Improved Performance of Compartments in Detecting the Activity of Axial Spondyloarthritis Based on IVIM DWI with Optimized Threshold b Value

Purpose. To explore the diagnostic performance of the optimized threshold b values on IVIM to detect the activity in axial spondyloarthritis (axSpA) patients. Method. 40 axSpA patients in the active group, 144 axSpA patients in the inactive group, and 20 healthy volunteers were used to evaluate the tissue diffusion coefficient ( D slow ), perfusion fraction ( f ), and pseudodiffusion coefficient ( D fast ) with b thresholds of 10, 20, and 30 s/mm2. The Kruskal-Wallis test and one way ANOVA test was used to compare the different activity among the three groups in axSpA patients, and receiver operating characteristic (ROC) curve analysis was applied to evaluate the performance for D slow , f , and D fast to detect the activity in axSpA patients, respectively. Results. D slow demonstrated a statistical difference between two groups ( P < 0.05 ) with all threshold b values. With the threshold b value of 30 s/mm2, f could discriminate the active from control groups ( P < 0.05 ). D slow had similar performance between the active and the inactive groups with threshold b values of 10, 20, and 30 s/mm2 (AUC: 0.877, 0.882, and 0.881, respectively, all P < 0.017 ). Using the optimized threshold b value of 30 s/mm2, f showed the best performance to separate the active from the inactive and the control groups with AUC of 0.613 and 0.738 (both P < 0.017 ) among all threshold b values. Conclusion. D slow and f exhibited increased diagnostic performance using the optimized threshold b value of 30 s/mm2 compared with 10 and 20 s/mm2, whereas D fast did not.

The effect of BKV reactivation on cytokines behavior in kidney transplanted patients

Background BK virus associated nephropathy (BKVAN) is one of the common causes of graft loss among kidney transplanted recipients (KTRs). The current treatment for BKV nephropathy is decreasing the immunosuppressive regimen in KTRs. Interleukin-27 (IL-27) is a multifunctional cytokine that might be the front-runner of an important pathway in this regard. Therefore, in current study it is tried to evaluate the changes in the expression level of IL-27 and some related molecules, resulting from BKV reactivation in KTR patients. Methods EDTA-treated blood samples were collected from all participants. Patients were divided into two groups, 31 kidney transplant recipients with active and 32 inactive BKV infection, after being monitored by Real time PCR (Taq-Man) in plasma. Total of 30 normal individuals were considered as healthy control group. Real time PCR (SYBR Green) technique is used to determine the expression level of studied genes. Results The results of gene expression comparisons showed that the expression level of IL-27, IFN-γ, TNF-α, TNFR2 and IRF7 genes was significantly higher in inactive group in comparison to active group. The expression level of TLR4 was lower in both active and inactive groups in comparison to control group. ROC curve analysis showed that IL-27 and IRF7 are significantly different amongst other studied genes. Finally, the analyses revealed that the expression level of most of the studied genes (except for TNF-α and TLR4) have significant correlation with viral load. Conclusions Our findings revealed that IL-27, IFN-γ, TNF-α, TNFR2 and IRF7 expression level is higher in inactive group and TLR4 expression level is lower in patients’ groups in comparison to control group. Also, ROC curve analysis showed IL-27 and IRF7 can significantly differentiate studied groups (BKV active vs. inactive). Therefore, these results might help elucidating the pattern in charge of BKV reactivation in kidney transplanted patients.

