Barriers and facilitators to older adult participation in intergenerational physical activity program: a systematic review.

BACKGROUND: The intergenerational physical activity program aims to promote the health, social engagement, and well-being of older adults. It is essential to comprehend the barriers and facilitators that affect their involvement to develop successful intervention strategies. This systematic review critically examines available research to identify the factors that impact the participation of older adults in intergenerational physical activity programs. METHODS: This study retrieved 13 electronic databases (from January 2000 to March 2023) and used a social-ecological model to classify and analyze the identified facilitators and barriers. RESULTS: A total of 12 articles were included, which identified 73 facilitators and 37 barriers. These factors were condensed into 7 primary themes and 14 sub-themes in total. CONCLUSIONS: The factors influencing the participation of older adults in intergenerational physical activities are multifaceted. These factors guide project developers, policymakers, and practitioners in developing and implementing intergenerational physical activity programs to help address global aging issues and promote intergenerational connections. TRIAL REGISTRY: PROSPERO ID: CRD42023420758.

Microsurgical Tissue Transfer in Complex Upper Extremity Trauma.

Microsurgical tissue transfer may provide reconstructive option for extensive loss of tissues due to upper extremity trauma or tumor resection. This article reviews the authors' experience in using microsurgical tissue transfers for reconstruction of upper extremity trauma.

3D Printing Technology in Planning Thumb Reconstructions with Second Toe Transplant.

OBJECTIVE: To report preoperative planning using 3D printing to plan thumb reconstructions with second toe transplant. METHODS: Between December 2013 and October 2015, the thumbs of five patients with grade 3 thumb defects were reconstructed using a wrap-around flap and second toe transplant aided by 3D printing technology. CT scans of hands and feet were analyzed using Boholo surgical simulator software (www.boholo.com). This allowed for the creation of a mirror image of the healthy thumb using the uninjured thumb. Using 3D images of the reconstructed thumb, a model of the big toe and the second toe was created to understand the dimensions of the donor site. This model was also used to repair the donor site defect by designing appropriate iliac bone and superficial circumflex iliac artery flaps. The polylactic acid model of the donor toes and reconstructed thumb was produced using 3D printing. Surgically, the wrap-around flap of the first dorsal metatarsal artery and vein combined with the joint and bone of the second toe was based upon the model donor site. Sensation was reconstructed by anastomosing the dorsal nerve of the foot and the plantar digital nerve of the great toe. Patients commenced exercises 2 weeks after surgery. RESULTS: All reconstructed thumbs survived, although partial flap necrosis occurred in one case. This was managed with regular dressing changes. Patients were followed up for 3-15 months. The lengths of the reconstructed thumbs are 34-49 mm. The widths of the thumb nail beds are 16-19 mm, and the thickness of the digital pulp is 16-20 mm. The thumb opposition function was 0-1.5 cm; the extension angle was 5°-20° (mean, 16°), and the angle of flexion was 38°-55° (mean, 47°). Two-point discrimination was 9-11 mm (mean, 9.6 mm). The reconstructed thumbs had good appearance, function and sensation. Based on the criteria set forth by the Standard on Approval of Reconstructed Thumb and Finger Functional Assessment of the Chinese Medical Association, the results were considered excellent for four cases and good for one case. The success rate was 100%. CONCLUSIONS: When planning a wrap-around flap and second toe transplant to reconstruct a thumb, both the donor and recipient sites can be modeled using 3D printing. This can shorten the operative time by supplying digital and accurate schematics for the operation. It can also optimize the function and appearance of the reconstructed thumb while minimizing damage to the donor site.

Exploring New Frontiers of Microsurgery: From Anatomy to Clinical Methods.

This article presents the authors' understanding and experience concerning anatomic studies and clinical methods in microsurgical hand reconstruction. The 4 parts of this article include anatomic study of the hand for developing new flaps; application of miniflaps from the hand, including clinical experience with 8 unique flaps in the hand; anatomic and clinical considerations concerning several flaps from other parts of the human body; And our experience with vascularized free toe joint transfer.

[Preliminary study on the pathogenic mechanism of myoglobin-induced endoplasmic reticulum stress and apoptosis in crush syndrome].

