Search Results (79)

This observational pilot study investigated neurocardiovascular responses to an active stand test using continuous physiological monitoring and functional data analysis (FDA) in older women. A sample of 25 community-dwelling female adults aged 59–78 years (mean age: 70.3 years) participated. Participants were dichotomized into comparison groups based on five factors: age (<70 vs. ≥70 years); the presence of initial orthostatic hypotension (IOH, yes/no); body mass index (BMI < 25 vs. ≥25 kg/m²); antihypertensive medication use (yes/no); and physical frailty status assessed by the Survey of Health, Ageing and Retirement in Europe—Frailty Instrument (SHARE-FI score < −0.5 vs. ≥−0.5). Each participant completed an active stand test during which six physiological signals were continuously recorded: systolic (sBP) and diastolic (dBP) blood pressure and heart rate (HR) via digital artery photoplethysmography and left frontal oxygenated hemoglobin (O₂Hb), deoxygenated hemoglobin (HHb), and tissue saturation index (TSI) via near-infrared spectroscopy (NIRS). The signal analysis focused on a standardized 200 s window spanning 50 s before to 150 s after the stand, with all signals resampled and synchronized at 5 Hz. FDA was used to statistically compare the full time series between groups for each signal. Group-level differences revealed that younger participants (<70 years) exhibited significantly higher HR in multiple periods following the stand (~10 s, ~30 s, ~90 s, and ~140 s post-stand) compared to their older counterparts. Participants with IOH demonstrated significantly lower sBP at ~10 s, ~80 s, and ~130 s post-stand and lower dBP at ~10 s post-stand. Among participants classified as overweight/obese (BMI ≥ 25 kg/m²), significantly lower levels of HHb were observed at ~10 s, ~30–50 s, and ~60 s post-stand, while O₂Hb levels were reduced at ~50 s, ~60 s, ~70–110 s, ~130 s, and ~140 s post-stand. No statistically significant group-level differences were observed based on antihypertensive medication use or frailty status. These findings demonstrate the utility of FDA in detecting subtle, time-dependent physiological variations during orthostatic challenge and underscore the value of continuous neurocardiovascular monitoring in assessing orthostatic tolerance in aging populations. Full article

Background: This study aimed to investigate the neurocardiovascular responses during an Active Stand (AS) test, utilizing both pre-processed and raw signals, to predict adverse health outcomes including orthostatic intolerance (OI) during the AS, and future falls and mortality. Methods: A total of 2794 participants from The Irish Longitudinal Study on Ageing (TILDA) were included. Continuous cardiovascular (heart rate (HR), systolic (sBP), and diastolic (dBP) blood pressure) and near infra-red spectroscopy-based neurovascular (tissue saturation index (TSI), oxygenated hemoglobin (O₂Hb), and deoxygenated hemoglobin (HHb)) signals were analyzed using Statistical Parametric Mapping (SPM) to identify significant group differences across health outcomes. Results: The results demonstrated that raw (unprocessed) signals, particularly O₂Hb and sBP/dBP, were more effective in capturing significant physiological differences associated with mortality and OI compared to pre-processed signals. Specifically, for OI, raw sBP and dBP captured significant changes across the entire test, whereas pre-processed signals showed intermittent significance. TSI captured OI only in its pre-processed form, at approximately 10 s post-stand. For mortality, raw O₂Hb was effective throughout the AS test. No significant differences were observed in either pre-processed or raw signals related to falls, suggesting that fall risk may require a multifactorial assessment beyond neurocardiovascular responses. Conclusions: These findings highlight the potential utility of raw signal analysis in improving risk stratification for OI and mortality, with further studies needed to validate these findings and refine predictive models for clinical applications. This study underscores the importance of retaining raw data for certain physiological assessments and provides a foundation for future work in developing machine-learning models for early health outcome detection. Full article

