Influence of Skeletal Muscle Mass and Spinal Alignment on Surgical Outcomes for Lumbar Spinal Stenosis

Study Design Retrospective observational study. Purpose We considered the relationship between spinal alignment and skeletal muscle mass on clinical outcomes following a surgery for lumbar spinal stenosis (LSS). Overview of Literature There are no reports of preoperative factors predicting residual low back pain following surgery for LSS. Methods Our target population included 34 women (mean age, 74.4 years) who underwent surgery for LSS. Prior to and 6 months after the surgery, systemic bone mineral density and lean soft tissue mass were measured using dual-energy X-ray absorptiometry. Skeletal muscle mass index (SMI) was calculated as the sum of the arm and leg lean mass in kilograms divided by height in meters squared. The spinal alignment was also measured. Clinical outcomes were evaluated using the Japanese Orthopedic Association scoring system, leg and low back pain Visual Analog Scale, and Roland–Morris Disability Questionnaire (RDQ). Additionally, we examined the bone mineral density, skeletal muscle mass, and spinal alignment before and after the surgery. We used the Spearman correlation coefficient to examine the associations among clinical outcomes, preoperative muscle mass, and spinal alignment. Results Sarcopenia (SMI 6.12), RDQ was significantly higher in subjects with sarcopenia (p =0.04). RDQ was significantly negatively correlated with SMI (r =−0.42, p <0.05). There was a significant positive correlation between postoperative RDQ and pelvic tilt (PT; r =0.41, p <0.05). SMI and PT were significantly negatively correlated (r =−0.39, r <0.05). Conclusions Good postoperative outcomes were negatively correlated with low preoperative appendicular muscle mass, suggesting that postoperative outcomes were inferior in cases of decreased appendicular muscle mass (sarcopenia). Posterior PT due to decreased limb muscle mass may contribute to postoperative back pain, showing that preoperatively reduced limb muscle mass and posterior PT are predictive factors in the persistence of postoperative low back pain

Composition of water-featured open spaces on Chinese university campuses

Influenced by traditional Chinese natural philosophy and increasing concern for environmental sustainability nowadays, water has been recognized as an embodiment of cultural identity and a desired component of the campus environment in China. This study focuses on the distinctive element, aims to clarify the characteristics of water-featured open spaces on Chinese university campuses, and tries to provide a typological method to define the presentation of water. From the viewpoint of the relationship between water and other spatial elements, 172 cases are investigated in three aspects: adaption to the site, creation of activity space, and scenery formation. Compositional typologies are categorized, and the characteristics of each typology and their relation to regional and historical backgrounds are analyzed and clarified. These characteristics show the evolution and variation of water-featured open spaces on Chinese campuses and demonstrate that water features can create spatial and scenic diversity with a flexible and adjustable relationship with other building and landscape elements. Furthermore, appropriate utilization of water features in the environmental design should be based on a thorough understanding of both cultural and spatial context

Physiological Study of Visual and Non-Visual Effects of Light Exposure

Light simultaneously induces visual and non-visual effects. Although the differences in the spectral sensitivity of intrinsic photosensitive retinal ganglion cells induce opposing influences on physiological responses, it is difficult to independently measure only non-visual effects. Therefore, the reported effects of light color on physiological responses are inconsistent. This study aimed to clarify the visual and non-visual effects of light color on physiological responses. Three different conditions were employed to construct a lighting environment in which light colors were difficult to perceive due to chromatic adaptation and change blindness: constant white light (baseline condition), a gradual transition from white to blue light, and a gradual transition from white to red light. The physiological responses (brain activity, heart rate variability, and electrodermal activity) of 21 participants were measured with and without light color perception. The results suggested that blue light causes more non-visual effects compared to red light as blue light induces brain activation in some regions of the PFC (p < 0.05) and increases sweating, although the differences were not statistically significant. A mean comparison suggested that the visual effects of blue light showed tendencies toward a calming role for the prefrontal cortex and inhibition of sweating, but the differences were not statistically significant. Another mean comparison suggested that the visual effects of red light tended to enhance sweating, but the differences were not statistically significant. Visual and non-visual effects did not cause significant differences in heart rate variability. Additionally, a mean comparison did not reveal any significant tendencies