Underestimation Of Size Research Articles

Preoperative imaging of gastric GISTs underestimates pathologic tumor size: A retrospective, single institution analysis.

How well imaging size agrees with pathologic size of gastric gastrointestinal stromal tumors (GISTs) is unknown. GIST risk stratification is based on pathologic size, location, and mitotic rate. To inform decision making, the size discrepancy between imaging and pathology for gastric GISTs was investigated. Imaging and pathology reports were reviewed for 113 patients. Bland-Altman analyses and intraclass correlation (ICC) assessed agreement of imaging and pathology. Changes in clinical risk category due to size discrepancy were identified. Computed tomography (CT) (n = 110) and endoscopic ultrasound (EUS) (n = 50) underestimated pathologic size for gastric GISTs by 0.42 cm, 95% confidence interval (CI): (0.11, 0.73), p = 0.008 and 0.54 cm, 95% CI: (0.25, 0.82), p < 0.001, respectively. ICCs were 0.94 and 0.88 for CT and EUS, respectively. For GISTs ≤ 3 cm, size underestimation was 0.24 cm for CT (n = 28), 95% CI: (0.01, 0.47), p = 0.039 and 0.56 cm for EUS (n = 26), 95% CI: (0.27, 0.84), p < 0.0001. ICCs were 0.72 and 0.55 for CT and EUS, respectively. Spearman's correlation was ≥0.84 for all groups. For GISTs ≤ 3 cm, 6/28 (21.4% p = 0.01) on CT and 7/26 (26.9% p = 0.005) on EUS upgraded risk category using pathologic size versus imaging size. No GISTs ≤ 3 cm downgraded risk categories. Size underestimation persisted for GISTs ≤ 2 cm on EUS (0.39 cm, 95% CI: [0.06, 0.72], p = 0.02, post hoc analysis). Imaging, particularly EUS, underestimates gastric GIST size. Caution should be exercised using imaging alone to risk-stratify gastric GISTs, and to decide between surveillance versus surgery.

Magnetic Seed Localization (Magseed) for excision of impalpable breast lesions-The North Wales experience.

The breast surgical community has faced huge challenges due to close working relationships with radiologists who are in short supply. Breast lesion localization is moving away from the traditional wire technique, which requires an on-site radiologist to support theater scheduling. In North Wales, the introduction of Magseed for impalpable breast lesion localization has facilitated theater scheduling in the absence of same day radiology presence. We audited our first 200 Magseed cases to assess the safety and efficacy of the technique, the ease of use, and patient experience. Data were entered prospectively into an excel data base relating to Magseed cases. Data collected included demographics, pre and postoperative lesion size, histology, margin positivity, and re-excision rates. Data were submitted in real time by the radiologist performing Magseed insertion to ascertain degree of difficulty. A PROMS questionnaire was designed and sent to patients undergoing Magseed vs wire localizations. Two hundred patients underwent Magseed-guided wide local excision between May 2018 and January 2020 across 2 district general hospital sites in North Wales. Histology: 69% IDC, 20% ILC, and 11% others. Mean preoperative size 12.3mm, postoperative size 19mm. Re-excision rate 15%. Re-excision for DCIS was significantly more likely than for invasive disease (p<0.0001). A significant difference was also observed between radiological mean preoperative tumor size estimate and actual histological tumor size in patients undergoing margin re-excision (p=0.000019). Wire-guided re-excision rate was 21% in the same unit. PROMs found the procedure well tolerated by patients. Surgeons and radiologists reported Magseed to be user-friendly with minimal learning curve. Magseed use for impalpable breast lesion localization is safe, user friendly, and well tolerated by patients. It produces favorable re-excision rates when compared to published figures for wire-guided excision. The presence of DCIS and preoperative radiological size underestimation was associated with margin re-excision.

Factors associated with inaccurate size estimation of colorectal polyps: A multicenter cross-sectional study.

