University of Human Arts and Sciences

Ultrasound imaging is used to measure the muscle–tendon junction (MTJ) to investigate the mechanical properties of the tendon and the interaction of the muscle–tendon unit in vivo. Although the MTJ can be observed clearly in the resting state, accurate tracking of the MTJ is difficult during muscle contractions due to changes in its morphology. We devised a novel method using an algorithm that extracts and tracks multiple feature points in ultrasound images to automatically measure the MTJ that moves during muscle contraction. Instead of using a single reference image, multiple feature points are used to improve the tracking performance during the deformation of the MTJ. Subsequently, we experimentally evaluated the usefulness of this method. Tests were conducted on 20 healthy participants performing isometric maximal contractions, and ultrasound echo images of the medial gastrocnemius and Achilles tendon junctions were recorded. MTJ excursion was calculated using the developed multiple feature point algorithm and two conventional methods—multi-updating template-matching and modified Lucas–Kanade (LK)—based on automatic and manual analyses. The root mean square error (RMSE) was used to compare the results. The intraclass correlation coefficient (ICC) was used to evaluate the repeatability among examiners. RMSE was 1.57 ± 0.62 for the proposed algorithm and 2.18 ± 0.89 and 1.84 ± 1.13 for the conventional methods. The Bland-Altman plot showed that the proposed method exhibited a lower 95% confidence interval than the two conventional methods. Thus, the proposed algorithm had the smallest error. Furthermore, the ICC values were 0.96, 0.40, and 0.86 for the proposed algorithm, multi-updating template-matching, and the modified LK method, respectively. When tracking an MTJ excursion that flexibly changes its shape, the use of multiple feature points provides robust results and achieves tracking that approximates the manual analysis results.

Managing rheumatic diseases requires teamwork, but referral patterns and challenges remain poorly understood. This study explored rheumatologists’ perspectives on referral patterns in the Gulf countries. We conducted a web-based, 21-question cross-sectional survey between November and December 2024, collecting data on rheumatologists’ demographics, referral patterns, influencing factors, and satisfaction. Participants were recruited through email invitations, WhatsApp groups and snowball sampling. Statistical analyses included descriptive and inferential methods, such as subgroup comparisons and logistic regression, to identify predictors of referral frequency and satisfaction. A total of 149 rheumatologists participated, with 58.4% being consultants. Approximately 55% had up to 10 years of post-training experience. The primary referral method was electronic health records (EHR) (84.8%). In the three months preceding the survey, 36.3% made 0–10 referrals, while 35.6% made over 20. Dermatology (85.5%) and physiotherapy (79.5%) were the most referred specialties, aligning with psoriatic arthritis and systemic lupus erythematosus as the most referred diseases. Most rheumatologists (78%) often or always followed up on referrals, and 37.4% reported moderate changes in their referral decision-making over time. Key influences on referral decisions included patient-, practice-, and diagnostic-related factors. Patient gender preference had no impact. Multidisciplinary meetings (78.2%), access to updated clinical guidelines (76.5%), attending multidisciplinary continuing medical education or training programs (67.2%), and improved EHR referral systems (64.7%) were the top resources for improving referrals. Satisfaction post-referral was affected by various factors such as patients’ experiences post-referral (61.5%), and healthcare professionals’ responsiveness to their questions (54.2%). Logistic regression analysis showed that age, employment status, practice setting, and geographical location were associated with referral decisions. This study is the first to provide valuable insights into referral practices among Gulf rheumatologists, identifying key influencing factors and areas for improvement. Findings suggest that enhancing EHR systems, multidisciplinary meetings, and clinical guidelines can optimize referrals and interdisciplinary care.

