Development of Synbiotic Milk Chocolate Enriched with Lactobacillus paracasei, D-tagatose and Galactooligosaccharide

Background and Objective: Prebiotics are food ingredients that induce the growth or activity of beneficial bacteria (Bifidobacteria and Lactobacilli). Galactooligosaccharide and tagatose are two main prebiotic compounds which are used in the food industry. Chocolate is widely consumed all over the world and could be used as an excellent vehicle for delivery of prebiotics. Furthermore, the incorporation of probiotics into chocolate, allows broadening the health claims of chocolate. The aim of the current study was to investigate the effect of tagatose and galactooligosaccharide on the physicochemical and sensory properties of milk chocolate and the survivability of Lactobacillus paracasei in the optimized formulation. Material and Methods: Probiotic milk chocolate containing Lactobacillus paracasei were formulated by replacing a portion of the sucrose with the galactooligosaccharide powder and tagatose. For this purpose various concentrations of galactooligosaccharide and tagatose (2.5, 5 and 7.5% w w-1) along with stevia were used in chocolate formulation. Nine formulations were examined to determine some physicochemical, mechanical and sensory properties in order to find the optimum concentrations of these components. The lyophilized Lactobacillus paracasei were incorporated in the optimal formulation of prebiotic milk chocolate. The viability of probiotic bacteria in milk chocolate was carried out during storage at 22°C for up to 6 months.Results and Conclusion: In general, chocolate formulations with high levels of galactooligosaccharide, achieved the highest plastic viscosity and yield stress. The lowest viscosity and yield stress were observed for the samples containing high concentrations of tagatose and in control. In addition, galactooligosaccharide at higher ratios induced the least desirable sensorial effects, whereas tagatose improved the overall acceptability. It can be concluded that the overall acceptability of milk chocolate samples were with (7.5), tagatose: galactooligosaccharide ratios of 2.5%-2.5%, presenting the optimal applicable range as prebiotic compounds. Numbers of live Lactobacillus paracasei cells remained above 8.0 log CFU g-1 until 6 months under ambient conditions. Milk chocolate was shown to be an excellent vehicle for the delivery of Lactobacillus paracasei, and the prebiotic ingredients galactooligosaccharide and tagatose did not interfere in its viability. Conflict of interest: The authors declare no conflict of interest

A modified empirical criterion for strength of transversely anisotropic rocks with metamorphic origin

A modified empirical criterion is proposed to determine the strength of transversely anisotropic rocks. In this regard, mechanical properties of intact anisotropic slate obtained from three different districts of Iran were taken into consideration. Afterward, triaxial rock strength criterion introduced by Rafiai was modified for transversely anisotropic rocks. The criterion was modified by adding a new parameter α for taking the influence of strength anisotropy into consideration. The results obtained have shown that the parameter α can be considered as the strength reduction parameter due to rock anisotropy. The modified criterion was compared to the modified Hoek–Brown (Saroglou and Tsiambaos) and Ramamurthy criteria for different anisotropic rocks. It was concluded that the criterion proposed in this paper is a more accurate and precise criterion in predicting the strength of anisotropic rocks

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

The Motivational Impact of Enhancing Reading Comprehension through Pictorial Fictions on the Involvement of Iranian EFL Students in Writing Activities

Determining the motivational impact of enhancing reading comprehension, through pictorial fictions, on the EFL students to involve them more in writing activities, is the prime purpose of the present study. The study took place in the Iranian Language Institute (ILI), the branch of Mahabad. Key English Test (KET) administrated to a hundred students to select the subjects of the present study. Finally, 60 male students were selected and randomly divided into the experimental and control groups. The experimental group received pictorial fictions as treatment, utilizing input reading comprehension enhancement through typographic elements, and direct and indirect feedback provided to them, while the control group received pictorial fiction texts without such inputs, then to collect the intended data, the "Academic Writing Motivation Questionnaire" (AWMQ) was administered to both groups separately in two stages of pre-tests and post-tests. The results showed that enhancing reading comprehension has a significant motivational impact on the writing engagement of Iranian EFL learners

Comparison of Abdominal Muscles Thickness Changes Different Postures beween Non-Specific Chronic Low Back Pain Patients and Healthy Males by Ultrasonography

