Changes in the levels of marker molecules salivary α-amylase and cortisol as a stress response to everyday activities of general practitioners in rural areas of the Republic of Bulgaria.

INTRODUCTION: Stress is a phenomenon accompanying everyday life. Various reactions of the body are activated during stress, including activation of the hypothalamo-pituitary-adrenal endocrine axis and the autonomous nervous system. Their activity could be assessed by the measurement of biological stress marker molecules - salivary α-amylase and cortisol - on one side and heart rate, and blood pressure monitoring, on the other. The aim of the present study is to determine whether the daily professional routines cause stress development among general practitioners (GPs) who work in rural, distant areas in the territory of the Republic of Bulgaria. METHODS: One hundred and twenty-eight GPs were asked to answer a questionnaire to assess their health conditions, habits, priority objectives and interests, as well as their moral and ethical relationships with the patients. On this basis 40 participants were selected and outlined for the present survey (n=40, mean age 55.92±8.8). Four salivary samples were collected from each participant during 1 week: two on Monday (one in the morning and one after work) and two on Friday, by the same mechanism. The salivary samples collection was followed by measurement of blood pressure and pulse. This non-invasive survey was based on an ELISA method for quantitative determination of the marker molecules in saliva. The blood pressure and pulse were measured by blood pressure monitor. RESULTS: The levels of the salivary α-amylase were significantly higher at the end of the working day, especially on Friday (142.28±23.34 U/mL, p=0.018), but not between the beginning and the end of the week. The normal cortisol awakening response, characterized by a peak in the levels of cortisol after wake-up, followed by a slow decrease during the day, was detected only at the beginning of the week. The data show a significant impairment of this regularity at the end of the week. Moreover, the levels of cortisol, measured for the morning samples, show a decrease at the end of the week (25.73±10.51 ng/mL) in comparison to the beginning of the week (30.1±10.84, p=0.033). The analyses on the effect of smoking (p=0.002) and alcohol consumption (p=0.036) on stress development show a significant increase in the levels of the salivary α-amylase, but not on the levels of salivary cortisol. The changes in the blood pressure indicate stress development at the end of the week (p=0.04), while the pulse showed changes within a day rather than during the week. The values of the pulse were higher at the end of the day. CONCLUSION: The professional lives of the GPs who work in distant and rural places are associated with stress development. Different habits from the daily routine, such as alcohol consumption, smoking and physical activity, could be considered as modulators of stress development.

Effects of COVID-19 in Endocrine Patients: A Cross-Sectional Study.

Introduction: Home confinement due to COVID-19 lockdown led to changes in daily routines, including social interactions, as well as restrictions on the possibility of playing sports and eating habits. These changes could have a greater impact on patients suffering from chronic diseases, such as endocrine patients, especially in emotional and behavioral dimensions. Materials and Methods: This study aimed to assess the effects of COVID-19-induced quarantine on daily habits in a group of patients with endocrine disorders, focusing on food consumption, eating habits and sleep during the confinement. Eighty-five endocrine patients were enrolled. A structured interview was administered to investigate socio-demographic information, general medical conditions, and habits adopted during quarantine. All patients underwent the Spielberger State Anxiety Inventory (STAI-Y1) to assess state anxiety. Result: Results showed that subjects mainly had a sedentary lifestyle. We found a significant increase in the number of cigarettes in smokers and in meals consumed during confinement, as well as a high rate of sleep disturbance, especially insomnia. Notably, physical well-being resulted to be a predictive factor (OR = 0.38; 95%CI = [0.95,0.66]), whereas anxiety was a risk factor for sleep disorder (OR = 1.22; 95%CI = [1.10,1.40]), as was working in public and private offices and being a student. Conclusions: Changes in daily habits were likely due to the alterations in routine, resulting in greater boredom and inactivity during the day. In addition, future research should focus on the importance of patient adherence to therapy.

Smoking and Physical Activity Significantly Influence Stromal Vascular Fraction Cell Yield and Viability.

