Feasibility of home-based sampling of salivary cortisol and cortisone in healthy adults

Abstract Objective Salivary cortisol and cortisone are used as biomarkers of physiological stress. Careful sampling of saliva for profiling of awakening response and the diurnal slope can be challenging in free-living environments, and validated sampling protocols are lacking. Therefore, we investigated (1) the level of compliance to a three-day home-based salivary sampling protocol, and (2) the within subject day-to-day variability of cortisol and cortisone outcomes and the required measuring days to obtain high reproducibility. Results Nineteen healthy adults (mean age: 42, 50% females) participated. Participants collected in total 434 salivary samples out of 456 scheduled (four samples per day over three consecutive days at two time points). We found high level of compliance to the proposed free-living salivary sampling protocol with 18 (95%) and 16 (84%) participants being compliant to numbers and timing of samples, respectively. The area under the curve for the morning salivary samples and peak-to-bed slope had moderate reproducibility for cortisol and cortisone (intraclass correlation coefficient: 0.51–0.68, and mean coefficient of variation: 14.7%-75.3%). Three-to-four measuring days were required for high reproducibility of the area under the curve for the morning salivary samples and peak-to-bed slope using this free-living salivary sampling protocol. Trial registration Clinical trial registered with www.clinicaltrials.gov (NCT03788525).

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Rigor and Reproducibility: A Systematic Review of Salivary Cortisol Sampling and Reporting Parameters Used in Cancer Survivorship Research

Biological Research For Nursing ◽

10.1177/1099800419835321 ◽

2019 ◽

Vol 21 (3) ◽

pp. 318-334 ◽

Cited By ~ 1

Author(s):

Jennifer M. Hulett ◽

Kristen L. Fessele ◽

Margaret F. Clayton ◽

Linda H. Eaton

Keyword(s):

Clinical Outcomes ◽

Cancer Survivorship ◽

Salivary Cortisol ◽

Cortisol Awakening Response ◽

Sampling Protocol ◽

Diurnal Cortisol ◽

Sampling Protocols ◽

Adult Cancer Survivors ◽

Comprehensive Search ◽

Physiological Outcomes

Salivary cortisol is a commonly used biomarker in cancer survivorship research; however, variations in sampling protocols and parameter reporting limit comparisons across studies. Standardized practices to provide rigor and reproducibility of diurnal salivary cortisol sampling and reporting are not well established. Previous systematic reviews examining relationships between diurnal salivary cortisol and clinical outcomes have resulted in mixed findings. It remains unclear which sampling protocols and reporting parameters offer the greatest utility for clinical research. This review examines diurnal salivary cortisol sampling protocols and reporting parameters to evaluate whether a standardized approach is recommended. A comprehensive search of intervention studies among adult cancer survivors including diurnal salivary cortisol resulted in 30 articles for review. Sampling protocols ranged from 1 to 4 days with the majority of studies sampling cortisol for 2 days. Sampling instances ranged from 2 to 7 times per day, with the majority collecting at 4 time points per day. Diurnal cortisol slope and cortisol awakening response (CAR) were the most commonly reported parameters associated with clinical outcomes. Flattened cortisol slopes, blunted CARs, and elevated evening cortisol concentrations were associated with poorer psychosocial and physiological outcomes. Based on our review, we propose that a rigorous, standardized diurnal salivary cortisol sampling protocol should include sampling at key diurnal times across ≥3 consecutive days to report diurnal cortisol parameters (i.e., CAR and slope) and objective measures of participant protocol adherence. Diminishing budgetary resources and efforts to minimize participant burden dictate the importance of standardized cortisol sampling protocols and reporting parameters.

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A Five-Ingredient Nutritional Supplement and Home-Based Resistance Exercise Improve Lean Mass and Strength in Free-Living Elderly

Nutrients ◽

10.3390/nu12082391 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2391 ◽

Cited By ~ 1

Author(s):

Mats I. Nilsson ◽

Andrew Mikhail ◽

Lucy Lan ◽

Alessia Di Carlo ◽

Bethanie Hamilton ◽

...

