Reliability, validity, and responsiveness of pinch strength assessment: a systematic review.

PURPOSE: To summarize and critically appraise the quality of studies investigating psychometric properties of pinch strength assessment. METHODS: Medical literature up to February 2024 was searched for studies reporting on at least one measurement property of pinch strength assessment. The quality of the evidence and the risk of bias were rated using COSMIN 2018 guidelines. RESULTS: Thirty-three studies (1962 participants) were included. The majority (16/19) of reliability studies were of adequate to very good quality. Seven of 12 studies of validity were rated as adequate or very good. The quality of the eight responsiveness studies was adequate. Reliability was good to excellent (ICC > 0.75) for neurological conditions, and excellent (ICC > 0.90) for musculoskeletal disorders and healthy participants. Pinch strength showed strong to very strong correlations with grip strength (r = 0.72-0.92), moderate to strong correlations with assessments of dexterity (r = 0.78-0.80), and weak to moderate correlation with patient-reported outcome measures (r = 0.03-0.50). Varied results were found for pinch strength responsiveness in a small number of studies. CONCLUSIONS: Pinch strength assessment is reliable. Validity and responsiveness are less reported, but there is a strong correlation between pinch and grip strength, and a moderate correlation with dexterity.

This review demonstrated that the reliability of pinch strength assessment is good to excellent.Clinicians can measure pinch strength and expect accurate results over repeated measurements and between raters.There is a strong correlation between pinch and grip strength, and a moderate correlation between pinch strength and hand dexterity.The low correlation between pinch strength and patient-reported outcome measures highlights the need to measure these outcomes independently of each other.

Sarcopenia Diagnostic Technique Based on Artificial Intelligence Using Bio-signal of Neuromuscular System: A Proof-of-Concept Study.

In this paper, we propose an artificial intelligence (AI)-based sarcopenia diagnostic technique for stroke patients utilizing bio-signals from the neuromuscular system. Handgrip, skeletal muscle mass index, and gait speed are prerequisite components for sarcopenia diagnoses. However, measurement of these parameters is often challenging for most hemiplegic stroke patients. For these reasons, there is an imperative need to develop a sarcopenia diagnostic technique that requires minimal volitional participation but nevertheless still assesses the muscle changes related to sarcopenia. The proposed AI diagnostic technique collects motor unit responses from stroke patients in a resting state via stimulated muscle contraction signals (SMCSs) recorded from surface electromyography while applying electrical stimulation to the muscle. For this study, we extracted features from SMCS collected from stroke patients and trained our AI model for sarcopenia diagnosis. We validated the performance of the trained AI models for each gender against other diagnostic parameters. The accuracy of the AI sarcopenia model was 96%, and 95% for male and females, respectively. Through these results, we were able to provide preliminary proof that SMCS could be a potential surrogate biomarker to reflect sarcopenia in stroke patients.

The development of resin-coating materials for enhancing elemental release of coated glass ionomer cements.

This study aimed to develop resin coatings containing monocalcium phosphate monohydrate (MCPM), Sr/F-doped bioactive glass (Sr/F-BAGs), and pre-reacted glass ionomer fillers (SPG) that enhance ion release without detrimentally affecting the mechanical properties of GIC. The objective of this study was to evaluate the degree of monomer conversion (DC), biaxial flexural strength, surface microhardness, and ion release of the GICs coated with experimental coating materials compared to a commercial product (EQUIA Coat, EC). Four experimental resin coating materials containing 10-20 wt% of MCPM with Sr/F-BAGs and 5-10 wt% SPG were prepared. The DC of the coating material was determined using ATR-FTIR. The flexural strength and surface microhardness of the coated GICs were assessed. Fluoride and elemental (Ca,P,Sr,Si,Al) release were measured using fluoride-specific electrodes and ICP-OES. The DC of the experimental coating material (60-69 %) was higher than that of EC (55 %). The strength of GICs coated with experimental materials (35-40 MPa) was comparable to EC (37 MPa). However, their surface microhardness (13-24 VHN) was lower than EC (44 VHN). The experimental coating materials reduced fluoride release by ∼43 %, similar to EC (∼40 %). However, experimental coating materials promoted higher P and Sr release than EC. In conclusion, GICs coated with the experimental resin coating containing ion-releasing additives exhibited mechanical properties similar to those of the commercial product. The new coating materials promoted a higher level of ion release for GICs. These properties could potentially enhance remineralizing actions for the coated GICs.

