PURPOSE Both increased sagittal vertical axis (SVA) and sarcopenia affect performance of daily activities and morbidity in the elderly; however, little is known regarding their relationship. The aim of this study was to analyze the association between sarcopenia and increased SVA. METHODS This retrospective study included 71 female patients aged between 60 and 85 years. Entire-spine radiography was used to measure radiological parameters. A bioelectrical impedance analyzer was used to measure the skeletal muscle mass index (SMI). Gait velocity (GV) and hand grip strength (HGS) were examined as well. Lumbar spine magnetic resonance imaging was employed to measure the functional cross-sectional area (FCSA) and fat signal fraction (FSF) of the paraspinal muscle as well. The subjects were divided into two groups according to the SVA (group I; SVA > 50 mm and group II; SVA ≤ 50 mm). RESULTS The group I showed lower GV, HGS, and SMI than the group II (p  less then  0.001,  less then  0.001, and = 0.001, respectively). The prevalence of sarcopenia was higher in the group I (56.7%) than in the group II (17.1%) (p = 0.001). The group I also showed lower FCSA and higher FSF than the group II (p  less then  0.001). In multivariate analysis, the FSF (odds ratio 1.308, p = 0.004) and HGS (odds ratio 0.792, p = 0.023) were correlated with increased SVA. In addition, the BMI (odds ratio 0.756, p = 0.037), SVA (odds ratio 1.051, p = 0.031), and FCSA (odds ratio 0.995, p = 0.012) were correlated with sarcopenia. CONCLUSION Sarcopenia and fatty degeneration of paraspinal muscle are closely related to increased SVA in the elderly.BACKGROUND Psychological factors have an influence on the manifestation as well as on the maintenance of chronic low back pain (CLBP) and are increasingly considered in research. OBJECTIVES The present study investigated the validity and clinical relevance of the Mainz Pain Staging System (MPSS) to replicate previous study results in the setting of inpatient multidisciplinary orthopedic rehabilitation (MOR). METHODS In this multicenter study, psychological and pain-related parameters were investigated among 1012 patients with nonspecific CLBP (ICD-10 M51/53/54) at the beginning of an inpatient MOR stratified according to the stage of pain in the MPSS (I-III). In addition, frequency distributions of scores in the clinical range for depression, anxiety, somatization, and pain-related self-efficacy were determined as a function of pain chronification. RESULTS Stage of pain had a significant effect on all psychological and pain-related parameters in the expected direction. Alongside patients with stage III, patients with stage II showed higher levels of impairment regarding psychological factors. Furthermore, patients with stage III often had higher clinical scores than expected for depression, anxiety, and somatization. CONCLUSION These results confirm the validity and clinical relevance of the MPSS. Moreover, the psychological burden of the patients increased with the stage of pain. Therefore, psychological treatments are required that are tailored to patients' needs. Thus, measurement of the MPSS and psychological diagnostic assessments are recommended.PURPOSE The study aimed to investigate the potential nephroprotective effects of vitamin D3 in metabolic syndrome (MetS) and the molecular basis of the underlying mechanisms of its action. METHODS MetS was induced in adult male Wistar rat‏s by adding fructose (10%) to every day drinking water and salt (3%) to the diet. Six weeks after fructose/salt consumption, fasting serum lipid profile and uric acid levels were determined, an oral glucose tolerance test (OGTT) was performed and kidney function was checked. MetS rats were then treated orally with vitamin D3 (10 µg/kg/day) for 6 weeks. At the end of the study period (12 weeks), the OGTT test was reperformed, anthropometrical parameters were measured, urine, blood and tissue samples were collected and the animals were euthanised. RESULTS The incidence of MetS was confirmed 6 weeks after fructose/salt consumption, when the rats exhibited significant weight gain, dyslipidemia, hyperuricemia, insulin resistance, hyperinsulinemia and impaired glucose tolerance. After 12 weeks, MetS rats displayed markedly declined renal function alongside with extravagant renal histopathological damages and interstitial fibrosis. Furthermore, significantly enhanced renal oxidative stress and inflammation were manifested. Vitamin D3 supplementation in MetS rats significantly reversed all the above-mentioned deleterious effects. CONCLUSION The study has indeed provided mounting evidence of the promising therapeutic potential of vitamin D3 against development and progression of MetS-induced nephropathy. A new insight has been introduced into the crucial role of dipeptidyl peptidase-4 inhibition and sirtuin-1/5'adenosine monophosphate-activated protein kinase activation in the renoprotective effects of vitamin D3.BACKGROUND AND AIMS Existing evidence on the possible effects of synbiotics on lipid profile is inconclusive. The aim of the present systematic review was to clarify the effects of synbiotics consumption on lipid profile. METHODS A systematic literature search of online databases PubMed, Scopus, ISI Web of science, Cochrane's library and Google Scholar was conducted up to January 2019. Randomized controlled trials (RCTs) investigating the effects of synbiotics on lipid profile in adults were included. The overall effect was presented as weighted mean difference (WMD) and 95% confidence interval (CI) in a random-effects meta-analysis model. RESULTS A total of 23 RCTs with 1338 participants were included. 3-Amino-9-ethylcarbazole price Synbiotic consumption resulted in a significant decrease in plasma concentrations of total cholesterol (WMD = - 10.17 mg/dL; 95% CI - 15.74 to - 4.60; p  8 weeks.Recent research has focused on mind wandering (MW), which is caused when a person's attention shifts from a primary task to unrelated internal thoughts. One of the research interests for this psychological action is the diversity of MW content from the future to the past, from the real to imaginary worlds, and from internal and external distractions. However, to date, there have been only a few studies that have explicitly examined MW content. Therefore, we attempted to fill this research gap, to some degree, through this exploratory study. We used an unbiased method that allowed the 59 participants to freely report their psychological experiences, after which their answers were categorized post hoc, to avoid any acquiescence. We found a substantial number of task-related thoughts, or task-related psychological experiences, during the typical MW task. The experiences were further analyzed using a data-driven method, which reported that metacognitive ability possibly contributed to MW. The occurrence of task-related thoughts and metacognitive ability should be given attention when evaluating MW.