From Sweat to Strain: An Epidemiological Analysis of Training-Related Injuries in CrossFit®.

Purpose: This study aims to conduct an epidemiological investigation into the types and causes of injuries during CrossFit® training in Germany. Patients and Methods: Voluntary athletes from various German CrossFit® gyms participated, providing personal information, training habits, and details on injuries through a standardized questionnaire. Results: The study involved 308 participants, with an equal sex split, a peak age of 20-40, and a BMI of 24.3 ± 3.3 kg/m2. Most participants trained for over two years (49.4%), primarily in supervised groups. Motivations for engaging in CrossFit® included health prevention (33.1%), athletic training (32.8%), and work-life balance support (17%). Injuries were reported by 28.6% of participants, with 61.4% experiencing single injuries. The majority of injuries (55.3%) occurred during the middle of workouts. Injury types included wounds (23.3%), contusions, sprains, or strains (cumulative 30.8%), and fractures (2.9%). Almost all injured individuals (96.5%) had a time-loss injury, with a return to sport ranging from a day to over three months. Treatments varied, with 50.6% not requiring medical intervention, 34.1% undergoing physiotherapy, 21.2% receiving medication and 8.2% needing surgery. Barbell exercises, notably Snatch and Clean, were main exercises with association to injuries, accounting for 36.3%. The Box Jump stood out as the exercise with the highest isolated injury prevalence (14.3%). Notable injury causes included falls during Pull-Ups and lumbar disc herniation linked to Deadlifts. Following injuries, 45.8% of participants made training adjustments. Conclusion: This study provides an epidemiological investigation into the types and causes of injuries during CrossFit® training in Germany. The shoulder and knee joint exhibited the highest injury prevalence. Barbell exercises, box jumps, and bar pull-ups were identified as major exercises with association to injuries. Prevention through technical training and the incorporation of soft boxes could reduce the risk of injuries in CrossFit®.

This study looks at the types and causes of injuries during CrossFit^® training in Germany. A total of 308 CrossFit^® athletes took part, with an equal number of men and women, mostly aged 20-40, and an average BMI of 24.3 ± 3.3 kg/m². Most had trained for over two years, often in supervised groups, and were motivated by health, fitness, and balancing work and life. About 28.6% of participants reported injuries, mostly single injuries happening in the middle of workouts. The types of injuries included cuts, bruises, sprains, strains, and fractures, with the shoulder and knee being the most commonly affected areas. Notably, exercises involving barbells like the Snatch and Clean caused a significant number (36.3%) of injuries, followed by Box Jumps (14.3%) and bar pull-ups. Causes of injuries included falls during pull-ups and back injuries from Deadlifts. After getting injured, nearly half of the participants changed their training routines. Treatments varied, with some not needing medical help and others undergoing physiotherapy, taking medication, or having surgery. The findings suggest that focusing on proper technique and using softer equipment, like softer landing surfaces for Box Jumps, could help reduce the risk of injuries in CrossFit^® training.

Can edoxaban be used at extremes of bodyweight and in patients with a creatinine clearance ≥95 ml/min? - A population pharmacokinetic analysis.

BACKGROUND: Clinical evidence surrounding edoxaban use in patients weighing <50 kg and >120 kg is lacking. The International Society of Thrombosis and Haemostasis Scientific and Standardisation Committee suggests avoiding edoxaban in patients >120 kg. Additionally, concerns exist regarding decreased efficacy in patients prescribed edoxaban for atrial fibrillation with a creatinine clearance (CrCl) >95 ml/min, a finding of the ENGAGE AF-TIMI 48 trial when edoxaban was compared to warfarin. OBJECTIVE: To derive a population pharmacokinetic (PopPK) model using clinical practice data, to understand the impact of bodyweight and renal function on edoxaban pharmacokinetics. METHOD: Edoxaban plasma concentrations and patient characteristics were collated from King's College Hospital anticoagulation clinics between 11/2016 and 08/2022. A PopPK model was developed using non-linear mixed effects modelling and used to simulate edoxaban concentrations at the extremes of bodyweight and with varying renal function. RESULTS: Data from 409 patients (46 < 50 kg, 34 > 120 kg and 123 with a CrCl > 95 ml/min) provided 455 edoxaban plasma concentrations. A one-compartment model with between-subject variability on clearance with a proportional error model best described the data. The most significant covariates impacting on edoxaban exposure were CrCl and bodyweight. Our work suggests that edoxaban exposure in patients weighing up to 140 kg is comparable to those weighing 75 kg. Edoxaban exposure is reduced in patients weighing <50 kg due to the recommended dose reductions. There is also a reduction in AUCss when CrCl > 95 ml/min compared to CrCl 80 ml/min. CONCLUSIONS: Our population PK model for edoxaban suggests that renal function is a key driver for overall edoxaban exposure. Further clinical outcome data is required to understand clinical effectiveness and adverse outcomes.

