Anthropomorphic Measurements Research Articles

Changes in segmental mass and inertia during pregnancy: A musculoskeletal model of the pregnant woman

BackgroundOne in four pregnant women falls at least once during her pregnancy. During pregnancy, the body undergoes tremendous vascular, hormonal, physiological, and psychological changes to accommodate the growing fetus. The pregnancy-induced mass gain of 10 to 25 kg is not evenly distributed and results in a large change in mass distribution and shift in segmental centers of mass. To accurately understand how the change in mass distribution leads to an increase in fall events, a musculoskeletal model of the pregnant body is necessary. Generic musculoskeletal models cannot accurately represent the morphology of pregnant women and the study of postural stability of pregnant women is limited by the lack of adapted musculoskeletal models. Research questionCould a model reflecting the change in segmental inertia during pregnancy explain the pregnancy-related risk of falling? MethodsWe built a musculoskeletal model of the pregnant women, combining literature anthropomorphic measurements with generic models. We optimized the dimensions of the anthropomorphic model shapes to fit the average measurements of 25 pregnant women. The mass, center of mass, and inertia of each segment are then computed throughout pregnancy. Finally, the stance phase of a gait cycle was modeled using the pregnancy-specific and the generic models. The ankle, knee, hip and lumbar joint moments during gait were compared between the two models. ResultsThe built musculoskeletal model of the pregnant woman includes changes in mass and geometry of the thorax, pelvis, thighs, and legs. The model reproduces the change in lumbar curvature during pregnancy. Gait simulation results show a limited impact of pregnancy on the ankle, knee, and hip moment, but a large impact on the lumbar moment. SignificanceSuch a musculoskeletal model will help elucidate the mechanisms leading to falls or low back pain during pregnancy.

The Association Between Prediabetes and Dyslipidemia Among Attendants of Primary Care Health Centers in Jeddah, Saudi Arabia.

IntroductionEarly detection and treatment of dysglycemia including diabetes and prediabetes is demonstrated to improve disease outcomes and prevent complications.ObjectiveTo assess the association of prediabetes with lipid metabolism disorders to clarify whether systematic screening for prediabetes should be proposed for individuals with dyslipidemia.Material and MethodsA cross-sectional study design, employing a stratified two-stage cluster sampling method recruited non-diabetic adults (age ≥18 years) from attendees of Primary Health Care (PHC) centers in Jeddah. Anthropomorphic measurements, demographic and clinical information were taken, and blood pressure was measured. Fasting blood sample was obtained for the measurement of plasma glucose (FPG), glycated hemoglobin (HbA1C), and lipid profile. Plasma glucose was estimated 1 hr after the ingestion of 50 g glucose (1h-OGTT). Prediabetes and dyslipidemia were defined according to international guidelines. Demographic and clinical factors of subjects with prediabetes, and those with normoglycemia were compared. Multiple logistic regression analysis was used to adjust for confounding factors.ResultsA total of 613 individuals were included with a mean age (±SD) of 32±11.8years, and 54.8% being female. Prediabetes was detected in 28.7%, and dyslipidemia in 54.2% of participants. After adjusting for age, an association was found for high low-density lipoprotein-cholesterol (LDL-C) and prediabetes based on any definition. After adjustment for body mass index (BMI), the association was retained for any type of dyslipidemia and in particular high LDL-C. After adjusting for both age and BMI, a significant association was found only between high LDL-C and prediabetes based on any definition (OR, 95% CI=1.50,1.02–2.19, P= 0.037).ConclusionEven though high LDL-C is associated with an increased probability of prediabetes, a recommendation for universal screening of dyslipidemic patients requires further cohort studies.

Increased hand digit length ratio (2D:4D) is associated with increased severity of hypospadias in pre-pubertal boys.

Hypospadias is a common congenital male disorder, with much research focusing on prenatal androgen exposure as a causative factor. Whilst digit length ratios were apparent in sexual dimorphism since the nineteenth century, their role in hypospadias remains unknown. The objective of our study was to determine the correlation between digit length (2D:4D) ratio, hypospadias severity, and anogenital distance. Pre-pubertal boys (<3years old) seen intra/postoperatively following hypospadias repair (June 2018-January 2019 inc.) were included. These were age-matched to non-hypospadias controls. Anthropomorphic measurements of digit lengths, penile/glans width, and anogenital distance were measured using digital calipers. Data measurements were collected for 105 boys with hypospadias (60 distal; 45 proximal) and 55 controls. There were significant differences in 2D:4D ratios in each hand (p < 0.001), as well as individual digits (p < 0.001), and a reduced anogenital distance (p < 0.001), when comparing the proximal group with distal or control groups. There were no significant differences in glans width, or between term- and preterm births. This study is the first to demonstrate increased 2D:4D ratios with proximal hypospadias, which also correlate with a shortened anogenital distance. This may provide a non-invasive, potentially antenatal, anthropomorphic measurement, as an indirect indicator of aberrant urogenital development.

