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Eliot L. Remembering the null hypothesis when searching for brain sex differences. Biol Sex Differ 2024; 15:14. [PMID: 38336816 PMCID: PMC10854110 DOI: 10.1186/s13293-024-00585-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 01/11/2024] [Indexed: 02/12/2024] Open
Abstract
Human brain sex differences have fascinated scholars for centuries and become a key focus of neuroscientists since the dawn of MRI. We recently published a major review in Neuroscience and Biobehavioral Reviews showing that most male-female brain differences in humans are small and few have been reliably replicated. Although widely cited, this work was the target of a critical Commentary by DeCasien et al. (Biol Sex Differ 13:43, 2022). In this response, I update our findings and confirm the small effect sizes and pronounced scatter across recent large neuroimaging studies of human sex/gender difference. Based on the sum of data, neuroscientists would be well-advised to take the null hypothesis seriously: that men and women's brains are fundamentally similar, or "monomorphic". This perspective has important implications for how we study the genesis of behavioral and neuropsychiatric gender disparities.
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Affiliation(s)
- Lise Eliot
- Stanson Toshok Center for Brain Function and Repair, Chicago Medical School, Rosalind Franklin University of Medicine & Science, North Chicago, IL, USA.
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Lin L, Guo J, Gelfand SB, Bhadra A, Delp EJ, Richards EA, Hennessy E, Eicher-Miller HA. Temporal Dietary Pattern Cluster Membership Varies on Weekdays and Weekends but Both Link to Health. J Nutr 2024; 154:722-733. [PMID: 38160806 PMCID: PMC10900253 DOI: 10.1016/j.tjnut.2023.12.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Energy and dietary quality are known to differ between weekdays and weekends. Data-driven approaches that incorporate time, amount, and duration of dietary intake have previously been used to partition participants' daily weekday dietary intake time series into clusters representing weekday temporal dietary patterns (TDPs) linked to health indicators in United States adults. Yet, neither the relationship of weekend day TDPs to health indicators nor how the TDP membership may change from weekday to weekend is known. OBJECTIVES This study was conducted to determine the association between TDPs on weekdays and weekend days and health indicators [diet quality, waist circumference (WC), body mass index (BMI), and obesity] and their overlap among participants. METHODS A weekday and weekend day 24-hour dietary recall of 9494 nonpregnant United States adults aged 20-65 years from the cross-sectional National Health and Nutrition Examination Survey 2007-2018 was used to determine the timing and amount of energy intake. Modified dynamic time warping and kernel k-means algorithm clustered participants into 4 TDPs on weekdays and weekend days. Multivariate regression models determined the associations between TDPs and health indicators, controlling for potential confounders and adjusting for the survey design and multiple comparisons. The percentages of overlap in cluster membership between TDPs on weekdays and weekend days were also determined. RESULTS United States adults with a TDP of evenly spaced, energy-balanced eating occasions, representing the TDP of more than one-third of all adults on weekdays and weekends, had significantly higher diet quality, lower BMI, WC, and odds of obesity when compared to those with other TDPs. Membership of most United States adults to TDPs varied from weekdays to weekends. CONCLUSIONS Both weekday and weekend TDPs were significantly associated with health indicators. TDP membership of most United States adults was not consistent on weekdays and weekends.
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Affiliation(s)
- Luotao Lin
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, New Mexico, United States
| | - Jiaqi Guo
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana, United States
| | - Saul B Gelfand
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana, United States
| | - Anindya Bhadra
- Department of Statistics, Purdue University, West Lafayette, Indiana, United States
| | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana, United States
| | | | - Erin Hennessy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States
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Nelson BJ, Kc P, Badal A, Jiang L, Masters SC, Zeng R. Pediatric evaluations for deep learning CT denoising. Med Phys 2024; 51:978-990. [PMID: 38127330 DOI: 10.1002/mp.16901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/13/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Deep learning (DL) CT denoising models have the potential to improve image quality for lower radiation dose exams. These models are generally trained with large quantities of adult patient image data. However, CT, and increasingly DL denoising methods, are used in both adult and pediatric populations. Pediatric body habitus and size can differ significantly from adults and vary dramatically from newborns to adolescents. Ensuring that pediatric subgroups of different body sizes are not disadvantaged by DL methods requires evaluations capable of assessing performance in each subgroup. PURPOSE To assess DL CT denoising in pediatric and adult-sized patients, we built a framework of computer simulated image quality (IQ) control phantoms and evaluation methodology. METHODS The computer simulated IQ phantoms in the framework featured pediatric-sized versions of standard CatPhan 600 and MITA-LCD phantoms with a range of diameters matching the mean effective diameters of pediatric patients ranging from newborns to 18 years old. These phantoms were used in simulating CT images that were then inputs for a DL denoiser to evaluate performance in different sized patients. Adult CT test images were simulated using standard-sized phantoms scanned with adult scan protocols. Pediatric CT test images were simulated with pediatric-sized phantoms and adjusted pediatric protocols. The framework's evaluation methodology consisted of denoising both adult and pediatric test images then assessing changes in image quality, including noise, image sharpness, CT number accuracy, and low contrast detectability. To demonstrate the use of the framework, a REDCNN denoising model trained on adult patient images was evaluated. To validate that the DL model performance measured with the proposed pediatric IQ phantoms was representative of performance in more realistic patient anatomy, anthropomorphic pediatric XCAT phantoms of the same age range were also used to compare noise reduction performance. RESULTS Using the proposed pediatric-sized IQ phantom framework, size differences between adult and pediatric-sized phantoms were observed to substantially influence the adult trained DL denoising model's performance. When applied to adult images, the DL model achieved a 60% reduction in noise standard deviation without substantial loss in sharpness in mid or high spatial frequencies. However, in smaller phantoms the denoising performance dropped due to different image noise textures resulting from the smaller field of view (FOV) between adult and pediatric protocols. In the validation study, noise reduction trends in the pediatric-sized IQ phantoms were found to be consistent with those found in anthropomorphic phantoms. CONCLUSION We developed a framework of using pediatric-sized IQ phantoms for pediatric subgroup evaluation of DL denoising models. Using the framework, we found the performance of an adult trained DL denoiser did not generalize well in the smaller diameter phantoms corresponding to younger pediatric patient sizes. Our work suggests noise texture differences from FOV changes between adult and pediatric protocols can contribute to poor generalizability in DL denoising and that the proposed framework is an effective means to identify these performance disparities for a given model.
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Affiliation(s)
- Brandon J Nelson
- Center for Devices and Radiological Health, Office of Science and Engineering Labs, Division of Imaging, Diagnostics, and Software Reliability, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Prabhat Kc
- Center for Devices and Radiological Health, Office of Science and Engineering Labs, Division of Imaging, Diagnostics, and Software Reliability, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Andreu Badal
- Center for Devices and Radiological Health, Office of Science and Engineering Labs, Division of Imaging, Diagnostics, and Software Reliability, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Lu Jiang
- Center for Devices and Radiological Health, Office of Product Evaluation and Quality, Office of Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Shane C Masters
- Center for Drug Evaluation and Research, Office of Specialty Medicine, Division of Imaging and Radiation Medicine, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Rongping Zeng
- Center for Devices and Radiological Health, Office of Science and Engineering Labs, Division of Imaging, Diagnostics, and Software Reliability, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
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Zeng B, Williams EM, Owen C, Zhang C, Davies SK, Evans K, Preudhomme SR. Exploring the acoustic and prosodic features of a lung-function-sensitive repeated-word speech articulation test. Front Psychol 2023; 14:1167902. [PMID: 37711334 PMCID: PMC10499508 DOI: 10.3389/fpsyg.2023.1167902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/03/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction Speech breathing is a term usually used to refer to the manner in which expired air and lung mechanics are utilized for the production of the airflow necessary for phonation. Neurologically, speech breathing overrides the normal rhythms of alveolar ventilation. Speech breathing is generated using the diaphragm, glottis, and tongue. The glottis is the opening between the vocal folds in the larynx; it is the primary valve between the lungs and the mouth, and by varying its degree of opening, the sound can be varied. The use of voice as an indicator of health has been widely reported. Chronic obstructive pulmonary disease (COPD) is the most common long-term respiratory disease. The main symptoms of COPD are increasing breathlessness, a persistent chesty cough with phlegm, frequent chest infections, and persistent wheezing. There is no cure for COPD, and it is one of the leading causes of death worldwide. The principal cause of COPD is tobacco smoking, and estimates indicate that COPD will become the third leading cause of death worldwide by 2030. The long-term aim of this research program is to understand how speech generation, breathing, and lung function are linked in people with chronic respiratory diseases such as COPD. Methods This pilot study was designed to test an articulatory speech task that uses a single word ("helicopter"), repeated multiple times, to challenge speech-generated breathing and breathlessness. Specifically, a single-word articulation task was used to challenge respiratory system endurance in people with healthy lungs by asking participants to rapidly repeat the word "helicopter" for three 20-s runs interspersed with two 20-s rest periods of silent relaxed breathing. Acoustic and prosodic features were then extracted from the audio recordings of each adult participant. Results and discussion The pause ratio increased from the first run to the third, representing an increasing demand for breath. These data show that the repeated articulation task challenges speech articulation in a quantifiable manner, which may prove useful in defining respiratory ill-health.
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Affiliation(s)
- Biao Zeng
- Department of Psychology, University of South Wales, Pontypridd, United Kingdom
| | - Edgar Mark Williams
- School of Care Sciences, University of South Wales, Pontypridd, United Kingdom
| | - Chelsea Owen
- Department of Psychology, University of South Wales, Pontypridd, United Kingdom
| | - Cong Zhang
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - Keira Evans
- Department of Psychology, University of South Wales, Pontypridd, United Kingdom
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Pharmacokinetic/Pharmacodynamic Evaluation of Aztreonam/Amoxicillin/Clavulanate Combination against New Delhi Metallo-β-Lactamase and Serine-β-Lactamase Co-Producing Escherichia coli and Klebsiella pneumoniae. Pharmaceutics 2023; 15:pharmaceutics15010251. [PMID: 36678879 PMCID: PMC9865866 DOI: 10.3390/pharmaceutics15010251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/04/2023] [Accepted: 01/08/2023] [Indexed: 01/12/2023] Open
Abstract
This study aimed to examine specific niches and usage for the aztreonam/amoxicillin/clavulanate combination and to use population pharmacokinetic simulations of clinical dosing regimens to predict the impact of this combination on restricting mutant selection. The in vitro susceptibility of 19 New-Delhi metallo-β-lactamase (NDM)-producing clinical isolates to amoxicillin/clavulanate and aztreonam alone and in co-administration was determined based on the minimum inhibitory concentration (MIC) and mutant prevention concentration (MPC). The fractions of a 24-h duration that the free drug concentration was within the mutant selection window (fTMSW) and above the MPC (fT>MPC) in both plasma and epithelial lining fluid were determined from simulations of 10,000 subject profiles based on regimens by renal function categories. This combination reduced the MIC of aztreonam and amoxicillin/clavulanate to values below their clinical breakpoint in 7/9 K. pneumoniae and 8/9 E. coli, depending on the β-lactamase genes detected in the isolate. In the majority of the tested isolates, the combination resulted in fT>MPC > 90% and fTMSW < 10% for both aztreonam and amoxicillin/clavulanate. Clinical dosing regimens of aztreonam and amoxicillin/clavulanate were sufficient to provide mutant restriction coverage for MPC and MIC ≤ 4 mg/L. This combination has limited coverage against NDM- and extended-spectrum β-lactamase co-producing E. coli and K. pneumoniae and is not effective against isolates carrying plasmid-mediated AmpC and KPC-2. This study offers a potential scope and limitations as to where the aztreonam/amoxicillin/clavulanate combination may succeed or fail.