Background: The role of tibialis anterior activity in sit-to-stand motion is unclear. We hypothesized that contraction of the tibialis anterior would slightly lift the forefoot and shift the center of pressure backward. Objectives: The objective of this study was to clarify this movement and its role in tibialis anterior activity. Methods: Ten healthy adults performed the sit-to-stand motion. Cross-correlation coefficients among tibialis anterior activity, shank inclination angle, and center of pressure were calculated. Whole-body joint moments were simulated when the center of pressure varied within the foot. The angle of the ground reaction force during seat-off was calculated. Results: The center of pressure moved backward in all trials for all participants. The mean lag time for peak cross-correlation coefficients between the tibialis anterior and shank tilt and between the tibialis anterior and center of pressure was 0.37 and 0.13 s, respectively. Simulating the center of pressure forward resulted in greater whole-body joint moments than those measured (mean 1.88 times). The ground reaction forces were nearly perpendicular to the floor. Conclusions: From the perspective of temporal synchrony, tibialis anterior activity significantly contributed to the backward shift of the center of pressure. The center of pressure shift minimized the force exerted by the entire body.

Background: The Society of Thoracic Surgeons surgical risk score (STS Score) is widely used to assess risk in cardiac surgery along with the Japan Score (Japan surgical risk score) in conjunction with the various biomarkers. Methods: Preoperative blood tests were performed on 127 patients who subsequently underwent cardiovascular surgery (78 men, 49 women; mean age, 69.5 years). Serum levels of growth differentiation factor (GDF)-15, endothelin-1, and adiponectin were measured by enzyme-linked immunosorbent assay and used as independent variables in multivariate regression analysis with the STS Score or Japan Score as the dependent variable. Results: Serum levels of GDF-15, endothelin-1, and adiponectin correlated positively with the STS Score, the Japan Score, and the plasma brain natriuretic peptide (BNP) level, and correlated negatively with the estimated glomerular filtration rate (eGFR) and hemoglobin and albumin levels. After adjustment for age, sex, and body mass index, multivariate linear regression analysis showed that log (GDF-15) defined log (STS Score), and log (GDF-15) and log (endothelin-1) were independent factors defining log (Japan Score) (GDF-15: β = 0.372, p < 0.001; endothelin-1: β = 0.213, p = 0.016). eGFR and levels of hemoglobin and albumin defined log (GDF-15), and log (BNP) defined log (endothelin-1). Conclusions: The STS Score and the Japan Score were associated with serum GDF-15 level in patients undergoing cardiovascular surgery. It is likely that the Japan Score had a stronger association with heart failure than the STS Score.

The split-belt treadmill task is an effective tool for studying walking adaptation, particularly the symmetry adaptation of spatiotemporal parameters such as step length and double support time. This study aimed to evaluate the relationship between symmetry adaptation of spatiotemporal parameters and dynamic stability during the double-support phase in split-belt walking. We hypothesized that restraining fast-side knee extension, which is necessary for step lengthening during adaptation, would decrease dynamic stability during the double-support phase. Ten able-bodied male participants performed split-belt walking tasks under three conditions: control, fast-side knee restraint, and slow-side knee restraint. Our findings revealed that slow-side knee restraint disrupted symmetry in double support time and significantly decreased stability on the fast side during the early and late adaptation phases. Contrary to our hypothesis, fast-side knee restraint did not have a statistically significant effect on dynamic stability or symmetry. These results suggest that decreased dynamic stability during the double-support phase, particularly due to limitations in the movement of the trailing leg, may hinder the adaptation process. This study highlights the importance of dynamic stability control during the double-support phase for successful walking adaptation. Future studies with larger sample sizes and varying speed conditions are recommended to generalize these findings and develop targeted interventions to improve walking adaptability and dynamic stability.

Purpose of Review This review examines the applications of point-of-care ultrasound (POCUS) in pediatric emergency departments in low-resource settings (LRS), assesses implementation challenges, highlights successful programs, and explores future directions, such as training, policy support, and technological advancements. Recent Findings POCUS has proven highly effective in diagnosing various pediatric emergencies, including respiratory conditions like pneumonia, bronchiolitis, and pleural effusions, as well as cardiac emergencies like pericardial effusion and left ventricular dysfunction. Successful POCUS programs in Pakistan, South Sudan, Uganda, Haiti, and Ghana underscore its feasibility and impact on patient care in LRS. These programs often involve focused training for healthcare providers, integration of POCUS into standard protocols, and ongoing mentorship. However, challenges remain, including inadequate infrastructure, training deficits, financial constraints, and cultural/institutional barriers. Summary POCUS has the potential to transform pediatric emergency care in LRS by enabling rapid and accurate diagnoses, facilitating timely interventions, and ultimately improving patient outcomes. To realize this potential, it is crucial to address implementation challenges through tailored training programs, sustainable funding models, supportive policies, and the integration of technologies like telemedicine and AI. By addressing these challenges, POCUS can become an indispensable tool for pediatric emergency care globally.

