Relative Deficiency Research Articles

The Concurrent Association of Magnesium and Calcium Deficiencies with Cognitive Function in Older Hospitalized Adults

Background/Objectives: Hypomagnesemia and hypocalcemia are common conditions among older adults that may contribute to cognitive decline. However, most of the existing research has focused primarily on dietary intake rather than the actual serum levels of these nutrients or examined them separately. This study aims to investigate the relationship between hypomagnesemia, hypocalcemia, and the concurrent presence of both deficiencies in relation to cognitive performance among seniors. Methods: A total of 1220 hospitalized patients aged 60 and older were included in the analysis. The participants were categorized into four groups: those with normal serum levels of magnesium and calcium, those with hypomagnesemia, those with hypocalcemia, and those with both serum magnesium and calcium deficiencies. To evaluate the potential influence of age, sex, common comorbidities, and disturbances in magnesium and calcium levels on cognitive performance, two general linear models were employed, using the Mini-Mental State Examination (MMSE) and Clock-Drawing Test (CDT) as dependent variables. Results: After adjusting for age, sex, body mass index, and comorbidities, the mean values for the MMSE and CDT were 23.33 (95%CI: 22.89–23.79) and 5.56 (95%CI: 5.29–5.83) for the group with normomagnesemia and normocalcemia, 22.59 (95%CI: 21.94–23.24) and 5.16 (95%CI: 4.77–5.54) for the group with hypomagnesemia, 19.53 (95%CI: 18.36–20.70) and 4.52 (95%CI: 3.83–5.21) for the group with hypocalcemia, and 21.14 (95%CI 19.99–22.29) and 4.28 (95%CI 3.61–4.95) for the group with both hypomagnesemia and hypocalcemia, respectively. Magnesium and calcium deficiencies contributed to MMSE and CDT variance in the general linear models. Conclusions: Our findings indicate that in addition to age, body mass index, and chronic heart failure, both hypomagnesemia and hypocalcemia are associated with reduced cognitive performance.

‘What should I do as a coach?’: an interview study with Swedish national team coaches about their professional practice and experiences in addressing potential health risks in elite sport

Through interviews with 12 Swedish national team coaches, this qualitative study explores the ways in which these coaches experience their professional work in relation to topics such as Relative Energy Deficiency in Sport (REDs) and disordered eating behaviours/eating disorders (DE/EDs). Using Andrew Abbott’s concepts of ‘diagnosis’, ‘inference’, and ‘treatment’ as the framework for the study, it suggests that coaches believe they have a role and sufficient knowledge to detect signs and symptoms of REDs or DE/EDs in the diagnosis phase. Following the International Olympic Committee’s guidelines, the coaches prefer to delegate the clinical treatment to members of the athlete’s health and performance team. However, they find that the connection between diagnosis (the problem) and treatment (the action) is unclear, resulting in coaches wanting to ‘infer’ support for their athletes. Implications of these findings are discussed within a professionalisation context along with topics such as education, boundary work, and legitimacy.

Laboratory Testing for ADAMTS13 for Thrombotic Thrombocytopenia Purpura and Beyond.

ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13), also called von Willebrand factor (VWF) cleaving protease, acts as a moderator of VWF activity. ADAMTS13 cleaves VWF multimers, thereby reducing VWF activity in blood. When ADAMTS13 is absent (e.g., in patients with TTP [thrombotic thrombocytopenia purpura]), accumulation of VWF in plasma can occur, particularly as "ultra-large" VWF multimers, with this leading to adverse outcomes such as thrombosis. Relative ADAMTS13 deficiencies also occur in several other conditions, including secondary thrombotic microangiopathies (TMA), cancer, and with severe infections such as in COVID-19 (coronavirus disease 2019). These situations might therefore be accompanied with relative loss of ADAMTS13, thereby potentially also leading to pathological VWF accumulation, with this then generating a prothrombotic milieu, thus contributing to enhance the risk of thrombosis. Laboratory testing for ADAMTS13 can aid in the diagnosis of such disorders (i.e., TTP, TMA), and help guide their management, with testing now accomplished using various assays. As most presentations of TTP reflect an acquired condition due to anti-ADAMTS13 antibodies, there may also be a need to test for these, as this will also influence clinical management. We herein provide an overview of TTP, note other conditions in which low levels of ADAMTS13 may be present, and then detail laboratory testing for both ADAMTS13 and associated inhibitors.