The pilot study of the effect of six-week robot-assisted ankle training on mobility and strength of lower extremity and life habits for children with cerebral palsy.

Background: Children with cerebral palsy often have weak ankle muscles and reduced ankle dorsiflexion, which leads to activity limitations and eventually affects quality of life. Robotic ankle training was recently developed to facilitates muscle function through a high repetition of exercises. This study investigated the effect of six-week ankle training using the Anklebot device to improve lower limb structural and functional impairments and the resulting impact on quality of life. Methods: Five children with spastic cerebral palsy aged between 4 and 11 years participated in six weeks of bilateral ankle assistive training using the Anklebot device. All lower limb muscle strength was measured with a hand-held dynameter, and range of motion was measured with a goniometer, at four different time points. Muscle architecture was assessed using a portable diagnostic ultrasound device, and quality of life was assessed using the Life Habits for Children scale, at two points in time only. Results: Muscle strength and range of motion for all lower limb joints demonstrated significant improvement on both sides after training. The ankle muscle architecture showed non-significant improvement, while an overall significant improvement in the total score of the Life Habits for Children scale was detected after training. Conclusion: Robot-assisted task-specific ankle training provides promising effects by allowing the required repetition to improve structural and functional muscle and joint impairments, which has a positive influence on the children's quality of life. However, due to a limited sample size, these results should be considered as preliminary; further study is needed.

Boosting physical performance in SD rats through brain-targeted delivery of caffeine-loaded transferrin liposomes.

This study aimed to explore the impact of caffeine (CAF) encapsulated in transferrin-modified, sterically-stabilized liposomes (Tf-SSL) on the physical performance of rats, specifically forelimb grip strength, running, and swimming. The brain-targeted drug delivery system, Tf-SSL, was used for the administration of caffeine. 168 male Sprague-Dawley (SD) rats were randomly assigned to different groups, including swimming, running, running wheel, and strength groups. Each group was further subdivided into high, medium, and low dose free caffeine (HCAF, MCAF, LCAF) and Tf-SSL CAF groups, along with a control group (CON). The strength, swimming, and running groups underwent training for four weeks, three times per week. The running wheel group was placed in rearing cages for a one-week adaptation period. After the final training session, the resistance, swimming, running, and running wheel exercise capacities of the rats were tested. The rats were administered treatment via tail vein injection, while the blank CON group received 0.9 % saline solution without treatment throughout the entire process. The results demonstrated a Tf-SSL CAF group encapsulation rate of 70.58 ± 5.14 %. Increasing the concentration of supplemented caffeine led to enhanced forelimb grip strength in rats, with significant differences observed in HCAF alone group, medium-dose Tf-SSL CAF (MTf-SSL CAF), and high-dose Tf-SSL CAF (HTf-SSL CAF) groups compared to the CON group. In the running and swimming experiments, higher caffeine supplementation concentrations correlated with increased running and swimming time to exhaustion, and the MTf-SSL CAF group showed longer running and swimming time compared to the HCAF alone group. The results of rat striatal dopamine levels indicated that increased caffeine supplementation concentrations led to higher dopamine secretion, with significantly different striatal concentrations in the HCAF group, MTf-SSL CAF group, and HTf-SSL CAF group compared to the CON group. The running wheel experiment revealed that rats in the medium- and high-dose Tf-SSL CAF groups exhibited greater 6-h running distances than the HCAF group and CON group. In conclusion, caffeine supplementation improved the physical performance of rats, with the high concentration CAF group outperforming the low and medium concentration groups. Furthermore, Tf-SSL CAF demonstrated superior physical enhancement compared to caffeine supplementation alone.

Assessing the Metabolic and Physical Effects of Combined DPP4 and SGLT2 Inhibitor Therapy in Patients with Type-2 Diabetes Mellitus: An Observational Prospective Pilot Study.

