Energy Trade-off and 4 Extreme Human Body Types.

BACKGROUND: Resource trade-off theory suggests that increased performance on a given trait comes at the cost of decreased performance on other traits. METHODS: Growth data from 1889 subjects (996 girls) were used from the GrowUp1974 Gothenburg study. Energy Trade-Off (ETO) between height and weight for individuals with extreme body types was characterized using a novel ETO-Score (ETOS). Four extreme body types were defined based on height and ETOI at early adulthood: tall-slender, short-stout, short-slender, and tall-stout; their growth trajectories assessed from ages 0.5-17.5 years.A GWAS using UK BioBank data was conducted to identify gene variants associated with height, BMI, and for the first time with ETOS. RESULTS: Height and ETOS trajectories show a two-hit pattern with profound changes during early infancy and at puberty for tall-slender and short-stout body types. Several loci (including FTO, ADCY3, GDF5, ) and pathways were identified by GWAS as being highly associated with ETOS. The most strongly associated pathways were related to "extracellular matrix," "signal transduction," "chromatin organization," and "energy metabolism." CONCLUSIONS: ETOS represents a novel anthropometric trait with utility in describing body types. We discovered the multiple genomic loci and pathways probably involved in energy trade-off.

Evaluation of safety and efficacy outcomes of direct oral anticoagulants versus warfarin in normal and extreme body weights for the treatment of atrial fibrillation or venous thromboembolism.

Despite evolving evidence, the use of direct oral anticoagulants (DOACs) in patients with extremes of body weight remains controversial. This study aimed to measure the impact of DOACs compared to warfarin on safety and efficacy outcomes in extreme body weight patients. This multi-center, health system, retrospective study examined the outcomes of patients with all body weights and extreme body weights prescribed a DOAC (rivaroxaban, apixaban, dabigatran, edoxaban) or warfarin for atrial fibrillation or venous thromboembolism over a 9-year period. The primary outcome was a composite of thromboembolism, symptomatic recurrent VTE, or severe bleeding; analyzed by pre-determined BMI cutoffs. A total of 19,697 patients were included in the study: 11,604 in the DOAC group and in the 8093 in the warfarin group. 295 patients were underweight and 9108 patients were pre-obese to obese class 3. After adjusting for potential confounders, warfarin patients had higher odds of experiencing the composite outcome compared to DOAC patients (OR 1.337, 95% CI 1.212-1.475). Additionally, obese patients were 24.6% more likely to experience the outcome compared to normal BMI patients. Adjusted modeling showed that warfarin patients experienced higher bleed rates compared to DOAC patients (OR 1.432, 95% CI 1.266-1.620). Obese patients were less likely to be diagnosed with a bleed (OR 0.749, 95% CI 0.658-0.854), and underweight patients were more likely to be diagnosed with a bleed (OR 1.522, 95% CI 1.095-2.115) compared to normal BMI patients. In conclusion, DOACs for atrial fibrillation or VTE in patients with extreme body weights appear safe and effective when compared to warfarin.

Two cases of pen ink scleral tattoos and a brief review of the literature.

PURPOSE: Scleral tattooing, also known as episcleral, subconjunctival, or simply eyeball tattooing, is a relatively new form of extreme body modification that first emerged in 2007. There are few reports of the management of these tattoos in the medical literature, and we aim to increase the body of knowledge surrounding this rare and potentially dangerous practice. OBSERVATIONS: We present two new cases of improvised scleral tattooing, both performed in prison using pen ink and insulin needles, and both with minimal complications and managed with topical medications. A brief review of the literature is included which details the dangers of scleral tattooing. CONCLUSIONS AND IMPORTANCE: We discuss management of complications for this new, previously unreported method of scleral tattooing using pen ink. Ophthalmologists should be aware of the presentation, possible complications, and management of these cases.