Keyword(s):

Resistance Exercise ◽

Old Age ◽

Body Fat ◽

Lean Mass ◽

Daily Intake ◽

Protein Supplementation ◽

Muscle Quality ◽

Free Living ◽

Home Based ◽

And Function

Old age is associated with lower physical activity levels, suboptimal protein intake, and desensitization to anabolic stimuli, predisposing for age-related muscle loss (sarcopenia). Although resistance exercise (RE) and protein supplementation partially protect against sarcopenia under controlled conditions, the efficacy of home-based, unsupervised RE (HBRE) and multi-ingredient supplementation (MIS) is largely unknown. In this randomized, placebo-controlled and double-blind trial, we examined the effects of HBRE/MIS on muscle mass, strength, and function in free-living, older men. Thirty-two sedentary men underwent twelve weeks of home-based resistance band training (3 d/week), in combination with daily intake of a novel five-nutrient supplement (‘Muscle5’; M5, n = 16, 77.4 ± 2.8 y) containing whey, micellar casein, creatine, vitamin D, and omega-3 fatty acids, or an isocaloric/isonitrogenous placebo (PLA; n = 16, 74.4 ± 1.3 y), containing collagen and sunflower oil. Appendicular and total lean mass (ASM; +3%, TLM; +2%), lean mass to fat ratios (ASM/% body fat; +6%, TLM/% body fat; +5%), maximal strength (grip; +8%, leg press; +17%), and function (5-Times Sit-to-Stand time; −9%) were significantly improved in the M5 group following HBRE/MIS therapy (pre vs. post tests; p < 0.05). Fast-twitch muscle fiber cross-sectional areas of the quadriceps muscle were also significantly increased in the M5 group post intervention (Type IIa; +30.9%, Type IIx, +28.5%, p < 0.05). Sub-group analysis indicated even greater gains in total lean mass in sarcopenic individuals following HBRE/MIS therapy (TLM; +1.65 kg/+3.4%, p < 0.05). We conclude that the Muscle5 supplement is a safe, well-tolerated, and effective complement to low-intensity, home-based resistance exercise and improves lean mass, strength, and overall muscle quality in old age.

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Changes in Muscle Hardness from Resting to Mid-Range Lengthened Positions Detected by Shear Wave Elastography (SWE) with a Novel Protocol of Ultrasound Probe Placement

Applied Sciences ◽

10.3390/app11010452 ◽

2021 ◽

Vol 11 (1) ◽

pp. 452

Author(s):

Long-Jun Ren ◽

Connie Lok-Kan Cheng ◽

Christina Zong-Hao Ma ◽

Yong-Ping Zheng

Keyword(s):

Shear Wave ◽

Intraclass Correlation ◽

Shear Wave Elastography ◽

Rectus Femoris ◽

Healthy Adults ◽

Physiological Status ◽

Ultrasound Probe ◽

Muscle Hardness ◽

Age Related ◽

Probe Placement

Muscle hardness and its relationship with different muscle lengths/positions are important for understanding its underlying physiological status, and yet remained unclear. This study aimed to detect the local muscle hardness at different muscle lengths and identify the influence of muscle position on muscle hardness in healthy adults. A total of 26 healthy adults participated in this study. Shear wave elastography (SWE) was used to measure the muscle hardness of the Rectus Femoris (RF), Tibialis Anterior (TA) and Gastrocnemius Medialis (GM). Each muscle was tested at both resting (RST) and mid-range lengthened (MRL) positions. A novel ultrasound probe placing method was introduced, applied, and evaluated in this study. Moderate to excellent intra-/inter-rater reliability (Intraclass Correlation Coefficient, ICC ≥ 0.70) was found for muscle hardness measurements. The muscle hardness significantly increased from the RST to MRL position for all three muscles (p < 0.001). This study found that the muscle hardness increased at its mid-range lengthened position from the resting position. The mid-range lengthened muscle position of TA and GM could also be sensitive enough to reflect the age-related changes in local muscle hardness. This study also highlights the importance of placing the assessed extremities in an appropriate and consistent position when assessing muscle qualities by ultrasonics in clinical practice.

