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Arora V, Kaur T, Singh K. The role of magnetic resonance imaging in acute abdominal pain in paediatric age group. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00709-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The purpose of this study is to evaluate the utility of magnetic resonance imaging in the assessment of acute atraumatic abdominal pain as the first line cross sectional modality in children, so as to prevent excessive radiation exposure from computed tomography scan and to review the magnetic resonance imaging features of common acute abdominal and pelvic conditions.
Results
30 patients (0–18 years) underwent rapid unenhanced magnetic resonance imaging. The results of our study indicated that for the diagnosis of causes for acute abdominal pain, magnetic resonance imaging had sensitivity of 92% (95% confidence interval 73.8–97.6%) and a specificity of 80% (95% confidence interval 28.4–99.5%). The positive predictive value was 95.8% (95% confidence interval 79.9–99.3%) and negative predictive value was 67% (95% confidence interval 33.1–89.0%) which had a highly significant statistical association (p < 0.001).
Conclusion
Unenhanced magnetic resonance imaging is an excellent option for the initial, detailed evaluation of acute abdominal emergencies in pediatric patients because it can diagnose the whole range of presenting abnormalities which include the causes of abdominal pain warranting surgical and nonsurgical management.
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The Helping Everyone Achieve Long Term Health Passport: exploring potential use of the HEALTH Passport in primary and secondary schools. J Public Health (Oxf) 2022:6565630. [DOI: 10.1093/pubmed/fdac039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/15/2021] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Chronic disease is a significant burden on the global population. The Helping Everyone Achieve Long Term Health (HEALTH) Passport is a paper-based approach previously utilized to help adults modify clinical risk factors through lifestyle, which may be effective in improving the long-term health of school-age children. This study investigates the feasibility of in-school use by engaging trainee teachers in primary and secondary education.
Methods
Two hundred and fifty six unique responses were collated to evaluate current teaching of the main health risk factors and HEALTH Passports specifically adapted for schools. Trainees attended workshops with pre- and post-questionnaires used to measure training efficacy and evaluate the Passports’ suitability for in-school use. Narrative analysis of feedback was performed.
Results
Feedback received for both Passports was positive overall. Trainees highlighted the need for the Passports to be further age differentiated. Significantly increased confidence (P < 0.01) in knowledge of exercise, type 2 diabetes, weight and blood pressure was shown. Confidence in smoking, drugs and alcohol knowledge was reduced highlighting the requirement for further teacher training.
Conclusions
The HEALTH Passport has potential as an intervention to improve health literacy in school-age children. Age adaptation is needed with references to weight measures removed. Emotional well-being should be focused on, and data management stringently assessed for child protection.
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Mostafa MS, Youssef AA, Soliman MH. Laparoscopic sleeve gastrectomy for treatment of type 2 diabetes mellitus in adolescents. ANNALS OF PEDIATRIC SURGERY 2022. [DOI: 10.1186/s43159-021-00139-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Metabolic diseases have been associated with childhood obesity no longer restricted to adults as previously known. Hypertension and diabetes mellitus (DM) have been reported in children with morbid obesity. Laparoscopic sleeve gastrectomy (LSG) has been used as a primary procedure for weight control among children and adolescents with acceptable records of effective weight loss together with evidence of improvement of associated co-morbidities.
Results
Thirty-two patients were diagnosed with morbid obesity and DM presented to obesity and nutrition clinic and were included in this study. Laparoscopic sleeve gastrectomy (LSG) was the chosen operation to treat their obesity and associated co-morbidities. Fasting blood sugar and HbA1c were measured before the operation and 1 year after surgery. Twenty-seven patients had significant improvement of their glycemic profile and managed to stop the hypoglycemic medication.
Conclusion
LSG may play an important role as a metabolic control procedure rather than a bariatric restrictive procedure only.
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Amer S, Kateeb E. Factors related to dietary habits, energy drink consumption, and physical activity in marginalized Palestinian schools: A cross-sectional study. Health Promot Perspect 2021; 11:329-336. [PMID: 34660228 PMCID: PMC8501479 DOI: 10.34172/hpp.2021.42] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 06/22/2021] [Indexed: 12/03/2022] Open
Abstract
Background: The current study assessed different dietary habits, energy drinks intake, body mass index (BMI) and physical activity and associated factors among Palestinian adolescents attending marginalized schools. Methods: A cross-sectional study targeted a random sample of 1480 students in the sixth andninth grades attending 20 marginalized public schools in the West Bank area of the occupied Palestinian Territories (oPt). Students were interviewed in-person by trained senior dental students about their dietary habits, physical activity, fathers’ employment and mothers’ level of education. Weight and height were measured, and BMI percentile was calculated. Descriptive statistics were generated for the study’s main variables and the dependent variables were compared by grade, gender, mothers’ level of education and father’s employment. Results: A total of 1282 students (98% response) completed the questionnaire. Of them, 6% were ‘underweight’ (fifth percentile or under) and 34% were ‘overweight’ or ‘obese’ (85thpercentile or over). Ninth graders had more added sugar than 6th graders (P=0.002), less frequent milk consumption (P<0.001), more frequent energy drink consumption (P=0.001),and less physical activity (P<0.0001). Frequency of carbonated and sweetened drink consumption was associated with being overweight or obese (P=0.016, P=0.001). Frequency of carbonated drinks consumption was higher among children of mothers with a high school level of education or less (P<0.001). In addition, children of mothers educated to high school level or below were associated with being underweight (P=0.05). Conclusion: Dietary habits and physical activity get worse between the ages of 12 and 15. Mothers’ level of education is an important factor in being overweight or underweight. Energy drink consumption among boys and milk consumption among girls are two challenges that need to be addressed urgently and adequately.
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Affiliation(s)
- Sami Amer
- MIT Media Lab, Massachusetts Institute of Technology, 77 Massachusetts Avenue Cambridge, MA 02139, USA
| | - Elham Kateeb
- Oral Health Research and Promotion Unit, Faculty of Dentistry, Al-Quds University, Jerusalem, State of Palestine
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Koetsier LW, van Mil MMA, Eilander MMA, van den Eynde E, Baan CA, Seidell JC, Halberstadt J. Conducting a psychosocial and lifestyle assessment as part of an integrated care approach for childhood obesity: experiences, needs and wishes of Dutch healthcare professionals. BMC Health Serv Res 2021; 21:611. [PMID: 34183008 PMCID: PMC8238479 DOI: 10.1186/s12913-021-06635-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/14/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The causes and consequences of childhood obesity are complex and multifaceted. Therefore, an integrated care approach is required to address weight-related issues and improve children's health, societal participation and quality of life. Conducting a psychosocial and lifestyle assessment is an essential part of an integrated care approach. The aim of this study was to explore the experiences, needs and wishes of healthcare professionals with respect to carrying out a psychosocial and lifestyle assessment of childhood obesity. METHODS Fourteen semi-structured interviews were conducted with Dutch healthcare professionals, who are responsible for coordinating the support and care for children with obesity (coordinating professionals, 'CPs'). The following topics were addressed in our interviews with these professionals: CPs' experiences of both using childhood obesity assessment tools and their content, and CPs' needs and wishes related to content, circumstances and required competences. The interviews comprised open-ended questions and were recorded and transcribed verbatim. The data was analysed using template analyses and complemented with open coding in MAXQDA. RESULTS Most CPs experienced both developing a trusting relationship with the children and their parents, as well as establishing the right tone when engaging in weight-related conversations as important. CPs indicated that visual materials were helpful in such conversations. All CPs used a supporting assessment tool to conduct the psychosocial and lifestyle assessment but they also indicated that a more optimal tool was desirable. They recognized the need for specific attributes that helped them to carry out these assessments, namely: sufficient knowledge about the complexity of obesity; having an affinity with obesity-related issues; their experience as a CP; using conversational techniques, such as solution-focused counselling and motivational interviewing; peer-to-peer coaching; and finally, maintaining an open-minded, non-stigmatizing stance and harmonizing their attitude with that of the child and their parents. CONCLUSIONS Alongside the need for a suitable tool for conducting a psychosocial and lifestyle assessment, CPs expressed the need for requisite knowledge, skills and attitudes. Further developing a supporting assessment tool is necessary in order to facilitate CPs and thereby improve the support and care for children with obesity and their families.
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Affiliation(s)
- L W Koetsier
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - M M A van Mil
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - M M A Eilander
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - E van den Eynde
- Erasmus MC, University Medical Center Rotterdam, Obesity Center CGG, Rotterdam, The Netherlands
| | - C A Baan
- Tilburg University, Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg, The Netherlands
| | - J C Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - J Halberstadt
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Karim A, Qaisar R. Anthropometric measurements of school-going-girls of the Punjab, Pakistan. BMC Pediatr 2020; 20:223. [PMID: 32416717 PMCID: PMC7229613 DOI: 10.1186/s12887-020-02135-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 05/11/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Child's growth has been considered an important indicator to evaluate health trends in a population and to devise strategies accordingly. The purpose of the present study was to determine most commonly occurring weight abnormalities among school-going girls from Punjab and to compare with international growth references devised by World Health Organization (WHO) and Centre for Disease Control and Prevention (CDC). METHODS In this cross-sectional study a sample of 10,050 child and adolescent girls from 12 districts, 35 public/private sector schools, located in rural, semi-urban and urban areas of northern, central and southern Punjab were included. Parameters were measured according to standardised techniques and centile curves obtained by Lambda, Mu, Sigma (LMS) method. RESULTS The results showed an increase in weight, height and BMI of the Punjabi girls until 15 years. When compared with international growth references, weight and BMI in our population were significantly lowered; however, height was lower during 12-16 years of age and the differences observed were more pronounced with CDC as compared to WHO. When 3rd, 50th and 90th percentiles of weight, height and BMI in our population were compared with international standards, the values were lower in our paediatric population. CONCLUSION The Punjabi schoolgirls significantly differed from CDC and WHO references, and this difference should be taken into consideration for evaluation of growth abnormalities in our paediatric population. However, in the absence of national reference data, WHO standards have been considered more appropriate for comparison.
