Neighborhoods matter; but for whom? Heterogeneity of neighborhood disadvantage on child obesity by sex.

Although evidence suggests that neighborhood context, particularly socioeconomic context, influences child obesity, little is known about how these neighborhood factors may be heterogeneous rather than monolithic. Using a novel dataset comprised of the electronic medical records for over 250,000 children aged 2-17 nested within 992 neighborhoods in the greater Houston area, we assessed whether neighborhoods influenced the obesity of children differently based on sex. Results indicated that neighborhood disadvantage, assessed using a comprehensive, multidimensional, latent profile analysis-generated measure, had a strong, positive association with the odds of obesity for both boys and girls. Interactions revealed that the relationship between disadvantage and obesity was stronger for girls, relative to boys. Our findings demonstrated the complex dynamics underlying the influence of residential neighborhood context on obesity for specific subgroups of children.

Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria.

AIM: To compare the prevalence of Functional gastrointestinal disorders (FGIDs) using ROME III and ROME II and to describe predictors of FGIDs among eating disorder (ED) patients. METHODS: Two similar cohorts of female ED inpatients, aged 17-50 years, with no organic gastrointestinal or systemic disorders, completed either the ROME III (n = 100) or the ROME II (n = 160) questionnaire on admission for ED treatment. The two ROME cohorts were compared on continuous demographic variables (e.g., age, BMI) using Student's t-tests, and on categorical variables (e.g., ED diagnosis) using χ(2)-tests. The relationship between ED diagnostic subtypes and FGID categories was explored using χ(2)-tests. Age, BMI, and psychological and behavioural predictors of the common (prevalence greater than 20%) ROME III FGIDs were tested using logistic regression analyses. RESULTS: The criteria for at least one FGID were fulfilled by 83% of the ROME III cohort, and 94% of the ROME II cohort. There were no significant differences in age, BMI, lowest ever BMI, ED diagnostic subtypes or ED-related quality of life (QOL) scores between ROME II and ROME III cohorts. The most prevalent FGIDs using ROME III were postprandial distress syndrome (PDS) (45%) and irritable bowel syndrome (IBS) (41%), followed by unspecified functional bowel disorders (U-FBD) (24%), and functional heartburn (FH) (22%). There was a 29% or 46% increase (depending on presence or absence of cyclic vomiting) in functional gastroduodenal disorders because of the introduction of PDS in ROME III compared to ROME II. There was a 35% decrease in functional bowel disorders (FBD) in Rome III (excluding U-FBD) compared to ROME II. The most significant predictor of PDS was starvation (P = 0.008). The predictor of FH (P = 0.021) and U-FBD (P = 0.007) was somatisation, and of IBS laxative use (P = 0.025). Age and BMI were not significant predictors. The addition of the 6-mo duration of symptoms requirement for a diagnosis in ROME III added precision to many FGIDs. CONCLUSION: ROME III confers higher precision in diagnosing FGIDs but self-induced vomiting should be excluded from the diagnosis of cyclic vomiting. Psychological factors appear to be more influential in ROME II than ROME III.

Knowledge, attitudes, and behaviors of low-income women considered high priority for receiving the novel influenza A (H1N1) vaccine.

The primary purpose of this qualitative study was to explore the knowledge, attitudes, and behaviors of low-income women considered high priority for receiving the novel influenza A (H1N1) vaccine to improve communication in emergency preparedness and response. Researchers sought to identify the factors that affect this high priority population's ability to successfully comply with vaccination recommendations. By utilizing an existing communication framework through the special supplemental nutrition program for women, infants, and children (WIC) they were able to document the systems and infrastructure needed to foster constructive responses in a sustainable manner in the future. Six focus group discussions with WIC clients (n = 56) and 10 individual interviews with staff members were conducted at two WIC clinics in Georgia (1 urban and 1 rural). Data were collected after the 2009-2010 influenza season and analyzed using thematic analysis. Knowledge and attitudes regarding H1N1 differed among participants with regard to perceived severity and perceived risk of influenza illness. Participants identified several barriers and motivators to receiving the vaccination, as well as information needs, sources, and information-seeking behaviors. Similarities emerged among both WIC clients and staff members regarding impressions of H1N1 and the vaccine's use, suggesting that while the information may be provided, it is not effectively understood or accepted. Comprehensive education, policy and planning development regarding pandemic influenza and vaccine acceptance among low-income women is necessary, including improvements in risk communication messages and identifying effective methods to disseminate trusted information to these high priority groups.

