Changes in Physical Activity and Television Viewing From Pre-pregnancy Through Postpartum Among a Socioeconomically Disadvantaged Perinatal Adolescent Population.

STUDY OBJECTIVE: Adolescent pregnancy contributes to accelerated trajectories of adiposity and cardiometabolic diseases. Two potentially low-cost prevention strategies include promoting physical activity (PA) and limiting television (TV) viewing. Few studies have explored these behavior patterns in perinatal adolescents. This study sought to characterize PA and TV viewing in a socioeconomically disadvantaged perinatal adolescent population. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: A cross-sectional, retrospective, 10-item survey was used to explore behavior patterns in 79 predominantly Black (86%) postpartum adolescents. MAIN OUTCOME MEASURES: Outcomes included self-reported changes in PA from pre-pregnancy through pregnancy, and 7-day recall of PA and TV viewing in postpartum. RESULTS: The majority of adolescents (66%) reported being active on ≥3 days/week in pre-pregnancy; however, many reported low PA (≤2 days/wk) in their first (59%), second (66%), and third (54%) trimesters. Adolescents who reported being active on ≥5 days/wk in pre-pregnancy (19%) experienced first trimester PA decline, which subsequently plateaued. This group remained the most active throughout pregnancy. In postpartum, over half (54%) of all adolescents reported low PA and irrespective of PA, spent considerable time watching TV (median = 1680.0 minutes, inerquartile range = 2940). CONCLUSION: Interventions promoting PA coupled with reducing TV viewing during pregnancy and in postpartum may benefit perinatal adolescents. The findings from this study suggest that PA history is a predictor of gestational PA, and low PA and high TV viewing in postpartum underscore the need for behavioral intervention. Conducting a brief assessment of PA history in early gestation may offer important insight.

Initial weight loss goals: have they changed and do they matter?

OBJECTIVE: Nearly 20 years ago, participants in behavioural weight loss programmes reported goals that greatly exceeded the amount of weight typically produced by these programmes. Whether having unrealistic weight loss goals impacts weight loss or attrition is unclear. The intent of the current study was to revisit current weight loss goals and examine whether goals impact outcomes. METHODS: Adults (N = 308, BMI = 33.7 ± 4.2 kg/m2) participated in a 12-month behavioural weight management programme and completed questionnaires about their goals. RESULTS: Participants' weight loss goal was 19.8 ± 7.9% of their body weight, and 90.4% selected a goal ≥10%. Weight goals were not associated with weight loss at 3 (p = 0.75) or 12 months (p = 0.47), or from 3 to 12 months (p = 0.55). Weight loss goals were not related to attrition at 3 (p = 0.91) or 12 months (p = 0.86). Participants believed that weight reduction would positively impact their health and psychosocial functioning. CONCLUSION: Weight loss goals have decreased, but still greatly exceed what can be expected by most. Unrealistic goals, however, had no impact on weight loss or attrition. These results question the utility of counseling people with obesity to set more realistic weight loss goals, which is typically practiced in behavioural weight management.

Impact of nitrogen flushing and oil choice on the progression of lipid oxidation in unwashed fried sliced potato crisps.

Unwashed, sliced, batch-fried potato crisps have a unique texture and are growing in popularity in the UK/EU premium snack food market. In this study, the storage stability of unwashed sliced (high surface starch) potatoes (crisps) fried in regular sunflower oil (SO) or in high oleic sunflower oil (HOSO) was compared over accelerated shelf life testing (45°C, 6 weeks); with and without nitrogen gas flushing. Primary oxidation products (lipid hydroperoxides) were measured with a ferrous oxidation-xylenol orange (FOX) assay and volatile secondary oxidation products (hexanal) were quantified by using solid phase micro-extraction gas chromatography mass spectrometry (HS-SPME-GC/MS). Results revealed that crisps fried in SO were the least stable. Flushing the stored crisps with nitrogen gas proved to be effective in slowing down the oxidation rate after frying with sunflower oil, significantly stabilizing the crisps. However, crisps fried in HOSO were the most stable, with the lowest rate of development of oxidation markers, and this has previously not been shown for crisps with a high free starch content.

