bluuebunny/crossref_metadata_2025 huggingface dataset:
Interface boundary value problems of Robin‐transmission type for the Stokes and Brinkman systems on n‐dimensional Lipschitz domains: applications
Authors: Fericean Denisa , Groşan Teodor , Kohr Mirela , Wendland Wolfgang L.
Published: March 2013

In this paper, we describe a layer potential analysis in order to show an existence result for an interface boundary value problem of Robin‐transmission type for the Stokes and Brinkman systems on Lipschitz domains in Euclidean setting, when the given boundary data belong to some Lp or Sobolev spaces associated to such domains. Applications related to an exterior three‐dimensional Stokes flow past two concentric porous spheres with stress jump conditions on the fluid‐porous interface are also considered. Copyright © 2013 John Wiley & Sons, Ltd.
Three‐dimensional morphometric mapping of rat muscle fibers
Authors: Kalpidis Ioannis P. , Kapoukranidou Dorothea , Charalambakis Nicolas , Chatzisotiriou Athanasios , Albani Maria
Published: March 2013

Introduction: Quantitative descriptions of fiber type organization in hind limb muscles are incomplete or rare. Methods: Fiber morphometrics for both rat tibialis anterior (TA) muscles were measured in 3 dimensions. Results: Slow oxidative fiber area and perimeter varied in all zones. Fast oxidative glycolytic fibers (FOG) were predominant in the mediolateral and posterior zones, and fast glycolytic fibers (FG) predominated in the anterior zone. The mean area of FOG and succinate dehydrogenase intermediate fibers was lowest in the anterior zone. Mean area of FG was highest in the proximal and distal parts of the muscle. The area and perimeter of fast fibers differed significantly between the right and left limbs in the medial zone. In the middle and lateral zones, they differed at the proximal and distal parts. Conclusions: This detailed analysis in a high resolution, 3‐dimensional map provides an essential tool for understanding the structure and function of TA muscles. Muscle Nerve 48: 951–957, 2013
Dyslipidemia links obesity to early cerebral neurochemical alterations
Authors: Haley Andreana P. , Gonzales Mitzi M. , Tarumi Takashi , Tanaka Hirofumi
Published: March 2013

Objective

To examine the role of hypertension, hyperglycemia, and dyslipidemia in potentially accounting for obesity‐related brain vulnerability in the form of altered cerebral neurochemistry.

Design and Methods

Sixty‐four adults, ages 40‐60 years, underwent a health screen and proton magnetic resonance spectroscopy (1H MRS) of occipitoparietal gray matter to measure N‐acetyl aspartate (NAA), choline (Cho), myo‐inositol (mI), and glutamate (Glu) relative to creatine (Cr). The causal steps approach and nonparametric bootstrapping were utilized to assess if fasting glucose, mean arterial pressure or peripheral lipid/lipoprotein levels mediate the relationship between body mass index (BMI) and cerebral neurochemistry.

Results

Higher BMI was significantly related to higher mI/Cr, independent of age and sex. BMI was also significantly related to two of the proposed mediators, triglyceride, and HDL‐cholesterol, which were also independently related to increased mI/Cr. Finally, the relationship between BMI and mI/Cr was significantly attenuated after inclusion of triglyceride and HDL‐cholesterol into the model, one at a time, indicating statistical mediation.

Conclusions

Higher triglyceride and lower HDL levels statistically account for the association between BMI and myo‐inositol, pointing toward a potentially critical role for dyslipidemia in the development of cerebral neurochemical alterations in obesity.
Childhood obesity as a risk factor for bone fracture: A mechanistic study
Authors: Kim Jong‐Eun , Hsieh Min‐Heng , Soni Bharat K. , Zayzafoon Majd , Allison David B.
Published: March 2013

Objective

To investigate the risk of bone fracture sustained by obese children exposed to falls. The bone fracture risk of obese children would be greater than that of their nonobese counterparts was hypothesized.

Design and Methods

Finite element‐based computational models for children that reflected various levels of obesity by varying body mass and the thickness of the subcutaneous adipose tissue layer was developed. The models took account of both the momentum effect of variation of body mass and the cushion effect of variation of soft tissue thickness and examined these two contradictory effects on pelvic bone fracture risk through a set of sideways fall simulations with a range of impact speeds.

Results

The critical impact speed that yielded pelvic bone fracture decreased as the levels of obesity increased, which meant that the momentum effect of a greater body mass took precedence over the cushion effect of the soft tissue layer.

Conclusions

The result suggests that obese children have a greater risk of pelvic bone fracture than do their nonobese counterparts in sideways falls. A further implication is that current child safety devices, systems, and regulations will need to be revisited as the prevalence of child obesity increases.
Structural and functional microvascular alterations in a rat model of metabolic syndrome induced by a high‐fat diet
Authors: Nascimento Alessandro R. , Machado Marcus , de Jesus Nathália , Gomes Fabiana , Lessa Marcos A. , Bonomo Isabela T. , Tibiriçá Eduardo
Published: March 2013

Objective

To investigate microvascular alterations in an experimental model of metabolic syndrome induced by a high‐fat diet (HFD) associated with salt supplementation (0.5% NaCl).

Design and Methods

Wistar Kyoto rats were fed standard chow (control group, CONT) or HFD for 20 weeks. The functional capillary density (FCD) was assessed using intravital fluorescence videomicroscopy.

