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Background and Objectives: The majority of patients who undergo hip fracture surgery do not recover their former level of physical function; hence, it is essential to establish a specific rehabilitation strategy for maximal functional recovery of patients after a hip fracture. Knowing which indicators of physical function in hip fracture patients have a significant impact on the decision regarding the place or timing of discharge would make it possible to plan and prepare for discharge as soon as possible. Therefore, this study aimed to investigate the relationship between physical function and discharge destination for older adult patients with hip fracture. Materials and Methods: In this retrospective cohort study, 150 hip fracture patients (mean age 78.9 ± 10.6 years) between January 2019 and June 2021 were enrolled. Patients were categorized into two groups according to their discharge destination, either home or facility. Demographic and disease-related characteristic data were collected from the medical records. All the patients completed performance-based physical function tests including the 10 Meter Walk Test (10MWT), Timed Up and Go test (TUG), Koval’s grade, and Berg Balance Scale (BBS) at the start of rehabilitation and at discharge. A backward stepwise binary logistic regression analysis was then performed to determine the independent factors of the discharge destination. Results: The home discharge group had a significantly lower Koval’s grade, lower TUG, higher BBS both at baseline and discharge, and younger age. Backward stepwise logistic binary regression analysis showed that TUG, BBS, and 10MWT at baseline and discharge were significant variables affecting the discharge destination after hip fracture. Conclusions: These results demonstrate that balance and gait in older adult patients with hip fractures are highly influential factors in the determining the discharge destination.

This study aimed to compare the Korean Activity Status Index (KASI) with the cardiopulmonary exercise test (CPET) among patients with acute myocardial infarction. A total of 2,268 patients (85.4% male; mean age, 59.3±10.2 years; range, 23-90 years) diagnosed with acute myocardial infarction were enrolled in the Regional Center Myocardial Infarction Registry between July 2016 and June 2019. The KASI is a tool used to measure functional capacity by asking patients about their ability to perform specific activities and then scoring their responses. In contrast, CPET is the gold standard for assessing the objective functional capacity in patients undergoing cardiac rehabilitation. Peak oxygen uptake (VO2peak) was used to analyze the correlation. Patients who completed two consecutive KASI and CPET evaluations during their first (KASI_1, VO2peak_1) and second visits (KASI_2, VO2peak_2) for cardiac rehabilitation were included in the study. The mean KASI_1 and KASI_2 scores were 43.3±14.3 and 49.8±13.9, respectively, and the mean VO2peak_1 and VO2peak_2 scores were 25.9±8.0 and 28.5±8.3, respectively. Both the KASI scores were significantly correlated with the measured VO2peak during each visit, with correlation coefficients of 0.385 (P

Introduction Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease affecting the axial skeleton, including the sacroiliac joint, which causes vertebral fusion in the advanced stage. However, reports of anterior cervical osteophytes compressing the esophagus and causing dysphagia in patients with AS are rare. Here, we present the case of a patient with AS and anterior cervical osteophytes who exhibited rapidly progressing dysphagia after thoracic spinal cord injury (SCI). Case Presentation The patient, a 79-year-old man, was previously diagnosed with AS and had syndesmophytes at C2-C7 without dysphagia for several years. In 2020, he began to experience paraplegia, hypesthesia, and bladder and bowel dysfunction after a fall. He also had T9 SCI American Spinal Injury Association Impairment Scale grade A due to a T10 transverse fracture. Four months after SCI, he developed aspiration pneumonia, and a videofluoroscopic swallowing study indicated dysphagia with epiglottic closing problems due to syndesmophytes at the C2-C3 and C3-C4 levels. He received treatment for dysphagia and VitalStim therapy thrice (once daily); however, the recurrent pneumonia and fever continued. He further underwent bedside physical therapy and functional electrical stimulation once daily. However, he died from atelectasis and exacerbation of sepsis. Discussion and Conclusion General deterioration of the patient’s physical condition due to SCI, sarcopenic dysphagia, and compression of cervical osteophytes seemed to be involved in rapid exacerbation following SCI. Early screening for dysphagia is vital in bedridden patients with AS or SCI. Additionally, assessment and follow-up are important if the number of rehabilitation treatments or the out-of-bed movement activity decreases because of pressure ulcers.

