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Moiré superlattices, constituted by two-dimensional materials, demonstrate a variety of strongly correlated and topological phenomena including correlated insulators, superconductivity, and integer/fractional Chern insulators. In the realm of topological nontrivial Chern insulators within specific moiré superlattices, previous studies usually observe a single Chern number at a given filling factor in a device. Here we present the observation of gate-tunable Chern numbers within the Chern insulator state of an ABC-stacked trilayer graphene/hexagonal boron nitride moiré superlattice device. Near quarter filling, the moiré superlattice exhibits spontaneous valley polarization and distinct ferromagnetism associated with the Chern insulator states over a range of the displacement field. Surprisingly we find a transition of the Chern number from C = 3 to 4 as the displacement field is increased. Our observation of gate-tunable correlated Chern insulators suggests new ways to control and manipulate topological states in a moiré superlattice device.

Advanced microelectronics in the future may require semiconducting channel materials beyond silicon. Two-dimensional (2D) semiconductors, with their atomically thin thickness, hold great promise for future electronic devices. One challenge to achieving high-performance 2D semiconductor field effect transistors (FET) is the high contact resistance at the metal-semiconductor interface. In this study, we develop a charge-transfer doping strategy with WSe 2 /α-RuCl 3 heterostructures to achieve low-resistance ohmic contact for p-type monolayer WSe 2 transistors. We show that hole doping as high as 3 × 10 13 cm -2 can be achieved in the WSe 2 /α-RuCl 3 heterostructure due to its type-III band alignment, resulting in an ohmic contact with resistance of 4 kΩ μm. Based on that, we demonstrate p-type WSe 2 transistors with an on-current of 35 μA·μm -1 and an I ON /I OFF ratio exceeding 10 9 at room temperature.

Electron superlattices allow the engineering of correlated and topological quantum phenomena. The recent emergence of moiré superlattices in two-dimensional heterostructures has led to exciting discoveries related to quantum phenomena. However, the requirement for the moiré pattern poses stringent limitations, and its potential cannot be switched on and off. Here, we demonstrate remote engineering and on/off switching of correlated states in bilayer graphene. Employing a remote Coulomb superlattice realized by localized electrons in twisted bilayer WS 2 , we impose a Coulomb superlattice in the bilayer graphene with period and strength determined by the twisted bilayer WS 2 . When the remote superlattice is turned off, the two-dimensional electron gas in the bilayer graphene is described by a Fermi liquid. When it is turned on, correlated insulating states at both integer and fractional filling factors emerge. This approach enables in situ control of correlated quantum phenomena in two-dimensional materials hosting a two-dimensional electron gas., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Fatigue is a frequent and distressing symptom in children undergoing leukemia treatment; however, little is known about factors influencing this symptom. Antioxidants such as glutathione can decrease symptom severity in adult oncology patients, but no study has evaluated antioxidants' effects on symptoms in pediatric oncology patients. This study describes fatigue patterns and associations of fatigue with antioxidants represented by reduced glutathione (GSH) and the reduced/oxidized glutathione (GSH/GSSG) ratio among children receiving leukemia treatment. A repeated measures design assessed fatigue and antioxidants among 38 children from two large U.S. cancer centers. Fatigue was assessed among school-age children and by parent proxy among young children. Antioxidants (GSH and GSH/GSSG ratio) were assessed from cerebrospinal fluid at four phases during leukemia treatment. Young children had a steady decline of fatigue from the end of induction treatment through the continuation phase of treatment, but no significant changes were noted among the school-age children. Mean antioxidant scores varied slightly over time; however, the GSH/GSSG ratios in these children were significantly lower than the normal ratio. Mean GSH/GSSG ratios significantly correlated to fatigue scores of the school-age children during early phases of treatment. Children with low mean GSH/GSSG ratios demonstrated oxidative stress. The low ratios noted early in therapy were significantly correlated with higher fatigue scores during induction and postinduction treatment phases. This finding suggests that increased oxidative stress during the more intensive phases of therapy may explain the experience of fatigue children report., (© The Author(s) 2016.)