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Affiliation(s)
- Asima Karim
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE.
- Department of Physiology & Cell Biology, University of Health Sciences, Lahore, Pakistan.
| | - Rizwan Qaisar
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE
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Duchen K, Faresjö ÅO, Klingberg S, Faresjö T, Ludvigsson J. Fatty fish intake in mothers during pregnancy and in their children in relation to the development of obesity and overweight in childhood: The prospective ABIS study. Obes Sci Pract 2020; 6:57-69. [PMID: 32128243 PMCID: PMC7042022 DOI: 10.1002/osp4.377] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 09/17/2019] [Accepted: 10/07/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Although controversial, lower maternal intake of n-3 polyunsaturated fatty acid (PUFA) during pregnancy and lower levels of omega-3 PUFA in serum phospholipids during childhood have been related to obesity. The main source of omega-3 PUFA is fatty fish in the diet. OBJECTIVES To assess the relationship between overweight/obesity and the intake of fatty fish in maternal diet during pregnancy and in children up to 8 years of age. METHODS The prospective cohort All Children in South-East Sweden (ABIS) followed babies from birth to 8 years of age. A total of 6749 children at 5 years of age (boys 52.6%) and 3017 children at 8 years (boys 52.3%) participated. A "fatty-fish index" was constructed on the basis of self-reports of nutritional habits. RESULTS The prevalence of overweight and obesity in children at 5 years were 12.9% and 4.2%, respectively. At 8 years, 12.2% of the children presented overweight and 2.3% obesity. Girls were more affected than boys by overweight/obesity. A higher fish index during pregnancy was not related to overweight/obesity in the children, whereas a higher fish index in the children during the first years of life was related to obesity at 5 and 8 years of age. This relationship disappeared in a multivariable analysis. Maternal body mass index (BMI), maternal education, maternal smoking during pregnancy, birth weight, and physical activity all remained related to overweight/obesity at both 5 and 8 years of age. CONCLUSION No relationships were found between a lower intake of fatty fish in the diet, neither in mothers during pregnancy nor in early childhood, and increased risk of overweight/obesity.
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Affiliation(s)
- Karel Duchen
- Crown Princess Victoria Children's Hospital, Region ÖstergötlandLinköpingSweden
- Division of Pediatrics, Department of Clinical and Experimental MedicineLinköping UniversityLinköpingSweden
| | - Åshild Olsen Faresjö
- Department of Medicine and Health, Division of Community MedicineLinköping UniversityLinköpingSweden
| | - Sofia Klingberg
- Department of Public Health and Community Medicine, Section of Epidemiology and Social MedicineSahlgrenska Academy at University of GothenburgGothenburgSweden
| | - Tomas Faresjö
- Department of Medicine and Health, Division of Community MedicineLinköping UniversityLinköpingSweden
| | - Johnny Ludvigsson
- Crown Princess Victoria Children's Hospital, Region ÖstergötlandLinköpingSweden
- Division of Pediatrics, Department of Clinical and Experimental MedicineLinköping UniversityLinköpingSweden
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8
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Abstract
OBJECTIVES Obesity in children can lead to morbidity and mortality due to metabolic and inflammatory comorbidities. AIMS The objective of the study was to investigate the alterations in acute inflammatory markers, serum amyloid P (SAP) and cortisol, and endocrine markers, leptin and insulin, in obese children. MATERIALS AND METHODS Serum leptin, insulin, cortisol, and amyloid P concentrations were measured in obese (BMI percentile >85, n = 17) and nonobese (BMI percentile < 75, n = 20) children using ELISA and Bio-Plex Bead-based assay. STATISTICAL ANALYSIS USED Serum concentrations of analytes were compared between normal and obese groups using 2-tailed student's t-test. RESULTS Mean leptin, insulin, and SAP serum concentrations were significantly higher in obese children as compared to the controls (97.19 vs. 4.06, P < 0.05; 21.31 vs 3.56, P < 0.05; 46.77 vs. 17.89, P < 0.05; respectively). No difference was found in mean serum cortisol levels of the two groups. However, cortisol values were higher in obese subjects compared to the control group (7.89 vs 6.30, P = 0.15). Leptin corelated with insulin (r = 0.42, P = 0.043) and cortisol (r = 0.48, P = 0.025) levels in the obese group. Furthermore, leptin, insulin, and SAP levels were corelated with BMI (r = 0.80, P < 0.000; r = 0.67, P = 0.015, respectively) and body weight (r = 0.52, P = 0.01; r = 0.52, P = 0.002; r = 0.54, P = 0.01, respectively) in the obese group but did not demonstrate a significant relationship in the nonobese group. CONCLUSION Elevated SAP levels and increase in leptin and insulin indicated a preeminent disposition of morbidly obese children to the development of low-grade inflammation and metabolic syndrome.
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Affiliation(s)
- Mehwish Anwer
- Centre for Research in Molecular Medicine, University of Lahore, Lahore, Pakistan
| | - Muhammad J. Iqbal
- Centre for Research in Molecular Medicine, University of Lahore, Lahore, Pakistan
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9
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Gade C, Christensen HR, Dalhoff KP, Holm JC, Holst H. Inconsistencies in dosage practice in children with overweight or obesity: A retrospective cohort study. Pharmacol Res Perspect 2018; 6:e00398. [PMID: 29721323 PMCID: PMC5909170 DOI: 10.1002/prp2.398] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 03/12/2018] [Indexed: 01/21/2023] Open
Abstract
Obesity can affect the pharmacokinetics of most drugs, which may result in under- or overdosing if traditional pediatric dosing strategies are used. To investigate currently applied dosage strategies in children with overweight or obesity (overweight/obesity), in a clinical treatment facility. In particular, whether dosing guidelines were available and metrics of body size applied. A retrospective cohort study of 200 patients admitted to the Danish Children's Obesity Clinic. Data were collected from 2007 to 2015. Overweight/obese children 3-18 years were included if they had at least one drug prescription. Overall there were 658 prescriptions, primarily analgesics, psychotropics, asthma medications, and antibiotics. Except for one prescription, guidelines for dosage of overweight/obese children were not available in the clinic. In one prescription of gentamicin, the dose was adjusted by a metric body size. Otherwise dose was predominately prescribed either by total body weight or as fixed dose by age, in accordance with the recommendations of normal weight children. In drugs with a narrow therapeutic interval, we found large interindividual variations in dosing regimens, that is, for gentamicin, paracetamol, and prednisolone. Reduction of dose to the maximum recommended adult dose was common practice, when the dose calculated by total body weight (ie, mg/kg) exceeded this maximum. This study highlights the shortage of dosing guidelines in overweight/obese children. We found a large interindividual variability in dosage regimens, even in drugs with narrow therapeutic intervals. The clinicians rely on "best practice", as evidence-based dosage regimens are missing for many drugs prescribed during childhood.
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Affiliation(s)
- Christina Gade
- Department of Clinical PharmacologyCopenhagen University HospitalBispebjerg and FrederiksbergCopenhagen NVDenmark
| | - Hanne R. Christensen
- Department of Clinical PharmacologyCopenhagen University HospitalBispebjerg and FrederiksbergCopenhagen NVDenmark
| | - Kim P. Dalhoff
- Department of Clinical PharmacologyCopenhagen University HospitalBispebjerg and FrederiksbergCopenhagen NVDenmark
| | - Jens Christian Holm
- Children's Obesity ClinicEuropean Center of Management (EASO)Department of PaediatricsZealand University HospitalHolbaekDenmark
| | - Helle Holst
- Department of Clinical PharmacologyCopenhagen University HospitalBispebjerg and FrederiksbergCopenhagen NVDenmark
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10
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Krishnan M, Thompson JMD, Mitchell EA, Murphy R, McCowan LME, Shelling AN, On Behalf Of The Children Of Scope Study Group G. Analysis of association of gene variants with obesity traits in New Zealand European children at 6 years of age. MOLECULAR BIOSYSTEMS 2018. [PMID: 28636007 DOI: 10.1039/c7mb00104e] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Childhood obesity is a public health problem, which is associated with a long-term increased risk of cardiovascular disease and premature mortality. Several gene variants have previously been identified that have provided novel insights into biological factors that contribute to the development of obesity. As obesity tracks through childhood into adulthood, identification of the genetic factors for obesity in early life is important. The objective of this study was to identify putative associations between genetic variants and obesity traits in children at 6 years of age. We recruited 1208 children of mothers from the New Zealand centre of the international Screening for Pregnancy Endpoints (SCOPE) study. Eighty common genetic variants associated with obesity traits were evaluated by the Sequenom assay. Body mass index standardised scores (BMI z-scores) and percentage body fat (PBF; measured by bio-impedance assay (BIA)) were used as anthropometric measures of obesity. A positive correlation was found between BMI z-scores and PBF (p < 0.001, r = 0.756). Two subsets of gene variants were associated with BMI z-scores (HOXB5-rs9299, SH2B1-rs7498665, NPC1-rs1805081 and MSRA-rs545854) and PBF (TMEM18-rs6548238, NPY-rs17149106, ETV-rs7647305, NPY-rs16139, TIMELESS-rs4630333, FTO-rs9939609, UCP2-rs659366, MAP2K5-rs2241423 and FAIM2-rs7138803) in the genotype models. However, there was an absence of overlapping association between any of the gene variants with BMI z-scores and PBF. A further five variants were associated with BMI z-scores (TMEM18-rs6548238, FTO-rs9939609 and MC4R-rs17782313) and PBF (SH2B1-rs7498665 and FTO-rs1421085) once separated by genetic models (additive, recessive and dominant) of inheritance. This study has identified significant associations between numerous gene variants selected on the basis of prior association with obesity and obesity traits in New Zealand European children.
