Citations

ABSTRACT Purpose Abnormal restrictions at myofascial interfaces are a key factor in chronic low back pain (CLBP) with myofascial pain syndrome (MPS), but no established imaging method exists for quantitative assessment. This pilot study evaluated the clinical feasibility of MR elastography (MRE)‐based slip interface imaging (SII) for visualizing myofascial mobility in CLBP‐MPS patients versus age−/sex‐/BMI‐matched healthy participants. A new SII biomarker, maximal normalized displacement discontinuity (), was introduced, and the previously developed normalized octahedral shear strain (NOSS) map was used for comparison. Preliminary assessments of vibration‐frequency effects, repeatability, and group differences in inter‐muscular mobility were conducted. Methods MRE was conducted at 30, 60, and 90 Hz to compare with NOSS for visualizing inter‐muscular slip interfaces at the quadratus lumborum‐erector spinae (QL‐ES) and erector spinae‐multifidus (ES‐M) muscle boundaries at L3‐L4. Repeatability of and NOSS was assessed at 30 Hz (identified as the best‐performing frequency) using within‐subject coefficients of variation and a linear mixed‐effects model from within‐ and between‐day scans. Clinical feasibility was then assessed via Wilcoxon rank‐sum tests in six CLBP‐MPS patients and matched controls. Results at 30 Hz exhibited superior delineation of slip interfaces compared to higher frequencies and NOSS. demonstrated significantly lower variation and better repeatability than NOSS. Healthy participants showed continuous, well‐defined slip interfaces, whereas CLBP‐MPS patients displayed disrupted interfaces with significant mobility reduction at L4 ES‐M. Conclusion SII with lower vibration frequency and map enhances visualization of lower back myofascial mobility and shows potential for assessing differences between healthy individuals and CLBP‐MPS patients.

The increasing adoption of plant-based diets (PBDs) has raised questions regarding their adequacy in supporting muscular strength and performance, particularly given concerns around the amino acid profile and bioavailability of plant proteins. This review synthesises current meta-analytical and clinical trial evidence to address the "plant protein paradox," which posits that plant proteins are inferior for maintaining muscle mass and strength. Recent high-quality data reveal no significant differences in muscular strength or athletic performance outcomes between plant-based and omnivorous diets when total protein intake and quality are optimised. Mechanistic studies demonstrate comparable muscle protein synthesis rates across protein sources, with soy and certain mixed plant proteins showing anabolic potential equivalent to animal proteins. Clinical recommendations emphasise attention to protein quantity, quality, leucine content, and micronutrient sufficiency to maximise muscle health on PBDs. Specific populations—including older adults and athletes—can safely adopt plant-based nutrition without compromising strength or functional performance. This evidence supports a shift beyond traditional, protein hierarchy models, positioning plant-based diets as a viable strategy for musculoskeletal health alongside their cardiovascular and environmental benefits.

Introduction Social media platforms, particularly X (formerly Twitter), play an influential role in professional networking and information dissemination. This study aimed to examine X usage trends among faculty in a single department of surgery at a large academic institution. Methods Faculty X accounts were analyzed from January to June 2022. Metrics such as follower count, number of accounts followed, and post (formerly: tweets) types (original/quoted reposts) were studied. Themes of posts were categorized as personal, promotional, educational, or related to academic events/conferences. Associations between faculty rank, division, gender, and post metrics were explored using Mann-Whitney U and Kruskal-Wallis tests. Results Of 133 faculty members, 53 (39.85%) had X accounts, with 3 excluded due to privacy settings. A total of 3476 posts were analyzed, averaging 0-34 posts/month per faculty. Categories included professional (63%, n = 2174), educational (19%, n = 653), and personal (13%, n = 436). No significant associations were found between faculty gender/division and posting rates. However, faculty rank correlated significantly with primary post categories ( P < 0.01). Associate professors, and professors posted more about academic events (2% and 1%) than instructors or assistant professors (1%). The most followed faculty actively promoted colleagues’ work through reposting. Conclusion Less than half the faculty in a single department of surgery engaged with X. Those active predominantly used it for promotion, followed by education and personal use. Adoption remains limited, highlighting opportunities for growth in utilizing X for academic dissemination.

Introduction Problematic alcohol use negatively impacts individuals, families and communities. While perceptions regarding alcohol use are likely vital to mitigating problematic alcohol use at the population level, little is known. Perceptions that demarcate normative versus problematic use may be relevant for interventions in communities with normative alcohol use. Our study explores ethnocentric perceptions of alcohol use in a community where alcohol use is historically integrated into its social fabric. Methods Mixed-methods study design using a culturally curated online survey with closed and open-ended responses assessed perceptions regarding alcohol use. Participants were members of the Kodava community: an affluent ethno-linguistic community in Southern India with an international presence. For Kodavas, alcohol consumption is normative and socially sanctioned. We studied perceptions of alcohol use among family members, including factors influencing its use and the impact of problematic alcohol drinking on immediate and extended family in three domains: health, finances and relationships. Results Of 711 total respondents, a small minority of 11.4% (n=81) stated that at least one immediate family member experienced negative impacts of alcohol use. Among respondents who reported on their extended family (n=639), 52.1% (n=333) endorsed at least one member experienced negative impacts. The integration of quantitative and qualitative data elucidates negative impacts of alcohol use within and at the intersections of health, relationships and finances. Conclusions First study to employ social media (WhatsApp) to survey a globally dispersed ethnic community on alcohol use impacts among family members. Interventions tailored to these perceptions, in culturally embedded communities, may improve outcomes. The framework and approach of this study can be replicated globally.

Objective: Evaluate patient-reported symptoms and quality of life (QOL) before and after female sterilization device (Essure) removal. Design: Multicenter prospective study. Setting: Three academic institutions. Population or Sample: Patients with device-attributed symptoms undergoing Essure removal. Methods: Symptoms were measured using a study-specific questionnaire and Short Form-8 (divided into Physical and Mental Component Scores). Scores at 4 months postoperative were compared to baseline using a mixed effects logistic regression and linear mixed model. Subgroup analysis was performed for hysterectomy and uterine-preserving groups. Main Outcome Measures: Patient-reported symptoms and Short Form-8 4 months after Essure removal compared to baseline. Results: A total of 80 patients enrolled in the study and underwent Essure removal: 53 (66.3%) with laparoscopic hysterectomy and 27 (33.8%) with laparoscopic bilateral salpingectomy or bilateral cornuectomy. Fifty-one participants (63.8%) completed the 4-month postoperative questionnaire. Of the 17 device-attributed symptoms evaluated, participants reported clinically important improvement in 16 of the symptoms postoperatively. QOL improved significantly following device removal, with the Physical Component Score improving by 9.9 points (95% CI: 7.0–12.9) and the Mental Component Score by 13.8 points (95% CI: 10.4–17.2). QOL improved in both physical and mental score domains after device removal with no difference between hysterectomy and uterine-preserving groups ( p = 0.83 and p = 0.06, respectively). Of the entire cohort, 92.2% ( n = 47) were satisfied with their surgical results. Conclusions: Patients undergoing Essure removal for device-attributed symptoms report improved symptoms and QOL following surgery. Device removal may benefit those experiencing device-attributed symptoms and is associated with high patient satisfaction.