An insight on Diabetes Mellitus: A comprehensive review

This paper thoroughly overviews diabetes mellitus, focusing on its introduction, classification, and management strategies. Initially, the paper outlines the fundamental concepts of diabetes mellitus, including its impact on global health and its underlying pathophysiological mechanisms. It distinguishes between the two primary types of diabetes: Type 1 diabetes (T1D), an autoimmune condition leading to the destruction of insulin-producing beta cells, and Type 2 diabetes (T2D), characterized by insulin resistance and relative insulin deficiency. The paper further explores gestational diabetes and its implications for maternal and fetal health. Management strategies for diabetes are examined in detail, encompassing lifestyle modifications, pharmacotherapy, Anthropo-therapeutic Healing, and technological interventions. Key aspects include dietary management, physical activity, and blood glucose monitoring to achieve glycemic control. Additionally, advancements in diabetes care, such as novel pharmacological agents, insulin delivery systems, and continuous glucose monitoring, are discussed. The paper aims to provide a comprehensive understanding of the types of diabetes mellitus and their management, offering insights into current practices and future directions for improving patient outcomes and enhancing quality of life.

Low energy availability surrogates are associated with Relative Energy Deficiency in Sport outcomes in male athletes

ObjectivesTo determine the association between surrogates of low energy availability (EA) and proposed health and performance outcomes of Relative Energy Deficiency in Sport (REDs) in a clinical sample of adolescent...

Genetic relationship between W mineralization and granitic intrusion in Nanling Region, South China: Constraints from zircon and cassiterite u-pb age from new drill holes in Shangping deposit

The Nanling metallogenic belt is known for the widely development of typical quartz vein type W deposit. These quartz veins that contain wolframite are frequently located in close proximity to granitic intrusions. The genetic relationship between tungsten mineralization and the associated granitic rocks is still a subject of controversy. The Shangping deposit stands out as a historically significant W deposit with a quartz vein type in the region of Nanling. However, the specific time that W mineralization occurred remains enigmatic. Granitic intrusions are absent from the mine and only granite porphyry dike is exposed, so the link between tungsten mineralization and magmatic activity remains unclear. Fortunately, in recent years, a concealed granite intrusive has been exposed in drill holes in the southeastern of the Shangping W deposit. To comprehensively address the connection between granitic magma activity and W mineralization, it is vital to make up a relative deficiency of geochronological information on granite and ore mineral. Here, in order to get the first direct age constraints on the origin of the Shangping W deposit, we use a combination of different techniques, incorporating the Hf isotope geochemistry of zirconium and cassiterite U-Pb assessment using laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS). Based on these robust data, we tentatively evaluated the connection between W mineralization and granitic intrusion.For the granite porphyry, the majority of representative U-Pb zircon assays establish a206Pb/238U age of 150.2 ± 0.5 Ma. An inferred emplacement age of ca. 151 Ma for the concealed granite in Kengweiwo is supported by a U-Pb isochron age from zircon. Combined with Hf isotopic characterization, it illuminates the mineralization potential of the Kengweiwo concealed granite. Cassiterite grains from hydrothermal quartz vein are subhedral to anhedral and have a lower intercept 206Pb/238U age of 153.9 ± 1.0 Ma. For the Shangping W deposit, all of these new geochronological dates provide well-constrained mineralization ages of 150–154 Ma. The dates of the concealed granite in the Kengweiwo area and the tungsten mineralization in the Shangping area are extremely concordant, indicating that they occurred roughly concurrently. The vein type tungsten mineralization in Shangping deposit may has a genetic link with crystallization of uncovered granite present at depth, which requires further investigation. These results emphasize the significance and potential of concealed granitic intrusion to host disseminated W mineralization in the deep part of Shangping deposit.