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Gait Analysis Using Accelerometry Data from a Single Smartphone: Agreement and Consistency between a Smartphone Application and Gold-Standard Gait Analysis System

Sensors ◽

10.3390/s21227497 ◽

2021 ◽

Vol 21 (22) ◽

pp. 7497

Author(s):

Roy T. Shahar ◽

Maayan Agmon

Keyword(s):

Gait Analysis ◽

Gold Standard ◽

Concurrent Validity ◽

Gait Cycle ◽

Intraclass Correlation ◽

Smartphone Application ◽

Healthy Adults ◽

Community Dwelling ◽

Human Gait ◽

Spatio Temporal

Spatio-temporal parameters of human gait, currently measured using different methods, provide valuable information on health. Inertial Measurement Units (IMUs) are one such method of gait analysis, with smartphone IMUs serving as a good substitute for current gold-standard techniques. Here we investigate the concurrent validity of a smartphone placed in a front-facing pocket to perform gait analysis. Sixty community-dwelling healthy adults equipped with a smartphone and an application for gait analysis completed a 2-min walk on a marked path. Concurrent validity was assessed against an APDM mobility lab (APDM Inc.; Portland, OR, USA). Bland–Altman plots and intraclass correlation coefficients (agreement and consistency) for gait speed, cadence, and step length indicate good to excellent agreement (ICC2,1 > 0.8). For right leg stance and swing % of gait cycle and double support % of gait cycle, results were moderate (0.52 < ICC2,1 < 0.62). For left leg stance and swing % of gait cycle left results show poor agreement (ICC2,1 < 0.5). Consistency of results was good to excellent for all tested parameters (ICC3,1 > 0.8). Thus we have a valid and reliable instrument for measuring healthy adults’ spatio-temporal gait parameters in a controlled walking environment.

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Specific mental disorder screening compilation may detect general mental disorders

Revista Brasileira de Medicina de Família e Comunidade ◽

10.5712/rbmfc13(40)1685 ◽

2018 ◽

Vol 13 (40) ◽

pp. 1-13

Author(s):

Lívia Maria Bolsoni ◽

Leonardo Moscovici ◽

João Mazzoncini De Azevedo Marques ◽

Antonio Waldo Zuardi

Keyword(s):

General Population ◽

Mental Disorders ◽

Emotional Disorders ◽

Intraclass Correlation ◽

Area Under The Curve ◽

Roc Curves ◽

Screening Tools ◽

Patient Health ◽

Two Phases ◽

Specific Disorders

Objective: To evaluate whether a short compilation of screening tools for specific disorders could identify Mental or Emotional Disorders (MEDs) in the general population. Methods: We selected validated screening tools for the most prevalent MEDs. In order to be selected, these tools should maintain the psychometric properties of the complete instrument with a reduced number of items. These instruments were: Patient Health Questionnaire-2 (PHQ-2), Generalized Anxiety Disorder Scale-2 (GAD-2), item 3 of the Alcohol Use Disorders Identification Test (AUDIT), and three items on the Adolescent Psychotic-Like Symptom Screener (APSS-3). We called this compilation of screening tools Mini Screening for Mental Disorders (Mini-SMD). The study was divided in two phases. Firstly, 545 subjects were interviewed with the Mini-SMD and COOP/WONCA-Feelings at their residences. Subsequently, subjects who had agreed to participate (230) were reinterviewed with Mini-SMD, COOP/WONCA-Feelings and MINI interview. Test-retest reliability was calculated by Intraclass Correlation Coefficient (ICC). Receiver operating characteristic (ROC) curves were generated for the analysis of discriminative validity. Concurrent validity was calculated by analyzing the correlation between Mini-SMD and COOP/WONCA-Feelings. Results: The joint administration of screening tools for specific disorders showed sensitivities that ranged from 0.76 to 0.88 and specificities from 0.67 to 0.85. The ICC value for the total score of Mini-SMD was 0.78. The area under the curve was 0.84, with a sensitivity of 0.74 and specificity of 0.76 (for a cutoff ≥ 4). Conclusion: This study showed that a short compilation of screening tools for specific disorders can detect MEDs in general population.

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An experimental assessment of the distribution of environmental DNA along the water column

10.1101/2020.11.30.402438 ◽

2020 ◽

Author(s):

André O. Agostinis ◽

Giorgi Dal Pont ◽

Alexandre Borio ◽

Aline Horodesky ◽

Ana Paula da Silva Bertão ◽

...

