Healthy Population Research Articles

Application of electrospray triple quadrupole mass spectrometry in assessing thalassemia in a population.

Thalassemia is widely prevalent in Asian countries and the Middle East region of the world. While the prevalence of α thal is around 5-20% in the population, the incidence of β thal is around 3-4%. The available data on thalassemia in Indians is based on chromatographic or electrophoretic techniques. The present study demonstrates the utility of mass spectrometry in detecting thalassemia in a small, healthy population from Tiptur, Karnataka. The study included a population of 315 individuals, spanning both children and adults, with ages ranging from 4 to 76 years. EDTA whole blood was collected after obtaining their written consent. The intensities of various globin chains were measured using a triple quadrupole mass spectrometer. The ratio of the peak areas of globin chains (α/β, δ/β (%)) served as biomarkers to detect thalassemia. Thirty random samples of α thalassemia were analyzed using GapPCR. The prevalence of a thal is 21.65% (68/314) based on α/β (< =0.8) and the prevalence of β thal is 3.8% (12/314) based on δ/β (%) (> =11.0). GapPCR detected three heteromutants of α deletion, one mutation in the HBA1 gene, and one a triplication (16.7%, 5/30). One sample was excluded from the analysis due to the presence of a variant. The utility of mass spectrometry for screening thalassemia in a population is demonstrated. The higher occurrence of α-thalassemia in the studied population underscores the importance of screening for thalassemia in regions with reportedly high prevalence rates.

Relationship between paraspinal muscle morphology and function in different directions in a healthy Chinese population at different ages: a cross-sectional study

BackgroundParaspinal muscle degeneration occurs with age; however, it is unknown whether strength and endurance change with muscle cross-sectional area (CSA) and fatty infiltration (FI) parameters in Chinese healthy individuals.MethodsA total of 94 asymptomatic Chinese volunteers were enrolled in this study. The participants were divided into three groups: young (20–39 years old, n = 27), middle-aged (40–59 years old, n = 49), and elderly (≥ 60 years old, n = 18). CSA and FI of the psoas (PS), quadratus lumborum (QL), multifidus (MF), and erector spinae (ES) were measured using magnetic resonance imaging. The Bionix Sim3 Pro was used to evaluate the maximum isometric torque and the Ito test to evaluate endurance.ResultsThe CSA of the PS and ES in the elderly group was smaller than those in the other groups, while the CSA of QL in the young group was larger than that in the other groups. There were differences in the MF and ES FI among the three groups. The maximum isometric torque and endurance test time decreased with increasing age; however, these differences were not statistically significant. Maximum isometric torque positively correlated with the average paraspinal muscle CSA and negatively correlated with the torque and FI of the MF and ES muscles. The endurance test was found to be positively correlated with the FCSA of the MF and to be negatively correlated with the FI of the MF and ES. PS and QL can predict the maximum isometric torque, and MF and PS can predict the endurance time.ConclusionMF and ES showed earlier degeneration than PS and QL. MF is the first paraspinal muscle to undergo functional area atrophy, and it plays an important role in the endurance test. The maximum moment of equal length in all directions of the lumbar spine is not completely symmetrical, but it is correlated with the imaging parameters of the paraspinal muscles. QL and PS were more activated in the lumbar activity.Trial registrationThe study was registered in Chinese Clinical Trial Registry and the registration number is ChiCTR2000039073 on 15/10/2020 (https://www.chictr.org.cn/showproj.html?proj=62785). Ethical Approval was obtained from the Peking University Third Hospital Medical Science Research Ethics Committee (IRB00006761-M2020305).

Advancements and Challenges in Exercise Training for Multiple Sclerosis: Comprehensive Review and Future Directions for Randomized Controlled Trials.

