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Background: Anthropometric data quality in large multicentre nutrition surveys is seldom adequately assessed. In preparation for the South African National Dietary Intake Survey (NDIS-2022), this study assessed site leads' and fieldworkers' intra- and inter-rater reliability for measuring weight, length/height, mid-upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC). Methods: Standardised training materials and measurement protocols were developed, and new anthropometric equipment was procured. Following two training rounds (12 site lead teams, 46 fieldworker teams), measurement reliability was assessed for both groups, using repeated measurements of volunteers similar to the survey target population. Reliability was statistically assessed using the technical error of measurement (TEM), relative TEM (%TEM), intra-class correlation coefficient (ICC) and coefficient of reliability (R). Agreement was visualised with Bland-Altman analysis. Results: By %TEM, the best reliability was achieved for weight (%TEM = 0.260–0.923) and length/height (%TEM = 0.434–0.855), and the poorest for MUAC by fieldworkers (%TEM = 2.592–3.199) and WC (%TEM = 2.353–2.945). Whole-sample ICC and R were excellent (> 0.90) for all parameters except site leads' CC inter-rater reliability (ICC = 0.896, R = 0.889) and fieldworkers' inter-rater reliability for MUAC in children under two (ICC = 0.851, R = 0.881). Bland-Altman analysis revealed no significant bias except in fieldworkers' intra-rater reliability of length/height measurement in adolescents/adults (+ 0.220 (0.042, 0.400) cm). Reliability was higher for site leads vs. fieldworkers, for intra-rater vs. inter-rater assessment, and for weight and length/height vs. circumference measurements. Conclusion: NDIS-2022 site leads and fieldworkers displayed acceptable reliability in performing anthropometric measurements, highlighting the importance of intensive training and standardised measurement protocols. Ongoing reliability assessment during data collection is recommended. [ABSTRACT FROM AUTHOR]

Background: Accurate assessment of body composition during infancy is an important marker of early growth. This study aimed to develop anthropometric models to predict body composition in 3–24-month-old infants from diverse socioeconomic settings and ethnic groups. Methods: An observational, longitudinal, prospective, multi-country study of infants from 3 to 24 months with body composition assessed at three monthly intervals using deuterium dilution (DD) and anthropometry. Linear mixed modelling was utilized to generate sex-specific fat mass (FM) and fat-free mass (FFM) prediction equations, using length(m), weight-for-length (kg/m), triceps and subscapular skinfolds and South Asian ethnicity as variables. The study sample consisted of 1896 (942 measurements from 310 girls) training data sets, 941 (441 measurements from 154 girls) validation data sets of 3–24 months from Brazil, Pakistan, South Africa and Sri Lanka. The external validation group (test) comprised 349 measurements from 250 (185 from 124 girls) infants 3–6 months of age from South Africa, Australia and India. Results: Sex-specific equations for three age categories (3–9 months; 10–18 months; 19–24 months) were developed, validated on same population and externally validated. Root mean squared error (RMSE) was similar between training, validation and test data for assessment of FM and FFM in boys and in girls. RMSPE and mean absolute percentage error (MAPE) were higher in validation compared to test data for predicting FM, however, in the assessment of FFM, both measures were lower in validation data. RMSE for test data from South Africa (M/F−0.46/0.45 kg) showed good agreement with validation data for assessment of FFM compared to Australia (M/F−0.51/0.33 kg) and India(M/F−0.77/0.80 kg). Conclusions: Anthropometry-based FFM prediction equations provide acceptable results. Assessments based on equations developed on similar populations are more applicable than those developed from a different population. [ABSTRACT FROM AUTHOR]

Background: Given the importance of infancy for establishing growth trajectories, with later-life health consequences, we investigated longitudinal body composition among infants from six economically and ethnically diverse countries. Methods: We recruited mother-infant dyads using the WHO Multicenter Growth Reference Study criteria. We measured fat-free mass (FFM) in 1393 (49% female) infants from birth to 6 months of age (Australia, India, and South Africa; n = 468), 3–24 months of age (Brazil, Pakistan, South Africa, and Sri Lanka; n = 925), and derived fat mass (FM), fat mass index (FMI), and fat-free mass index (FFMI). Height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length (WHZ) Z-scores were computed. Sex differences were assessed using a t-test, and country differences using a one-way analysis of covariance. We further compared subsamples of children with average (−0.25 > HAZ < +0.25), below-average (≤−0.25) and above-average (≥+0.25) HAZ. Results: HAZ performed well between 0 and 6 months, but less so between 3 and 24 months. The stunting prevalence peaked at 10.3% for boys and 7.8% for girls, at 24 months. By 24 months, girls had greater FMI (10%) than boys. There were significant differences in FFM (both sexes in all countries) and FM (Brazilian boys, Pakistani and South African girls) by 24 months of age between infants with average, above-average, and below-average HAZ. Conclusion: In a multi-country sample representing more ideal maternal conditions, body composition was heterogeneous even among infants who exhibited ideal length. Having a mean HAZ close to the median of the WHO standard for length reduced FFM between-country heterogeneity but not FM, suggesting that other factors may influence adiposity. [ABSTRACT FROM AUTHOR]

Introduction: Given the increasing incidence of chronic degenerative diseases related to changes in tissues, the availability of diagnostic tools with greater accuracy in the estimation of body composition (BC) has become necessary. Interpreting the BC values of individuals requires reference data obtained from a healthy population with the same ethnicity, to identify individuals at risk for the development of negative health outcomes. Objective: Generate reference values (RV) of body composition (BC) for Mexican children and adolescents. Methods: This was an urban-population-based cross-sectional study of healthy Mexican children and adolescents. BC estimations by anthropometry, multifrequency bioimpedance analysis (MF-BIA) and dual-energy X-ray absorptiometry (DXA) where used to create sex- and age-specific RV by means of generalized additive models for location, scale and shape (GAMLSS). Results: We assessed 2104 subjects, and after confirming a clinically and metabolically healthy status, we measured 1659 subjects aged 5–20 years, [806 females (49%) and 853 males (51%)] by anthropometry, MF-BIA and DXA to create sex- and age- smoothed reference centiles, lambda (L), mu (M), and sigma (S) values. We also built sex- and age-smoothed graphic curves for each variable of interest. Conclusions: We present valid RV and curves for BC variables estimated by anthropometry, MF-BIA and DXA from clinically and metabolically healthy urban Mexican children and adolescents. These RV are different from those reported for other populations, and therefore, should be used for clinical and research purposes involving urban Mexican children and adolescents. [ABSTRACT FROM AUTHOR]

Providing all infants with the best start to life is a universal but challenging goal for the global community. Historically, the size and shape of infants, quantified by anthropometry and commencing with birthweight, has been the common yardstick for physical growth and development. Anthropometry has long been considered a proxy for nutritional status during infancy when, under ideal circumstances, changes in size and shape are most rapid. Developed from data collected in the Multicentre Growth Reference Study (MGRS), WHO Child Growth Standards for healthy infants and children have been widely accepted and progressively adopted. In contrast, and somewhat surprisingly, much less is understood about the 'quality' of growth as reflected by body composition during infancy. Recent advances in body composition assessment, including the more widespread use of air displacement plethysmography (ADP) across the first months of life, have contributed to a progressive increase in our knowledge and understanding of growth and development. Along with stable isotope approaches, most commonly the deuterium dilution (DD) technique, the criterion measure of total body water (TBW), our ability to quantify lean and fat tissue using a two-compartment model, has been greatly enhanced. However, until now, global reference charts for the body composition of healthy infants have been lacking. This paper details some of the historical challenges associated with the assessment of body composition across the first two years of life, and references the logical next steps in growth assessments, including reference charts. [ABSTRACT FROM AUTHOR]

Background/Objective: Available evidence on infant body composition is limited. This study aimed to investigate factors associated with body composition at 6 and 24 months. Subjects/Methods: Multicenter study with data from a 0 to 6-mo cohort (Australia, India and South Africa) and a 3 to 24-mo cohort (Brazil, Pakistan, South Africa, and Sri Lanka). For the 0–6-mo cohort, body composition was assessed by air-displacement plethysmography (ADP) and for the 3–24-month cohort by the deuterium dilution (DD) technique. Fat mass (FM), fat-free mass (FFM), FM index (FMI), and FFM index (FFMI) were calculated. Independent variables comprised the Gini index of the country, maternal and infant characteristics, and breastfeeding pattern at 3 months. For the 3–24-mo cohort, breastfeeding, and minimum dietary diversity (MDD) at 12 months were also included. Crude and adjusted analyses stratified by sex were conducted by multilevel modelling using mixed models. Results: At 6 months, every 1 kg increase in birth weight was associated with an increase of 0.716 kg in FFM and 0.582 kg/m2 in FFMI in girls, whereas in boys, the increase was of 0.277 kg in FFM. At 24 months, compared to those weaned before 12 months, girls still breastfed at 12 months presented a decrease of 0.225 kg in FM, 0.645 kg in FFM and 0.459 kg/m2 in FFMI, and in boys the decreases were of 0.467 kg in FM, 0.603 kg in FFM and 0.628 kg/m2 in FFMI. Conclusion: Birth weight and breastfeeding are independent predictors of body composition in early life, irrespective of sex. [ABSTRACT FROM AUTHOR]

