Dietary Inflammatory Index and Dietary Diversity Score Associated with Sarcopenia and Its Components: Findings from a Nationwide Cross-Sectional Study.

Little is known about the independent and joint effects of the energy-adjusted dietary inflammatory index (E-DII) and dietary diversity score (DDS) on sarcopenia and its components (low muscle mass, low muscle strength, and low physical performance). A total of 155,669 UK Biobank participants with ≥1 (maximum 5) 24 h dietary assessments were included in this cross-sectional analysis. We used logistic regression models to investigate the associations of E-DII and DDS with sarcopenia and its three components. We further examined the joint effects of E-DII and DDS on sarcopenia and its components using additive and multiplicative interaction analyses. We observed that lower E-DII and higher DDS were associated with lower odds of sarcopenia and its components. There were significant joint associations of E-DII and DDS with sarcopenia and low physical performance (p-interaction < 0.05) on the multiplicative interactive scale. Our study suggests that lower dietary inflammatory potential and higher dietary diversity might be important protective factors against sarcopenia and its components. More cases of sarcopenia and low physical performance might be preventable by adherence to a more anti-inflammatory diet combined with a higher dietary diversity.

Ambient fine particulate matter chemical composition associated with in-hospital case fatality, hospital expenses, and length of hospital stay among patients with heart failure in China.

*Joint senior authorship. BACKGROUND: Previous studies have observed the adverse effects of ambient fine particulate matter pollution (PM2.5) on heart failure (HF). However, evidence regarding the impacts of specific PM2.5 components remains scarce. METHODS: We included 58 129 patients hospitalised for HF between 2013 and 2017 in 11 cities of Shanxi, China from inpatient discharge database. We evaluated exposure to PM2.5 and its components ((sulphate (SO42-), nitrate (NO3-), ammonium (NH4+), organic matter (OM) and black carbon (BC)), along with meteorological factors using bilinear interpolation at each patients' residential address. We used multivariable logistic and linear regression models to assess the associations of these components with in-hospital case fatality, hospital expenses, and length of hospital stay. RESULTS: Increase equivalents to the interquartile range (IQR) in OM (odds ratio (OR) = 1.13; 95% confidence interval (CI) = 1.02, 1.26) and BC (OR = 1.14; 95% CI = 1.02, 1.26) were linked to in-hospital case fatality. Per IQR increments in PM2.5, SO42-, NO3-, OM, and BC were associated with cost increases of 420.62 (95% CI = 285.75, 555.49), 221.83 (95% CI = 96.95, 346.71), 214.93 (95% CI = 68.66, 361.21), 300.06 (95% CI = 176.96, 423.16), and 303.09 (95% CI = 180.76, 425.42) CNY. Increases of 1 IQR in PM2.5, SO42-, OM, and BC were associated with increases in length of hospital stay of 0.10 (95% CI = 0.02, 0.19), 0.09 (95% CI = 0.02, 0.17), 0.10 (95% CI = 0.03, 0.17), and 0.16 (95% CI = 0.08, 0.23) days. CONCLUSIONS: Our findings suggest that ambient SO42-, OM, and BC might be significant risk factors for HF, emphasising the importance of formulating customised guidelines for the chemical constituents of PM and controlling the emissions of the most dangerous components.

Interactive effects of physical activity and sarcopenia on incident ischemic heart disease: Results from a nation-wide cohort study.