Accurate polyp size estimation is essential in deciding the therapeutic strategy of colorectal polyps and endoscopic surveillance intervals. However, many endoscopists frequently make incorrect size estimations without being aware of their errors. This cross-sectional study aimed to clarify the characteristics of endoscopists associated with inaccurate estimation. We previously conducted a web trial involving 261 endoscopists in 51 institutions in Japan to assess their ability to estimate polyp size. Participants answered questions about polyp size using visual estimates in a test involving images of 30 polyps. Here, we investigated the relationships between inaccurate size estimation and the backgrounds of participants. The rates of overestimation and underestimation of polyp size were also compared to clarify any trends in the answers of participants with low accuracy (<50%). Multivariable logistic regression analysis revealed that the number of colonoscopic procedures in the past year was the only factor associated with a low accuracy of polyp size estimation (odds ratio 0.750, 95% confidence interval 0.609-0.925; P=0.007). Endoscopists with low accuracy had a greater tendency to overestimate polyp size (42.3% overestimation and 21.2% underestimation, P<0.001) compared with other endoscopists (16.6% overestimation and 17.9% underestimation, P=0.951). Endoscopists with limited experience of colonoscopy in the past year were more likely to make frequent errors in size estimation. Furthermore, endoscopists making inaccurate size estimations had a propensity to overestimate polyp size.

Comparison between Sonography-based and Surgical Extent of Deep Endometriosis Using the Enzian Classification - A Prospective Diagnostic Accuracy Study

To compare a preoperative evaluation of deep endometriosis (DE) by transvaginal sonography (TVS) according to the Enzian classification with the intraoperatively assessed extent of DE using the Enzian system. Prospective diagnostic accuracy study. Tertiary referral center for endometriosis. Women undergoing TVS and surgery for DE between 2017 and 2019 (N = 195). Evaluation of DE lesion sizes according to the Enzian classification as evaluated by preoperative TVS compared with surgical findings. The rate of exact concordances between preoperative TVS-based predictions of DE lesion sizes and intraoperatively assessed lesion sizes according to the Enzian classification varied depending on anatomic localizations, that is, Enzian compartments, and evaluated lesion size. The highest rate of exact concordances was found in Enzian compartment C (rectosigmoid) in which 86% of all TVS C3 lesions were confirmed as such at surgery. Enzian compartment A (vagina, rectovaginal septum) showed similar results. The rates of exact concordances were slightly lower in Enzian compartment B (uterosacral ligaments, parametria), with confirmation at surgery of 71% of TVS B2 lesions. In most cases of discordant findings, an underestimation of the lesion size by 1 severity grade was observed compared with the intraoperative findings. In Enzian compartment FB (urinary bladder), 91% of the lesions seen at TVS and 98% of cases without any lesion at TVS were confirmed surgically. TVS could detect DE preoperatively in compartments A, B, C, and FB with an overall sensitivity of 84%, 91%, 92%, and 88%, respectively, and a specificity of 85%, 73%, 95%, and 99%, respectively. TVS provides a valuable preoperative estimation of DE localization and lesion size using the Enzian classification, especially for Enzian compartments A, C, and FB. For Enzian compartment B, the exact assessment of the lesion size using the Enzian system seems to be less precise than for the other compartments.

Non-contrast and portal venous phase computed tomography in breast cancer hepatic metastases: comparison of tumor measurements and impact on response assessment.

BackgroundFor many common malignancies, including breast cancer, evaluation for metastatic disease using multiphase computed tomography (CT) has fallen out of favor and been replaced by studies performed only in the portal venous phase. However, differences in tumor vascularity could produce differences in appearance on post-contrast imaging.PurposeTo assess non-contrast phase and portal venous phase computed tomography in detection and measurement of hepatic metastases from breast carcinoma.Materials and MethodsA total of 75 CT scans from 52 breast cancer patients were independently assessed by three body imagers for lesion presence, number and size. Readers randomly assessed portal venous phase or combined phase images at one session with cross-over reads performed four to six weeks later.ResultsIn the 58% of cases where index lesions measured larger on combined phase, the mean difference in lesion size was 5.7 mm. In this group, combined phase reads demonstrated an 8.4 mm increase in sum of largest diameters, and a mean percentage sum of largest diameters increase of 19% compared to portal venous phase-only reads.ConclusionAddition of non-contrast phase images results in increased index lesion size in most patients with hepatic metastases from breast cancer. If only the portal venous phase is utilized, there is potential for incorrectly diagnosing disease progression on follow-up due to underestimation of lesion size.

