Comparison between cuff-based and radial tonometry exercise-induced central blood pressure.

PURPOSE: Non-invasive central blood pressure assessed during exercise may provide better cardiovascular prognostic than measurements taken at rest. Radial tonometry is the only technique validated to perform this type of assessment; however, it relies on the experience of the tester. Cuff-based devices have been developed to avoid operator dependency, although these systems have yet to be validated during exercise. The purpose of this study was to compare exercise-induced central blood pressure estimations between a cuff-based device and radial tonometry. METHODS: Twenty young healthy subjects were recruited to perform a three-workload steady-state exercise test at blood lactate levels of < 2, 2-4, and > 4 mmol/L, respectively. Central systolic and diastolic blood pressure (cSBP and cDBP, respectively), central pulse pressure (cPP), and augmentation index (AIx) were assessed at rest and during each workload with a cuff-based device and radial tonometry. Statistical analysis included Bland-Altman analysis for agreement between techniques. Agreement was considered when 95% of the data set for each central blood pressure parameter was within 1.96 standard deviations from the mean difference. Significance was considered at α = 0.05. RESULTS: Central blood pressure measurements with the cuff device were obtained only at rest and during low-intensity exercise. During low-intensity exercise, all measurements showed agreement between both devices (cSBP 95% CI [- 6.0 to 10.7], cDBP 95% CI [- 4.5 to 6.3], cPP 95% CI [- 4.7 to 8.3], and AIx (95% CI [- 20.1 to 22.2]). CONCLUSION: A cuff-based device can estimate central blood pressure at low-intensity exercise, without operator dependency, and showing agreement to radial tonometry.

Acute dietary nitrate does not reduce resting metabolic rate or oxidative stress marker 8-isoprostane in healthy males and females.

To investigate changes in resting metabolic rate and 8-isoprostane, an oxidative stress biomarker, following acute dietary nitrate supplementation in healthy males and females. In a randomised, double-blind, cross-over study, 10 males and seven females (age range 19-25 years) underwent protocol familiarisation (visit 1), baseline assessments (visits 2 and 4) and assessments following supplementation, placebo or 6.2 mmol nitrate, 2 hours prior to visits 3 and 5. Participants completed a 30-minute RMR test with visits 2 and 3 on consecutive days, separated by a week-long washout period concluding with visits 4 and 5 on consecutive days. Plasma nitrate/nitrite (NOx) significantly increased (p ≤ 0.05) following dietary nitrate consumption compared to baseline values. No significant effect on resting metabolism (p = 0.194) or 8-isoprostane (p = 0.660) was observed following dietary nitrate supplementation. Dietary nitrate increases NO bioavailability, but acute supplementation does not effect resting metabolism or 8-isoprostane in healthy males and females.

Male meiotic spindle poles are stabilized by TACC3 and cKAP5/chTOG differently from female meiotic or somatic mitotic spindles in mice.

Transforming acidic acid coiled-coil protein 3 (TACC3) and cytoskeleton associated protein 5 (cKAP5; or colonic hepatic tumor overexpressed gene, chTOG) are vital for spindle assembly and stabilization initiated through TACC3 Aurora-A kinase interaction. Here, TACC3 and cKAP5/chTOG localization with monospecific antibodies is investigated in eGFP-centrin-2- expressing mouse meiotic spermatocytes. Both proteins bind spermatocyte spindle poles but neither kinetochore nor interpolar microtubules, unlike in mitotic mouse fibroblasts or female meiotic oocyte spindles. Spermatocytes do not display a liquid-like spindle domain (LISD), although fusing them into maturing oocytes generates LISD-like TACC3 condensates around sperm chromatin but sparse microtubule assembly. Microtubule inhibitors do not reduce TACC3 and cKAP5/chTOG spindle pole binding. MLN 8237 Aurora-A kinase inhibitor removes TACC3, not cKAP5/chTOG, disrupting spindle organization, chromosome alignment, and impacting spindle pole γ-tubulin intensity. The LISD disruptor 1,6-hexanediol abolished TACC3 in spermatocytes, impacting spindle bipolarity and chromosome organization. Cold microtubule disassembly and rescue experiments in the presence of 1,6-hexanediol reinforce the concept that spermatocyte TACC3 spindle pole presence is not required for spindle pole microtubule assembly. Collectively, meiotic spermatocytes without a LISD localize TACC3 and cKAP5/chTOG exclusively at spindle poles to support meiotic spindle pole stabilization during male meiosis, different from either female meiosis or mitosis.

Loneliness, Discrimination, Stress, and Type 2 Diabetes Risk in Young Adults.