Introduction: This study aimed to assess the efficacy of combined administration of dipeptidyl peptide-4 (DPP4) and sodium-glucose cotransporter-2 (SGLT2) inhibitors on metabolic disorders and their preferable and complementary effects. Methods: The effectiveness of a 24-week intervention on metabolic parameters (including glucose profile), physical functions (grip strength and calf circumference), and health-related quality of life (HR-QOL) was analyzed using the International Physical Activity Questionnaire and Geriatric Depression Scale 5. A total of 39 patients with type-2 diabetes mellitus (T2DM) treated with the combination of DPP4 and SGLT2 inhibitors were included in this multicenter pilot study. Results: Combination therapy significantly reduced the HbA1c level (median [interquartile range]) after 24 weeks (pretreatment: 7.7% [7.3-8.2] vs. posttreatment: 7.1% [6.6-7.9], P < 0.001). The grip strength significantly increased after 24 weeks (1.7 ± 2.7 kg, P < 0.001), while the mean calf circumference and body mass index significantly decreased. In particular, administration of the SGLT2 inhibitor significantly increased total physical activity in participants aged ≥65 years (P = 0.003), while psychological QOL did not significantly improve. Conclusions: Combination therapy with DPP4 and SGLT2 inhibitors decreased HbA1c levels and improved physical function in patients with T2DM. This study confirmed the effectiveness of combination therapy for metabolic disorders and suggested its beneficial and complementary effects. Therefore, advances in treatment plans to achieve further improvements in glucose profiles using DPP4 and SGLT2 inhibitors are recommended to enhance the QOL of patients with T2DM. Clinical trial number: University Hospital Medical Information Network Center: UMIN000045375.

Assessment of the Correlation Between Serum Phosphate Level and Muscle Strength as Measured by Handgrip Strength in Patients Treated With Hemodialysis.

Background: Sarcopenia, commonly observed in patients treated with hemodialysis, correlates with low serum phosphate levels. Although normophosphatemia is desired, dietary phosphate restriction is difficult to achieve and may result in undesirable protein restriction. Objective: We aimed to evaluate whether hyperphosphatemia is associated with higher muscle strength in patients receiving hemodialysis treatment. Design: A single-center prospective observational study. Setting: Ambulatory prevalent patients undergoing hemodialysis treatments in a dialysis unit of a tertiary hospital. Patients: Participants included prevalent patients treated with hemodialysis. All patients were above 18 years. Only patients with residual kidney function below 200 mL/24 hours were included to avoid bias. Measurements: Muscle strength was measured by handgrip strength (HGS). Each patient repeated 3 measurements, and the highest value was recorded. Handgrip strength cutoffs for low muscle strength were defined as <27 kg in men and <16 kg in women. Biochemical parameters, including serum phosphate level, were driven from routine monthly blood tests. Hyperphosphatemia was defined as serum phosphate above 4.5 mg/dL. Methods: Handgrip strength results were compared to nutritional, anthropometric, and biochemical parameters-in particular phosphate level. Long-term mortality was recorded. Results: Seventy-four patients were included in the final analysis. Handgrip strength was abnormally low in 33 patients (44.5%). Patients with abnormal HGS were older and more likely to have diabetes mellitus and lower albumin and creatinine levels. There was no correlation between HGS and phosphate level (r = 0.008, P = .945). On multivariable analysis, predictors of higher HGS were body mass index and creatinine. Diabetes mellitus and female sex predicted lower HGS. Hyperphosphatemia correlated with protein catabolic rate, blood urea nitrogen, and creatinine. On multivariable analysis, predictors of hyperphosphatemia were higher creatinine level, normal albumin level, and heart failure. During mean follow-up time of 7.66 ± 3.9 months, 11 patients died. Mortality was significantly higher in patients with abnormally low HGS compared with normal HGS (odds ratio = 9.32, P = .02). Limitations: A single-center study. All measurements were performed at one time point without repeated assessments. Direct dietary intake, degree of physical activity, and medication compliance were not assessed. Conclusion: Hyperphosphatemia correlated with increased protein intake as assessed by protein catabolic rate in patients treated with hemodialysis; however, neither correlated with higher muscle strength as measured by HGS.Trial registration: MOH 202125213.

