A Cross-Sectional Validation Study of Camry EH101 versus JAMAR Plus Handheld Dynamometers in Colorectal Cancer Patients and Their Correlations with Bioelectrical Impedance and Nutritional Status.

BACKGROUND: Reduced muscle strength (dynapenia) and mass (atrophy) are prognostic factors in oncology. Measuring maximal handgrip strength with dynamometers is feasible but limited by the cost of the reference device (JAMAR). METHODS: A cross-sectional study was conducted on colorectal cancer outpatients treated with chemotherapy or under active surveillance in our center from September 2022 to July 2023. Accuracy, reliability, and concordance were compared for two handheld dynamometers: the JAMAR Plus (the gold-standard device) and the Camry EH101 (a low-cost index device). A simultaneous nutritional diagnosis with GLIM criteria and bioelectrical impedance analysis (BIA) was carried out. RESULTS: A total of 134 participants were included. The median of maximal strength for the JAMAR Plus had a non-significant difference of 1.4 kg from the Camry EH101. The accuracy and reliability of the devices were high. Bland-Altman analysis showed a 0.8 kg bias and -4.1 to 5.6 kg limits of agreement (LoA); a 0.1 kg bias and -5.3 to 5.4 kg LoA in men; a 1.5 kg bias and -2.2 to 5.3 kg LoA in women. In total, 29.85% of the participants were malnourished. Prevalence of dynapenia increased from 3.67% with the JAMAR Plus to 5.14% with the Camry EH101. Both devices had a moderate and significant correlation with BIA-estimated muscle mass. CONCLUSIONS: The Camry EH101 was a cost-effective alternative to JAMAR Plus in our sample.

Morphofunctional Assessment beyond Malnutrition: Fat Mass Assessment in Adult Patients with Phenylketonuria-Systematic Review.

Morphofunctional assessment was developed to evaluate disease-related malnutrition. However, it can also be used to assess cardiometabolic risk, as excess adiposity increases this risk. Phenylketonuria (PKU) is the most prevalent inherited metabolic disease among adults, and obesity in PKU has recently gained interest, although fat mass correlates better with cardiometabolic risk than body mass index. In this systematic review, the objective was to assess whether adult patients with PKU have higher fat mass than healthy controls. Studies of adult PKU patients undergoing dietary treatment in a metabolic clinic reporting fat mass were included. The PubMed and EMBASE databases were searched. Relevance of articles, data collection, and risk of bias were evaluated by two independent reviewers. Ten articles were evaluated, six with a control group, including 310 subjects with PKU, 62 with mild hyperphenylalaninemia, and 157 controls. One study reported a significant and four a tendency towards an increased fat mass in all patients or only females with PKU. Limitations included not having a healthy control group, not reporting sex-specific results and using different techniques to assess fat mass. Evaluation of fat mass should be included in the morphofunctional assessment of cardiometabolic risk in adult patients with PKU.

Use of Muscle Ultrasonography in Morphofunctional Assessment of Amyotrophic Lateral Sclerosis (ALS).

