Bioassay functions, which are provided by the International Commission on Radiological Protection, are used to estimate the intake activity of radionuclides; however, they include considerable uncertainties in terms of the internal dosimetry for a particular individual. During a practical internal dose assessment, the uncertainty in the bioassay function is generally not introduced because of the difficulty in quantification. Therefore, to clarify the existence of uncertainty in the bioassay function and provide dosimetrists with an insight into this uncertainty, this study attempted to quantify the uncertainty in the thyroid retention function used for radioiodine exposure. The uncertainty was quantified using a probabilistic estimation of the thyroid retention function through the propagation of the distribution of biokinetic parameters by the Monte Carlo simulation technique. The uncertainties in the thyroid retention function, expressed in terms of the scattering factor, were in the ranges of 1.55–1.60 and 1.40–1.50 for within 24 h and after 24 h, respectively. In addition, the thyroid retention function within 24 h was compared with actual measurement data to confirm the uncertainty due to the use of first-order kinetics in the biokinetic model calculation. Significantly higher thyroid uptakes (by a factor of 1.9) were observed in the actual measurements. This study indicates that consideration of the uncertainty in the thyroid retention function can avoid a significant over- and under-estimation of the internal dose, particularly when a high dose is predicted. Intake estimation after internal exposure to radioiodine, which is one of the main fission products in a nuclear power plant, is typically carried out using thyroid bioassay measurements and corresponding bioassay functions . However, in addition to the measurement data, the thyroid retention function exhibits a significant uncertainty because of the lack of accurate knowledge on biokinetic models, inter-individual variability, and/or mathematical assumptions made for computational convenience . The uncIn practice, the uncertainty in the bioassay function is not introduced in general data fitting processes because of the difficulty in quantification. For this reason, dosimetrists may misinterpret the bioassay data and fitting result. For example, if a clear information of the intake time  is given but the bioassay fitting result is statistically rejected, a dosimetrist may misadjust the intake time to improve the fitting result rather than trust the given intake time information. This problem can occur if the dosimetrist is unaware that the bioassay function involves significant uncertainty in the case of a particular individual. Another example is the use of thyroid measurement data obtained within a day after exposure. After internal exposure, thyroid measurement is acquired as soon as possible; hence, dosimetrists sometimes need to evaluate the internal dose using the data measured in the early phase. However, because the thyroid activity rapidly increases until a day after exposure , the thyIn this study, to clarify the existence of uncertainty in the thyroid retention function and give dosimetrists an insight into its uncertainty, the uncertainty in the thyroid retention function was quantified through the uncertainty propagation of the biokinetic parameters. Further, the uncertainty was numerically expressed in terms of the scattering factor to practically apply it to the maximum likelihood fitting method, which is the most widely used fitting method. Within a day after exposure to radioiodine, the uncertainty in the thyroid retention function was separately analyzed and the uncertainty due to the use of first-order kinetics was additionally quantified in terms of the bias, through comparison with the available measurement data.The uncertainty quantification of the thyroid retention function was implemented through its probabilistic estimation, whereby the radioiodine activity in the thyroid is predicted not as a single value but in the form of a probability distribution. The probability distribution was generated via multiple calculations of the thyroid retention function with a set of biokinetic parameters assigned using the Monte Carlo simulation technique from the corresponding parameter distributions. The probability distributions of the thyroid retention functions were produced with a time interval of 1 h, and the scattering factors as indicators quantifying the variances of the distributions were derived from each distribution at each time step. L(I). In general, the i-th likelihood function, i(I)L, is defined as follows:i/I)PL should be expressed as in Eq. eI is the estimate of intake activity calculated using i/miM, and im is the bioassay function corresponding to iM. The probability distribution of Mi, P(Mi), represents the measurement uncertainty. The component of the measurement uncertainty can generally be divided into Type A  and Type B  errors. The Type A error is involved only in the counting statistics and is described by a Poisson distribution. The Type B error is involved in uncertainties other than the counting statistics and is generally described by a log-normal distribution; for example, the variability of the thyroid mass described by a log-normal distribution causes uncertainty in the counting efficiency, which is a Type B error. However, for simplicity, the overall uncertainty, P(Mi), can be assumed to be a log-normal distribution [i, P(mi), representing the uncertainty in the bioassay function, the type of distribution can be determined by the uncertainty propagation of the biokinetic parameters, which are used to calculate the bioassay functions. Irrespective of the type of distribution used for the biokinetic parameters, the type of distribution of the overall uncertainty, P(mi), should be inductively determined from the final distribution in which the biokinetic parameter uncertainties are combined. In this study, P(mi) will be described by the log-normal distribution (see i) and P(mi) can be described by log-normal distributions, as explained above, P(Ie/I) may also exhibit a log-normal distribution, and the scattering factor (SF) can be defined as its geometric standard deviation. Therefore, Li(I) can be written asiSF is the scattering factor as a measure of the uncertainty in eI, which can be expressed as a combination of the measurement uncertainty, MSF, and the bioassay function uncertainty, mSF, as follows.The principle of the maximum likelihood method for the bioassay has been explained in the IDEAS guidelines . In the entclass1pt{minimaribution . This aption see . If bothMSF can be derived from the experimental conditions, typical values can be used; for example, 1.2 has been suggested as the typical MSF for high-energy gamma (>200 keV) [mSF is the purpose of this study.Although laboratory-based 200 keV) . Derivinn measurement data are independent, the combined likelihood function, L(I), can be calculated by the product of the likelihood functions as in Eq. When L(I) is the maximum, the corresponding I is determined as the final intake estimate.Therefore, when 1f, for the ingestion of iodine was assumed to be 1. Although the thyroid retention functions were calculated for iodine-131, it is reasonable to apply the uncertainty quantification results to other iodine isotopes because only the biological parameters were considered as the uncertainty factors.iq is the amount of iodine in the i-th compartment, and ijr is the transfer rate from j- to i-th compartment. In this study, the thyroid retention functions were calculated only for an acute intake that was more likely to happen in emergency situations. The calculation of the thyroid retention function was conducted using the computer code developed in an earlier work [The thyroid retention function can be calculated using the biokinetic models, which can mathematically describe the behavior of radioiodine after intake. The biokinetic models were first written as a set of first-order differential equations, as in Eq. ier work , which pBiokinetic models generally include a respiratory tract model for inhalation intake, an alimentary tract model for ingestion intake, and a systemic model for describing the iodine behavior after uptake to blood. Although the uncertainty in the biokinetic model originates from both model structure and parameter, only the uncertainty in the biokinetic parameter was considered in this study. The uncertainties in the biokinetic parameters for radioiodine are explained in detail in the following with data sources.The ICRP developed a human respiratory tract model (ICRP 66) . Althoug1f, of iodine, the triangular distribution with a mode of 1.0 and a range of 0.9–1.0 provided by D. M. Hamby (1999) [The human alimentary tract model in ICRP 100 , which iy (1999)  was usedThe simple biokinetic model shown in The uncertainties in the transfer rates of the three-compartment model were investigated in various studies. In this study, the parameter distributions for the iodine systemic model were referenced from Hamby (1999) , as showA set of biokinetic parameters for the multiple calculations of the thyroid retention function was assigned from each corresponding distribution using a Latin hypercube sampling (LHS) method, which is the most widely used method for Monte Carlo sampling. Because the LHS method draws samples from evenly divided probability intervals of a cumulative density function, the entire range of the distribution is used for sampling . Thus, tM, obtained within a day by the bias. Thus, the corrected thyroid measurement data, correctedM, can be calculated using Eq. First-order kinetics were assumed for computational convenience. In the biokinetic model calculation with first-order kinetics, radioiodine can be removed only with constant half-life. However, the actual movement of radioiodine is more complicated, particularly in the early phase after intake. In this study, 24 h (1 d) was regarded as the time limit where the assumption of the first-order kinetics can introduce an uncertainty because after a day, most of the iodine is accumulated in the thyroid and eliminated gradually with a half-life of 80 d . The unc−1 and is completed within 2 h [( [) and normalized to the value at 24 h. Thereafter, the normalized %RAIUs were compared with the corresponding values calculated using the first-order kinetics. The bias was derived as the ratio of the measured values to the calculated values. Note that because the reported data used in this study were measured by well-collimated systems or were properly corrected with the background counts, the uncertainty due to the extra-thyroidal radioiodine was negligible.The bias was determined by comparing the measured and calculated radioiodine thyroid uptakes (%RAIU) within 24 h after iodine ingestion. Although the thyroid uptake data for intravenously injected iodine are required to clearly address the uncertainty related to the systemic model of iodine, the data obtained within and after 24 h in the same study were unavailable. Thus, the thyroid uptake after oral administration was used with the assumption that the mechanisms in the alimentary tract before iodine uptake to blood had little effect on the overall biokinetics of iodine. This assumption is reasonable because the absorption of iodide from the alimentary tract of humans is quite fast with a rate of approximately 