Singularidade e mito: o corpo como potência subversiva / Singularity and myth: the body as a subversive power / (Singularité et mythe: Le corps comme puissance subversive) / (Singularidad y Mito: El cuerpo como fuerza subversiva)

Através da investigação sobre o campo enunciativo próprio aos sujeitos que realizam modificações corporais extremas (construção da imagem corporal distinta do padrão clássico ocidental, com uso excessivo de técnicas como a tatuagem, piercing e cirurgia plástica), o presente artigo problematiza a singularidade, tomando-a como uma formação mítico-imaginária na qual a unicidade do ser seria não só um ancoradouro identitário, mas também uma expressão possível do desejo de tornar-se o poeta forte de sua história.

Based on analysis of narratives that are typical of subjects who perform extreme body modifications (establishing body images that differ from classic Western standards through excessive use of techniques such as tattoos, piercings and plastic surgery), this paper questions singularity, considering it a basis of mythical and imaginary formation, in which someone's unicity is an anchor of identity and a possible expression of the desire to become the strong poet of his or her own story

Au moyen d'une recherche sur le champ énonciatif de sujets qui effectuent des modifications corporelles extrêmes (construction d'une image corporelle différente du modèle occidental classique, marquée par l'usage excessif de techniques telles que le tatouage, le piercing et la chirurgie plastique), cet article discute la singularité en tant que formation mythico-imaginaire, dans laquelle l'unicité de l'être serait non seulement un ancrage de l'identité, mais aussi une expression possible du désir de devenir le poète fort de sa propre histoire.

Através de la investigación sobre el campo enunciativo propio de los sujetos que se realizan modificaciones corporales extremas (construcción de la imagen corporal diferente al estándar clásico occidental, con el uso excesivo de técnicas como: tatuaje, piercing y cirugía plástica), el presente artículo problematiza la singularidad, tomándola en la condición de una formación mítico-imaginaria, en la cual la unicidad del ser sería, no solamente, un anclaje identitario, sino también una posible expresión del deseo de convertirse en el poeta fuerte de su historia.

Durch die Forschung auf dem Gebiet des Selbstausdrucks von Subjekten die extreme körperliche Veränderung durchgehen (Konstruktion eines Erscheinungsbildes welches vom klassischen westlichen Muster abweicht, wie z.B. durch die übertriebene Anwendung von Tätowierungen, Piercings und/oder plastischer Chirurgie), problematisiert der vorliegende Artikel Singularität indem er diese als mythisch-imaginäres Konstrukt betrachtet. Die Einzigkeit des Selbst ist hier nicht nur eine identitärische Verankerung, sondern auch der mögliche Ausdruck des Wunsches, der Poet seiner eigenen Geschichte zu sein.

Corpos extremos, corpos infantis: proezas da cirurgia plástica e da linguagem do conto de fadas / Extreme bodies, children's bodies: feats of plastic surgery and the language of fairy tale

O corpo “extremo” pode deixar o pensamento e a palavra siderados diante da surpresa que oferece ao olhar. Com a criança, o conto de fadas, ao tomar “a infância como mediação entre o adulto e a criança”, pode ajudar a reencontrar ou a inventar espaço para uma palavra que não sature a realidade corporal, uma palavra capaz de acolher a cena do corpo e seu acontecimento. É isto o que acreditamos ter ocorrido com Antony e Alicia, pacientes gravemente mutilados e hospitalizados em um serviço cirúrgico. Já com relação ao adulto, no entanto, que palavra poderia se transformar em recurso e mediação? (AU)

The extreme body can leave the speech and the thought stuned by the frontal surprise catching the look. With a child, the fairy tale making «childhood as a mediation between the adult and the child» can help to find or create all over again some space for a word not overfilled by the body’s reality, some space able to be a place which can receive the stage and the issue of the body. This kind of thing seems to have happened with the little Antony and the young Alicia, both severely mutilated and then hospitalized in a restoring surgery department. But, with an adult, what kind of word can become a resource and a mediation? (AU)