BACKGROUND: Subcutaneous tissue is an abundant source of adipose-derived regenerative cells. It is readily available and easy to extract by means of liposuction, making it one of the most popular sources for tissue engineering and regenerative medical applications. METHODS: The stromal vascular fraction (SVF) cell yield and viability of the lipoaspirate obtained from 43 patients undergoing elective liposuction were examined in correlation with their age, gender, body mass index, smoking status, and physical activity. The lipoaspirate was processed with the Celution® 800/CRS system to isolate the SVF and a few drops of the obtained pellet were used for cell counting with NecleoCounter® NC-100TM. RESULTS: Twenty-eight (65.1%) were men and 15 (34.9%) were women with an average age of 40.7 ± 10.4 years (women) and 38.9 ± 11.8 years (men). Viable SVF cells/g fat was significantly correlated with smoking level (negative correlation, ρ= - 0.312, P < 0.05) and with marginal significance with female gender. Cell viability showed a significant negative correlation with physical activity level (ρ = - 0.432, P < 0.01); borderline significance for correlation of this parameter with smoking level should not be neglected. Other parameters did not influence the cell yield nor the viability of the stromal vascular fraction. CONCLUSION: Many factors may influence SVF cell yield and viability. Our findings indicate that age and smoking significantly influenced SVF cell yield, age positively while smoking negatively. Increased physical activity had a negative correlation with SVF cell viability. LEVEL OF EVIDENCE N/A: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Daily habits, diseases, drugs and knee osteoarthritis: a two-sample Mendelian randomization analysis.

Background: The causal relationship between daily habits, diseases, drugs, and knee osteoarthritis (KOA) remains unclear. This study utilized a two-sample Mendelian randomization (MR) method to investigate the causal links between these factors and KOA, providing new insights for KOA prevention. Methods: SNPs strongly associated with exposure factors (daily habits, diseases, drugs) were extracted from publicly available genome-wide association study (GWAS) as instrumental variables (IVs). We then selected GWAS of KOA as the outcome, conducting a two-sample MR analysis. Results: Our findings revealed significant causal relationships between several factors and KOA. There was a notable association with time spent watching TV (OR = 4.038; 95% CI: 1.859-8.770; P = 4.192E-04), frequency of friend/family visits (OR = 0.415; 95% CI: 0.219-0.788; P = 7.174E-03), smoking history (OR = 0.781; 95% CI: 0.663-0.921; P = 3.235E-03), gastroesophageal reflux disease (GERD) (OR = 1.519; 95% CI: 1.244-1.856; P = 4.183E-05), hypercholesterolemia (OR = 0.498; 95% CI: 0.290-0.855; P = 0.011), hypothyroidism (OR = 1.048; 95% CI: 1.013-1.084; P = 6.645E-03), use of antithrombotic agents (OR = 0.892; 95% CI: 0.816-0.976; P = 0.013), statin medication (OR = 0.956; 95% CI: 0.916-0.998; P = 0.041), and thyroid preparations (OR = 1.042; 95% CI: 1.014-1.071; P = 2.974E-03) with KOA. Specifically, KOA was positively associated with longer time spent watching TV, GERD, hypothyroidism and thyroid preparations, however showed a negative correlation with more frequent visits from friends or family, smoking history, hypercholesterolemia, antithrombotic agents and statin medication. Sensitivity analysis indicated no significant pleiotropy in these studies (P > 0.05). Conclusion: This comprehensive study underscores the significance of modifying certain habits to mitigate the risk of KOA. Additionally, the elevated risk of KOA among individuals with GERD, hypothyroidism, and those using thyroid preparations warrants attention. These results would be beneficial for clinical research and nursing education.

Executive functions and daily functioning in myotonic dystrophy type 1 ecological assessment with virtual reality.