Infections in children and adolescents with cancer are a significant cause of morbidity and mortality, especially in those receiving chemotherapy who are neutropenic and/or immunocompromised. The aim of this article is to review existing evidence in order to provide a practice recommendation to prevent or minimize infections in neutropenic and/or immunocompromised patients receiving chemotherapy and/or stem cell transplant. Systematic reviews were undertaken and research was graded according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. A variety of interventions are implemented to reduce infections in the neutropenic and/or immunocompromised population; however, few are supported by research evidence. Existing literature should continue to be reviewed to further identify interventions that can influence positive patient outcomes and provide opportunities for individuals in the medical field to work together to improve clinical care., (© 2014 by Association of Pediatric Hematology/Oncology Nurses.)

Unlabelled: The relationship between spinal curvature and bone mineral density (BMD) in women was examined. Significant relationships were observed between spinal curvature and BMD in both pre- and postmenopausal women. Excessive spinal curvature may be associated with low bone mass in premenopausal women., Introduction: The purpose of this study was to examine the associations between spinal measurements of thoracic and lumbar curvatures and bone mineral density in pre- and postmenopausal women., Methods: The data for this study were obtained from the Texas Woman's University Pioneer Project. Female participants (n = 242; premenopausal n = 104, postmenopausal n = 138) between the ages of 18 and 60 years were evaluated on multiple health measures. Thoracic and lumbar curvatures were measured with a 24-in. (60 cm) flexicurve. Bone mineral density was assessed via dual-energy X-ray absorptiometry (Lunar DPX IQ, version 4.6e). Pearson correlations and logistic regression analysis were used to examine the associations between the obtained spinal curvature measurements and bone mineral density. Significance was set at p < .05., Results: Significant correlations were observed for the femoral neck and lumbar spine bone mineral density with thoracic and lumbar curve in premenopausal women (r = -.344 to - .525; p < .001). Slightly weaker, but significant, correlations were observed for femoral neck and lumbar spine in relation to thoracic and lumbar curve in postmenopausal women (r = -.288 to -.397; p < .01). Premenopausal women with thoracic curvature greater than 4 cm had a greater risk of having low bone mass compared to premenopausal women with less than 4 cm of curvature (odds ratio = 3.982, 95 % CI = 1.206, 13.144)., Conclusions: The observed negative relationship suggests that as either thoracic or lumbar curvature increases, the regional bone mineral density decreases in both pre- and postmenopausal women.

Using real-time grazing-incidence small-angle x-ray scattering, we find that the processes of island formation and coalescence during the room-temperature vapor phase deposition of aluminum lead to dynamical scaling of the evolving surface morphology. The scaling is quantitatively consistent with the self-similarity predicted by the Family-Meakin model, which was developed to describe liquid droplet deposition, growth, and coalescence. The Family-Meakin model assumes only that atomic diffusion over the substrate between islands or droplets is negligible and that diffusion between impinging islands or droplets is sufficient to give complete coalescence. Therefore the dynamical scaling morphology evolution identified here may be common in the initial stages of those solid film growth processes which proceed by island formation and growth.

The anticancer anthracyclines doxorubicin and daunorubicin are used to treat a variety of cancers in dogs. The therapeutic utility of anthracyclines is limited by cardiotoxicity in some cases. Synthesis of anthracycline alcohol metabolites by carbonyl reductase 1 (CBR1) is crucial for the pathogenesis of cardiotoxicity. We hypothesize that genetic polymorphisms in canine cbr1 contribute to the variable pharmacodynamics of anthracyclines in dogs. DNA sequence variants in canine cbr1 were investigated in DNA samples from dogs of seven breeds. Thirteen SNPs were detected in canine cbr1. A 10-bp deletion in the 5'-untranslated region (5'-UTR) was found in specimens from the Labrador Retriever, Beagle, Siberian Husky, and Boxer breeds. The 5'-UTR also included a polymorphic "hot spot" region immediately downstream of the 10-bp deletion. DNA sequence variants in the "hot spot region" ranged from 1 to 21 bp in length. Bioinformatics searches identified a cluster of three to six potential binding sites for the transcription factor Sp1 in the DNA segment containing both the "hot spot" region and the 10-bp deletion. This information provides a foundation to allow us to investigate whether DNA sequence variants in the 5'-UTR of canine cbr1 impact the pharmacodynamics of anticancer anthracyclines in dogs.