Amyotrophic lateral sclerosis (ALS) is a progressive disease with a high prevalence of malnutrition that can influence prognosis. The main objective of this study is to compare the validity of muscle ultrasonography in the diagnosis of malnutrition and the prognosis of patients with ALS. METHODS: This is a prospective observational study that analyzes the nutritional status of patients at the beginning of nutritional monitoring. The morphofunctional assessment included the examination of anthropometric variables such as weight, height, body mass index (BMI), arm circumference, and calf circumference. Additionally, electrical bioimpedanciometry (BIA) was used to measure electrical parameters and estimate other relevant metrics. Muscle ultrasonography® (quadriceps rectus femoris (QRF)) assessed muscle mass parameters, including muscle area index (MARAI), anteroposterior diameter of the QRF (Y-axis) (cm), transverse diameter of the QRF (X-axis) (cm), and the sum of the quadriceps thickness (RF+VI) (cm), as well as muscle quality parameters such as echogenicity and the Y-X index. RESULTS: A total of 37 patients diagnosed with amyotrophic lateral sclerosis (ALS) were included in this study. Of these patients, 51.4% were men. The mean age was 64.27 (12.59) years. A total of 54.1% of the patients had a bulbar onset of amyotrophic lateral sclerosis, and 45.9% had spinal onset. The percentage of subjects with malnutrition diagnosed by the Global Leadership Initiative on Malnutrition (GLIM) criteria was 45.9% of patients. There was a direct correlation between muscle mass parameters assessed by muscle ultrasonography (RF+VI) and active mass markers measured by bioimpedanciometry (body cellular mass index (BCMI) (r = 0.62; p < 0.01), fat-free mass index (FFMI) (r = 0.75; p < 0.01), and appendicular skeletal mass index (ASMI) (r = 0.69; p < 0.01)). There was a direct correlation between echogenicity and resistance (r = 0.44; p = 0.02), as well as between the fat-free mass index and the Y-X index (r = 0.36; p = 0.14). Additionally, there was a negative correlation between echogenicity and BCMI (r = -0.46; p < 0.01) and ASMI (r = 0.34; p = 0.06). Patients with low quadriceps thickness (male < 2.49 cm; female < 1.84 cm) showed an increased risk of hospital admission adjusted by age, sex, and presence of dysphagia (OR: 7.84 (CI 95%: 1.09-56.07); p-value = 0.04), and patients with low-quality mass (Y-X index < 0.35) had a higher risk of hospital admission adjusted by age, sex, and presence of dysphagia (OR: 19.83 (CI 95%: 1.77-222.46); p-value = 0.02). CONCLUSIONS: In patients with ALS, ultrasonography echogenicity was inversely related to BCMI, FFMI, and ASMI, and the Y-X index was directly related to FFMI. The lowest quartiles of quadriceps thickness and Y-X index are risk factors for hospital admission.

Simple, inexpensive, and rapid approach to detect changes in the structure of soil free-living nematodes.

A general limitation of ecological investigations based on nematodes is related to the difficult and time-consuming taxonomic identification of species. Therefore, nematologists are investing many efforts to develop alternative approaches as proxies applicable in biomonitoring assessment. Recently, an alternative method that combines morpho-functional traits was proposed for detecting assemblage changes of marine nematodes. In view of the promising results, it was tested the same approach to document taxonomic structure changes of soil free-living and plant parasitic nematodes. Specifically, this attempt was carried out using three data sets that include studies from various European regions and different types of ecosystems: forests, grasslands and maize crops. Multivariate statistical analysis revealed that the simple combination of the four traits (i.e., buccal cavity cuticularization occurrence, amphideal fovea size and shape, morphology of the cuticle and pharynx) in a single code number perfectly mirrors the taxonomic structure trends of the nematode assemblage at genus level. Therefore, we predict that similar results can be also obtained by directly encoding nematode specimens with the selected traits and we point to new important advances if this procedure can be coupled with advanced machine learning.

Revisiting the beyond BMI paradigm in excess weight diagnosis and management: A call to action.

Adolphe Quételet, a 19th-century Belgian sociologist and statistician, pioneered the incorporation of statistics into social sciences. He initiated the development of anthropometry since he was interested in identifying the proportions of the 'ideal man'. He devised a ratio between weight and height, originally termed the Quételet Index, and today widely known and used as the body mass index or BMI. In 1835, he demonstrated that a normal curve accommodates the distribution of human traits articulating his reasoning on human variance around the average. Quételet's long-lasting legacy of the establishment of a simple measure to classify people's weight relative to an ideal for their height endures today with minor variations having dramatically influenced public health agendas. While being very useful, the limitations of the BMI are well known. Thus, revisiting the beyond BMI paradigm is a necessity in the era of precision medicine with morphofunctional assessment representing the way forward via incorporation of body composition and functionality appraisal. While healthcare systems were originally designed to address acute illnesses, today's demands require a radical rethinking together with an original reappraisal of our diagnosis and treatment approaches from a multidimensional perspective. Embracing new methodologies is the way forward to advance the field, gain a closer look at the underlying pathophysiology of excess weight, keep the spotlight on improving diagnostic performance and demonstrate its clinical validity. In order to provide every patient with the most accurate diagnosis together with the most appropriate management, a high degree of standardization and personalization is needed.

Phase angle and rectus femoris cross-sectional area as predictors of severe malnutrition and their relationship with complications in outpatients with post-critical SARS-CoV2 disease.