OBJECTIVE: To explore the pathogenic mechanism of myoglobin-induced endoplasmic reticulum stress (ERS) and apoptosis in tubular epithelial cells in acute kidney injury (AKI) mouse model of crush syndrome. METHODS: Eighteen C56BL/6 mice were randomly divided into control group, modeling 8 h group and modeling 24 h group. The AKI model of crush syndrome was established by intramuscular injection of 50% glycerol saline solution into thigh (8 microL/g), while equivalent volume of physiological saline was injected in control group. AKI was diagnosed when serum creatinine (sCr) level increased to double value of control group. The mice in the experimental groups were sacrificed at the time points of 8 h and 24 h after injection respectively. Serum Cr was detected and renal tissues was observed under electron microscopy. Apoptosis was detected by TUNEL technique. Marker proteins and mRNA of apoptosis and ERS were detected by immunohistochemistry and real-time PCR. Human kidney proximal tubular cell (HK-2) cells cultured in vitro were randomly divided into control, intervention 6 h and intervention 12 h groups. Control group were incubated in standard cell culture (DMEM/F12) and the two intervention groups were incubated in special DMEM/F12 in which ferrohemoglobin was added. After 6 h and 12 h incubation, the cells were collected and apoptosis was detected by flow cytometry. RESULTS: AKI model of crush syndrome was successfully established, which was proved with sCr doubling at the 8 h after the intramuscular injection of glycerol saline. Swelling of endoplasmic reticulum and mitochondria in proximal tubular epithelial cells was more obvious in the two model groups than that in control group. TUNEL staining showed the percentage of positive cells in AKI groups was higher than that in control group (P<0.05). Immunohistochemistry and real-time PCR showed the expressions of caspase3, caspase12 and CHOP in AKI groups were higher than those in control group (P<0.05). Flow cytometry showed cell apoptosis ratio was higher in model groups than control groiap (P<0.05). CONCLUSION: Myoglobin induced ERS and apoptosis may be involved in the pathogenesis of AKI in crush syndrome.

[The expression and significance of Notch1 in the human kidney tubular cell transdifferentiation induced by TGF-ß(1);].

AIM: To explore the dynamic expression and significance of Notch1 in the human kidney tubular epithelial cell transdifferentiation (KTECT)induced by TGF-ß(1);. METHODS: Normal human kidney epithelial cell line (HK-2) was cultured and then divided into blank group, and TGF-ß(1);(10 ng/mL) induced group. At the 12 h, 24 h, 48 h and 72 h, the morphologic changes of HK-2 cells were observed under an inverted phase contrast microscope. The expression of α-SMA, E-cadherin and Notchl as well as their mRNA were examined by immunohisto-chemistry staining and RT-PCR respictively. RESULTS: Compared with the normal control group, the expression levels ofα-SMA and Notchl markedly increased in TGF-ß(1); induced group (P<0.05), but the expression of E-cadherin obviously reduced(P<0.05). The expression of Notch1 protein and its mRNA was positively correlated to the expression ofα-SMA(r(protein);=0.958; r(mRNA);=0.944; P<0.05), and was negatively correlated to the expression of E-cadherin(r(protein);=-0.937; r(mRNA);=-0.921; P<0.05). CONCLUSION: Notch1 may participate in the KTECT induced by TGF-ß(1);.

Relationship between architectural parameters and sample volume of human cancellous bone in micro-CT scanning.

Truly representative architectural parameters of trabeculea can be extremely difficult to achieve based on scanning images because of variable porosity and distribution of trabeculae within the specific overall scanned volume of bone. Accordingly, in present study different selective volume of interests, measured from centroid of µ-CT scanned human vertebral body, were analyzed to determine the architectural parameters (BV/TV, BS/BV, Tb.Th, Tb.N, Tb.Sp) of trabeculae within these volumes and to suggest an optimal volume for representative architectural parameters of the overall scanned volume. Nonlinear curve fitting method was also applied to obtain the correlation between the parameters and the volume of interests. The results show different volumes of interests give different morphological indices of BV/TV, BS/BV, Tb.N and Tb.Sp within a specific scanned vertebral body. Tb.Th shows relatively small variation (0.8%) even with sample volume of less than (2mm)(3). Statistical analysis shows that with sample volume of less than (6mm)(3), significant different in the measured BV/TV comparing against the control group. Tb.N and Tb.Sp show significant different values against the control group for volume of interest less than (4mm)(3) and (5mm)(3), respectively. However, no significant differences were observed in the indices of BS/BV and Tb.Th. Present study shows that an optimal volume of interests of greater than (6mm)(3) be selected to predict the architectural parameters of trabeculae of human vertebral bodies.