Abstract Background The incidence and number of fragility hip fractures are gradually increasing, resulting in a wide consumption of medical resources. Various factors affecting functional recovery in patients with fragility hip fractures are known, and comorbid diseases are one of them. The purpose of this study is to determine the effect of comorbidities on functional outcomes in patients surgically treated for fragility hip fractures, thereby contributing to the efficient distribution of medical resources. Methods This was a retrospective cohort study performed in the three tertiary rehabilitation facilities. A total of 211 patients (50 men and 161 women; average age 81.6 ± 6.7 years) who had undergone surgery for fragility hip fractures were followed up from immediately after transfer to the Department of Rehabilitation Medicine to 6 months postoperatively. Comorbidities referred to a summary of the following conditions: hypertension, diabetes mellitus, chronic liver disease, dementia, cerebrovascular accident, and osteoporosis. Functional outcomes included Koval’s grade, Functional Ambulatory Category (FAC), Functional Independence Measure (FIM)-locomotion, Modified Rivermead Mobility Index, Berg Balance Scale (BBS), 4-Meter Walking speed Test (4MWT), the Korean version of the Mini-Mental State Examination(K-MMSE), Geriatric Depression Scale (GDS), EuroQol Five-Dimension (EQ-5D) questionnaire, the Korean version of the Modified Barthel Index (K-MBI), the Korean version of the Instrumental Activities of Daily Living (K-IADL), and Korean version of Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight scale (K-FRAIL). For all tests, each patient was assessed immediately after transfer and 6 months post-surgery. Results Multivariate linear regression analyses adjusted for age, sex, the initial variable of the functional outcomes, and comorbidities revealed that dementia had a significant negative impact on Koval’s grade and K-FRAIL 6 months postoperatively. Diabetes mellitus had a significant negative impact on the FAC, GDS, EQ-5D, K-IADL, and K-FRAIL 6 months postoperatively. Patients with osteoporosis showed a significant negative outcome of FIM-locomotion 6 months postoperatively. A cerebrovascular accident revealed a significant negative impact on the BBS 6 months postoperatively. In addition, hypertension led to significantly less favorable outcomes of the K-FRAIL 6 months postoperatively. Conclusions This study confirmed that comorbidities, particularly dementia and diabetes mellitus, significantly influence functional outcomes 6 months after fragility hip fracture surgeries.

Background Although total knee arthroplasty (TKA) is an effective treatment for knee osteoarthritis, assessment of postoperative outcomes remains unclear. This study aimed to identify postoperative physical performance factors that are correlated with self-reported physical function and quality of life (QoL) at 3 months after unilateral TKA. Methods In total, 158 patients who underwent unilateral primary TKA completed performance-based physical function tests at 3 months after surgery, including Stair Climbing Tests (SCT), 6-Minute Walk Tests (6MWT), Timed Up and Go tests (TUG), and instrumental gait analysis. We also measured the isometric knee flexor and extensor strengths of the operated and non-operated knees. Self-reported physical function and QoL were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Euro-QoL Five Dimensions (EQ-5D) questionnaire, respectively. Results Bivariate analyses showed that WOMAC function and EQ-5D were correlated with age, other self-reported measures, and performance-based measures. The WOMAC pain (r=0.71, p

