24-hour Profile Research Articles

Global trends in importance of 24-hour movement behaviors to pediatric health: Implications for South Korea.

Cultivating a 24-hour movement behavioral profile conducive to health and well-being, marked by adequate levels of physical activity, limited screen time, and sufficient sleep, has emerged as an important avenue for promoting pediatric health. We aimed to provide evidence of this potential, this multiphase, multimethod, and integrative review comprehensively investigated the global trends in health promotion initiatives and status of the Korean pediatric population. This integrative review comprised three phases employing various review methods: an environmental scan of existing guidelines for 24-hour movement behaviors worldwide, a rapid review of physical activity-related indicators from Global Matrix data, and a systematic review of 24-hour movement behaviors among children and adolescents in South Korea. The growing recognition of a holistic approach to the 24-hour movement behavior paradigm in pediatric health promotion has led to the establishment and adoption of 24-hour movement guidelines in different countries and by the World Health Organization (WHO). Korean health authorities have also responded to this need by releasing a translated report of the WHO guidelines for physical activity and sedentary behavior as well as the 2024 update of the Physical Activity Guidelines for Koreans. Accordingly, actions must be followed in policy, research, and practice. This is critical considering that Korean children and adolescents exhibit an unfavorable profile of 24-hour movement behaviors compared to the global average. Among those aged 0-6 years, the weighted averages for guideline adherence were 18.2% for physical activity, 38.1% for sedentary behavior, and 76.2% for sleep. For those aged 12-18 years, the weighted averages for guideline adherence were 20.4% for physical activity, 55.9% for sedentary behavior, and 26.2% for sleep. Building on these current findings, this integrative review provides three priorities for pediatric health promotion policy and practice and three recommendations for future research.

Changes in 24-hour blood pressure profile after 12 weeks of dapagliflozin treatment in patients with diabetic kidney disease: an Italian multicenter prospective study.

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) lower ambulatory blood pressure (ABP) in patients with type 2 diabetes mellitus; whether the same holds true in diabetic kidney disease (DKD) is unknown. This information is critical to the knowledge of mechanisms of nephroprotection and safety of this therapy. This multicenter prospective study evaluates the changes in ABP after 12weeks of dapagliflozin 10mg/day in a cohort of patients with type 2 DKD and glomerular filtration rate (GFR) >25mL/min/1.73 m2. Primary endpoint was the change of nighttime systolic blood pressure (SBP). Changes of daytime SBP, prevalence of normal dipping (day/night SBP ratio <0.9) and changes in ABP patterns, that is, sustained uncontrolled hypertension (SUCH), white coat uncontrolled hypertension (WUCH), masked uncontrolled hypertension (MUCH) and controlled hypertension (CH) were secondary endpoints. Eighty-three of 96 patients completed the study [age 68.7±8.9 years, 73.5% males, GFR 49±17mL/min/1.73 m2, median albuminuria: 0.18 (interquartile range 0.10-0.38) g/24h]. After 12weeks of dapagliflozin, nighttime SBP declined by -3.0mmHg (95% confidence interval -5.2/-0.8mmHg; P=.010) with an improvement of nighttime SBP goal (<110mmHg) from 18.0% to 27.0% (P<.001). Similarly, the prevalence of normal dipping increased (from 31.3% to 50.6%, P=.005). A decrease in daytime (-2.4mmHg; P=.046) and office (-7.9mmHg; P=.009) SBP was also found. The decline of ambulatory and office SBP was associated with increased prevalence of CH (from 6.0% to 18.0%) and significant improvement of SUCH, WUCH and MUCH (P=.009). Albuminuria decreased (P<.001), whereas eGFR did not change (P=.297). Urinary tract infection (4.2%) and acute kidney injury (3.6%) were the main causes of drop-out. Only one patient showed a drop of nighttime SBP below 90mmHg. Dapagliflozin is associated with improvement in circadian blood pressure rhythm with no major safety signal related to excessive blood pressure decrease.

24-hour arterial stiffness profile in asthma patients with obesity

Obesity is an important comorbidity in patients with asthma, and this combination is associated with increased cardiovascular risk.The aim of the study was to evaluate 24-hour arterial stiffness in asthma patients with excess body weight and obesity.Methods. The study included 100 patients with asthma who were divided into three groups according to their body mass index (BMI). The first group included 36 patients with normal BMI, the second – 40 patients with excess body weight, the third – 24 patients with obesity. The vascular stiffness parameters were evaluated in all patients using BPlab. Аоrtic pulse wave velocity, augmentation index, and arterial stiffness index were also assessed.Results. The 24-hour arterial stiffness, daytime and nighttime arterial stiffness values were increased in the patients with asthma and obesity. More than 80% of the asthma patients with obesity have higher pulse wave velocity in the daytime.Conclusion. Patients with bronchial asthma with obesity represent the risk of developing cardiovascular diseases and their complications.

