Sample records for extreme weight control

  1. The Relationship between Smoking and Unhealthy Weight Control Behaviors among Korean Adolescents: The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014

    PubMed Central

    Sim, Won Yong; Kang, Jae Heon; Park, Hyun Ah; Kim, Kyoung Woo; Hur, Yang Im; Shin, Koh Eun; Byeon, Gyeong Ran

    2017-01-01

    Background Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents. Methods This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. ‘Unhealthy weight control behaviors’ were subcategorized into ‘extreme weight control behaviors’ and ‘less extreme weight control behaviors.’ Results The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls. Conclusion Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors. PMID:28197330

  2. The Relationship between Smoking and Unhealthy Weight Control Behaviors among Korean Adolescents: The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014.

    PubMed

    Sim, Won Yong; Cho, Young Gyu; Kang, Jae Heon; Park, Hyun Ah; Kim, Kyoung Woo; Hur, Yang Im; Shin, Koh Eun; Byeon, Gyeong Ran

    2017-01-01

    Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents. This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. 'Unhealthy weight control behaviors' were subcategorized into 'extreme weight control behaviors' and 'less extreme weight control behaviors.' The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls. Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors.

  3. HEALTH STATUS OF EXTREMELY LOW BIRTH WEIGHT CHILDREN AT AGE 8 YEARS: CHILD AND PARENT PERSPECTIVE

    PubMed Central

    Hack, Maureen; Forrest, Christopher B; Schluchter, Mark; Taylor, H. Gerry; Drotar, Dennis; Holmbeck, Grayson; Andreias, Laura

    2013-01-01

    Context Parental proxy reports have indicated poorer health for preterm children as compared to normal birth weight controls. The perspective of their children may however differ. Objective To compare the self reported health of preterm children to normal birth weight controls and the children’s perspective to that of their parents. Design Study of extremely low birth weight (<1kg) and normal birth weight children and their parents conducted 2006–2009. Setting Children’s hospital. Participants Eight year old extremely low birth weight (n=202) and normal birth weight (n=176) children of similar sociodemographic status. Main Outcome Measures The Child Health and Illness Profile child and parent reports. Results There was poor agreement between the parent and child ratings of health for both the extremely low birth weight and normal birth weight cohorts. Extremely low birth weight children rated their health similar to normal birth weight children. In contrast parents of extremely low birth weight children reported significantly poorer health for their children than parents of normal birth weight controls including poorer Satisfaction with health, Comfort and Achievement and less Risk avoidance. Conclusion There is poor agreement between child and parent reports of health. Eight year old extremely low birth weight children rate their health similar to that of normal birth weight controls. Their parents however report significantly poorer health. Both child and parent perspective needs to be considered when making health care decisions. PMID:21969395

  4. Family, friend, and media factors are associated with patterns of weight-control behavior among adolescent girls.

    PubMed

    Balantekin, Katherine N; Birch, Leann L; Savage, Jennifer S

    2018-04-01

    To examine the relationship of family, friend, and media factors on weight-control group membership at 15 years separately and in a combined model. Subjects included 166 15 year girls. Latent class analysis identified four patterns of weight-control behaviors: non-dieters, lifestyle, dieters, and extreme dieters. Family (family functioning, priority of the family meals, maternal/paternal weight-teasing, and mother's/father's dieting), friend (weight-teasing and dieting), and media variables (media sensitivity and weekly TV time) were included as predictors of weight-control group membership. Family functioning and priority of family meals predicted membership in the Extreme Dieters group, and maternal weight-teasing predicted membership in both dieters and extreme dieters. Friend's dieting and weight-teasing predicted membership in both dieters and extreme dieters. Media sensitivity was significantly associated with membership in lifestyle, dieters, and extreme dieters. In a combined influence model with family, friend, and media factors included, the following remained significantly associated with weight-control group membership: family functioning, friends' dieting, and media sensitivity. Family, friends, and the media are three sources of sociocultural influence, which play a role in adolescent girls' use of patterns of weight-control behaviors; family functioning was a protective factor, whereas friend's dieting and media sensitivity were risk factors. These findings emphasize the need for multidimensional interventions, addressing risk factors for dieting and use of unhealthy weight-control behaviors at the family, peer, and community (e.g., media) levels.

  5. Familial correlates of extreme weight control behaviors among adolescents.

    PubMed

    Fonseca, Helena; Ireland, Marjorie; Resnick, Michael D

    2002-12-01

    To identify familial factors associated with extreme weight control among adolescents. Analysis of a comprehensive 1996 health survey of Connecticut students. Familial factors among extreme dieters who deliberately vomited, took diet pills, laxatives, or diuretics were compared with youth reporting none of these behaviors, using logistic regression controlling for age and body mass index. Nearly 7% of adolescents reported engaging in extreme weight control behaviors. Boys' risk factors included high parental supervision/monitoring and sexual abuse history. Protective factors included high parental expectations, maternal presence, and connectedness with friends and other adults. The only significant risk factor for girls was sexual abuse history. Protective factors included family connectedness, positive family communication, parental supervision/monitoring, and maternal presence. Extreme dieting appears to be less an expression of body composition than of psychosocial issues. That connectedness to family, other adults, and friends is protective further demonstrates interrelationships of extreme weight control behaviors with family/social issues. Copyright 2002 by Wiley Periodicals, Inc. Int J Eat Disord 32: 441-448, 2002.

  6. Patterns of Weight Control Behavior among 15 year old Girls

    PubMed Central

    Balantekin, Katherine N.; Birch, Leann L.; Savage, Jennifer S.

    2015-01-01

    Objective The objectives were to identify and predict patterns of weight control behavior in 15 year old (yo) girls and to examine weight control group differences in energy intake. Method Subjects included 166 girls assessed every 2 years (ys) from age 5 to 15. Latent class analysis was used to identify patterns of weight control behaviors. Antecedent variables (e.g. inhibitory control at 7ys), and concurrent variables (e.g. BMI and dietary intake at 15ys) were included as predictors. Assessments were a combination of survey, interview, and laboratory measures. Results LCA identified four classes of weight control behaviors, Non-dieters (26%), and three dieting groups: Lifestyle (16%), Dieters (43%), and Extreme Dieters (17%). Levels of restraint, weight concerns, and dieting frequency increased across groups, from Non-dieters to Extreme Dieters. BMI at 5ys and inhibitory control at 7ys predicted weight control group at 15ys; e.g. with every one-point decrease in inhibitory control, girls were twice as likely to be Extreme Dieters than Non-dieters. Girls in the Extreme Dieters group were mostly classified as under-reporters, and had the lowest self-reported intake, but ate significantly more in the laboratory. Discussion Among 15yo girls, “dieting” includes a range of both healthy and unhealthy behaviors. Risk factors for membership in a weight control groups are present as early as 5ys. Patterns of intake in the laboratory support the view that lower reported energy intake by Extreme Dieters is likely due under-reporting as an intent to decrease intake, not actual decreased intake. PMID:26284953

  7. Is prescribed lower extremity weight-bearing status after geriatric lower extremity trauma associated with increased mortality?

    PubMed

    Gitajn, Ida Leah; Connelly, Daniel; Mascarenhas, Daniel; Breazeale, Stephen; Berger, Peter; Schoonover, Carrie; Martin, Brook; O'Toole, Robert V; Pensy, Raymond; Sciadini, Marcus

    2018-02-01

    Evaluate whether mortality after discharge is elevated in geriatric fracture patients whose lower extremity weight-bearing is restricted. Retrospective cohort study SETTING: Urban Level 1 trauma center PATIENTS/PARTICIPANTS: 1746 patients >65 years of age INTERVENTION: Post-operative lower extremity weight-bearing status MAIN OUTCOME MEASURE: Mortality, as determined by the Social Security Death Index RESULTS: Univariate analysis demonstrated that patients who were weight-bearing as tolerated on bilateral lower extremities (BLE) had significantly higher 5-year mortality compared to patients with restricted weight-bearing on one lower extremity and restricted weight-bearing on BLE (30%, 21% and 22% respectively, p < 0.001). Cox regression analysis controlling for variables including age, Charlson Comorbidity Index, Injury Severity Scale, combined UE/LE injury, injury mechanism (high vs low), sex, BMI and GCS demonstrated that, in comparison to patients who were weight bearing as tolerated on BLE, restricted weight-bearing on one lower extremity had a hazard ratio (HR) of 0.97 (95% confidence interval 0.78 to 1.20, p = 0.76) and restricted weight-bearing in BLE had a HR of 0.91 (95% confidence interval 0.60 to 1.36, p = 0.73). In geriatric patients, prescribed weight-bearing status did not have a statistically significant association with mortality after discharge, when controlling for age, sex, body mass index, medical comorbidities, Injury Severity Scale (ISS), mechanism of injury, nonoperative treatment and admission GCS. This remained true in when the analysis was restricted to operative injuries only. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Visual memory and learning in extremely low-birth-weight/extremely preterm adolescents compared with controls: a geographic study.

    PubMed

    Molloy, Carly S; Wilson-Ching, Michelle; Doyle, Lex W; Anderson, Vicki A; Anderson, Peter J

    2014-04-01

    Contemporary data on visual memory and learning in survivors born extremely preterm (EP; <28 weeks gestation) or with extremely low birth weight (ELBW; <1,000 g) are lacking. Geographically determined cohort study of 298 consecutive EP/ELBW survivors born in 1991 and 1992, and 262 randomly selected normal-birth-weight controls. Visual learning and memory data were available for 221 (74.2%) EP/ELBW subjects and 159 (60.7%) controls. EP/ELBW adolescents exhibited significantly poorer performance across visual memory and learning variables compared with controls. Visual learning and delayed visual memory were particularly problematic and remained so after controlling for visual-motor integration and visual perception and excluding adolescents with neurosensory disability, and/or IQ <70. Male EP/ELBW adolescents or those treated with corticosteroids had poorer outcomes. EP/ELBW adolescents have poorer visual memory and learning outcomes compared with controls, which cannot be entirely explained by poor visual perceptual or visual constructional skills or intellectual impairment.

  9. Effects of sensorimotor foot training on the symmetry of weight distribution on the lower extremities of patients in the chronic phase after stroke

    PubMed Central

    Goliwas, Magdalena; Kocur, Piotr; Furmaniuk, Lech; Majchrzycki, Marian; Wiernicka, Marzena; Lewandowski, Jacek

    2015-01-01

    [Purpose] To assess the effects of sensorimotor foot stimulation on the symmetry of weight distribution on the feet of patients in the chronic post-stroke phase. [Subjects and Methods] This study was a prospective, single blind, randomized controlled trial. In the study we examined patients with chronic stroke (post-stroke duration > 1 year). They were randomly allocated to the study group (n=8) or to the control group (n=12). Both groups completed a standard six-week rehabilitation programme. In the study group, the standard rehabilitation programme was supplemented with sensorimotor foot stimulation training. Each patient underwent two assessments of symmetry of weight distribution on the lower extremities with and without visual control, on a treadmill, with stabilometry measurements, and under static conditions. [Results] Only the study group demonstrated a significant increase in the weight placed on the leg directly affected by stroke, and a reduction in asymmetry of weight-bearing on the lower extremities. [Conclusion] Sensorimotor stimulation of the feet enhanced of weight bearing on the foot on the side of the body directly affected by stroke, and a decreased asymmetry of weight distribution on the lower extremities of patients in the chronic post-stroke phase. PMID:26504326

  10. Effects of sensorimotor foot training on the symmetry of weight distribution on the lower extremities of patients in the chronic phase after stroke.

    PubMed

    Goliwas, Magdalena; Kocur, Piotr; Furmaniuk, Lech; Majchrzycki, Marian; Wiernicka, Marzena; Lewandowski, Jacek

    2015-09-01

    [Purpose] To assess the effects of sensorimotor foot stimulation on the symmetry of weight distribution on the feet of patients in the chronic post-stroke phase. [Subjects and Methods] This study was a prospective, single blind, randomized controlled trial. In the study we examined patients with chronic stroke (post-stroke duration > 1 year). They were randomly allocated to the study group (n=8) or to the control group (n=12). Both groups completed a standard six-week rehabilitation programme. In the study group, the standard rehabilitation programme was supplemented with sensorimotor foot stimulation training. Each patient underwent two assessments of symmetry of weight distribution on the lower extremities with and without visual control, on a treadmill, with stabilometry measurements, and under static conditions. [Results] Only the study group demonstrated a significant increase in the weight placed on the leg directly affected by stroke, and a reduction in asymmetry of weight-bearing on the lower extremities. [Conclusion] Sensorimotor stimulation of the feet enhanced of weight bearing on the foot on the side of the body directly affected by stroke, and a decreased asymmetry of weight distribution on the lower extremities of patients in the chronic post-stroke phase.

  11. Cognitive Outcomes for Extremely Preterm/Extremely Low Birth Weight Children in Kindergarten

    PubMed Central

    Orchinik, Leah J.; Taylor, H. Gerry; Espy, Kimberly Andrews; Minich, Nori; Klein, Nancy; Sheffield, Tiffany; Hack, Maureen

    2012-01-01

    Our objectives were to examine cognitive outcomes for extremely preterm/extremely low birth weight (EPT/ELBW, gestational age <28 weeks and/or birth weight <1000 g) children in kindergarten and the associations of these outcomes with neonatal factors, early childhood neurodevelopmental impairment, and socioeconomic status (SES). The sample comprised a hospital-based 2001-2003 birth cohort of 148 EPT/ELBW children (mean birth weight 818 g; mean gestational age 26 weeks) and a comparison group of 111 term-born normal birth weight (NBW) classmate controls. Controlling for background factors, the EPT/ELBW group had pervasive deficits relative to the NBW group on a comprehensive test battery, with rates of cognitive deficits that were 3 to 6 times higher in the EPT/ELBW group. Deficits on a measure of response inhibition were found in 48% versus 10%, OR (95% CI) = 7.32 (3.32, 16.16), p <.001. Deficits on measures of executive function and motor and perceptual-motor abilities were found even when controlling for acquired verbal knowledge. Neonatal risk factors, early neurodevelopmental impairment, and lower SES were associated with higher rates of deficits within the EPT/ELBW group. The findings document both global and selective cognitive deficits in EPT/ELBW children at school entry and justify efforts at early identification and intervention. PMID:21923973

  12. Trends in the prevalence of extreme obesity among Korean children and adolescents from 2001 to 2014.

    PubMed

    Nam, Hyo-Kyoung; Kim, Hye Ryun; Rhie, Young-Jun; Lee, Kee-Hyoung

    2017-05-01

    We assessed nationwide trends in extreme obesity prevalence and its impact on metabolic syndrome in Korean youth. Data from 19,593 youth (10,271 boys) aged 2-19 were obtained from the Korean National Health and Nutrition Examination Surveys (2001-2014). The prevalence of extreme obesity and the odds ratio of metabolic syndrome were calculated. Questionnaires on body weight perceptions and weight control behaviors were administered. The prevalence of extreme obesity increased significantly among boys (p<0.05). The odds ratios of extreme obesity on metabolic syndrome compared with obesity were 3.781 and 1.979 in boys and girls, respectively. Obese teenage girls with appropriate weight perception attempted to lose weight more frequently than obese teenage boys did. Although the prevalence of childhood obesity in Korea was similar since early 2000s, extreme obesity prevalence has increased, especially among teenage boys. Considering greater morbidity risks, preventing progression to extreme obesity is crucial.

  13. Extreme Weight-Control Behaviors and Suicide Risk among High School Students

    ERIC Educational Resources Information Center

    Johnson, Emily R.; Weiler, Robert M.; Barnett, Tracey E.; Pealer, Lisa N.

    2016-01-01

    Background: Suicide is the third leading cause of death for people ages 15-19. Research has established an association across numerous risk factors and suicide, including depression, substance abuse, bullying victimization, and feelings of alienation. However, the connection between disordered eating as manifested in extreme weight-control…

  14. School-Based Obesity-Prevention Policies and Practices and Weight-Control Behaviors among Adolescents.

    PubMed

    Larson, Nicole; Davey, Cynthia S; Caspi, Caitlin E; Kubik, Martha Y; Nanney, Marilyn S

    2017-02-01

    The promotion of healthy eating and physical activity within school settings is an important component of population-based strategies to prevent obesity; however, adolescents may be vulnerable to weight-related messages, as rapid development during this life stage often leads to preoccupation with body size and shape. This study examines secular trends in secondary school curricula topics relevant to the prevention of unhealthy weight-control behaviors; describes cross-sectional associations between weight-related curricula content and students' use of weight-control behaviors; and assesses whether implementation of school-based obesity-prevention policies/practices is longitudinally related to students' weight-control behaviors. The Minnesota School Health Profiles and Minnesota Student Survey (grades 9 and 12) data were used along with National Center for Education Statistics data to examine secular trends, cross-sectional associations (n=141 schools), and longitudinal associations (n=42 schools). Students self-reported their height and weight along with past-year use of healthy (eg, exercise), unhealthy (eg, fasting), and extreme (eg, use laxatives) weight-control behaviors. Descriptive statistics, generalized estimating equations, and generalized linear regression models accounting for school-level demographics. There was no observable pattern during the years 2008 to 2014 in the mean number of curricula topics addressing unhealthy weight-control behaviors, despite an increase in the prevalence of curricula addressing acceptance of body-size differences. Including three vs fewer weight-control topics and specifically including the topic of eating disorders in the curricula was related to a lower school-level percent of students using any extreme weight-control behaviors. In contrast, an overall measure of implementing school-based obesity-prevention policies/practices (eg, prohibited advertising) was unrelated to use of unhealthy or extreme behaviors. Results suggest obesity-prevention policies/practices do not have unintended consequences for student weight-control behaviors and support the importance of school-based health education as part of efforts to prevent unhealthy behaviors. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  15. School-based obesity prevention policies and practices and weight-control behaviors among adolescents

    PubMed Central

    Davey, Cynthia S.; Caspi, Caitlin E.; Kubik, Martha Y.; Nanney, Marilyn S.

    2016-01-01

    Background The promotion of healthy eating and physical activity within school settings is an important component of population-based strategies to prevent obesity; however, adolescents may be vulnerable to weight-related messages as rapid development during this lifestage often leads to preoccupation with body size and shape. Objective This study (1) examines secular trends in secondary school curricula topics relevant to the prevention of unhealthy weight-control behaviors; (2) describes cross-sectional associations between weight-related curricula content and students’ use of weight-control behaviors; and (3) assesses whether implementation of school-based obesity prevention policies/practices are longitudinally related to students’ weight-control behaviors. Design/participants The Minnesota School Health Profiles and Minnesota Student Survey (grades 9 and 12) data were used along with National Center for Education Statistics data to examine secular trends; cross-sectional associations (n=141 schools); and longitudinal associations (n=42 schools). Main Outcome Measures Students self-reported their height and weight along with past-year use of healthy (e.g., exercise), unhealthy (e.g., fasting), and extreme (e.g., use laxatives) weight-control behaviors. Statistical analyses performed Descriptive statistics, generalized estimating equations, and generalized linear regression models accounting for school-level demographics. Results There was no observable pattern over the years 2008 to 2014 in the mean number of curricula topics addressing unhealthy weight-control behaviors despite an increase in the prevalence of curricula addressing acceptance of body size differences. Including three versus fewer weight-control topics and specifically including the topic of eating disorders in the curricula were related to a lower school-level percent of students using any extreme weight-control behaviors. In contrast, an overall measure of implementing school-based obesity prevention policies/practices (e.g., prohibited advertising) was unrelated to use of unhealthy or extreme behaviors. Conclusions Results suggest obesity prevention policies/practices do not have unintended consequences for student weight-control behaviors and support the importance of school-based health education as part of efforts to prevent unhealthy behaviors. PMID:27889315

  16. The importance of extreme weight percentile in postoperative morbidity in children.

    PubMed

    Stey, Anne M; Moss, R Lawrence; Kraemer, Kari; Cohen, Mark E; Ko, Clifford Y; Lee Hall, Bruce

    2014-05-01

    Anthropometric data are important indicators of child health. This study sought to determine whether anthropometric data of extreme weight were significant predictors of perioperative morbidity in pediatric surgery. This was a cohort study of children 29 days up to 18 years of age undergoing surgical procedures at participating American College of Surgeons' NSQIP Pediatric hospitals in 2011 and 2012. The primary outcomes were composite morbidity and surgical site infection. The primary predictor of interest was weight percentile, which was divided into the following categories: ≤5(th) percentile, 6(th) to 94(th), or ≥95(th) percentile. A hierarchical multivariate logistic model, adjusting for procedure case mix, demographic, and clinical patient characteristic variables, was used to quantify the relationship between weight percentile category and outcomes. Children in the ≤5th weight percentile had 1.19-fold higher odds of overall postoperative morbidity developing than children in the nonextreme range (95% CI, 1.10-1.30) when controlling for clinical variables. Yet these children did not have higher odds of surgical site infection developing. Children in the ≥95(th) weight percentile did not have a significant increase in overall postoperative morbidity. However, they were at 1.35-fold increased odds of surgical site infection compared with those in the nonextreme range when controlling for clinical variables (95% CI, 1.16-1.57). Both extremely high and extremely low weight percentile scores can be associated with increased postoperative complications after controlling for clinical variables. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Percentage extremity fat, but not percentage trunk fat, is lower in adolescent boys with anorexia nervosa than in healthy adolescents123

    PubMed Central

    Misra, Madhusmita; Katzman, Debra K; Cord, Jennalee; Manning, Stephanie J; Mickley, Diane; Herzog, David B; Miller, Karen K; Klibanski, Anne

    2013-01-01

    Background Anorexia nervosa (AN) is a condition of severe undernutrition associated with altered regional fat distribution in females. Although primarily a disease of females, AN is increasingly being recognized in males and is associated with hypogonadism. Testosterone is a major regulator of body composition in males, and testosterone administration in adults decreases visceral fat. However, the effect of low testosterone and other hormonal alterations on body composition in boys with AN is not known. Objective We hypothesized that testosterone deficiency in boys with AN is associated with higher trunk fat, as opposed to extremity fat, compared with control subjects. Design We assessed body composition using dual-energy X-ray absorptiometry and measured fasting testosterone, estradiol, insulin-like growth factor-1, leptin, and active ghrelin concentrations in 15 boys with AN and in 15 control subjects of comparable maturity aged 12–19 y. Results Fat and lean mass in AN boys was 69% and 86% of that in control subjects. Percentage extremity fat and extremity lean mass were lower in boys with AN (P = 0.003 and 0.0008); however, percentage trunk fat and the trunk to extremity fat ratio were higher after weight was adjusted for (P = 0.005 and 0.003). Testosterone concentrations were lower in boys with AN, and, on regression modeling, positively predicted percentage extremity lean mass and inversely predicted percentage trunk fat and trunk to extremity fat ratio. Other independent predictors of regional body composition were bone age and weight. Conclusions In adolescent boys with AN, higher percentage trunk fat, higher trunk to extremity fat ratio, lower percentage extremity fat, and lower extremity lean mass (adjusted for weight) are related to the hypogonadal state. PMID:19064506

  18. Effects of exercise training using resistance bands on glycaemic control and strength in type 2 diabetes mellitus: a meta-analysis of randomised controlled trials.

    PubMed

    McGinley, Samantha K; Armstrong, Marni J; Boulé, Normand G; Sigal, Ronald J

    2015-04-01

    Resistance exercise using free weights or weight machines improves glycaemic control and strength in people with type 2 diabetes. Resistance band training is potentially less expensive and more accessible, but the effects of resistance band training on glycaemic control and strength in this population are not well understood. This paper aims to systematically review and meta-analyse the effect of resistance band training on haemoglobin A1c (HbA1c) and strength in adults with type 2 diabetes. Database searches were performed in August 2013 (MEDLINE, SPORTDiscus, EMBASE, and CINAHL). Reference lists of eligible articles were hand-searched for additional studies. Randomised trials evaluating the effects of resistance band training in adults with type 2 diabetes on HbA1c or objectively measured strength were selected. Baseline and post-intervention HbA1c and strength were extracted for the intervention and control groups. Details of the exercise interventions and methodological quality were collected. Seven trials met inclusion criteria. Post-intervention-weighted mean HbA1c was nonsignificantly lower in exercise groups compared to control groups [weighted mean difference (WMD) = -0.18 percentage points (-1.91 mmol/mol); P = 0.27]. Post-intervention strength was significantly higher in the exercise groups compared to the control groups in the lower extremities (WMD = 21.90 kg; P < 0.0001), but not in the upper extremities (WMD = 2.27 kg; P = 0.13) or handgrip (WMD = 1.98 kg; P = 0.46). All trials were small and had methodological limitations. Resistance band training did not significantly affect HbA1c, upper extremity, or handgrip strength but significantly increased the strength of the lower extremities in people with type 2 diabetes.

  19. Family meals and disordered eating in adolescents: longitudinal findings from project EAT.

    PubMed

    Neumark-Sztainer, Dianne; Eisenberg, Marla E; Fulkerson, Jayne A; Story, Mary; Larson, Nicole I

    2008-01-01

    To examine 5-year longitudinal associations between family meal frequency and disordered eating behaviors in adolescents. Longitudinal study. Participants from 31 Minnesota schools completed in-class assessments in 1999 (time 1) and mailed surveys in 2004 (time 2). Adolescents (N=2516) who completed Project EAT (Eating Among Teens)-I (time 1) and -II (time 2) assessments. Time 1 family meal frequency and time 2 disordered eating behaviors, including extreme weight control behaviors (self-induced vomiting and use of laxatives, diet pills, or diuretics), less extreme unhealthy weight control behaviors (eating very little, fasting, using food substitutes, skipping meals, or smoking), binge eating, and chronic dieting. Among adolescent girls, time 1 regular family meals (> or = 5 meals/wk) were associated with lower prevalences of time 2 extreme weight control behaviors (odds ratio, 0.71; 95% confidence interval, 0.52-0.97), even after adjusting for sociodemographic characteristics, body mass index, family connectedness, parental encouragement to diet, and extreme weight control behaviors at time 1. Associations with other disordered eating behaviors were also suggestive of a protective effect of family meals in unadjusted analyses but were not statistically significant in adjusted analyses. Among adolescent boys, regular family meals did not predict lower levels of disordered eating behaviors. The high prevalence of disordered eating behaviors among adolescent girls and the protective role of family meals suggest a need for interventions aimed at promoting family meals. Further exploration of predictors of disordered eating behaviors in adolescent boys and the role of family meals is warranted.

  20. Unhealthy Weight-control Behaviours, Dieting and Weight Status: A Cross-cultural Comparison between North American and Spanish Adolescents

    PubMed Central

    López-Guimerà, Gemma; Neumark-Sztainer, Dianne; Hannan, Peter; Fauquet, Jordi; Loth, Katie; Sánchez-Carracedo, David

    2013-01-01

    The aim of the current study was to examine and compare dieting and unhealthy weight-control behaviours (UWCB) in population-based samples in two large urban areas in Spain (Barcelona) and in the USA (Twin Cities of Minneapolis and St. Paul, Minnesota). Additionally, use of UWCB across weight categories was explored in both samples. Participants included 1501 adolescents from Barcelona (48% girls, 52% boys) and 2793 adolescents from the Twin Cities (53% girls, 47% boys). The main outcome measures were dieting, UWCB (less extreme and extreme) and weight status. Although dieting and UWCB were prevalent in both samples, particularly among girls, the prevalence was higher in the US sample. In both countries, the report of dieting and use of UWCB was highest among overweight and obese youth. Prevention interventions that address the broad spectrum of eating and weight-related problems should be warranted in light of the high prevalence and co-occurrence of overweight and unhealthy weight-related behaviours. PMID:23055262

  1. Optimal control theory (OWEM) applied to a helicopter in the hover and approach phase

    NASA Technical Reports Server (NTRS)

    Born, G. J.; Kai, T.

    1975-01-01

    A major difficulty in the practical application of linear-quadratic regulator theory is how to choose the weighting matrices in quadratic cost functions. The control system design with optimal weighting matrices was applied to a helicopter in the hover and approach phase. The weighting matrices were calculated to extremize the closed loop total system damping subject to constraints on the determinants. The extremization is really a minimization of the effects of disturbances, and interpreted as a compromise between the generalized system accuracy and the generalized system response speed. The trade-off between the accuracy and the response speed is adjusted by a single parameter, the ratio of determinants. By this approach an objective measure can be obtained for the design of a control system. The measure is to be determined by the system requirements.

  2. Neighborhood Influences on the Academic Achievement of Extremely Low Birth Weight Children

    PubMed Central

    Borawski, Elaine; Schluchter, Mark; Taylor, H.Gerry; Klein, Nancy; Hack, Maureen

    2010-01-01

    Objective To examine neighborhood effects on academic achievement of children with extremely low birth weight (ELBW <1000 g) and normal birth weight (NBW) controls. Methods The study included 183 8-year-old children with ELBW born during 1992–1995 and 176 sociodemographically similar NBW controls. Academic achievement was measured via The Woodcock–Johnson III Academic Skills Cluster. Results Children with ELBW had significantly lower achievement scores (89 ± 16 vs. 97 ± 13). A multilevel estimation of predictors of academic achievement revealed that neighborhood poverty was significantly associated with lower achievement (β = −.17; 95% CI −.3, −.05; p < .01). Additional correlates included birth weight status, male sex, and parent ratings of attention deficit hyperactivity disorder symptoms. Family characteristics included maternal education and parent protection. Conclusions Neighborhood characteristics affect academic achievement of both children with ELBW and NBW controls, over and above individual and family influences. Interventions designed to address family and neighborhood factors may potentially improve these outcomes. PMID:19584171

  3. Effects of Extreme Prematurity on Numerical Skills and Executive Function in Kindergarten Children: An Application of Partially Ordered Classification Modeling

    PubMed Central

    Tatsuoka, Curtis; McGowan, Bridget; Yamada, Tomoko; Espy, Kimberly Andrews; Minich, Nori; Taylor, H. Gerry

    2016-01-01

    Although mathematics disabilities (MD) are common in extremely preterm/extremely low birth weight (EPT/ELBW) children, little is known about the nature of these problems. In this study partially ordered set (POSET) models were applied to classify 140 EPT/ELBW kindergarten children (gestational age <28 weeks and/or birth weight <1000 g) and 110 normal birth weight (NBW) controls into profiles of numerical and cognitive skills. Models based on five numerical skills and five executive function and processing speed skills provided a good fit to performance data. The EPT/ELBW group had poorer skills in all areas than NBW controls but the models also revealed substantial individual variability in skill profiles. Weaknesses in executive function were associated with poorer mastery of numerical skills. The findings illustrate the applicability of POSET models to research on MD and suggest distinct types of early numerical deficits in EPT/ELBW children that are related to their impairments in executive function. PMID:27818602

  4. Effects of Extreme Prematurity on Numerical Skills and Executive Function in Kindergarten Children: An Application of Partially Ordered Classification Modeling.

    PubMed

    Tatsuoka, Curtis; McGowan, Bridget; Yamada, Tomoko; Espy, Kimberly Andrews; Minich, Nori; Taylor, H Gerry

    2016-07-01

    Although mathematics disabilities (MD) are common in extremely preterm/extremely low birth weight (EPT/ELBW) children, little is known about the nature of these problems. In this study partially ordered set (POSET) models were applied to classify 140 EPT/ELBW kindergarten children (gestational age <28 weeks and/or birth weight <1000 g) and 110 normal birth weight (NBW) controls into profiles of numerical and cognitive skills. Models based on five numerical skills and five executive function and processing speed skills provided a good fit to performance data. The EPT/ELBW group had poorer skills in all areas than NBW controls but the models also revealed substantial individual variability in skill profiles. Weaknesses in executive function were associated with poorer mastery of numerical skills. The findings illustrate the applicability of POSET models to research on MD and suggest distinct types of early numerical deficits in EPT/ELBW children that are related to their impairments in executive function.

  5. TRAJECTORY AND CORRELATES OF GROWTH OF EXTREMELY LOW BIRTH WEIGHT ADOLESCENTS

    PubMed Central

    Hack, Maureen; Schluchter, Mark; Margevicius, Seunghee; Andreias, Laura; Taylor, Gerry; Cuttler, Leona

    2014-01-01

    Background Catch-up growth may predispose to obesity and metabolic sequelae. We sought to examine the trajectory and correlates of growth and catch-up among extremely low birth weight (ELBW, <1 kg) adolescents. Methods Cohort study of 148 neurologically normal ELBW children and 115 normal birth weight (NBW) controls born 1992 through 1995. Longitudinal measures of gender-specific growth of ELBW children from birth, and growth and measures of obesity of ELBW and NBW children at 14 years. Results Following neonatal growth failure, ELBW children had accelerated growth, but at 8 years they still had lower weight and height z scores than NBW children. By 14 years ELBW boys had caught up in growth to their NBW controls but ELBW girls remained significantly smaller. ELBW children however did not differ from their controls in measures of obesity. In hierarchical multiple regression analyses only maternal BMI and weight gain during infancy and childhood predicted the ELBW children’s 14-year weight z scores, BMI z scores and abdominal circumference. Perinatal risk factors including intrauterine growth only predicted growth up to 20 months. Conclusion Maternal BMI and rate of growth, rather than perinatal factors, predict 14-year obesity among neurologically normal ELBW adolescents. PMID:24216539

  6. THE ABSCOPAL EFFECT OF X IRRADIATION ON BONE GROWTH IN RATS

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pappas, A.M.; Cohen, J.

    1963-06-01

    The abscopal effect of irradiation (that which is evident at a distance from the irradiated volume but within the same organism) was investigated in rats. It was possible to demonstrate the effects on growth locally and abscopally when x-ray doses of 400 and 800 r were delivered to the lower extremity and when 800 r was delivered to the knee alone. A distinction between abscopal effects after local irradiation and systemic effects after whole-body irradiation is discussed. The weights of control and irradiated animals were similar for the first 21 days, during which period they did not exhibit any untowardmore » effects of irradiation. However, after 21 days there was a decrease in weight gain, which persisted until the 72nd day. Group A (controls) was the heaviest group, with a mean weight of 412 g. Group B (800 r to the left hind extremity) had a mean weight of 378. Group C (400 r to the left hind extremity) and Group D (800 r to the left knee) exhibited mean weights of 391 and 394 g, respectively. Roentgenographic measurements revealed that all animals receiving irradiation had retardation in the growth of the irradiated tibiae, which were shorter than both the control and the contralateral (unirradiated) tibiae. Only the animals that had received 800 r to their leff hind extremity showed significant differences in the lengths of their unirradiated bones compared with the bones of the control animals of Group A, that is, a significant abscopal growth retardation. Although the abscopal effect appeared to be associated with the volume of tissue irradiated, the way this effect is mediated is not known. The weight gains of the animals demonstrated a strong association between decrease in weight gain, the volume of tissue irradiated, and the dose administered. The impaired weight gsin roughly paralleled the abscopal retardation of bone growth. The animals which received the highest dose of irradiation, 800 r, to the largest volume of tissue, 10% of the body volume, revealed the greatest deviation from the control group. It is concluded that irradiation effects in animals are composites of the responses of the whole organism to the injury, of the responses of local tissues, and vessels at their level of tissue organization, and of the responses of individual cells. All of these responses may be interdependent. The evidence indicates that a systemic inhibition of all bone growth and weight gain occurs when a sufficient volume of tissue is irradiated at a sufficiently high dosage. (BBB)« less

  7. Are food restriction and pressure-to-eat parenting practices associated with adolescent disordered eating behaviors?

    PubMed

    Loth, Katie A; MacLehose, Richard F; Fulkerson, Jayne A; Crow, Scott; Neumark-Sztainer, Dianne

    2014-04-01

    To examine associations between parental pressure-to-eat and food restriction and adolescent disordered eating behaviors, within a sample of parent-adolescent pairs. Adolescents (N = 2,231) and their parents (N = 3,431) participated in two, coordinated, population-based studies designed to examine factors associated with weight and weight-related behaviors in adolescents. Overall, higher levels of pressure-to-eat or food restriction were significantly and positively associated with use of disordered eating behaviors among boys. For every one unit increase [Scale Range: 1 (low control) to 4 (high control)] in mothers' food restriction, boys were twice as likely to engage in extreme weight control behaviors (p ≤ .01). Examination of the association between food-related parenting practices and disordered eating behaviors among girls revealed fewer significant associations. However, analyses revealed that for every one unit increase in mothers' food restriction, girls were 1.33 times more likely to engage in extreme weight control behaviors (p = .04). Study findings provide evidence of an association between controlling food-related parenting practices and adolescent disordered eating behaviors, particularly in boys. Future longitudinal research is needed to establish directionality of observed associations. Copyright © 2013 Wiley Periodicals, Inc.

  8. Are food restriction and pressure-to-eat parenting practices associated with adolescent disordered eating behaviors?

    PubMed Central

    Loth, Katie A.; MacLehose, Richard F.; Fulkerson, Jayne A.; Crow, Scott; Neumark-Sztainer, Dianne

    2014-01-01

    Objective To examine associations between parental pressure-to-eat and food restriction and adolescent disordered eating behaviors, within a sample of parent-adolescent pairs. Method Adolescents (N=2231) and their parents (N=3431) participated in two, coordinated, population-based studies designed to examine factors associated with weight and weight-related behaviors in adolescents. Results Overall, higher levels of pressure-to-eat or food restriction was significantly and positively associated with use of disordered eating behaviors among boys. For every one unit increase [Scale Range: 1-(low control) to 4 – (high control)] in mothers’ food restriction, boys were twice as likely to engage in extreme weight control behaviors (p≤0.01). Examination of the association between food-related parenting practices and disordered eating behaviors among girls revealed fewer significant associations. However, analyses did reveal that for every one unit increase in mothers’ food restriction, girls were 1.33 times more likely to engage in extreme weight control behaviors (p=0.04). Discussion Study findings provide evidence of an association between controlling food-related parenting practices and adolescent disordered eating behaviors, particularly in boys. Future longitudinal research is needed to establish directionality of observed associations. PMID:24105668

  9. Trajectory and correlates of growth of extremely-low-birth-weight adolescents.

    PubMed

    Hack, Maureen; Schluchter, Mark; Margevicius, Seunghee; Andreias, Laura; Taylor, H Gerry; Cuttler, Leona

    2014-02-01

    Catch-up growth may predispose to obesity and metabolic sequelae. We sought to examine the trajectory and correlates of growth and catch up among extremely-low-birth-weight (ELBW) (<1 kg) adolescents. A cohort study of 148 neurologically normal ELBW children and 115 normal-birth-weight (NBW) controls born during the period 1992-1995 was conducted. Longitudinal measures of gender-specific growth of ELBW children from birth, in addition to growth and measures of obesity of ELBW and NBW children at 14 y, were evaluated. Following neonatal growth failure, ELBW children had accelerated growth, but at 8 y, they still had lower weight and height z scores than NBW children. By 14 y, ELBW boys had caught up in growth to their NBW controls, but ELBW girls remained significantly smaller. ELBW children, however, did not differ from their controls in measures of obesity. In hierarchical multiple regression analyses, only maternal BMI and weight gain during infancy and childhood predicted the ELBW children's 14-y weight z scores, BMI z scores, and abdominal circumference. Perinatal risk factors, including intrauterine growth, only predicted growth up to 20 mo. Maternal BMI and rate of growth, rather than perinatal factors, predict 14-y obesity among neurologically normal ELBW adolescents.

  10. A Novel Extreme Learning Control Framework of Unmanned Surface Vehicles.

    PubMed

    Wang, Ning; Sun, Jing-Chao; Er, Meng Joo; Liu, Yan-Cheng

    2016-05-01

    In this paper, an extreme learning control (ELC) framework using the single-hidden-layer feedforward network (SLFN) with random hidden nodes for tracking an unmanned surface vehicle suffering from unknown dynamics and external disturbances is proposed. By combining tracking errors with derivatives, an error surface and transformed states are defined to encapsulate unknown dynamics and disturbances into a lumped vector field of transformed states. The lumped nonlinearity is further identified accurately by an extreme-learning-machine-based SLFN approximator which does not require a priori system knowledge nor tuning input weights. Only output weights of the SLFN need to be updated by adaptive projection-based laws derived from the Lyapunov approach. Moreover, an error compensator is incorporated to suppress approximation residuals, and thereby contributing to the robustness and global asymptotic stability of the closed-loop ELC system. Simulation studies and comprehensive comparisons demonstrate that the ELC framework achieves high accuracy in both tracking and approximation.

  11. Weight loss practices of college wrestlers.

    PubMed

    Oppliger, Robert A; Steen, Suzanne A Nelson; Scott, James R

    2003-03-01

    The purpose of this investigation was to examine the weight management (WM) behaviors of collegiate wrestlers after the implementation of the NCAA's new weight control rules. In the fall of 1999, a survey was distributed to 47 college wrestling teams stratified by collegiate division (i.e., I, II, III) and competitive quality. Forty-three teams returned surveys for a total of 741 responses. Comparisons were made using the collegiate division, weight class, and the wrestler's competitive winning percentage. The most weight lost during the season was 5.3 kg +/- 2.8 kg (mean +/- SD) or 6.9% +/- 4.7% of the wrestler's weight; weekly weight lost averaged 2.9 kg +/- 1.3 kg or 4.3% +/- 2.3% of the wrestler's weight; post-season, the average wrestler regained 5.5 kg +/- 3.6 kg or 8.6% +/- 5.4% of their weight. Coaches and fellow wrestlers were the primary influence on weight loss methods; however, 40.2% indicated that the new NCAA rules deterred extreme weight loss behaviors. The primary methods of weight loss reported were gradual dieting (79.4%) and increased exercise (75.2%). However, 54.8% fasted, 27.6% used saunas, and 26.7% used rubber/plastic suits at least once a month. Cathartics and vomiting were seldom used to lose weight, and only 5 met three or more of the criteria for bulimia nervosa. WM behaviors were more extreme among freshmen, lighter weight classes, and Division II wrestlers. Compared to previous surveys of high school wrestlers, this cohort of wrestlers reported more extreme WM behaviors. However, compared to college wrestlers in the 1980s, weight loss behaviors were less extreme. The WM practices of college wrestlers appeared to have improved compared to wrestlers sampled previously. Forty percent of the wrestlers were influenced by the new NCAA rules and curbed their weight loss practices. Education is still needed, as some wrestlers are still engaging in dangerous WM methods.

  12. Abnormalities in orbitofrontal cortex gyrification and mental health outcomes in adolescents born extremely preterm and/or at an extremely low birth weight.

    PubMed

    Ganella, Eleni P; Burnett, Alice; Cheong, Jeanie; Thompson, Deanne; Roberts, Gehan; Wood, Stephen; Lee, Katherine; Duff, Julianne; Anderson, Peter J; Pantelis, Christos; Doyle, Lex W; Bartholomeusz, Cali

    2015-03-01

    Extremely preterm (EP, <28 weeks) and/or extremely low birth weight (ELBW, <1000 g) infants are at high risk of aberrant neurodevelopment. Sulcogyral folding patterns of the orbitofrontal cortex (OFC) are determined during the third trimester, however little is known about OFC patterning in EP/ELBW cohorts, for whom this gestational period is disturbed. This study investigated whether the distribution of OFC pattern types and frequency of intermediate and/or posterior orbital sulci (IOS/POS) differed between EP/ELBW and control adolescents. This study also investigated whether OFC pattern type was associated with mental illness or executive function outcome in adolescence. Magnetic resonance images of 194 EP/ELBW and 147 full term (>37 completed weeks) and/or normal birth weight (> 2500 g) adolescents were acquired, from which the OFC pattern of each hemisphere was classified as Type I, II, or III. Compared with controls, more EP/ELBW adolescents possessed a Type II in the left hemisphere (P = 0.019). The EP/ELBW group had fewer IOS (P = 0.024) and more POS (P = 0.021) in the left hemisphere compared with controls. OFC pattern type was not associated with mental illness, however in terms of executive functioning, Type III in the left hemisphere was associated with better parent-reported metacognition scores overall (P = 0.008) and better self-reported behavioral regulation scores in the control group (P = 0.001) compared with Type I. We show, for the first time that EP/ELBW birth is associated with changes in orbitofrontal development, and that specific patterns of OFC folding are associated with executive function at age 18 years in both EP/ELBW and control subjects. © 2014 Wiley Periodicals, Inc.

  13. Persisting behavior problems in extremely low birth weight adolescents.

    PubMed

    Taylor, H Gerry; Margevicius, Seunghee; Schluchter, Mark; Andreias, Laura; Hack, Maureen

    2015-04-01

    To describe behavior problems in extremely low birth weight (ELBW, <1000 g) adolescents born 1992 through 1995 based on parent ratings and adolescent self-ratings at age 14 years and to examine changes in parent ratings from ages 8-14. Parent ratings of behavior problems and adolescent self-ratings were obtained for 169 ELBW adolescents (mean birth weight 815 g, gestational age 26 wk) and 115 normal birth weight (NBW) controls at 14 years. Parent ratings of behavior at age 8 years were also available. Behavior outcomes were assessed using symptom severity scores and rates of scores above DSM-IV symptom cutoffs for clinical disorder. The ELBW group had higher symptom severity scores on parent ratings at age 14 years than NBW controls for inattentive attention-deficit hyperactivity disorder (ADHD), anxiety, and social problems (all p's < .01). Rates of parent ratings meeting DSM-IV symptom criteria for inattentive ADHD were also higher for the ELBW group (12% vs. 1%, p < .01). In contrast, the ELBW group had lower symptom severity scores on self-ratings than controls for several scales. Group differences in parent ratings decreased over time for ADHD, especially among females, but were stable for anxiety and social problems. Extremely low birth weight adolescents continue to have behavior problems similar to those evident at a younger age, but these problems are not evident in behavioral self-ratings. The findings suggest that parent ratings provide contrasting perspectives on behavior problems in ELBW youth and support the need to identify and treat these problems early in childhood.

  14. The anabolic activity of bone tissue, suppressed by disuse, is normalized by brief exposure to extremely low-magnitude mechanical stimuli

    NASA Technical Reports Server (NTRS)

    Rubin, C.; Xu, G.; Judex, S.

    2001-01-01

    It is generally believed that mechanical signals must be large in order to be anabolic to bone tissue. Recent evidence indicates, however, that extremely low-magnitude (<10 microstrain) mechanical signals readily stimulate bone formation if induced at a high frequency. We examined the ability of extremely low-magnitude, high-frequency mechanical signals to restore anabolic bone cell activity inhibited by disuse. Adult female rats were randomly assigned to six groups: baseline control, age-matched control, mechanically stimulated for 10 min/day, disuse (hind limb suspension), disuse interrupted by 10 min/day of weight bearing, and disuse interrupted by 10 min/day of mechanical stimulation. After a 28 day protocol, bone formation rates (BFR) in the proximal tibia of mechanically stimulated rats increased compared with age-matched control (+97%). Disuse alone reduced BFR (-92%), a suppression only slightly curbed when disuse was interrupted by 10 min of weight bearing (-61%). In contrast, disuse interrupted by 10 min per day of low-level mechanical intervention normalized BFR to values seen in age-matched controls. This work indicates that this noninvasive, extremely low-level stimulus may provide an effective biomechanical intervention for the bone loss that plagues long-term space flight, bed rest, or immobilization caused by paralysis.

  15. [Changes in the outcome for infants, with birth weight under 500 grams, at our department (First Department of Obstetrics and Gynecology, Semmelweis University, Budapest)].

    PubMed

    Varga, Péter; Jeager, Judit; Harmath, Ágnes; Berecz, Botond; Kollár, Tímea; Pete, Barbara; Magyar, Zsófia; Rigó, János; Romicsné Görbe, Éva

    2015-03-08

    The mortality and morbidity of extremely low birth weight infants (birth weight below 1000 grams) are different from low birth weight and term infants. The Centers for Disease Control statistics from the year 2009 shows that the mortality of preterm infants with a birth weight less than 500 grams is 83.4% in the United States. In many cases, serious complications can be expected in survivals. The aim of this retrospective study was to find prognostic factors which may improve the survival of the group of extremely low birth weight infants (<500 grams). Data of extremely low birth weight infants with less than 500 grams born at the 1st Department of Obstetrics and Gynecology, Semmelweis University between January 1, 2006 and June 1, 2012 were analysed, and mortality and morbidity of infants between January 1, 2006 and December 31, 2008 (period I) were compared those found between January 1, 2009 and June 1, 2012 (period II). Statistical analysis was performed with probe-t, -F and -Chi-square. Survival rate of extremely low birth weight infants less than 500 grams in period 1 and II was 26.31% and 55.17%, respectively (p = 0.048), whereas the prevalence of complications were not significantly different between the period examined. The mean gestational age of survived infants (25.57 weeks) was higher than the gestational age of infants who did not survive (24.18 weeks) and the difference was statistically significant (p = 0.0045). Education of the team of the Neonatal Intensive Care Unit, professional routine and technical conditions may improve the survival chance of preterm infants. The use of treatment protocols, conditions of the Neonatal Intensive Care Unit and steroid prophylaxis may improve the survival rate of extremely low birth weight infants.

  16. Patterns and prevalence of disordered eating and weight control behaviors in women ages 25-45.

    PubMed

    Reba-Harrelson, L; Von Holle, A; Hamer, R M; Swann, R; Reyes, M L; Bulik, C M

    2009-12-01

    The current study describes detailed eating behaviors, dieting behaviors, and attitudes about shape and weight in 4023 women ages 25 to 45. The survey was delivered on-line and participants were identified using a national quota-sampling procedure. Disordered eating behaviors, extreme weight loss measures, and negative cognitions about shape and weight were widely endorsed by women in this age group and were not limited to White participants. Thirty-one percent of women without a history of anorexia nervosa or binge eating reported having purged to control weight, and 74.5% of women reported that their concerns about shape and weight interfered with their happiness. Unhealthy approaches to weight control and negative attitudes about shape and weight are pervasive even among women without eating disorders. The development of effective approaches to address the impact of these unhealthy behaviors and attitudes on the general well-being and functioning of women is required.

  17. Elite athletes in aesthetic and Olympic weight-class sports and the challenge of body weight and body compositions.

    PubMed

    Sundgot-Borgen, Jorunn; Garthe, Ina

    2011-01-01

    The use of dieting, rapid weight loss, and frequent weight fluctuation among athletes competing in weight-class and leanness sports have been considered a problem for years, but the extent of the problem and the health and performance consequences have yet to be fully examined. Most studies examining these issues have had weak methodology. However, results from this review indicate that a high proportion of athletes are using extreme weight-control methods and that the rules of some sports might be associated with the risk of continuous dieting, energy deficit, and/or use of extreme weight-loss methods that can be detrimental to health and performance. Thus, preventive strategies are justified for medical as well as performance reasons. The most urgent needs are: (1) to develop sport-specific educational programmes for athletic trainers, coaches, and athletes; (2) modifications to regulations; and (3) research related to minimum percentage body fat and judging patterns.

  18. Pain sensitivity and temperament in extremely low-birth-weight premature toddlers and preterm and full-term controls.

    PubMed

    Grunau, R V; Whitfield, M F; Petrie, J H

    1994-09-01

    High-technology medical care of extremely low-birth-weight (ELBW) infants (< 1001 g) involves repeated medical interventions which are potentially painful and may later affect reaction to pain. At 18 months corrected age (CCA), we examined parent ratings of pain sensitivity and how pain sensitivity ratings related to child temperament and parenting style in 2 groups of ELBW children (49 with a birth weight of 480-800 g and 75 with a birth weight of 801-1000 g) and 2 control groups (42 heavier preterm (1500-2499 g) and 29 full-birth-weight (FBW) children (> 2500 g). Both groups of ELBW toddlers were rated by parents as significantly lower in pain sensitivity compared with both control groups. The relationships between child temperament and pain sensitivity rating varied systematically across the groups. Temperament was strongly related to rated pain sensitivity in the FBW group, moderately related in the heavier preterm and ELBW 801-1000 g groups, and not related in the lowest birth-weight group (< 801 g). Parental style did not mediate ratings of pain sensitivity. The results suggest that parents perceive differences in pain behavior of ELBW toddlers compared with heavier preterm and FBW toddlers, especially for those less than 801 g. Longitudinal research into the development of pain behavior for infants who experience lengthy hospitalization is warranted.

  19. Real-time visual biofeedback during weight bearing improves therapy compliance in patients following lower extremity fractures.

    PubMed

    Raaben, Marco; Holtslag, Herman R; Leenen, Luke P H; Augustine, Robin; Blokhuis, Taco J

    2018-01-01

    Individuals with lower extremity fractures are often instructed on how much weight to bear on the affected extremity. Previous studies have shown limited therapy compliance in weight bearing during rehabilitation. In this study we investigated the effect of real-time visual biofeedback on weight bearing in individuals with lower extremity fractures in two conditions: full weight bearing and touch-down weight bearing. 11 participants with full weight bearing and 12 participants with touch-down weight bearing after lower extremity fractures have been measured with an ambulatory biofeedback system. The participants first walked 15m and the biofeedback system was only used to register the weight bearing. The same protocol was then repeated with real-time visual feedback during weight bearing. The participants could thereby adapt their loading to the desired level and improve therapy compliance. In participants with full weight bearing, real-time visual biofeedback resulted in a significant increase in loading from 50.9±7.51% bodyweight (BW) without feedback to 63.2±6.74%BW with feedback (P=0.0016). In participants with touch-down weight bearing, the exerted lower extremity load decreased from 16.7±9.77kg without feedback to 10.27±4.56kg with feedback (P=0.0718). More important, the variance between individual steps significantly decreased after feedback (P=0.018). Ambulatory monitoring weight bearing after lower extremity fractures showed that therapy compliance is low, both in full and touch-down weight bearing. Real-time visual biofeedback resulted in significantly higher peak loads in full weight bearing and increased accuracy of individual steps in touch-down weight bearing. Real-time visual biofeedback therefore results in improved therapy compliance after lower extremity fractures. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Does Extremely Low Birth Weight Predispose to Low-Renin Hypertension?

    PubMed

    Raaijmakers, Anke; Zhang, Zhen-Yu; Claessens, Jolien; Cauwenberghs, Nicholas; van Tienoven, Theun Pieter; Wei, Fang-Fei; Jacobs, Lotte; Levtchenko, Elena; Pauwels, Steven; Kuznetsova, Tatiana; Allegaert, Karel; Staessen, Jan A

    2017-03-01

    Low birth weight and prematurity are risk factors for hypertension in adulthood. Few studies in preterm or full-term born children reported on plasma renin activity (PRA). We tested the hypothesis that renin might modulate the incidence of hypertension associated with prematurity. We enrolled 93 prematurely born children with birth weight <1000 g and 87 healthy controls born at term, who were all examined at ≈11 years. Renal length and glomerular filtration rate derived from serum cystatin C were 0.28 cm (95% confidence interval, 0.09-0.47) and 11.5 mL/min per 1.73 m 2 (6.4-16.6) lower in cases, whereas their systolic/diastolic blood pressure (BP) was 7.5 mm Hg (4.8-10.3)/4.0 mm Hg (2.1-5.8) higher ( P <0.001 for all). The odds of having systolic prehypertension or systolic hypertension associated with extreme low birth weight were 6.43 (2.52-16.4; P <0.001) and 10.9 (2.46-48.4; P =0.002). Twenty-four hours of urinary sodium excretion was similar in cases and controls (102.1 versus 106.8 mmol; P =0.47). Sodium load per nephron was estimated as sodium excretion divided by kidney length (mmol/cm). PRA was 0.54 ng/mL per hour (0.23-0.85; P =0.001) lower in cases. PRA, systolic BP, and sodium load were available in 43 cases and 56 controls. PRA decreased with systolic BP (slope -0.022 ng/mL per hour/ - mm Hg ; P =0.048), but was unrelated to sodium load (slope +0.13 mmol/cm - mm Hg ; P =0.54). The slope of PRA on systolic BP was similar ( P =0.17) in cases and controls. In conclusion, extremely low birth weight predisposes young adolescents to low-renin hypertension, but does not affect the inverse association between PRA and BP. URL: https://www.clinicaltrials.gov. Unique identifier: NCT02147457. © 2017 American Heart Association, Inc.

  1. Overeating with and without loss of control: associations with weight status, weight-related characteristics, and psychosocial health

    PubMed Central

    Goldschmidt, Andrea B.; Loth, Katie A.; MacLehose, Richard F.; Pisetsky, Emily M.; Berge, Jerica M.; Neumark-Sztainer, Dianne

    2015-01-01

    Objective The relative importance of loss of control and overeating in the relationship between binge eating and eating-related and general psychopathology has been debated in the literature. This study assessed the prevalence and correlates of overeating with and without loss of control within a diverse, population-based sample of adolescents. Method A highly diverse (81.1% non-White) sample of adolescents (n=2,793) from EAT-2010 (Eating and Activity in Teens) completed self-report questionnaires assessing eating-related psychopathology, substance use, non-suicidal self-injury, depressive symptoms, and self-esteem. Results Overeating without loss of control was reported by 6.9% of girls and 5.0% of boys, while 9.6% of girls and 6.3% of boys reported overeating with loss of control (binge eating). Overall, overeating (with or without loss of control) was positively associated with unhealthy or extreme weight control behaviors, dieting, non-suicidal self-injury, lower body satisfaction and self-esteem, and higher depressive symptoms relative to no overeating. Among girls, binge eating was associated with unhealthy or extreme weight control behaviors, lower self-esteem, and higher depressive symptoms relative to overeating without loss of control, while in boys, binge eating was associated with greater cigarette usage, lower body satisfaction, and greater depressive symptoms than overeating without loss of control (although cigarette usage was comparable in boys reporting binge eating and no overeating). Discussion Any overeating, with or without loss of control, was associated with multiple adverse correlates among adolescents. Loss of control was uniquely associated with multiple health indicators, further highlighting its importance as a marker of severity of overeating. PMID:26368333

  2. Overeating with and without loss of control: Associations with weight status, weight-related characteristics, and psychosocial health.

    PubMed

    Goldschmidt, Andrea B; Loth, Katie A; MacLehose, Richard F; Pisetsky, Emily M; Berge, Jerica M; Neumark-Sztainer, Dianne

    2015-12-01

    The relative importance of loss of control and overeating in the relationship between binge eating and eating-related and general psychopathology has been debated in the literature. This study assessed the prevalence and correlates of overeating with and without loss of control within a diverse, population-based sample of adolescents. A highly diverse (81.1% non-White) sample of adolescents (n = 2,793) from EAT-2010 (Eating and Activity in Teens) completed self-report questionnaires assessing eating-related psychopathology, substance use, nonsuicidal self-injury, depressive symptoms, and self-esteem. Overeating without loss of control was reported by 6.9% of girls and 5.0% of boys, while 9.6% of girls and 6.3% of boys reported overeating with loss of control (binge eating). Overall, overeating (with or without loss of control) was positively associated with unhealthy or extreme weight control behaviors, dieting, nonsuicidal self-injury, lower body satisfaction, and self-esteem, and higher depressive symptoms relative to no overeating. Among girls, binge eating was associated with unhealthy or extreme weight control behaviors, lower self-esteem, and higher depressive symptoms relative to overeating without loss of control, while in boys, binge eating was associated with greater cigarette usage, lower body satisfaction, and greater depressive symptoms than overeating without loss of control (although cigarette usage was comparable in boys reporting binge eating and no overeating). Any overeating, with or without loss of control, was associated with multiple adverse correlates among adolescents. Loss of control was uniquely associated with multiple health indicators, further highlighting its importance as a marker of severity of overeating. © 2015 Wiley Periodicals, Inc.

  3. The Relationship of Maternal Prepregnancy Body Mass Index and Pregnancy Weight Gain to Neurocognitive Function at Age 10 Years among Children Born Extremely Preterm.

    PubMed

    Jensen, Elizabeth T; van der Burg, Jelske W; O'Shea, Thomas M; Joseph, Robert M; Allred, Elizabeth N; Heeren, Tim; Leviton, Alan; Kuban, Karl C K

    2017-08-01

    To assess the association between maternal prepregnancy body mass index and adequacy of pregnancy weight gain in relation to neurocognitive function in school-aged children born extremely preterm. Study participants were 535 ten-year-old children enrolled previously in the prospective multicenter Extremely Low Gestational Age Newborns cohort study who were products of singleton pregnancies. Soon after delivery, mothers provided information about prepregnancy weight. Prepregnancy body mass index and adequacy of weight gain were characterized based on this information. Children underwent a neurocognitive evaluation at 10 years of age. Maternal prepregnancy obesity was associated with increased odds of a lower score for Differential Ability Scales-II Verbal IQ, for Developmental Neuropsychological Assessment-II measures of processing speed and visual fine motor control, and for Wechsler Individual Achievement Test-III Spelling. Children born to mothers who gained an excessive amount of weight were at increased odds of a low score on the Oral and Written Language Scales Oral Expression assessment. Conversely, children whose mother did not gain an adequate amount of weight were at increased odds of a lower score on the Oral and Written Language Scales Oral Expression and Wechsler Individual Achievement Test-III Word Reading assessments. In this cohort of infants born extremely preterm, maternal obesity was associated with poorer performance on some assessments of neurocognitive function. Our findings are consistent with the observational and experimental literature and suggest that opportunities may exist to mitigate risk through education and behavioral intervention before pregnancy. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. The effects of gait training with body weight support (BWS) with no body weight support (no-BWS) in stroke patients.

    PubMed

    Ullah, Muhammad Asad; Shafi, Hina; Khan, Ghazanfar Ali; Malik, Arshad Nawaz; Amjad, Imran

    2017-07-01

    The purpose of this study was to measure the clinical outcomes for patients with stroke after gait training with body weight support (BWS) and with no body weight support (no-BWS).Experimental group was trained to walk by a BWS system with overhead harness (BWS group), and Control group was trained with full weight bearing walk on their lower extremities. Treatment session comprised of six weeks training. Treatment outcomes were assessed on the basis of Timed 10 Meter Walk Test, Timed Get Up and Go Test and Dynamic Gait Index. There was a significant (P<0.05) difference in BWS and NBWS for Dynamic Gait Index, Timed Get Up and Go Test, Timed 10 Meter Walk Test (Self-Selected Velocity), and Timed 10 Meter Walk Test (Fast-Velocity). Training of gait in stroke patients while a percentage of their body weight supported by a harness, resulted in better walking abilities than the Training of gait while full weight was placed on patient's lower extremities.

  5. Treadmill training with partial body-weight support after anterior cruciate ligament reconstruction: a randomized controlled trial.

    PubMed

    Luo, Yuan; Shen, Weizhong; Jiang, Zhong; Sha, Jiao

    2016-12-01

    [Purpose] To compare the effects of treadmill training with partial body weight support (TTPBWS) and conventional physical therapy (PT) on subjects with anterior cruciate ligament reconstructions. [Subjects and Methods] A total of 40 subjects were randomly allocated to either a treatment group or a control group. Subjects received either treadmill training with partial body weight support (treatment group) or conventional physical therapy (control group). The circumferences of the lower extremities, Holden classifications, 10-meter walking times and the International Knee Documentation Committee (IKDC) scores were compared at 12 and 24 weeks post-operation. The knee joint stability was tested at 24 weeks post-operation using a KT-1000. [Results] Significant differences were found between the two groups at the 12 weeks post-operation. For most of the measures, there was no significant difference between the groups at 24 weeks post-operation. Interestingly, for most of the measures, there was no significant difference between their values in the treatment group at 12 weeks and their values in the control group at 24 weeks post-operation. [Conclusion] The function of a subject's lower extremities can be improved and the improvement was clearly accelerated by the intervention of treadmill training with partial body weight support, without compromising the stability of the knee joints in a given follow-up period.

  6. Individual Differences and Short-Term Military Factors Associated With Unhealthy Weight Control Behaviors Among Active Duty and Reserve Army Soldiers

    DTIC Science & Technology

    2009-03-01

    syndrome eating disorders (Eisenberg & Neumark-Sztainer, 2008; Neumark-Sztainer et al., 2002; Rukavina & Pokrajac-Bulian, 2006). Although the...risk for developing full- syndrome eating disorders. Repeated periods of extreme weight loss behavior may reinforce that purging, fasting, or excessive...exercise are “good” ways to lose weight. In fact, many individuals with full syndrome eating disorders start by engaging in repeated periods of

  7. Respiratory function at age 8-9 after extremely low birthweight or preterm birth in Victoria in 1997.

    PubMed

    Hacking, Douglas F; Gibson, Anne-Marie; Robertson, Colin; Doyle, Lex W

    2013-05-01

    To determine if respiratory function at 8 years of age in extremely low birth weight (ELBW; birth weight <1,000 g) or extremely preterm (EPT, <28 weeks' gestation) children born in 1997 remains worse than normal birth weight (NBW; birth weight, >2,499 g) and term (37-42 weeks) controls, particularly in those ELBW/EPT children who had bronchopulmonary dysplasia (BPD). This was a cohort study of 201 consecutive ELBW/EPT survivors born in the state of Victoria during 1997, and 199 contemporaneous randomly selected NBW/term controls. Respiratory function was measured at 8 years of age according to standard guidelines, and compared with previous cohorts born in 1991-1992. Respiratory function data were available for almost 75% of both cohorts. ELBW/EPT subjects had substantial reductions in airflow compared with controls (e.g., mean difference in forced expiratory volume in 1 sec [FEV1 ] -0.91 SD, 95% confidence interval [CI] -1.19 to -0.63 SD, and in maximum expiratory flow between 25% and 75% of vital capacity [FEF25-75% ] -0.96 SD, 95% CI -1.22 to -0.71). These differences were similar to those observed between ELBW/EPT and controls subjects born in 1991-1992. Within the ELBW/EPT cohort, children who had BPD in the newborn period had significant reductions in both the FEV1 (-0.76 SD) and FEF25-75% (-0.58 SD) compared with those who did not have BPD, which were not statistically significant from those in the 1991-92 cohort. ELBW/EPT children born in 1997 still have significantly abnormal lung function compared with NBW/term controls, but results were similar to an earlier era when survival rates were lower. Pediatr Pulmonol. 2013; 48:449-455. © 2012 Wiley Periodicals, Inc. Copyright © 2012 Wiley Periodicals, Inc.

  8. Body mass index as a prognostic factor for fracturing of the proximal extremity of the femur: a case–control study☆☆☆

    PubMed Central

    Pagani, Renato Cavanus; Kunz, Rodrigo Ernesto; Girardi, Ricardo; Guerra, Marcelo

    2014-01-01

    Objectives To compare the body mass index (BMI) of patients with fractures in the proximal extremity of the femur with the BMI of patients without any previous history of fractures. Methods We investigated patients of both sexes, aged 65 years or over, who were admitted to Hospital Independência, Hospital Beneficência Portuguesa or ULBRA University Hospital, between December 2007 and December 2010, with histories of low-energy trauma such as falling from a standing position. These individuals were compared with patients of the same age but without any history of fracturing of the proximal extremity of the femur (n = 89), who were attended at the geriatrics outpatient clinic of the Sociedade Porto-Alegrense de Auxílio aos Necessitados (SPAAN). Results The age group of the patients with fractures in the proximal extremity of the femur ranged from 65 to 96 years (mean: 77.58). The main type of fracture was trochanteric (47; 62.2%), followed by femoral neck fractures (27; 36%). Among the patients who presented on fracturing the proximal extremity of the femur, 12% had low weight, 62.7% normal weight, 24% overweight, and 1.3% obesity. Among the patients without any history of fractures, 5.6% presented low weight, 43.8% normal weight, 33.7% overweight, and 9.8% obesity. It was observed that the patients with fractures in the proximal extremity of the femur (n = 75) presented a mean BMI of 22.6, while the patients without fractures presented a mean BMI of 25.5. Conclusion The patients in the group with fractures were significantly taller than those in the group without fractures and presented significantly lower BMI than those in the group without fractures. PMID:26229845

  9. Weight-related Teasing in the School Environment: Associations with Psychosocial Health and Weight Control Practices among Adolescent Boys and Girls

    PubMed Central

    Lampard, Amy M.; Maclehose, Richard F.; Eisenberg, Marla E.; Neumark-Sztainer, Dianne; Davison, Kirsten K.

    2014-01-01

    Weight-related teasing has been found to be associated with low self-esteem, depressive symptoms, body dissatisfaction, and weight control behaviors in adolescents. While research has typically examined weight-related teasing directed towards the individual, little is known about weight-related teasing at the school level. This study aimed to determine the association between the school-level prevalence of weight-related teasing and psychosocial factors, body dissatisfaction and weight control behaviors in adolescents. Adolescents (N = 2,793; 53.2% female) attending 20 US public middle and high schools were surveyed as part of the Eating and Activity in Teens (EAT) 2010 study. Generalized estimating equations were used to estimate the association between school-level weight-related teasing and health variables, controlling for individual-level weight-related teasing, clustering of individuals within schools, and relevant covariates. A greater school-level prevalence of weight-related teasing was associated with lower self-esteem and greater body fat dissatisfaction in girls, and greater depressive symptoms in boys, over and above individual-level weight-related teasing. Dieting was associated with the school-level prevalence of weight-related teasing in analysis adjusted for covariates in girls, but not following adjustment for individual-level weight-related teasing. Unhealthy weight control behaviors, extreme weight control behaviors, and muscle-enhancing behaviors were not associated with the school-level prevalence of weight-related teasing in girls or boys. Findings from the current study, in conjunction with previous findings showing associations between weight-related teasing, psychological concerns, and weight control behaviors, highlight the importance of implementing strategies to decrease weight-related teasing in schools. PMID:24395152

  10. 14 CFR 23.203 - Turning flight and accelerated turning stalls.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... use of the flight controls, but without increasing power and without— (1) Excessive loss of altitude...-to-weight ratio at 75 percent of maximum continuous power results in extreme nose-up attitudes, the...

  11. 14 CFR 23.203 - Turning flight and accelerated turning stalls.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... use of the flight controls, but without increasing power and without— (1) Excessive loss of altitude...-to-weight ratio at 75 percent of maximum continuous power results in extreme nose-up attitudes, the...

  12. Kindergarten classroom functioning of extremely preterm/extremely low birth weight children.

    PubMed

    Wong, Taylor; Taylor, H Gerry; Klein, Nancy; Espy, Kimberly A; Anselmo, Marcia G; Minich, Nori; Hack, Maureen

    2014-12-01

    Cognitive, behavioral, and learning problems are evident in extremely preterm/extremely low birth weight (EPT/ELBW, <28 weeks gestational age or <1000 g) children by early school age. However, we know little about how they function within the classroom once they start school. To determine how EPT/ELBW children function in kindergarten classrooms compared to termborn normal birth weight (NBW) classmates and identify factors related to difficulties in classroom functioning. A 2001-2003 birth cohort of 111 EPT/ELBW children and 110 NBW classmate controls were observed in regular kindergarten classrooms during a 1-hour instructional period using a time-sample method. The groups were compared on frequencies of individual teacher attention, competing or offtask behaviors, task management/preparation, and academic responding. Regression analysis was also conducted within the EPT/ELBW group to examine associations of these measures with neonatal and developmental risk factors, kindergarten neuropsychological and behavioral assessments, and classroom characteristics. The EPT/ELBW group received more individual teacher attention and was more often off-task than the NBW controls. Poorer classroom functioning in the EPT/ELBW group was associated with higher neonatal and developmental risk, poorer executive function skills, more negative teaching ratings of behavior and learning progress, and classroom characteristics. EPT/ELBW children require more teacher support and are less able to engage in instructional activities than their NBW classmates. Associations of classroom functioning with developmental history and cognitive and behavioral traits suggest that these factors may be useful in identifying the children most in need of special educational interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Changes in lean and skeletal muscle body mass in adult females with anorexia nervosa before and after weight restoration.

    PubMed

    El Ghoch, Marwan; Pourhassan, Maryam; Milanese, Chiara; Müller, Manfred J; Calugi, Simona; Bazzani, Paola Vittoria; Dalle Grave, Riccardo

    2017-02-01

    Data on the deficits in lean body mass (LBM) and total body skeletal muscle mass (SM) in anorexia nervosa (AN) is scarce and inconsistent. Furthermore, the usefulness of the reported body mass index (BMI) severity cut-off for AN has not been tested with respect to these important parameters. The study had two aims, namely to study LBM patterns and SM in adult females with AN before and after weight restoration, and to examine the clinical usefulness of the 16.5 kg/m 2 BMI cut-off for assessing the protein status in terms of LBM and SM in AN patients. Body composition was measured by dual-energy X-ray absorptiometry (DXA) before and after weight gain in 90 adult female inpatients with AN, and 90 controls matched by post-treatment BMI and age. Patients were stratified into two groups using BMI 16.5 kg/m 2 as a cut-off. Before weight restoration, patients in the BMI≤16.5 kg/m 2 subgroup (n = 65) had lower LBM, SM and lean extremity mass percentage, but higher %LBM and lean trunk-to-extremity ratio on average than controls. However, those with BMI >16.5 kg/m 2 (n = 25) displayed lower lean extremity mass percentage and higher %LBM, but no significant differences in LBM and SM with respect to controls. Moreover the time × subgroup interaction was significant in terms of LBM and SM, meaning that, changes occur in different manner over time in the two AN subgroups. However no differences were found between the two AN subgroups in either demographic or other eating disorder characteristics. After weight gain, normalization of LBM, %LBM, lean extremity mass percentage and SM was achieved across the entire AN sample, and the BMI≤16.5 kg/m 2 subgroup. The fat mass was the major determinant of gain in LBM; the higher the FM at baseline, the greater the increase in LBM. Our results suggest a BMI cut-off ≤16.5 kg/m 2 as a clinical threshold for determining AN severity. As short-term weight restoration is associated with a normalization in LBM and SM, it appears that biological regulation of weight gain remains intact in AN, i.e., unaffected by the severity of malnutrition. Changes in lean and skeletal muscle body mass in adult females with anorexia nervosa before and after weight restoration (ISRCTN168721194). Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  14. Evaluation of vaccine coverage for low birth weight infants during the first year of life in a large managed care population.

    PubMed

    Batra, Jagmohan S; Eriksen, Eileen M; Zangwill, Kenneth M; Lee, Martin; Marcy, S Michael; Ward, Joel I

    2009-03-01

    There are few recent population-based assessments of vaccine coverage in premature infants available. This study assesses and compares age- and dose-specific immunization coverage in children of different birth weight categories during the first year of life. We performed a retrospective cohort analysis of computerized vaccination data from a large managed care organization in southern California. The participants were children born between January 1, 1997, and December 31, 2002, and continuously enrolled from birth to at least 12 months of age in the Southern California Kaiser Permanente health plan. We measured age-specific up-to-date and age-appropriate immunization rates according to birth weight (extremely low birth weight: <1000 g; very low birth weight: 1000-1499 g; low birth weight: 1500-2499 g; normal birth weight: >/=2500 g) for 4 vaccines (hepatitis B, diphtheria and tetanus toxoids with pertussis, Haemophilus influenzae type b, and poliovirus) through the first year of life. We identified 127 833 infants born during the study period and continuously enrolled through the first year of life; 120 048 were normal birth weight infants; 6491 were low birth weight infants; 788 were very low birth weight infants; and 506 were extremely low birth weight infants. Vaccine-specific age-appropriate immunization rates were 3% to 15% lower for low birth weight infants and 17% to 33% lower for extremely low birth weight infants compared with the rates for normal birth weight infants in the first 6 months of life. Extremely low birth weight infants had the lowest age-specific up-to-date immunization levels (5%-31% lower) compared with normal birth weight infants at each age assessed. By 12 months, extremely low birth weight infants still had significantly lower up-to-date levels (87%) compared with very low birth weight, low birth weight, and normal birth weight infants (91%-92%). Despite recommendations that lower birth weight infants be vaccinated as the same chronological age as normal birth weight infants, extremely low birth weight and very low birth weight infants are immunized at significantly lower rates relative to low birth weight and normal birth weight infants at 2, 4, and 6 months of age. However, by 12 months of age this finding persists only in extremely low birth weight infants.

  15. Alignment in the transverse plane, but not sagittal or coronal plane, affects the risk of recurrent patella dislocation.

    PubMed

    Takagi, Shigeru; Sato, Takashi; Watanabe, Satoshi; Tanifuji, Osamu; Mochizuki, Tomoharu; Omori, Go; Endo, Naoto

    2017-11-17

    Abnormalities of lower extremity alignment (LEA) in recurrent patella dislocation (RPD) have been studied mostly by two-dimensional (2D) procedures leaving three-dimensional (3D) factors unknown. This study aimed to three-dimensionally examine risk factors for RPD in lower extremity alignment under the weight-bearing conditions. The alignment of 21 limbs in 15 RPD subjects was compared to the alignment of 24 limbs of 12 healthy young control subjects by an our previously reported 2D-3D image-matching technique. The sagittal, coronal, and transverse alignment in full extension as well as the torsional position of the femur (anteversion) and tibia (tibial torsion) under weight-bearing standing conditions were assessed by our previously reported 3D technique. The correlations between lower extremity alignment and RPD were assessed using multiple logistic regression analysis. The difference of lower extremity alignment in RPD between under the weight-bearing conditions and under the non-weight-bearing conditions was assessed. In the sagittal and coronal planes, there was no relationship (statistically or by clinically important difference) between lower extremity alignment angle and RPD. However, in the transverse plane, increased external tibial rotation [odds ratio (OR) 1.819; 95% confidence interval (CI) 1.282-2.581], increased femoral anteversion (OR 1.183; 95% CI 1.029-1.360), and increased external tibial torsion (OR 0.880; 95% CI 0.782-0.991) were all correlated with RPD. The tibia was more rotated relative to femur at the knee joint in the RPD group under the weight-bearing conditions compared to under the non-weight-bearing conditions (p < 0.05). This study showed that during weight-bearing, alignment parameters in the transverse plane related to the risk of RPD, while in the sagittal and coronal plane alignment parameters did not correlate with RPD. The clinical importance of this study is that the 3D measurements more directly, precisely, and sensitively detect rotational parameters associated with RPD and hence predict risk of RPD. III.

  16. Active Control Technique Evaluation for Spacecraft (ACES)

    DTIC Science & Technology

    1988-06-16

    spare Voyager Astromast built by ASTRO Research, Inc. It was supplied to MSFC by the Jet Propulsion Laboratory (JPL). The Astromast is extremely...assuming full controlled state availability, is u = - FXc . The control law designed via the modified control weighting matrix deserves comment...minimizes J has the form u(k) = - FXc (k) and can be found via standard software for solving the discrete algebraic Riccati

  17. Learning Problems in Kindergarten Students with Extremely Preterm Birth

    PubMed Central

    Taylor, H. Gerry; Klein, Nancy; Anselmo, Marcia G.; Minich, Nori; Espy, Kimberly A.; Hack, Maureen

    2012-01-01

    Objective To assess learning problems in extremely preterm children in kindergarten and identify risk factors. Design Cohort study. Setting Children’s hospital. Participants A cohort of extremely preterm children born January 2001 – December 2003 (n=148), defined as <28 weeks gestation and/or <1000 g birth weight, and term-born normal birth weight classmate controls (n=111). Main Interventions The children were enrolled during their first year in kindergarten and assessed on measures of learning progress. Main Outcome Measures Achievement testing, teacher ratings of learning progress, and individual educational assistance. Results The extremely preterm children had lower mean standard scores than controls on tests of spelling (8.52 points, 95% CI: 4.58, 12.46) and applied mathematics (11.02 points, 95% CI: 6.76, 15.28). They also had higher rates of substandard learning progress by teacher report in written language (OR = 4.23, 95% CI: 2.32, 7.73) and mathematics (OR = 7.08, 95% CI: 2.79, 17.95). Group differences on mathematics achievement and in teacher ratings of learning progress were significant even in children without neurosensory deficits or low global cognitive ability. Neonatal risk factors, early childhood neurodevelopmental impairment, and socioeconomic status predicted learning problems in extremely preterm children, yet many of the children with problems were not in a special education program. Conclusion Learning problems in extremely preterm children are evident in kindergarten and are associated with neonatal and early childhood risk factors. The findings support efforts to provide more extensive monitoring and interventions both prior to and during the first year in school. PMID:21893648

  18. ADHD among young adults born at extremely low birth weight: the role of fluid intelligence in childhood

    PubMed Central

    Lahat, Ayelet; Van Lieshout, Ryan J.; Saigal, Saroj; Boyle, Michael H.; Schmidt, Louis A.

    2014-01-01

    Poor executive function (EF) has been linked to attention-deficit/hyperactivity disorder (ADHD). Children born at extremely low birth weight (ELBW; <1000 g) have been found to show both poor EF, as well as elevated levels of symptoms of ADHD. In the present study, we examined whether fluid intelligence moderates the link between birth weight and later ADHD symptoms by prospectively following a cohort of 179 survivors who were born at ELBW. When participants were 8 years-old, they were matched with 145 normal birth weight (NBW; ≥2500 g) control participants. At age 8, fluid intelligence was measured, and during young adulthood (ages 22–26), participants' self-reported levels of ADHD symptoms were examined. We found that ELBW survivors, who also showed poor fluid intelligence, had the highest rates of ADHD symptoms, and particularly, symptoms of inattention. These findings point to the importance of examining developmental trajectories that contribute to risk for psychopathology in those exposed to intrauterine adversity. PMID:24904465

  19. Chromosome-wise dissection of the genome of the extremely big mouse line DU6i.

    PubMed

    Bevova, Marianna R; Aulchenko, Yurii S; Aksu, Soner; Renne, Ulla; Brockmann, Gudrun A

    2006-01-01

    The extreme high-body-weight-selected mouse line DU6i is a polygenic model for growth research, harboring many small-effect QTL. We dissected the genome of this line into 19 autosomes and the Y chromosome by the construction of a new panel of chromosome substitution strains (CSS). The DU6i chromosomes were transferred to a DBA/2 mice genetic background by marker-assisted recurrent backcrossing. Mitochondria and the X chromosome were of DBA/2 origin in the backcross. During the construction of these novel strains, >4000 animals were generated, phenotyped, and genotyped. Using these data, we studied the genetic control of variation in body weight and weight gain at 21, 42, and 63 days. The unique data set facilitated the analysis of chromosomal interaction with sex and parent-of-origin effects. All analyzed chromosomes affected body weight and weight gain either directly or in interaction with sex or parent of origin. The effects were age specific, with some chromosomes showing opposite effects at different stages of development.

  20. Comparison of psychosocial status in treatment-seeking women with class III vs. class I-II obesity.

    PubMed

    Wadden, Thomas A; Butryn, Meghan L; Sarwer, David B; Fabricatore, Anthony N; Crerand, Canice E; Lipschutz, Patti E; Faulconbridge, Lucy; Raper, Steven; Williams, Noel N

    2006-01-01

    This study compared the psychosocial status and weight loss expectations of women with extreme (class III) obesity who sought bariatric surgery with those of women with class I-II obesity who enrolled in a research study on behavioral weight control. Before treatment, all participants completed the Beck Depression Inventory-II and the Weight and Lifestyle Inventory. This latter questionnaire assesses several domains including symptoms of depression and low self-esteem, history of psychiatric complications, current stressors, and weight loss expectations. Women with class III obesity, as compared with class I-II, reported significantly more symptoms of depression. Fully 25% of women in the former group appeared to have a significant mood disorder that would benefit from treatment. As compared with women with class I-II obesity, significantly more women with class III obesity also reported a history of psychiatric complications, which included physical and sexual abuse and greater stress related to their physical health and financial/legal matters. Both groups of women had unrealistic weight loss expectations. Those who sought surgery expected to lose 47.6 +/- 9.3% of initial weight, compared with 24.8 +/- 8.7% for those who enrolled in behavioral weight control. These findings suggest that women with extreme obesity who seek bariatric surgery should be screened for psychosocial complications. Those determined to have significant psychiatric distress should be referred for behavioral or pharmacological treatment to alleviate their suffering. Long-term studies are needed to provide definitive guidance concerning the relationship between preoperative psychopathology and the outcome of bariatric surgery.

  1. A randomized clinical trial evaluating silicone earplugs for very low birth weight newborns in intensive care.

    PubMed

    Abou Turk, C; Williams, A L; Lasky, R E

    2009-05-01

    To determine whether very low birth weight (VLBW) newborns (<1500 g) wearing silicone earplugs grow larger and perform better on developmental exams than controls. VLBW newborns (n=34) were randomized to wearing earplugs or not. Hospital outcomes were abstracted from medical charts by research staff masked to intervention status. Fourteen extremely low birth weight (ELBW) newborns (<1000 g) were also evaluated at 18 to 22 months. After adjusting for birth weight, 11 surviving newborns in the earplug group were 225 g (95% CI: 45, 405) heavier at 34 weeks post menstrual age than the 13 controls. Six ELBW earplug infants scored 15.53 points (95% CI: 3.03, 28.02) higher than six controls on the Bayley Mental Development Index. Their head circumferences were 2.59 cm (95% CI: 0.97, 4.21) larger. Earplugs may facilitate weight gain in VLBW newborns. Better outcomes may persist at 18 to 22 months at least in ELBW infants.

  2. A Randomized Clinical Trial Evaluating Silicone Earplugs for Very Low Birth Weight Newborns in Intensive Care

    PubMed Central

    Turk, Chirine A. Abou; Williams, Amber L.; Lasky, Robert E.