Underestimation of Overweight and Health Beneficial Outcomes in Two Adolescent Cohorts in Norway – The HUNT Study

Underestimating overweight may prevent efforts toward reducing weight, but simultaneously benefit mental health and well-being. The magnitude of underestimation of overweight and obesity in adolescents is largely unknown, and so is to what extent this underestimation is associated with dieting behaviors, mental distress, and life satisfaction. As overweight has become more common during the past decades, associations between body size underestimation and mental health may have changed. Overweight (iso-body mass index, iso-BMI ≥25) adolescents (aged 13-19years) who participated in The Young-HUNT1 (1995-97, n= 1,338) or The Young-HUNT3 (2006-08, n= 1,833) surveys were included. Being overweight, but perceiving oneself as average-weighted or underweighted was defined as underestimation. Results were based on clinical examinations and self-report questionnaires. Multivariable logistic regression models were used to examine associations between body size underestimation, dieting behaviors, and symptoms of anxiety, depression, and life satisfaction. Among adolescents with overweight and obesity (iso-BMI ≥25), the prevalence of obesity (iso-BMI ≥30), body size underestimation, and having symptoms of anxiety and depression had increased from the first survey to the next. At both time points, body size underestimation was more common among boys than girls. In 2006-08, body size underestimation was negatively associated with symptoms of anxiety and depression in both sexes, and overall associated withhigher life satisfaction equally over time. Dieting behavior was negatively associated with underestimation of body size. Body size underestimation in adolescents with overweight/obesity has become more prevalent and a phenomenon associated with less dieting, better life satisfaction and mental health in both boys and girls.

Frequency of the loss of CAA interruption in the HTT CAG tract and implications for Huntington disease in the reduced penetrance range

PurposeIn some Huntington disease (HD) patients, the “loss of interruption” (LOI) variant eliminates an interrupting codon in the HTT CAG-repeat tract, which causes earlier age of onset (AOO). The magnitude of this effect is uncertain, since previous studies included few LOI carriers, and the variant also causes CAG size misestimation. We developed a rapid LOI detection screen, enabling unbiased frequency estimation among manifest HD patients. Additionally, we combined published data with clinical data from newly identified patients to accurately characterize the LOI’s effect on AOO. MethodsWe developed a LOI detection polymerase chain reaction (PCR) assay, and screened patients to estimate the frequency of the LOI variant and its effect on AOO. ResultsMean onset for LOI carriers (n=49) is 20.4 years earlier than expected based on diagnosed CAG size. After correcting for CAG size underestimation, the variant is still associated with onset 9.5 years earlier. The LOI is present in 1.02% of symptomatic HD patients, and in 32.2% of symptomatic reduced penetrance (RP) range patients (36–39 CAGs). ConclusionThe LOI causes significantly earlier onset, greater than expected by CAG length, particularly in persons with 36–39 CAG repeats. Detection of this variant has implications for HD families, especially for those in the RP range.

Correlates of over- or under-estimation of body size among resource-poor urban dwellers in a sub-Saharan African city

Background Individual perception of body size has implications for lifestyle behaviours including dietary habits and weight management practices. Aim To examine factors related to respondents’ estimation of their body sizes compared to their body mass index (BMI). Subjects and methods This cross-sectional survey comprised a sample of 917 adults in urban poor Accra, Ghana. Silhouette figure ratings were used to assess perceived body size and ideal body size at a community level. Logistic regression analysis was used to determine correlates of respondents overestimating or underestimating their body sizes. Results Approximately, 69% of respondents either underestimated or overestimated their body sizes. About a quarter of respondents perceived being overweight as the preferred ideal body size in their communities. The mean BMI of females and males who underestimated their body sizes were within the overweight category and normal weight category, respectively. Gender, educational level, employment status, the community of residence, and ethnicity were associated with how respondents correctly estimated, over- or under-estimated their body sizes. There was evidence of ethnicity mediating the association between the community of residence and body size estimation. Conclusion Weight management interventions must be mindful of the socio-demographic and cultural proclivities of the targeted populace for optimum impact.

CT reconstruction with thick slices not only underestimates lymph node size but also reduces data reproducibility in colorectal cancer.