First principles nonequilibrium plasma mixing.

We have performed nonequilibrium classical and quantum-mechanical molecular dynamics simulations that follow the interpenetration of deuterium-tritium (DT) and carbon (C) components through an interface initially in hydrostatic and thermal equilibrium. We concentrate on the warm, dense matter regime with initial densities of 2.5-5.5 g/cm3 and temperatures from 10 to 100 eV. The classical treatment employs a Yukawa pair-potential with the parameters adjusted to the plasma conditions, and the quantum treatment rests on an orbital-free density functional theory at the Thomas-Fermi-Dirac level. For times greater than about a picosecond, the component concentrations evolve in accordance with Fick's law for a classically diffusing fluid with the motion, though, described by the mutual diffusion coefficient of the mixed system rather than the self-diffusion of the individual components. For shorter times, microscopic processes control the clearly non-Fickian dynamics and require a detailed representation of the electron probability density in space and time.

A randomized comparison of a commercially available portion-controlled weight-loss intervention with a diabetes self-management education program.

OBJECTIVE: This study examined the efficacy of a commercially available, portion-controlled diet (PCD) on body weight and HbA1c over 6 months in obese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: One-hundred participants with a mean±s.d. age of 55.6±10.6 year, body weight of 102.9±18.4 kg and HbA1c of 7.7±1.3% were randomly assigned to a 9-session group lifestyle intervention that included a PCD or to a 9-session group program of diabetes self-management education (DSME). Participants in the two groups were prescribed the same goals for energy intake (1250-1550 kcal per day) and physical activity (200 min per week). RESULTS: While both groups produced significant improvements in weight and HbA1c after 6 months of treatment, PCD participants lost 7.3 kg [95% confidence interval (CI): -5.8 to -8.8 kg], compared with 2.2 kg (95% CI: -0.7 to -3.7 kg) in the DSME group (P<0.0001). Significantly more PCD than DSME participants lost 5% of initial weight (54.0% vs 14.0%, P<0.0001) and 10% (26.0% vs 6.0%, P<0.0001). HbA1c declined by 0.7% (95% CI: -0.4 to -1.0%) in the PCD group, compared with 0.4% (95% CI: -0.1 to -0.7%) in DSME (P<0.026). Across both groups, larger weight losses were associated with greater reductions in HbA1c (r=0.52, P<0.0001). CONCLUSIONS: These findings demonstrate that a commercially available portion-controlled meal plan can induce clinically meaningful improvements in weight and glycemic control in obese individuals with type 2 diabetes. These data have implications for the management of obesity in primary care, as now provided by the Centers for Medicare and Medicaid Services.

Optimizing weight gain in pregnancy to prevent obesity in women and children.

Pregnancy is now considered to be an important risk factor for new or persistent obesity among women during the childbearing years. High gestational weight gain is the strongest predictor of maternal overweight or obesity following pregnancy. A growing body of evidence also suggests that both high and low gestational weight gains are independently associated with an increased risk of childhood obesity, suggesting that influences occurring very early in life are contributing to obesity onset. In response to these data, the US Institute of Medicine (IOM) revised gestational weight gain guidelines in 2009 for the first time in nearly two decades. However, less than one third of pregnant women achieve guideline-recommended gains, with the majority gaining above IOM recommended levels. To date, interventions to optimize pregnancy weight gains have had mixed success. In this paper, we summarize the evidence from human and animal studies linking over-nutrition and under-nutrition in pregnancy to maternal and child obesity. In addition, we discuss published trials and ongoing interventions to achieve appropriate gestational weight gain as a strategy for obesity prevention in women and their children.

Preventing excessive gestational weight gain: a systematic review of interventions.