Background: There is emerging interest in obesity and its prevalence, outcomes, and management in people with multiple sclerosis (MS). Body mass index (BMI) is the traditional marker of obesity in MS, whereas body composition, inclusive of specific body tissue compartments (e.g., fat, bone, and muscle), is often overlooked despite its relevance. Objective: This narrative review (a) underscored the use and utility of dual-energy X-ray absorptiometry (DEXA) as an accurate and reliable measure of body composition; (b) thematically analyzed and synthesized the current evidence regarding body composition (using DEXA); and (c) determined gaps to be addressed in future research. Methods: The structure and reporting of this narrative review followed the guiding criteria outlined in the Scale for the Assessment of Narrative Review Articles (SANRA). The relevant literature for this narrative review was identified via a PubMed search utilizing combined search terms such as ‘body composition’ and ‘multiple sclerosis’. The identified research was then organized by the authors into major themes and sub-themes. The articles described within the narrative review were based on saturation of the identified themes and sub-themes. Results: Three major themes were identified, namely (1) comparison of body composition between people with MS and non-MS controls (2 meta-analyses); (2) examination of the relationships between body composition and a range of outcomes (14 cross-sectional studies); and (3) interventions that report and/or target body composition in MS (11 clinical trials). Conclusions: This narrative review mapped the existing evidence regarding body composition in MS, and posits body composition as a novel, informative, and targeted concept for this population. The narrative review underscores the importance of randomized controlled trials that focus on body composition as a significant and modifiable outcome. Such research could improve the understanding of obesity and poor body composition in MS and identify useful clinical recommendations for diagnosis and management. Full article

Background/Objectives: Fructose consumption in children is increasing, as is the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD). Despite evidence linking added sugars to metabolic syndrome, fructose’s impact on liver disease in youth remains unclear, especially in pediatrics. Our study aimed to evaluate the role of fructose intake in metabolic and liver dysfunction in a cohort of pre-school children and adolescents with obesity. Methods: We recruited 41 children and adolescents with obesity (age range: 2.5–16 years, BMI SDS 2.6 ± 0.5 kg/m²). Clinical and biochemical parameters were assessed. Through ultrasound (US), MASLD, hepatorenal index (HRI), subcutaneous adipose tissue (scAT), and visceral adipose tissue (vAT) were assessed. Dietary intake was evaluated using the IDEFICS FFQ and a fructose-specific questionnaire. Results: Pubertal subjects had more scAT and vAT, higher insulin resistance, and higher liver fibrosis parameters than those prepubertal. MASLD was detected in 12 subjects, associated with higher scAT and vAT. Pubertal subjects had lower weekly fructose intake than prepubertal subjects (p < 0.02). However, they consumed less fructose from fruits (p < 0.04) and more from other sugars (p < 0.04) than younger children. Patients with MASLD reported higher fructose intake (p < 0.01), primarily from fruits (p < 0.003), likely due to misreporting, alongside higher consumption of unhealthy food, mainly rich in saturated fats. Conclusions: Fructose intake and unhealthy dietary habits were associated with MASLD in pre-school and adolescents with obesity. Advice to pay attention to fructose intake and foods rich in saturated fats is mandatory to decrease both obesity and MASLD. Further high-powered studies in any pediatric age and different geographical areas are needed to better evaluate the MASLD history. Full article

Background: Although several studies have demonstrated a link between obesity and cognitive function, the majority have primarily utilized body mass index (BMI) and waist circumference, ignoring the distribution of body fat. Evidence regarding the association of metabolic score for visceral fat (METS-VF), a proposed measurement for visceral adipose tissue (VAT), with cognitive function remains limited. We mainly aimed to investigate this association in older adults in the United States. Methodology: Data were from the National Health and Nutrition Examination Survey (NHANES) 2011 to 2014. Weighted linear regression models were adopted to examine the association of METS-VF and cognitive function scores, with further exploration of these associations across different obesity subgroups. Smoothing curve analysis, along with threshold and saturation effect analysis, were conducted to explore potential non-linear relationships. Results: In the multivariable-adjusted model, participants in the highest quartile (Quartile 4) of METS-VF exhibited a β coefficient of −1.52 [95% CI (−2.43, −0.62)] for the CERAD score compared with those in the lowest quartile (Quartile 1). Threshold and saturation effect analysis revealed non-linear associations of METS-VF with DSST score and Z-score. Conclusions: The findings of this study indicate that elevated METS-VF scores are inversely related to cognitive function, highlighting the importance of considering visceral fat distribution in cognitive health assessments. Full article

