Functional Health Research Articles

Modified 5-Item Frailty Index (mFI-5) may predict postoperative outcomes after pancreatoduodenectomy for pancreatic Cancer.

Pancreatic Ductal Adenocarcinoma (PDAC) primarily affects older individuals with diminished physiological reserves. The Modified 5-Item Frailty Index (mFI-5) is a novel risk stratification tool proposed to predict postoperative morbidity and mortality. This study aimed to validate the mFI-5 for predicting surgical outcomes in patients undergoing pancreatoduodenectomy (PD) for PDAC. Our retrospective PDAC database included patients who underwent PD between 2014 and 2023. Patients were stratified by mFI-5 scores (0 best - 5 worst), which assess preoperative CHF, diabetes mellitus, history of COPD or pneumonia, functional health status, and hypertension requiring medication. Associations between mFI-5 scores and outcomes, including postoperative complications and mortality, were analyzed using logistic regression, Cox proportional hazards models, and Kaplan-Meier survival analysis. Among 250 PDAC patients undergoing PD, 142 (56.8%) had mFI-5 scores ≤ 1, and 25 (10%) had scores ≥ 3. No patients had scores > 4. Higher mFI-5 scores correlated with older age (p < 0.001) and tobacco use (p = 0.036). Multivariate analysis identified age (RR 1.02, p = 0.038), ASA class (ASA III; RR 2.61, p < 0.001; ASA IV; RR 2.63, p = 0.026), and moderate alcohol consumption (RR 0.56, p = 0.038) as frailty predictors. An mFI-5 score > 2 independently associated with higher mortality (HR 2.08, p = 0.026). Median overall survival was significantly lower for patients with mFI-5 scores > 2 than for those with scores ≤ 2 (21.3 vs. 42.1 months, p = 0.022). The mFI-5 is a valuable tool for predicting postoperative morbidity and mortality in PDAC patients undergoing PD. Integrating frailty assessment into preoperative evaluations can enhance patient selection and surgical outcomes. Future research should focus on incorporating frailty assessments into surgical planning and patient management to improve outcomes in this vulnerable population.

Chronic stress and functional health in older adults with concerns about falling: a study protocol of a randomized controlled trial with multicomponent exercise intervention (FEARFALL)

BackgroundMaintenance of physical function, mobility, and independent living are important goals for older adults. However, concerns about falling (CaF) play a central role in the vicious cycle of CaF, inflammation, loss of muscle mass, and decreasing physical function ultimately resulting in negative health outcomes. CaF, like other states of chronic stress and anxiety, can be considered as enduring adverse stimuli affecting the stress systems and the inflammatory system. Therefore, the aim of this study is to investigate whether a reduction of CaF leads to a reduction of stress and therefore possibly reduces chronic low-grade inflammation. Understanding the role and directionality of the effects of inflammation on CaF increases our understanding of age-related loss of mobility and physical function.MethodsIn this study, community-dwelling older adults, aged 70 years and older, will be randomly assigned to either a 4-month, multi-component intervention with exercise training and cognitive-behavioral components or to a sham control group with light stretching exercises, cognitive training, and educational health lectures. For the operationalization of specific CaF, the Falls Efficacy Scale—International will be used. Stress and related psychological symptoms will be monitored using established self-reports and by measuring salivary cortisol. Concentrations of C-reactive protein, interleukin 6, interleukin 10, and tumor-necrosis-factor-alpha, as well as gene expression of selected inflammatory transcripts, will be used as surrogate parameters of the inflammatory status at baseline, after the 4-month intervention and 8-month follow-up.DiscussionThis study will be the first to test whether CaF are related with stress system activity or reactivity or with markers of inflammation in the context of a multi-component intervention with exercise training and cognitive-behavioral components addressing CaF. The reduction of specific CaF or general psychological symptoms should reverse alterations in stress systems, and / or slow down low-grade inflammation. Changes in activity, as well as psychological and biological pathways leading from CaF to muscle loss will be measured, to disentangle the individual contribution to sarcopenia, and to provide an additional pathway to break or slow-down the vicious cycle of CaF and sarcopenia.Trial registrationGerman Clinical Trials Register (DRKS): DRKS00029171. Registered 22 July 2022.