Central nervous system dysfunction is characteristic of patients with myotonic dystrophy type 1 (DM1). Although no consensus exists regarding the exact cognitive profile of these patients, executive dysfunction has been suggested to play a role. Due to the impact of executive functions on daily performance, this study aimed to describe executive functioning in an ecological manner and to analyze its impact - and that of other clinical variables - on the functional performance of DM1 patients. A Virtual Reality executive functioning test (Nesplora Ice Cream), the Wechsler Adult Intelligence Scale-Fourth Edition, and self-report questionnaires (AES, FSS, ESS and LIFE-H) were administered to 20 patients. Statistical analyses included correlation and multiple regression analyses to analyze the best predictors of daily performance. DM1 patients did not show major difficulties in the executive functioning tasks or in their overall performance on daily habits. However, both cold and hot executive functions still seem necessary for the correct accomplishment of life habits, since planning and level of apathy explained 47.6% of the total variance of daily functioning. This was the first study to assess executive functions in DM1 using Virtual Reality, and our findings open a debate about their actual impairment in this population.

[Changes in sleep patterns and the doom-scrolling (doom-surfing) phenomenon as modifiable risk factors for anxiety due to continuous stress of the COVID-19 pandemic]. / Izmeneniya rezhima sna i potreblenie informatsii s negativnym kontentom v internete («dumskrolling¼, «dumserfing¼) kak upravlyaemye faktory riska razvitiya trevogi v usloviyakh stressa pandemii COVID-19.

OBJECTIVE: To evaluate the modifiable daily behavior patterns associated with increased anxiety indicators in the general population in response to the COVID-19 pandemic. MATERIAL AND METHODS: The study examined the characteristics of the Russian population (n=7777) of the international multicenter project COMET-G. In particular, variables were targeted to describe deviations in the behavior of adults during the period of application of measures of social isolation in connection with the pandemic, and revealing a relationship with the total score on the Spielberger State Anxiety Scale (STAI-S). Among these variables, experts selected those that could potentially be subject to change in the short term, that is, act as manageable or modifiable risk factors for the development of anxiety. The selected variables were analyzed in a statistical PLS-model to identify indicators that make the most significant contribution to the increase in the total anxiety score. RESULTS: Our statistical model explained 48.4% of the variability in the STAI-S anxiety total scores related to changes in daily life habits. In particular, doom-scrolling/doom-surfing about the spread of the virus and the COVID-19 pandemic, changes in sleep patterns and usual daily life activities due to social isolation measures presented as factors significantly contributing to the increase of state anxiety. CONCLUSION: Given the manageable or modifiable risk factors that we have identified, public awareness and therapeutic recommendations, pointing to the need to (I) control the amount of time spent in the internet and monitor their internet-based content consumption, (II) regulate sleep-wake patterns, (III) maintain daily habits and household activities, may reduce the likelihood of developing anxiety disorders in the context of the impact of a global chronic stress due to the COVID-19 pandemic and associated social isolation measures.

The impact of COVID-19 on the everyday life of blind and sighted individuals.

The COVID-19 pandemic caused unexpected and unavoidable changes in daily life worldwide. Governments and communities found ways to mitigate the impact of these changes, but many solutions were inaccessible to people with visual impairments. This work aimed to investigate how blind individuals subjectively experienced the restrictions and isolation caused by the COVID-19 pandemic. To this end, a group of twenty-seven blind and seventeen sighted people took part in a survey addressing how COVID-19 impacted life practically and psychologically, how it affected their daily habits, and how it changed their experiences of themselves and others. Results demonstrated that both sighted and blind individuals had a hard time adapting to the new situation. However, while sighted people struggled more with personal and social aspects, the frustration of the blind population derived mostly from more practical and logistical issues. Likely as consequences, results showed that blind people engaged more in their inner life and experienced fear and anger as main emotions. This study suggests that changes in life associated with COVID-19 have been subjectively experienced differently based on the presence or not of blindness, and that tailored future interventions should be considered to take care of the different needs of blind individuals.

Development and Validation of a Daily Habit Scale.

