Adherence to mobile-app-based dietary self-monitoring-Impact on weight loss in adults.

Objectives: Greater dietary self-monitoring adherence is associated with weight loss, however, the dietary self-monitoring adherence criteria that predict weight loss are unknown. The criteria used to define adherence to dietary self-monitoring in obesity treatment tend to vary, particularly in studies that include dietary self-monitoring via mobile applications (apps). The objectives of this study were to (a) determine weight change outcomes related to app-based dietary self-monitoring and (b) determine the associations between the frequency, consistency, and completeness of dietary self-monitoring and weight change. Methods: In this single-arm uncontrolled prospective study, employees at a large, urban health system who had overweight or obesity self-monitored dietary intake for 8 weeks using the Calorie Counter by FatSecret app. A paired sample t-test examined the association of app-based dietary self-monitoring and weight change; linear regression examined the associations of frequent, consistent, and complete dietary self-monitoring and weight change. Results: A significant mean difference [t (89) = 6.59, p < 0.001] was found between baseline and 8-week weight (M = -1.5 ± 2.1 kg) in the sample (N = 90). Linear regression revealed a significant association [F (1, 88) = 7.18, p = 0.009] between total weeks of consistent dietary self-monitoring (M = 4.4 ± 2.8) and percent weight loss (M = -1.54% ± 2.26%), and a significant association [F (1, 88) = 6.42, p = 0.013] between dietary self-monitoring frequency (M = 50.1% ± 33.3%) and percent weight loss. The total weeks of complete dietary self-monitoring (M = 3.42 ± 2.87) was not associated [F (1, 88) = 3.57, p = 0.062] with percent weight loss. Conclusions: Consistent and frequent app-based dietary self-monitoring were associated with short-term weight loss. Emphasizing these aspects of self-monitoring may be an avenue for decreasing the burden of self-monitoring.

Altered gait mechanics are associated with severity of chondropathy after hip arthroscopy for femoroacetabular impingement syndrome.

BACKGROUND: Suboptimal patient-reported function and movement impairments often persist after hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Individuals with FAIS with preoperative cartilage pathology (ie. chondropathy) demonstrate distinct movement patterns and have worse post-operative outcomes. It is unknown whether the presence of chondropathy after surgery negatively affects movement and function. RESEARCH QUESTION: Do sagittal plane gait mechanics differ based on chondropathy severity following arthroscopy for FAIS? METHODS: A cross-sectional walking gait analysis was performed for 25 participants post-arthroscopy (2.48 ±â€¯1.38y) and 12 healthy controls (HCs). Peak total support moment (TSM) and relative contributions of the hip, knee, and ankle were calculated during loading response. The Hip Osteoarthritis MRI Scoring System was used to categorize the FAIS group into no-mild or moderate-severe chondropathy groups based on 3 T magnetic resonance imaging of their surgical hip. The interactions of group by limb were evaluated for kinetic variables, covaried by gait speed. RESULTS: Groups did not differ based on age, BMI and sex distribution (P ≥ 0.14). 13 participants with FAIS presented with moderate-severe chondropathy and 12 presented with no-mild chondropathy. Participants with moderate-severe chondropathy walked significantly slower than both other groups (P = 0.006) and demonstrated lower peak TSM than those with no-mild chondropathy (P = 0.002). Participants with no-mild chondropathy demonstrated lower hip (61.5 %) and greater ankle (17.7 %) contributions to the TSM on the involved limb compared to the moderate-severe group (hip:73.4 %, P = 0.07; ankle:10.5 %, P = 0.007). SIGNIFICANCE: Slower gait speed alone did not explain the lower TSM strategy in participants with moderate-severe chondropathy. Interestingly, the joint contribution strategy of this group was not different than HCs. Participants with no-mild chondropathy demonstrated a TSM strategy that shifted the demand away from their hip and toward their ankle. Given the small sample size, and large variability in joint strategies, future work needs to examine whether these alterations in gait strategy, with or without advanced chondropathy, impact patient function.

Defining Adherence to Dietary Self-Monitoring Using a Mobile App: A Narrative Review.

Understanding how adherence to dietary self-monitoring with apps has been defined is a first step toward examining the relationship between adherence and weight loss. The purpose of this review was to explore how adherence to dietary self-monitoring has been defined in the empirical literature that addresses weight loss app use by overweight and obese adults. The integrative review method and the preferred reporting items for systematic reviews and meta-analyses guided this review. Scientific databases (n=5) were searched, which yielded 29 studies. Studies were screened, evaluated for data quality, and then analyzed according to the constant comparison method. Most studies were weak to moderate quality. Results indicated that adherence was operationally defined in two ways. Adherence was defined as either adherent or nonadherent based on the completion of recording a minimum amount of calorie intake or a calorie amount within a specific range of calories. Another way that adherence was defined was the frequency of dietary self-monitoring, which included the frequency of dietary intake recording, interaction with apps, and the timing of recording. Some studies defined adherence in both ways. Most included studies lacked diversity in study samples. Until a consensus is reached, it may be prudent to study multiple indicators of adherence to dietary self-monitoring using apps, and their respective relationships with weight loss. Studies are needed that address the type and degree of adherence to dietary self-monitoring with an app that is associated with weight loss in diverse populations.