Reliable size measurement of lymph node (LN) metastases is important for the evaluation of cancer treatment. However, image analyses without proper settings may result in inappropriate diagnoses and staging. To investigate whether reconstruction slice thickness in computed tomography (CT) affects measurements of LN size and reproducibility. We analyzed 48 patients with histological diagnoses of sigmoid colon and rectal cancer who underwent contrast-enhanced CT colonography as part of a surgical treatment preparation. A board-certified radiologist selected 106 LNs whose short-axis diameter was ≥5 mm on 1-mm-thick images; the short-axis diameters were measured on 1- and 5-mm-thick images by the radiologist and residents and compared using Wilcoxon matched-pairs signed rank test. Data variation and reproducibility were evaluated using the F test and Bland-Altman analysis. P<0.05 was considered significant. Short-axis diameters measured on 5-mm-thick images were significantly lower than those measured on 1-mm-thick images (P<0.01), even in the LNs whose short-axis diameters were over twice the slice thickness (P<0.05). Of the 106 LNs, 57 showed short-axis diameter <5 mm on 5-mm-thick images; the maximum short-axis diameter was 6.7 mm on a 1-mm thick image. Data variation was significantly larger on 5-mm thick images than 1-mm-thick images in small LNs (P<0.05) and reproducibility on 5-mm-thick images was inferior to that on 1-mm-thick images. Thick reconstruction slices in CT can result in an underestimation of LN size and reduce data reproducibility. When measuring LN size, a thin reconstruction slice would be recommended based on targeted LN size.

Accuracy of breast MRI in patients receiving neoadjuvant endocrine therapy: comprehensive imaging analysis and correlation with clinical and pathological assessments

PurposeTo assess the accuracy of magnetic resonance imaging (MRI) measurements in locally advanced oestrogen receptor-positive and human epidermal growth factor receptor 2-negative breast tumours before, during and after neoadjuvant endocrine treatment (NET) for evaluation of tumour response in comparison with clinical and pathological assessments.MethodsThis prospective study enrolled postmenopausal patients treated neoadjuvant with letrozole and exemestane given sequentially in an intra-patient cross-over regimen. Fifty-four patients were initially recruited, but only 35 fulfilled the inclusion criteria and confirmed to participate with a median age of 77. Tumours were scanned with MRI prior to treatment, during the eighth week of treatment and prior to surgery. Additionally, changes in longest diameter on clinical examination (CE) and tumour size at pathology were determined. Pre- and post-operative measurements of tumour size were compared in order to evaluate tumour response.ResultsThe correlation between post-treatment MRI size and pathology was moderate and higher with a correlation coefficient (r) 0.64 compared to the correlation between CE and pathology r = 0.25. Post-treatment MRI and clinical results had a negligible bias towards underestimation of lesion size. Tumour size on MRI and CE had 0.82 cm and 0.52 cm lower mean size than tumour size measured by pathology, respectively.ConclusionsThe higher correlation between measurements of residual disease obtained on MRI and those obtained with pathology validates the accuracy of imaging assessment during NET. MRI was found to be more accurate for estimating complete responses than clinical assessments and warrants further investigation in larger cohorts to validate this finding.

Level of agreement between objectively determined body composition and perceived body image in 6- to 8-year-old South African children: The Body Composition-Isotope Technique study.

To assess the level of agreement between body size self-perception and actual body size determined by body mass index (BMI) z-score and body fatness measured by the deuterium dilution method (DDM) in South African children aged 6–8 years. A cross-sectional sample of 202 children (83 boys and 119 girls) aged 6–8 years from the Body Composition–Isotope Technique study (BC–IT) was taken. Subjective measures of body image (silhouettes) were compared with the objective measures of BMI z-score and body fatness measured by the DDM. The World Health Organization BMI z-scores were used to classify the children as underweight, normal, overweight, or obese. DDM-measured fatness was classified based on the McCarthy centile curves set at 2nd, 85th and 95th in conjunction with fatness cut-off points of 25% in boys and 30% in girls. Data were analyzed using SPSS v26. Of 202 children, 32.2%, 55.1%, 8.8%, and 2.4% perceived their body size as underweight, normal, overweight, and obese, respectively. Based on BMI z-score, 18.8%, 72.8%, 6.9%, and 1.5% were classified as underweight, normal, overweight, and obese, respectively. Body fatness measurement showed that 2.5%, 48.0%, 21.8%, and 29.7% were underweight, normal weight, overweight, and obese, respectively. The application of silhouettes and BMI z-scores resulted in either overestimation or underestimation of own body size. Overall, the levels of agreements (kappa, κ) between body size perception, body fatness, and BMI for age respectively, were small (κ = 0.083, p = 0.053 and κ = 0.154, p<0.001). Level of agreement between body size perception, body fatness, and BMI z-score was poor. The use of silhouettes made children either overestimate their own body size while being underweight or underestimate their own body size while being overweight or obese. Given the potential health implications associated with misclassification of body size during childhood, correct self-assessment of body size is important, and may be key to the adoption of weight control strategies directed at curbing the escalating obesity epidemic in the country. Scalable measures to allow for more accurate self-assessment are urgently needed–one approach is behavior change communication at all levels.