Effect of Media Formulations on Chlorophyll, Antioxidant Activity of Chlorella vulgaris and Its Potential as a Health Supplement

Graphical Abstract Highlight Research Chlorella indigenous from waters of Rokan River estuary was identified. The using of 4 chemicals KNO3, KH2PO4, MgSO4.7H2O and FeSO4.7H2O can reduce production cost and obtain an optimal medium formulation. The manipulated media was obtained can replace the commercial media of Chlorella Chlorella vulgaris contains high antioxidant activity. Abstract Chlorella is a microalga that is rich in chlorophyll and antioxidants so it has the potential to be a functional food or health supplement, however, the quality of Chlorella depends on the nutrient composition in cultivation. The research aimed to evaluate the effect of different formulations in Chlorella cultivation on the content of chlorophyll a, chlorophyll b, total chlorophyll, carotenoids and antioxidants. Furthermore, to analyze the profile of amino acids, fatty acids and secondary metabolism in the best formulation. The experimental design used was a non-factorial Completely Randomized Design (CRD) with 5 formulations in Chlorella cultivation: control, F-1, F-2, F-3, and F-4 by manipulating the use of 4 chemicals: KNO3, KH2PO4, MgSO4.7H2O and FeSO4.7H2O. The data obtained were analyzed descriptively and analysis of variance (ANOVA). The results showed that F-1 treatment with the use of 1.50 KNO3, 1.25 KH2PO4, 1 MgSO4.7H2O and 0.0498 FeSO4.7H2O (g L-l) was the best treatment with the content of chlorophyll a 38.19 µg/mL, chlorophyll b 41.45 µg/mL, total chlorophyll 79.65 µg/mL, carotenoids 0.08 µg/mL, and antioxidants activity 49.52 mg/L (strong) which is the same as the control treatment. In addition, Chlorella cultivated with the F-1 formula has 17 amino acid profiles with a total of 301.52 mg/g, 7 fatty acids 84.32 mg/g, and secondary metabolites, namely alkaloid 109.471 mg/L, flavonoid 82.111 mg/L, saponin 1342.222 mg/L, tannin 411,591 mg/L, and phenolic 151.889 mg/L. Therefore, the F-1 formulation can be developed for large-scale Chlorella cultivation and applied as a health supplement.

Application Value of Iodine-131 Combined with Levothyroxine Sodium in Patients with Differentiated Thyroid Cancer after Surgery

Introduction: This study aimed to evaluate the clinical value of iodine-131 combined with levothyroxine sodium in the treatment of patients with differentiated thyroid cancer (DTC) after surgery. Methods: Prospective randomized controlled studies were conducted. A total of 374 DTC patients who underwent total or near-total thyroidectomy in the Department of Thyroid Surgery, Tianjin Union Medical Center and Tianjin Medical University General Hospital, from January 2019 to February 2022 were selected and divided into control group (187 cases) and observation group (187 cases) according to random number table method. The control group was treated with levothyroxine sodium after surgery, and the observation group was treated with iodine-131 on the basis of the control group. Gender, age, course of disease, tumor diameter, pathological type, TNM classification, treatment effect, thyroglobulin (Tg) levels before and after treatment, SF-36 health status questionnaires (SF-36), occurrence of adverse reactions after treatment, and recurrence rate of 1-year follow-up were compared and analyzed between the two groups. Results: There was no significant difference in baseline data between the two groups. After treatment, the effective rate of the observation group increased by 11.23% compared to the control group, with a statistically significant difference (91.98% vs. 80.75%, p < 0.05). There was no significant difference in Tg level and scores of SF-36 evaluation including physical functioning, physical problems, vitality, pain, mental health, emotional problems, social functioning, and general health perception between the two groups before surgery (p > 0.05), Tg levels and scores of SF-36 evaluation in all dimensions were significantly improved in both groups after treatment (p < 0.05), and the levels of Tg and scores of SF-36 in all dimensions in observation group were significantly better than those in control group after treatment (p < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups (p > 0.05). The recurrence rate in the observation group was 5.89% lower than that in the control group 1 year after treatment, with a statistically significant difference (2.67% vs. 8.56%, p < 0.05). Conclusions: The combination of iodine-131 and levothyroxine sodium in the postoperative treatment of DTC can improve the therapeutic effect and reduce the postoperative recurrence rate without increasing adverse reactions, which is worthy of clinical reference and promotion.

Enhanced biosensing with rhombic ring resonator in 2D photonic crystals for proteinuria detection

A two-dimensional (2D) photonic crystal (PC) based biosensor was developed and studied to detect albumin and urea levels in patients with proteinuria. Rhombic ring resonator structures are built with the help of FDTD (Finite Difference Time Domain). After the fields are computed using the 2D-FDTD approach, the normalized transmission spectra are produced by applying the Fast Fourier Transform (FFT) to them. The full width at half maximum (FWHM), Quality factor (Q-factor), Sensitivity, Figure of Merit (FOM), and Limit of Detection (LOD) are 15,466.5, 110 nm/RIU, 0.12 nm, 1100 RIU−1 and 54.34X10−6 RIU respectively, when the resonant wavelength is 1546 nm. The novelty of this the project lies in combining 2D photonic crystal, innovative rhombic ring resonator design and high-performance parameters. The achieved values are notably high, which is a novel achievement in the field of biosensing. The project aims to contribute to the field of biosensors and provide a potential tool for healthcare professionals to monitor diabetes, proteinuria, kidney function and overall health.

