Search Results (1,315)

Background and Objectives: The effect of growth hormone (GH) on body composition is well recognized, and recombinant human GH (rGH) therapy may improve lean mass and related parameters. The aim of this study was to analyze changes in body composition parameters and lipid profile under rGH treatment in children diagnosed with short stature and to explore potential influencing factors. Materials and Methods: A secondary data analysis was conducted in the Endocrinology Department of the Mures County Hospital, Romania, approved by the local Ethics Committee. All children diagnosed with short stature and receiving rGH treatment were eligible for inclusion if they had four body composition analyses at least 6 months apart. Analyzed variables included age, gender, environment, mean rGH dose, height and body mass index (BMI) SDS, body composition parameters assessed by bioimpedance, and family-related variables. Statistical analysis was performed using SPSS v.25 with a level of significance α = 0.05. Results: There was no statistically significant trend in body composition parameters taken during serial measurements, except for the sarcopenic index and height (p < 0.001). Environment, pubertal development, and family-related variables other than maternal BMI had no significant influence on body composition or lipid profile. Gender differences in body composition revealed that the change in muscle mass (p = 0.009) and skeletal muscle mass (p = 0.013) was statistically significantly higher for boys, and body fat (p = 0.013) for girls. In linear regression analysis, mother’s BMI emerged as a significant predictor for changes in high-density lipoprotein cholesterol (HDL-C) levels (p = 0.032, β = −0.691) during rGH therapy. Body composition changes did not differ by treatment indication. Conclusions: Gender may be associated with treatment-related changes in body composition during pediatric rGH therapy, while maternal BMI may predict HDL-C variation. rGH treatment appears to improve the sarcopenic index and has minimal and variable effects on the lipid profile. Full article

Background/Objectives: Obesity is associated with cognitive decline, and metabolic bariatric surgery (MBS) can improve both physical and cognitive outcomes. However, cognitive improvements post-surgery are variable. This study explores the role of skeletal muscle health, specifically muscle strength and mass, in cognitive performance after MBS, aiming to identify factors that influence cognitive recovery. Methods: In this prospective study, 55 patients scheduled for MBS were assessed 1 month before and 12 months after surgery. Body composition, including appendicular lean mass (ALM) and fat mass, was measured using dual-energy X-ray absorptiometry (DXA). Handgrip strength (HGS) was assessed via dynamometry, and neurocognitive performance was evaluated using a standardized test battery. Results: Significant improvements in cognitive performance were observed at 12 months post-surgery in attention, memory, language, executive functions and overall cognitive performance. Regarding body composition, significant reductions were observed in fat mass and body mass index (BMI). A decrease in ALM and no changes in HGS were observed; however, when adjusted for body size, both showed an increase. Regression analysis identified baseline HGS, but not muscle mass, as a significant predictor of cognitive performance at 12 months post-surgery. Conclusions: MBS leads to significant improvements in cognitive function. Our results suggest that baseline HGS may play a role in predicting cognitive outcomes post-surgery, highlighting the need for comprehensive assessments of both physical and cognitive health in patients undergoing MBS. Further longitudinal studies are needed to explore causal relationships and the potential reversibility of cognitive deficits post-surgery. Full article

Occupational exposure to sharps waste represents a critical challenge for public health systems, directly affecting healthcare workers’ safety, institutional costs, and environmental sustainability. This study aimed to analyze sharps waste management practices and to structure improvement actions for biosafety governance in Brazilian Emergency Care Units (ECUs) through the application of the Lean Six Sigma (LSS) and DMAIC method (Define, Measure, Analyze, Improve, and Control). A single multiple-case study was conducted across three public units in different regions of Brazil, combining direct observation, regulatory checklists based on ANVISA Resolution No. 222/2018 (RDC), and cause–and–effect (5M) analysis. The diagnostic phase identified recurrent nonconformities in labeling, documentation, and internal transport routes, primarily due to managerial and behavioral gaps. Based on these findings, the DMAIC framework supported the development of a low-cost, evidence-based action plan that outlined proposed interventions, including visual checklists, standardized internal routes, and key performance indicators (KPIs), intended to strengthen biosafety traceability and occupational safety. The se proposed actions are expected to support continuous learning, staff engagement, and a culture of shared responsibility for safe practices. Overall, the study provides a structured basis for future implementation and empirical validation of continuous improvement initiatives, aimed at enhancing public health governance and occupational safety in resource-constrained healthcare environments. Full article