Acordo entre o peso corporal, percepção materna e estado de peso em crianças

Antecedentes: As taxas de obesidade continuam aumentando, principalmente entre as crianças. Estudos apontam a subestimação do peso corporal como principal fator para a não adesão aos comportamentos de perda de peso e, em crianças, bem como a subestimação do tamanho do corpo, a percepção percebida pelos pais sobre o peso de seus próprios filhos. é crucial para a manutenção principal do sobrepeso e obesidade. Assim, enfatiza-se que a percepção acurada da imagem corporal de crianças e pais é essencial para combater a alta prevalência de sobrepeso e obesidade na população infantil. Objetivo: Avaliar a concordância entre a autopercepção e a percepção materna do peso corporal das crianças e seu status de peso corporal. Métodos: Foram avaliadas 935 crianças de 6 a 10 anos e 922 mães. O status do peso corporal foi avaliado por meio de medidas de peso e altura e a percepção da imagem corporal por meio de software para Avaliação da Percepção Corporal Infantil. Resultados: Crianças classificadas como "baixo peso" ou "peso normal" demonstraram maior acurácia em suas percepções e tendência à superestimação em meninas cujo status de peso é "normal", enquanto crianças obesas ou com excesso de peso tendem a superestimar seu status de peso. As mães, por outro lado, subestimaram o status de peso dos filhos, independentemente do sexo do filho. Conclusão: As crianças apresentaram percepções mais precisas do que as mães em relação ao peso / tamanho corporal.

Mathematical Modelling of Evaporating Droplets Dynamics in a Vortex Ring Using Moment Method

The quadrature method of moments (QMOM) and method of moments with a lognormal particle size distribution (PSD) are applied to simulate a cloud of evaporating droplets in a vortex ring flow. Results predicted by both methods are compared for the cases with a sinusoidal and lognormal initial particle size distribution, using Lagrangian particle tracking as a reference solution. Spatial distributions of droplet number density obtained by different methods are shown to be in a qualitative agreement. The method of moments with a lognormal PSD overestimates disappearance of particles leading to the underestimation of droplet mean size and higher values of the variance of PSD. QMOM showed better agreement with the Lagrangian approach than the method of moments with a lognormal PSD.

Accuracy of endoscopic size measurements of early gastric signet ring cell carcinoma.

Indications for endoscopic submucosal dissection (ESD) of early gastric cancer (EGC) are expanding, but signet ring cell carcinoma (SRC) is still unclear because of its unclear boundaries. The purpose of this study was to compare pathologic size and endoscopic size in SRC-type EGC and to find risk factors associated with tumor size underestimation. Medical records of 137 patients diagnosed with SRC-type EGC between January 2009 and December 2016 at our tertiary hospital were reviewed. According to pathologic and endoscopic tumor sizes, they were classified into correct estimation, underestimation, and overestimation groups, and risk factors related to underestimation were analyzed. Among 137 patients with SRC-type EGC, 77 patients (56.2%) had undergone correct estimation, 43 patients (31.4%) had undergone underestimation, and 17 patients (12.4%) had undergone overestimation. Mean pathologic size (SD) was 20.1 (13.8) mm and mean endoscopic size (SD) was 17.9 (10.1) mm, the correlation coefficients were 0.919 (p < 0.001) , and there was no significant difference between the two groups. Multivariate analysis showed that tumor size more than 20mm (OR 3.419; 95% CI 1.271-9.194; p = 0.015) and atrophy (OR 6.011; 95% CI 2.311-15.633; p = 0.001) were risk factors for tumor size underestimation. There was no significant difference in pathologic and endoscopic size in SRC-type EGC. Therefore, ESD may be considered as a therapeutic option if the size of the tumor is less than 20mm and atrophy is not present in the surrounding mucosa.