Background and aims: The diagnosis of malnutrition in post-critical COVID-19 patients is challenging as a result of the high prevalence of obesity, as well as the variability and previously reported inconsistencies across currently available assessment methods. Bioelectrical impedance vector analysis (BIVA) with phase angle (PhA) and nutritional ultrasound (NU®) are emerging techniques that have been proven successful in assessing body composition with high precision in previous studies. Our study aims to determine the performance and usefulness of PhA and rectus femoris cross-sectional area (RF-CSA) measurements in assessing body composition as part of the full routine morphofunctional assessment used in the clinical setting, as well as their capacity to predict severe malnutrition and to assess complications and aggressive therapy requirements during recent intensive care unit (ICU) admission, in a cohort of post-critically ill COVID-19 outpatients. Methods: This prospective observational study included 75 post-critical outpatients who recovered from severe COVID-19 pneumonia after requiring ICU admission. Correlations between all the morphofunctional parameters, complications, and aggressive therapy requirements during admission were analyzed. Multivariate logistic regression analysis and ROC curves were provided to determine the performance of NU® and PhA to predict severe malnutrition. Differences in complications and aggressive therapy requirements using the cutoff points obtained were analyzed. Results: In total, 54.7% of patients were classified by Subjective Global Assessment (SGA) as SGA-B and 45.3% as SGA-C, while 78.7% met the Global Leadership Initiative of Malnutrition (GLIM) criteria. PhA correlates positively with body cell mass/height (BCM/h) (r = 0.74), skeletal muscle index (SMI) (r = 0.29), RF-CSA (r = 0.22), RF-Y axis (r = 0.42), and handgrip strength (HGS) assessed using dynamometry (r = 0.42) and the Barthel scale (r = 0.29) and negatively with ICU stay (r = -0.48), total hospital stay (r = -0.57), need for invasive mechanical ventilation (IMV) (r = -0.39), days of IMV (r = -0.41), need for tracheostomy (r = -0.51), and number of prone maneuvers (r = -0.20). RF-CSA correlates positively with BCM/h (r = 0.41), SMI (r = 0.58), RF-Y axis (r = 0.69), and HGS assessed using dynamometry (r = 0.50) and the Barthel scale (r = 0.15) and negatively with total hospital stay (r = -0.22) and need for IMV (r = -0.28). Cutoff points of PhA < 5.4° and standardized phase angle (SPhA) < -0.79 showed good capacity to predict severe malnutrition according to SGA and revealed differences in ICU stay, total hospital stay, number of prone maneuvers, need for IMV, and need for rehabilitation, with statistical significance (p < 0.05). An RF-CSA/h < 2.52 cm2/m (for men) and <2.21 cm2/m (for women) also showed good performance in predicting severe malnutrition and revealed differences with statistical significance (p < 0.05) in ICU stay and total hospital stay. Conclusion: More than 75% of the post-critical COVID-19 survivors had malnutrition, and approximately half were obese. PhA, SPhA, RF-CSA, and RF-CSA/h, when applied to the assessment of body composition in post-critical COVID-19 patients, showed moderate-to-high correlation with other morphofunctional parameters and good performance to predict severe malnutrition and to assess complications and aggressive therapy requirements during ICU admission. Besides being readily available methods, BIVA and NU® can help improve the morphofunctional assessment of malnutrition in post-critical COVID-19 survivors; however, more studies are needed to assess the performance of these methods in other populations.

Is intraspecific trait differentiation in Parthenium hysterophorus a consequence of hereditary factors and/or phenotypic plasticity?