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Affiliation(s)
- Mohanraj Krishnan
- Department of Obstetrics and Gynaecology, University of Auckland, New Zealand.
| | - John M D Thompson
- Department of Obstetrics and Gynaecology, University of Auckland, New Zealand. and Department of Paediatrics: Child & Youth Health, University of Auckland, New Zealand
| | - Edwin A Mitchell
- Department of Paediatrics: Child & Youth Health, University of Auckland, New Zealand
| | - Rinki Murphy
- Department of Medicine, University of Auckland, New Zealand and Maurice Wilkins Centre for Biodiscovery, University of Auckland, New Zealand
| | - Lesley M E McCowan
- Department of Obstetrics and Gynaecology, University of Auckland, New Zealand.
| | - Andrew N Shelling
- Department of Obstetrics and Gynaecology, University of Auckland, New Zealand.
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Abstract
BACKGROUND The rising prevalence of childhood obesity and concomitant increase in comorbid disease pose significant challenges for the health care system. While mounting evidence demonstrates the safety and efficacy of bariatric surgery for severely obese adolescents, the potential role of robotic technology has not been well defined. OBJECTIVE The aim of this study was to establish the safety and efficacy of robotic-assisted laparoscopic sleeve gastrectomy (RSG) in treating severe adolescent obesity. In addition, 30-day outcomes and hospital charges were compared to subjects undergoing RSG versus laparoscopic sleeve gastrectomy (LSG). METHODS A retrospective analysis of 28 subjects (14 LSG vs. 14 RSG) at a single institution was conducted. Data collection included demographics, body mass index, comorbidities, hospital length of stay (LOS), operative time, 30-day outcomes, and hospital charges. Analysis was performed using chi-square, Fisher's exact, and nonparametric Wilcoxon rank sum tests. RESULTS There were no differences in subject demographics or comorbidities. While median operative time was longer for RSG vs. LSG (132 vs. 100 min, p = 0.0002), the median LOS for RSG compared to LSG was shorter (69.6 vs. 75.9 h, p = 0.0094). In addition, RSG-related hospital charges were higher ($56,646 vs. $49,498, p = 0.0366). No significant differences in post-operative outcomes or complications were observed. CONCLUSIONS RSG is equally safe and efficacious when compared to LSG among adolescents. Similar to studies in adults, LOS is shortened while hospital charges are higher. Larger prospective studies are needed to gain insight regarding cost benefit ratios.
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Muñoz AM, Velásquez CM, Agudelo GM, Uscátegui RM, Estrada A, Patiño FA, Parra BE, Parra MV, Bedoya G. Examining for an association between candidate gene polymorphisms in the metabolic syndrome components on excess weight and adiposity measures in youth: a cross-sectional study. GENES AND NUTRITION 2017; 12:19. [PMID: 28690685 PMCID: PMC5496328 DOI: 10.1186/s12263-017-0567-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 04/28/2017] [Indexed: 01/14/2023]
Abstract
Background A polymorphism in a gene may exert its effects on multiple phenotypes. The aim of this study is to explore the association of 10 metabolic syndrome candidate genes with excess weight and adiposity and evaluate the effect of perinatal and socioeconomic factors on these associations. Methods The anthropometry, socioeconomic and perinatal conditions and 10 polymorphisms were evaluated in 1081 young people between 10 and 18 years old. Genotypic associations were calculated using logistic and linear models adjusted by age, gender, and pubertal maturation, and a genetic risk score (GRS) was calculated by summing the number of effect alleles. Results We found that AGT-rs699 and the IRS2-rs1805097 variants were significantly associated with excess weight, OR = 1.25 (CI 95% 1.01–1.54; p = 0.034); OR = 0.77 (CI 95% 0.62–0.96; p = 0.022), respectively. AGT-rs699 and FTO-rs17817449 variants were significantly and directly associated with body mass index (BMI) (p = 0.036 and p = 0.031), while IRS2-rs1805097 and UCP3-rs1800849 were significantly and negatively associated with BMI and waist circumference, correspondingly. Each additional effect allele in GRS was associated with an increase of 0.020 log(BMI) (p = 0.004). No effects from the socioeconomic and perinatal factors evaluated on the association of the candidate genes with the phenotypes were detected. Conclusions Our observation suggests that AGT-rs699 and FTO-rs17817449 variants may contribute to the risk development of excess weight and an increase in the BMI, while IRS2-rs1805097 showed a protector effect; in addition, UCP3- rs1800849 showed a decreasing waist circumference. Socioeconomic and perinatal factors had no effect on the associations of the candidate gene. Electronic supplementary material The online version of this article (doi:10.1186/s12263-017-0567-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Angélica María Muñoz
- Research Group on Food and Human Nutrition, Universidad de Antioquia (UdeA), Calle 70 No. 52-21, Medellin, Colombia
| | - Claudia María Velásquez
- Research Group on Food and Human Nutrition, Universidad de Antioquia (UdeA), Calle 70 No. 52-21, Medellin, Colombia.,Sede de Investigación Universitaria (SIU), Universidad de Antioquia (UdeA), Calle 62 No. 52-59, Laboratorio 413, Medellin, Colombia
| | - Gloria María Agudelo
- Research Group on Food and Human Nutrition, Universidad de Antioquia (UdeA), Calle 70 No. 52-21, Medellin, Colombia.,Vidarium Research Group, Nutrition, Health and Wellness Research Center, Nutresa Business Group (Grupo Empresarial Nutresa), Calle 8 Sur No. 50-67, Medellin, Colombia
| | | | - Alejandro Estrada
- Research Group on Demography and Health, Universidad de Antioquia (UdeA), Calle 70 No. 52-21, Medellin, Colombia
| | - Fredy Alonso Patiño
- Research Group of Sciences Applied to Physical Activity and Sports, Universidad de Antioquia (UdeA), Calle 70 No. 52-21, Medellin, Colombia
| | - Beatriz Elena Parra
- Research Group on Food and Human Nutrition, Universidad de Antioquia (UdeA), Calle 70 No. 52-21, Medellin, Colombia
| | - María Victoria Parra
- Molecular Genetics Group, Universidad de Antioquia (UdeA), Calle 70 No. 52-21, Medellin, Colombia
| | - Gabriel Bedoya
- Molecular Genetics Group, Universidad de Antioquia (UdeA), Calle 70 No. 52-21, Medellin, Colombia
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Boyraz M, Yeşilkaya E, Ezgü F, Bideci A, Doğan H, Ulucan K, Cinaz P. Effect of Cytokine Signaling 3 Gene Polymorphisms in Childhood Obesity. J Clin Res Pediatr Endocrinol 2016; 8:452-460. [PMID: 27611604 PMCID: PMC5198005 DOI: 10.4274/jcrpe.3167] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Although polymorphisms in suppressor of cytokine signaling 3 (SOCS3) was reported to be related to obesity, Metabolic syndrome (MS), and type 2 diabetes mellitus in various adult studies, there is a lack of data in children. In this study, we examined eight reported polymorphisms of SOCS3 in obese Turkish children and adolescent with and without MS and compared the results with that of controls. METHODS One hundred and forty eight obese and 63 age- and sex-matched control subjects were enrolled in the study. Obesity classification was carried out according to body mass index. World Health Organization and National Cholesterol Education Program criteria were used for the diagnosis of MS. Genotyping procedure was carried out by polymerase chain reaction and Sanger sequencing protocol. RESULTS The frequency of rs2280148 polymorphism was significantly higher in obese subjects with MS than in the control group, whereas the frequency of rs8064821 polymorphism was significantly higher in obese subjects with MS than in obese children without MS. CONCLUSION The significant associations of certain SOCS3 polymorphisms with obesity parameters in both MS and MS -related insulin resistance, hypertension, and fatty liver suggest that polymorphisms in this gene may play a role in the pathogenesis of MS and also that they can be potentially used as a marker for attenuated or aggressive disease.
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Affiliation(s)
- Mehmet Boyraz
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | | | - Fatih Ezgü
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Aysun Bideci
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | | | - Korkut Ulucan
- Marmara University Faculty of Dentistry, Department of Medical Biology and Genetics, İstanbul, Turkey, Phone: +90 216 400 22 22- 2409 E-mail:
| | - Peyami Cinaz
- Gazi University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
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Xu X, Sharma M, Liu L, Hu P, Zhao Y. Mediation of the Physical Activity and Healthy Nutrition Behaviors of Preschool Children by Maternal Cognition in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13090909. [PMID: 27649215 PMCID: PMC5036742 DOI: 10.3390/ijerph13090909] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 08/23/2016] [Accepted: 09/07/2016] [Indexed: 11/30/2022]
Abstract
(1) Objective: We aimed to explore the role of social cognitive theory (SCT) of mothers in the physical activity and healthy nutrition behaviors of preschool children; (2) Methods: We used a self-administered five-point Likert common physical activity and nutrition behaviors scale in Chinese based on a social cognitive theory scale in English with established validity and reliability in the USA. The current study adopted the proportional sampling method to survey mothers of preschool children in four areas—namely, Chongqing, Chengdu, Taiyuan, and Shijiazhuang—of China; (3) Results: We included 1208 mothers (80.0% mothers of normal weight children, age 31.87 ± 4.19 years). Positive correlations were found between maternal social cognition and preschool children’s physical activity (PA) behavior (p < 0.0001). However, an insignificant correlation is observed between preschool children’s fruits and vegetables (FV) behavior, screen time (ST) behavior, and maternal social cognition; (4) Conclusions: This study provides some implications for increasing fruit and vegetable consumption, increasing physical activity time, and reducing screen time in preschool children using SCT in China. Maternal social cognition is associated with preschool children’s PA behavior, and the results suggest that maternal social cognition may not affect children FV and ST behaviors. Further research is necessary to test the mediation of maternal social cognition on preschool children’s ST behavior and the correlations between maternal social cognition and children’s ST behavior.