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Parenteau CS, Viano DC. Size and age of fatal drivers by crash type, vehicle type and gender. TRAFFIC INJURY PREVENTION 2022; 24:203-207. [PMID: 36383688 DOI: 10.1080/15389588.2022.2143235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Objective: The objective of this study was to determine the physical characteristics of fatal drivers in motor vehicle crashes with focus on rear impacts.Methods: 1998 to 2020 FARS data was analyzed for height, weight, and age of fatal drivers. The data was queried by gender, crash type and vehicle type.Results: The average fatal driver weighed 80.4 kg, was 173.4 cm tall, and was 43 years old. Females were 16.0 kg lighter and 14.2 cm shorter than males on average. The height was 151.2 cm for the 5th percentile female, 177.0 cm for the 50th male and 188.9 cm for the 95th male. The weight of fatal drivers increased linearly with calendar year. The increase rate was greater in females than in males. About 3% of fatal drivers were involved in rear crashes, 39.9% in frontal crashes and 36.8% in rollovers. The average fatal driver was 172.5 cm tall and weighed 81.0 kg in rear impacts. They were similar in height and weight to the overall sample. The average fatal driver in rear impacts was 46 years old, 3 years older than the overall average. Pickup truck drivers weighed 85.4 kg and were 176.8 cm tall on average. They were heavier and taller than passenger car drivers on average, which were 78.0 kg and 172.2 cm. Fatally injured minivan drivers were 10 years older than fatally injured passenger car drivers on average. The findings are compared with ATDs (anthropometric test devices) used in sled and crash testing.Conclusion: The average weight of fatal drivers increased with calendar year. The average size of fatal drivers was similar by crash types. Fatal drivers were older in rear impacts.
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Graci V, Griffith M, Seacrist T, Brase D, Mishra E, Pipkorn B, Lubbe N, Arbogast KB. Repositioning forward-leaning vehicle occupants with a pre-pretensioner belt and a startle-based warning in pre-crash scenarios. TRAFFIC INJURY PREVENTION 2022; 23:S32-S37. [PMID: 36026612 DOI: 10.1080/15389588.2022.2115294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Pre-pretensioner (PPT) seatbelts have been found to be effective in controlling vehicle occupants' motion response to disturbances in optimally positioned occupants, but it is not clear how the PPT performs when the occupant is initially forward leaning. Previous work demonstrated that an acoustic startling pre-stimulus (ASPS) reduced trunk out-of-position in sled-simulated pre-crash maneuvers. Therefore, the aim of this study was to determine if coupling the PPT with the ASPS could reduce the needed magnitude and rate of belt tension of the PPT to reposition forward leaning occupants to their optimal position within the seatbelt. METHODS Sixteen belt-restrained adult human volunteers (8 males and 8 females) restrained by a 3-point seatbelt on a vehicle seat in a forward leaning posture on a sled simulating pre-crash braking (approx. 1 g of maximum acceleration and 0.3 s duration) were exposed to sled perturbations with three belt configurations (low and high force PPT and no PPT), and two warning conditions (ASPS and no-ASPS). Head and trunk positions were extracted from the 3D motion-capture data. Repeated measure ANOVAs were used to understand the effect of sex, PPT, ASPS, and repetition on head and trunk positions. A survival analysis was also performed to understand the probability of the occupants moving rearward in the different conditions. RESULTS The probability of the head and trunk to move rearward from the initial position was greater with the PPT than without the PPT (p = 0.01) and with the high force level than the low force level (p = 0.01). The interaction effect of ASPS x PPT showed that with no PPT, there was a greater probability for the head to move rearward from the initial position with ASPS than without ASPS (p < 0.03). The trunk shows a similar trend to the head, but the ASPS vs no-ASPS differences were not statistically significant (p = 0.06). No sex differences were found. CONCLUSIONS The PPT, particularly the high level, may be an effective countermeasure on its own to reduce trunk and head out-of-position in forward leaning postures in pre-crash scenarios. The ASPS reduced the occupants' head forward position when the PPT was not available.
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Affiliation(s)
- V Graci
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- School of Biomedical Engineering, Science and Health System, Drexel University, Philadelphia, Pennsylvania
| | - M Griffith
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - T Seacrist
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - D Brase
- Autoliv Research, Vargarda, Sweden
| | - E Mishra
- Autoliv Research, Vargarda, Sweden
| | | | - N Lubbe
- Autoliv Research, Vargarda, Sweden
| | - K B Arbogast
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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İnce N, Öztürk M, Meseri R, Besler HT. Is Obesity Associated with Lower Mini Mental Test Scores among Elderly? A Cross Sectional Study. J Am Coll Nutr 2021; 41:600-607. [PMID: 34283003 DOI: 10.1080/07315724.2021.1946869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Obesity leads to many chronic diseases and its association with cognitive impairment is controversial. The objective was to investigate the association between obesity, anthropometric measurements and cognitive functions of elderly. METHODS Planned cross-sectionally, community-dwelling Cypriots (aged ≥ 50 years) without any neurological disorders, were included. Cognitive impairment evaluated by Mini Mental State Examination (MMSE) was the dependent variable. Socio-demographic variables, anthropometric measurements and obesity were the independent variables. The data was collected via face-to-face interview. Logistic regression models were constituted to determine the association of anthropometric measurements, obesity and dementia. RESULTS The mean age of participants (n = 541) was 60.0 ± 8.7 for women (n = 377) and 61.5 ± 6.0 years for men (n = 164). According to MMSE, 26.0% of women and 11.0% of men had mild-dementia, and the rest scored normal. After adjusted for age and sex, each unit increase in BMI (OR: 1.045, 95%CI: 1.008-1.091), Waist to height ratio (WHtR; OR: 1.030, 95%CI: 1.006-1.055) and Mid upper arm circumference (MUAC; OR: 1.077, 95%CI: 1.016-1.141) increases the risk of mild-dementia. When education, employment and smoking were included in the models, significance of anthropometric measurements was diminished and only sex and education were remained significant for all. CONCLUSION After controlled for age and sex, increment in anthropometric measurements increased the risk of dementia but when education was taken into consideration, this significant association was diminished showing that sex and education is more predominant in a heterogeneous group in means of education. Thus, for heterogeneous groups it might be better to revise MMSE. To determine the association between obesity and dementia cohort studies with longer follow-up duration with larger samples are needed.
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Affiliation(s)
- Nezire İnce
- Nutrition and Dietetic Department, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, Cyprus
| | - Müjgan Öztürk
- Nutrition and Dietetic Department, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, Cyprus
| | - Reci Meseri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ege University, Izmir, Turkey
| | - Halit Tanju Besler
- Nutrition and Dietetic Department, Faculty of Health Sciences, Istinye University, Istanbul, Turkey
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Fontanella CG, Arduino A, Toniolo I, Zampieri C, Bortolan L, Carniel EL. Computational methods for the investigation of ski boots ergonomics. SPORTS ENGINEERING 2021. [DOI: 10.1007/s12283-021-00352-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AbstractSki boots are known to cause vasoconstriction in the wearer’s lower limbs and, thus, cause a “cold leg” phenomenon. To address this problem, this work provides a computational framework for analysing interactions between the ski boot and the lower limb. The geometry of the lower limb was derived from magnetic resonance imaging and computed tomography techniques and anthropometric data. The geometry of the ski boot shell was obtained by means of three-dimensional computer aided design models from a manufacturer. Concerning the ski boot liner, laser scanning techniques were implemented to capture the geometry of each layer. The mechanical models of the ski boot and the lower limb were identified and validated by means of coupled experimental investigations and computational analyses. The computational models were exploited to simulate the buckling process and to investigate interaction phenomena between the boot and the lower limb. Similarly, experimental activities were performed to further analyse the buckling phenomena. The obtained computational and experimental results were compared regarding both interaction pressure and displacements between the buckle and the corresponding buckle hooks. These comparisons provided reasonable agreement (mean value of discrepancy between the model and mean experimental results in the tibial region: 20%), underlining the model’s capability to correctly interpret results from experimental measurements. Results identified the critical areas of the leg, such as the tibial region, the calcaneal region of the foot and the anterior sole, which may suffer the most due to the hydrostatic pressure and compressive strain exerted on them. The results highlight that computational methods allow investigation of the interaction phenomena between the lower leg and ski boot, potentially providing an effective framework for a more comfortable and ergonomic design of ski boots.
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Adamowicz L, Karahanoglu FI, Cicalo C, Zhang H, Demanuele C, Santamaria M, Cai X, Patel S. Assessment of Sit-to-Stand Transfers during Daily Life Using an Accelerometer on the Lower Back. SENSORS (BASEL, SWITZERLAND) 2020; 20:s20226618. [PMID: 33228035 PMCID: PMC7699326 DOI: 10.3390/s20226618] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/10/2020] [Accepted: 11/17/2020] [Indexed: 06/11/2023]
Abstract
The ability to perform sit-to-stand (STS) transfers has a significant impact on the functional mobility of an individual. Wearable technology has the potential to enable the objective, long-term monitoring of STS transfers during daily life. However, despite several recent efforts, most algorithms for detecting STS transfers rely on multiple sensing modalities or device locations and have predominantly been used for assessment during the performance of prescribed tasks in a lab setting. A novel wavelet-based algorithm for detecting STS transfers from data recorded using an accelerometer on the lower back is presented herein. The proposed algorithm is independent of device orientation and was validated on data captured in the lab from younger and older healthy adults as well as in people with Parkinson's disease (PwPD). The algorithm was then used for processing data captured in free-living conditions to assess the ability of multiple features extracted from STS transfers to detect age-related group differences and assess the impact of monitoring duration on the reliability of measurements. The results show that performance of the proposed algorithm was comparable or significantly better than that of a commercially available system (precision: 0.990 vs. 0.868 in healthy adults) and a previously published algorithm (precision: 0.988 vs. 0.643 in persons with Parkinson's disease). Moreover, features extracted from STS transfers at home were able to detect age-related group differences at a higher level of significance compared to data captured in the lab during the performance of prescribed tasks. Finally, simulation results showed that a monitoring duration of 3 days was sufficient to achieve good reliability for measurement of STS features. These results point towards the feasibility of using a single accelerometer on the lower back for detection and assessment of STS transfers during daily life. Future work in different patient populations is needed to evaluate the performance of the proposed algorithm, as well as assess the sensitivity and reliability of the STS features.
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Guan J, Hsiao H, Green JD, Whisler R. Anthropometric study of emergency medical services providers (EMSP) in the United States. JOURNAL OF SAFETY RESEARCH 2020; 74:187-197. [PMID: 32951783 DOI: 10.1016/j.jsr.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 04/14/2020] [Accepted: 06/23/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Design of next-generation ambulance patient compartment requires up-to date anthropometric data of emergency medical service providers (EMSP). Currently, no such data exist in the U.S. A large-scale anthropometric study of EMSP in the U.S. were conducted. This report provided the summary statistics (means, standard deviation, and percentiles) of the study's results and examined the anthropometric differences between the EMSP dataset and the U.S. general population, and between the EMSP dataset and U.S. military personnel dataset, respectively. METHOD An anthropometric study of 471 male and 161 female EMSP from across the continental US was conducted, using a sampling strategy that took into account age, sex, and race strata. RESULTS On average, male EMSP were found to be 18 mm taller and 7 kg heavier than US male general population, and 19 mm taller and 11 kg heavier than US male military personnel. Female EMSP were found to be 25 mm taller than US female general population, and 10 kg heavier than US female military personnel. CONCLUSIONS These results showed that it would be inappropriate to apply general population or military data to the design of next-generation ambulance patient compartment. This new dataset provided the most recent and accurate EMSP anthropometric measurements available in the US. Practical Application: Data from this study provided an invaluable resource for the design of next-generation ambulances in the US.