Heterogeneous microscale dynamics in the martensitic phase transition of cobalt is investigated with real-time x-ray scattering. During the transformation of the high-temperature face-centered cubic phase to the low-temperature hexagonal close-packed phase, the structure factor evolution suggests that an initial rapid local transformation is followed by a slower period during which strain relaxes. Coherent x-ray scattering measurements performed during the latter part of the transformation show that the kinetics is dominated by discontinuous sudden changes-avalanches. The spatial size of observed avalanches varies widely, from 100 nm to 10 μm, the size of the x-ray beam. An empirical avalanche amplitude quantifies this behavior, exhibiting a power-law distribution. The avalanche rate decreases with inverse time since the onset of the transformation.

Bone mineral density (BMD) loss is a medical concern for individuals with spinal cord injury (SCI). Concerns related to osteoporosis have lead researchers to use various interventions to address BMD loss within this population. Whole body vibration (WBV) has been reported to improve BMD for postmenopausal women and suggested for SCI. The purpose of this case study was to identify the effects of WBV on BMD for an individual with SCI. There were three progressive phases (standing only, partial standing, and combined stand with vibration), each lasting 10 weeks. Using the least significant change calculation, significant positive changes in BMD were reported at the trunk (0.46 g/cm(2)) and spine (.093 g/cm(2)) for phase 3 only. Increases in leg lean tissue mass and reduction in total body fat were noted in all three phases.

Undesirable changes in health-related parameters are thought to occur in retiring female athletes, but this has not been examined in longitudinal studies. The purpose of this study was to examine longitudinal changes in bone mineral density (BMD), body composition, and dietary intake in gymnasts and controls. Nonathletic, college-age women (: n = 9) were selected as a control group for comparison to the gymnasts (n = 10). Initial BMDs for the gymnasts were determined by using dual energy X-ray absorptiometry (Lunar, DPX) at the beginning of their final competitive year. Initial BMDs for the controls were measured during a similar time-frame. Follow-up measurements were made at least 1-year after the initial measurement. Gymnasts had significantly greater BMD of the femoral neck (1.262 versus 1.058 g/cm2, respectively), Ward's triangle (1.230 versus 1.008 g/cm2), greater trochanter (1002 versus 0.822 g/cm2), and total body (1.232 versus 1.145 g/cm2) than controls while still competing (P < .05). Following retirement from competition, (mean years of retirement, 4 years), BMD of the gymnasts remained significantly greater than controls at total body, femoral neck, trochanter, and Ward's triangle (P < .05). Significant declines in femoral neck, Ward's triangle, and greater trochanter BMD were found in both gymnasts and controls (0.72% to 1.9% per year), but only gymnasts had a significant decline at the lumbar spine (0.87% per year). In conclusion, BMD changes in former gymnasts appear to be site-specific, and gymnasts continue to have greater proximal femur BMD than controls, despite their decreased exercise, which may help postpone or prevent osteoporosis later in life.

Objective: To examine the effects of 15 months of resistance training on bone mineral density (BMD) in female adolescents (aged 14 to 17 years)., Study Design: Participants were randomly assigned to either a training (n = 46) or control group (n = 21). BMD and body composition were measured by using dual-energy x-ray absorptiometry. Strength was assessed by means of one-repetition maximums for the leg press and bench press. The exercise group trained 30 to 45 minutes a day, 3 days per week, using 15 different resistance exercises. Control participants remained sedentary (<2 hours of exercise per week)., Results: Leg strength increased significantly (40%) in the exercise group, but there were no changes in the control group. Femoral neck BMD increased significantly in the training group (1.035 to 1.073 g/cm(2), P <.01) but not in the control group (1.034 to 1.048 g/cm(2)). No significant changes were seen in either group in lumbar spine BMD (1.113 to 1.142 g/cm(2) and 1.158 to 1.190 g/cm(2), respectively) or total body BMD (1.103 to 1.134 g/cm(2) and 1.111 to 1.129 g/cm(2), respectively)., Conclusion: Resistance training is a potential method for increasing bone density in adolescents, although such a program would be best done as part of the school curriculum.

Background: Telomerase is the enzyme that is responsible for maintaining telomere length in human germ cells, tumor cells, and immortalized cells. Its specific role in the immortilization process is unknown. This study was performed to determined whether the level of telomerase activity in human neuroblastoma cell lines correlated with their level of differentiation. We proposed that as neuroblastoma cells differentiated into more mature or benign cells, the levels of telomerase expression would decrease., Materials and Methods: Two human neuroblastoma cells lines, SK-N-AS and SK-N-DZ, were differentiated using retinoic acid. These cells were assayed for telomerase activity by the telomere repeat amplification protocol (TRAP) before, during, and after treatment with retinoic acid for 8 days. Untreated cells were used for control and were compared to the retinoic acid-treated cells. Differentiation of the cell lines was confirmed by assaying expression of ret mRNA using the reverse-transcriptase polymerase chain reaction (RT-PCR) and gel electrophoresis of the radiolabeled products., Results: No statistical difference in telomerase activity was noted between control and treated groups., Conclusions: While telomerase activity has been shown by others to correlate with tumor aggressiveness in human neuroblastoma cells, the mechanism that is involved appears to be separate from cellular differentiation.