Objective: To investigate the prevalence of obesity with low muscle mass and its impact on physical function, quality of life (QOL) and pain in patients with end-stage knee osteoarthritis over 65 years old. Methods: In this cross-sectional study, we assessed a total of 562 patients. After separating the group into males and females, we divided patients into 4 further groups: normal BMI with normal muscle mass, obesity with normal muscle mass, normal BMI with low muscle mass and obesity with low muscle mass. All patients completed stair climbing test (SCT), 6-minute walk test, timed up and go test (TUG), instrumental gait analysis, Western Ontario McMaster Universities Osteoarthritis Index, VAS, and EuroQOL 5 dimensions questionnaire. Results: Obesity with low muscle mass was diagnosed in 6 males subjects (7.8%) and 9 female subjects (1.9%). Patients with obesity and low muscle mass performed the SCT-ascent and descent significantly slower than other body composition groups in both males and females. TUG in males and gait speed in females were also significantly slower in the obesity with low muscle mass group. Stepwise multiple linear regression analysis revealed that in males, obesity with low muscle mass was significantly predictive of SCT ascent (β = 0.409, p < 0.001), SCT-descent (β = 0.405, p < 0.001), and TUG (β = 0.283, p = 0.009), and in females, obesity with low muscle mass was significantly predictive of SCT-ascent (β = 0.231, p < 0.001), SCT-descent (β = 0.183, p < 0.001), and gait speed (β=-0.129, p = 0.004). Conclusions: This study confirms that the combination of obesity and low muscle mass is associated with impaired physical function in patients with end-stage knee osteoarthritis.

Objectives: This study aims to investigate the effectiveness of home-based cardiac rehabilitation (CR) on arterial stiffness in patients with acute myocardial infarction (AMI). Patients and methods: Between January 2015 and December 2017, a total of 135 patients (120 males, 15 females; mean age: 58.8±11.1 years) with AMI who were referred for CR were included. Home-based CR was prescribed based on a cardiopulmonary exercise test (CPET) for at least six months. All patients completed three consecutive CPETs and brachial-ankle pulse wave velocity (baPWV) measurements at one, four, and seven months after onset. Results: After six months of CR, there was an improvement in peak oxygen consumption (pVO2) (Month 1, 28.7±6.4 mL/kg/min; Month 4, 31.6±6.3 mL/kg/min; Month 7, 31.2±7.1 mL/kg/min, p<0.001) and a reduction in baPWV (Month 1, left, 1546.0±311.2 cm/sec, right 1545.5±301.5 cm/sec; Month 4, left, 1374.9±282.5 cm/sec, right 1371.6±287.5 cm/sec; Month 7, left, 1362.9±287.0 cm/sec, right 1365.5±281.1 cm/sec, p<0.001). Conclusion: In patients with AMI, arterial stiffness and aerobic capacity improved after six months of home-based CR, particularly in the early stages of rehabilitation. These results suggest that changes in baPWV are useful in determining the effectiveness of CR and pVO2 in the initial stages of CR. [ABSTRACT FROM AUTHOR]

Cosmic reionization by starlight from early galaxies affected their evolution, thereby impacting reionization itself. Star formation suppression, for example, may explain the observed underabundance of Local Group dwarfs relative to N-body predictions for cold dark matter. Reionization modelling requires simulating volumes large enough [~ (100 Mpc)³] to sample reionization 'patchiness', while resolving millions of galaxy sources above ~108 M⊚ combining gravitational and gas dynamics with radiative transfer. Modelling the Local Group requires initial cosmological density fluctuations pre-selected to form the well-known structures of the Local Universe today. Cosmic Dawn ('CoDa') is the first such fully coupled, radiation-hydrodynamics simulation of reionization of the Local Universe. Our new hybrid CPU-GPU code, RAMSES-CUDATON, performs hundreds of radiative transfer and ionization ratesolver timesteps on the GPUs for each hydro-gravity timestep on the CPUs. CoDa simulated (91Mpc)³ with 4096³ particles and cells, to redshift 4.23, on ORNL supercomputer Titan, utilizing 8192 cores and 8192 GPUs. Global reionization ended slightly later than observed. However, a simple temporal rescaling which brings the evolution of ionized fraction into agreement with observations also reconciles ionizing flux density, cosmic star formation history, CMB electron scattering optical depth and galaxy UV luminosity function with their observed values. Photoionization heating suppressed the star formation of haloes below ~2 × 109 M⊚, decreasing the abundance of faint galaxies around MAB1600 = [-10, -12]. For most of reionization, star formation was dominated by haloes between 1010-1011 M⊚, so low-mass halo suppression was not reflected by a distinct feature in the global star formation history. Intergalactic filaments display sheathed structures, with hot envelopes surrounding cooler cores, but do not self-shield, unlike regions denser than 100 <ρ>. [ABSTRACT FROM AUTHOR]