6437 Analysis of 17-OH-Progesterone (17OHP) and Androstenedione (A4) Profiles To Rationalise Biochemical Monitoring Of CAH Patients

Abstract Disclosure: N.R. Lawrence: None. N.P. Krone: None. J.F. Dawson: None. Z. Lang: None. W. Arlt: Advisory Board Member; Self; Diurnal. A. Brac de la Perriere: Research Investigator; Self; Diurnal. A.L. Hirschberg: Research Investigator; Self; Diurnal. A. Juul: Research Investigator; Self; Diurnal. D.P. Merke: Research Investigator; Self; Diurnal. J.D. Newell-Price: Research Investigator; Self; Diurnal. A. Prete: Research Investigator; Self; Diurnal. A.E. Taylor: None. A. Rees: Research Investigator; Self; Diurnal. N. Reisch: Research Investigator; Self; Diurnal. M. Stikkelbroeck: Research Investigator; Self; Diurnal. P.A. Touraine: Research Investigator; Self; Diurnal. G. Collins: None. R.J. Ross: Consulting Fee; Self; Diurnal. Background: There is no consensus on how to monitor biochemical control of CAH as excess ACTH overnight is common on standard therapy. Modified-release hydrocortisone (MRHC) gives potential for improved disease control and the need to understand this impact on disease monitoring.Aim: To define the relationship between 17OHP and A4, in healthy controls and CAH patients. Methods: Analysis of 24-hour 2-hourly 17OHP and A4 endocrine profiles in patients randomised to either standard treatment or MRHC (n=122, mean age 36.3 (SD 11.6) years, 78 female, 44 male) and a population of healthy controls (n=20, age 30.0 (12.3), 13 male, 7 female). Markers were regressed, cross correlated and assessed by Bayesian Change Point analysis using R. Results: Regressing the natural logarithms of 17OHP on A4, Bayesian multiple change point analysis converged on a stable changepoint equivalent to 17OHP of 4.5 nmol/L 149 ng/dl (95%, CI:4.2 to 4.7 nmol/L, Rhat &amp;lt; 1.008). Below the 17OHP change point A4 is proportionally lower than above, with no evidence of difference between sexes or steroid preparation. The relationship between 17OHP and A4 was different for healthy subjects, who for similar levels of A4 have lower levels of 17OHP than CAH patients in nmol/L (ng/dl): A4 of 1 (29) and 10 (286) associated with 17OHP 1.5 (50) and 8.8 (291) in healthy subjects’ vs 3.3 (109) and 71.2 (2353) in CAH patients, respectively. There was no consistent rhythm in either marker in healthy patients, shown by an autocorrelation function (ACF) that falls quickly to zero. ACF approaches zero more quickly in CAH patients on MRHC than those on standard therapy who more commonly exhibit a diurnal rhythm with an 0700hrs peak. There was no lag between markers, with cross-correlation function plots symmetrical. Conclusions: The relationship between 17OHP and A4 is different in CAH than healthy controls. In CAH, high A4 suggests poor control but a low A4 may still be associated with a raised 17OHP. In CAH patients, 17OHP concentrations within the healthy subject range are associated with A4 below levels seen in healthy subjects. When elevated in CAH patients, A4 and 17OHP rise and fall together with no lag; thus, A4 does not give more information on control over time. On MRHC the biomarkers show a reduced diurnal rhythm; therefore, individual measurements taken in clinic are more likely to reflect the daily average than measurements taken when on standard therapy. Presentation: 6/1/2024

Behavior Reallocations Within 24-hour Movement Profiles And Postpartum Mental Health

Behavior Reallocations Within 24-hour Movement Profiles And Postpartum Mental Health

A Study on 24-hour Monitoring of Blood Pressure in Acute Stroke and Its Correlation with Short Term Neurological Outcome.

The association between blood pressure (BP) at admission and clinical outcomes in patients with acute stroke has been investigated; however, results from these studies are contradictory. Hence, we designed this study to monitor circadian variation of BP in acute stroke and study its correlation with neurological outcome. A total of 108 cases of acute stroke (both ischemic and hemorrhagic) admitted within 24 hours were included in the study. On admission, three casual supine BP measurements were taken at 5-minute intervals, and the mean value was recorded. Ambulatory BP monitoring (ABPM) was done on day 1, and all the BP variables were recorded. On the day of admission, the functional status of all the cases was assessed using the Modified Rankin Scale (MRS 0-6). On day 6, again, three casual BP measurements were taken, and MRS was done. The 24-hour BP profile and neurological outcome were correlated on day 1 and day 6. On follow-up at 1 month, all the patients were thoroughly examined, and MRS was done to reassess the functional status post stroke. Circadian variation of BP shows that the majority of our cases were nondippers, followed by reverse dippers and dippers. It was seen that a higher mean 24-hour systolic BP (SBP), daytime SBP, as well as nighttime SBP, were all significantly associated with a poorer MRS score (4-6) both at day 6 and 1 month. Similarly, a higher mean value of the casual SBP, as well as diastolic BP (DBP) readings obtained on day 1 of stroke, adversely affected the outcome in terms of MRS scores both at day 6 and 1 month. It was also seen that the higher mean values of both the casual SBP and DBP readings obtained on day 6 of stroke adversely affected the outcome in terms of MRS scores at 1 month. A higher mean 24-hour SBP, mean daytime SBP, and mean nighttime SBP were associated with poor neurological outcomes at day 6 and 1 month.