An account is given of how a national diabetes care and education programme was developed in Ghana, a developing country, through international collaboration of medical schools, industry and government health care institutions. The approach is by way of trained diabetes teams consisting of physicians, dietitians and nurse educators at two tertiary institutional levels (teaching hospitals) who in turn trained teams consisting of physicians, dietitians or diettherapy nurses, nurse educators and pharmacists at regional and district/sub-regional levels to offer care and education to patients and the community. In three years all regional and about 63% of sub-regional/district health facilities had trained diabetes health care teams, run diabetes services and had diabetes registers at these institutions. Additionally a set of guidelines for diabetes care and education was produced. All programme objectives with the exception of one (deployment of diabetes kits) were met. Distances to be travelled by persons with diabetes to receive diabetes care had been reduced considerably. The success of the project has given an impetus to the collaborators to extend the programme to the primary health care level. The continuing prohibitive prices of diabetes medications and supplies however, could be addressed by removing taxes on such supplies. The Ghana diabetes care model, a 'top-down' approach, initially involving two diabetes centres is recommended to other developing countries, which intend to incorporate diabetes care and education into their health care system.

Good bone health is important to everyone, regardless of age. Osteoporosis is a preventable disease, and steps for increasing bone mass should begin at an early age. To increase bone mass, much of the recent evidence suggests that the best time for intervention with calcium or exercise may be during the prepubertal years. In the older female athlete, BMD is typically well above normal, but even young amenorrheic athletes can have bone density values equal to that of an elderly osteoporotic woman. Myriad treatment options are available for the person with low bone mass, but prevention is a much more preferable alternative.

Female athletes are under intense pressure to have a low percentage of body fat for performance, which may result in a vulnerable athlete resorting to disordered eating, developing amenorrhea, and suffering the consequences of osteoporosis. Prevention of disordered eating practices among female athletes requires a de-emphasis of a low percentage of body fat and a good nutrition education program. The female athlete triad is a serious syndrome that requires a multidisciplinary approach to diagnosis and treatment.

Objective: To assess the effect of screening glucose values and gestational diabetes mellitus (GDM) on birth weight in a community-based population of pregnant Hispanic women and infants in Detroit, Michigan., Methods: In a prospective cohort study of 372 mother-infant pairs, analysis of variance and multiple linear and logistic regression were used to examine the effects of maternal screening glucose and GDM status on mean birth weight and the risk of large for gestational age (LGA) and small for gestational age (SGA) births., Results: Screening glucose values of at least 135 mg/dL were found in 26.6% of the mothers and GDM in 5.1%. There was a significant relation between increasing maternal screening glucose level and adjusted mean birth weight (P < .005). As glucose level increased, there was a significant trend toward an increasing percentage of LGA infants and a decreasing percentage of SGA infants (Cochran-Armitage test for trend, P = .001 and P = .009, respectively). Among nondiabetic women, a 10-mg/dL increase in glucose value was associated with an adjusted 30.5-g increase in birth weight (standard error 9.0; P < .001), increased adjusted odds of LGA (adjusted odds ratio [OR] 1.17; 95% confidence interval [CI] 1.02, 1.34), and decreased adjusted odds of SGA (adjusted OR 0.69; 95% CI 0.52, 0.93)., Conclusion: Our findings showed a high prevalence of glucose abnormality and an independent effect of maternal glucose level on birth weight in our Hispanic population. Maternal glucose level should be included in studies of factors that affect birth weight, and appropriate prenatal care provided to Hispanic women with abnormal and borderline metabolic status.