    2008-01-01

    Objective Determine whether very low birth weight (VLBW) newborns (<1500 g) wearing silicone earplugs grow larger and perform better on developmental exams than controls. Study Design VLBW newborns (n=34) were randomized to wearing earplugs or not. Hospital outcomes were abstracted from medical charts by research staff masked to intervention status. Fourteen extremely low birth weight (ELBW) newborns (<1000 g) were also evaluated at 18−22 months. Result After adjusting for birth weight, 11 surviving newborns in the earplug group were 225 g (95% CI: 45, 405) heavier at 34 weeks post-menstrual age than the 13 controls. Six ELBW earplug infants scored 15.53 points (95% CI: 3.03, 28.02) higher than 6 controls on the Bayley Mental Development Index. Their head circumferences were 2.59 cms (95% CI: 0.97, 4.21) larger. Conclusion Earplugs may facilitate weight gain in VLBW newborns. Better outcomes may persist at 18−22 months at least in ELBW infants. PMID:19194455

  3. High prevalence of abnormal motor repertoire at 3 months corrected age in extremely preterm infants.

    PubMed

    Fjørtoft, Toril; Evensen, Kari Anne I; Øberg, Gunn Kristin; Songstad, Nils Thomas; Labori, Cathrine; Silberg, Inger Elisabeth; Loennecken, Marianne; Møinichen, Unn Inger; Vågen, Randi; Støen, Ragnhild; Adde, Lars

    2016-03-01

    To compare early motor repertoire between extremely preterm and term-born infants. An association between the motor repertoire and gestational age and birth weight was explored in extremely preterm infants without severe ultrasound abnormalities. In a multicentre study, the early motor repertoire of 82 infants born extremely preterm (ELGAN:<28 weeks) and/or with extremely low birth weight (ELBW:<1000 g) and 87 term-born infants were assessed by the "Assessment of Motor Repertoire - 2 to 5 Months" (AMR) which is part of Prechtl's "General Movement Assessment", at 12 weeks post-term age. Fidgety movements were classified as normal if present and abnormal if absent, sporadic or exaggerated. Concurrent motor repertoire was classified as normal if smooth and fluent and abnormal if monotonous, stiff, jerky and/or predominantly fast or slow. Eight-teen ELBW/ELGAN infants had abnormal fidgety movements (8 absent, 7 sporadic and 3 exaggerated fidgety movements) compared with 2 control infants (OR:12.0; 95%CI:2.7-53.4) and 46 ELBW/ELGAN infants had abnormal concurrent motor repertoire compared with 17 control infants (OR:5.3; 95%CI:2.6-10.5). Almost all detailed aspects of the AMR differed between the groups. Results were the same when three infants with severe ultrasound abnormalities were excluded. In the remaining ELBW/ELGAN infants, there was no association between motor repertoire and gestational age or birth weight. ELBW/ELGAN infants had poorer quality of early motor repertoire than term-born infants.The findings were not explained by severe abnormalities on neonatal ultrasound scans and were not correlated to the degree of prematurity. The consequences of these abnormal movement patterns remain to be seen in future follow-up studies. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  4. Weight-related concerns and diet behaviors among urban young females: A cross-sectional study

    PubMed Central

    Omidvar, Shabnam; Amiri, Fatemeh Nasiri; Bakouei, Fatemeh; Begum, Khyrunnisa

    2016-01-01

    Background: Females are more likely than males to perceive themselves as too heavy, this has been explained in terms of the equation of “female beauty with extreme thinness.” Therefore, females are in general prone to develop unhealthy behaviors for weight management. Wrong weight control behaviors have significant health consequences. Objectives: To investigate the body weight concerns, body satisfaction, and weight control behaviors among young females and their association with age and socioeconomic status (SES). Materials and Methods: A cross-sectional study conducted in urban areas from a major city in South India. About 650 healthy unmarried females aged 15–25 years formed the study population. Self-reporting questionnaires were used to obtain relevant data. The categorical data were analyzed using Chi-square, correlation, and regression analyses by SPSS version 16. Results: Most overweight and obese subjects perceived themselves as overweight. Adolescents were more likely to report themselves as overweight. The perceived weight, body satisfaction, and weight control behaviors are influenced by weight status and age of the subjects. However, SES of the participants did not exhibit effect of others’ opinion about their weight and body satisfaction as well as weight management behaviors. Conclusion: The high prevalence of weight-related concerns suggests that all females should be reached with appropriate information and interventions. Healthy weight control practices need to be explicitly promoted and unhealthy practices discouraged. Young females need special attention toward weight management. PMID:27843836

  5. Trajectories of psychopathology in extremely low birth weight survivors from early adolescence to adulthood: a 20-year longitudinal study.

    PubMed

    Van Lieshout, Ryan J; Ferro, Mark A; Schmidt, Louis A; Boyle, Michael H; Saigal, Saroj; Morrison, Katherine M; Mathewson, Karen J

    2018-04-18

    Individuals born extremely preterm are exposed to significant perinatal stresses that are associated with an increased risk of psychopathology. However, a paucity of longitudinal studies has prevented the empirical examination of long-term, dynamic effects of perinatal adversity on mental health. Here, internalizing and externalizing problems from adolescence through adulthood were compared in individuals born at extremely low birth weight (ELBW; <1,000 g) and normal birth weight (NBW; >2,500 g). Internalizing and externalizing data were collected over 20 years in three waves, during adolescence, young adulthood, and adulthood. Growth models were used to compare longitudinal trajectories in a geographically based sample of 151 ELBW survivors and 137 NBW control participants born between 1977 and 1982 matched for age, sex, and socioeconomic status at age 8. After adjusting for sex, socioeconomic and immigrant status, and family functioning, ELBW survivors failed to show the normative, age-related decline in internalizing problems over time relative to their NBW peers (β = .21; p < .01). Both groups exhibited small declines in externalizing problems over the same period. Self-esteem (but not physical health, IQ, or maternal mood) partially mediated the association between ELBW status and internalizing problems. Extremely low birth weight survivors experienced a blunting of the expected improvement in depression and anxiety from adolescence to adulthood. These findings suggest that altered physiological regulatory systems supporting emotional and cognitive processing may contribute to the maintenance of internalizing problems in this population. © 2018 Association for Child and Adolescent Mental Health.

  6. Delivery room management of extremely low birth weight infants in Italy: comparison between academic and non-academic birth centres.

    PubMed

    Mardegan, Veronica; Satariano, Irene; Doglioni, Nicoletta; Criscoli, Giulio; Cavallin, Francesco; Gizzi, Camilla; Martano, Claudio; Ciralli, Fabrizio; Torielli, Flaminia; Villani, Paolo Ernesto; Di Fabio, Sandra; Quartulli, Lorenzo; Giannini, Luigi; Trevisanuto, Daniele

    2016-01-01

    International Guidelines provide a standardised approach to newborn resuscitation in the DR and, in their most recent versions, recommendations dedicated to management of ELBWI were progressively increased. It is expected that introduction in clinical practice and dissemination of the most recent evidence should be more consistent in academic than in non-academic hospitals. The aim of the study was to compare adherence to the International Guidelines and consistency of practice in delivery room management of extremely low birth weight infants between academic and non-academic institutions. A questionnaire was sent to the directors of all Italian level III centres between April and August 2012. There was a 92% (n = 98/107) response rate. Apart from polyethylene wrapping to optimise thermal control, perinatal management approach was comparable between academic and non-academic centres. There were minor differences in management of extremely low birth weight infants between Italian academic and non-academic institutions, apart from thermal management. Although there was a good, overall adherence to the International Guidelines for Neonatal Resuscitation, temperature management was not in accordance with official recommendations and every effort has to be done to improve this aspect.

  7. [Effects of extremely low frequency electromagnetic radiation on cardiovascular system of workers].

    PubMed

    Zhao, Long-yu; Song, Chun-xiao; Yu, Duo; Liu, Xiao-liang; Guo, Jian-qiu; Wang, Chuan; Ding, Yuan-wei; Zhou, Hong-xia; Ma, Shu-mei; Liu, Xiao-dong; Liu, Xin

    2012-03-01

    To observe the exposure levels of extremely low frequency electromagnetic fields in workplaces and to analyze the effects of extremely low frequency electromagnetic radiation on cardiovascular system of occupationally exposed people. Intensity of electromagnetic fields in two workplaces (control and exposure groups) was detected with EFA-300 frequency electromagnetic field strength tester, and intensity of the noise was detected with AWA5610D integral sound level. The information of health physical indicators of 188 controls and 642 occupationally exposed workers was collected. Data were analyzed by SPSS17.0 statistic software. The intensity of electric fields and the magnetic fields in exposure groups was significantly higher than that in control group (P < 0.05), but there was no significant difference of noise between two workplaces (P > 0.05). The results of physical examination showed that the abnormal rates of HCY, ALT, AST, GGT, ECG in the exposure group were significantly higher than those in control group (P < 0.05). There were no differences of sex, age, height, weight between two groups (P > 0.05). Exposure to extremely low frequency electromagnetic radiation may have some effects on the cardiovascular system of workers.

  8. Special health care needs explains the effect of extremely low birth weight on math but not language achievement.

    PubMed

    Litt, Jonathan S; Minich, Nori; Taylor, H Gerry; Hack, Maureen

    2017-12-01

    Extremely low birth weight (ELBW; <1kg) adolescents are at risk for special health care needs (SHCN) and poor math achievement compared to normal birth weight (NBW) peers. SHCN are associated with poor academic achievement among NBW children. We hypothesize that SHCN explain the effect of ELBW on math achievement. We compared age 14 Woodcock-Johnson Calculation standard scores between 181 ELBW infants and 115 NBW controls. Persistent SHCN included: 1) prescription medication or equipment use, 2) subspecialty or therapeutic service use, or 3) hospitalization. We used nonlinear marginal effects models to decompose the total effect of ELBW on math into the following 4 components: the effect of ELBW controlling for SHCN, the effect of SHCN controlling for ELBW, effect modification by SHCN, and mediated interaction where SHCN is both causal mediator and effect modifier. Models were adjusted for sociodemographic factors. ELBW adolescents had lower mean math scores than NBW peers (81.3 vs. 96.4). SHCN were more common among ELBW adolescents (54.1% vs. 27%). The total effect of ELBW on math scores was -15.7 points (95% CI -21.0, -10.5). The effect of birth weight alone was -7.6 points (95% CI -13.7, -1.4); the effect of SHCN alone was negligible. SHCN interaction and mediated interaction effects each accounted for 25% of the total effect. Birth weight alone explains only half of the effect of ELBW on math achievement. We found evidence of effect modification and mediation by SHCN. Understanding these explanatory pathways may lead to targeted interventions for improved outcomes. Copyright © 2017. Published by Elsevier B.V.

  9. Novel All-Extremity High-Intensity Interval Training Improves Aerobic Fitness, Cardiac Function and Insulin Resistance in Healthy Older Adults

    PubMed Central

    Hwang, Chueh-Lung; Yoo, Jeung-Ki; Kim, Han-Kyul; Hwang, Moon-Hyon; Handberg, Eileen M.; Petersen, John W.; Christou, Demetra D.

    2016-01-01

    Aging is associated with decreased aerobic fitness and cardiac remodeling leading to increased risk for cardiovascular disease. High-intensity interval training (HIIT) on the treadmill has been reported to be more effective in ameliorating these risk factors compared with moderate-intensity continuous training (MICT) in patients with cardiometabolic disease. In older adults, however, weight-bearing activities are frequently limited due to musculoskeletal and balance problems. The purpose of this study was to examine the feasibility and safety of non-weight-bearing all-extremity HIIT in older adults. In addition, we tested the hypothesis that all-extremity HIIT will be more effective in improving aerobic fitness, cardiac function, and metabolic risk factors compared with all-extremity MICT. Fifty-one healthy sedentary older adults (age: 65±1 years) were randomized to HIIT (n=17), MICT (n=18) or non-exercise control (CONT; n=16). HIIT (4×4 minutes 90% of peak heart rate; HRpeak) and isocaloric MICT (70% of HRpeak) were performed on a non-weight-bearing all-extremity ergometer, 4x/week for 8 weeks under supervision. All-extremity HIIT was feasible in older adults and resulted in no adverse events. Aerobic fitness (peak oxygen consumption; VO2peak) and ejection fraction (echocardiography) improved by 11% (P<0.0001) and 4% (P=0.001) respectively in HIIT, while no changes were observed in MICT and CONT (P≥0.1). Greater improvements in ejection fraction were associated with greater improvements in VO2peak (r=0.57; P<0.0001). Insulin resistance (homeostatic model assessment) decreased only in HIIT by 26% (P=0.016). Diastolic function, body composition, glucose and lipids were unaffected (P≥0.1). In conclusion, all-extremity HIIT is feasible and safe in older adults. HIIT, but not MICT, improved aerobic fitness, ejection fraction, and insulin resistance. PMID:27346646

  10. Novel all-extremity high-intensity interval training improves aerobic fitness, cardiac function and insulin resistance in healthy older adults.

    PubMed

    Hwang, Chueh-Lung; Yoo, Jeung-Ki; Kim, Han-Kyul; Hwang, Moon-Hyon; Handberg, Eileen M; Petersen, John W; Christou, Demetra D

    2016-09-01

    Aging is associated with decreased aerobic fitness and cardiac remodeling leading to increased risk for cardiovascular disease. High-intensity interval training (HIIT) on the treadmill has been reported to be more effective in ameliorating these risk factors compared with moderate-intensity continuous training (MICT) in patients with cardiometabolic disease. In older adults, however, weight-bearing activities are frequently limited due to musculoskeletal and balance problems. The purpose of this study was to examine the feasibility and safety of non-weight-bearing all-extremity HIIT in older adults. In addition, we tested the hypothesis that all-extremity HIIT will be more effective in improving aerobic fitness, cardiac function, and metabolic risk factors compared with all-extremity MICT. Fifty-one healthy sedentary older adults (age: 65±1years) were randomized to HIIT (n=17), MICT (n=18) or non-exercise control (CONT; n=16). HIIT (4×4min 90% of peak heart rate; HRpeak) and isocaloric MICT (70% of HRpeak) were performed on a non-weight-bearing all-extremity ergometer, 4×/week for 8weeks under supervision. All-extremity HIIT was feasible in older adults and resulted in no adverse events. Aerobic fitness (peak oxygen consumption; VO2peak) and ejection fraction (echocardiography) improved by 11% (P<0.0001) and 4% (P=0.001), respectively in HIIT, while no changes were observed in MICT and CONT (P≥0.1). Greater improvements in ejection fraction were associated with greater improvements in VO2peak (r=0.57; P<0.0001). Insulin resistance (homeostatic model assessment) decreased only in HIIT by 26% (P=0.016). Diastolic function, body composition, glucose and lipids were unaffected (P≥0.1). In conclusion, all-extremity HIIT is feasible and safe in older adults. HIIT, but not MICT, improved aerobic fitness, ejection fraction, and insulin resistance. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Permissive weight bearing in trauma patients with fracture of the lower extremities: prospective multicenter comparative cohort study.

    PubMed

    Kalmet, Pishtiwan H S; Meys, Guido; V Horn, Yvette Y; Evers, Silvia M A A; Seelen, Henk A M; Hustinx, Paul; Janzing, Heinrich; Vd Veen, Alexander; Jaspars, Coen; Sintenie, Jan Bernard; Blokhuis, Taco J; Poeze, Martijn; Brink, Peter R G

    2018-02-02

    The standard aftercare treatment in surgically treated trauma patients with fractures around or in a joint, known as (peri)- or intra-articular fractures of the lower extremities, is either non-weight bearing or partial weight bearing. We have developed an early permissive weight bearing post-surgery rehabilitation protocol in surgically treated patients with fractures of the lower extremities. In this proposal we want to compare our early permissive weight bearing protocol to the existing current non-weight bearing guidelines in a prospective comparative cohort study. The study is a prospective multicenter comparative cohort study in which two rehabilitation aftercare treatments will be contrasted, i.e. permissive weight bearing and non-weight bearing according to the AO-guideline. The study population consists of patients with a surgically treated fracture of the pelvis/acetabulum or a surgically treated (peri)- or intra-articular fracture of the lower extremities. The inclusion period is 12 months. The duration of follow up is 6 months, with measurements taken at baseline, 2,6,12 and 26 weeks post-surgery. ADL with Lower Extremity Functional Scale. Outcome variables for compliance, as measured with an insole pressure measurement system, encompass peak load and step duration. This study will investigate the (cost-) effectiveness of a permissive weight bearing aftercare protocol. The results will provide evidence whether a permissive weight bearing protocol is more effective than the current non-weight bearing protocol. The study is registered in the Dutch Trial Register ( NTR6077 ). Date of registration: 01-09-2016.

  12. Neurodevelopmental outcome and growth at 18 to 22 months' corrected age in extremely low birth weight infants treated with early erythropoietin and iron.

    PubMed

    Ohls, Robin K; Ehrenkranz, Richard A; Das, Abhik; Dusick, Anna M; Yolton, Kimberly; Romano, Elaine; Delaney-Black, Virginia; Papile, Lu-Ann; Simon, Neal P; Steichen, Jean J; Lee, Kimberly G

    2004-11-01

    Clinical trials evaluating the use of erythropoietin (Epo) have demonstrated a limited reduction in transfusions; however, long-term developmental follow-up data are scarce. We compared anthropometric measurements, postdischarge events, need for transfusions, and developmental outcomes at 18 to 22 months' corrected age in extremely low birth weight (ELBW) infants treated with early Epo and supplemental iron therapy with that of placebo/control infants treated with supplemental iron alone. The National Institute of Child Health and Human Development Neonatal Research Network completed a randomized, controlled trial of early Epo and iron therapy in preterm infants < or =1250 g. A total of 172 ELBW (< or =1000-g birth weight) infants were enrolled (87 Epo and 85 placebo/control). Of the 72 Epo-treated and 70 placebo/control ELBW infants surviving to discharge, follow-up data (growth, development, rehospitalization, transfusions) at 18 to 22 months' corrected age were collected on 51 of 72 Epo-treated infants (71%) and 51 of 70 placebo/controls (73%) by certified examiners masked to the treatment group. Statistical significance was determined using chi2 analysis. There were no significant differences between treatment groups in weight or length or in the percentage of infants weighing <10th percentile either at the time of discharge or at follow-up, and no difference was found in the mean head circumference between groups. A similar percentage of infants in each group was rehospitalized (38% Epo and 35% placebo/control) for similar reasons. There were no differences between groups with respect to the percentage of infants with Bayley-II Mental Developmental Index <70 (34% Epo and 36% placebo/control), blindness (0% Epo and 2% placebo/control), deafness or hearing loss requiring amplification (2% Epo and 2% placebo/control), moderate to severe cerebral palsy (16% Epo and 18% placebo/control) or the percentage of infants with any of the above-described neurodevelopmental impairments (42% Epo and 44% placebo/control). Treatment of ELBW infants with early Epo and iron does not significantly influence anthropometric measurements, need for rehospitalization, transfusions after discharge, or developmental outcome at 18 to 22 months' corrected age.

  13. Early Working Memory in Children Born With Extremely Low Birth Weight: Assessed by Object Permanence

    PubMed Central

    Lowe, Jean; MacLean, Peggy C.; Shaffer, Michele L.; Watterberg, Kristi

    2011-01-01

    Object permanence is considered the earliest method for assessing working memory. Factors affecting object permanence performance in a sample of two hundred and thirty-three 18- to 22-month olds born with extremely low birth weight were examined. It was hypothesized that object permanence would be directly related to emotional and attention regulation, that children with lower birth weight and higher illness severity would have more difficulty on the object permanence task, and that no ethnic/racial differences would be found, as this is considered a culturally unbiased task. Attainment of object permanence had a significant positive association with emotional and attention regulation, even after controlling the medical severity and socioeconomic factors. More girls than boys passed the object permanence items. There was no ethnic/racial difference on object permanence. Our findings indicate that object permanence may be a culturally fair way of assessing development, and emotional and attention regulation are potential avenues of intervention for such skill. PMID:19339284

  14. Early working memory in children born with extremely low birth weight: assessed by object permanence.

    PubMed

    Lowe, Jean; MacLean, Peggy C; Shaffer, Michele L; Watterberg, Kristi

    2009-04-01

    Object permanence is considered the earliest method for assessing working memory. Factors affecting object permanence performance in a sample of two hundred and thirty-three 18- to 22-month olds born with extremely low birth weight were examined. It was hypothesized that object permanence would be directly related to emotional and attention regulation, that children with lower birth weight and higher illness severity would have more difficulty on the object permanence task, and that no ethnic/racial differences would be found, as this is considered a culturally unbiased task. Attainment of object permanence had a significant positive association with emotional and attention regulation, even after controlling the medical severity and socioeconomic factors. More girls than boys passed the object permanence items. There was no ethnic/racial difference on object permanence. Our findings indicate that object permanence may be a culturally fair way of assessing development, and emotional and attention regulation are potential avenues of intervention for such skill.

  15. Effect of a lateral step-up exercise protocol on quadriceps and lower extremity performance.

    PubMed

    Worrell, T W; Borchert, B; Erner, K; Fritz, J; Leerar, P

    1993-12-01

    Closed kinetic chain exercises have been promoted as more functional and more appropriate than open kinetic chain exercises. Limited research exists demonstrating the effect of closed kinetic chain exercise on quadriceps and lower extremity performance. The purpose of this study was to determine the effect of a lateral step-up exercise protocol on isokinetic quadriceps peak torque and the following lower extremity activities: 1) leg press, 2) maximal step-up repetitions with body weight plus 25%, 3) hop for distance, and 4) 6-m timed hop. Twenty subjects participated in a 4-week training period, and 18 subjects served as controls. For the experimental group, a repeated measure ANOVA comparing pretest and posttest values revealed significant improvements in the leg press (p < or = .05), step-ups (p < or = .05), hop for distance (p < or = .05), and hop for time (p < or = .05) and no significant increase in isokinetic quadriceps peak torque (p > or = .05). Over the course of the training period, weight used for the step-up exercise increased (p < or = .05), repetitions decreased (p < or = .05), and step-up work did not change (p > or = .05). For the control group, no significant change (p > or = .05) occurred in any variable. The inability of the isokinetic dynamometer to detect increases in quadriceps performance is important because the isokinetic values are frequently used as criteria for return to functional activities. We conclude that closed kinetic chain testing and exercise provide additional means to assess and rehabilitate the lower extremity.

  16. Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery.

    PubMed

    Hooper, M M; Stellato, T A; Hallowell, P T; Seitz, B A; Moskowitz, R W

    2007-01-01

    To determine the point prevalence of painful musculoskeletal (MSK) conditions in obese subjects before and after weight loss following bariatric surgery. Longitudinal, interventional, unblended. Forty-eight obese subjects (47 women, one man, mean age 44+/-9 years; mean body mass index (BMI) 51+/-8 kg/m(2)) recruited from an academic medical center bariatric surgery program. Comorbid medical conditions; MSK findings; BMI; Western Ontario McMaster Osteoarthritis Index (WOMAC) for pain, stiffness and function; and SF-36 for quality of life. Consecutive subjects were recruited from the University Hospitals of Cleveland Bariatric Surgery Program. Musculoskeletal signs and symptoms and non-MSK comorbid conditions were documented at baseline and at follow-up. SUBJECTS completed the SF-36 and the WOMAC questionnaires. Analyses were carried out for each MSK site, fibromyalgia syndrome (FMS) and for the cumulative effect on the spine, upper and lower extremities. The impact of change in comorbid medical conditions, BMI, physical and mental health domains of the SF-36 on the WOMAC pain subscale score was evaluated. SF-36 outcomes were compared to normal published controls. Forty-eight subjects were available for baseline and a follow-up assessment 6-12 months after gastric bypass surgery. They lost an average of 41+/-15 kg and the mean BMI decreased from 51+/-8 to 36+/-7 kg/m(2). Baseline comorbid medical conditions were present in 96% before surgery and 23% after weight loss. There was an increased prevalence of painful MSK conditions at baseline compared to general population frequencies. Musculoskeletal complaints had been present in 100% of obese subjects before, and 23% after weight loss. The greatest improvements occurred in the cervical and lumbar spine, the foot and in FMS (decreased by 90, 83, 83 and 92%, respectively). Seventy-nine percent had upper extremity MSK conditions before and 40% after weight loss. Before surgery, 100% had lower extremity MSK conditions and only 37% did after weight loss. The WOMAC subscale and composite scores all improved significantly, as did the SF-36((R)). Change in BMI was the main factor impacting the WOMAC pain score. There was a higher frequency of multiple MSK complaints, including non-weight-bearing sites compared to historical controls, before surgery, which decreased significantly at most sites following weight loss and physical activity. These benefits may improve further, as weight loss may continue for up to 24 months. The benefits seen with weight loss indicate that prevention and treatment of obesity can improve MSK health and function.

  17. Compelled Body Weight Shift Technique to Facilitate Rehabilitation of Individuals with Acute Stroke.

    PubMed

    Mohapatra, Sambit; Eviota, Aileen C; Ringquist, Keir L; Muthukrishnan, Sri Ranjini; Aruin, Alexander S

    2012-05-01

    The study evaluates the effectiveness of Compelled Body Weight Shift (CBWS) approach in the rehabilitation of individuals with stroke. CBWS involves a forced shift of body weight towards a person's affected side by means of a shoe insert that establishes a lift of the nonaffected lower extremity. Eleven patients with acute stroke were randomly assigned to experimental and control groups. The experimental group received a two-week conventional physical therapy combined with CBWS and the control group received only a two-week conventional therapy. Weight bearing, Gait velocity, Berg's Balance, and Fugl-Meyer's Scores were recorded before and after the intervention. Weight bearing on the affected side increased in the experimental group and decreased in the control group. The increase in gait velocity with treatment was significant in both the groups ( P < 0.05). However, experimental group ( P = 0.01) demonstrated larger improvements in gait velocity compared to the control group ( P = 0.002). Berg Balance and Fugl-Meyer scores increased for both the groups. The implementation of a two-week intervention with CBWS resulted in the improvement in weight bearing and gait velocity of individuals with acute stroke. The present preliminary study suggests that CBWS technique could be implemented as an adjunct to conventional rehabilitation program for individuals with acute stroke.

  18. [The bionic hand].

    PubMed

    Surke, Carsten; Ducommun Dit Boudry, Pascal; Vögelin, Esther

    2015-08-01

    The loss of the upper extremity implicates a grave insult in the life of the involved person. To compensate for the loss of function different powered prosthetic devices are available. Ever since their first development 70 years ago numerous improvements in terms of size, weight and wearing comfort have been developed, but issues regarding the control of upper extremity prostheses remain. Slow grasping speed, limited grip positions and especially failure to provide a sensory feedback limit the acceptance in patients. Recent developments are aimed to allow a more intuitive control of the prosthetic device and to provide a sensory feedback to the amputee. Targeted reinnervation reassignes existing muscles to different peripheral nerves thereby enabling them to fulfill alternate functions. Implanting electrodes into muscle bellies of the forearm allows a more accurate control of the prosthesis. Promising results are being achieved by implanting nerve electrodes by establishing bilateral communication between patient and prosthesis. The following review summarizes the current developments of bionic prostheses in the upper extremity.

  19. Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants with Spontaneous Intestinal Perforation or Surgical Necrotizing Enterocolitis

    PubMed Central

    Wadhawan, Rajan; Oh, William; Hintz, Susan R; Blakely, Martin L; Das, Abhik; Bell, Edward F.; Saha, Shampa; Laptook, Abbot R.; Shankaran, Seetha; Stoll, Barbara J.; Walsh, Michele C.; Higgins, Rosemary D.

    2013-01-01

    Objective To determine if extremely low birth weight infants with surgical necrotizing enterocolitis have a higher risk of death or neurodevelopmental impairment and neurodevelopmental impairment among survivors (secondary outcome) at 18–22 months corrected age compared to infants with spontaneous intestinal perforation and infants without necrotizing enterocolitis or spontaneous intestinal perforation. Study Design Retrospective analysis of the Neonatal Research Network very low birth weight registry, evaluating extremely low birth weight infants born between 2000–2005. The study infants were designated into 3 groups: 1) Spontaneous intestinal perforation without necrotizing enterocolitis; 2) Surgical necrotizing enterocolitis (Bell's stage III); and 3) Neither spontaneous intestinal perforation nor necrotizing enterocolitis. Multivariate logistic regression analysis was performed to evaluate the association between the clinical group and death or neurodevelopmental impairment, controlling for multiple confounding factors including center. Results Infants with surgical necrotizing enterocolitis had the highest rate of death prior to hospital discharge (53.5%) and death or neurodevelopmental impairment (82.3%) compared to infants in the spontaneous intestinal perforation group (39.1% and 79.3%) and no necrotizing enterocolitis/no spontaneous intestinal perforation group (22.1% and 53.3%; p<0.001). Similar results were observed for neurodevelopmental impairment among survivors. On logistic regression analysis, both spontaneous intestinal perforation and surgical necrotizing enterocolitis were associated with increased risk of death or neurodevelopmental impairment (adjusted OR 2.21, 95% CI: 1.5, 3.2 and adjusted OR 2.11, 95% CI: 1.5, 2.9 respectively) and neurodevelopmental impairment among survivors (adjusted OR 2.17, 95% CI: 1.4, 3.2 and adjusted OR 1.70, 95% CI: 1.2, 2.4 respectively). Conclusions Spontaneous intestinal perforation and surgical necrotizing enterocolitis are associated with a similar increase in the risk of death or neurodevelopmental impairment and neurodevelopmental impairment among extremely low birth weight survivors at 18–22 months corrected age. PMID:24135709

  20. [Effect of starvation on blood protein levels in the population of Dobrinja (1992-1995)].

    PubMed

    Hasković, E

    2000-01-01

    In nutritional protein deficiency, numerous studies verified utilization of amino acids generated from tissue degradation in intensive protein synthesis. Unlike liver, muscle protein synthesis is extremely dependent on external supplies of essential amino acids. Prolonged nutritional protein deficiency results in decrease of body weight as well as total protein concentration, in particular in early days of starvation. In prolonged starvation during the war, significant decrease of body weight was registered in 70 subjects while their total protein concentration remained within the expected range and did not significantly differ the values recorded in the control group. Concentration of serum albumines in the control group was lower than the concentration recorded in the tested group, while the serum globulins concentration was higher in the control group. Although the difference in body weight between the tested and the control group was statistically significant, no significant difference in the concentration of total proteins, albumines and globulines was recorded.

  1. Commercial programs' online weight loss claims as compared to results from randomized controlled trials

    PubMed Central

    Vakil, Rachit M.; Chaudhry, Zoobia W.; Doshi, Ruchi S.; Clark, Jeanne M.; Gudzune, Kimberly A.

    2017-01-01

    Objective To characterize weight-loss claims and disclaimers present on websites for commercial weight-loss programs and compare them to results from published randomized controlled trials (RCT). Methods We performed a content analysis of all homepages and testimonials available on the websites of 24 randomly selected programs. Two team members independently reviewed each page and abstracted information from text and images to capture relevant content including demographics, weight loss, and disclaimers. We performed a systematic review to evaluate the efficacy of these programs by searching MEDLINE and Cochrane Database of Systematic Reviews, and abstracted mean weight change from each included RCT. Results Overall, the amount of weight loss portrayed in the testimonials was extreme across all programs examined (range median weight loss 10.7 to 49.5 kg). Only 10 out of the 24 programs had eligible RCTs. Median weight losses reported in testimonials exceeded that achieved by trial participants. Most programs with RCTs (78%) provided disclaimers stating that the testimonial's results were non-typical and/or giving a range of typical weight loss. Conclusion Weight loss claims within testimonials were higher than results from RCTs. Future studies should examine whether commercial programs' advertising practices influence patients' expectations or satisfaction with modest weight loss results. PMID:28865085

  2. Fall and balance outcomes after an intervention to promote leg strength, balance, and walking in people with diabetic peripheral neuropathy: "feet first" randomized controlled trial.

    PubMed

    Kruse, Robin L; Lemaster, Joseph W; Madsen, Richard W

    2010-11-01

    Weight-bearing exercise has been discouraged for people with diabetes mellitus and peripheral neuropathy (DM+PN). However, people with diabetes mellitus and insensate feet have an increased risk of falling. Lower-extremity exercise and balance training reduce fall risk in some older adults. It is unknown whether those with neuropathy experience similar benefits. As part of a study of the effects of weight-bearing exercise on foot ulceration in people with DM+PN, the effects of a lower-extremity exercise and walking intervention on balance, lower-extremity strength (force-generating capacity), and fall incidence were determined. Design The study was an observer-masked, 12-month randomized controlled trial. Part 1 of the intervention took place in physical therapy offices, and part 2 took place in the community. The participants were 79 people who were mostly sedentary, who had DM+PN, and who were randomly assigned to either a control group (n=38) or an intervention group (n=41). Intervention Part 1 included leg strengthening and balance exercises and a graduated, self-monitored walking program; part 2 included motivational telephone calls. Both groups received regular foot care, foot care education, and 8 sessions with a physical therapist. The measurements collected were strength, balance, and participant-reported falls for the year after enrollment. There were no statistically significant differences between the groups for falls during follow-up. At 12 months, there was a small increase in the amount of time that participants in the intervention group could stand on 1 leg with their eyes closed. No other strength or balance measurements differed between the groups. The study was designed to detect differences in physical activity, not falls. The intensity of the intervention was insufficient to improve strength and balance in this population. The training program had a minimal effect on participants' balance and lower-extremity strength. Increasing weight-bearing activity did not alter the rate of falling for participants in the intervention group relative to that for participants in the control group. People who are sedentary and who have DM+PN appear to be able to increase activity without increasing their rate of falling.

  3. To compare growth outcomes and cost-effectiveness of "Kangaroo ward care" with "intermediate intensive care" in stable extremely low birth weight infants: randomized control trial.

    PubMed

    Sharma, Deepak; Murki, Srinivas; Pratap, Oleti Tejo

    2017-07-01

    To compare growth outcome and cost-effectiveness of "Kangaroo ward care" (KWC) with "Intermediate intensive care" (IIC) in stable extremely low birth weight (ELBW) infants. This is secondary analysis of the study and we analyzed 62 ELBW infants, 33 were randomized to KWC and 29 to IIC once the infant reached a weight of 1150 g. Infants in the KWC group were shifted to the Kangaroo ward immediately after randomization and in the IIC group received IIC care till they attain a weight of 1250 g before shifting to Kangaroo ward. The gain in weight (g/day), length (cm/week), and head circumference (cm/week) were comparable between the two groups. The mean weight, length, and head circumference were comparable at term gestational age. The infants in KWC group were shifted five days earlier to Kangaroo ward when compared to IIC group. The cost-effective analysis using "top-down" and "bottom-up" accounting method showed that there was significant reduction of hospital and parents expenditure in KWC group (p < 0.001) with approximate saving of 452 USD for each patient in the KWC group. Early shifting of ELBW infants for KWC is very efficacious and cost-effective intervention when compared to IIC. (CTRI/2014/05/004625).

  4. Early developmental influences on self-esteem trajectories from adolescence through adulthood: Impact of birth weight and motor skills.

    PubMed

    Poole, Kristie L; Schmidt, Louis A; Ferro, Mark A; Missiuna, Cheryl; Saigal, Saroj; Boyle, Michael H; Van Lieshout, Ryan J

    2018-02-01

    While the trajectory of self-esteem from adolescence to adulthood varies from person to person, little research has examined how differences in early developmental processes might affect these pathways. This study examined how early motor skill development interacted with preterm birth status to predict self-esteem from adolescence through the early 30s. We addressed this using the oldest known, prospectively followed cohort of extremely low birth weight (<1000 g) survivors (N = 179) and normal birth weight controls (N = 145) in the world, born between 1977 and 1982. Motor skills were measured using a performance-based assessment at age 8 and a retrospective self-report, and self-esteem was reported during three follow-up periods (age 12-16, age 22-26, and age 29-36). We found that birth weight status moderated the association between early motor skills and self-esteem. Stable over three decades, the self-esteem of normal birth weight participants was sensitive to early motor skills such that those with poorer motor functioning manifested lower self-esteem, while those with better motor skills manifested higher self-esteem. Conversely, differences in motor skill development did not affect the self-esteem from adolescence to adulthood in individuals born at extremely low birth weight. Early motor skill development may exert differential effects on self-esteem, depending on whether one is born at term or prematurely.

  5. The effects of extracorporeal shockwave on acute high-energy long bone fractures of the lower extremity.

    PubMed

    Wang, Ching-Jen; Liu, Hao-Chen; Fu, Te-Hu

    2007-02-01

    High-energy long bone fractures of the lower extremity are at risk of poor fracture healing and high rate of non-union. Extracorporeal shockwave was shown effective to heal non-union of long bone fracture. However, the effect of shockwave on acute fractures is unknown. The purpose of this study was to investigate the effects of shockwave on acute high-energy fractures of the lower extremity. Between January and October 2004, 56 patients with 59 acute high-energy fractures were enrolled in this study. Patients were randomly divided into two groups with 28 patients with 28 fractures in the study group and 28 patients with 31 fractures in the control group. Both groups showed similar age, gender, type of fracture and follow-up time. Patients in the study group received open reduction and internal fixation and shockwave treatment immediately after surgery on odd-numbered days of the week, whereas, patients in the control group received open reduction and internal fixation without shockwave treatment on even-numbered days of the week. Postoperative managements were similarly performed in both groups including crutch walking with non-weight bearing on the affected limb until fracture healing shown on radiographs. The evaluation parameters included clinical assessments of pain score and weight bearing status of the affected leg and serial radiographs at 3, 6 and 12 months. The primary end-point is the rate of non-union at 12 months, and the secondary end point is the rate of fracture healing at 3, 6 and 12 months. At 12 months, the rate of non-union was 11% for the study group versus 20% for the control group (P < 0.001). Significantly, better rate of fracture healing was noted in the study group than the control group at 3, 6 and 12 months (P < 0.001). Extracorporeal shockwave is effective on promoting fracture healing and decreasing the rate of non-union in acute high-energy fractures of the lower extremity.

  6. The case of GWAS of obesity: does body weight control play by the rules?

    PubMed

    Müller, Manfred J; Geisler, Corinna; Blundell, John; Dulloo, Abdul; Schutz, Yves; Krawczak, Michael; Bosy-Westphal, Anja; Enderle, Janna; Heymsfield, Steven B

    2018-05-24

    As yet, genome-wide association studies (GWAS) have not added much to our understanding of the mechanisms of body weight control and of the etiology of obesity. This shortcoming is widely attributed to the complexity of the issues. The appeal of this explanation notwithstanding, we surmise that (i) an oversimplification of the phenotype (namely by the use of crude anthropometric traits) and (ii) a lack of sound concepts of body weight control and, thus, a lack of a clear research focus have impeded better insights most. The idea of searching for polygenetic mechanisms underlying common forms of obesity was born out of the impressive findings made for monogenetic forms of extreme obesity. In the case of common obesity, however, observational studies on normal weight and overweight subjects never provided any strong evidence for a tight internal control of body weight. In addition, empirical studies of weight changes in normal weight and overweight subjects revealed an intra-individual variance that was similar to inter-individual variance suggesting the absence of tight control of body weight. Not least, this lack of coerciveness is reflected by the present obesity epidemic. Finally, data on detailed body composition highlight that body weight is too heterogeneous a phenotype to be controlled as a single entity. In summary GWAS of obesity using crude anthropometric traits have likely been misled by popular heritability estimates that may have been inflated in the first place. To facilitate more robust and useful insights into the mechanisms of internal control of human body weight and, consequently, the genetic basis of obesity, we argue in favor of a broad discussion between scientists from the areas of integrative physiologic and of genomics. This discussion should aim at better conceived studies employing biologically more meaningful phenotypes based on in depth body composition analysis. To advance the scientific community-including the editors of our top journals-needs a re-launch of future GWAS of obesity.

  7. Psychosocial Correlates of Frequent Indoor Tanning among Adolescent Boys

    PubMed Central

    Blashill, Aaron J.

    2012-01-01

    The aim of the current study was to assess psychosocial correlates (i.e., perceived weight, weight control strategies, substance use, and victimization) of frequent indoor tanning in adolescent boys—a group at high risk for developing skin cancer. Participants (N = 7,907) were drawn from a nationally-representative sample of adolescent boys attending high school in the United States. Binary logistic regression revealed that extreme weight control strategies, particularly steroid use (odds ratio = 3.67) and compensatory vomiting (odds ratio = 2.34), along with substance use and victimization, were significantly related to frequent indoor tanning. These results highlight the role of appearance-changing, and health-risk behaviors in the context of frequent indoor tanning. Skin cancer prevention interventions may benefit from adopting approaches that integrate the treatment of body dissatisfaction and subsequent maladaptive behaviors. PMID:23276832

  8. Psychosocial correlates of frequent indoor tanning among adolescent boys.

    PubMed

    Blashill, Aaron J

    2013-03-01

    The aim of the current study was to assess psychosocial correlates (i.e., perceived weight, weight control strategies, substance use, and victimization) of frequent indoor tanning in adolescent boys-a group at high risk for developing skin cancer. Participants (N=7,907) were drawn from a nationally representative sample of adolescent boys attending high school in the United States. Binary logistic regression revealed that extreme weight control strategies, particularly steroid use (odds ratio=3.67) and compensatory vomiting (odds ratio=2.34), along with substance use and victimization, were significantly related to frequent indoor tanning. These results highlight the role of appearance-changing, and health-risk behaviors in the context of frequent indoor tanning. Skin cancer prevention interventions may benefit from adopting approaches that integrate the treatment of body dissatisfaction and subsequent maladaptive behaviors. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Coordination Polymerization of Renewable 3-Methylenecyclopentene with Rare-Earth-Metal Precursors.

    PubMed

    Liu, Bo; Li, Shihui; Wang, Meiyan; Cui, Dongmei

    2017-04-10

    Coordination polymerization of renewable 3-methylenecyclopentene has been investigated for the first time using rare-earth metal-based precursors bearing various bulky ligands. All the prepared complexes catalyze controllable polymerization of 3-methylenecyclopentene into high molecular weight polymers, of which the NPN- and NSN-tridentate non-Cp ligated lutetium-based catalytic systems exhibited extremely high activities up to 11 520 kg/(mol Lu ⋅h) in a dilute toluene solution (3.2 g/100 mL) at room temperature. The resultant polymers have pure 1,4-regioregularity (>99 %) and tailorable number average molecular weights (1-20×10 4 ) with narrow molecular weight distributions (polydispersity index (PDI)=1.45-1.79). DFT simulations were employed to study the polymerization mechanism and stereoregularity control. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Indomethacin prophylaxis or expectant treatment of patent ductus arteriosus in extremely low birth weight infants?

    PubMed

    Cordero, L; Nankervis, C A; Delooze, D; Giannone, P J

    2007-03-01

    Indomethacin prophylaxis or expectant treatment are common strategies for the prevention or management of symptomatic patent ductus arteriosus (sPDA). To compare the clinical responses of extremely low birth weight (ELBW) infants to indomethacin prophylaxis with that of other infants who were managed expectantly by being treated with indomethacin or surgically only after an sPDA was detected. Retrospective cohort investigation of 167 ELBW infants who received indomethacin prophylaxis (study) and 167 ELBW infants (control) treated expectantly who were matched by year of birth (1999 to 2006), birth weight, gestational age (GA) and gender. Mothers of the two groups of infants were comparable demographically and on the history of preterm labor, pre-eclampsia, antepartum steroids and cesarean delivery. Study and control infants were similar in birth weight, GA, low 5 min Apgar scores, surfactant administration, the need for arterial blood pressure control, bronchopulmonary dysplasia and neonatal mortality. Necrotizing enterocolitis, spontaneous intestinal perforations, intraventricular hemorrhage grade III to IV, periventricular leukomalacia and stage 3 to 5 retinopathy of prematurity occurred also with similar frequency in both groups of infants. In the indomethacin prophylaxis group, 29% of the infants developed sPDA, and of them 38% responded to indomethacin treatment. In the expectantly treated group, 37% developed sPDA, and of them 59% responded to indomethacin treatment. Overall, surgical ligation rate for sPDA was similar between both groups of patients. In our experience, indomethacin prophylaxis does not show any advantages over expectant early treatment on the management of sPDA in ELBW infants. Although no deleterious effects were observed, prophylaxis exposed a significant number of infants who may have never developed sPDA, to potential indomethacin-related complications.

  11. Compelled Body Weight Shift Technique to Facilitate Rehabilitation of Individuals with Acute Stroke

    PubMed Central

    Mohapatra, Sambit; Eviota, Aileen C.; Ringquist, Keir L.; Muthukrishnan, Sri Ranjini; Aruin, Alexander S.

    2014-01-01

    Background The study evaluates the effectiveness of Compelled Body Weight Shift (CBWS) approach in the rehabilitation of individuals with stroke. CBWS involves a forced shift of body weight towards a person’s affected side by means of a shoe insert that establishes a lift of the nonaffected lower extremity. Methods Eleven patients with acute stroke were randomly assigned to experimental and control groups. The experimental group received a two-week conventional physical therapy combined with CBWS and the control group received only a two-week conventional therapy. Weight bearing, Gait velocity, Berg’s Balance, and Fugl-Meyer’s Scores were recorded before and after the intervention. Results Weight bearing on the affected side increased in the experimental group and decreased in the control group. The increase in gait velocity with treatment was significant in both the groups (P < 0.05). However, experimental group (P = 0.01) demonstrated larger improvements in gait velocity compared to the control group (P = 0.002). Berg Balance and Fugl-Meyer scores increased for both the groups. Conclusion The implementation of a two-week intervention with CBWS resulted in the improvement in weight bearing and gait velocity of individuals with acute stroke. The present preliminary study suggests that CBWS technique could be implemented as an adjunct to conventional rehabilitation program for individuals with acute stroke. PMID:25530888

  12. [Advances in medical care for extremely low birth weight infants worldwide].

    PubMed

    Chen, Chun; Zhang, Qian-Shen

    2013-08-01

    Dramatic advances in neonatal medicine over recent decades have resulted in decreased mortality and morbidity rates for extremely low birth weight infants. However, the survival of these infants is associated with short- and long-term morbidity, including severe intraventricular hemorrhage, periventricular leukomalacia, nosocomial infection and necrotizing enterocolitis, bronchopulmonary dysplasia, retinopathy of prematurity and adverse long-term neurodevelopmental sequelae. This article reviewed the latest advances in the medical care for extremely low birth weight infants including survival rate, ethical issues and short- and long-term morbidity, domestically and abroad.

  13. Adiposity and Physical Activity Are Not Related to Academic Achievement in School-Aged Children

    PubMed Central

    LeBlanc, Monique M.; Martin, Corby K.; Han, Hongmei; Newton, Robert; Sothern, Melinda; Webber, Larry S.; Davis, Allison B.; Williamson, Donald A.

    2012-01-01

    Objective To investigate the hypotheses that in elementary school students: 1) adiposity and academic achievement are negatively correlated and 2) physical activity and academic achievement are positively correlated. Method Participants were 1963 children in fourth through sixth grades. Adiposity was assessed by calculating body mass index (BMI) percentile and percent body fat and academic achievement with statewide standardized tests in four content areas. Socioeconomic status and age were control variables. A subset of participants (n = 261) wore an accelerometer for three days to provide objective measurement of physical activity. Additionally, the association between weight status and academic achievement was examined by comparing children who could be classified as “extremely obese” and the rest of the sample, as well as comparing children who could be classified as normal weight, overweight, or obese. Extreme obesity was defined as >= 1.2 times the 95th percentile. Results Results indicated that there were no significant associations between adiposity or physical activity and achievement in students. No academic achievement differences were found between children with BMI percentiles within the extreme obesity range and those who did not fall within the extreme obesity classification. Additionally, no academic achievement differences were found for children with BMI percentiles within the normal weight, overweight, or obese ranges. Conclusion These results do not support the hypotheses that increased adiposity is associated with decreased academic achievement or that greater physical activity is related to improved achievement. However, these results are limited by methodological weaknesses, especially the use of cross-sectional data. PMID:22617499

  14. Behavior Disorders in Extremely Preterm/Extremely Low Birth Weight Children in Kindergarten

    PubMed Central

    Scott, Megan N.; Taylor, H. Gerry; Fristad, Mary A.; Klein, Nancy; Espy, Kimberly Andrews; Minich, Nori; Hack, Maureen

    2012-01-01

    Objective To examine the prevalence of behavior disorders in a 2001–2003 birth cohort of extremely preterm/extremely low birth weight (EPT/ELBW, <28 weeks gestational age and/or <1000 g) children in kindergarten. Method We compared 148 EPT/ELBW children to 111 term-born normal birth weight (NBW) classmate controls on reports of psychiatric symptoms obtained from parent interview (P-ChIPS), parent and teacher ratings of behavior (CBCL, TRF, BRIEF), and teacher ratings of social functioning (SSBS-2). Associations of behavior disorders with global cognitive ability and tests of executive function were also examined within the EPT/ELBW group. Results Rates of ADHD Combined on psychiatric interview were about twice as high for the EPT/ELBW group than for the NBW group, OR (95% CI)=2.50 (1.34, 4.68), p=.004. The EPT/ELBW group also had much higher rates of teacher-identified disorders in attention, behavior self-regulation, and social functioning, with odds ratios (95% confidence intervals) ranging from 3.35 (1.64, 6.83) to 18.03 (4.12, 78.94), all p’s<.01. ADHD and impaired behavior self-regulation were associated with deficits on tests of executive function but not with global cognitive impairment. Conclusions The findings document elevated rates of disorders in attention, behavior self-regulation, and socialization in EPT/ELBW children and suggest that deficits on tests of executive function are associated with some of these disorders. Early identification and intervention for these disorders are needed to promote early adjustment to school and facilitate learning progress. PMID:22245934

  15. Adolescent smoking, weight changes, and binge-purge behavior: associations with secondary amenorrhea.

    PubMed

    Johnson, J; Whitaker, A H

    1992-01-01

    The association of secondary amenorrhea with extreme forms of substance use, weight control, and exercise in nonrepresentative samples raises questions as to whether adolescents in the general population who engage in these behaviors are at increased risk for secondary amenorrhea. We examined the prevalence and behavioral correlates of secondary amenorrhea in a county-wide high school population of 2544 girls aged 13 to 18. A survey questionnaire, which elicited menstrual history as well as weight history, weight control practices, level of exercise, and use of cigarettes, wine, and beer, was administered during school hours; absentees were also surveyed. The completion rate was 91%. The 1-year prevalence of secondary amenorrhea was 8.5%. Secondary amenorrhea was associated with smoking one or more packs of cigarettes per day (adjusted relative risk [RRa] = 1.96, 1.21-3.10), with multiple binge-eating behaviors in combination with laxative use or self-induced vomiting (RRa = 4.17, 2.54-6.32), and with weight fluctuation due to weight control (RRa = 2.59, 1.33-4.79). There was no association between amenorrhea and alcohol consumption or exercise level. Estimates of attributable risk are provided and indicate that bulimic behaviors and cigarette smoking may result in a considerable excess of cases of secondary amenorrhea in an adolescent population.

  16. High frequencies of elevated alkaline phosphatase activity and rickets exist in extremely low birth weight infants despite current nutritional support

    USDA-ARS?s Scientific Manuscript database

    Osteopenia and rickets are common among extremely low birth weight infants (ELBW, <1000 g birth weight) despite current practices of vitamin and mineral supplementation. Few data are available evaluating the usual course of markers of mineral status in this population. Our objectives in this study w...

  17. Gluconeogenesis is not regulated by either glucose or insulin in extremely low birth weight infants receiving total parenteral nutrition

    USDA-ARS?s Scientific Manuscript database

    The objective was to determine potential factors regulating gluconeogenesis (GNG) in extremely low birth weight infants receiving total parenteral nutrition. Seven infants (birth weight, 0.824 +/- 0.068 kg; gestational age, 25.4 +/- 0.5 weeks; postnatal age, 3.3 +/- 0.2 days) were studied for 11 hou...

  18. Exploring gender differences in the link between weight suppression and eating pathology.

    PubMed

    Burnette, C Blair; Simpson, Courtney C; Mazzeo, Suzanne E

    2017-12-01

    Weight suppression (WS), the difference in one's highest weight (excluding pregnancy) and current weight at current height, is associated with the onset of eating disorders. Previous research has explored the influence of WS in predominantly clinical, female samples. However, the transition to college is a particularly high-risk time for weight gain and the development of eating pathology and men with eating disorders often have higher premorbid weights. This study investigated the associations of WS and dimensions of eating pathology in an undergraduate sample (N=859) and examined the effect of gender. Results demonstrated that higher levels of WS were associated with more dietary restraint (p=0.004) and more frequent purging behaviors (p<0.001); WS was indirectly related to loss-of-control eating through dietary restraint for both men and women (p<0.001). Additionally, men with higher WS were more likely to engage in extreme weight control behaviors, such as vomiting and laxative abuse (p=0.036). Findings suggest that weight history might be especially important to assess in men at risk for disordered eating. This approach might be particularly beneficial with college students due to their heightened risk of eating and weight disturbances. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Quantitative trait loci that control body weight in DDD/Sgn and C57BL/6J inbred mice.

    PubMed

    Suto, Jun-Ichi; Kojima, Misaki

    2017-02-01

    Inbred DDD/Sgn mice are heavier than inbred C57BL/6J mice. In the present study, we performed quantitative trait loci (QTL) mapping for body weight using R/qtl in reciprocal F 2 male populations between the two strains. We identified four significant QTL on Chrs 1, 2, 5, and 17 (proximal region). The DDD/Sgn allele was associated with increased body weight at QTL on Chrs 1 and 5, and the DDD/Sgn allele was associated with decreased body weight at QTL on Chrs 2 and 17. A multiple regression analysis indicated that the detected QTL explain 30.94 % of the body weight variation. Because DDD/Sgn male mice have extremely high levels of circulating testosterone relative to other inbred mouse strains, we performed QTL mapping for plasma testosterone level to examine the effect of testosterone levels on body weight. We identified one suggestive QTL on Chr 5, which overlapped with body weight QTL. The DDD/Sgn allele was associated with increased testosterone level. Thus, we confirmed that there was a genetic basis for the changes in body weight and testosterone levels in male mice. These findings provide insights into the genetic mechanism by which body weight is controlled in male mice.

  20. Prevalence of Neck and Back Pain amongst Aircrew at the Extremes of Anthropometric Measurements

    DTIC Science & Technology

    2012-09-06

    of these safety systems, with potential to exceed the designed upper load limits. Current ergonomics assessments use the 1988 National Health and...position in UH-60 Long goggle flights NVG weight- neck sore. Long hours in poorly designed seats ; helmet/ NVGs and hours of manipulating control...landing Long hours in poorly designed seats ; helmet/ NVGs and hours of manipulating control display units in glass cockpits Repetitive use Poor ramp

  1. [Controlled weight bearing after osteosynthesis].

    PubMed

    Perren, T; Matter, P

    1993-01-01

    Patient compliance with postoperative partial weight bearing can be a difficult management problem. The problem may be intentional or unintentional. There is no objective way to assess the amount of weight placed on the lower extremity by the patient. It is our clinical suspicion that patients place more weight than is desirable on the effected limb. There are few reports in the literature on this topic. One study has confirmed our suspicion of poor patient compliance with postoperative weight bearing. Our goal is to develop a system to accurately assess weight bearing and to improve this aspect of postoperative fracture care. Through an active feedback device we hope to improve patient education and understanding. We plan to study the clinical applications of using a pressure sensitive shoe insert device. Our ultimate goal is to improve upon the present device and to study the clinical application of there use.

  2. Diet and weight changes of female bodybuilders before and after competition.

    PubMed

    Walberg-Rankin, J; Edmonds, C E; Gwazdauskas, F C

    1993-03-01

    This study assessed nutritional and body weight patterns in 6 female bodybuilders approximately a month before and after a competition. The women kept dietary and body weight records and two of them also agreed to collect morning urine samples to provide information about their menstrual cycle. All women lost weight before and gained weight after competition. Energy intake was modestly restricted and the subjects consumed a moderate-protein, low-fat, high-carbohydrate diet just prior to competition. Energy intake doubled, and total grams of fat increased approximately tenfold just after competition. Urinary data indicated that the cycle following competition was prolonged, with reduced reproductive hormone concentrations. In summary, the women practiced extreme dietary control while preparing for a competition but followed the event with a higher energy and fat intake. These changes in diet and body weight may contribute to the disturbances previously observed in the menstrual cycle of these athletes.

  3. Is early weight bearing resumption beneficial after total hip replacement?

    PubMed

    Merle, J; Rougier, P; Belaid, D; Cantalloube, S; Lamotte, D

    2009-04-01

    Current rehabilitation protocols of patients following total hip replacement recommend weight bearing on the operated extremity as early as possible. This strategy is likely to induce specific consequences on postural balance control; this study seeks to highlight these reactions to early loading. Eight men and six women, ranging in age from 57 to 85 years, volunteered enrolling this study on their arrival at our rehabilitation center. This study assessed their postural behavior using a system composed of two separate force platforms under two loading situations; in the course of these tests they were required to minimize their body sway as much as possible by keeping their eyes open. In the natural uncontrolled situation, the subjects adopted a comfortable body weight distribution. In the imposed (IMP) situation, they had to load their operated extremity more than in regular natural conditions in order to distribute their body weight more evenly. Three successive 32-s trials (sampled at 64 Hz) with intermediate recovery periods of equivalent duration were performed allowing period of rest between each trial. The balance strategies were evaluated through a frequency analysis of the resultant and plantar centers of pressure (CP(Res)) of each foot and of the estimated trajectories of the vertical projection of the center of gravity (CG), and from the difference CP(Res)-CG. No difference was found for the plantar CP trajectories in the situation where body weight is spontaneously distributed, whereas loading the implanted extremity induced increased CP(Res), CG, and CP(Res)-CG trajectory amplitudes along the mediolateral axis. No effect was observed along the anteroposterior axis. Finally, when comparing the two limbs for each testing condition, the statistical analysis demonstrated greater displacements along the ML axis for the trajectories measured under the healthy leg than under the implanted extremity. Loading the operated extremity early in the rehabilitation process leads to less stability (an increase in the CG movements) and to increased energy expenditure (an increase in the CP(Res)-CG movements). These postural behavior alterations can be explained by various factors including a loss of muscle strength, residual apprehension due to the disuse of this limb, and persistent pain, all of which are increased by limb loading. These features should be taken into consideration when elaborating the rehabilitation protocol for these patients.

  4. Nutrition Facts Use in Relation to Eating Behaviors and Healthy and Unhealthy Weight Control Behaviors.

    PubMed

    Christoph, Mary J; Loth, Katie A; Eisenberg, Marla E; Haynos, Ann F; Larson, Nicole; Neumark-Sztainer, Dianne

    2018-03-01

    Investigate the relationship between use of Nutrition Facts labels on packaged foods and weight-related behaviors. Cross-sectional survey in 2015-2016. Young adult respondents (n = 1,817; 57% women; average age 31.0 ± 1.6 years) to the Project Eating and Activity in Teens and Young Adults-IV survey, the fourth wave of a longitudinal cohort study. Use of Nutrition Facts labels on packaged foods; healthy, unhealthy, and extreme weight control behaviors; intuitive eating; binge eating. Linear and logistic regression models were adjusted for age, ethnicity/race, education, income, and weight status. In women, greater Nutrition Facts use was associated with a 23% and 10% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a 17% greater chance of engaging in binge eating. In men, greater label use was associated with a 27% and 17% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a lower level of intuitive eating. Professionals advising patients and clients on weight management may consider possible gender differences in response to weight loss and management guidance. Since label use was related to engagement in some unhealthy behaviors in addition to healthy behaviors, it is important to consider how individuals may use labels, particularly those at risk for, or engaging in, disordered eating behaviors. Future research investigating potential relationships between Nutrition Facts use, intuitive eating, and binge eating is needed. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  5. Overweight perception: associations with weight control goals, attempts and practices among Chinese female college students

    PubMed Central

    Tanenbaum, Hilary C.; Felicitas, Jamie Q.; Li, Yawen; Tobias, Malaika; Chou, Chih-Ping; Palmer, Paula H.; Spruijt-Metz, Donna; Reynolds, Kim D.; Johnson, C. Anderson; Xie, Bin

    2015-01-01

    Background Concurrent with the dramatic cultural and economic shifts occurring as Mainland China becomes increasingly “Westernized,” the weight perceptions, ideal body weight, and weight management goals and practices of Chinese females have also undergone significant changes. Objective To investigate relationships between overweight status, weight perception patterns, and weight management goals and practices in Chinese female college students. Design/Participants/Setting A cross-sectional analysis was conducted with data from 902 female subjects aged 18 to 25 years participating in the China Seven Cities Study, a health promotion and smoking prevention study conducted in Mainland China in 2003. Main Outcome Measures/ Statistical Analyses Logistic regression models were used to explore associations between overweight status, weight perception, specific weight management goals and practices, and current levels of vigorous-intensity physical activity and food consumption. Results Based on World Health Organization standards for Asian adults, 16.7% of college females were overweight or obese, although 50.8% considered themselves to be “too heavy.” Among participants perceiving themselves as overweight (n=458), 69.2% (n=371) were inaccurate, and did not meet criteria for overweight or obese. The percentage of participants attempting weight loss was 48.2%, and 33.1% wanted to maintain their current weight. Attempts to lose or maintain weight were related to actual and perceived weight status, but not to increased vigorous-intensity physical activity or fruit and vegetable intake, nor to decreased consumption of sweets, soda, Western fast foods and fried foods. Only 21.5% of participants desiring weight loss or maintenance reported using a combination of vigorous-intensity physical activity and a reduced fat and calorie diet, while 20.2% tried extreme methods such as fasting, using diet pills, vomiting, or smoking. Conclusions Our findings underscore the need to promote healthy weight management practices among Chinese female college students, with an emphasis on diet and physical activity strategies that encourage balance rather than extremes. PMID:26260670

  6. Overweight Perception: Associations with Weight Control Goals, Attempts, and Practices among Chinese Female College Students.

    PubMed

    Tanenbaum, Hilary C; Felicitas, Jamie Q; Li, Yawen; Tobias, Malaika; Chou, Chih-Ping; Palmer, Paula H; Spruijt-Metz, Donna; Reynolds, Kim D; Anderson Johnson, C; Xie, Bin

    2016-03-01

    Concurrent with the dramatic cultural and economic shifts occurring as mainland China becomes increasingly "Westernized," the weight perceptions, ideal body weight, and weight management goals and practices of Chinese females have also undergone significant changes. To investigate relationships between overweight status, weight perception patterns, and weight management goals and practices in Chinese female college students. A cross-sectional analysis was conducted with data from 902 female subjects aged 18 to 25 years participating in the China Seven Cities Study, a health promotion and smoking prevention study conducted in mainland China in 2003. Logistic regression models were used to explore associations between overweight status, weight perception, specific weight management goals and practices, and current levels of vigorous-intensity physical activity and food consumption. Based on World Health Organization standards for Asian adults, 16.7% of college females were overweight or obese, although 50.8% considered themselves to be "too heavy." Among participants perceiving themselves as overweight (n=458), 69.2% (n=371) were inaccurate and did not meet criteria for overweight or obese. The percentage of participants attempting weight loss was 48.2%, and 33.1% wanted to maintain their current weight. Attempts to lose or maintain weight were related to actual and perceived weight status, but not to increased vigorous-intensity physical activity or fruit and vegetable intake, nor to decreased consumption of sweets, soda, Western fast foods, and fried foods. Only 21.5% of participants desiring weight loss or maintenance reported using a combination of vigorous-intensity physical activity and a reduced-fat and -calorie diet, whereas 20.2% tried extreme methods such as fasting, using diet pills, vomiting, or smoking. Our findings underscore the need to promote healthy weight management practices among Chinese female college students, with an emphasis on diet and physical activity strategies that encourage balance rather than extremes. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  7. A novel tool for continuous fracture aftercare - Clinical feasibility and first results of a new telemetric gait analysis insole.

    PubMed

    Braun, Benedikt J; Bushuven, Eva; Hell, Rebecca; Veith, Nils T; Buschbaum, Jan; Holstein, Joerg H; Pohlemann, Tim

    2016-02-01

    Weight bearing after lower extremity fractures still remains a highly controversial issue. Even in ankle fractures, the most common lower extremity injury no standard aftercare protocol has been established. Average non weight bearing times range from 0 to 7 weeks, with standardised, radiological healing controls at fixed time intervals. Recent literature calls for patient-adapted aftercare protocols based on individual fracture and load scenarios. We show the clinical feasibility and first results of a new, insole embedded gait analysis tool for continuous monitoring of gait, load and activity. Ten patients were monitored with a new, independent gait analysis insole for up to 3 months postoperatively. Strict 20 kg partial weight bearing was ordered for 6 weeks. Overall activity, load spectrum, ground reaction forces, clinical scoring and general health data were recorded and correlated. Statistical analysis with power analysis, t-test and Spearman correlation was performed. Only one patient completely adhered to the set weight bearing limit. Average time in minutes over the limit was 374 min. Based on the parameters load, activity, gait time over 20 kg weight bearing and maximum ground reaction force high and low performers were defined after 3 weeks. Significant difference in time to painless full weight bearing between high and low performers was shown. Correlation analysis revealed a significant correlation between weight bearing and clinical scoring as well as pain (American Orthopaedic Foot and Ankle Society (AOFAS) Score rs=0.74; Olerud-Molander Score rs=0.93; VAS pain rs=-0.95). Early, continuous gait analysis is able to define aftercare performers with significant differences in time to full painless weight bearing where clinical or radiographic controls could not. Patient compliance to standardised weight bearing limits and protocols is low. Highly individual rehabilitation patterns were seen in all patients. Aftercare protocols should be adjusted to real-time patient conditions, rather than fixed intervals and limits. With a real-time measuring device high performers could be identified and influenced towards optimal healing conditions early, while low performers are recognised and missing healing influences could be corrected according to patient condition. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. 14 CFR 23.203 - Turning flight and accelerated turning stalls.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... § 23.201(b), it must be possible to regain wings level flight by normal use of the flight controls, but... percent of maximum continuous power results in extreme nose-up attitudes, the test may be carried out with..., if the power-to-weight ratio at 75 percent of maximum continuous power results in nose-high attitudes...

  9. Eating Disorder Symptomotology: The Role of Ethnic Identity in Caucasian and Hispanic College Women

    ERIC Educational Resources Information Center

    Avina, Vanessa

    2011-01-01

    A relative large number of women on college campuses report experiencing eating afflictions. About 61% of college women indicated that they either occasionally or regularly used extreme measures to control their weight (Mintz & Betz, 1988). No clear consensus on the relative prevalence of eating disorder symptoms across ethnic groups has…

  10. Development of the Junkers-diesel Aircraft Engine

    NASA Technical Reports Server (NTRS)

    Gasterstadt,

    1930-01-01

    The working process of the Junkers engine has resulted from a series of attempts to attain high performance and to control the necessarily rapid and complete combustion at extremely high speeds. The two main problems of Diesel engines in aircraft are addressed; namely, incomplete combustion and the greater weight of Diesel engine parts compared to gasoline engines.

  11. Effects of high versus standard early protein intake on growth of extremely low birth weight infants.

    PubMed

    Maggio, Luca; Cota, Francesco; Gallini, Francesca; Lauriola, Valeria; Zecca, Chiara; Romagnoli, Costantino

    2007-01-01

    Early provision of protein has been shown to limit catabolism and could improve growth. Our objective was to determine whether early aggressive protein intake improved growth outcomes of extremely low birth weight (ELBW) infants. ELBW infants were included in the study if they had no major congenital anomalies or renal failure and were still hospitalized at 36 weeks postmenstrual age. In 25 infants (HP) the early protein intake was planned to be 20% greater than in 31 historical controls (SP). The 2 groups were similar in the baseline characteristics. The mean protein intake during the first 14 days of life was significantly greater in the HP group (3.1 +/- 0.2 vs 2.5 +/- 0.2 g/kg/d; P<0.0001). HP group showed lower postnatal weight loss (-3.1%; 95% confidence interval [CI] -5.9, -0.2) and earlier regain of birth weight (-4.1 days; 95% CI -6.6, -1.7). Mean blood urea nitrogen and bicarbonate levels were similar; mean serum glucose level was lower in the HP group (-21,7 mg/dL; 95% CI -41.9,-1.5). HP infants had a reduced fall in weight z score (-0.57; 95% CI -1.01, -0.12) and in length z score (-0.51; 95% CI -0.97, -0.05) from birth to discharge. Early high protein intake was associated with improved weight and length growth outcomes at discharge. These findings highlight the benefits of aggressive protein intake immediately after birth.

  12. Understanding bulimia.

    PubMed

    Hay, Phillipa J

    2007-09-01

    Bulimia nervosa (BN) and related eating disorders such as binge eating disorder are common. General practitioners can play a key role in the identification and management of BN and related eating disorders. This article describes the presenting and associated features of BN and overviews evidence based treatment approaches. Key features are recurrent episodes of binge eating, extreme weight control behaviours and over concern about weight and shape issues. By definition people are not underweight. Risk factors include being from a western culture, obesity, exposure to a restrictive dieting environment and low self esteem. People are more likely to present asking for help in weight control or a physical problem secondary to the eating disorder. Evidenced based therapies with good outcomes in current use are cognitive behaviour therapy (in full or guided self help forms), high dose fluoxetine, and interpersonal psychotherapy. It is important to convey optimism about treatment efficacy and outcomes.

  13. Ghrelin gene: identification of missense variants and a frameshift mutation in extremely obese children and adolescents and healthy normal weight students.

    PubMed

    Hinney, Anke; Hoch, Anne; Geller, Frank; Schäfer, Helmut; Siegfried, Wolfgang; Goldschmidt, Hanspeter; Remschmidt, Helmut; Hebebrand, Johannes

    2002-06-01

    Ghrelin induces obesity via central and peripheral mechanisms. Administration of ghrelin leads to increased food intake and decreased fat utilisation in rodents. Ghrelin levels are decreased in obese individuals. Recently, a polymorphism (Arg-51-Gln) within the ghrelin gene (GHRL) was described to be associated with obesity. We screened the GHRL coding region in 215 extremely obese German Children and adolescents (study group 1) and 93 normal weight students (study group 2) by single strand conformation polymorphism analysis (SSCP). We found the two previously described single nucleotide polymorphisms (SNP: Arg-51-Gln and Leu-72-Met) in similar frequencies in study groups 1 and 2 (allele frequencies were: 0.019 and 0.016 for the 51-Gln allele and 0.091 and 0.086 for the 72-Met allele, respectively). Hence, we could not confirm the previous finding. Additionally, two novel variants were identified within the coding region: (1) We detected one healthy normal weight individual with a frameshift mutation (2bp deletion at codon 34). This frameshift mutation affects the coding region of the mature ghrelin. Hence, it is highly likely that the normal weight student is haplo-insufficient for ghrelin. (2) An A to T transversion leads to an amino acid exchange from Gln to Leu at amino acid position 90. The frequency of the 90-Leu allele was significantly higher in the extremely obese children and adolescents (0.063) than in the normal weight students (0.016; nominal p = 0.011). Additionally, we genotyped 134 underweight students and 44 normal weight adults for this SNP. Genotype frequencies were similar in extremely obese children and adolescents, underweight students and normal weight adults (p > 0.8). In conclusion, we identified four sequence variants in the coding region of the ghrelin gene in individuals belonging to different weight extremes. A frameshift mutation was detected in a normal weight individual. None of the variants seem to influence weight regulation.

  14. Early-Onset Invasive Candidiasis in Extremely Low Birth Weight Infants: Perinatal Acquisition Predicts Poor Outcome.

    PubMed

    Barton, Michelle; Shen, Alex; O'Brien, Karel; Robinson, Joan L; Davies, H Dele; Simpson, Kim; Asztalos, Elizabeth; Langley, Joanne; Le Saux, Nicole; Sauve, Reginald; Synnes, Anne; Tan, Ben; de Repentigny, Louis; Rubin, Earl; Hui, Chuck; Kovacs, Lajos; Yau, Yvonne C W; Richardson, Susan E

    2017-04-01

    Neonatal invasive candidiasis (IC) presenting in the first week of life is less common and less well described than later-onset IC. Risk factors, clinical features, and disease outcomes have not been studied in early-onset disease (EOD, ≤7 days) or compared to late-onset disease (LOD, >7 days). All extremely low birth weight (ELBW, <1000 g) cases with IC and controls from a multicenter study of neonatal candidiasis enrolled from 2001 to 2003 were included in this study. Factors associated with occurrence and outcome of EOD in ELBW infants were determined. Forty-five ELBW infants and their 84 matched controls were included. Fourteen (31%) ELBW infants had EOD. Birth weight <750 g, gestation <25 weeks, chorioamnionitis, and vaginal delivery were all strongly associated with EOD. Infection with Candida albicans, disseminated disease, pneumonia, and cardiovascular disease were significantly more common in EOD than in LOD. The EOD case fatality rate (71%) was higher than in LOD (32%) or controls (15%) (P = .0001). The rate of neurodevelopmental impairment and mortality combined was similar in EOD (86%) and LOD (72%), but higher than in controls (32%; P = .007). ELBW infants with EOD have a very poor prognosis compared to those with LOD. The role of perinatal transmission in EOD is supported by its association with chorioamnionitis, vaginal delivery, and pneumonia. Dissemination and cardiovascular involvement are common, and affected infants often die. Empiric treatment should be considered for ELBW infants delivered vaginally who have pneumonia and whose mothers have chorioamnionitis or an intrauterine foreign body. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  15. Body image and weight control in South Africans 15 years or older: SANHANES-1.

    PubMed

    Mchiza, Zandile J; Parker, Whadi-Ah; Makoae, Mokhantso; Sewpaul, Ronel; Kupamupindi, Takura; Labadarios, Demetre

    2015-09-30

    South African studies have suggested that differences in obesity prevalence between groups may be partly related to differences in body image and body size dissatisfaction. However, there has never been a national study that measured body image and its relationship to weight control in the country. Hence, the main aim of the study was to examine body image in relation to body mass index and weight control in South Africa. A cross-sectional survey and a secondary analyses of data were undertaken for 6 411 South Africans (15+ years) participating in the first South African National Health and Nutrition Examination Survey. Body image was investigated in relation to weight status and attempts to lose or gain weight. Data were analysed using STATA version 11.0. Descriptive statistics are presented as counts (numbers), percentages, means, standard error of means, and 95 % confidence intervals. Any differences in values were considered to be significantly different if the confidence intervals did not overlap. Overall, 84.5 % participants had a largely distorted body image and 45.3 % were highly dissatisfied about their body size. Overweight and obese participants under estimated their body size and desired to be thinner. On the other hand, normal- and under-weight participants over estimated their body size and desired to be fatter. Only 12.1 and 10.1 % of participants attempted to lose or gain weight, respectively, mainly by adjusting dietary intake and physical activity. Body mass index appears to influence body image and weight adjustment in South Africa. South Africans at the extreme ends of the body mass index range have a largely distorted body image and are highly dissatisfied by it. This suggests a need for health education and beneficial weight control strategies to halt the obesity epidemic in the country.

  16. Nonsurgical weight loss for extreme obesity in primary care settings: results of the Louisiana Obese Subjects Study.

    PubMed

    Ryan, Donna H; Johnson, William D; Myers, Valerie H; Prather, Tiffany L; McGlone, Meghan M; Rood, Jennifer; Brantley, Phillip J; Bray, George A; Gupta, Alok K; Broussard, Alan P; Barootes, Bryan G; Elkins, Brian L; Gaudin, David E; Savory, Robert L; Brock, Ricky D; Datz, Geralyn; Pothakamuri, Srininvasa R; McKnight, G Tipton; Stenlof, Kaj; Sjöström, Lars V

    2010-01-25

    Effective primary care practice (PCP) treatments are needed for extreme obesity. The Louisiana Obese Subjects Study (LOSS) tested whether, with brief training, PCPs could effectively implement weight loss for individuals with a body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) of 40 to 60. The LOSS, a 2-year (July 5, 2005, through January 30, 2008) randomized, controlled, "pragmatic clinical trial" trained 7 PCPs and 1 research clinic in obesity management. Primary outcome measure was year-2 percentage change from baseline weight. Volunteers (597) were screened and randomized to intensive medical intervention (IMI) (n = 200) or usual care condition (UCC) (n = 190). The UCC group had instruction in an Internet weight management program. The IMI group recommendations included a 900-kcal liquid diet for 12 weeks or less, group behavioral counseling, structured diet, and choice of pharmacotherapy (sibutramine hydrochloride, orlistat, or diethylpropion hydrochloride) during months 3 to 7 and continued use of medications and maintenance strategies for months 8 to 24. The mean age of participants was 47 years; 83% were women, and 75% were white. Retention rates were 51% for the IMI group and 46% for the UCC group (P = .30). After 2 years, the results were as follows: (1) among 390 randomized participants, 31% in the IMI group achieved a 5% or more weight loss and 7% achieved a 20% weight loss or more, compared with 9% and 1% of those in the UCC group. (2) The mean +/- SEM baseline observation carried forward analysis showed a weight loss of -4.9% +/- 0.8% in IMI and -0.2 +/- 0.3% in UCC. (3) Last observation carried forward analysis showed a weight loss of -8.3% +/- 0.79% for IMI, whereas UCC was -0.0% +/- 0.4%. (4) A total of 101 IMI completers lost -9.7% +/- 1.3% (-12.7 +/- 1.7 kg), whereas 89 UCC completers lost -0.4% +/- 0.7% (-0.5 +/- 0.9 kg); (P < .001 for all group differences). Many metabolic parameters improved. Primary care practices can initiate effective medical management for extreme obesity; future efforts must target improving retention and weight loss maintenance. clinicaltrials.gov Identifier: NCT00115063.

  17. The contribution of visual processing to academic achievement in adolescents born extremely preterm or extremely low birth weight.

    PubMed

    Molloy, Carly S; Di Battista, Ashley M; Anderson, Vicki A; Burnett, Alice; Lee, Katherine J; Roberts, Gehan; Cheong, Jeanie Ly; Anderson, Peter J; Doyle, Lex W

    2017-04-01

    Children born extremely preterm (EP, <28 weeks) and/or extremely low birth weight (ELBW, <1000 g) have more academic deficiencies than their term-born peers, which may be due to problems with visual processing. The aim of this study is to determine (1) if visual processing is related to poor academic outcomes in EP/ELBW adolescents, and (2) how much of the variance in academic achievement in EP/ELBW adolescents is explained by visual processing ability after controlling for perinatal risk factors and other known contributors to academic performance, particularly attention and working memory. A geographically determined cohort of 228 surviving EP/ELBW adolescents (mean age 17 years) was studied. The relationships between measures of visual processing (visual acuity, binocular stereopsis, eye convergence, and visual perception) and academic achievement were explored within the EP/ELBW group. Analyses were repeated controlling for perinatal and social risk, and measures of attention and working memory. It was found that visual acuity, convergence and visual perception are related to scores for academic achievement on univariable regression analyses. After controlling for potential confounds (perinatal and social risk, working memory and attention), visual acuity, convergence and visual perception remained associated with reading and math computation, but only convergence and visual perception are related to spelling. The additional variance explained by visual processing is up to 6.6% for reading, 2.7% for spelling, and 2.2% for math computation. None of the visual processing variables or visual motor integration are associated with handwriting on multivariable analysis. Working memory is generally a stronger predictor of reading, spelling, and math computation than visual processing. It was concluded that visual processing difficulties are significantly related to academic outcomes in EP/ELBW adolescents; therefore, specific attention should be paid to academic remediation strategies incorporating the management of working memory and visual processing in EP/ELBW children.

  18. Performance Evaluation of an Automotive-Grade, High Speed Gate Driver for SiC FETs, Type UCC27531, Over a Wide Temperature Range

    NASA Technical Reports Server (NTRS)

    Boomer, Kristen; Hammoud, Ahmad

    2015-01-01

    Silicon carbide (SiC) devices are becoming widely used in electronic power circuits as replacement for conventional silicon parts due to their attractive properties that include low on-state resistance, high temperature tolerance, and high frequency operation. These attributes have a significant impact by reducing system weight, saving board space, and conserving power. In this work, the performance of an automotive-grade high speed gate driver with potential use in controlling SiC FETs (field-Effect Transistors) in converters or motor control applications was evaluated under extreme temperatures and thermal cycling. The investigations were carried out to assess performance and to determine suitability of this device for use in space exploration missions under extreme temperature conditions.

  19. Self-Reported Adolescent Health Status of Extremely Low Birth Weight Children Born 1992–1995

    PubMed Central

    Schluchter, Mark; Forrest, Christopher B.; Taylor, H. Gerry; Drotar, Dennis; Holmbeck, Grayson; Youngstrom, Eric; Margevicius, Seunghee; Andreias, Laura

    2012-01-01

    OBJECTIVES: To compare the self-reported health of extremely low birth weight (ELBW, <1 kg) adolescents with that of normal birth weight (NBW) controls and the children’s assessments of their general health at ages 8 versus 14 years. METHODS: One hundred sixty-eight ELBW children and 115 NBW controls of similar gender and sociodemographic status completed the Child Health and Illness Profile–Adolescent Edition at age 14 years. It includes 6 domains: Satisfaction, Comfort, Resilience, Risk Avoidance, Achievement, and Disorders. At age 8 years, the children had completed the Child Health and Illness Profile–Child Edition. Results were compared between ELBW and NBW subjects adjusting for gender and sociodemographic status. RESULTS: ELBW adolescents rated their health similar to that of NBW adolescents in the domains of Satisfaction, Comfort, Resilience, Achievement and Disorders but reported more Risk Avoidance (effect size [ES] 0.6, P < .001). In the subdomain of Resilience, they also noted less physical activity (ES −0.58, P < .001), and in the subdomain of Disorders, more long-term surgical (ES −0.49) and psychosocial disorders (ES −0.49; both P < .01). Both ELBW and NBW children reported a decrease in general health between ages 8 and 14 years, which did not differ significantly between groups. CONCLUSIONS: ELBW adolescents report similar health and well-being compared with NBW controls but greater risk avoidance. Both ELBW and NBW children rate their general health to be poorer at age 14 than at age 8 years, possibly due to age-related developmental changes. PMID:22665412

  20. Risk factors for upper extremity venous thrombosis associated with peripherally inserted central venous catheters.

    PubMed

    Marnejon, Thomas; Angelo, Debra; Abu Abdou, Ahmed; Gemmel, David

    2012-01-01

    To identify clinically important risk factors associated with upper extremity venous thrombosis following peripherally inserted central venous catheters (PICC). A retrospective case control study of 400 consecutive patients with and without upper extremity venous thrombosis post-PICC insertion was performed. Patient data included demographics, body mass index (BMI), ethnicity, site of insertion, size and lumen of catheter, internal length, infusate, and co-morbidities, such as diabetes mellitus, congestive heart failure, and renal failure. Additional risk factors analyzed were active cancer, any history of cancer, recent trauma, smoking, a history of prior deep vein thrombosis, and recent surgery, defined as surgery within three months prior to PICC insertion. The prevalence of trauma, renal failure, and infusion with antibiotics and total parenteral nutrition (TPN) was higher among patients exhibiting upper extremity venous thrombosis (UEVT), when compared to controls. Patients developing UEVT were also more likely to have PICC line placement in a basilic vein and less likely to have brachial vein placement (P<.001). Left-sided PICC line sites also posed a greater risk (P=.026). The rate of standard DVT prophylaxis with low molecular weight heparin and unfractionated heparin and the use of warfarin was similar in both groups. Average length of hospital stay was almost double among patients developing UEVT, 19.5 days, when compared to patients undergoing PICC line insertion without thrombosis, 10.8 days (t=6.98, P<.001). In multivariate analysis, trauma, renal failure, left-sided catheters, basilic placement, TPN, and infusion with antibiotics, specifically vancomycin, were significant risk factors for UEVT associated with PICC insertion. Prophylaxis with low molecular weight heparin, unfractionated heparin or use of warfarin did not prevent the development of venous thrombosis in patients with PICCs. Length of hospital stay and cost are markedly increased in patients who develop PICC-associated upper extremity venous thrombosis.

  1. Head circumference growth among extremely preterm infants in Denmark has improved during the past two decades.

    PubMed

    Zachariassen, Gitte; Hansen, Bo Mølholm

    2015-07-01

    Treatment of extremely preterm and low birth weight infants is still evolving and improving. In this study, we evaluated if growth has improved from birth to two years of corrected age (CA) among extremely low birth weight (BW) and preterm born infants in Denmark. This was an observational study with comparison of head circumference (HC), weight and length growth in two Danish cohorts of extremely preterm (gestational age (GA) < 28 weeks) and extremely low birth weight (ELBW with a BW < 1,000 g) infants (A: 1994-1995 and B: 2004-2008). Infants in cohort A (n = 198) and B (n = 64) had a median GA and BW of 27 + 2 weeks and 948 g in A, and 27 + 3 weeks and 934 g in B. At discharge, infants in B compared with A had increased more in HC (p = 0.000), length (p = 0.008) and weight (p = 0.000). At two years CA, HC was still significantly larger in cohort B than A (p = 0.03), while no significant difference was recorded for length or weight. Growth during hospitalisation seems to have improved among extremely preterm and low birth weight infants from 1994-1995 to 2004-2008. This may be a result of improved nutrition in combination with improved intensive care during hospitalisation. Collection of data in the 2004-2008 cohort was supported by the Institute of Regional Health Services Research, the Egmont Foundation and the University of Southern Denmark. Collection of data from birth to two years of age in the 1994-1995 cohort was without financial support. For the 1994-1995 study, all eight regional Research Ethics Committees in Denmark at that time approved the study. The 2004-2008 study was approved by the Danish National Committee on Biomedical Research Ethics, and handling of data and registrations were approved by the Danish Data Protection Agency.

  2. Adolescent smoking, weight changes, and binge-purge behavior: associations with secondary amenorrhea.

    PubMed Central

    Johnson, J; Whitaker, A H

    1992-01-01

    BACKGROUND. The association of secondary amenorrhea with extreme forms of substance use, weight control, and exercise in nonrepresentative samples raises questions as to whether adolescents in the general population who engage in these behaviors are at increased risk for secondary amenorrhea. We examined the prevalence and behavioral correlates of secondary amenorrhea in a county-wide high school population of 2544 girls aged 13 to 18. METHODS. A survey questionnaire, which elicited menstrual history as well as weight history, weight control practices, level of exercise, and use of cigarettes, wine, and beer, was administered during school hours; absentees were also surveyed. The completion rate was 91%. RESULTS. The 1-year prevalence of secondary amenorrhea was 8.5%. Secondary amenorrhea was associated with smoking one or more packs of cigarettes per day (adjusted relative risk [RRa] = 1.96, 1.21-3.10), with multiple binge-eating behaviors in combination with laxative use or self-induced vomiting (RRa = 4.17, 2.54-6.32), and with weight fluctuation due to weight control (RRa = 2.59, 1.33-4.79). There was no association between amenorrhea and alcohol consumption or exercise level. CONCLUSIONS. Estimates of attributable risk are provided and indicate that bulimic behaviors and cigarette smoking may result in a considerable excess of cases of secondary amenorrhea in an adolescent population. PMID:1536334

  3. Quantitative trait loci segregating in crosses between New Hampshire and White Leghorn chicken lines: II. Muscle weight and carcass composition.

    PubMed

    Nassar, M K; Goraga, Z S; Brockmann, G A

    2012-12-01

    In order to identify genetic factors influencing muscle weight and carcass composition in chicken, a linkage analysis was performed with 278 F(2) males of reciprocal crosses between the extremely different inbred lines New Hampshire (NHI) and White Leghorn (WL77). The NHI line had been selected for high meat yield and the WL77 for low egg weight before inbreeding. Highly significant quantitative trait loci (QTL) controlling body weight and the weights of carcass, breast muscle, drumsticks-thighs and wings were identified on GGA4 between 151.5 and 160.5 cM and on GGA27 between 4 and 52 cM. These genomic regions explained 13.7-40.2% and 5.3-13.8% of the phenotypic F(2) variances of the corresponding traits respectively. Additional genome-wide highly significant QTL for the weight of drumsticks-thighs were mapped on GGA1, 5 and 7. Moreover, significant QTL controlling body weight were found on GGA2 and 11. The data obtained in this study can be used for increasing the mapping resolution and subsequent gene targeting on GGA4 and 27 by combining data with other crosses where the same QTL were found. © 2012 The Authors, Animal Genetics © 2012 Stichting International Foundation for Animal Genetics.

  4. Very Low Birth Weight Preterm Infants With Surgical Short Bowel Syndrome: Incidence, Morbidity and Mortality, and Growth Outcomes at 18 to 22 Months

    PubMed Central

    Cole, Conrad R.; Hansen, Nellie I.; Higgins, Rosemary D.; Ziegler, Thomas R.; Stoll, Barbara J.