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Affiliation(s)
- Xianglong Xu
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Manoj Sharma
- Behavioral & Environmental Health, Jackson State University, Jackson, MS 39213, USA.
| | - Lingli Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Ping Hu
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China.
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing 400016, China.
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Roura E, Milà-Villarroel R, Lucía Pareja S, Adot Caballero A. Assessment of Eating Habits and Physical Activity among Spanish Adolescents. The "Cooking and Active Leisure" TAS Program. PLoS One 2016; 11:e0159962. [PMID: 27463105 PMCID: PMC4962989 DOI: 10.1371/journal.pone.0159962] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 07/11/2016] [Indexed: 11/24/2022] Open
Abstract
Worldwide obesity has more than doubled in the last forty years. Even more worrying is the fact that the number of overweight and obese children and adolescents has considerably increased. Socioeconomic development, as well as educational, agricultural and marketing policies have significantly changed dietary and physical activity habits among the youngest, who are thus susceptible to develop chronic and disabling diseases such as diabetes, some cancers and cardiovascular disorders. Adolescence is a critical age, in which the adoption of healthy habits may have dramatic effects on the health state in adulthood. For this reason, prompt interventions are urgently required to prevent the onset of obesity in this time of life. In this regard, the CAL-TAS program from Alicia Foundation was born to combat obesity and promote healthy lifestyles in Spanish adolescents. A total of 2519 students, aged 13–14 years, from 79 schools distributed all over the 17 autonomous communities in Spain were asked to report through the CAL-TAS platform their food intake and physical activity over one week. The body mass index, the consumption of food and beverages, the intake of macronutrients and micronutrients, and the values obtained from the PAQ-A questionnaire, which evaluated physical activity, were analyzed. Twenty percent of the participants were overweight or obese. In general, adolescents did not or poorly respected the recommendations provided by the Spanish Society of Community Nutrition. For example, in more than half of the subjects, the ingestion of fruits and beverages was less than recommended, whereas the consumption of meat, baked goods and fried foods was excessive. Moreover, adolescents with higher body mass index also presented worse eating habits and more inactivity. In conclusion, Spanish adolescents present low adherence to recommendations provided by the Spanish Society of Community Nutrition (SENC) and by the World Health Organization. In order to prevent obesity-related disorders, effective educational programmes have to be designed. Indeed, adolescents and their families should be aware that the early adoption of healthy dietary habits and of a correct physical activity may strongly improve their future quality of life.
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Affiliation(s)
- Elena Roura
- Alicia Foundation, Barcelona, Spain
- * E-mail:
| | - Raimon Milà-Villarroel
- Research group on methodology, methods and models of health and social outcomes; Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Vic, Spain
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Cooper BR, Barale K, Funaiole A, Power TG, Combe A. Participant and Household Characteristics Associated With Graduation From the Expanded Food and Nutrition Education Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:453-460.e1. [PMID: 27373859 DOI: 10.1016/j.jneb.2016.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 04/04/2016] [Accepted: 04/10/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To examine empirically participant and household characteristics associated with Expanded Food and Nutrition Education Program (EFNEP) graduation and to determine whether they differ across 2 counties. DESIGN Survey of EFNEP participants from 2011 to 2012. SETTING Expanded Food and Nutrition Education Program sites serving limited-resource families in 1 rural and 1 urban/suburban county in Washington State. PARTICIPANTS Expanded Food and Nutrition Education Program participants (urban/suburban: n = 647; rural: n = 569). MAIN OUTCOME MEASURE Expanded Food and Nutrition Education Program completion/graduation. ANALYSIS Multivariate logistic regression was used to examine associations of participant (ethnicity, race, age, education, pregnancy status, and nutrition knowledge/behavior at baseline) and household (number of people in the house, place of residence, and public assistance services) characteristics with EFNEP graduation. RESULTS Associations were moderated by county. For the urban/suburban county, participants living with more people (after controlling for the total number of adults) were more likely to graduate. For the rural county, participants living with fewer total adults (after controlling for the total number in the house) and those with better food safety practices at baseline were more likely to graduate. CONCLUSIONS AND IMPLICATIONS This study aids in understanding which participants are more or less likely to complete EFNEP successfully, and therefore can inform strategies aimed at increasing graduation rates.
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Affiliation(s)
| | - Karen Barale
- Department of Human Development, Washington State University, Pullman, WA
| | - Angie Funaiole
- Department of Human Development, Washington State University, Pullman, WA
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA
| | - Angela Combe
- Head Start, Eastern Oregon University, La Grande, OR
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Pandita A, Sharma D, Pandita D, Pawar S, Tariq M, Kaul A. Childhood obesity: prevention is better than cure. Diabetes Metab Syndr Obes 2016; 9:83-9. [PMID: 27042133 PMCID: PMC4801195 DOI: 10.2147/dmso.s90783] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Obesity and its associated comorbidities have emerged as a major health problem garnering interests from both public health agencies and mainstream media consumers. With increasing awareness on its impact on health, finances, and community at large, it has come to the forefront for scientific research and development of health plans. The need for better strategies and novel interventions to manage obesity is now being recognized by the entire health care system. Obesity and overweight is now the fifth leading global risk factor for mortality. Strategic investment is thus urgently needed to implement population-based childhood obesity prevention programmes which are effective and also culturally appropriate. Population-based prevention is crucial to stem this rising tide of childhood obesity which is fast reaching epidemic proportions. Obesity has its onset very early in life; therefore, children constitute a major group of this disease. It is thus imperative to lay utmost importance on prevention of obesity in children and herald its progress, if present already. Furthermore, treatment is still in preliminary stage, so early prevention holds better than treatment at later stages. This article is an attempt to lay emphasis on childhood obesity as a problem that needs to be recognized early and measures for its prevention.
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Affiliation(s)
- Aakash Pandita
- Department of Pediatrics, SMGS Hospital Jammu, Jammu and Kashmir, India
- Correspondence: Aakash Pandita, Department of Pediatrics, SMGS Hospital, 55A Indira Nagar B.B, Jammu, Jammu and Kashmir, Srinagar, 190004 India, Email
| | - Deepak Sharma
- Department of Pediatrics, Pt Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Dharti Pandita
- Department of Microbiology Jammu University, Jammu, Jammu and Kashmir, India
| | - Smita Pawar
- Department of OBG Fernandez Hospital, Hyderabad,Telangana, India
| | - Mir Tariq
- Department of Orthopedics, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - Avinash Kaul
- Department of Surgery, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, Jammu and Kashmir, India
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18
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Pediatric Obesity: Pharmacokinetics and Implications for Drug Dosing. Clin Ther 2015; 37:1897-923. [DOI: 10.1016/j.clinthera.2015.05.495] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 05/14/2015] [Accepted: 05/19/2015] [Indexed: 02/01/2023]
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Matozinhos FP, Gomes CS, Andrade ACDS, Mendes LL, Pessoa MC, Friche AADL, Velasquez-Melendez G. Neighbourhood environments and obesity among adults: A multilevel analysis of an urban Brazilian context. Prev Med Rep 2015; 2:337-41. [PMID: 26844089 PMCID: PMC4721387 DOI: 10.1016/j.pmedr.2015.04.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective. This study identified environmental variables associated with obesity in the adult population of a city in Brazil. Methods. It was conducted using the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey from 2008 to 2010. The body mass index (BMI) was calculated from the participants' self-reported weight and height. Obesity was defined as a BMI ≥ 30 kg/m2. The food establishments, georeferenced areas conducive to physical activity, total income of the neighbourhood, homicide rate and population density were used to characterise the environment. In addition, individual variables were considered. A multilevel logistic regression was performed. Results. A total of 5273 individuals were evaluated. The odds of obesity was found to be significantly decreased with increases in the number of establishments that sell healthy food, number of restaurants, number of places for physical activity and total income - in different models. In addition, these associations remained significant after adjustment for age, gender, education and consumption of meat with visible fat. Conclusions. This study contributes to a better understanding of the complex interaction between environmental and individual determinants of obesity and may aid in the development of effective interventions, such as the expansion of obesity control programmes.