We use cosmological adaptive mesh refinement code ENZO zoom-in simulations to study the long-term evolution of the collapsing gas within dark matter haloes at z. This direct collapse process is a leading candidate for rapid formation of supermassive black hole (SMBH) seeds. To circumvent the Courant condition at small radii, we apply the sink particle method, focusing on evolution on scales ~0.01-10 pc. The collapse proceeds in two stages, with the secondary runaway happening within the central 10 pc. The sink particles form when the collapsing gas requires additional refinement of the grid size at the highest refinement level. Their growth is negligible with the sole exception of the central seed which grows dramatically to Mseed ~ 2 × 106M⊙ in ~2 Myr, confirming the feasibility of this path to the SMBH. The variability of angular momentum in the accreted gas results in the formation of two misaligned discs. Both discs lie within the Roche limit of the central seed. While the inner disc is geometrically thin and weakly asymmetric, the outer disc flares due to turbulent motions as a result of the massive inflow along a pair of penetrating filaments. The filamentary inflow determines the dominant Fourier modes in this disc - these modes have a non-self-gravitational origin. We do not confirm that m = 1 is a dominant mode that drives the inflow in the presence of a central massive object. The overall configuration appears to be generic, and is expected to form when the central seed becomes sufficiently massive. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to test if adjuvant hydrotherapy with viscosupplement is beneficial on management of pain, stiffness, function, and mental relaxation in knee osteoarthritis (OA). Methods: Nineteen patients with OA were randomly assigned to hydrotherapy or control groups. All patients received viscosupplement injections once a week for 3 weeks. Hydrotherapy group (n=9) had a spa containing green tea, 3 days a week for 2 weeks. The control group (n=10) received only injections. All patients were assessed at baseline and after the third injection. All were assessed for pain (visual analog scale, VAS), pain severity, and functional status (Western Ontario and McMaster Universities osteoarthritis index, WOMAC), emotional status, quality of life (Euro quality of life health-related quality of life inventory five dimension, EQ-5D), and relative spectral power of alpha waves in electroencephalography (EEG). Results: Both groups reported a statistically significant reduction of pain at the end of treatment and detailed assessment of pain, and function in WOMAC and the relative power of alpha in electroencephalogram showed statistical significant difference only in the hydrotherapy group. However, there were no significant intergroup differences, except for VAS score. Conclusion: Adjuvant 2-week hydrotherapy to viscosupplement might have a modest role in the management of pain and functional disability and the mental relaxation in patients with knee OA. Larger, randomized controlled trials with intervention of long term period to determine efficacy in treating knee OA are warranted. [ABSTRACT FROM AUTHOR]

