Sex disparities of human neuromuscular decline in older humans.

Females typically live longer than males but, paradoxically, spend a greater number of later years in poorer health. The neuromuscular system is a critical component of the progression to frailty, and motor unit (MU) characteristics differ by sex in healthy young individuals and may adapt to ageing in a sex-specific manner due to divergent hormonal profiles. The purpose of this study was to investigate sex differences in vastus lateralis (VL) MU structure and function in early to late elderly humans. Intramuscular electromyography signals from 50 healthy older adults (M/F: 26/24) were collected from VL during standardized submaximal contractions and decomposed to quantify MU characteristics. Muscle size and neuromuscular performance were also measured. Females had higher MU firing rate (FR) than males (P = 0.025), with no difference in MU structure or neuromuscular junction transmission (NMJ) instability. All MU characteristics increased from low- to mid-level contractions (P < 0.05) without sex × level interactions. Females had smaller cross-sectional area of VL, lower strength and poorer force steadiness (P < 0.05). From early to late elderly, both sexes showed decreased neuromuscular function (P < 0.05) without sex-specific patterns. Higher VL MUFRs at normalized contraction levels previously observed in young are also apparent in old individuals, with no sex-based difference of estimates of MU structure or NMJ transmission instability. From early to late elderly, the deterioration of neuromuscular function and MU characteristics did not differ between sexes, yet function was consistently greater in males. These parallel trajectories underscore the lower initial level for older females and may offer insights into identifying critical intervention periods. KEY POINTS: Females generally exhibit an extended lifespan when compared to males, yet this is accompanied by a poorer healthspan and higher rates of frailty. In healthy young people, motor unit firing rate (MUFR) at normalized contraction intensities is widely reported to be higher in females than in age-matched males. Here we show in 50 people that older females have higher MUFR than older males with little difference in other MU parameters. The trajectory of decline from early to late elderly does not differ between sexes, yet function is consistently lower in females. These findings highlight distinguishable sex disparities in some MU characteristics and neuromuscular function, and suggest early interventions are needed for females to prevent functional deterioration to reduce the ageing health-sex paradox.

Prevalence and trends of the diabetes epidemic in urban and rural India: A pooled systematic review and meta-analysis of 1.7 million adults.

PURPOSE: India has experienced a recent sharp increase in diabetes/pre-diabetes. We conducted a systematic-review and meta-analyses to describe the most recent prevalence and trends of pre-diabetes/diabetes in urban and rural India. METHODS: MethodsA literature search was conducted in PubMed and Scopus databases for population-based studies describing prevalence of diabetes/pre-diabetes in urban/rural populations. Trends were analysed in rural and urban settings overall, genderwise and statewise. RESULTS: The study reports data from 1,778,706 adults in India (69-studies), from surveys conducted from 1972-2017. Prevalence of diabetes increased in both rural and urban India from 2.4% and 3.3% in 1972 to 15.0% and 19.0% respectively in year 2015-2019. This was independently observed in both genders. Similar increasing prevalence was observed for pre-diabetes, overall and in both genders. In the latest decade (2010-2019) rural and urban prevalence was highest in states of Goa (17.4%) and Tamil Nadu (24.0%) respectively. Statewise analysis observed a wide disparity in prevalence between the North and the South of India. CONCLUSION: Pooled estimates show a relatively high burden of diabetes and pre-diabetes in rural and urban India, with narrowed urban-rural gap. Hence, it is important to plan urgent primary and secondary prevention strategies to minimize further increase in areas with high prevalence.

The range of non-traditional anthropometric parameters to define obesity and obesity-related disease in children: a systematic review.

Obesity is defined as an abnormal/excessive accumulation of body fat, associated with health consequences. Although overall obesity does confer a significant threat to the health of individuals, the distribution of body fat, especially abdominal/central obesity is of greater importance. For practical reasons, proxy anthropometric measurements have been developed to identify central obesity, however, major limitations are noted in these traditional measurements. The present study aims to evaluate the literature, to identify and describe non-traditional anthropometric measurements of overweight and obesity in children. The current systematic review was conducted in accordance with the PRISMA guidelines, and the search was undertaken in the PubMed® database, using MeSH (Medical Subject Headings) terms. Data extracted from each study were: (a) details of the study, (b) anthropometric parameter(s) evaluated in the study and its details, (c) study methods, (d) objectives of the study and/or comparisons, and (e) main findings/conclusions of the study. The search yielded a total of 3697 articles, of which 31 studies were deemed eligible to be included. The literature search identified 13 non-traditional anthropometric parameters. Data on non-traditional anthropometric parameters were derived from 24 countries. Majority were descriptive cross-sectional studies (n = 29), while sample size varied from 65 to 23,043. Non-traditional anthropometric parameters showed variable correlation with obesity and/or related metabolic risk factors. Some parameters involved complex calculations, while others were based on a single anthropometric measurement or derived from traditional measures. Most studies lacked comparison with a 'gold standard' assessment of body fat, hence further research is required to determine their accuracy and precision.