Contexte: La sarcopénie, qui est fréquemment observée chez les patients traités par hémodialyse, est corrélée à de faibles taux sériques de phosphate. Dans ce contexte, la normophosphatémie est souhaitée, mais la restriction alimentaire en phosphate est difficile à réaliser et peut entraîner une restriction indésirable en protéines. Objectif: Notre objectif était de déterminer si l'hyperphosphatémie est associée à une plus grande force musculaire chez les patients qui reçoivent un traitement par hémodialyse. Conception: Étude observationnelle prospective monocentrique. Cadre: Le service de dialyse d'un hôpital de soins tertiaires. Sujets: Des patients prévalents âgés de plus de 18 ans qui recevaient des traitements d'hémodialyse en ambulatoire dans le service de dialyse de l'hôpital. Afin de limiter les biais, seuls les patients avec une fonction rénale résiduelle inférieure à 200 ml/24 heures ont été inclus. Mesures: La force musculaire a été mesurée par le test de force de préhension (HGS - handgrip strength). Trois mesures ont été faites pour chaque patient et la valeur la plus élevée a été enregistrée. Les seuils de faible force musculaire à l'HGS ont été établis à < 27 kg pour les hommes et à < 16 kg pour les femmes. Les paramètres biochimiques, notamment le taux de phosphate sérique, ont été déterminés à partir des analyses sanguines mensuelles des patients. L'hyperphosphatémie a été définie par une concentration sérique en phosphate supérieure à 4,5 mg/dl. Méthodologie: Les résultats de l'HGS ont été comparés aux paramètres nutritionnels, anthropométriques et biochimiques ­ plus particulièrement au taux de phosphate. La mortalité à long terme a été enregistrée. Résultats: Soixante-quatorze patients ont été inclus dans l'analyse finale. Les résultats de l'HGS étaient anormalement faibles chez 33 patients (44,5 % des sujets). Les patients qui avaient obtenu un résultat anormal à l'HGS étaient plus âgés, plus susceptibles de souffrir de diabète, et présentaient des taux d'albumine et de créatinine plus faibles. Aucune corrélation n'a été observée entre le résultat à l'HGS et le taux sérique de phosphate (r=0.008; p=0.945). Dans l'analyse multivariée, l'indice de masse corporelle et le taux de créatinine étaient des prédicteurs d'un résultat plus élevé à l'HGS, alors que le diabète et le fait d'être une femme étaient prédictifs d'un résultat inférieur à l'HGS. L'hyperphosphatémie a été corrélée au taux de catabolisme des protéines, à l'urée et au taux de créatinine. Dans l'analyse multivariée, un taux de créatinine plus élevé, un taux d'albumine normal et une insuffisance cardiaque étaient des facteurs prédictifs d'une hyperphosphatémie. Au cours de la période moyenne de suivi (7,66 ± 3,9 mois), 11 patients sont décédés. La mortalité était significativement plus élevée chez les patients qui présentaient un résultat anormalement faible à l'HGS par rapport à la normale (RC: 9,32; p = 0,02). Limites: L'étude a été menée dans un seul centre. Toutes les mesures ont été effectuées à un moment donné sans évaluations répétées. L'apport alimentaire direct, le degré d'activité physique et l'observance des médicaments n'ont pas été évalués. Conclusion: Chez des patients traités par hémodialyse, l'hyperphosphatémie est corrélée à une augmentation de l'apport en protéines évalué par le taux de catabolisme des protéines, mais ni l'une ni l'autre n'est corrélée à une plus grande force musculaire mesurée par HGS.

Understanding musculoskeletal disorders in dancers: The role of lumbopelvic muscles and movement competency.

OBJECTIVE: To investigate whether transversus abdominis activation (TrA), hip strength, and movement competency are associated with the incidence of musculoskeletal disorder episodes (MDEs) in dancers when controlling for confounding variables. The secondary objectives were to determine if there were differences between professional and preprofessional dancers for the aforementioned factors, as well as to determine if there were differences in TrA activation and hip strength between the dominant and non-dominant sides. DESIGN: Prospective cohort study. METHODS: 118 dancers were recruited. The independent variables were collected at the beginning of the dance season: 1) TrA activation, 2) hip strength, and 3) movement competency. To assess the development of MDEs, a weekly electronic diary was used over a 38-week period. MDEs were compiled for each dancer's whole body and subdivided into total musculoskeletal disorder episodes (all body parts) and lower quadrant musculoskeletal disorder episodes (lower limb and lower back). RESULTS: Lower TrA, as well as higher hip abductor and external rotator strength, were associated with a lower incidence of MDEs. TrA activation (ß = 0.260, p = 0.023) and hip external rotator strength (ß = -0.537, p = 0.002) could significantly explain 25.4% of the variance of total MDEs, as well as 20.9% of the variance of lower quadrant musculoskeletal disorder episodes (ß = 0.272, p = 0.016; ß = -0.459, p = 0.011). No significant associations were found between movement competency and MDEs. CONCLUSIONS: Higher hip strength could be a protective factor for MDEs among dancers. Further studies are needed to better understand the involvement of the transversus abdominis in MDEs.

