Search Results (1,030)

Background: Body composition assessment is important in professional football as a measure of overall adaptation of the athlete to the training demand and calorie intake. However, it is operator-dependent, relying on subject positioning and the focus angle of the X-rays. In addition, the usual appendicular lean mass index (ALMI) does not include the pelvitrochanteric muscles, which are often implicated in athlete injuries. Methods: Three independent operators compared the reproducibility of dual-energy X-ray absorptiometry (DEXA) including pelvi-trochanteric muscle mass in twenty professional football players, using the standard and a new method. Results: Mean age, weight, and height of the footballers were 25.9 ± 4.9 years, 79.4 ± 9.4 kg, and 1.83 ± 0.09 m. Using the standard method, the ALMI was 9.28 ± 0.62, 9.20 ± 0.65, and 9.13 ± 0.64 kg/m² for the first, second and third operator, respectively. When including the pelvi-trochanteric muscles, the ALMI values were 11.90 ± 0.66, 11.84 ± 0.63, and 11.83 ± 0.65 kg/m² for the three operators. The difference between the two methods was significant (p < 0.001). The mean inter-operator difference was similar regardless of the method used (0.099 ± 0.06 kg/m²). The intraclass correlation coefficients (ICC) (A,1) were 0.949 [0.881; 0.979] for the standard method and 0.977 [0.951; 0.990] for the new method. The ICC (C,1) was 0.960 [0.918; 0.983] for the standard method and 0.979 [0.957; 0.991] for the new method. Conclusions: Thus, both new and conventional methods showed excellent reproducibility. However, reproducibility and inter-operator variability were better with the adjustment of the new scan lines. Moreover, the inclusion of a larger gluteal and adductors muscle mass was easy to achieve, providing additional information that could potentially be useful for early diagnosis and/or prevention of future muscular injuries in elite athletes. Full article

Objectives: We investigated the relationship between bone metabolic markers or bone mineral density (BMD) and sarcopenia in patients with type 2 diabetes mellitus (T2DM). Methods: In this cross-sectional study involving 119 subjects (76 women and 43 men), bone metabolic markers were evaluated by bone alkaline phosphatase and bone tartrate-resistant acid phosphatase (TRACP-5b). BMD was measured using the dual-energy X-ray absorptiometry method, and sarcopenia was diagnosed using skeletal muscle mass index (SMI), evaluated by body composition measurement and handgrip strength. Results: Significant correlation was observed between handgrip strength or SMI and TRACP-5b in both sexes (correlation coefficients were −0.50 in handgrip strength and −0.41 in SMI in men; −0.25 in handgrip strength and −0.21 in SMI in women). Furthermore, significant correlation was observed between handgrip strength or SMI and BMD of the femoral neck in both sexes (correlation coefficients were 0.33 in handgrip strength and 0.44 in SMI in men; 0.34 in handgrip strength and 0.47 in SMI in women). The concentrations of TRACP-5b with sarcopenia were significantly higher than those without (643.8 ± 261.9 vs. 455.7 ± 165.6 mU/dL), and BMD of femoral neck with sarcopenia was significantly lower than those without (0.54 ± 0.12 vs. 0.66 ± 0.16 g/cm²). TRACP-5b (odds ratio 1.05, 95% confidence interval 1.01–1.10) and femoral neck BMD (odds ratio 0.30, 95% confidence interval 0.14–0.68) were associated with the presence of sarcopenia after adjustment for confounders. Conclusions: TRACP-5b and BMD of the femoral neck were associated with sarcopenia in patients with T2DM. Full article

