Objective:While albumin and the weight-standardized hand grip strength(HGS/W)serve as valuable prognostic indicators for cancer patients,their correlation with the prognosis in frail cancer patients remains inadequate...Objective:While albumin and the weight-standardized hand grip strength(HGS/W)serve as valuable prognostic indicators for cancer patients,their correlation with the prognosis in frail cancer patients remains inadequately explored.This study aimed to investigate the prognostic importance of the albumin level and HGS/W in cancer patients with frailty and to further investigate their combined prognostic value.Moreover,this comprehensive evaluation aimed to facilitate timely intervention and treatment for frail patients.Methods:The research enrolled 5,794 cancer patients identified with frailty from a multicenter research database.The diagnosis of frailty was based on the FRAIL scale.An Albumin-HGS/W score was constructed by combining the albumin and HGS/W values.Cox proportional hazard regression was utilized to examine the association between the albumin level and HGS/W and patient outcomes.Results:Among these patients,2,543 were females and 3,251 were males,with a median age of 60.0 years.Optimal stratification based on patient survival revealed the ideal threshold for HGS/W to be 0.48 for males and 0.39 for females,and for albumin to be 38 for both sexes.The fully adjusted model revealed that higher Albumin-HGS/W scores were correlated with a poorer patient prognosis.Notably,an Albumin-HGS/W score of 2 was associated with a higher risk of mortality compared with a score of 0 in the total population(HR:1.813,95%CI:1.580-2.080,P<0.001).Conclusions:Low albumin or HGS/W values are associated with low survival in cancer patients with frailty.Elevated Albumin-HGS/W scores were linked to decreased survival rates in cancer patients with frailty.展开更多
Background: Since the minimum grip span of a standard Smedley hand dynamometer is 4 cm, the handgrip strength (HGS) value at a less than 4 cm grip span has not been reported. Objective: The present study examined the ...Background: Since the minimum grip span of a standard Smedley hand dynamometer is 4 cm, the handgrip strength (HGS) value at a less than 4 cm grip span has not been reported. Objective: The present study examined the impact of grip span on handgrip strength (HGS) in young children using a dynamometer ranging from 2 to 4.5 cm of grip span. Methods: A total of 93 (39 girls and 54 boys) children were recruited from a local kindergarten with the cooperation of their parents. Each participant performed one test trial and then five maximal trials using different grip spans (2.0, 3.0, 3.5, 4.0, and 4.5 cm) in random order and allowing a 1-minute rest between measures. Results: There was a statistically significant difference in HGS depending on which grip span was used, χ<sup>2</sup>(4) = 211.5 (p Conclusion: Our results recommended that the target grip span for measuring maximal HGS in young children is about 4 cm (4 ± 0.5 cm).展开更多
Frailty has emerged as a pivotal determinant of post-liver transplant(LT)outcomes,yet its integration into clinical practice remains inconsistent.Defined by functional impairments and reduced physiologic reserve,frail...Frailty has emerged as a pivotal determinant of post-liver transplant(LT)outcomes,yet its integration into clinical practice remains inconsistent.Defined by functional impairments and reduced physiologic reserve,frailty transcends traditional metrics like the model for end-stage liver disease(MELD)score,demonstrating increasing predictive value for mortality beyond the immediate postoperative period.Recent findings suggest that frail recipients experience significantly higher mortality within the first 12 months following transplantation—a period when traditional monitoring often wanes.This raises critical questions about the adequacy of current assessment and follow-up protocols.The observed dissociation between MELD scores and long-term survival underscores the limitations of existing selection criteria.Frailty,as a dynamic and modifiable condition,represents an opportunity for targeted intervention.Prehabilitation programs focusing on nutritional optimization,physical rehabilitation,and psychosocial support could enhance resilience in transplant candidates,reducing their risk profile and improving post-transplant outcomes.Furthermore,these findings call for an expanded approach to post-transplant monitoring.Extending surveillance for frail recipients beyond standard timelines may facilitate early detection of complications,mitigating their impact on survival.Incorporating frailty into both pre-and post-transplant protocols could redefine how transplant centers evaluate and manage risk.This editorial advocates for a paradigm shift:Frailty must no longer be viewed as a secondary consideration but as a core element in LT care.By addressing frailty comprehensively,we can move toward more personalized,effective strategies that improve survival and quality of life for LT recipients.展开更多