5% minthin 2 h . Therefon 2 h [ and nor2 = 0.98) with GM of 0.21 and GSD of 1.41. The value of ICRP 78 [The probability distributions of the thyroid retention function were generated with increasing elapsed time after exposure to quantify the time-dependent uncertainty in the thyroid retention function. Multiple calculations with 1,000 sets of parameter samples at each time step reduced the mean standard error of the distribution to below 2%; however, further calculations did not significantly improve the distribution. When the thyroid retention function at a particular time was drawn as a frequency distribution, it was log-normally distributed. For example, as shown in  ICRP 78  falls atConsidering the shape of the distribution of the thyroid retention function shown in . (1985) [The scattering factors and bias suggested in this study were applied to examples in which thyroid measurements within a day after exposure were included. First, the uncertainty was applied to the data reported by Floyd et al. (1985) , in whicThe determination of the type of uncertainty distribution is critical for interpreting and quantifying the uncertainty. The type of distribution of the thyroid retention function was inductively determined after propagation of the biokinetic parameter uncertainties. The log-normal distribution selected for explaining the distribution of the thyroid retention function is statistically valid and corresponds with the results of the other studies; for example, the time-integrated activity of ingested iodine in the thyroid, which was calculated by integrating the thyroid retention function, was also described by the log-normal distribution . Based oAlthough measurement uncertainty has been considered in general bioassay data fitting methods, this study showed that the thyroid retention function also exhibits a significant uncertainty. Considering the typical SF of 1.2 for the measurement uncertainty of high-energy gamma, as suggested by the IDEAS guidelines, the major uncertainty can be attributed to the uncertainty in the thyroid retention function, whose SF values are higher than 1.4. In particular, the magnitude of the uncertainty was relatively large in the thyroid retention function within a day after exposure. Because the thyroid activity in the early phase after exposure is influenced by various factors, such as the amount of iodine in blood, blood-to-thyroid transfer rate, and thyroid-to-rest of the body transfer rate, it is difficult to predict the thyroid activity before the early thyroid uptake is complete. In addition, this study showed that the thyroid retention function calculated using the first-order kinetics could underestimate the actual thyroid uptake within a day after exposure. Although sufficient measured data were unavailable, obvious discrepancies between the thyroid measurement data and the calculated values were observed. There could be other reasons for the discrepancies, such as the extra-thyroidal radioiodine contribution and other factors that cannot be identified clearly. However, we judged that the influence of other factors was minor and negligible compared to the uncertainty from the use of first-order kinetics.The effects of the uncertainty in the thyroid retention function were demonstrated in the previous examples. In the first example in which the true intake was known, applying the scattering factor and bias suggested herein made a difference in the statistical explanation ability of the calculated %RAIU curve. The correction using the scattering factor and bias produced p-value higher than 0.05. However, it should be noted that despite the statistical acceptance of the fitting, the discrepancy in the early data at 4 and 5 h indicated that the thyroid retention function in the early phase after intake would still involve a significant uncertainty. In the second example in which artificial measurement data were used, it was shown that the intake estimate could significantly vary depending on whether the uncertainty in the thyroid retention function was considered or not. In the example, the intake estimates changed by approximately 17%. In particular, the overestimation of the intake could be avoided by scaling down the data at 2 and 4 h, and the fitting curve became closer to the data after 24 h. From the results, it can be concluded that applying the uncertainty in the thyroid retention function reduces the importance of the unstable thyroid measurement data obtained within a day, but strengthens the relative reliability of the data obtained after a day. Depending on the situation, considering the uncertainty can also reduce the possibility of underestimation. If the exact time of intake is unknown, applying the bias can estimate an intake time later than that without the bias and thus result in a higher intake estimate.The best way to avoid the uncertainty from the unstable measurement data in the early phase is by measuring the thyroid after 1 d of exposure. If only data measured after 1 d are used, the uncertainty is relatively low, and the result of intake estimation using the bioassay data fitting may not change because equal weightings are induced to all the measurement data regardless of the time. In this case, introducing the uncertainty in the thyroid retention function to the data fitting can only affect the good of fit, and thus the determination of acceptance or rejection of fit. Moreover, the thyroid measurement after 1 d is preferred because it can reduce the background effect of extra-thyroidal iodine on the thyroid measurement. Until radioiodine is absorbed into the thyroid or excreted via urine, significant amounts of radioiodine distributed to organs or tissues other than the thyroid can influence the thyroid measurement counting. Nevertheless, in actual situations, dosimetrists often need to perform intake estimation using only the data obtained within a day or data obtained both before and after a day. The first dose assessment should not be delayed after internal exposure. Therefore, the time-dependent uncertainty is vital for practical dose assessments and should be considered particularly important when early measurement data are used.It is also important to clarify the exposure categories and situations where the uncertainty investigated in this study could be applied in practice. ICRP publication 103  has clasThis study attempted to quantify the uncertainty in the thyroid retention function for practical applications. More importantly, the objective was to provide insights to dosimetrists into the uncertainty in the thyroid retention function rather than giving the exact numerical values. Although the uncertainty is not considered numerically, the dosimetrist should understand the extent of uncertainty in the thyroid retention function and thus be able to practically judge which data are more important for intake estimation. Because the internal dose calculation depends on the judgment of the dosimetrist, a firm understanding of the uncertainty is essential to derive more accurate dose estimates.However, it should be noted that this study does not guarantee that applying the uncertainties suggested herein would always yield a more accurate dose estimate. Because the dose assessment needs to be based on a comprehensive understanding of the given data and conditions, dosimetrists should focus on the use of uncertainties depending on the situation.This study revealed the uncertainty in the thyroid retention function based on the Monte Carlo method and performed a comparison with actual measurement data. Moreover, the study provides new insights to dosimetrists into the uncertainty in the thyroid retention function and methods of applying it to practical dose assessments. The thyroid retention functions were assumed to be independent of one another; the accuracy of the uncertainty quantification can be improved by better understanding the correlation between the thyroid retention functions and through the development of a more extensive database. In addition, the use of recently developed biokinetic models for iodine can improve the accuracy of the thyroid retention function. This study lays a foundation for the uncertainty quantification of bioassay functions. Future studies should be directed toward quantifying the uncertainty in various bioassay functions for chronic intakes and for other radionuclides.The authors have no conflicts of interest to declare.This research was supported by a grant of the Korea Institute of Radiological and Medical Sciences (KIRAMS), funded by Ministry of Science and ICT (MSIT), Republic of Korea. (No.50445-2020).


This study aimed to evaluate the association between optical coherence tomography (OCT)-measured retinal layer thickness parameters with clinical and patient-centred visual outcomes in healthy eyes. Participants aged 40 and above were recruited from the Singapore Epidemiology of Eye Diseases Study, a multi-ethnic population-based study. Average macular, ganglion cell-inner plexiform layer (GCIPL), and outer retinal thickness parameters were obtained using the Cirrus High Definition-OCT. Measurements of best-corrected visual acuity (BCVA) and 11-item visual functioning questionnaire (VF-11) were performed. Associations between macular thickness parameters, with BCVA and Rasch-transformed VF-11 scores (in logits) were assessed using multivariable linear regression models with generalized estimating equations, adjusted for relevant confounders. 4,540 subjects  with a mean age of 58.8 ± 8.6 years were included. The mean BCVA (LogMAR) was 0.10 ± 0.11 and mean VF-11 score was 5.20 ± 1.29. In multivariable regression analysis, thicker macula  and GCIPL  were associated with better BCVA , while thicker macula  and GCIPL  were significantly associated with higher VF-11 scores . In conclusion, among healthy Asian eyes, thicker macula and GCIPL were associated with better vision and self-reported visual functioning. These findings provide further understanding on the potential influence of macular thickness on visual function. Using this technique, recent studies have shed insights on variations of macular thickness across gender, age, ethnicity, axial length and refractive error profiles8.Optical coherence tomography (OCT) is a non-invasive imaging technique and an essential clinical assessment tool in retinal diseases14, and macular thickness has thus been proposed as a potential surrogate for visual function. Previous studies also reported poorer vision in cases who presented with signs of disrupted retinal layers such as the retinal inner layers, external limiting membrane or the ellipsoid zone17. The association between macular thickness and self-reported visual functioning has only been evaluated in diseased eyes such as age-related macular degeneration18. However, the associations between macular thickness with visual acuity and visual functioning have yet been evaluated in healthy eyes. It is postulated that a thicker retina is correlated with better vision in non-pathological eyes, but this has not been evaluated comprehensively.A series of past studies has shown that changes in the retinal or its sublayer’s thickness in diseased eyes were associated with visual acuity and functionHence, the purpose of our study was to evaluate the association between macular thickness and visual acuity and visual functioning, in a multi-ethnic Asian population. The findings from this study may