Safety and tolerability of sustained exogenous ketosis using ketone monoester drinks for 28 days in healthy adults

Throughout history, the only way humans could raise their blood ketone levels was by several days of fasting or by following a strict low-carb, high-fat diet. A recently developed, dietary source of ketones, a ketone monoester, elevates d-β-hydroxybutyrate (βHB) to similar concentrations within minutes, with βHB remaining raised for several hours. To date, the longest human safety study of the exogenous ketone ester was for 5 days, but longer consumption times may be desired. Here we report results for 24 healthy adults, aged 18–70 years, who drank 25 ml (26.8 g) of the ketone monoester, (R)-3-hydroxybutyl (R)-3-hydroxybutyrate, three times a day for 28 days (a total of 2.1 L). Anthropomorphic measurements, plus fasting blood and urine analyses were made weekly. It was found that elevating blood βHB concentrations from 0.1 to 4.1 (±1.1) mM three times a day for 28 days had no effect on body weights or composition, fasting blood glucose, cholesterol, triglyceride or electrolyte concentrations, nor blood gases or kidney function, which were invariably normal. Mild nausea was reported following 6 of the 2,016 drinks consumed. We conclude that sustained exogenous ketosis using a ketone monoester is safe and well-tolerated by healthy adults.

P5546The benefit of one week immersion in lifestyle-based program for sustainable improvements in cardiovascular risk factors over time

Abstract Background Hypertension (HTN), hyperlipidemia (HLD) and obesity are traditional risk factors for cardiovascular disease (CVD). Lifestyle measures for prevention of CVD include exercise, dietary changes such as reducing saturated fats, increasing fruits and vegetables, and limiting sugar intake but most people are not successful at making meaningful changes without support. Purpose To demonstrate the feasibility of a short-term lifestyle-based immersion in improving anthropomorphic measurements, blood pressure (BP) and lipids after one week, and its ability to create sustainable change in a high risk cohort. Methods This was a one-week lifestyle immersion for employees of their company and a significant other who were considered high risk for CVD. Eighty participants went through a one-week, in-house, lifestyle-based program that included daily nutrition education, 100% plant-based food that was sugar, salt and oil free, exercise classes and stress management. Anthropomorphic measurements, BP and lipids were checked at onset and on day 6. Dietary survey (validated 14-point Mediterranean diet survey), functional capacity survey (DASI survey) and quality of life (QOL) survey (SF-36) were administered at day 0 and 3-months post immersion. Results Of the 80 participants, 64% were female, mean age was 47 years (range 21–71), mean weight was 194.95 lbs. and average BMI was 30.47 kg/m2. Risk factors for CVD were prevalent as 71.25% of the participants had HTN, 27.5% had HbA1c &gt;6%, and there were 35% former and 7.5% active smokers. After one-week lifestyle immersion, average BMI improved by 0.50±0.38 kg/m2 (p&lt;0.001), average weight improved by 3.28±2.62 lbs. (p&lt;0.001) and average waist size improved with a loss of 0.73±1.20 inches (p&lt;0.001). Average systolic BP (SBP) decreased by 6.67±15.17 mmHg (p&lt;0.001) and diastolic BP (DBP) by 5.00±9.82 mmHg (p&lt;0.001). Average total cholesterol improved by 20.40±15.44 mg/dL (p&lt;0.001), triglycerides by 31.78±44.06 mg/dL (p&lt;0.001), HDL by 3.13±5.83 mg/dL (p&lt;0.001) and LDL by 11.71±15.92 mg/dL (p&lt;0.001). In participants who had HTN at the start of the study, average SBP dropped by 10.91±14.30 mmHg (p&lt;0.001) and average DBP by 8.02±8.84 mmHg (p&lt;0.001). DASI and Mediterranean diet surveys were completed by 66% at day 0 and three months. Over the 3 months, there was a significant improvement in both functional capacity (7.03±11.17 points, p&lt;0.001) and average diet score (1.38±2.40 points, p&lt;0.001). The QOL survey was completed by 56% participants with an improvement in quality of life score of 22.02±17.68 points (p&lt;0.001). Conclusion Short term intensive lifestyle interventions can lead to immediate and significant improvements in BP, weight and lipid profiles and importantly can have longer lasting effects on exercise capacity, dietary compliance and QOL. Further research to assess benefits of immersion programs with access to larger populations and for longer durations is warranted. Acknowledgement/Funding Whole Foods, Inc via Total Health Immersions, LLC