Background: Roux-en-Y (RYGB) and one anastomosis gastric bypass (OAGB) represent two of the most used bariatric/metabolic surgery (BMS) procedures. Gut microbiota (GM) shift after bypass surgeries, currently understated, may be a possible key driver for the short- and long-term outcomes. Methods: Prospective, multicenter study enrolling patients with severe obesity, randomized between OAGB or RYGB. Fecal and blood samples were collected, pre- (T0) and 24 months postoperatively (T1). GM was determined by V3-V4 16S rRNA regions sequencing and home-made bioinformatic pipeline based on Qiime2 plugin and R packages. Objects: To compare OAGB vs RYGB microbiota profile at T1 and its impact on metabolic and nutritional status. Results: 54 patients completed the study, 27 for each procedure. An overall significant variation was detected in anthropometric and serum nutritional parameters at T1, with a significant, similar decrease in overall microbial alpha and beta diversity observed in both groups. An increase in relative abundances of Actinobacteria and Proteobacteria and a reduction of Bacteroidetes, no significant changes in Firmicutes and Verrucomicrobia, with an increase of the Firmicutes/Bacteroidetes ratio were observed. Conclusions: BMS promotes a dramatic change in GM composition. This is the first multicenter, RCT evaluating the impact of OAGB vs Roux-en-Y bypass on GM profile. The bypass technique per se did not impact differently on GM or other examined metabolic parameters. The emergence of slightly different GM profile postoperatively may be related to clinical conditions or may influence medium or long-term outcomes and as such GM profile may represent a biomarker for bariatric surgery's outcomes. [ABSTRACT FROM AUTHOR]

Background: Children with overweight and obesity are at risk for developing chronic kidney disease (CKD). During lifestyle adjustment, the first step in the treatment of childhood obesity, body proportions are likely to change. The aim of this study was to examine how lifestyle intervention affects creatinine-based kidney function estimation in children with overweight and obesity. Methods: This longitudinal lifestyle intervention study included 614 children with overweight and obesity (mean age 12.17 ± 3.28 years, 53.6% female, mean BMI z-score 3.32 ± 0.75). Loss to follow-up was present: 305, 146, 70, 26, and 10 children were included after 1, 2, 3, 4, and 5 (about yearly) follow-up visits, respectively. Serum creatinine (SCr) was rescaled using Q-age and Q-height polynomials. Results: At baseline, 95–97% of the children had a SCr/Q-height and SCr/Q-age in the normal reference range [0.67–1.33]. SCr/Q significantly increased each (about yearly) follow-up visit, and linear mixed regression analyses demonstrated slopes between 0.01 and 0.04 (corresponding with eGFR FAS reduction of 1.1–4.1 mL/min/1.73 m2) per visit. BMI z-score reduced in both sexes and this reduction was significantly higher in males. No correlation between change in rescaled SCr and BMI z-score reduction could be demonstrated. Conclusions: Rescaled serum creatinine (SCr/Q) slightly increases during multidiscipline lifestyle intervention in this cohort of children with overweight and obesity. This effect seems to be independent from change in BMI z-score. Whether this minor decrease in estimated kidney function has clinical consequences in the long term remains to be seen in trials with a longer follow-up period. Clinical Trial registration: ClinicalTrial.gov; Registration Number: NCT02091544. [ABSTRACT FROM AUTHOR]

Accurate assessment of body composition is essential for evaluating the risk of chronic disease. 3D body shape, obtainable using smartphones, correlates strongly with body composition. We present a novel method that fits a 3D body mesh to a dual-energy X-ray absorptiometry (DXA) silhouette (emulating a single photograph) paired with anthropometric traits, and apply it to the multi-phase Fenland study comprising 12,435 adults. Using baseline data, we derive models predicting total and regional body composition metrics from these meshes. In Fenland follow-up data, all metrics were predicted with high correlations (r > 0.86). We also evaluate a smartphone app which reconstructs a 3D mesh from phone images to predict body composition metrics; this analysis also showed strong correlations (r > 0.84) for all metrics. The 3D body shape approach is a valid alternative to medical imaging that could offer accessible health parameters for monitoring the efficacy of lifestyle intervention programmes. [ABSTRACT FROM AUTHOR]

Accurate sex estimation is crucial for comprehensive analysis of the biological profiles of unidentified human skeletal remains. However, there is a notable lack of research specifically addressing the morphometrics of the hard palate. Therefore, this study aimed to derive discriminant equations using the hard palate and assess their applicability for sexing partial skeletal remains in a contemporary Korean population. Statistical analyses were performed for 24 measurements derived from three-dimensional models of the hard palate, generated using computed tomography scans of 301 individuals (156 males, 145 females). Descriptive statistics revealed significant sexual dimorphism in the mean comparison of hard palate sizes between Korean males and females, with males exhibiting larger palates across all measurements (p < 0.05). Discriminant function score equations were generated to aid in sex determination. Univariate analysis yielded an accuracy range of 57.8–75.1%, whereas the stepwise method achieved an accuracy of 80.7% with five selected variables: IF-PNS, GFL-GFR, IF-GFR, Pr-EcL, and Pr-EnR. The results of this metric analysis demonstrate the usefulness of the hard palate for sex estimation in the contemporary Korean population. These findings have potential implications for forensic investigations, archeological studies, and population-specific anatomical research. [ABSTRACT FROM AUTHOR]

Purpose: Our study aimed to explore the efficacy of Bifidobacterium breve 207-1 on specific neurotransmitters and hormones and the ability to regulate lifestyle behaviors in healthy adults. Methods: In total, 120 healthy adults with high mental stress, overweight, insomnia, and constipation were randomly assigned to receive low-dose B. breve 207-1 (LD, n = 40), high-dose B. breve 207-1 (HD, n = 40), or placebo (n = 40) for 28 days. Fecal and blood samples were collected and questionnaires were answered before and after the trial. Neurotransmitters and serum hormones were detected using enzyme-linked immunosorbent assay. The gut microbiota composition was assessed using 16 S rRNA sequencing. Short–chain fatty acids (SCFAs) concentrations were determined via gas chromatography–mass spectrometry (GC–MS). Results: The primary outcome of our study was changes in mental wellness, including neurotransmitters, the hypothalamic–pituitary–adrena (HPA) axis hormones, and the psychological scales. The results showed that γ-aminobutyric acid (GABA) increased significantly and the HPA axis hormones were suppressed overall in the probiotic groups while 5-hydroxytryptamine (5-HT) did not change significantly. However, there was no significant change in mood scale scores. The secondary outcome focused on the ability of 207-1 to regulate the body and lifestyle of healthy adults (e.g., sleep, diet, exercise, etc.). The PSQI scores in the probiotics groups significantly decreased, indicating improved sleep quality. Meanwhile, the probiotic groups had a slight increase in exercise consumption while dietary intake stabilized. By physical examination, the participants showed weight loss although no statistically significant difference was observed between the groups. Then, validated by gut microbiota, changes in the gut microbiota were observed under the effective intervention of 207-1 while short-chain fatty acids (SCFAs) increased in the LD group, particularly acetic and propionic acids. There was a slight decrease in alpha–diversity in the HD group. Conclusion: Bifidobacterium breve 207-1 entered the organism and affected neurotransmitter and the HPA axis hormone levels via the microbiome-gut-brain axis. Meanwhile, 207-1 supplementation improved daily lifestyle behaviors in healthy adults, which may in turn lead to changes in their bodies (e.g. weight and lipid metabolism). However, this study did not find significant mood-modulating efficacy. The mechanism of the overall study is unclear, but we hypothesize that SCFAs may be the key pathway, and more experiments are needed for validation in the future. Trial registration: This trial was retrospectively registered in the Chinese Clinical Trial Registry under the accession number ChiCTR2300069453 on March 16, 2023. [ABSTRACT FROM AUTHOR]