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Affiliation(s)
- Jinhua Guan
- National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA.
| | - Hongwei Hsiao
- National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - James D Green
- National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Richard Whisler
- National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
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Berghmans T, Durieux V, Hendriks LEL, Dingemans AM. Immunotherapy: From Advanced NSCLC to Early Stages, an Evolving Concept. Front Med (Lausanne) 2020; 7:90. [PMID: 32266275 PMCID: PMC7105823 DOI: 10.3389/fmed.2020.00090] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/03/2020] [Indexed: 12/26/2022] Open
Abstract
Immunotherapy in lung cancer treatment is a long history paved with failures and some successes. During the last decade, the discovery of checkpoints inhibitors led to major advances in treating advanced and metastatic non-small cell lung cancer (NSCLC). Impressive data from early phase I-II studies were subsequently confirmed in large prospective randomized trials and meta-analyses (High-level of evidence). Three anti- programmed death-1 (PD1) (pembrolizumab, nivolumab) or antiPD-ligand(L)1 (atezolizumab) antibodies showed clinically significant improved survival compared to second-line docetaxel. Then, first-line pembrolizumab monotherapy demonstrated its superiority over platinum-doublet in high PD-L1 NSCLC. The addition of pembrolizumab or atezolizumab to chemotherapy derived the same results regardless of the PD-L1 status. On the opposite, antiCTLA4 (Cytotoxic T-Lymphocyte Associated 4) results are currently disappointing in unselected patients while recent development suggest that the combination of antiPD1 and antiCTLA4 (nivolumab-ipilimumab) positively impact on overall survival. Some secondary analyses also showed that immunotherapy has a positive impact on quality of life and that the clinical improvement can be done at an acceptable incremental cost per QALY. A lot of questions remain unresolved: which is the best treatment duration and is it the same for all patients, how to choose the patients that will have the highest benefit of immunotherapy, how to identify the patients who will have rapid progression, how to improve the current data (new targets, new combinations)….
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Affiliation(s)
- Thierry Berghmans
- Clinic of Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Valérie Durieux
- Bibliothèque des Sciences de la Santé, Université Libre de Bruxelles, Brussels, Belgium
| | - Lizza E. L. Hendriks
- Department of Pulmonary Diseases (GROW), School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Anne-Marie Dingemans
- Department of Pulmonary Diseases (GROW), School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, Netherlands
- Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, Netherlands
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13
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van Velzen AS, Eckhardt CL, Peters M, Oldenburg J, Cnossen M, Liesner R, Morfini M, Castaman G, McRae S, van der Bom JG, Fijnvandraat K. Product type and the risk of inhibitor development in nonsevere haemophilia A patients: a case-control study. Br J Haematol 2020; 189:1182-1191. [PMID: 32201943 PMCID: PMC7318706 DOI: 10.1111/bjh.16490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 12/24/2019] [Indexed: 11/27/2022]
Abstract
Inhibitor development is a major complication of treatment with factor VIII concentrates in nonsevere haemophilia A. It has been suggested that plasma-derived factor VIII (FVIII) concentrates elicit fewer inhibitors than recombinant FVIII concentrates, but studies in severe haemophilia A patients have shown conflicting results. We designed a case-control study to investigate the clinical and genetic risk factors for inhibitor development in nonsevere haemophilia A patients. We investigated whether the type of FVIII concentrate was associated with inhibitor development in nonsevere haemophilia A patients. This nested case-control study includes 75 inhibitor patients and 223 controls, from a source population of the INSIGHT study, including all nonsevere haemophilia A patients (FVIII:C 2-40%) that were treated with FVIII concentrates in 33 European and one Australian centre. Cases and controls were matched for date of birth and cumulative number of exposure days (CED) to FVIII concentrate. A conditional logistic regression model was used to calculate unadjusted and adjusted odds ratios. No increased risk for inhibitor development was found for any type of FVIII concentrate; either when comparing recombinant FVIII concentrates to plasma-derived FVIII concentrates (adjusted odds ratio 0·96, 95% confidence interval (CI) 0·36-2·52) or for specific types of FVIII concentrates.
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Affiliation(s)
- Alice S van Velzen
- Department of Pediatric Hematology, Immunology and Infectious Diseases, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands
| | - Corien L Eckhardt
- Department of Pediatric Hematology, Immunology and Infectious Diseases, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands
| | - Marjolein Peters
- Department of Pediatric Hematology, Immunology and Infectious Diseases, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands
| | - Johannes Oldenburg
- Institute of Experimental Haematology and Transfusion Medicine, University Clinic Bonn, Bonn, Germany
| | - Marjon Cnossen
- Department of Pediatric Oncology and Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Ri Liesner
- Department of Haematology & Oncology and Children's Haemophilia Comprehensive Care Centre, Great Ormond Street Children's Hospital & Institute of Child Health, London, UK
| | - Massimo Morfini
- Italian Association of Haemophilia Centres (AICE), Florence, Italy
| | - Giancarlo Castaman
- Department of Oncology, Center for Bleeding Disorders, Careggi University Hospital, Firenze, Italy
| | - Simon McRae
- Department of Haematology, Royal Adelaide Hospital, Adelaide, Australia
| | - Johanna G van der Bom
- Sanquin Research and Department of Clinical Epidemiology, Center for Clinical Transfusion Research, Leiden University Medical Center, Leiden, the Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Immunology and Infectious Diseases, Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands
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Cardiometabolic evaluation of small for gestational age children: protective effect of breast milk. NUTR HOSP 2020; 38:36-42. [PMID: 33319572 DOI: 10.20960/nh.03267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: human growth is the result of an interaction between genetic, hormonal, nutritional, and environmental factors. It is not yet fully understood what is predominant and decisive in determining an individual's weight and height. Objective: the aim of this study was to evaluate the cardiometabolic profile of exclusively breastfed children born small for gestational age (SGA). Methods: this is a prospective cohort study of children born at term who were classified as SGA, and as appropiate for gestational age (AGA), who were followed up to pre-school age. Anthropometric measures and body composition parameters were obtained. Breastfeeding duration was calculated in days, and achievement of catch up of weight was considered an increase in Z-score ≥ 0.67. The cardiometabolic profile was evaluated in the first month of life and repeated at pre-school age. At pre-school age, fasting blood glucose, insulin, HOMA-IR, and blood pressure were measured. Results: twenty SGA and 12 AGA children were studied. The mean duration of exclusive breastfeeding (EBF) was 180 days in both groups. Of SGA children, 85 % had recovery anthropometric parameters for age within the first six months, with a speed of weight gain significantly higher than the that of AGAs (p < 0.001). SGAs continued to be thinner and smaller than AGAs at pre-school age. There was no diagnosis of overweight or obesity in the studied sample, and no differences were foun between groups in laboratory tests. Conclusion: these findings suggest that EBF may confer protection until pre-school age in children born SGA, who are considered at higher risk for chronic non-communicable diseases.
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Schneider BK, Boyer A, Ciccolini J, Barlesi F, Wang K, Benzekry S, Mochel JP. Optimal Scheduling of Bevacizumab and Pemetrexed/Cisplatin Dosing in Non-Small Cell Lung Cancer. CPT Pharmacometrics Syst Pharmacol 2019; 8:577-586. [PMID: 31004380 PMCID: PMC6709425 DOI: 10.1002/psp4.12415] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 03/31/2019] [Indexed: 12/12/2022] Open
Abstract
Bevacizumab-pemetrexed/cisplatin (BEV-PEM/CIS) is a first-line therapeutic for advanced nonsquamous non-small cell lung cancer. Bevacizumab potentiates PEM/CIS cytotoxicity by inducing transient tumor vasculature normalization. BEV-PEM/CIS has a narrow therapeutic window. Therefore, it is an attractive target for administration schedule optimization. The present study leverages our previous work on BEV-PEM/CIS pharmacodynamic modeling in non-small cell lung cancer-bearing mice to estimate the optimal gap in the scheduling of sequential BEV-PEM/CIS. We predicted the optimal gap in BEV-PEM/CIS dosing to be 2.0 days in mice and 1.2 days in humans. Our simulations suggest that the efficacy loss in scheduling BEV-PEM/CIS at too great of a gap is much less than the efficacy loss in scheduling BEV-PEM/CIS at too short of a gap.
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Affiliation(s)
| | - Arnaud Boyer
- SMARTc UnitCentre de Recherche en Cancérologie de Marseille Unité Mixte de Recherche (UMR) Inserm U1068Aix Marseille UniversityMarseilleFrance
- Multidisciplinary Oncology and Therapeutic Innovations DepartmentAssistance Publique Hôpitaux de MarseilleMarseilleFrance
| | - Joseph Ciccolini
- SMARTc UnitCentre de Recherche en Cancérologie de Marseille Unité Mixte de Recherche (UMR) Inserm U1068Aix Marseille UniversityMarseilleFrance
| | - Fabrice Barlesi
- Multidisciplinary Oncology and Therapeutic Innovations DepartmentAssistance Publique Hôpitaux de MarseilleMarseilleFrance
| | | | - Sebastien Benzekry
- Iowa State University College of Veterinary MedicineAmesIowaUSA
- Team Modelisation en OncologieInria Bordeaux Sud‐OuestInstitut de Mathématiques de BordeauxTalenceFrance
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The Use of Age Assessment in the Context of Child Migration: Imprecise, Inaccurate, Inconclusive and Endangers Children's Rights. CHILDREN-BASEL 2019; 6:children6070085. [PMID: 31340464 PMCID: PMC6678520 DOI: 10.3390/children6070085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 11/16/2022]
Abstract
Anecdotal reports suggest migrant children at the US border have had to undergo age assessment procedures to prove to immigration officials they qualify for special protections afforded to those under age 18. There are a variety of methods to assess the chronological ages of minors, including imaging studies such as X-rays of the wrist, teeth, or collarbone. However, these procedures have come under great scrutiny for being arbitrary and inaccurate, with a significant margin of error, because they are generally based on reference materials that do not take into account ethnicity, nutritional status, disease, and developmental history, considerations which are especially relevant for individuals coming from conflict and/or resource-constrained environments. Using these procedures for migration purposes represent an unethical use of science and medicine, which can potentially deprive minors with the protections that they are owed under US and international laws, and which may have devastating consequences. We should advocate for the creation special protocols, educate law enforcement and legal actors, ensure such procedures are carried out only as a last resort and by independent actors, emphasize child protection and always put the child’s best interest at the core.
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Talma H, van Dommelen P, Schweizer JJ, Bakker B, Kist-van Holthe JE, Chinapaw JMM, Hirasing RA. Is mid-upper arm circumference in Dutch children useful in identifying obesity? Arch Dis Child 2019; 104:159-165. [PMID: 29982172 DOI: 10.1136/archdischild-2017-313528] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 05/15/2018] [Accepted: 06/19/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND Mid-upper arm circumference (MUAC) is suggested as being a valid measure in detecting overweight/obesity in children and adolescents, due to the strong relation with weight. We examined this relation and compared MUAC to body mass index (BMI) according to the International Obesity Task Force (IOTF) in children. METHODS Anthropometric data including MUAC were collected in 2009 by trained healthcare professionals in the context of the fifth Dutch Nationwide Growth Study, in a sample of 6167 children (2891 boys and 3276 girls) aged 2-18 years of Dutch origin. We propose MUAC SDS cut-off values for overweight and obesity, and compared MUAC with BMI IOTF in sex-specific and age-specific categories (2-5, 6-11, 12-18 years). RESULTS The area under the curve is used as a measure of diagnostic accuracy; the explained variance (R²) is good to excellent (0.88-0.94). Sensitivity ranges from 51.8% to 95.3% and specificity from 71.4% to 93.8%. Across age and gender groups, 65.1% to 89.0% participants are classified by both MUAC and BMI as normal weight, overweight or obese. We constructed three equations to predict weight using MUAC, with small differences between observed and predicted weight with an explained variance ranging from 0.88 to 0.94. CONCLUSIONS Compared with BMI, MUAC is a valid measure for detecting overweight and obesity and thus a good alternative for BMI. When weight has to be estimated, it can be accurately predicted using MUAC. Based on our observations, we recommend developing diagrams with international (IOTF) cut-offs for MUAC SDS similar to BMI.