    2009-01-01

    OBJECTIVES The objective of this study was to determine the (1) incidence of short bowel syndrome in very low birth weight (<1500 g) infants, (2) associated morbidity and mortality during initial hospitalization, and (3) impact on short-term growth and nutrition in extremely low birth weight (<1000 g) infants. METHODS Infants who were born from January 1, 2002, through June 30, 2005, and enrolled in the National Institute of Child Health and Human Development Neonatal Research Network were studied. Risk factors for developing short bowel syndrome as a result of partial bowel resection (surgical short bowel syndrome) and outcomes were evaluated for all neonates until hospital discharge, death, or 120 days. Extremely low birth weight survivors were further evaluated at 18 to 22 months’ corrected age for feeding methods and growth. RESULTS The incidence of surgical short bowel syndrome in this cohort of 12 316 very low birth weight infants was 0.7%. Necrotizing enterocolitis was the most common diagnosis associated with surgical short bowel syndrome. More very low birth weight infants with short bowel syndrome (20%) died during initial hospitalization than those without necrotizing enterocolitis or short bowel syndrome (12%) but fewer than the infants with surgical necrotizing enterocolitis without short bowel syndrome (53%). Among 5657 extremely low birth weight infants, the incidence of surgical short bowel syndrome was 1.1%. At 18 to 22 months, extremely low birth weight infants with short bowel syndrome were more likely to still require tube feeding (33%) and to have been rehospitalized (79%). Moreover, these infants had growth delay with shorter lengths and smaller head circumferences than infants without necrotizing enterocolitis or short bowel syndrome. CONCLUSIONS Short bowel syndrome is rare in neonates but has a high mortality rate. At 18 to 22 months’ corrected age, extremely low birth weight infants with short bowel syndrome were more likely to have growth failure than infants without short bowel syndrome. PMID:18762491

  5. Microstructural Design for Stress Wave Energy Management

    DTIC Science & Technology

    2013-04-01

    Polyurea based foam 7 4) Controlling transmission and reflection of pressure and shear waves in a multilayered anisotropic structure 10 5... Polyurea based foam consists of several factors including high energy absorption, light weight, higher elastic modulus to density ratio (compared with... Polyurea ), and collapsible voids under extreme loading. Pure Polyurea offers unique properties such as increased shear stiffness under large pressure

  6. Performance of High Temperature Operational Amplifier, Type LM2904WH, under Extreme Temperatures

    NASA Technical Reports Server (NTRS)

    Patterson, Richard; Hammoud, Ahmad; Elbuluk, Malik

    2008-01-01

    Operation of electronic parts and circuits under extreme temperatures is anticipated in NASA space exploration missions as well as terrestrial applications. Exposure of electronics to extreme temperatures and wide-range thermal swings greatly affects their performance via induced changes in the semiconductor material properties, packaging and interconnects, or due to incompatibility issues between interfaces that result from thermal expansion/contraction mismatch. Electronics that are designed to withstand operation and perform efficiently in extreme temperatures would mitigate risks for failure due to thermal stresses and, therefore, improve system reliability. In addition, they contribute to reducing system size and weight, simplifying its design, and reducing development cost through the elimination of otherwise required thermal control elements for proper ambient operation. A large DC voltage gain (100 dB) operational amplifier with a maximum junction temperature of 150 C was recently introduced by STMicroelectronics [1]. This LM2904WH chip comes in a plastic package and is designed specifically for automotive and industrial control systems. It operates from a single power supply over a wide range of voltages, and it consists of two independent, high gain, internally frequency compensated operational amplifiers. Table I shows some of the device manufacturer s specifications.

  7. Peritoneal drainage does not stabilize extremely low birth weight infants with perforated bowel: data from the NET Trial.

    PubMed

    Rees, Clare M; Eaton, Simon; Khoo, A Kate; Kiely, Edward M; Pierro, Agostino

    2010-02-01

    Proponents of peritoneal drainage (PD) hypothesize that it allows stabilization before laparotomy. We examined this hypothesis by comparing clinical status before and after either PD or primary laparotomy (LAP). In an ethically approved, international, prospective randomized controlled trial (2002-2006), extremely low birth weight (<1000 g) infants with pneumoperitoneum received primary PD (n = 35) or LAP (n = 34). Physiologic data were collected prospectively and organ failure scores calculated and compared between preprocedure and day 1 after procedure. Data, expressed as mean +/- SD or median (range), were analyzed using appropriate statistical tests. There was no postprocedure improvement in either PD or LAP group comparing heart rate (PD, P = 1.0; LAP, P = .6), blood pressure (PD, P = .6; LAP, P = .8), inotrope requirement (PD, P = .2; LAP, P = .3), or Arterial partial pressure of oxygen/fraction of inspired oxygen ratio (PD, P = .1; LAP, P = .5). Infants managed with PD had a worsening cardiovascular status (P = .05). There were no differences in total organ failure score in either group (PD, P = .5; LAP, P = 1). Only 4 infants survived with PD alone with no difference between preprocedure and postprocedure organ failure score (P = .4). Peritoneal drainage does not immediately improve clinical status in extremely low birth weight infants with bowel perforation. The use of PD as a stabilizing or temporizing measure is not supported by these results. Copyright 2010 Elsevier Inc. All rights reserved.

  8. Generalized wave operators, weighted Killing fields, and perturbations of higher dimensional spacetimes

    NASA Astrophysics Data System (ADS)

    Araneda, Bernardo

    2018-04-01

    We present weighted covariant derivatives and wave operators for perturbations of certain algebraically special Einstein spacetimes in arbitrary dimensions, under which the Teukolsky and related equations become weighted wave equations. We show that the higher dimensional generalization of the principal null directions are weighted conformal Killing vectors with respect to the modified covariant derivative. We also introduce a modified Laplace–de Rham-like operator acting on tensor-valued differential forms, and show that the wave-like equations are, at the linear level, appropriate projections off shell of this operator acting on the curvature tensor; the projection tensors being made out of weighted conformal Killing–Yano tensors. We give off shell operator identities that map the Einstein and Maxwell equations into weighted scalar equations, and using adjoint operators we construct solutions of the original field equations in a compact form from solutions of the wave-like equations. We study the extreme and zero boost weight cases; extreme boost corresponding to perturbations of Kundt spacetimes (which includes near horizon geometries of extreme black holes), and zero boost to static black holes in arbitrary dimensions. In 4D our results apply to Einstein spacetimes of Petrov type D and make use of weighted Killing spinors.

  9. Covariations of adolescent weight-control, health-risk and health-promoting behaviors.

    PubMed

    Rafiroiu, Codruta; Sargent, Roger G; Parra-Medina, Deborah; Drane, Wanzer J; Valois, Robert F

    2003-01-01

    To assess the prevalence of dieting and investigate clusters of risk behaviors among adolescents. Data were secured from a random sample of adolescents (4,636) and analyzed using bivariate methods and logistic regression. From the survey sample, 19.2% adolescents were classified as extreme, 43.2% as moderate dieters, 37.2% as nondieters. Extreme dieters were more likely to use alcohol, cigarettes, and/or marijuana and to attempt suicide and less likely to practice vigorous exercise. Moderate dieters were less likely to use cigarettes, marijuana and more likely to engage in vigorous exercise, with differences across gender-race categories. Results have relevance for developing multicomponent programs for adolescents.

  10. Optimization and evaluation of a proportional derivative controller for planar arm movement.

    PubMed

    Jagodnik, Kathleen M; van den Bogert, Antonie J

    2010-04-19

    In most clinical applications of functional electrical stimulation (FES), the timing and amplitude of electrical stimuli have been controlled by open-loop pattern generators. The control of upper extremity reaching movements, however, will require feedback control to achieve the required precision. Here we present three controllers using proportional derivative (PD) feedback to stimulate six arm muscles, using two joint angle sensors. Controllers were first optimized and then evaluated on a computational arm model that includes musculoskeletal dynamics. Feedback gains were optimized by minimizing a weighted sum of position errors and muscle forces. Generalizability of the controllers was evaluated by performing movements for which the controller was not optimized, and robustness was tested via model simulations with randomly weakened muscles. Robustness was further evaluated by adding joint friction and doubling the arm mass. After optimization with a properly weighted cost function, all PD controllers performed fast, accurate, and robust reaching movements in simulation. Oscillatory behavior was seen after improper tuning. Performance improved slightly as the complexity of the feedback gain matrix increased. Copyright 2009 Elsevier Ltd. All rights reserved.

  11. Optimization and evaluation of a proportional derivative controller for planar arm movement

    PubMed Central

    Jagodnik, Kathleen M.; van den Bogert, Antonie J.

    2013-01-01

    In most clinical applications of functional electrical stimulation (FES), the timing and amplitude of electrical stimuli have been controlled by open-loop pattern generators. The control of upper extremity reaching movements, however, will require feedback control to achieve the required precision. Here we present three controllers using proportional derivative (PD) feedback to stimulate six arm muscles, using two joint angle sensors. Controllers were first optimized and then evaluated on a computational arm model that includes musculoskeletal dynamics. Feedback gains were optimized by minimizing a weighted sum of position errors and muscle forces. Generalizability of the controllers was evaluated by performing movements for which the controller was not optimized, and robustness was tested via model simulations with randomly weakened muscles. Robustness was further evaluated by adding joint friction and doubling the arm mass. After optimization with a properly weighted cost function, all PD controllers performed fast, accurate, and robust reaching movements in simulation. Oscillatory behavior was seen after improper tuning. Performance improved slightly as the complexity of the feedback gain matrix increased. PMID:20097345

  12. Regional fat distribution in adolescent and adult females with anorexia nervosa: A longitudinal study.

    PubMed

    El Ghoch, Marwan; Milanese, Chiara; Calugi, Simona; Müller, Manfred J; Pourhassan, Maryam; Ruocco, Antonella; Dalle Grave, Riccardo

    2015-12-01

    No study has yet compared body fat distribution before and after weight restoration in adolescent and adult patients with anorexia nervosa (AN) treated according to the same protocol. The study was set up to measure body fat distribution before and after short-term weight restoration in adolescent and adult patients with AN treated according to the same protocol in a specialist inpatient unit. We recruited 33 consecutive adolescent female patients with AN, and 33 controls matched by age and post-treatment BMI centile, as well as 33 adult female patients with AN, and 33 controls matched by age and post-treatment BMI. Dual-energy X-ray absorptiometry (DXA) was used to assess body composition before and after short-term weight restoration (BMI ≥ 18.5 kg/m²). Compared with controls, both adolescents and adults with AN showed that a greater amount of fat was lost from the extremities than the trunk before weight restoration, and that there was a central adiposity phenotype after short-term weight restoration. There were no significant differences in body fat distribution between adolescents and adults with AN before or after short-term weight restoration. Adolescent and adult females with AN have similar body fat distribution both before and after short-term weight restoration, and show a central adiposity phenotype after short-term weight restoration. The clinical implications of this finding are as yet unknown. Clinical Trials Registry- Regional Fat Distribution in Adolescent Girls and Adults with Anorexia Nervosa (ISRCTN73572502). Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  13. Reduced brachial flow-mediated vasodilation in young adult ex extremely low birth weight preterm: a condition predictive of increased cardiovascular risk?

    PubMed

    Bassareo, P P; Fanos, V; Puddu, M; Demuru, P; Cadeddu, F; Balzarini, M; Mercuro, G

    2010-10-01

    Sporadic data present in literature report how preterm birth and low birth weight constitute the risk factors for the development of cardiovascular diseases in later life. To assess the presence of potential alterations to endothelial function in young adults born preterm at extremely low birth weight (<1000 g; ex ELBW). Thirty-two ex-ELBW subjects (10 males [M] and 22 females [F], aged 17-28 years, mean [+/- DS] 20.1 +/- 2.5 years) were compared with 32 healthy, age-matched subjects born at term (C, 9 M and 23 F). 1) pathological conditions known to affect endothelial function; 2) administration of drugs known to affect endothelial function. Endothelial function was assessed by non-invasive finger plethysmography, previously validated by the US Food and Drug Administration (Endopath; Itamar Medical Ltd., Cesarea, Israel). Endothelial function was significantly reduced in ex-ELBW subjects compared to C (1.94 +/- 0.37 vs. 2.68 +/- 0.41, p < 0.0001). Moreover, this function correlated significantly with gestational age (r = 0.56, p < 0.0009) and birth weight (r = 0.63, p < 0.0001). The results obtained reveal a significant decrease in endothelial function of ex-ELBW subjects compared to controls, underlining a probable correlation with preterm birth and low birth weight. Taken together, these results suggest that an ELBW may underlie the onset of early circulatory dysfunction predictive of increased cardiovascular risk.

  14. Beta 3-adrenergic-receptor allele distributions in children, adolescents and young adults with obesity, underweight or anorexia nervosa.

    PubMed

    Hinney, A; Lentes, K U; Rosenkranz, K; Barth, N; Roth, H; Ziegler, A; Hennighausen, K; Coners, H; Wurmser, H; Jacob, K; Römer, G; Winnikes, U; Mayer, H; Herzog, W; Lehmkuhl, G; Poustka, F; Schmidt, M H; Blum, W F; Pirke, K M; Schäfer, H; Grzeschik, K H; Remschmidt, H; Hebebrand, J

    1997-03-01

    The missense mutation (64Trp to 64Arg) in the beta 3-adrenergic-receptor has previously been described to confer a genetic predisposition to the development of obesity. To test the hypothesis we evaluated allele frequencies in children, adolescents and young adults who belonged to different weight groups that were delineated with percentiles for the body mass index (BMI; kg/m2). 99 underweight probands (BMI < or = 15th percentile). 80 normal weight probands (BMI: 5th-85th percentile). 238 obese children and adolescents (BMI > or = 97th percentile). 84 patients with anorexia nervosa (AN). The cohorts were screened by polymerase chain reaction with subsequent restriction fragment length polymorphism (PCR-RFLP) analysis. Data were statistically analysed for association. In addition to these case control studies, the transmission disequilibrium test (TDT) was applied to 80 families of obese probands and to 52 families of patients with AN. Both the tests for association and linkage were negative. The Trp64Arg allele frequencies in the three weight groups (obesity: 0.071; normal weight: 0.081; underweight: 0.056) and the AN patients (0.054) were similar. Extremely obese individuals showed no excess of the Trp64Arg allele. No homozygotes for the Trp64Arg allele were detected. Heterozygosity for the Trp64Arg allele is not of major importance in regulation of body weight in individuals younger than 35 y. Additionally, the extreme obese subgroup is not enriched for the polymorphism.

  15. Gravity compensation of an upper extremity exoskeleton.

    PubMed

    Moubarak, S; Pham, M T; Moreau, R; Redarce, T

    2010-01-01

    This paper presents a new gravity compensation method for an upper extremity exoskeleton mounted on a wheel chair. This new device is dedicated to regular and efficient rehabilitation training for post-stroke and injured people without the continuous presence of a therapist. The exoskeleton is a wearable robotic device attached to the human arm. The user provides information signals to the controller by means of the force sensors around the wrist and the arm, and the robot controller generates the appropriate control signals for different training strategies and paradigms. This upper extremity exoskeleton covers four basic degrees of freedom of the shoulder and the elbow joints with three additional adaptability degrees of freedom in order to match the arm anatomy of different users. For comfortable and efficient rehabilitation, a new heuristic method have been studied and applied on our prototype in order to calculate the gravity compensation model without the need to identify the mass parameters. It is based on the geometric model of the robot and accurate torque measurements of the prototype's actuators in a set of specifically chosen joint positions. The weight effect has been successfully compensated so that the user can move his arm freely while wearing the exoskeleton without feeling its mass.

  16. Combining Pharmacological and Psychological Treatments for Binge Eating Disorder: Current Status, Limitations, and Future Directions.

    PubMed

    Grilo, Carlos M; Reas, Deborah L; Mitchell, James E

    2016-06-01

    Binge eating disorder (BED) is characterized by recurrent binge eating and marked distress about binge eating without the extreme compensatory behaviors for weight control that characterize other eating disorders. BED is prevalent, associated strongly with obesity, and is associated with heightened levels of psychological, psychiatric, and medical concerns. This article provides an overview of randomized controlled treatments for combined psychological and pharmacological treatment of BED to inform current clinical practice and future treatment research. In contrast to the prevalence and significance of BED, to date, limited research has been performed on combining psychological and pharmacological treatments for BED to enhance outcomes. Our review here found that combining certain medications with cognitive behavioral therapy (CBT) or behavioral weight loss (BWL) interventions produces superior outcomes to pharmacotherapy only but does not substantially improve outcomes achieved with CBT/BWL only. One medication (orlistat) has improved weight losses with CBT/BWL albeit minimally, and only one medication (topiramate) has enhanced reductions achieved with CBT in both binge eating and weight. Implications for future research are discussed.

  17. Effect of poverty reduction program on nutritional status of the extreme poor in Bangladesh.

    PubMed

    Jalal, Chowdhury S B; Frongillo, Edward A

    2013-12-01

    Poverty alleviation programs for the extreme poor improve participants' economic status and may impact other important outcomes that are seldom evaluated. A program targeted to the extreme poor by BRAG, a development organization in Bangladesh, has been successful in significantly alleviating extreme poverty. We hypothesized that the program also improved the nutritional status of women and preschool children. A nonequivalent control, pre- and posttest quasi-experimental design that was longitudinal at the village level was used to test the hypotheses. Data were collected from a random sample of 4,131 children and 3,551 women from 3,409 households in 159 villages of 3 northern districts of Bangladesh in 2002 and 2006. Linear mixed random-intercept models accounted for clustering effects and potential confounders. The weight-for-height of children between 24 and 35 months of age from program households was significantly higher (p < .05) than that of children from control households. We found no significant differences between control and program households in three other growth and body-composition indicators in three other age categories of preschool children or in women. These results are important, as this is a large-scale program that has already been extended to more than half the country. The findings will contribute to judging the cost-benefit and cost-effectiveness of the program and in garnering support for the expansion of such programs.

  18. Integrated Application of Active Controls (IAAC) technology to an advanced subsonic transpot project-demonstration act system definition

    NASA Technical Reports Server (NTRS)

    Hanks, G. W.; Shomber, H. A.; Crumb, C. B.; Flora, C. C.; Macdonald, K. A. B.; Smith, R. D.; Sassi, A. P.; Dorwart, R. J.

    1982-01-01

    The 1985 ACT airplane is the Final Active Controls Technology (ACT) Airplane with the addition of three-axis fly by wire. Thus it retains all the efficiency features of the full ACT system plus the weight and cost savings accruing from deletion of the mechanical control system. The control system implements the full IAAC spectrum of active controls except flutter-mode control, judged essentially nonbeneficial, and incorporates new control surfaces called flaperons to make the most of wing-load alleviation. This redundant electronic system is conservatively designed to preserve the extreme reliability required of crucial short-period pitch augmentation, which provides more than half of the fuel savings.

  19. [Effect of extensively hydrolyzed formula on growth and development of infants with very/extremely low birth weight].

    PubMed

    Gu, Chun-Yan; Jiang, Hui-Fen; Wang, Jin-Xiu

    2017-08-01

    To study the effect of extensively hydrolyzed formula on the growth and development in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants. A total of 375 VLBW or ELBW infants were enrolled and divided into an observation group (187 infants) and a control group (188 infants) using a random number table. The infants in the observation group were given extensively hydrolyzed formula, and when the amount of extensively hydrolyzed formula reached 10 mL/time, it was changed to the standard formula for preterm infants. The infants in the control group were given standard formula for preterm infants. Both groups were fed for 4 consecutive weeks and were compared in terms of incidence rate of feeding intolerance, time to establish full enteral feeding, time to complete meconium excretion, number of spontaneous bowel movements, growth and development, motilin level at 4 and 10 days after feeding, and incidence rate of infection. Compared with the control group, the observation group had a lower rate of feeding intolerance (P<0.05), a shorter duration to full enteral feeding and time to complete meconium excretion (P<0.05), a higher mean number of daily spontaneous bowel movements (P<0.05), higher body weight (1 793±317 g vs 1 621±138 g; P<0.05), head circumference (30.5±1.1 cm vs 30.0±1.6 cm; P<0.05), and body length (43.9±1.2 cm vs 42.1±2.0 cm; P<0.05), a higher motilin level at 4 and 10 days after feeding (P<0.05), and a significantly lower infection rate (P<0.05). Extensively hydrolyzed formula can increase motilin level, improve gastrointestinal feeding tolerance, promote early growth and development, and reduce the incidence of infection in VLBW and ELBW infants.

  20. Exposure to overprotective parenting and psychopathology in extremely low birth weight survivors.

    PubMed

    Day, K L; Dobson, K G; Schmidt, L A; Ferro, M A; Saigal, S; Boyle, M H; Van Lieshout, R J

    2018-03-01

    Extremely low birth weight (ELBW; <1,000 g) infants are the most vulnerable babies and are at higher risk for experiencing overprotective (i.e., controlling and intrusive) parenting, which is hypothesized to contribute to the risk for mental disorders. Despite the increased risk for anxiety disorders and decreased risk for alcohol or substance use disorders seen in ELBW survivors, no research has examined the impact of parenting. This study investigated if overprotective parenting mediates links between ELBW birth status and psychiatric disorders in adulthood. Participants included ELBW survivors born in 1977-1982 and matched normal birth weight (≥2,500 g) control participants (ELBW n = 81; normal birth weight n = 87) prospectively followed in Ontario, Canada. These individuals retrospectively reported on whether either of their parents was overprotective using the Parental Bonding Instrument. Presence of a current anxiety disorder and of current alcohol or substance use disorders was assessed using the Mini International Neuropsychiatric Interview at age 29-36 years. Path analysis showed that overprotective parenting was a significant mediator of the association between ELBW status and risk for an anxiety disorder in adulthood and the risk for an alcohol or substance use disorder in adulthood in ELBW survivors. Overprotective parenting accounted for 53% of the association between ELBW status and the risk for an anxiety disorder in adulthood and 26% of the association between ELBW status and alcohol or substance use disorders. Overprotective parenting accounted for a substantial proportion of the increased risk for anxiety and alcohol or substance use disorders in adulthood in ELBW survivors. Despite their perceived vulnerabilities, it is important that the parents of ELBW survivors be supported in their attempts to facilitate their children's pursuit of independence during childhood and beyond. © 2017 John Wiley & Sons Ltd.

  1. Delayed introduction of progressive enteral feeds to prevent necrotising enterocolitis in very low birth weight infants.

    PubMed

    Morgan, Jessie; Young, Lauren; McGuire, William

    2014-01-01

    The introduction of enteral feeds for very preterm (less than 32 weeks' gestation) or very low birth weight (VLBW; less than 1500 g) infants is often delayed for several days or longer after birth due to concern that early introduction may not be tolerated and may increase the risk of necrotising enterocolitis (NEC). However, delaying enteral feeding could diminish the functional adaptation of the gastrointestinal tract and prolong the need for parenteral nutrition with its attendant infectious and metabolic risks. To determine the effect of delayed introduction of progressive enteral feeds on the incidence of NEC, mortality and other morbidities in very preterm or VLBW infants. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2014, Issue 8), MEDLINE (1966 to September 2014), EMBASE (1980 to September 2014), CINAHL (1982 to September 2014), conference proceedings and previous reviews. We included randomised or quasi-randomised controlled trials that assessed the effect of delayed (more than four days after birth) versus earlier introduction of progressive enteral feeds on the incidence of NEC, mortality and other morbidities in very preterm or VLBW infants. Two review authors independently assessed trial eligibility and risk of bias and undertook data extraction. We analysed the treatment effects in the individual trials and reported the risk ratio (RR) and risk difference for dichotomous data and mean difference for continuous data, with respective 95% confidence intervals (CI). We used a fixed-effect model in meta-analyses and explored the potential causes of heterogeneity in sensitivity analyses. We identified nine randomised controlled trials in which 1106 infants participated. Few participants were extremely preterm (less 28 weeks' gestation) or extremely low birth weight (less than 1000 g). The trials defined delayed introduction of progressive enteral feeds as later than four to seven days after birth and early introduction as four days or less after birth. Meta-analyses did not detect statistically significant effects on the risk of NEC (typical RR 0.93, 95% CI 0.64 to 1.34; 8 trials; 1092 infants) or all-cause mortality (typical RR 1.18, 95% CI 0.75 to 1.88; 7 trials; 967 infants). Four of the trials restricted participation to growth-restricted infants with Doppler ultrasound evidence of abnormal fetal circulatory distribution or flow. Planned subgroup analyses of these trials found no statistically significant effects on the risk of NEC or all-cause mortality. Infants who had delayed introduction of enteral feeds took longer to establish full enteral feeding (reported median differences two to four days). The evidence available from randomised controlled trials suggested that delaying the introduction of progressive enteral feeds beyond four days after birth did not reduce the risk of developing NEC in very preterm or VLBW infants, including growth-restricted infants. Delaying the introduction of progressive enteral feeds resulted in a few days' delay in establishing full enteral feeds but the clinical importance of this effect was unclear. The applicability of these findings to extremely preterm or extremely low birth weight was uncertain. Further randomised controlled trials in this population may be warranted.

  2. Haptic biofeedback for improving compliance with lower-extremity partial weight bearing.

    PubMed

    Fu, Michael C; DeLuke, Levi; Buerba, Rafael A; Fan, Richard E; Zheng, Ying Jean; Leslie, Michael P; Baumgaertner, Michael R; Grauer, Jonathan N

    2014-11-01

    After lower-extremity orthopedic trauma and surgery, patients are often advised to restrict weight bearing on the affected limb. Conventional training methods are not effective at enabling patients to comply with recommendations for partial weight bearing. The current study assessed a novel method of using real-time haptic (vibratory/vibrotactile) biofeedback to improve compliance with instructions for partial weight bearing. Thirty healthy, asymptomatic participants were randomized into 1 of 3 groups: verbal instruction, bathroom scale training, and haptic biofeedback. Participants were instructed to restrict lower-extremity weight bearing in a walking boot with crutches to 25 lb, with an acceptable range of 15 to 35 lb. A custom weight bearing sensor and biofeedback system was attached to all participants, but only those in the haptic biofeedback group were given a vibrotactile signal if they exceeded the acceptable range. Weight bearing in all groups was measured with a separate validated commercial system. The verbal instruction group bore an average of 60.3±30.5 lb (mean±standard deviation). The bathroom scale group averaged 43.8±17.2 lb, whereas the haptic biofeedback group averaged 22.4±9.1 lb (P<.05). As a percentage of body weight, the verbal instruction group averaged 40.2±19.3%, the bathroom scale group averaged 32.5±16.9%, and the haptic biofeedback group averaged 14.5±6.3% (P<.05). In this initial evaluation of the use of haptic biofeedback to improve compliance with lower-extremity partial weight bearing, haptic biofeedback was superior to conventional physical therapy methods. Further studies in patients with clinical orthopedic trauma are warranted. Copyright 2014, SLACK Incorporated.

  3. Methods of Constructing a Blended Performance Function Suitable for Formation Flight

    NASA Technical Reports Server (NTRS)

    Ryan, Jack

    2017-01-01

    Two methods for constructing performance functions for formation fight-for-drag-reduction suitable for use with an extreme-seeking control system are presented. The first method approximates an a prior measured or estimated drag-reduction performance function by combining real-time measurements of readily available parameters. The parameters are combined with weightings determined from a minimum squares optimization to form a blended performance function.

  4. All-Cause and Cause-Specific Mortality Associated with Bariatric Surgery: A Review.

    PubMed

    Adams, Ted D; Mehta, Tapan S; Davidson, Lance E; Hunt, Steven C

    2015-12-01

    The question of whether or not nonsurgical intentional or voluntary weight loss results in reduced mortality has been equivocal, with long-term mortality following weight loss being reported as increased, decreased, and not changed. In part, inconsistent results have been attributed to the uncertainty of whether the intentionality of weight loss is accurately reported in large population studies and also that achieving significant and sustained voluntary weight loss in large intervention trials is extremely difficult. Bariatric surgery has generally been free of these conflicts. Patients voluntarily undergo surgery and the resulting weight is typically significant and sustained. These elements, combined with possible non-weight loss-related mechanisms, have resulted in improved comorbidities, which likely contribute to a reduction in long-term mortality. This paper reviews the association between bariatric surgery and long-term mortality. From these studies, the general consensus is that bariatric surgical patients have: 1) significantly reduced long-term all-cause mortality when compared to severely obese non-bariatric surgical control groups; 2) greater mortality when compared to the general population, with the exception of one study; 3) reduced cardiovascular-, stroke-, and cancer-caused mortality when compared to severely obese non-operated controls; and 4) increased risk for externally caused death such as suicide.

  5. Correlates of appearance and weight satisfaction in a U.S. National Sample: Personality, attachment style, television viewing, self-esteem, and life satisfaction.

    PubMed

    Frederick, David A; Sandhu, Gaganjyot; Morse, Patrick J; Swami, Viren

    2016-06-01

    We examined the prevalence and correlates of satisfaction with appearance and weight. Participants (N=12,176) completed an online survey posted on the NBCNews.com and Today.com websites. Few men and women were very to extremely dissatisfied with their physical appearances (6%; 9%), but feeling very to extremely dissatisfied with weight was more common (15%; 20%). Only about one-fourth of men and women felt very to extremely satisfied with their appearances (28%; 26%) and weights (24%; 20%). Men and women with higher body masses reported higher appearance and weight dissatisfaction. Dissatisfied people had higher Neuroticism, more preoccupied and fearful attachment styles, and spent more hours watching television. In contrast, satisfied people had higher Openness, Conscientious, and Extraversion, were more secure in attachment style, and had higher self-esteem and life satisfaction. These findings highlight the high prevalence of body dissatisfaction and the factors linked to dissatisfaction among U.S. adults. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Novel application of lower body positive-pressure in the rehabilitation of an individual with multiple lower extremity fractures.

    PubMed

    Takacs, Judit; Leiter, Jeff R S; Peeler, Jason D

    2011-06-01

    Lower extremity fractures, if not treated appropriately, can increase the risk of morbidity. Partial weight-bearing after surgical repair is recommended; however, current methods of partial weight-bearing may cause excessive loads through the lower extremity. A new rehabilitation tool that uses lower body positive-pressure is described, that may allow partial weight-bearing while preventing excessive loads, thereby improving functional outcomes. A patient with multiple lower extremity fractures underwent a 6-month rehabilitation programme using bodyweight support technology 3 times per week, post-surgery. The patient experienced a reduction in pain and an improvement in ankle range of motion (p=0.002), walking speed (p>0.05) and physical function (p=0.004), as assessed by the Foot and Ankle Module of the American Academy of Orthopaedic Surgeons Lower Limb Outcomes Assessment Instrument. Training did not appear to affect fracture healing, as was evident on radiograph. The effect of lower body positive-pressure on effusion, which has not previously been reported in the literature, was also investigated. No significant difference in effusion of the foot and ankle when using lower body positive-pressure was found. Initial results suggest that this new technology may be a useful rehabilitation tool that allows partial weight-bearing during the treatment of lower extremity injuries.

  7. Noise and light exposures for extremely low birth weight newborns during their stay in the neonatal intensive care unit.

    PubMed

    Lasky, Robert E; Williams, Amber L

    2009-02-01

    The objectives of this study were to characterize noise and light levels for extremely low birth weight newborns throughout their stay in the NICU, evaluate factors influencing noise and light levels, and determine whether exposures meet recommendations from the American Academy of Pediatrics. Sound and light were measured inside the beds of extremely low birth weight newborns (n = 22) from birth to discharge. Measurements were recorded for 20 consecutive hours weekly from birth until 36 weeks' postmenstrual age, biweekly until 40 weeks, and every 4 weeks thereafter. Clinical variables including bed type and method of respiratory support were recorded at each session. Age-related changes in respiratory support and bed type explained the weekly increase of 0.22 dB in sound level and 3.67 lux in light level. Old incubators were the noisiest bed types, and new incubators were the quietest. Light levels were significantly higher in open beds than in incubators. The variations in noise and light levels over time were greatest for open beds. Noise and light levels were much less affected by respiratory support in incubators compared with open beds. A typical extremely low birth weight neonate was exposed to noise levels averaging 56.44 dB(A) and light levels averaging 70.56 lux during their stay from 26 to 42 weeks' postmenstrual age in the NICU. Noise levels were rarely within American Academy of Pediatrics recommendations (5.51% of the time), whereas light levels almost always met recommendations (99.37% of the time). Bed type and respiratory support explained differences in noise and light levels that extremely low birth weight newborns experience during their hospital stay. Noise levels exceeded recommendations, although evidence supporting those recommendations is lacking. Well-designed intervention studies are needed to determine the effects of noise reduction on the development of extremely low birth weight newborns.

  8. Short-term hunger intensity changes following ingestion of a meal replacement bar for weight control.

    PubMed

    Rothacker, Dana Q; Watemberg, Salo

    2004-05-01

    Meal replacement products for weight loss are popular and safe for most unsupervised consumers desiring to lose weight. Previously we reported that the thickness of meal replacement diet shakes had a direct and significant effect on hunger intensity during the first 2 h and that hunger intensity scores for liquid meal replacements were significantly below baseline for 3 h following consumption (Mattes & Rothacker, 2001) This study uses the same protocol to investigate meal replacement bars designed for overweight consumers. Subjects were prescreened to include only those that normally ate breakfast and liked chocolate. The bar used in this study contained 250 calories (about 30 more than most liquid diet shakes), 4 g dietary fiber, 14 g protein and 8 g fat. Subjects were instructed to consume the entire bar with a glass of water following an overnight fast when they would normally consume their first meal of the day and to assess their hunger on a 1 (not hungry at all) to 9 (as hungry as I have ever felt) scale before consumption, immediately after and hourly for 6 h (only on typical weekdays). Similar assessments were made for the perception of stomach fullness (1=empty, 9=extremely full), strength of the desire to eat (1=no desire, 9=extremely strong) and thirst (1=not at all thirsty, 9=extremely thirsty). One-hundred and eight subjects (23 male and 85 female) completed the study. No gender satiety differences were found. Hunger ratings and desire to eat remained significantly below baseline for 5 h following consumption. Stomach fullness scores were significantly above baseline for 5 h. Thirst scores were significantly below baseline for 3 h. In conclusion, although the meal replacement diet bars contained only 30 additional calories than liquids, they provided an additional 2 h of hunger suppression from baseline that may have an impact on overall weightloss success. These results support superior short-term hunger control with solid meal replacements.

  9. [Predictive factors of mortality in extremely preterm infants].

    PubMed

    Lin, L; Fang, M C; Jiang, H; Zhu, M L; Chen, S Q; Lin, Z L

    2018-04-02

    Objective: To investigate the predictive factors of mortality in extremely preterm infants. Methods: The retrospective case-control study was accomplished in the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University. A total of 268 extremely preterm infants seen from January 1, 1999 to December 31, 2015 were divided into survival group (192 cases) and death group (76 cases). The potential predictive factors of mortality were identified by univariate analysis, and then analyzed by multivariate unconditional Logistic regression analysis. The mortality and predictive factors were also compared between two time periods, which were January 1, 1999 to December 31, 2007 (65 cases) and January 1, 2008 to December 31, 2015 (203 cases). Results: The median gestational age (GA) of extremely preterm infants was 27 weeks (23 +3 -27 +6 weeks). The mortality was higher in infants with GA of 25-<26 weeks ( OR= 2.659, 95% CI: 1.211-5.840) and<25 weeks ( OR= 10.029, 95% CI: 3.266-30.792) compared to that in infants with GA> 26 weeks. From January 1, 2008 to December 31, 2015, the number of extremely preterm infants was increased significantly compared to the previous 9 years, while the mortality decreased significantly ( OR= 0.490, 95% CI: 0.272-0.884). Multivariate unconditional Logistic regression analysis showed that GA below 25 weeks ( OR= 6.033, 95% CI: 1.393-26.133), lower birth weight ( OR= 0.997, 95% CI: 0.995-1.000), stage Ⅲ necrotizing enterocolitis (NEC) ( OR= 15.907, 95% CI: 3.613-70.033), grade Ⅰ and Ⅱ intraventricular hemorrhage (IVH) ( OR= 0.260, 95% CI: 0.117-0.575) and dependence on invasive mechanical ventilation ( OR= 3.630, 95% CI: 1.111-11.867) were predictive factors of mortality in extremely preterm infants. Conclusions: GA below 25 weeks, lower birth weight, stage Ⅲ NEC and dependence on invasive mechanical ventilation are risk factors of mortality in extremely preterm infants. But grade ⅠandⅡ IVH is protective factor.

  10. Ambivalence toward palatable food and emotional eating predict weight fluctuations. Results of a longitudinal study with four waves.

    PubMed

    Keller, Carmen; Siegrist, Michael

    2015-02-01

    Weight fluctuations pose serious challenges to people's health. Research suggests that the interplay between cognitive dietary restraint and counter-regulative overeating impairs weight control. In a random sample from the general population (N = 2733, 49% male), a longitudinal survey was conducted over 4 consecutive years (2010-2013). Self-reported weight was used to calculate the variance of three weight changes from one wave to the next. Separate regression analyses for women and men were conducted. The dependent variable was weight fluctuation, and the independent variables were eating styles (emotional, external, and restrained) and ambivalence toward palatable food. Age and weight changes between the fourth and first years were controlled. A significant positive effect of emotional eating for men and women, and a significant positive effect of ambivalence for women, were found. Participants who demonstrated high levels of emotional eating, and women who had high levels of ambivalence in the beginning of the study, had more extreme relative weight fluctuations in the consecutive years than did persons with low levels of emotional eating or women with low levels of ambivalence. Restrained and external eating had no effect. The results suggest that emotional eating and ambivalence toward palatable food need to be addressed to prevent health-damaging weight fluctuations. Furthermore, ambivalence toward palatable food was revealed as an additional overeating tendency beyond emotional eating that must be considered to understand the interplay between dietary restraint and overeating. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. fMRI: blood oxygen level-dependent activation during a working memory-selective attention task in children born extremely preterm.

    PubMed

    Griffiths, Silja Torvik; Gundersen, Hilde; Neto, Emanuel; Elgen, Irene; Markestad, Trond; Aukland, Stein M; Hugdahl, Kenneth

    2013-08-01

    Extremely preterm (EPT)/extremely low-birth-weight (ELBW) children attaining school age and adolescence often have problems with executive functions such as working memory and selective attention. Our aim was to investigate a hypothesized difference in blood oxygen level-dependent (BOLD) activation during a selective attention-working memory task in EPT/ELBW children as compared with term-born controls. A regional cohort of 28 EPT/ELBW children and 28 term-born controls underwent functional magnetic resonance imaging (fMRI) scanning at 11 y of age while performing a combined Stroop n-back task. Group differences in BOLD activation were analyzed with Statistical Parametric Mapping 8 analysis software package, and reaction times (RTs) and response accuracy (RA) were compared in a multifactorial ANOVA test. The BOLD activation pattern in the preterm group involved the same areas (cingulate, prefrontal, and parietal cortexes), but all areas displayed significantly less activation than those in the control group, particularly when the cognitive load was increased. The RA results corresponded with the activation data in that the preterm group had significantly fewer correct responses. No group difference was found regarding RTs. Children born EPT/ELBW displayed reduced working memory and selective attention capacity as compared with term-born controls. These impairments had neuronal correlates with reduced BOLD activation in areas responsible for online stimulus monitoring, working memory, and cognitive control.

  12. Effects of Game-Based Constraint-Induced Movement Therapy on Balance in Patients with Stroke: A Single-Blind Randomized Controlled Trial.

    PubMed

    Choi, Ho-Suk; Shin, Won-Seob; Bang, Dae-Hyouk; Choi, Sung-Jin

    2017-03-01

    The aims of this work were to determine whether game-based constraint-induced movement therapy (CIMT) is effective at improving balance ability in patients with stroke, and to provide clinical knowledge of game-based training that allows application of CIMT to the lower extremities. Thirty-six patients with chronic stroke were randomly assigned to game-based CIMT (n = 12), general game-based training (n = 12), and conventional (n = 12) groups. All interventions were conducted 3 times a week for 4 weeks. The static balance control and weight-bearing symmetry were assessed, and the Functional Reach Test (FRT), modified Functional Reach Test (mFRT), and Timed Up and Go (TUG) test were performed to evaluate balance ability. All 3 groups showed significant improvement in anterior-posterior axis (AP-axis) distance, sway area, weight-bearing symmetry, FRT, mFRT, and TUG test after the intervention (P < 0.05). Post hoc analysis revealed significant differences in AP-axis, and sway area, weight-bearing symmetry of the game-based CIMT group compared with the other group (P < 0.05). Although the general game-based training and the game-based CIMT both improved on static and dynamic balance ability, game-based CIMT had a larger effect on static balance control, weight-bearing symmetry, and side-to-side weight shift.

  13. A Prospective Study of Extreme Weight Change Behaviors among Adolescent Boys and Girls

    ERIC Educational Resources Information Center

    McCabe, Marita P.; Ricciardelli, Lina A.

    2006-01-01

    This study examined changes in extreme weight change attitudes and behaviors (exercise dependence, food supplements, drive for thinness, bulimia) among adolescent boys and girls over a 16 month period. It also investigated the impact of body mass index, puberty, body image, depression and positive affect on these attitudes and behaviors 16 months…

  14. Self-Regulation in Children Born with Extremely Low Birth Weight at 2 Years Old: A Comparison Study

    ERIC Educational Resources Information Center

    Lynn, Lisa N.; Cuskelly, Monica; Gray, Peter H.; O'Callaghan, Michael J.

    2012-01-01

    Survival rates for children born with extremely low birth weight (ELBW) are increasing; however, many of these children experience later problems with learning. This study adopted an integrated approach to these problems, involving the self-regulatory tasks of inhibition and delay of gratification and relevant individual factors including…

  15. Compelled body weight shift approach in rehabilitation of individuals with chronic stroke.

    PubMed

    Aruin, Alexander S; Rao, Noel; Sharma, Asha; Chaudhuri, Gouri

    2012-01-01

    This study was designed to evaluate the effectiveness of the compelled body weight shift (CBWS) therapy approach in the rehabilitation of individuals with chronic stroke. CBWS involves a forced shift of body weight toward a person's affected side by means of a shoe insert that establishes a lift of the nonaffected lower extremity. Eighteen individuals with chronic, unilateral stroke (mean age 57.7 ± 11.9 years, with a range of 35-75 years; mean time since stroke 6.7 ± 3.9 years, with a range of 1.1-14.1 years) who showed asymmetrical stance were randomly divided into 2 groups: the experimental group received 6 weeks of physical therapy combined with CBWS therapy, and the control group received only physical therapy. Both groups underwent a battery of identical tests (Fugl-Meyer Assessment, Berg Balance Scale, weight bearing, and gait velocity) before the start of the rehabilitation intervention, following its completion, and 3 months after the end of therapy. After the intervention, weight bearing on the affected side (measured with the Balance Master) increased in the experimental group to a larger degree compared to the control group (9.7% vs 6.4%). Similarly, gait velocity increased 10.5% in the experimental group compared to the control group. Improvements in weight bearing and gait velocity were maintained in the experimental group after the 3-month retention period. The study outcome revealed that a 6-week intervention involving CBWS therapy could result in a long-lasting improvement of the symmetry of weight bearing and velocity of gait in individuals with chronic stroke.

  16. Impaired visually guided weight-shifting ability in children with cerebral palsy.

    PubMed

    Ballaz, Laurent; Robert, Maxime; Parent, Audrey; Prince, François; Lemay, Martin

    2014-09-01

    The ability to control voluntary weight shifting is crucial in many functional tasks. To our knowledge, weight shifting ability in response to a visual stimulus has never been evaluated in children with cerebral palsy (CP). The aim of the study was (1) to propose a new method to assess visually guided medio-lateral (M/L) weight shifting ability and (2) to compare weight-shifting ability in children with CP and typically developing (TD) children. Ten children with spastic diplegic CP (Gross Motor Function Classification System level I and II; age 7-12 years) and 10 TD age-matched children were tested. Participants played with the skiing game on the Wii Fit game console. Center of pressure (COP) displacements, trunk and lower-limb movements were recorded during the last virtual slalom. Maximal isometric lower limb strength and postural control during quiet standing were also assessed. Lower-limb muscle strength was reduced in children with CP compared to TD children and postural control during quiet standing was impaired in children with CP. As expected, the skiing game mainly resulted in M/L COP displacements. Children with CP showed lower M/L COP range and velocity as compared to TD children but larger trunk movements. Trunk and lower extremity movements were less in phase in children with CP compared to TD children. Commercially available active video games can be used to assess visually guided weight shifting ability. Children with spastic diplegic CP showed impaired visually guided weight shifting which can be explained by non-optimal coordination of postural movement and reduced muscular strength. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. The Baby Moves prospective cohort study protocol: using a smartphone application with the General Movements Assessment to predict neurodevelopmental outcomes at age 2 years for extremely preterm or extremely low birthweight infants

    PubMed Central

    Olsen, J; Kwong, A; Doyle, LW; Marschik, PB; Einspieler, C; Cheong, JLY

    2016-01-01

    Introduction Infants born extremely preterm (EP; <28 weeks' gestation) and/or with extremely low birth weight (ELBW; <1000 g birth weight) are at increased risk for adverse neurodevelopmental outcomes. However, it is challenging to predict those EP/ELBW infants destined to have long-term neurodevelopmental impairments in order to target early intervention to those in most need. The General Movements Assessment (GMA) in early infancy has high predictive validity for neurodevelopmental outcomes in preterm infants. However, access to a GMA may be limited by geographical constraints and a lack of GMA-trained health professionals. Baby Moves is a smartphone application (app) developed for caregivers to video and upload their infant's general movements to be scored remotely by a certified GMA assessor. The aim of this study is to determine the predictive ability of using the GMA via the Baby Moves app for neurodevelopmental impairment in infants born EP/ELBW. Methods and analysis This prospective cohort study will recruit infants born EP/ELBW across the state of Victoria, Australia in 2016 and 2017. A control group of normal birth weight (>2500 g birth weight), term-born (≥37 weeks' gestation) infants will also be recruited as a local reference group. Parents will video their infant's general movements at two time points between 3 and 4 months' corrected age using the Baby Moves app. Videos will be scored by certified GMA assessors and classified as normal or abnormal. Parental satisfaction using the Baby Moves app will be assessed via survey. Neurodevelopmental outcome at 2 years' corrected age includes developmental delay according to the Bayley Scales of Infant and Toddler Development-III and cerebral palsy diagnosis. Ethics and dissemination This study was approved by the Human Research and Ethics Committees at the Royal Children's Hospital, The Royal Women's Hospital, Monash Health and Mercy Health in Melbourne, Australia. Study findings will be disseminated via peer-reviewed publications and conference presentations. PMID:27697883

  18. Brown adipose tissue in young adults who were born preterm or small for gestational age.

    PubMed

    Kistner, Anna; Rydén, Henric; Anderstam, Björn; Hellström, Ann; Skorpil, Mikael

    2018-06-27

    Brown adipose tissue (BAT) is present and functions to dissipate energy as heat in young adults and can be assessed using magnetic resonance imaging (MRI) to estimate the voxel fat fraction, i.e. proton density fat fraction (PDFF). It is hypothesized that subjects born preterm or small for gestational age (SGA) may exhibit disrupted BAT formation coupled to metabolic factors. Our purpose was to assess the presence of BAT in young adults born extremely preterm or SGA in comparison with controls. We studied 30 healthy subjects (median age, 21 years): 10 born extremely preterm, 10 full term but SGA and 10 full term with a normal birth weight (controls). We utilized an MRI technique combining multiple scans to enable smaller echo spacing and an advanced fat-water separation method applying graph cuts to estimate B0 inhomogeneity. We measured supraclavicular/cervical PDFF, R2*, fat volume, insulin-like growth factor 1, glucagon, thyroid stimulating hormone and the BAT-associated hormones fibroblast growth factor 21 and irisin. The groups did not significantly differ in supraclavicular/cervical PDFF, R2*, fat volume or hormone levels. The mean supraclavicular/cervical PDFF was equivalent between the groups (range 75-77%). Young adults born extremely preterm or SGA show BAT development similar to those born full term at a normal birth weight. Thus, the increased risk of cardiovascular and metabolic disorders in these groups is not due to the absence of BAT, although our results do not exclude possible BAT involvement in this scenario. Larger studies are needed to understand these relationships.

  19. Up-date on the NeoVitaA Trial: Obstacles, challenges, perspectives, and local experiences.

    PubMed

    Meyer, Sascha; Gortner, Ludwig

    2017-09-01

    The aim of the NeoVitaA Trial is to assess the role of postnatal additional high-dose oral vitamin A supplementation for 28 days in reducing Bronchopulmonary dysplasia (BPD) or death in extremely low birth weight (ELBW) infants at 36 weeks postmenstrual age (PMA). All infants (both intervention and control group) will be provided with basic vitamin A (1000 IU/kg/day) in addition to trial intervention.In this short communication, we will give an up-date on obstacles, challenges as well as perspectives and potential solutions when putting into place a multicenter, double-blind, randomized trial in this cohort of extremely susceptible infants.

  20. A longitudinal study of ice hockey in boys aged 8--12.

    PubMed

    MacNab, R B

    1979-03-01

    A group of fifteen boys (experimental or competitive) were studied over a five year period of competitive ice hockey beginning at age 8. The subjects were members of a team which averaged 66 games per year, ranging from 50 at age 8 to 78 at age 12. In addition, they practiced twice a week with heavy stress on skating and individual puck handling skills. A second group of eleven boys (control or less competitive) were studied from age 10 to 12. The latter subjects played an average of 25 games per year and practiced once a week. All subjects were measured each year on skating and puck control skills, fitness-performance tests, grip strength, physical work capacity as well as height and weight. The results demonstrate learning curves for skating and puck control tests which, while typical in nature, show extremely high levels of achievement. Fitness-Performance, grip strength and physical work capacity levels of the competitive group are extremely high in comparison with data from other countries.

  1. The ineffectiveness and unintended consequences of the public health war on obesity.

    PubMed

    Ramos Salas, Ximena

    2015-02-03

    The public health war on obesity has had little impact on obesity prevalence and has resulted in unintended consequences. Its ineffectiveness has been attributed to: 1) heavy focus on individual-based approaches and lack of scaled-up socio-environmental policies and programs, 2) modest effects of interventions in reducing and preventing obesity at the population level, and 3) inappropriate focus on weight rather than health. An unintended consequence of these policies and programs is excessive weight preoccupation among the population, which can lead to stigma, body dissatisfaction, dieting, disordered eating, and even death from effects of extreme dieting, anorexia, and obesity surgery complications, or from suicide that results from weight-based bullying. Future public health approaches should: a) avoid simplistic obesity messages that focus solely on individuals' responsibility for weight and health, b) focus on health outcomes rather than weight control, and c) address the complexity of obesity and target both individual-level and system-level determinants of health.

  2. Positive fantasies or negative contrasts: the effect of media body ideals on restrained eaters' mood, weight satisfaction, and food intake.

    PubMed

    Boyce, Jessica A; Kuijer, Roeline G; Gleaves, David H

    2013-09-01

    Although viewing media body ideals promotes body dissatisfaction and problematic eating among women (e.g., extreme restraint/overeating), some argue that women only report such negative effects because they think that they are meant to (i.e., demand characteristics). Because restrained eaters are trying to lose weight, they might be vulnerable to such media exposure. However, because of demand characteristics, evidence is mixed. Therefore, we minimized demand characteristics and explored whether media body ideals would trigger restrained eaters to report negative (negative mood, weight dissatisfaction) or positive (positive mood, weight satisfaction) effects. We also hypothesized that this change (negative or positive) would encourage food intake. Restrained and unrestrained eaters (n=107) memorized media or control images. Restrained eaters exposed to media images reported decreased weight satisfaction and increased negative mood, but their food intake was not significantly affected. Perhaps paying advertent attention to the images caused goal-related negative affect, which triggered restraint. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Multi-objective optimization for model predictive control.

    PubMed

    Wojsznis, Willy; Mehta, Ashish; Wojsznis, Peter; Thiele, Dirk; Blevins, Terry

    2007-06-01

    This paper presents a technique of multi-objective optimization for Model Predictive Control (MPC) where the optimization has three levels of the objective function, in order of priority: handling constraints, maximizing economics, and maintaining control. The greatest weights are assigned dynamically to control or constraint variables that are predicted to be out of their limits. The weights assigned for economics have to out-weigh those assigned for control objectives. Control variables (CV) can be controlled at fixed targets or within one- or two-sided ranges around the targets. Manipulated Variables (MV) can have assigned targets too, which may be predefined values or current actual values. This MV functionality is extremely useful when economic objectives are not defined for some or all the MVs. To achieve this complex operation, handle process outputs predicted to go out of limits, and have a guaranteed solution for any condition, the technique makes use of the priority structure, penalties on slack variables, and redefinition of the constraint and control model. An engineering implementation of this approach is shown in the MPC embedded in an industrial control system. The optimization and control of a distillation column, the standard Shell heavy oil fractionator (HOF) problem, is adequately achieved with this MPC.

  4. Do early postnatal body weight changes contribute to neonatal morbidities in the extremely low birth weight infants.

    PubMed

    Verma, R; Shibly, S; Fang, H; Pollack, S

    2015-01-01

    The implications of early postnatal body weight changes (Δbw) in the morbidities related to body fluid metabolism in sick preterm infants in not well investigated. The extremely low birth weight infants (ELBW, birth weight <1000 g) have the highest incidence of such morbidities among all neonates. To determine the relationships between Δbw and neonatal morbidities associated with body fluid metabolism in the ELBW infants. In an observational study, the associations between daily weight changes from birth weight (DΔ bw) and oxygen dependence on postnatal day 28 (BPD28), patent ductus arteriosus (PDA), intraventricular-periventricular hemorrhage (IVH), antenatal steroid (ANS) and gestational age (GA) were evaluated. Maximum weight loss (MΔ bw) was correlated with GA, BPD28 and BPD36 (oxygen dependence on postmenstrual 36 weeks). Pearson's correlation co-efficient and multivariate logistic regressions were performed for analysis. DΔ bw correlated inversely with GA on days 1-8 of life (p <  0.01 for all, 0.06 for DOL 2). DΔ bw was associated with a lower risk of BPD28 on days 6 (OR 0.87, 95% CI 0.76-1), 10 (OR 0.86, 95% CI 0.76-0.98) and 11 (OR 0.87, 95% CI 0.77-0.99); with PDA on days 8-11 (OR ranging between 0.89 to 0.92 for the 4 days, 95% CI 0.83 to 0.99) and with IVH on day 5 (OR 0.93, 95% CI 0.86-1) after controlling for GA. DΔ bw was not identified as risk factor for the tested morbidities. ANS decreased DΔ bw on days 4 (OR 0.88, 95% CI 0.78-1) and 10 (OR 0.9, 95% CI 0.84-1). MΔbw correlated directly with BPD28 (r = 0.3, p = 0.004), which declined after controlling for GA (r = 0.2, p = 0.2). DΔ bw is protective for PDA, BPD28 and IVH, independent of gestational age, whereas, the effects of MΔ bw on BPD are governed by maturation in ELBW infants. ANS decreases DΔbw, which correlates inversely with GA during the first week of life.

  5. Effects of external radio transmitters on fish

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ross, M.J.; McCormick, J.H.

    1981-04-01

    Yellow perch (Perca flavescens) and largemouth bass (Micropterus salmoides) were studied to determine the effects of externally attached radio transmitter tags. Perch that had been tagged with dummy radio tags were more susceptible to predation and more sensitive to environmental stress than were controls. Feeding and respiration rates were similar among dummy tagged and control groups of perch over a 6-week period. The feeding rate of dummy tagged largemouth bass was lower than that of untagged fish over a 3,5-week period. On the basis of these studies, we conclude that weights of external transmitters in water should be less thanmore » 1.5% of the fish weight. Design considerations should include streamlining components and an anterior attachment wire at the extreme leading edge of an external transmitter to prevent entanglement of the tag in surrounding vegetation.« less

  6. High incidence of rickets in extremely low birth weight infants with severe parenteral nutrition-associated cholestasis and bronchopulmonary dysplasia.

    PubMed

    Lee, Soon Min; Namgung, Ran; Park, Min Soo; Eun, Ho Sun; Park, Kook In; Lee, Chul

    2012-12-01

    Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P < 0.001). In ELBW infants, the incidence of rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.

  7. High Incidence of Rickets in Extremely Low Birth Weight Infants with Severe Parenteral Nutrition-Associated Cholestasis and Bronchopulmonary Dysplasia

    PubMed Central

    Lee, Soon Min; Park, Min Soo; Eun, Ho Sun; Park, Kook In; Lee, Chul

    2012-01-01

    Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P < 0.001). In ELBW infants, the incidence of rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively. PMID:23255857

  8. Effects of off-axis elliptical training on reducing pain and improving knee function in individuals with patellofemoral pain

    PubMed Central

    Tsai, Liang-Ching; Lee, Song Joo; Yang, Aaron J.; Ren, Yupeng; Press, Joel M.; Zhang, Li-Qun

    2014-01-01

    Objective To examine whether an off-axis elliptical training program reduces pain and improves knee function in individuals with patellofemoral pain (PFP). Design Controlled laboratory study, pre-test-post-test. Setting University rehabilitation center. Participants Twelve adult subjects with PFP. Interventions Subjects with PFP completed an exercise program consisting of 18 sessions of lower extremity off-axis training using a custom-made elliptical trainer that allows frontal-plane sliding and transverse-plane pivoting of the footplates. Main Outcome Measures Changes in knee pain and function post-training and 6 weeks following training were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) scores. Lower extremity off-axis control was assessed by pivoting and sliding instability, calculated as the root mean square (RMS) of the footplate pivoting angle and sliding distance during elliptical exercise. Subjects’ single-leg hop distance and proprioception in detecting lower extremity pivoting motion were also evaluated. Results Subjects reported significantly greater KOOS and IKDC scores (increased by 12–18 points) and hop distance (increased by 0.2 m) following training. A significant decrease in the pivoting and sliding RMS was also observed following training. Additionally, subjects with PFP demonstrated improved pivoting proprioception when tested under a minimum-weight-bearing position. Conclusions An off-axis elliptical training program was effective in enhancing lower extremity neuromuscular control on the frontal and transverse planes, reducing pain and improving knee function in persons with PFP. PMID:25591131

  9. Executive Functions Profile in Extreme Eating/Weight Conditions: From Anorexia Nervosa to Obesity

    PubMed Central

    Fagundo, Ana B.; de la Torre, Rafael; Jiménez-Murcia, Susana; Agüera, Zaida; Granero, Roser; Tárrega, Salomé; Botella, Cristina; Baños, Rosa; Fernández-Real, Jose M.; Rodríguez, Roser; Forcano, Laura; Frühbeck, Gema; Gómez-Ambrosi, Javier; Tinahones, Francisco J.; Fernández-García, Jose C.; Casanueva, Felipe F.; Fernández-Aranda, Fernando

    2012-01-01

    Background Extreme weight conditions (EWC) groups along a continuum may share some biological risk factors and intermediate neurocognitive phenotypes. A core cognitive trait in EWC appears to be executive dysfunction, with a focus on decision making, response inhibition and cognitive flexibility. Differences between individuals in these areas are likely to contribute to the differences in vulnerability to EWC. The aim of the study was to investigate whether there is a common pattern of executive dysfunction in EWC while comparing anorexia nervosa patients (AN), obese subjects (OB) and healthy eating/weight controls (HC). Methods Thirty five AN patients, fifty two OB and one hundred thirty seven HC were compared using the Wisconsin Card Sorting Test (WCST); Stroop Color and Word Test (SCWT); and Iowa Gambling Task (IGT). All participants were female, aged between 18 and 60 years. Results There was a significant difference in IGT score (F(1.79); p<.001), with AN and OB groups showing the poorest performance compared to HC. On the WCST, AN and OB made significantly more errors than controls (F(25.73); p<.001), and had significantly fewer correct responses (F(2.71); p<.001). Post hoc analysis revealed that the two clinical groups were not significantly different from each other. Finally, OB showed a significant reduced performance in the inhibition response measured with the Stroop test (F(5.11); p<.001) compared with both AN and HC. Conclusions These findings suggest that EWC subjects (namely AN and OB) have similar dysfunctional executive profile that may play a role in the development and maintenance of such disorders. PMID:22927962

  10. Does pediatric body mass index affect surgical outcomes of lower-extremity external fixation?

    PubMed

    Fedorak, Graham T; Cuomo, Anna V; Otsuka, Norman Y

    2015-06-01

    Obese patients are highly prevalent in the pediatric orthopaedic surgeon's practice and obesity is an increasing issue in the United States. Increased body mass index (BMI) has been associated with increased complications in pediatric orthopaedic patients, but no study has looked specifically at external fixation. The purpose of this study was to determine whether obesity is a risk factor for increased complications in lower-extremity procedures requiring external fixation. A retrospective chart review was conducted of pediatric patients who underwent external fixation as definitive operative treatment for any condition at a tertiary care hospital over a 15-year period. Patients were grouped into normal weight, overweight, and obese based on Centers for Disease Control definitions. All orthopaedic complications were recorded. A total of 208 patients with a mean age of 11.2 years were identified. Ninety-four children were obese at the 95th percentile BMI or higher, 22 were overweight and 93 were normal weight. External fixation was applied to the tibia in 82 cases, to the femur in 77 and to both in 49. Mean duration of fixation was 160 days (range, 31 to 570 d) and patients were followed for a mean of 3.9 years (range, 1.0 to 12.0 y). There was no statistically significant difference in the rate of complications between the 3 groups (P=0.61). In the obese group complications occurred in 68.1% versus 66.7% in the overweight group and 61.3% in normal weight. In the setting of external fixator use for lower-extremity pathology in pediatric patients, there is no association between an increase in complications and obesity as defined by BMI. Complication rates are high when external fixation is utilized for the lower extremity, however, patients and families should not be counseled that increased BMI will add to the burden of orthopaedic complications in this situation. Level II-prognostic.

  11. Catch-up growth in the first two years of life in Extremely Low Birth Weight (ELBW) infants is associated with lower body fat in young adolescence.

    PubMed

    Raaijmakers, Anke; Jacobs, Lotte; Rayyan, Maissa; van Tienoven, Theun Pieter; Ortibus, Els; Levtchenko, Elena; Staessen, Jan A; Allegaert, Karel

    2017-01-01

    To investigate growth patterns and anthropometrics in former extremely low birth weight (ELBW, <1000 g) children and link these outcomes to neurocognition and body composition in childhood. ELBW children were examined at birth (n = 140), at 9 and 24 months (n≥96) and at approximately 11 years within the framework of the PREMATCH (PREMATurity as predictor children's of Cardiovascular and renal Health) case-control (n = 93-87) study. Regional growth charts were used to convert anthropometrics into Z-scores. Catch-up growth in the first two years of life was qualified as present if ΔZ-score >0.67 SDS. At 11 years, anthropometrics, neurocognitive performance, body composition, grip strength and puberty scores were assessed. ELBW neonates displayed extra-uterine growth restriction with mean Z-scores for height, weight and head circumference of -0.77, -0.93 and -0.46 at birth, -1.61, -1.67 and -0.72 at 9 months, -1.22, -1.61 and -0.84 at 24 months, and -0.42, -0.49 and -1.09 at 11 years. ELBW children performed consistently worse on neurocognitive testing with an average intelligence quotient equivalent at 11 years of 92.5 (SD 13.1). Catch-up growth was not associated with neurocognitive performance. Compared to controls, ELBW cases had lower grip strength (13.6 vs. 15.9 kg) and percentage lean body weight (75.1 vs. 80.5%), but higher body fat (24.6 vs. 19.2%) and advanced puberty scores at 11 years (all P≤0.025). Catch-up growth for weight and height in the first two years of life in cases was associated with a lower percentage body fat compared to cases without catch-up growth (16.8% catch-up growth for weight vs. 25.7%, P<0.001; 20.9% catch-up for height vs. 25.8%, P = 0.049). In young adolescence, former ELBW children still have difficulties to reach their target height. Compared to normal birth weight controls, ELBW adolescents show lower neurocognitive performance and grip strength and a higher percentage body fat, a potential risk factor for adverse health outcomes in adulthood. Our key finding is that catch-up growth in ELBW children in the first two years of life is associated with a lower percentage body fat and is therefore likely to be beneficial.

  12. Extreme Obesity and Outcomes in Critically Ill Patients

    PubMed Central

    Martino, Jenny L.; Wang, Miao; Day, Andrew G.; Cahill, Naomi E.; Dixon, Anne E.; Suratt, Benjamin T.; Heyland, Daren K.

    2011-01-01

    Background: Recent literature suggests that obese critically ill patients do not have worse outcomes than patients who are normal weight. However, outcomes in extreme obesity (BMI ≥ 40 kg/m2) are unclear. We sought to determine the association between extreme obesity and ICU outcomes. Methods: We analyzed data from a multicenter international observational study of ICU nutrition practices that occurred in 355 ICUs in 33 countries from 2007 to 2009. Included patients were mechanically ventilated adults ≥ 18 years old who remained in the ICU for > 72 h. Using generalized estimating equations and Cox proportional hazard modeling with clustering by ICU and adjusting for potential confounders, we compared extremely obese to normal-weight patients in terms of duration of mechanical ventilation (DMV), ICU length of stay (LOS), hospital LOS, and 60-day mortality. Results: Of the 8,813 patients included in this analysis, 3,490 were normal weight (BMI 18.5-24.9 kg/m2), 348 had BMI 40 to 49.9 kg/m2, 118 had BMI 50 to 59.9 kg/m2, and 58 had BMI ≥ 60 kg/m2. Unadjusted analyses suggested that extremely obese critically ill patients have improved mortality (OR for death, 0.77; 95% CI, 0.62-0.94), but this association was not significant after adjustment for confounders. However, an adjusted analysis of survivors found that extremely obese patients have a longer DMV and ICU LOS, with the most obese patients (BMI ≥ 60 kg/m2) also having longer hospital LOS. Conclusions: During critical illness, extreme obesity is not associated with a worse survival advantage compared with normal weight. However, among survivors, BMI ≥ 40 kg/m2 is associated with longer time on mechanical ventilation and in the ICU. These results may have prognostic implications for extremely obese critically ill patients. PMID:21816911

  13. Brain mass estimation by head circumference and body mass methods in neonatal glycaemic modelling and control.

    PubMed

    Gunn, Cameron Allan; Dickson, Jennifer L; Pretty, Christopher G; Alsweiler, Jane M; Lynn, Adrienne; Shaw, Geoffrey M; Chase, J Geoffrey

    2014-07-01

    Hyperglycaemia is a common complication of stress and prematurity in extremely low-birth-weight infants. Model-based insulin therapy protocols have the ability to safely improve glycaemic control for this group. Estimating non-insulin-mediated brain glucose uptake by the central nervous system in these models is typically done using population-based body weight models, which may not be ideal. A head circumference-based model that separately treats small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) infants is compared to a body weight model in a retrospective analysis of 48 patients with a median birth weight of 750g and median gestational age of 25 weeks. Estimated brain mass, model-based insulin sensitivity (SI) profiles, and projected glycaemic control outcomes are investigated. SGA infants (5) are also analyzed as a separate cohort. Across the entire cohort, estimated brain mass deviated by a median 10% between models, with a per-patient median difference in SI of 3.5%. For the SGA group, brain mass deviation was 42%, and per-patient SI deviation 13.7%. In virtual trials, 87-93% of recommended insulin rates were equal or slightly reduced (Δ<0.16mU/h) under the head circumference method, while glycaemic control outcomes showed little change. The results suggest that body weight methods are not as accurate as head circumference methods. Head circumference-based estimates may offer improved modelling accuracy and a small reduction in insulin administration, particularly for SGA infants. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Frontal Electroencephalogram Asymmetry, Salivary Cortisol, and Internalizing Behavior Problems in Young Adults Who Were Born at Extremely Low Birth Weight

    ERIC Educational Resources Information Center

    Schmidt, Louis A.; Miskovic, Vladimir; Boyle, Michael; Saigal, Saroj

    2010-01-01

    The authors examined internalizing behavior problems at middle childhood, adolescence, and young adulthood and brain-based measures of stress vulnerability in 154 right-handed, nonimpaired young adults (M age = 23 years): 71 (30 males, 41 females) born at extremely low birth weight (ELBW; less than 1,000 g) and 83 (35 males, 48 females) controls…

  15. Targeting 2.5 versus 4 g/kg/day of amino acids for extremely low birth weight infants: a randomized clinical trial.

    PubMed

    Burattini, Ilaria; Bellagamba, Maria Paola; Spagnoli, Cristina; D'Ascenzo, Rita; Mazzoni, Nadia; Peretti, Anna; Cogo, Paola E; Carnielli, Virgilio P

    2013-11-01

    To compare the effect of 2.5 vs 4 g/kg/d of amino acid (AA) in parenteral nutrition of extremely low birth weight infants on metabolic tolerance, short-term growth, and neurodevelopment. One hundred thirty-one infants with birth weight between 500 and 1249 g were randomized to 2.5 (standard AA [SAA] group) or 4 (high AA [HAA] group) g/kg/d AA intake, with equal nonprotein energy. The primary outcome was body size at 36 weeks. One hundred thirty-one patients were randomized and 114 analyzed (58 SAA group and 56 HAA group). Study groups had similar demographics and clinical characteristics. Elevated blood urea (BU >70 mg/dL = BU nitrogen >32.6 mg/dL) occurred in 24% vs 59% (P = .000) and hyperglycemia (>175 mg/dL) in 34% vs 11% (P = .003) of the SAA and HAA patients, respectively. Body weight, length, and head circumference at 36 weeks and 2 years were similar between groups. Bayley Scales of Infant and Toddler Development, Third Edition score was 94 ± 13 in the SAA group and 97 ± 15 in the HAA group (P = .35). The HAA group had higher BU levels and better glucose control. An extra 8 g/kg of AA over the first 10 days of life did not improve growth and neurodevelopment. Copyright © 2013 Mosby, Inc. All rights reserved.

  16. Coal gasification vessel

    DOEpatents

    Loo, Billy W.

    1982-01-01

    A vessel system (10) comprises an outer shell (14) of carbon fibers held in a binder, a coolant circulation mechanism (16) and control mechanism (42) and an inner shell (46) comprised of a refractory material and is of light weight and capable of withstanding the extreme temperature and pressure environment of, for example, a coal gasification process. The control mechanism (42) can be computer controlled and can be used to monitor and modulate the coolant which is provided through the circulation mechanism (16) for cooling and protecting the carbon fiber and outer shell (14). The control mechanism (42) is also used to locate any isolated hot spots which may occur through the local disintegration of the inner refractory shell (46).

  17. Motivational and psychological correlates of bodybuilding dependence

    PubMed Central

    EMINI, NEIM N.; BOND, MALCOLM J.

    2014-01-01

    Abstract Background and aims: Exercise may become physically and psychologically maladaptive if taken to extremes. One example is the dependence reported by some individuals who engage in weight training. The current study explored potential psychological, motivational, emotional and behavioural concomitants of bodybuilding dependence, with a particular focus on motives for weight training. Using a path analysis paradigm, putative causal models sought to explain associations among key study variables. Methods: A convenience sample of 101 men aged between 18 and 67 years was assembled from gymnasia in Adelaide, South Australia. Active weight trainers voluntarily completed a questionnaire that included measures of bodybuilding dependence (social dependency, training dependency, and mastery), anger, hostility and aggression, stress and motivations for weight training. Results: Three motives for weight training were identified: mood control, physique anxiety and personal challenge. Of these, personal challenge and mood control were the most directly salient to dependence. Social dependency was particularly relevant to personal challenge, whereas training dependency was associated with both personal challenge and mood control. Mastery demonstrated a direct link with physique anxiety, thus reflecting a unique component of exercise dependence. Conclusions: While it was not possible to determine causality with the available data, the joint roles of variables that influence, or are influenced by, bodybuilding dependence are identified. Results highlight unique motivations for bodybuilding and suggest that dependence could be a result of, and way of coping with, stress manifesting as aggression. A potential framework for future research is provided through the demonstration of plausible causal linkages among these variables. PMID:25317342

  18. Motivational and psychological correlates of bodybuilding dependence.

    PubMed

    Emini, Neim N; Bond, Malcolm J

    2014-09-01

    Exercise may become physically and psychologically maladaptive if taken to extremes. One example is the dependence reported by some individuals who engage in weight training. The current study explored potential psychological, motivational, emotional and behavioural concomitants of bodybuilding dependence, with a particular focus on motives for weight training. Using a path analysis paradigm, putative causal models sought to explain associations among key study variables. A convenience sample of 101 men aged between 18 and 67 years was assembled from gymnasia in Adelaide, South Australia. Active weight trainers voluntarily completed a questionnaire that included measures of bodybuilding dependence (social dependency, training dependency, and mastery), anger, hostility and aggression, stress and motivations for weight training. Three motives for weight training were identified: mood control, physique anxiety and personal challenge. Of these, personal challenge and mood control were the most directly salient to dependence. Social dependency was particularly relevant to personal challenge, whereas training dependency was associated with both personal challenge and mood control. Mastery demonstrated a direct link with physique anxiety, thus reflecting a unique component of exercise dependence. While it was not possible to determine causality with the available data, the joint roles of variables that influence, or are influenced by, bodybuilding dependence are identified. RESULTS highlight unique motivations for bodybuilding and suggest that dependence could be a result of, and way of coping with, stress manifesting as aggression. A potential framework for future research is provided through the demonstration of plausible causal linkages among these variables.

  19. Compelled Body-Weight Shift Approach in Rehabilitation of Individuals with Chronic Stroke

    PubMed Central

    Aruin, Alexander S.; Rao, Noel; Sharma, Asha; Chaudhuri, Gouri

    2013-01-01

    Purpose To evaluate the effectiveness of the Compelled Body Weight Shift (CBWS) therapy approach in the rehabilitation of individuals with chronic stroke. CBWS involves a forced shift of body weight towards a person’s affected side by means of a shoe insert that establishes a lift of the non-affected lower extremity. Method Eighteen individuals with chronic, unilateral stroke (mean age 57.7 ± 11.9 years, with a range of 35–75 years, mean time since stroke 6.7±3.9 years with a range of 1.1–14.1 years) who showed asymmetrical stance were randomly divided into two groups: the experimental group received a six-week physical therapy combined with CBWS therapy and the control group received only physical therapy. Both groups underwent a battery of identical tests (Fugl-Meyer assessment, Berg Balance Scale, weight bearing, and gait velocity) before the start of the rehabilitation intervention, following its completion, and three months after the end of therapy. Results After the intervention, weight bearing on the affected side (measured with the Balance Master®) increased in the experimental group to a larger degree compared to the control group (9.7% vs. 6.4%). Similarly, gait velocity increased 10.5% in the experimental group compared to the control group. Improvements in weight bearing and gait velocity were maintained in the experimental group after the three month retention period. Conclusion The study outcome revealed that a six-week intervention involving CBWS therapy could result in a long-lasting improvement of the symmetry of weight bearing and velocity of gait in individuals with chronic stroke. PMID:23192720

  20. Poor nutrition is a serious problem in children with cerebral palsy in Palawan, the Philippines.

    PubMed

    Socrates, C; Grantham-McGregor, S M; Harknett, S G; Seal, A J

    2000-09-01

    Children with cerebral palsy (CP) in developed countries have poor nutritional status; however there is little data from developing countries. In Palawan, in the Philippines, the nutritional status of 31 children with CP was compared to that of their siblings (n = 20) and a control group of neighbourhood children (n = 64), matched for age and sex. The children's weights, heights and armspans were measured. The heights of children with CP could not be measured and were estimated from their armspans using an equation relating height to armspan in siblings and controls. Haemoglobin levels of the study cases and siblings were measured. Siblings and controls had similar nutritional status. The children with CP had extremely poor nutritional status, and had significantly smaller weights for height, heights for age and weights for age than siblings or controls. Haemoglobin levels were not significantly different between the children with CP and their siblings. The nutritional status of children with quadriplegic CP was much poorer than that of similar children in the USA. The severity of malnutrition in children with CP is likely to be detrimental to their development, and a nutritional component should be incorporated into rehabilitation programmes. Also, there is a need to examine the nutritional status of children with CP in other developing countries.

  1. Effects of Progressive Body Weight Support Treadmill Forward and Backward Walking Training on Stroke Patients' Affected Side Lower Extremity's Walking Ability.

    PubMed

    Kim, Kyunghoon; Lee, Sukmin; Lee, Kyoungbo

    2014-12-01

    [Purpose] The purpose of the present study was to examine the effects of progressive body weight supported treadmill forward and backward walking training (PBWSTFBWT), progressive body weight supported treadmill forward walking training (PBWSTFWT), progressive body weight supported treadmill backward walking training (PBWSTBWT), on stroke patients' affected side lower extremity's walking ability. [Subjects and Methods] A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the affected side lower extremity's walking ability, step length of the affected side, stance phase of the affected side, swing phase of the affected side, single support of the affected side, and step time of the affected side were measured using optogait and the symmetry index. [Results] In the within group comparisons, all the three groups showed significant differences between before and after the intervention and in the comparison of the three groups, the PBWSTFBWT group showed more significant differences in all of the assessed items than the other two groups. [Conclusion] In the present study progressive body weight supported treadmill training was performed in an environment in which the subjects were actually walked, and PBWSTFBWT was more effective at efficiently training stroke patients' affected side lower extremity's walking ability.

  2. Perception and evaluation of women's bodies in adolescents and adults with anorexia nervosa.

    PubMed

    Horndasch, Stefanie; Heinrich, Hartmut; Kratz, Oliver; Mai, Sandra; Graap, Holmer; Moll, Gunther H

    2015-12-01

    Body image disturbance in anorexia nervosa (AN) has been widely studied with regard to the patient's own body, but little is known about perception of or attitude towards other women's bodies in AN. The aim of the present study was to investigate how 20 girls aged 12-18 years and 19 adult women suffering from AN compared to 37 healthy adolescent girls and women estimate weight and attractiveness of women's bodies belonging to different BMI categories (BMI 13.8-61.3 kg/m²). Weight and attractiveness ratings of the participant's own body and information on physical comparisons were obtained, and effects on others' weight and attractiveness ratings investigated. Differential evaluation processes were found: AN patients estimated other women's weight higher than control participants. Patients showed a bias towards assessing extremely underweight women as more attractive and normal weight and overweight women as less attractive than healthy girls and women. These effects were more pronounced in adult than in adolescent AN patients. The tendency to engage in physical comparison with others significantly correlated with weight as well as attractiveness ratings in patients. A logistic regression model encompassing own attractiveness ratings, attractiveness bias towards strongly underweight others' bodies and the interaction of this bias with age as predictors differentiated best between AN patients and controls. Our results indicate that females suffering from AN and healthy girls and women perceive other women's bodies differently. Assessment of others' weight and attractiveness may contribute to the maintenance of dysfunctional physical comparison processes.

  3. Asymptotically extremal polynomials with respect to varying weights and application to Sobolev orthogonality

    NASA Astrophysics Data System (ADS)

    Díaz Mendoza, C.; Orive, R.; Pijeira Cabrera, H.

    2008-10-01

    We study the asymptotic behavior of the zeros of a sequence of polynomials whose weighted norms, with respect to a sequence of weight functions, have the same nth root asymptotic behavior as the weighted norms of certain extremal polynomials. This result is applied to obtain the (contracted) weak zero distribution for orthogonal polynomials with respect to a Sobolev inner product with exponential weights of the form e-[phi](x), giving a unified treatment for the so-called Freud (i.e., when [phi] has polynomial growth at infinity) and Erdös (when [phi] grows faster than any polynomial at infinity) cases. In addition, we provide a new proof for the bound of the distance of the zeros to the convex hull of the support for these Sobolev orthogonal polynomials.

  4. High Flow Nasal Cannula Use Is Associated with Increased Morbidity and Length of Hospitalization in Extremely Low Birth Weight Infants.

    PubMed

    Taha, Dalal K; Kornhauser, Michael; Greenspan, Jay S; Dysart, Kevin C; Aghai, Zubair H

    2016-06-01

    To determine differences in the incidence of bronchopulmonary dysplasia (BPD) or death in extremely low birth weight infants managed on high flow nasal cannula (HFNC) vs continuous positive airway pressure (CPAP). This is a retrospective data analysis from the Alere Neonatal Database for infants born between January 2008 and July 2013, weighing ≤1000 g at birth, and received HFNC or CPAP. Baseline demographics, clinical characteristics, and neonatal outcomes were compared between the infants who received CPAP and HFNC, or HFNC ± CPAP. Multivariable regression analysis was performed to control for the variables that differ in bivariate analysis. A total of 2487 infants met the inclusion criteria (941 CPAP group, 333 HFNC group, and 1546 HFNC ± CPAP group). The primary outcome of BPD or death was significantly higher in the HFNC group (56.8%) compared with the CPAP group (50.4%, P < .05). Similarly, adjusted odds of developing BPD or death was greater in the HFNC ± CPAP group compared with the CPAP group (OR 1.085, 95% CI 1.035-1.137, P = .001). The number of ventilator days, postnatal steroid use, days to room air, days to initiate or reach full oral feeds, and length of hospitalization were significantly higher in the HFNC and HFNC ± CPAP groups compared with the CPAP group. In this retrospective study, use of HFNC in extremely low birth weight infants is associated with a higher risk of death or BPD, increased respiratory morbidities, delayed oral feeding, and prolonged hospitalization. A large clinical trial is needed to evaluate long-term safety and efficacy of HFNC in preterm infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. High Flow Nasal Cannula Use Is Associated with Increased Morbidity and Length of Hospitalization in Extremely Low Birth Weight Infants

    PubMed Central

    Taha, Dalal K.; Kornhauser, Michael; Greenspan, Jay S.; Dysart, Kevin C.; Aghai, Zubair H.

    2017-01-01

    Objective To determine differences in the incidence of bronchopulmonary dysplasia (BPD) or death in extremely low birth weight infants managed on high flow nasal cannula (HFNC) vs continuous positive airway pressure (CPAP). Study design This is aretrospective data analysis from the Alere Neonatal Database for infants born between January 2008 and July 2013, weighing ≤ 1000 g at birth, and received HFNC or CPAP. Baseline demographics, clinical characteristics, and neonatal outcomes were compared between the infants who received CPAP and HFNC, or HFNC ± CPAP. Multivariable regression analysis was performed to control for the variables that differ in bivariate analysis. Results A total of 2487 infants met the inclusion criteria (941 CPAP group, 333 HFNC group, and 1546 HFNC ± CPAP group). The primary outcome of BPD or death was significantly higher in the HFNC group (56.8%) compared with the CPAP group (50.4%, P < .05). Similarly, adjusted odds of developing BPD or death was greater in the HFNC ± CPAP group compared with the CPAP group (OR 1.085, 95% CI 1.035–1.137, P = .001). The number of ventilator days, postnatal steroid use, days to room air, days to initiate or reach full oral feeds, and length of hospitalization were significantly higher in the HFNC and HFNC ± CPAP groups compared with the CPAP group. Conclusions In this retrospective study, use of HFNC in extremely low birth weight infants is associated with a higher risk of death or BPD, increased respiratory morbidities, delayed oral feeding, and prolonged hospitalization. A large clinical trial is needed to evaluate long-term safety and efficacy of HFNC in preterm infants. PMID:27004673

  6. Influence of Lower Extremity Muscle Size and Quality on Stair-Climb Performance in Career Firefighters.

    PubMed

    Kleinberg, Craig R; Ryan, Eric D; Tweedell, Andrew J; Barnette, Timothy J; Wagoner, Chad W

    2016-06-01

    The purpose of this study was to examine the influence of lower extremity muscular size and quality on stair-climb performance (SCP) in career firefighters. Forty-six male career firefighters (age = 37.0 ± 7.2 years; stature = 180.2 ± 6.9 cm; body mass = 108.0 ± 19.8 kg) volunteered for this study. Panoramic ultrasound images of the vastus lateralis and rectus femoris were obtained to determine cross-sectional area (CSA) and echo intensity (EI) of each muscle. The CSA of each muscle was then summed together and normalized to body mass (CSA/BM [QCSA]). Additionally, EI was averaged across both muscles (QEI). Participants then performed a timed and weighted SCP assessment where they ascended and descended 26 stairs 4 times as quickly as possible while wearing a weighted vest (22.73 kg) to simulate the weight of their self-contained breathing apparatus and turnout gear. Bivariate correlations and stepwise regression analyses were used to examine the relationships among variables and the relative contributions of QCSA and QEI to SCP. Partial correlations were used to examine the relationship between QCSA and SCP and QEI and SCP while controlling for age and body mass index (BMI). The results indicated that QCSA and QEI were significantly related to SCP before (r = -0.492, p = 0.001; r = 0.363, p = 0.013, respectively) and after accounting for age and BMI (r = -0.324, p = 0.032; r = 0.413, p = 0.005, respectively). Both QCSA and QEI contributed significantly to the prediction of SCP (r = 0.560, p < 0.001). These findings indicate that lower extremity muscle size and quality are important contributors to critical firefighting tasks, which have been shown to be improved with resistance training.

  7. Climate Change and Fetal Health: The Impacts of Exposure to Extreme Temperatures in New York City

    NASA Technical Reports Server (NTRS)

    Ngo, Nicole S.; Horton, Radley M.

    2015-01-01

    Background: Climate change is projected to increase the frequency, intensity, and duration of heat waves while reducing cold extremes, yet few studies have examined the relationship between temperature and fetal health. Objectives: We estimate the impacts of extreme temperatures on birth weight and gestational age in Manhattan, a borough in New York City, and explore differences by socioeconomic status (SES). Methods: We combine average daily temperature from 1985 to 2010 with birth certificate data in Manhattan for the same time period. We then generate 33 downscaled climate model time series to project impacts on fetal health. Results: We find exposure to an extra day where average temperature 25 F and 85 F during pregnancy is associated with a 1.8 and 1.7 g (respectively) reduction in birth weight, but the impact varies by SES, particularly for extreme heat, where teen mothers seem most vulnerable. We find no meaningful, significant effect on gestational age. Using projections of temperature from these climate models, we project average net reductions in birth weight in the 2070- 2099 period of 4.6 g in the business-as-usual scenario. Conclusions: Results suggest that increasing heat events from climate change could adversely impact birth weight and vary by SES.

  8. Comparison in lower leg neuromuscular activity between runners with unilateral mid-portion Achilles tendinopathy and healthy individuals.

    PubMed

    Baur, Heiner; Müller, Steffen; Hirschmüller, Anja; Cassel, Michael; Weber, Josefine; Mayer, Frank

    2011-06-01

    Neuromuscular control in functional situations and possible impairments due to Achilles tendinopathy are not well understood. Thirty controls (CO) and 30 runners with Achilles tendinopathy (AT) were tested on a treadmill at 3.33 ms(-1) (12 km h(-1)). Neuromuscular activity of the lower leg (tibialis anterior, peroneal, and gastrocnemius muscle) was measured by surface electromyography. Mean amplitude values (MAV) for the gait cycle phases preactivation, weight acceptance and push-off were calculated and normalised to the mean activity of the entire gait cycle. MAVs of the tibialis anterior did not differ between CO and AT in any gait cycle phase. The activation of the peroneal muscle was lower in AT in weight acceptance (p=0.006), whereas no difference between CO and AT was found in preactivation (p=0.71) and push-off (p=0.83). Also, MAVs of the gastrocnemius muscle did not differ between AT and CO in preactivity (p=0.71) but were reduced in AT during weight acceptance (p=0.001) and push-off (p=0.04). Achilles tendinopathy does not seem to alter pre-programmed neural control but might induce mechanical deficits of the lower extremity during weight bearing (joint stability). This should be addressed in the therapy process of AT. Copyright © 2010 Elsevier Ltd. All rights reserved.

