Submaximal power output in adopted and biological siblings

Submaximal power output was determined in relative steady state on a bicycle ergometer at a heart rate of 150 beats per minute (PWC150). PWC150 was measured in 880 individuals, 9 to 26 years of age, belonging to 46 sibships of adopted sibs, 66 sibships of unrelated individuals including adoptees, 33 sibships of first-degree cousins, 225 sibships of biological sibs, 56 sibships of DZ twins and 54 sibships of MZ twins. PWC150, PWC150/kg of body weight, PWC150/kg lean body mass, PWC150/cm of height and PWC150/m2 of body surface area were submitted to analysis of variance and correlation analysis after statistical control over age and sex of subjects. Few significant resemblances were found in PWC measurements for adoptive siblings, unrelated sibs and cousins. Sibling resemblance was, however, significant for the sibships of biological sibs, and of DZ and MZ twins. Interclass correlations reached significance only in pairs of biological brothers and sisters, and in pairs of DZ and MZ twins. Estimates of total genetic effect in PWC150/kg in a population of free-living children, adolescents and young adults vary from 0.30 to 0.48. It is concluded that submaximal power output is only moderately affected by the genotype.     

BMI in the Trois‐Rivières study: Child–adult and child–parent relationships

This study evaluated intraindividual child–adult and interindividual child–parent relationships of body mass index (BMI) using data from the Trois‐Rivières semilongitudinal study of growth and development. Intraindividual correlations between age 12 and 35 years were substantial (r² = 36% of variance in women, 30% of variance in men). Interindividual child–parent correlations for mothers and fathers age 36.6 ± 0.4 and 39.5 ± 0.4 years, respectively, were very low to low for daughters age 12 years (r = 0.09, NS and 0.34, P < 0.001 vs. father and mother, respectively) but all very low for sons age 12 years (r = 0.07, NS and 0.16, NS vs. father and mother, respectively). A multiple regression analysis predicted adult BMI from the individual's BMI at 10, 11, 12 years plus the maternal and paternal BMIs as calculated from self‐reported heights and weights. The BMI at age 12 years was a better predictor of adult BMI than the parental BMI in both men and women (P < 0.001) and multivariate analysis revealed that this index at age 12 years was the sole significant predictor of adult BMI for both men and women. The results from our study do not support the hypothesis that parental BMI is a stronger predictor of adult BMI than childhood BMI. However, useful information for the prediction and prevention of adult overweight can be obtained from the BMI at age 12 years. Our results suggest that environmental influences may be the major factor in the present obesity epidemic. Am. J. Hum. Biol. 15:187–191, 2003. © 2003 Wiley‐Liss, Inc.     

Physical activity, aerobic fitness, and seven-year changes in adiposity in the Canadian population.

Associations among baseline physical activity, aerobic fitness, changes in physical activity, and 7-y changes in adiposity were determined. The sample consisted of 602 males and 644 females, aged 20-69 y, from the 1981 Canada Fitness Survey and the 1988 Campbell's Survey. Questionnaire-derived measures of physical activity level consisted of activity energy expenditure (AEE) and time spent on physical activity. Participants were grouped into physical activity level categories by AEE and physical activity intensity (based on MET values), and physical activity level changes were determined from movement between tertiles of AEE from baseline to follow-up. Aerobic fitness levels at baseline were determined using the Canadian Aerobic Fitness Test. Changes in body mass, the sum of five skinfolds (SF5), and waist circumference (WC) were used as indicators of adiposity change. ANCOVA and multiple regression analyses indicated that neither baseline physical activity levels, intensity, physical activity change categories, nor aerobic fitness levels were significant predictors of changes in adiposity. In conclusion, physical activity was not predictive of 7-y changes in indicators of adiposity in this sample.     