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Affiliation(s)
- Henk Talma
- Department Public and Occupational Health, Amsterdam Public Health, Child Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Paula van Dommelen
- Statistics, Netherlands Institute of Applied Sciences TNO, Leiden, The Netherlands
| | - Joachim J Schweizer
- Department of Paediatric Gastroenterology, Willem-Alexander Children's Hospital/Leiden University Medical Centre, Leiden, The Netherlands
| | - Boudewijn Bakker
- Department of Pediatrics, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Joana E Kist-van Holthe
- Department Public and Occupational Health, Amsterdam Public Health, Child Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - J Mai M Chinapaw
- Department Public and Occupational Health, Amsterdam Public Health, Child Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Remy A Hirasing
- Department Public and Occupational Health, Amsterdam Public Health, Child Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
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18
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Vasylenko VV, Masiuk SV, Ivanova OM, Pikta VO, Boiko ZN, Chepurny MI, Buderatska VB, Zadorozhna GM, Lytvynets LO, Kramarenko MS, Fedosenko GV, Kukush AG, Kuriata MS, Zhadan NS, Babenko TF. RESULTS OF WBC MEASUREMENTS WERE MADE AT RADIOACTIVELY CONTAMINATED TERRITORIES OF UKRAINE IN 1986-2014 (REVISION AND ANALYSIS). PROBLEMY RADIAT︠S︡IĬNOÏ MEDYT︠S︡YNY TA RADIOBIOLOHIÏ 2018; 23:120-138. [PMID: 30582841 DOI: 10.33145/2304-8336-2018-23-120-138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE revision, analysis, and significant improvement of quality of the database of WBC measurements made in1986-2014 at radioactively contaminated territories of Ukraine by the use of renewal of informational gaps andimprovement of the model for assessment of internal exposure doses. MATERIALS AND METHODS Inthe periodfrom 1986 to 2014 experts of the Whole Body Counters Laboratory of NRCRMaccumulated about 1.5 million results of WBC measurementsof radio-cesium incorporated in the body of personsresiding at the territories which are radioactively contaminated due to Chornobyl accident. Most of measurements(~64 %) were made during the first 15 years after the accident. The most of measurements were made in Kyiv (~23 %),Zhytomyr (~36 %), Rivne (~20 %) and Chernihiv (~5 %) Oblasts. Works on revision of database of WBC measurementsincluded: transformation of data saved in paper format into electronic form, checking for correctness and correspon-dence of information, renewal of lacking information at the fields of database, improvement of the model for eval-uation of internal exposure doses by the data of WBC measurements. In the model for evaluation of revised doses,it is assumed uniform content of radio-cesium during a year. Reference values are used of metabolism parametersand anthropometric human parameters recommended in publications of ICRP. RESULTS Revised doses have been reconstructed for 1,386,585 records of data base of WBC measurements that fitspecially elaborated criterions for estimation of quality of results. Among them 604,215 records are WBC measure-ments of children and adolescents younger than 18, and 782,370 records correspond to adult inhabitants of Ukraine,most of which reside in Zhytomyr, Kyiv, Rivne and Chenihiv Oblasts. CONCLUSIONS Obtained results serve as a ground for further works on improvement of models for evaluation of pass-port doses and individualized exposure doses of subjects registered in Ukrainian State Register - of persons thataffected due to Chornobyl accident. Evaluated doses can be used for epidemiological, clinical and other research.
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Affiliation(s)
- V V Vasylenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
| | - S V Masiuk
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
| | - O M Ivanova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
| | - V O Pikta
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
| | - Z N Boiko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
| | - M I Chepurny
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
| | - V B Buderatska
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
| | - G M Zadorozhna
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
| | - L O Lytvynets
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
| | - M S Kramarenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
| | - G V Fedosenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
| | - A G Kukush
- Taras Shevchenko National University of Kyiv, 60, Volodymyrska str., Kyiv, 01033, Ukraine
| | - M S Kuriata
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
| | - N S Zhadan
- Ukrainian Radiation Protection Institute of the Academy of Technological Sciences of Ukraine, 53, Melnykov str., PO Box 52, Kyiv, 04050, Ukraine
| | - T F Babenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53, Melnykova str., Kyiv, 04050, Ukraine
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19
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Clemente G, Gallo M, Giorgini M. Modalities for assessing the nutritional status in patients with diabetes and cancer. Diabetes Res Clin Pract 2018; 142:162-172. [PMID: 29857095 DOI: 10.1016/j.diabres.2018.05.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/01/2018] [Accepted: 05/23/2018] [Indexed: 01/03/2023]
Abstract
Epidemiological data have shown that an increased body mass index (BMI) is associated with a higher risk of various cancers, especially in obese diabetic patients. However, oncologic patients often present nutritional alterations that can worsen their prognosis. The aim of this review is to propose the use of cheaper and easy to use tools to assess the nutritional status of patients with cancer with altered glucose metabolism. Based on a literature review, we propose anthropometric measures to classify the degree of malnutrition. Moreover, the Karnofsky Performance Status (KPS) and the Eastern Cooperative Oncology Group's performance index (ECOG) are useful to assess the functional status of the body; the achievement of nutritional needs can be analysed with the PG-SGA questionnaire, while the quality of life can be investigated using the DTSQ, SF36, EQ-5D questionnaires and the Edmonton Symptom Assessment System. Pre-albumin dosage and lymphocyte count are proposed as nutritional parameters. The degree of hydration can be evaluated through the Bio-Impedance Test (BIA), and energy intake through the dairy food diary, which considers the type of nutrition and the consistency of the meals. It is possible to use a score for each tool used, which is useful to plan an adequate nutritional intervention.
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Affiliation(s)
- G Clemente
- Institute for Research on Population and Social Policies IRPPS - Italian National Research Council Penta di Fisciano (SA), Italy.
| | - M Gallo
- Oncological Endocrinology Unit, Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino - Turin, Italy
| | - M Giorgini
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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20
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Han JC, Reyes-Capo DP, Liu CY, Reynolds JC, Turkbey E, Turkbey IB, Bryant J, Marshall JD, Naggert JK, Gahl WA, Yanovski JA, Gunay-Aygun M. Comprehensive Endocrine-Metabolic Evaluation of Patients With Alström Syndrome Compared With BMI-Matched Controls. J Clin Endocrinol Metab 2018; 103:2707-2719. [PMID: 29718281 PMCID: PMC6276679 DOI: 10.1210/jc.2018-00496] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 04/24/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Alström syndrome (AS), a monogenic form of obesity, is caused by recessive mutations in the centrosome- and basal body-associated gene ALMS1. AS is characterized by retinal dystrophy, sensory hearing loss, cardiomyopathy, childhood obesity, and metabolic derangements. OBJECTIVE We sought to characterize the endocrine and metabolic features of AS while accounting for obesity as a confounder by comparing patients with AS to body mass index (BMI)-matched controls. METHODS We evaluated 38 patients with AS (age 2 to 38 years) who were matched with 76 controls (age 2 to 48 years) by age, sex, race, and BMI. Fasting biochemistries, mixed meal test (MMT), indirect calorimetry, dual-energy X-ray absorptiometry, and MRI/magnetic resonance spectroscopy were performed. RESULTS Frequent abnormalities in AS included 76% obesity, 37% type 2 diabetes mellitus (T2DM), 29% hypothyroidism (one-third central, two-thirds primary), 3% central adrenal insufficiency, 57% adult hypogonadism (one-third central, two-thirds primary), and 25% female hyperandrogenism. Patients with AS and controls had similar BMI z scores, body fat, waist circumference, abdominal visceral fat, muscle fat, resting energy expenditure (adjusted for lean mass), free fatty acids, glucagon, prolactin, ACTH, and cortisol. Compared with controls, patients with AS were shorter and had lower IGF-1 concentrations (Ps ≤ 0.001). Patients with AS had significantly greater fasting and MMT insulin resistance indices, higher MMT glucose, insulin, and C-peptide values, higher HbA1c, and higher prevalence of T2DM (Ps < 0.001). Patients with AS had significantly higher triglycerides, lower high-density lipoprotein cholesterol, and a 10-fold greater prevalence of metabolic syndrome (Ps < 0.001). Patients with AS demonstrated significantly greater liver triglyceride accumulation and higher transaminases (P < 0.001). CONCLUSION Severe insulin resistance and T2DM are the hallmarks of AS. However, patients with AS may present with multiple other endocrinopathies affecting growth and development.
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Affiliation(s)
- Joan C Han
- Unit on Metabolism and Neuroendocrinology, Eunice Kennedy Shriver National
Institute of Child Health and Human Development, National Institutes of Health, Bethesda,
Maryland
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of
Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
- Departments of Pediatrics and Physiology, University of Tennessee Health
Science Center and Le Bonheur Children’s Foundation Research Institute, Memphis,
Tennessee
- Correspondence and Reprint Requests: Joan C. Han, MD, Departments of Pediatrics and Physiology, University of Tennessee
Health Science Center and Le Bonheur Children’s Foundation Research Institute, 50 North
Dunlap Street, Room 454R, Memphis, Tennessee 38103. E-mail:
| | - Daniela P Reyes-Capo
- Unit on Metabolism and Neuroendocrinology, Eunice Kennedy Shriver National
Institute of Child Health and Human Development, National Institutes of Health, Bethesda,
Maryland
| | - Chia-Ying Liu
- Radiology and Imaging Sciences, National Institutes of Health Clinical Research
Center, Bethesda, Maryland
| | - James C Reynolds
- Radiology and Imaging Sciences, National Institutes of Health Clinical Research
Center, Bethesda, Maryland
| | - Evrim Turkbey
- Radiology and Imaging Sciences, National Institutes of Health Clinical Research
Center, Bethesda, Maryland
| | - Ismail Baris Turkbey
- Center for Cancer Research, National Cancer Institute, National Institutes of
Health, Bethesda, Maryland
| | - Joy Bryant
- Human Biochemical Genetics Section, Medical Genetics Branch, National Human
Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | | | | | - William A Gahl
- Human Biochemical Genetics Section, Medical Genetics Branch, National Human
Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Jack A Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of
Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Meral Gunay-Aygun
- Human Biochemical Genetics Section, Medical Genetics Branch, National Human
Genome Research Institute, National Institutes of Health, Bethesda, Maryland
- The McKusick-Nathans Institute of Genetic Medicine, Department of Pediatrics,
Johns Hopkins School of Medicine, Baltimore, Maryland
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Karunaratna AMDS, Ranasingha JGS, Mudiyanse RM. Zinc Status in Beta Thalassemia Major Patients. Biol Trace Elem Res 2018; 184:1-6. [PMID: 28940159 DOI: 10.1007/s12011-017-1158-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 09/18/2017] [Indexed: 01/19/2023]
Abstract
Beta thalassemia is a common monogenic hereditary hemoglobinopathy which is associated with compound complications. Zinc deficiency, which is commonly observed in thalassemia patients, is also associated with multiple health complications. The objective of this study was to determine the zinc status and its effect on the growth and immune functions of young beta thalassemia major patients. The study included 40 patients in comparison with age- and sex-matched 30 healthy individuals as controls. The patients were interviewed for socio-demographic variables, and their medical histories were obtained from the hospital files. Serum concentrations of zinc and ferritin, height, and body mass indices (BMI) were calculated. Mean serum zinc level in beta thalassemia major patients was 44.7 ± 24.2 μg/dl whereas in the control group it was 63.3 ± 30.3μg/dl. The mean serum zinc level is significantly low in beta thalassemia major patients with respect to the control group. The gender, age, duration of blood transfusion, blood transfusion volume, mean pretransfusion hemoglobin concentration, deferasirox dose, and serum ferritin level bear no relationship with serum zinc level of the beta thalassemia major patients. Zinc level showed no significant correlation with z-scores of stature, sitting height index, BMI, and frequency of recent infections of patients. Although zinc deficiency is common in beta thalassemia major patients, it was found to have no significant effect on physical growth and frequency of infections. Further studies are recommended to investigate zinc status of beta thalassemia major patients.
