Accuracy of the Common Predictive Equations for Estimating Resting Energy Expenditure among Normal and Overweight Girl University Students

Objective: The aim of the present study was to determine the accuracy of commonly used predictive formulas of resting metabolic rate (RMR) compared to measured RMR in normal and overweight young females.

Methods: In this cross-sectional study, 98 female university students aged 18–30 years with body mass index 18 to 30 kg/m² were recruited. Anthropometric indices and body compositions were measured. RMR was measured by indirect calorimetry (FitMate, Cosmed, Rome, Italy) and estimated by 11 predictive formulas. The accuracy of the RMR formulas and mean percentage differences between estimated and measured values were calculated. Paired t test was used to compare estimated and measured RMRs.

Result: There were no significant differences between measured and estimated RMR by the 4 commonly used formulas (Mifflin, Cunningham, and World Health Organization [WHO]/Food and Agriculture Organization [FAO]). Among all of the equations, the Mifflin formula showed the lowest bias (?2.97 ± 116.43 kcal/day) at the group level and was the most accurate formula (80.23%) in normal and overweight participants. The over- and underestimated values were about 14% and 5.5%, respectively. In normal and overweight females, Mifflin was the most accurate formula, with 75.51% and 84.61% accuracy, respectively.

Conclusion: Given the current lack of a standardized formula that consistently delivers accurate results, the Mifflin formula can be recommended for estimating energy requirements in normal and overweight females in clinical practice.     

Hexavalent chromium and isocyanate exposures during military aircraft painting under crossflow ventilation

Exposure control systems performance was investigated in an aircraft painting hangar. The ability of the ventilation system and respiratory protection program to limit worker exposures was examined through air sampling during painting of F/A-18C/D strike fighter aircraft, in four field surveys. Air velocities were measured across the supply filter, exhaust filter, and hangar midplane under crossflow ventilation. Air sampling conducted during painting process phases (wipe-down, primer spraying, and topcoat spraying) encompassed volatile organic compounds, total particulate matter, Cr[VI], metals, nitroethane, and hexamethylene diisocyanate, for two worker groups: sprayers and sprayer helpers (“hosemen”). One of six methyl ethyl ketone and two of six methyl isobutyl ketone samples exceeded the short term exposure limits of 300 and 75 ppm, with means 57 ppm and 63 ppm, respectively. All 12 Cr[VI] 8-hr time-weighted averages exceeded the recommended exposure limit of 1 µg/m³, 11 out of 12 exceeded the permissible exposure limit of 5 µg/m³, and 7 out of 12 exceeded the threshold limit value of 10 µg/m³, with means 38 µg/m³ for sprayers and 8.3 µg/m³ for hosemen. Hexamethylene diisocyanate means were 5.95 µg/m3 for sprayers and 0.645 µg/m³ for hosemen. Total reactive isocyanate group—the total of monomer and oligomer as NCO group mass—showed 6 of 15 personal samples exceeded the United Kingdom Health and Safety Executive workplace exposure limit of 20 µg/m³, with means 50.9 µg/m³ for sprayers and 7.29 µg/m³ for hosemen. Several exposure limits were exceeded, reinforcing continued use of personal protective equipment. The supply rate, 94.4 m³/s (200,000 cfm), produced a velocity of 8.58 m/s (157 fpm) at the supply filter, while the exhaust rate, 68.7 m³/s (146,000 cfm), drew 1.34 m/s (264 fpm) at the exhaust filter. Midway between supply and exhaust locations, the velocity was 0.528 m/s (104 fpm). Supply rate exceeding exhaust rate created re-circulations, turbulence, and fugitive emissions, while wasting energy. Smoke releases showing more effective ventilation here than in other aircraft painting facilities carries technical feasibility relevance.     

Nutritional and socio-economic determinants of cognitive function and educational achievement of Aboriginal schoolchildren in rural Malaysia

A community-based cross-sectional study was carried out among Aboriginal schoolchildren aged 7-12 years living in remote areas in Pos Betau, Pahang, Malaysia to investigate the potential determinants influencing the cognitive function and educational achievement of these children. Cognitive function was measured by intelligence quotient (IQ), while examination scores of selected school subjects were used in assessing educational achievement. Blood samples were collected to assess serum Fe status. All children were screened for soil-transmitted helminthes. Demographic and socio-economic data were collected using pre-tested questionnaires. Almost two-thirds (67·6?%) of the subjects had poor IQ and most of them (72·6?%) had insufficient educational achievement. Output of the stepwise multiple regression model showed that poor IQ was significantly associated with low household income which contributed the most to the regression variance (r2 0·059; P?=?0·020). Low maternal education was also identified as a significant predictor of low IQ scores (r2 0·042; P?=?0·043). With educational achievement, Fe-deficiency anaemia (IDA) was the only variable to show significant association (r2 0·025; P?=?0·015). In conclusion, the cognitive function and educational achievement of Aboriginal schoolchildren are poor and influenced by household income, maternal education and IDA. Thus, effective and integrated measures to improve the nutritional and socio-economic status of rural children would have a pronounced positive effect on their education.     