Results

The HFD group presented a higher systolic blood pressure, plasma glucose and insulin levels, total and LDL‐cholesterol levels, triglycerides, and visceral and epididymal fat when compared with the CONT group. When compared with the CONT group, the HFD group showed a lower FCD in the skeletal muscle (P < 0.05) but not in the skin (P > 0.05). The HFD group also had a lower capillary‐to‐fiber ratio in the skeletal muscle (P < 0.01). The capillary volume density‐to‐fiber volume density ratio in the left ventricle of the HFD was also reduced (P < 0.01). Finally, rats fed with HFD showed ventricular hypertrophy and increased cardiomyocyte diameter (P < 0.01).

Conclusions

The long‐term administration of a HFD associated with salt supplementation to rats generates an experimental model of metabolic syndrome characterized by central body fat deposition, insulin resistance, glucose intolerance, hypertriglyceridemia, hypercholesterolemia, arterial hypertension, cardiac remodeling, and rarefaction of the microcirculation in the heart and skeletal muscle.
Body weight misperception patterns and their association with health‐related factors among adolescents in South Korea
Authors: Lim Hyunjung , Wang Youfa
Published: March 2013

Objective

Examined body weight misperception and its association with health‐related factors among South Korean adolescents.

Design and Methods

The 2009 Korea Youth Risk Behavior Web‐based Survey data from 72,399 adolescents aged 12‐18 years were used. Based on agreements between weight status assessed according to self‐reported BMI and self‐perceived weight status, adolescents were classified as weight underestimate, accurate, and overestimate. Logistic regression models examined the associations controlling for covariates.

Results

Over 50% adolescents misclassified their own weight status: underestimation (23.4%) and overestimation (26.8%). Boys had a higher underestimation rate than girls (30.3% vs. 15.6%) and a lower overestimation rate (21.3% vs. 33.0%). In girls, overestimation was higher in high‐income families and well‐educated parents (41.0%). Compared to those with accurate weight perception, participants who underestimated their weight were more likely to have an unhealthy diet as indicated by higher daily consumption (≥once/day) of fast food [OR = 1.18 (1.00, 1.39)] and unhealthy snacks [OR = 1.11 (1.03, 1.19)]. Girls who overestimated their weight had more screen time [≥2 h/day, OR = 1.12 (1.03, 1.22)]. Participants who overestimated their weight were more likely to be stressed [OR = 1.24 (1.18, 1.31)] and depressed [OR = 1.18 (1.21, 1.25)].

Conclusions

Over half of Korean adolescents had misperception on own weight status, the rates varied by gender and socioeconomic status. Weight misperception is associated with health‐related outcomes compared to peers with accurate perceptions about own weight status.
Child food neophobia is heritable, associated with less compliant eating, and moderates familial resemblance for BMI
Authors: Faith Myles S. , Heo Moonseong , Keller Kathleen L. , Pietrobelli Angelo
Published: March 2013

Objective

The heritability of food neophobia, the tendency to avoid new foods, was tested in 4‐7‐year‐old twins. We also examined whether food neophobia is associated with parent‐child feeding relations or child body fat.

Design and Methods

66 same‐sex twin pairs, including 37 monozygotic (MZ) and 29 dizygotic (DZ) pairs were studied. Food neophobia was assessed by parent questionnaire (Child Food Neophobia Scale, CFNS), as were child‐feeding practices and “division of responsibility” feeding relations. Child anthropometry and percent body fat were directly measured.

Results

MZ and DZ twin pair correlations for food neophobia were r = 0.71 and r = −0.01, respectively: heritability= 72%. Greater food neophobia was associated with reduced child eating compliance of prompted foods (P < 0.001) reduced eating compliance of initially refused foods (P < 0.001), and – among girls only – fewer parental food demands (P = 0.01). Interestingly, the correlation between maternal BMI and child BMI z‐score was significant only for children high (P = 0.03), but not low (P = 0.55), in food neophobia.

Conclusion

Child food neophobia, a highly heritable trait previously linked to emotionality, was associated with less compliant parent–child feeding relations. Strategies to combat food neophobia and foster more harmonious feeding relationships may have a role in obesity prevention.
Identification and counseling for obesity among children on psychotropic medications in ambulatory settings
Authors: Eneli Ihuoma U. , Wang Wei , Kelleher Kelly
Published: March 2013

Objective

To examine identification and counseling for obesity at pediatric office visits associated with psychotropic medications.

Design and Methods

Analysis of ambulatory care visits by children 2‐17 years in the National Ambulatory Medical Care Surveys and outpatient component of the National Hospital Ambulatory Medical Care Surveys from 2005 to 2008. Physician identification of obesity was determined using ICD‐9 CM diagnostic codes.

Results

In 2005‐2008, there were 38,539 pediatric ambulatory care visits weighted to represent 600 million pediatric visits nationally. Psychotropic medications were associated with 5.2% of visits. The prevalence of overweight/obesity (BMI ≥ 85th%tile) was 15.9% for visits without psychotropic medication, 19.4% and 16.8% for visits associated with nonobesogenic and obesogenic psychotropic medications, respectively. Controlling for age, gender, and BMI, obesity was more likely to be identified at visits associated with psychotropic medications (OR 5.2, 95% CI 3‐8.8), among females (OR 1.6, 95% CI 1.1‐2.3) and non‐Hispanics (OR 1.5, 95% CI 1.0‐2.4). At visits with psychotropic medications, dietary counseling was provided at 11.4%, while blood pressure and cholesterol screening were obtained at 6.9% and 6.8% of these visits, respectively.