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Affiliation(s)
- Fernanda Penido Matozinhos
- Universidade Federal de Minas Gerais, Department of Maternal and Child Nursing and Public Health, Av. Alfredo Balena, 190, Bairro Santa Efigênia, 30130-100 Belo Horizonte, Minas Gerais, Brazil
| | - Crizian Saar Gomes
- Universidade Federal de Minas Gerais, Department of Maternal and Child Nursing and Public Health, Av. Alfredo Balena, 190, Bairro Santa Efigênia, 30130-100 Belo Horizonte, Minas Gerais, Brazil
| | - Amanda Cristina de Souza Andrade
- Universidade Federal de Minas Gerais, Observatory for Urban Health, Av. Alfredo Balena, 190, Bairro Santa Efigênia, 30130-100 Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Loures Mendes
- Universidade Federal de Juiz de Fora, R. José Lourenço Kelmer, Martelos, Juiz de Fora, MG, 36036-330 Juiz de Fora, Minas Gerais, Brazil
| | - Milene Cristine Pessoa
- Universidade Federal de Viçosa, Av. Peter Henry Rolfs, s/n, Campus Universitário, 36570-900 Viçosa, Minas Gerais, Brazil
| | - Amélia Augusta de Lima Friche
- Universidade Federal de Minas Gerais, Observatory for Urban Health, Av. Alfredo Balena, 190, Bairro Santa Efigênia, 30130-100 Belo Horizonte, Minas Gerais, Brazil
| | - Gustavo Velasquez-Melendez
- Universidade Federal de Minas Gerais, Department of Maternal and Child Nursing and Public Health, Av. Alfredo Balena, 190, Bairro Santa Efigênia, 30130-100 Belo Horizonte, Minas Gerais, Brazil
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Affiliation(s)
- Peter Gluckman
- Office of the Prime Minister's Chief Science Advisor, Auckland 1150, New Zealand.
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21
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Tong Y, Udupa JK, Torigian DA. Optimization of abdominal fat quantification on CT imaging through use of standardized anatomic space: a novel approach. Med Phys 2015; 41:063501. [PMID: 24877839 DOI: 10.1118/1.4876275] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE The quantification of body fat plays an important role in the study of numerous diseases. It is common current practice to use the fat area at a single abdominal computed tomography (CT) slice as a marker of the body fat content in studying various disease processes. This paper sets out to answer three questions related to this issue which have not been addressed in the literature. At what single anatomic slice location do the areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) estimated from the slice correlate maximally with the corresponding fat volume measures? How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? Are there combinations of multiple slices (not necessarily contiguous) whose area sum correlates better with volume than does single slice area with volume? METHODS The authors propose a novel strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. The authors then study the volume-to-area correlations and determine where they become maximal. To address the third issue, the authors carry out similar correlation studies by utilizing two and three slices for calculating area sum. RESULTS Based on 50 abdominal CT data sets, the proposed mapping achieves significantly improved consistency of anatomic localization compared to current practice. Maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized currently for single slice area estimation as a marker. CONCLUSIONS The maximum area-to-volume correlation achieved is quite high, suggesting that it may be reasonable to estimate body fat by measuring the area of fat from a single anatomic slice at the site of maximum correlation and use this as a marker. The site of maximum correlation is not at L4-L5 as commonly assumed, but is more superiorly located at T12-L1 for SAT and at L3-L4 for VAT. Furthermore, the optimal anatomic locations for SAT and VAT estimation are not the same, contrary to common assumption. The proposed standardized space mapping achieves high consistency of anatomic localization by accurately managing nonlinearities in the relationships among landmarks. Multiple slices achieve greater improvement in correlation for VAT than for SAT. The optimal locations in the case of multiple slices are not contiguous.
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Affiliation(s)
- Yubing Tong
- Department of Radiology, Medical Image Processing Group, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6021
| | - Jayaram K Udupa
- Department of Radiology, Medical Image Processing Group, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6021
| | - Drew A Torigian
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6021
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Jiang XY, Wang HM, Edwards TC, Chen YP, Lv YR, Patrick DL. Measurement properties of the Chinese version of the Youth Quality of Life Instrument-Weight Module (YQOL-W). PLoS One 2014; 9:e109221. [PMID: 25268884 PMCID: PMC4182632 DOI: 10.1371/journal.pone.0109221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 08/29/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Childhood obesity is a growing public health concern in China. It not only compromises physical health, but also has negative impacts on psychosocial well-being. As obesity rates increase, finding out what the perceptions of Chinese youth are regarding their weight is important for intervention planning and evaluation. However, there is a paucity of available obesity-specific instruments for children and adolescents in China and youth weight-specific quality of life (QOL) has been little reported. This study aimed to evaluate the measurement properties of the Chinese version of the Youth Quality of Life Instrument - Weight Module (YQOL-W). METHODS The Chinese version of the YQOL-W was administered to 840 youth aged 11-18 from nine schools. Measurement properties including measurement model, reliability, validity and burden were evaluated. RESULTS Confirmatory factor analysis showed that a three-factor model had acceptable model fit. The instrument had robust internal consistency reliability with Cronbach's α ranging from 0.84 to 0.96 and acceptable test-retest reliability with the intraclass correlation coefficients (ICCs) all higher than 0.7. The standard error of measurement (SEM) values for the Self, Social and Environment factors and total score were 10.352, 9.526, 12.086 and 8.425, respectively. The small real differences (SRDs) for the Self, Social and Environment factors and total score were 28.675, 26.387, 33.478, and 23.337, respectively. The Pearson's correlation coefficients between the YQOL-W and the PedsQL4.0 General Core Scales were stronger between comparable dimensions than those between less comparable dimensions, demonstrating convergent and discriminant evidence of construct validity. Significant differences were found in subscale and total scores across weight status, age and genders (P<0.01), supporting the known-groups validity of the instrument. CONCLUSION The Chinese version of the YQOL-W has acceptable measurement properties and can be used to assess the weight-specific QOL of children and adolescents in China.
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Affiliation(s)
- Xiao-Ying Jiang
- Institute of Social Medicine and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hong-Mei Wang
- Institute of Social Medicine and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Todd C. Edwards
- Department of Health Services, University of Washington, Seattle, Washington, United States of America
| | - Ying-Ping Chen
- Institute of Social Medicine and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yi-Ran Lv
- Institute of Social Medicine and Family Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Donald L. Patrick
- Department of Health Services, University of Washington, Seattle, Washington, United States of America
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Zeinoddini A, Heidari R, Talebpour M. Laparoscopic gastric plication in morbidly obese adolescents: a prospective study. Surg Obes Relat Dis 2014; 10:1135-9. [PMID: 24958648 DOI: 10.1016/j.soard.2014.02.039] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 02/11/2014] [Accepted: 02/24/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND The prevalence of obesity has increased rapidly among adolescents. Bariatric surgery is associated with significant weight loss and improvement in obesity related co-morbidities, but may be associated with serious complications. Therefore, attempts on finding a safe and effective bariatric procedure for adolescents are ongoing. The objective of this study was to evaluate safety and efficacy of laparoscopic gastric plication (LGP) on adolescents. METHOD A prospective study was performed on adolescents who underwent LGP from 2007-2013. Measured parameters included the percentage of excess weight (%EWL), percentage of body mass index loss (%BMIL), obesity related co-morbidities, operative time, and length of hospitalization and complications. RESULTS LGP was performed in 12 adolescents (9 female and 3 male). Mean (SD) age of the patients was 13.8±1 year. Mean preoperative weight and BMI were 112.4±19.7 kg and 46.0±4 kg/m(2), respectively. Mean (SD) %EWL and %EBMIL were 68.2±9.9% and 79.0±9.0%, respectively after 2 years. All medical co-morbidities were improved after LGP. There were no deaths. One patient required replication 4 days postoperatively due to obstruction at the site of the last knot. No other major complications were observed. No patient required rehospitalization. CONCLUSION LGP has the potential of being an ideal weight loss surgery for adolescents, resulting in excellent weight loss and minimal psychological disruption. It is associated with a minimal risk of leakage, bleeding, and nutritional deficiency. However, large well-designed studies with long-term follow-up are needed.
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Affiliation(s)
- Atefeh Zeinoddini
- Laparoscopic Ward, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Heidari
- Laparoscopic Ward, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Talebpour
- Laparoscopic Ward, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Mohaidly MA, Suliman A, Malawi H. Laparoscopic sleeve gastrectomy for a two-and half year old morbidly obese child. Int J Surg Case Rep 2013; 4:1057-60. [PMID: 24095691 PMCID: PMC3825971 DOI: 10.1016/j.ijscr.2013.07.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 06/13/2013] [Accepted: 07/10/2013] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Laparoscopic sleeve gastrectomy (LSG) is an accepted technique in bariatric surgery for reducing obesity. Recent reports indicate it to be effective even in children but it has not been tried in very young children. PRESENTATION OF CASE We report here a case of a 2 and half years old child subjected to LSG for his morbid obesity and associated obstructive sleep apnea and bowing of legs. LSG was performed after investigations ruled out hereditary or genetic causes of obesity. The procedure was well tolerated without any complications and 2 months post surgery, the obstructive sleep apnea decreased substantially. The child was followed up for two years. At the last follow up BMI was drastically reduced from a pre surgical value of 41.1–24 kg/m2 at 24 months post surgery. DISCUSSION Prior to our report the youngest child to undergo sleeve gastrectomy was 5 years old from Saudi Arabia. We observed LSG to be safe and effective in reducing obesity and related co morbidities in a two and half year's old child. CONCLUSION The results suggest that LSG can be a safe and effective alternative for weight control in morbidly obese children even of less than 3 years of age. However more studies and long term follow up is essential for monitoring the growth and development of children subjected to LSG.
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Affiliation(s)
- Mohammed Al Mohaidly
- Department of Pediatric Surgery, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia.
