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Background: Events such as global pandemics can force rapid adoption of new modes of assessment. We describe the evaluation of a modified neuropsychological assessment for web and telephone administration., Methods: Telephone and video conferencing-based neuropsychological assessment procedures were developed and implemented within an ongoing observational study, the Successful Aging following Elective Surgery II (SAGES) study (N = 420 persons). Repeated cognitive assessments were used (N = 2008 observations). Analyses using latent variable psychometric methods were used to compare the measurement modes, and a nested validation sub-study (N = 100 persons) was used to test for measurement equivalence. We used item response theory methods to calibrate data collected by different assessment modes. Measurement equivalence was assessed with Bland-Altman plots and regression analysis., Results: Only small differences were detected between in-person and video modes of assessment. The largest difference among factor loadings was shared for the Boston Naming Test and Visual Search and attention test, but the effects were very small (Cohen's q = 0.06) and not statistically significant (95% confidence interval on q, -0.06, +0.18). In terms of item difficulty differences between in-person and video, the Digit Span Backwards test was less difficult by video with a small-to-moderate effect size (Cohen's d of -0.28, 95% CI, -0.54, -0.01). The contrast of in-person and telephone assessment was larger, with telephone assessment being less difficult than in-person (largest shift in item difficulty for digit span backwards, d = -1.12 95% CI -1.35, -0.90). Calibrated scores from telephone and videoconference demonstrated good agreement (r = 0.72, 95% CI 0.61, 0.80), and the differences could be corrected with latent variable measurement models., Conclusions: Videoconference based neuropsychological assessment can be as precise as in-person. Calibration of ability estimates using latent variable measurement models can address measurement differences and generate scores without evidence of systematic bias., (© 2024 The American Geriatrics Society.)

Background/objectives: There is a subset of patients with pain who become worse after exercise. To explore this, we examined the responses of people with chronic primary pain to a standardized high intensity exercise protocol used to induce delayed onset muscle soreness (DOMS)., Methods: Ten participants with a diagnosis of chronic widespread muscle pain (CWMP) were matched by age and reported gender to ten participants without muscle pain (i.e., no pain (NP)). Participants completed a standardized DOMS protocol. Pain intensity in the arm at rest and with movement was assessed using daily electronic diaries. Peak pain, the timing of peak pain, and the time to recovery were compared between groups. Associations of pain variables with the functional connectivity of the sensorimotor (SMN), cerebellum, frontoparietal control (FPN), and default mode network (DMN) both within network nodes and the rest of the brain was assessed., Results: Significant differences in peak pain, the time to peak pain, and the time to recovery were noted between groups for both pain at rest and pain with movement after controlling for catastrophizing and pain resilience. Connectivity across the SMN, FPN, and DMN was associated with all pain-related variables. Significant group differences were identified between groups., Conclusions: A standardized muscle "injury" protocol resulted in more pain, a longer time to peak pain, and a longer time to resolve pain in the patient group compared to the NP group. These differences were associated with differences in connectivity across brain regions related to sensorimotor integration and appraisal. These findings provide preliminary evidence of the dysregulation of responses to muscle (micro)trauma in people with chronic pain.

Adverse reactions to foods and adverse drug reactions are inherent in product defects, medication errors, and differences in individual drug exposure. Pharmacogenetics is the study of genetic causes of individual variations in drug response and pharmacogenomics more broadly involves genome-wide analysis of the genetic determinants of drug efficacy and toxicity. The similarity of nutritional genomics and pharmacogenomics stems from the innate goal to identify genetic variants associated with metabolism and disease. Thus, nutrigenomics can be thought of as encompassing gene-diet interactions involving diverse compounds that are present in even the simplest foods. The advances in the knowledge base of the complex interactions among genotype, diet, lifestyle, and environment is the cornerstone that continues to elicit changes in current medical practice to ultimately yield personalized nutrition recommendations for health and risk assessment. This information could be used to understand how foods and dietary supplements uniquely affect the health of individuals and, hence, wellness. The individual's gut microbiota is not only paramount but pivotal in embracing the multiple-functional relationships with complex metabolic mechanisms involved in maintaining cellular homeostasis. The genetic revolution has ushered in an exciting era, one in which many new opportunities are expected for nutrition professionals with expertise in nutritional genomics. The American College of Nutrition's conference focused on "Personalized Nutrition: Translating the Science of NutriGenomics Into Practice" was designed to help to provide the education needed for the professional engagement of providers in the personalized medicine era.