Of the various strategies adopted by an invasive plant species for expanding its niche breadth, phenotypic differentiation (either due to plasticity and/or adaptive evolution) is proven to be the most successful. Lately, we studied the persistence of substantial morpho-functional variations within the individuals of alien invasive plant, Parthenium hysterophorus in Chandigarh, India, through field surveys. Based on observed differences, the individuals were categorized into two morphotypes, PA and PB. PA had higher leaf area, leaf biomass, and chlorophyll content as compared with PB. However, PB had a higher stem circumference, stem specific density, twig dry matter content, profuse branching, bigger canopy, and better reproductive output than PA. To substantiate the persistence of intraspecific variations in P. hysterophorus and to deduce the possible genesis of these variations, we propagated both the morphotypes under experimental conditions in winter and summer. Apart from the key morpho-functional differences observed during the field studies, protein and carbohydrate metabolism were studied in leaves and roots of the propagated plants. Differences in plant metabolism were observed only during the early growth period, whereas the morpho-functional traits varied in the mature flowering plants. The effect of growth season was highly significant on all the studied morpho-functional and biochemical parameters (p ≤ 0.05). Parent morphotypes (P) and interactions between morphotypes and seasons significantly affected several growth parameters (p ≤ 0.05). The analyses revealed that the contrasting growth conditions at the time of transplantation and early growth may regulate the phenotype of P. hysterophorus. The pattern of intraspecific variations observed during the study is justified to consider morphotype PA as winter biotype and morphotype PB as summer biotype of P. hysterophorus. The study points towards the role of plasticity or a combination of genetic and environmental (G × E) factors in producing the phenotypic variability observed in the population of P. hysterophorus.

Rectus Femoris Cross-Sectional Area and Phase Angle asPredictors of 12-Month Mortality in Idiopathic Pulmonary Fibrosis Patients.

BACKGROUND: The value of the phase angle (PhA), measured via bioelectrical impedance analysis (BIA), could be considered a good marker of the cell mass and the cell damage of a patient; however, there are new techniques, such as muscle ultrasonography, that allow the quantity and quality of muscle to be assessed in a minimally invasive way. The aim of this study is to determine the prognostic value of morphofunctional techniques in the prognosis of mortality in patients with idiopathic pulmonary fibrosis (IPF). METHODS: This multicenter, cross-sectional study included 86 patients with idiopathic pulmonary fibrosis with a mean age of 71 years, 82.7% of whom were male. The nutritional risk of the patients was assessed by means of questionnaires, such as the Subjective Global Assessment (SGA), and non-invasive functional techniques, including BIA, nutritional ultrasound, and hand grip strength (HGS). Statistical analysis of the sample was performed using JAMOVI version 2.3.22. RESULTS: Correlations were made between the RF-CSA techniques with PhA (r = 0.48, p < 0.001), BCM (r = 0.70, p < 0.001), SMI (r = 0.64, p < 0.001), and HGS (r = 0.54, p < 0.001). The cut-off points for 12-month mortality were PhA = 4.5° (AUC = 0.722, sensitivity of 72.7% and specificity of 66.6%), BCM = 28.8 kg (AUC = 0.609, sensitivity of 32.4% and specificity of 100.0%), RF-CSA = 3.00 cm2 (AUC = 0.857, sensitivity of 64.4% and specificity of 100.0%), 6MMW = 420 m (AUC = 0.830, sensitivity of 63.27% and specificity of 100.0%), and TUG = 7.2 s (AUC = 0.771, sensitivity of 100.0% and specificity of 56.67%). In addition, a multivariate analysis was performed with RF-CSA, HR = 8.11 (1.39-47.16, p = 0.020), and PhA of 6.35 (1.29-31.15, p = 0.023), taking into account age, sex, and BMI to determine mortality. Finally, a Kaplan-Meier survival analysis was conducted with low or normal values for classical parameters (GAP and T6MM) and new parameters (PhA, BCM, RF-CSA, and TUG). CONCLUSION: RF-CSA and PhA were shown to be good prognostic markers of 12-month mortality and could, therefore, be useful screening tools to complement the nutritional assessment of IPF patients.

Postcranial skeleton of Goodwin's brush-tailed mouse (Calomyscus elburzensis Goodwin, 1939) (Rodentia: Calomyscidae): Shape, size, function, and locomotor adaptation.