Lanthanide hydrogen-bonded organic frameworks (Ln-HOFs) integrating luminescent and proton-conductive properties hold significant promise for multifunctional sensing and energy applications, yet their development remains challenging due to the difficulty of balancing structural stability and functional diversity. In this context, this study successfully synthesized a novel neodymium(III)-based hydrogen-bonded framework material, formulated as {Nd(H₂O)₃(4-CPCA)[H(4-CPCA)]∙H₂O}ₙ (SNUT-15), via hydrothermal assembly using 1-(4-carboxyphenyl)-4-oxo-1,4-dihydropyridazine-3-carboxylic acid (H₂(4-CPCA)) as the ligand. Single-crystal X-ray diffraction analysis revealed a rare two-dimensional hydrogen-bonded bilayer structure stabilized by π-π stacking interactions and intermolecular hydrogen bonds. Hirshfeld surface analysis further corroborated the structural characteristics of this material. Moreover, leveraging the superior luminescent properties of lanthanide elements, this crystalline material exhibits dual functionality: selective fluorescence quenching toward Fe³⁺, La³⁺, and Mn²⁺ (with detection limits of 1.74 × 10⁻⁴, 1.88 × 10⁻⁴, and 3.57 × 10⁻⁴ mol·L⁻¹, respectively), as well as excellent proton conductivity reaching 7.92 × 10⁻³ S cm⁻¹ under conditions of 98% relative humidity and 353 K (80 °C). As a multifunctional neodymium(III)-based HOF material, SNUT-15 demonstrates its potential for applications in environmental monitoring and solid-state electrolytes, providing valuable insights into the rational design of lanthanide-containing frameworks. Full article

Chronic pancreatitis (CP) precipitates complex malnutrition through synergistic mechanisms: exocrine pancreatic insufficiency–driven maldigestion, duodenal or pancreatobiliary strictures limiting nutrient flow, cholestasis impairing micelle formation, alcohol-related anorexia, pain-induced hypophagia, proteolytic catabolism from type 3c diabetes, and a chronic inflammatory milieu that accelerates sarcopenia and bone demineralisation. Consequent calorie–protein depletion, micronutrient and fat-soluble vitamin deficits, and metabolic derangements markedly amplify morbidity. Pancreatic enzyme replacement therapy (PERT) with targeted micronutrient repletion is foundational; high-protein regimens co-administered with PERT curb muscle loss, and medium-chain triglycerides (MCTs) can augment caloric delivery by bypassing lipase dependence, although their benefit over personalised dietetic counselling is marginal. Optimal dietary fat thresholds and timing of escalation from oral to enteral or parenteral feeding remain unresolved. Comprehensive care also demands alcohol abstinence, effective analgesia and stringent glycaemic control. Serial monitoring—biochemical indices, densitometry, dual-energy X-ray absorptiometry and imaging-based body-composition metrics—permits early detection of high-risk patients and precision tailoring of interventions. Intensified multidisciplinary programmes already improve prognostic endpoints and are unveiling biomarkers of nutritional resilience. A structured, evidence-based strategy integrating PERT, macronutrient engineering, micronutrient repletion and metabolic surveillance is essential to mitigate nutrition-related morbidity, enhance long-term outcomes and optimise quality of life in CP. Full article

Background/Objectives: Chronic kidney disease (CKD) and diabetic kidney disease (DKD) are growing public health challenges. While diet and body composition influence metabolic and renal health, their combined role remains underexplored. This study investigates the association between the Planetary Health Diet Index (PHDI), body mass distribution, and the prevalence of CKD and DKD in U.S. adults. Methods: We analyzed data from 8093 adults aged ≥40 years from NHANES 2003–2018. PHDI was computed using two 24 h dietary recalls. Body composition was assessed using dual-energy X-ray absorptiometry (DXA), focusing on the android-to-gynoid fat ratio (AGFR) and lean mass ratio (AGLR). Survey-weighted linear and logistic regressions evaluated cross-sectional associations between PHDI score, body composition indices, and prevalence of CKD and DKD. Mediation analyses explored AGLR, AGFR, and body mass index (BMI) as potential mediators of the association between PHDI score and either CKD or DKD. Results: Higher PHDI scores were mildly associated with lower odds of CKD (OR per 10-point increase: 0.91; 95% CI: 0.83–0.99) and DKD (OR: 0.86; 95% CI: 0.76–0.97). Greater PHDI scores correlated with lower BMI, AGFR, and AGLR. Among participants with diabetes, AGLR mediated 17% of the relationship between a 10-point increase in PHDI score and decreased DKD prevalence, suggesting central lean mass distribution as a relevant pathway. No significant mediation was observed for AGFR, BMI, or for CKD. Conclusions: Adherence to PHD is associated with healthier body composition and lower prevalence of CKD and DKD. These findings support the promotion of dietary strategies that enhance metabolic and renal health in middle-aged and older individuals. Full article