provide further understanding on the relationship between retinal anatomical structure and visual function.21. Briefly, participants aged 40–80+ years residing in the Southwestern part of Singapore were recruited and underwent standardised ocular and systemic examinations. Our study population is made up of 3,353 Chinese from the baseline visit in year 2009–2011 (response rate 72.8%), 1,901 Malays from the 6-year follow up visit in 2011–2013 (response rate 72.1%), and 2,200 Indians from the 6-year follow up visit in year 2013–2015 (response rate 75.5%). The baseline visits in the Malay and Indian population did not undergo OCT assessments and hence were not included in this study. This study follows the principles of the Declaration of Helsinki with ethical approval obtained from SingHealth Centralised Institutional Review Board. Written informed consent was obtained from all participants.The Singapore Epidemiology of Eye Diseases (SEED) Study is a cross-sectional population-based study in Singapore and comprises of adults from three major ethnicities: Chinese, Malay, and Indian. The methodology of the SEED study has been previously describedAll participants who underwent an OCT scan were included in our study. Exclusion criteria included poor fundus photo quality e.g. dense media opacity and artefacts, low OCT signal strength of <6, history of glaucoma or high cup-disc ratio of >0.75, previous retinal procedures such as laser photocoagulation, retinal surgery, intravitreal injection, and pre-existing retinal diseases such as diabetic retinopathy, age-related macular degeneration, epiretinal membrane and macular hole.8. The presenting visual acuity (VA) was recorded and subjective refraction subsequently performed to ascertain best-corrected VA (BCVA) of each participant. Both parameters were measured in the units of logarithm of the minimum angle of resolution (LogMAR), using number chart  at 4 meters. High myopia was defined as spherical equivalent of −5 dioptres or more.A standardised examination protocol was used across all three ethnic groupsA detailed interviewer-administered questionnaire was used to collect information including demographics, ocular history, medical and surgical history and medication use, height, weight, blood pressure and pulse rate. Body mass index (BMI) between 18.5 to 25 was defined as normal, <18.5 as underweight, 25 to 30 as overweight, and> 30 as obese. A non-fasting venous blood sample was collected for serum lipids, glycosylated haemoglobin A1c (HbA1c), creatinine, and random glucose. Diabetes was defined as random glucose ≥ 11.1 mmol/L, HbA1c ≥ 6.5%, use of diabetic medications and/or self-reported history. Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, use of anti-hypertensive medications and/or self-reported history. Hyperlipidaemia was defined as total cholesterol ≥ 6.2 mmol/L, use of lipid-lowering medications and/or self-reported history. Cardiovascular disease (CVD) history was defined as self-reported history of angina, heart attack and/or stroke. Lastly, low socioeconomic status was defined as fulfilling all three criteria of primary education or below, monthly income <2,000 SGD and residing in 1 to 2-room public housing flat.22. The VF-11 is a modified version of VF-14 which has been validated to suit the local Singapore cultural context. The questionnaire was administered by interviewers fluent in English, Chinese, Malay and Tamil. The VF-11 assesses participants’ ability to perform activities of daily living, such as reading the newspaper, reading street signs, recognising friends, seeing stairs, watching television, cooking, and driving during the day or night. Items 1–9 were given a numerical grading from 0 to 4, where 0 represents no difficulty in performing such activity, and 4 represents inability to perform that activity, while items 10 and 11 were rated from 0 to 2. A non-applicable option for each item was available if participants did not do the activity for reasons other than their vision, and these data were excluded from the analyses.The VF-11 questionnaire was used to assess the impact of retinal thickness parameters on subjects’ vision functioning23. The scores were reversed so that higher scores represented better visual functioning. We used the overall VF Rasch-transformed score derived from items 1–9 of VF-11 questionnaire excluding item 10 and item 11 (‘driving during the day’ and ‘driving at night’) as Rasch analysis of the VF-11 revealed these two items to have high level of misfit.Rasch analysis, a form of Item Response Theory, was applied to assess the psychometric properties of the VF-11, in which raw VF-11 scores are transformed to estimates of interval level Rasch measures, expressed in log of the odds units or logits2 area centred on the fovea was acquired based on the 512 × 128 protocol and automatically analysed by the Cirrus HD-OCT software V6.5. The macula is subdivided into nine macular subfields as defined by the Early Treatment Diabetic Retinopathy Study (ETDRS) with the foveal central subfield defined as central 1 mm diameter, and the inner ring and outer ring with diameters of 3 mm and 6 mm, respectively. Both inner and outer rings are further divided into superior, inferior, nasal and temporal quadrants. The average overall macular thickness was measured from the internal limiting membrane to the retinal pigment epithelium (RPE) of the macular cube. The average ganglion cell-inner plexiform layer (GCIPL) thickness and outer retinal thickness were measured across an elliptical annulus within the 6 × 6 mm2 area. GCIPL was segmented from the outer boundaries of retinal nerve fibre layer to the inner plexiform layer, and outer retinal layer was segmented from the outer plexiform layer to the RPE layer  was used to capture images of the macula following pupil dilation. In each study eye, a macular cube scan of 6 × 6 mmAll statistical analyses were performed using Stata 14.0 . Eye-specific analysis data were used. Mean and standard deviation were reported for continuous variables, while frequency and percentage were reported for categorical variables. Univariate linear regression analysis was performed to examine the associations between demographic, systemic and ocular factors with the two outcomes of interest, BCVA and VF-11 Rasch-transformed scores. Variables significantly associated with the two outcomes in univariate analysis  and older age groups (≥60 years old) . Despite this close relationship, association between the respective macular thickness parameters with VF-11 scores remained significant after adjusting for presenting VA. This further substantiates the observed associations. Furthermore, as age and axial length were major determinants of macular and GCIPL thicknesses, we performed subgroup analyses by age and axial length profiles27. For example, a thicker OCT-measured macular thickness in eyes with vein occlusion or uveitis, as shown in the Standard Care vs. Corticosteroid for Retinal Vein Occlusion (SCORE) study and Multicentre Uveitis Steroid Treatment (MUST) trial, was associated with poorer baseline visual acuity. In comparison, our study evaluated this association in healthy eyes, whereby the differences in macular thickness represent a larger physiological variation among normative population, rather than as a sequela to a macular disease. Our finding of a positive correlation between thicker macula with vision and patient-centred visual function suggests that macular thickness could also be one of the determinants for visual outcomes. Our observed finding may be explained by the notion that thicker macula reflects a more abundant cell number especially of the ganglion cell type which functions to transmit crucial visual information from the retina to the brain28.To the best of our knowledge, this is a novel finding in healthy eyes. This contrasts with most other studies which looked at pathological eyes where increased macular thickness was generally associated with poorer visual acuityOur analysis showed that within the inner retinal layer, average GCIPL thickness was also significantly associated with better BCVA and visual functioning scores, but the outer retinal thickness was not. This may be because the majority of the ganglion cells are located in the inner retinal layer of the macular and have greater influence on visual function. Overall, our study supports the existing literature that GCIPL thickness is a determinant of visual outcomes, even in healthy eyes.18. They reported an inverted U-shaped correlation between central foveal thickness and visual function, assessed using National Eye Institute Visual Function Questionnaire (VFQ) scores, with best visual function peaking at 220 µm of macular thickness. In contrast, our study evaluated healthy eyes and further took into account a range of potential confounders including individual’s presenting vision status. This shows that, other than clinically measured vision status, macular and GCIPL thickness also potentially contributes to good visual functioning. In healthy eyes, macular thickness can possibly aid in other areas crucial for visual functioning such as depth perception, contrast sensitivity, stereo-acuity, and visual fields, further supporting the role of macular thickness as a factor associated with better visual functioning29. Overall, despite the statistically significant associations observed between macular parameters and visual functions, it should also be noted that the observed effect estimates were generally small. Hence, the clinical impact of these observed associations remained to be evaluated in future studies.We also presented a novel finding in which macular and GCIPL thickness were positively associated with self-reported outcomes in healthy eyes, independent of individual’s vision status. One study looked at the correlation between foveal morphology and visual function in participants with neovascular age-related macular degenerationStrengths of our study include a large, multi-ethnic population. Furthermore, measurements were conducted comprehensively and according to a standardized protocol, allowing us to account for a range of potential confounders. Our study is limited by the lack of other parameters that measure quality of vision (e.g. contrast sensitivity) and information on temporality, which limits inference on causality between retinal layer thickness and visual outcome. Thus, future longitudinal studies in this aspect are still warranted. Our study was also limited by some missing responses on VF-11 questionnaire, which ranged from 0.4 to 36.4% by individual question. However, only three items related to difficulty in cooking, playing games and filling out lottery forms had missing responses of >20%. The higher missing rates in these 3 items were unlikely to have impacted our original findings substantially. Lastly, although the GCIPL thickness was measured using an elliptical annulus area at the macula, we acknowledge that the effect of retinal ganglion cell displacement at the macula was still not fully accounted for in our measurements, and might impact inner retina-related evaluation.In conclusion, our study demonstrates that in an adult Asian population with healthy eyes, thicker macula and GCIPL were associated with better VA and better visual functioning. Our findings suggest that macular and GCIPL thickness parameters may be useful determinants for visual functions.Supplementary Tables.