Differences in Park Walking, Comparing the Physically Inactive and Active Groups: Data from mHealth Monitoring System in Seoul

Despite the overall increase in physical activities and park uses, the discrepancies between physically inactive and active people have increasing widened in recent times. This paper aims to empirically measure the differences in walking activity in urban parks between the physically inactive and active. As for the dataset, 22,744 peoples’ 550,234 walking bouts were collected from the mHealth system of the Seoul government, using the smartphone healthcare app, WalkOn, from September to November 2019, in Seocho-gu district, Seoul, Korea. We classified the physically inactive and active sample groups, based on their regular walking (≥150 min of moderate-to-vigorous walking activity a week), and analyzed their park walking activities. We found that while there was no significant difference in walking measures of non-park walking between the sample groups, the difference did exist in park walking. The park walking average in the physically active group had more steps (p = 0.021), longer time (p = 0.008), and higher intensity (p < 0.001) of walking than that in the inactive group. Each park also revealed differences in its on-site park walking quantity and quality, based on which we could draw the list of ‘well-walked parks’, which held more bouts and more moderate-to-vigorous physical activities (MVPAs) than other parks in Seocho-gu district. This paper addresses how park walking of physically inactive and active people is associated with multiple differences in everyday urban walking.

Effect of Physical Activity on the Development and the Resolution of Nonalcoholic Fatty Liver in Relation to Body Mass Index

BACKGROUND Data on whether physical activity (PA) levels are related to nonalcoholic fatty liver disease (NAFLD) when considering body mass index (BMI) are scarce. We assessed whether PA affects the development or resolution of NAFLD in conjunction with BMI changes. METHODS Overall, 130,144 participants who underwent health screening during 2011-2016 were enrolled. According to the PA level in the Korean version of the validated International PA Questionnaire Short Form, participants were classified into the inactive, active, and health-enhancing PA (HEPA) groups. RESULTS In participants with increased BMI, the hazard ratio (HR) and 95% confidence interval after multivariable Cox hazard model for incident NAFLD was 0.97 (0.94-1.01) in the active group and 0.94 (0.89-0.99) in the HEPA group, whereas that for NAFLD resolution was 1.03 (0.92-1.16) and 1.04 (0.88-1.23) (reference: inactive group). With increased BMI, high PA affected only new incident NAFLD. PA enhancement or maintenance of sufficient PA prevented new incident NAFLD. In participants with decreased BMI, the HRs were 0.98 (0.90-1.07) and 0.88 (0.78-0.99) for incident NAFLD and 1.07 (0.98-1.17) and 1.33 (1.18-1.49) for NAFLD resolution in the active and HEPA groups, respectively. With decreased BMI, high PA reduced incident NAFLD and increased NAFLD resolution. Maintenance of sufficient PA led to a considerable resolution of NAFLD. CONCLUSION In this large longitudinal study, PA prevented incident NAFLD regardless of BMI changes. For NAFLD resolution, sufficient PA was essential along with BMI decrease. Maintaining sufficient PA or increasing the PA level is crucial for NAFLD prevention or resolution.

Physical Activity Impacts Walking Distances and Energy Consumption of Patients with Peripheral Artery Disease

Lower extremity peripheral artery disease (PAD) is attributed to buildup of atherosclerotic plaques preventing adequate blood flow, leading to pain during walking, and ultimately physical inactivity. Normal day-to-day levels of physical activity may impact the distance a subject can walk before claudication pain onset, as well as their energy consumption capabilities. This study compared walking performance (initial claudication distance (ICD) and absolute claudication distance (ACD)), and energy consumption (EC) between active and inactive subjects with PAD. The distinction between groups was made using previous research that declared the average PAD patient walks 3586 steps/day. Ten subjects were classified as active (□3586 average steps/day) and sixteen participants as inactive (&lt;3586 steps/day) based on a 7-day accelerometer measurement. The Gardner progressive treadmill test was used to asses ICD, ACD, and EC. EC was measured using a metabolic cart and calculated from the second minute of walking and the last minute prior to stopping due to claudication pain. The average ICD and ACD for the active group were 130.6±106.7 meters and 306.0±184.7 meters, respectively and 143.8±119.0 meters and 248.0±156.0 meters, respectively for the inactive group. The average EC for the second minute and last minute were 9.6±1.9 mlkg-1min-1 and 11.5±2.4 mlkg-1min-1 respectively for active group and 7.0±3.1 mlkg-1min-1 and 8.1±3.8 mlkg-1min-1 respectively for inactive group. The data suggests that the active group had better walking performance and greater energy consumption indicating increased efficiency of oxygen transport and extraction capability in the leg muscles.