The "fast track" concept in surgery provides rapid rehabilitation of postoperative patients, using the operative trauma reduction, adequate anesthesia--for reduction of the organism stress answer on surgical intervention. Results of treatment were analyzed in 118 patients, in whom for calculous cholecystitis the one-port transumbilical laparoscopic cholecystectomy (OPTLCH) was performed. Duration of the patients stationary treatment without abdominal cavity drainage have constituted at average (1.49 ± 0.05) days, after drainage--2.22 days. Intensity of the pain impulsation, which was determined in accordance to concentration of proinflammatory cytokins, including interleukin-1 (IL-1) and a tumor necrosis factor-α (TNF-α) after standard laparoscopic cholecystectomy (LCH) was in 1.2 times higher, than after OPTLCH. In subjective estimation of the pain intensity in accordance to visual analogous scale in patients after OPTLCH have constituted (3.42 ± 0.16) cm, and after a standard one--(5.98 ± 0.19) cm (p < 0.05).

Visceral adipose tissue (VAT) is associated with increased risk for cardiovascular disease, and therefore, accurate methods to estimate VAT have been investigated. Computerized tomography (CT) is the gold standard measure of VAT, but its use is limited. We therefore compared waist measures and two dual-energy X-ray absorptiometry (DXA) methods (Ley and Lunar) that quantify abdominal regions of interest (ROIs) to CT-derived VAT in 166 black and 143 white South African women. Anthropometry, DXA ROI, and VAT (CT at L4-L5) were measured. Black women were younger (P < 0.001), shorter (P < 0.001), and had higher body fat (P < 0.05) than white women. There were no ethnic differences in waist (89.7 +/- 18.2 cm vs. 90.1 +/- 15.6 cm), waist:height ratio (WHtR, 0.56 +/- 0.12 vs. 0.54 +/- 0.09), or DXA ROI (Ley: 2.2 +/- 1.5 vs. 2.1 +/- 1.4; Lunar: 2.3 +/- 1.4 vs. 2.3 +/- 1.5), but black women had less VAT, after adjusting for age, height, weight, and fat mass (76 +/- 34 cm(2) vs. 98 +/- 35 cm(2); P < 0.001). Ley ROI and Lunar ROI were correlated in black (r = 0.983) and white (r = 0.988) women. VAT correlated with DXA ROI (Ley: r = 0.729 and r = 0.838, P < 0.01; Lunar: r = 0.739 and r = 0.847, P < 0.01) in black and white women, but with increasing ROI android fatness, black women had less VAT. Similarly, VAT was associated with waist (r = 0.732 and r = 0.836, P < 0.01) and WHtR (r = 0.721 and r = 0.824, P < 0.01) in black and white women. In conclusion, although DXA-derived ROIs correlate well with VAT as measured by CT, they are no better than waist or WHtR. Neither DXA nor anthropometric measures are able to accurately distinguish between high and low levels of VAT between population groups.

The objective of the study was to examine the association between a functional 4 bp proinsulin gene insertion polymorphism (IVS-69), fasting insulin concentrations, and body composition in black South African women. Body composition, body fat distribution, fasting glucose and insulin concentrations, and IVS-69 genotype were measured in 115 normal-weight (BMI<25 kg/m2) and 138 obese (BMI>or=30 kg/m2) premenopausal women. The frequency of the insertion allele was significantly higher in the class 2 obese (BMI>or=35 kg/m2) compared with the normal-weight group (P=0.029). Obese subjects with the insertion allele had greater fat mass (42.3+/-0.9 vs. 38.9+/-0.9 kg, P=0.034) and fat-free soft tissue mass (47.4+/-0.6 vs. 45.1+/-0.6 kg, P=0.014), and more abdominal subcutaneous adipose tissue (SAT, 595+/-17 vs. 531+/-17 cm2, P=0.025) but not visceral fat (P=0.739), than obese homozygotes for the wild-type allele. Only SAT was greater in normal-weight subjects with the insertion allele (P=0.048). There were no differences in fasting insulin or glucose levels between subjects with the insertion allele or homozygotes for the wild-type allele in the normal-weight or obese groups. In conclusion, the 4 bp proinsulin gene insertion allele is associated with extreme obesity, reflected by greater fat-free soft tissue mass and fat mass, particularly SAT, in obese black South African women.

Objective: Subsets of metabolically "healthy obese" and "at-risk" normal-weight individuals have been previously identified. The aim of this study was to explore the determinants of these phenotypes in black South African (SA) women., Methods and Procedures: From a total of 103 normal-weight (BMI or= 30 kg/m(2)) black SA women, body composition, fat distribution, blood pressure, fasting glucose levels, insulin resistance, and lipid profiles were measured. Questionnaires relating to family history, physical activity energy expenditure (PAEE), and socio-demographic variables were administered. The subjects were classified as insulin sensitive or insulin resistant according to the homeostasis model assessment of insulin resistance (HOMA-IR) (>or=1.95 insulin resistant)., Results: Our study showed that 22% of the normal-weight women were insulin resistant and 38% of the obese women were insulin sensitive. Increased visceral adipose tissue (VAT) (P=0.001) and decreased VAT/leg fat mass (P