Goodwin's brush-tailed mouse (Calomyscus elburzensis Goodwin, 1939) is a poorly known small rodent that occupies rocky habitats in Iran, Turkmenistan, Afghanistan, Pakistan, Azerbaijan, and Syria. Herein, a detailed description of the shape, size, and function of the postcranial skeleton of this species is presented for the first time. Trapping was carried out in eastern Iran between the years 2013 and 2015. Skeletal parts of 24 adult male specimens were removed using the papain digestion protocol, and several postcranial morphological characteristics and measurements were examined. We attempted to achieve a morpho-functional characterization of Goodwin's brush-tailed mouse and to match morphological specializations with previous information on the ecology, behavior, and phylogenetic inferences of this rodent. Goodwin's brush-tailed mouse has extended transverse processes and long zygapophyses in the first five caudal vertebrae along with a good innervation of the caudal vertebrae, which has resulted in a well-developed basal musculature of the tail. It has extended forelimb, long ilium, and short post-acetabular part of the innominate bone, loose hip joint with high degree of lateral movement of the hindlimb, and long distal elements of the hindlimb. These features have resulted in fast terrestrial movements in open microhabitats, including climbing and jumping. Although superficial scratching of the ground is observed, the species is incapable of digging burrows. Evaluation of postcranial morphological characteristics and character states further indicated the basal radiation of the genus Calomyscus among other Muroidea. Findings constitute a source of information for morpho-functional and phylogenetic comparisons between Calomyscidae and other mouse-like muroids.

Nutritional Ultrasonography, a Method to Evaluate Muscle Mass and Quality in Morphofunctional Assessment of Disease Related Malnutrition.

Nutritional ultrasonography is an emerging technique for measuring muscle mass and quality. The study aimed to evaluate the relationship between the parameters of body mass and quality of ultrasonography with other parameters of morphofunctional assessment in patients with disease-related malnutrition (DRM). METHODS: A cross-sectional study was developed on 144 patients diagnosed with DRM according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Morphofunctional evaluation was assessed with anthropometric variables, handgrip strength and bioelectrical impedanciometry (BIA). Nutritional ultrasonography of quadriceps rectus femoris (QRF) was made (muscle mass (Muscle Area of Rectus Femoris index (MARFI)), Y axis and muscle quality (X-Y index and echogenicity). RESULTS: The mean age of patients was 61.4 (17.34) years. The prevalence of sarcopenia in the sample was 33.3%. Patients with sarcopenia (S) had lower values of MARFI [(S: 1.09 (0.39) cm2/m2; NoS: 1.27 (0.45); p = 0.02), Y axis (S: 0.88 (0.27); NoS: 1.19 (0.60); p < 0.01) and X-Y index (S: 1.52 (0.61); NoS: 1.30 (0.53); p < 0.01)]. There was a correlation between BIA parameters (phase angle) and muscle mass ultrasonographic variables (MARFI) (r = 0.35; p < 0.01); there was an inverse correlation between muscle quality ultrasonographic variables (echogenicity) and handgrip strength (r = -0.36; p < 0.01). In the multivariate analysis adjusted by age, the highest quartile of the X-Y index had more risk of death OR: 4.54 CI95% (1.11-18.47). CONCLUSIONS: In patients with DRM and sarcopenia, standardized muscle mass and muscle quality parameters determined by ultrasonography of QRF are worse than in patients without sarcopenia. Muscle quality parameters had an inverse correlation with electric parameters from BIA and muscle strength. The highest quartile of the X-Y index determined by ultrasonography was associated with increased mortality risk.

[Morphofunctional cerebral changes associated with development of suicidal behavior]. / Morfofunktsional'nye izmeneniya golovnogo mozga, svyazannye s razvitiem suitsidal'nogo povedeniya.

THE AIM OF THE STUDY: Was to identify the cerebral areas, which demonstrate the most significant structural changes and damaged functional activity in patients with suicidal behavior. The original studies, presented in PubMed database, were used to analyze the literature. Additional literature in the form of atlases, review articles and publications, written in related spheres, was used to interpret the results. The study identified the 69 cerebral regions, demonstrating significant changes and the structures with the most significant deviations among them were selected. The regions of cerebral grey matter, in particular basal ganglia (structures of striatum and limbic system), as well as selected regions of cerebral cortex, specifically frontal, insularis, singulate and parietal mostly were included in the list. The decrease in grey matter volume, changes of neuronal and glial density, special patterns of activity and variations of functional association with other cerebral regions are described within mentioned structures. The literature review found that there was a lack of postmortem examinations in suicidal cases. Advanced study of the described structures is required in cases of completed suicide using new research methods.

