Free-living physical activity and energy expenditure of rural children and adolescents in the Nandi region of Kenya

Abstract

Purpose: To examine the relationship between physical activity and energy demands in children and adolescents with highly active lifestyles.

Methods: Physical activity patterns of 30 rural Kenyan children and adolescents (14?±?1 years, mean?±?SD) with median body mass index (BMI) z-score?=??1.06 [?3.29–0.67] median [range] were assessed by accelerometry over 1 week. Daily energy expenditure (DEE), activity-induced energy expenditure (AEE) and physical activity level (PAL) were simultaneously determined using doubly-labelled water (DLW). Active commuting to school was assessed by global positioning system.

Results: Mean DEE, AEE and PAL were 12.2?±?3.4, 5.7?±?3.0?MJ/day and 2.3?±?0.6, respectively. A model combining body mass, average accelerometer counts per minute and time in light activities predicted 45% of the variance in DEE (p?<?0.05) with a standard error of DEE estimate of 2.7?MJ/day. Furthermore, AEE accounted for ～47% of DEE. Distance to school was not related to variation in DEE, AEE or PAL and there was no association between active commuting and adiposity.

Conclusion: High physical activity levels were associated with much higher levels of energy expenditure than observed in Western societies. These results oppose the concept of physical activity being stable and constrained in humans.     

Cross-validation of pedometer-determined cut-points for healthy weight in British children from White and South Asian backgrounds

Background: Evidence-based pedometer cut-points for health have not been sufficiently examined in the context of ethnicity.

Objective: To (1) evaluate previously described steps/day cut-points in a sample of White and South Asian British primary school children and (2) use ROC analysis to generate alternative, ethnic specific, steps/day cut-offs for children.

Methods and procedures: Height, body mass and pedometer determined physical activity were assessed in 763 British children (357 boys and 406 girls) from White (n?=?593) and South Asian (n?=?170) ethnic groups, aged 8–11 years.

Results: The Vincent and Pangrazi cut-points significantly predicted BMI in white (p?=?0.006, Adjusted R^2?=?0.08) and South Asian children (p?=?0.039, Adjusted R^2?=?0.078). The Tudor-Locke et al. cut-points significantly predicted BMI in White children (p?=?0.0001, Adjusted R^2?=?0.079) but not South Asian children (p?p?=?0.04 or better, Adjusted R^2?=?0.091 for White and 0.09 for South Asian children). Subsequent cut-points associated with healthy weight, when translated to steps/day were 13?625 for White boys, 13?135 for White girls, 10?897 for South Asian boys and 10 161 for South Asian girls.

Conclusions: Previously published steps/day cut-points for healthy weight may not account for known ethnic variation in physical activity between White and South Asian children in the UK. Alternative, ethnic-specific, cut-points may be better placed to distinguish British children based on pedometer-determined physical activity.     

Analysis of ECG-trunk muscle signal amplitude and heart rate relationship

Abstract

The objective of this paper is to investigate if bioelectrical signals, generated from trunk muscles identified in an electrocardiogram (ECG) signal presented in this paper as ECG-Trunk Muscles Signals amplitude (Ecg-TMSA) are correlated with Heart rate (HR) during different levels of physical activity and also if Ecg-TMSA is not influenced by mental activity. HR and Ecg-TMSA were derived from ECG in 14 subjects when walking and jogging at different treadmill velocities from 4–10 (km?h^?1). The mean relationship for all 14 subjects was HR?=?(42.3?±?0.2)?+?(45.3?±?2.8) Ecg-TMSA, r^2?=?0.91. The result of one individual data points example for a 21?min experiment was (r^2?=?0.93, p?<?0.0001, n?=?336). The obtained results show a linear relationship between Ecg-TMSA and HR. Moreover, the Ecg-TMSA was not affected by mental activity.     