With rapid urbanization and population growth, efficient transportation systems are increasingly crucial, particularly in sectors like healthcare and pharmaceutical logistics, which face unique challenges. In Morocco, there is a lack of studies on pharmaceutical transport, especially regarding costs and delivery conditions, creating a need for a specialized model. This research presents the development and validation of a predictive model for optimizing urban transport in Morocco. Tested across key sectors—pharmaceuticals, agri-food, electronics, and manufactured goods—the model demonstrated strong performance, though variations emerged based on product complexity. Notably, the agri-food sector presented greater logistical challenges, while the manufacturing and electronics sectors yielded higher prediction accuracy. By integrating statistical process control (SPC) and Lean Six Sigma principles, the model ensures ongoing performance monitoring and continuous improvement. It supports cost reduction, time optimization, and lower environmental impact through enhanced route planning and delivery efficiency. The pharmaceutical sector was selected as a case study due to its critical logistical constraints, such as cold chain requirements and the need for high reliability. Python was used for model development, enabling rapid iteration and collaborative validation. The results confirm the model’s adaptability and generalizability to similar urban environments across North and Sub-Saharan Africa. The study offers a robust and scalable framework for improving transport efficiency while aligning with sustainability and smart mobility goals. Full article

Obesity is increasingly recognized not only as a metabolic disorder but also as a condition marked by the structural and functional deterioration of skeletal muscle and tendon tissues. Central to this process is the dysregulation of the extracellular matrix (ECM) resulting in fibrosis and ectopic fat accumulation, factors that contribute to impaired tissue mechanics. Myostatin (GDF-8), a member of the TGF-β superfamily, is known as a negative regulator of muscle mass. It can also mediate interaction between adipose and other tissues including muscles and tendons. In obesity, elevated myostatin levels have been reported to be associated with insulin resistance, muscle atrophy, and activation of SMAD2/3 signaling, while experimental and preclinical studies indicate that myostatin inhibition can improve glucose homeostasis and increase lean mass. Emerging evidence suggests that myostatin also plays a critical role in muscle ECM and tendon remodeling. Restoring its physiological levels may help reverse ECM disorganization and reduce tissue fragility associated with musculotendinous dysfunction. This review highlights the multifaceted role of myostatin in obesity, beyond its role in muscle catabolism, to include modulation of structural integrity, metabolism, and mechanical adaptability of the musculotendinous system. Understanding how myostatin responds to metabolic stress and affects biomechanical remodeling offers novel insights into obesity-related muscle and tendon dysfunction. Full article

Background/Objectives: Comprehensive knowledge of body composition and bone status across the lifespan is critical for clinical evaluation and public health initiatives. This study aimed to develop age- and sex-specific reference curves for body composition and bone status in a physically active Greek population aged 18–80 using dual-energy X-ray absorptiometry (DXA). A secondary objective was to examine age- and sex-related trends in fat distribution, lean mass (LM), and bone status. Methods: A cross-sectional analysis was conducted on 637 participants (275 men and 362 women). Physical activity was assessed through structured interviews evaluating type, frequency, and intensity, categorized using established guidelines from organizations such as the American Heart Association and World Health Organization. Anthropometric data and DXA scans were utilized to measure parameters including fat mass (FM), LM, and BMD. Participants were stratified into age categories, and percentile curves were generated using generalized additive models for location, scale, and shape (GAMLSS). Results: Among women, body mass increased by 20.9% and body fat percentage rose by 38.3% from the youngest to the oldest age group, accompanied by a 5.7% reduction in bone mineral density (BMD) and an 11.5% decline in bone mineral content (BMC). Men exhibited a 49.1% increase in body fat percentage, with LM remaining stable across age groups. In men, BMD decreased by 1.7%, while BMC showed minimal variation. Notable sex differences were observed in fat redistribution, with android fat (AF) increasing significantly in older individuals, particularly among women, highlighting distinct age-related patterns. Conclusions: This study provides essential reference data on body composition and bone status, emphasizing the need for tailored interventions to address sex- and age-related changes, particularly in fat distribution and bone density, to support improved health outcomes in aging populations. Full article