Internet Use and Higher-Level Functional Capacity Decline Suppression in Japanese Older Adults With Low Education: JAGES 2016-2019 Longitudinal Study.

Higher-level functional capacity (HLFC) is crucial for the independent living of older adults. While internet use positively impacts the health of older adults, its effect on HLFC and how this effect varies with educational attainment remains uncertain. This longitudinal study aimed to investigate whether internet use could mitigate the risk of HLFC decline and if this benefit extends to older adults with lower levels of education. The data were sourced from the Japan Gerontological Evaluation Study (JAGES), encompassing 8050 community-dwelling adults aged 65 years and older from 2016 to 2019. The study focused on those who remained self-sufficient from 2016 to 2019, identifying participants with independent HLFC in 2016. The Tokyo Metropolitan Institute of Gerontology Index of Competence defined HLFC operationally, consisting of 3 subscales, namely instrumental activities of daily living, intellectual activity, and social role. The primary variable was the frequency of internet use in 2016; participants who reported using the internet were classified as internet users, while those who answered "No" were identified as nonusers. The study compared the effects of internet use on HLFC decline across educational levels of ≤9 years, 10-12 years, and ≥13 years using Poisson regression analysis adjusted for robust SE to calculate the risk ratio (RR) and 95% CI for HLFC decline in 2019. After adjusting for demographic and health condition risk factors, internet use was significantly linked to a decreased risk of HLFC decline in older adults over 3 years, including those with lower educational levels. Internet users with ≤9 years of educational attainment experienced a suppressed decline in the total score (RR 0.57, 95% CI 0.43-0.76; P<.001); instrumental activities of daily living (RR 0.58, 95% CI 0.38-0.91; P=.02), intellectual activity (RR 0.60, 95% CI 0.41-0.89; P=.01), and social role (RR 0.74, 95% CI 0.56-0.97; P=.03) compared with nonusers. Participants with 10-12 years of education showed suppression rates of 0.78 (95% CI 0.63-0.98; P=.03), 0.59 (95% CI 0.39-0.90; P=.01), 0.91 (95% CI 0.63-1.31; P=.61), and 0.82 (95% CI 0.68-1.00; P=.05), respectively, and those with ≥13 years displayed suppression rates of 0.65 (95% CI 0.51-0.85; P=.001), 0.55 (95% CI 0.36-0.83; P=.01), 0.64 (95% CI 0.37-1.10; P=.11), and 0.83 (95% CI 0.64-1.08; P=.17), respectively. These findings indicate that internet use supports the maintenance of HLFC independence in older adults with higher education and those with lower educational levels. Encouraging internet use among older adults with lower levels of education through future policies could help narrow functional health disparities associated with educational attainment.

Remote monitoring of patients with chronic heart failure: A prospective randomized study

BACKGROUND: Chronic heart failure is one of the key problems of the Russian domestic healthcare system. E-health can be used to improve medical care quality and reduce the of hospitalizations and mortality. AIM: To examine the effect of telemedicine monitoring on mortality, frequency of hospitalizations, and clinical and functional states of patients with chronic heart failure. MATERIALS AND METHODS: A prospective, controlled, randomized study was conducted in the Central City Hospital No. 20 in Ekaterinburg (Russia), covering the period from December 2020 to December 2022. Patients with a confirmed diagnosis of chronic heart failure were randomized using the envelope method into three groups: group 1, a telephone control group (n=58); group 2, a remote control group using a Russian medical platform Medsenger (n=52); and group 3, the standard control group (n=103). All patients were examined, including NT-proBNP measurement and echocardiography on the first day of the study and at 3, 6, and 12 months. The occurrence of primary and secondary outcomes was evaluated at these reference points. Stata14 and jamovi software were used for statistical processing. RESULTS: The study involved 213 participants, and all three groups were comparable in terms of basic demographic and clinical characteristics. The advantage of remote control (groups 1 and 2) over face-to-face observation in reducing cardiovascular mortality was observed after 3 (odds ratio 2.73, 95% confidence interval 1.1–7.39; p=0.042) and 12 (odds ratio 2.1, 95% confidence interval 1.1–3.7; p=0.027) months and that in reducing the occurrence of the combined primary endpoint (odds ratio 2.1, 95% confidence interval 1.1–5.6; p=0.015) after 12 months. The use of the Medsenger platform also demonstrated an advantage over face-to-face observation in the development of the combined secondary endpoint (odds ratio 1.39, 95% confidence interval 0.19–0.81; p=0.011) after 3 months and over telephone control by a nurse after 12 months in reducing cardiovascular mortality (odds ratio 0.177, 95% confidence interval 0.06–0.487; p=0.021) and development of the combined secondary endpoint (odds ratio 0.427, 95% confidence interval 0.189–0.964; p=0.041). When using the Medsenger platform, the ejection fraction increased from 47% initially to 55% after 12 months (p=0.004). The NT-proBNP level decreased from 817 to 582 pg/mL (p 0.001) after 3 months and then to 233 pg/mL after 12 months (p 0.001). CONCLUSION: Remote monitoring protocols can be a good alternative to the traditional face-to-face monitoring of patients with chronic heart failure, which may improve clinical and functional health indicators.