Selected biologic markers of inflammation and activity of Crohn’s disease

Abstract

The study aimed to compare the accuracy of selected biologic markers in assessing the disease activity in patients with Crohn’s disease (CD). The analysis included serum IL-2, IL-6, IL-17, TNF-α, IFN-γ, hsCRP, peripheral CD4?+?CD25?+?FOXP3?+?regulatory T cells, as well as fecal calprotectin and lactoferrin. A group of 55 adults with CD was enrolled to the study. Disease activity was assessed using Crohn’s Disease Endoscopic Index of Severity (CDEIS), which currently represents the gold standard for the evaluation of endoscopic activity. For clinical activity scoring, the Crohn’s Disease Activity Index (CDAI) was used. Concentrations of investigated markers were estimated by means of flow cytometry and enzyme-linked immunosorbent assays, and the results were correlated with both indices. The study demonstrated that both fecal markers, i.e. calprotectin (r?=?0.827, p?<?0.001) and lactoferrin (r?=?0.704, p?<?0.001), correlate closely with CDEIS score, and might be used to evaluate the severity of CD in clinical setting. The correlation of those markers with CDAI was also significant, with r?=?0.742 for calprotectin (p?<?0.001) and r?=?0.675 for lactoferrin (p?<?0.05). As for the other investigated markers, only hsCRP (r?=?0.672, p?<?0.001) and IL-17 (r?=?0.296, p?<?0.005) correlated closely with CDEIS. The correlation of the markers with CDAI was also significant, though weaker, with r?=?0.518 for hsCRP (p?<?0.001) and r?=?0.296 for IL-17 (p?<?0.05). The study showed that IL-17, despite its vague role in the pathogenesis of CD, might be a useful marker, comparable with hsCRP, in assessing the activity of the disease.     

Comparison between body mass index and a body shape index with adiponectin/leptin ratio and markers of glucose metabolism among adolescents

Background: Besides body mass index (BMI), new parameters have been developed to classify individual body shape.

Aim: To investigate the relationship between BMI, waist circumference (WC), a body shape index (ABSI) and ABSI-adolescents among adolescents and verify which would better predict lower adiponectin/leptin (A/L) ratio and disturbances on glucose metabolism.

Subjects and methods: A cross-sectional study with 197 Brazilian adolescents of 14–18?years. Serum leptin, adiponectin, glucose and insulin were measured. A/L ratio, ABSI, ABSI-adolescents, BMI, homeostasis model assessment estimates of insulin resistance (HOMA-IR) and β-cell function (HOMA-β) and the quantitative insulin sensitivity check index (QUICKI) were calculated.

Results: ABSI-adolescents positively correlated with WC (r?=?0.83, p?r?=?0.66, p?r?=?0.95, p?p?r?=??0.63, p?p?r?=??0.75; HOMA-IR: r?=?0.76; HOMA-β: r?=?0.77; insulin: r?=?0.79). Associations were confirmed by linear regression analysis, adjusted for sex and age.

Conclusions: ABSI-adolescents, but not ABSI, was related to A/L ratio and to markers of glucose metabolism, but not more strongly than BMI and WC.     

Light-intensity activities are important for estimating physical activity energy expenditure using uniaxial and triaxial accelerometers

This study evaluated the validity of the total energy expenditure (TEE) estimated using uniaxial (ACCuni) and triaxial (ACCtri) accelerometers in the elderly. Thirty-two healthy elderly (64–87 years) participated in this study. TEE was measured using the doubly labeled water (DLW) method (TEE_DLW). TEE_ACCuni (6.79 ± 1.08 MJ day⁻¹) was significantly lower than TEE_DLW (7.85 ± 1.54 MJ day⁻¹) and showed wider limits of agreement (−3.15 to 1.12 MJ day⁻¹) with a smaller correlation coefficient (r = 0.703). TEE_ACCtri (7.88 ± 1.27 MJ day⁻¹) did not differ from TEE_DLW and showed narrower limits of agreement (−1.64 to 1.72 MJ day⁻¹) with a larger correlation coefficient (r = 0.835, P < 0.001). The estimated intensities of light activities were significantly lower with ACCuni. Greater mediolateral acceleration was observed during 6-min walk tests. The results suggest that ACCtri is a better choice than ACCuni for assessing TEE in the elderly.     