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Yazdani S, Yee CT, Chung PJ. Factors predicting physical activity among children with special needs. Prev Chronic Dis 2013; 10:E119. [PMID: 23866163 PMCID: PMC3716337 DOI: 10.5888/pcd10.120283] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Introduction Obesity is especially prevalent among children with special needs. Both lack of physical activity and unhealthful eating are major contributing factors. The objective of our study was to investigate barriers to physical activity among these children. Methods We surveyed parents of the 171 children attending Vista Del Mar School in Los Angeles, a nonprofit school serving a socioeconomically diverse group of children with special needs from kindergarten through 12th grade. Parents were asked about their child’s and their own physical activity habits, barriers to their child’s exercise, and demographics. The response rate was 67%. Multivariate logistic regression was used to examine predictors of children being physically active at least 3 hours per week. Results Parents reported that 45% of the children were diagnosed with attention deficit hyperactivity disorder, 38% with autism, and 34% with learning disabilities; 47% of children and 56% of parents were physically active less than 3 hours per week. The top barriers to physical activity were reported as child’s lack of interest (43%), lack of developmentally appropriate programs (33%), too many behavioral problems (32%), and parents’ lack of time (29%). However, child’s lack of interest was the only parent-reported barrier independently associated with children’s physical activity. Meanwhile, children whose parents were physically active at least 3 hours per week were 4.2 times as likely to be physically active as children whose parents were less physically active (P = .01). Conclusion In this group of students with special needs, children’s physical activity was strongly associated with parental physical activity; parent-reported barriers may have had less direct effect. Further studies should examine the importance of parental physical activity among children with special needs.
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Affiliation(s)
- Shahram Yazdani
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095-1752, USA.
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Penney TL, Rainham DGC, Dummer TJB, Kirk SFL. A spatial analysis of community level overweight and obesity. J Hum Nutr Diet 2013; 27 Suppl 2:65-74. [DOI: 10.1111/jhn.12055] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- T. L. Penney
- Applied Research Collaborations for Health (ARCH); School of Health and Human Performance; Faculty of Health Professions; Dalhousie University; Halifax NS Canada
| | - D. G. C. Rainham
- Environmental Science Program; Faculty of Science; Dalhousie University; Halifax NS Canada
| | - T. J. B. Dummer
- Population Cancer Research Program; Department of Pediatrics; Dalhousie University; Halifax NS Canada
| | - S. F. L. Kirk
- Applied Research Collaborations for Health (ARCH); School of Health and Human Performance; Faculty of Health Professions; Dalhousie University; Halifax NS Canada
- Medical Research Council; Human Nutrition Research; Cambridge UK
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Morrison H, Power TG, Nicklas T, Hughes SO. Exploring the effects of maternal eating patterns on maternal feeding and child eating. Appetite 2013; 63:77-83. [DOI: 10.1016/j.appet.2012.12.017] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 10/21/2012] [Accepted: 12/26/2012] [Indexed: 11/28/2022]
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Eficacia clínica y metabólica de una nueva terapia motivacional (OBEMAT) para el tratamiento de la obesidad en la adolescencia. An Pediatr (Barc) 2013; 78:157-66. [DOI: 10.1016/j.anpedi.2012.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 06/05/2012] [Accepted: 06/06/2012] [Indexed: 11/18/2022] Open
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Rorat M, Jurek T, Kuchar E, Szenborn L, Golema W, Halon A. Liver steatosis in Polish children assessed by medicolegal autopsies. World J Pediatr 2013; 9:68-72. [PMID: 23275099 DOI: 10.1007/s12519-012-0387-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 03/15/2012] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cases of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are increasing in the pediatric population. Their growing prevalence coincides with the obesity epidemic. Assessment of the incidence requires liver biopsies on a representative population sample, which are hampered by the absence of indications for invasive examination on children without clinical symptoms. The aim of the current study was to assess the incidence of liver steatosis in the population of children up to 18 years old from Lower Silesia. METHODS We retrospectively reviewed 342 medico-legal autopsy reports from 2000 to 2009. We separated a group of 256 children whose death was caused by trauma. Liver steatosis was diagnosed according to the results of histopathological examinations and typical macroscopic imaging. RESULTS In the 265 children who died from trauma, liver steatosis was reported in 11 (4.2%) children (6 boys) aged between 6 months and 18 years old. Six of the 11 children (54.5%) were found to be overweight. In all 342 children, steatosis was found in 18 (5.3%) children (13 boys), while NASH was diagnosed in 1 (0.3%). Excess body weight was observed in 55.6% (10/18) of children with steatosis. CONCLUSIONS Liver steatosis can occur at any age, even in infancy. Being overweight is a very important risk factor. Gross examination of the liver is insufficient for the diagnosis of steatosis because of its lower sensitivity and specificity. Verification of liver steatosis requires reference histopathological examination.
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Affiliation(s)
- Marta Rorat
- Department of Forensic Medicine, Wroclaw Medical University, Wroclaw, Poland.
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Silent slipped capital femoral epiphysis in overweight and obese children and adolescents. Eur J Pediatr 2012; 171:1461-5. [PMID: 22543567 DOI: 10.1007/s00431-012-1743-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 04/05/2012] [Accepted: 04/08/2012] [Indexed: 01/27/2023]
Abstract
Abnormal loading of the hip in obese children may lead to anatomic alterations and an increased prevalence of slipped capital femoral epiphysis (SCFE). The aims of this study were to examine the hip motion in obese children and adolescents and to estimate the prevalence of SCFE in a subgroup of patients characterized by pathological clinical examination and/or pain in the knee or hip joint. A total of 411 individuals (196 males), mean age 14.5 ± 2.5 years (7.8-20.4), mean BMI of 32.9 ± 5.6 kg/m(2) (20.3-51.5, z score +2.65) who were consecutively admitted for an inpatient weight loss program were included in the study. Twenty-six percent of the patients had load-dependent and 11.7 % had load-independent pain in the knee joint. A total of 9.3 % had load-dependent and 4.7 % had load-independent pain in the hip joint. Two patients (0.5 %) underwent surgical treatment of SCFE prior to entry. A total of 18.2 % of the patients showed a reduced range of motion for hip flexion (<90°) and 18.5 % a pathological decreased internal rotation (<10°). Radiological evaluation of the hips in the clinically conspicuous subgroup (n = 54) revealed an abnormal head-neck ratio as a sign of prior silent slipped capital femoral epiphysis in 11 patients (20.4 % of the 54 patients, 2.7 % of total cohort). In conclusion, these data show a high prevalence of SCFE-like tilt deformities in a selected group of severely obese children. Mild deformation of the epiphysis at young age might be a major predisposing factor for the development of hip osteoarthritis in obese adults.
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Joshi AA, Hu HH, Leahy RM, Goran MI, Nayak KS. Automatic intra-subject registration-based segmentation of abdominal fat from water-fat MRI. J Magn Reson Imaging 2012; 37:423-30. [PMID: 23011805 DOI: 10.1002/jmri.23813] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 08/07/2012] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To develop an automatic registration-based segmentation algorithm for measuring abdominal adipose tissue depot volumes and organ fat fraction content from three-dimensional (3D) water-fat MRI data, and to evaluate its performance against manual segmentation. MATERIALS AND METHODS Data were obtained from 11 subjects at two time points with intermediate repositioning, and from four subjects before and after a meal with repositioning. Imaging was performed on a 3 Tesla MRI, using the IDEAL chemical-shift water-fat pulse sequence. Adipose tissue (subcutaneous--SAT, visceral--VAT) and organs (liver, pancreas) were manually segmented twice for each scan by a single trained observer. Automated segmentations of each subject's second scan were generated using a nonrigid volume registration algorithm for water-fat MRI images that used a b-spline basis for deformation and minimized image dissimilarity after the deformation. Manual and automated segmentations were compared using Dice coefficients and linear regression of SAT and VAT volumes, organ volumes, and hepatic and pancreatic fat fractions (HFF, PFF). RESULTS Manual segmentations from the 11 repositioned subjects exhibited strong repeatability and set performance benchmarks. The average Dice coefficients were 0.9747 (SAT), 0.9424 (VAT), 0.9404 (liver), and 0.8205 (pancreas); the linear correlation coefficients were 0.9994 (SAT volume), 0.9974 (VAT volume), 0.9885 (liver volume), 0.9782 (pancreas volume), 0.9996 (HFF), and 0.9660 (PFF). When comparing manual and automated segmentations, the average Dice coefficients were 0.9043 (SAT volume), 0.8235 (VAT), 0.8942 (liver), and 0.7168 (pancreas); the linear correlation coefficients were 0.9493 (SAT volume), 0.9982 (VAT volume), 0.9326 (liver volume), 0.8876 (pancreas volume), 0.9972 (HFF), and 0.8617 (PFF). In the four pre- and post-prandial subjects, the Dice coefficients were 0.9024 (SAT), 0.7781 (VAT), 0.8799 (liver), and 0.5179 (pancreas); the linear correlation coefficients were 0.9889, 0.9902 (SAT, and VAT volume), 0.9523 (liver volume), 0.8760 (pancreas volume), 0.9991 (HFF), and 0.6338 (PFF). CONCLUSION Automated intra-subject registration-based segmentation is potentially suitable for the quantification of abdominal and organ fat and achieves comparable quantitative endpoints with respect to manual segmentation.
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Affiliation(s)
- Anand A Joshi
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California 90089-2564, USA.