We use numerical simulations to explore whether direct collapse can lead to the formation of supermassive black hole (SMBH) seeds at high redshifts. Using the adaptive mesh refinement code ENZO, we follow the evolution of gas within slowly tumbling dark matter (DM) halos of Mvir ~ 2 × 108M☉ and Rvir ~ 1 kpc. For our idealized simulations, we adopt cosmologically motivated DM and baryon density profiles and angular momentum distributions. Our principal goal is to understand how the collapsing flow overcomes the centrifugal barrier and whether it is subject to fragmentation which can potentially lead to star formation, decreasing the seed SMBH mass. We find that the collapse proceeds from inside out and leads either to a central runaway or to off-center fragmentation. A disk-like configuration is formed inside the centrifugal barrier, growing via accretion. For models with a more cuspy DM distribution, the gas collapses more and experiences a bar-like perturbation and a central runaway on scales of -1-10 pc.We have followed this inflow down to ~10-4 pc (~10 AU), where it is estimated to become optically thick. The flow remains isothermal and the specific angular momentum, j, is efficiently transferred by gravitational torques in a cascade of nested bars. This cascade is triggered by finite perturbations from the large-scale mass distribution and by gas self-gravity, and supports a self-similar, disk-like collapse where the axial ratios remain constant. The mass accretion rate shows a global minimum on scales of ~1-10 pc at the time of the central runaway. In the collapsing phase, virial supersonic turbulence develops and fragmentation is damped. Modelswith progressively larger initialDMcores evolve similarly, but the timescales become longer. Inmodelswith more organized initial rotation-when the rotation of spherical shells is constrained to be coplanar-a torus forms on scales~20-50 pc outside the disk, and appears to be supported by turbulent motions driven by accretion from the outside. The overall evolution of the models depends on the competition between two timescales, corresponding to the onset of the central runaway and of off-center fragmentation. In models with less organized rotation-when the rotation of spherical shells is randomized (but the total angular momentum remains unchanged)-the torus is greatly weakened, the central accretion timescale is shortened, and off-center fragmentation is suppressed-triggering the central runaway even in previously "stable" models. The resulting seed SMBH masses is found in the range M• ~ 2×104M☉-2×106M☉, substantially higher than the mass range of Population III remnants.We argue that the above upper limit on M• appears to be more realistic, and lies close to the cutoff mass of detected SMBHs. Corollaries of this model include a possible correlation between SMBH and DM halo masses, and similarity between the SMBH and halo mass functions, at time of formation. [ABSTRACT FROM AUTHOR]

Hemiballism describes involuntary severe, violent, arrhythmic, rotatory and large amplitude movements of limb from proximal joint. We experienced an elderly stroke patient with hemiballism accompanied dysphagia that persisted for several months severity was evaluated by the Universidade Federal de Minas Gerais Sydenham's chorea rating scale (USCRS) and videofluoroscopic swallowing study (VFSS). In this case, we observed the improvement of hemiballism by conventional rehabilitation therapy and low dose quetiapine. Therefore, we recommend geriatrists considers vthese therapies in elderly patients with hemiballism. [ABSTRACT FROM AUTHOR]

Lead Zirconate Titanate (PZT)-embedded microcantilevers were fabricated with dimensions of 30 × 90 × 3 μm3(width × length × thickness). A thicker PZT layer improved the actuation and enabled long-term data acquisition in common aqueous buffers with a frequency resolution of 20 Hz. A quantitative assay was conducted in the range of 1–20 μM and the resonant frequency was found to increase with the concentration of target DNAs and the probe DNAs were almost saturated at 20 μM. Back-filling with ethyleneglycol-modified alkanethiol was shown to facilitate the hybridization efficiency and stabilize the surface reaction, resulting in a signal enhancement of 40%. We report for the first time how secondary structures in oligonucleotide monolayer change the surface property of a dynamic mode microcantilever and subsequently affect its oscillating behavior. Using fabricated microcantilevers, the real time changes in resonant frequency upon hybridization were measured by utilizing different probe and target sets. The results revealed that the microcantilevers experienced a resonant frequency upshift during the hybridization with complementary DNAs if a dimer structure was present between DNA probes. A resonant frequency downshift was observed for DNA probes that did not contain any complex secondary structures. In addition, the results demonstrate the potential of using these microcantilevers to extract structural information of oligonucleotides. [ABSTRACT FROM AUTHOR]