BACKGROUND Morphomics,a computed tomography-based body composition assessment,helps predicting esophageal cancer outcomes,but its link to bioelectrical impedance analysis(BIA)and functional assessments such as hand gr...BACKGROUND Morphomics,a computed tomography-based body composition assessment,helps predicting esophageal cancer outcomes,but its link to bioelectrical impedance analysis(BIA)and functional assessments such as hand grip strength(HGS)and cardiopulmonary exercise testing(CPET)remains unclear.AIM To investigate correlations between morphomics and BIA,HGS,CPET,and assess its ability to predict low cardiorespiratory fitness(CRF).METHODS Fifty esophageal cancer patients underwent multi-level morphomics,BIA,HGS,and CPET.Correlations were analyzed using heatmaps and scatter plots,and logistic regression assessed morphomic predictive value for low CRF.RESULTS T11 is the only level with complete morphomic data,making it the most applicable.To ensure reliability,T11 and its adjacent levels,T10-12,were included in the subsequent analysis.Dorsal muscle group volume from T10-12 morphomics all correlated positively with BIA muscle components(r=0.56-0.68,all P<0.001),HGS(r=0.4-0.48,all P<0.001),and CPET variables(r=0.43-0.51,all P<0.001).Subcutaneous fat area and visceral fat area from morphomics correlated with body fat percentage(r=0.58-0.67,all P<0.001)and negatively with CPET parameters(r=-0.33 to-0.52,all P<0.05).Morphomics also showed potential in identifying low CRF,with an area under the receiver operating characteristic curve of 0.778.CONCLUSION T11 morphomics shows strong correlation with BIA,HGS,and CPET,and may serve as a practical tool for preoperative risk assessment in esophageal cancer patients.展开更多
Objective:To reveal the neural network of active and passive hand movements. Method:Seven healthy aged people were checked, and acquired functional magnetic resonance imaging data on a 1.5T scanner. Active movement co...Objective:To reveal the neural network of active and passive hand movements. Method:Seven healthy aged people were checked, and acquired functional magnetic resonance imaging data on a 1.5T scanner. Active movement consisted of repetitive grasping and loosening of hand; passive movement involved the same movement performed by examiner. Both types of hand movements were assessed separately. These data were analysed by Statistical Parametric Mapping Microsoft. Result:The main activated brain areas were the contralateral supplemental motor area, primary motor area, primary sensory area and the ipsilateral cerebellum when subjects gripped right hands actively and passively. The supplemental area was less active in passive hand movement than active hand movement. The activated brain areas were mainly within Brodmann area 4 during active hand movement; in the contrast, the voxels triggered by passive movement were mainly within Brodmann areas 3,1,2 areas. Conclusion:The results suggest that the neural networks of passive and active tasks spared some common areas, and the passive movement could be as effective as active movement to facilitate the recovery of limbs motor function in patients with brain damage.展开更多
This work was carried out to investigate the efficacy of sensory integration therapy in improving gross motor coordination and grip control in Down syndrome children. Thirty children were enrolled in this study and ra...This work was carried out to investigate the efficacy of sensory integration therapy in improving gross motor coordination and grip control in Down syndrome children. Thirty children were enrolled in this study and randomly assigned into two groups: group A received (sensory integration therapy program plus specific physiotherapy training) and group B received (specific physiotherapy training program only). Motor coordination test measures (Balancing backward, Hopping, Jumping from side to side and Transferring boxes) to test and follow gross motor coordination, handheld dynamometer to test and follow grip control ability and kinesthesia test to test and follow awareness of joint position and movement. These measurements were taken before initial treatment and after 12 weeks of treatment. The children parents in both groups A and B were instructed to complete 3 hours of the home routine program. Data analysis was available on the 30 Down syndrome children participating in the study. The difference between pre- and post-treatment results was more significant in Motor coordination test measures in the study group than the control group. Grip control ability and kinesthesia test demonstrate representative improvement in the study groups (p = 0.0001) while insignificant in the kinesthesia control group and significant in a grip control group. The addition of sensory integration therapy program to specific physiotherapy training is recommended in improving gross motor coordination and grip control abilities in Down syndrome, so this suggested approach may be used as a selective choice for improving posture control and hand functions in Down syndrome children.展开更多
BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pat...BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pathophysiological traits with NAFLD.An association exists between sarcopenia and increased NAFLD prevalence.However,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain inconsistent.AIM To analyze the prevalence and outcomes of sarcopenia in patients with NAFLD.METHODS We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June 2023.We included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse events.We also used the Newcastle-Ottawa scale for quality assessment.RESULTS Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for sarcopenia.Sarcopenia was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such association.Sarcopenia in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and mortality.CONCLUSION This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD patients.The variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent findings.This review demonstrates the multidimensional impact of sarcopenia on NAFLD,indicating its importance beyond liver-related events to include cardiovascular risks,mortality,and metabolic complications.展开更多
基金supported by a Henan Province Science and Technology Research Project(No.252102311033)the National Key Research and Development Program(No.2022YFC2009600 and No.2022YFC2009601).