Issues with integrating carbonate sand texture data generated by different analytical approaches: A comparison of standard sieve and laser-diffraction methods

Palaeoenvironmental reconstructive work relies on sediment-texture information as a proxy for particle-transport dynamics. As the integration of data from multiple sources is often sought for studies at the regional scale, a body of work exists that addresses compatibility levels of different analytical approaches. Past insights are derived predominantly from siliciclastic deposits. This study instead addresses standard sieve and laser-diffraction methods of texture analysis on a suite of carbonate beach sands from San Salvador Island, Bahamas. While the near-equant grain shapes of siliciclastic sands generate comparable results between methods, our findings show that laser diffraction tends to overestimate the coarser fractions in carbonate sands, given indiscriminate measurement of elongate particle axes. Peloidal grains that have width-to-length ratios on the order of 0.5 can pass through much smaller mesh sizes when sieved than diffraction would suggest. The resulting deviation in analytical outputs significantly influences measures of skewness, sorting, and other derivative metrics, which vary by up to several Wentworth classes between procedures. Meaningful integration of texture data obtained by different methods is ill-advised when dealing with carbonate beach sands. Similar problems are documented for muddy deposits, wherein platy clay minerals favor size-overestimation by laser diffraction and a size underestimation by settling tube technique. An improved understanding of methodological biases resulting from application of different particle-size methods is needed to help facilitate data-reconciliation efforts. This study provides a glimpse of issues facing the integration of carbonate sand-texture information, troublesome given prevalence of irregular grain shapes.

Population Change of Red Kites Milvus milvus in Central Southern England between 2011 and 2016 Derived from Line Transect Surveys and Multiple Covariate Distance Sampling

Successful reintroduction programmes are usually defined by an increase in size and extent of the new population after a given period of time. Among studies of birds, these population estimates are often focused on the monitoring of nesting attempts and productivity. For many raptors, however, this approach can overlook a large number of non-breeding adults and immature birds leading to underestimation of population size and reproductive potential. A more thorough approach is to generate assessments of total population size. In this study we used a line transect survey methodology and multiple covariate distance sampling to assess the change in population size of a reintroduced raptor species, Red Kite Milvus milvus, across a 2600 km2 area of central southern England. Surveys were performed in spring and autumn between 2011 and 2016 in an area 45 km to the south of the initial English reintroduction project which started 25 years previously. Survey routes avoided using roads where possible to counter the potential attraction that such landscape features may have (e.g. increased food availability, perches etc.). The use of roads was unavoidable in some instances; however, we found no evidence of Red Kite attraction to these landscape features when comparing distances of observations from stretches along roads with 5000 randomly-generated locations. Distance of detection was influenced by bird activity (greatest when the bird was on the ground or interacting with other birds) and extent of woodland but not by time of day, seasonality or when comparing between years. During the five years, estimated population size doubled from approximately 490 to 1100 individuals; a density of one Red Kite per 2.5–3.5 km2. This suggests an increase in the breeding population in the study area from c. 95 to 174 pairs. During the study, rate of population growth was not uniform; rapid growth was recorded in years two and three followed by a slowing over the last two years of the study. While an overall increase in population and availability of suitable nesting habitat across south-eastern England indicates that there is still potential for expansion of the Red Kite breeding population, other factors are potentially limiting this growth.

Body Painting of the Horse and Cow to Learn Surface Anatomy.