We investigate the effects of the change of cosmological parameters and star formation (SF) models on the cosmic SF history using cosmological smoothed particle hydrodynamics (SPH) simulations based on the cold dark matter (CDM) model. We vary the cosmological parameters within 1σ error from the Wilkinson Microwave Anisotropy Probe best-fitting parameters, and find that such changes in cosmological parameters mostly affect the amplitude of the cosmic SF history. At high redshift (hereafter high z), the SF rate (SFR) is sensitive to the cosmological parameters that control the small-scale power of the primordial power spectrum, while the cosmic matter content becomes important at lower redshifts. We also test two new SF models: (1) the ‘Pressure’ model based on the work by Schaye & Dalla Vecchia and (2) the ‘Blitz’ model that takes the effect of molecular hydrogen formation into account, based on the work by Blitz & Rosolowsky. Compared to the previous conventional SF model, the Pressure model reduces the SFR in low-density regions and shows better agreement with the observations of the Kennicutt–Schmidt law. This model also suppresses the early SF and shifts the peak of the cosmic SF history towards lower redshift, more consistently with the recent observational estimates of cosmic SFR density. The simulations with the new SF model also predict lower global stellar mass densities at high z, larger populations of low-mass galaxies and a higher gas fraction in high- z galaxies. Our results suggest that there is room left in the model uncertainties to reconcile the discrepancy that was found between the theory and observations of cosmic SF history and stellar mass density. Nevertheless, our simulations still predict higher stellar mass densities than most of the observational estimates. [ABSTRACT FROM AUTHOR]

We present the results of a numerical study on the effects of metal enrichment and metal cooling on galaxy formation and cosmic star formation (SF) history using cosmological hydrodynamic simulations. We find the following differences in the simulation with metal cooling when compared to the run without it: (i) the cosmic star formation rate is enhanced by about 50 and 20 per cent at and 3, respectively; (ii) the gas mass fraction in galaxies is lower; (iii) the total baryonic mass function (gas + star) at does not differ significantly, but shows an increase in the number of relatively massive galaxies at and (4) the baryonic mass fraction of intergalactic medium (IGM) is reduced at due to more efficient cooling and gas accretion on to galaxies. Our results suggest that the metal cooling enhances the galaxy growth by two different mechanisms: (i) increase in SF efficiency in the local interstellar medium and (ii) increase in IGM accretion on to galaxies. The former process is effective throughout most of the cosmic history, while the latter is effective only at when the IGM is sufficiently enriched by metals owing to feedback. [ABSTRACT FROM AUTHOR]

We investigate the dynamical mechanisms responsible for producing tidal tails from dwarf satellites using N-body simulations. We describe the essential dynamical mechanisms and morphological consequences of tail production in satellites with masses greater than 0.0001 of the host halo virial mass. We identify two important dynamical coconspirators: (1) the points where the attractive force of the host halo and satellite are balanced (X-points) do not occur at equal distances from the satellite centre or at the same equipotential value for massive satellites, breaking the morphological symmetry of the leading and trailing tails and (2) the escaped ejecta in the leading (trailing) tail continues to be decelerated (accelerated) by the satellite's gravity leading to large offsets of the ejecta orbits from the satellite orbit. The effect of the satellite's self-gravity decreases only weakly with a decreasing ratio of satellite mass to host halo mass, proportional to , demonstrating the importance of these effects over a wide range of subhalo masses. Not only will the morphology of the leading and trailing tails for massive satellites be different, but the observed radial velocities of the tails will be displaced from that of the satellite orbit; both the displacement and the maximum radial velocity is proportional to satellite mass. If the tails are assumed to follow the progenitor satellite orbits, the tails from satellites with masses greater than 0.0001 of the host halo virial mass in a spherical halo will appear to indicate a flattened halo. Therefore, a constraint on the Milky Way halo shape using tidal streams requires mass-dependent modelling. Similarly, we compute the distribution of tail orbits both in space and in space, advocated for identifying satellite stream relics. The acceleration of ejecta by a massive satellite during escape spreads the velocity distribution and obscures the signature of a well-defined ‘moving group’ in phase space. Although these findings complicate the interpretation of stellar streams and moving groups, the intrinsic mass dependence provides additional leverage on both halo and progenitor satellite properties. [ABSTRACT FROM AUTHOR]