Aerobic Exercise Training Protects Against Insulin Resistance, Despite Low-Sodium Diet-Induced Increased Inflammation and Visceral Adiposity.

Dietary sodium restriction increases plasma triglycerides (TG) and total cholesterol (TC) concentrations as well as causing insulin resistance and stimulation of the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system. Stimulation of the angiotensin II type-1 receptor (AT1) is associated with insulin resistance, inflammation, and the inhibition of adipogenesis. The current study investigated whether aerobic exercise training (AET) mitigates or inhibits the adverse effects of dietary sodium restriction on adiposity, inflammation, and insulin sensitivity in periepididymal adipose tissue. LDL receptor knockout mice were fed either a normal-sodium (NS; 1.27% NaCl) or a low-sodium (LS; 0.15% NaCl) diet and were either subjected to AET for 90 days or kept sedentary. Body mass, blood pressure (BP), hematocrit, plasma TC, TG, glucose and 24-hour urinary sodium (UNa) concentrations, insulin sensitivity, lipoprotein profile, histopathological analyses, and gene and protein expression were determined. The results were evaluated using two-way ANOVA. Differences were not observed in BP, hematocrit, diet consumption, and TC. The LS diet was found to enhance body mass, insulin resistance, plasma glucose, TG, LDL-C, and VLDL-TG and reduce UNa, HDL-C, and HDL-TG, showing a pro-atherogenic lipid profile. In periepididymal adipose tissue, the LS diet increased tissue mass, TG, TC, AT1 receptor, pro-inflammatory macro-phages contents, and the area of adipocytes; contrarily, the LS diet decreased anti-inflammatory macrophages, protein contents and the transcription of genes related to insulin sensitivity. The AET prevented insulin resistance, but did not protect against dyslipidemia, adipose tissue pro-inflammatory profile, increased tissue mass, AT1 receptor expression, TG, and TC induced by the LS diet.

Value of proprotein convertase subtilisin/kexin type 9 and inflammatory markers in the diagnosis of carotid atherosclerosis in hypertensive men

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is involved in lipid metabolism, has local and systemic effects in immunoregulation and atherogenesis in hypertensive patients.Aim. To personalize cardiovascular risk (CVR) stratification taking into account the diagnostic value of PCSK9 and inflammatory markers in men with hypertension and carotid atherosclerosis.Material and methods. The study included 162 males with stage I-III hypertension of various CVR. All patients underwent collection of complaints and medical history, physical examination with anthropometry. The following laboratory test were performed: complete blood count with white blood cell differential and erythrocyte sedimentation rate, assessment of fibrinogen, C-reactive protein (CRP), total cholesterol, low-density lipoprotein cholesterol, triglycerides, blood glucose, serum creatinine level. Glomerular filtration rate and microalbuminuria were also evaluated. Serum PCSK9, interleukins-8, 10 (IL-8, 10) were determined by enzyme immunoassay. In addition, 24-hour blood pressure monitoring, extracranial artery ultrasound with determination of intima-media thickness and carotid stenosis severity were performed. Patients were divided into 3 groups according to PCSK9 level.Results. Analysis of conventional cardiovascular factors and cytokine status (IL-8 and IL-10) in patients showed an inverse relationship between age and IL-8 (r=-0,230; p=0,036), IL-8/IL-10 (r=-0,309; p=0,005); heredity and IL-8/IL-10 (r=-0,423; p=0,001). There were following relationships between CVR factors and PCSK9: direct relationship between men's age (r=0,220, p=0,032), systolic and diastolic blood pressure (r=0,230, p=0,033; r=0,260, p=0,015) and PCSK9; inverse relationship between PCSK9 and heredity (r=-0,286, p=0,011). C-reactive protein and erythrocyte sedimentation rate were associated with IL-10 levels, which are associated with anti-inflammatory activity (r=0,78; p=0,02; r=0,78; p=0,02, respectively). The IL-8/IL-10 cytokine imbalance was most pronounced in patients with a night-peaker 24-hour systolic blood pressure profile (p=0,02). Patients with intima-media thickening and plaques had a highest level of PCSK9 (p=0,006). IL-8 levels were significantly higher with unchanged intima-media thickness (p=0,01).Conclusion. In patients with high levels of PCSK9, there is a close relationship between risk factors for hypertension and cytokine imbalance. The severity of extra­cranial artery atherosclerosis significantly depends on the increase in the levels of PCSK9 (p=0,006) and inflammatory markers (IL-10) (p=0,044).