Objective HIV-1 remains a global challenge, especially in high-prevalence areas like South Africa. This study explores the relationship between inflammation and metabolism in people with HIV, focusing on immune markers and the tryptophan–kynurenine (Trp–Kyn) pathway. Design This is a cross-sectional, observational study exploring the associations between peripheral inflammation and metabolism in treatment-naive South African people with HIV. Methods We examined immune markers (hsCRP, suPAR, IL-6, NGAL, and sCD163) and Trp–Kyn metabolites (QUIN, Trp, Kyn, Trp/Kyn ratio, and kynurenic acid) in n = 69 treatment-naive South African people with HIV using targeted liquid chromatography–tandem mass spectrometry (LC-MS/MS) metabolomics and various assays. Results We observed significant associations between immune markers and Trp–Kyn metabolites. IL-6 was negatively associated with Trp (P < 0.001) and positively with the Kyn/Trp ratio (P = 0.005). hsCRP was positively associated with QUIN (P = 0.036). suPAR showed significant negative associations with Trp (P = 0.036), positive associations with the Kyn/Trp ratio (P < 0.001), and QUIN (P = 0.007). sCD163 negatively associated with Trp (P < 0.001) and positively with the Kyn/Trp ratio (P < 0.001). When participants were stratified by inflammation levels (based on CRP), IL-6 (P = 0.002), QUIN (P = 0.009), and Kyn (P = 0.032) were significantly higher in the high inflammation group. Specific associations were observed only in certain groups, such as IL-6 negatively associating with Trp and kynurenic acid in the high inflammation group, and suPAR associating negatively with Trp in the low inflammation group. Conclusions These exploratory findings provide further insight into how peripheral inflammation and metabolism are interrelated in South African people with HIV, potentially guiding future therapeutic strategies."

Tamoxifen (TAM) has been used universally for the treatment of estrogen-sensitive breast cancer, but it is also known to decrease the count of cells such as leukocytes by induction of off-target apoptosis. In this study, we examined the effects of lipids, a biological component related to the cytotoxicity of TAM, by observing apoptosis in monocytic leukemia cells (U937 cells) cultured in the presence of palmitic acid (PA), a saturated fatty acid. PA significantly suppressed TAM-induced apoptosis in U937 cells in terms of DEVDase activity and nuclear aggregation/fragmentation. In contrast, oleic acid (OA) had a weaker inhibitory effect. In addition, 17β-estradiol (E2) had no effect on apoptosis induced by TAM, nor did it induce apoptosis on its own. Mitochondrial analysis revealed that PA suppressed TAM-induced inhibition of respiratory chain complex I and II (CI, II) activity. These results suggest that PA may reduce the estrogen receptor (ER) -independent cytotoxicity of TAM.

Desmoid fibromatosis (DF) is a rare, non-metastasizing but locally aggressive mesenchymal tumor arising from fibroblasts or myofibroblasts. We report a solitary case of DF involving the retropharyngeal and danger spaces, a location rarely documented. The patient, a woman in her 70s, presented with progressive pharyngeal discomfort over six months. Imaging studies revealed a soft-tissue mass consistent with DF, and the diagnosis was confirmed pathologically. The tumor demonstrated unique imaging findings, including band-like hypointense areas on T2-weighted imaging on magnetic resonance imaging and moderate 2-deoxy-2-[¹⁸F]fluoro-D-glucose uptake on positron emission tomography/computed tomography (PET/CT), which may aid in differentiating DF from malignant tumors in atypical locations. Furthermore, this case highlights the effectiveness of radiotherapy in achieving significant tumor reduction, offering insights into the management of DF in rare and challenging locations. These findings not only aid in refining the differential diagnosis but also provide evidence supporting radiotherapy as a viable treatment option in cases where surgical resection is unfeasible.