Obesity arises from chronic energy imbalance, where energy intake exceeds energy expenditure. Emerging evidence supports a key role of DNA methylation in the regulation of adipose tissue development and metabolism. We have recently discovered a key role of DNA methylation, catalyzed by DNA methyltransferase 1 or 3a (Dnmt1 or 3a), in the regulation of adipocyte differentiation and metabolism. Here, we aimed to investigate the role of adipose progenitor cell Dnmt3b—an enzyme mediating de novo DNA methylation—in energy metabolism and obesity. We generated a genetic model with Dnmt3b knockout in adipocyte progenitor cells (PD3bKO) by crossing Dnmt3b floxed mice with Platelet-derived growth factor receptor alpha (PDGFRα) Cre mice. Dnmt3b deletion in adipocyte progenitors enhanced thermogenic gene expression in brown adipose tissue, increased overall energy expenditure, and mitigated high-fat diet (HFD)-induced obesity in female mice. PD3bKO mice also displayed a lower respiratory exchange ratio (RER), indicative of a metabolic shift favoring fat utilization as an energy source. Furthermore, female PD3bKO mice exhibited improved insulin sensitivity alongside their lean phenotype. In contrast, male PD3bKO mice showed no changes in body weight but demonstrated decreased insulin sensitivity, revealing a sexually dimorphic metabolic response to Dnmt3b deletion in adipose progenitor cells. These findings underscore the critical role of Dnmt3b in regulating energy homeostasis, body weight, and metabolic health, with significant implications for understanding sex-specific mechanisms of obesity and metabolism. Full article

Background: Type 2 diabetes (T2D) has been linked to impairments in skeletal muscle performance, encompassing reductions in both muscle strength and muscle quality. While malnutrition is a known modifiable factor contributing to muscle quality deterioration, its specific relationship with the Geriatric Nutritional Risk Index (GNRI) in T2D remains underexplored. Using data from 743 participants in the KAMOGAWA-A cohort, this cross-sectional study evaluated the association between muscle quality and GNRI in individuals with type 2 diabetes. Methods: Muscle quality was defined as handgrip strength divided by arm lean mass. GNRI was calculated using serum albumin and body mass index. Multiple linear regression models were used to assess associations between GNRI and muscle quality. To account for BMI-related dependency in muscle quality measurements, we derived BMI-adjusted GNRI residuals and performed the same regression analysis to evaluate the stability of the observed relationship beyond BMI-induced confounding. Results: In the overall population, GNRI was inversely associated with muscle quality (β = −0.17, p < 0.001). Conversely, residual GNRI demonstrated a significant positive association with muscle quality (β = 0.13, p < 0.001), especially among men, individuals under 65 years of age, and across all BMI categories. Stratified analyses suggested that the strength and direction of associations varied by age, sex, and glycemic control status. Conclusions: The GNRI showed an inverse correlation with muscle quality, whereas residual GNRI showed a consistent positive relationship. These findings suggest that improving nutritional status may support muscle function in T2D, but BMI confounds the interpretation of GNRI in this context. Full article

Construction and demolition waste (CDW) constitute a menace in Zimbabwe. The industry’s image is tainted by rampant disposal on roadsides, in watercourses, and in landfills. Concerted practical efforts to proffer solutions to the problems of CDW disposal have achieved little. Therefore, this study aimed to develop a lean-based framework that could help reduce the impacts of CDW. An in-depth review of the related literature was conducted to establish that lean construction approaches have been adopted to minimise CDW. The literature review led to the compilation of a semi-structured questionnaire used to expedite survey research, which received insights and perspectives from 260 construction personnel gathered through a purposive sampling technique. The top-ranked lean CDW minimisation framework embeds recycling, recovering, and reuse, Kaizen (continuous improvement), Last Planner System (LPS), Just-in-Time (JIT), and Andon (visualisation). The four-step framework shows potential for reducing CDW in Zimbabwe and similar regional contexts. Some of the findings show that the recycling technologies needed to recycle construction waste are not yet available in Zimbabwe. The available regulatory frameworks are not very clear on using recovered, salvaged, and recycled construction materials. Designers are not designing in a way that controls waste streams on sites. Full article