The “Notch” in Unstable Layers and the Stability Minimum in the Tropics

Abstract In a previous paper, we identified a “notch” in unstable layers at Koror (7.3 0N, 134.5 0E), where there was a relative deficiency in thin unstable layers and a corresponding relative excess in thicker layers, at altitudes centered at 12 km. We hypothesized that this feature was associated with the previously identified stability minimum in the tropics at that same altitude. In this paper, we extend our studies of this “notch” and its association with the tropical stability minimum by examining other stations in the deep tropics and also some stations at higher latitudes within the tropics. We find that this “notch” feature is found at all the other radiosonde stations in the deep tropics that we examined. We also find that the annual variations in unstable layer occurrences at stations at higher latitudes within the tropics show variations consistent with our hypothesis that this “notch” is associated with the region of minimum stability in the tropics at altitudes centered around 12 km, in that the annual variation in this “notch” feature is consistent with the annual variation of minimum stability in this region. Two factors contribute to the “notch” feature. One is that the data quality control procedure of the analysis rejects many thin layers due to the small trend-to-noise ratio in the region of minimum stability. The other is that the cloud-top outflow, which was previously identified with the stability minimum, advects thicker unstable layers throughout the deep tropics at the altitudes of the “notch.”

Triad of female athletes

The female sports triad is a spectrum of dysfunctions related to energy availability, menstrual function, and bone mineral density. Energy availability is considered the trigger for the triad. Scientists have proven that women who do sports consume approximately 30% less energy and carbohydrates in relation to their body weight. Sufficient energy availability ensures the presence of a menstrual cycle, directly affects the stimulation of the production of female sex hormones (estrogen in particular). Thus, it prevents resorption of bone tissue. When energy availability is too low, a physiological mechanism reduces the amount of energy used for cell maintenance, thermoregulation, growth, and reproductive function. This compensation tends to restore energy balance and promotes survival, but impairs health. Low body weight in women of reproductive age, particularly in adolescence and the first reproductive age, is a biological marker of somatic and reproductive dysfunction. Osteoporosis in young female athletes is manifested by fractures unusual for young women or by frequent and multiple bone fractures during an athletic career. In this review article, an analytical review of literary and informational sources regarding the history of research on the problem of the triad of female athletes is carried out. The specifics of the negative impact of the athlete triad on the female body, the components of the athlete triad (amenorrhea, eating disorders, and osteoporosis) are examined in detail. The article focuses on its main cause - energy imbalance. The impact of the triad of female athletes on the psyche and behavior is considered. The question of its consequences for health both in the short-term and in the long-term perspective is considered. The prevention of RED-S syndrome was also investigated. The purpose of the study: Systematization of current knowledge about the triad of female athletes (relative energy deficiency syndrome (RED-S)). Research methods. Theoretical analysis of literary sources, systematization, generalization of scientific-methodical and special literature.

Computational Drug Design Approaches for the Identification of Novel Antidiabetic Compounds from Natural Resources through Molecular Docking, ADMET, and Toxicological Studies.