Women who gain excessive weight during pregnancy have an increased risk of post-partum obesity, and retention of gestational weight gain (GWG) post birth is a strong predictor of maternal overweight/obesity a decade or more after the birth. The aim of the current review was to identify, and evaluate the effect of key variables designed to modify risk factors for excessive weight gain in pregnant women that have been targeted in interventions over the last decade. The 10 interventions focused primarily on behavioural changes in relation to physical activity and/or to eating. While six studies reported significantly less weight gain in the intervention women, only three showed that women in the intervention were significantly more likely to gain within recommended guidelines. GWG was reduced in only normal-weight, low-income, obese, or overweight women, or not at all. Only one study reported a reduction in GWG in women with body mass indexes spanning the normal, overweight and obese categories. The findings were inconsistent in relation to what factors need to be targeted in intervention programmes to reduce GWG. Consideration of psychological factors relevant to pregnancy, in addition to behavioural changes in relation to eating and physical activity, is suggested for future intervention studies.

The effects of tooth extraction on alveolar bone biomechanics in the miniature pig, Sus scrofa.

OBJECTIVE: This study investigated the role of occlusion in the development of biomechanical properties of alveolar bone in the miniature pig, Sus scrofa. The hypothesis tested was that the tissues supporting an occluding tooth would show greater stiffness and less strain than that of a non-occluding tooth. DESIGN: Maxillary teeth opposing the erupting lower first molar (M(1)) were extracted on one side. Occlusion developed on the contralateral side. Serially administered fluorochrome labels tracked bone mineralisation apposition rate (MAR). A terminal experiment measured in vivo buccal alveolar bone strain on occluding and non-occluding sides during mastication. Ex vivo alveolar strains during occlusal loading were subsequently measured using a materials testing machine (MTS/Sintech). Whole specimen stiffness and principal strains were calculated. RESULTS: MAR tended to be higher on the extraction side during occlusion. In vivo buccal shear strains were higher in the alveolar bone of the occluding side vs. the extraction side (mean of 471 microvarepsilon vs. 281 microvarepsilon, respectively; p=0.04); however, ex vivo shear strains showed no significant differences between sides. Stiffness differed between extraction and occlusion side specimens, significantly so in the low load range (344 vs. 668 MPa, respectively; p=0.04). CONCLUSIONS: Greater in vivo shear strains may indicate more forceful chews on the occluding side, whereas the similarity in ex vivo bone strain magnitude suggests a similarity in alveolar bone structure and occlusal load transmission regardless of occlusal status. The big overall change in specimen stiffness that was observed was likely attributable to differences in the periodontal ligament rather than alveolar bone.

Dietary consistency and the midline sutures in growing pigs.

OBJECTIVES: The purpose of this study was to investigate the effects of reduced masticatory function on midline suture growth and morphology in growing pigs. SETTING AND SAMPLE POPULATION: The sample was 20 pigs separated into two dietary groups and raised at the Department of Anthropology, Harvard University. Midline suture specimens were analyzed at the Department of Orthodontics, University of Washington. MATERIALS AND METHODS: Ten farm pigs and 10 minipigs, all male, were randomly assigned to hard (n = 9) and soft-diet (n = 11) groups. Fluorochromic mineral labels were administered to document bone apposition, and the animals were killed after 12 weeks. Undecalcified sections of the interfrontal, interparietal, internasal, and intermaxillary sutures were evaluated for bone quantity and sutural thickness, interdigitation ratio and growth rate. RESULTS: Soft-diet pigs were characterized by a slower rate of weight gain and less bone than their hard-diet counterparts. Even after correction for weight gain, soft-diet pigs had reduced suture growth rate and thickness. However, no difference in interdigitation ratio was detected between dietary groups. CONCLUSIONS: Restriction to a soft diet reduces midline suture growth and bone apposition in the growing pig.

Evaluation of four cursor control devices during a target acquisition task for laparoscopic tool control.