Conclusions

Our results indicate suboptimal identification and counseling for obesity children who are prescribed psychotropic medications, despite their increased risk for weight gain.
Fat mass is a predictor of incident foot pain
Authors: Butterworth P.A. , Urquhart D.M. , Cicuttini F.M. , Menz H.B. , Strauss B.J. , Proietto J. , Dixon J.B. , Jones G. , Landorf K.B. , Wluka A.E.
Published: March 2013

Objective

Foot pain is a common complaint in adults. Increased BMI and fat mass have been linked only to foot pain prevalence. Therefore, a longitudinal study to examine the relationship between body composition and incident foot pain over 3 years was conducted.

Design and Methods

Sixty‐one community dwelling participants from a previous study of musculoskeletal health, who did not have foot pain at study inception in 2008, were invited to take part in this follow‐up study in 2011. Current foot pain was determined using the Manchester Foot Pain and Disability Index, and body composition was measured using dual X‐ray absorptiometry at study baseline.

Results

Of the 51 respondents (84% response rate, 37 females and 14 males), there were 11 who developed foot pain. BMI ranged from underweight to morbidly obese (17‐44 kg/m2), mean 27.0 ± 6.0 kg/m2. Incident foot pain was positively associated with both fat mass (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.03‐1.20) and fat‐mass index (OR 1.28, 95% CI 1.04‐1.57) in multivariate analysis.

Conclusions

Fat mass is a predictor of incident foot pain. This study supports the notion that incident foot pain in overweight individuals is associated with fat mass rather than body mass alone.
Relationship between sexual function and quality of life in obese persons seeking weight reduction
Authors: Moore Reneé H. , Sarwer David B. , Lavenberg Jeffrey A. , Lane Ilana B. , Evans Joanna L. , Volger Sheri , Wadden Thomas A.
Published: March 2013

Objective

This study investigated sexual functioning in persons with obesity and seeking weight loss, and the associations of sexual functioning with relevant demographic and clinical variables as well as quality of life were investigated.

Design and Methods

Participants were enrolled in a two‐year randomized clinical trial. Participants were obese and had at least two components of metabolic syndrome. Male and female sexual functioning was assessed by the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) respectively.

Results

The rate of female sexual dysfunction was 29%. The rate of erectile dysfunction (ED) was 45%. Of the characteristics considered, FSD was associated with age (P = 0.002). ED was significantly associated with age and physical functioning (both P < 0.01).

Conclusions

A large minority of patients with obesity reported sexual dysfunction. The occurrence of sexual dysfunction was associated with age, but, surprisingly, not weight‐related comorbidities. This may be the result of the nature of the study sample or the methods used to administer the questionnaires that assessed sexual functioning.
Body mass index and mortality among blacks and whites adults in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial
Authors: Xiao Qian , Hsing Ann W. , Park Yikyung , Moore Steven C. , Matthews Charles E. , Berrington de González Amy , Kitahara Cari M.
Published: March 2013

Objective

In a large prospective cohort, we examined the relationship of body mass index (BMI) with mortality among blacks and compared the results to those among whites in this population.

Design and Methods

The study population consisted of 7,446 non‐Hispanic black and 130,598 white participants, ages 49‐78 at enrollment, in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. BMI at baseline, BMI at age 20, and BMI change were calculated using self‐reported and recalled height and weight. Relative risks were stratified by race and sex and adjusted for age, education, marital status, and smoking.

Results

During follow‐up, 1,495 black and 18,236 white participants died (mean = 13 years). Clear J‐shaped associations between BMI and mortality were observed among white men and women. Among black men and women, the bottoms of these curves were flatter, and increasing risks of death with greater BMI were observed only at higher BMI levels (≥35.0). Associations for BMI at age 20 and BMI change also appeared to be stronger in magnitude in whites versus blacks, and these racial differences appeared to be more pronounced among women.

Conclusion

Our results suggest that BMI may be more weakly associated with mortality in blacks, particularly black women, than in whites.
An intragastric balloon in the treatment of obese individuals with metabolic syndrome: A randomized controlled study
Authors: Fuller Nicholas R. , Pearson Suzanne , Lau Namson S. , Wlodarczyk John , Halstead Michael B. , Tee Hoi‐Poh , Chettiar Raman , Kaffes Arthur J.
Published: March 2013

Objective

There are limited controlled data for intragastric balloons (IGB) in obesity treatment. This randomized, controlled study evaluated the efficacy and safety of an IGB in obese individuals with metabolic syndrome (MS).

Design and Methods

Sixty‐six adults (BMI: 30‐40 kg/m2) were randomized to IGB for 6 months, with a 12 month behavioral modification (IGB Group; “IGBG”), or 12 month behavioral modification alone (Control Group; “CG”). The primary outcome was percentage change in body weight.

Results

Thirty‐one subjects (female: 68%; mean age: 43; mean BMI: 36.0) were randomized to IGBG and 35 (66%; 48; 36.7) to CG. At 6 months, there was a significantly greater weight loss in the IGBG: −14.2 vs. −4.8; P < 0.0001. This was associated with a significantly greater reduction in waist circumference, and an improvement in quality of life, with a trend for a larger %MS remission (50% vs. 30%; n.s.). At month 12, the differences in weight loss were enduring: −9.2 vs. −5.2; P = 0.007. Gastrointestinal‐related adverse events were common in the IGBG, resolving predominantly within two weeks. The IGB was removed prematurely in three subjects (one for refractory gastrointestinal symptoms).