Effect of MnxOy Nanoparticles Stabilized with Methionine on Germination of Barley Seeds (Hordeum vulgare L.).

The aim of this research was to study the effect of MnxOy nanoparticles stabilized with L-methionine on the morphofunctional characteristics of the barley (Hordeum vulgare L.) crop. MnxOy nanoparticles stabilized with L-methionine were synthesized using potassium permanganate and L-methionine. We established that MnxOy nanoparticles have a diameter of 15 to 30 nm. According to quantum chemical modeling and IR spectroscopy, it is shown that the interaction of MnxOy nanoparticles with L-methionine occurs through the amino group. It is found that MnxOy nanoparticles stabilized with L-methionine have positive effects on the roots and seedling length, as well as the seed germination energy. The effect of MnxOy nanoparticles on Hordeum vulgare L. seeds is nonlinear. At a concentration of 0.05 mg/mL, there was a statistically significant increase in the length of seedlings by 68% compared to the control group. We found that the root lengths of samples treated with MnxOy nanoparticle sols with a concentration of 0.05 mg/mL were 62.8%, 32.7%, and 158.9% higher compared to samples treated with L-methionine, KMnO4, and the control sample, respectively. We have shown that at a concentration of 0.05 mg/mL, the germination energy of seeds increases by 50.0% compared to the control sample, by 10.0% compared to the samples treated with L-methionine, and by 13.8% compared to the samples treated with KMnO4.

Future lines of research on phase angle: Strengths and limitations.

Bioelectrical impedance analysis (BIA) is the most widely used technique in body composition analysis. When we focus the use of phase sensitive BIA on its raw parameters Resistance (R), Reactance (Xc) and Phase Angle (PhA), we eliminate the bias of using predictive equations based on reference models. In particular PhA, have demonstrated their prognostic utility in multiple aspects of health and disease. In recent years, as a strong association between prognostic and diagnostic factors has been observed, scientific interest in the utility of PhA has increased. In the different fields of knowledge in biomedical research, there are different ways of assessing the impact of a scientific-technical aspect such as PhA. Single frequency with phase detection bioimpedance analysis (SF-BIA) using a 50 kHz single frequency device and tetrapolar wrist-ankle electrode placement is the most widely used bioimpedance approach for characterization of whole-body composition. However, the incorporation of vector representation of raw bioelectrical parameters and direct mathematical calculations without the need for regression equations for the analysis of body compartments has been one of the most important aspects for the development of research in this area. These results provide new evidence for the validity of phase-sensitive bioelectrical measurements as biomarkers of fluid and nutritional status. To enable the development of clinical research that provides consistent results, it is essential to establish appropriate standardization of PhA measurement techniques. Standardization of test protocols will facilitate the diagnosis and assessment of the risk associated with reduced PhA and the evaluation of changes in response to therapeutic interventions. In this paper, we describe and overview the value of PhA in biomedical research, technical and instrumental aspects of PhA research, analysis of Areas of clinical research (cancer patients, digestive and liver diseases, critical and surgical patients, Respiratory, infectious, and COVID-19, obesity and metabolic diseases, Heart and kidney failure, Malnutrition and sarcopenia), characterisation of the different research outcomes, Morphofunctional assessment in disease-related malnutrition and other metabolic disorders: validation of PhA with reference clinical practice techniques, strengths and limitations. Based on the detailed study of the measurement technique, some of the key issues to be considered in future PhA research. On the other hand, it is important to assess the clinical conditions and the phenotype of the patients, as well as to establish a disease-specific clinical profile. The appropriate selection of the most critical outcomes is another fundamental aspect of research.

MORPHOFUNCTIONAL STATUS OF INSTRUCTORS OF HIGHER EDUCATIONAL INSTITUTIONS DURING THEIR PEDAGOGICAL ACTIVITIES.