Physical activity level measured by doubly labeled water and accelerometry in children

The present study investigated the use of a tri-axial accelerometer, Tracmor2, for the measurement of physical activity in children. Eleven children [age 6.9 (2.2) years, body mass 19.5 (5.3) kg and height 112.3 (14.4) cm] were studied. Total daily energy expenditure (TDEE) was measured using the doubly labeled water method over a 2-week period. In addition, basal metabolic rate (BMR) was determined by the ventilated hood system. Physical activity level (PAL) was defined as TDEE/BMR. Tracmor2 was worn during the same 2-week period throughout waking hours after which average counts per day were calculated. The average counts per day were shown to be highly correlated to PAL values measured by doubly labeled water: PAL = 1.156×10^–5×Tracmor2 average counts day^–1 + 0.978 (r=0.79, P<0.01). In conclusion, Tracmor2 is a valid instrument to measure physical activity in children under free-living conditions.     

Comparisons in ambulatory physical activity in children from the United Kingdom and Belgium

Aim: This study sought to examine ambulatory physical activity levels in adolescents from the UK and Belgium.

Methods: Following ethics approval, 2760 children (1247 boys, 1513 girls), aged 9–14 years from Belgium (n?=?1614) and the UK (n?=?1146), wore a pedometer for 4 days including at least 1 weekend day. Body mass index (BMI) was determined from height and mass.

Results: A 2 (gender)?×?2 (country) way ANCOVA, controlling for age and BMI, revealed a significant country-by-gender interaction for steps/day (p?=?0.0001). In both Belgium and the UK, boys were more physically active than girls (both p?=?0.0001), but the difference between boys and girls was greater for Belgian than UK children.

Conclusion: These results suggest there are differences in the ambulatory physical activity patterns of children in the UK and Belgium.     

Protective Reactivity and Alteration of the Brain Tissue in Alcoholics Evidenced by SOD1, MMP9 Immunohistochemistry,and Electron Microscopy

Abstract

Alcohol and its associated oxidative stress is one of the widespread contributors to the brain damage. Matrix metalloproteinases, which are extensively analyzed in brain pathology studies, are not sufficiently investigated in chronic alcohol consumption. This study evaluated regional brain damage caused by oxidative stress. Contribution of metalloproteinase-9 to this affection was evidenced in alcoholic subjects and correlated with ultrastructural changes. The authors found correlation between neuronal expression patterns of superoxide dismutase-1 and metalloproteinase-9 in nigral (r?=?0.532, p?<?0.001), striatal (r?=?0.327, p?<?0.001), and cortical (r?=?0.306, p?<?0.001) regions, and a significant decrease of nigral superoxide dismutase-1 median values accompanied by severe myelin damage.     

Physical inactivity and cognitive impairment in Korean older adults: gender differences in potential covariates

Background: Physical inactivity is one major lifestyle risk factor of mild cognitive impairment with ageing.

Aim: To investigate whether or not potential covariates modulate the association between physical activity (PA) and cognitive impairment in older adults.

Subjects and methods: Data from 10?245 Korean older adults (5817 women) were used.

Results: High PA older adults were younger and longer educated and had lower comorbidity and depression than low PA older adults. Compared with low PA men, moderate PA men only had a significantly lower odds-ratio (OR) and 95% confidence interval (95% CI) (OR?=?0.795, 95% CI?=?0.654?～?0.965, p?=?0.021) for having cognitive impairment, even after adjusting for measured covariates, which was no longer significant when additionally adjusted for comorbidity (OR?=?0.862, 95% CI?=?0.707?～?1.051, p?=?0.143). Compared with low PA women, moderate and high PA women had significantly lower risks of cognitive impairment (OR?=?0.830, 95% CI?=?0.712?～?0.969, p?=?0.018 and OR?=?0.784, 95% CI?=?0.651?～?0.943, p?=?0.010, respectively), even after adjusting for the measured covariates including comorbidity, which was no longer significant when additionally adjusted for depression (OR?=?0.897, 95% CI?=?0.776?～?1.049, p?=?0.173 and OR?=?0.919, 95% CI?=?0.761?～?1.111, p?=?0.385, respectively).

Conclusion: These findings suggest that gender differences in the covariates modulate the relationship between physical activity and cognitive decline in older Korean adults.     