Conclusions

Statistically significant and clinically relevant improvements in weight loss and health outcomes were observed with the IGBG at 6 months versus behavioral modification alone. The differential weight loss was still evident 6 months after IGB removal.
Genetic analysis of adiponectin variation and its association with type 2 diabetes in African Americans
Authors: Sandy An S. , Palmer Nicholette D. , Hanley Anthony J.G. , Ziegler Julie T. , Mark Brown W. , Freedman Barry I. , Register Thomas C. , Rotter Jerome I. , Guo Xiuqing , Ida Chen Y.‐D. , Wagenknecht Lynne E. , Langefeld Carl D. , Bowden Donald W.
Published: March 2013

Objective

Adiponectin is an adipocytokine that has been implicated in a variety of metabolic disorders, including T2D and cardiovascular disease. Studies evaluating genetic variants in ADIPOQ have been contradictory when testing association with T2D in different ethnic groups.

Design and Methods

In this study, 18 SNPs in ADIPOQ were tested for association with plasma adiponectin levels and diabetes status. SNPs were examined in two independent African‐American cohorts (nmax = 1,116) from the Insulin Resistance Atherosclerosis Family Study (IRASFS) and the African American‐Diabetes Heart Study (AA‐DHS).

Results

Five polymorphisms were nominally associated with plasma adiponectin levels in the meta‐analysis (P = 0.035‐1.02 × 10−6) including a low frequency arginine to cysteine mutation (R55C) which reduced plasma adiponectin levels to <15% of the mean. Variants were then tested for association with T2D in a meta‐analysis of these and the Wake Forest T2D case‐control study (n = 3,233 T2D, 2645 non‐T2D). Association with T2D was not observed (P ≥ 0.08), suggesting limited influence of ADIPOQ variants on T2D risk.

Conclusions

Despite identification of variants associated with adiponectin levels, a detailed genetic analysis of ADIPOQ revealed no association with T2D risk. This puts into question the role of adiponectin in T2D pathogenesis: whether low adiponectin levels are truly causal for or rather a consequence.
Associations between body mass index and suicide in the veterans affairs health system
Authors: McCarthy John F. , Ilgen Mark A. , Austin Karen , Blow Frederic C. , Katz Ira R.
Published: March 2013

Objectives

Associations between BMI and suicide risks and methods for individuals receiving care in the Veterans Health Administration (VHA) health system were evaluated.

Design and Methods

For 4,005,640 patients in fiscal years 2001‐2002, multivariable survival analyses assessed associations between BMI and suicide, through FY2009. Covariates included demographics, psychiatric, and nonpsychiatric diagnoses, receipt of VHA mental health encounters, and regional network. Among suicide decedents, multivariable Generalized Estimating Equations (GEE) regression examined associations between BMI and suicide method.

Results

1.3% of patients were underweight, 24.3% normal weight, 40.6% overweight, and 33.8% obese. Underweight was associated with increased suicide risk (adjusted hazard ratio [AHR] = 1.17, 95% CI: 1.01, 1.36) compared to normal. Overweight and obese status were associated with lower risk (AHR = 0.78, 95% CI: 0.74, 0.82; AHR = 0.63, 95% CI: 0.60, 0.66, respectively). Among suicide decedents, high lethality methods were most common among underweight and least common among obese individuals. Adjusting for covariates, BMI was not associated with method lethality, yet some associations were observed between BMI and specific methods.

Conclusion

Among VHA patients, BMI was negatively associated with suicide risks. These differences may partly relate to choice of suicide method. Low BMI offers an additional resource for clinical suicide risk assessments.
Psychosocial stress is positively associated with body mass index gain over 5 years: Evidence from the longitudinal AusDiab study
Authors: Harding Jessica L , Backholer Kathryn , Williams Emily D , Peeters Anna , Cameron Adrian J , Hare Matthew JL , Shaw Jonathan E , Magliano Dianna J
Published: March 2013

Objective

Emerging evidence suggests that psychosocial stress may influence weight gain. The relationship between stress and weight change and whether this was influenced by demographic and behavioral factors was explored.

Design and Methods

A total of 5,118 participants of AusDiab were prospectively followed from 2000 to 2005. The relationship between stress at baseline and BMI change was assessed using linear regression.

Results

Among those who maintained/gained weight, individuals with high levels of perceived stress at baseline experienced a 0.20 kg/m2 (95% CI: 0.07‐0.33) greater mean change in BMI compared with those with low stress. Additionally, individuals who experienced 2 or ≥3 stressful life events had a 0.13 kg/m2 (0.00‐0.26) and 0.26 kg/m2 (0.14‐0.38) greater increase in BMI compared with people with none. These relationships differed by age, smoking, and baseline BMI. Further, those with multiple sources of stressors were at the greatest risk of weight gain.

Conclusion

Psychosocial stress, including both perceived stress and life events stress, was positively associated with weight gain but not weight loss. These associations varied by age, smoking, obesity, and multiple sources of stressors. Future treatment and interventions for overweight and obese people should consider the psychosocial factors that may influence weight gain.
The independent and combined associations of physical activity and sedentary behavior with obesity in adults: NHANES 2003‐06
Authors: Maher Carol A. , Mire Emily , Harrington Deirdre M. , Staiano Amanda E. , Katzmarzyk Peter T.
Published: March 2013

Objective

To examine the combined influence of moderate‐to‐vigorous physical activity (MVPA) and sedentary behavior on obesity in US adults.

Design and Methods

Cross‐sectional analyses were undertaken on a nationally representative sample of 5,083 adults from the April 2003 and June 2005 National Health and Nutrition Examination Survey. Self‐reported TV time was divided into low, moderate, and high categories. Accelerometer‐derived total sedentary and MVPA minutes divided into low, moderate, and high tertiles. The independent associations between MVPA, TV, and total sedentary time and obesity were examined using logistic regression. Participants were then cross tabulated into nine MVPA–sedentary behavior groups, and logistic regression was used to examine the combined influence of MVPA and sedentary behavior on the odds of being obese.