Objective: The purpose of this study is to compare the abdominal muscles thickness change at alteration in seated stability between healthy and non–specific chronic low back pain male subjects. Materials & Methods: In this case–control study, twenty non–specific chronic low back pain male patients whom had refered to physiotherapy clinics of university of Social Welfare and Rehabilitation Sciences and twenty healthy men were selected conveniently and simply. The thickness of Transverse Abdominis, Internal Oblique, External Oblique and Rectus Abdominis muscles of right side were measured with B mode ultrasonography (7. 5 MHz linear head) in supine lying (Position 1) , relaxed sitting on a chair (Position 2) , relaxed sitting on a gym ball (Position 3) and sitting on a gym ball lifting the left foot off the floor (Position 4). Measurement were taken at the end of both inspiration and expiration. Data were analyzied by Paired T and Independent T tests. Results: Transverse Abdominis and Internal Oblique at all of position and Rectus Abdominis only at position 4 were thicker at the end of expiration in both healthy and patient groups (P<0.001). At the both status of inspiration and expirtion, there were significant differences in both groups in thickness change of Transvers Abdominis, Internal Oblique and Rectus Abdominis muscles between position 3 in comparison with position 2,position 4 with position 2 and position 4 with position 3 (P<0.001). Also there were significan differences in thickness change of External Oblique muscle between position 4 with position 2 and position 4 with position 3 in both groups (P<0.001). There were smaller increase in thickness of Transvers Abdominis in patients than healthy group (P<0.001) and smaller increase in thickness of Rectus Abdominis in healthy men than patient group (P=0.01). Conclusion: Abdominal muscles respond to postural changes and these muscles are automatically targeted by decreasing the seated stability. In non–specific chronic low back pain patients, activity of Transvers Abdominis was decreased and activity of Rectus Abdominis was increased

Altered Ultrasonographic Activity of Abdominal Muscles during Breathing in Males with and without Nonspecific Chronic Low Back Pain

Purpose This study aimed to investigate the altered ultrasonographic activity of abdominal muscles during breathing in males with and without nonspecifc chronic low back pain (NSCLBP). Design Cross-sectional study. Methods Twenty males with NSCLBP and 20 males without NSCLBP were recruited. Muscle thickness change was measured by ultrasonography during breathing in the end-inspiration and end-expiration phases for the transverse abdominis (TrA), internal oblique (IO), external oblique (EO), and rectus abdominis (RA) muscles. The data were normalized to the end-inspiration thickness. An independent t test was run to analyze the data at a confdence level of 95% (p<0.05). Results The participants with NSCLBP had thicker IO muscles in the end-inspiration (p =0.030) and end-expiration (p=0.017) phases as well as greater RA (p=0.006) and smaller EO (p=0.003) normalized thickness changes during breathing. Conclusion The normalized thickness changes during breathing difered between the participants with and without NSCLBP. Reduced EO and increased RA activity may predispose the spine to further injuries. Therefore, normalizing the breathing pattern should be considered in the management of people with NSCLBP. Keywords Low back pain · Abdominal muscles · Ultrasonography · Respiratio

The Effects of Challenging Walking Conditions on Kinematic Synergy and Stability of Gait in People with Knee Osteoarthritis: A Study Protocol

Background: Knee osteoarthritis (KOA) may considerably change the gait parameters, including the gait variability patterns. Uncontrolled manifold (UCM) analysis has been used to evaluate the relationship between motor control and gait variability as a useful index for assessing the multi‑segmental movements’ coordination during walking. To our knowledge, no research has evaluated the alterations in the gait kinematic parameters during normal and narrow path walking in individuals with KOA as compared to asymptomatic people. Materials and Methods: In this cross‑sectional study, individuals diagnosed with mild to moderate medial KOA and asymptomatic people will walk at their comfortable preferred speed on a treadmill. A motion capture system will be used to record at least 50 successful gait cycles. The kinematic variability of joints during gait will be analyzed using UCM, with the center of mass (COM) displacement considered as the performance variable. The primary outcome measure will be the lower limb synergy index. Variability of the COM displacement and changes in angles and angular velocities of lower extremity joints will be assessed as the secondary outcomes. Results: The results of this protocol study provide information on the lower limb kinematic synergy during gait on normal and narrow paths for individuals with KOA and asymptomatic controls. Conclusion: This information will help the researchers and clinicians understand KOA patients’ gait variability characteristics more deeply. Moreover, it may lead to an enhanced evidence‑based approach for clinical decision‑making concerning improving gait stability and decreasing the falling risk in these people

A concurrent cognitive task does not perturb quiet standing in fibromyalgia and chronic fatigue syndrome

Background and Objectives. Cognitive complaints are common in fibromyalgia (FM) and chronic fatigue syndrome (CFS). Fatigue as well as pain may require greater effort to perform cognitive tasks, thereby increasing the load on processing in the central nervous system and interfering with motor control. Methods. The effect of a concurrent arithmetic cognitive task on postural control during quiet standing was investigated in 75 women (aged 19–49 years) and compared between FM, CFS, and matched controls (/group). Quiet standing on a force plate was performed for 60 s/condition, with and without a concurrent cognitive task. The center of pressure data was decomposed into a slow component and a fast component representing postural sway and adjusting ankle torque. Results. Compared to controls, CFS and FM displayed lower frequency in the slow component (), and CFS displayed greater amplitude in the slow ( and ) and fast () components. There were no interactions indicating different responses to the added cognitive task between any of the three groups. Conclusion. Patients displayed insufficient postural control across both conditions, while the concurrent cognitive task did not perturb quiet standing. Fatigue but not pain correlated with postural control variables