Enzalutamide Monotherapy with EBRT for Intermediate Risk Prostate Cancer. A Phase 2 Study

To assess the efficacy of the anti-androgen, enzalutamide, as short course monotherapy in combination with external beam radiation for intermediate risk. 64 patients were entered into this IRB approved study through the DH/HCC. Patients had biopsy confirmed intermediate risk prostate cancer as defined by a Gleason Score of 7and/or PSA 10-20 and/or T2b/T2c examination. Patients received six 28 day cycles of daily enzalutamide at 120 mg/day. External Beam utilizing IMRT to the prostate and seminal vesicles was begun during the 3rd cycle. Radiation dose was 75.6-79.2Gy in 1.8Gy/fxn. Patients were seen monthly for pill exchange to ensure compliance and end of treatment visit was at 3 months after completion of the enzalutamide (enzalutamide washout). PSA was measured at each visit. In addition levels of several sex hormones and markers of bone metabolism were measured at the beginning of the third and fifth cycle and at the end of treatment. Quality of life questionnaire (EPIC, Pittsburg Sleep inventory. . . . ) were provided and anthropomorphic measures taken at these time points. Fat at biceps, triceps scapula and midriff were measured as well as breast size. Men were permitted to receive external beam to the breast for gynecomastia or mastadynia. The primary endpoint was the PSA level after the 6th cycle of enzalutamide and external beam radiation. The study was powered such that if 60% of patients did not achieve a PSA ≤ 0.2 the study would be negative. Data is available for 62 or 64 patients (2 withdrew consent). In no patient was there a rise in PSA from the nadir during enzalutamide administration. No grade 3 radiation acute toxicities were observed. Grade 3 hypertension was documented in 12% which was managed medically. Significant increases in serum (total) testosterone and estradiol was observed which decreased after discontinuation of the medication. 17 men were treated with breast irradiation due to gynecomastia or mastadynia. There was no significant change in body fat measurements or weight during treatment. There was no change in sleep patterns from baseline during treatment. Use of single agent enzalutamide in combination with external beam radiation was very effective at decreasing PSA to very low levels with minimal toxicity in men with intermediate risk prostate cancer. Breast enlargement/pain and hypertension were the only issues encountered in this study. Further studies are required to determine whether the new class of potent anti-androgens can replace LH-RHa as the hormonal treatment in men with intermediate risk prostate.Abstract 2655; Table 1PSA undetectablePSA ≤0.2ng/mlP ≤0.5ng/mlPSA>0.53849602 Open table in a new tab

Patient size parameters to guide use of the Impella device in pediatric patients.

To define patient and ventricular size parameters to guide Impella device (Abiomed, Inc., Danvers, MA) placement for mechanical circulatory support (MCS) in small pediatric patients (10-30 kg). There are few options for MCS in children, and there are no data on minimum patient size requirements for placement of the Impella 2.5 device. This was a multicenter study of echocardiographic and magnetic resonance imaging (MRI) derived dimensions of the left ventricle (LV) length and ascending aorta used to define minimum size parameters that are necessary for the placement of the Impella catheter. Data were collected from 44 cardiac MRIs conducted in healthy pediatric patients and 39 echocardiograms performed in pediatric patients with cardiomyopathy prior to surgical ventricular assist device (VAD) placement. The Impella 2.5 catheter is 7.5 cm from the pigtail to the aortic annulus marker, thus requiring an LV apical length of 7.5 cm to allow the device to function in an unconstrained fashion. In the cohort of patients undergoing consideration for VAD placement, a minimum LV length of 7.5 cm corresponded to a height of 122 cm, weight of 23 kg, and body surface area (BSA) of 0.89 m2 . In the MRI cohort, this corresponded to a height of 121 cm, weight of 23.9 kg, and BSA of 0.89 m2 . MCS with Impella devices is feasible in pediatric patients. This study defines anthropomorphic and anatomic measurements to guide providers in patient selection for MCS using the Impella devices.

Differences in Dietary Intake of Women with Standard Weight but Varying Body Fat Percentages in Japan

“Hidden obese people” have a high body fat percentage (BFP) despite having a normal BMI (18.5 &lt;BMI ? 25.0 BFP ?30) due to an excessive accumulation of visceral fat, which increases their risk of lifestyle-related diseases. We aimed to identify factors that contribute to hidden obesity among Japanese female students at the Nutritionist Training Facility University using their anthropomorphic measurements, lifestyle characteristics and nutritional intake. Characteristics of participants with hidden obesity physique (18.5 &lt;BMI ? 25.0 and BFP &gt;30%) (n = 160) and standard physique (18.5 &lt;BMI ? 25.0 and BFP &lt;30%) (n = 376) were compared using Student’s t-test or Welch’s t-test. The participants with hidden obesity physique have lower intake of energy (p = 0.044) and fat (p = 0.036) and a higher intake of carbohydrates (p = 0.023), cereals (p = 0.009) and sugary beverages (p = 0.020). This study suggests that a reduction in carbohydrate-dense foods is effective in preventing hidden obesity.