Although the empathy concept is relevant across all domains of human relations, it is often used in a vague and poorly defined way that limits its utility both in science and in real-world applications. Research indeed suggests that behaviors considered “empathic” vary across individuals and according to context. This research looked at the organizational context, by (a) in two studies, asking employees in many different work settings to rate a diverse list of workplace behaviors for how much each is empathic to them, and (b) in a third study, analyzing employees’ messages describing instances of fellow employees’ empathic behavior posted to their companies’ rewards platform. In Study 1 (N = 318), employees in different companies responded to a list of 44 discrete behaviors, and in Study 2 (N = 234), employees responded to the same behaviors as well as 25 more. In both studies, two conceptually different, but empirically related, types of empathy emerged, which we labeled Emotional Sensitivity and Professionalism. In Study 3, we coded for these two dimensions in 1,497 messages sent by employees on a company rewards platform where they described “empathic” workplace behaviors by co-workers. Results of all three studies suggest that in the workplace, behavioral manifestations of “empathy” extend beyond conventional notions of personal responsiveness to include task functions, thus demonstrating that “empathy” in the real world covers surprisingly wide territory. The research shows that context matters in discussions of empathy and provides a concrete vocabulary for scholars and organizations to use in research on workplace culture.

Background Advances in multimedia technologies' capabilities and accessibility have made it possible for stories to be digitally recorded, stored, and shared with a much wider audience. In mental health, digitalised lived experiences have been used to promote self-management and recovery during therapy, mental health awareness and literacy, and social relationships. In this paper, we describe the theory of change process we used to integrate The Human Aspect’s digitalised lived experiences (videos) into the Friendship Bench intervention. Results There was consensus from the stakeholders that digitalised lived experiences could be used as in-session and between-session resources for promoting the subjective psychological well-being of Friendship Bench clients. The stakeholders were of the same view that the digital videos be used as both an in-session and between-session intervention. Clients would be given the opportunity to choose the modality that works for them. It was agreed that the digitalised lived experiences stories could potentially be used to increase mental health awareness, improve mental health literacy, reduce mental health-related stigma and help facilitate recovery in Friendship Bench clients. Conclusions Theory of Change can be used to build consensus on how to integrate digitalised lived experiences into an existing evidence-based mental health intervention. There is now a need to evaluate the feasibility and acceptability of the integration as well as evaluate its effectiveness in reducing common mental disorders symptoms through an adequately powered study.

Although coconut oil (CO) has attracted great attention as a functional food, enough supportive scientific evidence is lacking. In addition, the beneficial effects of CO consumption on the prevention of metabolic disorders are controversial. Fetuin-A is a plasma glycoprotein secreted by hepatocytes and adipocytes. Circulating fetuin-A levels relate to insulin resistance due to macrophage-mediated adipose tissue inflammation. This study demonstrated that CO feeding significantly downregulated the hepatic expression of fetuin-A and reduced its plasma level in KK mice—an obese diabetic model animal. The expression of monocyte chemoattractant protein-1, a potent inducer for macrophage infiltration, decreased in epididymal white adipose tissue in CO-fed KK mice. The expression of CD68 and CD11c, markers of proinflammatory M1 macrophages, was significantly reduced by CO feeding in epididymal white adipose tissue of KK mice. However, the mice did not exhibit improved insulin resistance. Our results may further support the potential of CO as a dietary trigger that can reduce both circulating fetuin-A levels and infiltration of proinflammatory macrophages in visceral adipose tissue.