Indicators of plasma hemostasis in hypertensive patients of different age groups

Background. Scientific works of several authors determine age-related differences in hemocoagulation hemostasis. Thus, in older people, changes in hemovascular hemostasis are noted with impaired vasomotor, anticoagulant and fibrinolytic activity of the endothelium. Anticoagulant system disorders increase with age. There are few studies on plasma hemostasis in arterial hypertension patients, especially in older age groups. Aim: The study aimed at a complex research and comparative assessment of the plasma state hemostasis parameters in older and middle-aged hypertensive patients. Materials and methods. 134 patients who were divided into 2 groups were examined. Group I (n = 65) – the older hypertensive patients (60 - 74 years); group II (n = 69) – the middle-aged hypertensive patients (45 - 59 years) respectively. 15 people were involved in the control for each of the studied groups (group III – the older persons and group IV – the middle-aged persons) comparable to the main in terms of age and sex. They were divided into 2 groups of 24-hour day profile of blood pressure: dippers and non-dippers. Fibrinogen (g/l) was determined on an Amelung KC 1A hemocoagulometer to assess the plasma hemostasis state. The fibrinolytic activity of plasma (min) was according to the Kowalski method, antithrombin III (%) with the help of Humalyzer Junior filter photometer. Results. When comparing the plasma hemostasis indicators in the older and the middle-aged patients the value of antithrombin III in the middle-aged persons exceeded the similar indicator in the older persons. That is, in older patients, on the contrary, suppression of fibrinolytic and anticoagulant activity is noted. A significant slowing of the indicator of fibrinolysis activity was found in the middle-aged patients of the dipper group compared to the control group. A significant decrease in the fibrinogen level was found in the older patients in the dipper group and its increase in the non-dipper group relative to the control. The level of the antithrombin III significantly decreased in the non-dipper group compared to normative indicators. Conclusions. 1. The significant decrease in anticoagulant activity against the background of suppressed fibrinolysis according to indicators of the plasma hemostasis of the older patients was noted. 2. The thrombogenicity of blood plasma revealed by us during the study of plasma hemostasis indicates the high probability of thrombotic complications developing in patients. _________________________________________________________________________________________ Keywords: arterial hypertension; essential hypertension; plasma hemostasis; fibrinogen; fibrinolytic activity of plasma; antithrombin III

#2827 Beyond the scale: unveiling the kidney stone risk after bariatric surgery

Abstract Background and Aims Nephrolithiasis is a prevalent condition, with calcium oxalate being the primary component found in kidney stones. Both obesity and gastric bypass surgery pose as risk factors for nephrolithiasis. Malabsorptive bariatric procedures alter 24-hour urine profiles, leading to increased urinary oxalate and reduced urinary citrate levels. This study aims to evaluate the risk factors for calcium oxalate lithiasis in a population after gastric bypass surgery at our center. Method We performed a monocentric retrospective study to evaluate hyperoxaluria and urinary lithiasis in patients who underwent gastric bypass surgery between 2020 and 2021. We assessed urinary oxalate excretion, urinary citrate excretion, and urinary sodium excretion between 4 and 28 months after surgery. To confirm the adequacy of the collection, a comparison was made with the expected urinary creatinine value (20 to 25 mg/kg ideal weight for men and 15 to 20 mg/kg ideal weight for women). We developed a risk score: citraturia &amp;lt; 288 mg/24 h (1 point); oxaluria &amp;gt; 45 mg/L (1 point) and natriuresis &amp;gt; 97.75 mmol/24 h (1 point). Patients were classified as without risk (0 points), at low risk (1 point), at high risk (2 points), and at very high risk (3 points). Additionally, the patients’ historical incidence of lithiasis was examined, both preoperatively and postoperatively, using clinical records. Post-surgery assessments included imaging evidence of lithiasis (when available) or clinical episodes of renal colic. Results Fifty-six patients underwent a 24-hour urine collection. Twenty-two were excluded due to incomplete urine collection, determined by the expected urinary creatinine value and a time lapse exceeding 28 months between surgery and analytical assessment. The median time elapsed between surgery and analytical evaluation was 9.5 months [IQR 6.3 - 12] months. A total of 34 patients were included in the study, 8.8% were male and the median age of the patients was 51.5 [IQR 42.3–57.8] years. The median body mass index decreased from 43.1 [IQR 39.7–46.3] kg/m2 before to 31.8 [IQR 28.6–35.7] kg/m2 six months after surgery. The low risk for calcium oxalate lithiasis in the examined patient sample was 52.9% (n = 18); high risk 20.6% (n = 7), no risk 26.5% (n = 9) and very high risk 0%. We detected 3 (8.8%) patients with concentration hyperoxaluria, 20 (58.8%) patients with natriuresis &amp;gt; 97.75 mmol/24 h and 8 (23.5%) patients with reduced urinary citrate levels. All patients exhibited normal kidney function. The median follow-up duration was 27 months. Out of the total number of patients, only 3 reported renal colic episodes, and imaging evidence of lithiasis was found in just 2 of them before surgery. Among those with a risk score &amp;gt; 0, only 1 had a history of lithiasis. Throughout the follow-up period, none of the patients experienced new lithiasis post-surgery. Regarding the limitations of our study, we highlight the relatively brief duration of follow-up, which may pose challenges in comprehensively evaluating outcomes such as lithiasis. Additionally, the absence of imaging screening represents a notable constraint, impeding the comprehensive assessment of patients with asymptomatic lithiasis. Conclusion This study concludes that within the bariatric surgery population, a specific subgroup is at an elevated risk for renal lithiasis. Recognizing this subgroup promptly and instituting heightened preventive measures may prove advantageous within this demographic.