Habituation of the Skin Conductance Response to Strong Stimuli: A Twin Study

Skin conductance responses to a series of loud tones were measured bilaterally in 121 pairs of adult twins, 53 pairs reared together and 68 pairs reared apart. Subjects were given an absorbing task on which to focus their attention and instructed to ignore the meaningless tones. Rangecorrection eliminated hand and sex differences in SCR amplitude and also the correlation with age of this variable. For the combined group of 79 pairs of monozygotic (MZ) twins, the within-pair correlations for Y-intercept, the slope of the habituation curve, and the number of trials to habituation were near the limits of retest reliability for these variables. After range-correction, the correlation for Y-intercept for the 42 pairs of dizygotic (DZ) twins was about half the MZ value, suggesting that initial electrodermal reactivity is strongly genetic and can be interpreted according to a polygenic-additive model. Biometric model testing indicated that stable individual differences in uncorrected SCR amplitude and in habituation slope are primarily determined by non-additive genetic factors. About 40% of the total variance (and most of the stable variance) in number of trials to habituation is genetically determined. Co-twins of MZ twins who were electrodermal nonresponders tended also to be hyporesponsive while co-twins of DZ nonresponders tended to be normoresponsive.     

Phase II trial with D-Trp-6-LH-RH in prostatic carcinoma: comparison with other hormonal agents

Various approaches to hormonal treatment of prostate carcinoma are discussed. Eighty-one patients with prostatic carcinoma, eight with stage B, nine with stage C, and 64 with stage D disease, were treated subcutaneously daily for 3 months with the LH-RH agonist D-Trp-6-LH-RH (Decapeptyl) in order to evaluate the incidence of remissions according to WHO recommendations for oncologic trials. The findings were compared to those obtained with other hormonal therapies of prostatic carcinoma according to the statistical method of "expected response rate" as adapted by Lee and Wesley for phase II trials. Treatment with D-Trp-6-LH-RH greatly reduced serum LH and testosterone levels without raising serum prolactin. After 1-2 weeks of therapy, there was relief of subjective symptoms and a reversal of the signs of prostatism as well as a marked decrease in bone pain. At 90 days 52 patients had complete relief of prostatism and 21 had only mild signs and symptoms. Seventy patients were experiencing no bone pain and an additional six had only mild pain. Prostatic size, evaluated by rectal examination and transabdominal ultrasonography, reverted to normal in 26.4% of patients (complete remission) and was reduced by more than 50% in an additional 17.6% (partial remission), the overall rate of complete plus partial regression of prostatic enlargement being 44%. Scans showed a major improvement of bone lesions in 14.8% of cases. This response increased to 37% after more than 6 months of follow-up. Prostatic acid phosphatase levels were decreased by more than 50% in 61% of the patients, but this test appears to be a less valid marker than the lipid-associated sialic acid (LASA). The increase in LASA before treatment and a reduction after treatment can frequently be correlated with the objective volume of the neoplasms. No flare-up of the disease was encountered, and there were no side effects except for impotence. Statistical analyses of results by the method of Lee and Wesley indicated that the incidence of complete and partial regression (CR and PR) observed with D-Trp-6-LH-RH was not significantly different from that recorded in previous studies for another LH-RH analog, Buserelin. However, CR and PR obtained with D-Trp-6-LH-RH (44%) were significantly higher than with subcapsular orchiectomy (22%). Hormonal effects and some other actions of D-Trp-6-LH-RH were compared and contrasted with those produced by castration, estrogens, antiandrogens, and progestogens.(ABSTRACT TRUNCATED AT 400 WORDS)     

Coconut Oil Supplementation Does Not Affect Blood Pressure Variability and Oxidative Stress: A Placebo-Controlled Clinical Study in Stage-1 Hypertensive Patients

Exploring an alternative to improve the clinical management of hypertension, we tested the hypothesis that food supplementation with coconut oil (EVCO), alone or combined with aerobic exercise training, could exert an antihypertensive effect (primary outcome) in patients with stage 1 hypertension. Forty-five hypertensive volunteers of both genders participated in a placebo-controlled clinical trial. The volunteers were submitted to 24-hour ambulatory blood pressure monitoring, analysis of blood pressure variability (BPV), measurement of serum malondialdehyde (MDA) and nutritional assessment. Results indicate that EVCO consumption had no adverse effects. The supplementation did not increase the caloric intake compared with placebo, and the dietary constituents were similar between groups, except for the saturated fats, especially lauric acid. The analysis of blood pressure indicated absence of antihypertensive effect of EVCO alone or combined with physical training. Furthermore, no effects on blood pressure variability and oxidative stress were observed in the supplemented hypertensive patients. Thus, despite the results observed in pre-clinical studies, the current clinical study did not provide evidence to support the use of coconut oil as an adjuvant in the management of hypertension in humans.     