UV/VIS-imaging of white caffeine tablets for prediction of CQAs: API content, crushing strength, friability, disintegration time and dissolution profile.

The paper provides a demonstration of how UV/VIS imaging can be employed to evaluate the crushing strength, friability, disintegration time and dissolution profile of tablets comprised of solely white components. The samples were produced using different levels of compression force and API content of anhydrous caffeine. Images were acquired from both sides of the samples using UV illumination for the API content prediction, while the other parameters were assessed using VIS illumination. Based on the color histograms of the UV images, API content was predicted with 5.6 % relative error. Textural analysis of the VIS images yielded crushing strength predictions under 10 % relative error. Regarding friability, three groups were established according to the weight loss of the samples. Likewise, the evaluation of disintegration time led to the identification of three groups: less than 10 s, 11-35 s, and over 36 s. Successful classification of the samples was achieved with machine learning algorithms. Finally, immediate release dissolution profiles were accurately predicted under 5 % of RMSE with an artificial neural network. The 50 ms exposition time during image acquisition and the resulting outcomes underscore the practicality of machine vision for real-time quality control in solid dosage forms, regardless of the color of the API.

Variation of viscoelastic properties of extracellular polymeric substances and their relation to anaerobic granule's mechanical strength in full-scale treatment plants.

Extracellular polymeric substances (EPS) are considered to play a pivotal role in shaping granules' physical properties. In this contribution, we characterized the viscoelastic properties of EPS from granules of 9 full-scale industrial anaerobic reactors; and quantitatively investigate whether these properties correlate with granules' resistance to compression (Egranule) and shear strength (Sgranule). Most granules with a higher shear strength, also exhibited a stronger resistance to compression (r = 0.96, p = 0.002), except those granules that contained relatively more proteins in their EPS. Interestingly, these granules were also the most resistant to shear stress (Sgranule ≥ 110 ±â€¯40 h). Furthermore, the EPS hydrogels of these granules had slower softening rates (κ < 0.9) compared to the others (κ ranged between 0.95 and 1.20), indicating stronger gels were formed. These findings suggest that the EPS hydrogel softening rate could be a key parameter to explain granule's shear strength.

Optimal Drop Heights for Determining Reactive Strength Performance in Youth-Is 1 Drop Height Sufficient to Generate Trustworthy Conclusions for Training Practice?

This study critically examines the suitability of using a single drop height to assess the reaction strength index in trained and active participants, a key component of athletic performance. Using a cross-sectional design, 377 trained (n = 163) and active (n = 214) participants aged 14-18 years performing drop jumps from 4 different heights (24, 32, 40, and 48 cm) were studied. The primary aim was to explore the individual differences in reaction strength index at these heights and to assess whether a single height can reliably represent stretch-shortening cycle capabilities. While the repeated measures analysis of variance did not reveal any significant differences, the Bland-Altmann analysis revealed significant individual discrepancies between the performance of the drop heights, resulting in a mean absolute error of 32.1 and a mean absolute percentage error of 20.6%. These results strongly suggest that a single drop height is not sufficient to determine performance in the stretch-shortening cycle. This has important practical implications as it can lead to underestimates of performance trends. The study advocates the inclusion of a range of drop heights in routine testing to accurately measure reactive power and thus improve the effectiveness of individualized training programs for young athletes/active youth.

The impact of print orientation and graphene nanoplatelets on biaxial flexural strength and cytotoxicity of a 3D printable resin for occlusal splints.

OBJECTIVES: 3D printing found its way into various medical applications and could be particularly beneficial for dentistry. Currently, materials for 3D printing of occlusal splints lack mechanical strength compared to polymethyl methacrylate (PMMA) used for standard milling of occlusal splints. It is known that print orientation and graphene nanoplatelets (GNP) can increase biaxial strength in a variety of materials. Thus, the aim of this study was to assess if adjustment of print orientation and addition of GNP improve biaxial strength and if they affect cytotoxicity of a 3D printable resin for occlusal splints. METHODS: Specimens were printed vertically and horizontally with a stereolithography (SLA) printer and multilayered GNP powder was added to the resin at different concentrations. Printed specimens were characterized by Raman spectroscopy, optical profilometer analysis and scanning electron microscopy. Biaxial strength was evaluated by biaxial flexural testing. Cytotoxicity of specimens on L929 and gingival stromal cells (GSC) was assessed by the toxdent test, the resazurin-based toxicity assay and live-dead staining. RESULTS: Horizontally printed specimens showed significantly higher biaxial strength and lower deformation. GNP did not improve biaxial strength and material deformation of 3D-printed resins. None of the specimens were cytotoxic to L929 cells or GSC. SIGNIFICANCE: Print orientation in SLA printing has a significant impact on biaxial strength and material deformation. 3D printable materials can reach comparable or even improved biaxial strength compared to PMMA when using the optimal print orientation while GNP has no beneficial effects on the biaxial strength of resins for 3D printing of occlusal splints.