Background: Muscle-specific strength (MSS), defined as muscle strength relative to muscle mass, is a key indicator in the assessment of sarcopenia and functional status, especially in patients with cancer. Dual-energy X-ray absorptiometry (DXA) is the reference method for estimating muscle mass, but its limited accessibility hinders routine use. This study aimed to evaluate the correlation between DXA-based MSS and MSS estimated through more accessible techniques. Methods: A cross-sectional study was conducted in 205 adult oncology outpatients. Muscle strength was assessed by handgrip dynamometry, and muscle mass was estimated using DXA, bioimpedance (BIA), ultrasound, and anthropometry. MSS was calculated by dividing grip strength by each muscle mass parameter. Results: MSS calculated with BIA, body weight, and calf circumference showed very strong correlations with MSS-DXA (r > 0.90). Ultrasound-derived MSS showed only a moderate correlation (r = 0.55; p < 0.01). Similar patterns were observed in both men and women. Conclusions: BIA and anthropometric methods, particularly those using body weight and calf circumference, are reliable and accessible alternatives to DXA for estimating MSS in oncology patients. These tools may help improve the identification and monitoring of sarcopenia in clinical settings with limited resources. Full article

Rheumatoid arthritis (RA) is a chronic inflammatory disease frequently associated with alterations in body composition, including reduced lean mass and increased fat mass. These alterations are thought to be driven by persistent systemic inflammation, which may be influenced by inflammatory activity and by therapeutic interventions. Objectives: This pilot study aimed to provide preliminary data on changes in body composition and inflammatory activity in biologic-naive patients with active RA during the initial 6 months of TNF inhibitor treatment, and to compare baseline body composition with healthy controls. We conducted a single-center, observational, 24-week pilot study of 70 biologic-naive RA patients with moderate-to-severe disease activity and 70 matched healthy controls. Lean mass, fat mass, and lean mass index (LMI) were measured using dual-energy X-ray absorptiometry at baseline for both groups, and after 6 months only in the RA group. Clinical, laboratory, adipokines, and cytokine parameters were also recorded. At baseline, RA patients had lower lean mass and LMI than controls. Over 6 months, RA patients showed significant clinical and laboratory improvement, with a corresponding increase in lean mass and LMI. No statistically significant change was observed in fat mass. The increase in lean mass was paralleled by a reduction in inflammatory markers. The LMI was inversely associated with female sex (β = −0.562) and C-reactive protein (β = −0.432) and directly associated with body mass index (β = 0.570). Similar associations were observed for total lean mass and change in lean mass, as well as for DAS28 (β = −0.333). This pilot study provides preliminary evidence that TNF inhibitor therapy may be associated with increased lean mass and decreased inflammation in RA patients. Owing to the absence of a comparator RA group not receiving TNF inhibitors, these findings should be interpreted as hypothesis-generating. Full article

Background/Objectives: Platelets play a role in bone metabolism and fracture healing. This study aimed to investigate the association between platelet indices and the derived systemic immune inflammation index (SII) with fracture risk in postmenopausal women. Methods: Platelet count, mean platelet volume, platelet distribution width (PDW), platelet crit, percentage of large platelets (P-LCR), platelet–lymphocyte ratio, and the SII, calculated as (NxP)/L, where N, P, and L represented neutrophils, platelets and lymphocytes counts, respectively, were evaluated. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry. Results: A total of 124 women (mean age 68.4 ± 9 years) were stratified into two groups based on the median platelet count; the “lower platelet count group” (n = 58) had a count of 200,000 (174,000 to 226,000), while the “higher platelet count group” (n = 66) had a count of 281,500 (256,500 to 308,500). The higher platelet count group showed a higher hip fracture risk (7.4 vs. 4.5%, p = 0.08) and lower lumbar spine BMD (0.773 vs. 0.83 gr/cm², p = 0.03). By dividing the participants into two groups with higher SSI (950,848.6 ± 746,097.99) (n = 61) and lower SII (355,751.2 ± 88,662.6) (n = 63), the group with the higher SII showed the higher hip fracture risk (7.4 vs. 3.6%, p = 0.01). Univariate regression analysis revealed correlations between chronological age and PDW (r = 0.188, p = 0.047), and P-LCR (r = 0.208, p = 0.03), as well as associations between vitamin D status and P-LCR (r = −0.301, p = 0.034), and between SII and hip fracture risk (r = 0.12, p = 0.007). Conclusions: Platelet count and SII were associated with fracture risk in postmenopausal women undergoing osteoporosis assessment. Given their reproducibility and cost-effectiveness, these markers warrant further investigation in future prospective studies focused on bone fragility. Full article