Patients who have undergone hip fracture surgery have the primary goal of recovering their premorbid level of function across diverse functional domains, including walking ability, balance, cognitive function, emotional well-being, frailty, and activities of daily living. As the speed and level of recovery can vary substantially across functional domains and individuals, the varying recovery patterns of different outcome measures should be considered when designing rehabilitation plans for patients. However, the lack of knowledge of recovery trajectories and their variations in hip fracture patients impedes such efforts. In this study, we develop a multivariate time-series clustering algorithm to analyze the recovery patterns and identify patient groups with similar recovery patterns across multiple functional outcomes. Five distinct recovery patterns were observed that exhibit varying maximum recovery levels and speeds. These findings demonstrated the significance of utilizing multiple outcome measures concurrently to assess the patient’s recovery level. Recovery patterns are identified to exhibit variations across different domains, revealing contrasting trends between walking ability and cognitive outcomes. Furthermore, we present predictions on the trajectory of recovery during the post-acute phase solely based on the acute-phase information. This approach facilitates the early identification of patient groups with an unfavorable prognosis for recovery.

Using an isolated Milky Way-mass galaxy simulation, we compare results from nine state-of-the-art gravito-hydrodynamics codes widely used in the numerical community. We utilize the infrastructure we have built for the AGORA High-resolution Galaxy Simulations Comparison Project. This includes the common disk initial conditions, common physics models (e.g., radiative cooling and UV background by the standardized package Grackle) and common analysis toolkit yt, all of which are publicly available. Subgrid physics models such as Jeans pressure floor, star formation, supernova feedback energy, and metal production are carefully constrained across code platforms. With numerical accuracy that resolves the disk scale height, we find that the codes overall agree well with one another in many dimensions including: gas and stellar surface densities, rotation curves, velocity dispersions, density and temperature distribution functions, disk vertical heights, stellar clumps, star formation rates, and Kennicutt–Schmidt relations. Quantities such as velocity dispersions are very robust (agreement within a few tens of percent at all radii) while measures like newly formed stellar clump mass functions show more significant variation (difference by up to a factor of ∼3). Systematic differences exist, for example, between mesh-based and particle-based codes in the low-density region, and between more diffusive and less diffusive schemes in the high-density tail of the density distribution. Yet intrinsic code differences are generally small compared to the variations in numerical implementations of the common subgrid physics such as supernova feedback. Our experiment reassures that, if adequately designed in accordance with our proposed common parameters, results of a modern high-resolution galaxy formation simulation are more sensitive to input physics than to intrinsic differences in numerical schemes. [ABSTRACT FROM AUTHOR]

Density inhomogeneity in the intergalactic medium (IGM) can boost the recombination rate of ionized gas substantially, affecting the growth of H ii regions during reionization. Previous attempts to quantify this effect typically failed to resolve down to the Jeans scale in the preionization IGM, which is important in establishing this effect, along with the hydrodynamical back-reaction of reionization on it. Toward that end, we perform a set of fully coupled, radiation-hydrodynamics simulations from cosmological initial conditions, extending the mass resolution of previous work to the scale of minihalos. Pre-reionization structure is evolved until a redshift zi at which the ionizing radiation from external sources arrives to sweep an R-type ionization front supersonically across the volume in a few million years, until it is trapped on the surfaces of minihalos and converted to D-type, after which the minihalo gas is removed by photoevaporative winds. Small-scale density structures during this time lead to a high (>10) clumping factor for ionized gas, which hugely boosts the recombination rate until the structures are disrupted by the hydrodynamic feedback after ∼10–100 Myr. For incoming stellar radiation with intensity J21 in a 200 h−1 kpc box with the mean density contrast , the number of extra recombinations per H atom, on top of what is expected from homogeneously distributed gas, is given by . In models in which most of the volume is ionized toward the end of reionization, this can add more than one recombination per H atom to the ionizing photon budget to achieve reionization. [ABSTRACT FROM AUTHOR]