Strategies for minimizing muscle loss during use of incretin-mimetic drugs for treatment of obesity.

The rapid and widespread clinical adoption of highly effective incretin-mimetic drugs (IMDs), particularly semaglutide and tirzepatide, for the treatment of obesity has outpaced the updating of clinical practice guidelines. Consequently, many patients may be at risk for adverse effects and uncertain long-term outcomes related to the use of these drugs. Of emerging concern is the loss of skeletal muscle mass and function that can accompany rapid substantial weight reduction; such losses can lead to reduced functional and metabolic health, weight cycling, compromised quality of life, and other adverse outcomes. Available evidence suggests that clinical trial participants receiving IMDs for the treatment of obesity lost 10% or more of their muscle mass during the 68- to 72-week interventions, approximately equivalent to 20 years of age-related muscle loss. The ability to maintain muscle mass during caloric restriction-induced weight reduction is influenced by two key factors: nutrition and physical exercise. Nutrition therapy should ensure adequate intake and absorption of high-quality protein and micronutrients, which may require the use of oral nutritional supplements. Additionally, concurrent physical activity, especially resistance training, has been shown to effectively minimize loss of muscle mass and function during weight reduction therapy. All patients receiving IMDs for obesity should participate in comprehensive treatment programs emphasizing adequate protein and micronutrient intakes, as well as resistance training, to preserve muscle mass and function, maximize the benefit of IMD therapy, and minimize potential risks.

Protocol for a pilot clinical trial of the senolytic drug combination Dasatinib Plus Quercetin to mitigate age-related health and cognitive decline in mental disorders

Background Major depressive disorder (MDD) and schizophrenia are linked to accelerated aging leading to reduced lifespan, health span and cognitive decline. Cellular senescence, in which cells lose proliferative capacity and develop a senescence-associated secretory phenotype (SASP), plays a role in this process. Emerging research suggests that the senolytic regimen of dasatinib+quercetin (D+Q) reduces senescent cells, potentially mitigating age-related health and cognitive decline. This pilot study aims to assess the feasibility and safety of D+Q in older adults with schizophrenia, schizoaffective disorder, and treatment-resistant depression (TRD). Methods This single-center study will recruit 30 participants total aged 50 years or older with schizophrenia/schizoaffective disorder or 60 years or older with TRD; the difference in age limits is because individuals with schizophrenia are biologically about 10 years older than general population owing to metabolic burden. Each participant will receive two consecutive days of 100 mg oral dasatinib plus 1250 mg oral quercetin at baseline and weeks one through three, (i.e., two days on, five days off) along with lifestyle risk management education. Questionnaires and assessments will measure health and cognitive function as well as psychiatric function at baseline, week 10, and one year. Magnetic Resonance Imaging (MRI) will measure structural and functional brain health at baseline and 10 weeks. Blood sampling for SASP testing will occur at seven time points: baseline, weeks one through four, week 10, and one year. Conclusion This pilot aims to evaluate the safety and feasibility of the senolytic regimen and D+Q’s potential to counteract accelerated aging in adults with schizophrenia/schizoaffective disorder and TRD. Trial registration Dasatinib Plus Quercetin for Accelerated Aging in Mental Disorders is registered on ClinicalTrials.gov: NCT05838560; posted May 1, 2023.

Should We Work Smarter or Harder for Our Health? A Comparison of Intensity and Domain-Based Time-Use Compositions and Their Associations With Cognitive and Cardiometabolic Health.