Purpose: To describe adherence to sustainable healthy diets among a sample of 958 Chilean pre-schoolers (3–6 years) and explore associations between adherence and child and maternal sociodemographic and anthropometric characteristics. Methods: Children's adherence to sustainable healthy diets was calculated from single multiple-pass 24-h dietary recalls using the Planetary Health Diet Index for children and adolescents (PHDI-C). Higher PHDI-C scores (max score = 150 points) represent greater adherence. Adjusted linear regression models were fitted to explore associations between PHDI-C scores and child and maternal characteristics. Results: Children obtained low total PHDI-C scores (median 50.0 [IQR 39.5–59.8] points). This resulted from low consumption of nuts & peanuts, legumes, vegetables, whole cereals, and vegetable oils; a lack of balance between dark green and red & orange vegetables, inadequate consumption of tubers & potatoes and eggs & white meats, and excess consumption of dairy products, palm oil, red meats, and added sugars. Mean PHDI-C total score was significantly higher (50.6 [95%CI 49.6, 51.7] vs 47.3 [95%CI 45.0, 49.5]) among children whose mothers were ≥ 25 years compared to those with younger mothers. Positive associations were observed between scores for fruits and maternal education, vegetables and maternal age, added sugars and child weight status, while negative associations were observed between fruits and child age, and vegetable oils and maternal education. Scores for dairy products PHDI-C component were lower among girls. Conclusion: Adherence to sustainable healthy diets was low among this sample of Chilean children and was significantly associated with maternal age, being lower among children whose mothers were younger. [ABSTRACT FROM AUTHOR]

Introduction: Dysphagia after anti-reflux surgery (ARS) is one of the most common indications for re-operative anti-reflux surgery and a leading cause of patient dissatisfaction. Unfortunately, the factors affecting its development are poorly understood. We investigated the correlation between pre-operative manometric and the intra-operative impedance planimetry (EndoFLIP™) measurements and development of post-operative dysphagia. Methods: A review of patients who underwent index robotic ARS in our institution. Patients who underwent pre-operative manometry and intra-operative EndoFLIP™ were included in our study. Dysphagia was assessed pre-operatively and at 3-month after surgery. Results: Fifty-five patients (26.9%) reported post-operative dysphagia, and 34 (16.6%) reported new or worsening dysphagia. On pre-operative manometry, patients with post-operative dysphagia had a lower distal contractile integral [868.7 (IQR 402.2–1447) mmHg s cm vs 1207 (IQR 612.1–2111) mmHg s cm, p = 0.006) and lower esophageal sphincter (LES) pressure [14.7 IQR (8.9–23.6) mmHg vs 20.7 IQR (10.2–32.6) mmHg, p = 0.01] compared to those without post-operative dysphagia. They were also found to have higher pre-operative cross-sectional surface area (CSA) [83 IQR (44.5–112) mm2 vs 66 IQR (42–93) mm2, p = 0.02], and distensibility index (DI) [4.2 IQR (2.2–5.5) mm2/mmHg vs 2.9 IQR (1.6–4.6) mm2/mmHg, p = 0.003] compared to patients without post-operative dysphagia. Additionally, the decrease in CSA [− 34 (− 18.5, − 74.5) mm2 vs − 26.5 (− 10.5, − 53.7) mm2, p = 0.03] and DI [− 2.3 (− 1.2, − 3.7) mm2/mmHg vs − 1.6 (− 0.7, − 3.3) mm2/mmHg, p = 0.03] measurements were greater in patients with post-operative dysphagia. Conclusion: Patients who developed dysphagia post-operatively had poorer pre-operative motility and a greater change in LES characteristics intra-operatively. This finding suggests the utility of pre-operative manometry and intra-operative EndoFLIP in identifying patients at risk of developing dysphagia post-operatively. [ABSTRACT FROM AUTHOR]

Introduction: Anorexia nervosa (AN) in older adult women is primarily described through reviews or case reports focusing on psychiatric traits, with no comprehensive studies evaluating their complete nutritional and hormonal profiles. This study aimed to describe a group of women with anorexia nervosa aged above 35 years old (AN35), and compare them with young women with anorexia nervosa (ANY) and normal-weight control participants. Method: Anthropometric, metabolic, nutritional, and psychiatric parameters were collected and compared among three groups of women: 50 AN35, 37 ANY, and 38 controls. Results: AN35 exhibited a mean disease duration of 271 ± 19 months, with 94% chronic forms and 58% restrictive types. Despite having similar BMI as ANY, AN35 displayed more altered parameters, including higher liver enzymes (p = 0.007), free T3 (p = 0.0046) and leptin (p < 0.0001); and lower albumin (p = 0.0029), and white cells (p < 0.0001). AN35 showed significant heterogeneity in hormonal adaptation, such as free T3. Half of the patients aged above 51 years revealed high gonadotropin levels despite being undernourished. Additionally, AN35 groups presented with 50% of bones fractures, decreased T-scores under -2.5 (p < 0.0001 for femoral), and altered micro architectural HRPQT parameters compared to ANY. Conclusion: Anorexia nervosa in older adult women is predominantly chronic. Nutritional parameters changes with age suggests a significant heterogeneity and possible adaptation of energy balance and bodyweight set point for others. Complications may be severe, altering the quality of life, and sometimes potentially lethal. These findings highlight the potential adaptation of energy balance with age, and should assist clinicians in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Recently, there has been a growing interest in exploring AI-driven chatbots, such as ChatGPT, as a resource for disease management and education. Objective: The study aims to evaluate ChatGPT's accuracy and quality/clarity in providing nutritional management for Type 2 Diabetes (T2DM), the Metabolic syndrome (MetS) and its components, in accordance with the Academy of Nutrition and Dietetics' guidelines. Methods: Three nutrition management-related domains were considered: (1) Dietary management, (2) Nutrition care process (NCP) and (3) Menu planning (1500 kcal). A total of 63 prompts were used. Two experienced dietitians evaluated the chatbot output's concordance with the guidelines. Results: Both dietitians provided similar assessments for most conditions examined in the study. Gaps in the ChatGPT-derived outputs were identified and included weight loss recommendations, energy deficit, anthropometric assessment, specific nutrients of concern and the adoption of specific dietary interventions. Gaps in physical activity recommendations were also observed, highlighting ChatGPT's limitations in providing holistic lifestyle interventions. Within the NCP, the generated output provided incomplete examples of diagnostic documentation statements and had significant gaps in the monitoring and evaluation step. In the 1500 kcal one-day menus, the amounts of carbohydrates, fat, vitamin D and calcium were discordant with dietary recommendations. Regarding clarity, dietitians rated the output as either good or excellent. Conclusion: Although ChatGPT is an increasingly available resource for practitioners, users are encouraged to consider the gaps identified in this study in the dietary management of T2DM and the MetS. [ABSTRACT FROM AUTHOR]

Craniofacial anthropometry is important for identity, diagnosis of congenital anomalies etc. The incidence of craniofacial abnormalities is high in the Southeast Asian region. The population of Meghalaya differs in features from other states of Northeast India and the neighbouring East Asia. The objective was to study the craniofacial anthropometric features of the ethnic adults in the Meghalaya state of Northeast India. This cross-sectional study was conducted from 2022 to 2023 in the ENT OPD. OPD patients of Meghalayan ethnicity were included in the study. Head length (HL), head breadth (HB), Cephalic index (CI), intercanthal distance (ICD), lateral canthal distance (LCD) and ear length (EL) were measured. A total of 104 adults were included. The majority of the individuals belonged to the Khasi community 51 (49%) followed by the Garo community 27 (26%) and the Jaintia community 26 (25%). The mean ± S.D age of the total sample population was 29.5 ± 8.4 years. The mean CI of the total sample population was 79.13 (mesocephalic). No statistically significant difference was noted between male-female CI in the total and subpopulation groups. In our study, the common head types were dolichocephalic (29%), brachycephalic (29%), mesocephalic (21%), hyperbrachycephalic (16%) and ultrabrachycephalic (5%). A statistically significant difference was noted between Khasi and Jaintia in HL, HW, CI, LCD; between Khasi and Garo in HL, ICD, LCD and between Garo and Jaintia in HW, CI, ICD. We believe our conventional craniofacial anthropometry data could add to the pool of regional anthropometry data and be used for future scientific purposes like anthropology, maxillofacial surgeries, designing helmets, forensic analysis, and gender differentiation. [ABSTRACT FROM AUTHOR]