The Relationship between the Waist Circumference and Increased Carotid Intima Thickness in Obese Children.

Background: This study aimed to evaluate the cardiometabolic risk factors in normotensive obese and hypertensive obese (HT-obese) children by comparison of anthropomorphic measurements, fat distribution, carotid artery intima-media thickness (CIMT), and inflammatory markers. Methods: Fifty-three obese patients 10-18 years of age with a BMI-for-age/gender >95th percentile and 20 age- and gender-matched healthy volunteers enrolled in the study. Obese patients were divided into two groups according to the presence of hypertension (HT), as follows: HT-obese subgroup (n = 30) and nonhypertensive obese (non-HT-obese) subgroup (n = 23). Results: Weight standard deviation score (SDS), BMI-SDS, waist circumference (WC) SDS, and the fat tissue z-score were significantly higher (p < 0.001 for all) in the obese patients than the control groups. Obese patients had higher 24-hour systolic blood pressure (SBP) SDS and leptin, high-sensitivity C-reactive protein, tumor necrosis factor-alpha, and interleukin-6 levels. Furthermore, CIMT and CIMT-SDS were significantly higher in them. HT-obese patients (n = 30) had significantly higher WC-SDS and lower serum leptin and adiponectin levels than those of non-HT-obese group (n = 23). Finally, an association between increased CIMT-SDS and WC-SDS (β = 0.399, p = 0.002) and 24-hour SBP-SDS (β = 0.272, p = 0.009) was shown. Conclusions: Association between increased WC and HT implies the importance of central obesity in atherosclerosis. We concluded that WC measurement could be used to define risk groups since it is related to cardiometabolic complications.

The Implementation of a National Physical Activity Intervention in Colombia.

Background: In 2011, the Colombian government started a nationwide program, Hábitos y Estilos de Vida Saludable (HEVS; Healthy Life Habits), providing free, community-based physical activity classes for individuals across Colombia. This study describes the HEVS program, participant characteristics, and changes in anthropomorphic and health measures following the program. Methods: In this observational study, demographic information, current health status, lifestyle habits, and anthropomorphic measures were collected from adult HEVS participants at baseline and after program completion 11 months later. Changes in anthropomorphic and health measurements after the HEVS program were compared in the same participants using a paired t test and McNemar test, respectively. Results: A total of 56,472 adult participants (86.5% female) enrolled in the HEVS program. The greatest proportion of participants was between the ages of 18 and 34 years. Prior to participating in HEVS, mean body mass index and waist circumference were 26.3kg/m2 and 85.7cm, respectively. Postprogram data from 17,145 individuals showed statistically significant decreases in body mass index, waist circumference, and the proportion of patients with self-reported hypertension. Conclusions: The HEVS program successfully engaged a large number of Colombians in physical activity and resulted in significant improvements in their health, demonstrating the effectiveness of a government-supported, community-based physical activity program.

Anthropomorphism of Robots: Study of Appearance and Agency.