Each day is made up of a composition of "time-use behaviors." These can be classified by their intensity (eg, light or moderate-vigorous physical activity [PA]) or domain (eg, chores, socializing). Intensity-based time-use behaviors are linked with cognitive function and cardiometabolic health in older adults, but it is unknown whether these relationships differ depending on the domain (or type/context) of behavior. This study included 397 older adults (65.5 ± 3.0 years, 69% female, 16.0 ± 3.0 years education) from Adelaide and Newcastle, Australia. Time-use behaviors were recorded using the Multimedia Activity Recall for Children and Adults, cognitive function was measured using the Addenbrooke's Cognitive Examination III and Cambridge Neuropsychological Test Automated Battery, and systolic and diastolic blood pressure, total cholesterol, and waist-hip ratio were also recorded. Two 24-hour time-use compositions were derived from each participant's Multimedia Activity Recall for Children and Adults, including a 4-part intensity composition (sleep, sedentary behavior, light, and moderate-vigorous PA) and an 8-part domain composition (Sleep, Self-Care, Chores, Screen Time, Quiet Time, Household Administration, Sport/Exercise, and Social). Linear regressions found significant associations between the domain composition and both Addenbrooke's Cognitive Examination III (p = .010) and waist-hip ratio (p = .009), and between the intensity composition and waist-hip ratio (p = .025). Isotemporal substitution modeling demonstrated that the domains of sedentary behaviors and PA impacted their associations with Addenbrooke's Cognitive Examination III, while any PA appeared beneficial for waist-hip ratio. Findings suggest the domain of behavior should be considered when aiming to support cognitive function, whereas, for cardiometabolic health, it appears sufficient to promote any type of PA.

Evaluating the Efficacy and Safety of Cymbopogon Schoenanthus Syrup for Asthma and Allergies: A Two-Decade Clinical Study

Asthma and allergies are prevalent respiratory conditions affecting millions worldwide, often necessitating long-term management and treatment. Synthetic medications, while effective, may pose risks and adverse effects, prompting exploration into natural alternatives. This study investigates the efficacy and safety of a botanical syrup supplement derived from Cymbopogon Schoenanthus subsp. proximus, known as “Binj” or “Abba” in the United Arab Emirates (UAE), for the management of asthma and allergies. Through collaborative efforts with reputable laboratories and universities, the botanical syrup’s therapeutic potential was rigorously evaluated, encompassing phytochemical analysis, biological testing, and extensive clinical trials spanning two decades. Results demonstrate notable improvements in lung function and skin health among patients with asthma and allergies, evidenced by enhanced vital capacity, forced vital capacity, and visible reduction in skin allergy symptoms. Furthermore, safety assessments indicate a favorable profile, with minimal adverse events reported. The recognition of the botanical syrup by the UAE Ministry of Health and international pharmaceutical companies underscores its significance and potential for widespread application. This discovery represents a promising advancement in natural medicine, offering a safe and effective alternative for individuals seeking holistic respiratory wellness. Future research should focus on large-scale clinical trials and long-term safety studies to further elucidate its therapeutic benefits and optimize clinical outcomes.

Nutritional Interventions in Older Persons with Type 2 Diabetes and Frailty: A Scoping Systematic Review.

In the elderly, the coexistence of type 2 diabetes mellitus (T2DM) and frailty is frequent. Much has been described about pharmacological management and glycemic control goals. However, there is a knowledge gap in terms of the objectives and characteristics of interventions, especially nutritional ones, for this population. A scoping review was performed to document the objectives, characteristics, and results of nutritional interventions in older people with T2DM and frailty. The five-stage framework of Arksey and O'Malley was used, as was the PRISMA extension for scoping reviews. The results stand out for three trends, as follows: (1) experimental studies with multicomponent intervention physical exercise programs and nutritional programs based on educational processes or behavioral intervention; (2) observational studies with an association of the kind of diet assessed by scales and their relation to stages of frailty; (3) a review that updates recommendations on pharmacological and non-pharmacological, diet, exercise, management, as well as glucose control goals for diabetes in frail older persons. Finally, the evidence shows that management of T2DM in older adults with frailty requires goals and interventions tailored to their functional capacity and health condition. The exercise, diet, and education programs reviewed have demonstrated their effectiveness in improving physical performance, reducing the risk of frailty or progression to more advanced stages, and achieving better glycemic control.

Preliminary Investigation into the Association between Scoliosis and Hypoxia: A Retrospective Cohort Study on the Impact of Eliminating Hypoxic Factors on Scoliosis Outcomes.