Exercise training represents a health behavior for the treatment and management of the multi-faceted manifestations of multiple sclerosis (MS). This paper provides a comprehensive overview of evidence from randomized controlled trials (RCTs) regarding benefits, safety, participation, and guidelines for exercise training in MS, based on systematic reviews and meta-analyses. The paper then provides our opinions based on extensive experience regarding challenges for improving and expanding future RCTs that will advance our understanding of exercise training in MS. The comprehensive review of evidence from RCTs indicates that exercise training yields substantial improvements in aerobic and muscle fitness, mobility, fatigue and depression, quality of life, and participation outcomes. There is a non-significant increase in the risk of adverse events or serious adverse events with exercise training compared with control conditions or healthy populations. Rates of adherence and compliance with exercise training (i.e., participation) approximate 80% and 70%, respectively. The current prescriptive guidelines suggest 2-3days per week of aerobic and resistance exercise training as the minimal dose for safely benefiting from exercise training in MS. We propose 10 important topics as avenues for expanding the body of research and improving its scope for evidence-based practice in MS. Overall, the research on exercise training in MS is strong, but it can get stronger. The expansion and advancement of evidence are critical for moving exercise training into the clinical armamentarium of MS disease treatment and management.

A correlation analysis between passively assessed gait initiation signal data and brain tumours progress

BackgroundMagnetic resonance imaging (MRI) is commonly used to diagnosing and monitoring the progress of brain tumours.However, it is costly, not easily accessible, and requires frequent visits to specialised health centres. Method: This study explores the use of passively assessed gait initiation signal data (GISD) as a potential alternative to MRI. We evaluated three hypotheses: (1) Certain features extracted from GISD are more sensitive in identifying brain tumours; (2) Changes in GISD patterns are correlated with brain tumour progression; and (3) The locations of brain tumours are correlated with GISD features. Data from healthy individualsin the UK Biobank (N=240 x 7 days) were used to establish a baseline for signal analysis. Then, we assessed the sensitivity of 28 features extracted from GISD to differentiate this healthy population and brain tumours patients (BrainWear project, N=49 x 9 months). Results: Statistical tests revealed significant differences (p < 0.05) in subsets of GISD-extracted features between healthy individuals and cancer patients. Classification models achieved a maximum accuracy of 77 % in distinguishing between these two groups. However, the identification of tumour location was less accurate (33 % − 65 %), particularly for certain regions (e.g., right temporal). We also found evidence of correlation between GISD patterns and tumours progression and treatments. Conclusions: Passive GISD analysis shows promise as a complementary tool to MRI in diagnosing brain tumours. However, our small patient cohort and limited evaluation period highlight the need for larger studies to generalise these findings and derive more reliable clinical implications.

Validation of the German Purpose in Life Questionnaire (PLQ) in a healthy population and patients with cardiovascular disease

In this cross-sectional study, a German translation of the subscale “Purpose in Life” (PLQ) from the Scales of Psychological Well-being (SPWB) was validated in a representative sample of participants from healthy and cardiovascular populations. The main objectives were to assess the reliability, convergent, and discriminant validity using a large and representative sample (N = 466 healthy sample, N = 247 patients with an implanted cardioverter-defibrillator (ICD), N = 70 patients with a cardiovascular disease (CVD)).The findings indicated that the German PLQ is a reliable and valid measure of positive psychological well-being, showing a positive correlation with health-related quality of life, optimism, and positive affect. In turn, the PLQ score was significantly and negatively correlated with depressive symptom severity, anxiety, pessimism, and negative affect, while being distinct from these constructs. The comparability of the measurement properties of the German PLQ with the original English version further supports the validity of the translation. Additionally, the unidimensional structure of the German version mirrored that of the English PLQ.As this study used a large and representative sample, it provides the most up-to-date normative population value for the subscale of the SPWB. Moreover, this study represents the first known exploration of the questionnaire in a cardiovascular sample, revealing relationships between health-related quality of life, optimism, positive affect, and the German PLQ. However, in patients with ICD, the positive correlation between the PLQ and the physical component of the SF-12 did not reach significance. Despite these valuable findings, future research to enhance the understanding of the PLQ and its implications is warranted.