Keyword(s):

Water Column ◽

Environmental Dna ◽

Aquatic Communities ◽

Natural Conditions ◽

Sampling Protocol ◽

Experimental Assessment ◽

Qpcr Analysis ◽

Time Period ◽

Sampling Protocols ◽

Different Depths

AbstractThe study of environmental DNA (eDNA) is increasingly becoming a valuable tool to survey and monitor aquatic communities. However, there are important gaps in our understanding of the dynamics governing the distribution of eDNA under natural conditions. In this report we carry out controlled experiments to assess the extent and timing of eDNA distribution along the water column. A sample of known eDNA concentration was placed at the bottom of a 5-m high tube (20 cm in diameter and total volume of 160 L), and water samples were obtained at different depths over an 8 h-period. The presence of the target eDNA was assessed by qPCR analysis. This sampling protocol allowed for assessing the timescale for the diffusion of eDNA while minimizing the influence of turbulence. We demonstrate that, after a time-period of as little as 30 min, the eDNA had spread across the entire container. The implications of these results for eDNA sampling protocols in the field are discussed.

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Afternoon Spot Urine Osmolality as a Biomarker of Hydration in Free‐living Healthy Adults

The FASEB Journal ◽

10.1096/fasebj.29.1_supplement.967.4 ◽

2015 ◽

Vol 29 (S1) ◽

Author(s):

Guillaume LEMETAIS ◽

Jeanne BOTTIN ◽

Marie POUPIN ◽

Liliana JIMENEZ ◽

Erica PERRIER

Keyword(s):

Urine Osmolality ◽

Healthy Adults ◽

Free Living ◽

Spot Urine

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Day-to-Day Variability and Year-to-Year Reproducibility of Accelerometer-Measured Free-Living Sit-to-Stand Transitions Volume and Intensity among Community-Dwelling Older Adults

Sensors ◽

10.3390/s21186068 ◽

2021 ◽

Vol 21 (18) ◽

pp. 6068

Author(s):

Antti Löppönen ◽

Laura Karavirta ◽

Erja Portegijs ◽

Kaisa Koivunen ◽

Taina Rantanen ◽

...

Keyword(s):

Older Adults ◽

Angular Velocity ◽

Functional Disability ◽

Intraclass Correlation ◽

Living Environment ◽

Community Dwelling ◽

Free Living ◽

Sit To Stand ◽

Increased Risk ◽

Community Dwelling Older Adults

(1) Background: The purpose of this study was to evaluate the day-to-day variability and year-to-year reproducibility of an accelerometer-based algorithm for sit-to-stand (STS) transitions in a free-living environment among community-dwelling older adults. (2) Methods: Free-living thigh-worn accelerometry was recorded for three to seven days in 86 (women n = 55) community-dwelling older adults, on two occasions separated by one year, to evaluate the long-term consistency of free-living behavior. (3) Results: Year-to-year intraclass correlation coefficients (ICC) for the number of STS transitions were 0.79 (95% confidence interval, 0.70–0.86, p < 0.001), for mean angular velocity—0.81 (95% ci, 0.72–0.87, p < 0.001), and maximal angular velocity—0.73 (95% ci, 0.61–0.82, p < 0.001), respectively. Day-to-day ICCs were 0.63–0.72 for number of STS transitions (95% ci, 0.49–0.81, p < 0.001) and for mean angular velocity—0.75–0.80 (95% ci, 0.64–0.87, p < 0.001). Minimum detectable change (MDC) was 20.1 transitions/day for volume, 9.7°/s for mean intensity, and 31.7°/s for maximal intensity. (4) Conclusions: The volume and intensity of STS transitions monitored by a thigh-worn accelerometer and a sit-to-stand transitions algorithm are reproducible from day to day and year to year. The accelerometer can be used to reliably study STS transitions in free-living environments, which could add value to identifying individuals at increased risk for functional disability.