Type 2 diabetes mellitus (T2DM) is usually depicted by relative insulin deficiency, raised blood glucose levels, and the predominant risk factor, insulin resistance. Hence, the development of insulin sensitizer drugs targeting PPAR-γ receptors has expanded enormous interest as an attractive choice for T2DM treatment. Thiazolidinediones (TZD) enhance insulin sensitivity either by directly functioning on gene transcription of the PPARγ receptor related to glucose homeostasis or by systemic sensitization of insulin and, therefore, improved hyperglycemia in a wide range of patients. However, severe complications and adverse effects of TZDs necessitate the development of an efficacious and reliable insulin sensitizer from alternative resources. On the contrary, Nature is a rich source of anticipated effective and safer medicine; more than fifty percent of drugs on the market are developed from natural products. Hence, searching for a new PPAR-γ agonist from bioactive secondary compounds of medicinal plants along with greater efficacy and safety is a recognized and consistent tactic for developing novel antidiabetic agents. Pulicaria jaubertii is a fragrant perennial aromatic plant with anti-inflammatory, antidiabetic, antimicrobial, antimalarial, and insecticidal properties. The current study was designed to use a computer-aided drug design to explore the best antidiabetic compounds from P. jaubertii. Herein, the molecular docking study of 80 investigated ligands against the PPAR-γ receptor identifies the highest docking score for five ligands ranging from -8.9 kcal/mol to 8.0 kcal/mol, which is also more significant than the standard drug pioglitazone (-7.7 kcal/mol) determined by the PyRx 8.0 virtual screening software. GLN286, CYS285, SER289, TYR473, MET364, ARG288, ILE341, and LEU333 residues are found to be significant contributors to the non-bonded interaction between ligands and receptors. Molecular electrostatic potential (MEP), DFT, molecular orbital (MO), ADMET, and toxicological analyses were performed on the selected five high-scored ligands of P. jaubertii. Results documented that all investigated ligands, especially L4, show considerably excellent profiles in molecular docking, MEP, DFT, MO, ADMET, and toxicological predictions, suggesting our drug-designing approaches may contribute to the development of a novel antidiabetic drug for the treatment of T2DM from natural resources.

7672 Ketosis-Prone Diabetes - A Case Series

Abstract Disclosure: T. Ismail: None. A. Farooq: None. G. Acharya: None. J. Snitzer: None. Introduction Ketosis-prone diabetes (KPD) is a syndrome that primarily affects African Americans. It is characterized by ketoacidosis, which is like Type 1 Diabetes Mellitus (T1DM). KPD is unique because it lacks identifiable autoimmunity and has a relative insulin deficiency, resembling Type 2 Diabetes Mellitus (T2DM). Therefore, KPD is informally classified as Type 1.5 Diabetes Mellitus. However, the clinical course and outcomes of KPD are like those of T2DM, and managing blood sugar levels is possible through non-insulin antidiabetic medications and dietary interventions. Case Series: Our study involved six patients who were all of African-American ethnicity. There were an equal number of male and female patients, with ages ranging from 21 to 61 years. One patient had a BMI of 27.2, which is considered overweight, while the rest had a BMI in the obese category ory(BMI>30). Two out of six patients had a pre-existing diagnosis of type 2 diabetes mellitus (T2DM) before the initial diabetic ketoacidosis (DKA) event. One patient had prediabetes. All patients required hospitalization for ketoacidosis and hyperglycemia and were found to have a glycated hemoglobin (HbA1c) level of more than 10% during these DKA events. All patients received intravenous hydration and insulin drip treatment and were discharged with a combination of long and rapid-acting insulin regimens. Following the resolution of the first episode of diabetic ketoacidosis (DKA), all six patients experienced a decrease in their insulin requirements for optimal glycemic control. Currently, four patients have discontinued insulin entirely. Moreover, all six patients tested negative for the presence of GAD-65, insulin, and islet antigen-2 antibodies. Among the patients, only one had a previously established autoimmune disease, i.e., inflammatory bowel disease. None of the patients experienced a repeat episode of diabetic ketoacidosis. Conclusion: It is important to note that not all patients who present with Diabetic ketoacidosis have Type 1 Diabetes Mellitus (T1DM). Hence, checking auto-antibodies for T1DM before making a final diagnosis is crucial. C-peptide levels may not accurately reflect the degree of relative permanent insulin deficiency in this population if measured during or immediately after an episode of diabetic ketoacidosis due to glucose toxicity and other factors. Given its prevalence in obese individuals, weight loss through dietary modifications and GLP-1 receptor analogs may be beneficial. Presentation: 6/3/2024

Energy availability and its association with health-related outcomes among national athletes at risk of relative energy deficiency in sports (REDs)

BackgroundLow energy availability (LEA) occurs when athletes’ energy intake fails to match the energy expended during exercise, resulting in insufficient energy to support essential functions for optimal health, a condition...