As death approaches: a retrospective survey of the care of adults dying in Alice Springs Hospital

Objective: Australians are more likely to die in a hospital than anywhere else, and most of these deaths are ‘expected’. The aims of this survey were to identify if specific end‐of‐life issues were documented in clinical records of a regional hospital serving remote Australia. Design: A retrospective consecutive case‐note audit covering 18 months from 1 January 2006. Setting: Alice Springs Hospital. Participants: Adult deaths in Alice Springs Hospital. During this period there were 128 deaths. Outcome measures: Demographic, process (diagnosis of dying documented, ‘not for resuscitation’ documentation, intensive care unit (ICU) admission, social worker referral and specialised palliative care service referral) and outcome data (‘comfort at end of life’) were surveyed. Results: Of the 128 admissions, 55 cases were excluded: 10 were children under 18, 33 died in <48 hours, nine were coroner's cases and three files could no't be found. Of the 73 deaths surveyed (33 men), 47 (64%) were Aboriginal. A diagnosis of dying was made in 84%, 88% had an ‘not for resuscitation’ order, 48% were admitted to ICU during their last admission, 66% were referred to social workers, 68% were referred to palliative care and 85% of people were documented to be ‘comfortable’ during the dying process with no differential outcomes for Aboriginal and non‐Aboriginal decedents except age (P < 0.0001). Conclusion: This survey highlights the continuing need to diagnose dying, understand optimal use of intensive care and improve comfort care at the end of life.     

Intravitreal bevacizumab alone or combined with 1 mg triamcinolone in diabetic macular edema: a randomized clinical trial

Purpose

To compare the results of intravitreal bevacizumab (IVB) injection alone or in combination with intravitreal 1 mg triamcinolone acetonide (IVT) in center-involved diabetic macular edema.

Methods

In this randomized clinical trial study, ninety-two eyes of 46 patients with bilateral center-involved diabetic macular edema and no previous treatment were included in the study. One eye of each patient was randomly assigned to 1.25 mg of IVB injection or combination of 1.25 IVB and 1 mg IVT. Evaluation of best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP) and grading of lens opacity was conducted at baseline, and weeks 2, 4, 6, 8, 12 and 24 after treatment. Retreatment was performed at a 6-week interval whenever indicated based on CMT.

Results

Between the groups, BCVA changes were not statistically different until 24-week follow-up (P > 0.05), but at 24 weeks after treatment, BCVA improvement was significantly better in IVB group (P = 0.049). Significant CMT reduction was observed in each group along the follow-up period (P = 0.001). The mean CMT reduction was more significant in combination (IVB + IVT) group at 2 weeks of follow-up (P < 0.001), but CMT changes were not significant between the groups at weeks 12th and 24th after injection. Overall, retreatment was applied for 59 eyes up to 24 weeks (33 in the IVB group, 26 in the IVB + IVT group). Among patients with 2 or more injections, number of injections was significantly lower in IVB + IVT group (P = 0.043). Three eyes within IVB + IVT group developed IOP rise beyond 21 mmHg, which were controlled with topical anti-glaucoma medications within 1 week. Changes in lens opacity were not significant between two groups.

Conclusion

Eyes treated with IVB plus 1 mg IVT injections had more significant reduction in CMT in early post-injection, but this effect was transient. Although after 24 weeks visual acuity improvement was better in IVB group, combination therapy may decrease the number of injections. Combining 1 mg of intravitreal triamcinolone with bevacizumab was not accompanied with significant side effects.