Introduction: Sarcopenia is a systemic condition linked to increased morbidity and mortality in older adults. Point-of-Care Ultrasound (POCUS) offers a rapid, bedside method to assess muscle mass. This study evaluates the diagnostic accuracy of POCUS compared to Dual-energy X-ray Absorptiometry (DXA), the gold standard method, and explores its prognostic value in old patients undergoing surgery for hip fractures. Patients and Methods: In this prospective, single-center study, 126 patients aged ≥ 70 years and hospitalized with hip fractures were included. Sarcopenia was defined according to the revised 2018 EWGSOP2 criteria. Muscle mass was assessed by the Appendicular Skeletal Muscle Mass Index (ASMI) using DXA and by the thickness of the rectus femoris (RF) muscle using POCUS. Results: Of the 126 included patients, 52 had both DXA and POCUS assessments, and 43% of them met the diagnostic criteria for sarcopenia or severe sarcopenia. RF muscle thickness measured by POCUS was significantly associated with ASMI (R² = 0.30; p < 0.001). POCUS showed a fair diagnostic accuracy in women (AUC 0.652) and an excellent accuracy in men (AUC 0.905). Optimal diagnostic thresholds according to Youden’s index were 5.7 mm for women and 9.3 mm for men. Neither RF thickness, ASMI, nor sarcopenia status predicted mortality or major postoperative complications. Conclusions: POCUS is a promising, accessible tool for diagnosing sarcopenia in old adults with hip fractures. Nonetheless, its prognostic utility remains uncertain and should be further evaluated in long-term studies. Full article

Laboratory-based assessment of cardiorespiratory function is a widely applied method in sports science. Most performance evaluations focus on oxygen uptake parameters. Despite the well-established concept of oxygen deficit introduced by Hill in the 1920s, relatively few studies have examined its behavior during submaximal exercise, with limited exploration of deficit dynamics. The present study aimed to analyze the behavior of oxygen deficit in young female handball players (N = 42, age: 15.4 ± 1.3 years) during graded exercise. Oxygen deficit was estimated using the American College of Sports Medicine (ACSM) algorithm, restricted to subanaerobic threshold segments of a quasi-ramp exercise protocol. Cardiorespiratory parameters were measured with the spiroergometry test on treadmills, and body composition was assessed via Dual Energy X-ray Absorptiometry (DEXA). Cluster and principal component analyzes revealed two distinct athlete profiles with statistically significant differences in both morphological and physiological traits. Cluster 2 showed significantly higher relative VO₂ peak (51.43 ± 3.70 vs. 45.70 ± 2.87 mL·kg⁻¹·min⁻¹; p < 0.001; Cohen’s d = 1.76), yet also exhibited a greater oxygen deficit per kilogram (39.03 ± 16.71 vs. 32.56 ± 14.33 mL·kg⁻¹; p = 0.018; d = 0.80). Cluster 1 had higher absolute body mass (69.67 ± 8.13 vs. 59.66 ± 6.81 kg; p < 0.001), skeletal muscle mass (p < 0.001), and fat mass (p < 0.001), indicating that body composition strongly influenced oxygen deficit values. The observed differences in oxygen deficit profiles suggest a strong influence of genetic predispositions, particularly in cardiovascular and muscular oxygen utilization capacity. Age also emerged as a critical factor in determining the potential for adaptation. Oxygen deficit during submaximal exercise appears to be a multifactorial phenomenon shaped by structural and physiological traits. While certain influencing factors can be modified through training, others especially those of genetic origin pose inherent limitations. Early development of cardiorespiratory capacity may offer the most effective strategy for long-term optimization. Full article

