The obesity paradox in intracerebral hemorrhage: a systematic review and meta-analysis.

Background: Intracerebral hemorrhage (ICH) has a mortality rate which can reach 30-40%. Compared with other diseases, obesity is often associated with lower mortality; this is referred to as the 'obesity paradox'. Herein, we aimed to summarize the studies of the relations between obesity and mortality after ICH. Method: For this systematic review and meta-analysis (PROSPERO registry CRD42023426835), we conducted searches for relevant articles in both PubMed and Embase. Non-English language literature, irrelevant literature, and non-human trials were excluded. All included publications were then qualitatively described and summarized. Articles for which quantitative analyses were possible were evaluated using Cochrane's Review Manager. Results: Ten studies were included. Qualitative analysis revealed that each of the 10 studies showed varying degrees of a protective effect of obesity, which was statistically significant in 8 of them. Six studies were included in the quantitative meta-analysis, which showed that obesity was significantly associated with lower short-term (0.69 [0.67, 0.73], p<0.00001) and long-term (0.62 [0.53, 0.73], p<0.00001) mortality. (Data identified as (OR [95%CI], p)). Conclusion: Obesity is likely associated with lower post-ICH mortality, reflecting the obesity paradox in this disease. These findings support the need for large-scale trials using standardized obesity classification methods. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023426835, identifier CRD42023426835.

Changing the pattern of the back-muscle flexion-relaxation phenomenon through flexibility training in relatively inflexible young men.

Although several studies have investigated the back-muscle flexion-relaxation phenomenon (FRP), the effect of individual flexibility on the FRP has been discussed infrequently, with very limited data on the influence of flexibility training on the FRP. This study thus examined the effect of flexibility training on the change of back-muscle FRP pattern in relatively inflexible young men. We collected and analyzed the valid data from 20 male participants (10 each with high and low flexibility included in the control and trained groups, respectively) when flexing their trunks at seven trunk flexion positions (0°-90°, in increments of 15°); their erector spinae and hamstring activation, pelvic tilt, and lumbosacral angle were then recorded. After 7 weeks of flexibility training for the low-flexibility group, no difference in flexibility was discovered between this group and the control (originally high-flexibility) group. The trunk flexion experiment was then repeated. The results showed that before the training stage, the low-flexibility group had lower erector spinae and higher hamstring activation, a larger pelvic tilt, and a smaller lumbosacral angle. By contrast, after training, the erector spinae and hamstring activation, pelvic tilt, and lumbosacral angle were significantly changed, and no intergroup differences were observed in FRP patterns. The study results suggest that flexibility training changes lumbopelvic movement and thereby reduces the degree of the back-muscle FRP when trunk flexion is performed.

Optimal Span between Feet of Public Squat Toilet Based on Anthropometric Data and Squatting Stability Assessment.

Sitting toilets are preferred globally because they afford a relatively comfortable posture. However, squat toilets are among the most common toilets in numerous public areas because of their advantages, including personal hygiene, easy cleaning, and health benefits. This study attempted to determine optimal toilet design parameters and recruited 50 Taiwanese and 50 Southeast Asian women and collected span between feet (SBF) data for participants squatting in their most comfortable posture, and also surveyed maximum outer width (MOW) data of 28 public squat toilets in Taipei. Finally, we compared the squatting stability levels of 40 female participants (20 Taiwanese and 20 Southeast Asians) who squatted for 2 min at comfortable SBF and MOW-based SBF values. The results revealed that the minimum and maximum SBFs of Taiwanese were 14.52 cm and 18.40 cm, and that of Southeast Asians were 15.64 cm and 20.40 cm, respectively. No significant difference was observed in the SBFs between the two groups was observed. The mean (range) MOW of the surveyed toilets was 27.7 (27-29) cm. Analysis of variance results showed no difference in stability between the two SBFs. This implies that the comfortable SBF (i.e., 16 cm between the participants' heels) was narrower than the MOW, as commonly used, indicating that the comfortable SBF can be considered as an optimal toilet width parameter because of its constant stability.