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Validity, Reliability and Sensitivity to Change of Three Consumer-grade Activity Trackers in Controlled and Free-living Conditions among Older Adults (Preprint)

10.2196/preprints.27155 ◽

2021 ◽

Author(s):

Kaja Kastelic ◽

Marina Dobnik ◽

Stefan Loefler ◽

Christian Hofer ◽

Nejc Šarabon

Keyword(s):

Physical Activity ◽

Older Adults ◽

Intraclass Correlation ◽

Sleep Time ◽

Living Conditions ◽

Percentage Error ◽

Sensitivity To Change ◽

Free Living ◽

Activity Trackers ◽

Free Living Conditions

BACKGROUND Wrist worn consumer-grade activity trackers are popular devices, developed mainly for personal use, but with the potential to be used also for clinical and research purposes. OBJECTIVE The objective of this study was to explore the validity, reliability and sensitivity to change of movement behaviours metrics from three popular activity trackers (POLAR Vantage M, Garmin Vivosport and Garmin Vivoactive 4s) in controlled and free-living conditions when worn by older adults. METHODS Participants (n = 28; 74 ± 5 years) underwent a videotaped laboratory protocol while wearing all three activity trackers. On a separate occasion, participants wore one (randomly assigned) activity tracker and a research grade physical activity monitor ActiGraph wGT3X-BT simultaneously for six consecutive days for comparisons. RESULTS Both Garmin activity trackers showed excellent performance for step counts, with mean absolute percentage error (MAPE) below 20 % and intraclass correlation coefficient (ICC2,1) above 0.90 (P < .05), while Polar Vantage M substantially over counted steps (MAPE = 84 % and ICC2,1 = 0.37 for free-living conditions). MAPE for sleep time was within 10 % for all the trackers tested, while far beyond 20 % for all the physical activity and calories burned outputs. Both Garmin trackers showed fair agreement (ICC2,1 = 0.58–0.55) for measuring calories burned when compared with ActiGraph. CONCLUSIONS Garmin Vivoactive 4s showed overall best performance, especially for measuring steps and sleep time in healthy older adults. Minimal detectible change was consistently lower for an average day measures than for a single day measure, but still relatively high. The results provided in this study could be used to guide choice on activity trackers aiming for different purposes – individual use/care, longitudinal monitoring or in clinical trial setting.

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The reliability of home-based fitness assessments on health mobile application in healthy adults (Preprint)

10.2196/preprints.28040 ◽

2021 ◽

Author(s):

I-I Lin ◽

You-Lin Chen ◽

Li-Ling Chuang

Keyword(s):

Confidence Interval ◽

Mobile Application ◽

Healthy Adults ◽

Physiological Signals ◽

Health Conditions ◽

Systematic Bias ◽

Relative Reliability ◽

Fitness Assessment ◽

Balance Tests ◽

Home Based

BACKGROUND Poor physical fitness has negative impact on health conditions. More and more health-related applications (App) have emerged to reduce burden of medicine, and inconvenience of long distance. However, there were insufficient studies about home-based fitness tests on the app. Insufficient monitor of physiological signals during executing fitness assessment was noted. Therefore, we developed the fitness App incorporating all components of fitness assessments under physiological signals monitor. OBJECTIVE The first aim of study was to investigate the reliability of home-based fitness assessments on health mobile app in healthy adults. Secondly, we aimed to examine and compare the results of fitness assessment on the App. METHODS Thirty-one healthy young adults self-executed fitness assessments on the App for 2 trials in 2-3 day interval. The fitness assessments include cardiorespiratory endurance, strength, flexibility, mobility and balance tests. The intraclass correlation coefficient (ICC) was computed as relative reliability of fitness assessments and determined consistency between 2 trials. The standard error of measurement (SEM), smallest real difference at 90% confidence interval (SRD90), and Bland-Altman analyses were analyzed and used for agreement, sensitivity to real change, and systematic bias detection. RESULTS The relative reliability of fitness assessments was moderate to good (ICCs for raw scores= 0.8 to 0.99, for converting scores= 0.69 to 0.99). The SEM and SRD90 were 1.44 to 6.91 and 3.36 to 16.11, respectively in all fitness assessments. The 95% confidence interval of mean difference indicated no significant systematic error between 2 trials in strength, and balance tests. The Bland-Altman analyses revealed no significant systematic bias between 2 trials for all fitness assessments and few outliers. The Bland-Altman plots illustrated narrow limits of agreement for UE strength, trunk strength, and right leg stance tests, indicating good agreement between 2 trials. CONCLUSIONS Home-based fitness assessments on the health mobile application were reliable and feasible. The results of fitness assessments can offer comprehensive understanding of health conditions and help to prescribe safe and suitable exercise training. CLINICALTRIAL ChiCTR2000030905

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