INTRODUCTION: The aim of this study was to determine the associations between type 2 diabetes or prediabetes and loneliness and related social experiences in young adults, a population at increasingly high risk of type 2 diabetes. METHODS: This was a cross-sectional analysis using data from adults aged 18-35 years enrolled in the All of Us Research Program. Exposures included loneliness, social support, discrimination, neighborhood social cohesion, and stress, measured by standardized surveys. The main outcome was type 2 diabetes or prediabetes by self-report or linked health record. Logistic regression determined the odds of type 2 diabetes/prediabetes for each survey measure, adjusting for age, sex, race or ethnicity, income, and family history. Latent class analysis evaluated clustering of social experiences. Data were collected from 2018 to 2022 and analyzed in May 2023-June 2024. RESULTS: The cohort included 14,217 young adults (aged 28.2 ± 4.4 years, 73.1% [n=10,391] women, 64.1% [n=9,111] White, 10.6% [n=1,506] Hispanic, 5.7% [n=806] Black, and 9.1% [n=1,299] multiracial). Overall, 5.5% (n=777) had either prediabetes or type 2 diabetes. The 2 highest loneliness quartiles were associated with increased odds of prediabetes/type 2 diabetes (Q3: OR=1.42 [95% CI=1.15, 1.76] and Q4: OR=1.78 [95% CI=1.45, 2.19]). Greater stress and discrimination and lower social support and neighborhood social cohesion were also associated with increased odds of prediabetes/type 2 diabetes. Latent class analysis revealed 3 distinct phenotypes, with elevated odds of prediabetes/type 2 diabetes in the 2 with the most adverse social profiles (OR=2.32 [95% CI=1.89, 2.84] and OR=1.28 [95% CI=1.04, 1.58]). CONCLUSIONS: Loneliness and related experiences are strongly associated with type 2 diabetes and prediabetes in young adults. Whether these factors could be leveraged to reduce type 2 diabetes risk should be investigated.

Prediabetes Prevalence by Adverse Social Determinants of Health in Adolescents.

Importance: Several clinical practice guidelines advise race- and ethnicity-based screening for youth-onset type 2 diabetes (T2D) due to a higher prevalence among American Indian and Alaska Native, Asian, Black, and Hispanic youths compared with White youths. However, rather than a biological risk, this disparity likely reflects the inequitable distribution of adverse social determinants of health (SDOH), a product of interpersonal and structural racism. Objective: To evaluate prediabetes prevalence by presence or absence of adverse SDOH in adolescents eligible for T2D screening based on weight status. Design, Setting, and Participants: This cross-sectional study and analysis used data from the 2011 to 2018 cycles of the National Health and Nutrition Examination Survey. Data were analyzed from June 1, 2023, to April 5, 2024. Participants included youths aged 12 to 18 years with body mass index (BMI) at or above the 85th percentile without known diabetes. Main Outcomes and Measures: The main outcome consisted of an elevated hemoglobin A1c (HbA1c) level greater than or equal to 5.7% (prediabetes or undiagnosed presumed T2D). Independent variables included race, ethnicity, and adverse SDOH (food insecurity, nonprivate health insurance, and household income <130% of federal poverty level). Survey-weighted logistic regression was used to adjust for confounders of age, sex, and BMI z score and to determine adjusted marginal prediabetes prevalence by race, ethnicity, and adverse SDOH. Results: The sample included 1563 individuals representing 10 178 400 US youths aged 12 to 18 years (mean age, 15.5 [95% CI, 15.3-15.6] years; 50.5% [95% CI, 47.1%-53.9%] female; Asian, 3.0% [95% CI, 2.2%-3.9%]; Black, 14.9% [95% CI, 11.6%-19.1%]; Mexican American, 18.8% [95% CI, 15.4%-22.9%]; Other Hispanic, 8.1% [95% CI, 6.5%-10.1%]; White, 49.1% [95% CI, 43.2%-55.0%]; and >1 or other race, 6.1% [95% CI, 4.6%-8.0%]). Food insecurity (4.1% [95% CI, 0.7%-7.5%]), public insurance (5.3% [95% CI, 1.6%-9.1%]), and low income (5.7% [95% CI, 3.0%-8.3%]) were each independently associated with higher prediabetes prevalence after adjustment for race, ethnicity, and BMI z score. While Asian, Black, and Hispanic youths had higher prediabetes prevalence overall, increasing number of adverse SDOH was associated with higher prevalence among White youths (8.3% [95% CI, 4.9%-11.8%] for 3 vs 0.6% [95% CI, -0.7% to 2.0%] for 0 adverse SDOH). Conclusions and Relevance: Adverse SDOH were associated with higher prediabetes prevalence, across and within racial and ethnic categories. Consideration of adverse SDOH may offer a more actionable alternative to race- and ethnicity-based screening to evaluate T2D risk in youth.

The Association between Anthropometric Failure and Toilet Types: A Cross-Sectional Study from India.