Reliability assessment of dynamic line rating methods based on conductor temperature estimation

Dynamic line rating techniques are increasingly prevalent in the computation of ampacity for overhead transmission lines. Some of these methods, commonly employed by system operators, rely on real-time measurements to calculate conductor temperature, either directly or indirectly. Despite their widespread usage, the susceptibility of these techniques to measurement errors has been largely disregarded in prior research. In this regard, this paper includes a groundbreaking reliability analysis addressing the impact of measurement errors on various dynamic line rating techniques in overhead lines, based on conductor temperature estimation. Two case studies are presented, incorporating typical errors from simulations. The first case study adopts a standard 24-hour profile for the variables involved in the conductor ampacity calculation. In the second study, Monte Carlo simulations are conducted, in which meteorological variables are randomly assigned with five load levels to evaluate the current’s influence on measurement noise sensitivity. The resulting ampacity errors across all methods considered are remarkably high, with mean values exceeding 150% in specific scenarios. This unequivocally demonstrates that the commonly accepted levels of measurement accuracy in these widely used rating techniques yield estimations falling far below acceptable reliability standards.

Thermoelectric power generation system intelligent Runge Kutta control: A performance analysis using processor in loop testing

As an emerging source of clean electrical power, Thermoelectric generation (TEG) finds its applications in heat removal and electricity generation as an efficient improvement tool for thermal devices utilizing fossil fuels. TEG exhibits low power density and its temperature distribution is usually non-uniform over thermal conductive surfaces. Due to the non-uniformity of heat flow and loose surface contact, non-uniform temperature distribution (NTD) appears on TEG surfaces and the TEG control problem becomes complex, multi-solution, nonlinear, and highly sensitive to operating conditions. The bypass diode activation of TEG systems streamlines the power flow in a string of series-connected modules, generating multiple peak points. Classical techniques fail to address these issues of multiple maxima and lose efficiency. To solve this problem, a novel SI-based optimization algorithm, Runge Kutta Method (RUN), is applied as MPPT control. To gauge the performance of the proposed controller several distinct case studies are used, including varying temperatures gradient, NTD, 24-hour thermal profile stochastic temperature, and experimental verification. Additionally, MPPT rating analysis, economic assessment, and statistical studies are done for comparison with other state-of-the-art control techniques. The minimum tracking and settling times have been improved by RUN to 180 ms. For the additional hardware implementation, the maximum levelized cost of energy (LCOE) is about 0.16 $kWh1.07¥kWh. The power tracking efficiency of RUN can be above 99 % with energy harvest improvements of 6.3 %.

Exploring an objective measure of overactivity in children with rare genetic syndromes