A - 58 Grit and Resilience Predict Emotional Functioning in Pediatric Cancer Survivors

Abstract Objective Grit—one’s “perseverance and passion for long-term goals” (Duckworth et al., 2007)—is distinct from resilience, one’s ability to bounce back after negative events. In healthy populations, both promote emotional well-being and quality-of-life (Datu et al., 2019; Sharkey et al., 2017). Limited research has investigated how grit and resilience affect emotional functioning after pediatric cancer. We hypothesized resilience would mediate grit’s effects on emotional functioning in pediatric cancer survivors. Methods Our clinically referred sample of 214 pediatric cancer survivors ages 4–25 years was predominantly lower- to upper-middle class (73%) and racially diverse (Caucasian = 53%, Hispanic = 25%, Black = 12%). We administered the parent-report Behavior Assessment System for Children, Third Edition (BASC-3; variables: Resiliency, Anxiety, Depression), parent-report Short Grit Scale, and self-report BASC-3 (variables: Sense of Inadequacy, Locus of Control). Multiple regression and simple mediation analyses were conducted. Results Overall, the sample demonstrated average grit and resilience. Leukemia and brain tumor survivors demonstrated greater grit and resilience than survivors of other cancers. Grit predicted Anxiety (p = 0.026), Depression (p = 0.001), and Sense of Inadequacy (p ≤ 0.001). Resiliency had a significant indirect effect on grit’s prediction of Anxiety (β = −0.107, 95% CI [−0.206, −0.011]) and Depression (β = −0.192, 95% CI [−0.271, −0.117]), but not Sense of Inadequacy (β = −0.055, 95% CI [−0.200, 0.102]). Conclusion Higher levels of grit predicted better emotional outcomes in pediatric cancer survivors. Grit affected anxiety and depression in this sample via resiliency. Exploratory analyses regarding cancer type and age at diagnosis will be described. Findings support the need for further research on “positive neuropsychology” factors affecting neuropsychological outcomes in pediatric cancer survivors.

Real-time fMRI neurofeedback modulates induced hallucinations and underlying brain mechanisms

Hallucinations can occur in the healthy population, are clinically relevant and frequent symptoms in many neuropsychiatric conditions, and have been shown to mark disease progression in patients with neurodegenerative disorders where antipsychotic treatment remains challenging. Here, we combine MR-robotics capable of inducing a clinically-relevant hallucination, with real-time fMRI neurofeedback (fMRI-NF) to train healthy individuals to up-regulate a fronto-parietal brain network associated with the robotically-induced hallucination. Over three days, participants learned to modulate occurrences of and transition probabilities to this network, leading to heightened sensitivity to induced hallucinations after training. Moreover, participants who became sensitive and succeeded in fMRI-NF training, showed sustained and specific neural changes after training, characterized by increased hallucination network occurrences during induction and decreased hallucination network occurrences during a matched control condition. These data demonstrate that fMRI-NF modulates specific hallucination network dynamics and highlights the potential of fMRI-NF as a novel antipsychotic treatment in neurodegenerative disorders and schizophrenia.

Seasonal variation of total and bioavailable 25-hydroxyvitamin D [25(OH)D] in the healthy adult Slovenian population.