Machine learning and national health data to improve evidence: Finding segmentation in individuals without private insurance

ObjectiveIndividuals without private health insurance have less access to healthcare, therefore are more prone to experience poor health when compared to those who have. Segmentation is an approach to find homogenous groups of people with the purpose of tailoring services and products. In public policy, segmentation might be used to identify characteristics and needs of specific groups and deliver targeted programs and spare costs. We aim to identify and describe segments within the uninsured population to aid targeted policy actions and improve health.MethodsWe used secondary data collected from a representative, nationwide health survey (n=18,204). For the purpose of our analysis, we included data from individuals who answered “no” to the question: “Do you have private health insurance?” (n=12,134). Variables pertaining information on socio-demographic, health status, access and care were used. A multiple correspondence analysis was performed to find principal components followed by a hierarchical cluster.ResultsWe found three clusters. The first (54.12% of our sample) composed by a group of young, middle aged and professionally active individuals without health problems. The second (36.70%), a cluster of aging individuals composed especially by elderly women, either retired or fulfilling domestic tasks, with a long-term health problem. The last (9.17%) composed by elder people, with long-term health problem and scoring low in mental health related questions.ConclusionOur study found three clusters (profiles of individuals) among the uninsured. Ultimately, our findings aim to support policy makers to deliver customized actions to improve health and provide cost-effective policies.     

Comparing the Approach to Radical Prostatectomy Using the Multiport da Vinci Xi and da Vinci SP Robots: A Propensity Score Analysis of Perioperative Outcomes

BackgroundUse of the single-port da Vinci SP robotic platform for various urological procedures has been described by several groups. However, the comparative performance of the SP robot in relation to earlier models such as the da Vinci Xi is still unclear.ObjectiveTo compare intraoperative and short-term postoperative outcomes between the da Vinci Xi and SP robots for patients undergoing radical prostatectomy (RP) in a referral center.Design, setting, and participantsData were prospectively collected for patients undergoing RP from June 2019 to April 2020 in a single center. The da Vinci SP was used for 71 patients and the da Vinci Xi for 875 patients. After propensity score (PS) matching, two groups of 71 patients were selected for the comparative study.InterventionRP via a transperitoneal approach using the same technique steps and anatomy access with both robot consoles.Outcome measurements and statistical analysisA PS analysis was performed using the covariates age, body mass index, Charlson comorbidity index, Sexual Health Inventory for Men score, American Urological Association symptom score, prostate size, prostate-specific antigen levels, Gleason score, D’Amico risk group, and degree of nerve-sparing. Intraoperative performance and short-term functional (continence and potency) and oncological outcomes were compared between the groups.Results and limitationsMedian follow-up was 4.4 mo (interquartile range [IQR] 1.6–7.2) for the SP group and 3.2 mo (IQR 1.6–4.8) for the Xi group (p = 0.2). The median total operative time and median console time were both significantly higher in the SP group, with median differences of 14 min (95% confidence interval [CI] 9–19) and 5 min (95% CI 0–5), respectively. The proportion of patients with blood loss of >100 ml was significantly lower in the SP group (difference of 27%, 95% CI 12–42%). No intra- or postoperative complications were reported in either group. There were no significant differences in pain scores at 6, 12, and 18 h or in positive surgical margin rates between the groups. The SP group had a significantly higher percentage of extraprostatic extension than the Xi group (difference of 16%, 95% CI 4.6–27%). None of the patients experienced biochemical recurrence during follow-up. The difference in continence rates at 45 d between the SP and Xi groups was 11% (95% CI ?5.6% to 28%) and the difference in potency rates at 45 d was ?7.3% (95% CI ?21% to 6.2%). The short-term follow-up for comparison of functional and oncological outcomes is a limitation.ConclusionsDespite differences in trocar placement and technology between the two da Vinci consoles, the SP has satisfactory intraoperative performance compared to the Xi. SP surgery can be performed safely and effectively during the initial learning phase. However, longer-term follow-up is needed to provide further evidence on the impact of SP implementation on functional and oncological outcomes.Patient summaryWe compared intraoperative and short-term postoperative outcomes for patients who underwent radical prostatectomy using two different robots, the da Vinci Xi and the single-port da Vinci SP. We found that operative time was longer for the Single Port console. Studies with long-term follow-up are needed to compare the functional and oncological outcomes.