BACKGROUND AND AIMS: Lack of physical activity (PA) and sarcopenia is a known risk factors for ischemic heart disease (IHD). However, considering their coexistence in the middle-aged and elderly population, the interaction of these two factors remains uncertain. Here, we investigated the interactive effects of PA and sarcopenia on IHD. METHODS: We extracted 344,688 participants free of IHD at baseline from the UK Biobank. PA was classified into low, moderate, and high according to the International Physical Activity Questionnaire. Sarcopenia was identified in accordance with the European Working Group on Sarcopenia in Older People 2. Cox proportional hazard models were applied to estimate the effect of PA and sarcopenia on incident IHD and its subtypes. We also used objective PA data measured by wrist-worn devices to repeat these analyses. RESULTS: Over a median follow-up of 11.7 years, 24,809 (7.2%) participants developed incident IHD. Lack of PA was associated with a higher risk of IHD after adjusting for potential confounders. The hazard ratio (HR) was 1.09 (95% CI: 1.05-1.13) for individuals without sarcopenia and 1.29 (95% CI: 1.17-1.42) for those with sarcopenia. Regarding the joint effect, the combination of low PA and sarcopenia was associated with the highest risk of IHD, with an HR of 1.54 (95% CI: 1.44-1.66), and both additive and multiplicative interactions were significant (RERI 0.27, 95% CI: 0.14-0.39, p-interaction <0.01). For subtypes of IHD, the interaction was pronounced in acute myocardial infarction and chronic ischemic heart disease. CONCLUSIONS: These results suggest a synergistic interaction between lack of PA and sarcopenia on the risk of IHD. Findings from this study may help facilitate more effective primary prevention of IHD.

Sarcopenia and mild kidney dysfunction and risk of all-cause and cause-specific mortality in older adults.

BACKGROUND: Sarcopenia has been identified as a risk factor for increased mortality in individuals with CKD. However, when considering individuals with mild kidney dysfunction prior to CKD, the impact of sarcopenia on adverse outcomes, particularly mortality, remains uncertain. METHODS: This study included 323 801 participants from the UK Biobank. Mild kidney dysfunction was defined as eGFR between 60 and 89.9 mL/min/1.73 m2, and sarcopenia was defined according to the criteria of the 2019 European Working Group of Sarcopenia in Older People. Cox proportional hazard models with inverse probability weighting and competing risk models were used for analysis. RESULTS: During a median follow-up of 11.8 years, 20 146 participants died from all causes. Compared with participants with normal kidney function and without sarcopenia, those with mild kidney dysfunction or sarcopenia had significantly increased risks of all-cause mortality [hazard ratio (HR): 1.16, 95% confidence interval (CI): 1.12 to 1.19; HR: 1.29, 95% CI: 1.20 to 1.37]; those with both mild kidney dysfunction and sarcopenia had an even higher risk of all-cause mortality (HR: 1.61, 95% CI: 1.52 to 1.71), with a significant overall additive interaction (relative risk due to interaction 0.17, 95% CI: 0.05 to 0.29). Further subgroup analyses revealed that the associations of probable sarcopenia with all-cause and cause-specific mortality (non-accidental cause, non-communicable diseases, and cancer) were stronger among participants with mild kidney dysfunction than those with normal kidney function. CONCLUSIONS: The study indicates that sarcopenia and mild kidney dysfunction synergistically increase the risk of all-cause and cause-specific mortality. Early recognition and improvement of mild kidney function or sarcopenia in older people may reduce mortality risk but would require more prospective confirmation.

Maternal fasting glucose levels throughout the pregnancy and risk of adverse birth outcomes in newborns: a birth cohort study in Foshan city, Southern China.

OBJECTIVE: We aimed to investigate the associations between maternal fasting plasma glucose (FPG) levels and glycemic fluctuations during different trimesters and adverse birth outcomes among newborns. METHODS: This cohort study used data from 63 213 pregnant women and their offspring in Foshan city from November 2015 to January 2019. Associations between maternal FPG and glycemic fluctuations during different trimesters and adverse birth outcomes [congenital heart defect (CHD), macrosomia, small/large for gestational age (SGA/LGA), and preterm birth (PTB)] in newborns were estimated using mixed-effects logistic regression models. RESULTS: A total of 45 516 participants accepted at least one FPG test throughout pregnancy, and 7852 of whom had glycemic trajectory data. In the adjusted model, higher maternal FPG throughout the pregnancy was associated with an increased risk of adverse birth outcomes (except for SGA). Each 1 mmol/L increase in maternal FPG during trimester 1 was associated with higher odds of CHD (OR = 1.14 (95% CI: 1.02, 1.26)). The same increase in maternal FPG during trimester 3 was associated with a higher risk of PTB (OR = 1.05 (95% CI: 1.01, 1.10)). Increment of maternal FPG during trimester 2 and trimester 3 was associated with a higher risk of macrosomia and LGA. Increase in FPG throughout the pregnancy was associated with slightly lower odds of SGA. Similar results were observed when analyzing the associations between glycemic fluctuations during different trimesters and adverse birth outcomes. CONCLUSIONS: Our findings indicate higher maternal FPG levels during different trimesters were associated with different adverse birth outcomes, which suggests the importance of glycemic management throughout the pregnancy.