Appearance and disappearance of functional gastrointestinal disorders in patients with eating disorders.

BACKGROUND: Functional gastrointestinal disorders or 'functional gastrointestinal disorder-like' symptoms (FGIDs) occur commonly in eating disorders (ED), but it is not known if these disorders are stable over time. The aims were to evaluate the turnover of FGIDs in patients with ED, and to relate this turnover to changes in body mass index (BMI), ED behaviors, and psychological variables. METHODS: Patterns and repeated measures analysis of presence of individual FGIDs and regional FGID categories (esophageal, gastroduodenal, bowel, and anorectal) in ED patients (n = 73) at admission to hospital and at 12-month follow-up, using change in BMI and ED behaviors as between patient variables. KEY RESULTS: Functional gastrointestinal disorders prevalence was 97% at admission and 77% at follow-up. The only individual FGIDs to decrease over time were functional heartburn (admission 53%, follow-up 23%) and functional dysphagia (21%, 7%). There was significant patient variation in the disappearance, persistence, and appearance of both individual FGIDs and FGID regional categories. Twenty-five (34%) of patients acquired at least one new FGID regional category at follow-up. There was no relationship between changes in BMI, self-induced vomiting, laxative use, binge eating, anxiety, depression, somatization, and the turnover of individual or regional FGIDs. CONCLUSIONS & INFERENCES: Functional gastrointestinal disorders remain common after 12 months in patients with an ED. Considerable turnover of the FGIDs occurs, however, and the appearance of new FGIDs is not restricted to the original FGID regional category. There is no apparent relationship between the turnover of the FGIDs and ED behaviors, psychological variables or body weight change. These findings have implications for the clinical evaluation and management of FGIDs in ED patients.

Reactions of cyclopentadienyl-amidinate titanium imido compounds with CO2: cycloaddition-extrusion vs. cycloaddition-insertion.

A combined experimental and DFT study of the reactions of cyclopentadienyl-amidinate titanium imido complexes with CO(2) is reported. Cycloaddition reactions of the aryl imido compounds Ti(eta-C(5)R(4)Me)(NAr){R(2)C(NR(1))(2)} (R = H or Me; R(1), R(2) = SiMe(3), Ph or (i)Pr, Me) with CO(2) gave the corresponding N,O-bound carbamate complexes Ti(eta-C(5)R(4)Me){N(Ar)C(O)O}{R(2)C(NR(1))(2)}. These reacted further with CO(2) by insertion into the Ti-N(Ar) bond to afford the new dicarboxylates Ti(eta-C(5)R(4)Me){OC(O)N(Ar)C(O)O}{R(2)C(NR(1))(2)} in which the original Ti=NAr bond has been completely cleaved. The X-ray structures of two of these have been determined. The CO(2) insertion reactions of the para-substituted phenyl carbamate complexes Ti(eta-C(5)Me(5)){N(-4-C(6)H(4)X)C(O)O}{MeC(N(i)Pr)(2)} (X = Me, CF(3) or NMe(2)) were first order with respect to both carbamate complex and CO(2) and the pseudo first order rate constants were effectively independent of the para substituent. The corresponding tert-butyl imido compounds Ti(eta-C(5)R(4)Me)(N(t)Bu){R(2)C(NR(1))(2)} also reacted with CO(2) to form N,O-bound carbamate complexes, Ti(eta-C(5)R(4)Me){N((t)Bu)C(O)O}{R(2)C(NR(1))(2)}. However, these did not insert a further molecule of CO(2) and instead extruded (t)BuNCO to form the crystallographically characterized oxo-bridged dimers [Ti(eta-C(5)R(4)Me)(mu-O){R(2)C(NR(1))(2)}](2). These reactions proceeded via transient terminal oxo intermediates, one of which was trapped by the addition of TolNCO (Tol = p-tolyl). DFT (B3PW91) calculations on Ti(eta-C(5)H(5))(NR){MeC(NMe)(2)} (R = Me, Ph, 4-C(6)H(4)Me, 4-C(6)H(4)NMe(2), 4-C(6)H(4)CF(3)) reacting with CO(2) showed that the second CO(2) insertion is thermodynamically favoured over isocyanate extrusion, and that the rates of the two processes are similar. Calculations on Ti(eta-C(5)R(5))(N(t)Bu){MeC(N(i)Pr)(2)} (R = H or Me) showed that increasing the steric bulk increases the thermodynamic favourability of the isocyanate extrusion process and significantly raises the activation barrier for the second CO(2) insertion, making the latter process impossible.