Background/Objectives: In digital radiography imaging, dual-layer flat-panel detectors (DFDs), in which two flat-panel detector layers are stacked with a minimal distance between the layers and appropriate alignment, are commonly used in material decompositions as dual-energy applications with a single x-ray exposure. DFDs also enable more efficient use of incident photons, resulting in x-ray images with improved noise power spectrum (NPS) and detection quantum efficiency (DQE) performances as single-energy applications. Purpose: Although the development of DFD systems for material decomposition applications is actively underway, there is a lack of research on whether single-energy applications of DFD can achieve better performance than the single-layer case. In this paper, we experimentally observe the DFD performance in terms of the modulation transfer function (MTF), NPS, and DQE with discussions. Methods: Using prototypes of DFD, we experimentally measure the MTF, NPS, and DQE of the convex combination of the images acquired from the upper and lower detector layers of DFD. To optimize DFD performance, a two-step image registration is performed, where subpixel registration based on the maximum amplitude response to the transform based on the Fourier shift theorem and an affine transformation using cubic interpolation are adopted. The DFD performance is analyzed and discussed through extensive experiments for various scintillator thicknesses, x-ray beam conditions, and incident doses. Results: Under the RQA 9 beam conditions of 2.7 μGy dose, the DFD with the upper and lower scintillator thicknesses of 0.5 mm could achieve a zero-frequency DQE of 75%, compared to 56% when using a single-layer detector. This implies that the DFD using 75 % of the incident dose of a single-layer detector can provide the same signal-to-noise ratio as a single-layer detector. Conclusions: In single-energy radiography imaging, DFD can provide better NPS and DQE performances than the case of the single-layer detector, especially at relatively high x-ray energies, which enables low-dose imaging. Full article

Adjuvant endocrine therapy for early breast cancer significantly reduces recurrence but increases bone fragility. Given limited data on denosumab (60 mg every 6 months) in premenopausal patients receiving endocrine therapy for early breast cancer, we conducted a retrospective real-world study at the Gemelli Hospital (September 2018–January 2025). A descriptive analysis was performed. The primary endpoint was to assess efficacy, evaluated by changes in bone mineral density via dual-energy X-ray absorptiometry and by monitoring bone turnover markers, particularly serum C-terminal telopeptide of type I collagen. Safety was evaluated based on adverse endocrine therapy events (osteoporotic fractures) and adverse denosumab events (osteonecrosis of the jaw). Sixty-nine patients were eligible for the study. Endocrine therapy included ovarian function suppression with exemestane (89.8%) or tamoxifen (10.1%). Baseline spinal osteoporosis decreased from 20.3% to 5.8%, osteopenia from 39.1% to 34.8%, with normal T-scores rising from 17.4% to 34.8%. Femoral improvements were similar. Serum C-terminal telopeptide of type I collagen levels (evaluated in 35.8%) showed stable reduction in 97%. Denosumab adherence was 89.9%. One osteonecrosis of the jaw case occurred (1.4%); no fractures were reported. Denosumab demonstrated efficacy in improving bone density and reducing bone turnover, with excellent adherence and favorable safety. Longer follow-up is needed to assess post-discontinuation effects. Full article

Background/Objectives: Gut-derived tryptophan (Trp) metabolites play important roles in metabolic and cardiovascular regulation. Although animal studies suggest their protective effects against metabolic dysfunction, data in adolescents, particularly those with obesity, remain limited. The objective of this study was to evaluate associations between circulating gut-derived Trp metabolites and markers of cardiometabolic, vascular, and platelet health in adolescents with obesity. Methods: Data were analyzed from 28 adolescents (ages 13–18; mean BMI = 36 ± 6.4 kg/m²). Fasting blood was collected to assess lipid profiles using a clinical analyzer and insulin resistance using the homeostatic model assessment for insulin resistance (HOMA-IR). Gut-derived Trp metabolites were measured by UPLC–mass spectrometry, peak oxygen uptake (VO_{2 peak}) by gas exchange during an incremental cycle ergometer test, and body composition by dual-energy X-ray absorptiometry. Platelet spare respiratory capacity (SRC), endothelial function, and liver fat were measured using high-resolution respirometry, flow-mediated dilation (FMD) of the brachial artery, and magnetic resonance imaging respectively. Results: Indole-3-propionic acid was inversely associated with diastolic blood pressure (rho = −0.39, p = 0.047), total cholesterol (rho = −0.55, p = 0.002), and LDL-C (rho = −0.57, p = 0.0014), independent of sex and obesity severity. Indoxyl sulfate was positively correlated with fasting glucose (rho = 0.47, p = 0.012), and adolescents with impaired fasting glucose had 1.6-fold higher IS levels. Indole-3-acetaldehyde declined with age (rho = −0.50, p = 0.007), and Indole-3-acetic acid and indole were higher in Hispanics vs. non-Hispanics. No significant associations were observed between Trp metabolites and FMD, VO₂ peak, or SRC. Conclusions: Gut-derived Trp metabolites, particularly indole-3-propionic and indoxyl sulfate, are associated with markers of cardiometabolic risk in adolescents with obesity. These findings support their potential relevance in early-onset cardiovascular disease risk. Full article