Rehabilitation-Specific Predictors of Pain Intensity and Physical Activity Levels in Individuals With Acetabular Dysplasia 6 Months After Periacetabular Osteotomy.

INTRODUCTION: Individuals with acetabular dysplasia often report hip joint instability, pain, and poor hip-related function. Periacetabular osteotomy (PAO) is a surgical procedure that aims to reposition the acetabulum to improve joint congruency and improve pain and function. We aimed to examine the influence of presurgery clinical measures on functional recovery following PAO and the associations among clinical outcomes after PAO. METHODS: We screened 49 potential participants, 28 were enrolled, and 23 completed both study visits (pre-PAO and 6 months post-PAO). We evaluated dynamometer-measured hip and thigh strength, loading patterns during a squat and countermovement jump (CMJ), pain intensity, and device-measured physical activity (PA) levels (light, moderate-to-vigorous PA [MVPA], and daily steps). We used linear regression models to examine the influence of muscle strength (peak torque; limb symmetry index [LSI]) and loading patterns before PAO on pain intensity and PA levels in individuals 6 months following PAO. Additionally, we used Pearson correlation coefficient to examine cross-sectional associations among all variables 6 months following PAO. RESULTS: Lower extremity muscle strength and loading patterns during the squat and CMJ before PAO did not predict pain intensity or device-measured PA levels in individuals 6 months following PAO (p > 0.05). Six months following PAO, higher knee extensor LSI was associated with higher time spent in MVPA (r = 0.56; p = 0.016), higher hip abductor LSI was associated with both lower pain (r = 0.50; p = 0.036) and higher involved limb loading during the squat task (r = 0.59; p = 0.010). Lastly, higher hip flexor LSI was associated with higher CMJ takeoff involved limb loading (r = 0.52; p = 0.021) and higher involved hip extensor strength was associated with higher CMJ landing involved limb loading (r = 0.56; p = 0.012). CONCLUSION: Six months after PAO, higher hip and thigh muscle strength and strength symmetry were associated with lower pain, higher PA levels, and greater normalized limb loading during dynamic movement tasks.

Assessing Sarcopenia in Advanced-Stage Ovarian Cancer Patients Undergoing Neoadjuvant Chemotherapy: A Case Series.

OBJECTIVES: In ovarian and other cancers, low muscle mass and density are associated with poorer clinical outcomes. However, screening for cancer-related sarcopenia (typically defined as low muscle mass) is not routinely conducted. The European Working Group on Sarcopenia in Older People (EWGSOP) recommends an algorithm for sarcopenia screening and diagnosis in clinical settings, with sarcopenia based on muscle strength and mass, and severity on physical performance. We explored the application of the EWGSOP2 algorithm to assess sarcopenia in six ovarian cancer patients receiving neoadjuvant chemotherapy. METHODS: We assessed sarcopenia risk with the SARC-F screening questionnaire (at risk ≥4 points), muscle strength with a handgrip strength test (cut point <16 kg) and five times sit-to-stand test (cut point >15 s), muscle mass by skeletal muscle index (SMI in cm2/m2 from a single computed tomography [CT] image; cut point <38.5 cm2/m2), and physical performance with a 4-m gait speed test (cut point ≤0.8 m/s). RESULTS: Of six participants, none were identified as "at risk" for sarcopenia based on SARC-F scores. Two participants were severely sarcopenic based on EWGSOP2 criteria (had low muscle strength, mass, and physical performance), and five participants were sarcopenic based on muscle mass only. DISCUSSION: Ovarian cancer patients with low muscle mass during neoadjuvant chemotherapy may not be identified as sarcopenic based on the EWGSOP2 diagnostic algorithm. While lacking a universally accepted definition for cancer-related sarcopenia and cancer-specific recommendations for the screening, diagnosis, and treatment of sarcopenia, ovarian cancer clinicians should focus on the diagnosis and treatment of low muscle mass and density.