  9. Family meals and disordered eating in adolescents: are the benefits the same for everyone?

    PubMed

    Loth, Katie; Wall, Melanie; Choi, Chien-Wen; Bucchianeri, Michaela; Quick, Virginia; Larson, Nicole; Neumark-Sztainer, Dianne

    2015-01-01

    To examine the association between family meals and disordered eating behaviors within a diverse sample of adolescents and further investigate whether family-level variables moderate this association. Data from adolescents (EAT 2010: Eating and Activity in Teens) and their parents (Project F-EAT: Families and Eating and Activity among Teens) were collected in 2009-2010. Surveys were completed by 2,382 middle and high school students (53.2% girls, mean age = 14.4 years) from Minneapolis/St. Paul, MN, public schools. Parents/guardians (n = 2,792) completed surveys by mail or phone. Greater frequency of family meals was associated with decreased odds of engaging in unhealthy weight control behaviors in boys, and dieting, unhealthy and extreme weight control behaviors in girls. Results indicate that the protective effects of family meals are, in general, robust to family-level variables; 64 interactions were examined and only seven were statistically significant. For example, among girls, the protective nature of family meals against dieting and unhealthy weight control behaviors was diminished if they also reported family weight-related teasing (both p < .01). The results confirmed previous research indicating that participation in family meals is protective against disordered eating for youth, particularly girls. However, results suggest that in some cases, the protection offered by family meals may be modified by family-level variables. © 2014 Wiley Periodicals, Inc.

  10. Family Meals and Disordered Eating in Adolescents: Are the Benefits the Same for Everyone?

    PubMed Central

    Loth, Katie; Wall, Melanie; Choi, Chien-Wen; Bucchianeri, Michaela; Quick, Virginia; Larson, Nicole; Neumark-Sztainer, Dianne

    2016-01-01

    Objective To examine the association between family meals and disordered eating behaviors within a diverse sample of adolescents and further investigate whether family-level variables moderate this association. Method Data from adolescents (EAT 2010: Eating and Activity in Teens) and their parents (Project F-EAT: Families and Eating and Activity among Teens) were collected in 2009–2010. Surveys were completed by 2,382 middle and high school students (53.2% girls, mean age = 14.4 years) from Minneapolis/St. Paul, MN, public schools. Parents/guardians (n = 2,792) completed surveys by mail or phone. Results Greater frequency of family meals was associated with decreased odds of engaging in unhealthy weight control behaviors in boys, and dieting, unhealthy and extreme weight control behaviors in girls. Results indicate that the protective effects of family meals are, in general, robust to family-level variables; 64 interactions were examined and only seven were statistically significant. For example, among girls, the protective nature of family meals against dieting and unhealthy weight control behaviors was diminished if they also reported family weight-related teasing (both p < .01). Discussion The results confirmed previous research indicating that participation in family meals is protective against disordered eating for youth, particularly girls. However, results suggest that in some cases, the protection offered by family meals may be modified by family-level variables. PMID:25130186

  11. Associations between friends' disordered eating and muscle-enhancing behaviors

    PubMed Central

    Eisenberg, Marla E.; Wall, Melanie; Shim, Jin Joo; Bruening, Meg; Loth, Katie; Neumark-Sztainer, Dianne

    2012-01-01

    Dieting, unhealthy weight control and muscle-enhancing behaviors are common among adolescents: friends are a probable source of influence on these behaviors. The present study uses data provided by nominated friends to examine associations between friends' disordered eating and muscle-enhancing behaviors and participants' own behaviors in a diverse sample of American youth. Male and female adolescents (mean age = 14.4) completed surveys and identified their friends from a class roster; friends' survey data were then linked to each participant. Participants (N = 2126) who had at least one nominated friend were included in the analytic sample. Independent variables were created using the same weight control and muscle-enhancing behaviors reported by nominated friends, and were used in logistic regression models to test associations between participants' and their friends' behaviors, stratified by gender. Results indicated that dieting, disordered eating and muscle-enhancing behaviors were common in this sample, and selected friends' behaviors were associated with the same behaviors in participants. For example, girls whose friends reported extreme weight control behaviors had significantly greater odds of using these behaviors than girls whose friends did not report these same behaviors (OR = 2.39). This research suggests that friends' weight- and shape-related behaviors are a feature of social relationships, and is the first report demonstrating these associations for muscle-enhancing behaviors. Capitalizing on the social element may be important to the development of increasingly effective intervention and prevention programs. PMID:23010337

  12. Maternal Nutrient Restriction in Guinea Pigs as an Animal Model for Inducing Fetal Growth Restriction.

    PubMed

    Elias, Alexander A; Ghaly, Andrew; Matushewski, Brad; Regnault, Timothy R H; Richardson, Bryan S

    2016-02-01

    We determined the impact of moderate maternal nutrient restriction (MNR) in guinea pigs on pregnancy outcomes, maternal/fetal growth parameters, and blood analytes to further characterize the utility of this model for inducing fetal growth restriction (FGR). Thirty guinea pig sows were fed ad libitum (Control) or 70% of the control diet prepregnant switching to 90% at midpregnancy (MNR). Animals were necropsied near term with weights obtained on all sows, fetuses, and placenta. Fetal blood sampling and organ dissection were undertaken in appropriate for gestational age (AGA) fetuses from Control litters and FGR fetuses from MNR litters using > or < 80 g which approximated the 10th percentile for the population weight distribution of the Control fetuses. MNR fetal demise rates (1/43) were extremely low in contrast to that seen with uterine artery ligation/ablation models, albeit with increased preterm delivery in MNR sows (3 of 15). We confirm that MNR fetuses are smaller and have increased placental/fetal weight ratios as often seen in human FGR infants. We provide justification for using a fetal weight threshold for categorizing AGA Control and FGR-MNR cohorts reducing population variance, and show that FGR-MNR fetuses have asymmetrical organ growth, and are polycythemic and hypoglycemic which are also well associated with moderate FGR in humans. These findings further support the utility of moderate MNR in guinea pigs for inducing FGR with many similarities to that in humans with moderate growth restriction whether resulting from maternal undernourishment or placental insufficiency. © The Author(s) 2015.

  13. Weight Status in the First 2 Years of Life and Neurodevelopmental Impairment in Extremely Low Gestational Age Newborns.

    PubMed

    Belfort, Mandy B; Kuban, Karl C K; O'Shea, T Michael; Allred, Elizabeth N; Ehrenkranz, Richard A; Engelke, Stephen C; Leviton, Alan

    2016-01-01

    To examine the extent to which weight gain and weight status in the first 2 years of life relate to the risk of neurodevelopmental impairment in extremely preterm infants. In a cohort of 1070 infants born between 23 and 27 weeks' gestation, we examined weight gain from 7-28 days of life (in quartiles) and weight z-score at 12 and 24 months corrected age (in 4 categories: <-2; ≥-2, <-1; ≥1, <1; and ≥1) in relation to these adverse neurodevelopmental outcomes: Bayley-II mental development index <55, Bayley-II psychomotor development index <55, cerebral palsy, Gross Motor Function Classification System ≥1 (cannot walk without assistance), microcephaly. We adjusted for confounders in logistic regression, stratified by sex, and performed separate analyses including the entire sample, and excluding children unable to walk without assistance (motor impairment). Weight gain in the lowest quartile from 7-28 days was not associated with higher risk of adverse outcomes. Children with a 12-month weight z-score <-2 were at increased risk for all adverse outcomes in girls, and for microcephaly and Gross Motor Function Classification System ≥1 in boys. However, excluding children with motor impairment attenuated all associations except that of weight z-score <-2 with microcephaly in girls. Similarly, most associations of low weight z-score at 24 months with adverse outcomes were attenuated with exclusion of children with motor impairment. Excluding children who have gross motor impairment appears to eliminate the association of low weight status with neurodevelopmental impairments at 2 years in extremely preterm infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Weight information labels on media models reduce body dissatisfaction in adolescent girls.

    PubMed

    Veldhuis, Jolanda; Konijn, Elly A; Seidell, Jacob C

    2012-06-01

    To examine how weight information labels on variously sized media models affect (pre)adolescent girls' body perceptions and how they compare themselves with media models. We used a three (body shape: extremely thin vs. thin vs. normal weight) × three (information label: 6-kg underweight vs. 3-kg underweight vs. normal weight) experimental design in three age-groups (9-10 years, 12-13 years, and 15-16 years; n = 184). The girls completed questionnaires after exposure to media models. Weight information labels affected girls' body dissatisfaction, social comparison with media figures, and objectified body consciousness. Respondents exposed to an extremely thin body shape labeled to be of "normal weight" were most dissatisfied with their own bodies and showed highest levels of objectified body consciousness and comparison with media figures. An extremely thin body shape combined with a corresponding label (i.e., 6-kg underweight), however, induced less body dissatisfaction and less comparison with the media model. Age differences were also found to affect body perceptions: adolescent girls showed more negative body perceptions than preadolescents. Weight information labels may counteract the generally media-induced thin-body ideal. That is, when the weight labels appropriately informed the respondents about the actual thinness of the media model's body shape, girls were less affected. Weight information labels also instigated a normalization effect when a "normal-weight" label was attached to underweight-sized media models. Presenting underweight as a normal body shape, clearly increased body dissatisfaction in girls. Results also suggest age between preadolescence and adolescence as a critical criterion in responding to media models' body shape. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  15. The Baby Moves prospective cohort study protocol: using a smartphone application with the General Movements Assessment to predict neurodevelopmental outcomes at age 2 years for extremely preterm or extremely low birthweight infants.

    PubMed

    Spittle, A J; Olsen, J; Kwong, A; Doyle, L W; Marschik, P B; Einspieler, C; Cheong, Jly

    2016-10-03

    Infants born extremely preterm (EP; <28 weeks' gestation) and/or with extremely low birth weight (ELBW; <1000 g birth weight) are at increased risk for adverse neurodevelopmental outcomes. However, it is challenging to predict those EP/ELBW infants destined to have long-term neurodevelopmental impairments in order to target early intervention to those in most need. The General Movements Assessment (GMA) in early infancy has high predictive validity for neurodevelopmental outcomes in preterm infants. However, access to a GMA may be limited by geographical constraints and a lack of GMA-trained health professionals. Baby Moves is a smartphone application (app) developed for caregivers to video and upload their infant's general movements to be scored remotely by a certified GMA assessor. The aim of this study is to determine the predictive ability of using the GMA via the Baby Moves app for neurodevelopmental impairment in infants born EP/ELBW. This prospective cohort study will recruit infants born EP/ELBW across the state of Victoria, Australia in 2016 and 2017. A control group of normal birth weight (>2500 g birth weight), term-born (≥37 weeks' gestation) infants will also be recruited as a local reference group. Parents will video their infant's general movements at two time points between 3 and 4 months' corrected age using the Baby Moves app. Videos will be scored by certified GMA assessors and classified as normal or abnormal. Parental satisfaction using the Baby Moves app will be assessed via survey. Neurodevelopmental outcome at 2 years' corrected age includes developmental delay according to the Bayley Scales of Infant and Toddler Development-III and cerebral palsy diagnosis. This study was approved by the Human Research and Ethics Committees at the Royal Children's Hospital, The Royal Women's Hospital, Monash Health and Mercy Health in Melbourne, Australia. Study findings will be disseminated via peer-reviewed publications and conference presentations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Long-term Psychiatric Impact of Peer Victimization in Adults Born at Extremely Low Birth Weight.

    PubMed

    Day, Kimberly L; Schmidt, Louis A; Vaillancourt, Tracy; Saigal, Saroj; Boyle, Michael H; Van Lieshout, Ryan J

    2016-03-01

    While children born at extremely low birth weight (ELBW; <1000 g) are at elevated risk for peer victimization, no research has examined its effects on mental health in adulthood. ELBW survivors and matched normal birth weight (NBW; >2500 g) controls were part of a prospective, population-based study in Ontario, Canada. Peer victimization before age 16 was self-reported at age 22 to 26 years by using a 10-point measure. Presence of psychiatric disorders was examined at age 22 to 26 years (ELBW n = 142, NBW n = 133) and age 29 to 36 years (ELBW n = 84, NBW n = 90). After adjustment for confounding variables, for each 1-point increase in the peer victimization score, ELBW survivors had increased odds of current depressive (odds ratio [OR] = 1.67, 95% confidence interval [CI], 1.23-2.28), anxiety (OR = 1.36, 95% CI, 1.05-1.76), avoidant (OR = 1.39, 95% CI, 1.08-1.79), antisocial (OR = 1.92, 95% CI, 1.06-2.87), and attention-deficit/hyperactivity (OR = 1.39, 95% CI, 1.06-1.83) problems at age 22 to 26 years. At age 29 to 36 years, peer victimization score predicted increased odds of current panic disorder (OR = 1.69, 95% CI, 1.01-2.83) and obsessive-compulsive disorder (OR = 3.56, 95% CI, 1.25-10.09). For NBW controls, peer victimization predicted increased odds of antisocial problems at age 22 to 26 years. ELBW survivorsand NBW participants are vulnerable to the adverse psychiatric effects of childhood peer victimization in adulthood. Copyright © 2016 by the American Academy of Pediatrics.

  17. The effects of load carriage and muscle fatigue on lower-extremity joint mechanics.

    PubMed

    Wang, He; Frame, Jeff; Ozimek, Elicia; Leib, Daniel; Dugan, Eric L

    2013-09-01

    Military personnel are commonly afflicted by lower-extremity overuse injuries. Load carriage and muscular fatigue are major stressors during military basic training. To examine effects of load carriage and muscular fatigue on lower-extremity joint mechanics during walking. Eighteen men performed the following tasks: unloaded walking, walking with a 32-kg load, fatigued walking with a 32-kg load, and fatigued walking. After the second walking task, muscle fatigue was elicited through a fatiguing protocol consisting of metered step-ups and heel raises with a 16-kg load. Each walking task was performed at 1.67 m x s(-1) for 5 min. Walking movement was tracked by a VICON motion capture system at 120 Hz. Ground reaction forces were collected by a tandem force instrumented treadmill (AMTI) at 2,400 Hz. Lower-extremity joint mechanics were calculated in Visual 3D. There was no interaction between load carriage and fatigue on lower-extremity joint mechanics (p > .05). Both load carriage and fatigue led to pronounced alterations of lower-extremity joint mechanics (p < .05). Load carriage resulted in increases of pelvis anterior tilt, hip and knee flexion at heel contact, and increases of hip, knee, and ankle joint moments and powers during weight acceptance. Muscle fatigue led to decreases of ankle dorsiflexion at heel contact, dorsiflexor moment, and joint power at weight acceptance. In addition, muscle fatigue increased demand for hip extensor moment and power at weight acceptance. Statistically significant changes in lower-extremity joint mechanics during loaded and fatigued walking may expose military personnel to increased risk for overuse injuries.

  18. Age-related differences in muscle control of the lower extremity for support and propulsion during walking

    PubMed Central

    Toda, Haruki; Nagano, Akinori; Luo, Zhiwei

    2016-01-01

    [Purpose] This study examined age-related differences in muscle control for support and propulsion during walking in both males and females in order to develop optimal exercise regimens for muscle control. [Subjects and Methods] Twenty elderly people and 20 young people participated in this study. Coordinates of anatomical landmarks and ground reaction force during walking were obtained using a 3D motion analysis system and force plates. Muscle forces during walking were estimated using OpenSim. Muscle modules were obtained by using non-negative matrix factorization analysis. A two-way analysis of covariance was performed to examine the difference between the elderly and the young in muscle weightings using walking speed as a covariate. The similarities in activation timing profiles between the elderly and the young were analyzed by cross-correlation analysis in males and females. [Results] In the elderly, there was a change in the coordination of muscles around the ankle, and muscles of the lower extremity exhibited co-contraction in late stance. Timing and shape of these modules were similar between elderly and young people. [Conclusion] Our results suggested that age-related alteration of muscle control was associated with support and propulsion during walking. PMID:27134360

  19. Results of a strategic science study to inform policies targeting extreme thinness standards in the fashion industry.

    PubMed

    Rodgers, Rachel F; Ziff, Sara; Lowy, Alice S; Yu, Kimberly; Austin, S Bryn

    2017-03-01

    The appearance pressures experienced by fashion models have been criticized as harmful to their health, as well as increasing eating disorder risk among youth by promoting ideals of extreme thinness. Given recent legislation to protect models, we undertook a strategic science study to assess professional fashion models' perceptions of the potential impact and feasibility of seven policy proposals. A sample of 85 female fashion models, mean age = 22.7 years (SD 3.7) completed an online survey assessing unhealthy weight control behaviors (UWCB), perceived pressure from agencies to lose weight, as well as the perceived impact and feasibility of seven potential policy actions. Chi-squared analyses and multivariable logistic regressions compared UWCB among models who were asked to lose weight and those who were not. Friedman and Kendall's W tests were conducted to examine differences in impact and feasibility ratings across the seven policy proposals. Models reported high levels of pressure to lose weight, which was associated with higher odds of engaging in UWCB. The policy approaches rated as most impactful were those to increase worker protections, though they were rated as only moderately feasible. Requiring employers to provide food and a 30-min break for jobs longer than 6 h was rated as both impactful and feasible. Imposing restrictions on minimum BMI was rated as the least impactful. Approaches providing employment protections and healthier working conditions are most supported by professional models. These findings help to illuminate viable policy approaches from the perspective of key stakeholders. © 2017 Wiley Periodicals, Inc.

  20. A Force-Velocity Relationship and Coordination Patterns in Overarm Throwing

    PubMed Central

    van den Tillaar, Roland; Ettema, Gertjan

    2004-01-01

    A force-velocity relationship in overarm throwing was determined using ball weights varying from 0.2 to 0.8 kg. Seven experienced handball players were filmed at 240 frames per second. Velocity of joints of the upper extremity and ball together with the force on the ball were derived from the data. A statistically significant negative relationship between force and maximal ball velocity, as well as between ball weight and maximal ball velocity was observed. Also, with increase of ball weight the total throwing movement time increased. No significant change in relative timing of the different joints was demonstrated, suggesting that the subjects did not change their “global ”coordination pattern (kinematics) within the tested range of ball weights. A simple model revealed that 67% of ball velocity at ball release was explained by the summation of effects from the velocity of elbow extension and internal rotation of the shoulder. With regard to the upper extremity the internal rotation of the shoulder and elbow extension are two important contributors to the total ball velocity at release. Key Points An inverse relationship between load and velocity and a linear force-velocity exists in overarm throwing with ball weights varying from 0.2 to 0.8 kg. Qualitatively, no changes in coordination pattern (relative timing) occur with increasing ball weight within the tested range of ball weights. The absolute throwing movement time increased with ball weight. Quantitatively, with regard to the upper extremity, the internal rotation of the shoulder and elbow extension are two important contributors to the total ball velocity at release. PMID:24624005

  1. Effect of constrained weight shift on the static balance and muscle activation of stroke patients

    PubMed Central

    Kang, Kyung Woo; Kim, Kyoung; Lee, Na Kyung; Kwon, Jung Won; Son, Sung Min

    2015-01-01

    [Purpose] The purpose of this study was to evaluate the effects of constrained weight shift induced by shoe lift beneath the unaffected lower extremity, on balance functions and electromyography of the affected lower extremity of stroke patients. [Subjects and Methods] Twelve patients with unilateral stroke were recruited as volunteers for this study. The subjects were repeatedly measured in a randomized order under three conditions: no-shoe lift, and shoe lifts of 5 mm and 10 mm heights beneath the unaffected lower extremity. [Results] Standing with a 10 mm shoe lift for the unaffected lower extremity decreased the mean velocity of mediolateral sway compared to no-shoe lift. Regarding the velocity of anteroposterior sway, standing with 5 mm and 10 mm shoe lifts decreased the mean velocity of anteroposterior sway. The muscle activation of the affected lower extremity was not significantly different among the no-shoe lift, 5 mm shoe lift and 10 mm shoe lift conditions; however, the muscle activities of the rectus femoris, biceps femoris, tibialis anterior, and medial gastrocnemius of the affected lower extremity progressively improved with increasing height of the shoe lift. [Conclusion] A constrained weight shift to the affected side elicited by a shoe insole of 10 mm height on the unaffected side can improve the static standing balance of stroke patients, and it resulted in 14–24% increases in the muscle activities of the affected leg. PMID:25931729

  2. Employment and weight status: The extreme case of body concern in South Korea.

    PubMed

    Han, Seung-Yong; Brewis, Alexandra A; SturtzSreetharan, Cindi

    2018-05-01

    For an industrialized nation, obesity rates in South Korea are extremely low. Yet, reflecting an extremely fat-averse, thin-positive society, efforts to lose weight are now reportedly very common. Since the 1980s, South Korea has experienced an increasingly flexible and insecure labor market which was exacerbated by the 1997 economic recession. In this social and economic setting, body shape and weight status, as human capital, may have gained significant bargaining power in the labor market. Consequently, we propose that Koreans, particularly those who are employed in "stable" jobs (i.e., non-manual and regular jobs), would increasingly engage in intense weight management and reduction activities even when not technically overweight or obese as a means to job security and upward mobility. Using nationally-representative data from the Korean Nutrition and Health Examination Survey (KNHANES), we identify the changing role of weight concerns versus actual body weight in predicting South Korean efforts to lose weight between 2001 (KNHANES-phase 1) and 2007-2009 (phase 4). The patterns were examined by occupation type (manual and non-manual jobs) and status (regular and non-regular jobs). Oaxaca decomposition analysis supported that people's perception of being "fat," rather than actual weight status, was crucial to explaining accelerated weight management efforts in South Korea over the decade (coef. = 0.062 and p-value < .0001 for male with regular work; coef. = 0.031 and p-value = .002 for female with regular work). Occupation status, rather than employment in itself, mattered. Job stability predicted increased effort; the pattern of change through time suggests efforts to invest high levels of effort in appearance positively impacts both employment opportunity and stability. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Increasing low birth weight rates: deliveries in a tertiary hospital in istanbul.

    PubMed

    Akin, Yasemin; Cömert, Serdar; Turan, Cem; Unal, Orhan; Piçak, Abdülkadir; Ger, Lale; Telatar, Berrin

    2010-09-01

    Prevalence of low birth weight deliveries may vary across different environments. The necessity of determination of regional data prompted this study. Information of all deliveries from January 2004 to December 2008 was obtained from delivery registry records retrospectively. Initial data including birth weight, vital status, sex, maternal age and mode of delivery were recorded using medical files. The frequency of low birth weight, very low birth weight, extremely low birth weight and stillbirth deliveries were determined. Among 19,533 total births, there were 450 (23.04 per 1000) stillbirths. Low birth weight rate was 10.61%. A significant increase in yearly distribution of low birth weight deliveries was observed (P<0.001). Very low birth weight and extremely low birth weight delivery rates were 3.14% and 1.58% respectively. Among 2073 low birth weight infants, 333 (16.06%) were stillbirths. The stillbirth delivery rate and the birth of a female infant among low birth weight deliveries were significantly higher than infants with birth weight ≥2500g (P<0.001, OR=28.37), (P<0.001) retrospectively. There was no statistical difference between low birth weight and maternal age. The rate of cesarean section among low birth weight infants was 49.4%. High low birth weight and stillbirth rates, as well as the increase in low birth weight deliveries over the past five years in this study are striking. For reduction of increased low birth weight rates, appropriate intervention methods should be initiated.

  4. Narcissism as a moderator of satisfaction with body image in young women with extreme underweight and obesity.

    PubMed

    Lipowska, Małgorzata; Lipowski, Mariusz

    2015-01-01

    Body weight and age constitute main determinants of body image in women. We analyzed the role of narcissism as a moderator of body image in young women representing various extremes of body weight. The study included 325 women between 18 and 35 years, qualified into three BMI categories: obese women (BMI > 30.0, n = 72), severely underweight women who did not satisfy the remaining criteria of anorexia (BMI < 17.5, n = 85), and women with normal body weight (21.7 < "ideal BMI" > 22.7, n = 168). Satisfaction with body image was determined with Multidimensional Body-Self Relations Questionnaire and Body Esteem Scale, while narcissism was measured with Narcissistic Personality Inventory. We revealed that narcissism has significant impact on the body image of women who are extremely underweight or obese. Vanity and Leadership were narcissism dimensions which played significant role in slim women, as compared to Vanity and Self-Sufficiency in obese women. The role of narcissism as a modulator of self-satisfaction with one's body varies depending on BMI level: extremely underweight women and obese individuals constitute groups in which narcissism has the strongest impact on the self-satisfaction with body.

  5. Review of space radiation interaction with ZERODUR

    NASA Astrophysics Data System (ADS)

    Carré, Antoine; Westerhoff, Thomas; Hull, Tony; Doyle, D.

    2017-09-01

    ZERODUR has been and is still being successfully used as mirror substrates for a large number of space missions. Improvements in CNC machining at SCHOTT allow to achieve extremely light weighted substrates incorporating very thin ribs and face sheets. This paper is reviewing data published on the interaction of space radiation with ZERODUR. Additionally, this paper reports on considerations and experiments which are needed to confidently apply an updated model on ZERODUR behavior under space radiation for extremely light weighted ZERODUR substrates.

  6. Hybrid photonic signal processing

    NASA Astrophysics Data System (ADS)

    Ghauri, Farzan Naseer

    This thesis proposes research of novel hybrid photonic signal processing systems in the areas of optical communications, test and measurement, RF signal processing and extreme environment optical sensors. It will be shown that use of innovative hybrid techniques allows design of photonic signal processing systems with superior performance parameters and enhanced capabilities. These applications can be divided into domains of analog-digital hybrid signal processing applications and free-space---fiber-coupled hybrid optical sensors. The analog-digital hybrid signal processing applications include a high-performance analog-digital hybrid MEMS variable optical attenuator that can simultaneously provide high dynamic range as well as high resolution attenuation controls; an analog-digital hybrid MEMS beam profiler that allows high-power watt-level laser beam profiling and also provides both submicron-level high resolution and wide area profiling coverage; and all optical transversal RF filters that operate on the principle of broadband optical spectral control using MEMS and/or Acousto-Optic tunable Filters (AOTF) devices which can provide continuous, digital or hybrid signal time delay and weight selection. The hybrid optical sensors presented in the thesis are extreme environment pressure sensors and dual temperature-pressure sensors. The sensors employ hybrid free-space and fiber-coupled techniques for remotely monitoring a system under simultaneous extremely high temperatures and pressures.

  7. Effects of an Off-Axis Pivoting Elliptical Training Program on Gait Function in Persons With Spastic Cerebral Palsy: A Preliminary Study.

    PubMed

    Tsai, Liang-Ching; Ren, Yupeng; Gaebler-Spira, Deborah J; Revivo, Gadi A; Zhang, Li-Qun

    2017-07-01

    This preliminary study examined the effects of off-axis elliptical training on reducing transverse-plane gait deviations and improving gait function in 8 individuals with cerebral palsy (CP) (15.5 ± 4.1 years) who completed an training program using a custom-made elliptical trainer that allows transverse-plane pivoting of the footplates during exercise. Lower-extremity off-axis control during elliptical exercise was evaluated by quantifying the root-mean-square and maximal angular displacement of the footplate pivoting angle. Lower-extremity pivoting strength was assessed. Gait function and balance were evaluated using 10-m walk test, 6-minute-walk test, and Pediatric Balance Scale. Toe-in angles during gait were quantified. Participants with CP demonstrated a significant decrease in the pivoting angle (root mean square and maximal angular displacement; effect size, 1.00-2.00) and increase in the lower-extremity pivoting strength (effect size = 0.91-1.09) after training. Reduced 10-m walk test time (11.9 ± 3.7 seconds vs. 10.8 ± 3.0 seconds; P = 0.004; effect size = 1.46), increased Pediatric Balance Scale score (43.6 ± 12.9 vs. 45.6 ± 10.8; P = 0.042; effect size = 0.79), and decreased toe-in angle (3.7 ± 10.5 degrees vs. 0.7 ± 11.7 degrees; P = 0.011; effect size = 1.22) were observed after training. We present an intervention to challenge lower-extremity off-axis control during a weight-bearing and functional activity for individuals with CP. Our preliminary findings suggest that this intervention was effective in enhancing off-axis control, gait function, and balance and reducing in-toeing gait in persons with CP.

  8. [Effect of extremely low frequency magnetic field on glutathione in rat muscles].

    PubMed

    Ciejka, Elzbieta; Jakubowska, Ewa; Zelechowska, Paulina; Huk-Kolega, Halina; Kowalczyk, Agata; Goraca, Anna

    2014-01-01

    Free radicals (FR) are atoms, molecules or their fragments. Their excess leads to the development of oxidizing stress, the cause of many neoplastic, neurodegenerative and inflammatory diseases, and aging of the organism. Industrial pollution, tobacco smoke, ionizing radiation, ultrasound and magnetic field are the major FR exogenous sources. The low frequency magnetic field is still more commonly applied in the physical therapy. The aim of the presented study was to evaluate the effect of extremely low frequency magnetic field used in the magnetotherapy on the level of total glutathione, oxidized and reduced, and the redox state of the skeletal muscle cells, depending on the duration of exposure to magnetic field. The male rats, weight of 280-300 g, were randomly devided into 3 experimental groups: controls (group I) and treatment groups exposed to extremely low frequency magnetic field (ELF-MF) (group II exposed to 40 Hz, 7 mT for 0.5 h/day for 14 days and group III exposed to 40 Hz, 7 mT for 1 h/day for 14 days). Control rats were kept in a separate room not exposed to extremely low frequency magnetic field. Immediately after the last exposure, part of muscles was taken under pentobarbital anesthesia. Total glutathione, oxidized and reduced, and the redox state in the muscle tissue of animals were determined after exposure to magnetic fields. Exposure to low magnetic field: 40 Hz, 7 mT for 30 min/day and 60 min/day for 2 weeks significantly increased the total glutathione levels in the skeletal muscle compared to the control group (p < 0.001). Exposure to magnetic fields used in the magnetic therapy plays an important role in the development of adaptive mechanisms responsible for maintaining the oxidation-reduction balance in the body and depends on exposure duration.

  9. Guidance for the utility of linear models in meta-analysis of genetic association studies of binary phenotypes.

    PubMed

    Cook, James P; Mahajan, Anubha; Morris, Andrew P

    2017-02-01

    Linear mixed models are increasingly used for the analysis of genome-wide association studies (GWAS) of binary phenotypes because they can efficiently and robustly account for population stratification and relatedness through inclusion of random effects for a genetic relationship matrix. However, the utility of linear (mixed) models in the context of meta-analysis of GWAS of binary phenotypes has not been previously explored. In this investigation, we present simulations to compare the performance of linear and logistic regression models under alternative weighting schemes in a fixed-effects meta-analysis framework, considering designs that incorporate variable case-control imbalance, confounding factors and population stratification. Our results demonstrate that linear models can be used for meta-analysis of GWAS of binary phenotypes, without loss of power, even in the presence of extreme case-control imbalance, provided that one of the following schemes is used: (i) effective sample size weighting of Z-scores or (ii) inverse-variance weighting of allelic effect sizes after conversion onto the log-odds scale. Our conclusions thus provide essential recommendations for the development of robust protocols for meta-analysis of binary phenotypes with linear models.

  10. Wheat seed weight and quality differ temporally in sensitivity to warm or cool conditions during seed development and maturation

    PubMed Central

    Nasehzadeh, M

    2017-01-01

    Abstract Background and aims Short periods of extreme temperature may affect wheat (Triticum aestivum) seed weight, but also quality. Temporal sensitivity to extreme temperature during seed development and maturation was investigated. Methods Plants of ‘Tybalt’ grown at ambient temperature were moved to growth cabinets at 29/20°C or 34/20°C (2010), or 15/10°C or 34/20°C (2011), for successive 7-d periods from 7 DAA (days after anthesis) onwards, and also 7–65 DAA in 2011. Seed samples were harvested serially and moisture content, weight, ability to germinate, subsequent longevity in air-dry storage and bread-making quality were determined. Key Results High temperature (34/20°C) reduced final seed weight, with greatest temporal sensitivity at 7–14 or 14–21 DAA. Several aspects of bread-making quality were also most sensitive to high temperature then, but whereas protein quality decreased protein and sulphur concentrations improved. Early exposure to high temperature provided earlier development of ability to germinate and tolerate desiccation, but had little effect on maximum germination capacity. All treatments at 15/10°C resulted in ability to germinate declining between 58 and 65 DAA. Early exposure to high temperature hastened improvement in seed storage longevity, but the subsequent decline in late maturation preceded that in the control. Long (7–65 DAA) exposure to 15/10°C disrupted the development of seed longevity, with no improvement after seed filling ended. Longevity improved during maturation drying in other treatments. Early (7–14 DAA) exposure to high temperature reduced and low temperature increased subsequent longevity at harvest maturity, whereas late (35 or 42–49 DAA) exposure to high temperature increased and low temperature reduced it. Conclusions Temporal sensitivity to extreme temperature was detected. It varied considerably amongst the contrasting seed variables investigated. Subsequent seed longevity at harvest maturity responded negatively to temperature early in development, but positively later in development and throughout maturation. PMID:28637252

  11. Prevalence of respiratory tract infections, allergies and assessment of humoral immunity within the Malopolska region's cohort of 11- year old children born with extremely low birth weight in comparison with to their term born peers.

    PubMed

    Zasada, Magdalena; Klimek, Małgorzata; Durlak, Wojciech; Kotula, Monika; Tomasik, Tomasz; Kwinta, Przemko

    2016-01-01

    Children born with extremely low birth weight (ELBW) have more respiratory tract complications during childhood. Little is known about respiratory and allergy problems in ELBW children at the threshold of adolescence. A follow-up study was conducted at the age of 11 among ELBW children (n=65) and age-matched controls (n=36). The primary outcomes in the study were the occurrence of respiratory and allergy problems and the rate of hospitalization due to respiratory complications at the age of 11 years, assessed with a questionnaire. Secondary outcome variables were serum levels of immunoglobulin classes. ELBW children had more respiratory tract infections (31 vs.11%, p = 0.03), but less allergies (3 vs. 22%, p < 0.01) compared with controls and had lower level of serum tIgE (geometric mean: 46.5 vs. 89.3 kU/l, p = 0.02). The risk factors for the occurrence of respiratory tract disorders in the ELBW group were: low gestational age, need for surfactant therapy and length of ventilatory support in the neonatal period. ELBW children have more frequent respiratory tract complications, but fewer allergies at the age of 11 years compared with children born at term. Lower respiratory tract problems decrease in ELBW children with age. Respiratory tract infections are not connected with deficiency in humoral immunity.

  12. Parental perceptions of weight terminology that providers use with youth.

    PubMed

    Puhl, Rebecca M; Peterson, Jamie Lee; Luedicke, Joerg

    2011-10-01

    Little research has been performed to examine patient perceptions of weight-related language, especially related to childhood obesity. In this study we assessed parental perceptions of weight-based terminology used by health care providers to describe a child's excess weight and assessed perceived connotations associated with these terms including stigma, blame, and motivation to reduce weight. A national sample of American parents with children aged 2 to 18 years (N = 445) completed an online survey to assess their perceptions of 10 common terms to describe excess body weight in youth (including "extremely obese," "high BMI," "weight problem," "unhealthy weight," "weight," "heavy," "obese," "overweight," "chubby," and "fat"). Parents were asked to use a 5-point rating scale to indicate how much they perceived each term to be desirable, stigmatizing, blaming, or motivating to lose weight. Regression models revealed that the terms "weight" and "unhealthy weight" were rated as most desirable, and "unhealthy weight" and "weight problem" were rated as the most motivating to lose weight. The terms "fat," "obese," and "extremely obese" were rated as the most undesirable, stigmatizing, blaming, and least motivating. Parents' ratings were consistent across sociodemographic variables, body weight, and child's body weight. The results of this study have important implications for the improvement of health care for youth with obesity; it may be advantageous for health care providers to use or avoid using specific weight-based language during discussions about body weight with families. Pediatricians play a key role in obesity prevention and treatment, but their efforts may be undermined by stigmatizing or offensive language that can hinder important discussions about children's health.

  13. Peripheral Quantitative CT (pQCT) Using a Dedicated Extremity Cone-Beam CT Scanner

    PubMed Central

    Muhit, A. A.; Arora, S.; Ogawa, M.; Ding, Y.; Zbijewski, W.; Stayman, J. W.; Thawait, G.; Packard, N.; Senn, R.; Yang, D.; Yorkston, J.; Bingham, C.O.; Means, K.; Carrino, J. A.; Siewerdsen, J. H.

    2014-01-01

    Purpose We describe the initial assessment of the peripheral quantitative CT (pQCT) imaging capabilities of a cone-beam CT (CBCT) scanner dedicated to musculoskeletal extremity imaging. The aim is to accurately measure and quantify bone and joint morphology using information automatically acquired with each CBCT scan, thereby reducing the need for a separate pQCT exam. Methods A prototype CBCT scanner providing isotropic, sub-millimeter spatial resolution and soft-tissue contrast resolution comparable or superior to standard multi-detector CT (MDCT) has been developed for extremity imaging, including the capability for weight-bearing exams and multi-mode (radiography, fluoroscopy, and volumetric) imaging. Assessment of pQCT performance included measurement of bone mineral density (BMD), morphometric parameters of subchondral bone architecture, and joint space analysis. Measurements employed phantoms, cadavers, and patients from an ongoing pilot study imaged with the CBCT prototype (at various acquisition, calibration, and reconstruction techniques) in comparison to MDCT (using pQCT protocols for analysis of BMD) and micro-CT (for analysis of subchondral morphometry). Results The CBCT extremity scanner yielded BMD measurement within ±2–3% error in both phantom studies and cadaver extremity specimens. Subchondral bone architecture (bone volume fraction, trabecular thickness, degree of anisotropy, and structure model index) exhibited good correlation with gold standard micro-CT (error ~5%), surpassing the conventional limitations of spatial resolution in clinical MDCT scanners. Joint space analysis demonstrated the potential for sensitive 3D joint space mapping beyond that of qualitative radiographic scores in application to non-weight-bearing versus weight-bearing lower extremities and assessment of phalangeal joint space integrity in the upper extremities. Conclusion The CBCT extremity scanner demonstrated promising initial results in accurate pQCT analysis from images acquired with each CBCT scan. Future studies will include improved x-ray scatter correction and image reconstruction techniques to further improve accuracy and to correlate pQCT metrics with known pathology. PMID:25076823

  14. Physical Activity Patterns in the National Weight Control Registry

    PubMed Central

    Catenacci, Victoria A.; Ogden, Lorraine G.; Stuht, Jennifer; Phelan, Suzanne; Wing, Rena R.; Hill, James O.; Wyatt, Holly R.

    2015-01-01

    Objective The National Weight Control Registry (NWCR) was established in 1993 to examine the characteristics of those who are successful at weight loss: individuals maintaining a 13.6-kg weight loss for >1 year. The size of the registry has increased substantially since the early descriptions of this group a decade ago. The purpose of this study was to describe in detail the weekly physical activity habits of NWCR members, to examine the relationship between amount of activity and demographic characteristics, and to determine if changes in activity parameters have occurred over time. Methods and Procedures Participants were 887 men and 2,796 women who enrolled in the NWCR between 1993 and 2004. Physical activity was evaluated at registry entry using the Paffenbarger Physical Activity Questionnaire. Results NWCR entrants report an average of 2,621 ± 2,252 kcal/week in physical activity. There is considerable variability in the amount of activity reported: 25.3% report <1,000 kcal/week and 34.9% report >3,000 kcal/week. Activity level on registry entry is related to the magnitude but not the duration of weight loss. The amount of activity reported by men has decreased over time while no significant change was observed in women. Changes in the types of activities most frequently reported were also observed. Discussion Overall, NWCR participants are an extremely physically active group. However, the amount of activity reported is highly variable, making it difficult to develop a single recommendation for the optimum amount of physical activity for weight loss maintenance. A better understanding of individual-specific determinants of how much activity is required for weight loss maintenance ought to be a high research priority. PMID:18223628

  15. Use of an anti-gravity treadmill in the rehabilitation of the operated achilles tendon: a pilot study.

    PubMed

    Saxena, Amol; Granot, Allison

    2011-01-01

    Achilles surgical patients were evaluated using an "anti-gravity" Alter-G (AG) treadmill that allows for reduction of weightbearing pressure on the lower extremity. We studied our hypothesis, which was based on our prior clinical findings, that being able to run on the AG treadmill at 85% of body weight is sufficient to clear patients to run with full body weight outside. Patients undergoing Achilles tendon rupture or insertional repair surgery were prospectively studied. They were compared with a control group that had similar surgeries and a similar rehabilitation program during the same time period: the variable was not using the AG treadmill. The criteria for the study group to be allowed to run outside was being able to run for at least 10 minutes on the AG at 85% of body weight. Each group had 8 patients who underwent surgery for 2 complete tendon ruptures and 6 insertional repairs. There was no significant difference between the AG and control group as to age and postoperative follow-up. AG patients began their initial run on the treadmill at 70% of their body weight at 13.9 ± 3.4 weeks, 85% at 17.6 ± 3.9 weeks, and outside running at 18.1 ± 3.9 weeks. The control group's return to running outside time was 20.4 ± 4.1 weeks. This was not significantly different (p = .27). We confirmed our hypothesis that being able to run at 85% of body weight after Achilles surgery was sufficient to clear patients to run outside. Copyright © 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Childhood Obesity is Associated With Osteochondritis Dissecans of the Knee, Ankle, and Elbow in Children and Adolescents.

    PubMed

    Kessler, Jeffrey I; Jacobs, John C; Cannamela, Peter C; Shea, Kevin G; Weiss, Jennifer M

    Osteochondritis dissecans (OCD) is a joint disorder of the subchondral bone and articular cartilage whose association with obesity in children is not clearly known. The purpose of this study was to assess the magnitude of the association between childhood obesity and the occurrence of OCD of the knee, ankle, and elbow in children. A retrospective chart review of an integrated health system was performed on OCD patients aged 2 to 19 from 2007 to 2011, with over 1 million patients in this cohort. Lesion location, laterality, and all patient demographics were recorded. The body mass index (BMI) for each patient in the cohort was used to stratify patients into 5 weight classes (underweight, normal weight, overweight, moderately obese, and extremely obese) based on BMI-for-age. The associations between the 5 weight classes and OCD of the ankle, knee, and elbow were assessed using multiple logistic regression models to estimate odds ratios (OR) and 95% confidence intervals using multivariate analysis to adjust for patient demographic variables. In total, 269 patients fit the inclusion criteria. Mean BMI, both absolute and percentile, was significantly higher for patients with OCD of the knee, elbow, and ankle than patients without OCD. In the multivariate analysis, extremely obese patients were found to have an increased OR of OCD for all patients, with an 86% increased risk of any OCD compared with normal weight patients. In addition, assessment by different types of OCD revealed that extremely obese patients had an increased OR of OCD of the elbow and ankle individually, with a 3.1 times increased OCD elbow risk and 3.0 times increased risk of ankle OCD in extremely obese patients. Although extremely obese patients did not have a statistically significant increased risk of knee OCD, moderately obese patients did have a 1.8 times increased risk of knee OCD as compared with normal weight children. There were no significantly different risks of any type of OCD seen in overweight or underweight patients as compared with normal weight patients. In this population-based cohort study, extreme obesity is strongly associated with an increased risk of OCD overall and OCD of the elbow and ankle specifically. In addition, moderate obesity is associated with an increased risk of knee OCD. All types of OCD were also found to have a significantly greater average BMI when compared with patients without OCD. Level IV-descriptive epidemiology study.

  17. Measurement of the extreme ankle range of motion required by female ballet dancers.

    PubMed

    Russell, Jeffrey A; Kruse, David W; Nevill, Alan M; Koutedakis, Yiannis; Wyon, Matthew A

    2010-12-01

    Female ballet dancers require extreme ankle motion, especially plantar flexion, but research about measuring such motion is lacking. The purposes of this study were to determine in a sample of ballet dancers whether non-weight-bearing ankle range of motion is significantly different from the weight-bearing equivalent and whether inclinometric plantar flexion measurement is a suitable substitute for standard plantar flexion goniometry. Fifteen female ballet dancers (5 university, 5 vocational, and 5 professional dancers; age 21 ± 3.0 years) volunteered. Subjects received 5 assessments on 1 ankle: non-weight-bearing goniometry dorsiflexion (NDF) and plantar flexion (NPF), weight-bearing goniometry in the ballet positions demi-plié (WDF) and en pointe (WPF), and non-weight-bearing plantar flexion inclinometry (IPF). Mean NDF was significantly lower than WDF (17° ± 1.3° vs 30° ± 1.8°, P < .001). NPF (77° ± 2.5°) was significantly lower than both WPF (83° ± 2.2°, P = .01) and IPF (89° ± 1.6°, P < .001), and WPF was significantly lower than IPF (P = .013). Dorsiflexion tended to decrease and plantar flexion tended to increase with increasing ballet proficiency. The authors conclude that assessment of extreme ankle motion in female ballet dancers is challenging, and goniometry and inclinometry appear to measure plantar flexion differently.

  18. Proximity Navigation of Highly Constrained Spacecraft

    NASA Technical Reports Server (NTRS)

    Scarritt, S.; Swartwout, M.

    2007-01-01

    Bandit is a 3-kg automated spacecraft in development at Washington University in St. Louis. Bandit's primary mission is to demonstrate proximity navigation, including docking, around a 25-kg student-built host spacecraft. However, because of extreme constraints in mass, power and volume, traditional sensing and actuation methods are not available. In particular, Bandit carries only 8 fixed-magnitude cold-gas thrusters to control its 6 DOF motion. Bandit lacks true inertial sensing, and the ability to sense position relative to the host has error bounds that approach the size of the Bandit itself. Some of the navigation problems are addressed through an extremely robust, error-tolerant soft dock. In addition, we have identified a control methodology that performs well in this constrained environment: behavior-based velocity potential functions, which use a minimum-seeking method similar to Lyapunov functions. We have also adapted the discrete Kalman filter for use on Bandit for position estimation and have developed a similar measurement vs. propagation weighting algorithm for attitude estimation. This paper provides an overview of Bandit and describes the control and estimation approach. Results using our 6DOF flight simulator are provided, demonstrating that these methods show promise for flight use.

  19. Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study.

    PubMed

    Hunt, Kate; Gray, Cindy M; Maclean, Alice; Smillie, Susan; Bunn, Christopher; Wyke, Sally

    2014-01-21

    The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. A mixed-methods study analysing baseline data on 747 men aged 35-65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at 'very high' risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35-44, 45-54 and 55-64 years respectively). A further 21%, 16% and 13% were at 'extremely high' risk. Qualitative data revealed that the powerful 'draw' of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others 'like them' and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in circumstances that felt 'right' rather than threatening to themselves as men. FFIT is an example of how to facilitate health promotion activities in a way that is consistent with, rather than challenging to, common ideals of masculinity.

  20. Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study

    PubMed Central

    2014-01-01

    Background The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. Methods A mixed-methods study analysing baseline data on 747 men aged 35–65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. Results Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at ‘very high’ risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35–44, 45–54 and 55–64 years respectively). A further 21%, 16% and 13% were at ‘extremely high’ risk. Qualitative data revealed that the powerful ‘draw’ of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others ‘like them’ and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. Conclusions The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in circumstances that felt ‘right’ rather than threatening to themselves as men. FFIT is an example of how to facilitate health promotion activities in a way that is consistent with, rather than challenging to, common ideals of masculinity. PMID:24443845

  1. Compliant Walker

    NASA Technical Reports Server (NTRS)

    Kerley, James J.; Eklund, Wayne; Crane, Alan

    1992-01-01

    Walker supports person with limited use of legs and back. Enables person to stand upright, move with minimum load, and rest at will taking weight off legs. Consists of wheeled frame with body harness connected compliantly to side structures. Harness supports wearer upright when wearer relaxes and takes weight off lower extremities. Assumes partial to full body weight at user's discretion.

  2. Rickets and osteopenia are more common in infants <600g birth weight than those 600-1000g

    USDA-ARS?s Scientific Manuscript database

    Osteopenia and rickets are common among extremely low birth weight infants (ELBW, <1000g birth weight) despite current nutritional practices. To determine the incidence of osteopenia and rickets in ELBW infants. We evaluated all ELBW infants admitted to Texas Children's Hospital NICU in 2006 and 200...

  3. Eating Order: A 13-Week Trust Model Class for Dieting Casualties

    ERIC Educational Resources Information Center

    Jackson, Elizabeth G.

    2008-01-01

    Chronic dieting distorts eating behaviors and causes weight escalation. Desperation about losing weight results in pursuit of extreme weight loss measures. Instead of offering yet another diet, nutrition educators can teach chronic dieters (dieting casualties) to develop eating competence. Eating Order, a 13-week class for chronic dieters based on…

  4. Foot Loading Characteristics of Different Graduations of Partial Weight Bearing

    ERIC Educational Resources Information Center

    Gusinde, Johannes; Pauser, Johannes; Swoboda, Bernd; Gelse, Kolja; Carl, Hans-Dieter

    2011-01-01

    Limited weight bearing of the lower extremity is a commonly applied procedure in orthopaedic rehabilitation after reconstructive forefoot surgery, trauma surgery and joint replacement. The most frequent limitations are given as percentage of body weight (BW) and represent 10 or 50% BW. The extent of foot loading under these graduations of partial…

  5. Stress fracture of ulna due to excessive push-ups.

    PubMed

    Meena, Sanjay; Rastogi, Devarshi; Solanki, Bipin; Chowdhury, Buddhadev

    2014-01-01

    Stress fractures are most common in the weight-bearing bones of the lower extremities and spine, but are rarely found in non-weight-bearing bones of the body. Stress fracture of the ulna is extremely rare. We report a case of complete stress fracture of ulna caused due to excessive push ups in a young athlete. Conservative management was successful in healing of fracture and returning this patient back to his previous activity level. Physician should have high index of suspicion, whenever they encounter a young athlete complaining of forearm pain.

  6. Effectiveness and efficiency of different weight machine-based strength training programmes for patients with hip or knee osteoarthritis: a protocol for a quasi-experimental controlled study in the context of health services research.

    PubMed

    Krauss, Inga; Müller, Gerhard; Steinhilber, Benjamin; Haupt, Georg; Janssen, Pia; Martus, Peter

    2017-01-01

    Osteoarthritis is a chronic musculoskeletal disease with a major impact on the individual and the healthcare system. As there is no cure, therapy aims for symptom release and reduction of disease progression. Physical exercises have been defined as a core treatment for osteoarthritis. However, research questions related to dose response, sustainability of effects, economic efficiency and safety are still open and will be evaluated in this trial, investigating a progressive weight machine-based strength training. This is a quasi-experimental controlled trial in the context of health services research. The intervention group (n=300) is recruited from participants of an offer for insurants of a health insurance company suffering from hip or knee osteoarthritis. Potential participants of the control group are selected and written to from the insurance database according to predefined matching criteria. The final statistical twins from the control responders will be determined via propensity score matching (n=300). The training intervention comprises 24 supervised mandatory sessions (2/week) and another 12 facultative sessions (1/week). Exercises include resistance training for the lower extremity and core muscles by use of weight machines and small training devices. The training offer is available at two sites. They differ with respect to the weight machines in use resulting in different dosage parameters. Primary outcomes are self-reported pain and function immediately after the 12-week intervention period. Health-related quality of life, self-efficacy, cost utility and safety will be evaluated as secondary outcomes. Secondary analysis will be undertaken with two strata related to study site. Participants will be followed up 6, 12 and 24 months after baseline. German Clinical Trial Register DRKS00009257. Pre-results.

  7. Evaluation of the DSM-5 Severity Indicator for Bulimia Nervosa

    PubMed Central

    Grilo, Carlos M.; Ivezaj, Valentina; White, Marney A.

    2015-01-01

    This study examined the DSM-5 severity criterion for bulimia nervosa (BN) based on the frequency of inappropriate weight compensatory behaviors. 199 community volunteers classified with BN were categorized using DSM-5 severity levels and compared on demographic and clinical variables. 77 (39%) participants were categorized as mild, 68 (34%) as moderate, 32 (16%) as severe, and 22 (11%) as extreme. The severity groups did not differ significantly in demographic variables or body mass index. Shape and Weight concerns did not differ significantly across severity groups. Binge eating differed with the extreme group having higher frequency than the severe, moderate, and mild groups, which did not differ from each other. Restraint differed with the extreme group having significantly higher levels than the mild group. Eating concerns differed with the extreme group having higher levels than moderate and mild groups. Depression differed with the extreme group having higher levels than severe, moderate, and mild groups, which did not differ from each other. Findings from this non-clinical group provide new, albeit modest, support for DSM-5 severity rating for BN based on frequency of inappropriate weight compensatory behaviors. Statistical findings indicate that differences in collateral clinical variables associated with the DSM-5 severity ratings reflect small effect sizes. Further research is needed with treatment-seeking patient groups with BN to establish the validity of the DSM-5 severity specifier and should include broader clinical and functional validators. PMID:25744910

  8. Evaluation of the DSM-5 severity indicator for bulimia nervosa.

    PubMed

    Grilo, Carlos M; Ivezaj, Valentina; White, Marney A

    2015-04-01

    This study examined the DSM-5 severity criterion for bulimia nervosa (BN) based on the frequency of inappropriate weight compensatory behaviors. 199 community volunteers classified with BN were categorized using DSM-5 severity levels and compared on demographic and clinical variables. 77 (39%) participants were categorized as mild, 68 (34%) as moderate, 32 (16%) as severe, and 22 (11%) as extreme. The severity groups did not differ significantly in demographic variables or body mass index. Shape and Weight concerns did not differ significantly across severity groups. Binge eating differed with the extreme group having significantly higher frequency than the severe, moderate, and mild groups, which did not differ from each other. Restraint differed with the extreme group having significantly higher levels than the mild group. Eating concerns differed with the extreme group having significantly higher levels than moderate and mild groups. Depression differed with the extreme group having significantly higher levels than severe, moderate, and mild groups, which did not differ from each other. Findings from this non-clinical group provide new, albeit modest, support for DSM-5 severity rating for BN based on frequency of inappropriate weight compensatory behaviors. Statistical findings indicate that differences in collateral clinical variables associated with the DSM-5 severity ratings reflect small effect sizes. Further research is needed with treatment-seeking patient groups with BN to establish the validity of the DSM-5 severity specifier and should include broader clinical and functional validators. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Narcissism as a Moderator of Satisfaction with Body Image in Young Women with Extreme Underweight and Obesity

    PubMed Central

    Lipowska, Małgorzata; Lipowski, Mariusz

    2015-01-01

    Objective Body weight and age constitute main determinants of body image in women. We analyzed the role of narcissism as a moderator of body image in young women representing various extremes of body weight. Methods The study included 325 women between 18 and 35 years, qualified into three BMI categories: obese women (BMI > 30.0, n = 72), severely underweight women who did not satisfy the remaining criteria of anorexia (BMI < 17.5, n = 85), and women with normal body weight (21.7 < “ideal BMI” > 22.7, n = 168). Satisfaction with body image was determined with Multidimensional Body-Self Relations Questionnaire and Body Esteem Scale, while narcissism was measured with Narcissistic Personality Inventory. Principal Findings We revealed that narcissism has significant impact on the body image of women who are extremely underweight or obese. Vanity and Leadership were narcissism dimensions which played significant role in slim women, as compared to Vanity and Self-Sufficiency in obese women. Conclusion The role of narcissism as a modulator of self-satisfaction with one’s body varies depending on BMI level: extremely underweight women and obese individuals constitute groups in which narcissism has the strongest impact on the self-satisfaction with body. PMID:25961302

  10. The effects of extreme nutritional conditions on the neurochemistry of reward and addiction

    NASA Astrophysics Data System (ADS)

    Pothos, Emmanuel N.

    2001-08-01

    Weight loss is a frequent problem in space flights. We now claim that it may affect performance and drug-seeking behavior by altering midbrain neurochemistry. In food-deprived rats (20-30% underweight) basal extracellular dopamine levels in the nucleus accumbens decrease to 40-50% of normal and locomotion is depressed. However, amphetamine-induced dopamine release and locomotion are higher than in controls (1825% vs. 595% after a 25 μM d-amphetamine intraaccumbens infusion). The lower basal and the higher stimulated dopamine levels suggest that the neurotransmitter accumulates presynaptically in the accumbens of the underweight rats due to subnormal basal release. Psychostimulants are more rewarding for underweight subjects possibly because they release significantly more dopamine from elevated presynaptic stores into the accumbens. Consequently, weight loss can lead both to depression of performance and propensity to substance abuse. These effects should be considered when providing nutritional resources for space flights so that weight loss is limited.

  11. Evaluation of Advanced COTS Passive Devices for Extreme Temperature Operation

    NASA Technical Reports Server (NTRS)

    Patterson, Richard; Hammoud, Ahmad; Dones, Keishla R.

    2009-01-01

    Electronic sensors and circuits are often exposed to extreme temperatures in many of NASA deep space and planetary surface exploration missions. Electronics capable of operation in harsh environments would be beneficial as they simplify overall system design, relax thermal management constraints, and meet operational requirements. For example, cryogenic operation of electronic parts will improve reliability, increase energy density, and extend the operational lifetimes of space-based electronic systems. Similarly, electronic parts that are able to withstand and operate efficiently in high temperature environments will negate the need for thermal control elements and their associated structures, thereby reducing system size and weight, enhancing its reliability, improving its efficiency, and reducing cost. Passive devices play a critical role in the design of almost all electronic circuitry. To address the needs of systems for extreme temperature operation, some of the advanced and most recently introduced commercial-off-the-shelf (COTS) passive devices, which included resistors and capacitors, were examined for operation under a wide temperature regime. The types of resistors investigated included high temperature precision film, general purpose metal oxide, and wirewound.

  12. A case of severe anorexia, excessive weight loss and high peptide YY levels after sleeve gastrectomy.

    PubMed

    Pucci, Andrea; Cheung, Wui Hang; Jones, Jenny; Manning, Sean; Kingett, Helen; Adamo, Marco; Elkalaawy, Mohamed; Jenkinson, Andrew; Finer, Nicholas; Doyle, Jacqueline; Hashemi, Majid; Batterham, Rachel L

    2015-01-01

    Sleeve gastrectomy (SG) is the second most commonly performed bariatric procedure worldwide. Altered circulating gut hormones have been suggested to contribute post-operatively to appetite suppression, decreased caloric intake and weight reduction. In the present study, we report a 22-year-old woman who underwent laparoscopic SG for obesity (BMI 46 kg/m(2)). Post-operatively, she reported marked appetite reduction, which resulted in excessive weight loss (1-year post-SG: BMI 22 kg/m(2), weight loss 52%, >99th centile of 1-year percentage of weight loss from 453 SG patients). Gastrointestinal (GI) imaging, GI physiology/motility studies and endoscopy revealed no anatomical cause for her symptoms, and psychological assessments excluded an eating disorder. Despite nutritional supplements and anti-emetics, her weight loss continued (BMI 19 kg/m(2)), and she required nasogastric feeding. A random gut hormone assessment revealed high plasma peptide YY (PYY) levels. She underwent a 3 h meal study following an overnight fast to assess her subjective appetite and circulating gut hormone levels. Her fasted nausea scores were high, with low hunger, and these worsened with nutrient ingestion. Compared to ten other post-SG female patients, her fasted circulating PYY and nutrient-stimulated PYY and active glucagon-like peptide 1 (GLP1) levels were markedly elevated. Octreotide treatment was associated with suppressed circulating PYY and GLP1 levels, increased appetite, increased caloric intake and weight gain (BMI 22 kg/m(2) after 6 months). The present case highlights the value of measuring gut hormones in patients following bariatric surgery who present with anorexia and excessive weight loss and suggests that octreotide treatment can produce symptomatic relief and weight regain in this setting. Roux-en-Y gastric bypass and SG produce marked sustained weight reduction. However, there is a marked individual variability in this reduction, and post-operative weight loss follows a normal distribution with extremes of 'good' and 'poor' response.Profound anorexia and excessive weight loss post-SG may be associated with markedly elevated circulating fasted PYY and post-meal PYY and GLP1 levels.Octreotide treatment can produce symptomatic relief and weight regain for post-SG patients that have an extreme anorectic and weight loss response.The present case highlights the value of measuring circulating gut hormone levels in patients with post-operative anorexia and extreme weight loss.

  13. Cost-effective optical switch matrix for microwave phased-array

    NASA Technical Reports Server (NTRS)

    Pan, J. J.; Chia, S. L.; Li, W. Z.; Grove, C. H.

    1991-01-01

    An all-fiber (6x6) optical shutter switch matrix with the control system for microwave phased array has been demonstrated. The device offers the advantages of integrated configuration, low cost, low power consumption, small size, and light weight. The maximum extinction ratio (among 36 individual pixel) of this switch matrix at 840 nm is 24.2 dB, and the switching time is less than 120 microsec. In addition to phased array application, this low cost switch matrix is extremely attractive for fiber optic switching networks.

  14. Design and Development of a Two-Axis Thruster Gimbal with Xenon Propellant Lines

    NASA Technical Reports Server (NTRS)

    Asadurian, Armond

    2010-01-01

    A Two-Axis Thruster Gimbal was developed for a two degree-of-freedom tip-tilt gimbal application. This light weight gimbal mechanism is equipped with flexible xenon propellant lines and features numerous thermal control features for all its critical components. Unique thermal profiles and operating environments have been the key design drivers for this mechanism which is fully tolerant of extreme space environmental conditions. Providing thermal controls that are compatible with flexible components and are also capable of surviving launch vibration within this gimbal mechanism has proven to be especially demanding, requiring creativity and significant development effort. Some of these features, design drivers, and lessons learned will be examined herein.

  15. Development and Validation of the Pride in Eating Pathology Scale (PEP-S).

    PubMed

    Faija, Cintia L; Fox, John R E; Tierney, Stephanie; Peters, Sarah; Gooding, Patricia A

    2017-01-01

    There is a growing body of theoretical and clinical literature highlighting the role of pride in maintaining eating disordered behaviours. Despite its clinical importance, there are no measures to assess feelings of pride associated with eating psychopathology. This study describes the development and validation of the Pride in Eating Pathology Scale (PEP-S), a self-report questionnaire that examines feelings of pride towards eating disordered symptoms (e.g., pride in food restriction, thinness and weight loss). Participants were 390 females, recruited from university and community populations, whose mean age was 26.99 years. Respondents rated pride in eating pathology on a 7-point Likert-scale. Principal Component Analysis indicated that the 60-item scale comprised a four component structure: (1) pride in weight loss, food control and thinness, (2) pride in healthy weight and healthy eating, (3) pride in outperforming others and social recognition and (4) pride in capturing other people's attention due to extreme thinness. These four components explained a total of 65.31% of the variance. The PEP-S demonstrated very good internal reliability (α ranging from 0.88 to 0.98) and very good test-retest reliability over a 3-week time-span (r ranging from 0.81 to 0.93). The PEP-S also showed excellent convergent and discriminant validity. Furthermore, the scale discriminated between women with high and low levels of eating psychopathology. The PEP-S is a psychometrically robust measure of pride in eating pathology. It has the potential to advance theoretical understanding and may also be clinically useful. Copyright © 2015 John Wiley & Sons, Ltd. The PEP-S is a valid, reliable, quick and easy to administer self-report questionnaire that measures pride related to eating pathology. The PEP-S assesses four clinically relevant dimensions: (1) pride in weight loss, food control and thinness, (2) pride in healthy weight and healthy eating, (3) pride in outperforming others and social recognition and (4) pride in capturing other people's attention due to extreme thinness. The PEP-S has very good internal and test-retest reliability, and very good convergent and discriminant validity. The PEP-S distinguishes between women with higher and lower levels of eating psychopathology. The PEP-S makes an important contribution to understanding pride in eating psychopathology, which is essential from both clinical and theoretical perspectives. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Counting repetitions: an observational study of video game play in people with chronic poststroke hemiparesis.

    PubMed

    Peters, Denise M; McPherson, Aaron K; Fletcher, Blake; McClenaghan, Bruce A; Fritz, Stacy L

    2013-09-01

    The use of video gaming as a therapeutic intervention has increased in popularity; however, the number of repetitions in comparison with traditional therapy methods has yet to be investigated. The primary purpose of this study was to document and compare the number of repetitions performed while playing 1 of 2 video gaming systems for a time frame similar to that of a traditional therapy session in individuals with chronic stroke. Twelve participants with chronic stroke (mean age, 66.8 ± 8.2 years; time poststroke, 19.2 ± 15.4 months) completed video game play sessions, using either the Nintendo Wii or the Playstation 2 EyeToy. A total of 203 sessions were captured on video record; of these, 50 sessions for each gaming system were randomly selected for analysis. For each selected record, active upper and lower extremity repetitions were counted for a 36-minute segment of the recorded session. The Playstation 2 EyeToy group produced an average of 302.5 (228.1) upper extremity active movements and 189.3 (98.3) weight shifts, significantly higher than the Nintendo Wii group, which produced an average of 61.9 (65.7) upper extremity active movements and 109.7 (78.5) weight shifts. No significant differences were found in steps and other lower extremity active movements between the 2 systems. The Playstation 2 EyeToy group produced more upper extremity active movements and weight shifting movements than the Nintendo Wii group; the number and type of repetitions varied across games. Active gaming (specifically Playstation 2 EyeToy) provided more upper extremity repetitions than those reported in the literature by using traditional therapy, suggesting that it may be a modality to promote increased active movements in individuals poststroke.

  17. Unilateral and bilateral upper extremity weight-bearing effect on upper extremity impairment and functional performance after brain injury

    PubMed Central

    REISTETTER, TIMOTHY; ABREU, BEATRIZ C.; BEAR-LEHMAN, JANE; OTTENBACHER, KENNETH J.

    2010-01-01

    The purpose of the study was to investigate the effect of upper extremity (UE) weight bearing on UE impairment functional performance of persons with acquired brain injury (BI). A quasi-experimental design was used to examine a convenience sample of 99 persons with acquired BI and 22 without BI (WBI) living in a community re-entry centre. A computerized force-sensing array pressure map system was used to determine the UE pressure during unilateral and bilateral conditions. Differences between groups were examined using t-tests. Correlations were computed between UE weight bearing and hand function, and functional performance as measured by the Fugl-Meyer scale and functional independence measure (FIM) scale. The group of people with BI exerted significantly lower UE weight bearing during unilateral conditions as compared with persons WBI [left: t (119) = 2.34, p = 0.021; right: t (119) = 4.79, p = 0.043). UE weight-bearing measures correlated strongly with FIM motor scores with bilateral UE conditions yielded the highest significant correlation (bilateral left r = 0.487, p < 0.001; bilateral right r = 0.469, p < 0.01). The results indicated that UE weight-bearing pressure differs in unilateral and bilateral conditions, between persons with and WBI and between persons with stroke and traumatic brain injury. These findings may have implications for occupational therapists that use unilateral versus bilateral motor training for rehabilitation. There is a need to replicate the study design with a randomized and stratified sample of persons with BI. PMID:19551694

  18. Biologically-Inspired Control for a Planetary Exploration Tensegrity Robot

    NASA Technical Reports Server (NTRS)

    Leroy, Marc

    2017-01-01

    Tensegrity structures are becoming increasingly popular as mechanical structures for robots. Their inherent compliance makes them extremely robust to environmental disturbances, and their design allows them to have a high strength-to-weight ratio whilst being lightweight compared to traditional robots. For these reasons they would be of interest to the aerospace industry, particularly for planetary exploration. However, being such compliant structures thanks to their network of elastic elements also means that their control is not an easy task. Relying solely on traditional control strategies to generate efficient locomotion would surely be near impossible due to the complex oscillatory motions and nonlinear interactions of its members. The goal of this project was to use bio-inspired control techniques to generate locomotion for a tensegrity icosahedron, namely the SUPERball project of the Intelligent Robotics Group of NASA Ames Research Center.

  19. The Effect of the Weight of Equipment on Muscle Activity of the Lower Extremity in Soldiers

    PubMed Central

    Lindner, Tobias; Schulze, Christoph; Woitge, Sandra; Finze, Susanne; Mittelmeier, Wolfram; Bader, Rainer

    2012-01-01

    Due to their profession and the tasks it entails, soldiers are exposed to high levels of physical activity and strain. This can result in overexertion and pain in the locomotor system, partly caused by carrying items of equipment. The aim of this study was to analyse the extent of muscle activity in the lower extremities caused by carrying specific items of equipment. For this purpose, the activity of selected groups of muscles caused by different items of equipment (helmet, carrying strap, backpack, and rifle) in the upper and lower leg was measured by recording dynamic surface electromyograms. Electrogoniometers were also used to measure the angle of the knee over the entire gait cycle. In addition to measuring muscle activity, the study also aimed to determine out what influence increasing weight load has on the range of motion (ROM) of the knee joint during walking. The activity of recorded muscles of the lower extremity, that is, the tibialis anterior, peroneus longus, gastrocnemius lateralis, gastrocnemius medialis, rectus femoris, and biceps femoris, was found to depend on the weight of the items of equipment. There was no evidence, however, that items of equipment weighing a maximum of 34% of their carrier's body weight had an effect on the ROM of the knee joint. PMID:22973179

  20. Overrepresentation of extreme events in decision making reflects rational use of cognitive resources.

    PubMed

    Lieder, Falk; Griffiths, Thomas L; Hsu, Ming

    2018-01-01

    People's decisions and judgments are disproportionately swayed by improbable but extreme eventualities, such as terrorism, that come to mind easily. This article explores whether such availability biases can be reconciled with rational information processing by taking into account the fact that decision makers value their time and have limited cognitive resources. Our analysis suggests that to make optimal use of their finite time decision makers should overrepresent the most important potential consequences relative to less important, put potentially more probable, outcomes. To evaluate this account, we derive and test a model we call utility-weighted sampling. Utility-weighted sampling estimates the expected utility of potential actions by simulating their outcomes. Critically, outcomes with more extreme utilities have a higher probability of being simulated. We demonstrate that this model can explain not only people's availability bias in judging the frequency of extreme events but also a wide range of cognitive biases in decisions from experience, decisions from description, and memory recall. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  1. The effect of segmental weight of prosthesis on hemodynamic responses and energy expenditure of lower extremity amputees

    PubMed Central

    Mutlu, Akmer; Kharooty, Mohammad Dawood; Yakut, Yavuz

    2017-01-01

    [Purpose] The aim of this study was to investigate the effect of segmental weight of the prosthesis on hemodynamic responses and energy expenditure in lower extremity amputees. [Subjects and Methods] Thirteen patients with a mean age of 44 ± 15.84 years and with unilateral transtibial, transfemoral and Syme’s amputation were included to the study. The difference between the lightest and the heaviest prosthesis, 250 g used as the weight. All the patients completed the measurements first without weight and then with 250 g weight on the ankle joint. The blood pressure and heart rate of the patients were recorded before and after Six Minute Walk Test (6MWT) and 10 stairs up & down stairs test. Physiological Cost Index was used to calculate the energy expenditure. [Results] Heart rate and energy expenditure increased significantly when without weight and with weight results compared. [Conclusion] We conclude that the segmental weight of the prosthetic limb has a significant effect on the heart rate and energy expenditure but has no effect on the systolic and diastolic blood pressure of lower limb amputees. In order to generalize our results to lower limb amputees, more patients need to be included in future studies. PMID:28533599

  2. An innovative solid oral nutritional supplement to fight weight loss and anorexia: open, randomised controlled trial of efficacy in institutionalised, malnourished older adults.

    PubMed

    Pouyssegur, Valerie; Brocker, Patrice; Schneider, Stéphane M; Philip, Jean Luc; Barat, Philippe; Reichert, Ewa; Breugnon, Frederic; Brunet, Didier; Civalleri, Bruno; Solere, Jean Paul; Bensussan, Line; Lupi-Pegurier, Laurence

    2015-03-01

    To evaluate the impact of a solid nutritional supplement on the weight gain of institutionalised older adults>70 years with protein-energy malnutrition. The innovation of these high-protein and high-energy cookies was the texture adapted to edentulous patients (Protibis®, Solidages, France). An open, multicentre, randomised controlled trial. Seven nursing homes. One hundred and seventy-five malnourished older adults, aged 86±8 years. All participants received the standard institutional diet. In addition, Intervention group participants received eight cookies daily (11.5 g protein; 244 kcal) for 6 weeks (w0-w6). Five visits (w-4, w0, w6, w10 and w18). Percentage of weight gain from w0 to w6 (body mass in kg). Appetite, rated using a numerical scale (0: no appetite to 10: extremely good appetite); current episodes of pressure ulcers and diarrhea. Average weight increased in Intervention group (n=88) compared with Control group (n=87) without cookies supplementation (+1.6 versus -0.7%, P=0.038). Weight gain persisted 1 month (+3.0 versus -0.2%, P=0.025) and 3 months after the end of cookies consumption (+3.9 versus -0.9%, P=0.003), with diarrhea reduction (P=0.027). There was a synergistic effect with liquid/creamy dietary supplements. Subgroup analysis confirmed the positive impact of cookies supplementation alone on weight increase (P=0.024), appetite increase (P=0.009) and pressure ulcers reduction (P=0.031). The trial suggested that, to fight against anorexia, the stimulation of touch (finger food; chewing, even on edentulous gums) and hearing (intra-oral sounds) could be valuable alternatives to sight, smell and taste alterations. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Therapeutic orthosis and electrical stimulation for upper extremity hemiplegia after stroke: a review of effectiveness based on evidence.

    PubMed

    Aoyagi, Yoichiro; Tsubahara, Akio

    2004-01-01

    Upper extremity hemiplegia after stroke is common and disabling. Apart from conventional physical and occupational therapy, a number of additional approaches that use devices such as orthoses, prostheses, electrical stimulation, and robots have been introduced. The purpose of this review was to assess the clinical efficacy of such devices used for the affected upper extremities of acute, subacute, and chronic stroke patients. Assessments of their effectiveness and recommendations were based on the weight of published scientific evidence. The amount of evidence with respect to hand splints and shoulder slings is limited. Further study with a well-designed randomized controlled trial (RCT) is required to investigate accurately their short- and long-term efficacy. A number of studies suggested that the use of electrical stimulation for reducing shoulder subluxation or improving the function of wrist and finger extensors is effective during or shortly after the daily treatment period. The robotic approach to hemiplegic upper extremities appears to be a novel therapeutic strategy that may help improve hand and arm function. However, the longer term effectiveness after discontinuation as well as the motor recovery mechanism of electrical stimulation or robotic devices remains unclear. More research is needed to determine the evidence-based effectiveness of electrical stimulation or other devices for stroke survivors.

  4. Weight-bearing recommendations after operative fracture treatment-fact or fiction? Gait results with and feasibility of a dynamic, continuous pedobarography insole.

    PubMed

    Braun, Benedikt J; Veith, Nils T; Rollmann, Mika; Orth, Marcel; Fritz, Tobias; Herath, Steven C; Holstein, Jörg H; Pohlemann, Tim

    2017-08-01

    Rehabilitation after lower-extremity fractures is based on the physicians' recommendation for non-, partial-, or full weight-bearing. Clinical studies rely on this assumption, but continuous compliance or objective loading rates are unknown. The purpose of this study was to determine the compliance to weight-bearing recommendations by introducing a novel, pedobarography system continuously registering postoperative ground forces into ankle, tibial shaft and proximal femur fracture aftercare and test its feasibility for this purpose. In this prospective, observational study, a continuously measuring pedobarography insole was placed in the patients shoe during the immediate post-operative aftercare after ankle, tibial shaft and intertrochanteric femur fractures. Weight-bearing was ordered as per the institutional standard and controlled by physical therapy. The insole was retrieved after a maximum of six weeks (28 days [range 5-42 days]). Non-compliance was defined as a failure to maintain, or reach the ordered weight-bearing within 30%. Overall 30 patients were included in the study. Fourteen (47%) of the patients were compliant to the weight-bearing recommendations. Within two weeks after surgery patients deviated from the recommendation by over 50%. Sex, age and weight did not influence the performance (p > 0.05). Ankle fracture patients (partial weight-bearing) showed a significantly increased deviation from the recommendation (p = 0.01). Our study results show that, despite physical therapy training, weight-bearing compliance to recommended limits was low. Adherence to the partial weight-bearing task was further decreased over time. Uncontrolled weight-bearing recommendations should thus be viewed with caution and carefully considered as fiction. The presented insole is feasible to determine weight bearing continuously, could immediately help define real-time patient behaviour and establish realistic, individual weight-bearing recommendations.

  5. Quantifying population exposure to airborne particulate matter during extreme events in California due to climate change

    NASA Astrophysics Data System (ADS)

    Mahmud, A.; Hixson, M.; Kleeman, M. J.

    2012-02-01

    The effect of climate change on population-weighted concentrations of particulate matter (PM) during extreme events was studied using the Parallel Climate Model (PCM), the Weather Research and Forecasting (WRF) model and the UCD/CIT 3-D photochemical air quality model. A "business as usual" (B06.44) global emissions scenario was dynamically downscaled for the entire state of California between the years 2000-2006 and 2047-2053. Air quality simulations were carried out for 1008 days in each of the present-day and future climate conditions using year-2000 emissions. Population-weighted concentrations of PM0.1, PM2.5, and PM10 total mass, components species, and primary source contributions were calculated for California and three air basins: the Sacramento Valley air basin (SV), the San Joaquin Valley air basin (SJV) and the South Coast Air Basin (SoCAB). Results over annual-average periods were contrasted with extreme events. Climate change between 2000 vs. 2050 did not cause a statistically significant change in annual-average population-weighted PM2.5 mass concentrations within any major sub-region of California in the current study. Climate change did alter the annual-average composition of the airborne particles in the SoCAB, with notable reductions of elemental carbon (EC; -3%) and organic carbon (OC; -3%) due to increased annual-average wind speeds that diluted primary concentrations from gasoline combustion (-3%) and food cooking (-4%). In contrast, climate change caused significant increases in population-weighted PM2.5 mass concentrations in central California during extreme events. The maximum 24-h average PM2.5 concentration experienced by an average person during a ten-year period in the SJV increased by 21% due to enhanced production of secondary particulate matter (manifested as NH4NO3). In general, climate change caused increased stagnation during future extreme pollution events, leading to higher exposure to diesel engines particles (+32%) and wood combustion particles (+14%) when averaging across the population of the entire state. Enhanced stagnation also isolated populations from distant sources such as shipping (-61%) during extreme events. The combination of these factors altered the statewide population-averaged composition of particles during extreme events, with EC increasing by 23%, nitrate increasing by 58%, and sulfate decreasing by 46%.

  6. Quantifying population exposure to airborne particulate matter during extreme events in California due to climate change

    NASA Astrophysics Data System (ADS)

    Mahmud, A.; Hixson, M.; Kleeman, M. J.

    2012-08-01

    The effect of climate change on population-weighted concentrations of particulate matter (PM) during extreme pollution events was studied using the Parallel Climate Model (PCM), the Weather Research and Forecasting (WRF) model and the UCD/CIT 3-D photochemical air quality model. A "business as usual" (B06.44) global emissions scenario was dynamically downscaled for the entire state of California between the years 2000-2006 and 2047-2053. Air quality simulations were carried out for 1008 days in each of the present-day and future climate conditions using year-2000 emissions. Population-weighted concentrations of PM0.1, PM2.5, and PM10 total mass, components species, and primary source contributions were calculated for California and three air basins: the Sacramento Valley air basin (SV), the San Joaquin Valley air basin (SJV) and the South Coast Air Basin (SoCAB). Results over annual-average periods were contrasted with extreme events. The current study found that the change in annual-average population-weighted PM2.5 mass concentrations due to climate change between 2000 vs. 2050 within any major sub-region in California was not statistically significant. However, climate change did alter the annual-average composition of the airborne particles in the SoCAB, with notable reductions of elemental carbon (EC; -3%) and organic carbon (OC; -3%) due to increased annual-average wind speeds that diluted primary concentrations from gasoline combustion (-3%) and food cooking (-4%). In contrast, climate change caused significant increases in population-weighted PM2.5 mass concentrations in central California during extreme events. The maximum 24-h average PM2.5 concentration experienced by an average person during a ten-yr period in the SJV increased by 21% due to enhanced production of secondary particulate matter (manifested as NH4NO3). In general, climate change caused increased stagnation during future extreme pollution events, leading to higher exposure to diesel engines particles (+32%) and wood combustion particles (+14%) when averaging across the population of the entire state. Enhanced stagnation also isolated populations from distant sources such as shipping (-61%) during extreme events. The combination of these factors altered the statewide population-averaged composition of particles during extreme events, with EC increasing by 23 %, nitrate increasing by 58%, and sulfate decreasing by 46%.

  7. Estimating the extreme low-temperature event using nonparametric methods

    NASA Astrophysics Data System (ADS)

    D'Silva, Anisha

    This thesis presents a new method of estimating the one-in-N low temperature threshold using a non-parametric statistical method called kernel density estimation applied to daily average wind-adjusted temperatures. We apply our One-in-N Algorithm to local gas distribution companies (LDCs), as they have to forecast the daily natural gas needs of their consumers. In winter, demand for natural gas is high. Extreme low temperature events are not directly related to an LDCs gas demand forecasting, but knowledge of extreme low temperatures is important to ensure that an LDC has enough capacity to meet customer demands when extreme low temperatures are experienced. We present a detailed explanation of our One-in-N Algorithm and compare it to the methods using the generalized extreme value distribution, the normal distribution, and the variance-weighted composite distribution. We show that our One-in-N Algorithm estimates the one-in- N low temperature threshold more accurately than the methods using the generalized extreme value distribution, the normal distribution, and the variance-weighted composite distribution according to root mean square error (RMSE) measure at a 5% level of significance. The One-in- N Algorithm is tested by counting the number of times the daily average wind-adjusted temperature is less than or equal to the one-in- N low temperature threshold.

  8. Insulin Oedema in Newly Diagnosed Type 1 Diabetes Mellitus

    PubMed Central

    Çetinkaya, Semra; Yılmaz Ağladıoğlu, Sebahat; Peltek Kendirici, Havva Nur; Bilgili, Hatice; Yıldırım, Nurdan; Aycan, Zehra

    2010-01-01

    Despite the essential role of insulin in the management of patients with insulin deficiency, insulin use can lead to adverse effects such as hypoglycaemia and weight gain. Rarely, crucial fluid retention can occur with insulin therapy, resulting in an oedematous condition. Peripheral or generalised oedema is an extremely rare complication of insulin therapy in the absence of heart, liver or renal involvement. It has been reported in newly diagnosed type 1 diabetes, in poorly controlled type 2 diabetes following the initiation of insulin therapy, and in underweight patients on large doses of insulin. The oedema occurs shortly after the initiation of intensive insulin therapy. We describe two adolescent girls with newly diagnosed type 1 diabetes, who presented with oedema of the lower extremities approximately one week after the initiation of insulin treatment; other causes of oedema were excluded. Spontaneous recovery was observed in both patients. Conflict of interest:None declared. PMID:21274337

  9. Health Benefits of Gastric Bypass Surgery after 6 Years

    PubMed Central

    Adams, Ted D.; Davidson, Lance E.; Litwin, Sheldon E.; Kolotkin, Ronette L.; LaMonte, Michael J.; Pendleton, Robert C.; Strong, Michael B.; Vinik, Russell; Wanner, Nathan A.; Hopkins, Paul N.; Gress, Richard E.; Walker, James M.; Cloward, Tom V.; Tom Nuttall, R.; Hammoud, Ahmad; Greenwood, Jessica L. J.; Crosby, Ross D.; McKinlay, Rodrick; Simper, Steven C.; Smith, Sherman C.; Hunt, Steven C.

    2013-01-01

    Context Extreme obesity is associated with health and cardiovascular disease risks. Although gastric bypass surgery induces rapid weight loss and ameliorates many of these risks in the short term, long-term outcomes are uncertain. Objective To examine the association of Roux-en-Y gastric bypass (RYGB) with weight loss, diabetes mellitus, and other health risks 6 years after surgery. Design, Setting, and Participants A prospective Utah-based study conducted between July 2000 and June 2011 of 1156 severely obese (body mass index [BMI] ≥35) participants aged 18–72 years (82% women; mean BMI 45.9; 95% CI, 31.2–60.6) who sought and received RYGB surgery (n=418), sought but did not have surgery (n=417; control group 1), or were randomly selected from a population-based sample not seeking weight loss surgery (n=321; control group 2). Main Outcome Measures Weight loss, diabetes, hypertension, dyslipidemia, and health-related quality of life were compared between participants having RYGB surgery and control participants using propensity score adjustment. Results Six years after surgery, patients who received RYGB surgery (with 92.6% follow-up) lost 27.7% (95% CI, 26.6%–28.9%) of their initial body weight compared with 0.2% (95% CI, -1.1% to 1.4%) gain in control group 1 and 0% (95% CI, −1.2 to 1.2%) in control group 2. Weight loss maintenance was superior in patients who received RYGB surgery, with 94% (95% CI, 92%–96%) and 76% (95% CI, 72%–81%) of patients receiving RYGB surgery maintaining at least 20% weight loss 2 and 6 years after surgery, respectively. Diabetes remission rates 6 years after surgery were 62% (95% CI, 49%–75%) in the RYGB surgery group, 8% (95% CI, 0%–16%) in control group 1, and 6% (95% CI, 0%–13%) in control group 2, with remission odds ratios (ORs) of 16.5 (95% CI, 4.7–57.6; P<.001) vs control group 1 and 21.5 (95% CI, 5.4–85.6; P<.001) vs control group 2. The incidence of diabetes throughout the course of the study was reduced after RYGB surgery (2%; 95% CI, 0%–4%; versus 17%; 95% CI, 10%–24%; OR, 0.11; 95% CI, 0.04–0.34 compared with control group 1 and 15%; 95% CI, 9%–21%; OR, 0.21; 95% CI, 0.06–0.67 compared with control group 2; both P<.001). The numbers of participants with bariatric surgery-related hospitalizations were 33 (7.9%), 13 (3.9%), and 6 (2.0%) for RYGB surgery group and 2 control groups, respectively. Conclusion Among severely obese patients, compared with nonsurgical control patients, the use of RYGB surgery was associated with higher rates of diabetes remission and lower risk of cardiovascular and other health outcomes over 6 years. PMID:22990271

  10. Postdischarge growth assessment in very low birth weight infants.

    PubMed

    Park, Joon-Sik; Han, Jungho; Shin, Jeong Eun; Lee, Soon Min; Eun, Ho Seon; Park, Min-Soo; Park, Kook-In; Namgung, Ran

    2017-03-01

    The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved. We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24 months. Growth failure was defined as weight and height below the 10th percentile at 24 months. For the subgroup analysis, small-for-gestational age (SGA) and extremely low birth weight (ELBW) infants were evaluated. The growth patterns based on the Korean, World Health Organization (WHO), or Centers for Disease Control and Prevention (CDC) standard were serially compared over time. At postconception age (PCA) 40 weeks, 47 (58%) and 45 infants (55%) showed growth failure in terms of weight and height, respectively. At PCA 24 months, 20 infants (24%) showed growth failure for weight and 14 (18%) for height. Growth failure rates were higher for the SGA infants than for the appropriate-weight-for-gestational age infants at PCA 24 months ( P =0.045 for weight and P =0.038 for height). Growth failure rates were higher for the ELBW infants than for the non-ELBW infants at PCA 24 months ( P <0.001 for weight and P =0.003 for height). Significant differences were found among the WHO, CDC, and Korean standards ( P <0.001). Advancements in neonatal care have improved the catch-up growth of VLBW infants, but this is insufficient. Careful observation and aggressive interventions, especially in SGA and ELBW infants, are needed.