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22
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Gupta N, Lustig RH, Chao C, Vittinghoff E, Andrews H, Leu CS. Thiopurines are negatively associated with anthropometric parameters in pediatric Crohn's disease. World J Gastroenterol 2018; 24:2036-2046. [PMID: 29760546 PMCID: PMC5949716 DOI: 10.3748/wjg.v24.i18.2036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 04/12/2018] [Accepted: 04/26/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To determine the distribution of anthropometric parameter (AP)-z-scores and characterize associations between medications/serum biomarkers and AP-z-scores in pediatric Crohn's disease (CD). METHODS CD patients [< chronological age (CA) 21 years] were enrolled in a cross-sectional study. Descriptive statistics were generated for participants' demographic characteristics and key variables of interest. Paired t-tests were used to compare AP-z-scores calculated based on CA (CA z-scores) and bone age (BA) (BA z-scores) for interpretation of AP's. Linear regression was utilized to examine associations between medications and serum biomarkers with AP-z-scores calculated based on CA (n = 82) and BA (n = 49). We reported regression coefficients as well as their corresponding p-values and 95% confidence intervals. RESULTS Mean CA at the time of the study visit was 15.3 ± 3.5 (SD; range = 4.8-20.7) years. Mean triceps skinfold (P = 0.039), subscapular skinfold (P = 0.002) and mid-arm circumference (MAC) (P = 0.001) BA z-scores were higher than corresponding CA z-scores. Medications were positively associated with subscapular skinfold [adalimumab (P = 0.018) and methotrexate (P = 0.027)] and BMI CA z-scores [adalimumab (P = 0.029)]. Azathioprine/6-mercaptopurine were negatively associated with MAC (P = 0.045), subscapular skinfold (P = 0.014), weight (P = 0.002) and BMI (P = 0.013) CA z-scores. ESR, CRP, and WBC count were negatively associated, while albumin and IGF-1 BA z-scores were positively associated, with specific AP z-scores (P < 0.05). Mean height CA z-scores were higher in females, not males, treated with infliximab (P = 0.038). Hemoglobin (P = 0.018) was positively associated, while platelets (P = 0.005), ESR (P = 0.003) and CRP (P = 0.039) were negatively associated with height CA z-scores in males, not females. CONCLUSION Our results suggest poor efficacy of thiopurines and a possible sex difference in statural growth response to infliximab in pediatric CD. Prospective longitudinal studies are required.
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Affiliation(s)
- Neera Gupta
- Division of Gastroenterology and Nutrition, Department of Pediatrics, Weill Cornell Medicine, New York, NY 10021, United States
| | - Robert H Lustig
- Division of Endocrinology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA 94158, United States
| | - Cewin Chao
- Department of Nutrition and Food Services, University of California, San Francisco, San Francisco, CA 94143, United States
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94158, United States
| | - Howard Andrews
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, United States
| | - Cheng-Shiun Leu
- Department of Biostatistics, Columbia University Medical Center, New York, NY 10032, United States
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Stonebraker JS, Hajjar J, Orange JS. Latent therapeutic demand model for the immunoglobulin replacement therapy of primary immune deficiency disorders in the USA. Vox Sang 2018; 113:430-440. [PMID: 29675923 DOI: 10.1111/vox.12651] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 02/06/2018] [Accepted: 03/05/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND OBJECTIVES Our research aim is to model latent therapeutic demand (LTD) for the immunoglobulin replacement therapy (IgGRT) of primary immune deficiency disorders (PIDDs) in the USA. Given the high level of variability of IgGRT use and major differences among American and European practices in the management of patients with PIDDs, we develop a USA-specific LTD model for common variable immune deficiency (CVID), hyper IGM syndrome, severe combined immune deficiency, Wiskott-Aldrich syndrome and X-linked agammaglobulinemia (XLA). METHODS AND MATERIALS We use decision analysis methods to model the underlying IgGRT demand for PIDDs by assessing USA-specific epidemiology and treatment. Data for the epidemiology and treatment variables were obtained from the medical literature, USIDNET and Immune Deficiency Foundation. The uncertainty surrounding the variables was modelled using probability distributions and evaluated using Monte Carlo simulation. RESULTS The mean treatment dose from USIDNET and European Society for Immunodeficiencies (ESID) was significantly different for treating CVID, and the number of annual infusions from USIDNET and ESID was significantly different for treating CVID and XLA. The mean and standard deviation of LTD for all PIDDs is 105·1 ± 88·5 g per 1000 population, with CVID contributing the most to LTD. CONCLUSION Estimating country-specific LTD is important to ensure an adequate supply of IgGRT and an optimal treatment for patients with PIDDs and for improving national healthcare policymaking and production planning.
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Affiliation(s)
- J S Stonebraker
- Department of Business Management, Poole College of Management, North Carolina State University, Raleigh, NC, USA
| | - J Hajjar
- Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - J S Orange
- Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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For Black men, being tall increases threat stereotyping and police stops. Proc Natl Acad Sci U S A 2018; 115:2711-2715. [PMID: 29483263 DOI: 10.1073/pnas.1714454115] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Height seems beneficial for men in terms of salaries and success; however, past research on height examines only White men. For Black men, height may be more costly than beneficial, primarily signaling threat rather than competence. Three studies reveal the downsides of height in Black men. Study 1 analyzes over 1 million New York Police Department stop-and-frisk encounters and finds that tall Black men are especially likely to receive unjustified attention from police. Then, studies 2 and 3 experimentally demonstrate a causal link between perceptions of height and perceptions of threat for Black men, particularly for perceivers who endorse stereotypes that Black people are more threatening than White people. Together, these data reveal that height is sometimes a liability for Black men, particularly in contexts in which threat is salient.
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Nunes G, Barata AT, Santos CA, Patita M, Fonseca J. Nutritional deficiency during colonoscopy preparation: the forgotten iatrogeny. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2018; 110:285-291. [PMID: 29332407 DOI: 10.17235/reed.2018.5140/2017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS bowel preparation for colonoscopy induces a semi-fasting state, with a potential negative impact on fragile patients. The present study aims to quantify nutritional deficiency during colonoscopy preparation. METHODS this was an observational and cross-sectional study. A convenience sample was obtained that included adults that underwent colonoscopy after bowel preparation with Klean-Prep® according to the center protocol. Anthropometric evaluation was performed and nutritional deficiency was calculated via the quantification of energy and protein intake during the 48 hours prior to the examination which was compared with the individuals' needs. The association between nutritional deficiency with the quality of bowel preparation, age and status (hospitalized/ambulatory) was evaluated. RESULTS the study included 131 patients aged 21-91 years (mean 63.6 ± 13.2 years); 73 cases were male. Malnutrition reached 67.2% using specific anthropometric tools. A median preparation quality of six points was found when the Boston Bowel Preparation Scale was considered. The mean intake 48 hours prior to the procedure was 1,795 kcal and 100 g of protein. A daily energy intake of less than 50% of the individual needs was observed in 88 patients and less than 25% in 29 cases. The mean energy and protein deficiency were 59% (p < 0.01) and 45% (p < 0.01), and there was no correlation with preparation quality (p > 0.05). Nutritional defiency is similar in hospitalized and ambulatory patients (p > 0.05), but higher in older individuals (p = 0.04). CONCLUSIONS nutritional deficiency during colonoscopy preparation was significant, more so in older patients, and there was no correlation with the quality of bowel preparation. We conclude that bowel preparation regimens should be reformulated with an improved nutritional intake and the inclusion of nutritional supplements without residues.
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Affiliation(s)
| | | | | | - Marta Patita
- Gastroenterology Department, Hospital Garcia de Orta. Portugal
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Totah D, Kovalenko I, Saez M, Barton K. Manufacturing Choices for Ankle-Foot Orthoses: A Multi-objective Optimization. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.procir.2017.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Le QA, Bae YH, Kang JH. Cost-effectiveness analysis of trastuzumab emtansine (T-DM1) in human epidermal growth factor receptor 2 (HER2): positive advanced breast cancer. Breast Cancer Res Treat 2016; 159:565-73. [DOI: 10.1007/s10549-016-3958-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 08/24/2016] [Indexed: 01/13/2023]
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Harrison A, Lin S, Pounder N, Mikuni-Takagaki Y. Mode & mechanism of low intensity pulsed ultrasound (LIPUS) in fracture repair. ULTRASONICS 2016; 70:45-52. [PMID: 27130989 DOI: 10.1016/j.ultras.2016.03.016] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 03/22/2016] [Accepted: 03/28/2016] [Indexed: 06/05/2023]
Abstract
It has been 30years since the first level one clinical trial demonstrated low intensity pulsed ultrasound (LIPUS) could accelerate fracture repair. Since 1994 numerous investigations have been performed on the effect of LIPUS. The majority of these studies have used the same signal parameters comprised of an intensity of 30mW/cm(2) SATA, an ultrasound carrier frequency of 1.5MHz, pulsed at 1kHz with an exposure time of 20minutes per day. These studies show that a biological response is stimulated in the cell which produces bioactive molecules. The production of these molecules, linked with observations demonstrating the enhanced effects on mineralization by LIPUS, might be considered the general manner, or mode, of how LIPUS stimulates fractures to heal. We propose a mechanism for how the LIPUS signal can enhance fracture repair by combining the findings of numerous studies. The LIPUS signal is transmitted through tissue to the bone, where cells translate this mechanical signal to a biochemical response via integrin mechano-receptors. The cells enhance the production of cyclo-oxygenese 2 (COX-2) which in turn stimulates molecules to enhance fracture repair. The aim of this review is to present the state of the art data related to LIPUS effects and mechanism.
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Affiliation(s)
| | - Sheldon Lin
- Department of Orthopedics, Rutgers, New Jersey Medical School, USA
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Hambli R, Boughattas MH, Daniel JL, Kourta A. Prediction of denosumab effects on bone remodeling: A combined pharmacokinetics and finite element modeling. J Mech Behav Biomed Mater 2016; 60:492-504. [DOI: 10.1016/j.jmbbm.2016.03.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/08/2016] [Accepted: 03/10/2016] [Indexed: 01/23/2023]
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Comparison of proximal humeral bone stresses between stemless, short stem, and standard stem length: a finite element analysis. J Shoulder Elbow Surg 2016; 25:1076-83. [PMID: 26810016 DOI: 10.1016/j.jse.2015.11.011] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 11/04/2015] [Accepted: 11/10/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND The stem lengths of humeral components used in shoulder arthroplasty vary; however, the literature on these devices is limited. This finite element study investigates the effect of humeral component length on stresses in the proximal humerus. METHODS Intact and 3 reconstructed (standard length, short, and stemless implants) finite element models were created from shoulder computed tomography scan data (N = 5). Loading was simulated at varying abduction angles (15°, 45°, and 75°). The average bone stress (represented as a percentage of intact values) was reported at 8 transverse slices. In addition, the overall average change in cortical and trabecular bone stresses was quantified. RESULTS Cortical bone stresses in the most proximal slice for the standard (58% ± 12%) and short (78% ± 10%) stem models were significantly reduced compared with the intact (100%) and stemless (101% ± 6%) models (P = .005). These reductions persisted in the second cortical slice for the standard stem compared with the intact, stemless, and short models (P = .025). Interestingly, stresses in the trabecular bone within these proximal slices were significantly elevated when stemless implants were used compared with all other implants (P < .001), regardless of abduction angle. CONCLUSION Reducing stem length produced humeral stresses that more closely matched the intact stress distribution in proximal cortical bone. Opposing trends presented in the proximal trabecular bone, probably because of differences in load transfer when shorter stems are used. Accordingly, the results suggest that implant stem length is 1 variable that can be modified in an attempt to better mimic intact bone stresses during humeral component insertion, provided stem fixation is adequate.