Gross anatomy is considered one of the most challenging subjects in teaching veterinary medicine. The use of body painting is reported in teaching surface human anatomy, but such reports are scarce in veterinary medicine. The aim of this study was to describe a practical session for teaching surface anatomy using body painting with second-semester students of veterinary medicine. Two practical sessions using live animals (equine and bovine) were offered with a focus on the locomotor and nervous systems and splanchnology. Students believed that the body painting sessions helped them to understand the localization of structures, promoting long-term retention and integration of knowledge, and to approach large animals with more self-confidence. Forty-nine students took three short theoretical and practical exams: a pre-test on splanchnology (Q1), an immediate post-test on splanchnology (Q2), and a post-test after 7 weeks on the locomotor and nervous systems (Q3). Correct answers for theoretical Q1 and Q2 were statistically different (2.04 and 3.11 out of 5, respectively; p < .001), and higher scores were found for Q3 compared with Q1 (2.49 and 1.02 out of 5, respectively). The most common error observed in practical Q1 was underestimation of the real size of organs such as lungs, rumen in cattle, and cecum in horses. The results showed that body painting sessions improved learning of anatomical concepts and could serve as a bridge between cadaver anatomy and living animal anatomy. More body painting sessions could be included in other semesters of the veterinary medicine curriculum to better integrate anatomy knowledge.

Portion size estimation in dietary assessment: a systematic review of existing tools, their strengths and limitations.

Overestimation or underestimation of portion size leads to measurement error during dietary assessment. To identify portion size estimation elements (PSEEs) and evaluate their relative efficacy in relation to dietary assessment, and assess the quality of studies validating PSEEs. Electronic databases, internet sites, and cross-references of published records were searched, generating 16801 initial records, from which 334 records were reviewed and 542 PSEEs were identified, comprising 5% 1-dimensional tools (eg, food guides), 46% 2-dimensional tools (eg, photographic atlases), and 49% 3-dimensional tools (eg, household utensils). Out of 334 studies, 21 validated a PSEE (compared PSEE to actual food amounts) and 13 compared PSEEs with other PSEEs. Quality assessment showed that only a few validation studies were of high quality. According to the findings of validation and comparison studies, food image-based PSEEs were more accurate than food models and household utensils. Key factors to consider when selecting a PSEE include efficiency of the PSEE and its applicability to targeted settings and populations.

Information challenges on research concerning certified companies in ISO 14001 in Colombia

Although the environmental management model ISO 14001 is one of the most adopted in the world, the search for information on certified companies in this standard in Colombia faces great limitations. We analyze the main challenges encountered when undertaking research related to companies that are currently certified in ISO 14001 in the country and how the limited information reduces the possibilities of expanding knowledge. Lack of information makes it difficult to establish the precise number of certified companies, leading to statistical errors and underestimations of the sample size required for some studies, which also produces inaccurate conclusions about the companies’ performance. We found a lack of consolidated statistics of companies certified in ISO 14001 both in Colombia, with an specific focus on the metropolitan area of Valle de Aburrá, with high level of outdatedness of the little information obtained. We propose some guidelines that could improve the process of managing this type of information in the country.

Distortion and dissatisfaction with body size per the demographic and academic characteristics and the nutritional status of university students

To identify the prevalence of distortion and dissatisfaction with the body size of Brazilian university students, and establish their relationship with the demographic and academic characteristics and the anthropometric nutritional status. The sample consisted of students from a public university in the state of Sao Paulo. The Figure Rating Scale (FRS) for Brazilian adults was used as an instrument. The participants selected the figure that corresponded to the current body and another one for the desired body. The prevalence of distortion and dissatisfaction with body size was calculated with 95% confidence interval (95% CI). The association between the variables was evaluated by the Chi-Square Test (χ2). The significance level of 5% was adopted. A total of 356 students (women=71.63%) with a mean age of 20.95 (SD=2.55) years participated. The prevalence of distortion and dissatisfaction with body size was 73.03% (95% CI=68.23–77.83) and 79.49% (95% CI=75.3–83.68), respectively. There was a high prevalence of distortion with body size among individuals with low weight (χ2=9.523, p=0.009). Students who distorted the body size (52.31% [95% CI=47.12–57.50]) underestimated their body size. The type of distortion was related to sex (χ2=26.35, p<0.001), physical activity (χ2=4.51, p=0.034), use of supplements (χ2=4.62, p=0.032), and the anthropometric nutritional status (χ2=9.05, p=0.011). Students dissatisfied with the body (58.66% [95% CI=52.92–64.40]) wished to reduce the body size. The type of dissatisfaction was related to sex (χ2=5.79, p=0.016) and anthropometric nutritional status (χ2=89.83, p<0.001). The prevalence of body size underestimation was higher among men, students who practice physical activity, subjects using dietary supplements and underweight individuals. The wish to decrease body size was higher among women and overweight/obese individuals.