  11. 40 CFR 355.16 - How do I determine the quantity of extremely hazardous substances present for certain forms of...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... quantity of extremely hazardous substance present: (a) Solid in powdered form with a particle size less than 100 microns. Multiply the weight percent of solid with a particle size less than 100 microns in a...

  12. 40 CFR 355.16 - How do I determine the quantity of extremely hazardous substances present for certain forms of...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... quantity of extremely hazardous substance present: (a) Solid in powdered form with a particle size less than 100 microns. Multiply the weight percent of solid with a particle size less than 100 microns in a...

  13. 40 CFR 355.16 - How do I determine the quantity of extremely hazardous substances present for certain forms of...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... quantity of extremely hazardous substance present: (a) Solid in powdered form with a particle size less than 100 microns. Multiply the weight percent of solid with a particle size less than 100 microns in a...

  14. 40 CFR 355.16 - How do I determine the quantity of extremely hazardous substances present for certain forms of...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... quantity of extremely hazardous substance present: (a) Solid in powdered form with a particle size less than 100 microns. Multiply the weight percent of solid with a particle size less than 100 microns in a...

  15. 40 CFR 355.16 - How do I determine the quantity of extremely hazardous substances present for certain forms of...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... quantity of extremely hazardous substance present: (a) Solid in powdered form with a particle size less than 100 microns. Multiply the weight percent of solid with a particle size less than 100 microns in a...

  16. Reconstructing metabolic flux vectors from extreme pathways: defining the alpha-spectrum.

    PubMed

    Wiback, Sharon J; Mahadevan, Radhakrishnan; Palsson, Bernhard Ø

    2003-10-07

    The move towards genome-scale analysis of cellular functions has necessitated the development of analytical (in silico) methods to understand such large and complex biochemical reaction networks. One such method is extreme pathway analysis that uses stoichiometry and thermodynamic irreversibly to define mathematically unique, systemic metabolic pathways. These extreme pathways form the edges of a high-dimensional convex cone in the flux space that contains all the attainable steady state solutions, or flux distributions, for the metabolic network. By definition, any steady state flux distribution can be described as a nonnegative linear combination of the extreme pathways. To date, much effort has been focused on calculating, defining, and understanding these extreme pathways. However, little work has been performed to determine how these extreme pathways contribute to a given steady state flux distribution. This study represents an initial effort aimed at defining how physiological steady state solutions can be reconstructed from a network's extreme pathways. In general, there is not a unique set of nonnegative weightings on the extreme pathways that produce a given steady state flux distribution but rather a range of possible values. This range can be determined using linear optimization to maximize and minimize the weightings of a particular extreme pathway in the reconstruction, resulting in what we have termed the alpha-spectrum. The alpha-spectrum defines which extreme pathways can and cannot be included in the reconstruction of a given steady state flux distribution and to what extent they individually contribute to the reconstruction. It is shown that accounting for transcriptional regulatory constraints can considerably shrink the alpha-spectrum. The alpha-spectrum is computed and interpreted for two cases; first, optimal states of a skeleton representation of core metabolism that include transcriptional regulation, and second for human red blood cell metabolism under various physiological, non-optimal conditions.

  17. Effect of a low fat versus a low carbohydrate weight loss dietary intervention on biomarkers of long term survival in breast cancer patients ('CHOICE'): study protocol.

    PubMed

    Sedlacek, Scot M; Playdon, Mary C; Wolfe, Pamela; McGinley, John N; Wisthoff, Mark R; Daeninck, Elizabeth A; Jiang, Weiqin; Zhu, Zongjian; Thompson, Henry J

    2011-07-06

    Weight loss in overweight or obese breast cancer patients is associated with an improved prognosis for long term survival. However, it is not clear whether the macronutrient composition of the chosen weight loss dietary plan imparts further prognostic benefit. A study protocol is presented for a dietary intervention to investigate the effects of weight loss dietary patterns that vary markedly in fat and carbohydrate contents on biomarkers of exposure to metabolic processes that may promote tumorigenesis and that are predictive of long term survival. The study will also determine how much weight must be lost for biomarkers to change in a favorable direction. Approximately 370 overweight or obese postmenopausal breast cancer survivors (body mass index: 25.0 to 34.9 kg/m²) will be accrued and assigned to one of two weight loss intervention programs or a non-intervention control group. The dietary intervention is implemented in a free living population to test the two extremes of popular weight loss dietary patterns: a high carbohydrate, low fat diet versus a low carbohydrate, high fat diet. The effects of these dietary patterns on biomarkers for glucose homeostasis, chronic inflammation, cellular oxidation, and steroid sex hormone metabolism will be measured. Participants will attend 3 screening and dietary education visits, and 7 monthly one-on-one dietary counseling and clinical data measurement visits in addition to 5 group visits in the intervention arms. Participants in the control arm will attend two clinical data measurement visits at baseline and 6 months. The primary outcome is high sensitivity C-reactive protein. Secondary outcomes include interleukin-6, tumor necrosis factor-α, insulin-like growth factor-1 (IGF), IGF binding protein-3, 8-isoprostane-F2-alpha, estrone, estradiol, progesterone, sex hormone binding globulin, adiponectin, and leptin. While clinical data indicate that excess weight for height is associated with poor prognosis for long term survival, little attention is paid to weight control in the clinical management of breast cancer. This study will provide information that can be used to answer important patient questions about the effects of dietary pattern and magnitude of weight loss on long term survival following breast cancer treatment. CA125243.

  18. Ternary ceramic thermal spraying powder and method of manufacturing thermal sprayed coating using said powder

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vogli, Evelina; Sherman, Andrew J.; Glasgow, Curtis P.

    The invention describes a method for producing ternary and binary ceramic powders and their thermal spraying capable of manufacturing thermal sprayed coatings with superior properties. Powder contain at least 30% by weight ternary ceramic, at least 20% by weight binary molybdenum borides, at least one of the binary borides of Cr, Fe, Ni, W and Co and a maximum of 10% by weight of nano and submicro-sized boron nitride. The primary crystal phase of the manufactured thermal sprayed coatings from these powders is a ternary ceramic, while the secondary phases are binary ceramics. The coatings have extremely high resistance againstmore » corrosion of molten metal, extremely thermal shock resistance and superior tribological properties at low and at high temperatures.« less

  19. Weight Gain in Infancy and Overweight or Obesity in Childhood across the Gestational Spectrum: a Prospective Birth Cohort Study.

    PubMed

    Wang, Guoying; Johnson, Sara; Gong, Yiwei; Polk, Sarah; Divall, Sara; Radovick, Sally; Moon, Margaret; Paige, David; Hong, Xiumei; Caruso, Deanna; Chen, Zhu; Mallow, Eric; Walker, Sheila O; Mao, Guangyun; Pearson, Colleen; Wang, Mei-Cheng; Zuckerman, Barry; Cheng, Tina L; Wang, Xiaobin

    2016-07-15

    This study aimed to investigate the optimal degree of weight gain across the gestational spectrum in 1971 children enrolled at birth and followed up to age 7 years. Weight gain in infancy was categorized into four groups based on weight gain z-scores: slow (<-0.67), on track (-0.67 to 0.67), rapid (0.67 to 1.28), and extremely rapid (>1.28). Underweight and overweight or obesity (OWO) were defined as a body mass index ≤5(th) and ≥85(th) percentile, respectively, for age and gender. In our population, OWO was far more common than underweight (39.7% vs. 3.6%). Weight gain tracked strongly from age 4 to 24 months, and was positively associated with OWO and an unfavorable pattern of metabolic biomarkers, although the degree of weight gain for the risk was different across gestational categories. Extremely rapid weight gain led to a particularly high risk of OWO among children born early term and late preterm: odds ratio: 3.3 (95% confidence interval: 1.9 to 5.5) and 3.7 (1.8 to 7.5), respectively, as compared to those with on track weight gain. Our findings suggest that monitoring and ensuring optimal weight gain across the entire gestational spectrum beginning from birth represents a first step towards primary prevention of childhood obesity.

  20. Control of Precision Grip Force in Lifting and Holding of Low-Mass Objects

    PubMed Central

    Kimura, Daisuke; Kadota, Koji; Ito, Taro

    2015-01-01

    Few studies have investigated the control of grip force when manipulating an object with an extremely small mass using a precision grip, although some related information has been provided by studies conducted in an unusual microgravity environment. Grip-load force coordination was examined while healthy adults (N = 17) held a moveable instrumented apparatus with its mass changed between 6 g and 200 g in 14 steps, with its grip surface set as either sandpaper or rayon. Additional measurements of grip-force-dependent finger-surface contact area and finger skin indentation, as well as a test of weight discrimination, were also performed. For each surface condition, the static grip force was modulated in parallel with load force while holding the object of a mass above 30 g. For objects with mass smaller than 30 g, on the other hand, the parallel relationship was changed, resulting in a progressive increase in grip-to-load force (GF/LF) ratio. The rayon had a higher GF/LF force ratio across all mass levels. The proportion of safety margin in the static grip force and normalized moment-to-moment variability of the static grip force were also elevated towards the lower end of the object mass for both surfaces. These findings indicate that the strategy of grip force control for holding objects with an extremely small mass differs from that with a mass above 30 g. The data for the contact area, skin indentation, and weight discrimination suggest that a decreased level of cutaneous feedback signals from the finger pads could have played some role in a cost function in efficient grip force control with low-mass objects. The elevated grip force variability associated with signal-dependent and internal noises, and anticipated inertial force on the held object due to acceleration of the arm and hand, could also have contributed to the cost function. PMID:26376484

  1. Mental health assessed by the Strengths and Difficulties Questionnaire for children born extremely preterm without severe disabilities at 11 years of age: a Norwegian, national population-based study.

    PubMed

    Fevang, Silje Katrine Elgen; Hysing, Mari; Sommerfelt, Kristian; Elgen, Irene

    2017-12-01

    The aims were to investigate mental health problems with the Strength and Difficulties Questionnaire (SDQ) in children born extremely preterm/extremely low birth weight (EP/ELBW) without severe disabilities compared to controls, and to identify peri-, or neonatal factors possibly predicting later mental health problems. A national Norwegian cohort of 11-year-old EP/ELBW children, excluding those with intellectual disabilities, non-ambulatory cerebral palsy, blindness and/or deafness, was assessed. Parents and teachers completed the SDQ. Mean scores and scores ≥90th percentile for the control group, combined (parent and/or teacher reporting the child ≥90th percentile), and pervasive ratings (both parent and teacher reporting the child ≥90th percentile) were presented. The controls consisted of an unselected population of all 11-year-old children born in 1995 who attended public or private schools in Bergen. Of the eligible children, 216 (64%) EP/ELBW and 1882 (61%) control children participated. The EP/ELBW children had significantly higher scores and/or increased risk of parent, teacher, combined, and pervasive rated hyperactivity/inattention, emotional-, and peer problems (OR 2.1-6.3). Only parents reported the EP/ELBW children to be at an increased risk of conduct problems (OR 1.6, 95% CI 1.1-2.6). Only low maternal education at birth was significantly associated with mental health problems at 11 years of age (OR 2.5, 95% CI 1.2-5.4). EP/ELBW children without severe disabilities had increased risk of symptoms of hyperactivity/inattention, emotional-, and peer problems. None of the peri- or neonatal factors were significantly associated with later mental health problems, except for low maternal education.

  2. Gestational age, gender and parity specific centile charts for placental weight for singleton deliveries in Aberdeen, UK.

    PubMed

    Wallace, J M; Bhattacharya, S; Horgan, G W

    2013-03-01

    The weight of the placenta is a crude but useful proxy for its function in vivo. Accordingly extremes of placental weight are associated with adverse pregnancy outcomes while even normal variations in placental size may impact lifelong health. Centile charts of placental weight for gestational age and gender are used to identify placental weight extremes but none report the effect of parity. Thus the objective was to produce gender and gestational age specific centile charts for placental weight in nulliparous and multiparous women. Data was extracted from the Aberdeen Maternity and Neonatal Databank for all women delivering singleton babies in Aberdeen city and district after 24 weeks gestation. Gestational age specific centile charts for placental weight by gender and parity grouping (n = 88,649 deliveries over a 30 year period) were constructed using the LMS method after exclusion of outliers (0.63% of deliveries meeting study inclusion criteria). Tables and figures are presented for placental weight centiles according to gestational age, gender and parity grouping. Tables are additionally presented for the birth weight to placental weight ratio by gender. Placental weight and the fetal:placental weight ratio were higher in male versus female deliveries. Placental weight was greater in multiparous compared with nulliparous women. We present strong evidence that both gender and parity grouping influence placental weight centiles. The differences at any given gestational age are small and the effects of parity are greater overall than those of gender. In contrast the birth weight to placental weight ratio differs by gender only. These UK population specific centile charts may be useful in studies investigating the role of the placenta in mediating pregnancy outcome and lifelong health. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Unhealthy weight control behaviors among youth: Sex of sexual partner is linked to important differences.

    PubMed

    Watson, Ryan J; VanKim, Nicole A; Rose, Hilary A; Porta, Carolyn M; Gahagan, Jacqueline; Eisenberg, Marla E

    2018-03-30

    Unhealthy weight control behaviors (UWCBs) have been decreasing for most youth over time, yet little is known whether these behaviors have changed for sexual minority (e.g., non-heterosexual) youth. This is important because many studies have found that sexual minorities report some of the highest rates of UWCBs. To determine whether or not these behaviors have changed over time, given the extreme changes in social contexts over the past two decades, we utilised three waves of the Minnesota Student Survey (N = 55,597, M age  = 17). In doing so, we report trends, disparities, and changes in disparities of UWCBs. Overall, the prevalence of UWCBs has declined from 1999 to 2010 for all youth, but there are alarming disparities by sex of sexual partner. We found that both- and same-sex partnered male youth were more likely to fast, use diet pills, and vomit on purpose to lose weight compared to their opposite-sex partnered counterparts in all three survey years; specifically, both-sex partnered boys were up to 5.5× as likely to vomit on purpose compared to their opposite-sex partnered counterparts. Likewise, both-sex partnered girls were more likely to use diet pills and vomit on purpose to lose weight compared to opposite-sex partnered girls in all three survey years. Additionally, the disparity in fasting to lose weight widened for the same-sex partnered females compared to the opposite-sex partnered females from 1998 to 2004. This has implications for UWCB interventions and preventions targeted specifically towards sexual minorities.

  4. Maternal underweight and obesity and risk of orofacial clefts in a large international consortium of population-based studies.

    PubMed

    Kutbi, Hebah; Wehby, George L; Moreno Uribe, Lina M; Romitti, Paul A; Carmichael, Suzan; Shaw, Gary M; Olshan, Andrew F; DeRoo, Lisa; Rasmussen, Sonja A; Murray, Jeffrey C; Wilcox, Allen; Lie, Rolv T; Munger, Ronald G

    2017-02-01

    Evidence on association of maternal pre-pregnancy weight with risk of orofacial clefts is inconsistent. Six large case-control studies of orofacial clefts from Northern Europe and the USA were included in analyses pooling individual-level data. Cases included 4943 mothers of children with orofacial clefts (cleft lip only: 1135, cleft palate with cleft lip: 2081, cleft palate only: 1727) and controls included 10 592 mothers of unaffected children. Association of orofacial cleft risk with pre-pregnancy maternal weight classified by level of body mass index (BMI, kg/m 2 ) was evaluated using logistic regression adjusting for multiple covariates. Cleft palate, both alone and with cleft lip (CP+/-CL), was associated with maternal class II+ pre-pregnancy obesity (≥ 35)compared with normal weight [adjusted odds ratio (aOR) = 1.36; 95% confidence interval (CI) = 1.16, 1.58]. CP+/-CL was marginally associated with maternal underweight (aOR = 1.16; 95% CI = 0.98, 1.36). Cleft lip alone was not associated with BMI. In this largest population-based study to date, we found an increased risk of cleft palate, with or without cleft lip, in class II+ obese mothers compared with normal-weight mothers; underweight mothers may also have an increased risk, but this requires further study. These results also suggest that extremes of weight may have a specific effect on palatal development. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

  5. Gravitational Waves From the Kerr/CFT Correspondence

    NASA Astrophysics Data System (ADS)

    Porfyriadis, Achilleas

    Astronomical observation suggests the existence of near-extreme Kerr black holes in the sky. Properties of diffeomorphisms imply that dynamics of the near-horizon region of near-extreme Kerr are governed by an infinite-dimensional conformal symmetry. This symmetry may be exploited to analytically, rather than numerically, compute a variety of potentially observable processes. In this thesis we compute the gravitational radiation emitted by a small compact object that orbits in the near-horizon region and plunges into the horizon of a large rapidly rotating black hole. We study the holographically dual processes in the context of the Kerr/CFT correspondence and find our conformal field theory (CFT) computations in perfect agreement with the gravity results. We compute the radiation emitted by a particle on the innermost stable circular orbit (ISCO) of a rapidly spinning black hole. We confirm previous estimates of the overall scaling of the power radiated, but show that there are also small oscillations all the way to extremality. Furthermore, we reveal an intricate mode-by-mode structure in the flux to infinity, with only certain modes having the dominant scaling. The scaling of each mode is controlled by its conformal weight. Massive objects in adiabatic quasi-circular inspiral towards a near-extreme Kerr black hole quickly plunge into the horizon after passing the ISCO. The post-ISCO plunge trajectory is shown to be related by a conformal map to a circular orbit. Conformal symmetry of the near-horizon region is then used to compute analytically the gravitational radiation produced during the plunge phase. Most extreme-mass-ratio-inspirals of small compact objects into supermassive black holes end with a fast plunge from an eccentric last stable orbit. We use conformal transformations to analytically solve for the radiation emitted from various fast plunges into extreme and near-extreme Kerr black holes.

  6. Off-policy reinforcement learning for H∞ control design.

    PubMed

    Luo, Biao; Wu, Huai-Ning; Huang, Tingwen

    2015-01-01

    The H∞ control design problem is considered for nonlinear systems with unknown internal system model. It is known that the nonlinear H∞ control problem can be transformed into solving the so-called Hamilton-Jacobi-Isaacs (HJI) equation, which is a nonlinear partial differential equation that is generally impossible to be solved analytically. Even worse, model-based approaches cannot be used for approximately solving HJI equation, when the accurate system model is unavailable or costly to obtain in practice. To overcome these difficulties, an off-policy reinforcement leaning (RL) method is introduced to learn the solution of HJI equation from real system data instead of mathematical system model, and its convergence is proved. In the off-policy RL method, the system data can be generated with arbitrary policies rather than the evaluating policy, which is extremely important and promising for practical systems. For implementation purpose, a neural network (NN)-based actor-critic structure is employed and a least-square NN weight update algorithm is derived based on the method of weighted residuals. Finally, the developed NN-based off-policy RL method is tested on a linear F16 aircraft plant, and further applied to a rotational/translational actuator system.

  7. Antenatal calcium channel blocker exposure and subsequent patent ductus arteriosus in extremely low-birth-weight infants.

    PubMed

    McGuirl, Jennifer; Arzuaga, Bonnie; Lee, Ben H

    2012-01-01

    This study aimed to assess whether tocolytic fetal exposure to antenatal calcium channel blockers (aCCB) increases the risk for hemodynamically significant patent ductus arteriosus (hsPDA) in extremely low-birth-weight (ELBW) infants. This case-control study investigated ELBW infants (<1,000 g) without cardiac defects in a level 3 neonatal intensive care unit who had survived at least 7 days. Nifedipine was the only aCCB used for this study population. The measurements included the history of aCCB exposure, selected maternal data, hsPDA diagnosis, gestational age at birth, birth weight, mode of delivery, sex, maternal race, location of birth, Apgar scores, and selected neonatal morbidities. The end point of the study was hsPDA, defined as an echocardiographically confirmed PDA with clinical symptoms. A total of 180 infants met the study criteria. The diagnosis was hsPDA for 56% of these patients, 20% of whom had aCCB exposure. Of the infants without hsPDA, 11% had aCCB exposure (p = 0.09). No statistically significant associations were found between aCCB exposure and hsPDA after adjustment for gestational age (odds ratio [OR], 1.5; 95% confidence interval [CI], 0.6-3.7) or for gestational age and cumulative aCCB exposure of 100 mg or more (OR, 2.0; 95% CI, 0.6-6.5). A history of aCCB exposure does not appear to increase hsPDA risk in ELBW infants. Studies using neonatal serum nifedipine concentrations after antenatal exposure should be performed to confirm this conclusion.

  8. Children in the Extremes of Physical and Psychological Measurements

    ERIC Educational Resources Information Center

    Stine, Oscar C.; and others

    1969-01-01

    Study of children in Early School Admission Project in Baltimore confirms that among those in extremes of ten measurements there are previously identified correlations between height, weight and head circumference. No association found between low head circumference and intelligence on behavior. However, improved physical growth may affect mental…

  9. Weighted mining of massive collections of [Formula: see text]-values by convex optimization.

    PubMed

    Dobriban, Edgar

    2018-06-01

    Researchers in data-rich disciplines-think of computational genomics and observational cosmology-often wish to mine large bodies of [Formula: see text]-values looking for significant effects, while controlling the false discovery rate or family-wise error rate. Increasingly, researchers also wish to prioritize certain hypotheses, for example, those thought to have larger effect sizes, by upweighting, and to impose constraints on the underlying mining, such as monotonicity along a certain sequence. We introduce Princessp , a principled method for performing weighted multiple testing by constrained convex optimization. Our method elegantly allows one to prioritize certain hypotheses through upweighting and to discount others through downweighting, while constraining the underlying weights involved in the mining process. When the [Formula: see text]-values derive from monotone likelihood ratio families such as the Gaussian means model, the new method allows exact solution of an important optimal weighting problem previously thought to be non-convex and computationally infeasible. Our method scales to massive data set sizes. We illustrate the applications of Princessp on a series of standard genomics data sets and offer comparisons with several previous 'standard' methods. Princessp offers both ease of operation and the ability to scale to extremely large problem sizes. The method is available as open-source software from github.com/dobriban/pvalue_weighting_matlab (accessed 11 October 2017).

  10. Long-term visual outcomes in extremely low-birth-weight children (an American Ophthalmological Society thesis).

    PubMed

    Spencer, Rand

    2006-01-01

    The goal is to analyze the long-term visual outcome of extremely low-birth-weight children. This is a retrospective analysis of eyes of extremely low-birth-weight children on whom vision testing was performed. Visual outcomes were studied by analyzing acuity outcomes at >/=36 months of adjusted age, correlating early acuity testing with final visual outcome and evaluating adverse risk factors for vision. Data from 278 eyes are included. Mean birth weight was 731g, and mean gestational age at birth was 26 weeks. 248 eyes had grating acuity outcomes measured at 73 +/- 36 months, and 183 eyes had recognition acuity testing at 76 +/- 39 months. 54% had below normal grating acuities, and 66% had below normal recognition acuities. 27% of grating outcomes and 17% of recognition outcomes were /=3 years of age. A slower-than-normal rate of early visual development was predictive of abnormal grating acuity (P < .0001) and abnormal recognition acuity (P < .0001) at >/=3 years of age. Eyes diagnosed with maximal retinopathy of prematurity in zone I had lower acuity outcomes (P = .0002) than did those with maximal retinopathy of prematurity in zone II/III. Eyes of children born at 28 weeks gestational age. Eyes of children with poorer general health after premature birth had a 5.3 times greater risk of abnormal recognition acuity. Long-term visual development in extremely low-birth-weight infants is problematic and associated with a high risk of subnormal acuity. Early acuity testing is useful in identifying children at greatest risk for long-term visual abnormalities. Gestational age at birth of

  11. Extreme under‐reporting of body weight by young adults with obesity: relation to social desirability

    PubMed Central

    Cespedes, V. M.; Burden, G. K.; Brady, S. K.; Clement, L. R.; Abbott, E. M.; Baughman, K. S.; Joyner, S. E.; Clark, M. M.; Pury, C. L. S.

    2018-01-01

    Summary Objective The objective of this study was to determine whether there is an association between under‐reporting of body weight and social desirability as is found with self‐reports of energy intake. Methods Twenty‐seven lean individuals (mean body mass index ± standard deviation = 21.6 ± 2.0 kg m−2) and 26 individuals with obesity (mean body mass index = 35.4 ± 4.8 kg m−2) were e‐mailed a questionnaire on which they had to state their body weight and conduct a home food inventory. The next day, research team members went to their homes to weigh the participants, conduct their own food inventory and administer the Marlowe–Crowne scale for social desirability. Results Among individuals with obesity, lower social desirability scores were associated with a greater degree of under‐reporting body weight (r = +0.48, p < 0.02). Among lean individuals, the correlation was negative but statistically non‐significant (p = −0.22, p > 0.10). Nine individuals with obesity were extreme under‐reporters (2.27 kg or more), and eight of these had social desirability scores in the bottom half of the Marlowe–Crowne scale (p < 0.01). Six under‐reported on the home food inventory by three or more items. Conclusions Individuals with obesity and low social desirability scores are more likely than others to be extreme under‐reporters of body weight, possibly due to a lack of awareness of their own weight. PMID:29670750

  12. [Investigation of body weight ratios on joint structures at different knee flexion angles in patients with unilateral knee arthroplasty].

    PubMed

    Bakırhan, Serkan; Unver, Bayram; Karatosun, Vasfi

    2013-01-01

    The study aims to determine body weight ratios between extremities in patients with unilateral total knee arthroplasty (TKA) at 12 months postoperatively at the static-standing position at 30, 60 and 90 degrees of knee flexion. The study included 52 female patients (mean age 65.6±10.6 years; range 40 to 83 years) who underwent unilateral primary TKA. The force-platform was used to calculate the body-weight ratios of the patients. Body weight ratios on the operated and non-operated limbs of the unilateral TKA patients were examined at standing-static position at 30, 60 and 90 degrees of knee flexion on the force-platform according to their age and body mass index (BMI). The pain levels of the patients were evaluated using the visual analog scale. It was found that unilateral TKA patients placed their body weight on the non-operated limb more at the standing-static position, and 30, 60 and 90 degrees of knee flexion at 12 months postoperatively (p<0.05). It was also found that as the knee flexion degree increased with age, so did TKA patients place their body weight on the nonoperated limb more (p<0.05), and that BMI had no effect on the load distribution difference over the two extremities (p>0.05). During the postoperative period, load asymmetry between the two extremities in patients with unilateral TKA remains the same due to advancing age. This accelerates the osteoarthritis process on the non-operated knee. It is concluded that the age factor should be taken into account while planning physiotherapy and rehabilitation programs for unilateral TKA patients and knee exercise programs aiming to place load over the operated limb should be arranged.

  13. Effects of a hypogeomagnetic field on gravitropism and germination in soybean

    NASA Astrophysics Data System (ADS)

    Mo, Wei-chuan; Zhang, Zi-jian; Liu, Ying; Zhai, Guang-jie; Jiang, Yuan-da; He, Rong-qiao

    2011-05-01

    Any plants grown during long-term space missions will inevitably experience an extremely low magnetic field (i.e. a hypogeomagnetic field, HGMF). It is possible that the innate adaptation of plants to the earth's magnetic field (i.e. the geomagnetic field, GMF) would be disrupted. Effects of the HGMF on plant physiological and metabolic processes are unclear. In this study we established a hypogeomagnetic incubation system on the ground and investigated the effects of the HGMF on the gravitropism and germination of soybean seeds. The gravitropism angle, germination percentage, germination speed, water absorbance ratio, seed weight, radicle length, radicle weight, and radicle weight ratio of soybean seeds grown in the local field and the HGMF were compared. In general, the gravitropism angle in the HGMF was smaller than that in the local field when seeds were positioned before emergence in such a way that the direction of the radicle was opposite to that of gravity. The germination percentage, germination speed, and radicle weight ratio increased in the HGMF compared to the control. Our results indicate that the germination and gravitropism of soybean seeds are affected by elimination of the geomagnetic field.

  14. Identification of extremely premature infants at high risk of rehospitalization.

    PubMed

    Ambalavanan, Namasivayam; Carlo, Waldemar A; McDonald, Scott A; Yao, Qing; Das, Abhik; Higgins, Rosemary D

    2011-11-01

    Extremely low birth weight infants often require rehospitalization during infancy. Our objective was to identify at the time of discharge which extremely low birth weight infants are at higher risk for rehospitalization. Data from extremely low birth weight infants in Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers from 2002-2005 were analyzed. The primary outcome was rehospitalization by the 18- to 22-month follow-up, and secondary outcome was rehospitalization for respiratory causes in the first year. Using variables and odds ratios identified by stepwise logistic regression, scoring systems were developed with scores proportional to odds ratios. Classification and regression-tree analysis was performed by recursive partitioning and automatic selection of optimal cutoff points of variables. A total of 3787 infants were evaluated (mean ± SD birth weight: 787 ± 136 g; gestational age: 26 ± 2 weeks; 48% male, 42% black). Forty-five percent of the infants were rehospitalized by 18 to 22 months; 14.7% were rehospitalized for respiratory causes in the first year. Both regression models (area under the curve: 0.63) and classification and regression-tree models (mean misclassification rate: 40%-42%) were moderately accurate. Predictors for the primary outcome by regression were shunt surgery for hydrocephalus, hospital stay of >120 days for pulmonary reasons, necrotizing enterocolitis stage II or higher or spontaneous gastrointestinal perforation, higher fraction of inspired oxygen at 36 weeks, and male gender. By classification and regression-tree analysis, infants with hospital stays of >120 days for pulmonary reasons had a 66% rehospitalization rate compared with 42% without such a stay. The scoring systems and classification and regression-tree analysis models identified infants at higher risk of rehospitalization and might assist planning for care after discharge.

  15. Identification of Extremely Premature Infants at High Risk of Rehospitalization

    PubMed Central

    Carlo, Waldemar A.; McDonald, Scott A.; Yao, Qing; Das, Abhik; Higgins, Rosemary D.

    2011-01-01

    OBJECTIVE: Extremely low birth weight infants often require rehospitalization during infancy. Our objective was to identify at the time of discharge which extremely low birth weight infants are at higher risk for rehospitalization. METHODS: Data from extremely low birth weight infants in Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network centers from 2002–2005 were analyzed. The primary outcome was rehospitalization by the 18- to 22-month follow-up, and secondary outcome was rehospitalization for respiratory causes in the first year. Using variables and odds ratios identified by stepwise logistic regression, scoring systems were developed with scores proportional to odds ratios. Classification and regression-tree analysis was performed by recursive partitioning and automatic selection of optimal cutoff points of variables. RESULTS: A total of 3787 infants were evaluated (mean ± SD birth weight: 787 ± 136 g; gestational age: 26 ± 2 weeks; 48% male, 42% black). Forty-five percent of the infants were rehospitalized by 18 to 22 months; 14.7% were rehospitalized for respiratory causes in the first year. Both regression models (area under the curve: 0.63) and classification and regression-tree models (mean misclassification rate: 40%–42%) were moderately accurate. Predictors for the primary outcome by regression were shunt surgery for hydrocephalus, hospital stay of >120 days for pulmonary reasons, necrotizing enterocolitis stage II or higher or spontaneous gastrointestinal perforation, higher fraction of inspired oxygen at 36 weeks, and male gender. By classification and regression-tree analysis, infants with hospital stays of >120 days for pulmonary reasons had a 66% rehospitalization rate compared with 42% without such a stay. CONCLUSIONS: The scoring systems and classification and regression-tree analysis models identified infants at higher risk of rehospitalization and might assist planning for care after discharge. PMID:22007016

  16. Extreme Preterm Infant Rates of Overweight and Obesity at School Age in the SUPPORT Neuroimaging and Neurodevelopmental Outcomes Cohort.

    PubMed

    Vohr, Betty R; Heyne, Roy; Bann, Carla M; Das, Abhik; Higgins, Rosemary D; Hintz, Susan R

    2018-05-21

    To identify rates of overweight (body mass index [BMI] ≥85th percentile) and obesity (BMI ≥95th percentile) at 6-7 years of age and associated risk factors among extremely preterm infants born at <28 weeks of gestation. Anthropometrics, blood pressure, and active and sedentary activity levels were prospectively assessed. Three groups were compared, those with a BMI ≥85th percentile (overweight or obese for age, height, and sex) and ≥95th percentile (obese) vs <85th percentile. Multiple regression analyses estimated the relative risks of BMI ≥85th percentile and ≥95th percentile associated with perinatal and early childhood factors. Of 388 children, 22% had a BMI of ≥85th percentile and 10% were obese. Children with obesity and overweight compared with normal weight children had higher body fat (subscapular skinfold and triceps skinfold >85th percentile), central fat (waist circumference >90th percentile), spent more time in sedentary activity (20.5 vs 18.2 vs 16.7 hours/week), and had either systolic and/or diastolic hypertension (24% vs 26% vs 14%), respectively. Postdischarge weight gain velocities from 36 weeks postmenstrual age to 18 months, and 18 months to 6-7 years were independently associated with a BMI of ≥85th percentile, whereas weight gain velocity from 18 months to 6-7 years was associated with obesity. One in 5 former extremely preterm infants is overweight or obese and has central obesity at early school age. Postdischarge weight gain velocities were associated with overweight and obesity. These findings suggest the obesity epidemic is spreading to the most extremely preterm infants. ClinicalTrials.govNCT00063063 and NCT0000. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants.

    PubMed

    Cristofalo, Elizabeth A; Schanler, Richard J; Blanco, Cynthia L; Sullivan, Sandra; Trawoeger, Rudolf; Kiechl-Kohlendorfer, Ursula; Dudell, Golde; Rechtman, David J; Lee, Martin L; Lucas, Alan; Abrams, Steven

    2013-12-01

    To compare the duration of parenteral nutrition, growth, and morbidity in extremely premature infants fed exclusive diets of either bovine milk-based preterm formula (BOV) or donor human milk and human milk-based human milk fortifier (HUM), in a randomized trial of formula vs human milk. Multicenter randomized controlled trial. The authors studied extremely preterm infants whose mothers did not provide their milk. Infants were fed either BOV or an exclusive human milk diet of pasteurized donor human milk and HUM. The major outcome was duration of parenteral nutrition. Secondary outcomes were growth, respiratory support, and necrotizing enterocolitis (NEC). Birth weight (983 vs 996 g) and gestational age (27.5 vs 27.7 wk), in BOV and HUM, respectively, were similar. There was a significant difference in median parenteral nutrition days: 36 vs 27, in BOV vs HUM, respectively (P = .04). The incidence of NEC in BOV was 21% (5 cases) vs 3% in HUM (1 case), P = .08; surgical NEC was significantly higher in BOV (4 cases) than HUM (0 cases), P = .04. In extremely preterm infants given exclusive diets of preterm formula vs human milk, there was a significantly greater duration of parenteral nutrition and higher rate of surgical NEC in infants receiving preterm formula. This trial supports the use of an exclusive human milk diet to nourish extremely preterm infants in the neonatal intensive care unit. Copyright © 2013 Mosby, Inc. All rights reserved.

  18. A Preliminary Study of the Preparation of Slurry Fuels from Vaporized Magnesium

    NASA Technical Reports Server (NTRS)

    Witzke, Walter R; Prok, George M; Walsh, Thomas J

    1954-01-01

    Slurry fuels containing extremely small particles of magnesium were prepared by concentrating the dilute slurry product resulting from the shock-cooling of magnesium metal vapors with a liquid hydrocarbon spray. A complete description of the equipment and procedure used in preparing the fuel is given. Ninety-five percent by weight of the solid particles formed by this process passed through a 100-mesh screen. The particle-size distribution of the screened fraction of one run, as determined by sedimentation analysis, indicated that 73 percent by weight of the metal particles were finer than 2 microns in equivalent spherical diameter. The purity of the solid particles ranged as high as 98.9 percent by weight of free magnesium. The screened product was concentrated by means of a bowl-type centrifuge from 0.5 to more than 50 percent by weight solids content to form an extremely viscous, clay-like mass. By addition of a surface active agent, this viscous material was converted into a pumpable slurry fuel.

  19. CHANGE IN PREVALENCE OF CHRONIC CONDITIONS BETWEEN CHILDHOOD AND ADOLESCENCE AMONG EXTREMELY LOW BIRTH WEIGHT CHILDREN

    PubMed Central

    Hack, Maureen; Schluchter, Mark; Andreias, Laura; Margevicius, Seunghee; Taylor, H. Gerry; Drotar, Dennis; Cuttler, Leona

    2013-01-01

    Context Extremely low birth weight (ELBW, <1kg) children have high rates of chronic conditions during childhood. Information on their trajectory of health during the critical period of adolescence is needed for health care planning. Objective To examine changes in rates of chronic conditions between age 8 and 14 years among ELBW compared to normal birth weight (NBW) controls. Design, Setting and Participants Cohort study conducted from 2004 through2009 of 181 ELBW children (weight <1kg) and 115 NBW controls of similar sociodemographic status born 1992 through 1995 in Cleveland, Ohio. Main Outcome Measures Rates of chronic conditions overall (measured with the revised Questionnaire for Identifying Children with Chronic Conditions) and rates of asthma and obesity. Results The overall rates of chronic conditions did not change significantly between ages 8 and 14 years among ELBW children (75% at age 8 years vs 74% at age 14 years) or NBW controls (37% at 8 years vs 47% at age 14 years). In generalized estimating equations logistic regression, adjusting for sociodemographic status, sex and race, ELBW continued to have higher rates of chronic conditions than NBW controls at age 14 years (74% vs 47%, respectively adjusted odds ratio [AOR],2.8; 95% Confidence Interval {CI},1.7 to 4.6). Rates of asthma requiring medication did not change between 8 and 14 years among ELBW children (23% at both ages), but increased among NBW children from 8% at age 8 years to 17% at age 14 years (p=0.002). Differences in rates of asthma between ELBW and NBW children were no longer significant at the age of 14 years (23% vs 17%, respectively; AOR,1.5; [95%CI,0.8 to 2.8]. Mean z scores for body mass index increased in ELBW children from 0.06 at age 8 yesrs to 0.38 at age 14 years(p<0.001) and rates of obesity increased from 12% at age 8 years to 19% at age 14 years (p=0.02). However, the scores and rates did not change among NBW controls such that at the age of 14 years the differences between ELBW and NBW children in mean z-scores for body mass index (0.38 vs 0.56, respectively; adjusted mean difference −0.2; 95% CI, −0.5 to 0.1) or rates of obesity (19% vs 20%, respectively; AOR,1.1 [95%CI, 0.6to 2.0] were not significant.. Conclusions Among ELBW children rates of overall chronic conditions and asthma did not change between the ages of 8 and 14 years but the rates of obesityincreased. Compared with NBW controls, the rates of chronic conditions were higher but there were no significant differences in the rates of asthma or obesity. PMID:21791688

  20. Temperature Tolerant Evolvable Systems Utilizing FPGA Boards and Bias-Controlled Amplifiers

    NASA Technical Reports Server (NTRS)

    Kumar, Nikhil R.

    2005-01-01

    Space missions often require radiation and extreme-temperature hardened electronics to survive the harsh environments beyond Earth's atmosphere. Traditional approaches to preserve electronics incorporate shielding, insulation and redundancy at the expense of power and weight. However, a novel way of bypassing these problems is the concept of evolutionary hardware. A reconfigurable device, consisting of several switches interconnected with analog/digital parts, is controlled by an evolutionary processor (EP). When the EP detects degradation in the circuit it sends signals to reconfigure the switches, thus forming a new circuit with the desired output. This concept has been developed since the mid-l990s, but one problem remains-the EP cannot degrade substantially. For this reason, extensive testing at extreme temperatures (-180 to 120 C) has been done on devices found on FPGA boards (taking the role of the EP), such as the Analog to Digital and the Digital to Analog Converter. The EP is used in conjunction with a bias-controlled amplifier and a new prototype relay board, which is interconnected with 6 G4-FETs, a tri-input transistor-like element developed at JPL. The greatest improvements to be made lie in the reconfigurable device, so future design and testing of the G4-FET chip is required.

  1. How does knee pain affect trunk and knee motion during badminton forehand lunges?

    PubMed

    Huang, Ming-Tung; Lee, Hsing-Hsan; Lin, Cheng-Feng; Tsai, Yi-Ju; Liao, Jen-Chieh

    2014-01-01

    Badminton requires extensive lower extremity movement and a precise coordination of the upper extremity and trunk movements. Accordingly, this study investigated motions of the trunk and the knee, control of dynamic stability and muscle activation patterns of individuals with and without knee pain. Seventeen participants with chronic knee pain and 17 healthy participants participated in the study and performed forehand forward and backward diagonal lunges. This study showed that those with knee pain exhibited smaller knee motions in frontal and horizontal planes during forward lunge but greater knee motions in sagittal plane during backward lunge. By contrast, in both tasks, the injured group showed a smaller value on the activation level of the paraspinal muscles in pre-impact phase, hip-shoulder separation angle, trunk forward inclination range and peak centre of mass (COM) velocity. Badminton players with knee pain adopt a more conservative movement pattern of the knee to minimise recurrence of knee pain. The healthy group exhibit better weight-shifting ability due to a greater control of the trunk and knee muscles. Training programmes for badminton players with knee pain should be designed to improve both the neuromuscular control and muscle strength of the core muscles and the knee extensor with focus on the backward lunge motion.

  2. Chip Scale Ultra-Stable Clocks: Miniaturized Phonon Trap Timing Units for PNT of CubeSats

    NASA Technical Reports Server (NTRS)

    Rais-Zadeh, Mina; Altunc, Serhat; Hunter, Roger C.; Petro, Andrew

    2016-01-01

    The Chip Scale Ultra-Stable Clocks (CSUSC) project aims to provide a superior alternative to current solutions for low size, weight, and power timing devices. Currently available quartz-based clocks have problems adjusting to the high temperature and extreme acceleration found in space applications, especially when scaled down to match small spacecraft size, weight, and power requirements. The CSUSC project aims to utilize dual-mode resonators on an ovenized platform to achieve the exceptional temperature stability required for these systems. The dual-mode architecture utilizes a temperature sensitive and temperature stable mode simultaneously driven on the same device volume to eliminate ovenization error while maintaining extremely high performance. Using this technology it is possible to achieve parts-per-billion (ppb) levels of temperature stability with multiple orders of magnitude smaller size, weight, and power.

  3. Thermal control requirements for large space structures

    NASA Technical Reports Server (NTRS)

    Manoff, M.

    1978-01-01

    Performance capabilities and weight requirements of large space structure systems will be significantly influenced by thermal response characteristics. Analyses have been performed to determine temperature levels and gradients for structural configurations and elemental concepts proposed for advanced system applications ranging from relatively small, low-power communication antennas to extremely large, high-power Satellite Power Systems (SPS). Results are presented for selected platform configurations, candidate strut elements, and potential mission environments. The analyses also incorporate material and surface optical property variation. The results illustrate many of the thermal problems which may be encountered in the development of three systems.

  4. Health-related quality of life and emotional and behavioral difficulties after extreme preterm birth: developmental trajectories.

    PubMed

    Vederhus, Bente Johanne; Eide, Geir Egil; Natvig, Gerd Karin; Markestad, Trond; Graue, Marit; Halvorsen, Thomas

    2015-01-01

    Background. Knowledge of long-term health related outcomes in contemporary populations born extremely preterm (EP) is scarce. We aimed to explore developmental trajectories of health-related quality of life (HRQoL) and behavior from mid-childhood to early adulthood in extremely preterm and term-born individuals. Methods. Subjects born at gestational age ≤28 weeks or with birth weight ≤1,000 g within a region of Norway in 1991-92 and matched term-born control subjects were assessed at 10 and 18 years. HRQoL was measured with the Child Health Questionnaire (CHQ) and behavior with the Child Behavior Checklist (CBCL), using parent assessment at both ages and self-assessment at 18 years. Results. All eligible EP (n = 35) and control children participated at 10 years, and 31 (89%) and 29 (83%) at 18 years. At 10 years, the EP born boys were given significantly poorer scores by their parents than term-born controls on most CHQ and CBCL scales, but the differences were minor at 18 years; i.e., significant improvements had occurred in several CHQ (self-esteem, general health and parental impact-time) and CBCL (total problem, internalizing and anxious/depressed) scales. For the girls, the differences were smaller at 10 years and remained unchanged by 18 years. Emotional/behavioral difficulties at 10 years similarly predicted poorer improvement on CHQ-scales for both EP and term-born subjects at 18 years. Self-assessment of HRQoL and behavior at 18 years was similar in the EP and term-born groups on most scales. Conclusions. HRQoL and behavior improved towards adulthood for EP born boys, while the girls remained relatively similar, and early emotional and behavioral difficulties predicted poorer development in HRQoL through adolescence. These data indicate that gender and a longitudinal perspective should be considered when addressing health and wellbeing after extremely preterm birth.

  5. Effects of resistance training on muscle strength, exercise capacity, and mobility in middle-aged and elderly patients with coronary artery disease: A meta-analysis.

    PubMed

    Yamamoto, Shuhei; Hotta, Kazuki; Ota, Erika; Mori, Rintaro; Matsunaga, Atsuhiko

    2016-08-01

    Resistance training (RT) is a core component of cardiac rehabilitation. We investigated the effects of RT on exercise capacity, muscle strength, and mobility in middle-aged and elderly patients with coronary artery disease (CAD). We searched for randomized controlled trials of RT versus usual care, or combined RT and aerobic training (AT) versus AT alone, and identified 440 trials in total from inception to January 2014. Participants who had myocardial infarction, coronary revascularization, angina pectoris or CAD were included in the analysis. Those who had heart failure, heart transplants with either cardiac resynchronization therapy or implantable defibrillators were excluded. Twenty-two trials totaling 1095 participants were analyzed. We performed random-effects meta-analysis. In middle-aged participants, RT increased lower extremity muscle strength [standardized mean difference (SMD): 0.65, 95% confidence interval (CI): 0.35 to 0.95], upper extremity muscle strength (SMD: 0.73, 95% CI: 0.48 to 0.99) and peak oxygen consumption (VO2) [weight mean difference (WMD): 0.92mL/kg/min, 95% CI: 0.12 to 1.72], but did not improve mobility compared with the control. In elderly participants, RT increased lower extremity muscle strength (SMD: 0.63, 95% CI: 0.05 to 1.21), upper extremity muscle strength (SMD: 1.18, 95% CI: 0.56 to 1.80), and peak VO2 (WMD: 0.70mL/kg/min, 95% CI: 0.03 to 1.37), and improved mobility (SMD: 0.61, 95% CI: 0.21 to 1.01) compared with the control. Resistance training could increase exercise capacity and muscle strength in middle-aged and elderly patients, and mobility in elderly patients, with CAD. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  6. Free flap lower extremity reconstruction in the obese population: does weight matter?

    PubMed

    Cleveland, Emily C; Fischer, John P; Nelson, Jonas A; Wink, Jason D; Levin, L Scott; Kovach, Stephen J

    2014-05-01

    The obesity epidemic continues to grow, and we have observed greater numbers of obese individuals among patients seeking lower extremity reconstruction at our institution. These patients may present a greater reconstructive challenge, thus we sought to identify risk factors and differences in outcomes among patients undergoing lower extremity reconstruction.In this study we have performed a retrospective cohort analysis of patients undergoing lower extremity reconstruction with free tissue transfer at our institution from 2005 to 2012. Patients were classified using the World Health Organization criteria for obesity. Records were reviewed for patient characteristics, mechanism of injury, indications for reconstruction, and surgical technique, with a focus on intraoperative and early postoperative complications and outcomes.A total of 43 out of the 119 patients undergoing lower extremity reconstruction were obese (body mass index ≥ 30). Mechanism of injury, wound location, and the indications for reconstruction were similar in both cohorts. No significant differences were found in operative characteristics and techniques, including the type of flap utilized, operative time, or thrombotic events. No significant differences were seen in complication rates overall, however, obese patients more frequently needed second flaps (11.6 vs. 0%, p=0.005).This study concludes that successful lower extremity reconstruction can be performed in the obese population, with few differences in complication rates and outcomes relative to healthy weight patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. Influence of lower body pressure support on the walking patterns of healthy children and adults.

    PubMed

    Kurz, Max J; Deffeyes, Joan E; Arpin, David J; Karst, Gregory M; Stuberg, Wayne A

    2012-11-01

    The purpose of this investigation was to evaluate the effect of a lower body positive pressure support system on the joint kinematics and activity of the lower extremity antigravity musculature of adults and children during walking. Adults (age = 25 ± 4 years) and children (age = 13 ± 2 years) walked at a preferred speed and a speed that was based on the Froude number, while 0-80% of their body weight was supported. Electrogoniometers were used to monitor knee and ankle joint kinematics. Surface electromyography was used to quantify the magnitude of the vastus lateralis and gastrocnemius muscle activity. There were three key findings: (1) The lower extremity joint angles and activity of the lower extremity antigravity muscles of children did not differ from those of adults. (2) The magnitude of the changes in the lower extremity joint motion and antigravity muscle activity was dependent upon an interaction between body weight support and walking speed. (3) Lower body positive pressure support resulted in reduced activation of the antigravity musculature, and reduced range of motion of the knee and ankle joints.

  8. Extremely low birth weight and body size in early adulthood

    PubMed Central

    Doyle, L; Faber, B; Callanan, C; Ford, G; Davis, N

    2004-01-01

    Aims: To determine the body size of extremely low birth weight (ELBW, birth weight 500–999 g) subjects in early adulthood. Methods: Cohort study examining the height and weight of 42 ELBW survivors free of cerebral palsy between birth and 20 years of age. Weight and height measurements were converted to Z (SD) scores. Results: At birth the subjects had weight Z scores substantially below zero (mean birth weight Z score -0.90, 95% CI -1.25 to -0.54), and had been lighter than average at ages 2, 5, and 8 years. However, by 14, and again at 20 years of age their weight Z scores were not significantly different from zero. At ages 2, 5, 8, 14, and 20 years of age their height Z scores were significantly below zero. Their height at 20 years of age was, however, consistent with their parents' height. As a group they were relatively heavy for their height and their mean body mass index (BMI) Z score was almost significantly different from zero (mean difference 0.42, 95% CI -0.02 to 0.84). Their mean BMI (kg/m2) was 24.0 (SD 5.2); 14 had a BMI >25, and four had a BMI >30. Conclusions: Despite their early small size, by early adulthood the ELBW subjects had attained an average weight, and their height was consistent with their parents' height. They were, however, relatively heavy for their height. PMID:15033844

  9. SSTO rockets. A practical possibility

    NASA Technical Reports Server (NTRS)

    Bekey, Ivan

    1994-01-01

    Most experts agree that single-stage-to-orbit (SSTO) rockets would become feasible if more advanced technologies were available to reduce the vehicle dry weight, increase propulsion system performance, or both. However, these technologies are usually judged to be very ambitious and very far off. This notion persists despite major advances in technology and vehicle design in the past decade. There appears to be four major misperceptions about SSTOs, regarding their mass fraction, their presumed inadequate performance margin, their supposedly small payloads, and their extreme sensitivity to unanticipated vehicle weight growth. These misperceptions can be dispelled for SSTO rockets using advanced technologies that could be matured and demonstrated in the near term. These include a graphite-composite primary structure, graphite-composite and Al-Li propellant tanks with integral reusable thermal protection, long-life tripropellant or LOX-hydrogen engines, and several technologies related to operational effectiveness, including vehicle health monitoring, autonomous avionics/flight control, and operable launch and ground handling systems.

  10. SSTO rockets. A practical possibility

    NASA Astrophysics Data System (ADS)

    Bekey, Ivan

    1994-07-01

    Most experts agree that single-stage-to-orbit (SSTO) rockets would become feasible if more advanced technologies were available to reduce the vehicle dry weight, increase propulsion system performance, or both. However, these technologies are usually judged to be very ambitious and very far off. This notion persists despite major advances in technology and vehicle design in the past decade. There appears to be four major misperceptions about SSTOs, regarding their mass fraction, their presumed inadequate performance margin, their supposedly small payloads, and their extreme sensitivity to unanticipated vehicle weight growth. These misperceptions can be dispelled for SSTO rockets using advanced technologies that could be matured and demonstrated in the near term. These include a graphite-composite primary structure, graphite-composite and Al-Li propellant tanks with integral reusable thermal protection, long-life tripropellant or LOX-hydrogen engines, and several technologies related to operational effectiveness, including vehicle health monitoring, autonomous avionics/flight control, and operable launch and ground handling systems.

  11. Well-Defined High Molecular Weight Polystyrene with High Rates and High Livingness Synthesized via Two-Stage RAFT Emulsion Polymerization.

    PubMed

    Yan, Kun; Gao, Xiang; Luo, Yingwu

    2015-07-01

    A highly living polymer with over 100 kg mol(-1) molecular weight is very difficult to achieve by controlled radical polymerization since the unavoidable side reactions of irreversible radical termination and radical chain transfer to monomer reaction become significant. It is reported that over 500 kg mol(-1) polystyrene with high livingness and low dispersity could be synthesized by a facile two-stage reversible addition-fragmentation transfer emulsion polymerization. The monomer conversion reaches 90% within 10 h. High livingness of the product is ascribed to the extremely low initiator concentration and the chain transfer constant for monomer unexpectedly much lower than the well-accepted values in the conventional radical polymerization. The two-stage monomer feeding policy much decreases the dispersity of the product. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. NETL Extreme Drilling Laboratory Studies High Pressure High Temperature Drilling Phenomena

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lyons, K.D.; Honeygan, S.; Moroz, T.H.

    2008-12-01

    The U.S. Department of Energy's National Energy Technology Laboratory (NETL) established the Extreme Drilling Laboratory to engineer effective and efficient drilling technologies viable at depths greater than 20,000 ft. This paper details the challenges of ultradeep drilling, documents reports of decreased drilling rates as a result of increasing fluid pressure and temperature, and describes NETL's research and development activities. NETL is invested in laboratory-scale physical simulation. Its physical simulator will have capability of circulating drilling fluids at 30,000 psi and 480°F around a single drill cutter. This simulator is not yet operational; therefore, the results will be limited to themore » identification of leading hypotheses of drilling phenomena and NETL's test plans to validate or refute such theories. Of particular interest to the Extreme Drilling Laboratory's studies are the combinatorial effects of drilling fluid pressure, drilling fluid properties, rock properties, pore pressure, and drilling parameters, such as cutter rotational speed, weight on bit, and hydraulics associated with drilling fluid introduction to the rock-cutter interface. A detailed discussion of how each variable is controlled in a laboratory setting will be part of the conference paper and presentation.« less

  13. Analysis of Genes Involved in Body Weight Regulation by Targeted Re-Sequencing.

    PubMed

    Volckmar, Anna-Lena; Han, Chung Ting; Pütter, Carolin; Haas, Stefan; Vogel, Carla I G; Knoll, Nadja; Struve, Christoph; Göbel, Maria; Haas, Katharina; Herrfurth, Nikolas; Jarick, Ivonne; Grallert, Harald; Schürmann, Annette; Al-Hasani, Hadi; Hebebrand, Johannes; Sauer, Sascha; Hinney, Anke

    2016-01-01

    Genes involved in body weight regulation that were previously investigated in genome-wide association studies (GWAS) and in animal models were target-enriched followed by massive parallel next generation sequencing. We enriched and re-sequenced continuous genomic regions comprising FTO, MC4R, TMEM18, SDCCAG8, TKNS, MSRA and TBC1D1 in a screening sample of 196 extremely obese children and adolescents with age and sex specific body mass index (BMI) ≥ 99th percentile and 176 lean adults (BMI ≤ 15th percentile). 22 variants were confirmed by Sanger sequencing. Genotyping was performed in up to 705 independent obesity trios (extremely obese child and both parents), 243 extremely obese cases and 261 lean adults. We detected 20 different non-synonymous variants, one frame shift and one nonsense mutation in the 7 continuous genomic regions in study groups of different weight extremes. For SNP Arg695Cys (rs58983546) in TBC1D1 we detected nominal association with obesity (pTDT = 0.03 in 705 trios). Eleven of the variants were rare, thus were only detected heterozygously in up to ten individual(s) of the complete screening sample of 372 individuals. Two of them (in FTO and MSRA) were found in lean individuals, nine in extremely obese. In silico analyses of the 11 variants did not reveal functional implications for the mutations. Concordant with our hypothesis we detected a rare variant that potentially leads to loss of FTO function in a lean individual. For TBC1D1, in contrary to our hypothesis, the loss of function variant (Arg443Stop) was found in an obese individual. Functional in vitro studies are warranted.

  14. Exercise for the Overweight Patient.

    ERIC Educational Resources Information Center

    Work, Janis A.

    1990-01-01

    Exercise can help patients maintain lean body mass during weight loss. Although exercise is not extremely useful in shedding excess pounds, it helps keep off weight lost through calorie restriction. This article discusses the specifics of exercise prescription, types of exercise, motivation to exercise, and special problems such as diabetes. (SM)

  15. Evaluation of the National Weather Service Extreme Cold Warning Experiment in North Dakota

    PubMed Central

    Chiu, Cindy H.; Vagi, Sara J.; Wolkin, Amy F.; Martin, John Paul; Noe, Rebecca S.

    2016-01-01

    Dangerously cold weather threatens life and property. During periods of extreme cold due to wind chill, the National Weather Service (NWS) issues wind chill warnings to prompt the public to take action to mitigate risks. Wind chill warnings are based on ambient temperatures and wind speeds. Since 2010, NWS has piloted a new extreme cold warning issued for cold temperatures in wind and nonwind conditions. The North Dakota Department of Health, NWS, and the Centers for Disease Control and Prevention collaborated in conducting household surveys in Burleigh County, North Dakota, to evaluate this new warning. The objectives of the evaluation were to assess whether residents heard the new warning and to determine if protective behaviors were prompted by the warning. This was a cross-sectional survey design using the Community Assessment for Public Health Emergency Response (CASPER) methodology to select a statistically representative sample of households from Burleigh County. From 10 to 11 April 2012, 188 door-to-door household interviews were completed. The CASPER methodology uses probability sampling with weighted analysis to estimate the number and percentage of households with a specific response within Burleigh County. The majority of households reported having heard both the extreme cold and wind chill warnings, and both warnings prompted protective behaviors. These results suggest this community heard the new warning and took protective actions after hearing the warning. PMID:27239260

  16. Intra-arterial Ultra-low-Dose CT Angiography of Lower Extremity in Diabetic Patients

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Özgen, Ali, E-mail: draliozgen@hotmail.com; Sanioğlu, Soner; Bingöl, Uğur Anıl

    2016-08-15

    PurposeTo image lower extremity arteries by CT angiography using a very low-dose intra-arterial contrast medium in patients with high risk of developing contrast-induced nephropathy (CIN).Materials and MethodsThree cases with long-standing diabetes mellitus and signs of lower extremity atherosclerotic disease were evaluated by CT angiography using 0.1 ml/kg of the body weight of contrast medium given via 10-cm-long 4F introducer by puncturing the CFA. Images were evaluated by an interventional radiologist and a cardiovascular surgeon. Density values of the lower extremity arteries were also calculated. Findings in two cases were compared with digital subtraction angiography images performed for percutaneous revascularization. Blood creatininemore » levels were followed for possible CIN.ResultsIntra-arterial CT angiography images were considered diagnostic in all patients and optimal in one patient. No patient developed CIN after intra-arterial CT angiography, while one patient developed CIN after percutaneous intervention.ConclusionIntra-arterial CT angiography of lower extremity might be performed in selected patients with high risk of developing CIN. Our limited experience suggests that as low as of 0.1 ml/kg of the body weight of contrast medium may result in adequate diagnostic imaging.« less

  17. Progressive Changes in Walking Kinematics and Kinetics After Anterior Cruciate Ligament Injury and Reconstruction: A Review and Meta-Analysis.

    PubMed

    Slater, Lindsay V; Hart, Joseph M; Kelly, Adam R; Kuenze, Christopher M

    2017-09-01

      Anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) result in persistent alterations in lower extremity movement patterns. The progression of lower extremity biomechanics from the time of injury has not been described.   To compare the 3-dimensional (3D) lower extremity kinematics and kinetics of walking among individuals with ACL deficiency (ACLD), individuals with ACLR, and healthy control participants from 3 to 64 months after ACLR.   We searched PubMed and Web of Science from 1970 through 2013.   We selected only articles that provided peak kinematic and kinetic values during walking in individuals with ACLD or ACLR and comparison with a healthy control group or the contralateral uninjured limb.   A total of 27 of 511 identified studies were included. Weighted means, pooled standard deviations, and 95% confidence intervals were calculated for the healthy control, ACLD, and ACLR groups at each reported time since surgery. The magnitude of between-groups (ACLR versus ACLD, control, or contralateral limb) differences at each time point was evaluated using Cohen d effect sizes and associated 95% confidence intervals. Peak knee-flexion angle (Cohen d = -0.41) and external knee-extensor moment (Cohen d = -0.68) were smaller in the ACLD than in the healthy control group. Peak knee-flexion angle (Cohen d range = -0.78 to -1.23) and external knee-extensor moment (Cohen d range = -1.39 to -2.16) were smaller in the ACLR group from 10 to 40 months after ACLR. Reductions in external knee-adduction moment (Cohen d range = -0.50 to -1.23) were present from 9 to 42 months after ACLR.   Reductions in peak knee-flexion angle, external knee-flexion moment, and external knee-adduction moment were present in the ACLD and ACLR groups. This movement profile during the loading phase of gait has been linked to knee-cartilage degeneration and may contribute to the development of osteoarthritis after ACLR.

  18. Patterns of postnatal weight changes in infants with very low and extremely low birth weights.

    PubMed

    Smith, S L; Kirchhoff, K T; Chan, G M; Squire, S J

    1994-01-01

    To describe (1) short-term postnatal weight loss and gain patterns in infants with very low and extremely low birth weights and (2) the variables that may affect these weight change patterns. Descriptive, retrospective review. University hospital in the intermountain western United States. Sixty-two charts of infants admitted to a university neonatal intensive care unit from July 1990 through November 1992 were reviewed. Infants who weighed 1000 grams or less were categorized as extremely low birth weight (ELBW) and infants weighing 1001 to 1500 grams were categorized as very low birth weight (VLBW). Each group was comprised of 31 infants. Fifty percent of the sample were male, and 50% were female. Eighty-five percent of the sample were Anglo-American, and 15% were non-Anglo-American. Data were collected on a three-part data collection tool and included demographic and treatment variables. A significant difference was found in the maximum percent weight lost between the two groups, with the ELBW group losing a mean of 14.77% of birth weight and the VLBW group losing a mean of 11.35% of birth weight (t = 2.45, p < 0.05). The day the infants reached their nadir weight was significantly different between the two groups. The ELBW group reached their nadir on day of life 7, and the VLBW group reached their nadir on day of life 6 (t = 2.00, p < 0.05). No significant difference was noted in the time to return to birth weight between the two groups, with a mean of 15 days to return to birth weight. Factors associated with postnatal weight changes were intraventricular hemorrhage, use of diuretics and steroids, day of life when nadir weight occurred, and maximum percent of weight lost. Many of the independent variables were significantly interrelated to each other (r = -0.90 to r = 0.91, p < 0.01 to p < 0.001). However, only the variables that correlated with time to return to birth weight were entered into the regression analysis. These variables included number of days diuretics were given before return to birth weight, maximum percent of weight lost, and day of life the infants reached their nadir weight. Number of days diuretics were given before return to birth weight correlated significantly with time to return to birth weight (r = 0.77, F = 26.66, p < 0.0001) although maximum percent of weight lost and day of life the infants reached their nadir weight had a minimal effect. Further research into the effects of diuretic therapy on weight changes in this population of infants may lead to interventions to minimize the negative effects of diuretics on return to birth weight. In addition, the older growth charts may not be applicable to this population of infants. Generation of new growth charts that provide growth curves based on these data could be useful in developing nutritional therapies that would promote growth and possibly decrease the length of hospital stay for these infants.

  19. Salivary Telomere Length and Lung Function in Adolescents Born Very Preterm: A Prospective Multicenter Study.

    PubMed

    Hadchouel, Alice; Marchand-Martin, Laetitia; Franco-Montoya, Marie-Laure; Peaudecerf, Laetitia; Ancel, Pierre-Yves; Delacourt, Christophe

    2015-01-01

    Preterm birth is associated with abnormal respiratory functions throughout life. The mechanisms underlying these long-term consequences are still unclear. Shortening of telomeres was associated with many conditions, such as chronic obstructive pulmonary disease. We aimed to search for an association between telomere length and lung function in adolescents born preterm. Lung function and telomere length were measured in 236 adolescents born preterm and 38 born full-term from the longitudinal EPIPAGE cohort. Associations between telomere length and spirometric indices were tested in univariate and multivariate models accounting for confounding factors in the study population. Airflows were significantly lower in adolescents born preterm than controls; forced expiratory volume in one second was 12% lower in the extremely preterm born group than controls (p<0.001). Lower birth weight, bronchopulmonary dysplasia and postnatal sepsis were significantly associated with lower airflow values. Gender was the only factor that was significantly associated with telomere length. Telomere length correlated with forced expiratory flow 25-75 in the extremely preterm adolescent group in univariate and multivariate analyses (p = 0.01 and p = 0.02, respectively). We evidenced an association between telomere length and abnormal airflow in a population of adolescents born extremely preterm. There was no evident association with perinatal events. This suggests other involved factors, such as a continuing airway oxidative stress leading to persistent inflammation and altered lung function, ultimately increasing susceptibility to chronic obstructive pulmonary disease.

  20. Introduction of percutaneous-tunneled transfontanellar external ventricular drainage in the management of hydrocephalus in extremely low-birth-weight infants.

    PubMed

    Zucchelli, Mino; Lefosse, Mariella; Corvaglia, Luigi; Martini, Silvia; Sandri, Fabrizio; Soffritti, Silvia; Ancora, Gina; Mammoliti, Palma; Gargano, Giancarlo; Galassi, Ercole

    2016-07-01

    OBJECTIVE Hydrocephalus treatment in extremely low-birth-weight (ELBW) infants still represents a challenge for the pediatric neurosurgeon, particularly when the patient weighs far less than 1000 g. In such cases, the benefits in terms of neurological outcome following early treatment do not always outweigh the surgical risks, especially considering the great difference in the surgical risk before patient weight increases. To assess the efficacy and reliability of a percutaneous-tunneled, transfontanellar external ventricular drain (PTTEVD) in ELBW infants, the authors started a new protocol for the early surgical treatment of hydrocephalus. METHODS Ten cases of posthemorrhagic hydrocephalus (PHH) in ELBW infants (5 cases < 700 g, range for all cases 550-1000 g) were treated with a PTTEVD that was implanted at bedside as the first measure in a stepwise approach. RESULTS The average duration of the procedure was 7 minutes, and there was no blood loss. The drain remained in place for an average of 24 days (range 8-45 days). In all cases early control of the hydrocephalus was achieved. One patient had a single episode of CSF leakage (due to insufficient CSF removal). In another patient Enterococcus in the CSF sample was detected the day after abdominal surgery with ileostomy (infection resolved with intrathecal vancomycin). One patient died of Streptococcus sepsis, a systemic infection existing prior to drain placement that never resolved. One patient had Pseudomonas aeruginosa sepsis prior to drain insertion; a PTTEVD was implanted, the infection resolved, and the hydrocephalus was treated in the same way as with a traditional EVD, while the advantages of a quick, minimally invasive, bedside procedure were maintained. Once a patient reached 1 kg in weight, when necessary, a ventriculoperitoneal shunt was implanted and the PTTEVD was removed. CONCLUSIONS The introduction of PTTEVD placement in our standard protocol for the management of PHH has proved to be a wise option for small patients.

  1. Comparison of body weight-supported treadmill training versus body weight-supported overground training in people with incomplete tetraplegia: a pilot randomized trial.

    PubMed

    Senthilvelkumar, Thangavelu; Magimairaj, Henry; Fletcher, Jebaraj; Tharion, George; George, Jacob

    2015-01-01

    To compare the effectiveness of body weight-supported treadmill training and body weight-supported overground training for improving gait and strength in people with traumatic incomplete tetraplegia. Assessor blinded randomized trial. Rehabilitation institute of a tertiary care teaching hospital in India. Sixteen participants with traumatic motor incomplete tetraplegia and within two years of injury. Participants were randomised to one of two groups: body weight-supported overground training on level ground and body weight-supported treadmill training. Both groups received 30 minutes of gait training per day, five days a week for eight weeks. In addition, both groups received regular rehabilitation which included flexibility, strength, balance, self care and functional training. The primary outcome measure was the Walking Index for Spinal Cord Injury (/20 points) and the secondary outcome was the Lower Extremity Muscle Score (/50 points). There was no statistically significant between group differences in the Walking Index for Spinal Cord Injury [mean difference=0.3points; 95% CI (-4.8 to 5.4); p=0.748] or the Lower Extremity Muscle Score [mean difference=0.2 points; 95% CI (-3.8 to 5.1); p=0.749]. Gait training with body weight-supported overground training is comparable to treadmill training for improving locomotion in people with traumatic incomplete tetraplegia. © The Author(s) 2014.

  2. Maternal KIR in combination with paternal HLA-C2 regulate human birth weight.

    PubMed

    Hiby, Susan E; Apps, Richard; Chazara, Olympe; Farrell, Lydia E; Magnus, Per; Trogstad, Lill; Gjessing, Håkon K; Carrington, Mary; Moffett, Ashley

    2014-06-01

    Human birth weight is subject to stabilizing selection; babies born too small or too large are less likely to survive. Particular combinations of maternal/fetal immune system genes are associated with pregnancies where the babies are ≤ 5th birth weight centile, specifically an inhibitory maternal KIR AA genotype with a paternally derived fetal HLA-C2 ligand. We have now analyzed maternal KIR and fetal HLA-C combinations at the opposite end of the birth weight spectrum. Mother/baby pairs (n = 1316) were genotyped for maternal KIR as well as fetal and maternal HLA-C. Presence of a maternal-activating KIR2DS1 gene was associated with increased birth weight in linear or logistic regression analyses of all pregnancies >5th centile (p = 0.005, n = 1316). Effect of KIR2DS1 was most significant in pregnancies where its ligand, HLA-C2, was paternally but not maternally inherited by a fetus (p = 0.005, odds ratio = 2.65). Thus, maternal KIR are more frequently inhibitory with small babies but activating with big babies. At both extremes of birth weight, the KIR associations occur when their HLA-C2 ligand is paternally inherited by a fetus. We conclude that the two polymorphic immune gene systems, KIR and HLA-C, contribute to successful reproduction by maintaining birth weight between two extremes with a clear role for paternal HLA.

  3. Electro-Mechanical Systems for Extreme Space Environments

    NASA Technical Reports Server (NTRS)

    Mojarradi, Mohammad M.; Tyler, Tony R.; Abel, Phillip B.; Levanas, Greg

    2011-01-01

    Exploration beyond low earth orbit presents challenges for hardware that must operate in extreme environments. The current state of the art is to isolate and provide heating for sensitive hardware in order to survive. However, this protection results in penalties of weight and power for the spacecraft. This is particularly true for electro-mechanical based technology such as electronics, actuators and sensors. Especially when considering distributed electronics, many electro-mechanical systems need to be located in appendage type locations, making it much harder to protect from the extreme environments. The purpose of this paper to describe the advances made in the area of developing electro-mechanical technology to survive these environments with minimal protection. The Jet Propulsion Lab (JPL), the Glenn Research Center (GRC), the Langley Research Center (LaRC), and Aeroflex, Inc. over the last few years have worked to develop and test electro-mechanical hardware that will meet the stringent environmental demands of the moon, and which can also be leveraged for other challenging space exploration missions. Prototype actuators and electronics have been built and tested. Brushless DC actuators designed by Aeroflex, Inc have been tested with interface temperatures as low as 14 degrees Kelvin. Testing of the Aeroflex design has shown that a brushless DC motor with a single stage planetary gearbox can operate in low temperature environments for at least 120 million cycles (measured at motor) if long life is considered as part of the design. A motor control distributed electronics concept developed by JPL was built and operated at temperatures as low as -160 C, with many components still operational down to -245 C. Testing identified the components not capable of meeting the low temperature goal of -230 C. This distributed controller is universal in design with the ability to control different types of motors and read many different types of sensors. The controller form factor was designed to surround or be at the actuator. Communication with the slave controllers is accomplished by a bus, thus limiting the number of wires that must be routed to the extremity locations. Efforts have also been made to increase the power capability of these electronics for the ability to power and control actuators up to 2.5KW and still meet the environmental challenges. For commutation and control of the actuator, a resolver was integrated and tested with the actuator. Testing of this resolver demonstrated temperature limitations. Subsequent failure analysis isolated the low temperature failure mechanism and a design solution was negotiated with the manufacturer. Several years of work have resulted in specialized electro-mechanical hardware to meet extreme space exploration environments, a test history that verifies and finds limitations of the designs and a growing knowledge base that can be leveraged by future space exploration missions.

  4. A fast and accurate online sequential learning algorithm for feedforward networks.

    PubMed

    Liang, Nan-Ying; Huang, Guang-Bin; Saratchandran, P; Sundararajan, N

    2006-11-01

    In this paper, we develop an online sequential learning algorithm for single hidden layer feedforward networks (SLFNs) with additive or radial basis function (RBF) hidden nodes in a unified framework. The algorithm is referred to as online sequential extreme learning machine (OS-ELM) and can learn data one-by-one or chunk-by-chunk (a block of data) with fixed or varying chunk size. The activation functions for additive nodes in OS-ELM can be any bounded nonconstant piecewise continuous functions and the activation functions for RBF nodes can be any integrable piecewise continuous functions. In OS-ELM, the parameters of hidden nodes (the input weights and biases of additive nodes or the centers and impact factors of RBF nodes) are randomly selected and the output weights are analytically determined based on the sequentially arriving data. The algorithm uses the ideas of ELM of Huang et al. developed for batch learning which has been shown to be extremely fast with generalization performance better than other batch training methods. Apart from selecting the number of hidden nodes, no other control parameters have to be manually chosen. Detailed performance comparison of OS-ELM is done with other popular sequential learning algorithms on benchmark problems drawn from the regression, classification and time series prediction areas. The results show that the OS-ELM is faster than the other sequential algorithms and produces better generalization performance.

  5. Modelling audiovisual integration of affect from videos and music.

    PubMed

    Gao, Chuanji; Wedell, Douglas H; Kim, Jongwan; Weber, Christine E; Shinkareva, Svetlana V

    2018-05-01

    Two experiments examined how affective values from visual and auditory modalities are integrated. Experiment 1 paired music and videos drawn from three levels of valence while holding arousal constant. Experiment 2 included a parallel combination of three levels of arousal while holding valence constant. In each experiment, participants rated their affective states after unimodal and multimodal presentations. Experiment 1 revealed a congruency effect in which stimulus combinations of the same extreme valence resulted in more extreme state ratings than component stimuli presented in isolation. An interaction between music and video valence reflected the greater influence of negative affect. Video valence was found to have a significantly greater effect on combined ratings than music valence. The pattern of data was explained by a five parameter differential weight averaging model that attributed greater weight to the visual modality and increased weight with decreasing values of valence. Experiment 2 revealed a congruency effect only for high arousal combinations and no interaction effects. This pattern was explained by a three parameter constant weight averaging model with greater weight for the auditory modality and a very low arousal value for the initial state. These results demonstrate key differences in audiovisual integration between valence and arousal.

  6. Eating Disorders: Facts about Eating Disorders and the Search for Solutions.

    ERIC Educational Resources Information Center

    Spearing, Melissa

    Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight. Anorexia nervosa and bulimia nervosa are the two main types of eating disorders. Eating disorders frequently co-occur with…

  7. Extremely Selective Attention: Eye-Tracking Studies of the Dynamic Allocation of Attention to Stimulus Features in Categorization

    ERIC Educational Resources Information Center

    Blair, Mark R.; Watson, Marcus R.; Walshe, R. Calen; Maj, Fillip

    2009-01-01

    Humans have an extremely flexible ability to categorize regularities in their environment, in part because of attentional systems that allow them to focus on important perceptual information. In formal theories of categorization, attention is typically modeled with weights that selectively bias the processing of stimulus features. These theories…

  8. Greater mortality and mordidity in extremely preterm infants fed a diet containing cow milk protein products

    USDA-ARS?s Scientific Manuscript database

    Provision of human milk has important implications for the health and outcomes of extremely preterm (EP) infants. This study evaluated the effects of an exclusive human milk diet on the health of EP infants during their stay in the neonatal intensive care unit. EP infants <1,250 g birth weight recei...

  9. Bullying of preterm children and emotional problems at school age: cross-culturally invariant effects.

    PubMed

    Wolke, Dieter; Baumann, Nicole; Strauss, Victoria; Johnson, Samantha; Marlow, Neil

    2015-06-01

    To investigate whether adolescents who were born extremely preterm (<26 weeks gestation), very preterm (<32 weeks gestation), or with very low birth weight (<1500 g) are more often bullied, and whether this contributes to higher emotional problem scores. We used 2 whole population samples: the German Bavarian Longitudinal Study (BLS) (287 very preterm/very low birth weight and 293 term comparison children) and the UK EPICure Study (183 extremely preterm and 102 term comparison children). Peer bullying was assessed by parent report in both cohorts at school years 2 and 6/7. The primary outcome was emotional problems in year 6/7. The effects of prematurity and bullying on emotional problems were investigated with regression analysis and controlled for sex, socioeconomic status, disability, and preexisting emotional problems. Preterm-born children were more often bullied in both cohorts than term comparisons (BLS: relative risk, 1.27; 95% CI, 1.07-1.50; EPICure: relative risk, 1.69; 95% CI, 1.19-2.41). Both preterm birth and being bullied predicted emotional problems, but after controlling for confounders, only being bullied at both ages remained a significant predictor of emotional problem scores in both cohorts (BLS: B, 0.78; 95% CI, 0.28-1.27; P < .01; EPICure: B, 1.55; 95% CI, 0.79-2.30; P < .001). In the EPICure sample, being born preterm and being bullied at just a single time point also predicted emotional problems. Preterm-born children are more vulnerable to being bullied by peers. Those children who experience bullying over years are more likely to develop emotional problems. Health professionals should routinely ask about peer relationships. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Effects of Volitional Spine Stabilization and Lower-Extremity Fatigue on the Knee and Ankle During Landing Performance in a Population With Recurrent Low Back Pain.

    PubMed

    Haddas, Ram; Sawyer, Steven F; Sizer, Phillip S; Brooks, Toby; Chyu, Ming-Chien; James, C Roger

    2017-09-01

    Recurrent lower back pain (rLBP) and neuromuscular fatigue are independently thought to increase the risk of lower extremity (LE) injury. Volitional preemptive abdominal contraction (VPAC) is thought to improve lumbar spine and pelvis control in individuals with rLBP. The effects of VPAC on fatigued landing performance in individuals with rLBP are unknown. To determine the effects of VPAC and LE fatigue on landing performance in a rLBP population. Cross-sectional pretest-posttest cohort control design. A clinical biomechanics laboratory. 32 rLBP (age 21.2 ± 2.7 y) but without current symptoms and 33 healthy (age 20.9 ± 2.3 y) subjects. (i) Volitional preemptive abdominal contraction using abdominal bracing and (ii) fatigue using submaximal free-weight squat protocol with 15% body weight until task failure was achieved. Knee and ankle angles, moments, electromyographic measurements from semitendinosus and vastus medialis muscles, and ground reaction force (GRF) were collected during 0.30 m drop-jump landings. The VPAC resulted in significantly earlier muscle onsets across all muscles with and without fatigue in both groups (mean ± SD, 0.063 ± 0.016 s earlier; P ≤ .001). Fatigue significantly delayed semitendinosus muscle onsets (0.033 ± 0.024 s later; P ≤ .001), decreased GRF (P ≤ .001), and altered landing kinematics in a variety of ways. The rLBP group exhibited delayed semitendinosus and vastus medialis muscle onsets (0.031 ± 0.028 s later; P ≤ .001) and 1.8° less knee flexion at initial contact (P ≤ .008). The VPAC decreases some of the detrimental effects of fatigue on landing biomechanics and thus may reduce LE injury risk in a rLBP population.

  11. Neuromuscular training improves performance and lower-extremity biomechanics in female athletes.

    PubMed

    Myer, Gregory D; Ford, Kevin R; Palumbo, Joseph P; Hewett, Timothy E

    2005-02-01

    The purpose of this study was to examine the effects of a comprehensive neuromuscular training program on measures of performance and lower-extremity movement biomechanics in female athletes. The hypothesis was that significant improvements in measures of performance would be demonstrated concomitant with improved biomechanical measures related to anterior cruciate ligament injury risk. Forty-one female basketball, soccer, and volleyball players (age, 15.3 +/- 0.9 years; weight, 64.8 +/- 9.96 kg; height, 171.2 +/- 7.21 cm) underwent 6 weeks of training that included 4 main components (plyometric and movement, core strengthening and balance, resistance training, and speed training). Twelve age-, height-, and weight-matched controls underwent the same testing protocol twice 6 weeks apart. Trained athletes demonstrated increased predicted 1 repetition maximum squat (92%) and bench press (20%). Right and left single-leg hop distance increased 10.39 cm and 8.53 cm, respectively, and vertical jump also increased from 39.9 +/- 0.9 cm to 43.2 +/- 1.1 cm with training. Speed in a 9.1-m sprint improved from 1.80 +/- 0.02 seconds to 1.73 +/- 0.01 seconds. Pre- and posttest 3-dimensional motion analysis demonstrated increased knee flexion-extension range of motion during the landing phase of a vertical jump (right, 71.9 +/- 1.4 degrees to 76.9 +/- 1.4 degrees ; left, 71.3 +/- 1.5 degrees to 77.3 +/- 1.4 degrees ). Training decreased knee valgus (28%) and varus (38%) torques. Control subjects did not demonstrate significant alterations during the 6-week interval. The results of this study support the hypothesis that the combination of multiple-injury prevention-training components into a comprehensive program improves measures of performance and movement biomechanics.

  12. Can Sequential Coagulation Monitoring Predict Major Haemorrhage in Extremely Low Birth Weight Infants?

    PubMed

    Thanhaeuser, Margarita; Binder, Christoph; Derhaschnig, Ulla; Jilma, Bernd; Kornsteiner-Krenn, Margit; Huber-Dangl, Mercedes; Repa, Andreas; Kreissl, Alexandra; Berger, Angelika; Haiden, Nadja

    2018-06-04

     Bleeds such as intra-ventricular (IVH) and pulmonary haemorrhage (PH) are life-threatening events in extremely low birth weight (ELBW) infants. Serial coagulation monitoring by measuring the international normalized ratio (INR) with small volume samples might facilitate early diagnosis and possibly prevent major bleeds.  This was a prospective longitudinal study performed in ELBW infants, who received serial INR monitoring by point of care testing during their first 30 days of life. The primary objective was to explore whether INR monitoring could predict major bleeding events (IVH, PH). Secondary objectives were mortality and feasibility in this patient population.  A total of 127 ELBW infants were stratified into a bleeding and a non-bleeding group. Bleeding events occurred in 31% (39/127) of the infants, whereupon 24% developed IVH and 9% PH. Infants in the bleeding group were 4 days younger at birth ( p  = 0.05) and had a substantially higher mortality rate of 26% versus 5% in controls ( p  = 0.005). Median INR during the first 3 days before a bleeding event was 1.55 (95% confidence interval [CI]: 1.39-1.74) compared with the control group with 1.45 (95% CI: 1.44-1.58; p  = 0.81). Platelet counts were significantly lower in the bleeding group on the 3rd day and during the 2nd to 4th week of life.  Serial coagulation monitoring by an INR point of care testing is feasible in ELBW infants but could not predict bleeding events. Further studies with daily monitoring of INR and platelet counts during the first days of life might be able to more precisely detect a risk of major haemorrhage in ELBW infants. Schattauer GmbH Stuttgart.

  13. Effects of total knee and hip arthroplasty on body weight.

    PubMed

    Duchman, Kyle R; Gao, Yubo; Phisitkul, Phinit

    2014-03-01

    Patients frequently report functional and subjective improvement following total hip (THA) and knee arthroplasty (TKA), but these improvements do not correlate with decreased body weight at 1- and 2-year follow-up. The purpose of this retrospective study was to investigate changes in body weight following THA and TKA at longer follow-up than the 1- to 2-year follow-up frequently reported in the literature. A retrospective review of patients undergoing THA and TKA, as well as other commonly performed lower extremity orthopedic surgeries, was completed for January 2002 to October 2011 at a single tertiary care facility. Adults who underwent a single lower extremity orthopedic procedure during that time period were included in the study. Patients undergoing THA and TKA were analyzed for clinically and statistically significant weight changes at 1- and minimum 2-year follow-up. At a mean follow-up of 4.82 years, TKA resulted in a statistically significant decrease in mean body weight (1.47 kg; P=.0109). This finding was unique to TKA. The proportion of individuals who experienced clinically significant weight loss between the 1- and minimum 2-year follow-up was higher than the proportion of individuals who gained clinically significant weight over the same time period following THA and TKA. The results of this study suggest that clinically significant weight loss may continue for several years beyond the 1- and 2-year follow-up that is frequently reported in the literature. Copyright 2014, SLACK Incorporated.

  14. Short- and Long-term Pulmonary Outcome of Palivizumab in Children Born Extremely Prematurely.

    PubMed

    Prais, Dario; Kaplan, Eytan; Klinger, Gil; Mussaffi, Huda; Mei-Zahav, Meir; Bar-Yishay, Ephraim; Stafler, Patrick; Steuer, Guy; Sirota, Lea; Blau, Hannah

    2016-03-01

    Palivizumab reduces the severity of respiratory syncytial virus infection in premature infants, but whether there is a protective effect beyond the preschool age is unknown. This study sought to assess the short- and long-term effects of palivizumab immunization on respiratory morbidity and pulmonary function at school age in children born extremely prematurely. Infants born before 29 weeks' gestation in 2000 to 2003 were assessed at school age by parental questionnaire, hospital chart review, and lung function tests. Children born immediately before the introduction of routine palivizumab prophylaxis were compared with age-matched children who received palivizumab prophylaxis during the first respiratory syncytial virus season. Sixty-three children with a mean age 8.9 years were included: 30 had received palivizumab and 33 had not (control subjects). The groups were similar in terms of gestational age, birth weight, need for mechanical ventilation, and oxygen supplementation. Fifty-three percent of the palivizumab group, compared with 39% of the control group, had bronchopulmonary dysplasia (P = .14). Wheezing occurred in the first 2 years of life in 27% of the palivizumab group and in 70% of control subjects (P = .008); respective hospitalization rates were 33% and 70% (P = .001). At school age, rates of hyperresponsiveness (provocative concentration leading to a 20% fall in FEV1 < 1 mg/mL) were 33% and 48%, respectively (P = .38). Spirometry, lung volumes, diffusion, and exhaled nitric oxide were within normal limits, with no significant differences between groups. Palivizumab prophylaxis was associated with reduced wheezing episodes and hospitalizations during the first 2 years of life in children born extremely prematurely. However, it did not affect pulmonary outcome at school age. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  15. Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight.