Pedometer determined physical activity and obesity prevalence of Greek children aged 4–6 years

Background: Pre-school age is important for developing healthy attitudes towards physical activity (PA). However, research on pre-schoolers’ pedometer-determined PA is limited.

Aim: To describe pre-schoolers’ ambulatory activity; investigate step count differences in respect to Body Mass Index (BMI) categories and examine the prevalence of obesity.

Subjects and methods: Pre-school aged children (n?=?250; 5.5?±?0.4 years) from Komotini (Greece) wore Omron HJ-720IT-E2 pedometers for 10 consecutive days. Height and weight were measured and BMI was calculated.

Results: Three-way repeated measures ANOVAs revealed that children performed more steps on weekdays than during weekends (p?p?p?p?p?p?p?t-test analysis, children’s daily steps were significantly different from the 10?000 steps/day guideline, while obesity prevalence was 15.6%.

Conclusion: School-based ambulatory activity is lower than after school ambulatory activity, independent of BMI-category and gender, although obese children demonstrated fewer steps. Taking into account the high rate of both the obesity prevalence and children not meeting the 10?000 steps/day guideline, the need for preventive policies becomes obvious.     

Testing ecological and universal models of body shape and child health using a global sample of infants and young children

Aim: To test whether a risk of child illness is best predicted by deviations from a population-specific growth distribution or a universal growth distribution.

Subjects and methods: Child weight for height and child illness data from 433 776 children (1–59 months) from 47 different low and lower income countries are used in regression models to estimate for each country the child basal weight for height. This study assesses the extent to which individuals within populations deviate from their basal slenderness. It uses correlation and regression techniques to estimate the relationship between child illness (diarrhoea, fever or cough) and basal weight for height, and residual weight for height.

Results: In bivariate tests, basal weight for height z-score did not predict the country level prevalence of child illness (r²?=?–0.01, n?=?47, p?=?0.53), but excess weight for height did (r²?=?0.14, p?p?n?=?433 776) and basal weight for height was not (beta?=?0.20, p?=?0.27). Deviations from country-specific basal weight for height were negatively associated with the likelihood of illness (beta?=?–0.13, p?Conclusion: These results are consistent with the idea that populations may differ in their body slenderness, and that deviations from this body form may predict the risk of childhood illness.     

Validation of the Fitbit One,Garmin Vivofit and Jawbone UP activity tracker in estimation of energy expenditure during treadmill walking and running

Objectives: To determine the validity of energy expenditure estimation made by the Fitbit One, Garmin Vivofit and Jawbone UP activity trackers during treadmill walking and running. Determining validity of such trackers will inform the interpretation of the data they generate.

Design: Cross-sectional study.

Method: Fourteen adults walked at 0.70, 1.25, 1.80?ms^?1 and ran at 2.22, 2.78, 3.33?ms^?1 on a treadmill wearing a Fitbit One, Garmin Vivofit and Jawbone UP. Estimation of energy expenditure from each tracker was compared to measurement from indirect calorimetry (criterion). Paired t-tests, correlation coefficients and Bland–Altman plots assessed agreement and proportional bias. Mean percentage difference assessed magnitude of difference between estimated and criterion energy expenditure for each speed.

Results: Energy expenditure estimates from the Fitbit One and Garmin Vivofit correlated significantly (pr=?0.702; 0.854) with criterion across all gait speeds (0.70–3.33?ms^?1). Fitbit One, Garmin Vivofit and Jawbone UP correlated significantly (p?r?=?0.729; 0.711; 0.591) with criterion across all walking speeds (0.70–1.80?ms^?1). However, only the Garmin Vivofit correlated significantly (pr?=?0.346) with energy expenditure estimations from criterion across running speeds (2.22–3.33?ms^?1). Bland–Altman plots showed proportional bias for the Fitbit One and Garmin Vivofit. Energy expenditure estimations of single speeds were overestimated by the Fitbit One and underestimated by the Garmin Vivofit.

Conclusions: Energy expenditure reported by the devices distinguished between walking and running, with a general increase as exercise intensity increased. However, the reported energy expenditure from these devices should be interpreted with caution, given their potential bias and error.

• Practical implications

• Although devices report the same outcome of EE estimation, they are not equivalent to each other and differ from criterion measurements during walking and running.