Time budgets differ in horses during continuous and space-restricted rotational grazing.

Horses can become obese and develop related health issues such as laminitis from excessive grazing on high-quality pasture grass; limiting pasture intake can allow weight loss to occur. The objective of this study was to determine the effect of space-restricted rotational grazing on body weight (BW) and time budgets in horses. Eight mature geldings and mares with maintenance-only requirements were randomly assigned to either a space-restricted rotational grazing group (SRG; BW 512 ± 6 kg; n = 4) or a continuous grazing group (CG; BW 517 ± 49 kg; n = 4) for 42 d SRG horses grazed an area with dimensions to provide 80-90 % of mean digestible energy requirement for the 4 horses over a 7-d grazing period; whereas, the CG horses continuously grazed similar non-toxic endophyte-infected tall fescue pasture providing greater than maintenance requirements for the 42 d Horses in the SRG group were moved to a new area every 7 d for 6 weeks. On d 7 at 1600 h of each week, horses were brought inside, and feed was withheld overnight. At 0700 h the next day, BWs were recorded prior to turnout. Observers recorded behaviors simultaneously on SRG and CG horses every six minutes throughout the day three days per week according to an ethogram. This included 30 s scans of all horses. Proportion of grazing and standing had an inverse relationship. Proportion of grazing was affected by the treatment by time interaction, which grazing was displayed more in SRG than CG during weeks 2 and 3, and then reversed weeks 4, 5 and 6.

Evaluating the safety and effectiveness of direct oral anticoagulants compared with warfarin in very elderly patients with atrial fibrillation with and without low bodyweight.

BACKGROUND: Limited data exist on the safety and effectiveness of using direct oral anticoagulants (DOACs) in patients with atrial fibrillation aged 80 years or more with and without low bodyweight (LBW). OBJECTIVES: We aimed to evaluate the safety and effectiveness of using DOACs in this population compared with warfarin. METHODS: This retrospective active comparator new-user cohort study included veteran patients with atrial fibrillation who were newly initiated on either warfarin or DOACs between January 1, 2015, and January 1, 2021. The primary outcome was incidence of major bleeding and ischemic stroke. All outcomes were compared between treatment groups in 2 propensity score-matched cohorts of patients aged 80 years older with (AW) and without LBW (age-only cohort). Cox proportional hazard models were used to estimate adjusted hazard ratios (aHRs). RESULTS: Matched AW and age-only cohorts included 493 and 11 909 patients, respectively, in each of the DOAC and warfarin exposure groups. Greater than 90% were male, with a mean age of ∼87 years. The rate of major bleeding was lower in the DOAC group compared with warfarin in both the AW (aHR, 0.63; 95% CI, 0.46-0.87) and age-only cohorts (aHR, 0.58; 95% CI, 0.49-0.77). A significantly lower rate of ischemic stroke occurred in the DOAC group compared with warfarin in the AW cohort (aHR, 0.62; 95% CI, 0.45-0.84) and age-only cohort (aHR, 0.63; 95% CI, 0.58-0.68). CONCLUSION: DOAC use was associated with lower risk of major bleeding and ischemic stroke compared with warfarin in patients aged 80 years or older with and without LBW.

Impaired Perception of Body-Weight Distribution Marks Functional Mobility Problems in Patients Undergoing Total Hip Arthroplasty.

Hip osteoarthritis and total hip arthroplasty imply damaged articular and periarticular structures responsible for proprioception, and this damage may impair the accurate perception of body-weight distribution. In this study, we investigated proprioceptive abilities and accuracy perceiving body-weight distribution in patients undergoing total hip arthroplasty, and we assessed the associations between these abilities and body perception accuracy with functional mobility testing in 20 patients scheduled for total hip arthroplasty and 20 age-matched healthy participants. We assessed (a) absolute error in hip joint position sense (AE-JPS), (b) absolute error in body-weight distribution (AE-BWD) during standing and sit-to-stand tasks with open and closed eyes, and (c) functional mobility with the Timed Up and Go Test (TUG). We assessed patients undergoing hip arthroplasty before (T0) and five days after their surgery (T1), while control participants underwent a single evaluation. Relative to controls, participants undergoing surgery showed higher AE-JPS at 15° of hip flexion at T0 (p = .003) and at T1 (p = .007), greater AE-BWD during sit-to-stand with open eyes at T1 (p = .014) and with closed eyes at both T0 (p = .014) and at T1 (p < .001), and worse TUG at both T0 (p = .009) and T1 (p < .001). AE-BWD during sit-to-stand with closed eyes positively correlated with TUG at T0 (r = 0.55, p = .011) and at T1 (r = 0.51, p = .027). These findings suggested that impairments in body-weight distribution perception were evident both before and immediately after total hip arthroplasty, suggesting that these impairments may regularly mark these patients' functional mobility problems.