    PubMed

    Du, Meng-Kai; Ge, Li-Ya; Zhou, Meng-Lin; Ying, Jun; Qu, Fan; Dong, Min-Yue; Chen, Dan-Qing

    To evaluate the effects of maternal pre-pregnancy body mass index (pre-BMI) and gestational weight gain (GWG) on neonatal birth weight (NBW) in the population of Chinese healthy pregnant women, attempting to guide weight control in pregnancy. A retrospective cohort study of 3772 Chinese women was conducted. The population was stratified by maternal pre-BMI categories as underweight (<18.5 kg/m 2 ), normal weight (18.5-23.9 kg/m 2 ), overweight (24.0-27.9 kg/m 2 ), and obesity (≥28.0 kg/m 2 ). The NBW differences were tested among the four groups, and then deeper associations among maternal pre-BMI, GWG, and NBW were investigated by multivariate analysis. NBW increased significantly with the increase of maternal pre-BMI level (P<0.05), except overweight to obesity (P>0.05). The multivariate analysis showed that both pre-BMI and GWG were positively correlated with NBW (P<0.05). Compared with normal pre-BMI, underweight predicted an increased odds ratio of small-for-gestational-age (SGA) and decreased odds ratio for macrosomia and large-for-gestational-age (LGA), and the results were opposite for overweight. With the increase of GWG, the risk of SGA decreased and the risks of macrosomia and LGA increased. In addition, in different pre-BMI categories, the effects of weight gain in the first trimester on NBW were different (P<0.05). NBW is positively affected by both maternal pre-BMI and GWG, extreme pre-BMI and GWG are both associated with increased risks of abnormal birth weight, and maternal pre-BMI may modify the effect of weight gain in each trimester on NBW. A valid GWG guideline for Chinese women is an urgent requirement, whereas existing recommendations seem to be not very suitable for the Chinese.

  16. Dieting and encouragement to diet by significant others: associations with disordered eating in young adults

    PubMed Central

    Eisenberg, Marla E.; Berge, Jerica M.; Neumark-Sztainer, Dianne

    2013-01-01

    Purpose Examine the role of perceived significant other's modeling or encouragement of dieting in young adults' disordered eating behaviors. Design Online survey data were collected (2008–2009) as part of an ongoing study examining weight and related issues in young people. Setting Participants were originally recruited as students at middle and high schools in Minnesota (1998–1999). Subjects 1,030 young adults (mean age 25.3, 55% female, 50% white) with significant others. Measures Participants were asked if their significant other diets or encourages them to diet. Behaviors included unhealthy weight control, extreme weight control, and binge eating. Analysis General linear models estimated the predicted probability of using each behavior across levels of significant other's dieting or encouraging dieting, stratifying by gender and adjusting for demographics and BMI. Results Perceived dieting and encouragement to diet by significant others were common. Disordered eating behaviors were positively associated with significant other's dieting and encouragement to diet, particularly for females. In models including both perceived dieting and encouragement, encouragement remained significantly associated with disordered eating. For example, women's binge eating was almost doubled if their significant other encouraged dieting “very much” (25.5%) compared to “not at all” (13.6%, p=.015). Conclusion There is a strong association between disordered eating behaviors and perceived modeling and encouragement to diet by significant others in young adulthood. PMID:23398133

  17. Does cognitive behavioral therapy strengthen the effect of bariatric surgery for obesity? Design and methods of a randomized and controlled study.

    PubMed

    Paul, Linda; van Rongen, Sofie; van Hoeken, Daphne; Deen, Mathijs; Klaassen, René; Biter, L Ulas; Hoek, Hans W; van der Heiden, Colin

    2015-05-01

    (Extreme) obesity is a chronic harmful condition with high risk of medical comorbidities and negative social and emotional consequences. Bariatric surgery is an effective intervention for obesity, but approximately 20 to 30% of the patients experience adverse outcomes after surgery and there is a need for augmentation of current treatment strategies. This study examines the added value of pre-operative cognitive behavioral therapy (CBT) focused on modification of thoughts and behaviors in terms of eating behavior and physical exercise as well as preparation for surgery and postoperative life style. We hypothesize that pre-operative CBT will result in better weight loss maintenance, reduction of maladaptive eating behavior and better adherence to postoperative lifestyle on the long term as compared to bariatric surgery alone. One hundred and twenty eight patients that are on a waiting list for bariatric surgery are randomly assigned to the control or treatment condition. Patients in the treatment condition receive 10 sessions of CBT before surgery aimed at modifying dysfunctional eating habits and behaviors and developing more rational weight and body-related beliefs in order to enable long term maintenance of a healthier lifestyle after surgery. Weight loss, eating behavior, eating disorders, depression, quality of life and psychological distress are assessed before and after treatment, as well as 1, 3, and 5 year following surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Hierarchical extreme learning machine based reinforcement learning for goal localization

    NASA Astrophysics Data System (ADS)

    AlDahoul, Nouar; Zaw Htike, Zaw; Akmeliawati, Rini

    2017-03-01

    The objective of goal localization is to find the location of goals in noisy environments. Simple actions are performed to move the agent towards the goal. The goal detector should be capable of minimizing the error between the predicted locations and the true ones. Few regions need to be processed by the agent to reduce the computational effort and increase the speed of convergence. In this paper, reinforcement learning (RL) method was utilized to find optimal series of actions to localize the goal region. The visual data, a set of images, is high dimensional unstructured data and needs to be represented efficiently to get a robust detector. Different deep Reinforcement models have already been used to localize a goal but most of them take long time to learn the model. This long learning time results from the weights fine tuning stage that is applied iteratively to find an accurate model. Hierarchical Extreme Learning Machine (H-ELM) was used as a fast deep model that doesn’t fine tune the weights. In other words, hidden weights are generated randomly and output weights are calculated analytically. H-ELM algorithm was used in this work to find good features for effective representation. This paper proposes a combination of Hierarchical Extreme learning machine and Reinforcement learning to find an optimal policy directly from visual input. This combination outperforms other methods in terms of accuracy and learning speed. The simulations and results were analysed by using MATLAB.

  19. Effects of prophylactic indomethacin in extremely low-birth-weight infants with and without adequate exposure to antenatal corticosteroids.

    PubMed

    Schmidt, Barbara; Seshia, Mary; Shankaran, Seetha; Mildenhall, Lindsay; Tyson, Jon; Lui, Kei; Fok, Tai; Roberts, Robin

    2011-07-01

    To examine whether treatment with antenatal corticosteroids modifies the immediate and long-term effects of prophylactic indomethacin sodium trihydrate in extremely low-birth-weight infants. Post hoc subgroup analysis of data from the Trial of Indomethacin Prophylaxis in Preterms. Thirty-two neonatal intensive care units in Canada, the United States, Australia, New Zealand, and Hong Kong. A total of 1195 infants with birth weights of 500 to 999 g and known exposure to antenatal corticosteroids. We defined as adequate any exposure to antenatal corticosteroids that occurred at least 24 hours before delivery. Indomethacin or placebo intravenously once daily for the first 3 days. Death or survival to 18 months with cerebral palsy, cognitive delay, severe hearing loss, or bilateral blindness; severe periventricular and intraventricular hemorrhage; patent ductus arteriosus; and surgical closure of a patent ductus arteriosus. Of the 1195 infants in this analysis cohort, 670 had adequate and 525 had inadequate exposure to antenatal corticosteroids. There was little statistical evidence of heterogeneity in the effects of prophylactic indomethacin between the subgroups for any of the outcomes. The adjusted P values for interaction were as low as .15 for the outcome of death or impairment at 18 months and as high as .80 for the outcome of surgical duct closure. We find little evidence that the effects of prophylactic indomethacin vary in extremely low-birth-weight infants with and without adequate exposure to antenatal corticosteroids. Trial Registration clinicaltrials.gov Identifier: NCT00009646.

  20. Determination of Interlaminar Toughness of IM7/977-2 Composites at Temperature Extremes and Different Thicknesses

    NASA Technical Reports Server (NTRS)

    Johnson, W. S.; Pavlick, M. M.; Oliver, M. S.

    2005-01-01

    Composite materials are being used in the aerospace industry as a means of reducing vehicle weight. In particular, polymer matrix composites (PMC) are good candidates due to their high strength-to-weight and high stiffness-to-weight ratios. Future reusable space launch vehicles and space exploration structures will need advanced light weight composites in order to minimize vehicle weight while demonstrating robustness and durability, guaranteeing high factors of safety. In particular, the implementation of composite cryogenic propellant fuel tanks (cryotanks) for future reusable launch vehicles (RLVs) could greatly reduce the vehicle's weight versus identically sized cryotanks constructed of metallic materials. One candidate composite material for future cryotank designs is IM7/977-2, which is a graphite/epoxy system. A successful candidate must demonstrate reasonable structural properties over a wide range of temperatures. Since the matrix material is normally the weak link in the composite, tests that emphasize matrix-dominated behavior need to be conducted. Therefore, the objective of this work is to determine the mode I interlaminar fracture toughness of "unidirectional" 8-ply and 16-ply IM7/977-2 through experimental testing. Tests were performed at -196 degrees Celsius (-320 degrees Fahrenheit), 22 degrees Celsius (72 degrees Fahrenheit), 93 degrees Celsius (200 degrees Fahrenheit) and 160 degrees C (320 degrees Fahrenheit). Low temperature testing was completed while the specimen was submerged in a liquid nitrogen bath. High temperature testing was completed in a temperature-controlled oven.

  1. Outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation.

    PubMed

    Wyckoff, Myra H; Salhab, Walid A; Heyne, Roy J; Kendrick, Douglas E; Stoll, Barbara J; Laptook, Abbot R

    2012-02-01

    To determine whether delivery room cardiopulmonary resuscitation (DR-CPR) independently predicts morbidities and neurodevelopmental impairment (NDI) in extremely low birth weight infants. We conducted a cohort study of infants born with birth weight of 401 to 1000 g and gestational age of 23 to 30 weeks. DR-CPR was defined as chest compressions, medications, or both. Logistic regression was used to determine associations among DR-CPR and morbidities, mortality, and NDI at 18 to 24 months of age (Bayley II mental or psychomotor index <70, cerebral palsy, blindness, or deafness). Data are adjusted ORs with 95% CIs. Of 8685 infants, 1333 (15%) received DR-CPR. Infants who received DR-CPR had lower birth weight (708±141 g versus 764±146g, P<.0001) and gestational age (25±2 weeks versus 26±2 weeks, P<.0001). Infants who received DR-CPR had more pneumothoraces (OR, 1.28; 95% CI, 1.48-2.99), grade 3 to 4 intraventricular hemorrhage (OR, 1.47; 95% CI, 1.23-1.74), bronchopulmonary dysplasia (OR, 1.34; 95% CI, 1.13-1.59), death by 12 hours (OR, 3.69; 95% CI, 2.98-4.57), and death by 120 days after birth (OR, 2.22; 95% CI, 1.93-2.57). Rates of NDI in survivors (OR, 1.23; 95% CI, 1.02-1.49) and death or NDI (OR, 1.70; 95% CI, 1.46-1.99) were higher for DR-CPR infants. Only 14% of DR-CPR recipients with 5-minute Apgar score <2 survived without NDI. DR-CPR is a prognostic marker for higher rates of mortality and NDI for extremely low birth weight infants. New DR-CPR strategies are needed for this population. Copyright © 2012 Mosby, Inc. All rights reserved.

  2. Body Building Boons From Apollo

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The Exer-Genie program utilizes familiar types of exercise, such as isometrics (pushing or pulling against an immovable object) and isotonics (motive exercises such as calisthenics or weight lifting) but with the important added factor of controlled resistance. The device is an arrangement of hand grips and nylon cord wrapped around an aluminum shaft. Controlled friction determines the resistance and the user can set the amount of resistive force to his own physical conditioning needs. Since Apollo days, the Exer-Genie and a similar device called the Apollo Exerciser have found wide acceptance among professional, collegiate and high school athletic teams, and among the growing number of individuals interested in physical fitness. These devices are efficient and economical replacements for conventional conditioning equipment and extremely versatile, allowing more than 100 basic exercises for shaping up specific muscle groups.

  3. Physical Function in Older Men With Hyperkyphosis

    PubMed Central

    Harrison, Stephanie L.; Fink, Howard A.; Marshall, Lynn M.; Orwoll, Eric; Barrett-Connor, Elizabeth; Cawthon, Peggy M.; Kado, Deborah M.

    2015-01-01

    Background. Age-related hyperkyphosis has been associated with poor physical function and is a well-established predictor of adverse health outcomes in older women, but its impact on health in older men is less well understood. Methods. We conducted a cross-sectional study to evaluate the association of hyperkyphosis and physical function in 2,363 men, aged 71–98 (M = 79) from the Osteoporotic Fractures in Men Study. Kyphosis was measured using the Rancho Bernardo Study block method. Measurements of grip strength and lower extremity function, including gait speed over 6 m, narrow walk (measure of dynamic balance), repeated chair stands ability and time, and lower extremity power (Nottingham Power Rig) were included separately as primary outcomes. We investigated associations of kyphosis and each outcome in age-adjusted and multivariable linear or logistic regression models, controlling for age, clinic, education, race, bone mineral density, height, weight, diabetes, and physical activity. Results. In multivariate linear regression, we observed a dose-related response of worse scores on each lower extremity physical function test as number of blocks increased, p for trend ≤.001. Using a cutoff of ≥4 blocks, 20% (N = 469) of men were characterized with hyperkyphosis. In multivariate logistic regression, men with hyperkyphosis had increased odds (range 1.5–1.8) of being in the worst quartile of performing lower extremity physical function tasks (p < .001 for each outcome). Kyphosis was not associated with grip strength in any multivariate analysis. Conclusions. Hyperkyphosis is associated with impaired lower extremity physical function in older men. Further studies are needed to determine the direction of causality. PMID:25431353

  4. Evaluation of extreme temperature events in northern Spain based on process control charts

    NASA Astrophysics Data System (ADS)

    Villeta, M.; Valencia, J. L.; Saá, A.; Tarquis, A. M.

    2018-02-01

    Extreme climate events have recently attracted the attention of a growing number of researchers because these events impose a large cost on agriculture and associated insurance planning. This study focuses on extreme temperature events and proposes a new method for their evaluation based on statistical process control tools, which are unusual in climate studies. A series of minimum and maximum daily temperatures for 12 geographical areas of a Spanish region between 1931 and 2009 were evaluated by applying statistical process control charts to statistically test whether evidence existed for an increase or a decrease of extreme temperature events. Specification limits were determined for each geographical area and used to define four types of extreme anomalies: lower and upper extremes for the minimum and maximum anomalies. A new binomial Markov extended process that considers the autocorrelation between extreme temperature events was generated for each geographical area and extreme anomaly type to establish the attribute control charts for the annual fraction of extreme days and to monitor the occurrence of annual extreme days. This method was used to assess the significance of changes and trends of extreme temperature events in the analysed region. The results demonstrate the effectiveness of an attribute control chart for evaluating extreme temperature events. For example, the evaluation of extreme maximum temperature events using the proposed statistical process control charts was consistent with the evidence of an increase in maximum temperatures during the last decades of the last century.

  5. Eating style in seasonal affective disorder: who will gain weight in winter?

    PubMed

    Kräuchi, K; Reich, S; Wirz-Justice, A

    1997-01-01

    Patients with seasonal affective disorder (SAD) selectively eat more carbohydrates (CHO), particularly sweets but also starch-rich foods, during their depression in winter. The Dutch Eating Behaviour Questionnaire (DEBQ) was administered to female SAD patients, healthy female controls, and female medical students to determine their eating style, together with the modified Seasonal Pattern Assessment Questionnaire (SPAQ+). SAD patients showed higher values for "emotional" (EMOT) eating than the students, and these in turn had higher values than the controls. In comparison to controls, SAD patients and students head high values for the factor "external" (EXT) eating, but there was no difference between the groups with respect to "restraint" (REST) eating. This is in strong contrast to patients with bulimia and anorexia nervosa, who are high REST eaters, indicating that SAD patients do not have a similar eating disorder. Additional items showed that SAD patients selectively eat sweets under emotionally difficult conditions (when depressed, anxious, or lonely). Configural frequency analysis showed that seasonal body weight change (SBWC) is high in subjects with high EMOT and REST eating together with a high body mass index (BMI). This result is in accordance with the concept of disinhibition of dietary restraint in extreme emotional situations, e.g., the depressive state.

  6. Imaging of upper extremity stress fractures in the athlete.

    PubMed

    Anderson, Mark W

    2006-07-01

    Although it is much less common than injuries in the lower extremities, an upper extremity stress injury can have a significant impact on an athlete. If an accurate and timely diagnosis is to be made, the clinician must have a high index of suspicion of a stress fracture in any athlete who is involved in a throwing, weightlifting, or upper extremity weight-bearing sport and presents with chronic pain in the upper extremity. Imaging should play an integral role in the work-up of these patients; if initial radiographs are unrevealing, further cross-sectional imaging should be strongly considered. Although a three-phase bone scan is highly sensitive in this regard, MRI has become the study of choice at most centers.

  7. Design and Analysis of Wind Turbine Blade Hub using Aluminium Alloy AA 6061-T6

    NASA Astrophysics Data System (ADS)

    Ravikumar, S.; Jaswanthvenkatram, V.; Sai kumar, Y. J. N. V.; Sohaib, S. Md.

    2017-05-01

    This work presents the design and analysis of horizontal axis wind turbine blade hub using different material. The hub is very crucial part of the wind turbine, which experience the loads from the blades and the loads were transmitted to the main shaft. At present wind turbine is more expensive and weights more than a million pounds, with the nacelle, rotor hub and blades accounting for most of the weight. In this work Spheroidal graphite cast iron GGG 40.3 is replaced by aluminium alloy 6061-T6 to enhance the casting properties and also to improve the strength-weight ratio. This transition of material leads to reduction in weight of the wind turbine. All the loads caused by wind and extreme loads on the blades are transferred to the hub. Considering the IEC 61400-1 standard for defining extreme loads on the hub the stress and deflection were calculated on the hub by using Finite element Analysis. Result obtained from ANSYS is compared and discussed with the existing design.

  8. Lower-extremity ground reaction forces in collegiate baseball pitchers.

    PubMed

    Guido, John A; Werner, Sherry L

    2012-07-01

    The purpose of this study was to investigate ground reaction forces (GRF) in collegiate baseball pitchers and their relationship to pitching mechanics. Fourteen healthy collegiate baseball pitchers participated in this study. High-speed video and force plate data were collected for fastballs from each pitcher. The average ball speed was 35 ± 3 m/sec (78 ± 7 mph). Peak GRFs of 245 ± 20% body weight (BW) were generated in an anterior or braking direction to control descent. Horizontal GRFs tended to occur in a laterally directed fashion, reaching a peak of 45 ± 63% BW. The maximum vertical GRF averaged 202 ± 43% BW approximately 45 milliseconds after stride foot contact. A correlation between braking force and ball velocity was evident. Because of the downward inclination and rotation of the pitching motion, in addition to volume, shear forces may occur in the musculoskeletal tissues of the stride limb leading to many of the lower-extremity injuries seen in this athletic population.

  9. Aflatoxicosis chemoprevention by probiotic Lactobacillius and lack of effect on the major histocompatibility complex.

    PubMed

    Rawal, Sumit; Bauer, Miranda M; Mendoza, Kristelle M; El-Nezami, Hani; Hall, Jeffery R; Kim, Ji Eun; Stevens, John R; Reed, Kent M; Coulombe, Roger A

    2014-10-01

    Turkeys are extremely sensitive to aflatoxin B1 (AFB1) which causes decreased growth, immunosuppression and liver necrosis. The purpose of this study was to determine whether probiotic Lactobacillus, shown to be protective in animal and clinical studies, would likewise confer protection in turkeys, which were treated for 11 days with either AFB1 (AFB; 1 ppm in diet), probiotic (PB; 1 × 10(11) CFU/ml; oral, daily), probiotic + AFB1 (PBAFB), or PBS control (CNTL). The AFB1 induced drop in body and liver weights were restored to normal in CNTL and PBAFB groups. Hepatotoxicity markers were not significantly reduced by probiotic treatment. Major histocompatibility complex (MHC) genes BG1 and BG4, which are differentially expressed in liver and spleens, were not significantly affected by treatments. These data indicate modest protection, but the relatively high dietary AFB1 treatment, and the extreme sensitivity of this species may reveal limits of probiotic-based protection strategies. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Left ventricular hypertrophy in ascending aortic stenosis mice: anoikis and the progression to early failure

    NASA Technical Reports Server (NTRS)

    Ding, B.; Price, R. L.; Goldsmith, E. C.; Borg, T. K.; Yan, X.; Douglas, P. S.; Weinberg, E. O.; Bartunek, J.; Thielen, T.; Didenko, V. V.; hide

    2000-01-01

    BACKGROUND: To determine potential mechanisms of the transition from hypertrophy to very early failure, we examined apoptosis in a model of ascending aortic stenosis (AS) in male FVB/n mice. METHODS AND RESULTS: Compared with age-matched controls, 4-week and 7-week AS animals (n=12 to 16 per group) had increased ratios of left ventricular weight to body weight (4.7+/-0.7 versus 3.1+/-0.2 and 5. 7+/-0.4 versus 2.7+/-0.1 mg/g, respectively, P<0.05) with similar body weights. Myocyte width was also increased in 4-week and 7-week AS mice compared with controls (19.0+/-0.8 and 25.2+/-1.8 versus 14. 1+/-0.5 microm, respectively, P<0.01). By 7 weeks, AS myocytes displayed branching with distinct differences in intercalated disk size and staining for beta(1)-integrin on both cell surface and adjacent extracellular matrix. In vivo left ventricular systolic developed pressure per gram as well as endocardial fractional shortening were similar in 4-week AS and controls but depressed in 7-week AS mice. Myocyte apoptosis estimated by in situ nick end-labeling (TUNEL) was extremely rare in 4-week AS and control mice; however, a low prevalence of TUNEL-positive myocytes and DNA laddering were detected in 7-week AS mice. The specificity of TUNEL labeling was confirmed by in situ ligation of hairpin oligonucleotides. CONCLUSIONS: Our findings indicate that myocyte apoptosis develops during the transition from hypertrophy to early failure in mice with chronic biomechanical stress and support the hypothesis that the disruption of normal myocyte anchorage to adjacent extracellular matrix and cells, a process called anoikis, may signal apoptosis.

  11. SOI N-Channel Field Effect Transistors, CHT-NMOS80, for Extreme Temperatures

    NASA Technical Reports Server (NTRS)

    Patterson, Richard L.; Hammoud, Almad

    2009-01-01

    Extreme temperatures, both hot and cold, are anticipated in many of NASA space exploration missions as well as in terrestrial applications. One can seldom find electronics that are capable of operation under both regimes. Even for operation under one (hot or cold) temperature extreme, some thermal controls need to be introduced to provide appropriate ambient temperatures so that spacecraft on-board or field on-site electronic systems work properly. The inclusion of these controls, which comprise of heating elements and radiators along with their associated structures, adds to the complexity in the design of the system, increases cost and weight, and affects overall reliability. Thus, it would be highly desirable and very beneficial to eliminate these thermal measures in order to simplify system's design, improve efficiency, reduce development and launch costs, and improve reliability. These requirements can only be met through the development of electronic parts that are designed for proper and efficient operation under extreme temperature conditions. Silicon-on-insulator (SOI) based devices are finding more use in harsh environments due to the benefits that their inherent design offers in terms of reduced leakage currents, less power consumption, faster switching speeds, good radiation tolerance, and extreme temperature operability. Little is known, however, about their performance at cryogenic temperatures and under wide thermal swings. The objective of this work was to evaluate the performance of a new commercial-off-the-shelf (COTS) SOI parts over an extended temperature range and to determine the effects of thermal cycling on their performance. The results will establish a baseline on the suitability of such devices for use in space exploration missions under extreme temperatures, and will aid mission planners and circuit designers in the proper selection of electronic parts and circuits. The electronic part investigated in this work comprised of a CHT-NMOS80 high temperature N-channel MOSFET (metal-oxide semiconductor field-effect transistor) device that was manufactured by CISSOID. This high voltage, medium-power transistor is fabricated using SOI processes and is designed for extreme wide temperature applications such as geothermal well logging, aerospace and avionics, and automotive industry. It has a high DC current capability and is specified for operation in the temperature range of -55 C to +225 C

  12. LONG-TERM VISUAL OUTCOMES IN EXTREMELY LOW-BIRTH-WEIGHT CHILDREN (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)

    PubMed Central

    Spencer, Rand

    2006-01-01

    Purpose The goal is to analyze the long-term visual outcome of extremely low-birth-weight children. Methods This is a retrospective analysis of eyes of extremely low-birth-weight children on whom vision testing was performed. Visual outcomes were studied by analyzing acuity outcomes at ≥36 months of adjusted age, correlating early acuity testing with final visual outcome and evaluating adverse risk factors for vision. Results Data from 278 eyes are included. Mean birth weight was 731g, and mean gestational age at birth was 26 weeks. 248 eyes had grating acuity outcomes measured at 73 ± 36 months, and 183 eyes had recognition acuity testing at 76 ± 39 months. 54% had below normal grating acuities, and 66% had below normal recognition acuities. 27% of grating outcomes and 17% of recognition outcomes were ≤20/200. Abnormal early grating acuity testing was predictive of abnormal grating (P < .0001) and recognition (P = .0001) acuity testing at ≥3 years of age. A slower-than-normal rate of early visual development was predictive of abnormal grating acuity (P < .0001) and abnormal recognition acuity (P < .0001) at ≥3 years of age. Eyes diagnosed with maximal retinopathy of prematurity in zone I had lower acuity outcomes (P = .0002) than did those with maximal retinopathy of prematurity in zone II/III. Eyes of children born at ≤28 weeks gestational age had 4.1 times greater risk for abnormal recognition acuity than did those of children born at >28 weeks gestational age. Eyes of children with poorer general health after premature birth had a 5.3 times greater risk of abnormal recognition acuity. Conclusions Long-term visual development in extremely low-birth-weight infants is problematic and associated with a high risk of subnormal acuity. Early acuity testing is useful in identifying children at greatest risk for long-term visual abnormalities. Gestational age at birth of ≤ 28 weeks was associated with a higher risk of an abnormal long-term outcome. PMID:17471358

  13. Food intake in women two years or more after bariatric surgery meets adequate intake requirements.

    PubMed

    Novais, Patrícia Fátima Sousa; Rasera, Irineu; Leite, Celso Vieira de Souza; Marin, Flávia Andréia; de Oliveira, Maria Rita Marques

    2012-05-01

    Restricted food intake after bariatric surgery can be an important factor both in the long-term control of body weight and in the onset of nutritional deficiencies. The objective of this study was to assess the adequacy of food intake in women two or more years after bariatric surgery according to the excess weight lost. A group of 141 women who underwent banded Roux-en-Y gastric bypass (RYGB) was divided according to the percentage of excess weight they lost (%EWL)<50; 50┤75; = 75. The habitual energy and nutrient intakes were determined by a 24-hour recall over two days and the probability of adequate intake was based on the Dietary Reference Intake. The mean total estimated energy requirement (EER) as well as energy, macronutrient and cholesterol intakes did not differ among the groups. Only the %EWL<50 group had an intake equal to their EER, but they presented a higher number of inadequacies, such as low levels of magnesium, folic acid and vitamins C and E. Calcium and dietary fiber intakes were extremely low in all three groups. In conclusion, weight loss after surgery is associated with food habits that favor energy intake over micronutrient intake. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Solar central receiver heliostat reflector assembly

    DOEpatents

    Horton, Richard H.; Zdeb, John J.

    1980-01-01

    A heliostat reflector assembly for a solar central receiver system comprises a light-weight, readily assemblable frame which supports a sheet of stretchable reflective material and includes mechanism for selectively applying tension to and positioning the sheet to stretch it to optical flatness. The frame is mounted on and supported by a pipe pedestal assembly that, in turn, is installed in the ground. The frame is controllably driven in a predetermined way by a light-weight drive system so as to be angularly adjustable in both elevation and azimuth to track the sun and efficiently continuously reflect the sun's rays to a focal zone, i.e. central receiver, which forms part of a solar energy utilization system, such as a solar energy fueled electrical power generation system. The frame may include a built-in system for testing for optical flatness of the reflector. The preferable geometric configuration of the reflector is octagonal; however, it may be other shapes, such as hexagonal, pentagonal or square. Several different embodiments of means for tensioning and positioning the reflector to achieve optical flatness are disclosed. The reflector assembly is based on the stretch frame concept which provides an extremely light-weight, simple, low-cost reflector assembly that may be driven for positioning and tracking by a light-weight, inexpensive drive system.

  15. Research of the BWS system for lower extremity rehabilitation robot.

    PubMed

    Zhang, Xiao; Li, Weida; Li, Juan; Cai, Xiaowei

    2017-07-01

    Body weight support (BWS) system is increasingly used in conjunction with treadmills to assist the patients with neurological impairments. Owing to lower limbs of the patients unable to bear the whole weight during the rehabilitation training, some weight can be removed to help the patients recover the basic walking ability gradually. Therefore, considering the man-machine relationship and the effects of the rehabilitation, a wire-driven BWS system is designed. The main unit of the system is an active closed-loop controlled drive to generate the exact desired force. The force acted on the body is through the adjustment of the length of the rope which is connected to the harness worn by the patient. The structure designed in the research is easy to operate to realize the goal of the rehabilitation. To verify the effectiveness and practicability of the BWS system, some experiments have been curried out. From the results, not only the constant unloading force can be realized, but also the response time is limited in a small range which can bring a positive effect on correcting gait, improving balance and reducing muscle spasms. Also, compared to the traditional body weight support system, such as static system or passive elastic system, it has the advantages of the fast response, small errors and constant unloading force.

  16. The Relationship of Parental Knowledge to the Development of Extremely Low Birth Weight Infants.

    ERIC Educational Resources Information Center

    Dichtelmiller, Margo; And Others

    1992-01-01

    This study found that mothers (n=40) of extremely high-risk infants (averaging 1000 grams birthweight and 28 weeks gestational age) called upon the same experiences and sources of information as mothers of full-term infants. Infants of mothers with above average knowledge about infancy scored significantly higher on tests of infant development at…

  17. Proximal fibular osteotomy: a new surgery for pain relief and improvement of joint function in patients with knee osteoarthritis.

    PubMed

    Wang, Xiaohu; Wei, Lei; Lv, Zhi; Zhao, Bin; Duan, Zhiqing; Wu, Wenjin; Zhang, Bin; Wei, Xiaochun

    2017-02-01

    Objective To explore the effects of proximal fibular osteotomy as a new surgery for pain relief and improvement of medial joint space and function in patients with knee osteoarthritis. Methods From January 2015 to May 2015, 47 patients who underwent proximal fibular osteotomy for medial compartment osteoarthritis were retrospectively followed up. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity and ratio of the knee joint space (medial/lateral compartment). Knee pain was assessed using a visual analogue scale, and knee ambulation activities were evaluated using the American Knee Society score preoperatively and postoperatively. Results Medial pain relief was observed in almost all patients after proximal fibular osteotomy. Most patients exhibited improved walking postoperatively. Weight-bearing lower extremity radiographs showed an average increase in the postoperative medial knee joint space. Additionally, obvious correction of alignment was observed in the whole lower extremity radiographs in 8 of 47 patients. Conclusions The present study demonstrates that proximal fibular osteotomy effectively relieves pain and improves joint function in patients with medial compartment osteoarthritis at a mean of 13.38 months postoperatively.

  18. [The status of protein intake and energy supply in the early life of very/extremely low birth weight infants].

    PubMed

    Bi, Chun-Yu; Ru, Xi-Fang; Feng, Qi; Wang, Ying; Zhang, Xin; Li, Xing; Meng, Jing-Wen

    2013-05-01

    To study the relationship of protein intake and energy supply with the physical growth in very/extremely low birth weight infant at their early life. Retrospective survey was performed in Neonatal Intensive Care Unit (NICU) in Peking University First Hospital. Inclusion criteria were preterm infant, birth weight < 1500 g, hospitalization for longer than 2 weeks, discharge with body weight greater than 1800 g. The infants were divided into two groups according to gestational age (GA). GA < 32 weeks and ≥ 32 weeks. Physical growth and its relation with the protein intake and energy supply were analyzed. The predictive value of serum blood urea nitrogen (BUN) on protein intake was studied. Ninety-three very/extremely low birth weight infants were involved, 69 in GA < 32 weeks group and 24 in GA ≥ 32 weeks group.Compared with GA ≥ 32 group, GA < 32 weeks preterm infants had more weight loss, (9.2 ± 4.4)% vs. (5.0 ± 3.1)%, P = 0.000; slower birth weight recovery (10.6 ± 3.8) d vs. (7.1 ± 2.6) d, P = 0.000; poorer weight gain at 1, 4, 5 weeks of life, (-4.5 ± 9.3) g/ (kg·d) vs. (3.4 ± 6.9) g/ (kg·d), P = 0.000 , (13.5 ± 7.3) g/ (kg·d) vs. (19.2 ± 4.9) g/ (kg·d), P = 0.001, (14.6 ± 5.6) g/ (kg·d) vs. (18.2 ± 4.5) g/ (kg·d), P = 0.031; less energy supply at 1 to 5 weeks (P value was 0.000,0.000,0.025,0.001,0.008 respectively) and less protein intake at 1, 4, 5 weeks of life (P value was 0.009,0.006,0.032). Extrauterine growth retardation (EUGR) was still predominant in our subjects, 47.8% in GA < 32 weeks group, and 95.8% in GA ≥ 32 weeks group, P = 0.000. The incidence increased greater in GA < 32 weeks infants, 43.5% vs. 20.8%, P = 0.000.The duration of weight loss and mechanical ventilation correlated negatively with weight gain rate, respectively β = -0.591, P = 0.000 and β = -0.281, P = 0.005; the average energy supply and time taken to reach full enteral feeding were factors improving weight gain, respectively β = 0.202, P = 0.021 and β = 0.354, P = 0.000. After birth, serum BUN declined gradually. Positive relation showed between average protein intake at 3(rd) week and BUN level at the end of 3 weeks, r = 0.420, P = 0.000. Serum BUN 1.44, 1.49 mmol/L at the end of 3(rd) and 4(th) week were cut-off predictors for protein intake less than 3 g/(kg·d) at related period, sensitivity and specificity were 65.3%, 83.3% and 60%, 80% respectively. No enough protein intake and energy supply, poor weight gain are critical problems in the management of very/extremely low birth weight infants. Prevention from NEC, appropriate parenteral/enteral nutrition transforming will benefit their physical growth. Low serum BUN after 3 weeks of life is a valuable predictor of low protein intake.

  19. Hip abductor function and lower extremity landing kinematics: sex differences.

    PubMed

    Jacobs, Cale A; Uhl, Timothy L; Mattacola, Carl G; Shapiro, Robert; Rayens, William S

    2007-01-01

    Rapid deceleration during sporting activities, such as landing from a jump, has been identified as a common mechanism of acute knee injury. Research into the role of potential sex differences in hip abductor function with lower extremity kinematics when landing from a jump is limited. To evaluate sex differences in hip abductor function in relation to lower extremity landing kinematics. 2 x 2 mixed-model factorial design using a between-subjects factor (sex) and a repeated factor (test). University laboratory. A sample of convenience consisting of 30 healthy adults (15 women, 15 men) with no history of lower extremity surgery and no lower extremity injuries within 6 months of testing. Landing kinematics were assessed as subjects performed 3 pre-exercise landing trials that required them to hop from 2 legs and land on a single leg. Isometric peak torque (PT) of the hip abductors was measured, followed by an endurance test during which subjects maintained 50% of their PT to the limits of endurance. After a 15-minute rest period, subjects completed a 30-second bout of isometric hip abduction, from which we calculated the percentage of endurance capacity (%E). Immediately after exercise, subjects completed 3 postexercise landing trials. PT, %E, and peak joint displacement (PJD) of the hip and knee in all 3 planes of motion. Women demonstrated lower PT values (5.8 +/- 1.2% normalized to body weight and height) than did their male counterparts (7.2 +/- 1.5% normalized to body weight and height, P = .009). However, no sex differences were seen in %E. Women also demonstrated larger knee valgus PJD (7.26 degrees +/- 6.61 degrees) than did men (3.29 degrees +/- 3.54 degrees, P = .04). Women's PT was moderately correlated with hip flexion, adduction, and knee valgus PJD; however, PT did not significantly correlate with men's landing kinematics. Regardless of sex, hip flexion (P = .002) and hip adduction (P = .001) were significantly increased following the 30-second bout of exercise. Women demonstrated lower hip abductor PT and increased knee valgus PJD when landing from a jump, potentially increasing the risk of acute knee injury. Furthermore, correlations between hip abductor strength and landing kinematics were generally larger for women than for men, suggesting that hip abductor strength may play a more important role in neuromuscular control of the knee for women.

  20. Brain early infarct detection using gamma correction extreme-level eliminating with weighting distribution.

    PubMed

    Teh, V; Sim, K S; Wong, E K

    2016-11-01

    According to the statistic from World Health Organization (WHO), stroke is one of the major causes of death globally. Computed tomography (CT) scan is one of the main medical diagnosis system used for diagnosis of ischemic stroke. CT scan provides brain images in Digital Imaging and Communication in Medicine (DICOM) format. The presentation of CT brain images is mainly relied on the window setting (window center and window width), which converts an image from DICOM format into normal grayscale format. Nevertheless, the ordinary window parameter could not deliver a proper contrast on CT brain images for ischemic stroke detection. In this paper, a new proposed method namely gamma correction extreme-level eliminating with weighting distribution (GCELEWD) is implemented to improve the contrast on CT brain images. GCELEWD is capable of highlighting the hypodense region for diagnosis of ischemic stroke. The performance of this new proposed technique, GCELEWD, is compared with four of the existing contrast enhancement technique such as brightness preserving bi-histogram equalization (BBHE), dualistic sub-image histogram equalization (DSIHE), extreme-level eliminating histogram equalization (ELEHE), and adaptive gamma correction with weighting distribution (AGCWD). GCELEWD shows better visualization for ischemic stroke detection and higher values with image quality assessment (IQA) module. SCANNING 38:842-856, 2016. © 2016 Wiley Periodicals, Inc. © Wiley Periodicals, Inc.

  1. The space shuttle program from challenge to achievement: Space exploration rolling on tires

    NASA Technical Reports Server (NTRS)

    Felder, G. L.

    1985-01-01

    The Space Shuttle Transportation System is the first space program to employ the pneumatic tire as a part of space exploration. For aircraft tires, this program establishes new expectations as to what constitutes acceptable performance within a set of tough environmental and operational conditions. Tire design, stresses the usual low weight, high load, high speed, and excellent air retention features but at extremes well outside industry standards. Tires will continue to be an integral part of the Shuttle's landing phase in the immediate future since they afford a unique combination of directional control, braking traction, flotation and shock absorption not available by other systems.

  2. Rare presentations of hyperthyroidism--Basedow's paraplegia and pancytopenia.

    PubMed

    Chen, Yi-Hsien; Lin, Hung-Jung; Chen, Kuo-Tai

    2009-02-01

    Typical presentations of hyperthyroidism are palpitation, nervousness, tremor, malaise, and weight loss. Hyperthyroidism affects nearly every system in the body, and some patients may manifest neurologic or hematologic symptoms. Atypical presentations of hyperthyroidism often pose a great challenge in diagnosis and treatment. We report a case of Basedow's paraplegia and pancytopenia that was precipitated by hyperthyroidism. The unusual manifestations led to unnecessary examinations and delayed the treatment of hyperthyroidism. The classical symptoms of Basedow's paraplegia are subacute symmetric weakness of the lower extremities with areflexia and sparing sensation or sphincter involvement. Control of the hyperthyroidism mitigated the neurologic and hematologic complications and prevented unnecessary studies.

  3. Neuromodulation of the lumbar spinal locomotor circuit.

    PubMed

    AuYong, Nicholas; Lu, Daniel C

    2014-01-01

    The lumbar spinal cord contains the necessary circuitry to independently drive locomotor behaviors. This function is retained following spinal cord injury (SCI) and is amenable to rehabilitation. Although the effectiveness of task-specific training and pharmacologic modulation has been repeatedly demonstrated in animal studies, results from human studies are less striking. Recently, lumbar epidural stimulation (EDS) along with locomotor training was shown to restore weight-bearing function and lower-extremity voluntary control in a chronic, motor-complete human SCI subject. Related animal studies incorporating EDS as part of the therapeutic regiment are also encouraging. EDS is emerging as a promising neuromodulatory tool for SCI. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. A polytetrafluorethylene insulated cable for high temperature oxygen aerospace applications

    NASA Technical Reports Server (NTRS)

    Sheppard, A. T.; Webber, R. G.

    1983-01-01

    For electrical cables to function and survive in the severe high temperature oxygen environment that will be experienced in the external tanks of the space shuttle, extreme cleanliness and material purity is required. A flexible light weight cable has been developed for use in pure oxygen at worst case temperatures of -190 to +260 degrees Centigrade and pressures as high as 44 pounds per square inch absolute. A comprehensive series of tests were performed on cables manufactured to the best commercial practices in order to establish the basic guidelines for control of build configuration as well as each material used in construction of the cable.

  5. A polytetrafluorethylene insulated cable for high temperature oxygen aerospace applications

    NASA Astrophysics Data System (ADS)

    Sheppard, A. T.; Webber, R. G.

    For electrical cables to function and survive in the severe high temperature oxygen environment that will be experienced in the external tanks of the space shuttle, extreme cleanliness and material purity is required. A flexible light weight cable has been developed for use in pure oxygen at worst case temperatures of -190 to +260 degrees Centigrade and pressures as high as 44 pounds per square inch absolute. A comprehensive series of tests were performed on cables manufactured to the best commercial practices in order to establish the basic guidelines for control of build configuration as well as each material used in construction of the cable.

  6. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial.

    PubMed

    Morey, Miriam C; Snyder, Denise C; Sloane, Richard; Cohen, Harvey Jay; Peterson, Bercedis; Hartman, Terryl J; Miller, Paige; Mitchell, Diane C; Demark-Wahnefried, Wendy

    2009-05-13

    Five-year survival rates for early stage colorectal, breast, and prostate cancer currently exceed 90% and are increasing. Cancer survivors are at greater risk for second malignancies, other comorbidities, and accelerated functional decline. Lifestyle interventions may provide benefit, but it is unknown whether long-term cancer survivors can modify their lifestyle behaviors sufficiently to improve functional status. To determine whether a telephone counseling and mailed print material-based diet and exercise intervention is effective in reorienting functional decline in older, overweight cancer survivors. Randomized controlled trial of 641 overweight (body mass index > or = 25 and < 40), long-term (> or = 5 years) survivors (aged 65-91 years) of colorectal, breast, and prostate cancer, who were randomly assigned to an intervention group (n = 319) or delayed intervention (control) group (n = 322) in Canada, the United Kingdom, and 21 US states. Individuals were recruited for the Reach out to Enhance Wellness (RENEW) trial from July 1, 2005, through May 17, 2007. A 12-month, home-based tailored program of telephone counseling and mailed materials promoting exercise, improved diet quality, and modest weight loss. The control group was wait-listed for 12 months. Change in self-reported physical function on the Short-Form 36 physical function subscale (score range, 0-100; a high score indicates better functioning) from baseline to 12 months was the primary end point. Secondary outcomes included changes in function on the basic and advanced lower extremity function subscales of the Late Life Function and Disability Index (score range, 0-100), physical activity, body mass index, and overall health-related quality of life. The mean baseline Short-Form 36 physical function score was 75.7. At the 12-month follow-up, the mean function scores declined less rapidly in the intervention group (-2.15; 95% confidence interval [CI], -0.36 to -3.93) compared with the control group (-4.84; 95% CI, -3.04 to -6.63) (P = .03). The mean baseline basic lower extremity function score was 78.2. The mean changes in basic lower extremity function were 0.34 (95% CI, -0.84 to 1.52) in the intervention group compared with -1.89 (95% CI, -0.70 to -3.09) in the control group (P = .005). Physical activity, dietary behaviors, and overall quality of life increased significantly in the intervention group compared with the control group, and weight loss also was greater (2.06 kg [95% CI, 1.69 to 2.43 kg] vs 0.92 kg [95% CI, 0.51 to 1.33 kg], respectively; P < .001). Among older, long-term survivors of colorectal, breast, and prostate cancer, a diet and exercise intervention reduced the rate of self-reported functional decline compared with no intervention. clinicaltrials.gov Identifier: NCT00303875.

  7. Plasma Ceramides, Mediterranean Diet, and Incident Cardiovascular Disease in the PREDIMED Trial

    PubMed Central

    Wang, Dong D.; Toledo, Estefanía; Hruby, Adela; Rosner, Bernard A.; Willett, Walter C.; Sun, Qi; Razquin, Cristina; Zheng, Yan; Ruiz-Canela, Miguel; Guasch-Ferré, Marta; Corella, Dolores; Gómez-Gracia, Enrique; Fiol, Miquel; Estruch, Ramón; Ros, Emilio; Lapetra, José; Fito, Montserrat; Aros, Fernando; Serra-Majem, Luis; Lee, Chih-Hao; Clish, Clary B.; Liang, Liming; Salas-Salvadó, Jordi; Martínez-González, Miguel A.; Hu, Frank B.

    2017-01-01

    Background Although in vitro studies and investigations in animal models and small clinical populations have suggested that ceramides may represent an intermediate link between over-nutrition and certain pathological mechanisms underlying cardiovascular disease (CVD), no prospective studies have investigated the association between plasma ceramides and risk of CVD. Methods The study population consisted of 980 participants from the PREDIMED trial, including 230 incident cases of CVD and 787 randomly selected participants at baseline (including 37 overlapping cases), followed for up to 7.4 years. Participants were randomized to a Mediterranean diet (MedDiet) supplemented with extra-virgin olive oil, a MedDiet supplemented with nuts, or a control diet. Plasma ceramide concentrations were measured on a liquid chromatography tandem mass spectrometry metabolomics platform. The primary outcome was a composite of non-fatal acute myocardial infarction, non-fatal stroke, or cardiovascular death. Hazard Ratios (HRs) were estimated with weighted Cox regression models, using Barlow weights to account for the case-cohort design. Results The multivariable HRs [95% confidence interval (CI)] comparing the extreme quartiles of plasma concentrations of C16:0, C22:0, C24:0 and C24:1 ceramides were 2.39 (1.49–3.83, P trend <0.001), 1.91 (1.21–3.01, P trend =0.003), 1.97 (1.21–3.01, P trend =0.004), and 1.73 (1.09–2.74, P trend =0.011), respectively. The ceramide score, calculated as a weighted sum of concentrations of four ceramides, was associated with a 2.18-fold higher risk of CVD across extreme quartiles (HR =2.18, 95% CI, 1.36–3.49, P trend <0.001). The association between baseline ceramide score and incident CVD varied significantly by treatment groups (P interaction =0.010). Participants with a higher ceramide score and assigned to either of the two active intervention arms of the trial showed similar CVD risk to those with a lower ceramide score, whereas participants with a higher ceramide score and assigned to the control arm presented significantly higher CVD risk. Changes in ceramide concentration were not significantly different between MedDiet and control groups during the first year of follow-up. Conclusions Our study documented a novel positive association between baseline plasma ceramide concentrations and incident CVD. In addition, a Mediterranean dietary intervention may mitigate potential deleterious effects of elevated plasma ceramide concentrations on CVD. Clinical Trial Registration Controlled-Trials.com number, ISRCTN35739639. http://www.isrctn.com/ISRCTN35739639 PMID:28280233

  8. Influence of Clinical Status on the Association Between Plasma Total and Unbound Bilirubin and Death or Adverse Neurodevelopmental Outcomes in Extremely Low Birth Weight Infants

    PubMed Central

    Oh, William; Stevenson, David K.; Tyson, Jon E.; Morris, Brenda H.; Ahlfors, Charles E.; Bender, G. Jesse; Wong, Ronald J.; Perritt, Rebecca; Vohr, Betty R.; Van Meurs, Krista P.; Vreman, Hendrik J.; Das, Abhik; Phelps, Dale L.; O’Shea, T. Michael; Higgins, Rosemary D.

    2010-01-01

    Objectives To assess the influence of clinical status on the association between total plasma bilirubin and unbound bilirubin on death or adverse neurodevelopmental outcomes at 18–22 months corrected age in extremely low birth weight infants. Method Total plasma biirubin and unbound biirubin were measured in 1,101 extremely low birth weight infants at 5±1 day of age. Clinical criteria were used to classify infants as clinically stable or unstable. Survivors were examined at 18–22 months corrected age by certified examiners. Outcome variables were death or neurodevelopmental impairment, death or cerebral palsy, death or hearing loss, and death prior to follow-up. For all outcomes, the interaction between bilirubin variables and clinical status was assessed in logistic regression analyses adjusted for multiple risk factors. Results Regardless of clinical status, an increasing level of unbound bilirubin was associated with higher rates of death or neurodevelopmental impairment, death or cerebral palsy, death or hearing loss and death before follow-up. Total plasma bilirubin values were directly associated with death or neurodevelopmental impairment, death or cerebral palsy, death or hearing loss, and death before follow-up in unstable infants, but not in stable infants. An inverse association between total plasma bilirubin and death or cerebral palsy was found in stable infants. Conclusions In extremely low birth weight infants, clinical status at 5 days of age affects the association between total plasma and unbound bilirubin and death or adverse neurodevelopmental outcomes at 18–22 months of corrected age. An increasing level of UB is associated a higher risk of death or adverse neurodevelopmental outcomes regardless of clinical status. Increasing levels of total plasma bilirubin are directly associated with increasing risk of death or adverse neurodevelopmental outcomes in unstable, but not in stable infants. PMID:20105142

  9. Self-esteem and quality of life in adolescents with extreme obesity in Saudi Arabia: the effect of weight loss after laparoscopic sleeve gastrectomy.

    PubMed

    Aldaqal, Saleh M; Sehlo, Mohammad G

    2013-01-01

    To evaluate the self-esteem and quality of life in adolescents with extreme obesity before and one year after laparoscopic sleeve gastrectomy as obesity is a major challenging medical problem, not only in adults but also in children and adolescents in Saudi Arabia. In a prospective cohort study, 32 adolescents (aged 13-17 years) with extreme obesity (Group 1) presenting for laparoscopic sleeve gastrectomy (LSG) were compared with 32 matched, healthy, nonobese adolescents (aged 14-17 years) (Group 2) with regards to self-esteem and quality of life. Assessment was done using the Rosenberg Self-Esteem Scale and Pediatric Quality of Life Inventory version 4.0 (self- and parent report), respectively. Body mass index (BMI) Z scores were calculated for both groups. We found significantly poor self-esteem and impairment in all domains of quality of life (self- and parent report) in Group 1 compared with Group 2 (P<.001). Self esteem and quality of life (self- and parent reports) significantly improved 1 year after LSG (P<.001), and the weight loss induced by LSG, reflected by a decrease in BMI Z scores, was a significant predictor for the improvement in self-esteem (R2=0.28 and P=.003) and quality of life (R(2)=0.67 and P<.001). LSG was found to be a safe and effective operation in adolescents with extreme obesity: LSG leads to weight loss, with subsequent improvement in self-esteem and quality of life. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. A diet containing soybean oil heated for three hours increases adipose tissue weight but decreases body weight in C57BL/6 J mice.

    PubMed

    Penumetcha, Meera; Schneider, Mary K; Cheek, Holly A; Karabina, Sonia

    2013-03-06

    Our previous work showed that dietary oxidized linoleic acid given, as a single fatty acid, to LDL receptor knockout mice decreased weight gain as compared to control mice. Other studies have also reported that animals fed oils heated for 24 h or greater showed reduced weight gain. These observations, while important, have limited significance since fried foods in the typical human diet do not contain the extreme levels of oxidized lipids used in these studies. The main goal of this study was to investigate the effects of a diet containing soybean oil heated for 3 h on weight gain and fat pad mass in mice. Additionally, because PPARγ and UCP-1 mediate adipocyte differentiation and thermogenesis, respectively, the effect of this diet on these proteins was also examined. Four to six week old male C57BL/6 J mice were randomly divided into three groups and given either a low fat diet with heated soybean oil (HSO) or unheated soybean oil (USO) or pair fed for 16 weeks. Weight and food intake were monitored and fat pads were harvested upon the study's termination. Mice consuming the HSO diet had significantly increased fat pad mass but gained less weight as compared to mice in the USO group despite a similar caloric intake and similar levels of PPARγ and UCP1. This is the first study to show that a diet containing soybean oil heated for a short time increases fat mass despite a decreased weight gain in C57BL/6 J mice. The subsequent metabolic consequences of this increased fat mass merits further investigation.

  11. In situ adaptive response to climate and habitat quality variation: spatial and temporal variation in European badger (Meles meles) body weight.

    PubMed

    Byrne, Andrew W; Fogarty, Ursula; O'Keeffe, James; Newman, Chris

    2015-09-01

    Variation in climatic and habitat conditions can affect populations through a variety of mechanisms, and these relationships can act at different temporal and spatial scales. Using post-mortem badger body weight records from 15 878 individuals captured across the Republic of Ireland (7224 setts across ca. 15 000 km(2) ; 2009-2012), we employed a hierarchical multilevel mixed model to evaluate the effects of climate (rainfall and temperature) and habitat quality (landscape suitability), while controlling for local abundance (unique badgers caught/sett/year). Body weight was affected strongly by temperature across a number of temporal scales (preceding month or season), with badgers being heavier if preceding temperatures (particularly during winter/spring) were warmer than the long-term seasonal mean. There was less support for rainfall across different temporal scales, although badgers did exhibit heavier weights when greater rainfall occurred one or 2 months prior to capture. Badgers were also heavier in areas with higher landscape habitat quality, modulated by the number of individuals captured per sett, consistent with density-dependent effects reducing weights. Overall, the mean badger body weight of culled individuals rose during the study period (2009-2012), more so for males than for females. With predicted increases in temperature, and rainfall, augmented by ongoing agricultural land conversion in this region, we project heavier individual badger body weights in the future. Increased body weight has been associated with higher fecundity, recruitment and survival rates in badgers, due to improved food availability and energetic budgets. We thus predict that climate change could increase the badger population across the Republic of Ireland. Nevertheless, we emphasize that, locally, populations could still be vulnerable to extreme weather variability coupled with detrimental agricultural practice, including population management. © 2015 John Wiley & Sons Ltd.

  12. Individualized correction for maternal weight in calculating the risk of chromosomal abnormalities with first-trimester screening data.

    PubMed

    Merz, E; Thode, C; Eiben, B; Faber, R; Hackelöer, B J; Huesgen, G; Pruggmaier, M; Wellek, S

    2011-02-01

    In the algorithm developed by the Fetal Medicine Foundation (FMF) Germany designed to evaluate the findings of routine first-trimester screening, the false-positive rate (FPR) was determined for the entire study group without stratification by maternal weight. Based on the data received from the continuous audit we were able to identify an increase in the FPR for the weight-related subgroups of patients, particularly for patients with extremely high body weights. The aim of this study was to demonstrate that the variability of the FPR can be reduced through adjusting the concentrations of free β-HCG and PAPP-A measured in the maternal serum by means of a nonlinear regression function modeling the dependence of these values on maternal weight. The database used to establish a version of the algorithm enabling control of the FPR over the whole range of maternal weight consisted of n = 123 546 pregnancies resulting in the birth of a child without chromosomal anomalies. The group with positive outcomes covered n = 500 cases of trisomy 21 and n = 159 trisomies 13 or 18. The dependency of the serum parameters free β-HCG and PAPP-A on maternal weight was analyzed in the sample of negative outcomes by means of nonlinear regression. The fitted regression curve was of exponential form with negative slope. Using this model, all individual measurements were corrected through multiplication with a factor obtained as the ratio of the concentration level predicted by the model to belong to the average maternal body weight of 68.2 kg, over the ordinate of that point on the regression curve which belongs to the weight actually measured. Subsequently, the totality of all values of free β-HCG and PAPP-A corrected for deviation from average weight were used as input data for carrying out the construction of diagnostic discrimination rules described in our recent paper for a database to which no corrections for over- or under-weight had been applied. This entailed in particular the construction of new reference bands for the corrected biochemical values as the basis for calculating the degree of extremeness (DOE) measures to replace the more traditional MOMs. In the final and most crucial step, stratified FPRs were computed and compared over a set of intervals partitioning the whole range of maternal weight into 18 classes. For the posterior risks of both trisomy 21 and 13 / 18 computed from the weight-corrected database, the use of a cutoff value of 1:150 turned out to be an appropriate choice. For T 21, the overall FPR obtained through comparing the individual risks with this cutoff was found to be 3.51 %. The corresponding proportion of ascertained cases of trisomy 21 detected by means of the new algorithm was 86.2 %. For the trisomy 13 / 18 group, the analogous results were a FPR of 2.07 % and a detection rate (DTR) of 83.0 %, respectively. A comparison between the FPRs obtained for the 18 intervals into which the range of maternal weight had been partitioned, showed the deviation of the strata-specific from the overall FPR to be fairly small: for T 21, the FPR ranged from 2.72 to 4.86 %, and the maximum was found in the group of 87.5 - 95.0 kg. For women with a weight of more than 120 kg, the FPR was only slightly above the FPR for the total sample (3.69 as compared to 3.51 %). Similar results were obtained for the discrimination rule constructed for diagnosing T 13 / 18: here, the minimum FPR (1.17 %) was found for patients weighing more than 120 kg, whereas the maximum (2.66 %) occurred in the interval 75.0 - 77.5 kg. In this study we demonstrated that the new algorithm developed by the FMF Germany to estimate risks for fetal trisomies 21 and 13 / 18 combines very good misclassification rates with a far-reaching stability of the false-positive rate against even extreme deviations from the average maternal weight. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Impacts of Model Bias on the Climate Change Signal and Effects of Weighted Ensembles of Regional Climate Model Simulations: A Case Study over Southern Québec, Canada

    DOE PAGES

    Eum, Hyung-Il; Gachon, Philippe; Laprise, René

    2016-01-01

    This study examined the impact of model biases on climate change signals for daily precipitation and for minimum and maximum temperatures. Through the use of multiple climate scenarios from 12 regional climate model simulations, the ensemble mean, and three synthetic simulations generated by a weighting procedure, we investigated intermodel seasonal climate change signals between current and future periods, for both median and extreme precipitation/temperature values. A significant dependence of seasonal climate change signals on the model biases over southern Québec in Canada was detected for temperatures, but not for precipitation. This suggests that the regional temperature change signal is affectedmore » by local processes. Seasonally, model bias affects future mean and extreme values in winter and summer. In addition, potentially large increases in future extremes of temperature and precipitation values were projected. For three synthetic scenarios, systematically less bias and a narrow range of mean change for all variables were projected compared to those of climate model simulations. In addition, synthetic scenarios were found to better capture the spatial variability of extreme cold temperatures than the ensemble mean scenario. Finally, these results indicate that the synthetic scenarios have greater potential to reduce the uncertainty of future climate projections and capture the spatial variability of extreme climate events.« less

  14. Impacts of Model Bias on the Climate Change Signal and Effects of Weighted Ensembles of Regional Climate Model Simulations: A Case Study over Southern Québec, Canada

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Eum, Hyung-Il; Gachon, Philippe; Laprise, René

    This study examined the impact of model biases on climate change signals for daily precipitation and for minimum and maximum temperatures. Through the use of multiple climate scenarios from 12 regional climate model simulations, the ensemble mean, and three synthetic simulations generated by a weighting procedure, we investigated intermodel seasonal climate change signals between current and future periods, for both median and extreme precipitation/temperature values. A significant dependence of seasonal climate change signals on the model biases over southern Québec in Canada was detected for temperatures, but not for precipitation. This suggests that the regional temperature change signal is affectedmore » by local processes. Seasonally, model bias affects future mean and extreme values in winter and summer. In addition, potentially large increases in future extremes of temperature and precipitation values were projected. For three synthetic scenarios, systematically less bias and a narrow range of mean change for all variables were projected compared to those of climate model simulations. In addition, synthetic scenarios were found to better capture the spatial variability of extreme cold temperatures than the ensemble mean scenario. Finally, these results indicate that the synthetic scenarios have greater potential to reduce the uncertainty of future climate projections and capture the spatial variability of extreme climate events.« less

  15. Climate change and the impact of extreme temperatures on aviation

    NASA Astrophysics Data System (ADS)

    Coffel, E.; Horton, R.

    2014-12-01

    Weather is the most significant factor affecting aircraft operations, accounting for 70-80% of passenger delays and costing airlines hundreds of millions of dollars per year in lost revenue. Temperature and airport elevation significantly influence the maximum allowable takeoff weight of an aircraft by changing the surface air density and thus the lift produced at a given speed. For a given runway length, airport elevation, and aircraft type there is a temperature threshold above which the airplane cannot take off at its maximum weight and thus must be weight restricted. The number of summer days necessitating weight restriction has increased since 1980 along with the observed increase in surface temperature. Climate change is projected to increase mean temperatures at all airports and significantly increase the frequency and severity of extreme heat events at some. These changes will negatively affect aircraft performance, leading to increased weight restrictions especially at airports with short runways and little room to expand. For a Boeing 737-800 aircraft, we find that the number of weight restriction days between May and September will increase by 50-100% at four major airports in the United States by 2050-2070 under the RCP8.5 high emissions scenario. These performance reductions may have a significant economic effect on the airline industry, leading to lower profits and higher passenger fares. Increased weight restrictions have previously been identified as potential impacts of climate change, but this study is the first to quantify the effect of higher temperatures on commercial aviation.

  16. Comparison of joint kinetics during free weight and flywheel resistance exercise.

    PubMed

    Chiu, Loren Z F; Salem, George J

    2006-08-01

    The most common modality for resistance exercise is free weight resistance. Alternative methods of providing external resistance have been investigated, in particular for use in microgravity environments such as space flight. One alternative modality is flywheel inertial resistance, which generates resistance as a function of the mass, distribution of mass, and angular acceleration of the flywheel. The purpose of this investigation was to characterize net joint kinetics of multijoint exercises performed with a flywheel inertial resistance device in comparison to free weights. Eleven trained men and women performed the front squat, lunge, and push press on separate days with free weight or flywheel resistance, while instrumented for biomechanical analysis. Front squats performed with flywheel resistance required greater contribution of the hip and ankle, and less contribution of the knee, compared to free weight. Push presses performed with flywheel resistance had similar impulse requirements at the knee compared to free weight, but greater impulse requirement at the hip and ankle. As used in this investigation, flywheel inertial resistance increases the demand on the hip extensors and ankle plantarflexors and decreases the mechanical demand on the knee extensors for lower extremity exercises such as the front squat and lunge. Exercises involving dynamic lower and upper extremity actions, such as the push press, may benefit from flywheel inertial resistance, due to the increased mechanical demand on the knee extensors.

  17. Serotonin neurotransmission in anorexia nervosa.

    PubMed

    Haleem, Darakhshan Jabeen

    2012-09-01

    Patients with anorexia nervosa (AN) show extreme dieting weight loss, hyperactivity, depression/anxiety, self-control, and behavioral impulsivity. 5-Hydroxytryptamine (5-HT; serotonin) is involved in almost all the behavioral changes observed in AN patients. Both genetic and environmental factors contribute toward the pathogenesis of AN. It is a frequent disorder among adolescent girls and young women and starts as an attempt to lose weight to look beautiful and attractive. Failure to see the turning point when fasting becomes unreasonable leads to malnutrition and AN. Tryptophan, the precursor of serotonin and an essential amino acid, is only available in the diet. It is therefore likely that excessive diet restriction and malnutrition decrease brain serotonin stores because the precursor is less available to the rate-limiting enzyme of 5-HT biosynthesis, which normally exists unsaturated with its substrate. Evidence shows that diet restriction-induced exaggerated feedback control over 5-HT synthesis and the smaller availability of tryptophan decreases serotonin neurotransmission at postsynaptic sites, leading to hyperactivity, depression, and behavioral impulsivity. A compensatory upregulation of postsynaptic 5-HT-1A receptors and hypophagic serotonin receptors may be involved in anxiety and suppression of appetite. It is suggested that tryptophan supplementation may improve pharmacotherapy in AN.

  18. Effects of high-intensity swimming training on GLUT-4 and glucose transport activity in rat skeletal muscle.

    PubMed

    Terada, S; Yokozeki, T; Kawanaka, K; Ogawa, K; Higuchi, M; Ezaki, O; Tabata, I

    2001-06-01

    This study was performed to assess the effects of short-term, extremely high-intensity intermittent exercise training on the GLUT-4 content of rat skeletal muscle. Three- to four-week-old male Sprague-Dawley rats with an initial body weight ranging from 45 to 55 g were used for this study. These rats were randomly assigned to an 8-day period of high-intensity intermittent exercise training (HIT), relatively high-intensity intermittent prolonged exercise training (RHT), or low-intensity prolonged exercise training (LIT). Age-matched sedentary rats were used as a control. In the HIT group, the rats repeated fourteen 20-s swimming bouts with a weight equivalent to 14, 15, and 16% of body weight for the first 2, the next 4, and the last 2 days, respectively. Between exercise bouts, a 10-s pause was allowed. RHT consisted of five 17-min swimming bouts with a 3-min rest between bouts. During the first bout, the rat swam without weight, whereas during the following four bouts, the rat was attached to a weight equivalent to 4 and 5% of its body weight for the first 5 days and the following 3 days, respectively. Rats in the LIT group swam 6 h/day for 8 days in two 3-h bouts separated by 45 min of rest. In the first experiment, the HIT, LIT, and control rats were compared. GLUT-4 content in the epitrochlearis muscle in the HIT and LIT groups after training was significantly higher than that in the control rats by 83 and 91%, respectively. Furthermore, glucose transport activity, stimulated maximally by both insulin (2 mU/ml) (HIT: 48%, LIT: 75%) and contractions (25 10-s tetani) (HIT: 55%, LIT: 69%), was higher in the training groups than in the control rats. However, no significant differences in GLUT-4 content or in maximal glucose transport activity in response to both insulin and contractions were observed between the two training groups. The second experiment demonstrated that GLUT-4 content after HIT did not differ from that after RHT (66% higher in trained rats than in control). In conclusion, the present investigation demonstrated that 8 days of HIT lasting only 280 s elevated both GLUT-4 content and maximal glucose transport activity in rat skeletal muscle to a level similar to that attained after LIT, which has been considered a tool to increase GLUT-4 content maximally.

  19. Reliability and validity of a low load endurance strength test for upper and lower extremities in patients with fibromyalgia.

    PubMed

    Munguía-Izquierdo, Diego; Legaz-Arrese, Alejandro

    2012-11-01

    To evaluate the reliability, standard error of the mean (SEM), clinical significant change, and known group validity of 2 assessments of endurance strength to low loads in patients with fibromyalgia syndrome (FS). Cross-sectional reliability and comparative study. University Pablo de Olavide, Seville, Spain. Middle-aged women with FS (n=95) and healthy women (n=64) matched for age, weight, and body mass index (BMI) were recruited for the study. Not applicable. The endurance strength to low loads tests of the upper and lower extremities and anthropometric measures (BMI) were used for the evaluations. The differences between the readings (tests 1 and 2) and the SDs of the differences, intraclass correlation coefficient (ICC) model (2,1), 95% confidence interval for the ICC, coefficient of repeatability, intrapatient SD, SEM, Wilcoxon signed-rank test, and Bland-Altman plots were used to examine reliability. A Mann-Whitney U test was used to analyze the differences in test values between the patient group and the control group. We hypothesized that patients with FS would have an endurance strength to low loads performance in lower and upper extremities at least twice as low as that of the healthy controls. Satisfactory test-retest reliability and SEMs were found for the lower extremity, dominant arm, and nondominant arm tests (ICC=.973-.979; P<.001; SEMs=1.44-1.66 repetitions). The differences in the mean between the test and retest were lower than the SEM for all performed tests, varying from -.10 to .29 repetitions. No significant differences were found between the test and retest (P>.05 for all). The Bland-Altman plots showed 95% limits of agreement for the lower extremity (4.7 to -4.5), dominant arm (3.8 to -4.4), and nondominant arm (3.9 to -4.1) tests. The endurance strength to low loads test scores for the patients with FS were 4-fold lower than for the controls in all performed tests (P<.001 for all). The endurance strength to low loads tests showed good reliability and known group validity and can be recommended for evaluating endurance strength to low loads in patients with FS. For individual evaluation, however, an improved score of at least 4 and 5 repetitions for the upper and lower extremities, respectively, was required for the differences to be considered as substantial clinical change. Patients with FS showed impaired endurance strength to low loads performance when compared with the general population. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  20. Serum Levels of Fetal Antigen 1 in Extreme Nutritional States

    PubMed Central

    Andries, Alin; Niemeier, Andreas; Støving, Rene K.; Abdallah, Basem M.; Wolf, Anna-Maria; Hørder, Kirsten; Kassem, Moustapha

    2012-01-01

    Objective. Recent data suggest that fetal antigen (FA1) is linked to disorders of body weight. Thus, we measured FA1 serum levels in two extreme nutritional states of morbid obesity (MO) and anorexia nervosa (AN) and monitored its response to weight changes. Design. FA1 and insulin serum concentrations were assessed in a cross-sectional study design at defined time points after gastric restrictive surgery for 25 MO patients and 15 women with AN. Results. Absolute FA1 serum levels were within the assay normal range and were not different between the groups at baseline. However, the ratio of FA1/BMI was significantly higher in AN. FA1 was inversely correlated with BMI before and after weight change in AN, but not in MO patients. In addition, MO patients displayed a significant concomitant decrease of FA1 and insulin with the first 25% of EWL, while in AN patients a significant increase of FA1 was observed in association with weight gain. Conclusion. FA1 is a sensitive indicator of metabolic adaptation during weight change. While FA1 serum levels in humans generally do not correlate with BMI, our results suggest that changes in FA1 serum levels reflect changes in adipose tissue turnover. PMID:22844611

  1. Weight-loss strategies of South African female university students and comparison of weight management-related characteristics between dieters and non-dieters.

    PubMed

    Senekal, Marjanne; Lasker, Gabrielle L; van Velden, Lindsay; Laubscher, Ria; Temple, Norman J

    2016-09-01

    Female university students are at risk for weight gain and use of inappropriate weight-loss strategies. By gaining a greater understanding of the weight-loss strategies used by and weight management related characteristics of these students, effective weight management interventions for this vulnerable group can be developed. Two hundred and fifty female students from South Africa universities, aged 18-25 years, participated in this cross-sectional study; 162 attempted weight loss during the year preceding the study (dieters) and 88 were non-dieters. Weight and height were measured and BMI (kg/m(2)) computed. A self-administered questionnaire was used to record all other variables. Weight loss strategies were described for dieters and compared between BMI groups within the dieters group. Weight management related characteristics were compared between dieters and non-dieters. Statistical tests included Pearson Chi-square test, independent samples t-test or Mann-Whitney U test (depending on distribution of the data). Predictors for a higher BMI and being overweight/obese (BMI ≥25 kg/m(2)) were identified using regression models. Healthy weight-loss strategies included increased exercise and fruit/vegetable intake and decreased intake of sugar and fat containing items; unhealthy methods included eating little food and skipping meals; and extreme weight loss strategies included laxatives and vomiting. The most commonly used weight-loss product was Herbex. Dieters were characterized by a higher BMI, overestimation of their weight (especially normal weight students), dissatisfaction with weight and select body parts, higher intake of breakfast and healthy foods, lower intake of unhealthy foods, higher levels of vigorous physical activity, higher use of select informal weight-loss information sources and experiencing more pressure to lose weight from mothers, siblings and friends. Predictors of higher BMI and/or increased risk for BMI ≥25 included weight-loss attempt during the past year, race, dissatisfaction with waist, perception of currently being "chubby," and higher frequencies of intake of a snack and fatty foods. Attempting weight-loss is common among female students and predicts BMI. Healthy (mainly), unhealthy and extreme weight loss methods are used. Dieters are characterized by a less realistic body image, lower body satisfaction, higher pressure to lose weight, use of informal weight-management information and a healthier life-style.

  2. Effect of extremes of body weight on the pharmacokinetics, pharmacodynamics, safety and tolerability of apixaban in healthy subjects

    PubMed Central

    Upreti, Vijay V; Wang, Jessie; Barrett, Yu Chen; Byon, Wonkyung; Boyd, Rebecca A; Pursley, Janice; LaCreta, Frank P; Frost, Charles E

    2013-01-01

    Aim Apixaban is an oral, direct, factor-Xa inhibitor approved for thromboprophylaxis in patients who have undergone elective hip or knee replacement surgery and for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation. This open label, parallel group study investigated effects of extremes of body weight on apixaban pharmacokinetics, pharmacodynamics, safety and tolerability. Method Fifty-four healthy subjects were enrolled [18 each into low (≤50 kg), reference (65–85 kg) and high (≥120 kg) body weight groups]. Following administration of a single oral dose of 10 mg apixaban, plasma and urine samples were collected for determination of apixaban pharmacokinetics and anti-factor Xa activity. Adverse events, vital signs and laboratory assessments were monitored. Results Compared with the reference body weight group, low body weight had approximately 27% [90% confidence interval (CI): 8–51%] and 20% (90% CI: 11–42%) higher apixaban maximum observed plasma concentration (Cmax) and area under the concentration–time curve extrapolated to infinity (AUC(0,∞)), respectively, and high body weight had approximately 31% (90% CI: 18–41%) and 23% (90% CI: 9–35%) lower apixaban Cmax and AUC(0,∞), respectively. Apixaban renal clearance was similar across the weight groups. Plasma anti-factor Xa activity showed a direct, linear relationship with apixaban plasma concentration, regardless of body weight group. Apixaban was well tolerated in this study. Conclusion The modest change in apixaban exposure is unlikely to require dose adjustment for apixaban based on body weight alone. However, caution is warranted in the presence of additional factors (such as severe renal impairment) that could increase apixaban exposure. PMID:23488672

  3. NETL Extreme Drilling Laboratory Studies High Pressure High Temperature Drilling Phenomena

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lyons, K.D.; Honeygan, S.; Moroz, T

    2007-06-01

    The U.S. Department of Energy’s National Energy Technology Laboratory (NETL) established an Extreme Drilling Lab to engineer effective and efficient drilling technologies viable at depths greater than 20,000 feet. This paper details the challenges of ultra-deep drilling, documents reports of decreased drilling rates as a result of increasing fluid pressure and temperature, and describes NETL’s Research and Development activities. NETL is invested in laboratory-scale physical simulation. Their physical simulator will have capability of circulating drilling fluids at 30,000 psi and 480 °F around a single drill cutter. This simulator will not yet be operational by the planned conference dates; therefore,more » the results will be limited to identification of leading hypotheses of drilling phenomena and NETL’s test plans to validate or refute such theories. Of particular interest to the Extreme Drilling Lab’s studies are the combinatorial effects of drilling fluid pressure, drilling fluid properties, rock properties, pore pressure, and drilling parameters, such as cutter rotational speed, weight on bit, and hydraulics associated with drilling fluid introduction to the rock-cutter interface. A detailed discussion of how each variable is controlled in a laboratory setting will be part of the conference paper and presentation.« less

  4. The addition of body armor diminishes dynamic postural stability in military soldiers.

    PubMed

    Sell, Timothy C; Pederson, Jonathan J; Abt, John P; Nagai, Takashi; Deluzio, Jennifer; Wirt, Michael D; McCord, Larry J; Lephart, Scott M

    2013-01-01

    Poor postural stability has been identified as a risk factor for lower extremity musculoskeletal injury. The additional weight of body armor carried by Soldiers alters static postural stability and may predispose Soldiers to lower extremity musculoskeletal injuries. However, static postural stability tasks poorly replicate the dynamic military environment, which places considerable stress on the postural control system during tactical training and combat. Therefore, the purpose of this study was to examine the effects of body armor on dynamic postural stability during single-leg jump landings. Thirty-six 101st Airborne Division (Air Assault) Soldiers performed single-leg jump landings in the anterior direction with and without wearing body armor. The dynamic postural stability index and the individual stability indices (medial-lateral stability index, anterior-posterior stability index, and vertical stability index) were calculated for each condition. Paired sample t-tests were performed to determine differences between conditions. Significant differences existed for the medial-lateral stability index, anterior-posterior stability index, vertical stability index, and dynamic postural stability index (p < 0.05). The addition of body armor resulted in diminished dynamic postural stability, which may result in increased lower extremity injuries. Training programs should address the altered dynamic postural stability while wearing body armor in attempts to promote adaptations that will result in safer performance during dynamic tasks.

  5. Chronic spinal cord injury in the cervical spine of a young soccer player.

    PubMed

    Kato, Yoshihiko; Koga, Michiaki; Taguchi, Toshihiko

    2010-05-12

    A 17-year-old male soccer player presented with numbness in the upper- and lower-left extremities of 6 months' duration. He had no apparent history of trauma but experienced neck pain during heading of the ball 5 years prior. A high-signal intensity area was seen on T2-weighted magnetic resonance imaging (MRI) of the cervical spine. No muscle weakness was observed. Hypoesthesia was observed in bilateral forearms, hands, and extremities below the inguinal region. Plain radiographs in the neutral position showed local kyphosis at C3/4. A small protrusion of the C3/4 disk was observed on T1-weighted MRI. A high-signal area in the spinal cord at the C3/4 level was observed on T2-weighted MRI, but this was not enhanced by gadolinium. Multiple sclerosis, intramedullary spinal cord tumor, sarcoidosis and malignant lymphoma, and spinal cord injury were all considered in the differential diagnosis. However, in view of the clinical, laboratory, and radiological investigations, we concluded that repeated impacts to the neck caused by heading of the ball during soccer induced a chronic, minor spinal cord injury. This contributed to the high-signal intensity change of the spinal cord in T2-weighted MRI. The present case demonstrates that repeated impact may cause chronic spinal cord injury. Soccer, American football, or rugby players presenting with neck or extremity symptoms should not be overlooked for the possibility of latent spinal cord injury, as this could present later development of more severe or unrecoverable spinal cord injuries. Copyright 2010, SLACK Incorporated.

  6. Fasting - the ultimate diet?

    PubMed

    Johnstone, A M

    2007-05-01

    Adult humans often undertake acute fasts for cosmetic, religious or medical reasons. For example, an estimated 14% of US adults have reported using fasting as a means to control body weight and this approach has long been advocated as an intermittent treatment for gross refractory obesity. There are unique historical data sets on extreme forms of food restriction that give insight into the consequences of starvation or semi-starvation in previously healthy, but usually non-obese subjects. These include documented medical reports on victims of hunger strike, famine and prisoners of war. Such data provide a detailed account on how the body adapts to prolonged starvation. It has previously been shown that fasting for the biblical period of 40 days and 40 nights is well within the overall physiological capabilities of a healthy adult. However, the specific effects on the human body and mind are less clearly documented, either in the short term (hours) or in the longer term (days). This review asks the following three questions, pertinent to any weight-loss therapy, (i) how effective is the regime in achieving weight loss, (ii) what impact does it have on psychology? and finally, (iii) does it work long-term?

  7. Angular-velocity control approach for stance-control orthoses.

    PubMed

    Lemaire, Edward D; Goudreau, Louis; Yakimovich, Terris; Kofman, Jonathan

    2009-10-01

    Currently, stance-control knee orthoses require external control mechanisms to control knee flexion during stance and allow free knee motion during the swing phase of gait. A new angular-velocity control approach that uses a rotary-hydraulic device to resist knee flexion when the knee angular velocity passes a preset threshold is presented. This angular-velocity approach for orthotic stance control is based on the premise that knee-flexion angular velocity during a knee-collapse event, such as a stumble or fall, is greater than that during walking. The new hydraulic knee-flexion control device does not require an external control mechanism to switch from free motion to stance control mode. Functional test results demonstrated that the hydraulic angular-velocity activated knee joint provided free knee motion during walking, engaged upon knee collapse, and supported body weight while the end-user recovered to a safe body position. The joint was tested to 51.6 Nm in single loading tests and passed 200,000 repeated loading cycles with a peak load of 88 Nm per cycle. The hydraulic, angular velocity activation approach has potential to improve safety and security for people with lower extremity weakness or when recovering from joint trauma.

  8. The cost of model reference adaptive control - Analysis, experiments, and optimization

    NASA Technical Reports Server (NTRS)

    Messer, R. S.; Haftka, R. T.; Cudney, H. H.

    1993-01-01

    In this paper the performance of Model Reference Adaptive Control (MRAC) is studied in numerical simulations and verified experimentally with the objective of understanding how differences between the plant and the reference model affect the control effort. MRAC is applied analytically and experimentally to a single degree of freedom system and analytically to a MIMO system with controlled differences between the model and the plant. It is shown that the control effort is sensitive to differences between the plant and the reference model. The effects of increased damping in the reference model are considered, and it is shown that requiring the controller to provide increased damping actually decreases the required control effort when differences between the plant and reference model exist. This result is useful because one of the first attempts to counteract the increased control effort due to differences between the plant and reference model might be to require less damping, however, this would actually increase the control effort. Optimization of weighting matrices is shown to help reduce the increase in required control effort. However, it was found that eventually the optimization resulted in a design that required an extremely high sampling rate for successful realization.

  9. Heritable Environmental Variance Causes Nonlinear Relationships Between Traits: Application to Birth Weight and Stillbirth of Pigs

    PubMed Central

    Mulder, Herman A.; Hill, William G.; Knol, Egbert F.

    2015-01-01

    There is recent evidence from laboratory experiments and analysis of livestock populations that not only the phenotype itself, but also its environmental variance, is under genetic control. Little is known about the relationships between the environmental variance of one trait and mean levels of other traits, however. A genetic covariance between these is expected to lead to nonlinearity between them, for example between birth weight and survival of piglets, where animals of extreme weights have lower survival. The objectives were to derive this nonlinear relationship analytically using multiple regression and apply it to data on piglet birth weight and survival. This study provides a framework to study such nonlinear relationships caused by genetic covariance of environmental variance of one trait and the mean of the other. It is shown that positions of phenotypic and genetic optima may differ and that genetic relationships are likely to be more curvilinear than phenotypic relationships, dependent mainly on the environmental correlation between these traits. Genetic correlations may change if the population means change relative to the optimal phenotypes. Data of piglet birth weight and survival show that the presence of nonlinearity can be partly explained by the genetic covariance between environmental variance of birth weight and survival. The framework developed can be used to assess effects of artificial and natural selection on means and variances of traits and the statistical method presented can be used to estimate trade-offs between environmental variance of one trait and mean levels of others. PMID:25631318

  10. Physical function in older men with hyperkyphosis.

    PubMed

    Katzman, Wendy B; Harrison, Stephanie L; Fink, Howard A; Marshall, Lynn M; Orwoll, Eric; Barrett-Connor, Elizabeth; Cawthon, Peggy M; Kado, Deborah M

    2015-05-01

    Age-related hyperkyphosis has been associated with poor physical function and is a well-established predictor of adverse health outcomes in older women, but its impact on health in older men is less well understood. We conducted a cross-sectional study to evaluate the association of hyperkyphosis and physical function in 2,363 men, aged 71-98 (M = 79) from the Osteoporotic Fractures in Men Study. Kyphosis was measured using the Rancho Bernardo Study block method. Measurements of grip strength and lower extremity function, including gait speed over 6 m, narrow walk (measure of dynamic balance), repeated chair stands ability and time, and lower extremity power (Nottingham Power Rig) were included separately as primary outcomes. We investigated associations of kyphosis and each outcome in age-adjusted and multivariable linear or logistic regression models, controlling for age, clinic, education, race, bone mineral density, height, weight, diabetes, and physical activity. In multivariate linear regression, we observed a dose-related response of worse scores on each lower extremity physical function test as number of blocks increased, p for trend ≤.001. Using a cutoff of ≥4 blocks, 20% (N = 469) of men were characterized with hyperkyphosis. In multivariate logistic regression, men with hyperkyphosis had increased odds (range 1.5-1.8) of being in the worst quartile of performing lower extremity physical function tasks (p < .001 for each outcome). Kyphosis was not associated with grip strength in any multivariate analysis. Hyperkyphosis is associated with impaired lower extremity physical function in older men. Further studies are needed to determine the direction of causality. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Developmental programming of happiness.

    PubMed

    Schmidt, Louis A; Fortier, Paz; Lahat, Ayelet; Tang, Alva; Mathewson, Karen J; Saigal, Saroj; Boyle, Michael H; Van Lieshout, Ryan J

    2017-09-01

    Being born at an extremely low birth weight (ELBW; <1,000 grams) is presumed to reflect a suboptimal intrauterine environment and thus presents an opportunity for examining developmental programming hypotheses. Interfacing prenatal programming and differential susceptibility hypotheses, we tested whether individuals with ELBW in different childhood rearing environments showed different attention biases to positive and negative facial emotions in adulthood. Using the oldest known, prospectively followed cohort of ELBW survivors, we found that relative to normal birth weight controls (NBW; >2,500 grams), ELBW survivors displayed the highest and lowest attention bias to happy faces at age 30-35, depending on whether their total family income at age 8 was relatively low (environmental match) or high (environmental mismatch), respectively. This bias to happy faces was associated with a reduced likelihood of emotional problems. Findings suggest that differential susceptibility to positive emotions may be prenatally programmed, with effects lasting into adulthood. We discuss implications for integrating prenatal programming and differential susceptibility hypotheses, and the developmental origins of postnatal plasticity and resilience. © 2017 Wiley Periodicals, Inc.

  12. Effect of dietary patterns differing in carbohydrate and fat content on blood lipid and glucose profiles based on weight-loss success of breast-cancer survivors.

    PubMed

    Thompson, Henry J; Sedlacek, Scot M; Paul, Devchand; Wolfe, Pamela; McGinley, John N; Playdon, Mary C; Daeninck, Elizabeth A; Bartels, Sara N; Wisthoff, Mark R

    2012-01-06

    Healthy body weight is an important factor for prevention of breast cancer recurrence. Yet, weight loss and weight gain are not currently included in clinical-practice guidelines for posttreatment of breast cancer. The work reported addresses one of the questions that must be considered in recommending weight loss to patients: does it matter what diet plan is used, a question of particular importance because breast cancer treatment can increase risk for cardiovascular disease. Women who completed treatment for breast cancer were enrolled in a nonrandomized, controlled study investigating effects of weight loss achieved by using two dietary patterns at the extremes of macronutrient composition, although both diet arms were equivalent in protein: high fat, low carbohydrate versus low fat, high carbohydrate. A nonintervention group served as the control arm; women were assigned to intervention arms based on dietary preferences. During the 6-month weight-loss program, which was menu and recipe defined, participants had monthly clinical visits at which anthropometric data were collected and fasting blood was obtained for safety monitoring for plasma lipid profiles and fasting glucose. Results from 142 participants are reported. Adverse effects on fasting blood lipids or glucose were not observed in either dietary arm. A decrease in fasting glucose was observed with progressive weight loss and was greater in participants who lost more weight, but the effect was not statistically significant, even though it was observed across both diet groups (P = 0.21). Beneficial effects of weight loss on cholesterol (4.7%; P = 0.001), triglycerides (21.8%; P = 0.01), and low-density lipoprotein (LDL) cholesterol (5.8%; P = 0.06) were observed in both groups. For cholesterol (P = 0.07) and LDL cholesterol (P = 0.13), greater reduction trends were seen on the low-fat diet pattern; whereas, for triglycerides (P = 0.01) and high-density lipoprotein (HDL) cholesterol (P = 0.08), a decrease or increase, respectively, was greater on the low-carbohydrate diet pattern. Because an individual's dietary preferences can affect dietary adherence and weight-loss success, the lack of evidence of a negative effect of dietary pattern on biomarkers associated with cardiovascular risk is an important consideration in the development of breast cancer practice guidelines for physicians who recommend that their patients lose weight. Whether dietary pattern affects biomarkers that predict long-term survival is a primary question in this ongoing clinical trial.