Summary: We wanted to determine if there are any associations between birth factors and adult fracture risk. For women only, shorter birth length was associated with lower relative fracture risk. For women and men, individuals who were long at birth as well as tall in adulthood had a substantially higher relative fracture risk. Purpose: We aimed to examine associations between birth anthropometry and adult fracture risk and to investigate if developmental mismatch is associated with fracture risk. Methods: We included 4635 participants (476 women and 4159 men; born 1921–1950) with hospital and national registry-based data on birth anthropometry and adult fractures (≥ 50 years). We tested associations by Cox proportional hazards regressions and present hazard ratios (HR) with 95% confidence intervals. Results: In total, 1215 (26%) suffered ≥ 1 fracture during a mean observation period of 26 years. In women, unadjusted analyses indicated that both higher birth weight (HR 1.42 per kg (1.10–1.84)) and birth length (1.10 per cm (1.05–1.17)) were associated to higher adult fracture risk. After adjustment (year of birth and gestational age), statistical significance remained only for birth length, HR 1.10 per cm (1.04–1.17). For men, no associations were apparent. We found no associations between developmental mismatch (lower birth weight followed by higher adult weight) and adult fracture risk. However, for both sexes, being born tall and staying tall into adulthood was associated with a markedly higher (55–105%) relative fracture risk (HR women 2.09 (1.18–3.68), men 1.55 (1.19–2.03)) compared to being born short and remaining short in adulthood. Conclusion: In this study, being born shorter and lighter was associated with a lower risk for fractures ≥ 50 years in women. However, analyses indicated that tall adults who were also long at birth may be at markedly higher risk of fractures; this warrants further examinations. [ABSTRACT FROM AUTHOR]

In hospitalized children, height should be measured. When world health organization (WHO) height measurement gold standards is impossible, the ideal height estimation technique is still unclear. We conducted an international prospective study in eight different pediatric intensive care units to assess the accuracy, precision, practicability, safety, and inter-rater reliability of 12 different height estimation techniques, based on body segment measurement extrapolation, or other calculations using previous or projected heights. All extrapolation techniques were performed on each child, and later compared to their WHO gold standard heights. A total of 476 patients were enrolled. In the < 2-year subgroup, board length use and growth chart extrapolation performed best. In the ≥ 2-year subgroup, growth chart extrapolation and parents' report were the most accurate, followed by height measurement alongside the body with a tape measure. In both groups, body segment extrapolations were poorly predictive and showed mean bias and limits of agreement that varied a lot with age. Most body segment-based techniques presented with frequent measurement difficulties, but children's safety was rarely compromised. The inter-rater reliability of body segment measurement was low in the < 2-year subgroup. Conclusions: To accurately estimate height in hospitalized children, health care professionals should integrate the accuracy, precision, practicability, and reliability of each measurement technique to select the most appropriate one. Body segment-based techniques were the least accurate and should probably not be used. Simple techniques like growth chart extrapolation, or measurement alongside the body (and length board measurement in the youngest) should be implemented in daily practice. Trial Registration: The study protocol was registered (12th April 2019) on the clinical-trial.gov website (NCT03913247). What is Known: • Height should be measured in hospitalized children to assess nutritional status and calculate various clinical parameters. • Many hospitalized children cannot be measured using WHO conventional height measurement methods. The ideal height estimation method has not been identified yet. What is New: • Most estimation methods based on body segment measurement extrapolation fail to accurately predict height. • Board length use and growth chart extrapolation performed best in young children (≥2 years). Growth chart extrapolation and parents' report were the most accurate, followed by height measurement alongside the body with a tape measure in older children. [ABSTRACT FROM AUTHOR]

Despite strong evidence in favor of physical activity (PA), adults with autism spectrum disorder (ASD) are not meeting established PA guidelines to engage in at least 150 min of moderate to vigorous PA per week. Barriers to daily PA engagement include limited access to health services, transportation, and reduced self-determined motivation. Telehealth provides a potential alternative to deliver PA programming in a more accessible platform for adults with ASD. This pilot randomized controlled trial (RCT) assessed the preliminary efficacy of a 10-week PA intervention program called Physical Activity Connections via Telehealth (PACT) that utilized telehealth and remote technology, including Fitbit wearable device use, peer-guidance, and individualized home exercise program among adults with ASD. Primary health outcomes, collected at baseline before randomization and post-intervention, included self-determined motivation assessment via Behavioral Exercise Regulation Scale (BREQ-2), self-report PA via Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLT-PAQ), steps per day PA via Fitbit device, body mass index (BMI), and waist-to-height ratio (WtHR). A total of 18 adults, 11 males, with a mean age of 26.4 years, with a primary diagnosis of ASD participated in the study. Although there were no changes in BMI or WtHR at post-intervention, participants receiving PACT, significantly increased both their self-report PA scores (GSLT-PAQ) from 26 to 68, (p = 0.002), and steps per day from 5,828 to 7,443, (p = 0.015) with a moderate effect size (d = 0.72). The results of this pilot study support peer supported telehealth-based PA intervention for adults with ASD to increase PA. [ABSTRACT FROM AUTHOR]

Background: Gastrostomy tube (GT) feeding is used to promote nutrition and growth in children with chronic kidney disease (CKD). We explored the relationship between gastrostomy feeding and growth parameters in children with CKD, looking specifically at the nutritional composition of feeds. Methods: Children with CKD stages 3–5 or on dialysis in a tertiary children's kidney unit were studied. Data on anthropometry, biochemistry, and nutritional composition of feeds were collected from the time of GT insertion for 3 years or until transplantation. Results: Forty children (18 female) were included. Nineteen children were on peritoneal dialysis, 8 on hemodialysis, and 13 had CKD stages 3–5. The median (interquartile range [IQR]) age at GT insertion was 1.26 (0.61–3.58) years, with 31 (77.5%) under 5 years of age. The median duration of gastrostomy feeding was 5.32 (3.05–6.31) years. None received growth hormone treatment. Children showed a significant increase in weight standard deviation score (SDS) (p = 0.0005), weight-for-height SDS (p = 0.0007) and body mass index (BMI) SDS (p < 0.0001). None of the children developed obesity. Although not statistically significant, the median height-SDS increased into the normal range (from -2.29 to -1.85). Weight-SDS positively correlated with the percentage of energy requirements from feeds (p = 0.02), and the BMI-SDS correlated with the percentage of total energy intake as fat (p < 0.001). Conclusion: GT feeding improves weight-SDS and BMI-SDS without leading to obesity. GT feeding improved height-SDS but this did not reach statistical significance, suggesting that factors in addition to nutritional optimization need to be considered for statural growth. [ABSTRACT FROM AUTHOR]

The biological aspects of infancy within late Upper Palaeolithic populations and the role of southern refugia at the end of the Last Glacial Maximum are not yet fully understood. This study presents a multidisciplinary, high temporal resolution investigation of an Upper Palaeolithic infant from Grotta delle Mura (Apulia, southern Italy) combining palaeogenomics, dental palaeohistology, spatially-resolved geochemical analyses, direct radiocarbon dating, and traditional anthropological studies. The skeletal remains of the infant – Le Mura 1 – were directly dated to 17,320-16,910 cal BP. The results portray a biological history of the infant's development, early life, health and death (estimated at ~72 weeks). They identify, several phenotypic traits and a potential congenital disease in the infant, the mother's low mobility during gestation, and a high level of endogamy. Furthermore, the genomic data indicates an early spread of the Villabruna-like components along the Italian peninsula, confirming a population turnover around the time of the Last Glacial Maximum, and highlighting a general reduction in genetic variability from northern to southern Italy. Overall, Le Mura 1 contributes to our better understanding of the early stages of life and the genetic puzzle in the Italian peninsula at the end of the Last Glacial Maximum. Here, the authors present paleogenomics, dental histology, geochemistry, radiocarbon dating, and bioarchaeological analysis of an Upper Palaeolithic infant from Grotta delle Mura (southern Italy). These data depict the health and development of the individual and point to regional population turnover at the time. [ABSTRACT FROM AUTHOR]