In the fall of 1995, each of the five provincial hospitals in southern Ghana was visited and facilities and resources for diabetes care assessed. In addition, health facilities and standards of care questionnaires were completed. Only Korle Bu Teaching Hospital run a diabetes clinic and had diabetologists. Only two facilities had an eye specialist or trained dietician. None of the five facilities had a trained diabetes educator or chiropodist. Except for sphygmomanometers, basic equipment for clinical care were lacking. Basic biochemistry tests were available at all facilities. Creatinine clearance and 24-h urine protein, glycated haemoglobin, fasting triglyceride, total cholesterol and HDL cholesterol were available at only one centre. None of the facilities measured C-peptide, islet cell antibody and urine microalbumin. None of the facilities had chronic haemodialysis service. Insulin supply was erratic at two institutions. Three regions had active diabetes associations. The facilities and system of diabetes care in southern Ghana revealed in this study are far from satisfactory. Training of health care personnel in diabetes management and education may enhance diabetes care despite the existing constraints. Furthermore, the development of international and regional guidelines for facilities and resources may facilitate implementation of international resolutions and clinical practice guidelines.

Background: The purpose of this study was to determine if there were significant differences in lumbar bone mineral density (L2-L4, g/cm2) or several hormones among 3 groups of adolescent females: 10 amenorrheic runners, 10 eumenorrheic runners, and 10 eumenorrheic controls., Experimental Design: comparative., Setting: Cooper Clinic, Aerobics Center, Dallas, Texas., Patients or Participants: The subjects were white, non-smokers, aged 15.1-18.8 years, who were not taking birth control pills. All amenorrheic runners had less than 5 menstrual period in the past year, averaging 2,4 periods. The runners averaged approximately 36 miles/week (58.1 km) during the last 9 months of their training season and had been running for 1-5 years., Interventions: None., Measures: Lumbar bone mineral density (BMD), 10 hormones, percentage of body fat, and dietary intake were measured., Results: Mean lumbar BMD (g/cm2) did not differ significantly among groups (amenorrheic runners = 1.134, eumenorrheic runners = 1.165, controls = 1.148). However, expected trends were observed. Compared to the controls, the amenorrheic runners tended to have lower lumbar BMD and the eumenorrheic runners, higher. Although there were significant differences in concentrations of five serum hormones measured, all mean hormonal values were within normal ranges. Calcium intakes were low for all groups., Conclusions: In this study, with its small number of subjects and great variability within each group, it was concluded that there is no significant difference among amenorrheic runners, eumenorrheic runners, and controls in lumbar BMD. However, a longer period of amenorrhea might result in significantly lower BMD for the amenorrheic runners.

The purpose of this study was to determine if differences exist in premenopausal women between z-scores for lumbar spine and proximal femoral bone mineral densities (BMD). Participants were 237 women ranging in age from 20 to 45 years. BMDs of the lumbar spine and proximal femur (femoral neck, Ward's area, and trochanter) were assessed using dual-energy X-ray absorptiometry (Lunar DPX). Mean (+/-SD) age, height, and weight of the participants were 29.4 +/- 6.9 years, 164.4 +/- 6.1 cm, and 64.9 +/- 12.1 kg, respectively. Lumbar spine BMD and BMD at the femoral neck, Ward's area, and trochanter were significantly correlated with large SEEs (r = 0.59-0. 65; SEE = 0.09-0.11). No positive correlation with age and BMD at any site was seen in this population but a significant negative correlation with age was seen in the proximal femur beginning at age 30. Twenty to 24% of the 20-29-year-olds exhibited a difference in z-scores of greater than 1 between the spine and sites in the proximal femur. This percentage increased to 32-46% in the 30-45-year-olds but the nature of the observed differences changed. The differences in spine and proximal femoral z-scores that are seen in the older age group appear to be the result of the earlier onset of bone loss in the proximal femur rather than an initial difference in peak bone mass which has been maintained.

The purpose of this study was to determine if differences existed between right and left proximal femur bone mineral density (BMD) in a group of women. Participants for the study were 198 women ranging in age from 16 to 73 years. Bone mineral densities of both proximal femurs (femoral neck, Ward's area, and trochanter) were assessed using dual energy X-ray absorptiometry (Lunar DPX). Mean (+/-SD) age, height, and weight of the participants were 32.9 +/- 18 years, 164 +/- 7.4 cm, and 64.9 +/- 12.1 kg, respectively. Significant differences between right and left femoral BMDs were found only in the trochanter. Overall, mean differences in BMD were low (neck = 0. 7%, Ward's = 0.2%, and trochanter = 1.9%) but individual variations were as high as 22%. Based on BMD z-scores of <-1.0, 84 women were classified as "at risk" for osteoporosis. When right and left z-scores were compared, misclassifications of at risk women were 4, 15, and 11 for neck, Ward's area, and trochanter, respectively. In conclusion, analyses of both right and left proximal femurs may not be necessary for either the researcher or the clinician.