We employ high-resolution cosmological zoom-in simulations focusing on a high-sigma peak and an average cosmological field at z ∼ 6–12 in order to investigate the influence of environment and baryonic feedback on galaxy evolution in the reionization epoch. Strong feedback, e.g., galactic winds, caused by elevated star formation rates (SFRs) is expected to play an important role in this evolution. We compare different outflow prescriptions: (i) constant wind velocity (CW), (ii) variable wind scaling with galaxy properties (VW), and (iii) no outflows (NW). The overdensity leads to accelerated evolution of dark matter and baryonic structures, absent from the “normal” region, and to shallow galaxy stellar mass functions at the low-mass end. Although CW shows little dependence on the environment, the more physically motivated VW model does exhibit this effect. In addition, VW can reproduce the observed specific SFR (sSFR) and the sSFR–stellar mass relation, which CW and NW fail to satisfy simultaneously. Winds also differ substantially in affecting the state of the intergalactic medium (IGM). The difference lies in the volume-filling factor of hot, high-metallicity gas, which is near unity for CW, while such gas remains confined in massive filaments for VW, and locked up in galaxies for NW. Such gas is nearly absent from the normal region. Although all wind models suffer from deficiencies, the VW model seems to be promising in correlating the outflow properties with those of host galaxies. Further constraints on the state of the IGM at high z are needed to separate different wind models. [ABSTRACT FROM AUTHOR]

Introduction Among chronic diseases affecting older adults, metabolic syndrome (MetS) is known to be closely related to sarcopenia. Insulin resistance may play a key role in the increased frequency of sarcopenia associated with metabolic disorders. To date, an exercise–nutrition combined intervention has been the treatment of choice for sarcopenia. However, trials of combined interventions for individuals with sarcopenia and MetS are still lacking. This study aims to develop and conduct a standardised intervention, named the Multidisciplinary combined Exercise and Nutrition inTervention fOR Sarcopenia (MENTORS), for sarcopenic older patients with MetS.Methods and analysis This multicentre, randomised controlled trial includes 168 community-dwelling older adults with sarcopenia and MetS. The 12-week MENTORS comprises an exercise intervention consisting of an introductory phase (3 weeks; twice-weekly visits), an expanded phase (3 weeks; twice-weekly visits) and a maintenance phase (6 weeks; once-weekly visits); and a nutrition intervention tailored to the nutritional status of individual subjects. Outcomes will be measured at 0-week, 12-week and 24-week postintervention. The data will be analysed using the intention-to-treat and per-protocol principle.Ethics and dissemination Before screening, all participants will be provided with oral and written information. Ethical approval has already been obtained from all participating hospitals. The study results will be disseminated in peer-reviewed publications and conference presentations.Trial registration number NCT04948736

Background and objectives: Aquatic exercises have demonstrated several advantages over land-based exercise, but only a few studies have compared the workout intensities and efficiencies in a stage-specific manner. This study aimed to investigate workout intensity during aquatic and land-based running, based on the rating of perceived exertion (RPE). Materials and Methods: Twenty healthy young male subjects underwent a land-based running test (LRT) and an aquatic running test (ART), in the form of a cardiopulmonary exercise treadmill test and a shallow-water running test. The seven stages of the ART were composed of 3 minutes each of the Bruce protocol performed during the LRT. In the ART, the participants were instructed to run in a swimming pool with matching RPE to that obtained at each stage of the LRT. Results: Heart rate (HR) during both LRT and ART exhibited a linear relationship (r = 0.997 and 0.996, respectively; p < 0.001). During the initial and middle period, HR was higher in the ART than in the LRT. However, in the final period, HR was higher in the LRT than in the ART. Conclusions: In aquatic exercises based on the RPE obtained from the LRT, HR exhibited a linear relationship in both the ART and the LRT. The ART appears to increase cardiac loading more efficiently in the initial period and does not increase cardiac loading abruptly at a later period. Although there is no precise, objective, controlled parameter to compare the ART and the LRT, the RPE may be used as a convenient measurement for workout intensity in aquatic running.