     

Dynamic heat capacity and relaxation time of ultraviscous melt and glassy acetaminophen

The real and imaginary components, C'(p) and C'(p), of the complex heat capacity, C*(p)=C'(p)-iC"(p) of supercooled, ultraviscous melt of acetaminophen have been measured at different temperatures during cooling through its vitrification range and during heating through its glass-softening range by using a modulation frequency of 3.3 mHz. From these data, the distribution of relaxation time parameter, beta, and a characteristic (calorimetric or configurational) relaxation time, tau(cal), have been determined. A constant value of 0.65 for beta fits the data, and tau(cal) varies with the temperature according to the Vogel-Fulcher-Tammann equation, tau(cal) = 10(-12.95) exp[1813/(T - 240.5)]. This relation differs significantly from the one deduced by others in which the configurational entropy theory was used to deduce tau(cal). The C'(p) and C'(p) values measured during the cooling of its ultraviscous melt and during the heating of its glassy state show a small hysteresis only at low temperatures. These investigations also provide a comparison of calorimetric and dielectric relaxation times in ultraviscous acetaminophen and highlight the role of faster modes of relaxation at low temperatures in organic, molecular glasses that can help in a better understanding of the crystal nucleation process in glasses at T below their T(g).     

Development of a sandwich enzyme-linked immunosorbent assay (ELISA) for determining of bovine serum albumin (BSA) in trivalent measles-mump-rubella (MMR) vaccines

A sandwich enzyme-linked immunosorbent assay (ELISA), using polyclonal antibody, was developed and compared with the commercial kit for detecting and estimating of BSA content in Measles-Mump-Rubella (MMR) vaccine samples in detection limit of nanogram level. The test depends on the capturing and detecting of BSA antigen by the polyclonal antibody. Initially, a detection range of 0-64 ng/ml was established, could be used for estimation of BSA content according to WHO requirement (50 ng/ml) in MMR vaccines. Comparative analysis of the test results for 85 MMR vaccine samples obtained with the commercial kit gave a sensitivity of 58.8% and a specificity of 97%. A high correlation (r = 0.94) was observed between BSA sandwich ELISA and commercial kit for BSA content in MMR samples. However, variations in values also were observed for the two assays. These variations may have been due to difference of upper limit of detection range of BSA content in commercial kit (32 ng/ml) and new sandwich ELISA (64 ng/ml) as well as the use of a different polyclonal antibody. In concerning the cutoff value for the WHO requirement and employment of standard solution of 64 ng/ml in developing assay, it would be adequate to use this test for assessing BSA content in viral vaccines same as MMR vaccines.     

Risk factors for ovarian cancer: an overview with emphasis on hormonal factors

Ovarian cancer is the fifth most frequently occurring cancer among women and leading cause of gynecological cancer deaths in North America. Although the etiology of ovarian cancer is not clear, certain factors are implicated in the etiology of this disease, such as ovulation, gonadotropic and steroid hormones, germ cell depletion, oncogenes and tumor suppressor genes, growth factors, cytokines, and environmental agents. Family history of breast or ovarian cancer is a prominent risk factor for ovarian cancer, with 5-10% of ovarian cancers due to heritable risk. Reproductive factors such as age at menopause and infertility contribute to greater risk of ovarian cancer, whereas pregnancy, tubal ligation, and hysterectomy reduce risk. Oral contraceptive (OC) use has clearly been shown to be protective against ovarian cancer. In contrast, large epidemiologic studies found hormone replacement therapy (HRT) to be a greater risk factor for ovarian cancer. The marked influence of hormones and reproductive factors on ovarian cancer suggests that endocrine disrupters may impact risk; however, there is a notable lack of research in this area. Lifestyle factors such as cigarette smoking, obesity, and diet may affect ovarian cancer risk. Exposure to certain environmental agents such as talc, pesticides, and herbicides may increase risk of ovarian cancer; however, these studies are limited. Further research is needed to strengthen the database of information from which an assessment of environmental and toxicological risk factors for ovarian cancer can be made.     

Complete and partial deficiencies of complement factor D in a Dutch family.

A young man suffering from recurrent Neisseria infections was shown to lack detectable serum complement factor D hemolytic activity. Addition to the patient's serum of purified factor D to a final concentration of 1 microgram/ml resulted in full restoration of the activity of the alternative pathway. Using an enzyme-linked immunosorbent assay, it was shown that the patient's serum did not contain measurable amounts of factor D antigen either. The sister, the father, as well as the parents of the mother had factor D levels within the normal range, and the factor D level of the mother was decreased. The capacity of the patient's serum, at concentrations up to 5%, to promote phagocytosis of Escherichia coli by normal human granulocytes was low when compared to normal serum. Substitution of the patient's serum with purified factor D resulted in a full restoration of opsonic activity. This study describes the first complete deficiency of factor D, and demonstrates its possible relation to recurrent Neisseria infections.