The antioxidant system in islets of Langerhans is weak, which can lead to diabetes. Meanwhile, the main component of cloves that produce antioxidant effects is eugenol. Accordingly, the present study was conducted to investigate the antioxidant effect of eugenol on oxidative stress induced by hydrogen peroxide . Finally, the islet's lipid peroxidation and antioxidants levels were measured by the ELISA assay method.  In this experimental study, adult Naval Medical Research Institute (NMRI) mice (20-25 g) were prepared. The collagenase digestion method was used for dissecting the islets of Langerhans. HP < 0.05). MDA diminished in H2O2+eugenol 50, 100, and 200 μM (P < 0.01) groups versus the H2O2. TAC was elevated when eugenol 50, 100, and 200 μM was administered in oxidative stress-induced islets (P < 0.001). Also, CAT increased in the H2O2+eugenol 50 (P < 0.05) group in comparison with the H2O2 group.  Malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), and catalase (CAT) increased in all groups when compared to the control (2O2 induced oxidative stress and lipid peroxidation in the islets, and administration of eugenol recovered these alterations by raising the level of TAC and CAT, while reducing MDA as a lipid peroxidation biomarker. In conclusion, H NumerouIn this experimental study, adult Naval Medical Research Institute (NMRI) mice (20-25 g) were kept at a 12 : 12 hour light : dark cycle. The animals were treated in accordance with the principles and guidelines on animal care of Dezful University of Medical Sciences as reviewed by an ethics committee (IR.DUMS.REC.1398.022), as well as free access to tap water and commercial chow ad libitum.The islets of Langerhans were isolated by the protocol for the isolation of islets from rodent pancreas using collagenase digestion. Briefly, the animals were anesthetized with ketamine/xylazine (70/10 mg/kg), and their pancreas removed and transferred to a Petri dish containing Krebs-bicarbonate buffer solution . Then, the separated pancreas was cut into 1 mm pieces and centrifuged at 100 ×g for 5 min. Krebs-bicarbonate buffer solution plus collagenase type P (1-2 mg/pancreas)  were added to the sediment of the centrifuged conical tube to separate the islets from exocrine tissue. Next, the conical tube was transferred to an incubator at 37°C with 800 oscillations for 5-10 min. Then, a cold Krebs-bicarbonate buffer was added to the conical tube to stop collagenase digestion and centrifuged at 500 ×g for 5 min. Finally, the isolated islets were transferred to a Petri dish and separated manually under a stereomicroscope .2O2 (50 μM) was added to each islet's sample and incubated for 30 min. Then, the samples were centrifuged at 400 ×g for 10 min. In order to reduce the oxidative stress in islets, 50, 100, and 200 μM of eugenol were added to each islet's sample and incubated for 2 hours at 37°C; after the incubation period, the oxidative-induced protocol with H2O2 (50 μM) was repeated. Finally, the supernatant of each microtube was stored at -70°C until the experimental measurement. Each microtube contained 7 islets, and the number of samples is repeated 6 times for each group [To create oxidative stress in the isolated islets of Langerhans, Hch group , 19.Group 1: controlGroup 2: H2O2 (it received 50 μM of H2O2 for 30 min)Group 3: H2O2+eugenol (50 μM) (it received 50 μM of eugenol for 2 hours after which H2O2 (50 μM) was added to each sample for 30 min)Group 4: H2O2+eugenol (100 μM) (it received 100 μM of eugenol for 2 hours after which H2O2 (50 μM) was added to each sample for 30 min)Group 5: H2O2+eugenol (200 μM) (it received 200 μM of eugenol for 2 hours after which H2O2 (50 μM) was added to each sample for 30 min)To measure the level of MDA, total antioxidant capacity (TAC), SOD, and CAT in the isolated islets of Langerhans, the ELISA method as well as specific commercial kits  was used.P was considered significant at less than 0.05 in all experiments.The results were statistically analyzed using the Statistical Package for Social Sciences (SPSS) software with one-way analysis of variance (ANOVA), followed by post hoc least significant difference (LSD) tests. All results were represented as mean ± standard error (SE) where P < 0.001). This lipid peroxidation variable diminished in H2O2 plus eugenol 50 (P < 0.001), 100, and 200 μM (P < 0.01) administrated groups versus the H2O2 group , as well as H2O2 plus eugenol 50, 100, and 200 μM (P < 0.001) groups compared with the control. This variable revealed a significant increase following eugenol 50, 100, and 200 μM (P < 0.001) administration under oxidative stress islets compared to the H2O2 group (The islets' level of TAC increased in HO2 group .P < 0.01). However, this antioxidant enzyme did not show any significant alteration across the H2O2-administered groups  and H2O2 plus eugenol 50 (P < 0.001), 100, and 200 μM (P < 0.01) groups compared to the control. Also, this enzyme was elevated in the H2O2 plus eugenol 50 μM (P < 0.05) group in comparison with the H2O2 group (CAT level increases in HO2 group .2O2 would lead to higher MDA levels in the isolated islets of Langerhans. However, H2O2 could increase TAC, SOD, and CAT, but this increasing effect could not improve the damage induced by oxidative stress and lipid peroxidation in the islets. The administration of eugenol decreased MDA along with increase TAC and CAT in pancreatic islets under oxidative stress condition induced by H2O2. Also, the effect of low doses of eugenol on improving the damage induced by oxidative stress was greater than that of other doses. This effect can be attributed to the fact that a low dose of eugenol resulted in a significant increase in catalase as well as in further reduction in MDA in the isolated islets.The results of the present study showed that the induction of oxidative stress by Hβ cells are sensitive to oxidative stress where ROS may play a central role in β cell death causing T1DM. Also, this disorder has a secondary pathogenic role in the development of T2DM. On the other hand, it was demonstrated that antioxidants such as phenolic compounds reduced this complication. H2O2 has multiple effects on β cells including metabolic inhibition and enhancing plasma membrane permeability, impairing glucose metabolism, and reducing insulin secretion [β cell, causing type 1 and type 2 diabetes [2O2-induced proliferation inhibition in β cell, and it was suggested that these antioxidants can be used in T2DM to increase β cell proliferation [Pancreatic ecretion . Oxidatidiabetes . In addiferation . Diabeteferation . Overproferation . Accordi2O2 at higher concentrations [It was revealed that antioxidant agents such as polyphenols or flavonoids scavenge free radicals depending on their concentration . Furthertrations . So, in 2O2 induced oxidative stress and lipid peroxidation in the isolated islet of Langerhans, and administration of eugenol recovered these alterations by raising the level of TAC and CAT and reducing MDA as a lipid peroxidation biomarker. Also, among the administered concentrations of eugenol, a low dose of this phenolic compound was more potent to produce a therapeutic effect in the function of antioxidant enzymes and reducing the oxidative stress of the pancreatic islet. Hence, this dose of eugenol could be used to treat diabetes by improving the function of β cells in the islets of Langerhans, but a future clinical study is required to clarify this finding.In conclusion, H


The present study suggested that early mobilization after cardiac surgery may improve physical function at discharge.The objective effects of early mobilization on physical function in patients after cardiac surgery remain unknown. The purpose of the present study was to clarify the effects of early mobilization on physical function in patients after cardiac surgery through meta-analysis. Four electronic databases were searched on 2 August 2019. We used search keywords related to “early mobilization”, “cardiac surgery”, and “randomized controlled trials”. All randomized controlled trials conducting early mobilization after cardiac surgery were included. We defined early mobilization as the application of physical activity within the first five postoperative days. Citations and data extraction were independently screened in duplicate by two authors. The meta-analysis was conducted using random-effects modeling with EZR software. The primary outcome was the distance walked during the six-minute walking test at hospital discharge. Six randomized controlled trials comprising 391 patients were included following screening of 591 studies. All studies included coronary artery bypass grafting as the cardiac surgery conducted. Early mobilization started on postoperative days 1–2 and was conducting twice daily. Early mobilization showed a trend of being combined with respiratory exercise or psychoeducation. The meta-analysis showed that the distance walked during the 6-min walking test improved by 54 m (95% confidence interval, 31.1–76.9; I Cardiovascular diseases (CVD) such as coronary artery disease (CAD) are a major cause of mortality worldwide . With raEarly mobilization is defined as the application of physical activity within the first two to five days of critical illness or injury ,8. In crA decline of physical function (gait speed) with bed rest was seen in 17% of patients after surgery . FurtherRamos Dos Santos et al. found that three quarters of the studies related to cardiac surgery that they analyzed reported early mobilization to have significant effects on improving physical function such as that assessed in the 6MWT . HoweverThis systematic review and meta-analysis was conducted according to the PRISMA statement . We inclStudies were identified by searching four electronic databases . We searched for keywords related to “early mobilization”, “cardiac surgery”, and “randomized controlled trials” . The lasEligibility assessment was performed independently in a standardized unblinded manner by two independent reviewers (Y.K. and T.S.). First, we screened the titles and abstracts of each study. After the results of this screening were integrated, we screened the full text of the manuscripts. Disagreements regarding inclusion of a study were reconciled via consensus.We used datasheets based on the Cochrane Consumers and Communication Review Group’s data extraction template. Two reviewers independently extracted the data listed below from the included studies. After that, each result was integrated, and disagreements were resolved by discussion between the two independent reviewers (Y.K. and T.S.). If agreement could not be reached, we requested intermediation by a third party. We contacted seven authors directly to collect additional data. After that, three full texts and the details of the results of two studies were collected and included in the present analysis. The following information was extracted from the included studies: patient characteristics , interventions , and outcomes .To assess the validity of the included studies, two reviewers independently used the “Cochrane risk of bias tool”, which consists of seven items that were evaluated as “low risk”, “high risk”, or “unclear risk” and are summarized in p-value was < 0.05 in the Cochrane Q test or >50% in the I2 test as a measure of inconsistency. No other additional analyses were conducted.The distance walked during the 6MWT at discharge was the primary outcome of the intervention effect. In the meta-analysis, we calculated the mean distance walked during the 6MWT in each group at discharge using the weighted average “random-effect model” included in the EZR analysis software . We judgWe searched 591 studies through four database