Current laparoscopic surgery instruments create awkward postures which produce fatigue and pressure points in surgeons. In order to alleviate some of this discomfort a new laparoscopic tool had been developed with the inclusion of an articulating end-effector manipulated by a trackball. The current study was developed to access the performance of four input devices which could replace the manual trackball in a powered laparoscopic tool. A simple Fitts' law task was conducted and the devices' performance was evaluated with both subjective and objective measures. This article makes three main contributions to the scientific community. First, it provides a comparison of four control devices (TouchPad, Mouse Button Module, MiniJoystick Module and MicroJoystick) for use in a powered laparoscopic tool. Second, it provides an understanding of how the non-traditional measure of target re-entry can be utilized to compare control devices and how this relates to the more traditional measures of throughput and error rate. Finally, it contributes to the understanding of how a user's familiarity with a control device could affect the subjective and objective performance of the device. The main results indicate that the TouchPad and MicroJoystick are the best candidate-devices for use in a powered laparoscopic tool. The article also provides support for utilizing the new measure target re-entry when comparing control performance. Although studied in the application of laparoscopic surgery, the results can be generalized for the design of any hand-held device in which the speed and accuracy of the control device is critical.

Evaluation of a two cursor control device for development of a powered laparoscopic surgical tool.

The current study was performed to test two electronic cursor control devices (a Touchpad and a MicroJoystick) for use in an articulating powered laparoscopic tool. A simple target acquisition test was conducted to test how well the cursor control devices could be manipulated and how accurate they were (including endpoint and movement path). The study varied the width (0.27, 0.54 and 1.07 cm) of the target as well as the hand position used (thumb and index finger control). Additionally, each participant was able to choose their ideal operating cursor speed for each cursor control device. The MicroJoystick had a higher throughput and movement variability than the Touchpad. In all other categories tested, the cursor control devices did not differ significantly. The speed of the cursor control devices did not affect the performance of the devices; therefore, the ideal cursor speed could be chosen by the participant. Finally, the hand position did not affect the performance of the devices. This experiment found both hand positions, cursor control devices and all speeds could be used to effectively manipulate an articulating end-effector in a powered, cauterising, laparoscopic tool. This article addresses the advantages and limitations of two control mechanisms for laparoscopic tool controls considering both the subjective and objective data. The controls are tested in two hand positions to test how well the participants can manipulate the device while minimising perceived fatigue.

Functional cues in the development of osseous tooth support in the pig, Sus scrofa.

Alveolar bone supports teeth during chewing through a ligamentous interface with tooth roots. Although tooth loads are presumed to direct the development and adaptation of these tissues, strain distribution in the alveolar bone at different stages of tooth eruption and periodontal development is unknown. This study investigates the biomechanical effects of tooth loading on developing alveolar bone as a tooth erupts into occlusion. Mandibular segments from miniature pigs, Sus scrofa, containing M(1) either erupting or in functional occlusion, were loaded in compression. Simultaneous recordings were made from rosette strain gages affixed to the lingual alveolar bone and the M(2) crypt. Overall, specimens with erupting M(1)s were more deformable than specimens with occluding M(1)s (mean stiffness of 246 vs. 944 MPa, respectively, p=0.004). The major difference in alveolar strain between the two stages was in orientation. The vertically applied compressive loads were more directly reflected in the alveolar bone strains of erupting M(1)s, than those of occluding M(1)s, presumably because of the mediation of a more mature periodontal ligament (PDL) in the latter. The PDL interface between occluding teeth and alveolar bone is likely to stiffen the system, allowing transmission of occlusal loads. Alveolar strains may provide a stimulus for bone growth in the alveolar process and crest.

Who should conduct and interpret the neuropsychological assessment in sports-related concussion?