Prevalence of Ischemia, Health-Related Quality of Life, Medical use and Expenses by Physical Activity and Ischemia Status in Korean Adults

PURPOSE: The purpose of this study is to analyze the different prevalence of ischemia of Korea adults, and to compare the HealthRelated Quality of Life (HRQoL), annual personal medical use and expenses according to physical activity and ischemia status.METHODS: The 2018 Korea Medical Panel data was used (13,791 adults and 604 ischemia). Physical activity was measured with IPAQ and converted to MET-minutes per week. The physical activity group was classified as less than 600 MET-min per week in the inactive group, 600-3,000 MET-min per week in the minimally active group, and 3,000 MET-min more per week in the active group.RESULTS: The prevalence of ischemia was low in the inactive group compared to the minimally active group and the active group (OR=0.75, p<.01) and the active group (OR=0.36, p<.001). In both ischemic and non-ischemic groups, HRQoL was the lowest in the inactive group (p<.05). Inpatient days and emergency days showed no significant difference in according to the physical activity level and the ischemia status. However, within the group with ischemia, the outpatient days of inactive group were 42.8% higher (p<.05) and minimally active group was 4.3% higher (p>.05) compared to the active group (32.5±32.1 days) respectively. Within the group with ischemia, the medical expenses of inactive group were 5.2% lower (p>.05) and minimally active group was 33.9% lower (p<.05) compared to the active group ($1,738±2,457) respectively.CONCLUSIONS: Higher physical activity results in a lower prevalence of ischemia, and higher physical activity results in positive HRQoL and outpatient days in ischemia group. However Annual personal medical expenses showed a significant difference according to the level of physical activity in ischemia group.

Effect of Physical Activity on Cardiovascular Event Risk in a Population-Based Cohort of Patients with Type 2 Diabetes

Cardiovascular disease (CVD) is the most common cause of morbidity and mortality among patients with type 2 diabetes (T2D). Physical activity (PA) is one of the few modifiable factors that can reduce this risk. The aim of this study was to estimate to what extent PA can contribute to reducing CVD risk and all-cause mortality in patients with T2D. Information from a population-based cohort including 26,587 patients with T2D from the Navarre Health System who were followed for five years was gathered from electronic clinical records. Multivariate Cox regression models were fitted to estimate the effect of PA on CVD risk and all-cause mortality, and the approach was complemented using conditional logistic regression models within a matched nested case–control design. A total of 5111 (19.2%) patients died during follow-up, which corresponds to 37.8% of the inactive group, 23.9% of the partially active group and 12.4% of the active group. CVD events occurred in 2362 (8.9%) patients, which corresponds to 11.6%, 10.1% and 7.6% of these groups. Compared with patients in the inactive group, and after matching and adjusting for confounders, the OR of having a CVD event was 0.84 (95% CI: 0.66–1.07) for the partially active group and 0.71 (95% CI: 0.56–0.91) for the active group. A slightly more pronounced gradient was obtained when focused on all-cause mortality, with ORs equal to 0.72 (95% CI: 0.61–0.85) and 0.50 (95% CI: 0.42–0.59), respectively. This study provides further evidence that physically active patients with T2D may have a reduced risk of CVD-related complications and all-cause mortality.

Too masculine for healthcare, too feminine for intense sports: correlation between gender conformity and pro-health behaviours