searches along with four additional studies obtained from the Ramos Dos Santos et al. study . After dEarly mobilization started on postoperative days 1–2 and was conducted twice daily by physical therapists or nurses. The exercise protocol was performed via a progressive approach, and it consisted of such activities as active upper and lower limb exercise training, ambulation, cycle ergometer, and ascent/descent of stairs. Ambulation was started by postoperative day 1 or 2 in almost all studies. Interventions in four studies were continued until discharge, although in two studies, they were continued until 4 months after surgery. Respiratory physiotherapy  and psychoeducation were implemented as additional interventions with early mobilization. The aim of psychoeducation was to improve disease coping skills  by applying a patient-centered approach. These interventions in two of the studies were conducted in the same institution. In addition, the psychoeducation was conducted four times per patient by trained nurses and was based on the Human Becoming Practice Methodologies . Herdy e2 test was 52%, and the P-value for heterogeneity was 0.06, and although these results indicated moderate heterogeneity in the six studies, early mobilization significantly increased the distance walked during the 6MWT at hospital discharge.In the meta-analysis of all included studies, the distance walked during the 6MWT at discharge was set as the objective variable. In total, 391 patients were included in the analyzed studies . The results of the meta-analysis are shown in In the present meta-analysis, early mobilization was shown to clinically significantly improve physical function at discharge. To our best knowledge, this is the first meta-analysis to examine the effectiveness of early mobilization on physical function in patients after cardiac surgery.In a previous systematic review, early mobilization was shown to have a positive effect on improving physical function . The outAccording to previous studies, the minimum important clinical difference in the 6MWT is an increase in distance walked of 25 m for patients with CAD and 14.0–30.5 m for patients with other diseases ,32. The Bed rest induces changes in skeletal muscle atrophy and inflammatory markers . CardiacThe present analysis showed that not only early mobilization but also respiratory exercise and psychoeducation were conducted as interventions after cardiac surgery. Respiratory dysfunction and depression are reported likely to occur after cardiac surgery ,39. In tNone of the analyzed studies reported adverse events during early mobilization. Serious adverse events are uncommon during early mobilization when safety considerations are addressed prior to mobilization ,30. TakeThere are several limitations in the present meta-analysis. First, only six studies were included, and these studies were conducted only in Brazil and Denmark. In addition, two of the six studies were from 10 years ago. As the technology and context of cardiac surgery have continued to advance in the last decade, such as in the reduction of its invasiveness, the background of these older studies is likely to be different. Although the present analysis could not clarify this, the combination of current improvements in cardiac surgery and earlier mobilization may have resulted in a better postoperative prognosis compared to the results reported here. Moreover, this meta-analysis included only 391 patients after cardiac surgery, and the female ratio was 13–45%. In the present meta-analysis, about 60% of the patients were from the studies of Hojskov et al., and thus, this could influence the results of the meta-analysis, which included only six studies. Based on the above results, this meta-analysis shows heterogeneity, and the possibility of overestimation may be present. Second, only patients diagnosed as having CAD or ischemic heart disease and underwent CABG only were included. In addition, the present study could not distinguish whether on-pump or off-pump CABG was performed. If off-pump CABG is conducted, patients benefit from early discharge and recover their physical function better at hospital discharge. On the other hand, to the best of our knowledge, there are few RCTs examining the effects of early mobilization after other types of cardiac surgery, such as aortic valve replacement and mitral valve plasty, on physical function. The type of cardiac surgery is a determinant of distance walked during the 6MWT , so furtThird, the effect of early mobilization alone was not considered because respiratory exercise and psychoeducation were also conducted as interventions along with early mobilization in the included studies. On the other hand, early mobilization suggests a comprehensive intervention that includes respiratory exercise and psychoeducation. These interventions will be performed in almost 100% of postcardiac surgery patients in the clinical setting. However, the novelty of the present meta-analysis was to clarify the effect of these interventions on improving physical function at hospital discharge. In addition, in almost all included studies, the difficulty of blinding the participants and personnel to early mobilization itself indicated a high risk of bias. Fourth, only the 6MWT was included in the present assessment of physical function. Other assessments of physical function  were included in the analyzed studies, and thus, these indexes should also be studied. Finally, the primary outcome was assessed only at discharge from hospital, and the effects of early mobilization on long-term factors of prognosis such as mortality and hospital readmission were not considered. In fact, one of the included studies showing significant differences in the 6MWT between the intervention and control groups reported that the significant difference in the 6MWT was lost at four weeks after discharge . As a neBy integrating the data of RCTs of early mobilization for physical function in patients after cardiac surgery, the findings of the present meta-analysis underscore the fact that early mobilization after cardiac surgery may improve physical function  at hospital discharge. Five of the six included studies showed a significantly positive effect of early mobilization, and no adverse events occurred during early mobilization after cardiac surgery. Early mobilization after cardiac surgery also tended to be combined with respiratory exercise and psychoeducation. Further study is required to examine the effectiveness of early mobilization with increased numbers of studies and patients and for other types of cardiac surgery.


Vigna unguiculata) plays a key role in family farming systems in Senegal. It makes an essential contribution to economic, nutritional and food security. Although it is crucial, little is known about how farmers classify the diversity of local varieties or about the social practices associated with them. The aim of this study is to characterize the farming practices associated with growing cowpea in Senegal. Surveys were conducted involving 335 rural farmers living in 37 villages, spread across seven regions that produce cowpea. An average of ten farmers were randomly selected in each village. The results reveal that cowpea is a key feature of cropping systems in the studied area. Our findings highlight the high diversity of local cowpea varieties with 59 local names inventoried. In 75% of cases, the name refers to the seed’s morphology or color. Cowpea production is more diverse in Diourbel and Louga and less diverse in the south. More than half the farmers (57%) acquired their cowpea seeds  outside their village, either from markets, seed suppliers or NGOs. This new understanding of farmers’ expertize in the management of cowpea and its local variability will help to valorize local diversity in breeding programs.Cowpea (The online version contains supplementary material available at 10.1186/s13002-022-00506-y. Vigna unguiculata (L.) Walp.) is one of the most important leguminous plant grown in tropical savannah zones in Africa [Cowpea  and valorization of this legume. It is particularly relevant for breeding programs, which require the availability of a wide genetic diversity . In thisBased on new collections and specific more exhaustive surveys, this study aims to characterize the farming practices associated with growing cowpea in Senegal for the first time. In particular, it aims to: (i) identify the role that cowpea has in the cropping system, by describing the range of species that it is associated with; (ii) survey and characterize its diversity based on the local nomenclature and the date to reach maturity and (iii) identify the farmers’ seed supply.The surveys were conducted between September 2015 and March 2016 in the main cowpea producing regions in Senegal . The Kédougou region was also surveyed in order to identify the characteristics of the cowpea varieties grown in this area. The villages surveyed were chosen in consultation with agents from the services of Regional Rural Development Division to facilitate access to villages that grow cowpea. To optimize the coverage of the main cowpea producing zones, three departments were visited in each region  in Senegal for conservation.The villages’ geographic coordinates were recorded on a tablet with the aid of the software Sygic: GPS Navigation 17.3.27 Android.The age, ethnic group and profession were used to characterize the farmers interviewed. The frequency, the average salience and Smith’s index for each species and variety were calculated with the R AnthroTools package . The freThe number of cowpea morphotypes that farmers identified and named was used to estimate the varietal richness . To furtStats and FactoMinR were used for exploratory statistical analyses and to test the hypothesis.The farmers’ responses regarding the sowing and harvest dates allowed to propose a classification system according to the phenology of the cowpea varieties. The association between the variety types and the regions was checked using a Chi-square test. The maps showing the village locations and the spatial distribution of the accessions were compiled using the software R (version 3.6.0 for Windows). The software packages The panel of interviewees comprised 156 women and 179 men, for a total of 335 people. In the different regions, on average, about ten farmers were randomly selected per village—except in the Kédougou Region, where it was only possible to interview four farmers per village . Among those interviewed, 50.8% spoke Wolof, which is the language mainly spoken in the regions of Thiès, Louga, Diourbel and Saint-Louis. The Serer, which represented 17.9% of the interviewees, are found in the Fatick, Thiès and Diourbel regions. Lastly, the Toucouleur (10.5%) and Moors (3.3%) occupy the Louga and Saint-Louis regions, while the Mandinka, Jola, Bainuk, Bedick and Manjak live in the Fatick, Kédougou and Sédhiou regions Table .Table 2CTwenty-four (24) different species grown with cowpea were identified in the seven regions which were studied. The most frequently cited species grown with cowpea were groundnut and millet, which on average are grown, respectively, by 85% and 71% of the farmers interviewed Table . Howeverp-value = 0.008).The correspondence analysis shows that the regions of Thiès, Sédhiou, Louga, Fatick and Diourbel have similar cropping profiles: red sorrel, sesame and sorghum, in addition to cowpea, groundnut and pearl millet. The Saint-Louis region differs, with watermelon (grown by 62.9% of interviewees) and onion (22.6%), melon, cucumber and tomato, whereas the Kédougou region is characterized by fonio, pearl millet and cotton, rarely grown elsewhere , “Sosso” is used by