OBJECTIVE: This paper seeks to (i) describe the education and training of clinical neuropsychologists, (ii) discuss the significant differences between test administration and clinical assessment, (iii) outline the complex factors involved in psychometric test theory and test interpretation, and (iv) provide a framework for the role of clinical neuropsychologists in the interpretation and administration of neuropsychological instruments within the sports context. DESIGN: Review of pertinent professional practice, empirical and theoretical literature. INTERVENTION: Pubmed, Medline and Psych Info databases were reviewed. In total, 35 articles and 2 books were reviewed. RESULTS: The decision to return an athlete to play following sports-related brain injury is complex and requires the analysis of several sources of data. The decision is determined by a team physician; ideally within the context of a multidisciplinary team that employs comprehensive concussion surveillance and management, including baseline and post-injury neuropsychological assessment. Neuropsychologists possess the training and skill sets necessary to provide unique expertise in the assessment of cognitive functioning and post-injury neurocognitive and psychological assessment. CONCLUSIONS: Baseline neuropsychological testing is a technical procedure that can be conducted by technicians under the supervision/guidance of a neuropsychologist. Post-injury assessment requires advanced neuropsychological expertise that is best provided by a clinical neuropsychologist. Significant international differences exist with respect to the training and availability of clinical neuropsychologists, which require modification of these views on a country by country basis.

Behaviour and emotional problems in toddlers with pervasive developmental disorders and developmental delay: associations with parental mental health and family functioning.

BACKGROUND: Behavioural and emotional problems occur at a high rate in children and adolescents with intellectual disability, often from a young age. Some studies have indicated that children and adolescents with autism present with even higher rates. Less is known about the presentation, development and family impact of these difficulties in young children with autism. This study aimed to explore these issues in toddlers with pervasive developmental disorders (PDDs), those with delay without a PDD, and their families. METHODS: Participants were 123 children aged 20-51 months, referred to a developmental assessment clinic. Parents completed a checklist on child behavioural and emotional problems, and individual questionnaires on family functioning, their own mental health, and stress in relation to parenting their child. The child's language and cognitive skills, adaptive functioning and behaviour were assessed by standardized measures. Measures were repeated 1 year postdiagnosis. Behavioural and emotional problems in young children with a PDD were compared with those in children with developmental delay without a PDD, and their impact on parental outcomes explored over time. RESULTS: Initial and follow-up measures of child behaviour and emotional problems, parent mental health problems, parent stress and family functioning were significantly correlated, providing some evidence of stability over time. Child emotional and behavioural problems contributed significantly more to mother stress, parent mental health problems, and perceived family dysfunction than child diagnosis (PDD/non-PDD), delay or gender. Compared with mothers, all fathers reported significantly less stress in relation to parenting their child. CONCLUSION: Results highlighted the importance of addressing emotional and behavioural problems in very young children with autism and/or developmental delay. The need for early support and intervention for mothers, fathers and families in this context was also evidenced. As research has shown that behavioural and emotional problems persist into adolescence and young adulthood, understanding of these issues in very young children and their parents has important implications for intervention and long-term outcomes.

Dynamic mechanics in the pig mandibular symphysis.

During mastication, various biomechanical events occur at the mammalian jaw symphysis. Previously, these events have been studied in the static environment, or by direct recording of surface bone strains. Thus far, however, it has not been possible to demonstrate directly the forces and torques passing through the symphysis in association with dynamically changing muscle tensions. Therefore, we modified a previously published dynamic pig jaw model to predict the forces and torques at the symphysis, and related these to simulated masticatory muscle tensions, and bite, joint and food bolus forces. An artificial rigid joint was modelled at the symphysis, allowing measurements of the tri-axial forces and torques passing through it. The model successfully confirmed three previously postulated loading patterns at the symphysis. Dorsoventral shear occurred when the lower teeth hit the artificial food bolus. It was associated with balancing-side jaw adductor forces, and reaction forces from the working-side bite point. Medial transverse bending occurred during jaw opening, and was associated with bilateral tensions in the lateral pterygoid. Lateral transverse bending (wishboning) occurred at the late stage of the power stroke, and was associated with the actions of the deep and superficial masseters. The largest predicted force was dorsoventral shear force, and the largest torque was a 'wishboning' torque about the superoinferior axis. We suggest that dynamic modelling offers a new and powerful method for studying jaw biomechanics, especially when the parameters involved are difficult or impossible to measure in vivo.

Condylar mineralization following mandibular distraction in rats.