OBJECTIVE: The aim: To research the morphofunctional status of instructors of higher educational institutions of di"erent age groups in the process of their pedagogical activities. PATIENTS AND METHODS: Materials and methods: The research was conducted in the period from 2019 to 2021. The research involved 126 instructor offcers (men) of different age groups: under 30 years of age - 21 people, 31-35 years of age - 27 people, 36-40 years of age - 32 people, 41-45 years of age - 27 people, over 45 years of age - 19 people. Morphofunctional status of the instructor offcers was assessed by the indicators of their height, body weight, lung vital capacity, wrist dynamometry, heart rate, blood pressure and relevant indices. RESULTS: Results: It was found that during the study (2019-2020) the Kettle index, vital index, strength index, Robinson index and duration of recovery processes deteriorated among instructor offcers of all age groups. However, in instructor offcers of 36-40, 41-45 and over 45 years of age most of indices deteriorated reliably (P < 0.05). The values of the studied indices are below average or low in most instructors of all age groups, most instructors are overweight. CONCLUSION: Conclusions: It was found that the level of morphofunctional status of the instructional sta" is insuffcient to perform the tasks of their pedagogical activities. Rationally organized health-improving physical training sessions, taking into account the age group, morphofunctional status of instructors and the time of training sessions during the working day can be an effective way to solve this problem.

Expert Consensus on Morphofunctional Assessment in Disease-Related Malnutrition. Grade Review and Delphi Study.

Disease-related malnutrition (DRM) affects approximately a third of hospitalized patients and is associated with an increased risk of morbimortality. However, DRM is often underdiagnosed and undertreated. Our aim is to evaluate the prognostic value of morphofunctional tools and tests for nutritional assessment in clinical practice. A systematic literature review was conducted to identify studies relating to the morphofunctional assessment of nutritional status and mortality or complications. Evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) method. Twelve GRADE recommendations were made and divided into seven topics: food intake and nutrient assimilation, anthropometry, biochemical analysis, hand grip strength, phase angle, muscle imaging, and functional status and quality of life. From these recommendations, 37 statements were developed and scored in a two-survey Delphi method by 183 experts. A consensus was reached on accepting 26/37 statements. Surveys had high internal consistency and high inter-rater reliability. In conclusion, evidence-based recommendations were made on the prognostic value of morphofunctional assessment tools and tests to assess malnutrition, most of which were found to be feasible in routine clinical practice, according to expert opinions.

Comparative morpho-functional analysis of the humerus and ulna in three Western European moles species of the genus Talpa, including the newly described T. aquitania.

The forelimb is involved in many behaviours including locomotion. Notably, the humero-ulnar articulation, implicated in the elbow joint, is of particular importance for both mobility and stability. Functional constraints, induced in part by environmental plasticity, are thought to drive an important part of the bone shape as bone directly responds and remodels in response to both muscle and external forces. In this context, the study of subterranean moles is of particular interest. These moles occupy a hard and heavy medium in comparison with air or water, requiring a powerful body structure to shear and shift the soil. Their general morphology is therefore adapted to digging and to their subterranean lifestyle. The various morpho-functional patterns, which drive diverse abilities according to the environment, are likely targets of natural selection and it is, therefore, useful to understand the relationships between the bone shape and their function. Here, we quantify, through 3D geometric morphometric methods, the interspecific variability in the morphology of the ulna and humerus of three Talpa species, including the new species Talpa aquitania, to infer their potential consequence in species digging performance. We also quantify shape covariation and morphological integration between the humerus and the ulna to test whether these bones evolve as a uniform functional unit or as more or less independent modules. Our results show that interspecific anatomical differences in the humerus and ulna exist among the three species. Shape changes are mostly located at the level of joints and muscle attachments. As the species tend to live in allopatry and the fossorial lifestyle induces strong ecological constraints, interspecific variations could be explained by the properties of the environment in which they live, such as the compactness of the soil. Our results also show that the humerus and ulna are highly integrated. The covariation between the humerus and ulna in moles is dominated by variation in the attachment areas and particularly of the attachment areas of shoulder muscles concerning the humerus, which affect the mechanical force deployed during locomotion and digging. This study also highlights that in the new species, T. aquitania, variations in anatomical structure (general shape and joints) exist and are related to the locality of collect of the individuals.

Real World Practice Study of the Effect of a Specific Oral Nutritional Supplement for Diabetes Mellitus on the Morphofunctional Assessment and Protein Energy Requirements.