Adipose tissue of obese people secretes a number of adipokines, including adiponectin and resistin, which have an antagonistic effect on the human metabolism, influencing the pathogenesis of many diseases based on low-grade inflammation. Body composition analysis using bioelectrical impedance analysis (BIA) was performed in 84 adults with obesity, i.e., body mass index (BMI) greater than or equal to 30 kg/m². Serum was collected to analyze the concentration of adiponectin (ApN) and resistin. The subjects additionally completed a food frequency questionnaire FFQ-6 and a three-day food diary. Adiponectin-resistin index (AR index) was calculated. The results show a positive correlation between resistin levels and BMI and subcutaneous fat content. AR index value was also positively associated with the amount of adipose tissue and body mass. Adiponectin level in the serum of the studied individuals decreased with the content of lean tissue. Adiponectin level also decreased with the amount of carbohydrates, amount of starch, and glycemic load of the diet. Resistin decreased in patients who frequently consumed white pasta and red meat, while AR index was positively associated with the amount of white rice and saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs) consumed but negatively associated with the frequent consumption of carbohydrates, including starch. Physical activity was negatively correlated with adiponectin levels and AR index. We concluded that body composition significantly influenced serum resistin and adiponectin concentrations the AR index. Dietary components also had a significant effect. Full article

This study investigated the impacts of light spectra on oxidative stress and nutrient quality of the fish Plectropomus leopardus in indoor recirculating aquaculture systems. The fish (100 g ± 0.45 g [wet weight]) were cultures in five different light spectra (full-spectrum (400–800 nm), blue (450 nm), green (530 nm), red (630 nm), and dark) for 60 days. After experimentation, blood and muscle tissue were collected and analyzed for biochemical variables and nutritional quality. We demonstrated that the total cholesterol, triglycerides activities of P. leopardus in the dark groups were substantially elevated, relative to other groups (p < 0.05). Glutathione and glutathione peroxidase activities were elevated in the green light group versus other red groups, and cortisol was drastically reduced in the red group relative to other groups (p < 0.05). The crude ash concentration in the blue and full-spectrum group was substantially more elevated than in other groups (p < 0.05). Thr, Glu, Cys, Val, Met, Ile, Leu, Phe, Lys, His, Arg were markedly higher in the blue light versus the red light group (p < 0.05). The muscle of P. leopardus was rich in lysine and its essential AA index was in the order of blue light, full-spectrum, green light, dark and red group. The content of total saturated fatty acids in the blue light group was drastically lower relative to the dark, green and red groups (p < 0.05), and the total polyunsaturated fatty acids and DHA + EPA contents in the blue light group were substantially elevated relative to the other groups (p < 0.05). These results revealed that different light environments had certain effects on blood biochemical, antioxidant capacity, nutrient composition and proportion of P. leopardus. A comprehensive evaluation found that the blue light environment had more positive effects on the physiological, biochemical and nutritional quality of P. leopardus. This result provides a theoretical reference for the lighting strategy of an indoor recirculating aquaculture system. Full article