Background: The goal of this paper is to examine to what extent levels of femininity and masculinity are associated with practicing several types of health behaviours among individuals who are physically active and inactive. Material/Methods: A total of 559 individuals aged between 35 and 45 (M = 39.4; SD = 3.2) took part in the study. The inactive group consisted of 211 individuals (n = 85 women, n = 126 men), and the active group consisted of 348 individuals (n = 131 women, n = 217 men). The participants completed the following pen-and-paper questionnaires: the Psychological Gender Inventory, the Health Behaviours Inventory, and the Inventory of Physical Activity Objectives. Results: Physical activity and androgynous psychological gender were shown to be associated with the levels of health behaviours in men and women. Among men, femininity turned out to be a factor protective against hegemonic masculinity, while among women it was observed that it is mainly masculinity that correlates with health behaviours. Physical activity was associated with a better psychological attitude. Conclusion: It is possible to treat physical activity as a protective factor against decreased mood and an aid in coping with decreased mood. Society and culture should encourage the development of femininity and masculinity from the earliest years. Future research on masculinity and femininity and pro-health behaviours should be aimed at looking for ways to promote physical activity among undifferentiated individuals.

Correlation Between Physical Activity Level and Functional Status of Subjects with High Spinal Cord Injury

Background. Spinal cord injuries are one of the main causes of disability in Poland and in the world. Quadriparesis, limitations in activities of daily living, lack of full autonomy and psycho-social problems are consequences of cervical spinal cord injury. Due to the consequences, especially motor paralysis and sedentary lifestyle resulting from spinal injuries, much attention is drawn to physical activity in subjects with this type of injuries. Objective. The aim of the study is to assess the effect of regular physical activity on functional fitness and independent existence of subjects after high spinal cord injury.Methods. 80 subjects with transverse injury of cervical spinal cord were enrolled in the study. The study group included men aged 20-50, in which group 40 (50%) of the subjects were qualified to the physically active group – subjects doing wheelchair sport, and 40 (50%) of the subjects were qualified to the physically inactive group – subjects taking no physical activity. The physically active men were qualified on the basis of their participation in organised activities - wheelchair rugby. Minimum participation was 90 minutes a day twice a week. Subjects from the physically inactive group had a passive lifestyle and participated in no sports activities. Results. Highly significant differences were observed during the study between the physically active and inactive men with regard to the functionality status. The study subjects taking regular physical exercise had better results in all assessed activities. The biggest differences were observed in the field of toilet and dressing up. Conclusions. The study confirmed that regular physical activity is correlated with better fitness. The study also showed that the subjects playing wheelchair rugby are more independent, which results in their better functional status in everyday life.

Correlation between C-Reactive Protein to Albumin Ratio and Disease Activity in Patients with Axial Spondyloarthritis

Background. The C-reactive protein (CRP) to albumin (ALB) ratio (CAR) has emerged as a novel inflammatory biomarker. This study was designed to investigate the role of CAR in the disease activity of axial spondyloarthritis (axSpA). Methods. A total of 241 patients and 61 healthy controls were retrospectively enrolled in this study. AxSpA patients were further divided into the inactive group ( n = 176 ) and active group ( n = 65 ) according to Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) cutoff value of 4. Laboratory data and clinical assessment indices were recorded. Spearman’s correlation analysis, receiver operation characteristic (ROC) curve analysis, and binary logistic regression analysis were performed. Results. In axSpA patients, CAR was significantly higher than the healthy group ( P < 0.001 ). Similarly, axSpA patients in the active group had higher CAR than the inactive group ( P < 0.001 ). Besides, CAR was positively correlated with erythrocyte sedimentation rate (ESR) ( r = 0.704 , P < 0.001 ), CRP ( r = 0.996 , P < 0.001 ), BASDAI ( r = 0.329 , P < 0.001 ), and Bath Ankylosing Spondylitis Functional Index (BASFI) ( r = 0.330 , P < 0.001 ). ROC curve analysis suggested that the area under the curve (AUC) of CAR for axSpA of the active group was 0.701, which was higher than that of CRP and ESR. The optimal cutoff point of CAR for axSpA of the active group was 0.3644, with a sensitivity and specificity of 58.5% and 79.0%. Binary logistic analysis results revealed that CAR was an independent predictive factor for axSpA disease activity ( odds ratio = 4.673 , 95% CI: 1.423-15.348, P = 0.011 ). Conclusions. CAR was increased in axSpA and axSpA of the active group. CAR may be a novel and reliable indicator for axSpA disease activity.