Objective: The aim of our study was to compare the total 25(OH)D fraction, the bioavailable vitamin fraction, and the free vitamin D fraction in spring and fall in a group of healthy individuals. Methods: In our study, we collected blood samples from healthy participants at the end of both summer and winter, and measured serum levels of albumin, DBP, and 25(OH)D. Utilizing these data, we calculated the percentage of free and bioavailable vitamin D. Our cohort comprised 87 participants, with a male-to-female ratio of 14:73, aged 35.95 ± 12.55years, ranging from 19 to 70years. We employed the chemiluminescence method to determine the vitamin 25(OH)D levels, the ELISA method was utilized to determine DBP levels, the albumin BCP Assay was performed using the ADVIA biochemical analyzer (Siemens) and an online calculator was used to determine the free and bioavailable 25(OH)D levels. Results: Our findings indicate significantly lower 25(OH)D levels in winter (44.13 ± 17.82nmol/L) compared to summer (74.97 ± 22.75nmol/L; p < 0.001). For vitamin D binding protein there was no significant difference from summer (236.2 ± 164.39mg/L) to winter (239.86 ± 141.9mg/L; p = 0.77), albumin levels were significantly higher in summer (49.37 ± 4.15g/L vs. 47.97 ± 3.91g/L, p = 0.01), but the magnitude of the change may not be large enough to be solely responsible for the stability of vitamin D levels throughout the year. In the winter season a significantly lower calculated bioavailable 25(OH)D vitamin (7.45 ± 5.66nmol/L against 13.11 ± 8.27nmol/L; p < 0.001) was observed, and the free fraction also showed a significant decrease (17.3 ± 12.9pmol/L versus 29.7 ± 19.1pmol/L; p < 0.0001). We observed a moderately positive correlation between 25(OH)D and bioavailable percentage in winter (r = 0.680; p < 0.001), in contrast with a lower positive association in summer (r = 0.343; p < 0.001). Conclusion: Our data suggest a positive correlation between total and bioavailable 25(OH)D levels. In addition to the statistically significant variation in 25(OH)D between the two observation periods, there was an additional variation in the free vitamin D percentage. The summertime synthesis of vitamin D in the skin could contribute directly to the free fraction of vitamin D. Standardizing the measurement of free 25(OH)D and clinical studies is necessary to establish reference values before these methods can be implemented in clinical practice.

Prevalence of Anisakiasis in Madrid (Spain) after 20 Years of Preventive Legislation.

Historical seroprevalence data for Anisakis in Spain vary greatly depending on the sampling region owing to different fish consumption habits. As a result of European Regulation (EC) No. 853/2004, the Royal Decree 1420/2006 on the prevention of parasitosis by Anisakis in fishery products supplied by establishments that serve food to final consumers or to communities came into force in Spain. In this study, a prevalence study of Anisakis in Madrid has been conducted to verify the prophylactic effects of the application of the law. Sera from 500 blood donors from the Fundación Jiménez Díaz University Hospital (Madrid/2021-2023) were collected, and the levels of anti-Anisakis IgG, IgA, and IgE were analyzed by ELISA, comparing them with those obtained with 110 donors from the Red Cross and the "Gómez Ulla" Central Defense Hospital (Madrid/2001-2002). The percentages of positivity in the 2021-2023 donor group were IgG (13.6%), IgA (13.6%), and IgE (2.2%), while in the 2001-2002 donors they were positive for IgG (15.45%), IgA (14.54%), and IgE (11.65%). A reduction of more than 80% was observed in the prevalence of anti-Anisakis IgE in the healthy population of Madrid, which confirmed the positive effect of RD1420/2006, which was later incorporated into RD1021/2022.

Revealing alterations in heart rate fluctuations during the progression of Chagas disease.

The heart rate variability (HRV) continually evolves throughout life, reflecting modifications in the architecture of the sinoatrial node (SAN) and in the regulation of heart rate by the autonomic nervous system (ANS). Both can be considerably affected by Chagas disease, causing important changes in the complex nature of HRV. We aim to evaluate the ability of an index based on the false nearest neighbors method (FN10) to reflect these changes during disease progression. We perform a retrospective, descriptive, and cross-sectional study analyzing HRV time series of participants with Chagas disease. We determine the dependence of FN10 on age and sex in a healthy population, and then evaluate FN10 in individuals with Chagas disease. In the healthy population, FN10 has a scaling behavior with age, which is independent of sex. In Chagas disease, some individuals show FN10 values significantly above those seen in the healthy population. We relate the findings to the pathophysiological mechanisms that determine the progression of the disease. The results indicate that FN10 may be a candidate prognostic biomarker for heart disease.