Background: The lack of standardization of the norms and aesthetic concept of the lower third of the face and lips creates challenges in reconstructive surgery and aesthetic procedures. A large-scale, anthropometric measurements summary poses an alternative for establishing universal patterns. Methods: A systematic review was conducted by searching PubMed, Embase, Google Scholar and Web of Science using keywords: lip, face, aesthetics, beauty, anthropometry and Caucasian. Seventy records were included in the review and checked in detail in terms of available data. Results: The study contains a meta-analysis of twelve parameters with sufficient quantitative data—lip width, nose width, facial width, lower third of the face height, midline mandible height, total height of the upper and lower lip, upper and lower vermilion height, cutaneous upper lip height and nasolabial and mentolabial angle. Conclusions: The review provides a detailed database of primary anthropometric studies of lips and perioral regions of the healthy Caucasian population. The attractiveness of the region is focused on uniformity of proportions. Notably, results acquired with different methods of measurement are not interchangeable. Despite many published anthropometric studies, systems for conducting the measurements and reporting the results are not sufficiently unified to quantitatively assess meticulous key aesthetic clinical parameters. Level of Evidence I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background: In breast surgery, achieving esthetic outcomes with symmetry is crucial. The nipple–areolar complex (NAC) plays a significant role in breast characteristic measurement. Various technologies have advanced measurement techniques, and light detection and ranging (LiDAR) technology using three-dimensional scanning has been introduced in engineering. Increasing effort has been exerted to integrate such technologies into the medical field. This study focused on measuring NAC using a LiDAR camera, comparing it with traditional methods, and aimed to establish the clinical utility of LiDAR for obtaining favorable esthetic results. Methods: A total of 44 patients, who underwent breast reconstruction surgery, and 65 NACs were enrolled. Measurements were taken (areolar width [AW], nipple width [NW] and nipple projection [NP]) using traditional methods (ruler and photometry) and LiDAR camera. To assess correlations and explore clinical implications, patient demographics and measurement values were collected. Results: NAC measurements using a periscope and LiDAR methods were compared and correlated. LiDAR measurement accuracy was found to be high, with values above 95% for AW, NW and NP. Significant positive correlations were observed between measurements obtained through both methods for all parameters. When comparing body mass index, breast volume with AW and NW with NP, significant correlations were observed. These findings demonstrate the reliability and utility of LiDAR-based measurements in NAC profile assessment and provide valuable insights into the relationship between patient demographics and NAC parameters. Conclusions: LiDAR-based measurements are effective and can replace classical methods in NAC anthropometry, contributing to consistent and favorable esthetic outcomes in breast surgery. Level of Evidence II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Background: Strength training (ST) primarily enhances physical fitness (e.g., muscle strength, power, speed) and bone density in female soccer players. Less information is available on the injury preventive effects of ST in female athletes. Accordingly, this study aimed to investigate the effects of a 12-week in-season ST on measures of physical fitness and injury occurrence in young elite female soccer players. Methods: Thirty elite female soccer players (15.4 ± 1.9 years; maturity offset + 2.3 ± 1.1 years) participated in this study, and were randomly assigned to a strength training group (STG, n = 14) or an active control (CG, n = 16) group. ST lasted twelve weeks and included full body muscle strengthening exercises using primarily weight machines at progressive intensities ranging between 40 and 85% of the one-repetition-maximum (1-RM). The CG practiced a traditional soccer training program. Overall, training volumes of the two groups were similar with a training load (rating of perceived exertion × time) of 1158.4 ± 67.7 arbitrary unity (AU) for the STG and 1188.8 ± 44.1 AU for the CG. Pre and post training, the following physical fitness tests were applied: dynamic muscle strength (relative [to body mass] and absolute 1-RM bench/leg press, lat-pull down), jump performance (countermovement jump [CMJ], squat jump [SJ], five-jump-test [5JT]), linear-sprint speed (5-m, 10-m, 30-m), change-of-direction speed (T-test with and without ball), sport-specific performance (Yo-Yo Intermittent Level1 [YYIRTL1], and repeated shuttle sprint ability [RSSA]). The injury rate per 1000-h exposure was monitored throughout the soccer season. Results: No significant baseline differences were observed between groups. Statistically significant group-by-time interactions were found for absolute (p < 0.001, d = 2.59) and relative 1-RM bench press (p < 0.001, d = 2.39), absolute 1-RM lat-pull down (p < 0.001, d = 1.68), and relative 1-RM leg press (p < 0.001, d = 1.72). Significant group-by-time interactions were observed for CMJ (p = 0.005, d = 1.27), RSSAmean (p = 0.007, d = 0.81), and RSSAtotal (p < 0.001, d = 1.90). Post-hoc tests indicated that the STG group demonstrated greater improvements in all tested variables compared to CG (1.2 < d < 2.5). However, no significant interaction effects were noted for measures of linear sprint speed and YYIRTL1 performance. Additionally, non-contact injuries during the season were significantly lower (p = 0.003, d = 1.31) in the STG (0.48/1000 h of exposure) than the CG (2.62/1000 h of exposure). Conclusions: Twelve weeks of an in-season ST resulted in larger physical fitness improvements and fewer injuries compared with an active control in elite young female soccer players. Accordingly, ST should be systematically applied in female soccer to enhance performance and prevent injuries. Key Finding: This study showed that the incorporation of 12 weeks of strength training with two weekly sessions during the soccer season improves anthropometric and body composition characteristics as well as measures of physical fitness in adolescent elite female soccer players. Strength training reduces the incidence of non-contact injuries in young female soccer players. The usage of strength training machines is safe in elite young female soccer players with no previous experience in weightlifting. [ABSTRACT FROM AUTHOR]

Different taxa of insects have been reported to modify the skeletal remains of vertebrates during feeding or the creation of their larval and pupal chambers. Anecdotal reports on the modification of skeletal remains by ants exist but are rare. In this paper, a case of modification of bone due to the feeding activity of the ant, Crematogaster cf. liengmei (Hymenoptera: Formicidae), is reported. In November 2022, a bone was encountered incidentally in the vicinity of the Table Mountain National Park. The bone had been colonized by several individuals of Crematogaster cf. liengmei. Several ants were observed feeding on and removing bone particles and soft tissue remnants. A closer observation revealed striae/furrows on the epiphyseal ends of the bone. A 60-kg pig cadaver used in a winter decomposition trial in the same area was similarly colonized by this ant species, resulting in soft-tissue modification. Due to the similarity in the striae/furrows observed on the bone and the bitemarks inflicted by the ants on the right ear of the pig cadaver in the vicinity, it was concluded that the striae/furrows seen on the bone were created by the ants. Our observations show that Crematogaster cf. liengmei is an important taphonomic bio-agent that can contribute to the modification of skeletal remains in terrestrial environments. [ABSTRACT FROM AUTHOR]

Sex assessment is one of the first steps of routine forensic anthropological examinations and it provides a crucial element to identify a set of human skeletal remains. In bioarchaeological contexts, this assessment is also important, as it helps in the reconstruction of past societies. Sex determination can be achieved by using several morphological or metric traits of the skull and postcranial skeleton, which have been found to have varying degrees of accuracy. In 1969 Phenice proposed a methodology focusing on three traits located on the pubis. These traits were described as either having a female or male morphology with ambiguity being rare. Phenice's method became regularly utilized as it was considered to be reliable. In 2012, Klales and colleagues published a revision of Phenice's method, as they found that it did not capture the variation in the expression of the three traits. Klales and co-authors created a visual ordinal scale of 1–5 for each of the three traits Phenice originally identified, thus adding three extra possible forms of expression. The purpose of the present research was to test both the original and revised methodologies on the same skeletal population in order to evaluate their suitability for the assessment of sex. The Luís Lopes Anthropological collection in Lisbon was used; 117 males and 117 females were scored using both methodologies. The results showed that the original method performed better (96.5% accuracy) than the revised method (92.7%). [ABSTRACT FROM AUTHOR]

Purpose: To determine the contribution of ultra-processed foods (UPFs) to overall macronutrient intake and their association with anthropometric measurements, and to explore the perceptions regarding UPF consumption among young adults in Puducherry, India. Methods: This study included 630 participants from three colleges selected using multistage cluster sampling. Following the demonstration of portion estimation, dietary data from previous day were collected using a Google Form-based tool. The participant's anthropometric measures were taken. Food items were classified into NOVA groups and intake analysis was performed using DietSoft software. The participants with low and high consumption were identified and focus group discussions were conducted in each group using criterion sampling. Results: Of all the participants, 178 (28.3%) were overweight or obese. UPF contributed 9.3% of total energy intake and 2.8% protein, 9.9% fat, and 9.9% carbohydrates. The most consumed UPFs were biscuits, wafers (25%), and potato chips(16.2%). No significant association was found between anthropometric measures and UPF consumption. Qualitative findings revealed four major themes, further explained using the socio-ecological framework. Conclusion: UPF consumption in the region was lower than that reported in other global and Indian studies. While our study did not find a significant association between UPF consumption and anthropometric measures, there is a concerning shift from traditional diets to increased UPF reliance, driven by convenience and commercial factors. Addressing this is crucial for healthier choices and combating non-communicable diseases during this pivotal life stage. [ABSTRACT FROM AUTHOR]

Purpose: In adults, diets rich in protein seem beneficial in relation to satiety, weight loss, and weight management; however, studies investigating dietary protein and weight development in children are scarce and inconsistent. This nonrandomized controlled trial aimed to investigate the effect of a higher protein diet during lifestyle intervention on anthropometry and metabolic biomarkers in children with overweight and obesity. Methods: Children (n:208) were recruited from two multicomponent lifestyle camps. One camp was assigned as the intervention group. In the intervention group, carbohydrates-rich foods at breakfast and two in-between-meals were replaced with protein-containing foods to increase the amount of protein from ~ 10–15 energy percent (E%) per day to ~ 25E% per day. Other components were similar between groups. Anthropometry and biochemical measurements were collected at baseline, 10 weeks (after camp) and 52 weeks. Results: The intervention group had a non-significant improvement in BMI-SDS (− 0.07 SD (− 0.19; 0.05), p = 0.24) compared to the control group, but in general, there was no effect of a higher protein diet on anthropometry and metabolic biomarkers. Overall, 10 weeks at camp resulted in a more favorable body composition [− 6.50 kg (p < 0.00), − 0.58 BMI-SDS (p < 0.00), and − 5.92% body fat (p < 0.00)], and improved metabolic health, with most changes maintained at 52 weeks. Conclusion: A higher protein diet had no significant effect on body composition and metabolic health; however, these lifestyle camps are an efficiatious treatment strategy for childhood obesity. Clinical trial registration: clinicaltrials.gov with ID: NCT04522921. Preregistered August 21st 2020. [ABSTRACT FROM AUTHOR]