Bone fractures are associated with hypoxia, but no longitudinal studies of perfusion measurements in human patients have been reported despite the clinical and research potential. In this longitudinal observational cohort study, the near-infrared spectroscopy (NIRS) device PortaMon was used to assess oxy-(O₂Hb), deoxy-(HHb) and total (tHb) haemoglobin, as well as the differences between O₂Hb and HHb (Hb_Diff) and the tissue saturation index (TSI) at three different depths in the fracture gap. Linear mixed effect models were fitted to analyse time effects. One-way ANOVAs were conducted to compare groups. The time points corresponding to minima were calculated via linear regression. In this study, 11 patients with tibial shaft fractures underwent longitudinal measurements. Additionally, 9 patients with diagnosed tibial shaft nonunion and 23 age-matched controls were measured once. In the longitudinal group, all fractures healed, and decreases in O₂Hb and Hb_Diff (all p < 0.05) were observed, with minima occurring 19–21 days after fracture. O₂Hb values in nonunion patients did not differ from the minima in longitudinally measured union patients, whereas differences in HHb and tHb were significant (all p < 0.05). Previously, the onset of hypoxia has been assumed to be much faster. The characteristic trajectories of the NIRS parameters O₂Hb and Hb_Diff can be used to fulfil the need for a non-invasive method to monitor fracture healing. These results suggest that NIRS could supplement radiographs and clinical impressions in daily clinical practice and may enable earlier diagnosis of nonunion. Full article

Human skeletal muscle contains different types of tissues with skeletal muscle fibers (SMFs) and intermuscular adipose tissues (IMATs) as the main components. We maintained human skeletal muscle tissues from 12 study participants under native conditions in vitro for 11 days to investigate the dynamics of macrophages that reside in adjacent IMATs and SMFs simultaneously. The samples were subjected to immunohistochemical analysis for macrophage phenotyping and mitochondrial mass assessment before and after maintenance in vitro. Multiplex protein analysis was used to determine cytokine/chemokine expression in tissue extracts. The results revealed significant correlations between donor age or body mass index (BMI) and distinct phenotypes of resident macrophages in SMFs and IMATs. The dynamics of SMF- and IMAT-resident macrophages differed significantly in vitro and exhibited inverse correlations with chemokine/cytokine expression levels and mitochondrial activity. Moreover, the responses of macrophages to saturated and unsaturated fatty acids (FAs) differed substantially between SMFs and IMATs. These findings showed the functional diversity of phenotypically identical macrophages in adjacent niches. Thus, the currently available macrophage markers cannot capture the functional diversity of human tissue-resident macrophages. The model used in the present study may help elucidate how macrophages affect muscle homeostasis and disease in humans. Full article

Dextro-transposition of the great arteries (D-TGA) is a critical congenital heart defect that can impact neurodevelopment due to cerebral perfusion and oxygenation disorders followed by alterations in synaptogenesis, gyrification, sulcation, and the microstructure. Brain injuries can occur both pre-operatively and postoperatively, especially white matter injuries, neuronal loss, and stroke. Materials and Methods: In a retrospective study conducted at a tertiary center between 2016 and 2023, we investigated the early effects of Prostaglandin E1 (PGE1) administration and balloon atrial septostomy (BAS) on cerebral blood flow and oxygenation in inborn neonates with D-TGA. Cerebral Doppler Ultrasound in the anterior cerebral artery (ACA) was performed to assess the resistive index (RI), Peak Systolic Velocity (PSV), and End-Diastolic Velocity (EVD) before PGE1, before the BAS procedure, and 24 h after birth. Cerebral regional saturations of oxygen (crSO₂) and cerebral fractional tissue oxygen extraction (cFTOE) were evaluated. D-TGA patients were divided into the PGE1 group and the PGE1 + BAS group. Age-matched healthy controls were used for comparison. Results: All 83 D-TGA newborns received PGE1 within two hours after delivery, of whom 46 (55.42%) underwent BAS. In addition, 77 newborns composed the control group. PGE1 administration increased crSO₂ from 47% to 50% in the PGE1 group, but lower than in controls at 24 h of life, while cFTOE remained elevated. The RI increased 24 h after delivery (0.718 vs. 0.769; p = 0.000002) due to decreased EDV (10.71 vs. 8.74; p < 0.0001) following PGE1 treatment. The BAS procedure resulted in a significant increase in crSO₂ from 42% to 51% at 24 h of life in the PGE1 + BAS group. Doppler parameters exhibited a similar trend as observed in the PGE1 group. Conclusions: PGE1 treatment and BAS are lifesaving interventions that may improve cerebral perfusion and oxygenation in newborns with D-TGA during the transition period, as reflected by increasing SpO₂ and crSO₂. Full article