Temporal changes in emotional intelligence (EI) among medical undergraduates: a 5-year follow up study.

BACKGROUND: Emotional intelligence (EI) is thought to play a significant role in professional and academic success. EI is important for medical personnel to cope with highly stressful circumstances during clinical and academic settings. The present prospective follow-up study intends to evaluate the changes in EI and their correlates among medical undergraduates over a five-year period. METHODS: Data were collected in 2015 and 2020 at the Faculty of Medicine, University of Colombo, Sri Lanka. EI was assessed using the validated 33-item self-assessment tool, Schutte Self-Report Emotional Intelligence Test (SSEIT). In addition, socio-demographic details, students' involvement in extracurricular-activities during undergraduate life, students' satisfaction regarding the choice of studying medicine and plans to do postgraduate studies were also evaluated. A multiple-regression analysis was conducted among all students using percentage change in EI score as the continuous dependent variable, together with other independent variables (plan to do postgraduate studies, satisfaction in choice of medicine and extracurricular-activities). RESULTS: Sample size was 170 (response rates-96.6%), with 41.2% males (n = 70). Mean EI scores at baseline among all students was 122.7 ± 11.6, and it had significantly increased at follow-up to 128.9 ± 11.2 (p <  0.001). This significant increase was independently observed in both males (122.1 ± 12.2 vs. 130.0 ± 12.4, p <  0.001) and females (123.1 ± 11.1 vs. 128.2 ± 10.3, p = 0.001). During follow-up, an increase in EI score was observed in students of all religions and ethnicities. Mean EI score also increased in all categories of monthly income, irrespective of the employment status or attainment of higher education of either parent. An increase in mean EI score during follow-up was observed in students irrespective of their engagement in or number of extracurricular-activities, they were involved. In the multiple regression analysis, being satisfied regarding their choice of the medical undergraduate programme (OR:11.75, p = 0.001) was the only significant factor associated with the percentage change in EI score. CONCLUSION: EI in this group significantly improved over 5-years of follow-up and was independent of gender, religion, ethnicity, socio-economic parameters and academic performance. Satisfaction in the chosen field was a significant predictor of the overall change in EI. Future studies are  needed to identify and measure factors responsible for improvement in EI among medical undergraduates.

Exploring the Therapeutic Benefits of Pranayama (Yogic Breathing): A Systematic Review.

BACKGROUND: Pranayama (yogic breathing) has demonstrated numerous beneficial health effects. At present, there are no systematic reviews evaluating the beneficial health effects of pranayama alone as a practice. AIM: The aim of this study is to perform a systematic review about the beneficial health effects of pranayama. METHODS: Data were obtained using a stepwise search process by searching the online PubMed, Web of Science, and SciVerse Scopus databases using keywords. Controlled clinical trials in humans, using "Pranayama" as an intervention with an appropriate control group and evaluating health-related outcomes were selected for inclusion. RESULTS: Initial database searching indicated 669 potentially eligible articles, of which 18 studies satisfying the inclusion/exclusion criteria were selected. All were controlled trials, of which 13 were randomized and 1 was a crossover study. Number of participants ranged from 16 to 160, and the duration of pranayama practice varied from 4 days to 6 months. Studies demonstrated a significant effect on cardiorespiratory functions, in patients with bronchial asthma, with the improvement of pulse rate, systolic blood pressure, and respiratory function measurements. Furthermore, reduction in the frequency of attacks, severity, and medication requirement was also observed, with improved quality of life (QOL). In patients with chronic obstructive pulmonary disease, symptom, activity, and impact scores were improved. QOL improvement was also noted in cancer patients. CONCLUSIONS: Available evidence on pranayama indicates physiological and psychological benefits. Beneficial effects were mostly observed in patients with respiratory diseases such as bronchial asthma. It also helped those with cancer and cardiovascular disease. However, further high-quality randomized trials are required to provide definitive evidence.