Exploring Facial Somatosensory Distortion in Chronic Migraine: The Role of Laterality and Emotion Recognition—A Cross-Sectional Study

Background: In addition to being highly distressing, chronic migraine headaches are a major socioeconomic challenge. Like other pain syndromes, migraine headaches are associated with psychological and physiological impairments, including sensorimotor and somatosensory deficits. Aim: This study aims to explore whether patients with high-frequency or chronic migraine differ from a healthy population in the areas of laterality recognition (LAT) and facial emotion recognition (FER) and whether there are correlations between these areas and central sensitization of pain and psychological components like stress, depression, anxiety, and alexithymia. Methods: Using a cross-sectional design, individuals with high-frequency or chronic (ICHD classification) migraine (migraine group MG = 45) and healthy individuals (control group CG = 25) were studied using LAT testing (hand, neck, and face); FER testing; and questionnaires, including the Central Sensitization Inventory (CSI) and the Toronto Alexithymia Scale (TAS-20). Results: Data from 70 participants were collected for analysis. Statistically significant differences were found only in the assessment of central sensitization (p &lt; 0.001). Weak to moderate monotonic correlations were found for the MG, especially between alexithymia detection (TAS-20) and facial emotion recognition (FER test). Discussion: The methodological procedure and its accompanying challenges can be seen as limitations of this study. The lack of significant effects must be mentioned, but the selection of the collected questionnaires, the uniform diagnostics, and the statistical processing of a large amount of data represent methodological strengths. Conclusion: The CSI and the TAS-20 could be used in combination with FER to assess chronic migraine. Implementing the described sensorimotor parameters as a therapeutic intervention requires further investigation.

Genomic diversity and population structure of Carniolan honey bee in its native habitat

BackgroundResearch into the genetic diversity of honey bee (Apis melliferaL.) populations has become increasingly significant in recent decades, primarily due to population declines attributed to human activities and climate change. As a species of great importance, breeding programs that leverage understanding of genomic diversity could offer solutions to mitigate these challenges. The objective of this study was to examine the genomic diversity and population structure of Carniolan honey bees (Apis mellifera carnica) using the Illumina SNP chip on a large honey bee sample collected from Central and South-Eastern European countries. The study also aims to offer recommendations for future breeding programs.ResultsOur analysis involved Discriminant Analysis of Principal Components (DAPC), heterozygosity, admixture analysis, fixation indices (FST), Neighbour-Joining tree, gene flow and Isolation-by-distance analysis. DAPC indicated distinct separation between the Carniolan and Italian honey bee (Apis mellifera ligustica) populations, whereas the admixture analysis revealed varying levels of gene flow and genetic admixture within the Carniolan honey bee populations, demonstrating closer relationships between specific geographic regions (confirmed by Isolation-by-distance analysis). Furthermore, the research of heterozygosity, genomic inbreeding, pairwise FST values, and Neighbour-Joining tree provided insights into the patterns of genetic differentiation and similarity among the populations of Carniolan honey bee within its natural habitat. We have observed genetic homogeneity of the Carniolan honey bee population when considered in a broader genetic/geographical context. However, the Carniolan honey bee has sufficient genetic diversity in its geographical home range that needs to be carefully monitored and maintained.ConclusionsThis study provides important insights into the genetic composition, differentiation, and relationships among Carniolan honey bee populations in Central and South-Eastern European countries. The findings are crucial for conservation efforts, breeding programs, and sustainable beekeeping practices. They emphasise the importance of considering genetic factors and population structure in the breeding and management of honey bees. By understanding these genetic relationships, we can develop strategies to preserve genetic diversity, improve breeding outcomes, and ensure the resilience of honey bee populations in the face of environmental changes and challenges. This knowledge can also inform policy makers and stakeholders on best practices to maintain healthy bee populations, which are vital for ecosystem services and agricultural productivity.

Association between endothelial function and skin advanced glycation end-products (AGEs) accumulation in a sample of predominantly young and healthy adults