Weakness Status is Differentially Associated with Time to Diabetes in Americans.

Background: The purpose of this study was to evaluate the associations of (1) individual absolute and body size normalized weakness cut-points, and (2) the collective weakness classifications on time to diabetes in Americans. Methods: We analyzed data from 9577 adults aged at least 50-years from the Health and Retirement Study. Diabetes diagnosis was self-reported. A handgrip dynamometer measured handgrip strength (HGS). Males with HGS <35.5 kg (absolute), <0.45 kg/kg (normalized to body weight), or <1.05 kg/kg/m2 (normalized to BMI) were categorized as weak. Females were classified as weak if their HGS was <20.0 kg, <0.337 kg/kg, or <0.79 kg/kg/m2. Compounding weakness included falling below 1, 2, or all 3 cut-points. Results: Persons below the body weight normalized weakness cut-points had a 1.29 (95% confidence interval (CI): 1.15-1.47) higher hazard for incident diabetes, while those below the BMI normalized cut-points had a 1.30 (CI: 1.13-1.51) higher hazard. The association between absolute weakness and incident diabetes was insignificant (hazard ratio: 1.06; CI: 0.91-1.24). Americans below 1, 2, or all 3 collective weakness categories had a 1.28 (CI: 1.10-1.50), 1.29 (CI: 1.08-1.52), and 1.33 (CI: 1.09-1.63) higher hazard for the incidence of diabetes, respectively. Conclusions: Our findings indicate that while absolute weakness, which is confounded by body size, was not associated with time to diabetes, adjusting for the influence of body size by normalizing HGS to body weight and BMI was significantly associated with time to diabetes. This suggests that muscle strength, not body size, may be driving such associations with time to diabetes.

Simultaneous Effect of Diameter and Concentration of Multi-Walled Carbon Nanotubes on Mechanical and Electrical Properties of Cement Mortars: With and without Biosilica.

In this work, the effect of multi-walled carbon nanotubes (MWCNT1, MWCNT2, and MWCNT3) with different outer diameters and specific surface areas on the mechanical and electrical properties of cement mortar have been investigated. Various concentrations of MWCNTs were used (0.05, 0.10, and 0.15%), the effective dispersion of which was carried out by an Ultrasonic machine (for 40 min with 160 W power and a 24 kHz frequency) using a surfactant. Composites have been processed with a biosilica content of 10% by weight of cement and without it. Compressive strength tests were carried out on days 7 and 28 of curing. The 7-day compressive strength of samples prepared without biosilica increased compared to the result of the control sample (6.4% for MWCNT1, 7.4% for MWCNT2, and 10.8% for MWCNT3), as did those using biosilica (6.7% in the case of MWCNT1, 29.2% for MWCNT2, and 2.1% for MWCNT3). Compressive strength tests of 28-day specimens yielded the following results: 21.7% for MWCNT1, 3.8% for MWCNT2, and 4.2% for MWCNT3 in the absence of biosilica and 8.5%, 12.6%, and 6.3% with biosilica, respectively. The maximum increase in compressive strength was observed in the composites treated with a 0.1% MWCNT concentration, while in the case of 0.05 and 0.15% concentrations, the compressive strengths were relatively low. The MWCNT-reinforced cement matrix obtained electrical properties due to the high electrical conductivity of these particles. The effect of MWCNT concentrations of 0.05, 0.10, and 0.15 wt% on the electrical properties of cement mortar, especially the bulk electrical resistivity and piezoresistive characteristics of cement mortar, was studied in this work. At a concentration of 0.05%, the lowest value of resistivity was obtained, and then it started to increase. The obtained results show that all investigated specimens have piezoresistive properties and that the measurements led to a deviation in fractional change in resistivity.

Ionic fuel-powered hydrogel actuators for soft robotics.