Purpose: Short-term intake of the egg-protein hydrolysate Newtricious (NWT)-03 improved executive function, but underlying mechanisms and long-term effects, including other cognitive domains, are unknown. Methods: A 36-week randomized controlled trial involving 44 overweight/obese individuals experiencing elevated Subjective Cognitive Failures (SCF; aged 60–75 years) assessed the impact of daily consumption of 5.7 g of NWT-03 or placebo powders on cognitive performance (psychomotor speed, executive function, memory) and Cerebral Blood Flow (CBF), a marker of brain vascular function. Cognitive performance was evaluated using a neurophysiological test battery (CANTAB) and CBF was measured using magnetic resonance imaging perfusion method Arterial Spin Labeling (ASL). Serum samples were collected to determine brain-derived neurotrophic factor (BDNF) concentrations. Results: Anthropometrics, and energy and nutrient intakes remained stable throughout the trial. NWT-03 was well tolerated, and compliance was excellent (median: 99%; range: 87–103%). No overall intervention effects were observed on cognitive performance or CBF, but post-hoc analyses revealed significant improvements on executive function in women, but not men. Specifically, a reduction of 74 ms in reaction latency on the multitasking task (95% CI: −134 to −15; p = 0.02), a reduction of 9 between errors (95%CI: −14 to −3; p < 0.001), and a reduction of 9 total errors (95%CI: −15 to −3; p < 0.001) on the spatial working memory task were found in women. No intervention effects were observed on serum BDNF concentrations (p = 0.31). Conclusion: Long-term consumption of NWT-03 improved multitasking abilities and working memory in women with elevated SCF. Brain vascular function remained unaffected. Sex differences in executive function require additional clarification. [ABSTRACT FROM AUTHOR]

Background: Steroids, the mainstay of treatment for nephrotic syndrome in children, have multiple adverse effects including growth suppression. Methods: Anthropometric measurements in children < 18 years enrolled in the Nephrotic Syndrome Study Network (NEPTUNE) were collected. The longitudinal association of medication exposure and nephrotic syndrome characteristics with height z-score and growth velocity was determined using adjusted Generalized Estimating Equation regression and linear regression. Results: A total of 318 children (57.2% males) with a baseline age of 7.64 ± 5.04 years were analyzed. The cumulative steroid dose was 216.4 (IQR 61.5, 652.7) mg/kg (N = 233). Overall, height z-scores were not significantly different at the last follow-up compared to baseline (− 0.13 ± 1.21 vs. − 0.23 ± 1.71, p = 0.21). In models adjusted for age, sex, and eGFR, greater cumulative steroid exposure (β − 7.5 × 10−6, CI − 1.2 × 10−5, − 3 × 10−6, p = 0.001) and incident cases of NS (vs. prevalent) (β − 1.1, CI − 2.22, − 0.11, p = 0.03) were significantly associated with lower height z-scores over time. Rituximab exposure was associated with higher height z-scores (β 0.16, CI 0.04, 0.29, p = 0.01) over time. Conclusion: Steroid dose was associated with lower height z-score, while rituximab use was associated with higher height z-score. [ABSTRACT FROM AUTHOR]

The grid and link search methods are used to recover scattered skeletal remains. Neither have not been compared robustly and clear guidelines for the link method have not been sufficiently developed. The study aimed to compare the effectiveness and efficiency of both methods and propose guidelines for the link method. The scattering patterns of two scavengers of forensic relevance—slender mongooses (Galerella sanguinea) and black-backed jackals (Canis mesomelas)—were recreated using four pig skeletons (Sus scrofa domesticus). Two groups (n = 6 each) were assigned a different method to recover the scattered remains. The length of the search and when each bone was located for each scatter pattern was recorded for each group and scatter pattern. A Likert scale questionnaire assessed participants' perceptions of their assigned method. A paired t-test (p = 0.005) compared the efficiency of each method and the questionnaire answers. Both methods were effective, recovering 100% of all remains. The link method was more efficient for both scatter patterns, despite there being no statistical significance (jackal: p = 0.089; mongoose: p = 0.464). Participants indicated favorable views for both methods; however, the link method scored significantly more favorably (p = 0.01) for efficiency. Specific guidelines were developed for the use of the link method. The link method is suggested for the recovery of scattered remains in forensic contexts, especially when the scavenger, its behavior, and scattering pattern is known or suspected. [ABSTRACT FROM AUTHOR]

Estimation of the exposure temperature of skeletal remains can be done by means of colourimetry and a previously published decision model for the colourimetric data, resulting in clusters that represent a range of exposure temperature. The method was based on thermally altered freshly burned human skeletal remains. However, in practice the origin or pre-burning condition of (possibly fragmentary) burned remains can be unknown. Further, in order to use the colourimetric analysis, and accompanying decision model, it is important to have a reference or test set. Fresh human material is not available for this purpose in all countries. Hence, the classification accuracy of the decision model was tested for, in some countries more readily available substitutes for fresh bone; embalmed human bone and non-human bone. The model yielded high accuracies for these sample materials, making it possible to create a reference or test set from fresh non-human and embalmed human bone as substitute for human, and also to use the decision model for these deviating samples in practice. [ABSTRACT FROM AUTHOR]

The assessment of body fat of children in primary care requires consideration of the dynamic changes in height, weight, lean mass, and fat mass during childhood growth. To achieve this, we aim to develop a predictive equation based on anthropometric values, with optimal diagnostic utility. This is a cross-sectional observational study, involving schoolgoers aged 11–17 years in the Vigo metropolitan area. Out of 10,747 individuals, 577 were randomly recruited. Variables: age, sex, ethnicity/country of origin, weight, height, 8 skinfolds, 3 diameters, 7 perimeters, and 85% percentile of body fat mass as the gold standard. Generalized additive regression was selected by cross-validation and compared using receiver operating characteristic curves (ROC curves). Sensitivity, specificity, positive and negative predictive values, true positive and true negative values, false positive and false negative values, accuracy, and positive and negative likelihood ratios were calculated. Two models were identified. The optimal model includes sex, weight, height, leg perimeter, and arm perimeter, with sensitivity of 0.93 (0.83–1.00), specificity of 0.91 (0.83–0.96), accuracy of 0.91 (0.84–0.96), and area under the curve (AUC) of 0.957 (0.928–0.986). The second model includes sex, age, and body mass index, with sensitivity of 0.93 (0.81–1.00), specificity of 0.90 (0.80–0.97), accuracy of 0.90 (0.82–0.96), and an AUC of 0.944 (0.903–0.984). Conclusion: Two predictive models, with the 85th percentile of fat mass as the gold standard, built with basic anthropometric measures, show very high diagnostic utility parameters. Their calculation is facilitated by a complementary online calculator. What is Known: • In routine clinical practice, mainly in primary care, BMI is used to determine overweight and obesity. This index has its weaknesses in the assessment of children. What is New: • We provide a calculator whose validated algorithm, through the determination of fat mass by impedanciometry, makes it possible to determine the risk of overweight and obesity in the community setting, through anthropometric measurements, providing a new practical, accessible and reliable model that improves the classification of overweight and obesity in children with respect to that obtained by determining BMI. [ABSTRACT FROM AUTHOR]

Aim: This cross-sectional study aims to investigate the correlations between food security, diet quality and weight change among working women during the endemic phase of COVID-19 in the Klang Valley of Malaysia. Methods: Working women aged 18–49 years were required to self-report their socio-demographics and pre-pandemic body weight (body weight during February 2020). Body height and current body weight were measured using a SECA stadiometer and TANITA weighing scale. Food security was assessed using the Food Insecurity Experience Scale (FIES); the diet quality was determined with the Diet Quality Questionnaire (DQQ) for Malaysia. Results: The prevalence of moderate-to-severe food insecurity was 19.9%. It is noted that 64.3% of working women gained weight throughout the pandemic, with an average weight gain of 4.36 ± 3.19 kg. Concerning diet quality, the majority (82.5%) achieved the Minimum Dietary Diversity for Women (MDD-W). Findings from linear regression revealed that food security was not significantly correlated with weight change. However, working women who failed to achieve the MDD-W gained, on average, 1.853 kg more than those who did (p = 0.040). On the other hand, no significant correlation was observed between food security status and diet quality in weight change of working women. Conclusion: The current study shall provide an impetus to develop intervention strategies for promoting healthy eating among working women. [ABSTRACT FROM AUTHOR]