the Mandinka, “Niao” by the Serer, “Deulleugane” by the Moors and “Oufithion” by the Manjak.During the survey, 702 cowpea accessions were collected in Thiès (84), Louga (155), Diourbel (158), Fatick (85), Saint-Louis (122), Kédougou (19) and Sédhiou (79) . One to A wide range of reasons is used by the farmers to identify their cowpea varieties. Indeed, 75% of names make reference to morphology (seed color and size or vegetative cycle), 14% are named after a person  and 1% refer to the geographic origin (the zone they came from). Lastly, 9% have names that refer to a specific event (details not provided here) or are arbitrary Table .Table 6PMost of the time, the names of varieties are composed of a generic name for cowpea in the local language plus a second term, which either refers to simple morphological characteristics (seed color), people’s names or zone of origin. Among the Mandinka, for example, cowpea is known by the generic name “Sosso.” In order to identify red cowpea, farmers add the suffix “wouléroung” (red) to the name “Sosso.” In all the regions visited, the names generally referred to morphology, particularly seed color . Sometimes seed size is added . Some cowpea names are associated with the seeds’ geographic origin (Fouta cowpea) or a person . In Senegal, the GOANA agriculture program, launched in 2008 by the former President of the Republic, Abdoulaye Wade, coincided with the introduction of a cowpea variety that is now called after the program. The Goana variety is sometimes called “pea” (because the shape of the seed is quite round or full) or “nenou naat,” which means “guinea fowl’s egg,” in reference to the marks on the seed’s integument Table .Table 7LAfter standardizing the spelling and identifying the synonyms, 36 names of varieties were kept. Irrespective of the ethnic group, the cowpea varieties called white cowpea , red cowpea (25%) and black cowpea (15%), and Baye Ngagne (9%) are the most commonly grown in Senegal.The zone in the north and center of the groundnut producing area has the greatest diversity (Louga and Diourbel), whereas Kédougou has the fewest varieties. Cowpea production is more diversified in the regions of Diourbel and Louga, followed by Thiès, Saint-Louis and Sédhiou, respectively Fig. .Fig. 5AvThe average number of cowpea varieties per farmer ranged from 1 (Kédougou) to 3 (Diourbel and Louga) Table . The DioThe majority of the farmers interviewed grow cowpea as a single crop (65%). This method of cultivating cowpea is far more frequent in four regions in Senegal, namely Louga, Diourbel, Kédougou and Saint-Louis. Groundnut is the species most commonly associated with cowpea. This association was described for 28% of the farmers surveyed, especially in the regions of Thiès, Fatick, Sédhiou and Diourbel. Cowpea is also associated with maize (3%) in the Saint-Louis region, millet (0.3%) in the Kédougou region and market gardening (0.85%) in the regions of Louga, Saint-Louis and Kédougou Table .Table 9CIn the regions of Thiès, Fatick, Diourbel, Kédougou and Sédhiou, cowpea is grown in the rainy season. In general, sowing is in June and July (53.42%) and harvesting is in September and October (93.44%). In the Louga region and part of the Saint-Louis and Diourbel regions, sowing is in August and September (42.60%) and harvesting is in November. Floodplain cultivation of cowpea is only found in the Saint-Louis region (3.99%). For this type of production, sowing occurs between November and January and harvesting is between February and March.There are three groups of cowpea varieties grown in Senegal that can be distinguished according to their development cycle: early (number of days < 70), semi-early (between 70 and 90 days) or late (number of days ≥ 90). The early maturity varieties represent 81.34% of the varieties grown. They are found in all regions, except Kédougou. Semi-early varieties (3.84%) are grown in Louga and Diourbel. Lastly, late maturity varieties (14.67%) are generally grown in the regions of Kédougou, Thiès and Saint-Louis Table .Table 10Most of the interviewees (57%) stated that they obtained their first cowpea seeds at markets or from seed suppliers, NGOs, cooperatives or farmer organizations outside the village. Forty-two percent (42%) obtained them from relatives or neighbors in the village. How seeds are acquired varies depending on the region Table . Eighty-Drawing on the new collections and the recent surveys, which were more exhaustive than earlier surveys, the aim of this study was to characterize the farming practices associated with growing cowpea in Senegal. It focused particularly on the range of species grown in association with cowpea. The richness and variability of cowpea varieties were established in reference to the farmers’ nomenclature. We also identified where farmers obtained their seeds.In all the zones surveyed, cowpea producers also grow groundnut and millet. In Senegalese farming systems, these three species are complementary. Along with sorghum, cassava, watermelon and red sorrel, they are the main cash crops grown in the center and north of the groundnut growing area, which is ideal for growing cowpea. Our findings on the regional distribution of species diversity are similar to those obtained when the FAO conducted inventories of the agricultural species in rural areas , in whicThe majority of farmers surveyed grow cowpea as a single crop. This cropping system is found in the regions of Louga, Diourbel and Kédougou. In the groundnut growing area, which includes the regions of Diourbel and Louga, there has been a rainfall deficit for decades. However, cowpea is adapted to these conditions. More and more land is being used to grow cowpea. Between 2012–2017, cowpea was grown on 165 452 ha, on average. This increased to 257 219 ha in 2019 . In thesIn the regions of Thiès and Louga, young people grow cowpea, which could help reduce immigration. In fact, in this part of the country, the legume is grown as a cash crop on large areas of land. In the Sédhiou region, young people also grow cowpea, although it is often neglected in favor of other crops. This could be explained by the fact that varieties from other crops are better adapted to the groundnut producing zone, such as the Sédhiou region. In Sédhiou, cowpea is traditionally valorized by women. In the regions of Diourbel, Fatick and Saint-Louis, cowpea is grown by aged farmers, who probably know more about traditional accessions and their cropping practices.This study helped to confirm the area of distribution of cowpea production in Senegal. In fact, in the regions of Diourbel, Louga, Thiès and Saint-Louis, collecting several varieties from one farmer is common, whereas in the Sédhiou and Kédougou regions, cowpea is less common and, on average, there is seldom more than one variety per farmer. The cultivation of this legume is more diversified in Diourbel and Louga. This reveals the importance and richness of the species in the central north and north, the main cowpea growing areas in Senegal . The depThe analysis of diversity based on the local names for cowpea allowed us to identify six appellations for the cowpea species. On a varietal level, 59 different names were identified. Varieties whose seeds have the same morphological features may have different names depending on the ethnic group. These names essentially refer to seed color, size or people’s names. Thus, the farmer manages diversity by recognizing perceptible characteristics, especially morphological features . By stud. (2007), on a local level, cowpea diversity is generally due to its phenological adaptability to environmental constraints. The abundance of early maturing accessions may be due to the adoption of improved varieties that are early. Late varieties are no longer grown in the main cowpea producing areas because rainfall has been irregular or insufficient for four decades. This may also explain the high number of early varieties. The earliest varieties were collected in Sédhiou, which has the longest rainy season. However, in this region, very small areas were cultivated for home-consumption. The variability of rainfall in the different regions could explain the phenological diversity observed. In fact, more late accessions are grown in the Kédougou region, where rainfall is higher, and in the Saint-Louis region, where floodplain cropping plays an important role. These types of varieties are valuable because they are dual purpose and can be used as seed and fodder. In fact, under favorable conditions, they produce a large amount of seeds and fodder [Cowpea is mainly grown during the rainy season in all the zones surveyed, except the Saint-Louis region, where cowpea is also grown on the floodplain. Three groups  were identified according to the varieties’ development cycle. According to Kouakou et ald fodder . The latd fodder , late mad fodder .In the last two decades, most of the seeds in the farmers’ possession were purchased at the market or obtained from agricultural services, NGOs, farmers’ organizations and cooperatives. These types of structure are common to several villages. Consequently, the same variety can be found in different villages or regions, even if it has different names. Thus, the pleasing appearance of seeds of one cowpea variety can encourage people to buy it at a market, even if they are unaware of its germination performance and agricultural value.Many of the people surveyed obtained their first seeds in the village, either through donations or by trading with relatives, friends or neighbors. Similarly, married women obtain their first seeds from their husband or parents-in-law, along with plots of land, after leaving their place of birth to go to their husband’s place of residence. Thus, women rarely take seeds from their home or continue to obtain seeds from their relatives, especially if they live in different villages.The majority of seeds from the season preceding this study were home-grown. In fact, farmers keep a share of their previous harvest for seed. Consequently, farmers only purchase or obtain seeds at the market or from relatives or neighbors the year after a poor harvest or a food shortage.Identifying the nomenclature for the local cowpea varieties and their seed management system is essential for optimizing local diversity. This study revealed the considerable diversity of local names. This diversity is an indicator of the importance of cowpea in Senegalese farming systems. The names primarily refer to the seed morphology or color, a feature that facilitates identification. The named diversity of cowpea is greater in regions where the crop systems are less diversified. In the studied area, more than half the cowpea seeds grown by farmers are obtained from markets, NGOs, agricultural services and projects and then farmers produce and conserve their own seeds. Cowpea is generally grown as a single crop or associated with groundnut or maize. The length of the growing cycle is rarely used by farmers to identify their varieties. However, we classified varieties in terms of development cycles because of the difference observed between sowing and harvesting dates. This study made it possible to characterize the diversity of cowpea grown in Senegal. Undoubtedly, the diversity of farming practices and cowpea cropping systems is closely linked to the diversity of the biological types grown in the country and vice versa.Additional file 1: Collection areas and socio-cultural characteristics of surveyed farmers.Additional file 2: The various species cultivated with cowpea in the areas visited.Additional file 3: List of the 702 cowpeas accessions, their local names and signification, regions of collection, acquisition and cycle.