This study delves into the implications of adenoidectomy for scoliosis progression, investigating the intricate nexus of hypoxia, spinal curvature, and surgical intervention. With adenoidectomy being a common procedure for addressing pediatric sleep-disordered breathing, this research study explores its potential impact on spinal health. Employing a retrospective cohort design, this study gathered data from patients who underwent adenoidectomy, including those with scoliosis, between January 2017 and March 2023. Initial and follow-up evaluations involved clinical and radiological assessments, notably measuring the Cobb angle to quantify spinal curvature. This study enrolled 218 patients under 10 years old. Among them, 18 exhibited Cobb angles of 10° or more, with a mean Cobb angle of 12.8°. In the follow-up evaluation, 83% of patients with initial Cobb angles of 10° or more were reached out to, along with 84.6% of those with Cobb angles below 10°. The postoperative follow-up revealed a notable decrease in Cobb angles for most patients, particularly those with an initial Cobb angle exceeding 10°. This study underscores the potential connection between adenoidectomy, hypoxia, and scoliosis regression, highlighting the importance of early intervention for scoliosis management. Despite certain limitations, this investigation lays the foundation for future research involving larger patient cohorts and multifaceted analyses. The observed interactions between airway function, hypoxia, and spinal health open avenues for refining clinical strategies in scoliosis treatment.

Glial swip-10 controls systemic mitochondrial function, oxidative stress, and neuronal viability via copper ion homeostasis

Cuprous copper [Cu(I)] is an essential cofactor for enzymes that support many fundamental cellular functions including mitochondrial respiration and suppression of oxidative stress. Neurons are particularly reliant on mitochondrial production of ATP, with many neurodegenerative diseases, including Parkinson's disease, associated with diminished mitochondrial function. The gene MBLAC1 encodes a ribonuclease that targets pre-mRNA of replication-dependent histones, proteins recently found in yeast to reduce Cu(II) to Cu(I), and when mutated disrupt ATP production, elevates oxidative stress, and severely impacts cell growth. Whether this process supports neuronal and/or systemic physiology in higher eukaryotes is unknown. Previously, we identified swip-10, the putative Caenorhabditis elegans ortholog of MBLAC1, establishing a role for glial swip-10 in limiting dopamine (DA) neuron excitability and sustaining DA neuron viability. Here, we provide evidence from computational modeling that SWIP-10 protein structure mirrors that of MBLAC1 and locates a loss of function coding mutation at a site expected to disrupt histone RNA hydrolysis. Moreover, we find through genetic, biochemical, and pharmacological studies that deletion of swip-10 in worms negatively impacts systemic Cu(I) levels, leading to deficits in mitochondrial respiration and ATP production, increased oxidative stress, and neurodegeneration. These phenotypes can be offset in swip-10 mutants by the Cu(I) enhancing molecule elesclomol and through glial expression of wildtype swip-10. Together, these studies reveal a glial-expressed pathway that supports systemic mitochondrial function and neuronal health via regulation of Cu(I) homeostasis, a mechanism that may lend itself to therapeutic strategies to treat devastating neurodegenerative diseases.

Neuropsychological and Health Literacy Correlates of Science Knowledge Among Older and Younger Healthy Adults.

Science knowledge refers to the depth and breadth of facts acquired within the life, social, and earth sciences, and it has implications for both public and personal health. Drawing from cognitive aging theory, we examine whether levels of science knowledge are associated with age, neuropsychological functioning, and personal health literacy. Fifty-two younger and fifty older healthy adults completed our telephone-based study that included a commonly used test of science knowledge, as well as measures of neuropsychological functioning, health literacy, and relevant descriptives (e.g., mood). Adjusting for other demographics and neuropsychological functioning, older adults had significantly lower science knowledge test scores than younger adults. In the full sample, lower science knowledge showed medium-to-large associations with episodic memory, executive functions, and health literacy, independent of years of education. These results suggest that older adults' science knowledge falls slightly below that of their younger counterparts and is independently associated with higher order neuropsychological functions and aspects of personal health, which may have implications for accessing, understanding, and using relevant public health information across the lifespan.

Trunk-to-leg volume and appendicular lean mass from a commercial 3-dimensional optical body scanner for disease risk identification