Time since menarche, weight gain and body image awareness among adolescent girls: onset of eating disorders?

BACKGROUND: Eating, body weight and shape feelings and behaviours of female adolescents in relation to the time since their first menstrual period were studied. METHOD: Three hundred sixty three female school students, aged 12-17 years participated in a cross-sectional computer survey. RESULTS: There was a significant increase in body weight following menarche including a rapid rise from 7-12 months after menarche (47.4 kg, 95% CI 45.2-49.7, 56.9 kg 95% CI 54.0-59.8). Students did not immediately adjust their perception of body weight to incorporate this rapid rise. The discrepancy between actual and desired weight was greatest 7-12 and 13-24 months after menarche. Weight losing behaviours and associated feelings around body image increased significantly following menarche in adolescents of all body weights. Increases were related to body weight and time since menarche, but not to age. Binge eating commenced more than 6 months after menarche and purging behaviour after 12 months. CONCLUSION: Both time since menarche and increase in body weight following menarche are associated with increasing concerns about eating, body image and weight losing behaviour. Some young women develop eating disorders. Menarche and subsequent weight gain appear as a risk factor for the onset of eating disorders.

Implementation of a physician assistant/hospitalist service in an academic medical center: impact on efficiency and patient outcomes.

BACKGROUND: Accreditation Council on Graduate Medical Education (ACGME) duty hour restrictions have led to the widespread implementation of non-house staff services in academic medical centers, yet little is known about the quality and efficiency of patient care on such services. OBJECTIVE: To evaluate the quality and efficiency of patient care on a physician assistant/hospitalist service compared with that of traditional house staff services. DESIGN: Retrospective cohort study. SETTING: Inpatient general medicine service of a 747-bed academic medical center. PATIENTS: A total of 5194 consecutive patients admitted to the general medical service from July 2005 to June 2006, including 992 patients on the physician assistant/hospitalist service and 4202 patients on a traditional house staff service. INTERVENTION: A geographically localized service staffed with physician assistants and supervised by hospitalists. MEASUREMENTS: Length of stay (LOS), cost of care, inpatient mortality, intensive care unit (ICU) transfers, readmissions, and patient satisfaction. RESULTS: Patients admitted to the study service were younger, had lower comorbidity scores, and were more likely to be admitted at night. After adjustment for these and other factors, and for clustering by attending physician, total cost of care was marginally lower on the study service (adjusted costs 3.9% lower; 95% confidence interval [CI] -7.5% to -0.3%), but LOS was not significantly different (adjusted LOS 5.0% higher; 95% CI, -0.4% to +10%) as compared with house staff services. No difference was seen in inpatient mortality, ICU transfers, readmissions, or patient satisfaction. CONCLUSIONS: For general medicine inpatients admitted to an academic medical center, a service staffed by hospitalists and physician assistants can provide a safe alternative to house staff services, with comparable efficiency.

Exercise behaviours and feelings in eating disorder and non-eating disorder groups.