BackgroundAs the prevalence of robots increases each year, understanding how we anthropomorphize and interact with them is extremely important. The three-factor theory of anthropomorphism, called the Sociality, Effectance, Elicited agent Knowledge model, guided this study. As anthropomorphism involves a person making attributions of human likeness toward a nonhuman object, this model implies that anthropomorphism can be influenced either by factors related to the person or the object.ObjectiveThe aim of this study was to explore factors influencing the anthropomorphism of robots, specifically the robot’s appearance (humanoid vs nonhumanoid) and agency (autonomous vs nonautonomous). We expected a humanoid robot would be anthropomorphized to a greater extent than one that was nonhumanoid. In addition, we expected that inducing an agency belief to the effect that a robot was making its own decisions would increase anthropomorphism compared with a nonagency belief that the robot was being remotely controlled by a human. We also sought to identify any role gender might play in anthropomorphizing the robot.MethodsParticipants (N=99) were primed for agency or nonagency belief conditions and then saw a brief video depicting either a humanoid or nonhumanoid robot interacting with a confederate. After viewing the video, they completed 4 measures: perception to humanoid robots scale (PERNOD), the Epley anthropomorphic adjectives measure, the Fussel anthropomorphic adjective checklist, and the Anthropomorphic Tendencies Scale (ATS).ResultsFindings with the PERNOD scale indicated subjects did perceive the 2 robots differently, F6,86=6.59, P<.001, which means the appearance manipulation was effective. Results with the Epley adjectives indicated that participants were more willing to attribute humanlike behavioral traits to the nonhumanoid rather than the humanoid robot, F1,91=5.76, P=.02. The Fussel adjective checklist results showed that subjects were more willing to attribute humanlike social qualities to the remote controlled than the autonomous robot, F1,91=5.30, P=.02. Finally, the ATS revealed the only gender effects in this study, with females reporting more endorsement of anthropomorphism for pets (P=.02) and less for showing negative emotions toward anthropomorphized objects (P<.001) if they had witnessed the humanoid rather than the nonhumanoid robot.ConclusionsContrary to our expectations, participants were less willing to make humanlike attributions toward a robot when its morphology was more humanlike and were more willing to make those attributions when they were told that the robot was being remotely controlled by a person rather than acting on its own. In retrospect, these outcomes may have occurred because the humanoid robot used here had a smaller overall stature than the nonhumanoid robot, perhaps making it seem more toylike and because subjects made attributions toward the person behind the remote-controlled robot rather than toward the robot itself.

MODERN SPECIFIC FEATURES OF THE PHYSICAL DEVELOPMENT OF SCHOOL STUDENTS OF YEKATERINBURG

Introduction. An investigation aimed at studying the modern specific features of the physical development of children of school age of Yekaterinburg city was performed. Material and Methods. Somatic (body length, body weight, chest circumference) and physiometric (vital lung capacity, hand strength) physical development indices of 1378 school students of the city of Yekaterinburg aged from 8 to 16 years were surveyed and studied using the anthropomorphic measurement method (cross-sectional studies). The obtained results were compared with the equivalent physical development results collected from the children within the period between 1894 and 2000, as well as physical development data of school students residing in the large cities of the Russian Federation; Student’s t-test, regression analysis were used. Results. A decline in somatometric indices of the physical development (body length, weight, chest circumference) in all age and gender groups of school students was noted within the period between 1894 and 2017, but the decreased average values of the physiometric parameters, i.e. vital lung capacity, hand strength, were noted from 1985. The average body length and average body weight of school students of the city of Yekaterinburg are not significantly different or higher as compared to the peers residing in the large cities of the Russian Federation. In contrast to the regional physical development standards (as of 2000), each third school student has high or higher than average physical development indices: body length by 26.4%, body weight - 36%, chest circumference - 29.8%; a high incidence of low physiometric parameters was noted: low and lower than average indices of the vital lung capacity are characteristic to 35.1% of school students, hand strength - to 20.4% (right) and 22.9% (left) school students. Conclusion. The obtained results are indicative of the epoch-making changes in the physical development of children of the school age, as well as of certain regional distinguishing features, which may be associated with changes in the social and economic, environmental situation, and life style peculiarities of the modern school students.

A randomized controlled trial of exercise to prevent muscle mass and functional loss in elderly hemodialysis patients: Rationale, study design, and baseline sample.

BackgroundElderly maintenance hemodialysis (MHD) patients exhibit muscle wasting and impaired physical function. This trial determines whether MHD patients benefit from a 12-week home-based exercise program, protein supplementation, or both.Designand Methods: This is a randomized, blinded controlled trial involving 60 elderly MHD patients with impaired exercise capacity and function. Patients are randomized into either a homebased exercise program or normal care over a 12-week period. Measures at baseline include peak VO2, strength and body composition as well as cognitive and disease-specific questionnaires. Muscle biopsies are obtained and analyzed for protein signaling, expression of IGF-1, androgen receptors, and myostatin.ResultsAt baseline, patient characteristics in the exercise and normal care groups were similar by age, gender and anthropomorphic measures. Peak VO2 was impaired (14.7 ± 3.3 ml/kg/min), representing 55 ± 14% of the age-predicted value. Six-minute walk distance was 322 ± 71 m, and the mean 1-min sit to stand test was 18 ± 8 repetitions, representing 69 ± 16% and 55 ± 22% of the age-predicted values, respectively. Indices of muscle function, including upper and lower body and hand grip strength all indicate marked impairment. Quality of life (QoL) using the SF36, the Beeson cognitive test, and KDQOL all suggest marked impairments compared to age-expected reference values for non-MHD patients.ConclusionsPatients undergoing MHD exhibit markedly reduced physical function and QoL. Thus, there are potentially significant gains to be made through a program of aerobic and resistance exercise. We anticipate this trial will demonstrate that home-based exercise improves cardiopulmonary function, protein signaling and QoL, and increases muscle mass, strength, and body composition.