Introduction: The prevalence of malnutrition in patients with diabetes mellitus is high. In these patients, monitoring nutritional intervention is complex. Aims: To evaluate the evolution in the nutritional status in patients with diabetes/prediabetes and malnutrition with a diabetes-specific enteral formula. Methods: Real-life study of one arm in 60 patients with diabetes and prediabetes, performing a dietary adaptation with diabetes-specific oral nutritional supplementation. A morphofunctional assessment was performed, consisting of intake assessment, anthropometry, body composition (bioimpedance and muscle ultrasound), handgrip strength and biochemical markers. The diagnosis of malnutrition was made using the criteria of the Global Leadership Initiative on Malnutrition (GLIM). The variables were measured at baseline and 3 months after starting the intervention. Results: The mean age was 67.13 (14.9) years. In total, 30 (50%) of the patients were women. Of the total, 60% of the patients had diabetes mellitus and 40% of the patients had prediabetes. The initial body mass index was 24.65 (5.35) kg/m2. It was observed that 80% of the patients had malnutrition, whereas after the intervention, the prevalence was 51.7% (p < 0.01). At the beginning of the study, 20% of the patients suffered from sarcopenia and after the intervention it was 16.7% (p = 0.19). Conclusions: Medical Nutrition Therapy with an adapted oral diet associated with diabetes-specific oral nutritional supplementation reduces malnutrition in patients at nutritional risk and disturbances of carbohydrate metabolism.

A morphofunctional analysis of the regurgitant mitral valve as a guide to repair: Another point of view.

Based on Carpentier's classification and principles, the techniques for mitral valve repair continue to evolve. We herein report our experience with the morphofunctional echocardiographic analysis of single mitral leaflets, as different anatomic features, even if conflicting, may coexist not only in the two leaflets but in the same leaflet as well. A classification is proposed, based on the length (normal, short, or long) and mobility (normal, restricted, or excessive) of mitral leaflets. The surgical techniques adopted for mitral valve repair are the direct consequence of this analysis.

Veterinary Biotypology: a review and new possibilities

The truths surrounding medical practices are seasonally challenged by innovative concepts that can aggregate changing procedures in many degrees. The Galtonian eugenics issues supported the pure-breed idea in dictatorial governments, and introduced mesological studies, turning possible to join genetic concepts to the physiology and psychology of the human organism. Following human medicine, more therapeutic models need to forthcoming in domestic animals. The companionship necessity and the highly responsive behavior have addressed the domestication of dogs and their relationship to owners, to an endpoint that both share the same pathologies. Thus, traditional human concepts of biotypology could be extended to companion animals. Grauvogl (1811-1877) proposeda simple biochemical correlation between physiological states and the miasmas of sick individuals (oxygenoid -syphilis, hydrogenoid -sycosis, carbo-nitrogenoid -psora). Antoine Nebel (1870-1954) correlated biochemical status with the musculoskeletal system and behavior as well. Leon Vannier (1880-1963) model, whose morphophysiological distortions and behavioral inconsistencies were explained by the carbon element and variations in its bonds with phosphorus or fluor radicals was another attempt to categorize and predefine physiology states. Following the advent of structural and functional identification of thyroid hormone in the 1940s, Henri Bernard described the neuro-morphofunctional plasticity of individuals guided by their predominant embryonic leaflet and consequent hormonal diseases. Methods:This work is a narrative review with the purpose of describing and discussingthe legacy ofbiotypology studies and their applicability in dog therapy, and proposinga new homeopathic approach in veterinary medicine based on the miasmas, also contributing to the scarcelyavailable literature. Results:Based on cellular exchanges and consequent metabolic rate, animals can be classified into psoric (no evidence of clinical signs, stable behavior, and adequate exonerative cellular processes); sycotic (cellular dysfunction with alterations in oxidative phosphorylation processes allowing accumulation of cellular toxins such as reactive oxygen and nitrogen species; clinically culminating in chronic inflammations in noble organs, and purulent discharges; unstable and polarized behavior) and syphilitic (whose cellular alterations have reached the molecular level, reducing protein expression and determining cellular toxicity and loss of function; indifferentbehavior). Generalities such as temperature influence, weight, thirst and feedingshall also be considered. Discussion and Conclusion: Thismodel could benefit stray animals, newly adopted or even from shelters, whose actual behavior is unknown, and the search for the Simillimum may be impaired.