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Lu W, McKyer ELJ, Dowdy D, Evans A, Ory M, Hoelscher DM, Wang S, Miao J. Evaluating the Influence of the Revised Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food Allocation Package on Healthy Food Availability, Accessibility, and Affordability in Texas. J Acad Nutr Diet 2015; 116:292-301. [PMID: 26673523 DOI: 10.1016/j.jand.2015.10.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 10/22/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was implemented to improve the health of pregnant women and children of low socioeconomic status. In 2009, the program was revised to provide a wider variety of healthy food choices (eg, fresh fruits, vegetables, and whole-grain items). OBJECTIVES The purpose of this study was to evaluate (1) the impact of the revised WIC Nutrition Program's food allocation package on the availability, accessibility, and affordability of healthy foods in WIC-authorized grocery stores in Texas; and (2) how the impact of the policy change differed by store types and between rural and urban regions. DESIGN WIC-approved stores (n=105) across Texas were assessed using a validated instrument (88 items). Pre- (June-September 2009) and post-new WIC package implementation (June-September 2012) audits were conducted. Paired-sample t tests were conducted to compare the differences between pre- and post-implementation audits on shelf width and number of varieties (ie, availability), visibility (ie, accessibility), and inflation-adjusted price (ie, affordability). RESULTS Across the 105 stores, post-implementation audits showed increased availability in terms of shelf space for most key healthy food options, including fruit (P<0.001), vegetables (P<0.01), cereal (P<0.001), and varieties of vegetables (P<0.001). Food visibility increased for fresh juices (P<0.001). Visibility of WIC labeling improved for foods such as fruits (P<0.05), WIC cereal (P<0.05), and whole-grain or whole-wheat bread (P<0.01). Inflation-adjusted prices decreased only for bread (P<0.001) and dry grain beans (P<0.001). The positive effects of the policy change on food availability and visibility were observed in stores of different types and in different locations, although smaller or fewer effects were noted in small stores and stores in rural regions. CONCLUSIONS Implementation of the revised WIC food package has generally improved availability and accessibility, but not affordability, of healthy foods in WIC-authorized stores in Texas. Future studies are needed to explore the impact of the revised program on healthy food option purchases and consumption patterns among Texas WIC participants.
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Sommerich CM, Lavender SA, Radin Umar RZ, Li J, Park S, Dutt M. A biomechanical and subjective comparison of two powered ambulance cots. ERGONOMICS 2015; 58:1885-1896. [PMID: 26245484 DOI: 10.1080/00140139.2015.1039604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UNLABELLED This study investigated biomechanical effects of different leg folding/unfolding mechanisms used for loading/unloading two powered cots (Cots A and B) into and from a simulated ambulance. Sixteen experienced emergency medical service (EMS) workers loaded and unloaded cots with weights of 45, 68 and 91 kg placed on the cots to simulate patients. Peak back and shoulder/arm muscle activity was reduced 52-87% when using Cot A in comparison to Cot B. Peak ground reaction force (PGRF) was reduced by 74% with Cot A. Adding weight resulted in increased muscle activity and PGRF when using Cot B, but had little effect when using Cot A. Task time was longer with Cot A, though was not perceived unfavourably by participants. This study confirmed that it is possible to substantially reduce physical stress imposed on EMS workers when loading and unloading a cot to and from an ambulance through improvements in cot design. PRACTITIONER SUMMARY This study compared two powered ambulance cots, one that lifts/lowers the front and rear wheels independently and one that lifts/lowers the four wheels simultaneously during ambulance loading and unloading. Measured muscle activity, ground reaction forces and operator perceptions support using cot designs that lift/lower the front and rear wheels independently.
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Affiliation(s)
- Carolyn M Sommerich
- a Department of Integrated Systems Engineering , The Ohio State University , Columbus , USA
| | - Steven A Lavender
- a Department of Integrated Systems Engineering , The Ohio State University , Columbus , USA
| | - Radin Zaid Radin Umar
- a Department of Integrated Systems Engineering , The Ohio State University , Columbus , USA
| | - Jing Li
- a Department of Integrated Systems Engineering , The Ohio State University , Columbus , USA
| | - SangHyun Park
- a Department of Integrated Systems Engineering , The Ohio State University , Columbus , USA
| | - Mohini Dutt
- a Department of Integrated Systems Engineering , The Ohio State University , Columbus , USA
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Fong CK, Keay L, Coxon K, Clarke E, Brown J. Seat belt use and fit among drivers aged 75 years and older in their own vehicles. TRAFFIC INJURY PREVENTION 2015; 17:142-150. [PMID: 26158309 DOI: 10.1080/15389588.2015.1052420] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE This article aims to describe seat belt wearing patterns and quality of seat belt fit among drivers aged 75 years and older. A secondary aim is to explore associations between body shape, comfort, and seat belt use patterns. METHODS This is an observation and survey study of a cohort of 380 drivers aged 75 years and over. During home visits, photographs were taken of the drivers in their vehicles for later analysis of belt fit and a short survey was also administered to collect demographic data and information about seat belt use and comfort. Seat belt fit and use of belt and seat accessories were analyzed from the photographs. RESULTS Data from 367 participants with photographs were analyzed. Whereas 97% reported using a seat belt and 90% reported their seat belt to be comfortable, 21% reported repositioning their seat belt to improve comfort. Good sash and lap belt fit were achieved in 53 and 59% of participants, respectively, but only 35% achieved overall good fit. Both poor sash and lap belt fit were observed in 23% of participants. Drivers who were in the obese category had over twice the odds (95% confidence interval [CI], 1.2-4.1) of having a poor lap belt fit than those in the normal body mass index [BMI] range, and drivers who were overweight had 1.8 times the odds (95% CI, 1.1-2.9) of having poor lap belt fit. Older females also had twice the odds (95% CI, 1.3-3.5) of poor lap belt fit compared to older males, regardless of BMI. Sash belt fit did not vary significantly by BMI, stature, or gender. However older drivers who reported that they had not made any adjustments to the D-ring height had 1.7 times the odds of having poor sash belt fit than those who made adjustments (1.2-2.9). Females were 7.3 times more likely to report comfort problems than males (95% CI, 3.2, 16.3) but there was no association between reported comfort and BMI or seat belt fit. Drivers who reported comfort problems had 6 times the odds (3.2-13.6) of also reporting active repositioning of the belt. CONCLUSIONS The results suggest that older drivers face challenges in achieving comfortable and correct seat belt fit. This may have a negative impact on crash protection. Belt fit problems appear to be associated with body shape, particularly high BMI and gender. There is a need for further investigation of comfort accessories; in the interim, older drivers and occupants should be encouraged to use features such as D-ring adjusters to improve sash belt fit.
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Affiliation(s)
- Cameron K Fong
- a Neuroscience Research Australia, University of New South Wales , Randwick , New South Wales , Australia
- b School of Medical Sciences, University of New South Wales , Randwick , New South Wales , Australia
| | - Lisa Keay
- c The George Institute for Global Health, University of Sydney , Sydney , New South Wales , Australia
| | - Kristy Coxon
- c The George Institute for Global Health, University of Sydney , Sydney , New South Wales , Australia
| | - Elizabeth Clarke
- d The Kolling Institute of Medical Research, Sydney Medical School, The University of Sydney, RNS Hospital , St. Leonards , New South Wales , Australia
| | - Julie Brown
- a Neuroscience Research Australia, University of New South Wales , Randwick , New South Wales , Australia
- b School of Medical Sciences, University of New South Wales , Randwick , New South Wales , Australia
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Mwiru RS, Spiegelman D, Duggan C, Seage GR, Semu H, Chalamilla G, Kisenge R, Fawzi WW. Nutritional Status and Other Baseline Predictors of Mortality among HIV-Infected Children Initiating Antiretroviral Therapy in Tanzania. J Int Assoc Provid AIDS Care 2015; 14:172-9. [PMID: 24106055 PMCID: PMC4627587 DOI: 10.1177/2325957413500852] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND We assembled a prospective cohort of 3144 children less than 15 years of age initiating antiretroviral therapy (ART) in Dar es Salaam, Tanzania. METHODS The relationships of nutritional status and other baseline characteristics in relation to mortality were examined using Cox proportional hazards model. RESULTS Compared with children with weight for age (WAZ) > -1, those with WAZ ≤ -2 to < -3 had a nearly double risk of death (relative risk [RR], 1.85; 95% confidence interval [CI], 1.10-3.11), and among those with WAZ ≤ -3, the risk more than tripled (RR, 3.36; 95% CI, 2.12-5.32). Other baseline risk factors for overall mortality included severe anemia (P < .001), severe immune suppression (P = .02), history of tuberculosis (P = .01), opportunistic infections (P < .001), living in the poorest district (P < .001), and advanced World Health Organization stage (P = .003). CONCLUSIONS To sustain the obtained benefit of ART in this setting, interventions to improve nutritional status may be used as an adjunct to ART.
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Affiliation(s)
- Ramadhani S Mwiru
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA Management and Development for Health (MDH), Dar es Salaam, Tanzania
| | - Donna Spiegelman
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Christopher Duggan
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA Division of GI/Nutrition, Center for Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - George R Seage
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Helen Semu
- Ministry of Health and Social Welfare, Dar es Salaam, Tanzania
| | - Guerino Chalamilla
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA Management and Development for Health (MDH), Dar es Salaam, Tanzania
| | - Rodrick Kisenge
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Wafaie W Fawzi
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA
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Association of pulmonary function with adiposity and metabolic abnormalities in urban minority adolescents. Ann Am Thorac Soc 2015; 11:744-52. [PMID: 24785169 DOI: 10.1513/annalsats.201311-403oc] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Childhood obesity is a known risk factor for pulmonary diseases, likely due to obesity-mediated alteration of pulmonary function. Inflammation and mechanical fat load are two proposed causative mechanisms for altered pulmonary function among obese children; however, the association of metabolic abnormalities with pulmonary function among children is poorly understood. OBJECTIVES We investigated the independent association of truncal and general adiposity and metabolic abnormalities with pulmonary function in a sample of urban minority adolescents. METHODS Spirometry and lung volume indices were compared between adolescents with general (body mass index [BMI] > 95th percentile) or truncal adiposity (waist circumference > 90th percentile) and normal-weight (BMI < 85th percentile or waist circumference ≤ 90th percentile) and between those with metabolic abnormalities (homeostatic model assessment of insulin resistance [HOMA-IR] in the top quartile or high-density lipoprotein [HDL] < 40 mg/dl) and those with a normal metabolic profile. MEASUREMENTS AND MAIN RESULTS Obese adolescents had lower lung volumes, including residual volume (RV), RV/TLC ratio, expiratory reserve volume (ERV), and FRC, and higher inspiratory capacity (IC) than normal-weight adolescents, but did not differ in measures of lower airway obstruction, FEV1/FVC ratio, and mid-expiratory flow rate. Adolescents with high HOMA-IR had lower FEV1/FVC ratio, RV, RV/TLC ratio, ERV, and FRC and higher IC, whereas those with low HDL had lower FEV1/FVC and RV/TLC ratios. After adjusting for adiposity, HOMA-IR remained a predictor of ERV (β = -1.4; P = 0.02) and FEV1/FVC ratio (β = -0.5; P = 0.03), and HDL remained a predictor of FEV1/FVC ratio (β = 0.1; P = 0.01). General adiposity was a predictor of FRC (β = -0.5; P < 0.001), IC (β = 0.3; P < 0.001), RV (β = -0.8; P < 0.0001), and RV/TLC ratio (β = -0.2; P < 0.0001), and truncal adiposity was a predictor of RV (β = -20.3; P = 0.03) and FRC (β = -13.8; P = 0.004). Thus, adiposity and metabolic abnormalities were independent predictors of ERV, but only metabolic abnormalities independently predicted FEV1/FVC ratio. Although general adiposity predicted RV and RV/TLC ratio, truncal adiposity was predictive of RV and FRC, conferring additional risk above general adiposity. CONCLUSIONS These results suggest that metabolic abnormalities and adiposity are independently associated with pulmonary function deficits among urban adolescents. Metabolic assessment of obese adolescents may identify those at risk of developing obesity-associated pulmonary morbidity.