Results

MVPA was consistently inversely associated with obesity, regardless of sedentary behavior [odds ratio (OR) = 1.80‐4.00]. There were inconsistent positive associations between TV time and risk of obesity in men, but not between total sedentary time and risk of obesity in either men or women.

Conclusions

Obesity was more strongly related to MVPA than either TV time or total sedentary time in US adults. Small differences in daily MVPA (5‐10 min) were associated with relatively large differences in risk of obesity.
Lifestyle intervention and/or statins for the reduction of C‐reactive protein in type 2 diabetes: From the look AHEAD study
Authors: Belalcazar L. Maria , Haffner Steven M. , Lang Wei , Hoogeveen Ron C. , Rushing Julia , Schwenke Dawn C. , Tracy Russell P. , Pi‐Sunyer F. Xavier , Kriska Andrea M. , Ballantyne and the Look AHEAD (Action for Health in Diabetes Christie M.
Published: March 2013

Objective:

Cardiovascular risk remains high despite statin use. Overweight/obese diabetic persons usually have normal/low LDL‐cholesterol but high C‐reactive protein (CRP) levels. We aimed to examine the effects of intensive lifestyle intervention for weight loss (ILI) on CRP levels in overweight/obese diabetic individuals by statin use.

Design and Methods:

Look AHEAD was a randomized trial in overweight/obese type 2 diabetic individuals testing whether ILI would reduce cardiovascular mortality, when compared to usual care. CRP changes in 1,431 participants with biomarker levels, who remained on or off statin treatment for 1 year, were evaluated.

Results:

The reduction in CRP levels with ILI at 1 year in men and women on statins was −44.9 and −42.3%, respectively, compared to −13.7 and −21.0% for those on statins and usual care (P < 0.0001). At 1 year, median CRP levels were: 1.8 mg L−1 in participants randomized to ILI on statin therapy; 2.6 mg L−1 for those on statins randomized to usual care and 2.9 mg L−1 for participants not on statins but randomized to ILI. Weight loss was associated with 1‐year CRP reduction (P < 0.0001) in statin and nonstatin users.

Conclusions:

Our findings suggest that in overweight/obese diabetic persons, ILI and statin therapy may have substantial additive anti‐inflammatory benefits.
Randomized double‐blind placebo‐controlled study of leptin administration after gastric bypass
Authors: Korner Judith , Conroy Rushika , Febres Gerardo , J. McMahon Donald , Conwell Irene , Karmally Wahida , Aronne Louis J.
Published: March 2013

Objective:

Obese individuals have high levels of circulating leptin and are resistant to the weight‐reducing effect of leptin administration at physiological doses. Although Roux‐en‐Y gastric bypass (RYGB) is an effective weight loss procedure, there is a plateau in weight loss and most individuals remain obese. This plateau may be partly due to the decline in leptin resulting in a state of relative leptin insufficiency. The main objective of this study was to determine whether leptin administration to post‐RYGB patients would promote further weight reduction.

Design and Methods:

This was a randomized, double‐blind, placebo‐controlled cross‐over study of 27 women who were at least 18 months post‐RYGB and lost on average 30.8% of their presurgical body weight. Subjects received either leptin or placebo via subcutaneous injection twice daily for 16 weeks, then crossed over to receive the alternate treatment for 16 weeks.

Results:

Weight change after 16 weeks of placebo was not significantly different from that after 16 weeks of leptin. No changes were observed in percent fat mass, resting energy expenditure, thyroid hormones, or cortisol levels.

Conclusion:

Contrary to our hypothesis, we did not observe a significant effect of leptin treatment on body weight in women with relative hypoleptinemia after RYGB.
Changes in Visceral Adiposity and Serum Cholesterol with a Novel Viscous Polysaccharide in Japanese Adults with Abdominal Obesity
Authors: Reimer Raylene A. , Yamaguchi Hideyo , Eller Lindsay K. , Lyon Michael R. , Gahler Roland J. , Kacinik Veronica , Juneja Prateek , Wood Simon
Published: March 2013

Objective: Evidence supports the role of dietary fiber in improving metabolic health. PolyGlycopleX® (PGX®), a viscous functional polysaccharide improves lipidemia and glycemia in healthy adults. Our objective was to examine the effects of PGX® on risk factors associated with the metabolic syndrome in Japanese adults with abdominal obesity.

Design and Methods: Sixty four subjects assigned to 14 weeks of 15 g day−1 of PGX® or placebo were assessed in a randomized, double‐blind, placebo‐controlled, parallel group trial. At week 0 and 14, primary outcome measures were serum lipids, abdominal adiposity, glucose tolerance and blood pressure.

Results: Total and LDL cholesterol were reduced at week 14 with PGX® but not placebo (P < 0.05). The reduction in waist circumference at week 14 was greater with PGX® versus placebo (P < 0.05). In females, abdominal visceral fat was decreased to a greater extent with PGX® versus placebo (P < 0.05). While glucose tolerance worsened with placebo over time, PGX® reduced glucose total area under the curve from week 0 to 6 (P = 0.039). Serum concentrations of resistin and IL6 increased slightly in placebo and decreased slightly with PGX®.

Conclusions: PGX® is a functional fiber that shows promise in reducing risk factors related to the metabolic syndrome in Japanese adults with abdominal obesity.
Obesity and incident injury among career firefighters in the central United States
Authors: Jahnke S.A. , Poston W.S.C. , Haddock C.K. , Jitnarin N.
Published: March 2013

Objective

Firefighting is a dangerous profession with high injury rates, particularly musculoskeletal (MS), but limited longitudinal data is available to examine predictors of MS injuries in this population.