Sustainable Development Goal 6.2 aims to end open defecation by 2030 by ensuring universal access to private household toilets. However, private toilets might not be feasible for poor households. As a result, policy makers and academics have suggested well-managed shared sanitation facilities as an alternative solution. Less is known about the associations between shared sanitation use and health. Using data from the fifth round of the National Family Health Survey from 2019 to 2021, we estimated the association between usual defecation location and child anthropometry outcomes among children under 2 years in India. The primary exposure was usual defecation location at the household level. We compared both shared improved toilet use and open defecation to private, improved toilet use. We used linear regression to estimate the associations between the exposures and linear outcomes: height-for-age Z-score, weight-for-height Z-score, and weight-for-age Z-score. We used Poisson regression with a log link to estimate the prevalence ratios of stunting, wasting, and underweight. After controlling for environmental, maternal, socioeconomic, and child confounders, we found no differences in six child anthropometry outcomes when comparing shared toilet use or open defecation to private toilet use. This finding was consistent across both urban and rural households. Our findings confirm the null associations between private toilet use and child growth found in previous studies, and that this association does not vary if the toilet is being shared. Future research should examine these differences between private and shared toilets in the context of other health outcomes.

"Someone Should be There to Take Care of It": A Case Study of Users' Views of Managed Shared Sanitation Facilities in Jharkhand, India.

The Sustainable Development Goals have set an ambitious target to end open defecation by 2030 by building private household toilets. These toilets are categorized based on quality indicators. However, toilets that are shared among households are considered "limited," disincentivizing governments and implementers from investing in this infrastructure despite being more appropriate in certain contexts. Furthermore, unlike private toilets, shared toilets are not distinguished based on their quality. As such, there is a need to understand what attributes constitute well-managed shared toilets. These types of facilities could play an important role in helping people move up the sanitation ladder away from open defecation in certain contexts. Therefore, we conducted 41 one-on-one in-depth interviews with users of managed shared sanitation facilities. We found that maintenance and accessibility are key indicators of well-managed shared sanitation. Maintenance includes the provision of water for flushing and self-cleaning, cleaning, and high-quality built infrastructure. Accessibility is defined by the distance people have to walk to reach the facility, the amount of time they have to wait in line, and design features of the facility that encourage use. These findings could help distinguish managed versus unmanaged shared sanitation and could help inform global sanitation policies.

Who Eats School Breakfast? Parent Perceptions of School Breakfast in a State With Very Low Participation.

BACKGROUND: Having breakfast is correlated with health and academic benefits; yet, many children do not consume breakfast, and participation in the federal School Breakfast Program remains low. The purpose of this study was to examine parent perceptions of school breakfast and identify relationships between those who consume breakfast at school and those who do not. METHODS: A random sample of 100 schools, representing 29 school districts, across the state of Utah was selected to participate in the survey. Administrators were asked to distribute an online survey link to the parents of their school. Parents answered questions about their oldest kindergarten through 12th grade child. Qualitative and quantitative analyses were performed. RESULTS: A total of 488 parents completed the survey. In a multilevel model, child grade level, participation in free and reduced-price lunch, and perceive benefits to school breakfast were significantly related to eating breakfast at school. Some major themes from the qualitative analysis included no need for school breakfast, perception of regional values, and logistical issues. CONCLUSIONS: Parent perception of school meals is related to participation. This study identifies several areas of perception that could be address through parent education to increase school breakfast participation.

Internal validation of an automated system for brachial and femoral flow mediated dilation.

BACKGROUND: Flow Mediated Dilation (FMD) has immense potential to become a clinical, non-invasive biomarker of endothelial function and nitric oxide bioavailability, which regulate vasomotor activity. Unfortunately, FMD analysis techniques could deviate significantly in different laboratories if a validation process is not involved. The purpose of this study was to provide validation to the assessment of FMD analysis in our laboratory and to standardize this process before reporting results of FMD. METHODS: Brachial and femoral arteries FMD were performed on 28 apparently healthy participants (15 male and 13 female, ages 18-35 years). For the intratester reliability study, nine subjects were asked to come to the lab for a second brachial FMD within 48 h. All FMD procedures were performed by the same investigator, while the FMD analyses were performed by 2 independent testers who were blind to each other's analyses. FMD analyses included baseline artery diameter measurements, peak artery diameter after 5 min of ischemia, and FMD. Analysis was completed via an automated edge detection system by both testers after training of the methodical process of analysis to minimize variability. Intratester and intertester reliability were determined by using coefficient of variation (CV) between first and second visit (intratester) and between results obtained by both testers (intertester). RESULTS: The intratester CVs for tester 1 and 2 were 3.28 and 2.62%, 3.74 and 3.27%, and 4.95 and 2.38% for brachial baseline artery diameter, brachial peak artery dilation, and brachial FMD, respectively. In the intertester CVs were 2.40, 3.16, and 3.37% for brachial baseline artery diameter, peak artery dilation, and FMD, respectively and 4.52, 5.50, and 3.46% for femoral baseline artery diameter, peak artery dilation, and FMD, respectively. CONCLUSION: All CVs were under or around 5%, confirming a strong reliability of the method. Our laboratory has shown that the FMD protocol is reproducible due to the significantly low coefficient of variation. This is one step closer to use FMD as a biomarker for endothelial function in our laboratory.