Sleepiness is a common perception during viral infection. Nevertheless, very little is known about the effects of viral infection on sleep. The aim of the present study was to test whether sleep was altered by influenza viral infection in mice. After 2-3 days of baseline sleep recordings, Swiss-Webster mice were infected intranasally with a lethal (H1N1) or a nonlethal (H3N2) strain of influenza virus. Sleep was recorded again for an additional 3 days. Non-rapid eye movement sleep (NREMS) was dramatically increased after inoculation of the H1N1 virus with a latency about 16 hr. Rapid eye movement sleep (REMS) was significantly suppressed after a long latency. Both changes lasted until the end of the recording and occurred in both young (35-day-old) and adult (90- to 100-day-old) animals. Control animals did not show changes in sleep after sham infection with allantoic fluid. The H1N1 virus also caused dramatic decreases in body temperature and locomotor activities with a latency about 4-5 hr after viral inoculation. The H3N2 virus induced very similar changes in sleep, although the effects were much smaller in magnitude than those induced by the H1N1 virus, even though a much higher dose (10-fold) of the H3N2 virus was used. The present study shows that influenza viral infection induces profound and long-lasting increase of NREMS and suppression of REMS. These viral-induced changes in sleep likely represent a host-defense response.

The associations of body fat distribution, sex hormone levels, and bone mineral density (BMD) were examined in 52 postmenopausal Caucasian women. Body fat distribution was assessed by waist to hip ratio (WHR) and abdominal fat weight (between the iliac crest and L1), as determined by dual energy x-ray absorptiometry. Bone mineral densities were determined by dual energy x-ray absorptiometry, and total estradiol, total testosterone, and sex hormone-binding globulin (SHBG) levels were determined by RIA. Subjects taking hormone replacement had significantly greater total estradiol and SHBG concentrations and a lower free androgen index. BMDs tended to be higher in subjects taking estrogen replacement after adjustment for body weight. There was no difference between subjects taking hormone replacement or not taking hormone replacement in WHR or abdominal fat weight. Subjects with a gynoid (lower body) distribution of body fat had higher SHBG concentrations than subjects with a more android (upper body) distribution of body fat. Subjects with an android distribution of body fat had greater BMDs than subjects with a gynoid distribution of body fat. Abdominal fat weight and WHR were significant predictors in regression models for all BMD parameters. The results of this study suggest that there is an association between body fat distribution and BMD, with the android distribution having higher BMDs.

The purpose of this study was to examine relationships between regional body composition and bone mineral density (BMD) in college females. Subjects were 12 nonathletic females (< 3 h.wk-1 of exercise) and 46 female varsity athletes: basketball (N = 14), volleyball (N = 13), gymnastics (N = 13), and tennis (N = 6). Dual energy x-ray absorptiometry was used to determine BMD and body composition. The mean (+/- SD) age, height, weight, and menarche for the subjects were 19.9 +/- 2.1 yr, 167.9 +/- 9.4 cm, 62.1 +/- 9.0 kg, and 13.6 +/- 1.7 yr, respectively. Mean lumbar (1.327 g.cm-2), femoral neck (1.172 g.cm-2), and total body (1.200 g.cm-2) BMD of the athletes were significantly greater than nonathletes (P < 0.05) but did not differ among the teams. Significant correlations were found between regional leg BMD and leg lean tissue mass (LTM) (r = 0.59, P < 0.001) and between arm LTM and arm and lumbar BMD (r = 0.47 and 0.56, respectively). Significant correlations were also found between leg fat mass and leg BMD (r = 0.40). However, only regional LTM was a significant predictor of BMD using stepwise multiple regression. In summary, regional LTM appears to be a better predictor of BMD than regional fat mass.