Is ambient air pollution associated with sarcopenia? Results from a nation-wide cross-sectional study.

BACKGROUND: sarcopenia is a disease that involves the degeneration of muscle strength, muscle mass and physical performance. It remains unknown whether air pollution exposure increases the risk of sarcopenia. METHODS: the baseline survey of the UK Biobank was used in this study. Sarcopenia was identified according to European Working Group on Sarcopenia in Older People 2 (EWGSOP2) and classified into non-sarcopenia and probable sarcopenia. Land use regressions were used to estimate concentrations of particulate matter (PM2.5), coarse particles (PMcoarse), PM10, PM2.5 absorbance, nitrogen dioxide (NO2) and nitrogen oxides (NOx). Logistic regression models were applied to estimate the associations between air pollution and sarcopenia and its components. RESULTS: out of 352,265 participants, 28,710 (8.2%) were identified with probable sarcopenia. In adjusted models, there were increased odds of probable sarcopenia for each interquartile range increase in PM2.5 (OR: 1.06; 95% CI: 1.04, 1.07), PM10 (OR: 1.15; 95% CI: 1.13, 1.17), PMcoarse (OR: 1.02; 95% CI:1.01, 1.03), PM2.5 absorbance (OR: 1.08; 95% CI: 1.07, 1.10), NO2 (OR: 1.12; 95% CI:1.10, 1.14) and NOx (OR: 1.06; 95% CI: 1.05, 1.08). CONCLUSIONS: this study suggests that exposure to ambient air pollution might be one risk factor of sarcopenia. Prospective studies are needed to further confirm our findings.

Tactile Sensing for Minimally Invasive Surgery: Conventional Methods and Potential Emerging Tactile Technologies.

As opposed to open surgery procedures, minimally invasive surgery (MIS) utilizes small skin incisions to insert a camera and surgical instruments. MIS has numerous advantages such as reduced postoperative pain, shorter hospital stay, faster recovery time, and reduced learning curve for surgical trainees. MIS comprises surgical approaches, including laparoscopic surgery, endoscopic surgery, and robotic-assisted surgery. Despite the advantages that MIS provides to patients and surgeons, it remains limited by the lost sense of touch due to the indirect contact with tissues under operation, especially in robotic-assisted surgery. Surgeons, without haptic feedback, could unintentionally apply excessive forces that may cause tissue damage. Therefore, incorporating tactile sensation into MIS tools has become an interesting research topic. Designing, fabricating, and integrating force sensors onto different locations on the surgical tools are currently under development by several companies and research groups. In this context, electrical force sensing modality, including piezoelectric, resistive, and capacitive sensors, is the most conventionally considered approach to measure the grasping force, manipulation force, torque, and tissue compliance. For instance, piezoelectric sensors exhibit high sensitivity and accuracy, but the drawbacks of thermal sensitivity and the inability to detect static loads constrain their adoption in MIS tools. Optical-based tactile sensing is another conventional approach that facilitates electrically passive force sensing compatible with magnetic resonance imaging. Estimations of applied loadings are calculated from the induced changes in the intensity, wavelength, or phase of light transmitted through optical fibers. Nonetheless, new emerging technologies are also evoking a high potential of contributions to the field of smart surgical tools. The recent development of flexible, highly sensitive tactile microfluidic-based sensors has become an emerging field in tactile sensing, which contributed to wearable electronics and smart-skin applications. Another emerging technology is imaging-based tactile sensing that achieved superior multi-axial force measurements by implementing image sensors with high pixel densities and frame rates to track visual changes on a sensing surface. This article aims to review the literature on MIS tactile sensing technologies in terms of working principles, design requirements, and specifications. Moreover, this work highlights and discusses the promising potential of a few emerging technologies towards establishing low-cost, high-performance MIS force sensing.