  13. MRI assessment of the thigh musculature in dermatomyositis and healthy subjects using diffusion tensor imaging, intravoxel incoherent motion and dynamic DTI.

    PubMed

    Sigmund, E E; Baete, S H; Luo, T; Patel, K; Wang, D; Rossi, I; Duarte, A; Bruno, M; Mossa, D; Femia, A; Ramachandran, S; Stoffel, D; Babb, J S; Franks, A; Bencardino, J

    2018-06-04

    Dermatomyositis (DM) is an idiopathic inflammatory myopathy involving severe debilitation in need of diagnostics. We evaluated the proximal lower extremity musculature with diffusion tensor imaging (DTI), intravoxel incoherent motion (IVIM) and dynamic DTI in DM patients and controls and compared with standard clinical workup.  METHODS: In this IRB-approved, HIPAA-compliant study with written informed consent, anatomical, Dixon fat/water and diffusion imaging were collected in bilateral thigh MRI of 22 controls and 27 DM patients in a 3T scanner. Compartments were scored on T1/T2 scales. Single voxel dynamic DTI metrics in quadriceps before and after 3-min leg exercise were measured. Spearman rank correlation and mixed model analysis of variance/covariance (ANOVA/ANCOVA) were used to correlate with T1 and T2 scores and to compare patients with controls. DM patients showed significantly lower pseudo-diffusion and volume in quadriceps than controls. All subjects showed significant correlation between T1 score and signal-weighted fat fraction; tissue diffusion and pseudo-diffusion varied significantly with T1 and T2 score in patients. Radial and mean diffusion exercise response in patients was significantly higher than controls. Static and dynamic diffusion imaging metrics show correlation with conventional imaging scores, reveal spatial heterogeneity, and provide means to differentiate dermatomyositis patients from controls. • Diffusion imaging shows regional differences between thigh muscles of dermatomyositis patients and controls. • Signal-weighted fat fraction and diffusion metrics correlate with T1/T2 scores of disease severity. • Dermatomyositis patients show significantly higher radial diffusion exercise response than controls.

  14. Weight-Related Correlates of Psychological Dysregulation in Adolescent and Young Adult (AYA) Females with Severe Obesity

    PubMed Central

    Gowey, Marissa A.; Reiter-Purtill, Jennifer; Becnel, Jennifer; Peugh, James; Mitchell, James E.; Zeller, Meg H.

    2016-01-01

    Objective Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. Methods Fifty-four AYA females with severe obesity (MBMI=48.71 kg/m2; Mage=18.29, R=15–21 years; 59.3% White) completed self-report measures of psychological dysregulation and weight-related constructs including meal patterns, problematic eating behaviors, and body and weight dissatisfaction, as non-surgical comparison participants in a multi-site study of adolescent bariatric surgery outcomes. Pearson and bivariate correlations were conducted and stratified by age group to analyze associations between dysregulation subscales (affective, behavioral, cognitive) and weight-related variables. Results Breakfast was the most frequently skipped meal (consumed 3–4 times/week). Eating out was common (4–5 times/week) and mostly occurred at fast-food restaurants. Evening hyperphagia (61.11%) and eating in the absence of hunger (37.04%) were commonly endorsed, while unplanned eating (29.63%), a sense of loss of control over eating (22.22%), eating beyond satiety (22.22%), night eating (12.96%), and binge eating (11.11%) were less common. Almost half of the sample endorsed extreme weight dissatisfaction. Dysregulation was associated with most weight-related attitudes and behaviors of interest in young adults but select patterns emerged for adolescents. Conclusions Higher levels of psychological dysregulation are associated with greater BMI, problematic eating patterns and behaviors, and body dissatisfaction in AYA females with severe obesity. These findings have implications for developing novel intervention strategies for severe obesity in AYAs that may have a multidimensional impact on functioning (e.g., psychosocial health, weight loss behaviors). PMID:26775646

  15. Perinatal outcome and long-term follow-up of extremely low birth weight infants depending on the mode of delivery.

    PubMed

    Minguez-Milio, José Angel; Alcázar, Juan Luis; Aubá, María; Ruiz-Zambrana, Alvaro; Minguez, José

    2011-10-01

    To assess the effect of the mode of delivery (vaginal or cesarean section) on survival, morbidity, and long-term psychomotor development of extremely low birth weight (ELBW) infants. A longitudinal observational study including 138 ELBW infants (73 born by c-section and 65 vaginally) was conducted. We analyzed the survival and short-term morbidity. We also studied the long-term neurocognitive and motor development using the McCarthy Scales of Children's Abilities (MSCA). Mortality was significantly higher in newborns delivered vaginally (49.3%) than those delivered by c-section (23.1%). Newborns delivered vaginally had a higher incidence of retinopathy and peri-intraventricular hemorrhage (P-IVH). Children who died had lower gestational age at birth and lower birth weight. After multivariate analysis only birth weight, gestational age at birth and P-IVH were independently associated to mortality. Regarding the long-term evaluation (MSCA), we observed that children born by c-section had lower incidence of abnormal results. The mode of delivery does not affect survival. Cesarean section provides lower morbidity and better prognosis for neurodevelopment long-term outcome in ELBW infants.

  16. Characterization of Courtesy Stigma Perceived by Parents of Overweight Children with Bardet-Biedl Syndrome.

    PubMed

    Hamlington, Barbara; Ivey, Lauren E; Brenna, Ethan; Biesecker, Leslie G; Biesecker, Barbara B; Sapp, Julie C

    2015-01-01

    A child's obesity is generally perceived by the public to be under the control of the child's parents. While the health consequences of childhood obesity are well understood, less is known about psychological and social effects of having an obese child on parents. We set out to characterize stigma and courtesy stigma experiences surrounding obesity among children with Bardet-Biedl syndrome (BBS), a multisystem genetic disorder, and their parents. Twenty-eight parents of children with BBS participated in semi-structured interviews informed by social stigmatization theory, which describes courtesy stigma as parental perception of stigmatization by association with a stigmatized child. Parents were asked to describe such experiences. Parents of children with BBS reported the child's obesity as the most frequent target of stigmatization. They perceived health care providers as the predominant source of courtesy stigma, describing interactions that resulted in feeling devalued and judged as incompetent parents. Parents of children with BBS feel blamed by others for their child's obesity and described experiences that suggest health care providers may contribute to courtesy stigma and thus impede effective communication about managing obesity. Health care providers may reinforce parental feelings of guilt and responsibility by repeating information parents may have previously heard and ignoring extremely challenging barriers to weight management, such as a genetic predisposition to obesity. Strategies to understand and incorporate parents' perceptions and causal attributions of their children's weight may improve communication about weight control.

  17. Fatness and fitness: exposing the logic of evolutionary explanations for obesity.

    PubMed

    Higginson, Andrew D; McNamara, John M; Houston, Alasdair I

    2016-01-13

    To explore the logic of evolutionary explanations of obesity we modelled food consumption in an animal that minimizes mortality (starvation plus predation) by switching between activities that differ in energy gain and predation. We show that if switching does not incur extra predation risk, the animal should have a single threshold level of reserves above which it performs the safe activity and below which it performs the dangerous activity. The value of the threshold is determined by the environmental conditions, implying that animals should have variable 'set points'. Selection pressure to prevent energy stores exceeding the optimal level is usually weak, suggesting that immediate rewards might easily overcome the controls against becoming overweight. The risk of starvation can have a strong influence on the strategy even when starvation is extremely uncommon, so the incidence of mortality during famine in human history may be unimportant for explanations for obesity. If there is an extra risk of switching between activities, the animal should have two distinct thresholds: one to initiate weight gain and one to initiate weight loss. Contrary to the dual intervention point model, these thresholds will be inter-dependent, such that altering the predation risk alters the location of both thresholds; a result that undermines the evolutionary basis of the drifty genes hypothesis. Our work implies that understanding the causes of obesity can benefit from a better understanding of how evolution shapes the mechanisms that control body weight. © 2016 The Authors.

  18. Fatness and fitness: exposing the logic of evolutionary explanations for obesity

    PubMed Central

    Higginson, Andrew D.; McNamara, John M.; Houston, Alasdair I.

    2016-01-01

    To explore the logic of evolutionary explanations of obesity we modelled food consumption in an animal that minimizes mortality (starvation plus predation) by switching between activities that differ in energy gain and predation. We show that if switching does not incur extra predation risk, the animal should have a single threshold level of reserves above which it performs the safe activity and below which it performs the dangerous activity. The value of the threshold is determined by the environmental conditions, implying that animals should have variable ‘set points’. Selection pressure to prevent energy stores exceeding the optimal level is usually weak, suggesting that immediate rewards might easily overcome the controls against becoming overweight. The risk of starvation can have a strong influence on the strategy even when starvation is extremely uncommon, so the incidence of mortality during famine in human history may be unimportant for explanations for obesity. If there is an extra risk of switching between activities, the animal should have two distinct thresholds: one to initiate weight gain and one to initiate weight loss. Contrary to the dual intervention point model, these thresholds will be inter-dependent, such that altering the predation risk alters the location of both thresholds; a result that undermines the evolutionary basis of the drifty genes hypothesis. Our work implies that understanding the causes of obesity can benefit from a better understanding of how evolution shapes the mechanisms that control body weight. PMID:26740612

  19. Costs of necrotizing enterocolitis and cost-effectiveness of exclusively human milk-based products in feeding extremely premature infants.

    PubMed

    Ganapathy, Vaidyanathan; Hay, Joel W; Kim, Jae H

    2012-02-01

    This study evaluated the cost-effectiveness of a 100% human milk-based diet composed of mother's milk fortified with a donor human milk-based human milk fortifier (HMF) versus mother's milk fortified with bovine milk-based HMF to initiate enteral nutrition among extremely premature infants in the neonatal intensive care unit (NICU). A net expected costs calculator was developed to compare the total NICU costs among extremely premature infants who were fed either a bovine milk-based HMF-fortified diet or a 100% human milk-based diet, based on the previously observed risks of overall necrotizing enterocolitis (NEC) and surgical NEC in a randomized controlled study that compared outcomes of these two feeding strategies among 207 very low birth weight infants. The average NICU costs for an extremely premature infant without NEC and the incremental costs due to medical and surgical NEC were derived from a separate analysis of hospital discharges in the state of California in 2007. The sensitivity of cost-effectiveness results to the risks and costs of NEC and to prices of milk supplements was studied. The adjusted incremental costs of medical NEC and surgical NEC over and above the average costs incurred for extremely premature infants without NEC, in 2011 US$, were $74,004 (95% confidence interval, $47,051-$100,957) and $198,040 (95% confidence interval, $159,261-$236,819) per infant, respectively. Extremely premature infants fed with 100% human-milk based products had lower expected NICU length of stay and total expected costs of hospitalization, resulting in net direct savings of 3.9 NICU days and $8,167.17 (95% confidence interval, $4,405-$11,930) per extremely premature infant (p < 0.0001). Costs savings from the donor HMF strategy were sensitive to price and quantity of donor HMF, percentage reduction in risk of overall NEC and surgical NEC achieved, and incremental costs of surgical NEC. Compared with feeding extremely premature infants with mother's milk fortified with bovine milk-based supplements, a 100% human milk-based diet that includes mother's milk fortified with donor human milk-based HMF may result in potential net savings on medical care resources by preventing NEC.

  20. Neurodevelopmental, health, and growth status at age 6 years of children with birth weights less than 1001 grams.

    PubMed

    Teplin, S W; Burchinal, M; Johnson-Martin, N; Humphry, R A; Kraybill, E N

    1991-05-01

    The neurodevelopmental, health, and growth outcomes for 28 six-year-old extremely low birth weight (ELBW) (birth weight less than 1001 gm) children were compared with those of 26 control children born at term. The two groups did not differ in mean weight or height, but the ELBW group had smaller head circumferences (p = 0.015). Kaufman mental processing scores correlated with head circumference (p = 0.0003). Significantly more of the ELBW children (61%) had mild or moderate to severe neurologic problems compared with control children (23%) (p = 0.003). Three ELBW children had mild spastic diplegia; one was blind. Eighteen (64%) of the ELBW children had required rehospitalization versus five (20%) of the comparison group. The mean Kaufman Mental Processing Composite was lower for the ELBW group, but when the data were analyzed by maternal education, only those children whose mothers had a twelfth-grade education had significantly lower scores (p = 0.0001). A similar pattern of group differences was seen for scores on visual-motor function (p = 0.0045), visual-perceptual abilities (p = 0.003), and attention span (p = 0.0001). No group differences were seen regarding hyperactivity or parental stress. Overall functional disability among the ELBW children was considered absent in 46%, mild in 36%, and moderate to severe in 18%. There was a significant association (p = 0.029) between classification of handicap at 12 to 34 months and classification at 6 years. No neonatal factors correlated with 6-year outcome. A significant proportion of ELBW children had no severe disabilities, but many had dysfunctions likely to affect learning and behavior in school.

  1. Ultra-high field upper extremity peripheral nerve and non-contrast enhanced vascular imaging

    PubMed Central

    Raval, Shailesh B.; Britton, Cynthia A.; Zhao, Tiejun; Krishnamurthy, Narayanan; Santini, Tales; Gorantla, Vijay S.; Ibrahim, Tamer S.

    2017-01-01

    Objective The purpose of this study was to explore the efficacy of Ultra-high field [UHF] 7 Tesla [T] MRI as compared to 3T MRI in non-contrast enhanced [nCE] imaging of structural anatomy in the elbow, forearm, and hand [upper extremity]. Materials and method A wide range of sequences including T1 weighted [T1] volumetric interpolate breath-hold exam [VIBE], T2 weighted [T2] double-echo steady state [DESS], susceptibility weighted imaging [SWI], time-of-flight [TOF], diffusion tensor imaging [DTI], and diffusion spectrum imaging [DSI] were optimized and incorporated with a radiofrequency [RF] coil system composed of a transverse electromagnetic [TEM] transmit coil combined with an 8-channel receive-only array for 7T upper extremity [UE] imaging. In addition, Siemens optimized protocol/sequences were used on a 3T scanner and the resulting images from T1 VIBE and T2 DESS were compared to that obtained at 7T qualitatively and quantitatively [SWI was only qualitatively compared]. DSI studio was utilized to identify nerves based on analysis of diffusion weighted derived fractional anisotropy images. Images of forearm vasculature were extracted using a paint grow manual segmentation method based on MIPAV [Medical Image Processing, Analysis, and Visualization]. Results High resolution and high quality signal-to-noise ratio [SNR] and contrast-to-noise ratio [CNR]—images of the hand, forearm, and elbow were acquired with nearly homogeneous 7T excitation. Measured [performed on the T1 VIBE and T2 DESS sequences] SNR and CNR values were almost doubled at 7T vs. 3T. Cartilage, synovial fluid and tendon structures could be seen with higher clarity in the 7T T1 and T2 weighted images. SWI allowed high resolution and better quality imaging of large and medium sized arteries and veins, capillary networks and arteriovenous anastomoses at 7T when compared to 3T. 7T diffusion weighted sequence [not performed at 3T] demonstrates that the forearm nerves are clearly delineated by fiber tractography. The proper digital palmar arteries and superficial palmar arch could also be clearly visualized using TOF nCE 7T MRI. Conclusion Ultra-high resolution neurovascular imaging in upper extremities is possible at 7T without use of renal toxic intravenous contrast. 7T MRI can provide superior peripheral nerve [based on fiber anisotropy and diffusion coefficient parameters derived from diffusion tensor/spectrum imaging] and vascular [nCE MRA and vessel segmentation] imaging. PMID:28662061

  2. The pitch of short-duration fundamental frequency glissandos.

    PubMed

    d'Alessandro, C; Rosset, S; Rossi, J P

    1998-10-01

    Pitch perception for short-duration fundamental frequency (F0) glissandos was studied. In the first part, new measurements using the method of adjustment are reported. Stimuli were F0 glissandos centered at 220 Hz. The parameters under study were: F0 glissando extents (0, 0.8, 1.5, 3, 6, and 12 semitones, i.e., 0, 10.17, 18.74, 38.17, 76.63, and 155.56 Hz), F0 glissando durations (50, 100, 200, and 300 ms), F0 glissando directions (rising or falling), and the extremity of F0 glissandos matched (beginning or end). In the second part, the main results are discussed: (1) perception seems to correspond to an average of the frequencies present in the vicinity of the extremity matched; (2) the higher extremities of the glissando seem more important; (3) adjustments at the end are closer to the extremities than adjustments at the beginning. In the third part, numerical models accounting for the experimental data are proposed: a time-average model and a weighted time-average model. Optimal parameters for these models are derived. The weighted time-average model achieves a 94% accurate prediction rate for the experimental data. The numerical model is successful in predicting the pitch of short-duration F0 glissandos.

  3. Evaluation of the DSM-5 severity indicator for binge eating disorder in a clinical sample

    PubMed Central

    Grilo, Carlos M.; Ivezaj, Valentina; White, Marney A.

    2015-01-01

    Objective This study tested the new DSM-5 severity criterion for binge eating disorder (BED) based on frequency of binge-eating in a clinical sample. This study also tested overvaluation of shape/weight as an alternative severity specifier. Method Participants were 834 treatment-seeking adults diagnosed with DSM-5 BED using semistructured diagnostic and eating-disorder interviews. Participants sub-grouped based on DSM-5 severity levels and on overvaluation of shape/weight were compared on demographic and clinical variables. Results Based on DSM-5 severity definitions, 331 (39.7%) participants were categorized as mild, 395 (47.5%) as moderate, 83 (10.0%) as severe, and 25 (3.0%) as extreme. Analyses comparing three (mild, moderate, and severe/extreme) severity groups revealed no significant differences in demographic variables or body mass index (BMI). Analyses revealed significantly higher eating-disorder psychopathology in the severe/extreme than moderate and mild groups and higher depression in moderate and severe/extreme groups than the mild group; effect sizes were small. Participants characterized with overvaluation (N = 449; 54%) versus without overvaluation (N = 384; 46%) did not differ significantly in age, sex, BMI, or binge-eating frequency, but had significantly greater eating-disorder psychopathology and depression. The robustly greater eating-disorder psychopathology and depression levels (medium-to-large effect sizes) in the overvaluation group was observed without attenuation of effect sizes after adjusting for ethnicity/race and binge-eating severity/frequency. Conclusions Our findings provide support for overvaluation of shape/weight as a severity specifier for BED as it provides stronger information about the severity of homogeneous groupings of patients than the DSM-5 rating based on binge-eating. PMID:26114779

  4. The Heat Exposure Integrated Deprivation Index (HEIDI): A data-driven approach to quantifying neighborhood risk during extreme hot weather.

    PubMed

    Krstic, Nikolas; Yuchi, Weiran; Ho, Hung Chak; Walker, Blake B; Knudby, Anders J; Henderson, Sarah B

    2017-12-01

    Mortality attributable to extreme hot weather is a growing concern in many urban environments, and spatial heat vulnerability indexes are often used to identify areas at relatively higher and lower risk. Three indexes were developed for greater Vancouver, Canada using a pool of 20 potentially predictive variables categorized to reflect social vulnerability, population density, temperature exposure, and urban form. One variable was chosen from each category: an existing deprivation index, senior population density, apparent temperature, and road density, respectively. The three indexes were constructed from these variables using (1) unweighted, (2) weighted, and (3) data-driven Heat Exposure Integrated Deprivation Index (HEIDI) approaches. The performance of each index was assessed using mortality data from 1998-2014, and the maps were compared with respect to spatial patterns identified. The population-weighted spatial correlation between the three indexes ranged from 0.68-0.89. The HEIDI approach produced a graduated map of vulnerability, whereas the other approaches primarily identified areas of highest risk. All indexes performed best under extreme temperatures, but HEIDI was more useful at lower thresholds. Each of the indexes in isolation provides valuable information for public health protection, but combining the HEIDI approach with unweighted and weighted methods provides richer information about areas most vulnerable to heat. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Effect of individualised dietary education at medical check-ups on maternal and fetal outcomes in pregnant Japanese women.

    PubMed

    Tajirika-Shirai, Reiko; Takimoto, Hidemi; Yokoyama, Tetsuji; Kaneko, Hitoshi; Kubota, Toshiro; Miyasaka, Naoyuki

    2018-01-01

    An increased prevalence of low maternal weight and insufficient pregnancy weight gain may be responsible for an increase in low birthweight infants in Japan. We aimed to examine the effects of individualised dietary education at medical check-ups on maternal/fetal outcomes in Japanese women. Four hundred and six underweight and normal weight singleton pregnant women, who attended check-ups at an obstetric facility until ≥30 weeks gestation and delivered at 36-41 weeks gestation, were selected for analyses. Weight gain was assessed at each check-up based on the official "Dietary Guidelines for Pregnant and Lactating Women". Individual dietary advice was provided by dieticians to those with insufficient or excess weight gain status around 28 weeks gestation. The medical records from uncomplicated singleton deliveries (36-41 weeks gestation) at the same facility from 2008-2010 were used (n=792) to examine the effect of dietary education on maternal/fetal outcomes. Pre-pregnancy underweight was present in >24% of women in both the intervention and non-intervention groups. Adequate weight gain occurred more frequently in the intervention group (p<0.01). There were no significant differences in mean birthweight or the proportion of low birthweight infants. However, the proportion of extremely small for gestational age infants (birthweight <3rd percentile) was lower in the intervention group (p=0.011). There were no differences in the frequency of caesarean delivery, pregnancy induced hypertension, or infant Apgar scores <7. Dietary education during pregnancy check-ups promotes adequate maternal weight gain and helps prevent extreme fetal growth restraint.

  6. Advancing maternal age and infant birth weight among urban African Americans: the effect of neighborhood poverty.

    PubMed

    Collins, James W; Simon, Dyan M; Jackson, Tara A; Drolet, Aimee

    2006-01-01

    This study sought to determine whether neighborhood poverty modifies the relationship between maternal age and infant birth weight among urban African Americans. Stratified analyses were performed on the vital records of African Americans born in Chicago by means of 1992-1995 computerized birth file with appended 1990 US Census income and 1995 Chicago Department of Public Health data. Four neighborhood-level variables (low median family income, high rates of unemployment, homicide, and lead poisoning) were analyzed. This is a population-based study. Twenty-one percent (n=21,811) of women resided in nonimpoverished neighborhoods (zero ecologic risk factors); 23% (n=24,914) of women lived in extremely impoverished neighborhoods (four ecologic risk factors). In nonimpoverished neighborhoods, 30-34 year old women had a moderately low birth weight (1500-2499 g) rate of 13.9% compared to 10.3% for women aged 20-24 years; risk difference (95% confidence interval [CI])=3.5 (2.2-4.6). In contrast, extremely impoverished women aged 30-34 years had a moderately low birth weight rate of 19.8% compared to 11.8% for women aged 20-24 years; risk difference (95% CI)=7.7 (6.1-9.3). This trend persisted among women who received early prenatal care and were primagravids or of low parity. Neighborhood poverty did not modify the association of advancing maternal age and the risk of very low birth weight (<1500 g). Neighborhood poverty accelerates the rise in moderately low birth weight but not very low birth weight; rates were associated with advancing maternal age among urban African Americans.

  7. Desmopressin

    MedlinePlus

    ... nausea vomiting loss of appetite weight gain headache irritability restlessness extreme tiredness confusion slowed reflexes muscle weakness, ... response to desmopressin.Do not let anyone else use your medication. Ask your pharmacist any questions you ...

  8. Higher protein intake strategies in human milk fortification for preterms infants feeding. Auxological and neurodevelopmental outcome.

    PubMed

    Biasini, A; Neri, C; China, M C; Monti, F; Di Nicola, P; Bertino, E

    2012-01-01

    Postnatal growth restriction and failure to thrive still remain a major problem in Extremely Low Birth Weight (ELBW) infants . The goal for the nutritional care of these infants is to achieve rate of growth similar to those of the fetus in utero at the equivalent gestational age. Human milk fortified remains the best food for all these preterms. Two groups of preterm of weight 580-1250 g and gestational age 23-32 wk, were fed with different protein intake in the human/maternal milk fortified ( 3,5 g Kg-1 per day and 4,8 g Kg-1 per day in the control and intervention group respectively).The feeding tolerance, intrahospital growth, neurological outcome and anthropometric data until 12 months of corrected age, were evaluated. The protein supplemented group (PSG) showed an intrahospital highter growth rate ( mostly in head circumference, p 0,02, and length growth, p 0,04) only in the preterms with 580-980 g and 23-30 wk. In the same preterms, Griffith Development Mental Score at 3 and 12 months corrected age showed higher score than in the control group in the Performance (p 0,04) and Hearing/Language (p 0,03) items. The auxological evaluation in the postdischarge period showed in the PSG group mean z-score values for length higher than those in the control group at 9 (p 0,04) months of corrected age.

  9. Pharmacological Treatment of Binge Eating Disorder: Update Review and Synthesis

    PubMed Central

    Reas, Deborah L.; Grilo, Carlos M.

    2015-01-01

    Introduction Binge-eating disorder (BED), a formal eating-disorder diagnosis in the DSM-5, is characterized by recurrent binge-eating, marked distress about binge-eating, and the absence of extreme weight compensatory behaviors. BED is more prevalent than other eating-disorders, with broader distribution across age, sex, and ethnic/racial groups, and is associated strongly with obesity and heightened risk for psychiatric/medical comorbidities. Areas Covered This article provides an overview of pharmacotherapy for BED with a focus on III randomized controlled trials (RCTs). The search with minimal methodological inclusion requirements yielded 22 RCTs investigating several different medication classes; most were pharmacotherapy-only trials with eight trials testing combination approaches with psychological-behavioral methods. Expert Opinion The evidence base regarding pharmacotherapy for BED remains limited, although this year the FDA approved the first medication (i.e., lisdexamfetamine dimesylate; LDX) specifically for moderate-to-severe BED. Data from RCTs suggests certain medications are superior to placebo for reducing binge-eating over the short-term; almost no data exist regarding longer-term effects of pharmacotherapy for BED. Except for topiramate, which significantly reduces both binge-eating and weight, tested medications yield minimal weight loss and LDX is not indicated for weight loss. Psychological-behavioral and combination approaches with certain medications yield superior outcomes to pharmacotherapy-only acutely and over longer-term follow-up. PMID:26044518

  10. Betweenness centrality in a weighted network

    NASA Astrophysics Data System (ADS)

    Wang, Huijuan; Hernandez, Javier Martin; van Mieghem, Piet

    2008-04-01

    When transport in networks follows the shortest paths, the union of all shortest path trees G∪SPT can be regarded as the “transport overlay network.” Overlay networks such as peer-to-peer networks or virtual private networks can be considered as a subgraph of G∪SPT . The traffic through the network is examined by the betweenness Bl of links in the overlay G∪SPT . The strength of disorder can be controlled by, e.g., tuning the extreme value index α of the independent and identically distributed polynomial link weights. In the strong disorder limit (α→0) , all transport flows over a critical backbone, the minimum spanning tree (MST). We investigate the betweenness distributions of wide classes of trees, such as the MST of those well-known network models and of various real-world complex networks. All these trees with different degree distributions (e.g., uniform, exponential, or power law) are found to possess a power law betweenness distribution Pr[Bl=j]˜j-c . The exponent c seems to be positively correlated with the degree variance of the tree and to be insensitive of the size N of a network. In the weak disorder regime, transport in the network traverses many links. We show that a link with smaller link weight tends to carry more traffic. This negative correlation between link weight and betweenness depends on α and the structure of the underlying topology.

  11. Tetrahydrocannabinol and endocannabinoids in feeding and appetite.

    PubMed

    Berry, Elliot M; Mechoulam, Raphael

    2002-08-01

    The physiological control of appetite and satiety, in which numerous neurotransmitters and neuropeptides play a role, is extremely complex. Here we describe the involvement of endocannabinoids in these processes. These endogenous neuromodulators enhance appetite in animals. The same effect is observed in animals and in humans with the psychotropic plant cannabinoid Delta(9)-tetrahydrocannabinol, which is an approved appetite-enhancing drug. The CB(1) cannabinoid receptor antagonist SR141716A blocks the effects on feeding produced by the endocannabinoids. If administered to mice pups, this antagonist blocks suckling. In obese humans, it causes weight reduction. Very little is known about the physiological and biochemical mechanisms involved in the effects of Delta(9)-tetrahydrocannabinol and the cannabinoids in feeding and appetite.

  12. Hydatidiform mole

    MedlinePlus

    ... hands , or unexplained weight loss Symptoms similar to preeclampsia that occur in the first trimester or early ... always a sign of a hydatidiform mole, because preeclampsia is extremely rare this early in a normal ...

  13. Quality prediction modeling for sintered ores based on mechanism models of sintering and extreme learning machine based error compensation

    NASA Astrophysics Data System (ADS)

    Tiebin, Wu; Yunlian, Liu; Xinjun, Li; Yi, Yu; Bin, Zhang

    2018-06-01

    Aiming at the difficulty in quality prediction of sintered ores, a hybrid prediction model is established based on mechanism models of sintering and time-weighted error compensation on the basis of the extreme learning machine (ELM). At first, mechanism models of drum index, total iron, and alkalinity are constructed according to the chemical reaction mechanism and conservation of matter in the sintering process. As the process is simplified in the mechanism models, these models are not able to describe high nonlinearity. Therefore, errors are inevitable. For this reason, the time-weighted ELM based error compensation model is established. Simulation results verify that the hybrid model has a high accuracy and can meet the requirement for industrial applications.

  14. Comparison of neonatal nurse practitioners' and pediatric residents' care of extremely low-birth-weight infants.

    PubMed

    Karlowicz, M G; McMurray, J L

    2000-11-01

    To compare outcomes and charges of health care delivery to extremely low-birth-weight infants by neonatal nurse practitioners (NNP) and pediatric residents. Retrospective cohort study. A 56-bed neonatal intensive care unit (NICU) in a university teaching hospital. Study population included all infants with birth weights less than 1000 g who were admitted to the NICU during the 2-year period between September 1, 1994, and August 31, 1996. Infants who died earlier than 12 hours of age, or who were admitted after 1 week of age or with major malformations, chromosomal abnormalities, or congenital infections were excluded. There were separate teams of NNPs and residents providing care around the clock. The study group included 201 infants with birth weights of less than 1000 g. The NNP team cared for 94 infants and the resident team cared for 107 infants. Survival, length of stay, and total charges. Survival to discharge occurred for 71 NNP team infants (76%) and 82 resident team infants (77%) (P =.87). The median total length of stay was 87 days (range, 39-230 days) for NNP team infants and 88 days (range, 41-365 days) for resident team infants (P =.54). There were no significant differences between NNP infants and resident team infants in the prevalence of severe intracranial hemorrhage, threshold retinopathy of prematurity, or chronic lung disease at 36 weeks postconceptual age. Median total NICU hospital charges were $141,624 (range, $52,020-$693,018) for NNP team infants and $139,388 (range, $50,178-$990,865) for resident team infants (P =.89). There were no significant differences between NNP team infants and resident team infants in NICU charges for laboratory, radiology, or pharmacy services. Neonatal nurse practitioners and pediatric residents provided comparable patient care to extremely low-birth-weight infants, with similar outcomes and similar charges.

  15. Preterm birth and low birth weight among in vitro fertilization twins: a systematic review and meta-analyses.

    PubMed

    McDonald, Sarah D; Han, Zhen; Mulla, Sohail; Ohlsson, Arne; Beyene, Joseph; Murphy, Kellie E

    2010-02-01

    The objective of this systematic review and meta-analyses was to determine the risks of preterm birth (PTB) and low birth weight (LBW) in twins conceived through in vitro fertilization (IVF) or IVF/intracytoplasmic sperm injection (ICSI) compared to spontaneously-conceived twins after matching or controlling for at least maternal age. The MOOSE guidelines for meta-analysis of observational studies were followed. Medline and Embase were searched using comprehensive search strategies. Bibliographies of identified articles were reviewed. English language studies of twins conceived by IVF or IVF/ICSI, compared with spontaneously twins, that matched or controlled for at least maternal age. Two reviewers independently assessed titles, abstracts, articles and study quality and extracted data. Statistical analyses were performed using the Review Manager (RevMan 5.0) software using a random effects model. Dichotomous data were meta-analyzed using relative risks (RR) and continuous data with a weighted mean difference. Twelve studies were included which had a total of 4385 twins conceived after IVF or IVF/ICSI (one stillbirth was excluded) and 11,793 spontaneously-conceived twins. After matching or controlling for maternal age and often other factors, compared to spontaneously-conceived twins, IVF twins had increased risks of both our primary outcomes: PTB (RR 1.23, 95% CI 1.09, 1.41) and LBW (<2500 g, RR 1.14, 95% CI 1.06, 1.22). They were at increased risk for PTB <32-33 weeks (RR 1.63, 95% CI 1.17, 2.27) although the risks of late PTB (32-36 weeks, RR 1.12, 95% CI 0.85, 1.47), very LBW (<1500 g, RR 1.28, 95% CI 0.73, 2.24), extremely LBW (<1000 g, RR 0.88, 0.04, 19.40), intrauterine growth restriction (RR 1.06, 95% CI 0.72, 1.55) and the difference in the duration of gestation (-0.5 weeks, 95% CI -1.2 weeks, 0.2 weeks) were not statistically significantly increased compared to spontaneously-conceived twins. IVF twins had significantly lower mean birth weights (-105 g, 95% CI -204 g, -3 g). IVF twins have small but significantly increased risks of PTB, LBW, and lower mean birth weight compared to spontaneously-conceived twins after matching or controlling for at least maternal age. 2009 Elsevier Ireland Ltd. All rights reserved.

  16. Modifying effects of low-intensity extremely high-frequency electromagnetic radiation on content and composition of fatty acids in thymus of mice exposed to X-rays.

    PubMed

    Gapeyev, Andrew B; Aripovsky, Alexander V; Kulagina, Tatiana P

    2015-03-01

    The effects of extremely high-frequency electromagnetic radiation (EHF EMR) on thymus weight and its fatty acids (FA) content and FA composition in X-irradiated mice were studied to test the involvement of FA in possible protective effects of EHF EMR against ionizing radiation. Mice were exposed to low-intensity pulse-modulated EHF EMR (42.2 GHz, 0.1 mW/cm(2), 20 min exposure, 1 Hz modulation) and/or X-rays at a dose of 4 Gy with different sequences of the treatments. In 4-5 hours, 10, 30, and 40 days after the last exposure, the thymuses were weighed; total FA content and FA composition of the thymuses were determined on days 1, 10, and 30 using a gas chromatography. It was shown that after X-irradiation of mice the total FA content per mg of thymic tissue was significantly increased in 4-5 h and decreased in 10 and 30 days after the treatment. On days 30 and 40 after X-irradiation, the thymus weight remained significantly reduced. The first and tenth days after X-rays injury independently of the presence and sequence of EHF EMR exposure were characterized by an increased content of polyunsaturated FA (PUFA) and a decreased content of monounsaturated FA (MUFA) with unchanged content of saturated FA (SFA). Exposure of mice to EHF EMR before or after X-irradiation prevented changes in the total FA content in thymic tissue, returned the summary content of PUFA and MUFA to the control level and decreased the summary content of SFA on the 30th day after the treatments, and promoted the restoration of the thymus weight of X-irradiated mice to the 40th day of the observations. Changes in the content and composition of PUFA in the early period after treatments as well as at the restoration of the thymus weight under the combined action of EHF EMR and X-rays indicate to an active participation of FA in the acceleration of post-radiation recovery of the thymus by EHF EMR exposure.

  17. I know why you voted for Trump: (Over)inferring motives based on choice.

    PubMed

    Barasz, Kate; Kim, Tami; Evangelidis, Ioannis

    2018-05-10

    People often speculate about why others make the choices they do. This paper investigates how such inferences are formed as a function of what is chosen. Specifically, when observers encounter someone else's choice (e.g., of political candidate), they use the chosen option's attribute values (e.g., a candidate's specific stance on a policy issue) to infer the importance of that attribute (e.g., the policy issue) to the decision-maker. Consequently, when a chosen option has an attribute whose value is extreme (e.g., an extreme policy stance), observers infer-sometimes incorrectly-that this attribute disproportionately motivated the decision-maker's choice. Seven studies demonstrate how observers use an attribute's value to infer its weight-the value-weight heuristic-and identify the role of perceived diagnosticity: more extreme attribute values give observers the subjective sense that they know more about a decision-maker's preferences, and in turn, increase the attribute's perceived importance. The paper explores how this heuristic can produce erroneous inferences and influence broader beliefs about decision-makers. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Multi-hazard Assessment and Scenario Toolbox (MhAST): A Framework for Analyzing Compounding Effects of Multiple Hazards

    NASA Astrophysics Data System (ADS)

    Sadegh, M.; Moftakhari, H.; AghaKouchak, A.

    2017-12-01

    Many natural hazards are driven by multiple forcing variables, and concurrence/consecutive extreme events significantly increases risk of infrastructure/system failure. It is a common practice to use univariate analysis based upon a perceived ruling driver to estimate design quantiles and/or return periods of extreme events. A multivariate analysis, however, permits modeling simultaneous occurrence of multiple forcing variables. In this presentation, we introduce the Multi-hazard Assessment and Scenario Toolbox (MhAST) that comprehensively analyzes marginal and joint probability distributions of natural hazards. MhAST also offers a wide range of scenarios of return period and design levels and their likelihoods. Contribution of this study is four-fold: 1. comprehensive analysis of marginal and joint probability of multiple drivers through 17 continuous distributions and 26 copulas, 2. multiple scenario analysis of concurrent extremes based upon the most likely joint occurrence, one ruling variable, and weighted random sampling of joint occurrences with similar exceedance probabilities, 3. weighted average scenario analysis based on a expected event, and 4. uncertainty analysis of the most likely joint occurrence scenario using a Bayesian framework.

  19. Dedicated Cone-Beam CT System for Extremity Imaging

    PubMed Central

    Al Muhit, Abdullah; Zbijewski, Wojciech; Thawait, Gaurav K.; Stayman, J. Webster; Packard, Nathan; Senn, Robert; Yang, Dong; Foos, David H.; Yorkston, John; Siewerdsen, Jeffrey H.

    2014-01-01

    Purpose To provide initial assessment of image quality and dose for a cone-beam computed tomographic (CT) scanner dedicated to extremity imaging. Materials and Methods A prototype cone-beam CT scanner has been developed for imaging the extremities, including the weight-bearing lower extremities. Initial technical assessment included evaluation of radiation dose measured as a function of kilovolt peak and tube output (in milliampere seconds), contrast resolution assessed in terms of the signal difference–to-noise ratio (SDNR), spatial resolution semiquantitatively assessed by using a line-pair module from a phantom, and qualitative evaluation of cadaver images for potential diagnostic value and image artifacts by an expert CT observer (musculoskeletal radiologist). Results The dose for a nominal scan protocol (80 kVp, 108 mAs) was 9 mGy (absolute dose measured at the center of a CT dose index phantom). SDNR was maximized with the 80-kVp scan technique, and contrast resolution was sufficient for visualization of muscle, fat, ligaments and/or tendons, cartilage joint space, and bone. Spatial resolution in the axial plane exceeded 15 line pairs per centimeter. Streaks associated with x-ray scatter (in thicker regions of the patient—eg, the knee), beam hardening (about cortical bone—eg, the femoral shaft), and cone-beam artifacts (at joint space surfaces oriented along the scanning plane—eg, the interphalangeal joints) presented a slight impediment to visualization. Cadaver images (elbow, hand, knee, and foot) demonstrated excellent visibility of bone detail and good soft-tissue visibility suitable to a broad spectrum of musculoskeletal indications. Conclusion A dedicated extremity cone-beam CT scanner capable of imaging upper and lower extremities (including weight-bearing examinations) provides sufficient image quality and favorable dose characteristics to warrant further evaluation for clinical use. © RSNA, 2013 Online supplemental material is available for this article. PMID:24475803

  20. Behavioral Outcomes of Extremely Low Birth Weight Children at Age 8 Years

    PubMed Central

    Hack, Maureen; Taylor, Hudson G.; Schluchter, Mark; Andreias, Laura; Drotar, Dennis; Klein, Nancy

    2011-01-01

    Objective To describe the prevalence of behavioral problems and symptomatology suggestive of Autism and Asperger’s disorders at age 8 years among extremely low birth weight (ELBW, <1 kg) children, born 1992 through 1995. Method Parent reports of the behavior of 219 ELBW (mean birth weight, 810 g; gestational age 26 weeks) were compared with 176 normal birth weight children of similar maternal sociodemographic status, sex, and age. Behavior was assessed via the Child Symptom Inventory that includes both Symptom Severity Scores and scores meeting DSM-IV criteria for disorders. Results ELBW compared with normal birth weight children had significantly higher mean Symptom Severity Scores for the inattentive, hyperactive, and combined types of attention-deficit hyperactivity disorder (all p < .001) as well as higher scores for Generalized Anxiety (p < .01) and Autistic (p < .001) and Asperger’s (p < .01) disorders. When DSM-IV criteria were considered, ELBW children also had significantly higher rates of attention-deficit hyperactivity disorder of the inattentive (10% vs 3%, p < .01) and combined (5% vs 0.6%, p < .05) types. Conclusions Attention-deficit hyperactivity disorder, mainly the inattentive type is prevalent among ELBW children. Our findings of an increase in symptoms pertaining to Autistic and Asperger’s disorders at school age agree with recent reports of others during early childhood. Early identification and intervention for these problems might improve child functioning and ameliorate parent and child distress. PMID:19322106

  1. Analysis of extreme rainfall events using attributes control charts in temporal rainfall processes

    NASA Astrophysics Data System (ADS)

    Villeta, María; Valencia, Jose Luis; Saá-Requejo, Antonio; María Tarquis, Ana

    2015-04-01

    The impacts of most intense rainfall events on agriculture and insurance industry can be very severe. This research focuses in the analysis of extreme rainfall events throughout the use of attributes control charts, which constitutes a usual tool in Statistical Process Control (SPC) but unusual in climate studios. Here, series of daily precipitations for the years 1931-2009 within a Spanish region are analyzed, based on a new type of attributes control chart that takes into account the autocorrelation between the extreme rainfall events. The aim is to conclude if there exist or not evidence of a change in the extreme rainfall model of the considered series. After adjusting seasonally the precipitation series and considering the data of the first 30 years, a frequency-based criterion allowed fixing specification limits in order to discriminate between extreme observed rainfall days and normal observed rainfall days. The autocorrelation amongst maximum precipitation is taken into account by a New Binomial Markov Extended Process obtained for each rainfall series. These modelling of the extreme rainfall processes provide a way to generate the attributes control charts for the annual fraction of rainfall extreme days. The extreme rainfall processes along the rest of the years under study can then be monitored by such attributes control charts. The results of the application of this methodology show evidence of change in the model of extreme rainfall events in some of the analyzed precipitation series. This suggests that the attributes control charts proposed for the analysis of the most intense precipitation events will be of practical interest to agriculture and insurance sectors in next future.

  2. Early Development of the Low SES Infant Weighing Less Than 1001 Grams at Birth.

    ERIC Educational Resources Information Center

    Finello, Karen M.; And Others

    To evaluate outcomes in infants of very low birth weight born in 1982-83 to families of extremely low socioeconomic status (SES), 33 infants who weighed less than 1001 grams at birth and survived the nursery period were followed for 1 year. The sample was 79 percent Hispanic and 58 percent female. Mean birth weight was 868 grams and mean…

  3. Nutrient intake, peripheral edema, and weight change in elderly recuperative care patients.

    PubMed

    Sullivan, Dennis H; Johnson, Larry E; Dennis, Richard A; Roberson, Paula K; Garner, Kimberly K; Padala, Prasad R; Padala, Kalpana P; Bopp, Melinda M

    2013-06-01

    It is unclear whether serial measures of body weight are valid indicators of nutritional status in older patients recovering from illness. Objectives. Investigate the relative influence of nutrient intake and changes in peripheral edema on weight change. A prospective cohort study of 404 older men (mean age = 78.7±7.5 years) admitted to a transitional care unit of a Department of Veterans Affairs nursing home. Body weight and several indicators of lower extremity edema were measured at both unit admission and discharge. Complete nutrient intake assessments were performed daily. Over a median length of stay of 23 days (interquartile range: 15-41 days), 216 (53%) participants gained or lost more than or equal to 2.5% of their body weight. Two hundred eighty-two (70%) participants had recognizable lower extremity pitting edema at admission and/or discharge. The amount of weight change was strongly and positively correlated with multiple indicators of both nutrient intake and the change in the amount of peripheral edema. By multivariable analysis, the strongest predictor of weight change was maximal calf circumference change (partial R (2) = .35, p < .0001), followed by average daily energy intake (partial R (2) = .14, p < .0001), and the interaction of energy intake by time (partial R (2) = .02, p < .0001). Many older patients either gain or lose a significant amount of weight after admission to a transitional care unit. Because of the apparent high prevalence of co-occurring changes in total body water, the weight changes do not necessarily represent changes in nutritional status. Although repeat calf circumference measurements may provide some indication as to how much of the weight change is due to changes in body water, there is currently no viable alternative to monitoring the nutrient intake of older recuperative care patients in order to ensure that their nutrient needs are being met.

  4. Project Ares 3

    NASA Technical Reports Server (NTRS)

    Raymer, Dan; Russell, Phyllis; Fox, Tim; Meyers, Doug; Lovric, Steven; Grabow, Robert; Epp, Manfred; Wynn, Warren, Jr.; Mako, Zoltan; Linzner, Gunther

    1992-01-01

    The mission of Project Ares is to design and fabricate an Earth prototype, autonomous flying rover capable of flying on the Martian surface. The project was awarded to California State University, Northridge (CSUN) in 1989 where an in-depth paper study was completed. The second year's group, Project Ares 2, designed and fabricated a full-scale flight demonstration aircraft. Project Ares 3, the third and final group, is responsible for propulsion system design and installation, controls and instrumentation, and high altitude testing. The propulsion system consists of a motor and its power supply, geartrain, and propeller. The motor is a four-brush DC motor powered by a 50-V NiCd battery supply. A pulley and belt arrangement is used for the geartrain and includes light weight, low temperature materials. The propeller is constructed from composite materials which ensures high strength and light weight, and is specifically developed to provide thrust at extremely high altitudes. The aircraft is controlled with a ground-based radio control system and an autopilot which will activate in the event that the control signal is lost. A transponder is used to maintain radar contact for ground tracking purposes. The aircraft possesses a small, onboard computer for collecting and storing flight data. To safeguard the possibility of computer failure, all flight data is transmitted to a ground station via a telemetry system. An initial, unpowered, low-level test flight was completed in August of 1991. Testing of systems integration in the second low-level test flight resulted in loss of elevator control which caused considerable damage on landing. Complete failure analysis and repairs are scheduled for September of 1992.

  5. Increased medial longitudinal arch mobility, lower extremity kinematics, and ground reaction forces in high-arched runners.

    PubMed

    Williams, D S Blaise; Tierney, Robin N; Butler, Robert J

    2014-01-01

    Runners with high medial longitudinal arch structure demonstrate unique kinematics and kinetics that may lead to running injuries. The mobility of the midfoot as measured by the change in arch height is also suspected to play a role in lower extremity function during running. The effect of arch mobility in high-arched runners is an important factor in prescribing footwear, training, and rehabilitating the running athlete after injury. To examine the effect of medial longitudinal arch mobility on running kinematics, ground reaction forces, and loading rates in high-arched runners. Cross-sectional study. Human movement research laboratory. A total of 104 runners were screened for arch height. Runners were then identified as having high arches if the arch height index was greater than 0.5 SD above the mean. Of the runners with high arches, 11 rigid runners with the lowest arch mobility (R) were compared with 8 mobile runners with the highest arch mobility (M). Arch mobility was determined by calculating the left arch height index in all runners. Three-dimensional motion analysis of running over ground. Rearfoot and tibial angular excursions, eversion-to-tibial internal-rotation ratio, vertical ground reaction forces, and the associated loading rates. Runners with mobile arches exhibited decreased tibial internal-rotation excursion (mobile: 5.6° ± 2.3° versus rigid: 8.0° ± 3.0°), greater eversion-to-tibial internal-rotation ratio (mobile: 2.1 ± 0.8 versus rigid: 1.5 ± 0.5), decreased second peak vertical ground reaction force values (mobile: 2.3 ± 0.2 × body weight versus rigid: 2.4 ± 0.1 × body weight), and decreased vertical loading rate values (mobile: 55.7 ± 14.1 × body weight/s versus rigid: 65.9 ± 11.4 × body weight/s). Based on the results of this study, it appears that runners with high arch structure but differing arch mobility exhibited differences in select lower extremity movement patterns and forces. Future authors should investigate the impact of arch mobility on running-related injuries.

  6. Design and evaluation of a quasi-passive knee exoskeleton for investigation of motor adaptation in lower extremity joints.

    PubMed

    Shamaei, Kamran; Cenciarini, Massimo; Adams, Albert A; Gregorczyk, Karen N; Schiffman, Jeffrey M; Dollar, Aaron M

    2014-06-01

    In this study, we describe the mechanical design and control scheme of a quasi-passive knee exoskeleton intended to investigate the biomechanical behavior of the knee joint during interaction with externally applied impedances. As the human knee behaves much like a linear spring during the stance phase of normal walking gait, the exoskeleton implements a spring across the knee in the weight acceptance (WA) phase of the gait while allowing free motion throughout the rest of the gait cycle, accomplished via an electromechanical clutch. The stiffness of the device is able to be varied by swapping springs, and the timing of engagement/disengagement changed to accommodate different loading profiles. After describing the design and control, we validate the mechanical performance and reliability of the exoskeleton through cyclic testing on a mechanical knee simulator. We then describe a preliminary experiment on three healthy adults to evaluate the functionality of the device on both left and right legs. The kinetic and kinematic analyses of these subjects show that the exoskeleton assistance can partially/fully replace the function of the knee joint and obtain nearly invariant moment and angle profiles for the hip and ankle joints, and the overall knee joint and exoskeleton complex under the applied moments of the exoskeleton versus the control condition, implying that the subjects undergo a considerable amount of motor adaptation in their lower extremities to the exoskeletal impedances, and encouraging more in-depth future experiments with the device.

  7. Consumer acceptance of vegetarian sweet potato products intended for space missions.

    PubMed

    Wilson, C D; Pace, R D; Bromfield, E; Jones, G; Lu, J Y

    1998-01-01

    Sweet potato is one of the crops selected for NASA's Advanced Life Support Program for potential long-duration lunar/Mars missions. This article presents recipes of products made from sweet potato and determines the consumer acceptability of products containing from 6% to 20% sweet potato on a dry weight basis. These products were developed for use in nutritious and palatable meals for future space explorers. Sensory evaluation (appearance/color, aroma, texture, flavor/taste, and overall acceptability) studies were conducted to determine the consumer acceptability of vegetarian products made with sweet potato using panelists at NASA/Johnson Space Center in Houston, TX. None of these products including the controls, contained any ingredient of animal origin with the exception of sweet potato pie. A 9-point hedonic scale (9 being like extremely and 1 being dislike extremely) was used to evaluate 10 products and compare them to similar commercially available products used as controls. The products tested were pancakes, waffles, tortillas, bread, pie, pound cake, pasta, vegetable patties, doughnuts, and pretzels. All of the products were either liked moderately or liked slightly with the exception of the sweet potato vegetable patties, which were neither liked nor disliked. Mean comparisons of sensory scores of sweet potato recipes and their controls were accomplished by using the Student t-test. Because of their nutritional adequacy and consumer acceptability, these products are being recommended to NASA's Advanced Life Support Program for inclusion in a vegetarian menu plan designed for lunar/Mars space missions.

  8. Patient Compliance with Postoperative Lower-Extremity Non-Weight-Bearing Restrictions.

    PubMed

    Chiodo, Christopher P; Macaulay, Alec A; Palms, David A; Smith, Jeremy T; Bluman, Eric M

    2016-09-21

    A period of non-weight-bearing is prescribed following many orthopaedic injuries and procedures. It is believed that a period of non-weight-bearing is important for proper healing and recovery. The degree to which patients are compliant with non-weight-bearing instructions is unknown. The purpose of this study was to measure patient compliance with a period of prescribed non-weight-bearing. In this single-blinded study, pressure-sensitive film was embedded into short leg casts of 51 consecutive adult orthopaedic patients with unilateral lower-extremity abnormality who had been instructed to be strictly non-weight-bearing. Sensors were retrieved at the time of cast removal (mean, 24.3 days [range, 7 to 48 days]) and then were analyzed for force distribution and magnitude. Noncompliance was defined as maximum detectable pressure exerted on ≥50% of the film. Patient characteristics and the time of year that the casts were worn were also examined to determine if they correlated with weight-bearing. Fourteen (27.5%) of 51 patients were noncompliant with the non-weight-bearing restriction. Six (42.9%) of the 14 noncompliant patients compared with 11 (29.7%) of the 37 compliant patients experienced an adverse event (p = 0.51). Sex, age, language spoken, body mass index, time in the cast, and the treating surgeon did not have a significant influence on weight-bearing performance (p > 0.05). Significantly greater weight-bearing was found (p = 0.04) in warmer months (June to October) than in colder months (November to March) in the United States. The noncompliance rate with the postoperative non-weight-bearing restriction was 27.5% (95% confidence interval, 15.2% to 39.8%) in this patient group, despite explicit instructions and education about possible complications associated with weight-bearing. The only factor found to have a significant effect on weight-bearing compliance was the time of year that the cast was worn. No significant difference was found between the complication rate of the compliant patients and that of the noncompliant patients. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

  9. Network community-detection enhancement by proper weighting

    NASA Astrophysics Data System (ADS)

    Khadivi, Alireza; Ajdari Rad, Ali; Hasler, Martin

    2011-04-01

    In this paper, we show how proper assignment of weights to the edges of a complex network can enhance the detection of communities and how it can circumvent the resolution limit and the extreme degeneracy problems associated with modularity. Our general weighting scheme takes advantage of graph theoretic measures and it introduces two heuristics for tuning its parameters. We use this weighting as a preprocessing step for the greedy modularity optimization algorithm of Newman to improve its performance. The result of the experiments of our approach on computer-generated and real-world data networks confirm that the proposed approach not only mitigates the problems of modularity but also improves the modularity optimization.

  10. Neighboring extremal optimal control design including model mismatch errors

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kim, T.J.; Hull, D.G.

    1994-11-01

    The mismatch control technique that is used to simplify model equations of motion in order to determine analytic optimal control laws is extended using neighboring extremal theory. The first variation optimal control equations are linearized about the extremal path to account for perturbations in the initial state and the final constraint manifold. A numerical example demonstrates that the tuning procedure inherent in the mismatch control method increases the performance of the controls to the level of a numerically-determined piecewise-linear controller.

  11. Increased ambient air temperature alters the severity of soil water repellency

    NASA Astrophysics Data System (ADS)

    van Keulen, Geertje; Sinclair, Kat; Hallin, Ingrid; Doerr, Stefan; Urbanek, Emilia; Quinn, Gerry; Matthews, Peter; Dudley, Ed; Francis, Lewis; Gazze, S. Andrea; Whalley, Richard

    2017-04-01

    Soil repellency, the inability of soils to wet readily, has detrimental environmental impacts such as increased runoff, erosion and flooding, reduced biomass production, inefficient use of irrigation water and preferential leaching of pollutants. Its impacts may exacerbate (summer) flood risks associated with more extreme drought and precipitation events. In this study we have tested the hypothesis that transitions between hydrophobic and hydrophilic soil particle surface characteristics, in conjunction with soil structural properties, strongly influence the hydrological behaviour of UK soils under current and predicted UK climatic conditions. We have addressed the hypothesis by applying different ambient air temperatures under controlled conditions to simulate the effect of predicted UK climatic conditions on the wettability of soils prone to develop repellency at different severities. Three UK silt-loam soils under permanent vegetation were selected for controlled soil perturbation studies. The soils were chosen based on the severity of hydrophobicity that can be achieved in the field: severe to extreme (Cefn Bryn, Gower, Wales), intermediate to severe (National Botanical Garden, Wales), and subcritical (Park Grass, Rothamsted Research near London). The latter is already highly characterised so was also used as a control. Soils were fully saturated with water and then allowed to dry out gradually upon exposure to controlled laboratory conditions. Soils were allowed to adapt for a few hours to a new temperature prior to initiation of the controlled experiments. Soil wettability was determined at highly regular intervals by measuring water droplet penetration times. Samples were collected at four time points: fully wettable, just prior to and after the critical soil moisture concentrations (CSC), and upon reaching air dryness (to constant weight), for further (ultra)metaproteomic and nanomechanical studies to allow integration of bulk soil characterisations with functional expression and nanoscale studies to generate deep mechanistic understanding of the roles of microbes in soil ecosystems. Our controlled soil pertubation studies have shown that an increase in ambient temperature has consistently affected the severity of soil water repellency. Surprisingly, a higher ambient air temperature impacts soils that in the field develop subcritical and extreme repellency, differently under controlled laboratory conditions. We will discuss the impact of these results in relation to predicted UK climatic conditions. Soil metaproteomics will provide mechanistic insight at the molecular level whether differential microbial adaptation is correlated with the apparent different response to a higher ambient air temperature.

  12. Injuries in karate: systematic review.

    PubMed

    Thomas, Roger E; Ornstein, Jodie

    2018-05-22

    to identify all studies of Karate injuries and assess injury rates, types, location, and causes. Six electronic and four grey literature databases were searched. Two reviewers independently assessed titles/abstracts, abstracted data and assessed risk-of-bias with the Newcastle-Ottawa scale. Average injury rates/1000AE (AE = athletic-encounter) and/1000minutesAE, injury location and type weighted by study size were calculated. In competitions rates of injury/1000AE and/1000 minutesAE were similar for males (111.4/1000AE, 75.4/1000 minAE) and females (105.8/1000AE, 72.8/1000 minAE). Location of injury rates/1000AE for males were 44.0 for head/neck, 11.9 lower extremities, 8.1 torso and 5.4 upper extremities and were similar for females: 41.2 head/neck, 12.4 lower extremities, 9.1 torso and 6.3 upper extremities. Injury rates varied widely by study. Rates/1000AE for type of injury were contusions/abrasions/lacerations/bruises/tooth avulsion for males (68.1) and females (30.4); hematomas/bleeding/epistaxis males (11.4) and females (12.1); strains/sprains males (3.5) and females (0.1); dislocations males (2.9) and females (0.9); concussions males (2.5) and females (3.9); and fractures males (2.9) and females (1.4). Punches were a more common mechanism of injury for males (59.8) than females (40.8) and kicks similar (males 19.7, females 21.7). Weighted averages were not calculated for weight class or belt colour because there were too few studies. Nineteen injury surveys reported annual injury rates from 30% to rates ten times higher but used different reporting methods. Studies provided no data to explain wide rate ranges. Studies need to adopt one injury definition, one data-collection form, and collect comprehensive data for each study for both training and competitions. More data are needed to measure the effect of weight, age and experience on injuries, rates and types of injury during training, and for competitors with high injury rates. RCTs are needed of interventions such as training and feedback of performance data to reduce injury rates.

  13. Potassium Loss during Galvanotaxis of Slime Mold

    PubMed Central

    Anderson, John D.

    1962-01-01

    The posterior reticulated regions of the plasmodia of the slime mold, Physarum polycephalum, whose migration has been oriented by direct current (3.0 to 5.0 µa/mm2 in the agar substrate), contain 30 per cent less potassium than the advancing non-reticulated region. The anterior regions have the same potassium concentration as that of the controls, approximately 32 meq/kg wet weight. Differences in potassium concentration between anterior and posterior regions of control plasmodia, not oriented by electric current, are less than 5 per cent. Sodium, in contrast to potassium, is generally less concentrated in the anterior than in the posterior regions of electrically oriented plasmodia, but sodium concentrations are extremely variable. No significant difference in protein concentration was found between oriented and control plasmodia. Thirty-five per cent of the total potassium, but none of the sodium, is found in acidified ethanol precipitates from plasmodial homogenates. Potassium, but not sodium, appears to be closely associated with processes which differentiate anterior from posterior in an oriented plasmodium. PMID:13861244

  14. Plasma Ceramides, Mediterranean Diet, and Incident Cardiovascular Disease in the PREDIMED Trial (Prevención con Dieta Mediterránea).

    PubMed

    Wang, Dong D; Toledo, Estefanía; Hruby, Adela; Rosner, Bernard A; Willett, Walter C; Sun, Qi; Razquin, Cristina; Zheng, Yan; Ruiz-Canela, Miguel; Guasch-Ferré, Marta; Corella, Dolores; Gómez-Gracia, Enrique; Fiol, Miquel; Estruch, Ramón; Ros, Emilio; Lapetra, José; Fito, Montserrat; Aros, Fernando; Serra-Majem, Luis; Lee, Chih-Hao; Clish, Clary B; Liang, Liming; Salas-Salvadó, Jordi; Martínez-González, Miguel A; Hu, Frank B

    2017-05-23

    Although in vitro studies and investigations in animal models and small clinical populations have suggested that ceramides may represent an intermediate link between overnutrition and certain pathological mechanisms underlying cardiovascular disease (CVD), no prospective studies have investigated the association between plasma ceramides and risk of CVD. The study population consisted of 980 participants from the PREDIMED trial (Prevención con Dieta Mediterránea), including 230 incident cases of CVD and 787 randomly selected participants at baseline (including 37 overlapping cases) followed for ≤7.4 years. Participants were randomized to a Mediterranean diet supplemented with extra virgin olive oil, a Mediterranean diet supplemented with nuts, or a control diet. Plasma ceramide concentrations were measured on a liquid chromatography tandem mass spectrometry metabolomics platform. The primary outcome was a composite of nonfatal acute myocardial infarction, nonfatal stroke, or cardiovascular death. Hazard ratios were estimated with weighted Cox regression models using Barlow weights to account for the case-cohort design. The multivariable hazard ratios (HR) and 95% confidence intervals (CIs) comparing the extreme quartiles of plasma concentrations of C16:0, C22:0, C24:0, and C24:1 ceramides were 2.39 (1.49-3.83, P trend <0.001), 1.91 (1.21-3.01, P trend =0.003), 1.97 (1.21-3.20, P trend =0.004), and 1.73 (1.09-2.74, P trend =0.011), respectively. The ceramide score, calculated as a weighted sum of concentrations of four ceramides, was associated with a 2.18-fold higher risk of CVD across extreme quartiles (HR, 2.18; 95% CI, 1.36-3.49; P trend <0.001). The association between baseline ceramide score and incident CVD varied significantly by treatment groups ( P interaction =0.010). Participants with a higher ceramide score and assigned to either of the 2 active intervention arms of the trial showed similar CVD risk to those with a lower ceramide score, whereas participants with a higher ceramide score and assigned to the control arm presented significantly higher CVD risk. Changes in ceramide concentration were not significantly different between Mediterranean diet and control groups during the first year of follow-up. Our study documented a novel positive association between baseline plasma ceramide concentrations and incident CVD. In addition, a Mediterranean dietary intervention may mitigate potential deleterious effects of elevated plasma ceramide concentrations on CVD. URL: http://www.isrctn.com. Unique identifier: ISRCTN35739639. © 2017 American Heart Association, Inc.

  15. Elite Female Basketball Players' Body-Weight Neuromuscular Training and Performance on the Y-Balance Test

    PubMed Central

    Benis, Roberto; Bonato, Matteo; Torre, Antonio La

    2016-01-01

    Context: Neuromuscular training enhances unconscious motor responses by stimulating both the afferent signals and central mechanisms responsible for dynamic joint control. Dynamic joint-control training is a vital component of injury-prevention programs. Objective: To investigate the effects of body-weight neuromuscular training on Y-Balance Test (YBT) performance and postural control in female basketball players. Design: Randomized controlled clinical trial. Setting: Basketball practice sessions. Patients or Other Participants: A total of 28 healthy elite female basketball players were randomly assigned to an experimental (n = 14) or a control group (n = 14). Intervention(s): Before their regular practice sessions, the experimental group warmed up with body-weight neuromuscular exercises and the control group with standard tactical-technical exercises twice weekly for 8 weeks. Main Outcome Measure(s): Anterior-, posteromedial-, and posterolateral-reach and composite YBT scores were measured before and after 8 weeks of training. Results: Improvement over baseline scores was noted in the posteromedial (right = 86.5 ± 4.5 cm versus 89.6 ± 2.2 cm, +3.5%, P = .049; left = 85.5 ± 4.3 cm versus 90.2 ± 2.7 cm, +5.5%, P = .038)- and posterolateral (right = 90.7 ± 3.6 cm versus 94.0 ± 2.7 cm, +3.6%, P = .016; left = 90.9 ± 3.5 cm versus 94.2 ± 2.6 cm, +3.6%, P = .011)-reach directions and in the composite YBT scores (right = 88.6% ± 3.2% versus 94.0% ± 1.8%, +5.4%, P = .0004; left = 89.2% ± 3.2% versus 94.5% ± 3.0%, +5.8%, P = .001) of the experimental group. No differences in anterior reach were detected in either group. Differences were noted in postintervention scores for posteromedial reach (right = 89.6 ± 2.2 cm versus 84.3 ± 4.4 cm, +4.1%, P = .005; left = 94.2 ± 2.6 cm versus 84.8 ± 4.4 cm, +10%, P = .003) and composite scores (right = 94.0% ± 1.8% versus 87.3% ± 2.0%, +7.1%, P = .003; left = 94.8% ± 3.0% versus 87.9% ± 3.4%, +7.3%, P < .0001) between the experimental and control groups. Conclusions: Body-weight neuromuscular training improved postural control and lower limb stability in female basketball players as assessed with the YBT. Incorporating neuromuscular training into the workout routines for basketball players may enhance joint awareness and reduce the risk of lower extremity injury. PMID:27824252

  16. Elite Female Basketball Players' Body-Weight Neuromuscular Training and Performance on the Y-Balance Test.

    PubMed

    Benis, Roberto; Bonato, Matteo; La Torre, Antonio La

    2016-09-01

    Neuromuscular training enhances unconscious motor responses by stimulating both the afferent signals and central mechanisms responsible for dynamic joint control. Dynamic joint-control training is a vital component of injury-prevention programs. To investigate the effects of body-weight neuromuscular training on Y-Balance Test (YBT) performance and postural control in female basketball players. Randomized controlled clinical trial. Basketball practice sessions. A total of 28 healthy elite female basketball players were randomly assigned to an experimental (n = 14) or a control group (n = 14). Before their regular practice sessions, the experimental group warmed up with body-weight neuromuscular exercises and the control group with standard tactical-technical exercises twice weekly for 8 weeks. Anterior-, posteromedial-, and posterolateral-reach and composite YBT scores were measured before and after 8 weeks of training. Improvement over baseline scores was noted in the posteromedial (right = 86.5 ± 4.5 cm versus 89.6 ± 2.2 cm, +3.5%, P = .049; left = 85.5 ± 4.3 cm versus 90.2 ± 2.7 cm, +5.5%, P = .038)- and posterolateral (right = 90.7 ± 3.6 cm versus 94.0 ± 2.7 cm, +3.6%, P = .016; left = 90.9 ± 3.5 cm versus 94.2 ± 2.6 cm, +3.6%, P = .011)-reach directions and in the composite YBT scores (right = 88.6% ± 3.2% versus 94.0% ± 1.8%, +5.4%, P = .0004; left = 89.2% ± 3.2% versus 94.5% ± 3.0%, +5.8%, P = .001) of the experimental group. No differences in anterior reach were detected in either group. Differences were noted in postintervention scores for posteromedial reach (right = 89.6 ± 2.2 cm versus 84.3 ± 4.4 cm, +4.1%, P = .005; left = 94.2 ± 2.6 cm versus 84.8 ± 4.4 cm, +10%, P = .003) and composite scores (right = 94.0% ± 1.8% versus 87.3% ± 2.0%, +7.1%, P = .003; left = 94.8% ± 3.0% versus 87.9% ± 3.4%, +7.3%, P < .0001) between the experimental and control groups. Body-weight neuromuscular training improved postural control and lower limb stability in female basketball players as assessed with the YBT. Incorporating neuromuscular training into the workout routines for basketball players may enhance joint awareness and reduce the risk of lower extremity injury.

  17. Passive control of temperature excursion and uniformity in high-energy Li-ion battery packs at high current and ambient temperature

    NASA Astrophysics Data System (ADS)

    Kizilel, R.; Lateef, A.; Sabbah, R.; Farid, M. M.; Selman, J. R.; Al-Hallaj, S.

    A strategy for portable high-power applications with a controlled thermal environment has been developed and has demonstrated the advantage of using the novel phase change material (PCM) thermal management systems over conventional active cooling systems. A passive thermal management system using PCM for Li-ion batteries is tested for extreme conditions, such as ambient temperature of 45 °C and discharge rate of 2.08 C-rate (10 A). Contrary to Li-ion packs without thermal management system, high-energy packs with PCM are discharged safely at high currents and degrading rate of capacity of the Li-ion packs lowered by half. Moreover, the compactness of the packs not only decreases the volume occupied by the packs and its associated complex cooling system, but also decreases the total weight for large power application.

  18. The establishment and application of direct coupled electrostatic-structural field model in electrostatically controlled deployable membrane antenna

    NASA Astrophysics Data System (ADS)

    Gu, Yongzhen; Duan, Baoyan; Du, Jingli

    2018-05-01

    The electrostatically controlled deployable membrane antenna (ECDMA) is a promising space structure due to its low weight, large aperture and high precision characteristics. However, it is an extreme challenge to describe the coupled field between electrostatic and membrane structure accurately. A direct coupled method is applied to solve the coupled problem in this paper. Firstly, the membrane structure and electrostatic field are uniformly described by energy, considering the coupled problem is an energy conservation phenomenon. Then the direct coupled electrostatic-structural field governing equilibrium equations are obtained by energy variation approach. Numerical results show that the direct coupled method improves the computing efficiency by 36% compared with the traditional indirect coupled method with the same level accuracy. Finally, the prototype has been manufactured and tested and the ECDMA finite element simulations show good agreement with the experiment results as the maximum surface error difference is 6%.

  19. WE-G-217BCD-04: Diagnostic Image Quality Evaluation of a Dedicated Extremity Cone- Beam CT Scanner: Pre-Clinical Studies and First Clinical Results.

    PubMed

    Muhit, A; Zbijewski, W; Stayman, J; Thawait, G; Yorkston, J; Foos, D; Packard, N; Yang, D; Senn, R; Carrino, J; Siewerdsen, J

    2012-06-01

    To assess the diagnostic performance of a prototype cone-beam CT (CBCT) scanner developed for musculoskeletal extremity imaging. Studies involved controlled observer studies conducted subsequent to rigorous technical assessment as well as patient images from the first clinical trial in imaging the hand and knee. Performance assessment included: 1.) rigorous technical assessment; 2.) controlled observer studies using CBCT images of cadaveric specimens; and 3.) first clinical images. Technical assessment included measurement of spatial resolution (MTF), constrast, and noise (SDNR) versus kVp and dose using standard CT phantoms. Diagnostic performance in comparison to multi- detector CT (MDCT) was assessed in controlled observer studies involving 12 cadaveric hands and knees scanned with and without abnormality (fracture). Observer studies involved five radiologists rating pertinent diagnostics tasks in 9-point preference and 10-point diagnostic satisfaction scales. Finally, the first clinical images from an ongoing pilot study were assessed in terms of diagnostic utility in disease assessment and overall workflow in patient setup. Quantitative assessment demonstrated sub-mm spatial resolution (MTF exceeding 10% out to 15-20 cm-1) and SDNR sufficient for relevant soft-tissue visualization tasks at dose <10 mGy. Observer studies confirmed optimal acquisition techniques and demonstrated superior utility of combined soft-tissue visualization and isotropic spatial resolution in diagnostic tasks. Images from the patient trial demonstrate exquisite contrast and detail and the ability to detect tissue impingement in weight-bearing exams. The prototype CBCT scanner provides isotropic spatial resolution superior to standard-protocol MDCT with soft-tissue visibility sufficient for a broad range of diagnostic tasks in musculoskeletal radiology. Dosimetry and workflow were advantageous in comparison to whole-body MDCT. Multi-mode and weight-bearing capabilities add valuable functionality. An ongoing clinical study further assesses diagnostic utility and defines the role of such technology in the diagnostic arsenal. - Research Grant, Carestream Health - Research Grant, National Institutes of Health 2R01-CA-112163. © 2012 American Association of Physicists in Medicine.

  20. Drilling and Production Activity Related to Unconventional Gas Development and Severity of Preterm Birth.

    PubMed

    Walker Whitworth, Kristina; Kaye Marshall, Amanda; Symanski, Elaine

    2018-03-20

    Studies of unconventional gas development (UGD) and preterm birth (PTB) have not presented risk estimates by well development phase or trimester. We examined phase and trimester-specific associations between UGD activity and PTB. We conducted a case-control study of women with singleton births in the Barnett Shale area, Texas, from 30 November 2010 to 29 November 2012. We individually age- and race/ethnicity-matched five controls to each PTB case ( n =13,328) and truncated controls' time at risk according to the matched case's gestational age. We created phase-specific UGD-activity metrics: a ) inverse squared distance-weighted (IDW) count of wells in the drilling phase ≤0.5 mi (804.7 meters) of the residence and b ) IDW sum of natural gas produced ≤0.5 mi of the residence. We also constructed trimester- and gestation-specific metrics. Metrics were categorized as follows: zero wells (reference), first, second, third tertiles of UGD activity. Analyses were repeated by PTB severity: extreme, very, and moderate (<28, 28 to<32, and 32 to<37 completed weeks). Data were analyzed using conditional logistic regression. We found increased odds of PTB in the third tertile of the UGD drilling {odds ratio (OR)=1.20 [95% confidence interval (CI): 1.06, 1.37]} and UGD-production [OR=1.15 (1.05, 1.26)] metrics. Among women in the third tertile of UGD-production, associations were strongest in trimesters one [OR=1.18 (1.02, 1.37)] and two [OR=1.14 (0.99, 1.31). The greatest risk was observed for extremely PTB [third tertile ORs: UGD drilling, 2.00 (1.23, 3.24); UGD production, 1.53 (1.03-2.27)]. We found evidence of differences in phase- and trimester-specific associations of UGD and PTB and indication of particular risk associated with extremely preterm birth. Future studies should focus on quantifying specific chemical and nonchemical stressors associated with UGD. https://doi.org/10.1289/EHP2622.

  1. The Effect of Shoulder Plyometric Training on Amortization Time and Upper-Extremity Kinematics.

    PubMed

    Swanik, Kathleen A; Thomas, Stephen J; Struminger, Aaron H; Bliven, Kellie C Huxel; Kelly, John D; Swanik, Charles B

    2016-12-01

    Plyometric training is credited with providing benefits in performance and dynamic restraint. However, limited prospective data exist quantifying kinematic adaptations such as amortization time, glenohumeral rotation, and scapulothoracic position, which may underlie the efficacy of plyometric training for upper-extremity rehabilitation or performance enhancement. To measure upper-extremity kinematics and plyometric phase times before and after an 8-wk upper-extremity strength- and plyometric-training program. Randomized pretest-posttest design. Research laboratory. 40 recreationally active men (plyometric group, age 20.43 ± 1.40 y, height 180.00 ± 8.80 cm, weight 73.07 ± 7.21 kg; strength group, age 21.95 ± 3.40 y, height 173.98 ± 11.91 cm, weight 74.79 ± 13.55 kg). Participants were randomly assigned to either a strength-training group or a strength- and plyometric-training group. Each participant performed the assigned training for 8 wk. Dynamic and static glenohumeral and scapular-rotation measurements were taken before and after the training programs. Dynamic measurement of scapular rotation and time spent in each plyometric phase (concentric, eccentric, and amortization) during a ball-toss exercise were recorded while the subjects were fitted with an electromagnetic tracking system. Static measures included scapular upward rotation at 3 different glenohumeral-abduction angles, glenohumeral internal rotation, and glenohumeral external rotation. Posttesting showed that both groups significantly decreased the time spent in the amortization, concentric, and eccentric phases of a ball-toss exercise (P < .01). Both groups also exhibited significantly decreased static external rotation and increased dynamic scapular upward rotation after the training period (P < .01). The only difference between the training protocols was that the plyometric-training group exhibited an increase in internal rotation that was not present in the strength-training group (P < .01). These findings support the use of both upper-extremity plyometrics and strength training for reducing commonly identified upper-extremity-injury risk factors and improving upper-extremity performance.

  2. Spatial Interpolation of Historical Seasonal Rainfall Indices over Peninsular Malaysia

    NASA Astrophysics Data System (ADS)

    Hassan, Zulkarnain; Haidir, Ahmad; Saad, Farah Naemah Mohd; Ayob, Afizah; Rahim, Mustaqqim Abdul; Ghazaly, Zuhayr Md.

    2018-03-01

    The inconsistency in inter-seasonal rainfall due to climate change will cause a different pattern in the rainfall characteristics and distribution. Peninsular Malaysia is not an exception for this inconsistency, in which it is resulting extreme events such as flood and water scarcity. This study evaluates the seasonal patterns in rainfall indices such as total amount of rainfall, the frequency of wet days, rainfall intensity, extreme frequency, and extreme intensity in Peninsular Malaysia. 40 years (1975-2015) data records have been interpolated using Inverse Distance Weighted method. The results show that the formation of rainfall characteristics are significance during the Northeast monsoon (NEM), as compared to Southwest monsoon (SWM). Also, there is a high rainfall intensity and frequency related to extreme over eastern coasts of Peninsula during the NEM season.

  3. Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength.

    PubMed

    Sinaki, Mehrsheed; Brey, Robert H; Hughes, Christine A; Larson, Dirk R; Kaufman, Kenton R

    2005-08-01

    This controlled trial was designed to investigate the influence of osteoporosis-related kyphosis (O-K) on falls. Twelve community-dwelling women with O-K (Cobb angle, 50-65 degrees measured from spine radiographs) and 13 healthy women serving as controls were enrolled. Mean age of the O-K group was 76 years (+/-5.1), height 158 cm (+/-5), and weight 61 kg (+/-7.9), and mean age of the control group was 71 years (+/-4.6), height 161 cm (+/-3.8), and weight 66 kg (+/-11.7). Quantitative isometric strength data were collected. Gait was monitored during unobstructed level walking and during stepping over an obstacle of four different heights randomly assigned (2.5%, 5%, 10%, and 15% of the subject's height). Balance was objectively assessed with computerized dynamic posturography consisting of the sensory organization test. Back extensor strength, grip strength, and all lower extremity muscle groups were significantly weaker in the O-K group than the control group (P <0.05), except right ankle plantar flexors (P =0.09). There was a significant difference in the anteroposterior and mediolateral displacements and velocities. The O-K subjects had less anteroposterior displacement, greater mediolateral displacement, reduced anteroposterior velocity, and increased mediolateral velocity compared with controls for all conditions of unobstructed and obstructed level walking. Obstacle height had a significant effect on all center-of-mass variables. The O-K subjects had significantly greater balance abnormalities on computerized dynamic posturography than the control group (P =0.002). Data show that thoracic hyperkyphosis on a background of reduced muscle strength plays an important role in increasing body sway, gait unsteadiness, and risk of falls in osteoporosis.

  4. Upper extremity transplantation: current concepts and challenges in an emerging field.

    PubMed

    Elliott, River M; Tintle, Scott M; Levin, L Scott

    2014-03-01

    Loss of an isolated upper limb is an emotionally and physically devastating event that results in significant impairment. Patients who lose both upper extremities experience profound disability that affects nearly every aspect of their lives. While prosthetics and surgery can eventually provide the single limb amputee with a suitable assisting hand, limited utility, minimal haptic feedback, weight, and discomfort are persistent problems with these techniques that contribute to high rates of prosthetic rejection. Moreover, despite ongoing advances in prosthetic technology, bilateral amputees continue to experience high levels of dependency, disability, and distress. Hand and upper extremity transplantation holds several advantages over prosthetic rehabilitation. The missing limb is replaced with one of similar skin color and size. Sensibility, voluntary motor control, and proprioception are restored to a greater degree, and afford better dexterity and function than prosthetics. The main shortcomings of transplantation include the hazards of immunosuppression, the complications of rejection and its treatment, and high cost. Hand and upper limb transplantation represents the most commonly performed surgery in the growing field of Vascularized Composite Allotransplantation (VCA). As upper limb transplantation and VCA have become more widespread, several important challenges and controversies have emerged. These include: refining indications for transplantation, optimizing immunosuppression, establishing reliable criteria for monitoring, diagnosing, and treating rejection, and standardizing outcome measures. This article will summarize the historical background of hand transplantation and review the current literature and concepts surrounding it.

  5. A low arm and leg muscle mass to total body weight ratio is associated with an increased prevalence of metabolic syndrome: The Korea National Health and Nutrition Examination Survey 2010-2011.

    PubMed

    Kim, Yong Hwan; So, Wi-Young

    2016-09-14

    The aim of this study was to investigate the association between metabolic syndrome (MetS) and arm and leg muscle mass to total weight ratios in Korean adults. This was a randomized, controlled, cross-sectional study. Data from 2,383 adults (1,030 men and 1,353 women) were collected from the Korea National Health and Nutrition Examination Survey 2010-2011. Blood lipid profiles, blood pressure, and anthropometric characteristics, including weight, height, waist circumference, and muscle mass on dual energy X-ray absorptiometry (DXA), were evaluated in the participants. MetS was defined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III. The average mass of both arms and legs was determined using regional muscle analysis by DXA. Afterwards, the arm and leg muscle mass to total body weight ratio was determined and classified into 4 quartiles (i.e., quartile 1 [highest muscle ratio] to quartile 4 [lowest muscle ratio]). According to the arm muscle and leg muscle ratios, there was a higher prevalence of MetS in quartile 4 than in quartile 1 in both men and women. A low arm and leg muscle mass to body weight ratio was associated with a higher prevalence of MetS after adjusting for age, physical activity, frequency of smoking, and frequency of alcohol consumption. In conclusion, MetS patients demonstrated a lower arm and leg muscle mass to body weight ratio. Strength training for the lower and upper extremities is recommended because it can have a positive effect on MetS prevention.

  6. Application of multivariable search techniques to structural design optimization

    NASA Technical Reports Server (NTRS)

    Jones, R. T.; Hague, D. S.

    1972-01-01

    Multivariable optimization techniques are applied to a particular class of minimum weight structural design problems: the design of an axially loaded, pressurized, stiffened cylinder. Minimum weight designs are obtained by a variety of search algorithms: first- and second-order, elemental perturbation, and randomized techniques. An exterior penalty function approach to constrained minimization is employed. Some comparisons are made with solutions obtained by an interior penalty function procedure. In general, it would appear that an interior penalty function approach may not be as well suited to the class of design problems considered as the exterior penalty function approach. It is also shown that a combination of search algorithms will tend to arrive at an extremal design in a more reliable manner than a single algorithm. The effect of incorporating realistic geometrical constraints on stiffener cross-sections is investigated. A limited comparison is made between minimum weight cylinders designed on the basis of a linear stability analysis and cylinders designed on the basis of empirical buckling data. Finally, a technique for locating more than one extremal is demonstrated.

  7. Diagnosis and Treatment of Diseases of Tactical Importance to US CENTCOM Forces

    DTIC Science & Technology

    1990-01-01

    dysphagia . This is followed by a symmetrical, descending, progrrssive weakness of the extremities along with weakness of the respiratory muscles ...liver and spleen abscesses anorexia 6. Pulmonary (15-251)s cough 7. Systemic (almost 100%): fever night sweats malaiseweakness weight loss 8. Cutaneous...following algorithm provides an effective, effi- cient approach: Symtom: S stools/day, fever, abdominal j pain, weight loss , blood, pus, or mucus in stool

  8. Cellular Viscosity in Prokaryotes and Thermal Stability of Low Molecular Weight Biomolecules.

    PubMed

    Cuecas, Alba; Cruces, Jorge; Galisteo-López, Juan F; Peng, Xiaojun; Gonzalez, Juan M

    2016-08-23

    Some low molecular weight biomolecules, i.e., NAD(P)H, are unstable at high temperatures. The use of these biomolecules by thermophilic microorganisms has been scarcely analyzed. Herein, NADH stability has been studied at different temperatures and viscosities. NADH decay increased at increasing temperatures. At increasing viscosities, NADH decay rates decreased. Thus, maintaining relatively high cellular viscosity in cells could result in increased stability of low molecular weight biomolecules (i.e., NADH) at high temperatures, unlike what was previously deduced from studies in diluted water solutions. Cellular viscosity was determined using a fluorescent molecular rotor in various prokaryotes covering the range from 10 to 100°C. Some mesophiles showed the capability of changing cellular viscosity depending on growth temperature. Thermophiles and extreme thermophiles presented a relatively high cellular viscosity, suggesting this strategy as a reasonable mechanism to thrive under these high temperatures. Results substantiate the capability of thermophiles and extreme thermophiles (growth range 50-80°C) to stabilize and use generally considered unstable, universal low molecular weight biomolecules. In addition, this study represents a first report, to our knowledge, on cellular viscosity measurements in prokaryotes and it shows the dependency of prokaryotic cellular viscosity on species and growth temperature. Copyright © 2016 Biophysical Society. Published by Elsevier Inc. All rights reserved.

  9. Telomere length in the two extremes of abnormal fetal growth and the programming effect of maternal arterial hypertension.

    PubMed

    Tellechea, Mariana; Gianotti, Tomas Fernandéz; Alvariñas, Jorge; González, Claudio D; Sookoian, Silvia; Pirola, Carlos J

    2015-01-19

    We tested the hypothesis that leukocyte telomere length (LTL) is associated with birth weight in both extremes of abnormal fetal growth: small (SGA) and large for gestational age newborns (LGA). Clinical and laboratory variables of the mothers and the neonates were explored; 45 newborns with appropriate weight for gestational age (AGA), 12 SGA and 12 LGA were included. Whether the differences might be explained by variation in OBFC1 (rs9419958) and CTC1 (rs3027234) genes associated with LTL was determined. A significant association between birth weight and LTL was observed; LTL was significantly shorter in LGA newborns (1.01 ± 0.12) compared with SGA (1.73 ± 0.19) p < 0.005, mean ± SE. Maternal (Spearman R = -0.6, p = 0.03) and neonatal LTL (R = -0.25, p = 0.03) were significantly and inversely correlated with maternal history of arterial hypertension in previous gestations. Neonatal LTL was not significantly associated with either rs9419950 or rs3027234, suggesting that the association between neonatal LTL and birth weight is not influenced by genetic variation in genes that modify the interindividual LTL. In conclusion, telomere biology seems to be modulated by abnormal fetal growth; modifications in telomere length might be programmed by an adverse environment in utero.