The purpose of this study was to examine the effect of 27 wk of gymnastics training on bone mineral density (BMD), body composition, insulin-like growth factor I (IGF-I), and osteocalcin. Subjects were 11 female intercollegiate gymnasts and 11 controls. Dual energy x-ray absorptiometry (Lunar DPX) was used to determine BMD (L2-L4 and femur) and to assess body composition. The gymnasts were significantly lower in weight (53.9 and 60.8 kg) and % body fat (22.6 and 30.6) compared with controls. After training, body weights of gymnasts remained the same but there was a significant increase in lean tissue mass of 2.9 kg (6.7%, P < 0.05). No changes in body composition were observed in the controls. The gymnasts had significantly higher mean lumbar (1.321 vs 1.225), and femoral neck (1.163 vs 1.079) BMD (g.cm-2) than the controls. Lumbar BMD increased significantly (1.3%) in gymnasts following training but femoral neck BMD did not increase. No BMD changes occurred in the control group. Regarding serum IGF-I, no differences were seen between the groups or across time. Serum osteocalcin values were significantly higher in the gymnasts than the controls, but no differences were found across time. In conclusion, gymnasts had significantly higher BMDs than controls, and a significant increase in lumbar BMD was seen in the gymnasts following 27 wk of training.

Objective: The purpose of this study was to evaluate human follicular fluid (FF) for the presence of cyclo(His-Pro)-like immunoreactivity (CHP-LI). After verifying its presence, we quantitated the levels and investigated correlations with other follicular parameters, including hormone levels., Methods: Follicular fluid was collected from female volunteers undergoing controlled ovarian hyperstimulation. Fluid was collected by follicular puncture, either transvaginally (in vitro fertilization) or laparoscopically (gamete intrafallopian transfer) at the time of oocyte retrieval (N = 137). Follicular size was determined ultrasonographically. Assays for steroid and peptide hormones were determined with commercially available radioimmunoassay kits. CHP-LI was measured using a previously reported assay; parallel dilution curves and column chromatography aided in immunoidentity., Results: The mean FF CHP-LI concentration (13.10 +/- 1.83 nmol/L, N = 137) was greater than the corresponding serum values (9.42 +/- 2.45 nmol/L; N = 21) (P < .05). Large follicles (20 mm or greater; 14.45 +/- 1.74 nmol/L) contained significantly more CHP-LI than either medium follicles (16-19 mm; 11.51 +/- 1.88 nmol/L) or small follicles (15 mm or smaller; 10.83 +/- 2.12 nmol/L) (P < .05). Positive correlations were found between FF CHP-LI values and corresponding FF progesterone and prolactin concentrations (r = 0.67 and 0.62, respectively; P < .05)., Conclusion: Mean CHP-LI levels in the FF are greater than those in the corresponding serum. We suggest that the neuropeptide may be originating from either peptidase cleavage of precursor peptides or from granulosa cell production.

Body size, body composition, and physiology are basically similar in boys and girls before puberty. The adolescent growth spurt and puberty mark the period in life when sex differentiation and development begin. Peak height velocity for girls ranges from 10.5 to 13 years and for boys, 12.5 to 15 years. Peak weight velocity and menarche occur approximately 6 months and 1 year, respectively, after the height peak. On average, women have a larger surface area-to-mass ratio; lower bone mass; and wider, shallower pelvis compared with men. The implication of these characteristics is that women may have an advantage in dry heat, are more at risk for osteoporosis, and may be predisposed to experiencing knee problems. Overall, adult women have more body fat, less lean muscle mass, a gynoidal fat distribution, a lower resting metabolic rate, lower red blood cell mass, and lower hemoglobin and hematocrit compared with adult men. The difference in muscle strength between trained women and men can be explained by muscle mass size and not to differences in muscle fiber type or muscle adaptation. The lower resting metabolic rate is not related to gender per se, but to the fact that muscle mass is more metabolically active compared with fat. The lower VO2max in female athletes is explained primarily by differences in body composition and oxygen transport system between the sexes. A major problem occurring among female athletes is the misuse of prescribing low body fat for appearance and performance. The outcome is an athlete who appears to be in a negative caloric balance, and who is deficient in key nutrients. The consequences could result in the following cascading problems: disordered eating, iron deficiency anemia, amenorrhea, premature osteoporosis, and injuries.

We hypothesized that menstrual disturbances in female athletes arise from opioid-induced abnormalities in gonadotropin and/or prolactin (PRL) secretion. To investigate this hypothesis, we measured luteinizing hormone, follicle-stimulating hormone, and PRL levels in eumenorrheic and amenorrheic athletes during thyrotropin-releasing hormone and gonadotropin-releasing hormone tests at baseline, after naloxone infusions, after exercise to exhaustion, and after similar exercise during naloxone infusions. Contrary to our hypothesis, amenorrheic runners did not have significant alterations in basal, postexercise, or stimulated hormone levels compared with eumenorrheic runners. In addition, opioid blockade by naloxone did not enhance gonadotropin release by amenorrheic athletes.