OBJECTIVES: To compare exercise feelings and behaviours between female eating disorder (ED) (n = 287) and non-ED (n = 613) groups. To determine if exercise feelings and behaviours predict the presence of an ED. METHODS: Nine hundred females completed questions about their exercise behaviours and feelings. RESULTS: Both groups did similar amounts and days of exercise; the ED group scored higher on all other exercise behaviours and feelings except feeling that exercise was important for mood, and for weight loss. Best predictors of an ED diagnosis (VE 15.2%) were; 'being annoyed if exercise interrupted' (OR: 1.49; 95% CI 1.04-2.15), 'others feeling you exercise a lot' (OR: 1.61; 95% CI 1.06-2.44), 'feeling bad if unable to exercise a certain amount' (OR: 1.53; 95% CI 1.34-1.74), 'feeling that you have/have had problems with exercise' (OR: 2.12; 95% CI 1.33-3.39). DISCUSSION: Clinicians assessing eating disordered individuals should address specific exercise feelings, rather than exercise amount or frequency.

When energy in does not equal energy out: disordered energy control.

OBJECTIVE: To explore women's fear of loss of control and excessive inappropriate control of eating, exercise or their body in relation to patient/nonpatient status. To examine the utility of a concept of Disordered Energy Control (DEC). METHODS: Comparison of the features of DEC of 169 female eating disorder, first admission inpatients, 61 previous inpatients ('recovering') and 225 female students who completed computer questions including the Quality of Life Eating Disorder (QOL ED). RESULTS: Fear of loss of control was reported by 89% of inpatients, 36% of 'recovering' patients and 34% of students. Fear of loss of control or excessive controlling behaviour (defined as BMI <15.5, vomiting >7 days/month) was reported by 96% of inpatients (97% anorexia nervosa, 100% bulimia nervosa, 89% EDNOS), 51% of 'recovering' patients and 35% of students. There was significantly more impact on QOL ED psychological aspects, daily living, and acute medical health for student and patient groups reporting control issues compared to those who did not. DEC was present in 13% of students, 94% of inpatients and 28% of recovering patients. DISCUSSION: The concept of disordered energy control warrants further investigation particularly in overweight and obese groups. A biological measure of inappropriate energy control associated with medical and psychological problems would be useful.

Donor breast milk versus infant formula for preterm infants: systematic review and meta-analysis.

OBJECTIVES: To compare the effect of donor breast milk with infant formula in preterm infants. Separate comparisons with formula were made for donor breast milk that was: (1) given as a sole diet; (2) given as a supplement to mother's own breast milk; and (3) fortified with macronutrients and micronutrients. The main outcomes were death, necrotising enterocolitis (NEC), infection, growth and development. DATA SOURCES: Electronic databases-Cochrane, CENTRAL, MEDLINE, EMBASE, CINAHL, and HMIC: DH. REVIEW METHODS: Systematic review and meta-analysis of trials and observational studies of preterm or low birthweight infants. RESULTS: Seven studies (including five randomised controlled trials), all from the 1970s and 1980s, fulfilled the inclusion criteria. All studies compared the effect of sole donor breast milk with formula (combined n = 471). One of these also compared the effect of donor breast milk with formula given as a supplement to mother's own milk (n = 343). No studies examined fortified donor breast milk. A meta-analysis based on three studies found a lower risk of NEC in infants receiving donor breast milk compared with formula (combined RR 0.21, 95% CI 0.06 to 0.76). Donor breast milk was associated with slower growth in the early postnatal period, but its long-term effect is unclear. CONCLUSION: Donor breast milk is associated with a lower risk of NEC and slower growth in the early postnatal period, but the quality of the evidence is limited. Further research is needed to confirm these findings and measure the effect of fortified or supplemented donor breast milk.

Quality of life: eating disorders.

OBJECTIVE: There is a lack of measurements with predictive validity that are specific for quality of life (QOL) in patients with eating disorders. METHOD: A total of 306 eating disorder patients treated as inpatients completed the Quality of Life for Eating Disorders (QOL ED): 109 at both admission and discharge from hospital, 65 at both admission and after 12 months. Patients also completed well-validated measures of eating disorders, psychological dysfunction and general physical and mental QOL. QOL ED consists of 20 self-report questions that provide scores for the domains of behaviour, eating disorder feelings, psychological feelings, effects on daily life, effects on acute medical status and body weight, and a global score. RESULTS: QOL ED domain scores correlated appropriately with previously validated well-known measures of eating disorders, psychological dysfunction, general QOL and behaviour and body weight (p < 0.001). The QOL ED shows high reliability (Cronbach's alpha = 0.93). All scores changed significantly and appropriately during inpatient hospital treatment and between admission and 12 months after discharge from hospital (p < 0.001). The scores differed for anorexia nervosa, bulimia, eating disorder not specified (EDNOS) and no diagnosis. All no diagnosis (recovered) domain and global scores were significantly different from all diagnoses scores (p < 0.001). CONCLUSION: This quick, simple instrument fulfils all potential uses for QOL assessments in the clinical and research settings associated with eating disorders, including outcome.