Background/Objective: The Relative Fat Mass (RFM) is an alternative index to body mass index (BMI) for estimating whole body fat percentage (BF%). Our aims were to determine the accuracy of the RFM for 1) identifying individuals with elevated BF% and, 2) estimating the BF% compared to Dual-energy X-ray absorptiometry (DXA) in a Chilean adult population. Subjects/Methods: Body composition was assessed by DXA in 270 healthy participants (125 women/145 men). Anthropometric measurements were assessed to calculate RFM and BMI. Receiver operating characteristic (ROC) curves were obtained to assess the sensitivity and specificity of both, RFM and BMI. Bland–Altman analysis between BF% measured by DXA vs. predicted BF% derived from RFM was performed to assess validity. Pearson´s correlation coefficients to analyze the association between BMI, RFM and DXA were also calculated. Results: For RFM, the cut-off for elevated BF% was ≥22.7% for men and ≥32.4% for women and for BMI was ≥24.4 kg/m2 for men and ≥24.1 kg/m2 for women. The area under the ROC curve between RFM and BMI was not significantly different in men (0.970 vs. 0.959; p = 0.420) and women (0.946 vs. 0.942, p = 0.750). The Bland–Altman analysis showed that the estimation bias is more pronounced in men than in women. Conclusion: RFM is an accurate tool for identifying individuals with elevated BF%, although it was not as accurate as DXA for estimating the BF%. RFM may be an alternative method useful in primary care to select individuals for lifestyle counseling and in research to select patients for epidemiological studies. [ABSTRACT FROM AUTHOR]

Background: Haemodialysis (HD) patients are reported to be at greater risk of malnourishment, and at risk of increased morbidity and mortality. However, most studies report from economically advanced countries. We therefore assessed the nutritional status and diet among HD patients attending a public university hospital in a sub-Saharan African country. Subjects: We performed nutritional assessments in HD patients attending the largest dialysis centre, in the country, collecting demographic and clinical data, dietary intake, along with anthropometric and bioimpedance body composition measurements in May 2022. Malnutrition was classified according to subjective global assessment score (SGA). Additional assessments of protein energy wasting (PEW), clinical frailty, and sarcopenia were made. Results: All 97 HD patients were recruited, mean age 44.7 ± 12.2 years, with 55 (56.7%) males. Malnutrition was present in 43.8%, PEW 20.6%, frailty 17.6% and sarcopenia 4.1%. On multivariable logistic regression higher serum albumin (adjusted odds ratio (AOR) 0.89, 95% confidence intervals (CI) 0.85-0.95, p < 0.001), creatinine (AOR 0.99, 95%CI 0.98–0.99, p < 0.001), greater mid upper arm circumference (AOR 0.89, 95%CI 0.83–0.95, p = 0.001), body cell mass (BCM) (AOR 0.79, 95%CI 0.67–0.95, p = 0.013) and employment (AOR 0.45, 95%CI 0.23–0.87, p = 0.017), were are all protective against malnourishment. Almost 75% had reduced dietary protein intake. Conclusions: Despite a younger, less co-morbid patient population, malnutrition is common in this resource poor setting. The staple diet is based on maize, a low protein foodstuff. Employment improved finances and potentially allows better nutrition. Further studies are required to determine whether additional dietary protein can reduce the prevalence of malnutrition in this population. [ABSTRACT FROM AUTHOR]

Background/Objectives: Reduced serum magnesium (Mg) levels have been associated with obesity, insulin resistance (IR), type 2 diabetes, and metabolic syndrome in adults. However, in the children population, the evidence is still limited. In this cross-sectional study, we aimed to analyze the association of serum Mg levels with the frequency of overweight and obesity and cardiometabolic traits in 189 schoolchildren (91 girls and 98 boys) between 6 and 12 years old from Mexico City. Subjects/Methods: Anthropometrical data were collected and biochemical parameters were measured by enzymatic colorimetric assay. Serum Mg level was analyzed by inductively coupled plasma mass spectrometry (ICP-MS). The triglyceride-glucose (TyG) index was used as a surrogate marker to evaluate IR. Results: Serum Mg level was negatively associated with overweight (Odds ratio [OR] = 0.377, 95% confidence interval [CI] 0.231–0.614, p < 0.001) and obesity (OR = 0.345, 95% CI 0.202–0.589, p < 0.001). Serum Mg level resulted negatively associated with body mass index (BMI, β = −1.16 ± 0.26, p < 0.001), BMI z-score (β = −0.48 ± 0.10, p < 0.001) and TyG index (β = −0.04 ± 0.04, p = 0.041). Through a mediation analysis was estimated that BMI z-score accounts for 60.5% of the negative association of serum Mg level with IR (Sobel test: z = 2.761; p = 0.005). Conclusion: Our results evidence that BMI z-score mediate part of the negative association of serum Mg level and IR in Mexican schoolchildren. [ABSTRACT FROM AUTHOR]

Purpose: Although bariatric surgery is associated with a decrease in obesity complications, it may affect the children's growth by a maternal nutritional deficiency. This study was conducted to assess the effect of maternal bariatric surgery on offspring anthropometry. Materials and Methods: In a mixed cohort, anthropometric status of children aged 5 years or less born to mothers with a history of bariatric surgery was compared with a control group consists of peers born to mothers with obesity but without bariatric surgery. Anthropometric indices including crude and quantile values for BMI, weight, height, and head circumference at birth and the first 5 years of life were measured. Then, the adjusted effect of maternal surgical history on anthropometric status was estimated by linear regression. Results: From a total of 56 children, 28 born to mothers with a history of bariatric surgery, and 28 born to mothers with obesity but without bariatric surgery. At birth, weight (2915 vs 3225 g) and BMI (11.72 vs 12.94 kg/m2) were lower in the group with maternal bariatric surgery than in the control group (P = 0.02 and P = 0.03, respectively), although after regression adjustment, there was only a significant difference between the two groups in height for age value in children less than 5 years old (B = 0.872, P-value = 0.001). Conclusion: Bariatric surgery with decrease of weight indices at birth has a probable influence on growth and development in next years. Therefore, it is recommended further studies to identify unknown effect of types of preconception surgical procedures on childhood outcomes. [ABSTRACT FROM AUTHOR]

Objective: This cross-sectional study was planned to evaluate the relationship between serum nesfatin-1 levels, glucose regulation and anthropometric measurements of individuals who had undergone sleeve gastrectomy. Methods: A total of 40 participants aged between 19 and 64 years with a body mass index (BMI) greater than 30 kg/m2 who underwent sleeve gastrectomy participated in the study. Before and 1 month after the surgery, serum nesfatin-1, fasting insulin levels, anthropometric measurements and biochemical parameters were assessed. Results: Serum nesfatin-1 levels significantly decreased 4 weeks after the surgery (108.3 ± 58.35 pg/mL versus 74.6 ± 40.12 pg/mL: p = 0.003). Serum insulin levels (µIU/ml) showed a similar decrease (p < 0.001). Change in serum nesfatin-1 levels significantly correlated with change in BMI and body fat mass (p = 0.009, p = 0.007, respectively). Furthermore, serum nesfatin-1 levels significantly correlated with total cholesterol levels (p = 0.037). However, despite the significant decreases in both nesfatin-1 levels and glucose regulation markers, no correlation was found between them. The significant decrease observed in post-operative serum nesfatin-1 levels was found to be correlated with anthropometric measurements. Conclusions: This finding highlights the anorexigenic effects of nesfatin-1, and therefore, nesfatin-1 may be an effective factor in obesity treatment and diabetes. [ABSTRACT FROM AUTHOR]

Objective: During an oral glucose tolerance test (OGTT), typically fasting plasma glucose is lower than 2-h postprandial plasma glucose. However, postprandial plasma glucose (PPG) levels lower than fasting plasma glucose (FPG) levels may also occur. This study aims to describe the prevalence, clinical characteristics and contributing risk factors for PPG ≤ FPG in a large diverse Chinese population. Methods: We conducted a cross-sectional analysis of baseline data from a nationwide cohort study conducted in China. In addition to sociodemographic and anthropometric data collection, individuals had OGTT and blood chemistry tests. We determined the prevalence of PPG ≤ FPG ('Low Post Load' group) and PPG > FPG ('High Post Load' group) and used logistic regression to evaluate the association of risk factors with the occurrence of Low Post Load. Results: The prevalence of Low Post Load was 26.04% (n = 3773) and High Post Load was 73.96% (n = 10,714). Low Post Load was found to be related to younger age, male, lower BMI, lower blood pressure, higher HDL cholesterol levels and lower triglycerides levels. Compared with participants in the High Post Load group, participants in Low Post Load group had lower PPG (4.59 ± 0.83 mmol/L vs 7.15 ± 1.41 mmol/L) and HbA1c (5.30 ± 0.43% vs 5.39 ± 0.45%). People in Low Post Load group were more likely to have hypoglycaemic episodes (2.12% vs 0.01%) and impaired fasting glucose (12.30% vs 4.81%) compared with people with High Post Load, all p < 0.001. Conclusions: We found a high prevalence of people with Low Post Load glucose (26.04%) in a Chinese population cohort. The relationship between Low Post Load and the progression to or protection from diabetes and related complications and future incidence of cardiovascular disease needs further exploration in longitudinal analyses. [ABSTRACT FROM AUTHOR]