Polytrichum have been shown to contain rare benzonaphthoxanthenones compounds, and many of these have been reported to have important biological activities. In this study, extracts from Polytrichum formosum were analyzed in vitro for their inhibitory properties on collagenase and tyrosinase activity, two important cosmetic target enzymes involved respectively in skin aging and pigmentation. The 70% ethanol extract showed a dose-dependent inhibitory effect against collagenase (IC50 = 4.65 mg/mL). The methanol extract showed a mild inhibitory effect of 44% against tyrosinase at 5.33 mg/mL. Both extracts were investigated to find the constituents having a specific affinity to the enzyme targets collagenase and tyrosinase. The known compounds ohioensin A (1), ohioensin C (3), and communin B (4), together with nor-ohioensin D (2), a new benzonaphthoxanthenone, were isolated from P. formosum. Their structures were determined by mass spectrometry and NMR spectroscopy. Compounds 1 (IC50 = 71.99 µM) and 2 (IC50 = 167.33 µM) showed inhibitory activity against collagenase. Compound 1 also exhibited inhibition of 30% against tyrosinase activity at 200 µM. The binding mode of the active compounds was theoretically generated by an in-silico approach against the 3D structures of collagenase and tyrosinase. These current results present the potential application from the moss P. formosum as a new natural source of collagenase and tyrosinase inhibitors.Mosses from the genus  Polytrichum formosum Hedw. is a moss that belongs to the genus Polytrichum (Polytrichaceae). Polytrichum species are known to have ethnobotanical applications as a hair growth stimulant, burn and wound healing and anti-inflammatory agents, diuretic, antipyretic, antidotal, and also for the treatment of pneumonia  + and 387.0880 [M − H] −) with UVλmax at 268 and 345 nm  was collected in the Black Forest, Germany , in April 2018 and taxonomically identified by Professor Dr. Nils Cronberg . The specimen is identical to the voucher specimen with ID no MT20211 sent for deposition at the Lund University Botanical Museum (LD). In this study, the whole plant was used for analysis.P. formosum was dried at room temperature and ground to a fine powder using a bead mill. The dried powder was homogenized in 70% ethanol (v/v) in water, methanol and ethyl acetate solvents for the extraction of small molecules. The solution (1:10 g/mL of dry weight to solvent ratio) was macerated for 30 min by rotating mixer at room temperature. After centrifugation, the supernatant was collected and used for analysis. Then, 70% ethanol and methanol extracts were diluted to the final concentrations as indicated in each experiment. The ethyl acetate extract was evaporated and the dry extract was dissolved in ethanol absolute (1:10 g/mL of dry plant weight to solvent ratio).Clostridium histolyticum  from Sigma-Aldrich was determined by the procedure previously described by Chajra et al. [50 values were calculated from the equation generated by a logarithm fit of the experimental data.Collagenase inhibition activity was measured by following the enzymatic conversion of the synthetic substrate FALGPA (N-[3-(2-Furyl)acryloyl]-Leu-Gly-Pro-Ala) purchased from Bachem (ref. 4006713.0025) to FAL (N-(3[2-Furyl]acryloyl)-Leu) + Gly-Pro-Ala (GPA). The collagenase activity from a et al. . EthylenThe mushroom tyrosinase inhibitory activity was determined by a spectrophotometric method using a microplate reader, Synergy HT (Biotek), based on Kamkaen et al.  with modTyrosinase-driven conversion of L-Tyr to dopachrome was followed by an increase in the absorbance of the samples at 475 nm for 25 minutes. All tested samples were incubated at 25 °C during the process of data acquisition. Kojic acid  was used as a positive control. The points in the linear range of the absorbance versus time plots were applied to calculate the slopes, directly proportional to tyrosinase activity. Then, the values of tyrosinase inhibition, expressed as the percent of the activity of the test samples versus the control experiment (pure solvent), were calculated for all samples according to the following equation:P. formosum to collagenase and tyrosinase was investigated by the Target Binding® technology [Clostridium histolyticum (type IA) was prepared at 1.5 mg/mL in 50 mM phosphate buffer (pH 7.5). Moreover, mushroom tyrosinase was prepared at 1.25 mg/mL in 50 mM ammonium acetate buffer. Collagenase and tyrosinase solutions were mixed with the corresponding plant extract and incubated at room temperature for 10 min and 5 min, respectively. After the incubation step, the mixtures were filtered using a 10 kDa cut-off centrifugal filter. After a series of washing steps to eliminate the unbound compounds, the target–ligand complexes were solubilized in water and the recovery of bound compounds was obtained by the addition of acetonitrile. All experiments were performed in duplicate.The affinity of the constituents from chnology , a methochnology  with few® for collagenase was performed using the analytical method containing water and 0.1% vol. of formic acid (A) and pure acetonitrile (B) in 0.5 mL/min with the gradient mobile phase of B phase as follows: 5–45% (0–12.50 min); 45–95% (12.50–17.50 min); hold at 95% (17.50–20.49 min); 95–5% (20.49–20.50); hold at 5% (20.50–22.50 min) in the Kinetex EVO C18 reverse-phase column , maintained at 40 °C. Target Binding® for tyrosinase was performed using the analytical method containing water and 0.1% vol. of formic acid (A) and pure acetonitrile (B) in 0.5 mL/min with the gradient mobile phase of B phase as follows: 5–25% (0–6 min); 25–90% (6–15.45 min); 90–95% (15.45–15.50 min) hold at 95% (15.50–18.90 min); 95–5% (18.90–19 min); hold at 5% (19–21.50 min) in the Kinetex Biphenyl reverse-phase column , maintained at 40 °C.Finally, the ligands and raw extracts were analyzed by UHPLC  with a photodiode array detector coupled to the LCMS2020 mass spectrometer (electrospray ionization in negative and positive ion mode). Target Bindingv/v) in water, three times, at 40 °C for 30 min in the ultrasound bath followed by 24 h in an agitation mixer. The combined extracts were concentrated under a vacuum at 40 °C. The dry crude extract (1.00 g) was partitioned in distilled water and ethyl acetate to concentrate and remove more polar compounds. The ethyl acetate phase was evaporated and 160 mg of dry extract was then dissolved in 2.4 mL of absolute ethanol. The solution was used to separate the compounds 1–4 by preparative liquid chromatography (LC) Armen Spot Prep II (Armen) with a C18 column . The fractions were purified using water containing 0.1% vol. of formic acid (A) and pure acetonitrile (B) with the gradient mobile phase of B of 45% (0–12.5 min), 45–70% (12.5–18 min), 70–95% (18–20 min), 95% (20–25 min) at a flow rate of 120 mL/min and an UV detection at 250 and 270 nm. The fractions containing the purified compounds 1–4 were evaporated under vacuum which provided the corresponding quantities: 1  >95%); 2  82%); 3  >95%) and 4  73%). All isolated compounds were analyzed using the HPLC Agilent 1200 system (Agilent) with an Agilent 1260 Infinity Diode array Detector (applied range: 210–600 nm) coupled to a mass spectrometer Agilent 6120 Quadrupole LC/MS , using a Vydac Denali C18 reverse-phase column  maintained at 25 °C during all analyses. The mobile phase was composed of water containing 0.1% vol. of formic acid (A) and pure acetonitrile (B), delivered at 1.5 mL/min with the gradient of B phase as follows: 45% (0–12.5 min), 45–70% (12.5–18 min), 70–95% (18–20 min), 95% (20–25 min).The dried and powdered plant (1:10 g/mL of dry weight to solvent ratio) was extracted with 70% ethanol , using water/acetonitrile mobile phase, both containing formic acid at 20 mM (phase A/B respectively). Phase B increased from 10% to 100% in 10 min, then held at 100% B for 2 min, returned to 10% in 0.1 min, and equilibrated for 2 min at a flow rate of 350 µL/min, and column temperature of 40 °C.Ultra-high performance liquid chromatography-high-resolution mass spectrometry (UHPLC-HRMS) was realized on Agilent 1290 Infinity II UHPLC (Agilent Technologies) with diode array detector (DAD) coupled to an Agilent 6545 QTOF with an electrospray ionization source. Analyses were performed in negative and positive ion mode. Compound The raw data were processed by MassHunter workstation software (Agilent Technologies), Qualitative Analysis (version B.07.00).1H and 13C chemical shifts are reported relative to TMS (δ(1H) = 0.0 ppm, (δ(13C) = 0.0 ppm) using the solvent signals as secondary reference (DMSO: δ(1H) = 2.49 ppm and δ(13C) = 39.5 ppm; acetone: δ(1H) = 2.05 ppm and δ(13C) =29.9 ppm). The HSQC spectra were acquired using a data matrix of 4096 × 1024 complex points with acquisition times of 200 and 15 ms in F2 and F1, respectively. Adiabatic bilevel 1H decoupling was employed during acquisition. The HMBC spectra were acquired using a data matrix of 4096 × 512 complex points with acquisition times of 220 and 6 ms in F2 and F1, respectively. The DQF-COSY spectra were acquired using a data matrix of 4096 × 1024 complex points with acquisition times of 220 and 53 ms in F2 and F1, respectively. NMR spectroscopic data are provided in the The presented NMR spectra were recorded on either a 600 MHz Avance III HD spectrometer equipped with a BBFO SmartProbe or an 800 MHz Avance III HD spectrometer equipped with a 5 mm TCI CryoProbe (Bruker Biospin). All compounds were designed by ChemBioDraw Ultra 14.0 while the protein file was downloaded from the protein data bank . P. formosum extracts and isolated ohioensins. Molecular docking was utilized to suggest the binding modes of the compounds inside the tested enzymes. Additional biological assays should be performed to verify the efficacy and safety of application for human use. The obtained results encourage further investigation of the active compounds from bryophytes to the cosmetic and medicinal fields. Moreover, bryophyte species are being increasingly used in biotechnological applications, especially for their advantage to grow in bioreactor-based cultivation systems [Polytrichum species, a protonema suspension culture of the species Polytrichum juniperinum was already established as a potential platform to produce bioactive compounds of interest [In conclusion, this study reports the first in vitro analysis on collagenase and tyrosinase inhibitory activities of  systems . In the interest . Therefo


The overall pelvic floor dysfunction rate in the WPHR group was lower when compared with both control groups (95% CI: 2.15–3.62 vs. 2.34–3.54 in women from PAW group and vs. 3.0–4.56 in women from WNPA group). Based on this study, it can be concluded that all of the pelvic floor related symptoms, their frequency, and severity levels do not qualify recreational horseback riding as being a risk factor for developing pelvic floor dysfunction in women.The aim of this study was to compare the condition of the pelvic floor in women who are involved in regular recreational horseback riding, with both physically active women as well as women not undertaking any recreational physical activity. Taking into account horseback riding and physical activity, 140 healthy women aged 17 to 61 were divided into three groups: women practicing horseback riding (WPHR) (46 persons), physically active women (PAW) (47 persons) and women not physically active (WNPA) (47 persons). The Australian Pelvic Floor Questionnaire (APFQ) was used to measure the extent of pelvic floor dysfunctions in women from all three groups. The lowest average values were found in the group of women practicing recreational horseback riding, and the highest in the group of women not physically active . Statistically significant intergroup differences were recorded only for the bowel function rate ( In recent years, there has been an increasing interest in horseback riding as a form of leisure and recreational activity for women in Poland. According to the data by the Polish Equestrian Federation , the numHorseback riding is a physical activity of a moderate effort at 3–6 MET, with the aerobic cost increasing as the horse speed accelerates . PositivPositive effects of horseback riding on body posture and motor skills are connected with movements of the back of the horse that forces rider’s pelvis to move. Depending on the speed of riding, these movements may almost accurately imitate pelvis movements when walking. During the slowest horse gait, the walk, the rider’s body is subjected to a rocking motion of up-down, forward-back, and right-left movements. Hence, horse movement is described as three-dimensional. When the saddle is raised, the pelvis is subjected to a retroversion, and when it falls the pelvis undergoes an anteversion, which is opposite to the direction of the saddle movement. The forward-back movement of the pelvis