文摘Objective:While albumin and the weight-standardized hand grip strength(HGS/W)serve as valuable prognostic indicators for cancer patients,their correlation with the prognosis in frail cancer patients remains inadequately explored.This study aimed to investigate the prognostic importance of the albumin level and HGS/W in cancer patients with frailty and to further investigate their combined prognostic value.Moreover,this comprehensive evaluation aimed to facilitate timely intervention and treatment for frail patients.Methods:The research enrolled 5,794 cancer patients identified with frailty from a multicenter research database.The diagnosis of frailty was based on the FRAIL scale.An Albumin-HGS/W score was constructed by combining the albumin and HGS/W values.Cox proportional hazard regression was utilized to examine the association between the albumin level and HGS/W and patient outcomes.Results:Among these patients,2,543 were females and 3,251 were males,with a median age of 60.0 years.Optimal stratification based on patient survival revealed the ideal threshold for HGS/W to be 0.48 for males and 0.39 for females,and for albumin to be 38 for both sexes.The fully adjusted model revealed that higher Albumin-HGS/W scores were correlated with a poorer patient prognosis.Notably,an Albumin-HGS/W score of 2 was associated with a higher risk of mortality compared with a score of 0 in the total population(HR:1.813,95%CI:1.580-2.080,P<0.001).Conclusions:Low albumin or HGS/W values are associated with low survival in cancer patients with frailty.Elevated Albumin-HGS/W scores were linked to decreased survival rates in cancer patients with frailty.
文摘Background: Since the minimum grip span of a standard Smedley hand dynamometer is 4 cm, the handgrip strength (HGS) value at a less than 4 cm grip span has not been reported. Objective: The present study examined the impact of grip span on handgrip strength (HGS) in young children using a dynamometer ranging from 2 to 4.5 cm of grip span. Methods: A total of 93 (39 girls and 54 boys) children were recruited from a local kindergarten with the cooperation of their parents. Each participant performed one test trial and then five maximal trials using different grip spans (2.0, 3.0, 3.5, 4.0, and 4.5 cm) in random order and allowing a 1-minute rest between measures. Results: There was a statistically significant difference in HGS depending on which grip span was used, χ<sup>2</sup>(4) = 211.5 (p Conclusion: Our results recommended that the target grip span for measuring maximal HGS in young children is about 4 cm (4 ± 0.5 cm).
文摘Frailty has emerged as a pivotal determinant of post-liver transplant(LT)outcomes,yet its integration into clinical practice remains inconsistent.Defined by functional impairments and reduced physiologic reserve,frailty transcends traditional metrics like the model for end-stage liver disease(MELD)score,demonstrating increasing predictive value for mortality beyond the immediate postoperative period.Recent findings suggest that frail recipients experience significantly higher mortality within the first 12 months following transplantation—a period when traditional monitoring often wanes.This raises critical questions about the adequacy of current assessment and follow-up protocols.The observed dissociation between MELD scores and long-term survival underscores the limitations of existing selection criteria.Frailty,as a dynamic and modifiable condition,represents an opportunity for targeted intervention.Prehabilitation programs focusing on nutritional optimization,physical rehabilitation,and psychosocial support could enhance resilience in transplant candidates,reducing their risk profile and improving post-transplant outcomes.Furthermore,these findings call for an expanded approach to post-transplant monitoring.Extending surveillance for frail recipients beyond standard timelines may facilitate early detection of complications,mitigating their impact on survival.Incorporating frailty into both pre-and post-transplant protocols could redefine how transplant centers evaluate and manage risk.This editorial advocates for a paradigm shift:Frailty must no longer be viewed as a secondary consideration but as a core element in LT care.By addressing frailty comprehensively,we can move toward more personalized,effective strategies that improve survival and quality of life for LT recipients.
基金Supported by Chang Gung Memorial Hospital,Taiwan,No.CMRPG3N1171,No.CMRPG3N1172,No.CORPVVN0071,No.CMRPVVK0111-3 and No.CMRPVVL0121-3National Science and Technology Council,Taiwan,No.MOST 114-2314-B-182A-066-.