• These devices are not suitable as research measurement tools for recording precise and accurate EE estimates but may be suitable for use in interventions of behaviour change as they provide feedback to user on trends in energy expenditure.

• If intending to use these devices in studies where precise measurements of energy expenditure are required, researchers need to undertake specific validation and reliability studies prior to interventions and the collection of cross-sectional data.

     

A single bout of breast milk expression does not increase resting metabolic rate

Introduction

Breastfeeding women have elevated resting metabolic rate (RMR); however, whether a single bout of lactation increases RMR is unknown. This study aimed to determine if a single bout of lactation acutely increased RMR.

Methods

Twenty-two lactating women (age: 31 ± 0.9 year, body mass index: 27.3 ± 1.2 kg/m²) were recruited. RMR was assessed at baseline and at 1- and 2-h following breast milk expression.

Results

RMR was unchanged in lactating women following a single bout of lactation (baseline: 1437 ± 39; 1 h: 1425 ± 37 2 h: 1440 ± 31 kcal/day) (p > .05). RMR was not correlated to daily milk produced (r = 0.05, p > .05), but was correlated to body mass (r = 0.74, p < .001), fat-free mass (kg) (r = 0.61, p < .01), and fat mass (kg) (r = 0.71, p < .01).

Conclusion

RMR in lactating women appears to be more related to body mass or composition in the postpartum period rather than lactation.     

Tracking of BMI,fatness and cardiorespiratory fitness from adolescence to middle adulthood: the Zagreb Growth and Development Longitudinal Study

Background: Effective intervention strategies aiming to improve cardiorespiratory fitness and to decrease body fatness are needed. However, long-term stability of these traits is not well understood.

Aim: To assess long-term tracking of cardiorespiratory fitness and body fatness from late adolescence to middle adulthood.

Subjects and methods: The sample consisted of 50 participants (31 boys) from the Zagreb Growth and Development Longitudinal Study who were followed up in adulthood (median age?=?43). Fatness was evaluated through BMI and skin-folds, while cardiorespiratory fitness was assessed using a cardiopulmonary exercise test. Inter-age partial correlation coefficients were calculated to evaluate tracking.

Results: Body mass index and skin-folds showed moderate tracking from age 15 years to middle adulthood (partial r?=?0.55, p?r?=?0.52, p?r?=?0.38, p?r?=?0.30, p?=?0.03), while ventilatory aerobic and anaerobic thresholds did not show significant tracking.

Conclusions: The results of this study indicate that preventive efforts aiming to increase cardiorespiratory fitness should include all adolescents, irrespective of their cardiorespiratory fitness status. Conversely, strategies aiming at obesity prevention should focus on high-risk groups of adolescents.     

Association of FTO and IRX3 genetic variants to obesity risk in north India

Abstract

Objective: Validation of body adiposity index (BAI) in a paediatrics sample; and to develop, if necessary, a valid BAI for paediatrics (i.e. BAI_p).

Methods: A total of 1615 children (52% boys) aged 5–12 years underwent anthropometry. Their body composition was assessed using a foot-to-foot bioimpedance. The validity of BAI?=?(Hip circumference/Height^1.5)???18 was tested by combining correlation and agreement statistics. Then, the sample was split into two sub-samples for the construction of BAI_p. A regression was used to compute the prediction equation for BAI_p-based percentage of body fat (%BF).

Results: The initial BAI over-estimated the %BF of children by 49% (29.6?±?4.2% versus 19.8?±?6.8%; p?<?0.0001). The original methodology led to a BAI_p?=?(Hip circumference/Height^0.8) ? 38 in children. When compared to BAI, BAI_p showed both better correlation (r?=?0.57; p?<?0.01 versus r?=?0.74; p?<?0.0001) and agreement (ICC?=?0.34; [95% CI?=??0.19–0.65] versus ICC?=?0.83; [95% CI?=?0.81–0.84]). However, there were some systematic biases between the two values of %BF as exemplified by the large 95% limit of agreement [?9.1%; 8.8%] obtained.