is superimposed by up-down and right-left movements, which in practice looks as if the ilia were moving along two ellipses, separate for the right side and the left side . During Thus, horseback riding is a form of physical activity that, more than any other physical activity, directly affects the female pelvis. This effect is both, movement-related (connected with the pelvic movements adjusted to the speed of riding), as well as sensation-related (resulting from a direct contact between the lower part of the pelvis and the saddle). Therefore, by engaging the pelvis to such an extent, horse-back riding has a significant impact on the female pelvic floor. During the vaginal electrode EMG tests, it was demonstrated that the tension of the female pelvic floor increased with the increase in the horse’s speed rate. The highest tension was recorded in the canter in a two-point position, slightly lower in the sit-position canter, and it returned to the resting state when the horse was stationary . On the A cross-sectional study investigated the occurrence of symptoms of pelvic floor dysfunctions among 140 potentially healthy women aged 17 to 61. Taking into account the horseback riding and physical activity, the analyzed women were divided into three groups: women practicing horseback riding (WPHR), physically active women (PAW) and women not physically active (WNPA). The criterion for inclusion in the group of women engaged in recreational equestrian activities was to practice horseback riding for at least one year for a minimum of 1 h per week. The criterion for inclusion in the group of physically active women was to do other forms of recreational physical activity also for at least one year for a minimum of 1 h per week. Finally, the criterion for inclusion in the group of women not physically active was lack of doing any recreational activities. The exclusion criteria for all of the three groups were as follows: poor health, chronic cardiovascular and respiratory diseases, metabolic disorders, renal diseases and mobility impairment. Women who did not know the Polish language to the extent allowing them to understand the questionnaire and answer the questions in an informed manner were also excluded from the study. In the group of women practicing horseback riding, the additional criterion for exclusion was regular recreational exercise of additional physical activity and in the group of women physically active . The enrolment process of the surveyed women is presented in Finally, 46 women aged between 17 and 61 were enrolled in the group of women systematically involved in a recreational horseback riding. In this group of women, the actual number of years of equestrian experience varied between 6 and 32 (16.1 ± 6.2) and the number of hours they spent on horseback riding was between 1 and 6 h a week (3.3 ± 1.9). A total of 47 women aged 21–60 were included in the group of physically active women, most of whom attended fitness activities (42.6%) for 1 h twice a week, did jogging (19.2% of the group) between 1 and 7 h a week or attended the gym (14.9%) one to three times a week. The group of women not physically active comprised of women aged 20–60 who declared a lack of any recreational form of physical activity taken regularly. The study was conducted using anonymous surveys. A group of women involved in recreational horseback riding was selected from all over Poland. The questionnaires were distributed during nationwide training on horseback riding, at the national conference of hippotherapists in Poznań, and among women who use the services of boarded horses in Silesia. Printed copies of anonymous surveys in the form of a stapled set comprising of a cover letter explaining the circumstances and purpose of the stilt; a survey with socio-demographic data; a questionnaire on the pelvic floor ailments; and a pen were distributed either in a white envelope marked with a stamp and a return address or in a white unmarked envelope when it was possible to return the surveys to the survey collection container. Physically active women were tested in the same way in fitness centers, gyms, swimming pools or recreational areas in parks in Upper Silesia. Women not physically active were selected from the civil servants in the voivodeship of Silesia. The survey did not specify the time required to complete the questionnaire; it was possible to return the surveys back on the same day or the next day or send them back by post.The Australian Pelvic Floor Questionnaire (APFQ)  was usedThe surveyed women completed the questionnaire anonymously and on their own. The study was authorized by the Bioethics Committee for Scientific Studies at the Jerzy Kukuczka Academy of Physical Education of Katowice. All of the study procedures were performed according to the Helsinki Declaration of Human Rights of 1975 (modified in 1983).2 test. The level of significance was set at p < 0.05.The characteristics of the participants were described by mean and standard deviation. The occurrence of pelvic floor dysfunction symptoms is presented as a percentage within the groups. Differences in the demographic parameters  and the APFQ scores were analyzed by a one-way analysis of variance (ANOVA) with the “group” as a between-subjects factor. For significant results, the post hoc Tukey’s analysis was performed. Differences in the number of childbirths and the frequency of the symptoms were analyzed by the Chip = 0.025 and PAW group p = 0.016) did not have significant impact on the values of the individual indicators of the pelvic floor dysfunction symptoms . p = 0.021). The post-hoc analysis (Tukey’s test) confirmed significantly lower values of this rate in the WPHR group (p = 0.033) and in the PAW group (p = 0.05) as compared to the WNPA group. 2 test did not reveal any statistically significant differences . (Most of the surveyed women claimed that they did not have any negative symptoms of urinary bladder or lower urinary tract function (except for the urgency symptom in the WNPA group). The surveyed women who complained of such symptoms, usually reported that these symptoms were present occasionally (score—1 point). In individual cases, some women claimed that the symptom occurred always/daily or more than 15 times (for urinary frequency) and more than 3 times (for nocturia symptoms), which were rated at 3 points. In the WPHR group, this was the case for urinary frequency (in three women), in the case of urgency (one woman), in the case of a weak stream (one woman), in the sense of incomplete bladder emptying (one woman), and in the case of dysuria (one woman). In addition, in individual cases, the highest severity of the symptoms (3 points) was reported by women in the PAW group . A similar situation was observed by the members of WNPA group, where one person reported the maximum severity with regard to the following symptoms: nocturia, stress incontinence, incomplete bladder emptying, and dysuria. For most of the symptoms rated in this part of the questionnaire, the women practicing horseback riding recreationally reported the symptoms of urinary bladder and lower urinary tract dysfunctions the least frequently. On the contrary, the women not physically active usually indicated the occurrence of such symptoms the most often. However, the Chi 0.061). .2 test showed that problems with bowel consistency were statistically significant more frequently in the women in the WNPA group as compared to the women in the WHR and PAW groups (p = 0.0045). At a level close to the statistical significance (p = 0.052), there were differences in the occurrence of obstructed defecation between the members of the PAW group and the WPHR group.  occurrence of this symptom . Only two women not physically active reported a daily (3 points) occurrence of this symptom. With regard to other bowel symptoms, it was only among the women in the WNPA group where the majority reported having such problems. These symptoms were related to the bowel consistency symptom (72.34%) and the occurrence of fecal urgency (51.06%). No women in the WPHR group reported the maximum severity of the bowel symptoms (score—3 points). Among the women in the PAW group, this applied to one case (incomplete bowel movement). Most often, the highest degree of severity was recorded among the members of the WNPA group . The ChiR group. .Amongst all of the symptoms related to the pelvic floor dysfunction, surveyed women indicated that the occurrence of prolapse symptoms was the least frequent. In both, the WPHR and PAW groups, symptoms of this type occurred in five cases , and in each case the symptoms were sporadic (APFQ score—1 point). In the WNPA group, these types of symptoms occurred in six women , and were occasional (<1/week). .2 test showed statistically significant differences (p = 0.0059). (The same number of women (5) in each of the groups were not sexually active. A similar percentage of women was sexually active most days or daily . Sexual function disorders were found in a small proportion of the respondents, with the exception of dyspareunia symptoms in the WNPA group being present in 40.42% of the women. Nobody in the WPHR or PAW groups reported a high severity of the symptoms (APFQ score —3). On the other hand, in the WNPA group, this was indicated by six women . Only for occasional coital incontinence symptoms , the Chi0.0059). .Horse riding is a physical activity that significantly engages not only the pelvis but also pelvic floor itself. However, the survey results show that recreational horseback riding does not affect the subjective sensation of the pelvic floor adversely.The assessment of the pelvic floor was applied to bladder function, bowel function, prolapse of reproductive organs, and sexual function.The movement of a horse in each gait vast majority of the time is carried out in the vertical axis (up and down), with this movement being the most clearly seen in the canter. In the trot the movement amplitude is lower, but the frequency is higher, which makes it difficult for the rider’s joints to absorb the moves in a smooth way. Jumps, as a part of physical activity, are identified by the researchers as a risk factor that may contribute to urinary incontinence in women ,23. The Bowel function of women practicing horseback riding and physically active women is very similar, whereas a greater degree of constipation is observed in the group of women not physically active. According to the studies on constipation in the group of 62,032 women aged 36–61, the occurrence of constipation depends on the level of physical activity and the diet maintained, in particular on the fiber content in the diet . StudiesThe results of the studies showed that the prolapse of pelvic organs was not a problem in any of the surveyed groups.In regard to sexual function, the women practicing horseback riding rated this function as slightly better than the women from the reference groups. However, this was not confirmed statistically. These results confirm the observations indicating that horseback riding does not have a negative impact on this area of life for female recreational horseback riders. This is in line with the results obtained by Alanee et al. .The results of this cross-sectional study indicate that recreational horseback riding performed by women does not result in increased symptoms of pelvic floor dysfunction compared with control groups. It is unknown whether such a risk could occur in women who undertake this type of activity later in life . Therefore, further study should be undertaken to assess the influence of horseback riding on the pelvic floor in the period around and after the menopause, which is critical for the appearance of dysfunction in this part of the body. It is also unknown what effect different riding techniques exert on the activity of the pelvic floor. In future studies, the pre-activity and reflex activity of pelvic floor muscles during horseback riding should therefore be analyzed, both in women with a properly functioning pelvic floor and in women with symptoms of pelvic floor dysfunction. Such study would allow to assess the possible therapeutic potential of horseback riding in relation to pelvic floor dysfunction. The results of the study show that women practicing horseback riding are not suffering from severe lower urinary tract problems and that there is no negative impact of recreational equestrianism on bowel function. Moreover, this study has demonstrated that there are no severe symptoms related to the prolapse of pelvic organs and no adverse effects on sexual function among women practicing recreational horseback riding were found. Therefore, it can be concluded that compared to women practicing other types of physical activity and physically inactive women, horseback riding does not contribute to the appearance of symptoms of pelvic floor dysfunction in women.