  10. Virtual screening by a new Clustering-based Weighted Similarity Extreme Learning Machine approach

    PubMed Central

    Kudisthalert, Wasu

    2018-01-01

    Machine learning techniques are becoming popular in virtual screening tasks. One of the powerful machine learning algorithms is Extreme Learning Machine (ELM) which has been applied to many applications and has recently been applied to virtual screening. We propose the Weighted Similarity ELM (WS-ELM) which is based on a single layer feed-forward neural network in a conjunction of 16 different similarity coefficients as activation function in the hidden layer. It is known that the performance of conventional ELM is not robust due to random weight selection in the hidden layer. Thus, we propose a Clustering-based WS-ELM (CWS-ELM) that deterministically assigns weights by utilising clustering algorithms i.e. k-means clustering and support vector clustering. The experiments were conducted on one of the most challenging datasets–Maximum Unbiased Validation Dataset–which contains 17 activity classes carefully selected from PubChem. The proposed algorithms were then compared with other machine learning techniques such as support vector machine, random forest, and similarity searching. The results show that CWS-ELM in conjunction with support vector clustering yields the best performance when utilised together with Sokal/Sneath(1) coefficient. Furthermore, ECFP_6 fingerprint presents the best results in our framework compared to the other types of fingerprints, namely ECFP_4, FCFP_4, and FCFP_6. PMID:29652912

  11. Major Risk Factors for Heart Disease: Overweight and Obesity

    MedlinePlus

    ... Major Risk Factors for Heart Disease Overweight and Obesity A healthy weight is important for a long, vigorous life. Yet overweight and obesity (extreme overweight) have reached epidemic levels in the ...

  12. Vocal fold paralysis following surgical ductal closure in extremely low birth weight infants: A case series of feeding and respiratory complications

    PubMed Central

    Malcolm, William F.; Hornik, Christoph; Smith, P. Brian; Evans, Adele; Cotten, C. Michael

    2010-01-01

    Surgical closure of a Patent Ductus Arteriosus (PDA) continues to be frequent among Extremely Low Birth Weight (ELBW) infants, despite improvements in the medical management of PDA’s and rising questions about its pathophysiologic role. Among other possible complications of this surgical intervention, left vocal fold paralysis (LVFP) has been reported. Only more recently, however, neonatologists are realizing the frequency and impact of this complication on chronic respiratory and feeding difficulties in the ELBW population. In this case series, we describe the clinical course of three sets of multiple births, for which at least one infant underwent surgical closure of his PDA and subsequently developed feeding and/or respiratory difficulties due to LVFP, and compare them to their respective siblings who did not sustain this complication. PMID:18974752

  13. Neurodevelopmental Outcomes of Extremely Preterm Infants Randomized to Stress Dose Hydrocortisone.

    PubMed

    Parikh, Nehal A; Kennedy, Kathleen A; Lasky, Robert E; Tyson, Jon E

    2015-01-01

    To compare the effects of stress dose hydrocortisone therapy with placebo on survival without neurodevelopmental impairments in high-risk preterm infants. We recruited 64 extremely low birth weight (birth weight ≤1000 g) infants between the ages of 10 and 21 postnatal days who were ventilator-dependent and at high-risk for bronchopulmonary dysplasia. Infants were randomized to a tapering 7-day course of stress dose hydrocortisone or saline placebo. The primary outcome at follow-up was a composite of death, cognitive or language delay, cerebral palsy, severe hearing loss, or bilateral blindness at a corrected age of 18-22 months. Secondary outcomes included continued use of respiratory therapies and somatic growth. Fifty-seven infants had adequate data for the primary outcome. Of the 28 infants randomized to hydrocortisone, 19 (68%) died or survived with impairment compared with 22 of the 29 infants (76%) assigned to placebo (relative risk: 0.83; 95% CI, 0.61 to 1.14). The rates of death for those in the hydrocortisone and placebo groups were 31% and 41%, respectively (P = 0.42). Randomization to hydrocortisone also did not significantly affect the frequency of supplemental oxygen use, positive airway pressure support, or need for respiratory medications. In high-risk extremely low birth weight infants, stress dose hydrocortisone therapy after 10 days of age had no statistically significant effect on the incidence of death or neurodevelopmental impairment at 18-22 months. These results may inform the design and conduct of future clinical trials. ClinicalTrials.gov NCT00167544.

  14. Postdischarge growth failure among extremely low birth weight infants: Correlates and consequences

    PubMed Central

    Sices, Laura; Wilson-Costello, Deanne; Minich, Nori; Friedman, Harriet; Hack, Maureen

    2007-01-01

    OBJECTIVE To describe the prevalence and correlates of postdis-charge growth failure among extremely low birth weight (ELBW) infants (weighing less than 1 kg) and its impact on growth and development. METHODS One hundred fifty-four ELBW infants were followed to 20 months corrected age. Growth failure was defined as a decrease in weight z score (standard deviation score) of over 0.67 during one of three periods: between 40 weeks and four months (period I), between four and eight months (period II), and between eight and 20 months corrected age (period III). A decrease in weight z score of this magnitude is comparable to crossing major growth percentiles (eg, from 25th to 10th percentile). Developmental outcomes were assessed at 20 months. RESULTS Growth failure occurred in 8% of infants during period I, 28% during period II and 12% during period III. This resulted in poorer growth attainment and motor function at 20 months. Significant predictors of growth failure included chronic lung disease during periods I and III, and cerebral palsy during period III. Growth failure during period II, while more common, was not associated with specific sequelae of prematurity. It may represent a physiological process comparable to shifts in weight percentiles in term-born infants. CONCLUSIONS Postdischarge growth failure is common among ELBW infants and contributes to poorer growth outcomes. It is associated with poorer motor outcomes when it occurs early after discharge or later in infancy. A decrease in weight z score of over 0.67 can serve as a useful indicator of growth failure in ELBW infants. PMID:19030335

  15. Apparatus for measurement of thermal conductivity of insulation systems subjected to extreme temperature differences

    NASA Technical Reports Server (NTRS)

    Dube, W. P.; Sparks, L. L.; Slifka, A. J.; Bitsy, R. M.

    1990-01-01

    Advanced aerospace designs require thermal insulation systems which are consistent with cryogenic fluids, high thermal loads, and design restrictions such as weight and volume. To evaluate the thermal performance of these insulating systems, an apparatus capable of measuring thermal conductivity using extreme temperature differences (27 to 1100 K) is being developed. This system is described along with estimates of precision and accuracy in selected operating conditions. Preliminary data are presented.

  16. Apparatus for measurement of thermal conductivity of insulation systems subjected to extreme temperature differences

    NASA Astrophysics Data System (ADS)

    Dube, W. P.; Sparks, L. L.; Slifka, A. J.; Bitsy, R. M.

    Advanced aerospace designs require thermal insulation systems which are consistent with cryogenic fluids, high thermal loads, and design restrictions such as weight and volume. To evaluate the thermal performance of these insulating systems, an apparatus capable of measuring thermal conductivity using extreme temperature differences (27 to 1100 K) is being developed. This system is described along with estimates of precision and accuracy in selected operating conditions. Preliminary data are presented.

  17. Development of Korean Academy of Medical Sciences Guideline for rating physical disability of upper extremity.

    PubMed

    Park, Jung Ho; Kim, Hee-Chun; Lee, Jae Hoon; Kim, Jin Soo; Roh, Si Young; Yi, Cheol Ho; Kang, Yoon Kyoo; Kwon, Bum Sun

    2009-05-01

    While the lower extremities support the weight and move the body, the upper extremities are essential for the activities of daily living, which require many detailed movements. Therefore, a disability of the upper extremity function should include a limitation of all motions of the joints and sensory loss, which affects the activities. In this study, disabilities of the upper extremities were evaluated according to the following conditions: 1) amputation, 2) joint contracture, 3) diseases of upper extremity, 4) weakness, 5) sensory loss of the finger tips, and 6) vascular and lymphatic diseases. The order of 1) to 6) is the order of major disability and there is no need to evaluate a lower order disability when a higher order one exists in the same joint or a part of the upper extremity. However, some disabilities can be either added or substituted when there are special contributions from multiple disabilities. An upper extremity disability should be evaluated after the completion of treatment and full adaptation when further functional changes are not expected. The dominance of the right or left hand before the disability should not be considered when there is a higher rate of disability.

  18. Controlling extreme events on complex networks

    NASA Astrophysics Data System (ADS)

    Chen, Yu-Zhong; Huang, Zi-Gang; Lai, Ying-Cheng

    2014-08-01

    Extreme events, a type of collective behavior in complex networked dynamical systems, often can have catastrophic consequences. To develop effective strategies to control extreme events is of fundamental importance and practical interest. Utilizing transportation dynamics on complex networks as a prototypical setting, we find that making the network ``mobile'' can effectively suppress extreme events. A striking, resonance-like phenomenon is uncovered, where an optimal degree of mobility exists for which the probability of extreme events is minimized. We derive an analytic theory to understand the mechanism of control at a detailed and quantitative level, and validate the theory numerically. Implications of our finding to current areas such as cybersecurity are discussed.

  19. Upright CT of the knee: the effect of weight-bearing on joint alignment.

    PubMed

    Hirschmann, Anna; Buck, Florian M; Fucentese, Sandro F; Pfirrmann, Christian W A

    2015-11-01

    To prospectively compare patellofemoral and femorotibial alignment in supine non-weight-bearing computed tomography (NWBCT) and upright weight-bearing CT (WBCT) and assess the differences in joint alignment. NWBCT and WBCT images of the knee were obtained in 26 patients (mean age, 57.0 ± 15.9 years; range, 21-81) using multiple detector CT for NWBCT and cone-beam extremity CT for WBCT. Two musculoskeletal radiologists independently quantified joint alignment by measuring femorotibial rotation, tibial tuberosity-trochlear groove distance (TTTG), lateral patellar tilt angle, lateral patellar shift, and medial and lateral femorotibial joint space widths. Significant differences between NWBCT and WBCT were sought using Wilcoxon signed-rank test (P-value < 0.05). Significant differences were found for femorotibial rotation (the NWBCT mean changed from 2.7° ± 5.1 (reader 1)/2.6° ± 5.6 (reader 2) external rotation to WBCT 0.4° ± 7.7/0.2° ± 7.5 internal rotation; P = 0.009/P = 0.004), TTTG (decrease from NWBCT (13.8 mm ± 5.1/13.9 mm ± 3.9) to WBCT (10.5 mm ± 5.0/10.9 mm ± 5.2; P = 0.008/P = 0.002), lateral patellar tilt angle (decrease from NWBCT (15.6° ± 6.7/16.9° ± 7.4) to WBCT (12.5° ± 7.7/15.0° ± 6.2; P = 0.011/P = 0.188). The medial femorotibial joint space decreased from NWBCT (3.9 mm ± 1.4/4.5 mm ± 1.3) to WBCT (2.9 mm ± 2.2/3.5 mm ± 2.2; P = 0.003/P = 0.004). Inter-reader agreement ranged from 0.52-0.97. Knee joint alignment changes significantly in the upright weight-bearing position using CT when compared to supine non-weight-bearing CT. • Cone-beam extremity CT offers upright weight-bearing examinations of the lower extremities. • Knee alignment changes significantly in an upright position compared to supine position. • Tibial tuberosity-trochlear groove distance (TTTG) is less pronounced in a weight-bearing position. • The weight-bearing position leads to a decrease of the lateral patellar tilt angle.

  20. Virtual reality in the treatment of body image disturbances after bariatric surgery: a clinical case.

    PubMed

    Riva, Giuseppe; Cárdenas-López, Georgina; Duran, Ximena; Torres-Villalobos, Gonzalo M; Gaggioli, Andrea

    2012-01-01

    Bariatric surgery is an operation on the stomach and/or intestines that helps patients with extreme obesity to lose weight. Even if bariatric surgery, compared with traditional obesity treatment, is more effective in reducing BMI, this approach does not achieve equal results in every patient. More, following bariatric surgery common problems are body image dissatisfaction and body disparagement: there is a significant difference between the weight loss clinicians consider successful (50% of excess weight) and the weight loss potential patients expect to achieve (at least 67% of the excess weight). The paper discusses the possible role of virtual reality (VR) in addressing this problem within an integrated treatment approach. More, the clinical case of a female bariatric patient who experienced body dissatisfaction even after a 30% body weight loss and a 62% excess body weight loss, is presented and discussed.

  1. COMplex Fracture Orthopedic Rehabilitation (COMFORT) - Real-time visual biofeedback on weight bearing versus standard training methods in the treatment of proximal femur fractures in the elderly: study protocol for a multicenter randomized controlled trial.

    PubMed

    Raaben, Marco; Redzwan, Syaiful; Augustine, Robin; Blokhuis, Taco Johan

    2018-04-12

    Proximal femur fractures are a common injury after low energy trauma in the elderly. Most rehabilitation programs are based on restoring mobility and early resumption of weight-bearing. However, therapy compliance is low in patients following lower extremity fractures. Moreover, little is known about the relevance of gait parameters and how to steer the rehabilitation after proximal femur fractures in the elderly. Therefore, the aim of this prospective, randomized controlled trial is to gain insight in gait parameters and evaluate if real-time visual biofeedback can improve therapy compliance after proximal femur fractures in the elderly. This is a two-arm, parallel-design, prospective, randomized controlled trial. Inclusion criteria are age ≥ 60 years, a proximal femur fracture following low energy trauma, and unrestricted-weight bearing. Exclusion criteria are cognitive impairment and limited mobility before trauma. Participants are randomized into either the control group, which receives care as usual, or the intervention group, which receives real-time visual biofeedback about weight-bearing during gait in addition to care as usual. Spatiotemporal gait parameters will be measured in 94 participants per group during a 30-m walk with an ambulatory biofeedback system (SensiStep). The progress of rehabilitation will be evaluated by the primary outcome parameters maximum peak load and step duration in relation to the discharge date. Secondary outcome parameters include other spatiotemporal gait parameters in relation to discharge date. Furthermore, the gait parameters will be related to three validated clinical tests: Elderly Mobility Scale; Functional Ambulation Categories; and Visual Analogue Scale. The primary hypothesis is that participants in the intervention group will show improved and faster rehabilitation compared to the control group. The first aim of this multicenter trial is to investigate the normal gait patterns after proximal femur fractures in the elderly. The use of biofeedback systems during rehabilitation after proximal femur fractures in the elderly is promising; therefore, the second aim is to investigate the effect of real-time visual biofeedback on gait after proximal femur fractures in the elderly. This could lead to improved outcome. In addition, analysis of the population may indicate characteristics of subgroups that benefit from feedback, making a differentiated approach in rehabilitation strategy possible. TrialRegister.nl, NTR6794 . Registered on 31 October 2017.

  2. Muscular development and lean body weight in body builders and weight lifters.

    PubMed

    Katch, V L; Katch, F I; Moffatt, R; Gittleson, M

    1980-01-01

    The extent of extreme muscular development in 39 males identified as body builders (N = 18), power weight lifters (N = 13), and Olympic weight lifters (N = 8) were studied. Body composition and anthropometric data, including calculations of pre-excess muscle body weight (scale weight minus excess muscle) were obtained. The lean body weight and percent fats of the subjects were: body builders = 74.6 kg, 9.3%; power weight lifters = 73.3 kg, 9.1%; and Olympic weight lifters = 68.2 kg, 10.8%. No group differences were present in frame size, percent fat, lean body weight, skinfolds, and diameter measurements. The only group differences were for the shoulders, chest, biceps relaxed and flexed, and forearm girths. In each case the body builders were larger. Calculations of excess muscle by the Behnke method revealed that the body builders had 15.6 kg excess muscle, power weight lifters 14.8 kg, and Olympic weight lifters 13.1 kg. Somatographic comparisons revealed only slight differences between the groups, while differences with reference man were substantial.

  3. Commercial production of tiger puffer ( Takifugu rubripes) in winter using a recirculating aquaculture system

    NASA Astrophysics Data System (ADS)

    Lin, Zhongling; Wang, Hua; Yu, Chunyan; Lv, Fenghe; Liu, Hengming; Zhang, Tao

    2017-02-01

    Tiger puffer ( Takifugu rubripes) is a promising species for aquaculture production because of its high value and limited supply. However, in the north of China, using sea cages to culture this species in winter is hampered by the fact that the seawater temperature is extremely low. Here, a large scale commercial production of tiger puffer has been successfully realized using a recirculating aquaculture system (RAS) from 3 October 2012 to 31 May 2013. The RAS was comprised of nine culture tanks (total water volume 200 m3) and stocked with approximately a total of 14400 fish (initial mean weight 160 g). The tiger puffer was hand-fed at a rate of 0.7% of total body weight per day, and the feed conversion rate was (1.21 ± 0.3) kg kg-1. The recycle water in RAS was treated by a sieve bend screen, a foam fractionator, a submerged biofilter, an UV sterilizer and a submersible aerator. During the whole culture period, an excellent water quality control was achieved in RAS. At the end of this experiment, the survival rate of tiger puffer was more than 98%. The final tank densities averaged 31.2 kg m-3, and the final individual mean weight was 440 g.

  4. Relationship Between Past Food Deprivation and Current Dietary Practices and Weight Status Among Cambodian Refugee Women in Lowell, MA

    PubMed Central

    Wilde, Parke E.; Liang, Sidney; Bermudez, Odilia I.; Silka, Linda; Rogers, Beatrice Lorge

    2010-01-01

    Objectives. We investigated Cambodian refugee women's past food experiences and the relationship between those experiences and current food beliefs, dietary practices, and weight status. Methods. Focus group participants (n = 11) described past food experiences and current health-related food beliefs and behaviors. We randomly selected survey participants (n = 133) from a comprehensive list of Cambodian households in Lowell, Massachusetts. We collected height, weight, 24-hour dietary recall, food beliefs, past food experience, and demographic information. We constructed a measure of past food deprivation from focus group and survey responses. We analyzed data with multivariate logistic and linear regression models. Results. Participants experienced severe past food deprivation and insecurity. Those with higher past food-deprivation scores were more likely to currently report eating meat with fat (odds ratio [OR] = 1.14 for every point increase on the 9-to-27–point food-deprivation measure), and to be overweight or obese by Centers for Disease Control and Prevention (OR = 1.28) and World Health Organization (OR = 1.18) standards. Conclusions. Refugees who experienced extensive food deprivation or insecurity may be more likely to engage in unhealthful eating practices and to be overweight or obese than are those who experienced less-extreme food deprivation or insecurity. PMID:20724691

  5. Relationship between past food deprivation and current dietary practices and weight status among Cambodian refugee women in Lowell, MA.

    PubMed

    Peterman, Jerusha Nelson; Wilde, Parke E; Liang, Sidney; Bermudez, Odilia I; Silka, Linda; Rogers, Beatrice Lorge

    2010-10-01

    We investigated Cambodian refugee women's past food experiences and the relationship between those experiences and current food beliefs, dietary practices, and weight status. Focus group participants (n = 11) described past food experiences and current health-related food beliefs and behaviors. We randomly selected survey participants (n = 133) from a comprehensive list of Cambodian households in Lowell, Massachusetts. We collected height, weight, 24-hour dietary recall, food beliefs, past food experience, and demographic information. We constructed a measure of past food deprivation from focus group and survey responses. We analyzed data with multivariate logistic and linear regression models. Participants experienced severe past food deprivation and insecurity. Those with higher past food-deprivation scores were more likely to currently report eating meat with fat (odds ratio [OR] = 1.14 for every point increase on the 9-to-27-point food-deprivation measure), and to be overweight or obese by Centers for Disease Control and Prevention (OR = 1.28) and World Health Organization (OR = 1.18) standards. Refugees who experienced extensive food deprivation or insecurity may be more likely to engage in unhealthful eating practices and to be overweight or obese than are those who experienced less-extreme food deprivation or insecurity.

  6. [Specific weight loss in hyper- and hypothyroidism (author's transl)].

    PubMed

    Schlick, W; Schmid, P; Irsigler, K

    1975-02-07

    By means of a new method of extremely precise weight measurement (buoyancy scale) it is possible to measure the continuous weight loss of the human body. This weight loss is made up of three components, viz. the weight difference between produced CO2 and consumed O2, water loss through the lungs and transpiration through the skin. In relation to body weight it is called "specific weight loss." This parameter was measured in healthy human subjects and found to be within a relatively narrow range (16.42 plus or minus 2.55 mg/min/kp body weight). In four patients with hypothyroidism the values were very low (5.5 to 8.5 mg/min/kp). An increased specific weight loss was found in patients with hyperthyroidism (38 to 102 mg/min/kp in clinically severe cases). The applicability of this method to examination of thyroid function is discussed. It is compared to the classical method of basal metabolic rate measurement and its advantages are enumerated.

  7. Control of vertical posture while standing on a sliding board and pushing an object.

    PubMed

    Lee, Yun-Ju; Chen, Bing; Liang, Jing-Nong; Aruin, Alexander S

    2018-03-01

    Voluntary pushing or translation perturbation of the support surface each induces a body perturbation that affects postural control. The objective of the study was to investigate anticipatory (APA) and compensatory (CPA) postural adjustments when pushing an object (that induces self-initiated perturbation) and standing on a sliding board (that induces translational perturbation). Thirteen healthy young participants were instructed to push a handle with both hands while standing on a sliding board that was either free to move in the anterior-posterior direction or stationary. Electromyographic activity (EMG) of trunk and lower extremity muscles, center of pressure (COP) displacements, and the forces exerted by the hand were recorded and analyzed during the APA and CPA phases. When the sliding board was free to move during pushing (translation perturbation), onsets of activity of ventral leg muscles and COP displacement were delayed as compared to pushing when standing on a stationary board. Moreover, magnitudes of shank muscle activity and the COP displacement were decreased. When pushing heavier weight, magnitudes of muscle activity, COP displacement, and pushing force increased. The magnitude of activity of the shank muscles during the APA and CPA phases in conditions with translational perturbation varied with the magnitude of the pushing weight. The outcome of the study suggests that the central nervous system prioritizes the pushing task while attenuates the source of additional perturbation induced by translation perturbation. These results could be used in the development of balance re-training paradigms involving pushing weight while standing on a sliding surface.

  8. Evaluation of changes to foot shape in females 5 years after mastectomy: a case-control study.

    PubMed

    Głowacka-Mrotek, Iwona; Sowa, Magdalena; Siedlecki, Zygmunt; Nowikiewicz, Tomasz; Hagner, Wojciech; Zegarski, Wojciech

    2017-06-01

    The aim of this study was to evaluate changes in foot shape of women 5 years after undergoing breast amputation. Evaluation of foot shape was performed using a non-invasive device for computer analysis of the plantar surface of the foot. Obtained results were compared between feet on the healthy breast side (F1) and on the amputated breast side (F2). 128 women aged 63.60 ± 8.83, 5-6 years after breast amputation were enrolled in this case-control study. Weight bearing on the lower extremity on the amputated breast side (F1) compared with the healthy breast side (F2) showed statistically significant differences (p < 0.01). Patients put more weight onto the healthy breast side. No statistically significant difference was found with regard to F1 and F2 foot length (p = 0.4239), as well as BETA (p = 0.4470) and GAMMA (p = 0.4566) angles. Highly statistically significant differences were noted with respect to foot width, ALPHA angle, and Sztriter-Godunov index-higher values were observed on the healthy breast side (p < 0.001). Highly statistically significant differences were also noted while comparing Clark's angles, higher values being observed on the operated breast side (p < 0.001). Differences in foot shape on the healthy breast side and amputated breast side constitute a long-term negative consequence of mastectomy, and can be caused by unbalanced weight put on feet on the healthy breast side compared to the amputated breast side.

  9. The Effect of Aerobic or Aerobic-Strength Exercise on Body Composition and Functional Capacity in Patients with BMI ≥35 after Bariatric Surgery: a Randomized Control Trial.

    PubMed

    Hassannejad, Alireza; Khalaj, Alireza; Mansournia, Mohammad Ali; Rajabian Tabesh, Mastaneh; Alizadeh, Zahra

    2017-11-01

    Although previous studies suggested that bariatric surgery is the most effective and sustainable treatment method for morbid obesity in long term, but without changing in lifestyle, maintaining optimal weight loss is almost impossible. Sixty morbid obese patients (BMI ≥ 35) were evaluated before and after 12 weeks of bariatric surgery in order to compare the impact of two different exercise programs on body composition and functional capacity outcomes. Participants were divided into three groups: aerobic (A), aerobic-strength (AS), and control (C) group. Aerobic capacity was assessed with 12-min walk-run test (12MWRT). One-repetition maximum (1RM) test was performed to evaluation upper limb muscle strength. Lower extremity functional capacity was assessed by sit-to-stand test. Weight, percent body fat (PBF), and fat mass (FM) reduced greater in the trial groups in comparison to the C group (P < 0.05). In the AS group, the reduction of fat-free mass (FFM) was significantly lower than that in the other groups. Mean changes in 12MWRT increased significantly in the intervention groups. The mean change in the sit-to-stand scores was not statistically significant between the three groups. Comparing the intervention groups showed that mean changes in 1RM variables increased in AS group (P = 0.03). The data suggests a positive effect of exercise on weight and PBF decrease after surgery, and it leads to significant improvement on aerobic capacity. Moreover, doing resisted exercise caused greater preserving of lean mass.

  10. Longitudinal assessment of renal size and function in extremely low birth weight children at 7 and 11 years of age.

    PubMed

    Starzec, Katarzyna; Klimek, Małgorzata; Grudzień, Andrzej; Jagła, Mateusz; Kwinta, Przemko

    2016-11-01

    There are a lack of studies describing a longitudinal association between preterm delivery and renal complications later in life. We assessed renal size and function in preterm infants born with extremely low birth weight (ELBW) during 4 years of follow-up, comparing these parameters to age-matched children born full term (term controls). The results of selected renal laboratory tests [levels of cystatin C, creatinine, blood urea nitrogen (BUN)] and of renal ultrasound evaluations were compared between the ELBW group and the term control group at age 7 and 11 years. The study population consisted of 64 children born with ELBW (ELBW children) who had been recruited at birth and 36 children born at term (term children) who took part in both follow-up assessments. Renal ultrasound examination revealed a significantly smaller renal volume in the 7- and 11-year-old ELBW children compared to the term controls [right kidney volume: 50.8 vs. 61.2 ml/m(2), respectively, at 7 years (p <0.01) and 51.4 vs. 58.2 ml/m(2), respectively, at 11 years (p <0.01); left kidney volume: 51.4 vs. 60.3 ml/m(2), respectively, at 7 years (p <0.01) and 55.2 vs. 60.7 ml/m(2), respectively, at 11 years (p = 0.02)]. Renal function in ELBW children was also affected. Serum cystatin C levels were significantly higher in ELBW children than in the controls at 7 years of age, and this difference remained statistically significant at 11 years of age [0.63 vs. 0.59 mg/l, respectively, at 7 years (p = 0.02) and 0.72 vs. 0.61 mg/l, respectively, at 11 years (p = 0.01)]. Six ELBW children also had elevated cystatin C levels (0.97-1.11 mg/l) at 11 years of age. Cystatin C levels were within normal range in the ELBW children at age 7 years and in term children in both follow-up studies. BUN levels were higher in ELBW children at the age of 11 years (4.49 vs. 4.15 mmol/l; p = 0.028). Continued follow-up of these patients will reveal whether the observed worsening in renal function will persist into adulthood.

  11. A case study of a workplace wellness program that offers financial incentives for weight loss.

    PubMed

    Cawley, John; Price, Joshua A

    2013-09-01

    Employers are increasingly adopting workplace wellness programs designed to improve employee health and decrease employer costs associated with health insurance and job absenteeism. This paper examines the outcomes of 2635 workers across 24 worksites who were offered financial incentives for weight loss that took various forms, including fixed payments and forfeitable bonds. We document extremely high attrition and modest weight loss associated with the financial incentives in this program, which contrasts with the better outcomes associated with pilot programs. We conclude by offering suggestions, motivated by behavioral economics, for increasing the effectiveness of financial incentives for weight loss. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Sensorimotor control and neuromuscular activity of the shoulder in adolescent competitive swimmers with generalized joint hypermobility.

    PubMed

    Frydendal, Thomas; Eshøj, Henrik; Liaghat, Behnam; Edouard, Pascal; Søgaard, Karen; Juul-Kristensen, Birgit

    2018-05-05

    Shoulder pain is highly prevalent in competitive swimmers, and generalized joint hypermobility (GJH) is considered a risk factor. Sensorimotor control deficiencies and altered neuromuscular activation of the shoulder may represent underlying factors. To investigate whether competitive swimmers with GJH including shoulder hypermobility (GJHS) differ in shoulder sensorimotor control and muscle activity from those without GJH and no shoulder hypermobility (NGJH). Competitive swimmers (aged 13-17) were recruited. GJHS or NGJH status was determined using the Beighton score (0-9) and Rotès-Quérol test (positive/negative). Inclusion criteria for GJHS were a Beighton score ≥5 and minimum one hypermobile shoulder, while NGJH was defined as a Beighton score ≤3 and no shoulder hypermobility. Three prone lying, upper-extremity weight-bearing shoulder stabilometric tests were performed on a force platform: Bilateral upper-extremity support eyes open (BL-EO) and eyes closed (BL-EC) and unilateral upper-extremity support eyes open (UL-EO). Surface electromyography (SEMG) was measured from the upper trapezius, lower trapezius, serratus anterior, infraspinatus and pectoralis major muscles. SEMG was normalized using maximal voluntary isometric contractions and presented relative to maximal voluntary SEMG (%MVE). Co-contraction index (CCI) was calculated for the following muscle pairs: upper trapezius-lower trapezius, upper trapezius-serratus anterior, and infraspinatus-pectoralis major. Between-group differences in stabilometric parameters, %MVE, and CCI were analyzed with a mixed effects model. Thirty-eight swimmers were enrolled as GJHS (n = 19) or NGJH (n = 19). There were no group differences in stabilometric parameters or CCI. GJHS displayed significantly decreased (29%) pectoralis major activity during BL-EO compared to NGJH (5.35 ± 1.77%MVE vs. 7.51 ± 1.96%MVE; p = 0.043). Adolescent competitive swimmers with GJHS displayed no shoulder sensorimotor control deficiencies and no generally altered shoulder muscle activity pattern, except for decreased pectoralis major activity in BL-EO. Longitudinal studies are needed to investigate whether decreased pectoralis major activation contributes to the development of shoulder pain in swimmers with GJHS. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Freeze-thaw durability of composite materials.

    DOT National Transportation Integrated Search

    1996-01-01

    Composite materials, produced from polymer resins and high strength fibers, have the potential to be widely used in construction because of their corrosion resistance and high strength-to-weight ratio, However, such environmental factors as extreme t...

  14. Extreme Temperatures May Increase Risk for Low Birth Weight at Term

    MedlinePlus

    ... research in the United States and throughout the world on fetal, infant and child development; maternal, child and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit ...

  15. Human trophoblast cell during first trimester after IVF-ET differs from natural conceived pregnancy in development and function.

    PubMed

    Yang, Rui; Liu, Ying-Ying; Zhao, Liang; Wang, Ying; Li, Rong; Liu, Ping; Ma, Cai-Hong; Chen, Xin-Na; Qiao, Jie

    2017-03-01

    To explore the differences of the trophoblast cell function in first trimester between natural pregnancy and pregnancy after IVF-ET therapy. 102 cases with twin to singleton fetal reduction after IVF-ET treatment from July 2010 to August 2013 in Peking University Third Hospital were involved in analysis, and eight specimens were obtained from this group. 10 natural-pregnancy cases undergoing artificial abortion with unwanted pregnancy were recruited as control. Semi-quantitative immunohistochemical method was used to detect the expression of EGFR, Bcl-2, tubulin-α, metallothionein and AFP in villi in both groups. Of the 102 cases, 14 cases (13.73%) were aborted. Preterm birth occurred in seven cases (7.86%). Low birth weight occurred in three patients (3.37%), and extremely low birth weight occurred in four cases (4.49%). The expression of EGFR, tubulin-α, Bcl-2, and metallothionein in the IVF-ET group was significantly lower than that in the control group (P<0.05). However, AFP expression was significantly higher in IVF-ET group than in control group (P<0.05). In IVF-ET group, the miscarriage case had weaker EGFR, tubulin-α, and metallothionein expression than full-term pregnancy; the early preterm labor case had weaker Bcl-2, tubulin-α, and metallothionein expression; and velamentous cord insertion case had weaker tubulin-α expression. The trophoblast cell function of IVF-ET group in first trimester is different from control group in proliferation, invasion, apoptosis and vascular development, and optimal pregnancy outcome depends on the self-healing balance of trophoblast cells.

  16. On Bernstein type inequalities and a weighted Chebyshev approximation problem on ellipses

    NASA Technical Reports Server (NTRS)

    Freund, Roland

    1989-01-01

    A classical inequality due to Bernstein which estimates the norm of polynomials on any given ellipse in terms of their norm on any smaller ellipse with the same foci is examined. For the uniform and a certain weighted uniform norm, and for the case that the two ellipses are not too close, sharp estimates of this type were derived and the corresponding extremal polynomials were determined. These Bernstein type inequalities are closely connected with certain constrained Chebyshev approximation problems on ellipses. Some new results were also presented for a weighted approximation problem of this type.

  17. Production of ELZM mirrors: performance coupled with attractive schedule, cost, and risk factors

    NASA Astrophysics Data System (ADS)

    Leys, Antoine; Hull, Tony; Westerhoff, Thomas

    2016-08-01

    Extreme light weighted ZERODUR Mirrors (ELZM) have been developed to exploit the superb thermal characteristics of ZERODUR. Coupled with up to date mechanical and optical fabrication methods this becomes an attractive technical approach. However the process of making mirror substrates has demonstrated to be unusually rapid and especially cost-effective. ELZM is aimed at the knee of the cost as a function of light weighting curve. ELZM mirrors are available at 88% light weighted. Together with their low risk, low cost production methods, this is presented as a strong option for NASA Explorer and Probe class missions.

  18. Iron aluminide alloy container for solid oxide fuel cells

    DOEpatents

    Judkins, Roddie Reagan; Singh, Prabhakar; Sikka, Vinod Kumar

    2000-01-01

    A container for fuel cells is made from an iron aluminide alloy. The container alloy preferably includes from about 13 to about 22 weight percent Al, from about 2 to about 8 weight percent Cr, from about 0.1 to about 4 weight percent M selected from Zr and Hf, from about 0.005 to about 0.5 weight percent B or from about 0.001 to about 1 weight percent C, and the balance Fe and incidental impurities. The iron aluminide container alloy is extremely resistant to corrosion and metal loss when exposed to dual reducing and oxidizing atmospheres at elevated temperatures. The alloy is particularly useful for containment vessels for solid oxide fuel cells, as a replacement for stainless steel alloys which are currently used.

  19. The Concept of Limitation of the Vibration Generated by Rail-Vehicles at Railway Stations and Railway Crossings

    NASA Astrophysics Data System (ADS)

    Adamczyk, Jan; Targosz, Jan

    2011-03-01

    One of the possibilities of limitation of effects of dynamic influence of the rail-vehicles is the application of the complex objects of vibroinsulation when the mass of the vibroinsulating element is significant, and that is the case of the transporting machines and devices, when the geometric dimensions of the elements of vibroinsulation system are similar to the slab, where the process of modelling of the vibroinsulation mechanism as a discrete system, creates extreme hazards. The article presents the concept of limitation of effects of dynamic influence of the rail-vehicles and tram-vehicles, mainly in the railway tracks located at the railway stations, tram-stops and other engineering structures. The digital model was developed for simulation regarding the propagation of the vibration to the environment. The results of simulation were the basis for development of the vibroinsulation system for the rail-tracks located at the engineering structures such as railway stations, viaducts. The second part of the article presents the approach for controlling of the tension as a function of load of the railway crossing, which was modelled as discrete-continous model. The continuous systems consist of two elements, that is of the support made of elastomer and of the tension members with controlled tension depending on the crossing load. Together with development and more popular application of tension member systems in engineering structures, among others in vibroinsulation systems, it is important to include into calculations and experiments the dynamic loads of the tension member with the mass attached to it. In case of complex objects of vibroinsulation when the mass of the vibroinsulator is significant, and that is the case of the transporting machines and devices, when the geometric dimensions of the elements of vibroinsulation system are similar to the slab, where the process of modelling of the vibroinsulation mechanism as a discrete system, creates extreme hazards when the vibroinsulation is chosen without consideration of its mass. The most serious of the hazards is occurrence of the wave effect of the springdumper elements, since it cannot be assumed that the elements are weight free. In such an elastic element wave phenomena might occur, which in turn might cause that the effect of vibroinsulation is opposite to the expected, that is to the limitation of the dynamic influence on the environment. To prevent such a possibility it is necessary to estimate the natural frequency of the vibroinsulating system based on the consideration of the system as a continuous model and discrete-continuous model. In case when the vibroinsulating elements (rubber or tension member) are characterised by their mass distributed evenly, the frequencies for uniform prismatic systems, e.g. rubber systems, might be estimated based on the method presented in the article. Based on the presented analysis of the proposed control system it can be stated that there exists the possibility of application of that type of control for controlling of the rigidity of the vibroinsulation system of the subgrade. Based on the numerous simulations with different weights of the crossing vehicles and different times of crossing it should be considered to use experimental method for calculation of the PID coefficients for different configurations of the weight and crossing time to dynamically adjust the coefficients based on the information on the speed and weight of the vehicle.

  20. Assessing the features of extreme smog in China and the differentiated treatment strategy

    NASA Astrophysics Data System (ADS)

    Deng, Lu; Zhang, Zhengjun

    2018-01-01

    Extreme smog can have potentially harmful effects on human health, the economy and daily life. However, the average (mean) values do not provide strategically useful information on the hazard analysis and control of extreme smog. This article investigates China's smog extremes by applying extreme value analysis to hourly PM2.5 data from 2014 to 2016 obtained from monitoring stations across China. By fitting a generalized extreme value (GEV) distribution to exceedances over a station-specific extreme smog level at each monitoring location, all study stations are grouped into eight different categories based on the estimated mean and shape parameter values of fitted GEV distributions. The extreme features characterized by the mean of the fitted extreme value distribution, the maximum frequency and the tail index of extreme smog at each location are analysed. These features can provide useful information for central/local government to conduct differentiated treatments in cities within different categories and conduct similar prevention goals and control strategies among those cities belonging to the same category in a range of areas. Furthermore, hazardous hours, breaking probability and the 1-year return level of each station are demonstrated by category, based on which the future control and reduction targets of extreme smog are proposed for the cities of Beijing, Tianjin and Hebei as an example.

  1. Evaluation of the Human/Extreme Environment Interaction: Implications for Enhancing Operational Performance and Recovery

    DTIC Science & Technology

    2011-10-01

    healthy conditions such as exercise (6) and weight loss (22,48) while fission (degradation, dysfunction) is associated with obesity and disease (3,4...before each trial. Following an overnight 12 hour fast , participants arrived at the laboratory in the early morning to complete testing. Upon...type 2 diabetes, obesity , weight loss, and the regulatory role of tumor necrosis factor alpha and interleukin-6. Diabetes 54: 2685-2693, 2005. 4

  2. Case 24: Stress Fracture of the Tibia

    DTIC Science & Technology

    2008-03-01

    extremity weight bearing bones. Most often this micro trauma is found in military recruits and athletes taking part in running activities. A...application of force most commonly related to running and jumping results in micro trauma to the cortical bone. The weight bearing bones of the lower...year old active duty U.S Army combat soldier deployed to Iraq. He had had progressive pain over his lower right leg that radiated to his knee joint

  3. Signal and power roll ring testing update

    NASA Technical Reports Server (NTRS)

    Smith, Dennis W.

    1989-01-01

    The development of the roll ring as a long-life, low-torque alternative to the slip ring is discussed. A roll ring consists of one or more circular flexures captured by their own spring force in the annular space between two concentric conductors or contact rings. The advantages of roll rings over other types of electrical transfer devices are: extremely low drag torque, high transfer efficiencies in high-power configurations, extremely low wear debris generation, long life, and low weight for high-power applications.

  4. The influence of birth size on intelligence in healthy children.

    PubMed

    Broekman, Birit F P; Chan, Yiong-Huak; Chong, Yap-Seng; Quek, Swee-Chye; Fung, Daniel; Low, Yen-Ling; Ooi, Yoon-Phaik; Gluckman, Peter D; Meaney, Michael J; Wong, Tien-Yin; Saw, Seang-Mei

    2009-06-01

    Birth parameters have been hypothesized to have an influence on IQ. However, studies within the range of normal birth size have been sparse. With this study we examined the associations between birth length, birth weight, head circumference, and gestational age within the normal birth size range in relation to childhood IQ in Asian children. A cohort of 1979 of 2913 Asian children aged 7 to 9 years, recruited from 3 schools in Singapore, were followed yearly from 1999 onward. Birth parameters were recorded by health personnel. Childhood IQ was measured with the Raven's Standard Progressive Matrices at ages 8 to 12. The mean IQ score across the sample (n = 1645) was 114.2. After controlling for multiple confounders for every 1-cm increment in birth length, 1 kg in birth weight, or 1 cm in head circumference, there was a corresponding increase in IQ of 0.49 points (P for trend < .001), 2.19 points (P for trend = .007) and .62 points (P for trend = .003), respectively. These associations persisted even after exclusion of premature children and children with extreme weights and head circumferences. Longer birth length, higher birth weight, or larger head circumferences within the normal birth size range are associated with higher IQ scores in Asian children. Our results suggest that antenatal factors reflected in altered rates of growth but within the normative range of pregnancy experiences play a role in generating cognitive potential. This has implications for targeting early intervention and preventative programs.

  5. Relative optical navigation around small bodies via Extreme Learning Machine

    NASA Astrophysics Data System (ADS)

    Law, Andrew M.

    To perform close proximity operations under a low-gravity environment, relative and absolute positions are vital information to the maneuver. Hence navigation is inseparably integrated in space travel. Extreme Learning Machine (ELM) is presented as an optical navigation method around small celestial bodies. Optical Navigation uses visual observation instruments such as a camera to acquire useful data and determine spacecraft position. The required input data for operation is merely a single image strip and a nadir image. ELM is a machine learning Single Layer feed-Forward Network (SLFN), a type of neural network (NN). The algorithm is developed on the predicate that input weights and biases can be randomly assigned and does not require back-propagation. The learned model is the output layer weights which are used to calculate a prediction. Together, Extreme Learning Machine Optical Navigation (ELM OpNav) utilizes optical images and ELM algorithm to train the machine to navigate around a target body. In this thesis the asteroid, Vesta, is the designated celestial body. The trained ELMs estimate the position of the spacecraft during operation with a single data set. The results show the approach is promising and potentially suitable for on-board navigation.

  6. Laser guide star wavefront sensing for ground-layer adaptive optics on extremely large telescopes.

    PubMed

    Clare, Richard M; Le Louarn, Miska; Béchet, Clementine

    2011-02-01

    We propose ground-layer adaptive optics (GLAO) to improve the seeing on the 42 m European Extremely Large Telescope. Shack-Hartmann wavefront sensors (WFSs) with laser guide stars (LGSs) will experience significant spot elongation due to off-axis observation. This spot elongation influences the design of the laser launch location, laser power, WFS detector, and centroiding algorithm for LGS GLAO on an extremely large telescope. We show, using end-to-end numerical simulations, that with a noise-weighted matrix-vector-multiply reconstructor, the performance in terms of 50% ensquared energy (EE) of the side and central launch of the lasers is equivalent, the matched filter and weighted center of gravity centroiding algorithms are the most promising, and approximately 10×10 undersampled pixels are optimal. Significant improvement in the 50% EE can be observed with a few tens of photons/subaperture/frame, and no significant gain is seen by adding more than 200 photons/subaperture/frame. The LGS GLAO is not particularly sensitive to the sodium profile present in the mesosphere nor to a short-timescale (less than 100 s) evolution of the sodium profile. The performance of LGS GLAO is, however, sensitive to the atmospheric turbulence profile.

  7. Changes in levels of peripheral hormones controlling appetite are inconsistent with hyperphagia in leptin-deficient subjects.

    PubMed

    Saeed, Sadia; Bech, Paul R; Hafeez, Tayyaba; Alam, Rabail; Falchi, Mario; Ghatei, Mohammad A; Bloom, Stephen R; Arslan, Muhammad; Froguel, Philippe

    2014-04-01

    Congenital leptin deficiency, a rare genetic disorder due to a homozygous mutation in the leptin gene (LEP), is accompanied by extreme obesity and hyperphagia. A number of gastrointestinal hormones have been shown to critically regulate food intake but their physiological role in hyperphagic response in congenital leptin deficiency has not been elucidated. This study is the first to evaluate the fasting and postprandial profiles of gut-derived hormones in homozygous and heterozygous carriers of LEP mutation. The study subjects from two consanguineous families consisted of five homozygous and eight heterozygous carriers of LEP mutation, c.398delG. Ten wild-type normal-weight subjects served as controls. Fasting and 1-h postprandial plasma ghrelin, glucagon-like peptide (GLP) 1, peptide YY (PYY), leptin and insulin levels were measured by immunoassays. Fasting plasma ghrelin levels in homozygotes remained remarkably unchanged following food consumption (P = 0.33) in contrast to a significant decline in heterozygous (P < 0.03) and normal (P < 0.02) subjects. A significant postprandial increase in PYY was observed in heterozygous (P < 0.02) and control subjects (P < 0.01), but not in the homozygous group (P = 0.22). A postprandial rise in GLP-1 levels was significant (P < 0.02) in all groups. Interestingly, fasting leptin levels in heterozygotes were not significantly different from controls and did not change significantly following meal. Our results demonstrate that gut hormones play little or no physiological role in driving the hyperphagic response of leptin-deficient subjects. In contrast, fasting and postprandial levels of gut hormones in heterozygous mutation carriers were comparable to those of normal-weight controls.

  8. 76 FR 29251 - Guidance for Industry and Food and Drug Administration Staff; Class II Special Controls; Guidance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-20

    ...: Topical Oxygen Chamber for Extremities; Availability; Correction AGENCY: Food and Drug Administration, HHS... Special Controls Guidance Documents: Topical Oxygen Chamber for Extremities.'' The document published... Oxygen Chamber for Extremities'' to the Division of Small Manufacturers, International, and Consumer...

  9. Menstrual Cycle: What's Normal, What's Not

    MedlinePlus

    ... loss or excessive exercising. Eating disorders — such as anorexia nervosa — extreme weight loss and increased physical activity can ... Treatment for any underlying problems, such as an eating disorder, also might help. However, some menstrual irregularities can' ...

  10. Associations of body weight perception and weight control behaviors with problematic internet use among Korean adolescents.

    PubMed

    Park, Subin; Lee, Yeeun

    2017-05-01

    We examined the association of body mass index (BMI), body weight perception, and weight control behaviors with problematic Internet use in a nationwide sample of Korean adolescents. Cross-sectional data from the 2010 Korean Youth Risk Behavior Web-based Survey collected from 37,041 boys and 33,655 girls in middle- and high- schools (grades 7-12) were analyzed. Participants were classified into groups based on BMI (underweight, normal weight, overweight, and obese), body weight perception (underweight, normal weight, and overweight), and weight control behavior (no weight control behavior, appropriate weight control behavior, inappropriate weight control behavior). The risk of problematic Internet use was assessed with the Korean Internet Addiction Proneness Scale for Youth-Short Form. Both boys and girls with inappropriate weight control behavior were more likely to have problematic Internet use. Underweight, overweight, and obese boys and girls were more likely to have problematic Internet use. For both boys and girls, subjective perception of underweight and overweight were positively associated with problematic Internet use. Given the negative effect of inappropriate weight control behavior, special attention needs to be given to adolescents' inappropriate weight control behavior, and an educational intervention for adolescents to control their weight in healthy ways is needed. Copyright © 2017. Published by Elsevier B.V.

  11. Cognitive and motor function of neurologically impaired extremely low birth weight children.

    PubMed

    Bernardo, Janine; Friedman, Harriet; Minich, Nori; Taylor, H Gerry; Wilson-Costello, Deanne; Hack, Maureen

    2015-01-01

    Rates of neurological impairment among extremely low birth weight children (ELBW [<1 kg]) have decreased since 2000; however, their functioning is unexamined. To compare motor and cognitive functioning of ELBW children with neurological impairment, including cerebral palsy and severe hypotonia/hypertonia, between two periods: 1990 to 1999 (n=83) and 2000 to 2005 (n=34). Measures of function at 20 months corrected age included the Mental and Psychomotor Developmental Indexes of the Bayley Scales of Infant Development and the Gross Motor Functional Classification System as primary outcomes and individual motor function items as secondary outcomes. Analysis failed to reveal significant differences for the primary outcomes, although during 2000 to 2005, sitting significantly improved in children with neurological impairment (P=0.003). Decreases in rates of neurological impairment among ELBW children have been accompanied by a suggestion of improved motor function, although cognitive function has not changed.

  12. Analysis and prediction of operating vehicle load effects on Highway bridges under the weight charge policy

    NASA Astrophysics Data System (ADS)

    Huang, Haiyun; Zhang, Junping; Li, Yonghe

    2018-05-01

    Under the weight charge policy, the weigh in motion data at a toll station on the Jing-Zhu Expressway were collected. The statistic analysis of vehicle load data was carried out. For calculating the operating vehicle load effects on bridges, by Monte Carlo method used to generate random traffic flow and influence line loading method, the maximum bending moment effect of simple supported beams were obtained. The extreme value I distribution and normal distribution were used to simulate the distribution of the maximum bending moment effect. By the extrapolation of Rice formula and the extreme value I distribution, the predicted values of the maximum load effects were obtained. By comparing with vehicle load effect according to current specification, some references were provided for the management of the operating vehicles and the revision of the bridge specifications.

  13. Variation of Extreme and Fatigue Design Loads on the Main Bearing of a Front Mounted Direct Drive System

    NASA Astrophysics Data System (ADS)

    Abrahamsen, Asger Bech; Natarajan, Anand

    2016-09-01

    The drivetrain of a 10 MW wind turbine has been designed as a direct drive transmission with a superconducting generator mounted in front of the hub and connected to the main frame through a King-pin stiff assembly by DNV-GL. The aeroelastic design loads of such an arrangement are evaluated based on the thrust and bending moments at the main bearing, both for ultimate design and in fatigue. It is found that the initial superconductor generator weight of 363 tons must be reduced by 25% in order not to result in higher extreme loads on main and yaw bearing than the reference10 MW geared reference drive train. A weight reduction of 50% is needed in order to maintain main bearing fatigue damage equivalent to the reference drive train. Thus a target mass of front mounted superconducting direct drive generators is found to be between 183-272 tons.

  14. The Effect of Manipulating Subject Mass on Lower Extremity Torque Patterns During Locomotion

    NASA Technical Reports Server (NTRS)

    DeWitt, John K.; Cromwell, Ronita L.; Hagan, R. Donald

    2007-01-01

    During locomotion, humans adapt their motor patterns to maintain coordination despite changing conditions (Reisman et al., 2005). Bernstein (1967) proposed that in addition to the present state of a given joint, other factors, including limb inertia and velocity, must be taken into account to allow proper motion to occur. During locomotion with added mass counterbalanced using vertical suspension to maintain body weight, vertical ground reaction forces (GRF's) increase during walking but decrease during running, suggesting that adaptation may be velocity-specific (De Witt et al., 2006). It is not known, however, how lower extremity joint torques adapt to changes in inertial forces. The purpose of this investigation was to examine the effects of increasing body mass while maintaining body weight upon lower-limb joint torque during walking and running. We hypothesized that adaptations in joint torque patterns would occur with the addition of body mass.

  15. Selective serotonin reuptake inhibitor discontinuation: side effects and other factors that influence medication adherence.

    PubMed

    Goethe, John W; Woolley, Stephen B; Cardoni, Alex A; Woznicki, Brenda A; Piez, Deborah A

    2007-10-01

    Patients with major depression discontinue taking their antidepressants for many reasons. Although side effects are often cited as the reason for discontinuation, few prospective studies have addressed this question, and none has specifically examined discontinuation in patients with severe depression. Inpatients and outpatients treated with a selective serotonin reuptake inhibitor for major depressive disorder were identified after admission. Three months later, patients were contacted and interviewed to determine antidepressant usage and the side effects experienced, including when these were experienced and their severity. Between October 2001 and April 2003, 406 English- or Spanish-speaking patients aged 18 to 75 years were followed up. One in 4 patients discontinued the index antidepressant. Among specific side effects noted, only "change in weight" and "anxiety" were significant predictors of discontinuation after controlling for confounders. Experiencing 1 or more "extremely" bothersome side effects was associated with more than a doubling of the risk of discontinuation, but the presence of side effects and side effects less severe than "extremely" bothersome were not significant predictors. There were no differences among selective serotonin reuptake inhibitor antidepressants in either the presence/absence of side effects or in the discontinuation rates. The results suggest that the contribution of side effects to antidepressant discontinuation is more complex than previously suggested. Disparate findings from earlier studies may reflect aspects of study design, such as examining populations whose severity of depression varied widely or not controlling for important confounding factors. Future research should separately examine high-risk groups (or control for severity of depression) and carefully rule out other potential contributors to discontinuation.

  16. Validation of accuracy and community acceptance of the BIRTHweigh III scale for categorizing newborn weight in rural India.

    PubMed

    Darmstadt, G L; Kumar, V; Shearer, J C; Misra, R; Mohanty, S; Baqui, A H; Coffey, P S; Awasthi, S; Singh, J V; Santosham, M

    2007-10-01

    To determine the accuracy and acceptability of a handheld scale prototype designed for nonliterate users to classify newborns into three weight categories (>or=2,500 g; 2,000 to 2,499 g; and <2,000 g). Weights of 1,100 newborns in Uttar Pradesh, India, were measured on the test scale and validated against a gold standard. Mothers, family members and community health stakeholders were interviewed to assess the acceptability of the test scale. The test scale was highly sensitive and specific at classifying newborn weight (normal weight: 95.3 and 96.3%, respectively; low birth weight: 90.4 and 99.2%, respectively; very low birth weight: 91.7 and 98.4%, respectively). It was the overall agreement of the community that the test scale was more practical and easier to interpret than the gold standard. The BIRTHweigh III scale accurately identifies low birth weight and very low birth weight newborns to target weight-specific interventions. The scale is extremely practical and useful for resource-poor settings, especially those with low levels of literacy.

  17. Evidence for effects of weight on reproduction in women.

    PubMed

    Davies, Michael J

    2006-05-01

    Body weight, and its constituent components of fat mass and lean tissue, plays an important role modulating reproductive development and functioning. Body weight influences the timing of menarche and the capacity to achieve a pregnancy. The nature of this relationship appears to be some variant on a 'U' shape. Extremes in body weight are associated with infertility and a range of adverse outcomes for both mother and baby across the course of pregnancy and perinatal period. Whereas underweight is associated with poor fetal growth and elevated pregnancy loss, overweight is more strongly associated with diseases in pregnancy, pregnancy loss and stillbirth and high birth weight. An emerging area of interest is the role of obesity on fertility, and the intergenerational 'tracking' of high maternal body weight into the second and subsequent generations, resulting not only in an increased risk of metabolic disease, but also perturbed reproductive functioning in the offspring.

  18. Study on the relationship between backpack use and back and neck pain among adolescents.

    PubMed

    Navuluri, Neelima; Navuluri, Ramesh B

    2006-12-01

    A descriptive correlation study was conducted in Hobbs, New Mexico, USA, to find the relationship between backpack use and back and neck pain among adolescent boys and girls. A higher percentage of girls than boys rated their pain as being moderate to extremely strong. The correlation between pain and backpack weight per body mass index among girls was positive and significant, but negative and non-significant among boys. The correlation between pain and backpack weight was positive and non-significant among both boys and girls. The correlation between pain and each of the variables of backpack weight per body weight, backpack weight per height, and backpack weight per body surface area was negative and non-significant among boys, but positive and non-significant among girls. Gender-based research studies with additional variables and safe backpack use education in schools are recommended.

  19. Survival and developmental disability in infants with birth weights of 501 to 800 grams, born between 1979 and 1994.

    PubMed

    O'Shea, T M; Klinepeter, K L; Goldstein, D J; Jackson, B W; Dillard, R G

    1997-12-01

    Because the survival rate has increased for extremely low birth weight neonates, many have raised the concern that the rate of developmental disability among survivors will also increase. To address this concern, we analyzed changes over time in survival and major neurosensory impairment in a sample of extremely low birth weight infants born between July 1, 1979, and June 30, 1994. The study sample included 513 infants with birth weights of 501 to 800 g who were cared for in either of the two neonatal intensive care units that serve a 17-county region in northwest North Carolina and who were born to mothers residing in that region. At 1 year of age (corrected for gestation), survivors were examined by a pediatrician and were tested using the Bayley Scales of Infant Development. Major neurosensory impairment was defined as cerebral palsy, a Bayley Mental Developmental Index <68, or blindness. A total of 209/216 (97%) of survivors were examined at 1 year of age. Epoch of birth was defined as follows: epoch 1, July 1, 1979 to June 30, 1984; epoch 2, July 1, 1984 to June 30, 1989; and epoch 3, July 1, 1989 to June 30, 1994. Survival rates for epochs 1, 2, and 3 were, respectively, 24/120 (20%), 63/175 (36%), and 129/218 (59%). In contrast, the proportions with a major neurosensory impairment did not increase over time; rates for successive epochs were 6/24 (25%), 17/61 (28%), and 26/124 (21%). Rates of cerebral palsy were 3/24 (13%), 12/61 (20%), and 9/124 (7%); rates of delayed mental development were 4/24 (17%), 12/61 (20%), and 17/124 (14%); and rates of blindness were 2/24 (8%), 0/62, and 5/124 (4%), respectively. This analysis suggests that the increasing survival of extremely low birth weight neonates since the late 1970s has not resulted in an increased rate of major developmental problems identifiable at 1 year of age.

  20. Management of Chronic Pain of Cervical Disc Herniation and Radiculitis with Fluoroscopic Cervical Interlaminar Epidural Injections

    PubMed Central

    Manchikanti, Laxmaiah; Cash, Kimberly A.; Pampati, Vidyasagar; Wargo, Bradley W.; Malla, Yogesh

    2012-01-01

    Study Design: A randomized, double-blind, active controlled trial. Objective: To evaluate the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids in the management of chronic neck pain and upper extremity pain in patients with disc herniation and radiculitis. Summary of Background Data: Epidural injections in managing chronic neck and upper extremity pain are commonly employed interventions. However, their long-term effectiveness, indications, and medical necessity, of their use and their role in various pathologies responsible for persistent neck and upper extremity pain continue to be debated, even though, neck and upper extremity pain secondary to disc herniation and radiculitis, is described as the common indication. There is also paucity of high quality literature. Methods: One-hundred twenty patients were randomly assigned to one of 2 groups: Group I patients received cervical interlaminar epidural injections of local anesthetic (lidocaine 0.5%, 5 mL); Group II patients received 0.5% lidocaine, 4 mL, mixed with 1 mL of nonparticulate betamethasone. Primary outcome measure was ≥ 50 improvement in pain and function. Outcome assessments included Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), opioid intake, employment, and changes in weight. Results: Significant pain relief and functional status improvement (≥ 50%) was demonstrated in 72% of patients who received local anesthetic only and 68% who received local anesthetic and steroids. In the successful group of participants, significant improvement was illustrated in 77% in local anesthetic group and 82% in local anesthetic with steroid group. Conclusions: Cervical interlaminar epidural injections with or without steroids may provide significant improvement in pain and function for patients with cervical disc herniation and radiculitis. PMID:22859902

  1. Management of chronic pain of cervical disc herniation and radiculitis with fluoroscopic cervical interlaminar epidural injections.

    PubMed

    Manchikanti, Laxmaiah; Cash, Kimberly A; Pampati, Vidyasagar; Wargo, Bradley W; Malla, Yogesh

    2012-01-01

    A randomized, double-blind, active controlled trial. To evaluate the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids in the management of chronic neck pain and upper extremity pain in patients with disc herniation and radiculitis. Epidural injections in managing chronic neck and upper extremity pain are commonly employed interventions. However, their long-term effectiveness, indications, and medical necessity, of their use and their role in various pathologies responsible for persistent neck and upper extremity pain continue to be debated, even though, neck and upper extremity pain secondary to disc herniation and radiculitis, is described as the common indication. There is also paucity of high quality literature. One-hundred twenty patients were randomly assigned to one of 2 groups: Group I patients received cervical interlaminar epidural injections of local anesthetic (lidocaine 0.5%, 5 mL); Group II patients received 0.5% lidocaine, 4 mL, mixed with 1 mL of nonparticulate betamethasone. Primary outcome measure was ≥ 50 improvement in pain and function. Outcome assessments included Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), opioid intake, employment, and changes in weight. Significant pain relief and functional status improvement (≥ 50%) was demonstrated in 72% of patients who received local anesthetic only and 68% who received local anesthetic and steroids. In the successful group of participants, significant improvement was illustrated in 77% in local anesthetic group and 82% in local anesthetic with steroid group. Cervical interlaminar epidural injections with or without steroids may provide significant improvement in pain and function for patients with cervical disc herniation and radiculitis.

  2. MaRIE: an experimental facility concept revolutionizing materials in extremes

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Barnes, Cris W

    The Matter-Radiation Interactions in Extremes (MaRIE) project intends to create an experimental facility that will revolutionize the control of materials in extremes. That control extends to extreme regimes where solid material has failed and begins to flow - the regimes of fluid dynamics and turbulent mixing. This presentation introduces the MaRIE facility concept, demonstrates examples of the science case that determine its functional requirements, and kicks-off the discussion of the decadal scientific challenges of mixing in extremes, including those MaRIE might address.

  3. Age Differences in Energy Absorption in the Upper Extremity During a Descent Movement: Implications for Arresting a Fall

    PubMed Central

    Stotz, Paula J.; Normandin, Sarah C.; Robinovitch, Stephen N.

    2010-01-01

    Background Falls are the number one cause of unintentional injury in older adults. The protective response of “breaking the fall” with the outstretched hand is often essential for avoiding injury to the hip and head. In this study, we compared the ability of young and older women to absorb the impact energy of a fall in the outstretched arms. Methods Twenty young (mean age = 21 years) and 20 older (M = 78 years) women were instructed to slowly lower their body weight, similar to the descent phase of a push-up, from body lean angles ranging from 15° to 90°. Measures were acquired of peak upper extremity energy absorption, arm deflection, and hand contact force. Results On average, older women were able to absorb 45% less energy in the dominant arm than young women (1.7 ± 0.5% vs 3.1 ± 0.4% of their body weight × body height; p < .001). These results suggest that, even when both arms participate equally, the average energy content of a forward fall exceeds by 5-fold the average energy that our older participants could absorb and exceeds by 2.7-fold the average energy that young participants could absorb. Conclusions During a descent movement that simulates fall arrest, the energy-absorbing capacity of the upper extremities in older women is nearly half that of young women. Absorbing the full energy of a fall in the upper extremities is a challenging task even for healthy young women. Strengthening of upper extremity muscles should enhance this ability and presumably reduce the risk for injury to the hip and head during a fall. PMID:19861641

  4. Age differences in energy absorption in the upper extremity during a descent movement: implications for arresting a fall.

    PubMed

    Sran, Meena M; Stotz, Paula J; Normandin, Sarah C; Robinovitch, Stephen N

    2010-03-01

    Falls are the number one cause of unintentional injury in older adults. The protective response of "breaking the fall" with the outstretched hand is often essential for avoiding injury to the hip and head. In this study, we compared the ability of young and older women to absorb the impact energy of a fall in the outstretched arms. Twenty young (mean age = 21 years) and 20 older (M = 78 years) women were instructed to slowly lower their body weight, similar to the descent phase of a push-up, from body lean angles ranging from 15 degrees to 90 degrees . Measures were acquired of peak upper extremity energy absorption, arm deflection, and hand contact force. On average, older women were able to absorb 45% less energy in the dominant arm than young women (1.7 +/- 0.5% vs 3.1 +/- 0.4% of their body weight x body height; p < .001). These results suggest that, even when both arms participate equally, the average energy content of a forward fall exceeds by 5-fold the average energy that our older participants could absorb and exceeds by 2.7-fold the average energy that young participants could absorb. During a descent movement that simulates fall arrest, the energy-absorbing capacity of the upper extremities in older women is nearly half that of young women. Absorbing the full energy of a fall in the upper extremities is a challenging task even for healthy young women. Strengthening of upper extremity muscles should enhance this ability and presumably reduce the risk for injury to the hip and head during a fall.

  5. Lower extremity strength, systemic inflammation and all-cause mortality: Application to the "fat but fit" paradigm using cross-sectional and longitudinal designs.

    PubMed

    Buckner, Samuel L; Loenneke, Jeremy P; Loprinzi, Paul D

    2015-10-01

    No study has applied the "fat-but-fit" paradigm with respect to muscular strength as an index of fitness, despite muscular strength being independently associated with functional ability and mortality. To examine the relationship between lower extremity muscular strength, C-reactive protein (CRP), and all-cause mortality among normal weight, overweight and obese individuals. Data from the 1999-2002 NHANES were used (N=2740 adults; ≥ 50 years). CRP values were obtained from a blood sample. Lower body isokinetic knee extensor strength (IKES) was assessed using a Kin Kom MP isokinetic dynamometer. Participant data was linked to death certificate data from the National Death Index to ascertain all-cause mortality status. Participants were classified, based on body mass index (BMI) and strength as: normal weight and unfit (<75th IKES percentile); overweight and unfit; obese and unfit: normal weight and fit (≥ 75th IKES percentile); overweight and fit; and obese and fit. Independent of physical activity and other confounders, compared to those who were normal weight and unfit, unfit overweight (β=.14, p=0.009), unfit obese (β=.33, p<0.001), and obese and fit (β=.17, p=0.008) participants, had higher CRP levels. However, there was no difference in CRP levels between normal weight and unfit participants and overweight and fit participants (β=0.04, p=0.35). Compared to normal weight unfit adults, overweight fit (HR=0.28; 95% CI: 0.11-0.70; p=0.008) adults had a lower hazard rate for all-cause mortality. These finding suggest that increased lower body strength, independent of physical activity, may reduce premature all-cause mortality and attenuate systemic inflammation among overweight adults. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Weight-control behaviour and weight-concerns in young elite athletes – a systematic review

    PubMed Central

    2013-01-01

    Weight-control behaviour is commonly observed in a wide range of elite sports, especially leanness sports, where control over body weight is crucial for high peak performance. Nonetheless, there is only a fine line between purely functional behaviour and clinically relevant eating disorders. Especially the rapid form of weight manipulation seems to foster later eating disorders. So far, most studies have focussed on adult athletes and concentrated on manifest eating disorders. In contrast, our review concentrates on young athletes and weight-control behaviour as a risk factor for eating disorders. An electronic search according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement was performed using Pubmed, PsychInfo and Spolit. The following search terms were used: weight-control, weight-control behaviour, weight gain, weight loss, pathogenic weight-control behaviour and weight-concerns, each of them combined with elite athlete, young elite athlete, adolescent elite athlete and elite sports. Overall, data are inconsistent. In general, athletes do not seem to be at a higher risk for pathogenic weight concerns and weight-control behaviour. It does seem to be more prevalent in leanness sports, though. There is evidence for pathogenic weight-control behaviour in both genders; male athletes mostly trying to gain weight whereas females emphasise weight reduction. There is not enough data to make predictions about connections with age of onset. Young elite athletes do show weight-control behaviour with varying degrees of frequency and severity. In particular, leanness sports seem to be a risk factor for weight manipulation. Further research is needed for more details and possible connections. PMID:24999399

  7. Neurodevelopmental Outcomes of Extremely Preterm Infants Randomized to Stress Dose Hydrocortisone

    PubMed Central

    Parikh, Nehal A.; Kennedy, Kathleen A.; Tyson, Jon E.

    2015-01-01

    Objective To compare the effects of stress dose hydrocortisone therapy with placebo on survival without neurodevelopmental impairments in high-risk preterm infants. Study Design We recruited 64 extremely low birth weight (birth weight ≤1000g) infants between the ages of 10 and 21 postnatal days who were ventilator-dependent and at high-risk for bronchopulmonary dysplasia. Infants were randomized to a tapering 7-day course of stress dose hydrocortisone or saline placebo. The primary outcome at follow-up was a composite of death, cognitive or language delay, cerebral palsy, severe hearing loss, or bilateral blindness at a corrected age of 18–22 months. Secondary outcomes included continued use of respiratory therapies and somatic growth. Results Fifty-seven infants had adequate data for the primary outcome. Of the 28 infants randomized to hydrocortisone, 19 (68%) died or survived with impairment compared with 22 of the 29 infants (76%) assigned to placebo (relative risk: 0.83; 95% CI, 0.61 to 1.14). The rates of death for those in the hydrocortisone and placebo groups were 31% and 41%, respectively (P = 0.42). Randomization to hydrocortisone also did not significantly affect the frequency of supplemental oxygen use, positive airway pressure support, or need for respiratory medications. Conclusions In high-risk extremely low birth weight infants, stress dose hydrocortisone therapy after 10 days of age had no statistically significant effect on the incidence of death or neurodevelopmental impairment at 18–22 months. These results may inform the design and conduct of future clinical trials. Trial Registration ClinicalTrials.gov NCT00167544 PMID:26376074

  8. Arterial blood pressure response to heavy resistance exercise.

    PubMed

    MacDougall, J D; Tuxen, D; Sale, D G; Moroz, J R; Sutton, J R

    1985-03-01

    The purpose of this study was to record the blood pressure response to heavy weight-lifting exercise in five experienced body builders. Blood pressure was directly recorded by means of a capacitance transducer connected to a catheter in the brachial artery. Intrathoracic pressure with the Valsalva maneuver was recorded as mouth pressure by having the subject maintain an open glottis while expiring against a column of Hg during the lifts. Exercises included single-arm curls, overhead presses, and both double- and single-leg presses performed to failure at 80, 90, 95, and 100% of maximum. Systolic and diastolic blood pressures rose rapidly to extremely high values during the concentric contraction phase for each lift and declined with the eccentric contraction. The greatest peak pressures occurred during the double-leg press where the mean value for the group was 320/250 mmHg, with pressures in one subject exceeding 480/350 mmHg. Peak pressures with the single-arm curl exercise reached a mean group value of 255/190 mmHg when repetitions were continued to failure. Mouth pressures of 30-50 Torr during a single maximum lift, or as subjects approached failure with a submaximal weight, indicate that a portion of the observed increase in blood pressure was caused by a Valsalva maneuver. It was concluded that when healthy young subjects perform weight-lifting exercises the mechanical compression of blood vessels combines with a potent pressor response and a Valsalva response to produce extreme elevations in blood pressure. Pressures are extreme even when exercise is performed with a relatively small muscle mass.

  9. Outcome Trajectories in Extremely Preterm Infants

    PubMed Central

    Carlo, Waldemar A.; Tyson, Jon E.; Langer, John C.; Walsh, Michele C.; Parikh, Nehal A.; Das, Abhik; Van Meurs, Krisa P.; Shankaran, Seetha; Stoll, Barbara J.; Higgins, Rosemary D.

    2012-01-01

    OBJECTIVE: Methods are required to predict prognosis with changes in clinical course. Death or neurodevelopmental impairment in extremely premature neonates can be predicted at birth/admission to the ICU by considering gender, antenatal steroids, multiple birth, birth weight, and gestational age. Predictions may be improved by using additional information available later during the clinical course. Our objective was to develop serial predictions of outcome by using prognostic factors available over the course of NICU hospitalization. METHODS: Data on infants with birth weight ≤1.0 kg admitted to 18 large academic tertiary NICUs during 1998–2005 were used to develop multivariable regression models following stepwise variable selection. Models were developed by using all survivors at specific times during hospitalization (in delivery room [n = 8713], 7-day [n = 6996], 28-day [n = 6241], and 36-week postmenstrual age [n = 5118]) to predict death or death/neurodevelopmental impairment at 18 to 22 months. RESULTS: Prediction of death or neurodevelopmental impairment in extremely premature infants is improved by using information available later during the clinical course. The importance of birth weight declines, whereas the importance of respiratory illness severity increases with advancing postnatal age. The c-statistic in validation models ranged from 0.74 to 0.80 with misclassification rates ranging from 0.28 to 0.30. CONCLUSIONS: Dynamic models of the changing probability of individual outcome can improve outcome predictions in preterm infants. Various current and future scenarios can be modeled by input of different clinical possibilities to develop individual “outcome trajectories” and evaluate impact of possible morbidities on outcome. PMID:22689874

  10. Comparison at 32-37 Weeks Postconception of Infants Born 1983-1989 and 1995-2004 on the Neurobehavioral Assessment of the Preterm Infant

    ERIC Educational Resources Information Center

    Brown, Josephine V.; Bakeman, Roger; Sampers, Jackie S.; Korner, Anneliese F.; Constantinou, Janet C.; Anand, K. J. S.

    2008-01-01

    In spite of numerous recent outcome studies of extremely low birth weight (ELBW) infants, no data exist on their development prior to term. In this study we traced and compared the neurobehavioral development of 251 ELBW (less than 1,000 g) and 240 low birth weight (LBW; 1,000 g-2,500 g) preterms born between 1995 and 2004 from 32 to 37 weeks…

  11. Malnutrition in school children in an urban-rural region of the extreme South of São Paulo city.

    PubMed

    Pandolfi, Marcela Maria; Sandrini, Fabio; Oliveira, Maurício Rocco de; Armond, Jane de Eston; Zöllner, Ana Cristina Ribeiro; Juliano, Yara; Souza, Patrícia Colombo de

    2011-12-01

    To evaluate the persistence of nutritional deficit in a sample of schoolchildren. A cross-sectional study of 1,761 schoolchildren between 6 and 10 years from 3 schools. They were assessed by Z scores of weight for height and height for age, according to the World Health Organization. The variables studied were gender, age, grade and school year. The χ² test was used to relate the nutritional deficit with the variables. Of all children 8.5% were malnourished according to the weight for height Z score, 21.6%, according to height for age. The analysis of the weight for height Z score revealed that 59.7% were male and 40.3% female. The mean age was 8.9 years. As to the Z score of height for age, 53.9% were males and 46.1% females. The risk of malnutrition was higher among boys: 59.7% for the weight for height index and 53.9% for height for age. There was no statistical difference between schools, gender and school year. As to nutritional status, school period (p < 0.0001) and students' grade (p = 0.0105), we observed statistical significance. Malnutrition still persists among the low-income population and males had a higher percentage of malnutrition. Nutritional evaluation of students is an extremely important tool for understanding the dynamics of child nutrition and development.

  12. Better Glycemic Control Is Associated With Maintenance of Lower-Extremity Function Over Time in Mexican American and European American Older Adults With Diabetes

    PubMed Central

    Wang, Chen-Pin; Hazuda, Helen P.

    2011-01-01

    OBJECTIVE Diabetes is a major cause of functional decline among older adults, but the role of glycemic control remains unclear. This article assesses whether better glycemic control is associated with better maintenance of lower-extremity function over time in older adults with diabetes. RESEARCH DESIGN AND METHODS Participants (n = 119) in the San Antonio Longitudinal Study of Aging, ages 71–85, who met American Diabetes Association diabetes criteria were followed over a 36-month period. Seven measures of A1C (HbA1c) were obtained at 6-month intervals; three measures of lower-extremity function were obtained at 18-month intervals using the Short Physical Performance Battery (SPPB). A two-step analytic approach was used, first, to identify distinct glycemic control classes using latent growth mixture modeling and, second, to examine trajectories of lower-extremity function based on these classes using path analysis. RESULTS Two glycemic control classes were identified: a poorer control class with higher means (all >7%) and higher within-subject variability in HbA1c and a better control class with lower means (all <7%) and lower within-subject variability. The short-term and long-term maintenance of lower-extremity function, assessed by the association between the first and second SPPB measures and the first and third SPPB measures, were both greater in the better control class than in the poorer control class. CONCLUSIONS Among older adults with diabetes, better glycemic control may improve both short-term and long-term maintenance of lower-extremity function. PMID:21216857

  13. Better glycemic control is associated with maintenance of lower-extremity function over time in Mexican American and European American older adults with diabetes.

    PubMed

    Wang, Chen-Pin; Hazuda, Helen P

    2011-02-01

    Diabetes is a major cause of functional decline among older adults, but the role of glycemic control remains unclear. This article assesses whether better glycemic control is associated with better maintenance of lower-extremity function over time in older adults with diabetes. Participants (n = 119) in the San Antonio Longitudinal Study of Aging, ages 71-85, who met American Diabetes Association diabetes criteria were followed over a 36-month period. Seven measures of A1C (HbA(1c)) were obtained at 6-month intervals; three measures of lower-extremity function were obtained at 18-month intervals using the Short Physical Performance Battery (SPPB). A two-step analytic approach was used, first, to identify distinct glycemic control classes using latent growth mixture modeling and, second, to examine trajectories of lower-extremity function based on these classes using path analysis. Two glycemic control classes were identified: a poorer control class with higher means (all >7%) and higher within-subject variability in HbA(1c) and a better control class with lower means (all <7%) and lower within-subject variability. The short-term and long-term maintenance of lower-extremity function, assessed by the association between the first and second SPPB measures and the first and third SPPB measures, were both greater in the better control class than in the poorer control class. Among older adults with diabetes, better glycemic control may improve both short-term and long-term maintenance of lower-extremity function.

  14. Acute Responses to Diuretic Therapy in Extremely Low Gestational Age Newborns: Results from the Prematurity and Respiratory Outcomes Program Cohort Study.

    PubMed

    Blaisdell, Carol J; Troendle, James; Zajicek, Anne

    2018-06-01

    To determine if daily respiratory status improved more in extremely low gestational age (GA) premature infants after diuretic exposure compared with those not exposed in modern neonatal intensive care units. The Prematurity and Respiratory Outcomes Program (PROP) was a multicenter observational cohort study of 835 extremely premature infants, GAs of 23 0/7 -28 6/7 weeks, enrolled in the first week of life from 13 US tertiary neonatal intensive care units. We analyzed the PROP study daily medication and respiratory support records of infants ≤34 weeks postmenstrual age. We determined whether there was a temporal association between the administration of diuretics and an acute change in respiratory status in premature infants in the neonatal intensive care unit, using an ordered categorical ranking of respiratory status. Infants in the diuretic exposed group of PROP were of lower mean GA and lower mean birth weight (P < .0001). Compared with infants unexposed to diuretics, the probability (adjusted for infant characteristics including GA, birth weight, sex, and respiratory status before receiving diuretics) that the exposed infants were on a higher level of respiratory support was significantly greater (OR, >1) for each day after the initial day of diuretic exposure. Our analysis did not support the ability of diuretics to substantially improve the extremely premature infant's respiratory status. Further study of both safety and efficacy of diuretics in this setting are warranted. Clinicaltrials.gov: NCT01435187. Published by Elsevier Inc.

  15. The effect of sensory-motor training on hand and upper extremity sensory and motor function in patients with idiopathic Parkinson disease.

    PubMed

    Taghizadeh, Ghorban; Azad, Akram; Kashefi, Sepiede; Fallah, Soheila; Daneshjoo, Fatemeh

    2017-11-14

    Blinded randomized controlled trial. Patients with Parkinson disease (PD) have sensory problems, but there is still no accurate understanding of the effects of sensory-motor interventions on PD. To investigate the effects of sensory-motor training (SMT) on hand and upper extremity sensory and motor function in patients with PD. Forty patients with PD were allocated to the SMT group or the control group (CG) (mean ages ± standard deviation: SMT, 61.05 ± 13.9 years; CG, 59.15 ± 11.26 years). The CG received the common rehabilitation therapies, whereas the SMT group received SMT. The SMT included discrimination of temperatures, weights, textures, shapes, and objects and was performed 5 times each week for 2 weeks. Significantly reducing the error rates in the haptic object recognition test (dominant hand [DH]: F = 15.36, P = .001, and effect size [ES] = 0.29; nondominant hand [NDH]: F = 9.33, P = .004, and ES = 0.21) and the error means in the wrist proprioception sensation test (DH: F = 9.11, P = .005, and ES = 0.19; NDH: F = 13.04, P = .001, and ES = 0.26) and increasing matched objects in the hand active sensation test (DH: F = 12.15, P = .001, and ES = 0.24; NDH: F = 5.03, P = .03, and ES = 0.12) founded in the SMT. Also, the DH (F = 6.65, P = .01, and ES = 0.15), both hands (F = 7.61, P = .009, and ES = 0.17), and assembly (F = 7.02, P = .01, and ES = 0.15) subtests of fine motor performance, as well as DH (F = 10.1, P = .003, and ES = 0.21) and NDH (F = 8.37, P = .006, and ES = 0.18) in upper extremity functional performance, were improved in the SMT. SMT improved hand and upper extremity sensory-motor function in patients with PD. The SMT group showed improved sensory and motor function. But these results were limited to levels 1 to 3 of the Hoehn and Yahr Scale. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  16. Association of Antegrade Pulmonary Artery Diastolic Velocity with Spontaneous Closure of the Patent Ductus Arteriosus in Extremely Low-Birth-Weight Infants.

    PubMed

    Weiss, Dawn M; Kaiser, Jeffrey R; Swearingen, Christopher; Malik, Sadia; Sachdeva, Ritu

    2015-11-01

    This study aims to determine echocardiographic parameters associated with spontaneous patent ductus arteriosus (PDA) closure in extremely low-birth-weight (ELBW) infants. Retrospective demographic review and analysis of echocardiograms from 189 ELBW infants with suspected and confirmed hemodynamically significant PDA identified on an initial echocardiogram was performed. Comparison of echocardiographic parameters was made between infants with spontaneous closure versus those who received treatment. The mean birth weight (787 ± 142 vs. 724 ± 141 g, p = 0.04) and gestational age (27.4 ± 2.8 vs. 26.2 ± 1.6 weeks, p = 0.03) were higher in the spontaneous closure versus the treatment group. Antegrade pulmonary artery (PA) diastolic velocity was lower in infants with spontaneous PDA closure versus those who received treatment (0.15 ± 0.06 vs. 0.22 ± 0.12 m/s, p = 0.009). Heavier and more mature ELBW infants with a lower antegrade PA diastolic velocity were likely to have spontaneous closure of the PDA. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  17. ZERODUR iso-grid design of a 3m class light weighted mirror blank for the E-ELT M5

    NASA Astrophysics Data System (ADS)

    Jedamzik, Ralf; Leys, Antoine; Seibert, Volker; Westerhoff, Thomas

    2014-07-01

    The tip and tilt M5 mirror of the European Extremly Large Telescope (E-ELT) requires a demanding approach in light weighting. The approximately 3 m x 2.5 m elliptical plano mirror is specified to a weight of less than 500 kg with high Eigenfrequencies and low deformation under different inclination angles. In 2011 SCHOTT has presented a study to develop a design for the M5 mirror blank of the ESO E-ELT. The design presented was based on a radial square design to achieve the best compromise between performance and manufacturability. With the fabrication of a prototype section SCHOTT demonstrated its capability to manufacture the demanding features including pockets with 350 mm depth, thin walls and sloped pocket bottoms. Now 3 years later SCHOTT presents an iso-grid based design that is in accordance with the manufacturability progress that has been demonstrated in various ELZM (Extremely Lightweighted ZERODUR Mirrors) publications in the last two years. The achievements on the specified mechanical parameters are compared to the first approach from 2011. In this paper the results are presented and the performance parameters are discussed.

  18. Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants Ventilated With Continuous Positive Airway Pressure vs. Mechanical Ventilation

    PubMed Central

    Thomas, Cameron W.; Meinzen-Derr, Jareen; Hoath, Steven B.; Narendran, Vivek

    2012-01-01

    OBJECTIVE To compare continuous positive airway pressure (CPAP) vs. traditional mechanical ventilation (MV) at 24 h of age as predictors of neurodevelopmental (ND) outcomes in extremely low birth weight (ELBW) infants at 18-22 mo corrected gestational age (CGA). METHODS Infants ≤ 1000g birth weight born from January 2000 through December 2006 at two hospitals at the Cincinnati site of the National Institute of Child Health and Human Development Neonatal Research Network were evaluated comparing CPAP (N = 198) vs. MV (N = 109). Primary outcomes included the Bayley Score of Infant Development Version II (BSID-II), presence of deafness, blindness, cerebral palsy, bronchopulmonary dysplasia and death. RESULTS Ventilatory groups were similar in gender, rates of preterm prolonged rupture of membranes, antepartum hemorrhage, use of antenatal antibiotics, steroids, and tocolytics. Infants receiving CPAP weighed more, were older, were more likely to be non-Caucasian and from a singleton pregnancy. Infants receiving CPAP had better BSID-II scores, and lower rates of BPD and death. CONCLUSIONS After adjusting for acuity differences, ventilatory strategy at 24 h of age independently predicts long-term neurodevelopmental outcome in ELBW infants. PMID:21853318

  19. The role of patent ductus arteriosus ligation in bronchopulmonary dysplasia: reexamining a randomized controlled trial.

    PubMed

    Clyman, Ronald; Cassady, George; Kirklin, James K; Collins, Monica; Philips, Joseph B

    2009-06-01

    To reexamine data from a randomized controlled trial of prophylactic ductus ligation to determine whether ligation contributes directly to the development of bronchopulmonary dysplasia (BPD) in extremely low birth weight infants. The control group underwent ligation only if they had development of a symptomatic patent ductus arteriosus (PDA). The Prophylactic Ligation group underwent ligation within 24 hours of birth regardless of the presence or absence of symptoms of a PDA. We hypothesized that the incidence of BPD would be higher in the prophylactic ligation group because more ligations were performed than in the control group. Prophylactic ligation significantly increased the incidence of BPD (defined as a supplemental oxygen requirement at 36 weeks postmenstrual age) and the incidence of mechanical ventilation at 36 weeks. The groups were statistically similar in gestation, sex, race, fluid administration, intraventricular hemorrhage, pulmonary air leaks, and survival to 36 weeks. The lower incidence of BPD in the control group occurred despite the fact that the incidence of necrotizing enterocolitis (a known risk factor for BPD) was significantly elevated in the control group. Only infants who had previously undergone a PDA ligation had development of BPD in the control group. Prophylactic ligation, while eliminating the PDA, increases the risk for BPD.

  20. A PYY Q62P variant linked to human obesity

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ahituv, Nadav; Kavaslar, Nihan; Schackwitz, Wendy

    2005-06-27

    Members of the pancreatic polypeptide family and the irreceptors have been implicated in the control of food intake in rodents and humans. To investigate whether nucleotide changes in these candidate genes result in abnormal weight in humans, we sequenced the coding exons and splice sites of seven family members (NPY, PYY, PPY, NPY1R, NPY2R, NPY4R, and NPY5R) in a large cohort of extremely obese (n=379) and lean (n=378) individuals. In total we found eleven rare non-synonymous variants, four of which exhibited familial segregation, NPY1R L53P and PPY P63L with leanness and NPY2R D42G and PYY Q62P with obesity. Functional analysismore » of the obese variants revealed NPY2R D42G to have reduced cell surface expression, while previous cell culture based studies indicated variant PYY Q62P to have altered receptor binding selectivity and we show that it fails to reduce food intake through mouse peptide injection experiments. These results support that rare non-synonymous variants within these genes can alter susceptibility to human body mass index extremes.« less

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