BackgroundIn populations with chronic disease, skin autofluorescence (SAF), a measure of long-term fluorescent advanced glycation end-products (AGEs) accumulation in body tissues, has been associated with vascular endothelial function, measured using flow-mediated dilation (FMD). The primary aim of this study was to quantify the relationship between endothelial function and tissue accumulation of AGEs in adults from the general population to determine whether SAF could be used as a marker to predict early impairment of the endothelium.MethodsA cross-sectional study was conducted with 125 participants (median age: 28.5 y, IQR: 24.4–36.0; 54% women). Endothelial function was measured by fasting FMD. Skin AGEs were measured as SAF using an AGE Reader. Participant anthropometry, blood pressure, and blood biomarkers were also measured. Associations were evaluated using multivariable regression analysis and were adjusted for significant covariates.ResultsFMD was inversely correlated with SAF (ρ = -0.50, P < 0.001) and chronological age (ρ = -0.51, P < 0.001). In the multivariable analysis, SAF, chronological age, and male sex were independently associated with reduced FMD (B [95% CI]; -2.60 [-4.40, -0.80]; -0.10 [-0.16, -0.03]; 1.40 [0.14, 2.67], respectively), with the multivariable model adjusted R2 = 0.31, P < 0.001.ConclusionsHigher skin AGE levels, as measured by SAF, were associated with lower FMD values, in a predominantly young, healthy population. Additionally, older age and male participants exhibited significantly lower FMD values, corresponding with compromised endothelial function. These results suggest that SAF, a simple and inexpensive marker, could be used to predict endothelial impairment before the emergence of any structural artery pathophysiology or classic cardiovascular disease risk markers.Trial registrationThe study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12621000821897) and concurrently entered into the WHO International Clinical Trials Registry Platform under the same ID number.

High prevalence of multi-drug resistant organisms in the gut flora of healthy rural individuals in northern India.

Background & objectives Presence of resistant gut flora in the community is associated with increasing multi-drug resistance (MDR) infections. In this study, the prevalence of MDR organisms in the gut flora of a healthy rural population residing in northern India was determined. Methods Healthy individuals aged 18-45 yr from Nuh district, Haryana, India were included in this study. Risk factors associated with dysbiosis, diet, lifestyle and exposure to animals was assessed. Qualitative food frequency questionnaire and inflammatory diet score was calculated. Pathogens in stool sample were detected by MALDI-TOF. Evaluation of antimicrobial susceptibility was done by automated Vitek-2 System. The presence of antimicrobial resistance (AMR) genes was evaluated using PCR. An isolate having resistance to at least one antibiotic out of the three or more classes of antibiotics tested was labelled as MDR. Results Among 153 individuals included in this study (mean age-32.5±8.6 yr, females-58.2%, vegetarian-68.6%), the most frequent organism isolated was E. coli (n=137, 89.5%) followed by K. pneumoniae (n=19, 12.4%) and Enterobacter species (n=23, 15%). Forty seven (30.7%) individuals had sensitive and 42 (27.4%) had MDR organisms. Fifty one (33.3%) were positive for ESBL, 5 (3.3%) were positive for carbapenems, and 18 (11.8%) were positive for both genes. Age, gender, body mass index, diet pattern, or diet score were similar between participants with sensitive and resistant organisms. Resistance against fluoroquinolones was highest [92(48.7%)] among all isolates. Forty nine (25.9%), 25 (13.2%), 24 (12.7%) and 21 (11.1%) isolates, respectively were positive for blaTEM, blaSHV, blaCTXM-1 and OXA-48 genes. Interpretation & conclusions Overall the study findings suggest that 27 per cent individuals from rural northern India carry MDR organisms in their fecal flora, with an ESBL carriage rate of 44 per cent.

Aged mice exhibit faster acquisition of intravenous opioid self-administration with variable effects on intake.

Although opioid abuse is more prevalent in young individuals, opioid use, overdose, and use disorders continue to climb at a rapid rate among the elderly. Little is known about abuse potential in a healthy aged population, in part due to technical and logistical difficulties testing intravenous self-administration in aged rodents. The goal of this study was to address the critical gap in the literature regarding age-dependent differences in opioid (remifentanil and fentanyl) self-administration between old and young mice. Male and female mice were grouped into young (mean: 19 weeks) and old (mean: 101 weeks), and were trained to self-administer intravenous fentanyl or remifentanil in daily sessions. In both old and young mice, acquisition, intake, and cue-responding after forced abstinence were measured for both drugs, and a dose-response curve (remifentanil) and dose-escalation (fentanyl) were conducted. Surprisingly, old mice learned to self-administer both remifentanil and fentanyl faster and more accurately than young mice. Baseline intake of remifentanil was also substantially greater in old mice compared to their young counterparts; however, we did not see increased intake of fentanyl with age at either dose tested. Further, compared to young mice, the old mice showed a greater incubation of responding for cues previously associated with remifentanil after a forced abstinence, but again this was not observed with fentanyl. Together these data suggest that an aged population may have an increased drug-abuse vulnerability for opioids compared to young counterparts and underscore the importance of future work on mechanisms responsible for this increased vulnerability.