With increasing global challenges related to water scarcity and phosphorus depletion, the recovery and reuse of wastewater-derived nutrients offer a sustainable path forward. This study evaluates the dual role of lanthanides (Ce³⁺ and La³⁺) in recovering phosphorus from municipal wastewater and supporting corn (Zea mays) cultivation through lanthanide phosphate (Ln-P) and lanthanide-reclaimed wastewater (LRWW, wastewater spiked with lanthanide). High-purity precipitates of CePO₄ (98%) and LaPO₄ (92%) were successfully obtained without pH adjustment, as confirmed by X-ray photoelectron spectroscopy (XPS) and energy-dispersive spectroscopy (EDS). Germination assays revealed that lanthanides, even at concentrations up to 2000 mg/L, did not significantly alter germination rates compared to traditional coagulants, though root and shoot development declined above this threshold—likely due to reduced hydrogen peroxide (H₂O₂) production and elevated total dissolved solids (TDSs), which induced physiological drought. Greenhouse experiments using desert-like soil amended with Ln-P and irrigated with LRWW showed no statistically significant differences in corn growth parameters—including plant height, stem diameter, leaf number, leaf area, and biomass—when compared to control treatments. Photosynthetic performance, including stomatal conductance, quantum efficiency, and chlorophyll content, remained unaffected by lanthanide application. Metal uptake analysis indicated that lanthanides did not inhibit phosphorus absorption and even enhanced the uptake of calcium and magnesium. Minimal lanthanide accumulation was detected in plant tissues, with most retained in the root zone, highlighting their limited mobility. These findings suggest that lanthanides can be safely and effectively used for phosphorus recovery and agricultural reuse, contributing to sustainable nutrient cycling and aligning with the United Nations’ Sustainable Development Goals of zero hunger and sustainable cities. Full article

Background and Objectives: Body composition changes with aging and menopause, often leading to increased adiposity and a shift in fat distribution. While BMI is commonly used in clinical practice, it does not accurately reflect fat mass or distribution. This study aims to evaluate age-related changes in both total and regional adiposity using DXA-derived indices in Korean women aged ≥ 40 years and to assess the limitations of BMI-based obesity classification. Materials and Methods: This retrospective multicenter study analyzed the DXA scans and clinical records of 914 Korean women aged 40–80 years who attended menopause clinics across multiple institutions between 2018 and 2021. We analyzed five adiposity indices: body mass index (BMI), total body fat percentage (TB%F), fat mass index (FMI), visceral adipose tissue (VAT) area, and android-to-gynoid (A/G) fat ratio. Excess adiposity was defined as BMI ≥ 23 kg/m², TB%F ≥ 40%, FMI ≥ 9 kg/m², VAT > 100 cm², or A/G ratio > 1.0. Age group comparisons were made using ANOVA, and misclassification was assessed by comparing BMI with other indices. Results: Mean BMI increased with age, peaking in the 60s before declining in the 70s. TB%F and FMI peaked in the 50s, while VAT and A/G ratio increased continuously with age. Excess adiposity was found in 41.9% of women by TB%F, 40.5% by FMI, and 59.4% by VAT in the 70s. Notably, 22% of women with normal BMI (<23 kg/m²) had VAT > 100 cm², and 35.7% had A/G > 1.0, indicating central obesity. Conclusions: DXA-based indices provide a more accurate assessment of adiposity and associated cardiometabolic risks in aging women than BMI alone. Clinical screening strategies should consider incorporating regional fat distribution markers, particularly in midlife and postmenopausal populations, to better identify individuals at risk. Full article