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Barr R, Nayiager T, Gordon C, Marriott C, Athale U. Body composition and bone health in long-term survivors of acute lymphoblastic leukaemia in childhood and adolescence: the protocol for a cross-sectional cohort study. BMJ Open 2015; 5:e006191. [PMID: 25603918 PMCID: PMC4305072 DOI: 10.1136/bmjopen-2014-006191] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 10/28/2014] [Accepted: 10/30/2014] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Success in the treatment of young people with cancer, as measured conventionally by survival rates, is mitigated by late effects of therapy that impose a burden of morbidity and limit life expectancy. Among these adverse sequelae are altered body composition, especially obesity, and compromised bone health in the form of osteoporosis and increased fragility. These outcomes are potentially reversible and even preventable. This study will examine measures of body composition and bone health in long-term survivors of acute lymphoblastic leukaemia (ALL) in childhood and adolescence. These measures will be complemented by measures of physical activity and health-related quality of life (HRQL). METHODS AND ANALYSIS Survivors of ALL who are at least 10 years from diagnosis, following treatment on uniform protocols, will undergo measurements of body mass index; triceps skin fold thickness and mid-upper arm circumference; fat mass, lean body mass, skeletal muscle mass and bone mineral density by dual energy X-ray absorptiometry; trabecular and cortical bone indices and muscle density by peripheral quantitative CT; physical activity by the Habitual Activity Estimation Scale; and HRQL by Health Utilities Index instruments. Descriptive measures will be used for continuous variables and number (percent) for categorical variables. Associations between variables will be assessed using Fisher's exact t test and the χ(2) test; correlations will be tested by the Pearson correlation coefficient. ETHICS AND DISSEMINATION The study is approved by the institutional research ethics board and is supported by a competitive funding award. Dissemination of the results will occur by presentations to scientific meetings and publications in peer-reviewed journals, and by posting summaries of the results on websites accessed by adolescent and young adult survivors of cancer.
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Affiliation(s)
- Ronald Barr
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Hematology-Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Trishana Nayiager
- Division of Hematology-Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Christopher Gordon
- Department of Nuclear Medicine, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Christopher Marriott
- Department of Nuclear Medicine, Hamilton Health Sciences, Hamilton, Ontario, Canada
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | - Uma Athale
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Hematology-Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
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Madden AM, Smith S. Body composition and morphological assessment of nutritional status in adults: a review of anthropometric variables. J Hum Nutr Diet 2014; 29:7-25. [PMID: 25420774 DOI: 10.1111/jhn.12278] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Evaluation of body composition is an important part of assessing nutritional status and provides prognostically useful data and an opportunity to monitor the effects of nutrition-related disease progression and nutritional intervention. The aim of this narrative review is to critically evaluate body composition methodology in adults, focusing on anthropometric variables. The variables considered include height, weight, body mass index and alternative indices, trunk measurements (waist and hip circumferences and sagittal abdominal diameter) and limb measurements (mid-upper arm and calf circumferences) and skinfold thickness. The importance of adhering to a defined measurement protocol, checking measurement error and the need to interpret measurements using appropriate population-specific cut-off values to identify health risks were highlighted. Selecting the optimum method for assessing body composition using anthropometry depends on the purpose (i.e. evaluating obesity or undernutrition) and requires practitioners to have a good understanding of both practical and theoretical limitations and to be able to interpret the results wisely.
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Affiliation(s)
- A M Madden
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - S Smith
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
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Salehi-Abargouei A, Shiranian A, Ehsani S, Surkan PJ, Esmaillzadeh A. Caesarean delivery is associated with childhood general obesity but not abdominal obesity in Iranian elementary school children. Acta Paediatr 2014; 103:e383-7. [PMID: 24903542 DOI: 10.1111/apa.12711] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 03/03/2014] [Accepted: 06/02/2014] [Indexed: 11/29/2022]
Abstract
AIM This study examined the association between Caesarean delivery and general and abdominal obesity among children. METHODS In a cross-sectional study, 635 children aged from 6 to 12 years of age (476 girls and 159 boys) were randomly selected from Isfahan elementary schools. Weight, height and waist circumference were measured. General obesity and abdominal obesity were defined based on World Health Organization growth charts and Iranian national cut-off points, respectively. Parents were asked about delivery type and other factors potentially related to childhood obesity using a self-administered questionnaire. The association between delivery type and obesity was examined using univariate and multivariate logistic regression models. RESULTS The overall prevalence of general and central obesity was 17.6% and 17.1%, respectively, and Caesarean delivery was significantly associated with general obesity after controlling for potential confounders (OR: 2.46; 95% CI: 1.30-4.63, p = 0.005). We observed a significant association between Caesarean delivery and abdominal obesity in crude analyses (OR: 1.66; 1.02-2.69, p = 0.04), but this disappeared after adjusting for covariates (OR: 1.96; 0.82-4.69, p = 0.13). CONCLUSION Our results suggest that Caesarean delivery is adversely associated with general childhood obesity, but not abdominal obesity. This provides support for recommending vaginal births, unless contraindicated. Further research in large populations is required to confirm these findings.
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Affiliation(s)
- Amin Salehi-Abargouei
- Food Security Research Center; Isfahan University of Medical Sciences; Isfahan Iran
- Department of Community Nutrition; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
- Student Research Committee; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
| | - Afshin Shiranian
- Food Security Research Center; Isfahan University of Medical Sciences; Isfahan Iran
- Department of Community Nutrition; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
- Student Research Committee; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
| | - Simin Ehsani
- Food Security Research Center; Isfahan University of Medical Sciences; Isfahan Iran
- Department of Community Nutrition; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
- Student Research Committee; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
| | - Pamela J. Surkan
- Department of International Health; Johns Hopkins Bloomberg School of Public Health; Baltimore MD USA
| | - Ahmad Esmaillzadeh
- Food Security Research Center; Isfahan University of Medical Sciences; Isfahan Iran
- Department of Community Nutrition; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
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Chiu EM, Thomas KA, Persike M, Quan JR, Bridgeman B. A Slippery Slope: Estimated Slant of Hills Increases with Distance. Perception 2014; 43:631-46. [DOI: 10.1068/p7658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The slopes of hills tend to be greatly overestimated. Previous studies have found that slope estimates are significantly greater when estimated verbally than with a proprioceptive measure. It has yet to be determined whether these estimates are made for the entire extent of the slope, or whether the estimates in closest proximity are estimated using a different process. Since some parietal cortex neurons respond differently to objects within arm's reach, short-distance slope estimation may utilize these or analogous neurons. Alternatively, greater implied effort might make longer slopes seem steeper. We determined that both verbal and proprioceptive reports of slope are overestimates that increase logarithmically with distance from the observer, contradicting both theories. Consistent with previous work, proprioceptive estimates were more accurate at all ranges. Our results can be interpreted as a function of the angle between the observer's gaze and the plane of the hill, modified by depth cues available at only near distances.
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Affiliation(s)
- Eric M Chiu
- Cognitive and Information Sciences, University of California Merced, 5200 North Lake Road, Merced, CA 95343, USA
| | - Kyle A Thomas
- Department of Psychology, Harvard University, William James Hall 964, 33 Kirkland Street, Cambridge, MA 02138, USA
| | - Malte Persike
- Psychologisches Institut, Methodenlehre & Stastistik, Johannes Gutenberg-Universität Mainz, D-55122 Mainz, Germany
| | - Joshua R Quan
- Department of Psychology, University of California Santa Cruz, 1156 High Street, Santa Cruz, CA 95064, USA
| | - Bruce Bridgeman
- Department of Psychology, University of California Santa Cruz, 1156 High Street, Santa Cruz, CA 95064, USA
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Kuebler M, Yom-Tov E, Pelleg D, Puhl RM, Muennig P. When overweight is the normal weight: an examination of obesity using a social media internet database. PLoS One 2013; 8:e73479. [PMID: 24058478 PMCID: PMC3776815 DOI: 10.1371/journal.pone.0073479] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 07/21/2013] [Indexed: 11/26/2022] Open
Abstract
Using a large social media database, Yahoo Answers, we explored postings to an online forum in which posters asked whether their height and weight qualify themselves as "skinny," "thin," "fat," or "obese" over time and across forum topics. We used these data to better understand whether a higher-than-average body mass index (BMI) in one's county might, in some ways, be protective for one's mental and physical health. For instance, we explored whether higher proportions of obese people in one's county predicts lower levels of bullying or "am I fat?" questions from those with a normal BMI relative to his/her actual BMI. Most women asking whether they were themselves fat/obese were not actually fat/obese. Both men and women who were actually overweight/obese were significantly more likely in the future to ask for advice about bullying than thinner individuals. Moreover, as mean county-level BMI increased, bullying decreased and then increased again (in a U-shape curve). Regardless of where they lived, posters who asked "am I fat?" who had a BMI in the healthy range were more likely than other posters to subsequently post on health problems, but the proportions of such posters also declined greatly as county-level BMI increased. Our findings suggest that obese people residing in counties with higher levels of BMI may have better physical and mental health than obese people living in counties with lower levels of BMI by some measures, but these improvements are modest.
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Affiliation(s)
- Meghan Kuebler
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | | | | | - Rebecca M. Puhl
- Rudd Center for Food Policy and Obesity, Yale University, New Haven, Connecticut, United States of America
| | - Peter Muennig
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, New York, United States of America
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Kim JE, Hsieh MH, Soni BK, Zayzafoon M, Allison DB. Childhood obesity as a risk factor for bone fracture: a mechanistic study. Obesity (Silver Spring) 2013; 21:1459-66. [PMID: 23512354 PMCID: PMC3740028 DOI: 10.1002/oby.20355] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 12/03/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the risk of bone fracture sustained by obese children exposed to falls. The bone fracture risk of obese children would be greater than that of their nonobese counterparts was hypothesized. DESIGN AND METHODS Finite element-based computational models for children that reflected various levels of obesity by varying body mass and the thickness of the subcutaneous adipose tissue layer was developed. The models took account of both the momentum effect of variation of body mass and the cushion effect of variation of soft tissue thickness and examined these two contradictory effects on pelvic bone fracture risk through a set of sideways fall simulations with a range of impact speeds. RESULTS The critical impact speed that yielded pelvic bone fracture decreased as the levels of obesity increased, which meant that the momentum effect of a greater body mass took precedence over the cushion effect of the soft tissue layer. CONCLUSIONS The result suggests that obese children have a greater risk of pelvic bone fracture than do their nonobese counterparts in sideways falls. A further implication is that current child safety devices, systems, and regulations will need to be revisited as the prevalence of child obesity increases.
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Affiliation(s)
- Jong-Eun Kim
- Department of Mechanical Engineering, University of Alabama at Birmingham, AL, USA.
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Walter RB, Brasky TM, Buckley SA, Potter JD, White E. Height as an explanatory factor for sex differences in human cancer. J Natl Cancer Inst 2013; 105:860-8. [PMID: 23708052 PMCID: PMC3687370 DOI: 10.1093/jnci/djt102] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 01/26/2013] [Accepted: 02/28/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Most cancers occur more frequently in men. Numerous explanations for this excess risk have been proposed, yet no study has quantified the degree to which height explains the sex difference even though greater height has been associated with increased risk for many cancers. METHODS During the period from 2000 to 2002, 65308 volunteers aged 50 to 76 years were recruited to the Vitamins And Lifestyle (VITAL) study. Cancers of shared anatomic sites (n = 3466) were prospectively identified through 2009 through the Surveillance, Epidemiology, and End Results cancer registry. Age- and race-adjusted hazard ratios (HRs) for the associations between sex and incident cancers were estimated using Cox proportional hazards models, with and without adjustment for height and height squared as measures of body size. RESULTS Men had a 55% increased risk of cancer at shared sites (HR = 1.55; 95% confidence interval [CI] = 1.45 to 1.66). When height was accounted for, 33.8% (95% CI = 10.2% to 57.3%) of the excess risk for men was explained by the height differences between sexes. The proportion mediated by height was 90.9%, 57.3%, and 49.6% for kidney, melanoma, and hematologic malignancies, respectively, with little evidence that height mediates the sex difference for gastrointestinal tract, lung, and bladder cancers. For comparison, more than 35 lifestyle and medical risk factors only explained 23.1% of the sex difference in cancer risk at shared sites. CONCLUSIONS Height is an important explanatory factor for the excess risk for men for many shared-site cancers. This suggests that some of the excess risk is due to factors associated with height (eg, number of susceptible cells in a specific organ or growth-influencing exposures in childhood).