Conclusion: BAI over-estimates the %BF in children. In contrast, BAI_p appears as a new index for children’s body fatness, with acceptable accuracy. In its current form, this index is valid only for large-scale studies.     

Association between lifestyle and physical activity level in the elderly: a study using doubly labeled water and simplified physical activity record

Purpose

Physical activity level (PAL) is associated with all-cause mortality in the elderly. However, few studies have attempted to clarify the relationship between lifestyle and PAL in the elderly. This study aimed to examine the determinants of PAL in the elderly in terms of behavioral patterns and exercise intensity, and to validate the simplified physical activity record (sPAR).

Methods

Thirty healthy, elderly individuals, aged 64–87 years, participated in the study. Total energy expenditure (TEE_DLW), physical activity energy expenditure (PAEE_DLW), and PAL (PAL_DLW) were calculated based on doubly labeled water (DLW) and measured basal metabolic rate. Physical activity was recorded using the sPAR.

Results

PAL_DLW was significantly correlated with PAL estimated by sPAR (r = 0.588, P < 0.001). Good agreement was observed between TEE_DLW (1,860 ± 373 kcal/day) and TEE estimated by sPAR (1,854 ± 377 kcal/day) (r = 0.825, P < 0.001). Good agreement was also observed between PAEE_DLW (552 ± 242 kcal/day) and PAEE estimated by sPAR (562 ± 240 kcal/day) (r = 0.666, P < 0.001). The high PAL_DLW group had significantly shorter durations of ‘sleeping time and rest periods’ and ‘daily life sedentary activities’, and significantly longer durations of ‘bicycling with moderate speed’, ‘housekeeping with standing’, ‘gymnastics, tai chi, stretching’ and "swimming, hill climbing, fast jogging" than the low PAL group (P < 0.05).

Conclusions

The sPAR provides valid estimates of TEE and PAEE in the healthy elderly. The results suggest that engaging in housekeeping or sports activities for longer and being less sedentary may increase PAL_DLW in healthy elderly individuals.     

Does the antiviral therapy of patients with chronic hepatitis exert nephrotoxic effects?

Introduction: HBV and HCV chronic hepatitis can be accompanied by secondary renal disease. In addition, these patients receive antiviral drugs with potential nephrotoxicity. It is known that interferon (IFN) therapy in HCV-infected kidney transplant recipients is followed by rejection of the transplant in 50% of the cases. Ribavirin is contraindicated in hemodialyzed patients and in patients with a GFR <50?ml/min/1.73 m². IFN therapy requires dosage reduction and close monitoring in patients with a GFR <50?ml/min/1.73 m² and in patients with end stage renal disease. The aim of our study was to assess the nephrotoxicity of antiviral drugs in patients with chronic hepatitis by measuring three renal biomarkers: urinary albumin, N-acetyl-β-d-glucosaminidase (NAG) and α 1-microglobulin, as well as glomerular filtration rate (GFR-MDRD4) before and at 6 months of therapy.

Methods: Fifty-five patients (28 male and 27 female, with a mean age of 47.85?±?12.03 years) with chronic hepatitis (40 patients with HCV, 13 patients with HBV, 1 patient with HBV+HCV, and 1 patient with HBV+HDV) were enrolled into the study. Different antiviral drug associations were used on a case-by-case basis. The 40 patients with HCV chronic hepatitis received either Peg-IFN-α 2a+Ribavirin (37 patients) or Peg-IFN-α 2b+Ribavirin (3 patients). The 13 patients with HBV chronic hepatitis received Peg-IFN-α 2a (9 patients), Lamivudine (2 patients), Entecavir (1 patient), or Adefovir (1 patient). The patient with HBV+HCV chronic hepatitis received Peg-IFN-α 2a+Ribavirin. The patient with HBV+HDV chronic hepatitis received IFN-α 2a. Urinary albumin (ELISA), NAG (colorimetrical method), α 1-microglobulin (ELISA), and serum creatinine were measured before and at 6 months of antiviral therapy. Urinary markers were expressed as either mg/gCr (for albumin and α 1-microglobulin) or U/gCr (for NAG). Statistical analysis (Pearson’s correlation coefficient, paired t-test and χ²-test) was performed.