Effects of participation in an eight-week, online video body-weight resistance training on cognitive function and physical fitness in older adults: A randomized control trial.

The purpose of this study was to investigate the effects of an eight-week online video bodyweight resistance training on cognitive function and physical fitness in older adults. A total of 30 older adults was randomly assigned into either an exercise group or a control group. The exercise group participated in the exercise and the control group was required to maintain daily living. Mini mental status examination (MMSE) and senior fit-ness tests (SFT) were measured pre- and post-eight weeks of intervention. Participating in the exercise experienced increases in cognitive functions of attention (p < 0.05) and calculation (p < 0.05), recall (p < 0.05), and repetition (p < 0.05) from the MMSE. Also, older adults in the exercise group demonstrated improved two-minute walk (p < 0.05), chair sit tests (p < 0.05), and results of the SFT. The online video resistance training may help to increase cognitive function and fitness in older adults.

Lignocellulose and probiotic supplementation in broiler chicken diet: effect on growth performance, digestive health, litter quality, and genes expression.

Three hundred one-day-old Avian 48 broiler chicks were used to investigate the effect of lignocellulose (LC) and probiotic supplementation in broiler chicken diet on growth performance, digestive health, litter quality, and some gene expression. Experimental treatments consisted of 3 × 2 factorial arrangements with 3 levels of LC without or with probiotics to formulate 6 experimental groups. Groups 1, 2, and 3 were fed on the basal diet with dietary LC inclusion at 0, 0.5, and 1.0%, respectively, while groups 4, 5, and 6 were fed on the previously mentioned design with Bacillus subtilis at 100 gm/ton. The results revealed that Dietary LC inclusion nonsignificantly (P ≥ 0.05) reduced body weight (BW), body weight gain (BWG), and feed intake. Meanwhile, B. subtilis supplementation improved BW and BWG and enhanced the effect of LC on the broilers' weight. The group fed a 0.5% LC and B. subtilis-supplemented diet recorded the best (P ≥ 0.05) BW, BWG, FCR, PER, EEU, and PI. LC and or B. subtilis supplementation improved carcass traits of broiler (higher dressing% with lower abdominal fat% compared with a control group), intestinal health, and absorptive capacity. LC potentiates the effect of B. subtilis supplementation in broilers' diet in modulating intestinal microflora (lowered (P ≥ 0.05) cecal Coliform and increased Lactobacillus counts), the highest Coliform counts were recorded in group fed 0.5 or 1.0% LC plus B. subtilis. LC at 0.5 or 1.0% and or B. subtilis supplementation reduced (P ≥ 0.05) litter moisture% at the 2nd, 4th, and 6th wk compared to the control group. Dietary inclusion of LC and or B. subtilis supplementation significantly (P < 0.001) up-regulated hepatic growth-related genes (growth hormone receptor (GHR) and insulin growth factor1 (IGF-1)) and antioxidant-related genes (superoxide dismutase 1 (SOD1), glutathione peroxidase (GPX1) and uncoupling protein (UCP) and down-regulated (P < 0.001) splenic toll-like receptor 4 (TLRP) gene expression while had no significant effect on splenic interleukin 8 (IL8) and tumor necrosis factor (TNF) with the best-obtained results with 1.0% followed by 0.5% LC with B. subtilis supplementation. We concluded that dietary LC and/or B. subtilis supplementation positively affected the growth performance, feed efficiency, carcass quality, intestinal absorptive capacity and health, litter quality and growth, and antioxidant and immune-related gene expression.

The impact of slaughter weight and sex on the carbon footprint of pig feed intake.