文摘BACKGROUND Morphomics,a computed tomography-based body composition assessment,helps predicting esophageal cancer outcomes,but its link to bioelectrical impedance analysis(BIA)and functional assessments such as hand grip strength(HGS)and cardiopulmonary exercise testing(CPET)remains unclear.AIM To investigate correlations between morphomics and BIA,HGS,CPET,and assess its ability to predict low cardiorespiratory fitness(CRF).METHODS Fifty esophageal cancer patients underwent multi-level morphomics,BIA,HGS,and CPET.Correlations were analyzed using heatmaps and scatter plots,and logistic regression assessed morphomic predictive value for low CRF.RESULTS T11 is the only level with complete morphomic data,making it the most applicable.To ensure reliability,T11 and its adjacent levels,T10-12,were included in the subsequent analysis.Dorsal muscle group volume from T10-12 morphomics all correlated positively with BIA muscle components(r=0.56-0.68,all P<0.001),HGS(r=0.4-0.48,all P<0.001),and CPET variables(r=0.43-0.51,all P<0.001).Subcutaneous fat area and visceral fat area from morphomics correlated with body fat percentage(r=0.58-0.67,all P<0.001)and negatively with CPET parameters(r=-0.33 to-0.52,all P<0.05).Morphomics also showed potential in identifying low CRF,with an area under the receiver operating characteristic curve of 0.778.CONCLUSION T11 morphomics shows strong correlation with BIA,HGS,and CPET,and may serve as a practical tool for preoperative risk assessment in esophageal cancer patients.
基金supported by the Key Projects of Shanghai Science and Technology on Biomedicine(NO.10DZ1950800)the Major Project of Shanghai Zhabei District Health Bureau (No. 2011ZD01)
文摘Objective:To reveal the neural network of active and passive hand movements. Method:Seven healthy aged people were checked, and acquired functional magnetic resonance imaging data on a 1.5T scanner. Active movement consisted of repetitive grasping and loosening of hand; passive movement involved the same movement performed by examiner. Both types of hand movements were assessed separately. These data were analysed by Statistical Parametric Mapping Microsoft. Result:The main activated brain areas were the contralateral supplemental motor area, primary motor area, primary sensory area and the ipsilateral cerebellum when subjects gripped right hands actively and passively. The supplemental area was less active in passive hand movement than active hand movement. The activated brain areas were mainly within Brodmann area 4 during active hand movement; in the contrast, the voxels triggered by passive movement were mainly within Brodmann areas 3,1,2 areas. Conclusion:The results suggest that the neural networks of passive and active tasks spared some common areas, and the passive movement could be as effective as active movement to facilitate the recovery of limbs motor function in patients with brain damage.
文摘This work was carried out to investigate the efficacy of sensory integration therapy in improving gross motor coordination and grip control in Down syndrome children. Thirty children were enrolled in this study and randomly assigned into two groups: group A received (sensory integration therapy program plus specific physiotherapy training) and group B received (specific physiotherapy training program only). Motor coordination test measures (Balancing backward, Hopping, Jumping from side to side and Transferring boxes) to test and follow gross motor coordination, handheld dynamometer to test and follow grip control ability and kinesthesia test to test and follow awareness of joint position and movement. These measurements were taken before initial treatment and after 12 weeks of treatment. The children parents in both groups A and B were instructed to complete 3 hours of the home routine program. Data analysis was available on the 30 Down syndrome children participating in the study. The difference between pre- and post-treatment results was more significant in Motor coordination test measures in the study group than the control group. Grip control ability and kinesthesia test demonstrate representative improvement in the study groups (p = 0.0001) while insignificant in the kinesthesia control group and significant in a grip control group. The addition of sensory integration therapy program to specific physiotherapy training is recommended in improving gross motor coordination and grip control abilities in Down syndrome, so this suggested approach may be used as a selective choice for improving posture control and hand functions in Down syndrome children.
文摘BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pathophysiological traits with NAFLD.An association exists between sarcopenia and increased NAFLD prevalence.However,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain inconsistent.AIM To analyze the prevalence and outcomes of sarcopenia in patients with NAFLD.METHODS We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June 2023.We included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse events.We also used the Newcastle-Ottawa scale for quality assessment.RESULTS Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for sarcopenia.Sarcopenia was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such association.Sarcopenia in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and mortality.CONCLUSION This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD patients.The variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent findings.This review demonstrates the multidimensional impact of sarcopenia on NAFLD,indicating its importance beyond liver-related events to include cardiovascular risks,mortality,and metabolic complications.