Results: At 6 months of therapy urinary albumin/gCr did not increase significantly: 16.58?±?23.39 vs. 15.85?±?24.96?mg/gCr before therapy, p?=?0.87. Urinary NAG/gCr did not increase significantly: 4.21?±?3.37 vs. 3.83?±?3.2?U/gCr before therapy, p?=?0.53. Urinary α 1-microglobulin/gCr was almost unchanged: 4.38?±?4.47 vs. 4.38?±?3.57?mg/gCr before therapy, p?=?0.99. The GFR did not decline significantly: 92.41?±?22.21 vs. 94.59?±?36.1?ml/min/1.73 m² before therapy, p?=?0.7. Ten patients (18.18%) were albuminuric before therapy, and 14 patients (25.45%) were albuminuric at 6 months of therapy, a non-significant increase (p?=?0.35). We found a correlation between urinary albumin/gCr and NAG/gCr and between urinary albumin/gCr and α 1-microglobulin/gCr both at baseline and at 6 months of therapy: r?=?0.54, p?=?0.0005; r?=?0.29, p?=?0.03; r?=?0.51, p?=?0.0005; and r?=?0.4, p?=?0.002, respectively. In the patient receiving Adefovir, a known nephrotoxic drug, two of the three biomarkers (urinary albumin/gCr and NAG/gCr) increased, most notably NAG/gCr. Both HCV and HBV chronic hepatitis therapy were associated with non-significant changes in renal biomarker excretion and GFR.

Conclusions: With the exception of Adefovir, all of the drug associations used in this study were safe.     

A multi-level analysis of individual- and school-level correlates of physical fitness in children

Background: Children’s physical fitness is potentially influenced by biological, behavioural and environmental factors.

Aim: To investigate the importance of individual-level and school-level characteristics in explaining variation in children’s physical fitness.

Subjects and methods: The sample comprised 354 Portuguese children, aged 5–10?years. Physical fitness [(handgrip (HG) strength, standing long jump (SLJ), shuttle-run (SR), total physical fitness score (PFz)], gross motor coordination (GMC) and body mass index (BMI) were assessed. Moderate-to-vigorous physical activity (MVPA) was objectively monitored; birth weight and socio-economic status (SES) were obtained by questionnaire. School contexts were assessed via an objective audit. Multilevel models using the Bayesian approach were used.

Results: Age was positively associated with HG, SLJ and PFz (p?<?0.05); BMI was positively associated with HG (p?<?0.05) and GMC with all physical fitness components (p?<?0.05); MVPA was only associated with PFz (p?<?0.05); children with level A SES outperformed those with level C SES in HG (p?<?0.05), but those with level B SES outperformed their level A SES peers in SR (p?<?0.05). Within the school context, no equipment for physical education was negatively associated with HG (p?<?0.05).

Conclusion: In the primary school years, individual-level characteristics were more important than the school context in explaining variations in physical fitness.     

Computerized acoustic cardiography correlates with echocardiography and invasive haemodynamics after percutaneous transvenous mitral commissurotomy

Background:?Rheumatic mitral stenosis severity has been assessed by the systolic time interval between the QRS onset and the first heart sound (QS1) by phonocardiography. We hypothesized that non-invasive computerized acoustic cardiography could evaluate mitral stenosis severity compared with echocardiography and invasive haemodynamics in patients undergoing percutaneous transvenous mitral commissurotomy (PTMC).

Methods:?27 patients underwent computerized acoustic cardiography, echocardiography, and invasive haemodynamic measurements prior to and after PTMC.

Results:?The mean age was 31?±?10 years, and 21 (78%) were female. By echocardiography, mitral valve area increased from 0.82?±?0.14 to 1.50?±?0.24 cm² (p?<?0.0001). The QS1 interval decreased from 101.7?±?12.9 to 93.2?±?9.2?ms (p?<?0.0001). The change in the QS1 interval correlated with the change in mitral valve area by echocardiography (p?=?0.037), right ventricular systolic pressure (p?<?0.0001), and the invasive mitral valve gradient (p?=?0.076).

Conclusions:?Acoustic cardiography may be used as an adjunctive non-invasive diagnostic tool to assess mitral stenosis severity.