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Affiliation(s)
- Roland B Walter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
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Sousa AS, de Sousa OL, Amaral TF. The effect of posture on body circumferences in older adults. J Hum Nutr Diet 2013; 27:80-7. [PMID: 23763599 DOI: 10.1111/jhn.12093] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Standards for anthropometrical assessment define that measurements must be carried out with the subject in the standing position, although this is not always possible. The effect of body position on girth measurement has not been evaluated, even though this issue is clinically relevant because it may bias nutritional assessment results. The present study aimed to evaluate the effect of body position and symmetry on girth measurement. METHODS A cross-sectional study was conducted on 102 older adults aged ≥65 years from care homes and tertiary hospitals. Right and left arm, waist, hip mid-thigh and calf girths were obtained with the subject standing or in the supine position. Mini-Nutritional Assessment Short-Form (MNA-SF) score and reference data percentiles (NHANES IV) misclassification according to girths assessed in the supine position was evaluated. RESULTS A high intraclass correlation coefficient (ICC > 0.97) and quartiles agreement (k > 0.89) were found between girth measurements conducted on participants in the standing and supine positions. According to MNA-SF, 23.5% of the participants were undernourished and 51% were at risk of undernutrition. A high agreement between MNA-SF score using calf circumference measured on standing or supine position was found (k = 0.96). A relevant agreement for NHANES IV girth percentiles by sex and age was also found (ICC > 0.89). CONCLUSIONS Agreement between girth measurements on standing and supine positions among older adults is high and differences do not have any clinically relevant impact on MNA-SF classification and reference data percentiles.
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Affiliation(s)
- A S Sousa
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
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Global variance in female population height: the influence of education, income, human development, life expectancy, mortality and gender inequality in 96 nations. J Biosoc Sci 2013; 46:107-21. [PMID: 23544661 DOI: 10.1017/s0021932013000175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Human height is a heritable trait that is known to be influenced by environmental factors and general standard of living. Individual and population stature is correlated with health, education and economic achievement. Strong sexual selection pressures for stature have been observed in multiple diverse populations, however; there is significant global variance in gender equality and prohibitions on female mate selection. This paper explores the contribution of general standard of living and gender inequality to the variance in global female population heights. Female population heights of 96 nations were culled from previously published sources and public access databases. Factor analysis with United Nations international data on education rates, life expectancy, incomes, maternal and childhood mortality rates, ratios of gender participation in education and politics, the Human Development Index (HDI) and the Gender Inequality Index (GII) was run. Results indicate that population heights vary more closely with gender inequality than with population health, income or education.
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Wirth M, Vena JE, Smith EK, Bauer SE, Violanti J, Burch J. The epidemiology of cancer among police officers. Am J Ind Med 2013; 56:439-53. [PMID: 23255299 PMCID: PMC3655699 DOI: 10.1002/ajim.22145] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND This review summarizes peer-reviewed studies examining cancer risks among police officers. It provides an overview of existing research limitations and uncertainties and the plausible etiologic risk factors associated with cancer in this understudied occupation. METHODS Previous cancer studies among police officers were obtained via a systematic review of the MEDLINE, CABDirect, and Web of Science bibliographic databases. RESULTS Quality observational studies of cancer among police officers are sparse and subject to limitations in exposure assessment and other methods. Results from three studies suggested possible increased mortality risks for all cancers, and cancers of the colon, kidney, digestive system, esophagus, male breast, and testis, as well as Hodgkin's disease. Few incidence studies have been performed, and results have been mixed, although some associations with police work have been observed for thyroid, skin, and male breast cancer. CONCLUSIONS Police are exposed to a mix of known or suspected agents or activities that increase cancer risk. Epidemiologic evidence to date is sparse and inconsistent. There is a critical need for more research to understand the biological and social processes underlying exposures and the suggested disproportionate risks and to identify effective prevention strategies.
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Affiliation(s)
- Michael Wirth
- South Carolina Statewide Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
| | - John E. Vena
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
- Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, New York
| | - Emily K. Smith
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
| | - Sarah E. Bauer
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia
| | - John Violanti
- Department of Social and Preventive Medicine, State University of New York at Buffalo, Buffalo, New York
| | - James Burch
- South Carolina Statewide Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
- Dorn Department of Veteran’s Affairs Medical Center, Columbia, South Carolina
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Senbanjo IO, Oshikoya KA, Olutekunbi OA, Njokanma OF. Body fat distribution of children and adolescents in Abeokuta, Southwest Nigeria. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2013; 150:647-54. [PMID: 23446950 DOI: 10.1002/ajpa.22241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Accepted: 01/18/2013] [Indexed: 11/11/2022]
Abstract
Excessive central fat in children and adolescents is a risk factor for cardiovascular and metabolic disorders. This study aimed to compare the body fat distribution patterns of children and adolescents in Abeokuta, Nigeria with international reference standards. Five hundred seventy children aged 5 to 19 years were selected from seven schools using multistage random sampling. Weight, height, triceps and subscapular skinfold thickness (TSF, SSF), and circumference at the waist and hips (WC, HC) were measured. Body mass index (BMI), subscapular:triceps skinfold ratio (STR), waist:hip circumference ratio (WHR), and waist: height ratio (WHtR) were derived. Females had higher mean BMI, TSF, SSF, WC, HC, WHR, and WHtR, while males had significantly higher STR. The mean BMI, WC, TSF, and SSF values were lower for our subjects than for African-American subjects at all ages. On the other hand, in both sexes, STR was higher among Nigerian than African-American subjects up to 12 years old. Thereafter the values were similar. The mean WC was similar to those reported for African-American males up to 8 years, and females up to 7 years of age; thereafter, African-American had higher values. The prevalence of central obesity using WC and WHtR measures was 4.4% and 5.8%, respectively. There is a need to validate each index against serum lipid profiles and other cardiovascular and metabolic risk factors.
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Affiliation(s)
- Idowu O Senbanjo
- Department of Paediatrics and Child Health, Lagos State University College of Medicine, Ikeja, Lagos State, 100001, Nigeria.
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Sánchez FJ, Martínez-Patiño MJ, Vilain E. The new policy on hyperandrogenism in elite female athletes is not about "sex testing". JOURNAL OF SEX RESEARCH 2013; 50:112-5. [PMID: 23320653 PMCID: PMC3554857 DOI: 10.1080/00224499.2012.752429] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In April 2011, the International Olympic Committee (IOC) and the International Association of Athletics Federations (IAAF) updated their regulations regarding elite female athletes with hyperandrogenism: Women whose testosterone levels crossed into the male range could not compete with other women unless it was shown that they are resistant to the effects of testosterone. Although the new rule is a marked improvement over past attempts to ensure that men were not trying to compete as women in elite competition, several criticisms have been leveled against the new regulations. Here we offer our reactions to claims that the new regulation promotes a sex-verification test, claims that intersex athletes will automatically be disqualified from competition, and proposals to either divide athletes based on variables beyond sex or completely eliminate sex groupings. Although elite sports can never achieve a perfectly level playing field, there should be parameters to which athletes must conform for a given sport. Yet elite athletes themselves should play a decisive role in what is best for their sport.
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Hamby S, Finkelhor D, Turner H. Perpetrator and victim gender patterns for 21 forms of youth victimization in the National Survey of Children's Exposure to Violence. VIOLENCE AND VICTIMS 2013; 28:915-939. [PMID: 24547672 DOI: 10.1891/0886-6708.vv-d-12-00067] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Most interest in violence and gender has focused on certain types of victimization such as sex offenses and relational aggression. This study examined gender patterns across numerous forms of youth victimization. The data are from the National Survey of Children's Exposure to Violence (NatSCEV), a nationally representative U.S. sample of 4,549 children ages 1 month to 17 years obtained through a telephone survey of caregivers and youth. For 18 of 21 victimization types, male perpetration was significantly more common than female perpetration. Perpetrator-victim patterns revealed that most forms of physical assault and bullying showed a predominantly male-on-male pattern. All forms of sexual assault, plus kidnapping, showed a predominantly male-on-female pattern. Nonphysical maltreatment showed a mixed pattern, with fairly similar rates across all four gender configurations. Many violence types were more severe when perpetrated by males versus females as indicated by higher injury rates and greater victim fear. Higher order analyses by victimization type indicated, among other findings, that victimization types with more stranger perpetrators had more male perpetrators, victimizations with higher percentages of male-on-female and female-on-male incidents were more likely to be sexual offenses, and higher percentages of female-on-female incidents were associated with verbal victimizations. Results also suggest that males are more likely to aggress in more impersonal contexts compared to females. Gender socialization, physical power, and social power appear to intersect in ways that create gendered patterns of violence. These factors, versus a focus on skills deficits, need more attention in prevention and intervention.
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Affiliation(s)
- Sherry Hamby
- Department of Psychology and Life Paths Research Program, Sewanee, the University of the South, Sewanee, TN 37383, USA.
| | - David Finkelhor
- Crimes Against Children Research Center, University of New Hampshire, USA
| | - Heather Turner
- Crimes Against Children Research Center, University of New Hampshire, USA
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Runfola CD, Von Holle A, Peat CM, Gagne DA, Brownley KA, Hofmeier SM, Bulik CM. Characteristics of women with body size satisfaction at midlife: results of the Gender and Body Image (GABI) Study. J Women Aging 2013; 25:287-304. [PMID: 24116991 PMCID: PMC3816007 DOI: 10.1080/08952841.2013.816215] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study characterizes the profile of women (N = 1,789) ages 50 and over who report body size satisfaction on a figure rating scale. Satisfied women (12.2%) had a lower body mass index and reported fewer eating disorder symptoms, dieting behaviors, and weight and appearance dissatisfaction. Interestingly, satisfied women exercised more than dissatisfied women, and weight and shape still played a primary role in their self-evaluation. Weight monitoring and appearance-altering behaviors did not differ between groups. Body satisfaction was associated with better overall functioning. This end point appears to represent effortful body satisfaction rather than passive contentment.
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Affiliation(s)
- Cristin D. Runfola
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Ann Von Holle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Christine M. Peat
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Danielle A. Gagne
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Kimberly A. Brownley
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Sara M. Hofmeier
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Fanelli Kuczmarski M, Mason MA, Beydoun MA, Allegro D, Zonderman AB, Evans MK. Dietary patterns and sarcopenia in an urban African American and White population in the United States. J Nutr Gerontol Geriatr 2013; 32:291-316. [PMID: 24224938 PMCID: PMC4669047 DOI: 10.1080/21551197.2013.840255] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The primary objective of this cross-sectional study was to characterize dietary patterns of African Americans and Whites, 30 to 64 years, examined in the Healthy Aging in Neighborhoods of Diversity across the Life Span study. Other objectives of the study were to evaluate micronutrient adequacy of each pattern and to determine the association of diet with sarcopenia. Cluster analysis was used to determine patterns and mean adequacy ratio (MAR) to determine adequacy of 15 micronutrients. Ten clusters were identified: sandwich, sweet drink, pizza, poultry, frozen meal, dessert, alcoholic drink, bread, starchy vegetables, and pasta/rice dish. MAR ranged from 69 for the sweet drink cluster to 82 for the pasta/rice dish cluster. Sarcopenia was present in 6.4% of the sample, ranging from 1.5% in the poultry cluster to 14.1% in the alcoholic drink cluster. This study is the first to report an association between diet and sarcopenia in people younger than 65 years. The identification of presarcopenia has important implications for dietary interventions that might delay age-associated loss of lean mass.
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Affiliation(s)
- Marie Fanelli Kuczmarski
- a Department of Behavioral Health and Nutrition , University of Delaware , Newark , Delaware , USA
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