Body shape expressed as the trunk-to-leg volume ratio is associated with diabetes and mortality due to the associations between higher adiposity and lower lean mass with Metabolic Syndrome (MetS) risk. Reduced appendicular muscle mass is associated with malnutrition risk and age-related frailty, and is a risk factor for poor treatment outcomes related to MetS and other clinical conditions (e.g.; cancer). These measures are traditionally assessed by dual-energy X-ray absorptiometry (DXA), which can be difficult to access in clinical settings. The Shape Up! Adults trial (SUA) demonstrated the accuracy and precision of 3-dimensional optical imaging (3DO) for body composition as compared to DXA and other criterion measures. Here we assessed whether trunk-to-leg volume estimates derived from 3DO are associated with MetS risk in a similar way as when measured by DXA. We further explored if estimations of appendicular lean mass (ALM) could be made using 3DO to further improve the accessibility of measuring this important frailty and disease risk factor. SUA recruited participants across sex, age (18-40, 40-60, >60 years), BMI (under, normal, overweight, obese), and race/ethnicity (non-Hispanic [NH] Black, NH White, Hispanic, Asian, Native Hawaiian/Pacific Islander) categories. Each participant had whole-body DXA and 3DO scans, and measures of cardiovascular health. The 3DO measures of trunk and leg volumes were calibrated to DXA to express equivalent trunk-to-leg volume ratios. We expressed each blood measure and overall MetS risk in quartile gradations of trunk-to-leg volume previously defined by National Health and Nutrition Examination Survey (NHANES). Finally, we utilized 3DO measures to estimate DXA ALM using ten-fold cross-validation of the entire dataset. Participants were 502 (273 female) adults, mean age=46.0±16.5y, BMI=27.6±7.1kg/m2 and a mean DXA trunk-to-leg volume ratio of 1.47±0.22 (females: 1.43±0.23; males: 1.52±0.20). After adjustments for age and sex, each standard deviation increase in trunk-to-leg volume by 3DO was associated with a 3.3 (95% odds ratio [OR]=2.4-4.2) times greater risk of MetS, with individuals in the highest quartile of trunk-to-leg at 27.4 (95% CI: 9.0-53.1) times greater risk of MetS compared to the lowest quartile. Risks of elevated blood biomarkers as related to high 3DO trunk-to-leg volume ratios were similar to previously published comparisons using DXA trunk-to-leg volume ratios. Estimated ALM by 3DO was correlated to DXA (r2=0.96, root mean square error=1.5kg) using ten-fold cross-validation. Using thresholds of trunk-to-leg associated with MetS developed on a sample of US-representative adults, trunk-to-leg ratio by 3DO after adjustments for offsets showed significant associations to blood parameters and MetS risk. 3DO scans provide a precise and accurate estimation of ALM across the range of body sizes included in the study sample. The development of these additional measures improves the clinical utility of 3DO for the assessment of MetS risk as well as the identification of low muscle mass associated with poor cardiometabolic and functional health.

Sleep Quality, Daytime Sleepiness and Sleep Hygiene Among Youth in a Rural District in South India: A Cross-Sectional Study.

Background Adequate sleep is crucial for youth cognitive function, academic performance, and mental health. However, various factors, including academic pressure, technology use, and socio-cultural norms can significantly impact sleep patterns, particularly in rural settings. This cross-sectional study assessed sleep quality, daytime sleepiness prevalence, and sleep hygiene practices among youth in a rural South Indian district. We also investigated factors associated with these sleep parameters in this understudied population Methods This was a cross-sectional study among 852 young subjects who were assessed with a self-reported proforma of socio-demographic details, behavioural factors,Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. Regression model was created to analyse the predictor for sleep quality and daytime sleepiness with respect to sociodemographic variables, behavioural factors and sleep hygiene practices. Results Our study revealed that 49.4% (n=421) of participants exhibited poor sleep quality, while 29.5% (n=251) reported abnormal daytime sleepiness. The most prevalent sleep hygiene practices were reading in bed (68.5%, n=584) and pre-bedtime eating (56.22%, n=479). Multivariate analysis indicated that sleep quality was significantly associated with accommodation type, with increased odds for those in private accommodation (adjusted odds ratio (AOR) 1.29, 95% CI: 1.14-1.62) and hostels (AOR 3.79, 95% CI: 1.79-8.06). Additionally, eating in bed (AOR 1.42, 95% CI: 1.03-1.95) and pre-bedtime eating (AOR 1.41, 95% CI: 1.07-1.88) were also associated with poor sleep quality. Factors significantly associated with daytime sleepiness included younger age (AOR 0.84, 95% CI: 0.75-0.94), non-medical academic streams (AOR 1.94, 95% CI: 1.33-2.83), extensive internet usage (three or more hours) (AOR 1.87, 95% CI: 1.15-3.13), watching TV in bed (AOR 1.46, 95% CI: 1.06-1.99), writing (AOR 1.45, 95% CI: 1.02-2.06), and eating in bed (AOR 1.55, 95% CI: 1.09-2.21). Conclusion This study reveals a significant incidence of poor sleep quality and daytime drowsiness among young individuals residing in rural areas of South India. The results of our study emphasize significant connections between sleep disturbances and several modifiable aspects, such as the kind of accommodation, eating habits, and use of technology. The impact of eating behaviours, both in bed and before bedtime, on sleep quality and daytime sleepiness underscores the importance of proper sleep hygiene education. Furthermore, the relationship between extensive internet usage and daytime sleepiness points to the growing influence of digital technology on youth sleep patterns. These findings emphasize the need for comprehensive sleep health programs tailored to rural youth. Such initiatives should address environmental factors, promote healthy sleep hygiene practices, and provide guidance on balanced technology use. Additionally, the varying impact of academic streams on sleep parameters suggests that sleep health strategies may need to be customized for different educational contexts.