Predictors of functional and exercise amenorrhoea among eating and exercise disordered patients.

BACKGROUND: The aim of this study was to investigate the predictors of amenorrhoea self-reported by patients who are suffering or recovering from eating or exercise disorders. METHODS: Menstrual status, eating and exercise behaviours and feelings, and weight history of 268 female patients, 16-40 years old and not taking oral contraception or hormone replacement, were assessed on admission to hospital or 12 months later. RESULTS: Most (134) had secondary amenorrhoea, 39 had oligomenorrhoea and 95 regular spontaneous menses. Amenorrhoea occurs in women with all types of eating disorder diagnoses including EDNOS (eating disorder not otherwise classified). The predictors of secondary amenorrhoea were: lower current BMI [odds ratio (OR) 0.59, confidence interval (CI) 0.50-0.68); a greater amount of body weight lost (OR 1.19, CI 1.06-1.33); exercising for mood, to burn up energy or for body image reasons (OR 1.50, CI 1.14-1.97); and younger age (OR 0.93, CI 0.87-1.00). Eating disorder patients with an exercise disorder were significantly more likely to report trying to reduce their food intake, to feel compelled to exercise and to have amenorrhoea/ oligomenorrhoea than eating disorder patients without an exercise disorder. CONCLUSION: The greater the self-report behaviours and feelings associated with energy debt, the more likely menstruation is to be disturbed. Energy balance needs to be assessed in all amenorrhoeic patients.

Usefulness of amenorrhoea in the diagnoses of eating disorder patients.

We investigated the usefulness of amenorrhoea as a criterion in eating disorder diagnoses. Menstrual history, eating disordered behavior and weight history of 251 female eating disorder inpatients were assessed on admission to hospital. Menstrual status of 88 (35%) could not be assessed (80 taking hormonal contraception, 5 (< 16 years) had never menstruated, one hysterectomized, 2 postmenopausal). Of the remaining 163; 90 had secondary amenorrhoea (no periods for > 3 months), 19 irregular periods and 54 regular cycles. Some patients with recent changes in energy status, who warranted inpatient treatment for their eating disorder did not develop amenorrhoea until later during their admission. Menstrual disturbance is not limited to anorexia nervosa, 24% of patients with an eating disorder not otherwise specified (EDNOS) and 15% of bulimic patients had amenorrhoea/oligomenorrhoea on admission. The best predictors (82% cases, 83% noncases, R2 = 0.41) of secondary amenorrhoea at admission, were; current BMI < or = 18, and having rules for exercising. Menstrual status of women with an eating disorder diagnosis cannot always be assessed, is mostly measuring low body weight and exercise and is not useful in planning or initiating treatment. There is insufficient evidence to support the use of amenorrhoea as a criterion for any eating disorder.

Psychological features are important predictors of functional gastrointestinal disorders in patients with eating disorders.