Analytical Performance of the FreeStyle Libre 2 Glucose Sensor in Healthy Male Adults.

Continuous Glucose Monitoring (CGM) not only can be used for glycemic control in chronic diseases (e.g., diabetes), but is increasingly being utilized by individuals and athletes to monitor fluctuations in training and everyday life. However, it is not clear how accurately CGM reflects plasma glucose concentration in a healthy population in the absence of chronic diseases. In an oral glucose tolerance test (OGTT) with forty-four healthy male subjects (25.5 ± 4.5 years), the interstitial fluid glucose (ISFG) concentration obtained by a CGM sensor was compared against finger-prick capillary plasma glucose (CPG) concentration at fasting baseline (T0) and 30 (T30), 60 (T60), 90 (T90), and 120 (T120) min post OGTT to investigate differences in measurement accuracy. The overall mean absolute relative difference (MARD) was 12.9% (95%-CI: 11.8-14.0%). Approximately 100% of the ISFG values were within zones A and B in the Consensus Error Grid, indicating clinical accuracy. A paired t-test revealed statistically significant differences between CPG and ISFG at all time points (T0: 97.3 mg/dL vs. 89.7 mg/dL, T30: 159.9 mg/dL vs. 144.3 mg/dL, T60: 134.8 mg/dL vs. 126.2 mg/dL, T90: 113.7 mg/dL vs. 99.3 mg/dL, and T120: 91.8 mg/dL vs. 82.6 mg/dL; p < 0.001) with medium to large effect sizes (d = 0.57-1.02) and with ISFG systematically under-reporting the reference system CPG. CGM sensors provide a convenient and reliable method for monitoring blood glucose in the everyday lives of healthy adults. Nonetheless, their use in clinical settings wherein implications are drawn from CGM readings should be handled carefully.

Hindi translation and validation of the English version of the gastrointestinal symptom rating scale questionnaire: An observational study.

The gastrointestinal symptom rating scale (GSRS) is a questionnaire in English language which is designed to assess the clinical symptoms in patients with irritable bowel syndrome (IBS) and peptic ulcer disease. This validated scale has questions on around 15 items and has been validated in patients with dyspepsia and IBS. To translate and validate the English version of the GSRS questionnaire to the Hindi version. The purpose of the present work was to create a Hindi version of this questionnaire for use in the Indian population. The process involved various steps as per the World Health Organization methodology including initial forward translation, backward translation, and assessment by an expert committee. Initial pilot testing was followed by testing in healthy and diseased individuals. The Hindi translation was pilot tested in 20 individuals and further validated in healthy controls (n = 30, 15 females) and diseased individuals (n = 72, 27 females). The diseased group included patients with functional dyspepsia and IBS. Cronbach's alpha for internal consistency on the final translated GSRS questionnaire was 0.715 which is considered adequate. Twelve questions significantly differentiated the diseased population from the healthy population (P value < 0.05) in the translated Hindi version of the GSRS. The translated Hindi GSRS can be used to evaluate gastrointestinal function in clinical trials and community surveys in Hindi speaking populations.