Objectives The purpose was to directly assess in-competition thermoregulatory responses in recreational runners during a city marathon conducted in cool, ambient conditions using a two-pill ingestion strategy. Methods Thirty-two recreational runners (age: 38.7 ± 10.2 years, mass: 73.9 ± 11.0 kg, height: 177 ± 8 cm) were invited to participate in this study. Core temperature was continuously assessed using telemetric ingestible pills. Each runner swallowed two pills: the first pill (Pill 1) 11 h:47 min ± 1 h:01 min pre-race (before overnight sleep) and the second (Pill 2) 2 h:35 min ± 0 h:54 min pre-race (on wakening). Results Pre-race core temperature for Pill 1 was significantly different from Pill 2, with values of 37.4 ± 0.4 °C and 37.1 ± 0.6 °C, respectively (p=0.006). The mean core temperature during the race was higher for Pill 1 compared to Pill 2 (38.5 ± 0.5 °C and 37.8 ± 1.0 °C, respectively; p<0.001). Peak core temperature was higher for Pill 1 compared to Pill 2 (39.1 ± 0.5 °C and 38.8 ± 0.5 °C, respectively; p=0.03). Post-race core temperature was higher for Pill 1 compared to Pill 2 (38.8 ± 0.7 °C and 38.1 ± 1.3 °C, respectively; p=0.02). Conclusions The timing of pill ingestion significantly impacted core temperature and hence timing of pill ingestion should be standardised (5 h:30 min–7 h prior to measurement). Despite the relatively cool ambient conditions during the race, a significant number of runners achieved a high core body temperature (≥39 °C), which was not accompanied by any signs of heat illness.

This study introduces “UpperLimbs,” an advanced upper limb motion measurement system that utilizes a monocular web camera and inference AI to simplify the traditional elaborate setups required for three-dimensional motion measurement. Using the MediaPipe AI framework, this system is capable of identifying joint positions and depth information from a single camera’s video feed. The efficacy of UpperLimbs was validated against a traditional marker-based system, demonstrating comparable accuracy and potential for significant improvements in rehabilitation and prosthetic training. Further enhancements were explored through various image processing techniques, including image sharpening, noise reductions. The implementation of low-pass filters in time domain and calculated offsets further optimized the system’s accuracy, making UpperLimbs a promising tool for accessible and efficient upper limb motion analysis, particularly for individuals using prosthetic hand.

Aim This study examined the psychological impact of the COVID‐19 pandemic on university students, focusing on how adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) influence mental health. Methods A web‐based survey was administered to 3000 university students from October 26 to 31, 2022, following the peak of the COVID‐19 pandemic. Mental health assessments included the Japanese version of the Kessler Psychological Distress 6‐Item Scale (K6) for depressive/anxiety symptoms, the Impact of Event Scale‐Revised (IES‐R‐J) for distress, fear of COVID‐19, and a three‐item loneliness scale. Results Of the respondents, 46.9% reported depressive/anxiety symptoms, 55.4% reported distress, and 37.3% reported fear of COVID‐19. Factors such as current psychiatric treatment history and reduced income (either parental or personal) were predictive of worsening depressive/anxiety symptoms, distress, and loneliness. ACEs were found to exacerbate depressive/anxiety symptoms and distress, while PCEs mitigated these symptoms, and vice versa. Conclusion This study underscores the importance of considering both ACEs and PCEs in supporting the mental health of university students. PCEs were found to independently prevent mental health deterioration, including depressive/anxiety symptoms and distress, which may include post‐traumatic stress disorder symptoms, even in the presence of ACEs. Recognizing and fostering PCEs emerged as an effective strategy for mitigating mental health issues.

Various selection pressures have shaped human uniqueness, for instance, music. When and why did musical universality and diversity emerge? Our hypothesis is that “music” initially originated from manipulative calls with limited musical elements. Thereafter, vocalizations became more complex and flexible along with a greater degree of social learning. Finally, constructed musical instruments and the language faculty resulted in diverse and context-specific music. Music precursors correspond to vocal communication among nonhuman primates, songbirds, and cetaceans. To place this scenario in hominin history, a three-phase scheme for music evolution is presented herein. We emphasize (1) the evolution of sociality and life history in australopithecines, (2) the evolution of cognitive and learning abilities in early/middle Homo, and (3) cultural evolution, primarily in Homo sapiens. Human musical capacity and products should be due to the hominin-specific combination of several biosocial features, including bipedalism, stable pair bonding, alloparenting, expanded brain size, and sexual selection.

