Background: Little is known of the effect of wearable devices on metabolic impairments in clinical settings. We hypothesized that a wearable device that can monitor and provide feedback on physical activity may help resolve metabolic syndrome. Objective: This study aimed to examine the objective effects of the use of these devices on metabolic syndrome resolution. Methods: Patients diagnosed with metabolic syndrome were recruited. Participants were prescribed regular walking using a wearable device (Coffee WALKIE +Dv.3, GC Healthcare CI, Korea) on their wrist for 12 weeks. Participants received self-feedback on the amount of their exercise through an app on their mobile phone. The information on physical activities of the participants was uploaded automatically to a website. Thus, a trained nurse could provide individuals with feedback regarding the physical activity via telephone consultation on alternate weeks. Blood pressure (BP), body composition, fasting plasma glucose, and lipid profiles were recorded. The primary outcome was metabolic syndrome resolution. The secondary outcome was an improvement in the components of metabolic impairment. Results: Of the 53 participants recruited, 20 participants with a median age of 46 (range 36-50) years completed the trial. There was no significant difference in the amount of calorie expenditure at weeks 4, 8, and 12. After 12 weeks, metabolic syndrome was resolved in 9 of 20 participants (45%), and the mean number of metabolic impairment components per person decreased from 3.4 to 2.9. Particularly, the mean systolic and diastolic BP decreased from mean 136.6 (SD 18.5) mm Hg to mean 127.4 (SD 19.5) mm Hg and from mean 84.0 (SD 8.1) mm Hg to mean 77.4 (SD 14.4) mm Hg (both P=.02), respectively. Conclusions: This study found that a 12-week intervention via feedback, based on a wearable physical activity monitor, helped metabolic syndrome patients to be more engaged in regular walking and it improved impaired metabolic components, especially in BP. However, some practical challenges regarding patients’ adherence and sustained engagement were observed.

In this study, computational simulations and experiments were performed to investigate the mechanical behavior of the aorta wall because of the increasing occurrences of aorta-related diseases. The study focused on the deformation and strength of porcine and healthy human abdominal aortic tissues under uniaxial tensile loading. The experiments for the mechanical behavior of the arterial tissue were conducted using a uniaxial tensile test apparatus to validate the simulation results. In addition, the strength and stretching of the tissues in the abdominal aorta of a healthy human as a function of age were investigated based on the uniaxial tensile tests. Moreover, computational simulations using the ABAQUS finite element analysis program were conducted on the experimental scenarios based on age, and the Holzapfel–Gasser–Ogden (HGO) model was applied during the simulation. The material parameters and formulae to be used in the HGO model were proposed to identify the failure stress and stretch correlation with age.

Purpose: Information and communication technology (ICT)-based training devices for older adults’ care related to dementia are being developed to enhance older adults’ cognitive functions. Older adults who require bicycle training devices can improve muscle strength and balance of lower limbs by continuously contracting and relaxing lower-limb muscles and improving cognitive function to prevent dementia. This study was conducted to investigate the effects of an ICT-based multicomponent program on body composition and cognitive function in older adults. Patients and Methods: In a randomized controlled intervention test on 20 people over the age of 60 (exercise group: n = 10; control: n = 10), the multicomponent program was applied to the exercise group twice per week, once per day for 12 weeks, at 30 min per session, whereas the control group was advised to maintain their usual daily activities. Results: Comparing body composition changes and cognitive function changes before and after intervention exhibited statistically significant differences in skeletal muscle mass (P=0.01) and modified Alzheimer’s disease assessment scale–cognitive score (P=0.01) between the two groups. Conclusion: It can be difficult to be engaged in a simple repetitive exercise program. Therefore, to meet older adults’ interests and expectations, a customized ICT-based multicomponent program, which can improve body composition and cognitive function in older adults and is believed to help prevent dementia, is recommended. Trial Registration: UMIN000042129 (https://www.umin.ac.jp/english/).