Managing chronic limb-threatening ischemia (CLTI) is challenging due to difficulties in assessing tissue oxygen saturation in ulcers. Near-infrared spectroscopy (NIRS) is a non-invasive method for measuring tissue oxygen saturation (StO₂). This study evaluated the effects of endovascular treatment (EVT) on StO₂ and wound healing in CLTI patients, comparing NIRS to standard ankle–brachial index (ABI) measurements. Using the Duesseldorf PTA Registry, 43 CLTI patients were analyzed: 27 underwent EVT, and 16 received conservative treatment. ABI assessed macrocirculation, while NIRS measured wound, wound area, and mean foot StO₂ at baseline, post-EVT, and four-month follow-up. Wound severity was classified by wound area and wound, ischemia, and foot infection (WIfI) score. Wound StO₂ increased significantly (median (interquartile range (IQR)), 38 (49.3) to 60 (34.5)%, p = 0.004), as did wound area StO₂ (median (IQR), 70.9 (21.6) to 72.8 (18.3)%, p < 0.001), with no significant changes in the control group by four-month follow-up. Wound area decreased significantly after EVT (mean ± SD, 343.1 ± 267.8 to 178.1 ± 268.5 mm², p = 0.01) but not in the control group. Changes in wound StO₂, wound area StO₂, and WIfI score correlated with wound area reduction, unlike ABI. This small exploratory study shows that NIRS-measured StO₂ improvements after EVT correlate with reduced wound area and WIfI scores, highlighting NIRS as a potential enhancement for CLTI wound management in addition to ABI. Full article

Acute respiratory distress syndrome (ARDS) is a critical illness in critically unwell patients, characterized by refractory hypoxemia and shock. This study evaluates an early detection tool and investigates the relationship between hypoxia and circulatory shock in ARDS, to improve diagnostic precision and therapy customization. We used a porcine model, inducing ARDS with mechanical ventilation and intratracheal plus intravenous lipopolysaccharide (LPS) injection. Hemodynamic changes were monitored using an Acumen IQ sensor and a ForeSight Elite sensor connected to the HemoSphere platform. We evaluated tissue damage, inflammatory response, and hypoxia-inducible factor (HIF) alterations using enzyme-linked immunosorbent assay and immunohistochemistry. The results showed severe hypotension and increased heart rates post-LPS exposure, with a notable rise in the hypotension prediction index (HPI) during acute lung injury (p = 0.024). Tissue oxygen saturation dropped considerably in the right brain region. Interestingly, post-injury HIF-2α levels were lower at the end of the experiment. Our findings imply that the HPI can effectively predict ARDS-related hypotension. HIF expression levels may serve as possible markers of rapid ARDS progression. Further research should be conducted on the clinical value of this novel approach in critical care, as well as the relationship between the HIF pathway and ARDS-associated hypotension. Full article

Background: Cerebrovascular autoregulation (CAR) is often impaired in preterm infants but requires invasive mean arterial blood pressure (MABP) measurements for continuous assessment. We aimed to assess whether using heart rate (HR) results in different CAR assessment compared with using MABP. Methods: We compared CAR (moving window correlation-coefficient with cerebral oxygenation saturation (r_cSO₂)), and percentage of time with impaired CAR (%timeCARi) calculated by either HR (TOHRx, tissue oxygenation heart rate reactivity index) or MABP (COx, cerebral oximetry index) during the first 72 h after birth, and its association with short-term cerebral injury. Results: We included 32 infants, median gestational age of 25 + 5/7 weeks (interquartile range 24 + 6/7–27 + 5/7). COx and TOHRx correlation coefficients (cc) were significantly different in the first two days after birth (individual means ranging from 0.02 to 0.07 and −0.05 to 0.01). %TimeCARi using MABP (cc cut-off 0.3), was higher on day 1 (26.1% vs. 17.7%) and day 3 (23.4% vs. 16.9%) compared with HR (cc cutoff −0.3). During 65.7–69.6% of the time, both methods indicated impaired CAR simultaneously. The aforementioned calculations were not associated with early cerebral injury. Conclusions: In conclusion, HR and MABP do not seem interchangeable when assessing CAR in preterm infants. Full article