86P Muscle 3D models to investigate LGMDD2 transportin 3 related deficiency: insights into myogenic processes and contractile dysfunction

86P Muscle 3D models to investigate LGMDD2 transportin 3 related deficiency: insights into myogenic processes and contractile dysfunction

Prevalence of physiological and perceptual markers of low energy availability in male academy football players: a study protocol for a cross-sectional study

Low energy availability (LEA) is a core feature of the female athlete triad and relative energy deficiency in sport (REDs). LEA underpins multiple adverse health and performance outcomes in various...

Using Advanced Imaging To Evaluate Bone Quality And Relative Energy Deficiency Risk In Elite Athletes

Using Advanced Imaging To Evaluate Bone Quality And Relative Energy Deficiency Risk In Elite Athletes

Self-reported Eating Behavior Is Correlated With Health Consequences Of Relative Energy Deficiency In Sport

Self-reported Eating Behavior Is Correlated With Health Consequences Of Relative Energy Deficiency In Sport

Forefoot Pain In Young Female Runner With Relative Energy Deficiency In Sport

Forefoot Pain In Young Female Runner With Relative Energy Deficiency In Sport

Low Energy Availability Surrogates Are Associated With Relative Energy Deficiency In Sport Outcomes In Male Athletes

Low Energy Availability Surrogates Are Associated With Relative Energy Deficiency In Sport Outcomes In Male Athletes

Prevalence of Signs and Symptoms of Relative Energy Deficiency in Sport Amongst Collegiate Athletes with Varying Levels of Access to Sports Registered Dietitian Nutritionists

Prevalence of Signs and Symptoms of Relative Energy Deficiency in Sport Amongst Collegiate Athletes with Varying Levels of Access to Sports Registered Dietitian Nutritionists

Bone Characteristics Among Female Endurance Athletes At Risk For Relative Energy Deficiency In Sport

Bone Characteristics Among Female Endurance Athletes At Risk For Relative Energy Deficiency In Sport

Euglycemic Ketoacidosis Associated with SGLT-2 Inhibitors in Non-diabetic Patients-A Narrative Review.

Euglycemic ketoacidosis is an acute, life-threatening emergency that is characterized by euglycemia, metabolic acidosis, and ketonemia. It is a well-recognized adverse event in diabetic patients taking sodium-glucose cotransporter-2 inhibitor (SGLT-2 inhibitor). However, there is limited data on SGLT-2 inhibitor-related euglycemic ketoacidosis in non-diabetic patients. The mechanism behind SGLT-2 inhibitor-associated euglycemic ketoacidosis involves a general state of starvation or relative insulin deficiency, which exacerbates the mild baseline ketonemia caused by this class of medications while normoglycemia is maintained. The incidence of euglycemic ketoacidosis will likely increase with the increasing use of SGLT-2 inhibitors for various indications in addition to diabetes mellitus type 2, predominantly for congestive heart failure (CHF). Recognizing the signs and symptoms of this life-threatening condition is essential to treat it effectively. Our objective is to comprehensively revisit the pathophysiology of euglycemic ketoacidosis associated with SGLT-2 inhibitors and the risk factors for the condition, review the available data, and summarize the reported cases of euglycemic ketoacidosis in non-diabetic patients on SGLT-2 inhibitors. Our literature search identified five articles with six cases of euglycemic ketoacidosis in non-diabetic patients who were on SGLT-2 inhibitors for heart failure with reduced ejection fraction. The common risk factor in five out of the six cases was decreased oral intake due to acute illness, fasting, or a perioperative state.