OBJECTIVE: Gastrointestinal symptoms that occur without evidence of structural gastrointestinal disease are a well-recognized feature of patients with eating disorders (EDs). Despite this, the spectrum and predictors of specific functional gastrointestinal disorders (FGIDs), documented using standardized and validated questionnaires, have received little attention. The aims of the study were to describe the prevalence and type of FGIDs in patients suffering from anorexia nervosa (AN), bulimia nervosa (BN) and eating disorders not otherwise specified (EDNOS), and to determine the relationships between psychological features, eating-disordered attitudes and behaviours, demographic characteristics and the type and number of FGIDs present. MATERIAL AND METHODS: A total of 101 consecutive female patients admitted to an eating disorder unit (AN 44%, BN 22%, EDNOS 34%, mean age 21 years) completed the Rome II modular questionnaire and a range of other validated self-reported questionnaires detailing illness history, psychological features and eating and exercise behaviour. RESULTS: The criteria for at least one FGID were fulfilled by 98% of the sample. The most prevalent FGIDs were irritable bowel syndrome (IBS: 52%), functional heartburn (FH: 51%), functional abdominal bloating (31%), functional constipation (FC: 24%), functional dysphagia (23%) and functional anorectal pain disorder (FAno: 22%); 52% of the sample satisfied the criteria for at least three coexistent FGIDs. Psychological variables (somatization, neuroticism, state and trait anxiety), age and binge eating were significant predictors of specific, and > or =3 coexistent FGIDs. Other disordered eating characteristics, including body mass index, were not predictors. CONCLUSIONS: In patients with EDs, specific psychological traits predict FGID type and the presence of multiple coexistent FGIDs. These findings support the role of specific psychological features as important contributors to certain FGIDs.

New titanium imido synthons: syntheses and supramolecular structures.

Reactions of Ti(NMe(2))(2)Cl(2) with a wide range of primary alkyl and arylamines RNH(2) afforded the corresponding 5-coordinate imido titanium compounds Ti(NR)Cl(2)(NHMe(2))(2) (R = (t)Bu (1), (i)Pr (2), CH(2)Ph (3), Ph (4), 2,6-C(6)H(3)Me(2) (5), 2,6-C(6)H(3)(i)Pr(2) (6), 2,4,6-C(6)H(2)F(3) (7), 2,3,5,6-C(6)HF(4) (8), C(6)F(5) (9), 4-C(6)H(4)Cl (10), 2,3,5,6-C(6)HCl(4) (11), 2-C(6)H(4)CF(3) (12), 2-C(6)H(4)(t)Bu (13)). The compounds 1-13 are monomeric in solution but in the solid state form either N-H...Cl hydrogen bonded dimers or chains or perfluorophenyl pi-stacked chains, depending on the imido R-group. The compound 13 was also prepared in a "one-pot" synthesis from RNH(2) and Ti(NMe(2))(4) and Me(3)SiCl. Reaction of certain Ti(NR)Cl(2)(NHMe(2))(2) compounds with an excess of pyridine afforded the corresponding bis- or tris-pyridine analogues [Ti(NR)Cl(2)(py)(x)](y) (x = 3, y = 1; x = y = 2), and the structure of Ti(2)(NC(6)F(5))(2)Cl(2)(mu-Cl)(2)(py)(4) shows pi-stacking of perfluorophenyl rings. Reaction of Ti(NMe(2))(2)Cl(2) with cross-linked aminomethyl polystyrene gave quantitative conversion to the corresponding solid-supported titanium imido complex. This paper represents the first detailed study of how supramolecular structures of imido compounds may be influenced by simple variation of the imido ligand N-substituent.

New and versatile routes to zirconium imido dichloride compounds.

Reactions of zirconium dialkyl- or bis(amido)-dichloride complexes "[Zr(CH2SiMe3)2Cl2(Et2O)2]" or [Zr(NMe2)2Cl2(THF)2] with primary alkyl and aryl amines are described. Reaction of "[Zr(CH2SiMe3)2Cl2(Et2O)2]" with RNH2 in THF afforded dimeric [Zr2(mu-NR)2Cl4(THF)4](R=2,6-C6H3iPr2 (1), 2,6-C6H3Me2 (2) or Ph (3)), [Zr2(mu-NR)2Cl4(THF)3](R=tBu (5), iPr (6), CH2Ph (7)), or the "ate" complex [Zr2(mu-NC6F5)2Cl6(THF)2{Li(THF)3}2](4, the LiCl coming from the in situ prepared "[Zr(CH2SiMe3)2Cl2(Et2O)2]"). With [Zr(NMe2)2Cl2(THF)2] the compounds [Zr2(mu-NR)2Cl4(L)x(L')y](R=2,6-C6H3iPr2 (8), 2,6-C6H3Me2 (9), Ph (10) or C6F5 (11); (L)x(L')y=(NHMe2)3(THF), (NHMe2)2(THF)2 or undefined), [Zr2(mu-NtBu)2Cl4(NHMe2)3] (12) and insoluble [Zr(NR)Cl2(NHMe2)]x(R=iPr (13) or CH2Ph (14)) were obtained. Attempts to form monomeric terminal imido compounds by reaction of or with an excess of pyridine led, respectively, to the corresponding dimeric adducts [Zr2(mu-2,6-C6H3Me2)2Cl4(py)4] (15) and [Zr2(mu-NtBu)2Cl4(py)3] (16). The X-ray structures of 1, 2, 4, 8, 12 and 15 have been determined.