Endothelial dysfunction decreases exercise limb blood flow (BF) and muscle oxygenation. Acute L-Citrulline supplementation (CIT) improves muscle tissue oxygen saturation index (TSI) and deoxygenated hemoglobin (HHb) during exercise. Although CIT improves endothelial function (flow-mediated dilation [FMD]) in hypertensive women, the impact of CIT on exercise BF and muscle oxygenation (TSI) and extraction (HHb) are unknown. We examined the effects of CIT (10 g/day) and a placebo for 4 weeks on blood pressure (BP), arterial vasodilation (FMD, BF, and vascular conductance [VC]), and forearm muscle oxygenation (TSI and HHb) at rest and during exercise in 22 hypertensive postmenopausal women. Compared to the placebo, CIT significantly (p < 0.05) increased FMD (Δ−0.7 ± 0.6% vs. Δ1.6 ± 0.7%) and reduced aortic systolic BP (Δ3 ± 5 vs. Δ−4 ± 6 mmHg) at rest and improved exercise BF (Δ17 ± 12 vs. Δ48 ± 16 mL/min), VC (Δ−21 ± 9 vs. Δ41 ± 14 mL/mmHg/min), TSI (Δ−0.84 ± 0.58% vs. Δ1.61 ± 0.46%), and HHb (Δ1.03 ± 0.69 vs. Δ−2.76 ± 0.77 μM). Exercise BF and VC were positively correlated with improved FMD and TSI during exercise (all p < 0.05). CIT improved exercise artery vasodilation and muscle oxygenation via increased endothelial function in hypertensive postmenopausal women. Full article

Background and Objectives: Temporomandibular disorders or dysfunction (TMDs) encompass a range of complex conditions that impact the temporomandibular joint (TMJ), chewing muscles, teeth, and/or their supporting tissues. Stress is one of the most associated factors studied as a TMD predictor. The aim is to figure out the influence of stress on TMJ status and salivary cortisol in university students during and before exams. Materials and Methods: The study was non-experimental, employing a longitudinal, analytical, observational cohort design. The study population consisted of students enrolled in the physiotherapy degree program at the Alfonso X El Sabio University (Madrid, Spain). Data were collected during two distinct academic periods: the first period was characterized by low academic stress and no exams, and the second period coincided with the high academic stress of final course exams. The collected results included sociodemographic data, assessment of TMJ status (Fonseca Index), evaluation of muscle evaluation (masseter, upper trapezius, and sternocleidomastoid) using a MOXY Monitor (muscle oxygenation) and Neurotrac^® (surface EMG, sEMG), assessment of perceived stress (PSS-14), and measurement of salivary cortisol (enzyme immunoassay with Elisa). The statistical analysis was conducted with a confidence level of 95% (p ≤ 0.05) and asymptotic or bilateral significance. Results: 70 students were analyzed during two different measurement periods. According to the Fonseca Index, initially, 37.14% of the analyzed students showed mild TMDs, 17.14% moderate TMDs, and 45.72% showed no TMDs. In general terms, stress increased with age and is related to female sex, maximum mouth opening decreased with age, oxygen saturation decreased with age and academic stress, and myoglobin concentration was related to age. Furthermore, muscle contraction decreased during higher academic stress and increased with age. For women, age was a risk factor for suffering from TMDs, and stress worsened the transition from having TMDs to having no TMDs in both sexes. Conclusions: Academic stress influences TMJ status and muscle outcomes such as oxygen saturation, myoglobin concentration, and muscle contraction, although more research is needed. Full article