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Laparoscopic sleeve gastrectomy in 108 obese children and adolescents aged 5 to 21 years. Ann Surg 2012; 256:266-73. [PMID: 22504281 DOI: 10.1097/sla.0b013e318251e92b] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To report experience with laparoscopic sleeve gastrectomy (LSG) in 108 severely obese children and adolescents. BACKGROUND Obesity during childhood and adolescence can be accompanied by serious long-term adverse health and longevity outcomes. With increased use of bariatric surgery to treat obesity in these patients, diverse guidelines have been published, most of which exclude children aged younger than 14 years. Few reports describe LSG in children and adolescents, delaying determining its safety and effectiveness and developing guidance regarding its use. METHODS A retrospective review of LSG performed from March 2008 through February 2011 by a single surgeon at King Saud University Hospitals, Riyadh, Saudi Arabia, included 108 patients aged 5 through 21 years. RESULTS Patients attending follow-up visits at 3 (n = 88), 6 (n = 76), 12 (n = 41), and 24 (n = 8) months postoperatively experienced median excess weight loss (EWL) of 28.9%, 48.1%, 61.3%, and 62.3%, respectively. At 6 and 12 months follow-up, 42.1% (n = 32) and 73.2% (n = 30) of patients achieved at least 50% EWL, whereas 7.9% (n = 6) and 4.9% (n = 2) had 25% or less EWL, respectively. There were no serious postoperative complications and no adverse sequelae developed during the current follow-up. Available comorbidity data indicate resolution of dyslipidemia, 21 of 30 (70.0%); hypertension, 27 of 36 (75.0%); prehypertension, 15 of 18 (83.3%); symptoms of obstructive sleep apnea, 20 of 22 (90.9%); diabetes, 15 of 16 (93.8%); and prediabetes, 11 of 11 (100.0%). CONCLUSIONS LSG resulted in successful short-term weight loss in more than 90% of pediatric patients and 70% or more comorbidity resolution during up to 24 months of follow-up. Long-term data are necessary to evaluate persistence of weight loss and maturation to adulthood.
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Ultrafast 3-T MRI in the evaluation of children with acute lower abdominal pain for the detection of appendicitis. AJR Am J Roentgenol 2012; 198:1424-30. [PMID: 22623558 DOI: 10.2214/ajr.11.7436] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The purpose of this study is to evaluate the feasibility of ultrafast 3-T MRI in the evaluation of children with acute lower abdominal pain for the detection of appendicitis. SUBJECTS AND METHODS Forty-two pediatric patients (30 girls and 12 boys; mean age, 11.5 years; age range, 4-17 years) with acute abdominal pain were prospectively studied. Ultrafast 3-T MRI was performed with a three-plane single-shot turbo spin-echo sequence and an axial T2-weighted turbo spin-echo sequence with fat suppression. All scans were performed without sedation or oral or IV contrast agent. Scan times were less than 8 minutes 45 seconds (median, 5 minutes 40 seconds). Patients underwent CT or ultrasound or both as a comparison study to the MRI examination. The MRI, CT, and ultrasound examinations were interpreted independently by four board-certified radiologists who were blinded to patient information, study interpretations, surgical pathologic findings, and final diagnosis. RESULTS Twelve of 42 cases of acute appendicitis were detected with 100% sensitivity, 99% specificity, 100% negative predictive value, and 98% positive predictive value, all of which were statistically significant (p < 0.01). The pooled and individual receiver operating characteristic curves for radiologists' interpretation of the diagnosis of acute appendicitis were greater than 0.95 in all cases (p < 0.01) CONCLUSION Ultrafast 3-T MRI is a feasible alternative imaging modality for the diagnosis of acute appendicitis in children, particularly in cases where ultrasound is equivocal or nondiagnostic, as an alternative to CT. Ultrafast MRI requires no sedation and no oral or IV contrast agent and has no associated radiation exposure risks.
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Harkins PJ, Lundgren JD, Spresser CD, Hampl SE. Childhood obesity: survey of physician assessment and treatment practices. Child Obes 2012; 8:155-61. [PMID: 22799515 DOI: 10.1089/chi.2011.0062] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND This study examined physician experience with the 2007 Expert Committee Recommendations (ECR) on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity. METHODS Pediatricians and family physicians (n = 194) practicing in the Midwest completed a survey designed to assess knowledge of, adherence to, and self-efficacy in implementing the 2007 Expert Committee recommendations. RESULTS The majority of physicians (71%) were aware of the ECR and adhered to approximately 60% of the recommendations. Adherence was significantly higher for physicians who were aware of the ECR. Differences in awareness of and adherence to the ECR were noted among physician groups by specialty and location. Self-efficacy for assessing and treating pediatric obesity was significantly positively correlated with adherence to the ECR (Pearson r = 0.46). When asked for strategies that would facilitate improved pediatric weight management, physicians most often reported desiring to learn effective methods to increase patient motivation. CONCLUSIONS Efforts to improve adherence to the Expert Committee recommendations should focus on improving physician awareness of and training in the use of the recommendations and on improved training and development of self-efficacy in pediatric weight assessment and patient counseling skills.
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Affiliation(s)
- Paula J Harkins
- University of Missouri-Kansas City, Department of Psychology, USA
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Diet quality, physical activity, body weight and health-related quality of life among grade 5 students in Canada. Public Health Nutr 2011; 15:75-81. [DOI: 10.1017/s1368980011002412] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AbstractObjectiveTo assess how diet quality, physical activity and body weight are related to health-related quality of life (HRQOL) among children in the Canadian province of Alberta.DesignIn 2008, we surveyed 3421 grade 5 students and their parents from 148 randomly selected schools. Students completed the Harvard Food Frequency Questionnaire, questions on physical activities, and had their height and weight measured. The HRQOL of the students was assessed using the EQ-5D-Y. Parents completed questions on socio-economic background and children's lifestyle. We applied multilevel regression methods to examine the importance of children's diet quality, physical activity and weight status for the EQ-5D-Y Visual Analogue Scale and for the EQ-5D-Y dimensions.SettingThe province of Alberta, Canada.SubjectsGrade 5 students.ResultsStudents with better diet quality, higher physical activity levels and normal body weights were statistically significantly more likely to report better HRQOL than students who ate less healthily, were less active or were overweight or obese.ConclusionsThe importance of diet quality, physical activity and body weight status for HRQOL may help justify broader implementation of school health programmes that promote healthy eating and active living, as these programmes will help reduce the burden of childhood obesity and improve quality of life.
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A simulation of affordability and effectiveness of childhood obesity interventions. Acad Pediatr 2011; 11:342-50. [PMID: 21764018 DOI: 10.1016/j.acap.2011.04.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 04/19/2011] [Accepted: 04/21/2011] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This study seeks to project at what level of effectiveness and cost a population-based or targeted intervention would yield a positive net economic benefit. METHODS Data sources include prevalence of obesity at all ages from the National Health and Nutrition Examination Survey, the persistence of obesity from childhood to adulthood from a literature review, and a cost estimate from the 2006 Medical Expenditures Panel Survey. Econometric analysis was used to estimate medical cost related to obesity. Lifetime medical cost related to obesity is calculated by race, gender, and smoking status. Simulations were conducted to estimate the break-even point for interventions that take place between ages 0 and 6 years, ages 7 and 12 years, and ages 13 to 18 years, with a range of effectiveness. RESULTS Results of simulations reveal that, from a pure medical cost perspective, spending approximately $1.4 to $1.7 billion at present value for each birth cohort will break even if 1 percentage point reduction in obesity among children is achieved. Population-based interventions can spend up to between $280 and $339 per child at present value if 1 percentage point reduction in obesity rate could be achieved; in contrast, should we invest in interventions that only target obese children, we can spend up to $1648 to $2735 per obese child for every 1 percentage point reduction in obesity rate. CONCLUSIONS This study has several important policy implications; early interventions make economic sense. Targeted interventions could yield higher cost savings than population-based interventions for young children (aged 0-6 years), whereas a population-based approach could yield greater economic net benefits for adolescents (aged 13-18 years). Our simulation shows that childhood obesity interventions, even with moderate effectiveness, would make economic sense, which should motivate policy makers to take action.
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Spence JC, Carson V, Casey L, Boule N. Examining behavioural susceptibility to obesity among Canadian pre-school children: The role of eating behaviours. ACTA ACUST UNITED AC 2011; 6:e501-7. [DOI: 10.3109/17477166.2010.512087] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
As the prevalence of obesity continues to rise, rapid and accurate tools for assessing abdominal body and organ fat quantity and distribution are critically needed to assist researchers investigating therapeutic and preventive measures against obesity and its comorbidities. Magnetic resonance imaging (MRI) is the most promising modality to address such need. It is non-invasive, utilizes no ionizing radiation, provides unmatched 3-D visualization, is repeatable, and is applicable to subject cohorts of all ages. This article is aimed to provide the reader with an overview of current and state-of-the-art techniques in MRI and associated image analysis methods for fat quantification. The principles underlying traditional approaches such as T(1) -weighted imaging and magnetic resonance spectroscopy as well as more modern chemical-shift imaging techniques are discussed and compared. The benefits of contiguous 3-D acquisitions over 2-D multislice approaches are highlighted. Typical post-processing procedures for extracting adipose tissue depot volumes and percent organ fat content from abdominal MRI data sets are explained. Furthermore, the advantages and disadvantages of each MRI approach with respect to imaging parameters, spatial resolution, subject motion, scan time and appropriate fat quantitative endpoints are also provided. Practical considerations in implementing these methods are also presented.
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Affiliation(s)
- H H Hu
- Ming Hsieh Department of Electrical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.