Design and Methods

The relationship between personal individual, nonoccupational factors (e.g., demographic characteristics, body composition, fitness, and health behaviors) and incident injury and incident MS injury in a prospective cohort of 347 firefighters from the central United States was examined.

Results

Baseline weight status was a significant predictor of incident MS injury, with obese (BMI ≥ 30 kg m−2) firefighters 5.2 times more likely (95% CI = 1.1‐23.4) to experience a MS injury than their normal weight (BMI = 18.5‐24.9 kg m−2) colleagues over the course of the study. Similarly, firefighters who were obese based on WC (>102.0 cm) were almost three times as likely (OR = 2.8, 95% CI = 1.2‐6.4) to have a MS injury at follow‐up.

Conclusions

Findings highlight the importance of focusing on firefighters' body composition, nutrition and fitness as a means of decreasing risk for injury.
Effects of sugar‐sweetened beverages on plasma acylation stimulating protein, leptin and adiponectin: Relationships with Metabolic Outcomes
Authors: Rezvani Reza , Cianflone Katherine , McGahan John P. , Berglund Lars , Bremer Andrew A. , Keim Nancy L. , Griffen Steven C. , Havel Peter J. , Stanhope Kimber L.
Published: March 2013

Objective

The effects of fructose and glucose consumption on plasma acylation stimulating protein (ASP), adiponectin, and leptin concentrations relative to energy intake, body weight, adiposity, circulating triglycerides, and insulin sensitivity were determined.

Design and Methods

Thirty two overweight/obese adults consumed glucose‐ or fructose‐sweetened beverages (25% energy requirement) with their ad libitum diets for 8 weeks, followed by sweetened beverage consumption for 2 weeks with a standardized, energy‐balanced diet. Plasma variables were measured at baseline, 2, 8, and 10 weeks, and body adiposity and insulin sensitivity at baseline and 10 weeks.

Results

Fasting and postprandial ASP concentrations increased at 2 and/or 8 weeks. ASP increases correlated with changes in late‐evening triglyceride concentrations. At 10 weeks, fasting adiponectin levels decreased in both groups, and decreases were inversely associated with baseline intra‐abdominal fat volume. Sugar consumption increased fasting leptin concentrations; increases were associated with body weight changes. The 24‐h leptin profiles increased during glucose consumption and decreased during fructose consumption. These changes correlated with changes of 24‐h insulin levels.

Conclusions

The consumption of fructose and glucose beverages induced changes in plasma concentrations of ASP, adiponectin, and leptin. Further study is required to determine if these changes contribute to the metabolic dysfunction observed during fructose consumption.
Metabolomic signatures in lipid‐loaded HepaRGs reveal pathways involved in steatotic progression
Authors: Brown Meredith V. , Compton Sarah A. , Milburn Michael V. , Lawton Kay A. , Cheatham Bentley
Published: March 2013

Objectives

A spectrum of disorders including simple steatosis, nonalcoholic steatohepatitis, fibrosis, and cirrhosis is described by nonalcoholic fatty liver disease (NAFLD). With the increased prevalence of obesity, and consequently NAFLD, there is a need for novel therapeutics in this area. To facilitate this effort, a cellular model of hepatic steatosis was developed using HepaRG cells and the resulting biochemical alterations were determined.

Design and Methods

Using global metabolomic profiling, by means of a novel metabolite extraction procedure, the metabolic profiles in response to the saturated fatty acid palmitate, and a mixture of saturated and unsaturated fatty acids, palmitate and oleate (1:2) were examined.

Results

We observed elevated levels of the branched chain amino acids, tricarboxylic acid cycle intermediates, sphingosine and acylcarnitines, and reduced levels of carnitine in the steatotic HepaRG model with both palmitate and palmitate:oleate treatments. In addition, elevated levels of diacylglycerols and monoacylglycerols as well as altered bile acid metabolism were selectively displayed by palmitate‐induced steatotic cells.

Conclusions

Biochemical changes in pathways important in the transition to hepatic steatosis including insulin resistance, altered mitochondrial metabolism, and oxidative stress are revealed by this global metabolomic approach. Moreover, the utility of this in vitro model for investigating the mechanisms of steatotic progression, insulin resistance, and lipotoxicity in NAFLD was demonstrated.
Surgical control of obesity and diabetes: The role of intestinal vs. gastric mechanisms in the regulation of body weight and glucose homeostasis
Authors: Patel Rajesh T. , Shukla Alpana P. , Ahn Soo Min , Moreira Marlus , Rubino Francesco
Published: March 2013

Objective

To elucidate the specific role of gastric vs. intestinal manipulations in the regulation of body weight and glucose homeostasis.

Design and Methods

The effects of intestinal bypass alone (duodenal‐jejunal bypass ‐DJB) and gastric resection alone (SG) in Zucker Diabetic Fatty (ZDF) rats were compared. Additional animals underwent a combination procedure (SG + DJB). Outcome measures included changes in weight, food intake (FI), oral glucose tolerance (GT) and gut hormones.

Results

DJB did not substantially affect weight and FI, whereas SG significantly reduced weight gain and food consumption. DJB rats showed weight‐independent improvement in GT, which improved less after SG. Furthermore, SG significantly suppressed plasma ghrelin and increased insulin, glucagon like peptide‐1 (GLP‐1), glucose‐dependent insulinotropic peptide and peptide YY response to oral glucose whereas DJB had no effects on postprandial levels of these hormones. DJB restored postprandial glucagon suppression in diabetic rats whereas SG did not affect glucagon response. The combination procedure (SG + DJB) induced greater weight loss and better GT than SG alone without reducing food intake further.