Ontogeny equations with probability distributions for anthropomorphic measurements in preterm and term neonates and infants for use in a PBPK model

Fitted algebraic equations with probability distributions are presented to predict the maturation of selected physiological parameters that occur postnatally in preterm and term neonates through early infancy. The neonatal population, in particular preterm neonates, remains a challenge for the development of physiologically based pharmacokinetic (PBPK) models. The need to make available these building blocks for PBPK models for this age group is important for this field to advance. While the equations do not represent an exhaustive evaluation of anatomy, equations with 90% prediction intervals, where data permits, are presented for body weight, organ and tissue growth, blood flows, cardiac output, plasma albumin concentration, and glomerular filtration rate. Ontogeny measurements for blood flows to organs and tissues are limited. Longitudinal anthropomorphic measurements versus intrauterine or newborn measurements in preterm neonates would help reduce the uncertainty in the growth trajectories of neonates.

A body shape index (ABSI) reflects body composition changes in response to testosterone treatment in obese men.

Interventions such as testosterone treatment may change body composition and metabolic outcomes without substantial changes in weight and BMI. Using testosterone treatment as a paradigm, we hypothesized that a body shape index (ABSI) reflects body composition changes more accurately than traditional markers, such as weight, BMI and waist circumference. Secondary analysis of a 56-week RCT in 100 dieting obese men with low-normal testosterone receiving testosterone treatment or placebo, and subsequent off-treatment follow-up. At the end of the trial period, ABSI-unlike weight, BMI or waist circumference-had significantly decreased in the treatment group, compared with placebo (mean adjusted difference -0.18 [95% CI:-0.32, -0.05] × 10-2 m11/6kg-2/3, overall P<0.001). Changes in ABSI during the active trial phase correlated with changes in fat mass (tau = 0.18, P = 0.02), and not with lean mass (tau = -0.11, P = 0.14), BMI (tau = 0.10, P = 0.17), or visceral fat (tau = 0.07, P = 0.37). ABSI baseline values were positively correlated with waist circumference (tau = 0.21, P = 0.002) and visceral fat (tau = 0.18, P = 0.009), correlated inversely with lean mass (tau = -0.21, P = 0.002), and were uncorrelated with BMI (tau = -0.10, P = 0.15) and fat mass (tau = 0.01, P = 0.83). Two years after cessation of treatment, ABSI again reflected body composition as the between-group differences in all parameters did not persist. A readily obtainable anthropomorphic measure, ABSI reflects the differential loss of fat mass mediated by testosterone in dieting obese men more closely than BMI or waist circumference. It may serve as a clinically useful marker to monitor body composition changes, particularly in response to interventions.

Evaluation of dietary patterns among men and women over 80 years of age living in a rural area of south-west Poland

Background: Proper nutrition is an important factor in maintaining health and preventing disease development or progression regardless of age, but is especially relevant for elderly people. Seniors rarely follow nutritional and life-style guidelines, which may correlate with poor health, multiple morbidities, polypharmacy and premature death. Aim of the study: The aim of this study was to evaluate the nutritional pattern, food choices, knowledge about healthy eating, body mass and health issues among men and women over 80 years of age living in a rural area of south-west Poland. Material and methods: 100 participants, women and men, aged 79.6–93.3 years, responded to a questionnaire on nutritional choices. Anthropomorphic measurements were also taken. Results: Only 40% of responders declared drinking 2 litres of water daily. Fruit and vegetables were eaten in inadequate quantities: only 10% of responders declared eating fruit and vegetables at least twice a day. Wholegrain products were regularly chosen by 30%. Dairy products were eaten once daily by 50% of seniors. 45% of the elderly chose meat, including red meat and its products, three to four times a week, and 66% chose fish only once a week. Almost 50% of responders ate only three meals a day. All participants declared suffering from at least one disease (chronic or acute). 45% of seniors had never heard of any nutritional guidelines. Conclusions: Based on this study most responders do not follow the nutritional guidelines for elderly people. Intake of water, dairy products, fruit and vegetables was inadequate. These food choices by the elderly may impact on their health and well-being.

