintaining satellite cells in adult muscle.

Pneumonia risks in bedridden patients receiving oral care and their screening tool: Malnutrition and urinary tract infection-induced inflammation.

AIM: Pneumonia develops in bedridden patients even when they are receiving oral care. However, the pneumonia risk in bedridden patients remains unclear, and no screening tool has been developed to assess this risk by using daily hospital data. METHODS: We retrospectively examined pneumonia risk factors by analyzing the records of 102 bedridden patients receiving oral care. RESULTS: Body mass index, peripheral blood hemoglobin, and serum concentrations of total protein, albumin, total cholesterol and uric acid in the pneumonia group (n = 51; mean age 73.4 years) were lower than those in the non-pneumonia group (n = 51; mean age 68.1 years). In the univariate analysis, body mass index; leukocytosis; high C-reactive protein; low levels of hemoglobin, total protein and albumin (<3.5 g/dL); and urine bacteria were associated with the development of pneumonia. Furthermore, in the multivariate analysis, low levels of albumin and urine bacteria were independently associated with pneumonia. We developed a bedridden patient pneumonia risk (BPPR) score using these two risk factors to assess pneumonia risk. We applied scores of zero (0) or one (1) according to the absence or presence of the two risk factors and summed the scores in each patient. The proportion of pneumonia patients increased with increasing BPPR score when the patients were divided into three groups - low, moderate and high risk - according to the BPPR score (0, 1 or 2, respectively). CONCLUSIONS: Malnutrition, urinary tract infection-induced inflammation and anemia were associated with pneumonia in bedridden patients. BPPR scoring might be useful for assessing pneumonia risk and managing affected patients. Geriatr Gerontol Int 2018; 18: 714-722.

Youth baseball players with elbow and shoulder pain have both low back and knee pain: a cross-sectional study.

PURPOSE: Serious arm injuries in youth baseball players have been increasing. Though a breakage in the kinetic chain could affect arm injuries, an association between arm injuries and insufficient support of the trunk and lower extremities is not well understood. The purpose of this study was to investigate the association of low back and knee pain with elbow and/or shoulder complaints among youth baseball players. METHODS: A self-administered questionnaire and document informed consent were mailed to youth athletes belonging to the Miyagi Amateur Sports Association. Multiple logistic regression analysis was used to examine the association of low back and knee pain with elbow and/or shoulder pain at the time of the questionnaire. Variables considered in the models were as follows: sex, age, BMI, years of athletic experience, position, team level, the amount of practice, participating day in team practice and game per week, frequency of participation in games, and practice intensity. RESULTS: The final study population was comprised 1582 youth baseball players (aged 6-15 years old, male 95.6 %) who had responded to the questionnaire. A total of 24.8 % (n = 381) had elbow and/or shoulder pain, whereas 8.5 % (n = 130) had low back pain and 13.1 % (n = 201) had knee pain. The prevalence of elbow and/or shoulder pain with concomitant low back and knee pain was 61.2 % (n = 82) and 51.9 % (n = 108) (p < 0.001), respectively. The presence of low back and knee pain was significantly associated with the prevalence of elbow and/or shoulder pain among youth baseball players [adjusted odds ratio (ORs): 4.31, 95 % confidence interval (95 % CI): 2.86-6.51, p < 0.001, and ORs: 2.92, 95 % CI: 2.09-4.09, p < 0.001, respectively]. For other variables, older age (10- and 11-year old: ORs: 1.73, 95 % CI 1.10-2.73, p = 0.018; 12-15 year old: ORs: 1.62, 95 % CI: 1.18-2.58, p = 0.006), pitcher (ORs: 1.46, 95 % CI: 1.10-1.94, p = 0.009), catcher (ORs: 1.69, 95 % CI: 1.24-2.31, p = 0.001,), and practice intensity (ORs: 1.58, 95 % CI: 1.22-2.06, p = 0.001) were significantly associated with elbow and/or shoulder pain. CONCLUSION: Both low back and knee pain were significantly associated with elbow and/or shoulder pain in youth baseball players. Clinicians should check the complaints of the trunk and lower extremities as well as those of the elbow and shoulder for preventing severe injuries in youth baseball players. Level of Evidence III.