The impact of pork production on global livestock's greenhouse gas emissions is substantial. Understanding the factors influencing these emissions is crucial in achieving a more sustainable pig husbandry. In two independent experiments, the impact of slaughter weight on the carbon footprint (CFP) of pig feed intake (CFPFI) was evaluated for growing-finishing pigs of different sexes (entire males (EM), barrows (BA), immunocastrates (IC) and gilts (GI)). In experiment 1 118 animals were raised individually in experimental conditions. In experiment 2 384 animals were housed in group (four pigs per pen), in controlled commercial farm circumstances. All animals were fed ad libitum in a three-phase feeding regime and slaughtered at different BW, ranging from 110 to 148 kg (experiment 1) and from 99 to 138 kg (experiment 2). When only the fattening period was considered, the CFPFI was expressed per kg carcass growth. When the production of piglets was also taken into account, the CFPFI was calculated per kg carcass weight. For all sexes, the heavier the pig, the higher the CFPFI per kg carcass growth (P < 0.05, experiment 1; P < 0.001, experiment 2) and per kg carcass weight (P < 0.05, experiment 1; P < 0.01, experiment 2). In addition, BA had a significantly higher CFPFI per kg carcass growth and per kg carcass weight compared to EM and IC and to EM, IC and GI in respectively experiments 1 and 2 (P < 0.001). When performing a desk study with a soy-free (i.e. reduced CFP) feed in the third phase of experiment 2, slaughter weight no longer affected the CFPFI per kg carcass growth (P = 0.133) and per kg carcass weight (P = 0.856). A higher slaughter weight thus implies a lower sustainability, unless a sufficiently low-CFP feed is provided in the finisher phase.

Bodyweight Exercise of Lower and Upper Extremities for Female Patients with Rheumatoid Arthritis and the Timed Up-and-Go Test.

Objectives: At our hospital, orthopedic surgeons and physical and occupational therapists have developed bodyweight exercises for the lower and upper extremities (BELU) for rheumatoid arthritis (RA) patients, including walking [Timed Up-and-Go (TUG) test and figure-of-eight walking) and weight exercises. We aimed to clarify the effect of bodyweight exercise and the Health Assessment Questionnaire (HAQ) cut-off value for a TUG test result of 12 s (or longer) as a risk factor for a fall. Methods: All patients underwent BELU twice weekly at home for 6 weeks. We assessed the HAQ score, TUG time, and the strengths of quadriceps femoris, biceps brachii, handgrip, side pinch, and pulp pinch before and after the intervention. Results: We analyzed the data of 42 participants. The mean age was 67.0 ± 12.1 years. The mean Disease Activity Score-28 for rheumatoid arthritis with erythrocyte sedimentation rate was 2.91 ± 0.91. The mean HAQ score was 0.69 ± 0.62. The dominant quadriceps femoris, biceps brachii, pulp pinch, and side pinch strengths were significantly strengthened. TUG time was improved from 9.0 ± 3.0 s to 8.6 ± 3.2 s (P=0.009). The receiver operating characteristic analysis revealed the cut-off value of HAQ for a TUG time of 12 s (or longer) was 1.0 (AUC 0.903, 95% confidence interval 0.792-1.0). Conclusions: Bodyweight exercises strengthened the muscles in female patients with RA, resulting in improved TUG test results. An indicative HAQ cut-off value of 1.0 (or greater) was identified for a TUG test result of 12 s or longer.

Self-perceived body weight and weight status: analysis of concordance by age group and sex.

OBJECTIVES: Previous studies suggest that there is discordance between actual weight status and body-weight perception. This fact has implications when it comes to designing public health interventions. The aim of this study was to estimate the prevalence of the different categories of weight status and body-weight perception and to analyse their concordance in a representative Spanish population sample. STUDY DESIGN: Cross-sectional study. METHODS: Data were sourced from the 2018 Galician Risk Behaviour Data System, with the target population being all persons aged 16 years and above. We collected data on self-perceived body weight and assessed weight status on the basis of body mass index (BMI). BMI was estimated using self-reported measures of weight and height. To estimate concordance, Cohen's kappa coefficient, both unweighted and weighted with Cicchetti weights, was calculated. RESULTS: Data were obtained for 7853 individuals aged 16 years and above, whereas the overall unweighted concordance was 0.393 (95%CI: 0.377-0.409), with an agreement percentage of 61.6%, weighted concordance was 0.503 (0.490-0.517), with an agreement percentage of 86.6%. The highest concordance between self-perceived body weight and weight status was observed in women. By age group, the highest concordance was observed in the youngest group (16-24 years) for the BMI categories of underweight and overweight, and in the 45-64 age group for the category of obesity. CONCLUSIONS: The results highlight the existence of differences between self-perceived body weight and weight status, according to sex and age.

Enhancing squat movement classification performance with a gated long-short term memory with transformer network model.

Bodyweight squat is one of the basic sports training exercises. Automatic classification of aberrant squat movements can guide safe and effective bodyweight squat exercise in sports training. This study presents a novel gated long-short term memory with transformer network (GLTN) model for the classification of bodyweight squat movements. Twenty-two healthy young male participants were involved in an experimental study, where they were instructed to perform bodyweight squat in nine different movement patterns, including one acceptable movement defined according to the National Strength and Conditioning Association and eight aberrant movements. Data were acquired from four customised inertial measurement units placed at the thorax, waist, right thigh, and right shank, with a sampling frequency of 200 Hz. The results show that compared to state-of-art deep learning models, our model enhances squat movement classification performance with 96.34% accuracy, 96.31% precision, 96.45% recall, and 96.32% F-score. The proposed model provides a feasible wearable solution to monitoring aberrant squat movements that can facilitate performance and injury risk assessment during sports training. However, this model should not serve as a one-size-fits-all solution, and coaches and practitioners should consider individual's specific needs and training goals when using it.