Perioperative Nutritional, Functional, and Bone Health Optimization in Spine Surgery: A National Investigation of Spine Surgeons' Perceptions and Practices.

While perioperative nutritional, functional, and bone health status optimization in spine surgery is supported with ample evidence, the implementation and surgeon perception regarding such efforts in clinical practice remain largely unexplored. This study sought to assess the current perception of spine surgeons and implementation regarding the nutritional, functional status, and bone health perioperative optimization. An anonymous 30-question survey was distributed to orthopaedic spine fellowship and neurosurgery program directors identified through the North American Spine Society and American Association of Neurological Surgeons contact databases. The questionnaire was completed by 51 surgeon survey respondents. Among those, 62% reported no current formal nutritional optimization protocols with 14% not recommending an optimization plan, despite only 10% doubting benefits of nutritional optimization. While 5% of respondents perceived functional status optimization as nonbeneficial, 68% of respondents reported no protocol in place and 46% noted a functional status assessment relying on patient dependency. Among the respondents, 85% routinely ordered DEXA scan if there was suspicion of osteoporosis and 85% usually rescheduled surgery if bone health optimization goals were not achieved while 6% reported being suspicious of benefit from such interventions. While most responding spine surgeons believe in the benefit of perioperative nutritional and functional optimization, logistical and patient compliance challenges were noted as critical barriers toward optimization. Understanding surgeon perception and current practices may guide future efforts toward advancement of optimization protocols.

Mental Health and Quality of Life of Patients with Differentiated Thyroid Cancer Pre and Post Radioactive Iodine Treatment: A Prospective Study.

Background: Although patients with differentiated thyroid cancer (DTC) have a good prognosis, their long-term clinical course can influence their mental health and their health-related quality of life (HRQoL). However, few studies have evaluated the psychological factors that influence subsequent HRQoL in this population, particularly during the initial treatment stage. Methods: In this 1-month cohort study, we evaluated depressive and anxiety symptoms and HRQoL of patients with DTC and examined possible predictors of further HRQoL impairment. Results: In total, 181 patients completed questionnaires where they self-rated their psychological status (the Chinese Health Questionnaire [CHQ], Taiwanese Depression Questionnaire [TDQ]) and HRQoL (the 36-item Short Form Health Survey [SF-36]) at baseline and 1 month after radioactive iodine (RAI) therapy. Compared with the general Taiwanese population, patients with DTC reported a worse HRQoL in all dimensions of the SF-36. Multivariate regression models indicated that anxiety and depressive symptoms were inversely correlated with some dimensions (physical functioning, bodily pain, and general health perceptions for the CHQ; role limitations due to physical problems and social functioning for the TDQ). However, psychiatric follow-up and treatment history were significantly associated with physical functioning and role limitations owing to the physical problem dimensions of HRQoL. Conclusions: In conclusion, although anxiety and depressive symptoms may negatively affect certain HRQoL domains, psychiatric follow-up can improve the physical dimensions.

Effectiveness of monopolar diathermy by radiofrequency combined with exercise in patients with chronic low back pain: A randomized clinical trial.

Chronic low back pain can severely affect quality of life. While several treatments are available, the combination of therapies often results in better outcomes. This study delves into the comparative effectiveness of combining monopolar dielectric diathermy radiofrequency (MDR) with supervised therapeutic exercise against the latter treatment alone. A randomized single-blind controlled trial was conducted. The intervention group (n= 30) received MDR with supervised therapeutic exercises for eight weekly sessions for four weeks. The control group (n= 30) received only the same exercise protocol. The following self-report measures were assessed before the first treatment session, at four, and 12 weeks: disability, pain, kinesiophobia, quality of life, sleep quality, emotional distress, isometric trunk strength, and trunk flexion range. Repeated ANOVA measures revealed significant time*group interactions for the McQuade test (p= 0.003), the physical role (p= 0.011), vitality (p= 0.023), social function (p= 0.006), and mental health subscales (p= 0.042). Between-group analyses showed significant differences for all outcomes at each follow-up: RMDQ (post-treatment, p= 0.040), ODI (post-treatment and 12-week, p= 0.040), VAS (p< 0.001), TSK (p< 0.001), and McQuade Test (p< 0.020). The combination of diathermy radiofrequency with supervised therapeutic exercise significantly surpasses the efficacy of supervised therapeutic exercise alone, showcasing improvements in pain, disability, kinesiophobia, lumbar mobility in flexion, and overall quality of life in patients with chronic low back pain.