Conclusions

These findings reveal a dominant role of the stomach in the regulation of body weight and incretin response to oral glucose whereas intestinal bypass primarily affects glucose homeostasis by a weight‐, insulin‐ and incretin‐independent mechanism
Working memory‐related brain activity is associated with outcome of lifestyle intervention
Authors: Hege M.A. , Stingl K.T. , Ketterer C. , Häring H.U. , Heni M. , Fritsche A. , Preissl H.
Published: March 2013

Objective

Lifestyle interventions including reduction of caloric intake are still the most pursued option to treat obesity. However, their outcome in terms of weight loss strongly differs between participants. In our study, we hypothesized that initial differences in brain activation in a food specific memory task are associated with weight change during a lifestyle intervention.

Design and Methods

Magnetic brain activity was recorded during a one‐back visual memory task with food and nonfood pictures in 33 overweight and obese subjects before they underwent a lifestyle intervention. The intervention lasted 6 months and aimed for a reduction in daily caloric intake by 400 kcal. Body mass index (BMI) was determined before and after the intervention.

Results

Differences between outer tertiles representing people who increased their BMI by 1.4% ± 1.1% (non‐responders) and who reduced their BMI by −6.9% ± 2.6% (responders) are reported. Neuronal activity was related to BMI change in sensor and source space. Non‐responders showed higher activation in right inferior frontal and left occipital visual areas, whereas responders showed increased activation in right temporal areas including hippocampus and fusiform gyrus.

Conclusions

Differences in the cerebral response during a food specific memory task indicate an altered cognitive control over food intake. These differences might determine the ability to eat less and successfully lose weight.
Optimism, pessimism and bias in self‐reported body weight among older adults
Authors: Sutin Angelina R.
Published: March 2013

Objective

Body mass index (BMI) and obesity (BMI ≥ 30) are often derived from self‐reported weight and height; psychological dispositions may bias how participants report these physical characteristics. The present research used a large national sample of US adults to examine the correspondence between reported and measured body weight and height and to test whether optimists and pessimists misreport their weight/height in ways that are consistent with their worldviews.

Methods

Participants in the Health and Retirement Study (N = 11,207) reported their weight and height and completed a measure of dispositional optimism and pessimism; trained interviewers measured participants’ weight and height.

Results

There was a high correlation between measured and reported weight (r = 0.98) and height (r = 0.92). Consistent with their positive and negative worldviews, respectively, optimists under‐reported and pessimists over‐reported their weight. There was not a consistent association with misreported height. Optimism and pessimism were also associated with actual BMI and risk of obesity, but the protective/risk effects were amplified when using reported weight to derive BMI.

Conclusions

These findings suggested that reported body weight tends to be accurate, but that biases associated with psychological dispositions may inflate the relation between the disposition and obesity. Such biases may extend to associations with other self‐reported factors thought to be related to optimism and pessimism.
Associations between plasma polyunsaturated fatty acids, plasma stearoyl‐CoA desaturase indices and body fat
Authors: Vinknes Kathrine J. , Elshorbagy Amany K. , Drevon Christian A. , Nurk Eha , Tell Grethe S. , Nygård Ottar , Vollset Stein E. , Refsum Helga
Published: March 2013

Objective

Stearoyl‐CoA desaturase (SCD)‐1 deficient mice are resistant to obesity and plasma SCD indices are related to obesity in humans. Both n‐3 and n‐6 polyunsaturated fatty acids (PUFA) regulate expression of the SCD enzymes. Whether higher plasma PUFA were associated with lower SCD indices in humans was examined.

Design and Methods

Population‐based study of 2,021 elderly subjects from the Hordaland Health Study. Using multivariate linear regression, the cross‐sectional associations among plasma PUFA, estimated SCD indices (from fatty acid profiles in plasma total lipids), and fat mass measured by dual‐energy X‐ray absorptiometry were explored. Two plasma SCD indices were used: SCD‐16 (16:1n‐7/16:0) and SCD‐18 (18:1n‐9/18:0).

Results

Plasma total, n‐6 and n‐3 PUFA were inversely associated with both SCD indices (P < 0.001 for all). Among the individual PUFA, 18:2n‐6 showed the strongest association with SCD‐16 (partial r = −0.59, P < 0.001) followed by 20:5n‐3 (partial r = −0.13; P < 0.001). Plasma total, n‐6 and n‐3 PUFA were inversely associated with body fat (P < 0.001 for all); the associations were markedly attenuated following adjustment for SCD‐16.

Conclusions

The epidemiological data are in line with animal studies and suggest that PUFA may decrease SCD1 activity in humans, with possible reduction in body fat.
Blood pressure assessment in severe obesity: Validation of a forearm approach
Authors: Leblanc Marie‐Éve , Croteau Sara , Ferland Annie , Bussières Jean , Cloutier Lyne , Hould Frédéric‐Simon , Biertho Laurent , Moustarah Fady , Marceau Simon , Poirier Paul
Published: March 2013

Objective

Obesity is frequently associated with systemic hypertension. Blood pressure measure is inaccurate in severely obese patients because of poor cuff size fitting. The aim of the study is to assess the degree of agreement between the intra‐arterial method as the gold standard vs. noninvasive methods, i.e., forearm blood pressure and upper‐arm blood pressure measures.

Design and Methods

A total of 1285 measures of intra‐arterial and forearm blood pressure were taken in 51 severely obese patients in a supine position in the operating and the recovery room. A subset of 352 upper‐arm measures were taken in the recovery room and compared to the intra‐arterial and the forearm methods.