Changes in Height and Body Weight Within a Time Period of 35 Years in Males of the Same Age / Cambios en la Altura y el Peso Corporal en un Período de 35 Años en Hombres de la Misma Edad

SUMMARY: Height and body weight measurements are among the most important anthropometric variables when assessing a population's growth, development and body composition. This study aimed to evaluate the height and body weight variability of male entities aged 17-18 years within 35 years. This goal was realized by comparing the height and body weight of the population of the same gender and age in three different time studies. The descriptive statistical parameters and T-test for independent groups show systematic and significant differences in measured variables between three measurements in different timelines. Both in body height and body weight, from measurement to measurement, significant systematic and statistically significant differences (p<0.01) have been identified (1985: BH= 172.8cm, BW= 61.7kg; 2004: BH=176.8 cm, BW=66.9 kg; 2019: BH=178.5 cm, BW=72 kg). The results of this study prove that the change in the socio-economic status of a population over a period time of 35 years can significantly affect the growth and development of children/adolescents.

Las medidas de altura y peso corporal se encuentran entre las variables antropométricas más importantes a la hora de evaluar el crecimiento, el desarrollo y la composición corporal de una población. Este estudio tuvo como objetivo evaluar la variabilidad de la altura y el peso corporal de entidades masculinas de 17 a 18 años dentro de 35 años. Este objetivo se logró comparando la altura y el peso corporal de la población del mismo sexo y edad en tres estudios temporales diferentes. Los parámetros estadísticos descriptivos y la prueba T para grupos independientes muestran diferencias sistemáticas y significativas en las variables medidas entre tres mediciones en diferentes líneas de tiempo. Tanto en la altura como en el peso corporal, de medición en medición, se han identificado diferencias significativas sistemáticas y estadísticamente significativas (p<0,01) (1985: BH= 172,8 cm, BW= 61,7 kg; 2004: BH=176,8 cm, BW=66,9 kg; 2019: BH=178,5 cm, BW=72 kg). Los resultados de este estudio demuestran que el cambio en el estatus socioeconómico de una población durante un período de 35 años puede afectar significativamente el crecimiento y desarrollo de niños/ adolescentes.

The effect of coconut oil and palm oil on anthropometric parameters: a clinical trial.

BACKGROUND: During recent years several studies have investigated the impact of different dietary oils on body weight. They have shown differential positive and negative effects on anthropometry. We investigated the effects of palm and coconut oils on body weight and other anthropometric parameters, considering their importance as a primary source of saturated fat, controlling for other confounding variable such as total energy intake. METHODS: The study was conducted as a sequential feeding clinical trial with 40 healthy men and women divided into two feeding periods of initial palm oil (8 weeks) and subsequent coconut oil (8 weeks), with a 16-week washout period in between. Each participant received a pre-determined volume of each oil, which were integrated into their routine main meals and snacks during the respective study periods. Changes in body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR) were evaluated. Physical activity levels and dietary intake were also evaluated as potential confounding factors. RESULTS: Thirty-seven participants completed both oil treatment periods. The mean (± SD) age of the participants was 39 (± 13.1) years. There were no significant differences in any of the anthropometric parameters between the initial point of feeding coconut oil and the initial point of feeding palm oil. Following both oil treatment phases, no significant changes in the subjects' body weight, BMI, or other anthropometric measurements (WC, HC, and WHR) were observed. CONCLUSION: Neither coconut oil nor palm oil significantly changed anthropometry-related cardiovascular risk factors such as body weight, BMI, WC, HC, and WHR. TRIAL REGISTRATION: Sri Lankan Clinical Trial Registry: SLCTR/2019/034 on 4th October 2019 ( https://slctr.lk/trials/slctr-2019-034 ).

Dose-response effects on HbA1c and bodyweight reduction of survodutide, a dual glucagon/GLP-1 receptor agonist, compared with placebo and open-label semaglutide in people with type 2 diabetes: a randomised clinical trial.