Lean implementations often deploy tools in isolation, leaving gaps in how abnormalities are exposed, resolved at the root cause, escalated when needed, and converted into organisational learning. This study proposes a five-stage closed-loop routine for daily factory management that integrates problem visibility, standardised shop-floor cadence, disciplined problem-solving, and tiered escalation within a single operating logic. The novelty lies not in the individual Lean tools, but in the specification of cadence, triggers, accountable roles, and verification steps that connect them into a replicable end-to-end routine. The model was evaluated through a 19-month longitudinal, single-site field intervention (quasi-experimental before–and–after) on the bottleneck production line of a pharmaceutical plant in Hengoed, Wales (UK). Line OEE increased by over 50% in relative terms. At factory level, total output increased by 20% year-on-year in 2024 (context indicator), alongside qualitative field observations of shorter time-to-resolution and improved cross-functional coordination. As a single-site study, external validity is context-dependent; nevertheless, the paper provides a specified closed-loop routine and field evidence on the operational effects of embedding an integrated Lean cycle into daily management. Practically, the study provides a specified routine that practitioners can replicate and adapt; academically, it contributes to Lean implementation research by showing how tool bundles can be operationalised as an end-to-end daily management routine with observable performance effects. Full article

Background/Objectives: This study evaluated the validity of DEXA-derived muscle quantification by assessing its agreement with AI-assisted CT measurements of muscle volume and intramuscular adipose tissue. It also examined whether inter-limb asymmetry improves DEXA–CT agreement beyond absolute DEXA values. The influence of lower-limb rotation on DEXA measurements was assessed, and the study aimed to clarify how DEXA should be obtained and interpreted to more accurately reflect true muscle status. Methods: Fifty-two patients who completed CT and DEXA within 14 days were included. CT was used to obtain pure muscle volume and intramuscular adipose tissue (IMAT) using a standardized AI segmentation protocol, and corresponding DEXA thigh segmentation provided lean mass and fat percentage. Position-specific correlation analysis, regression, and Bland–Altman agreement testing were performed for 104 limbs. The same analyses were applied to inter-limb differences to isolate within-person asymmetry and reduce between-person variance. Results: DEXA lean mass correlated with CT pure muscle volume (r = 0.776, p < 0.001), and inter-limb asymmetry further improved alignment with CT (r = 0.857, p < 0.001). However, DEXA fat mass asymmetry demonstrated no association with CT IMAT asymmetry (r = −0.004, p = 0.979). When results were stratified by the recorded rotational groups, the highest correlation was observed in the neutral position (r = 0.900, p < 0.001). Bland–Altman analyses showed wide limits of agreement for all absolute measurements, whereas inter-limb asymmetry demonstrated markedly narrower limits of agreement, indicating superior numerical consistency. Conclusions: Absolute DEXA estimates showed limited agreement with CT and varied with limb position. Inter-limb asymmetry improved lean mass assessment, whereas fat mass and percentage did not correspond to CT-based IMAT. DEXA may therefore be used as a complementary tool for evaluating regional muscle quantity, but not for assessing muscle quality. Full article

Metabolic syndrome (MetS) is a multifactorial disorder characterized by central obesity, insulin resistance, dyslipidemia, and hypertension, all of which increase the risk of type 2 diabetes and cardiovascular diseases. This study investigates the potential complementary effects of the standardized green and black ADM ComplexTea Extract (CTE) and the heat-treated postbiotic (BPL1^® HT) on the cardiometabolic alterations associated with MetS in a murine model. C57BL/6J mice were fed a high-fat/high-sucrose (HFHS) diet and treated with CTE, BPL1^® HT, or their combination for 20 weeks. Metabolic, inflammatory, oxidative, vascular parameters, and fecal microbiota composition were assessed. Both CTE and BPL1^® HT individually attenuated weight gain, organ hypertrophy, insulin resistance, and inflammation. However, their combined administration exerted synergistic effects, fully normalizing body weight, adipocyte size, lipid profiles, HOMA-IR index, and insulin sensitivity to levels comparable to lean controls. Co-treatment also restored PI3K/Akt signaling in liver and muscle, reduced hepatic steatosis, and normalized the expression of inflammatory and oxidative stress markers across multiple tissues. Furthermore, vascular function was significantly improved, with enhanced endothelium-dependent relaxation and reduced vasoconstrictor responses, particularly to angiotensin II. CTE, BPL1^®HT, and the blend prevented bacterial richness reduction caused by HFHS; the blend achieved higher bacterial richness than mice in Chow diet. Additionally, the blend prevented the increase in Flintibacter butyricus, which is associated with MetS clinical parameters, and showed a tendency to increase the abundance of Bifidobacterium. These findings suggest that the combination of CTE and BPL1^® HT offers a potential nutritional strategy to counteract the metabolic and cardiovascular complications of MetS through complementary mechanisms involving improved insulin signaling, reduced inflammation and oxidative stress, enhanced vascular function, and modulation of gut microbiota. Full article