Daily Consumption of Oregon Hazelnuts Affects α-Tocopherol Status in Healthy Older Adults: A Pre-Post Intervention Study

Inadequate vitamin E and magnesium intakes are of concern for older adults owing to the associated incidence of age-related diseases. This study was designed to determine the extent to which a 16-wk intervention with hazelnuts alters vitamin E and magnesium status in a group of older men and women, and used a pre-post intervention design without a control group to adjust for temporal changes. Participants (n=32 including 22 women; mean±SD age: 63±6 y) consumed hazelnuts (∼57 g/d) for 16 wk. Blood and urine samples and anthropomorphic measures were taken at the start and end of the intervention to determine plasma concentrations of α-tocopherol and serum concentrations of magnesium, lipids, glucose, insulin, and high-sensitivity C-reactive protein along with urinary vitamin E metabolites; several other micronutrients were measured by a lymphocyte proliferation assay. There were 3 primary endpoints, calculated as the mean changes in measurements between baseline and the end of the 16-wk intervention for 1) plasma α-tocopherol, 2) urinary α-carboxyethyl hydroxychromanol (α-CEHC; an α-tocopherol metabolite), and 3) serum magnesium. Hazelnut consumption increased concentrations of the urinary α-tocopherol metabolite α-CEHC (mean±SD: 0.84±0.45 to 1.14±0.50 µmol/g creatinine; P=0.0006). In addition, hazelnut consumption increased serum concentrations of magnesium (+2.1%, P=0.05), decreased concentrations of fasting glucose (-3.4%, P=0.03) and LDL cholesterol (-6.0%, P=0.02), and decreased total:HDL cholesterol ratios (-4.5%, P=0.009). No significant changes were observed in blood pressure, lymphocyte proliferation assays, and serum concentrations of insulin, high-sensitivity C-reactive protein, triglyceride, α-tocopherol, or HDL cholesterol. Consuming hazelnuts improves a biomarker of vitamin E status in older adults. Vitamin E is a shortfall micronutrient, as identified by the Dietary Guidelines for Americans 2015-2020, which frequently is consumed at levels less than the Estimated Average Requirement of 12 mg/d; thus, hazelnuts should be considered as part of a healthy dietary pattern. This trial was registered at clinicaltrials.gov as NCT03485989.

Vitamin D During Pregnancy and Infant Growth: A Long Shot

Research Article| December 01 2018 Vitamin D During Pregnancy and Infant Growth: A Long Shot AAP Grand Rounds (2018) 40 (6): 69. https://doi.org/10.1542/gr.40-6-69 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Vitamin D During Pregnancy and Infant Growth: A Long Shot. AAP Grand Rounds December 2018; 40 (6): 69. https://doi.org/10.1542/gr.40-6-69 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Source: Roth DE, Morris SK, Zlotkin S, et al. Vitamin D supplementation in pregnancy and lactation and infant growth. N Engl J Med. 2018; 379(6): 535– 546; doi: https://doi.org/10.1056/NEJMoa1800927Google Scholar Investigators from multiple institutions conducted a randomized controlled trial to determine the efficacy of maternal vitamin D supplementation (VDS) on infant growth in regions where vitamin D deficiency is common. Participants were healthy pregnant women living in Bangladesh who were 17–24 weeks’ gestation. At enrollment, participants were randomized to 1 of 5 groups, based on receipt of (a) a placebo tablet through the prenatal period and for 26 weeks postpartum, (b) prenatal VDS only at 4,200 IU/week, (c) prenatal VDS only at 16,800 IU/week, (d) prenatal VDS only at 28,000 IU/week, and (e) prenatal VDS at 28,000 IU/week and postpartum VDS at 28,000 IU/week for 26 weeks. All tablets were identical in taste and appearance, and they were administered under direct observation when possible. Demographic data and maternal serum 25-hydroxyvitamin D concentrations were collected at baseline, with vitamin D deficiency defined as 25-hydroxyvitamin D concentrations <30 nmol/L. The primary outcome was infant length-for-age z score at 1 year of age, defined as the mean of 2 independent measurements performed by trained study personnel plotted on WHO child growth standards. Secondary outcomes included confirmed maternal hypercalcemia, defined as a serum calcium concentration of >2.6 mmol/L on a repeat specimen or >2.8 mmol/L on a single specimen at enrollment through 6 months postpartum. Other secondary outcomes included other infant anthropomorphic measures at 1 year of age, infant serum 25-hydroxyvitamin D concentrations at 3, 6, and 12 months of age, and maternal serum 25-hydroxyvitamin D concentrations at delivery and 3 and 6 months postpartum. Investigators used t-tests and compared outcomes across groups using an intention-to-treat analysis. There were 1,300 participants enrolled and randomized to the 5 groups. Baseline characteristics, including baseline maternal 25-hydroxyvitamin D levels, were not significantly different across groups. Overall, 64% of participants were vitamin D deficient at baseline. There was no significant difference in infant length-for-age z scores at 1 year across the 5 groups (P=0.23). There were also no significant differences in other infant anthropomorphic measures at 1 year of age across treatment groups. There was a significant, dose-dependent effect in maternal and infant 25-hydroxyvitamin D concentrations, with infants and mothers in the fifth group having the highest concentrations. There was confirmed maternal hypercalcemia in 0.7% of participants, but frequencies did not differ significantly by group. The investigators conclude that maternal VDS does not improve infant growth in a population with widespread vitamin D deficiency. Dr Chung has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Vitamin D deficiency is a global health problem; some countries in the Middle East and South Asia have vitamin D deficiency prevalence rates... You do not currently have access to this content.