AIMS/HYPOTHESIS: The aim of this study was to assess the dose-response effects of the subcutaneous glucagon receptor/glucagon-like peptide-1 receptor dual agonist survodutide (BI 456906) on HbA1c levels and bodyweight reduction. METHODS: This Phase II, multicentre, randomised, double-blind, parallel-group, placebo-controlled study, conducted in clinical research centres, assessed survodutide in participants aged 18-75 years with type 2 diabetes, an HbA1c level of 53-86 mmol/mol (7.0-10.0%) and a BMI of 25-50 kg/m2 on a background of metformin therapy. Participants were randomised via interactive response technology to receive survodutide (up to 0.3, 0.9, 1.8 or 2.7 mg once weekly [qw; dose group (DG) 1-4, respectively] or 1.2 or 1.8 mg twice weekly [DG 5 and 6, respectively]), placebo or semaglutide (up to 1.0 mg qw). Participants and all those involved in the trial conduct/analysis were blinded; the semaglutide arm was open-label. The primary endpoint was absolute change from baseline in HbA1c after 16 weeks' treatment. The key secondary endpoint was relative change from baseline in bodyweight after 16 weeks' treatment. RESULTS: A total of 413 participants were randomised (DG1, n=50; DG2, n=50; DG3, n=52; DG4, n=50; DG5, n=51; DG6, n=50; semaglutide, n=50; placebo, n=60). The full analysis set comprised 411 treated participants (DG6, n=49; placebo, n=59). Adjusted mean (95% CI) HbA1c decreased from baseline (mean ± SD 64.7±9.2 mmol/mol [8.07±0.84%] after 16 weeks' treatment: DG1 (n=41), -9.92 mmol/mol (-12.27, -7.56; -0.91% [-1.12, -0.69]); DG2 (n=46), -15.95 mmol/mol (-18.27, -13.63; -1.46% [-1.67, -1.25]); DG3 (n=36), -18.72 mmol/mol (-21.15, -16.29; -1.71% [-1.94, -1.49]); DG4 (n=33), -17.01 mmol/mol (-19.59, -14.43; -1.56% [-1.79, -1.32]); DG5 (n=44), -17.84 mmol/mol (-20.18, -15.51; -1.63% [-1.85, -1.42]); DG6 (n=36), -18.38 mmol/mol (-20.90, -15.87; -1.68% [-1.91, -1.45]). The mean reduction in HbA1c was similar with low-dose survodutide (DG2: -15.95 mmol/mol [-1.46%]; n=46) and semaglutide (-16.07 mmol/mol [-1.47%]; n=45). Mean (95% CI) bodyweight decreased dose-dependently up to -8.7% (-10.1, -7.3; DG6, n=37); survodutide ≥1.8 mg qw produced greater bodyweight reductions than semaglutide (-5.3% [-6.6, -4.1]; n=45). Adverse events (AEs) were reported for 77.8% of survodutide-treated participants (mainly gastrointestinal), 52.5% receiving placebo and 52.0% receiving semaglutide. CONCLUSIONS/INTERPRETATION: Survodutide reduced HbA1c levels and bodyweight after 16 weeks' treatment in participants with type 2 diabetes. Dose-related gastrointestinal AEs could be mitigated with slower dose escalations. TRIAL REGISTRATION: ClinicalTrials.gov NCT04153929 and EudraCT 2019-002390-60. FUNDING: Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany.

Modelling individual infancy growth trajectories to predict excessive gain in BMI z-score: a comparison of growth measures in the ABCD and GECKO Drenthe cohorts.

BACKGROUND: Excessive weight gain during childhood is a strong predictor for adult overweight, but it remains unknown which growth measures in infancy (0-2 years of age), besides predictors known at birth, are the strongest predictors for excessive weight gain between 2 and 5-7 years of age. METHODS: The Amsterdam Born Children and their Development (ABCD) study formed the derivation cohort, and the Groningen Expert Center for Kids with Obesity (GECKO) Drenthe study formed the validation cohort. Change (Δ) in body mass index (BMI) z-score between 2 and 5-7 years was the outcome of interest. The growth measures considered were weight, weight-for-length (WfL), and body mass index (BMI). Formats considered for each growth measure were values at 1, 6, 12, and 24 months, at the BMI peak, the change between aforementioned ages, and prepeak velocity. 10 model structures combining different variable formats and including predictors at birth were derived for each growth measure, resulting in 30 linear regression models. A Parsimonious Model considering all growth measures and a Birth Model considering none were also derived. RESULTS: The derivation cohort consisted of 3139 infants of which 373 (11.9%) had excessive gain in BMI z-score (> 0.67). The validation cohort contained 2201 infants of which 592 (26.9%) had excessive gain. Across the 3 growth measures, 5 model structures which included measures related to the BMI peak and prepeak velocity (derivation cohort area under the curve [AUC] range = 0.765-0.855) achieved more accurate estimates than 3 model structures which included growth measure change over time (0.706-0.795). All model structures which used BMI were superior to those using weight or WfL. The AUC across all models was on average 0.126 lower in the validation cohort. The Parsimonious Model's AUCs in the derivation and validation cohorts were 0.856 and 0.766, respectively, compared to 0.690 and 0.491, respectively, for the Birth Model. The respective false positive rates were 28.2% and 20.1% for the Parsimonious Model and 70.0% and 74.6% for the Birth Model. CONCLUSION: Models' performances varied significantly across model structures and growth measures. Developing the optimal model requires extensive testing of the many possibilities.