The impact of mandibular distraction on condyles is poorly understood. To examine how condylar mineralization is affected, we performed distraction in 128 one-month-old rapidly and 126 three-month-old slowly growing rats. The rate of distraction was 0.0 mm (sham), 0.2 mm (slow), 0.4 mm (moderate), or 0.6 mm (rapid). From 7 to 9 rats from each rate (n = 29-32) were killed at 4 time periods (D6, D10, D24, and D38) following osteotomy. Calcein and alizarin were injected 6 and 3 days, respectively, prior to death. Methacrylate-embedded sagittal condylar sections were examined under epifluorescence, and mineral apposition rates were measured. Results indicated that: (1) rapidly growing rats showed higher mineral apposition rates (p < 0.01-0.001) than did slowly growing rats; (2) mineral apposition rates were lower in distracted sides at all times in rapidly growing rats (p < 0.05-0.01), while this side-dependency was seen only at D24 in slowly growing rats (p < 0.05); and (3) distraction rates had little effect on mineral apposition rates. Thus, mandibular distraction decreases condylar mineral apposition rates, but only in rapidly growing rats, which is related to surgery and its functional consequences, not to the distraction rate.

3,4-Epoxy-1-butene, a reactive metabolite of 1,3-butadiene, induces somatic mutations in Xpc-null mice.

Xpc-null (Xpc-/-) mice, deficient in the global genome repair subpathway of nucleotide excision repair (NER-GGR), were exposed by intraperitoneal (i.p.) injection to a 300 mg/kg mutagenic dose of 3,4-epoxy-1-butene (EB), to investigate NER's potential role in repairing butadiene (BD) epoxide DNA lesions. Mutagenic sensitivity was assessed using the Hprt assay. Xpc-/- mice were significantly more sensitive to EB exposure, exhibiting an average 2.8-fold increase in Hprt mutant frequency (MF) relative to those of exposed Xpc+/+ (wild-type) mice. As a positive control for NER-GGR, additional mice were exposed by i.p. injection to a 150 mg/kg mutagenic dose of benzo[a]pyrene (B[a]P). The Xpc-/- mice had MFs 2.9-fold higher than those of exposed Xpc+/+ mice. These results suggest that NER-GGR plays a role in recognizing and repairing some of the DNA adducts formed following in vivo exposure to EB. Additional research is needed to examine the response of Xpc-/- mice, as well as other NER-deficient strains, to inhaled BD. Furthermore, it is likely that alternative DNA repair pathways also are involved in restoring genomic integrity compromised by BD-epoxide DNA damage. Collaborative studies are currently underway to address these critical issues.

Bone--special problems of the craniofacial region.

PROBLEMS: The craniofacial region presents special problems for tissue engineering. First, the stresses and strains that engineered tissues will encounter are mostly unknown. Second, if tissue engineering is to be useful in ameliorating craniofacial anomalies, it will have to mimic the growth activity of the native tissues. These problems are interrelated in that bone growth responds to loading conditions. METHODS: Our work uses miniature technology to measure skull deformation during function in the miniature pig. Growth is quantified in the same animals by labeling replicating cells with bromodeoxyuridine and newly mineralized bone with fluorochromes. The mandibular condyle and the cranial sutures are both candidate areas for tissue engineering, and craniofacial periosteum is a promising graft material. RESULTS: The condyle is compressed by the reaction load at the temporomandibular joint (TMJ). Cell divisions in the perichondrium are negatively correlated with bone strain. Craniofacial sutures deform during function much more than adjacent bones, and strains can be either tensile or compressive. In contrast to expectation, functional tension is not correlated with sutural growth rate. However, functional strain does predict sutural morphology, with compressed sutures showing complex interdigitation. Periosteum shows striking differences between resorptive and appositional surfaces. The resorptive medial side of the zygomatic arch is under pressure during function. Tensile strain perpendicular to the surface is probably greater on the temporal than on the zygomatic bone, thus correlating with more rapid periosteal apposition on the temporal. CONCLUSION: Engineered implants may be more likely to succeed if their architecture suits the strain environment in which they will function.