Developmentally restricted actin-regulatory molecules control morphogenetic cell movements in the zebrafish gastrula.

Although our understanding of the regulation of cellular actin and its control during the development of invertebrates is increasing, the question as to how such actin dynamics are regulated differentially across the vertebrate embryo to effect its relatively complex morphogenetic cell movements remains poorly understood. Intercellular signaling that provides spatial and temporal cues to modulate the subcellular localization and activity of actin regulatory molecules represents one important mechanism. Here we explore whether the localized gene expression of specific actin regulatory molecules represents another developmental mechanism. We have identified a cap1 homolog and a novel guanine nucleotide exchange factor (GEF), quattro (quo), that share a restricted gene expression domain in the anterior mesendoderm of the zebrafish gastrula. Each gene is required for specific cellular behaviors during the anterior migration of this tissue; furthermore, cap1 regulates cortical actin distribution specifically in these cells. Finally, although cap1 and quo are autonomously required for the normal behaviors of these cells, they are also nonautonomously required for convergence and extension movements of posterior tissues. Our results provide direct evidence for the deployment of developmentally restricted actin-regulatory molecules in the control of morphogenetic cell movements during vertebrate development.

Predictors of the accuracy of self-reported height and weight in adolescent female school students.

OBJECTIVE: The authors investigated predictors of the accuracy of self-reported values of body weight and height in adolescent females. METHOD: Self-reported and measured weight and height values were obtained for 683 school students aged 11-18 years. Predictors of accuracy were determined for self-reported weight, height, and body mass index (BMI; based on self-reported values). RESULTS: Self-reported weight was underestimated. This was most likely for students with higher BMI values and actual weight. Younger, early pubertal and premenarcheal students were most likely to underestimate their height whereas older, postmenarcheal (more than 3 years) students were most likely to overestimate their height. The more exercise reported, the more accurate the height estimation. This translates to a greater underestimation of BMI as adolescents become older, have a longer duration since menarche, and exercise more. DISCUSSION: When accurate information is required, clinicians should measure height and weight, particularly if the adolescent female is perimenarcheal or appears to differ from population averages for height and weight.

Randomized controlled study of human zona pellucida dissection using the zona infrared laser optical system: evaluation of blastomere damage, embryo development, and subsequent hatching.

OBJECTIVE: To assess the effect of laser hatching on human embryo damage and subsequent development using the Zona Infrared Laser Optical System (ZILOS). DESIGN: Randomized controlled study. SETTING: Tertiary care fertility clinic. PATIENT(S): One hundred fourteen donated and discarded frozen human embryos. INTERVENTION(S): Embryos were thawed, cultured with cleavage and morphology evaluated periodically, and randomized into control, partial hatching, or complete hatching groups. The laser hatching procedure was performed by ZILOS. Zona thickness and embryo diameter were recorded. Complete hatching involved the production of a full-thickness defect in the zona and partial hatching, a defect in the outer half of the zona. No laser treatment was administered to the control group. MAIN OUTCOME MEASURE(S): Blastocyst development and completion of hatching process. RESULT(S): No significant difference was noted between the three study groups for their baseline characteristics. There was no significant difference in blastocyst development among the three groups. However, the complete hatching group showed a significant increase in hatching compared to the control group. CONCLUSION(S): Complete laser hatching of human embryos using the ZILOS does not have an adverse effect on subsequent development and increases the rate of completion of hatching.