Cyclic guanosine 3' ,5'-monophosphate(cyclic GMP) levels were increased in incubated tissue slices from rat cerebral cortex in response to added cholinomimetic agents (carbachol and choline chloride) and neuroleptic compounds (chlorpromazine, 8-hydroxychlorpromazine, 7-hydroxychlorpromazine methiodide, haloperidol, thioridazine, chlorpromazine sulfoxide and promethazine). Calcium ion was required for this effect. Moreover, selected agents namely, 7,8-dihydroxychlorpromazine, 7,8-dimethoxychlorpromazine, chlorpromazine and clozapine prevented the rise in cyclic GMP induced by carbachol.

The most commonly tested hypothetical cause of athletic amenorrhea has been low body fat. Test results have conflicted because of mixed groups of athletes and methodologic problems. In this study, we measured body fat only in distance runners (greater than 53 km X wk-1) of the same somatotype who clearly had regular menses or secondary amenorrhea; this permitted more valid group comparison of body fat using hydrostatic weighing. The regularly menstruating group (N = 7) had 12 periods X yr-1 at intervals of 26.5 +/- 1.0 (SE) days with a duration of 4.1 +/- 0.4 days. In the athletic amenorrhea group (N = 7), menstrual periods had been absent for 1 to 10 yr (average = 3.9 +/- 1.3 yr); they were gynecologically evaluated to restrict the group to those with athletic amenorrhea. The groups were similar in a number of categories: weight, height, age, menarcheal age, weekly training mileage, days/week training, years of training, and maximum oxygen uptake. Percent body fat for the two groups was the same: 17.7 +/- 2.1% for the amenorrheic athletes and 17.4 +/- 1.2% for the regularly menstruating athletes (P = 0.91). These data do not support the idea that low body fat per se causes athletic amenorrhea.

Ovarian tissue from immature rats treated with pregnant mare serum gonadotrophin (PMSG) or PMSG and human chorionic gonadotrophin was incubated in Medium 199. Stimulation of the formation of cyclic AMP in follicular and luteal tissue by terbutaline (10(-5) mol/l), a selective beta 2-agonist, was blocked by butoxamine (10(-5) mol/l), a selective beta 2-antagonist, whereas practolol (10(-5) mol/l), a selective beta 1-antagonist, was ineffective. Propranolol (10(-5) mol/l) a non-selective beta-antagonist, butoxamine nor practolol affected the increase in cyclic AMP promoted by the addition of 1 microgram LH. Stimulation of the production of progesterone in both follicular and luteal tissue by terbutaline was blocked by butoxamine, but not by practolol. These findings indicated that beta-adrenergic stimulation of ovarian cyclic AMP and progesterone is mediated by beta 2-adrenergic receptors.

While studying amenorrheic runners, the authors became aware of psychiatric differences between them. Psychiatric interviews of 13 amenorrheic and 19 regularly menstruating runners revealed that of the amenorrheic runners, 11 reported major affective disorders in themselves or in first- and second-degree relatives and eight reported eating disorders in themselves. Among the regularly menstruating runners, however, there were no eating disorders or major affective disorders, and only one had first-degree relatives with major affective disorders. These data suggest a link between athletic amenorrhea in runners, major affective disorders, and eating disorders.

We randomly assigned 42 subjects for treatment with transcutaneous electrical nerve stimulation (TENS) to one of three groups: conventional TENS--80 Hz; low frequency TENS--2 Hz; and a control group--TENS without batteries. Pain threshold measurements and blood beta-endorphin levels were obtained at regular intervals before, during, and for 17 hours after TENS application. We found no significant difference in blood beta-endorphin levels between the groups before, during, or immediately after TENS application. The differences in pain threshold and beta-endorphin levels appeared to be a function of the patient-selection process and not the application of TENS. The results indicated that TENS, with the stimulation characteristics used in this study, did not significantly change the measured plasma levels of beta-endorphin. The blind administration of naloxone hydrochloride, an opiate antagonist, did not significantly alter the perceived experimental pain of these subjects. We could find no evidence that TENS altered experimental pain threshold or plasma beta-endorphin levels.