Influence of Inula helenium rhizomes and Matricaria chamomilla inflorescences on the biochemical and physiological parameters in male rats fed a high-fat diet.

Background: Pharmacological correction of a high-fat diet is of great interest to prevent the development of obesity and hypertension. More and more research is being done on the preventive use of medicinal herbs for excess caloric intake. Objective: The aim of this study was to determine the general physiological effect of I. helenium rhizomes and M. chamomilla inflorescences used in the diet of male rats consuming excess amounts of fat and calories in the daily diet. Material and methods: In a 30-day experiment, we determined the effect of I. helenium rhizome and M. chamomilla on the physiological activity and metabolic processes of laboratory rats consuming a high-fat diet. The physical activity was evaluated according to the mass gain of animals and change in the relative mass of the internal organs, and also the functional conditions of the central nervous system. The influence on the metabolic processes was revealed by biochemical and clinical blood analyses. Results: In a laboratory experiment on male rats, it was found that the addition of dry crushed rhizomes of Inula helenium L. and inflorescences of Matricaria chamomilla L. to the diet caused opposite changes in body weight. In the control group, the animals slightly increased their body weight (up to 111.5% of the initial weight by the end of the experiment); the rhizomes of I. helenium caused a decrease in body weight gain (up to 105.5% on the 30th day of the experiment compared to the initial weight); rats fed M. chamomilla inflorescences gained 123.2% of their initial body weight during the month of the experiment. The rhizomes of I. helenium caused an increase in the stomach relative mass. A decrease in the thymus relative weight was observed when animals were fed M. chamomilla inflorescences. The rhizomes of I. helenium stimulated an increase of blood protein concentration (mainly due to globulins), an increase in the alkaline phosphatase activity and cholesterol, and a decrease in the triglycerides concentration. M. chamomilla inflorescences reduced the blood urea concentration and increased the activity of alkaline phosphatase, causing strong changes in fat metabolism. Under the influence of the diet with the addition of M. chamomilla inflorescences, the atherogenic index increased in animals by 6.5 times relatively to the control group (due to a decrease in the concentration of high-density lipoprotein cholesterol and an increase in the concentration of low-density lipoprotein cholesterol, an increase in the total cholesterol concentration). When M. chamomilla was added to the diet, the blood triglycerides concentration in animals decreased sharply and the concentration of leukocytes increased. The concentration of monocytes exceeded the limits of the physiological norm both in the control group and in the group of animals fed on M. chamomilla inflorescences. Conclusions: The results of the studies show the promise for further research of I. helenium rhizomes in the prevention of hypertension and also indicate strong risks when using M. chamomilla inflorescences for preventive purposes during high-fat and hypercaloric diet.

The Rapid Changes in Bodyweight and Glycemic Control Are Determined by Pre-status After Bariatric Surgery in Both Genders in Young Chinese Individuals.

PURPOSES: The primary aim of this clinical study is to identify the factors associated with rapid glycemic, bodyweight, and lipid profile remission in young obese patients following bariatric surgery. MATERIALS AND METHODS: In a total of 131 Chinese in-patients at Shanghai Pudong Hospital, China, we retrospectively analyzed in-patient data of metabolic parameters, including BMI, waist circumference, blood pressure (BP), and blood laboratory tests, such as plasma lipids and lipoprotein, hemoglobulin A1c (HbA1c), and oral glucose tolerance tests (OGTT) before bariatric surgery. We followed up these indices at the first month, third months, half-year, and one year later. RESULTS: The results showed that bodyweight, BP, fasting plasma glucose (FPG), HbA1c, and triglyceride (TG) levels decreased significantly in one to three months following surgery in both male and female patients (p<0.05). We demonstrated that age (male: ß=-0.181; female: ß=-0.292) and the pre-operation HbA1c levels (male: ß=0.935; female: ß=0.919) were independent predictors of HbA1c reduction in both young obese male and female patients in three months after surgery. For body weight loss, age (ß=-0.229) and pre-operation bodyweight (ß=0.735) are the predictors in females, but only pre-operation body weight (ß=0.798) is the independent predictor in obese young male patients. CONCLUSION:  This study discovered that changes in bodyweight were determined by age, pre-operation status of bodyweight, and HbA1C in obese young Chinese.