HYPOTHESIS: Hydrogel actuators powered by chemical fuels are pivotal in autonomous soft robotics. Nevertheless, chemical waste accumulation caused by chemical fuels hampers the development of programmable and reusable hydrogel actuating systems. We propose the concept of ionic fuel-powered soft robotics which are constructed by programmable salt-responsive actuators and use waste-free ionic fuels. EXPERIMENTS: Herein, soft hydrogel actuators were developed by orchestrating the Janus bilayer hydrogels' capacity for swelling and shrinking. Decomposable and easily removable ionic fuels were applied to power the actuators. Swelling tests were used to evaluate the deformability of the hydrogels. Tensile tests were performed to investigate the modulus of the hydrogels. The bonded interface composed of the interpenetrating polymer chains from both hydrogel layers bilayer was evidenced by the optical microscopy and scanning electron microscopy. The ionic conductivities of solutions were determined by a conductivity meter. Furthermore, a range of biomimetic soft robots with various shapes and asymmetrical structures have been designed and fabricated to execute complex functions. FINDINGS: The programmable actuators powered by ionic fuel exhibit adjustable bending orientations, amplitudes, and durations, along with consistent cyclic actuations enabled by replenishment of the fuel without noticeable loss in performance. Many life-like programmable soft robotic systems were designed, indicating spatiotemporally controllable functions.

An ensemble learning-based prediction model for the compressive strength degradation of concrete containing superabsorbent polymers (SAP).

Super absorbent polymer (SAP) has a capacity to enhance the characteristics of cementitious composites in both their fresh and hardened forms. However, it is essential to recognize that the strength of SAP concrete may decrease. By altering the concrete composition and selecting the appropriate type of SAP, it is possible to reduce this reduction. This work employs machine learning (ML) to tackle the issue of strength degradation. The analysis considers ten distinct variables linked to concrete composition and the type of SAP. The study uses machine learning approaches that involve both regression and classification tasks. The use of ensemble learning greatly improves the quality and accuracy of the results, showing its superiority in combining several models to produce more precise predictions. The findings demonstrate that the Support Vector Machines (SVM) and Extreme Gradient Boosting (XGBoost) regression algorithms accurately forecasted the percentage of reduction in strength in SAP concrete. These predictions were based on the concrete composition and SAP details, resulting in R2 values of 0.90 and 0.88, respectively. Furthermore, XGBoost exhibited the highest accuracy, reaching 0.94, when compared to the various categorization algorithms. According to the results, the mean squared error (MSE) of the ensemble model demonstrated superior outcomes. Furthermore, the SHapley Additive exPlanations (SHAP) reveal that some variables, including SAP%, SAP size, and compressive strength, have a significant influence on the strength reduction model. This study aims to bridge the gap between academic research and practical application by developing a web application that employs ensemble learning to precisely forecast the reduction in compressive strength caused by the usage of SAP.

Strength-based strategies for addressing racial stressors in African American families: lessons learned from developing the LEADS health promotion intervention.

Recognizing the real-life impact of racial stress on physical and psychological health is vital for creating impactful health promotion interventions among African American families. Despite the known link between racial stress and poor physical health outcomes, no existing intervention to date has targeted stress management strategies to buffer racial stress and build positive health behaviors among African American families. The current study outlines the lessons learned throughout the development of the Linking Exercise for Advancing Daily Stress (LEADS) Management and Resilience program, a 10-week family-based health promotion, stress management, and resilience intervention that aimed to improve physical activity, healthy eating, and well-being among African American adolescents and parents. We highlight the evolution of the LEADS intervention from a health promotion and stress management intervention to a culturally salient health promotion, stress management, and resilience intervention utilizing community-based participatory research strategies. This paper chronicles our systematic journey in making those changes and the lessons we learned along the way. We provide specific recommendations and implications for future health promotion interventions developed for African American families. Overall, we argue for a research orientation that respects cultural and racial contexts, embraces diversity within research teams and self-reflection, recognizes the heterogeneity among African American populations, and applies strength-based approaches.

Persistent plastic: Insights from seawater weathering and simulated whale gut.

Single-use plastics make up 60-95 % of marine plastic pollution, including common commodity films used for packaging and bags. Plastic film breaks down as a function of environmental variables like wave action, wind, temperature, and UV radiation. Here, we focus on how films degrade in cold waters across depths, time, and simulated mammal digestion. Five types of single-use film plastics (HDPE thin & thick, LDPE, PP, PE) were weathered for eight months in temperate waters at surface and depth in the Salish Sea, WA, USA, and subsequently exposed to a laboratory-simulated gray whale stomach. None of the types of plastics examined here fully degraded during the course of this 8 months study. Weathering time and depth significantly impacted many of the physical attributes of plastics, while exposure to a simulated whale gut did not. If unable to degrade plastics through digestion, whales risk long-term exposure to physical and chemical attributes of plastics.