Age-related annual changes in arterial stiffness in healthy adults: Insights from a large Korean cohort study

Background and aimsArterial stiffness, a known cardiovascular risk factor, is associated with increasing age and arteriosclerosis. This study examines age-related annual changes in arterial stiffness in a large cohort of healthy individuals without cardiovascular disease, hypertension, or diabetes mellitus. MethodsThe study included 195,405 Korean adults aged 30–79 years who attended a health check-up between 2006 and 2019. Arterial stiffness was assessed using brachial-ankle pulse wave velocity (baPWV), and the final cohort for the baPWV annual change analysis comprised 147,313 participants. ResultsThe study found that baPWV values increase progressively with age in both sexes, with the most notable changes occurring in the 70–79 age group. The spread in baPWV measurements, as indicated by the interquartile ranges, generally increases with age but was particularly pronounced in women in the 50s and 60s age groups, with men showing a greater spread in the 70–79 age group. The average annual change in baPWV (ΔbaPWV) values increased from 1.48 cm/s (95 % CI: 0.80–2.16) in the 30–39 age group to 23.72 cm/s (95 % CI: 16.25–31.19) in the 70–79 age group in men. Similarly, for women, the average ΔbaPWV values increased from 1.80 cm/s (95 % CI: 0.93–2.68) to 18.51 cm/s (95 % CI: 7.18–29.85) in the 30–39 and 70–79 age groups, respectively. The study observed that arterial stiffness in men consistently increases across all age groups, whereas in women, it does not significantly increase annually before age 50 but shows a steeper rise after this age. ConclusionsThis study emphasizes the progressive nature of arterial stiffness with aging in a healthy population. It highlights notable differences in the rate of progression and the distribution of baPWV between men and women, with men exhibiting a greater spread in the oldest age group.

COMPARISON OF STRENGTH OF ELBOW FLEXORS MEASURED BY MANUAL MUSCLE TESTING AND HAND-HELD DYNAMOMETRY IN YOUNG FEMALES: A CROSS-SECTIONAL STUDY

Objective: This study compared manual muscle testing with the objective measures of the Hand-Held dynamometer for detecting strength deficit across grades 4 and 5 in elbow flexors of young females. Materials and Methods: In this cross-sectional study, 300 young females in the age group of 18–39 years, having strength in grades 4 and 5, were recruited by non-probability convenient sampling. The strength of elbow flexors of dominant and non-dominant extremities was measured according to standard protocols of manual muscle testing and make test of Hand-held dynamometry. The data were tabulated and analyzed by SPSS version 25. The tests used were independent sample t-tests to compare the mean of strength variation in the normal population. A comparison of both tools to predict the extent of variation in the variable of strength was made through Pearson correlation. Results: The weakness in elbow flexors was revealed by grade 4 of manual muscle testing in the young healthy female population. Quantified strength by dynamometer presented a varied range of strength, with overlap in strength in grades 4 and 5. There was a significantly weaker correlation in both techniques (0.242 on non-dominant side and 0.317 on the dominant side) in the detection of strength differences at a p-value of 0.00. Conclusion: This study quantified the strength variation across the subjective realm of grades 4 and 5 through dynamometric measures in the elbow flexors of young females. The comparison of strength across both grades showed a weak correlation for the quantification of strength measured through a dynamometer. Keywords: Muscle strength, Dynamometer, Elbow Flexors, Manual Muscle testing.

Pseudodominance in RFC1-Spectrum Disorder.

Cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS) and disease spectrum is an autosomal recessive disorder associated with biallelic repeat expansion (RE) in the RFC1 gene. A high carrier frequency in the healthy population determines the possibility of having affected members in two consecutive generations. We describe pseudodominance in two families affected with RFC1 disorder (10 affected, 5 oligo/asymptomatic individuals). In Family A, after the 75-year-old index case was diagnosed with CANVAS, the 73-year-old wife decided to undergo screening for carrier testing. Although she did not report any symptoms, she resulted positive for the biallelic AAGGG RE thus leading to a diagnosis in the asymptomatic offspring as well and revealing a pseudodominant pattern of inheritance. In Family B pseudodominance was suspected after the identification of the RFC1 RE in the proband affected by sensitive neuropathy because of a positive family history for undetermined polyneuropathy in the mother. The post-mortem identification of the RFC1 RE in a sample specimen from the deceased mother, who had been under our care, allowed the solution of a "cold case". Our report suggests that pseudodominance is a confounding phenomenon to consider in RFC1-spectrum disorder and genetic counselling is instrumental in families with affected individuals.