BACKGROUND:Sarcopenia is common among cancer patients and is associated with adverse clinical outcomes. The strength, assistance in walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire is a simple screening tool for evaluating sarcopenia; however, no validated Hindi version is currently available for use in Indian oncology practice. AIM:To translate and culturally adapt the SARC-F questionnaire into Hindi and assess its reliability and content validity. METHODS:This single-center cross-sectional study was conducted at a tertiary cancer center in India. The questionnaire was translated using forward-backward translation following World Health Organization and International Society for Pharmacoeconomics and Outcomes Research guidelines. Pilot testing assessed clarity and cultural relevance. Adult Hindi-speaking cancer patients completed the finalized questionnaire. Reliability and content validity were evaluated using Cronbach's alpha and content validity indices, and descriptive statistics with Pearson correlation analyses were performed. RESULTS:A total of 100 patients were included (mean age 50.9 ± 12.6 years; 63% female). The Hindi SARC-F demonstrated acceptable internal consistency (Cronbach's α = 0.70). Content validity was excellent, with a scale-level content validity index of 0.92 and item-level indices ranging from 0.80 to 1.00. The median SARC-F score was 1 (interquartile range 0-3). No statistically significant correlations were observed between SARC-F scores and age, performance status, or body composition parameters (all P > 0.05). CONCLUSION:The Hindi SARC-F is linguistically valid, culturally appropriate, and suitable for functional sarcopenia screening in Hindi-speaking cancer patients.
Fragility fractures represent a significant global health burden, with osteoporosis affecting over 500 million individuals and contributing to nearly 9 million fractures annually. Conventional diagnosis relies on dual-energy X-ray absorptiometry (DEXA) to measure bone mineral density (BMD), yet BMD alone explains only part of fracture risk. Many fractures occur in patients without osteoporosis by DEXA criteria, underscoring the limitations of bone quantity-based assessment. Advances in imaging and biomarker research highlight the importance of bone quality, microarchitecture, and marrow composition in fracture prediction. Quantitative magnetic resonance imaging (MRI) techniques - including T1ρ, T2 mapping, proton density fat fraction, and diffusion-weighted imaging - offer non-invasive insights into collagen integrity, proteoglycan content, water distribution, and marrow adiposity. These parameters correlate with trabecular deterioration and cortical porosity, enhancing risk stratification beyond BMD. Similarly, Vertebral Bone Quality (VBQ) scoring, derived from routine T1-weighted MRI, provides a practical surrogate for bone quality by quantifying vertebral marrow signal intensity relative to cerebrospinal fluid. Modified VBQ improves accuracy by minimising posterior vertebral artefacts, demonstrating stronger correlation with DEXA T scores and trabecular microarchitecture. Studies show VBQ predicts vertebral fragility fractures independently of BMD, with sensitivity exceeding 90% and discriminatory ability comparable to the fracture risk assessment tool and trabecular bone score. Integration of quantitative MRI and VBQ/modified VBQ into predictive models, supported by artificial intelligence, enables opportunistic, radiation-free screening and more precise fracture risk assessment. Together, these advanced imaging biomarkers represent a paradigm shift toward comprehensive evaluation of bone strength, bridging the gap between bone quantity and quality for improved prevention and management of fragility fractures.
Pancreatic nerves exhibit significant anatomical and functional disparities across species, with profound implications for metabolism and clinical practices like pancreatic transplantation and disease treatment. In humans, pancreatic nerves feature a complex distribution of sympathetic and parasympathetic fibers, forming intricate plexuses that closely interact with surrounding organs, playing a crucial role in regulating both endocrine (e.g., insulin and glucagon release) and exocrine secretions to maintain metabolic balance. Rodents, such as rats and mice-common experimental models-have relatively simpler pancreatic nerve architectures; for instance, mice show more concentrated nerve fibers around islets, while rats display greater variability in nerve density across pancreatic regions, which influences their responses to metabolic stimuli and makes them valuable but not fully analogous to human models. Canines and felines, often used in translational studies, possess pancreatic nerve systems that share some similarities with humans, such as comparable nerve plexus organization, yet differ in fiber type proportions, affecting their susceptibility to metabolic abnormalities like pancreatitis-related glucose dysregulation. These species-specific differences in pancreatic nerves directly impact metabolic processes: In humans, impaired nerve function is linked to metabolic disorders like diabetes and obesity, whereas in animal models, variations in neural control of hormone release and pancreatic homeostasis lead to differences in disease progression and response to interventions. Understanding these discrepancies is vital: It not only helps interpret findings from animal studies when translating to human therapies but also guides pancreatic transplantation by highlighting the need for species-specific considerations in nerve reconstruction to restore metabolic function, and identifies potential therapeutic targets tailored to the unique neural-metabolic interactions of each species.