Neonatal-Maternal Bodyweight Ratio at Birth: An Indicator for First-Week Survival Prognosis in Canine Newborns.

Objectives. In dogs, neonatal bodyweight (NBW) varies at birth. Size-specific reference values for NBW are essential to correctly manage newborns. The present study aimed to define a new tool to evaluate NBW that could be routinely applied in canine neonatology, promptly identifying puppies requiring more care. Methods. The records of 89 litters were retrospectively evaluated. Data were grouped according to maternal bodyweight (MBW) in five categories: toy (≤5 kg), small (5.1-9.9 kg), medium (10-24.9 kg), large (25-39.9 kg), and giant (≥40 kg) dogs. At birth, the NBW of 412 puppies, alongside their litter size (LS) and gender (G), were recorded. Neonatal mortality within the first week was considered. The influence of MBW, LS, and G on NBW and the effect of NBW on the 1-week outcome were evaluated using ANOVA (p < 0.05). The ratio between NBW and MBW expressed as a percentage (N-MBW%), was assessed for each puppy. Through Receiver-Operating Characteristic (ROC) curves, N-MBW% thresholds between puppies alive or dead at one week of age were calculated in each group. Results. The LS was different among groups, except for small vs. medium dogs. In small litters, N-MBW% was lower in medium-, large- and giant-sized dogs than in toy and small dogs. In medium and large litters, N-MBW% differed among the five groups. Male and female N-MBW% differed among the five groups. Only in large and giant sizes did LS affect N-MBW%, which was lower in a large LS. The N-MBW% was higher in healthy puppies than in those who died within one week. The ROC-derived N-MBW% thresholds were as follows: 4.5% in toy-, 3.2% in small-, 1.5% in medium-, 1.2% in large-, and 1% in giant dogs. Clinical significance. The ROC-derived N-MBW% thresholds can be used to cautiously identify puppies at increased risk for one-week mortality and may be helpful in clinical practice, representing a suitable parameter to give a prognosis on 1-week survival immediately at birth.

The association between obesity with treatment duration, ICU length of stay and the risk of death in critically ill patients with COVID-19.

BACKGROUND: Despite the confirmed association between higher BMI with increased risk of the acute respiratory distress syndrome (ARDS), the association between obesity with mortality in critically ill patients with coronavirus disease 2019 (COVID-19) is not clear. The present study aimed to investigate the association between obesity with treatment duration, ICU length of stay, and the risk of death in critically ill patients with COVID-19. METHODS: This case-control study was performed on 223 patients with COVID-19 including 148 surviving patients as the control group and 75 eventually dead patients as the case group in Rasht, Iran. Data on demographic factors, comorbidities, anthropometric measurements, the length of hospitalization and the mortality were obtained from patients' medical records. RESULTS: The mortality rate was significantly associated with weight (OR = 1.04, 95% CI: 1.002-1.083, p = .04), but not with BMI after adjustments for age, gender, length of stay in ICU, chronic diseases and smoking. The results did not change after further adjustments for biochemical and pathological factors. CONCLUSIONS: Weight was positively associated with mortality after controlling for confounding variables. Further studies should consider the patient's body composition such as fat mass to establish the relationship between obesity and COVID-19 outcomes.

Hand loading, rates of perceived exertion, and usability during assisted walking in patients with type 2 diabetes mellitus.

BACKGROUND: Patients suffering from a diabetic foot ulcer often receive a non-weight bearing prescription of the affected limb to promote healing. Total unilalteral offloading of the affected foot necessitates walking aids that require loading at the hands during ambulation. Excessive loading at the hands can increase of the risk of crutch palsy. In addition, certain walking aids can also be more strenuous and less comfortable to use than others, resulting in lower prescription compliance. This study aimed to investigate hand loading, rates of perceived exertion, and usability of typically prescribed walking aids in patients with Type 2 Diabetes. METHODS: Twenty patients (12 F | 8 M, 61.0 ± 10.36 yrs., 90.54 ± 13.34 kg, 1.71 ± 0.08 m) walked as much as 200 m without assistance and with crutches, walkers, and a wheeled knee walker instrumented with flexible force-sensing pads on walking aid handles. Patients rated exertion using a Modified Borg Scale and completed a System Usability Scale questionnaire after each walking condition with or without walking aids. FINDINGS: Results show that using a wheeled knee walker required 94% less hand loading than crutches and walkers. Patients reported 45% lower exertion with the WKW compared to crutches and walkers, and scored the usability of the wheeled knee walker 106% higher than crutches and walkers. INTERPRETATION: The wheeled knee walker could be the preferred walking aid for total unilateral offloading because of the reduced loading demand at the hands, lower exertion during use, and greater usability compared to crutches and walkers.