Purpose Our study aimed to compare the immediate and prolonged effects of submaximal eccentric (ECC) and concentric (CON) fatiguing protocols on the etiology of hamstrings’ motor performance fatigue. Methods On separate days, 16 males performed sets of 5 unilateral ECC or CON hamstrings' contractions at 80% of their 1 Repetition Maximum (1 RM) until a 20% decrement in maximal voluntary isometric contraction (MVC) torque was reached. Electrical stimulations were delivered during and after MVCs at several time points: before, throughout, immediately after (POST) and 24 h (POST 24) after the exercise. Potentiated twitch torques (T100 and T10, respectively) were recorded in response to high and low frequency paired electrical stimulations, and hamstrings’ voluntary activation (VA) level was determined using the interpolated twitch technique. For statistical analysis, all indices of hamstrings’ motor performance fatigue were expressed as a percentage of their respective baseline value. Results At POST, T100 (ECC: -13.3%; CON: −9.7%; p < 0.001), T10 (ECC: −5.1%; CON: −11.8%; p < 0.05) and hamstrings' VA level (ECC: −3.0%; CON: −2.4%; p < 0.001) were significantly reduced from baseline, without statistical differences between fatigue conditions. At POST24, all indices of hamstrings’ motor performance fatigue returned to their baseline values. Conclusion These results suggest that the contribution of muscular and neural mechanisms in hamstrings’ motor performance fatigue may not depend on contraction type. This may have implications for practitioners, as ECC and CON strengthening could be similarly effective to improve hamstrings’ fatigue resistance.

Canine malignant melanoma provides a clinically relevant, large animal parallel patient population to study the GD2-reactive hu14.18-IL-2 immunocytokine as it is similar to human melanoma and expresses GD2. The objectives of this study were to evaluate safety, radiation fractionation, and identify informative biomarkers of an in-situ tumor vaccine involving local radiation therapy plus intratumoral–immunocytokine in melanoma tumor-bearing dogs. Twelve dogs (six dogs/arm) with locally advanced or metastatic melanoma were randomized to receive a single 8 Gy fraction (arm A) or three 8 Gy fractions over 1 week (arm B) to the primary site and regional lymph nodes (when clinically involved) with the single or last fraction 5 days before intratumoral–immunocytokine at 12 mg/m ² on 3 consecutive days. Serial tumor biopsies were obtained. All 12 dogs completed protocol treatment, and none experienced significant or unexpected adverse events. Evidence of antitumor activity includes one dog with a complete response at day 60, one dog with a partial response at day 60, and four dogs with mixed responses. Histology of serial biopsies shows a variably timed increase in intratumoral lymphocytic inflammation in some dogs. Canine NanoString analyses of serial biopsies identified changes in gene signatures of innate and adaptive cell types versus baseline. There were no significant differences in NanoString results between arm A and arm B. We conclude that intratumoral–immunocytokine in combination with local radiation therapy in canine melanoma is well tolerated and has antitumor activity with the potential to inform clinical development in melanoma patients.

Much research has been conducted to determine how hair regeneration is regulated, as this could provide therapeutic, cosmetic, and even psychological interventions for hair loss. The current study focused on the hair growth effect and effective utilization of fatty oil obtained from Bryde’s whales through a high-throughput DNA microarray approach in conjunction with immunohistochemical observations. The research also examined the mechanisms and factors involved in hair growth. In an experiment using female C57BL/6J mice, the vehicle control group (VC: propylene glycol: ethanol: water), the positive control group (MXD: 3% minoxidil), and the experimental group (WO: 20% whale oil) were topically applied to the dorsal skin of the mouse. The results showed that 3% MXD and 20% WO were more effective than VC in promoting hair growth, especially 20% WO. Furthermore, in hematoxylin and eosin-stained dorsal skin tissue, an increase in the number of hair follicles and subcutaneous tissue thickness was observed with 20% WO. Whole-genome transcriptome analysis also confirmed increases for 20% WO in filaggrin (Flg), a gene related to skin barrier function; fibroblast growth factor 21 (Fgf21), which is involved in hair follicle development; and cysteine-rich secretory protein 1 (Crisp1), a candidate gene for alopecia areata. Furthermore, the results of KEGG pathway analysis indicated that 20% WO may have lower stress and inflammatory responses than 3% MXD. Therefore, WO is expected to be a safe hair growth agent.