Results

Correlation between the intra‐arterial and the forearm measures was 0.90 (P < 0.001) for the 2570 data (systolic and diastolic). Compared to intra‐arterial, the forearm method overestimated systolic (6 ± 16 mm Hg, P < 0.001) and underestimated diastolic blood pressure (2 ± 11 mm Hg, P = 0.03). Compared to intra‐arterial, upper‐arm underestimated systolic (8 ± 16 mm Hg, P < 0.01) and overestimated diastolic blood pressure (9 ± 7 mm Hg, P < 0.001).

Conclusion

The magnitude of differences between the intra‐arterial and forearm method was less than differences between the intra‐arterial and upper‐arm method. Our results suggest that forearm method may be a more accurate alternative to upper‐arm measurement to assess blood pressure in severely obese patients.
Chemotherapy medication errors in a pediatric cancer treatment center: Prospective characterization of error types and frequency and development of a quality improvement initiative to lower the error rate
Authors: Watts Raymond G. , Parsons Kerry
Published: March 2013

Background

Chemotherapy medication errors occur in all cancer treatment programs. Such errors have potential severe consequences: either enhanced toxicity or impaired disease control. Understanding and limiting chemotherapy errors are imperative.

Procedure

A multi‐disciplinary team developed and implemented a prospective pharmacy surveillance system of chemotherapy prescribing and administration errors from 2008 to 2011 at a Children's Oncology Group‐affiliated, pediatric cancer treatment program. Every chemotherapy order was prospectively reviewed for errors at the time of order submission. All chemotherapy errors were graded using standard error severity codes. Error rates were calculated by number of patient encounters and chemotherapy doses dispensed. Process improvement was utilized to develop techniques to minimize errors with a goal of zero errors reaching the patient.

Results

Over the duration of the study, more than 20,000 chemotherapy orders were reviewed. Error rates were low (6/1,000 patient encounters and 3.9/1,000 medications dispensed) at the start of the project and reduced by 50% to 3/1,000 patient encounters and 1.8/1,000 medications dispensed during the initiative. Error types included chemotherapy dosing or prescribing errors (42% of errors), treatment roadmap errors (26%), supportive care errors (15%), timing errors (12%), and pharmacy dispensing errors (4%). Ninety‐two percent of errors were intercepted before reaching the patient. No error caused identified patient harm. Efforts to lower rates were successful but have not succeeded in preventing all errors.

Conclusions

Chemotherapy medication errors are possibly unavoidable, but can be minimized by thoughtful, multispecialty review of current policies and procedures. Pediatr Blood Cancer 2013;601320‐1324. © 2013 Wiley Periodicals, Inc.
Determining response and recurrence in pediatric B‐cell lymphomas of the bone
Authors: Borst Alexandra J. , States Lisa J. , Reilly Anne F. , Rheingold Susan R.
Published: March 2013

Background

Primary lymphomas of the bone are rare in children, but have an excellent response to therapy. Evaluating patients for remission and recurrence can be challenging given the difficulties of distinguishing healing bone from residual tumor on imaging. A review of imaging in patients treated for primary bone lymphoma (PBL) in one center was performed in an effort to determine best practice.

Methods

Twelve cases of PBL diagnosed and treated from 2000 to 2011 at the Children's Hospital of Philadelphia were identified. Information about presentation, histology, imaging, treatment, and outcomes was collected.

Results

There were no recurrences of the primary bone tumor after therapy. One patient developed therapy‐related AML. Although PET‐avid lesions usually fell below a SUVmax of 3 within 3 months, low‐level SUVmax lesions often remained up to 12 months post‐therapy. At no point during therapy did radiographs, MRI, bone scans or CT of bones normalize, most remaining abnormal for several months to years. Patients were exposed to significant ionizing radiation, with estimated levels ranging from 9.5 to 183.1 mSv per patient. Over 10% of scans had incidental findings, which led to 17 extra imaging studies and 4 biopsies, but no clinically significant outcomes.

Conclusions

In our cohort, frequent imaging did not affect or improve outcome. Due to the low risk of relapse and high rate of repeated imaging for incidental findings, minimization of post‐therapy imaging should be considered. This modification in practice will significantly reduce radiation exposure, as well as potentially decrease parent and patient anxiety. Pediatr Blood Cancer 2013;601281‐1286. © 2013 Wiley Periodicals, Inc.
Membrane protein shaving with thermolysin can be used to evaluate topology predictors
Authors: Bendz Maria , Skwark Marcin , Nilsson Daniel , Granholm Viktor , Cristobal Susana , Käll Lukas , Elofsson Arne
Published: March 2013

Topology analysis of membrane proteins can be obtained by enzymatic shaving in combination with MS identification of peptides. Ideally, such analysis could provide quite detailed information about the membrane spanning regions. Here, we examine the ability of some shaving enzymes to provide large‐scale analysis of membrane proteome topologies. To compare different shaving enzymes, we first analyzed the detected peptides from two over‐expressed proteins. Second, we analyzed the peptides from non‐over‐expressed Escherichia coli membrane proteins with known structure to evaluate the shaving methods. Finally, the identified peptides were used to test the accuracy of a number of topology predictors. At the end we suggest that the usage of thermolysin, an enzyme working at the natural pH of the cell for membrane shaving, is superior because: (i) we detect a similar number of peptides and proteins using thermolysin and trypsin; (ii) thermolysin shaving can be run at a natural pH and (iii) the incubation time is quite short. (iv) Fewer detected peptides from thermolysin shaving originate from the transmembrane regions. Using thermolysin shaving we can also provide a clear separation between the best and the less accurate topology predictors, indicating that using data from shaving can provide valuable information when developing new topology predictors.