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Kuhle S, Kirk S, Ohinmaa A, Yasui Y, Allen AC, Veugelers PJ. Use and cost of health services among overweight and obese Canadian children. ACTA ACUST UNITED AC 2011; 6:142-8. [DOI: 10.3109/17477166.2010.486834] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pagels P, Boldemann C, Raustorp A. Comparison of pedometer and accelerometer measures of physical activity during preschool time on 3- to 5-year-old children. Acta Paediatr 2011; 100:116-20. [PMID: 20678161 DOI: 10.1111/j.1651-2227.2010.01962.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To compare pedometer steps with accelerometer counts and to analyse minutes of engagement in light, moderate and vigorous physical activity in 3- to 5-year-old children during preschool time. METHODS Physical activity was recorded during preschool time for five consecutive days in 55 three- to five-year-old children. The children wore a Yamax SW200 pedometer and an Actigraph GTIM Monitor. RESULTS The average time spent at preschool was 7.22 h/day with an average step of 7313 (±3042). Steps during preschool time increased with increasing age. The overall correlation between mean step counts and mean accelerometer counts (r = 0.67, p < 0.001), as well as time in light to vigorous activity (r = 0.76, p < 0.001), were moderately high. Step counts and moderate to vigorous physical activity minutes were poorly correlated in 3 years old (r = 0.19, p < 0.191) and moderately correlated (r = 0.50, p < 0.001) for children 4 to 5 years old. CONCLUSION Correlation between the preschool children's pedometer-determined step counts and total engagement in physical activity during preschool time was moderately high. Children's step counts at preschool were low, and the time spent in moderate and vigorous physical activity at preschool was very short.
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Carson V, Kuhle S, Spence JC, Veugelers PJ. Parents' perception of neighbourhood environment as a determinant of screen time, physical activity and active transport. Canadian Journal of Public Health 2010. [PMID: 20524376 DOI: 10.1007/bf03404356] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To study the importance of parents' perception of neighbourhood environment for health behaviours such as screen time, physical activity, and active transport in a Canadian context. METHODS As part of the REAL Kids Alberta project, 3,421 grade five students from 148 randomly selected schools in Alberta and their parents were surveyed in the spring of 2008. Physical activity was assessed by self-report using an adapted version of the Physical Activity Questionnaire for Older Children (PAQ-C). Screen time and active transport (walking and biking) was assessed by parent proxy reports. Parents were also surveyed on their perception of their neighbourhoods. These responses were reduced to three components (satisfaction/services, safety, sidewalks/parks) through principal component analysis. Subsequent multilevel logistic regression analyses were conducted to quantify the associations of these principal neighbourhood components with screen time, physical activity, and active transport. RESULTS Children residing in neighbourhoods with good satisfaction/services and sidewalks/parks were significantly more likely to engage in 2 hours or less of screen time and to be physically active. Children in neighbourhoods with good sidewalks/parks were also more likely to engage in active transport to and from school. However, perceived neighbourhood safety had little impact on activity. CONCLUSION The findings suggest physical activity and active transport may be increased and sedentary behaviours reduced through 1) increasing access to parks, playgrounds, and play spaces, 2) increasing access to sports and recreation programs, and 3) provision of sidewalks such that children and youth can walk or bike to school.
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Affiliation(s)
- Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB
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Abstract
ABSTRACT
OBJECTIVES
To review pharmacokinetics in obese children and to provide medication dosing recommendations.
METHODS
EMBASE, MEDLINE, and International Pharmaceutical Abstracts databases were searched using the following terms: obesity, morbid obesity, overweight, pharmacokinetics, drug, dose, kidney function test, creatinine, pediatric, and child.
RESULTS
We identified 10 studies in which the authors examined drug dosing or pharmacokinetics for obese children. No information was found for drug absorption or metabolism. Obese children have a higher percent fat mass and a lower percent lean mass compared with normal-weight children. Therefore, in obese children, the volume of distribution of lipophilic drugs is most likely higher, and that of hydrophilic drugs is most likely lower, than in normal-weight children. Serum creatinine concentrations are higher in obese than normal-weight children. Total body weight is an appropriate size descriptor for calculating doses of antineoplastics, cefazolin, and succinylcholine in obese children. Initial tobramycin doses may be determined using an adjusted body weight, although using total body weight in the context of monitoring serum tobramycin concentrations would also be an appropriate strategy. We found no information for any of the opioids; antibiotics such as penicillins, carbapenems, vancomycin, and linezolid; antifungals; cardiac drugs such as digoxin and amiodarone; corticosteroids; benzodiazepines; and anticonvulsants. In particular, we found no information about medications that are widely distributed to adipose tissue or that can accumulate there.
CONCLUSIONS
The available data are limited because of the small numbers of participating children, study design, or both. The number and type of drugs that have been studied limit our understanding of the pharmacokinetics in obese children. In the absence of dosing information for obese children, it is important to consider the nature and severity of a child's illness, comorbidities, organ function, and side effects and physiochemical properties of the drug. Extrapolating from available adult data is possible, as long as practitioners consider the effects of growth and development on the pharmacokinetics relevant to the child's age.
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Affiliation(s)
| | - Roxane R. Carr
- Faculty of Pharmaceutical Sciences, The University of British Columbia
- Department of Pharmacy Department, Children's and Women's Health Centre of British Columbia, Vancouver, British Columbia
| | - Mary H. H. Ensom
- Faculty of Pharmaceutical Sciences, The University of British Columbia
- Department of Pharmacy Department, Children's and Women's Health Centre of British Columbia, Vancouver, British Columbia
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Kelly SA, Melnyk BM. Systematic review of multicomponent interventions with overweight middle adolescents: implications for clinical practice and research. Worldviews Evid Based Nurs 2009; 5:113-35. [PMID: 19076911 DOI: 10.1111/j.1741-6787.2008.00131.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Being overweight is a global epidemic that occurs in more than 10% of school-aged children (age 5-17) worldwide. The rate of adolescents being overweight continues to rise despite numerous public health campaigns and programs to increase awareness and modify unhealthy lifestyle patterns. AIMS The purpose of this systematic review was to determine the most efficacious intervention for treating overweight adolescents. Evidence from this systematic review could guide clinical practice and future research with this high-risk population in youth. METHODS In adolescents of 13-17 years of age who are above ideal body weight, are multicomponent interventions that integrate nutrition, activity, and behavioral components more efficacious than any type of comparison group in improving weight, body mass index (BMI), percentage body fat, or behaviors of dietary intake or activity level? Literature searches were completed in Cochrane Library, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO databases as well as hand searching. RESULTS Due to a lack of consistency among the studies regarding methods and rigor of the studies, the evidence is not entirely clear on the best multicomponent program for addressing overweight in middle adolescents. The success of an intervention was associated with the dose of the intervention received by the adolescent and parent. CONCLUSIONS A structured program addressing nutrition, physical activity, and behavioral skills appears to be efficacious in reducing weight and cardiovascular risk factors. Primarily, interventions have included the individual and varying degrees of parental participation. In the past few years, more research has addressed the multiple levels of the ecological model. Further research addressing the five levels of the ecological model will assist in illuminating the impact of the environment on behavior change in adolescents.
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Affiliation(s)
- Stephanie A Kelly
- Arizona State University College of Nursing and Healthcare Innovation, Phoenix, Arizona 85004, USA.
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Nutritional status and obesity in children and young adults with disabilities in Punta Arenas, Patagonia, Chile. Int J Rehabil Res 2009; 31:305-13. [PMID: 19008679 DOI: 10.1097/mrr.0b013e3282fb7d3c] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Childhood obesity is reaching epidemic proportions throughout the world; however, little is known on the nutritional status of children with disabilities. To address this issue, medical records of 748 children aged 18 years or younger receiving physical therapy during 2004-2005 at a privately sponsored free rehabilitation clinic in Punta Arenas, Patagonia, Chile were abstracted. Data included demographic, clinical, and anthropometric information recorded at the first visit. As a comparison, height and weight were also collected in 215 children attending local schools. Nutritional status was calculated as body mass index (above 6 years of age) or evaluated by growth curves (6 years of age or below) as undernourished, normal, overweight, obese, or morbidly obese. Logistic regression was used to determine risk factors for obesity in these children. Overall, a significant difference in nutritional status between disabled and non-disabled children was found (P<0.001). Children with disabilities had a higher prevalence of both below and above normal weight than non-disabled children. Risk factors for obesity included increasing age and living with a grandparent independent of other socioeconomic factors. Compared with normal children, risk of obesity was doubled for those with developmental delays [odds ratio (OR): 1.96; 95% confidence interval (CI): 1.16-3.34] and neurological disorders (OR: 2.58, 95% CI: 1.26-5.29), whereas individuals with cerebral palsy were less than half as likely to be obese than non-disabled children (OR: 0.46, 95% CI: 0.20-1.03). We conclude that overnutrition continues to be a problem for both disabled and non-disabled children in Patagonia. Programs to increase physical activity and improve nutrition are needed in this isolated part of the world.
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Children's overweight and obesity: Local and national monitoring using electronic health records. Scand J Public Health 2009; 37:201-5. [DOI: 10.1177/1403494808098507] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: To test the feasibility of a system for monitoring children's obesity and overweight based on data from electronic health records in the school health services. Methods: Data on weight and height from electronic health records at school health services were collected for 10-year-olds in 2003—2004, 2004—2005 and 2005—2006. School health personnel extracted group-level data with a simple program installed on the computer containing the health records. Four Swedish municipalities were included in the study: Karlstad, Umeå, Västerås, and Ystad. Results: The system achieved coverage of 92—96% of all children in 2005—2006. The overall prevalence rates were 4.2% (3.8—4.7%) obese and 22.0% (21.1—23.0%) overweight, including obesity. Conclusions: A system based on electronic health records from the school health services can successfully provide data. The system has practical, economical and ethical strengths.
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Bibliography. Current world literature. Growth and development. Curr Opin Endocrinol Diabetes Obes 2008; 15:79-101. [PMID: 18185067 DOI: 10.1097/med.0b013e3282f4f084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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