This study aimed to determine the relationship between sarcopenia and physical function, and the best method of diagnosing sarcopenia in healthy adults. Early prevention of sarcopenia is important; however, no studies have been conducted in healthy and relatively young adults. In addition, it remains unclear whether calf circumference is associated with sarcopenia-defined variables. A total of 85 healthy male participants were enrolled, and the mean standard deviation age of the participants was 59.76 (8.12) years. Abdominal computed tomography (CT) was performed to measure muscle areas. All subjects were divided into sarcopenia and non-sarcopenia groups based on skeletal muscle mass index using computed tomography. Sarcopenia showed a tendency to be related to lower grip strength, five times sit-to-stand and timed up and go tests for physical function. This result shows that overweight and obesity in the sarcopenia group had fully adjusted odds ratios of 0.026 (95% CI: 0.002–0.317) and 0.008 (95% CI: 0.001–0.096), respectively. Calf circumference was higher specificity (71.43 and 64.86) better than bioelectrical impedance analysis-based skeletal mass index and had a similar sensitivity (72.09 and 82.35). In conclusion, calf circumference suggests the need to consider its use as a tool for assessing muscle mass in the diagnosis of sarcopenia.

Background: There are higher numbers of Asian individuals with metabolically obese, normal weight (MONW) who are susceptible to diabetes than other ethnic groups. The homeostatic model assessment for insulin resistance (HOMA-IR) has been used for years to evaluate IR; however, the triglyceride-glucose (TyG) index has been highlighted as a reliable and cost-effective insulin resistance indicator. Thus, this study explored the association of the HOMA-IR versus the TyG index with diabetes in individuals without underweight or obesity. Methods: This cross-sectional study included 10,471 Korean individuals whose body mass index was ≥18.5 and <25.0 kg/m². Depending on metabolic syndrome criteria, subjects with no conditions, one or two conditions, and three or more conditions were assigned to the metabolically healthy and normal weight (MHNW), pre-MONW, and MONW groups, respectively. Diabetes was diagnosed based on HbA1C and medication information. Results: The HOMA-IR and TyG index discriminated between each group, showing an increasing trend from the MHNW group to the MONW group. However, this trend was more robust for the TyG index. The cut-off values in the TyG index and HOMA-IR were >8.9 and >1.6 in males and >8.7 and >1.6 in females, respectively. The TyG index’s area under the curve was higher than that of the HOMA-IR in both sexes. MONWs distinguished by the cut-off values of the TyG index and HOMA-IR were 2.370 and 1.726 for males and 2.249 and 1.710 for females times more likely to develop diabetes. Conclusions: The TyG index showed a stronger association with diabetes in Korean individuals without underweight or obesity than the HOMA-IR.

Blunt traumatic aortic injury (BTAI) is rare and fatal. Treatment has evolved with advances in imaging and the emergence of thoracic endovascular aortic repair (TEVAR). This study reports a single-center, 5-year experience of TEVAR and open repair for BTAI. Patients with BTAI treated at a level I trauma center from 2014 to 2019 were retrospectively reviewed with patient charts and successive computed tomography angiography images. Patients were grouped according to treatment modality: open repair, TEVAR, or medical management, chosen based on patients' characteristics and injury severity. Groups were compared in terms of preoperative demographics, injury characteristics, operative variables, short-term, and long-term outcomes. Forty-two patients were included in the study: 16 (38%) underwent open repair, 17 (40.4%) underwent TEVAR, seven (16.6%) were managed medically, and two (4.7%) died during triage. The median age was 49 years (interquartile range [IQR], 38-57.5 years), and 92.5% were male; the median Injury Severity Score was 33 (IQR, 29-41). Overall mortality was 7.5%. The median hospital stay was 33 days (IQR, 19.5-58.5). Patients undergoing open repair were significantly younger (43 vs. 55 years; p = 0.002) and had a smaller aortic diameter (22.3 vs. 24.0 mm; p=<0.001) than those undergoing TEVAR. No BTAI-related late mortality or reintervention was observed during follow-ups. This study demonstrated excellent outcomes with multidisciplinary team efforts and appropriate application of treatment modality. TEVAR is ideal for older or severely injured patients; open repair is an important alternative for young patients or patients with unsuitable aortic anatomy.