Background: The study examined sex differences in countermovement jump (CMJ) force plate metrics and neuromuscular responses to a standardized dynamic warm-up in physically active college students. Methods: Forty-one participants (21 males, 20 females) completed pre- and post-warm-up assessments of CMJ performance using a dual force plate system. Body composition was measured via bioelectrical impedance analysis, and performance metrics included force, velocity, power, and other jump metrics. Percent change scores were calculated for all metrics. Results: Males demonstrated significantly greater improvements in braking force metrics compared to females, including force at minimum displacement (11.4% Δ male vs. 5.7% Δ female, p = 0.043), average braking force (10.6% Δ male vs. 5.0% Δ female, p = 0.043), and peak braking force (11.5% Δ male vs. 5.7% Δ female, p = 0.043). No significant sex differences were found in velocity, power, propulsive force, or other general CMJ performance variables. Hierarchical regression analyses revealed that sex was a significant (p ≤ 0.043 for all) predictor of changes in braking force metrics, while lean body mass did not enhance model fit or independently predict force changes. The addition of lean body mass slightly attenuated the sex effect but did not contribute meaningfully to the models. Conclusions: Findings suggest males may experience greater braking force adaptation to a dynamic warm-up, while other performance outcomes appear similar between sexes. These results may inform sex-specific warm-up strategies targeting neuromuscular readiness and braking force development. Full article

Objectives: This study examined whether integrating an isometric exercise program into physical education (PE) lessons influences functional outcomes and cardiovascular risk markers in adolescents beyond the effects of standard PE alone. Methods: Boys aged 14–15 years were randomly assigned to an experimental group (EG, n = 19) or a control group (CG, n = 21). The EG completed a 6-week isometric exercise program integrated into PE lessons, while the CG followed the regular PE curriculum only. The intervention was based on hold isometric muscle actions (HIMA) with progressively increased volume. Anthropometric measures included body height, body mass, and body mass index (BMI). Body composition was assessed using bioelectrical impedance analysis. Functional capacity was evaluated using field-based measures of lower-limb strength and power (isometric mid-thigh pull, standing broad jump, squat jump, and countermovement jump). Systolic and diastolic blood pressure were measured as indicators of cardiovascular health. Results: A mixed model ANOVA showed that no significant group × time interactions were observed for body composition, functional outcomes, or blood pressure (all p > 0.05). Lean body mass increased over time in both groups (p < 0.01). Improvements in isometric mid-thigh pull (p < 0.01) and standing broad jump (p = 0.01) occurred irrespective of group allocation. Blood pressure remained unchanged. Linear regression revealed that biological maturation did not moderate intervention effects; however, more mature participants demonstrated higher absolute strength levels independent of the intervention (p < 0.05). Conclusions: The inclusion of an isometric exercise program within PE lessons did not provide additional benefits for health-related functional outcomes beyond standard PE alone. In its current format, isometric exercise does not appear to add sufficient value to justify its implementation as a stand-alone strategy in school-based PE. Full article

Fecal microbiota transplantation (FMT) has demonstrated potential in reshaping gut microbiota to improve animal phenotypes, yet its application in lean-type to obese-type pigs like Ningxiang (NX) pigs remains unclear. To address this, we investigated the effects of Lean Duroc × Landrace × Yorkshire (DLY) pig-derived fecal microbiota on the growth, gut microbiota composition, and serum metabolism of obese NX pigs. Thirty-six 50-day-old castrated male NX pigs of similar initial body weight were randomly assigned to either a control group or FMT group. The trial lasted for 35 days. Results indicated that FMT significantly improved the average daily gain and increased nutrient digestibility. Serum biochemical analysis revealed elevated levels of globulin and total protein and reduced low-density lipoprotein cholesterol in the FMT group. In addition, 16S rRNA sequencing demonstrated that FMT modified gut microbiota composition and diversity, enriching beneficial genera such as Blautia, Agathobacter, Faecalibacterium, and Eubacterium_coprostanoligenes_group. Untargeted serum metabolomics further revealed altered metabolite profiles linked to lipid and amino acid metabolism. Correlation analysis further revealed a link between these enriched bacteria and metabolites changes. Overall, these findings demonstrate that transplantation of the fecal microbiota from lean DLY pigs significantly improved the growth performance of obese NX pigs by improving nutrient digestibility and modulating the gut microbiota–host metabolic axis. Full article