Association of Obesity With Risk of Early-Onset Colorectal Cancer Among Women

Colorectal cancer (CRC) incidence and mortality among individuals younger than 50 years (early-onset CRC) are increasing. The reasons for such increases are largely unknown, although the increasing prevalence of obesity may be partially responsible. To investigate prospectively the association between obesity and weight gain since early adulthood with the risk of early-onset CRC. The Nurses' Health Study II is a prospective, ongoing cohort study of US female nurses aged 25 to 42 years at study enrollment (1989). A total of 85 256 women free of cancer and inflammatory bowel disease at enrollment were included in this analysis, with follow-up through December 31, 2011. Validated anthropomorphic measures and lifestyle information were self-reported biennially. Statistical analysis was performed from June 12, 2017, to June 28, 2018. Current body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared), BMI at 18 years of age, and weight gain since 18 years of age. Relative risk (RR) for incident early-onset CRC. Among the 85 256 women studied, 114 cases of early-onset CRC were documented (median age at diagnosis, 45 years; interquartile range, 41-47 years) during 1 196 452 person-years of follow-up. Compared with women with a BMI of 18.5 to 22.9, the multivariable RR was 1.37 (95% CI, 0.81-2.30) for overweight women (BMI, 25.0-29.9) and 1.93 (95% CI, 1.15-3.25) for obese women (BMI, ≥30.0). The RR for each 5-unit increment in BMI was 1.20 (95% CI, 1.05-1.38; P = .01 for trend). Similar associations were observed among women without a family history of CRC and without lower endoscopy within the past 10 years. Both BMI at 18 years of age and weight gain since 18 years of age contributed to this observation. Compared with women with a BMI of 18.5 to 20.9 at 18 years of age, the RR of early-onset CRC was 1.32 (95% CI, 0.80-2.16) for women with a BMI of 21.0 to 22.9 and 1.63 (95% CI, 1.01-2.61) for women with a BMI of 23.0 or greater at 18 years of age (P = .66 for trend). Compared with women who had gained less than 5.0 kg or had lost weight, the RR of early-onset CRC was 1.65 (95% CI, 0.96-2.81) for women gaining 20.0 to 39.9 kg and 2.15 (95% CI, 1.01-4.55) for women gaining 40.0 kg or more (P = .007 for trend). Obesity was associated with an increased risk of early-onset CRC among women. Further investigations among men and to elucidate the underlying biological mechanisms are warranted.

Validation and clinical implementation of an accurate Monte Carlo code for pencil beam scanning proton therapy.

Monte Carlo (MC)‐based dose calculations are generally superior to analytical dose calculations (ADC) in modeling the dose distribution for proton pencil beam scanning (PBS) treatments. The purpose of this paper is to present a methodology for commissioning and validating an accurate MC code for PBS utilizing a parameterized source model, including an implementation of a range shifter, that can independently check the ADC in commercial treatment planning system (TPS) and fast Monte Carlo dose calculation in opensource platform (MCsquare). The source model parameters (including beam size, angular divergence and energy spread) and protons per MU were extracted and tuned at the nozzle exit by comparing Tool for Particle Simulation (TOPAS) simulations with a series of commissioning measurements using scintillation screen/CCD camera detector and ionization chambers. The range shifter was simulated as an independent object with geometric and material information. The MC calculation platform was validated through comprehensive measurements of single spots, field size factors (FSF) and three‐dimensional dose distributions of spread‐out Bragg peaks (SOBPs), both without and with the range shifter. Differences in field size factors and absolute output at various depths of SOBPs between measurement and simulation were within 2.2%, with and without a range shifter, indicating an accurate source model. TOPAS was also validated against anthropomorphic lung phantom measurements. Comparison of dose distributions and DVHs for representative liver and lung cases between independent MC and analytical dose calculations from a commercial TPS further highlights the limitations of the ADC in situations of highly heterogeneous geometries. The fast MC platform has been implemented within our clinical practice to provide additional independent dose validation/QA of the commercial ADC for patient plans. Using the independent MC, we can more efficiently commission ADC by reducing the amount of measured data required for low dose “halo” modeling, especially when a range shifter is employed.