BackgroundOveractivity is prevalent in several rare genetic neurodevelopmental syndromes, including Smith-Magenis syndrome, Angelman syndrome, and tuberous sclerosis complex, although has been predominantly assessed using questionnaire techniques. Threats to the precision and validity of questionnaire data may undermine existing insights into this behaviour. Previous research indicates objective measures, namely actigraphy, can effectively differentiate non-overactive children from those with attention-deficit hyperactivity disorder. This study is the first to examine the sensitivity of actigraphy to overactivity across rare genetic syndromes associated with intellectual disability, through comparisons with typically-developing peers and questionnaire overactivity estimates.MethodsA secondary analysis of actigraphy data and overactivity estimates from The Activity Questionnaire (TAQ) was conducted for children aged 4-15 years with Smith-Magenis syndrome (N=20), Angelman syndrome (N=26), tuberous sclerosis complex (N=16), and typically-developing children (N=61). Actigraphy data were summarized using the M10 non-parametric circadian rhythm variable, and 24-hour activity profiles were modelled via functional linear modelling. Associations between actigraphy data and TAQ overactivity estimates were explored. Differences in actigraphy-defined activity were also examined between syndrome and typically-developing groups, and between children with high and low TAQ overactivity scores within syndromes.ResultsM10 and TAQ overactivity scores were strongly positively correlated for children with Angelman syndrome and Smith-Magenis syndrome. M10 did not substantially differ between the syndrome and typically-developing groups. Higher early morning activity and lower evening activity was observed across all syndrome groups relative to typically-developing peers. High and low TAQ group comparisons revealed syndrome-specific profiles of overactivity, persisting throughout the day in Angelman syndrome, occurring during the early morning and early afternoon in Smith-Magenis syndrome, and manifesting briefly in the evening in tuberous sclerosis complex.DiscussionThese findings provide some support for the sensitivity of actigraphy to overactivity in children with rare genetic syndromes, and offer syndrome-specific temporal descriptions of overactivity. The findings advance existing descriptions of overactivity, provided by questionnaire techniques, in children with rare genetic syndromes and have implications for the measurement of overactivity. Future studies should examine the impact of syndrome-related characteristics on actigraphy-defined activity and overactivity estimates from actigraphy and questionnaire techniques.

Twenty-four hour physical activity, sedentary behaviour and sleep profiles in adults living with rheumatoid arthritis: a cross-sectional latent class analysis

BackgroundRheumatoid Arthritis (RA), an autoimmune systemic inflammatory disease, affects more than 17 million people globally. People with RA have higher risk of premature mortality; often experience chronic fatigue, pain and disrupted sleep; and are less physically active and more sedentary than healthy counterparts. It remains unclear how people with RA may balance sleep and awake movement activities over 24-hours, or how differences in 24-hour behaviours may be associated with determinants of health, or alignment with published activity guidelines.MethodsCross-sectional exploration of objective measures of 24-hour sleep-wake activities in 203 people with RA. Latent Class Analysis (LCA) derived classes from time, by tertile, in six sleep-awake activities over 24 h. Comparisons of model fit statistics, class separation and interpretability defined best fit for number of classes. Variations in sleep-awake behaviour across classes and association of profile allocation with determinants of health, quality metrics for sleep, sitting and walking and alignment with published guidelines were explored. Multinomial logistic regression identified factors associated with likelihood of profile allocation.ResultsLCA identified 2 to 6 classes and a 4-class model was determined as best fit for 24-hour sleep-awake behaviour profiles. One profile (26%) presented with more balanced 24-hour sleep, sitting and walking behaviours. The other three profiles demonstrated progressively less balanced 24-hour behaviours including: having low (< 7 h), high (> 8 h), or recommended (7–8 h) sleep duration in respective combination with high sitting (> 10 h), limited walking (< 3 h) or both when awake. Age, existing sitting and walking habit strength and fatigue were associated with likelihood of belonging to different profiles. More balanced 24-hour behaviour was aligned with better quality metrics for sleep, sitting and walking and published guidelines.DiscussionFor people living with RA it is important to understand the ‘whole person’ and their ‘whole day’ to define who may benefit from support to modify 24-hour sleep-awake behaviours and which behaviours to modify. Supports should be informed by an understanding of personal or health-related factors that could act as barriers or facilitators for behavioural change, including exploring existing habitual sitting and walking behaviours.Trial registrationsClinicalTrials.gov ID: NCT02554474 (2015-09-16) and ClinicalTrials.gov ID: NCT03404245 (2018-01-11)

Sleep quality and cardiovascular risk in the watch setting in the Far North

Background. The study shows gender differences in sleep quality and also association of sleep disturbances (SD) with cardiovascular diseases (CVD). The watch work contributes to the biorhythms of the body disorders, including SD. Autonomous nervous system is the key regulator of circadian rhythms.Aim: To study sleep quality (SQ) in the gender aspect and cardiovascular risk in the workers of the Far North watch.Material and methods. In Yamburg, the settlement in the Far North (68° 21’ 40” north latitude), 99 males (M) and 81 females (F) with SD and normal sleep, comparable in age, northern experience, level of office blood pressure (BP) were examined. SQ analysis was conducted according to the questionnaire (Pittsburg Sleep Quality Index – PSQI). 24-hour BP monitoring, biochemical blood analysis, ultrasound examination of the carotid arteries, echocardiography, and assessment of autonomic changes was performed.Results. M significantly more often than F assessed their sleep subjectively better (p = 0.046); M and F with SD had elevated variability of systolic BP at night (p = 0.036; p = 0.039), BP 24-hour profile disorder did not depend on SQ (p = 0.2607), SD in both genders was accompanied by the increase of volumes and indices of left atrium (p = 0.0285; p = 0.0445), enhanced probability of left ventricle diastolic dysfunction for 1.9 times. SD in F enhanced the level of insulin (p = 0.0267), С-peptide (p = 0.0424), NTpro-BNP (p = 0.042) and was accompanied by autonomic dysfunction.Conclusion. In the conditions of the Arctic watch, SD is often revealed in F, is accompanied by the signs of autonomic dysfunction, more evident in F. 24-hour BP profile disorder typical for the watch work is not connected with SQ and more evident in M. SD in both genders is associated with atrial remodeling, the formation of diastolic dysfunction, but an increase in the frequency of atherosclerotic lesions of the carotid arteries, an increase in vascular inflammation factors, metabolic disorders, and neurohumoral activation, more pronounced in F, which may determine an increased risk of CVD in F in Arctic watch work conditions.