Novel t(1;2)(p36.1;q23) and t(7;19)(q32;q13.3) chromosomal translocations in ischemic fasciitis: expanding the spectrum of pseudosarcomatous lesions with clonal pathogenetic link.

BACKGROUND: Ischemic fasciitis is a distinctive pseudosarcomatous entity with a marked predilection for elderly and physically debilitated or immobilized patients. The etiology of these lesions is unknown but felt to be related to ischemic vascular events. CASE PRESENTATION: Herein, we report for the first time, two cytogenetic translocations, t(1;2)(p36.1;q23) and t(7;19)(q32;q13.3) in a 75 year-old ambulating female with a history of left total hip arthroplasty 20 years ago. CONCLUSION: These translocations suggest a possible clonal pathogenetic link though their significance remains to be established.

Massive localized lymphedema: a clinicopathologic study of 46 patients with an enrichment for multiplicity.

Massive localized lymphedema is a monstrous tumefactive pseudosarcoma seen in middle-aged morbidly obese adults. Since its initial description in 1998, the etiology remains unknown, although associations with trauma, surgeries, and hypothyroidism have been reported. Herein, we report the largest study of massive localized lymphedema and expand upon its clinicopathologic features. Fifty-four cases from 46 patients were retrospectively identified from the institutional archives of The Ohio State University Wexner Medical Center between 2002 and 2015. Forty-six patients (21 males and 25 females, mean age 50 years) presented with large masses developing over a 5-60-month period. The majority of patients were Caucasian (n=39). All patients were obese with a mean weight of 384.7 lb and a mean body mass index of 59.6 kg/m(2). Thirty-six patients had a history of atherosclerotic cardiovascular disease and diabetes mellitus type 2 was present in 22 patients. Eight patients had multifocal massive localized lymphedema. The sites included thigh (n=33), abdomen (n=17), suprapubic region (n=1), mons pubis (n=6), scrotum (n=2), perianal region (n=1), and right flank (n=1). Mostly, the clinical impression was benign processes, including pannus or lymphedema pseudotumor. Grossly, the mean weight was 8237 g and the mean size was 53.2 cm. Histologically, eight cases showed a unique pattern of dystrophic calcifications mimicking hyperchromatic, atypical nuclei that might lead to misdiagnosis of liposarcoma, four cases showed focal metaplastic ossification, and three cases showed multinucleated cells in addition to prototypic features of massive localized lymphedema. We report that this is the largest series of massive localized lymphedema. This is a lesion mostly seen in morbidly obese patients and the thigh is the most common site of involvement. We note a marked racial predilection for Caucasians and a tendency towards multiplicity. We suggest that obesity itself and the related metabolic syndrome have an important role in its pathogenesis.

Use of phosphorus ligand NMR probes to investigate electronic and second-sphere solvent effects in ligand substitution reactions at manganese(II) and manganese(III).

Manganese/ligand association dynamics were studied using a series of structurally related anionic phosphorus ester ligand probes [CH(3)OP(O)(X)(Y)(-), where X = CH(3)O, CH(3)CH(2), or H and Y = O, S, or BH(3)]. Reactions of the probe ions with Mn(H(2)O)(6)(2+) and a manganese(III) porphyrin (Mn(III)TMPyP(5+)) were studied in aqueous solution by paramagnetic (31)P NMR line-broadening techniques. A satisfactory linear free energy relationship for reactions of the probe ions with Mn(H(2)O)(6)(2+) and Mn(III)TMPyP(5+) required consideration of both the basicity and solvent affinity of the probe ligands: log(k(app)) = log(k(0)) + alpha pK(a) + beta log(K(ext)), where k(0), alpha, and beta are metal complex dependent parameters and pK(a) and K(ext) represent the measured Bronsted acidity and water/n-butanol extraction constant for the probe anions, respectively. Reactions of Mn(H(2)O)(6)(2+) were relatively insensitive to changes in ligand basicity (alpha = -0.04) and favored the more hydrophilic anions (beta = -0.54). These observations are consistent with a dissociative ligand exchange mechanism wherein the outer-sphere complex is stabilized by hydrogen bonding between Mn(H(2)O)(6)(2+) and the incoming ligand. In contrast, reactions with Mn(III)TMPyP(5+) are accelerated by decreases in both the basicity (alpha = -0.43) and the hydrophilicity (beta = +0.97) of the probe. We conclude that reactions of Mn(III)TMPyP(5+) are also dissociative but that the aromatic groups of the porphyrin provide a hydrophobic environment surrounding the ligand binding site in Mn(III)TMPyP(5+). Thus, the probe/water solvent interactions must be significantly weakened in order to form the outer-sphere complex that leads to ligand substitution. This work demonstrates the utility of phosphorus relaxation enhancement (PhoRE) techniques for characterizing the second coordination sphere environment of metal complexes leading to ligation and will allow comparison of the second coordination spheres of Mn(H(2)O)(6)(2+) and Mn(III)TMPyP(5+) to those of other metal complexes.