Habits are defined as automatic behaviours triggered by cues and performed without awareness. They are difficult to control and mentally efficient, which contrasts with goal-directed behaviour, which is characterised by active thought, high computational effort, and the ability to modify this behaviour in response to a changing environment and contextual demands. Habits are not only defined by the frequency with which a behaviour is performed but represent a complex construct that also includes the strength and automaticity of the habitual behaviour. We report here the development and validation of a Daily Habit Scale (DHS) to assess the frequency, automaticity, and strength of daily habits in healthy individuals. Item reduction based on factor analysis resulted in a scale with 38 items grouped into eight factors explaining 52.91% of the variance. The DHS showed very good internal consistency (Cronbach alpha = 0.738) and test-retest reliability (Intraclass correlation coefficient = 0.892, p<0.001) as well as convergent and divergent reliability compared to other scales measuring habits. We found a significant effect of age, gender, anxiety, and depression on the DHS. Considering certain limitations of the DHS, such as not considering the context of performance of habits, and the absence of certain items, such as transportation use, the results of this study suggest that DHS is a reliable and valid measure of daily habits that can be used by both clinicians and researchers as a measure of daily habits.

Patterns of oral hygiene behaviors, daily habits, and caries prevalence in India and dominican republic: A comparative study.

BACKGROUND: The purpose of the study was to gain integrative knowledge on oral hygiene behaviors and daily habits affecting caries experience among rural people in India and Dominican Republic (DR). MATERIALS AND METHODS: Participants were recruited in two countries: La Esquina community, Province Maria Trinidad Sanchez in DR and in Ramgarh, district Chhindwara in the state of Madhya Pradesh in India. A total of 104 participants (18-80 years) were in the DR sample while 202 participants (18-85 years) were in the Indian sample. Face-to-face interviews collected information on oral hygiene behaviors, daily habits, and dental care. The caries experience was quantified using decayed, missing, and filled teeth (DMFT) index. RESULTS: There were significant differences in a few oral hygiene behaviors, daily habits, and levels of caries experience between the Dominican and Indian subgroups. Use of toothbrush (χ2 = 65.2; P < 0.001), self-reported use of fluoridated toothpaste (χ2 = 94.04; P < 0.001), use of tobacco (χ2 = 32.4; P < 0.001), dental visit (χ2 = 24.84; P < 0.001), attitude toward seeking professional dental care (χ2 = 85.07; P < 0.001), and DMFT scores (F = 13.3; P < 0.001) were significantly different between the two countries. The caries experience was higher in the Dominicans (9.6 ± 8.0 vs. 4.0 ± 5.7) than India's rural. CONCLUSIONS: Oral health practices varied considerably between rural populations in these two countries. Caries prevalence was significantly higher in Dominicans despite higher consumption of tobacco and lesser use of toothbrush among rural Indians in the subcontinent.

Peripheral Blood Mononuclear Cells Antioxidant Adaptations to Regular Physical Activity in Elderly People.

Regular physical activity prescription is a key point for healthy aging and chronic disease management and prevention. Our aim was to evaluate the antioxidant defense system and the mitochondrial status in peripheral blood mononuclear cells (PBMCs) and the level of oxidative damage in plasma in active, intermediate and inactive elderly. In total, 127 healthy men and women >55 years old participated in the study and were classified according on their level of declared physical activity. A more active lifestyle was accompanied by lower weight, fat mass and body mass index when compared to a more sedentary life-style. Active participants exhibited lower circulating PBMCs than inactive peers. Participants who reported higher levels of exercise had increased antioxidant protein levels when compared to more sedentary partakers. Carbonylated protein levels exhibited similar behavior, accompanied by a significant raise in expression of cytochrome c oxidase subunit IV in PBMCs. No significant changes were found in the activities of antioxidant enzymes and in the expression of structural (MitND5) and mitochondrial dynamic-related (PGC1α and Mitofusins1/2.) proteins. Active lifestyle and daily activities exert beneficial effects on body composition and it enhances the antioxidant defenses and oxidative metabolism capabilities in PBMCs from healthy elderly.