Clinical profile, dietary zinc content, and lifestyle habits of adult male and female hbss and hbsc patients

Objective: Males and females have been reported to show significant variation with respect to clinical profile of sickle cell disease (SCD) (e.g. cardiovascular, musculoskeletal and chronic end-organ complications). Clinical features of SCD are also influenced by lifestyle and dietary habits. Thus, the study was conducted to examine whether the distributions of other manifestations (e.g. priapism, pain frequency, leg ulcers rates) and habits (lifestyle, dietary) of SCD patients in Osun state, Nigeria are influenced by gender or genotype.&#x0D; Material and methods: Questionnaires were administered to obtain information on age, gender, concoction/herbal preparations, and fruit/vegetable consumption, as well as zinc contents of 24-hour meal recall, physical exercise, lifestyle parameters and clinical profile of SCD. Descriptive (relative frequency) and inferential (Chi-square (χ2) test of independence) statistics were employed. Statistical significant was set at p&lt;0.05.&#x0D; Results and discussion: HbSS rather than HbSC showed higher distributions of pain frequency and more frequent hospitalization rates at p= .001 and p=.001 respectively. There was no significant relationship between hemoglobin genotype and the following variables: leg ulcers, priapism, fruit intake, herb/concoction consumption, 24-hour dietary zinc content. Moreover, all the variables were not influenced by gender not only among HbSS but also HbSC patients.&#x0D; Conclusion: There are indications from data obtained that clinical profile of SCD such as priapism, leg ulcers, high hospitalization rates and pain episodes are present among HbSS and HbSC SCD patients in Osun state Nigeria. Although only pain episodes and hospitalization rates were significantly higher among HbSS than HbSC, for either variable though there was no gender bias in its distribution. Similarly the distributions of other variables (such as exercise, dietary, etc) for each of SCD (HbSS, HbSC) categories were not influenced by gender.&#x0D; Bangladesh Journal of Medical Science Vol. 23 No. 01 January’24 Page : 74-82

Effects of a Novel Glucokinase Activator, Dorzagliatin, on Glycemic Control and Glucose Fluctuation in Drug-Naïve Patients with Type 2 Diabetes Mellitus.

The prevalence rate of type 2 diabetes mellitus (T2DM) has been increasing and a large proportion of patients still do not achieve adequate or sustainable glycemic control on the basis of previous hypoglycemic treatment. In this present study, we explored whether dorzagliatin, a novel glucokinase activator (GKA), could improve glycemic control and lessen glucose fluctuation in drug-naïve patients with T2DM. A self-comparative observational study of 25 drug-naïve patients with T2DM (aged 18-75 years and HbA1c of 7.5%-11.0%) treated with dorzagliatin 75 mg twice daily for 52 weeks. Before and after dorzagliatin intervention, the serum levels of hemoglobin A1c (HbA1c), insulin, and C-peptide were measured repeatedly during fasting and after a mixed meal. The continuous glucose monitoring (CGM) device was also used to obtain 24-hour glucose profiles and assess the changes in glycemic variability parameters. After 52 weeks of treatment with dorzagliatin, a numerally greater reduction in HbA1c of 1.03% from the baseline was observed in patients with T2DM, accompanied by significant improvement in insulin resistance and insulin secretion. Moreover, the standard deviation of blood glucose (SDBG) and the mean amplitude of glycemic excursion (MAGE) derived from CGM data were significantly decreased after dorzagliatin therapy. The 24-h glucose variation profile showed that study patients had obviously lower mean glucose levels during the postprandial period from the baseline to week 52, an effect also demonstrated by the significant decrease in the incremental area under glucose concentration versus time curve for 2 h (iAUC0-2 h) after meals. This study suggests that dorzagliatin therapy could effectively improve glycemic control and glucose fluctuation in drug-naïve patients with T2DM.

Temperature status of domestic refrigerators and its effect on the risk of listeriosis from ready-to-eat (RTE) cooked meat products

Inadequate domestic refrigeration is frequently cited as a factor that contributes to foodborne poisoning and infection, and consumer behaviour in this regard can vary largely. This study provides insight into the temperature profiles of domestic refrigerators in the Netherlands and the impact on the number of listeriosis cases related to ready-to-eat (RTE) cooked meat products. A survey was conducted among Dutch consumers (n = 1020) to assess their knowledge and behaviour related to refrigerators. Out of these participants, 534 measured their refrigerator's temperature, revealing an average temperature of 5.7 °C (standard deviation (SD) of 2.2 °C) with a maximum of 17 °C. Elderly people (65 years and older) had refrigerators with temperatures that were on average 0.6 °C higher than those of younger people (35 years or younger). The 24-hour temperature profiles of an additional set of actively surveyed refrigerators (n = 50) showed that the temperature measured on the upper shelf was significantly higher (mean 7.7 °C, SD 2.7 °C) than the temperature measured on the bottom shelf (5.7 °C, SD 2.1 °C). Quantitative Microbiological Risk Assessment (QMRA) predicted that the primary factors contributing to the risk of listeriosis were the initial concentration and the time and temperature during household storage. Scenario analysis revealed that storing opened RTE cooked meat products at home for either <7 days or at temperatures <7 °C resulted in a significant reduction of over 80 % in predicted illness cases. Among all illness cases, the elderly represented nearly 90 %. When assessing the impact of the disease in terms of Years of Life Lost (YLL), the contribution of the elderly was 59 %. Targeted communication, particularly directed towards the elderly, on the importance of storing RTE cooked meat products at the recommended temperature on the bottom or middle shelf as well as consuming within two to three days after opening, holds the potential to significantly reduce the number of cases.

Glycemic Variability and Its Correlation with Large for Gestation-age Babies in Gestational Diabetic Pregnancies.

Although glycemic variability (GV) has been shown to be associated with endothelial dysfunction in diabetes mellitus (DM), there is a dearth of literature on its correlation in gestational diabetic pregnancies. To compare GV and 24-hour ambulatory glucose profile (AGP) in gestational diabetic pregnancies with and without large for gestation-age (LGA) babies. It was a cross-sectional observational study. A total of 40 pregnant females between 19 and 35 years with gestational DM (GDM) controlled on pharmacotherapy fulfilling inclusion criteria were recruited. A flash glucose monitor (FGM) was used to record AGP between 32 and 36 weeks of gestation in these women. A total of 400 patient days with 38,400 glucose values in the study group were analyzed. Various glucose measures were compared between the GDM pregnancies with or without LGA babies. The incidence of LGA was 15% in these pregnant women who were on pharmacotherapy and apparently controlled as evidenced by self-monitoring of blood sugar values. All the parameters of 24-hour AGP except dinner values were significantly high in the LGA group when compared with the non-LGA group [mean amplitude of glycemic excursion (MAGE) LGA vs non-LGA 74.58 ± 16.83 vs 49.86 ± 12.83 mg/dL, p = 0.002; standard deviation (SD) LGA vs non-LGA 30.19 ± 9.69 vs 20.10 ± 5.97 mg/dL, p = 0.001]. Variables of GV: MAGE and SD were significantly high in the LGA group (p < 0.001). Time below range (TBR) and time above range (TAR) were also significantly altered in the LGA group (p < 0.001). High GV and time in the range are the important parameters that can be well correlated with LGA babies in gestational diabetic pregnancies on pharmacotherapy. An FGM is a good monitoring device to measure this parameter and can be used as an adjunct to modify measures to control the glucose values within range in these pregnancies.

Temporal dynamics of muscle mitochondrial uncoupling-induced integrated stress response and ferroptosis defense.

Mitochondria play multifaceted roles in cellular function, and impairments across domains of mitochondrial biology are known to promote cellular integrated stress response (ISR) pathways as well as systemic metabolic adaptations. However, the temporal dynamics of specific mitochondrial ISR related to physiological variations in tissue-specific energy demands remains unknown. Here, we conducted a comprehensive 24-hour muscle and plasma profiling of male and female mice with ectopic mitochondrial respiratory uncoupling in skeletal muscle (mUcp1-transgenic, TG). TG mice are characterized by increased muscle ISR, elevated oxidative stress defense, and increased secretion of FGF21 and GDF15 as ISR-induced myokines. We observed a temporal signature of both cell-autonomous and systemic ISR in the context of endocrine myokine signaling and cellular redox balance, but not of ferroptotic signature which was also increased in TG muscle. We show a progressive increase of muscle ISR on transcriptional level during the active phase (night time), with a subsequent peak in circulating FGF21 and GDF15 in the early resting phase. Moreover, we found highest levels of muscle oxidative defense (GPX and NQO1 activity) between the late active to early resting phase, which could aim to counteract excessive iron-dependent lipid peroxidation and ferroptosis in muscle of TG mice. These findings highlight the temporal dynamics of cell-autonomous and endocrine ISR signaling under skeletal muscle mitochondrial uncoupling, emphasizing the importance of considering such dissociation in translational strategies and sample collection for diagnostic biomarker analysis.