Objective: Malnutrition, reduced muscle function, and reduced quality of life are common problems among patients undergoing maintenance hemodialysis (MHD). This study aimed to evaluate nutritional risk, handgrip strength, and quality of life between patients with and without diabetes undergoing MHD to improve the nutrition, handgrip strength, and quality of life of patients with diabetic. Methods: This study was a descriptive cross-sectional design. Relevant survey scales were used to evaluate the nutritional status, handgrip strength, quality of life, and anthropometric measurements of patients receiving MHD. Logistic regression analysis was used to identify factors affecting MHD in patients with and without diabetes. Results: Compared to patients without diabetes undergoing MHD, patients with diabetes had a significantly higher malnutrition-inflammation score (MIS) (p = 0.003), a higher proportion of malnourished patients (p = 0.011), and weaker handgrip strength (p < 0.001). Regarding quality of life, compared with patients without diabetes undergoing MHD, patients with diabetes undergoing MHD had a lower score of physical component summary (PCS) (p = 0.001), mental component summary (MCS) (p = 0.005), and 36-item short-form health survey (SF-36)(p = 0.001). In multivariate logistic analyses, MHD duration (p = 0.008), handgrip strength (p = 0.001), score of PCS (p = 0.013), and employment status (p < 0.001) were the major factors. Conclusion: Nutrition and quality of life of patients with diabetes undergoing MHD were worse than those of patients without diabetes. Additionally, patients with diabetes undergoing MHD had weaker handgrip strength and exercised less. Therefore, it is necessary to take effective measures to prevent further declines in nutritional status, handgrip strength, and quality of life. [ABSTRACT FROM AUTHOR]

Purpose: Cardiovascular disease (CVD) is the primary cause of death worldwide but there is a variation in its burden across some nations that seems to be related to dietary habits. Mediterranean populations have lower rates of morbidity and mortality from CVD. Thus, this systematic review and meta-analysis aimed to assess the impacts of the Mediterranean diet (MedDiet) enriched with olive oil on blood lipids, glycemic indices, blood pressure, and anthropometric indices. Methods: A comprehensive search of the Web of Science, PubMed (MEDLINE), Scopus, Cochrane Library, Google Scholar, Embase, and CINAHL databases until March 2024 was conducted to identify clinical trials studying the effects of MedDiet enriched with olive oil on the aforementioned parameters. Results: In total, 3303 records were retrieved. A total of 18 clinical trials met the inclusion criteria after records were screened for eligibility. According to the pooled analysis from the random-effects model, the MedDiet enriched with olive oil significantly reduced triglycerides (TG) compared with the control group (WMD = −2.40 mg/dl; 95%CI, −4.533 to −0.262; P = 0.027). Strong heterogeneity was observed. Sensitivity analysis did not change our results and no significant effect of any trial on the overall effect sizes of all variables were found. There was a concern about the reporting bias for some studies which reported some main outcomes. Conclusion: MedDiet enriched with olive oil showed no consistent effects on any of the reported markers of cardiovascular health except on TG. Systematic review registration: CRD42023424641 [ABSTRACT FROM AUTHOR]

Purpose: Vitamin A is related to concentrations of insulin-like growth factor type 1, a protein produced in response to growth hormone, and to increased mobilization of body iron stores. Thus, vitamin A aids in increased hematopoiesis and may be useful in preventing stunting and anemia. This study aimed to identify the association between vitamin A supplementation from the National Vitamin A Supplementation Program instituted in Brazil and stunting and anemia in socially vulnerable Brazilian children. Methods: This is a Cross-sectional population-based study. Children aged 6–59 months old, living in favelas of a capital city in the Northeast of Brazil, were included. Sociodemographic variables were collected. Vitamin A supplementation was also evaluated using the child's vaccination card information. Anthropometric and capillary hemoglobin evaluations were performed to identify the presence of stunting and anemia, respectively. The association analysis was performed using Poisson regression with robust variance estimation. Results: 598 children participated in this study; 11.3% and 55.6% had stunting and anemia, respectively. As for vitamin A supplementation, 59.5% had taken at least one dose of the supplement,and 3.5% were on the complete supplementation scheme. In the adjusted association analysis, vitamin A supplementation decreased the likelihood of children having stunting and anemia by 8% (RP:0.86; 95% IC 0.86–0.98; p = 0.014) and 31% (RP:0.69; 95% IC 0.53–0.89; p = 0.004), respectively. Children who were fully supplemented were 58% (RP:0.42; 95% IC 0.24–0.77; p = 0.008) less likely to have anemia. Conclusion: Thus, vitamin A supplementation is a protective tool against stunting and anemia in children living in a situation of social vulnerability. [ABSTRACT FROM AUTHOR]

Background: Among the medications used to treat knee osteoarthritis (OA), oral patented crystalline glucosamine sulfate (pCGS) and platelet-rich plasma (PRP) have become popular alternatives to painkillers or nonsteroidal anti-inflammatory drugs (NSAIDs). Although studies have shown that pCGS and PRP improve clinical outcomes, no study has compared outcomes between these optional treatments. We compared functional performance outcomes from baseline to the 1-year follow-up (FU) between oral pCGS and PRP in patients with knee OA. Materials and methods: Three hundred eighty-two patients receiving oral pCGS and 122 patients receiving PRP injections were enrolled for a review of functional performance outcomes, including a five-time sit-to-stand test (5xSST), time up-and-go test (TUGT), and 3-minute walk distance test (3MWDT). The patients were followed up for one year. The pCGS group received 1500 mg daily, whereas the PRP group received 2 cycles of intra-articular injections at week 0 and week 6. Using propensity score matching based on age, sex, height, weight, BMI, and Kellgren and Lawrence (KL) classification, all three functional performance outcomes were compared between the baseline (pretreatment), 6-week, 12-week, 24-week, and 1-year FUs. Results: With a ratio of 2:1 (pCGS: PRP), 204 patients in the pCGS group were matched with 102 patients in the PRP group. Compared with the baseline levels, the PRP group showed significant improvements in 5xSST and TUGT outcomes from 6 weeks and significant improvements in 3MWDT outcomes from 12 weeks, whereas the pCGS group showed significant improvements in TUGT outcomes from 6 weeks and significant improvements in 5xSST and 3MWDT outcomes from 12 weeks. At the 24-week and 1-year FU, both groups showed significant improvements in all three functional performance tests without adverse events. Conclusions: Although the PRP group showed faster improvements in 5xSST outcomes at six weeks, from the 12-week to 1-year FU, both the pCGS and PRP groups showed significant improvements in 5xSST, TUGT, and 3MWDT outcomes. As the use of PRP is more complicated and invasive than the use of oral pCGS, the benefits and drawbacks of selecting PRP over pCGS in knee OA treatment should be examined. [ABSTRACT FROM AUTHOR]

This study aims to identify the determinants associated with physical activity (PA) behavior in newly diagnosed obstructive sleep apnea (OSA) patients by applying the Health Action Process Approach (HAPA) with a longitudinal design. Anthropometric and clinical (OSA severity, subjective somnolence, use of continuous positive airway pressure (CPAP)) variables, the determinants of physical activity specified in the HAPA (motivational self-efficacy, outcome expectancies, risk perception, intention, maintenance self-efficacy, action planning, coping planning, social support), as well as physical activity behavior were assessed using a longitudinal (T1 and T2) design in a sample of 57 OSA patients in routine care. Applying regression analyses, regarding the motivation phase, the amount of explained variance in intention was 77% and 39% of the variance in physical activity. In the motivational phase, motivational self-efficacy, risk perception and outcome expectancies were associated with intention. In the volitional phase, physical activity at T1 and social support (family) were related with physical activity at T2. In conclusion, the assumptions of HAPA were partially found in the context of newly diagnosed OSA patients. This study provided additional evidence regarding the role of motivational self-efficacy, outcome expectancies and risk perception during motivational phase, and highlighted the important role of social support from the family in the PA in this population. [ABSTRACT FROM AUTHOR]

Depression and anxiety are prevalent and disabling conditions among adolescents. The aim of this study was to examine the relationship between adherence to the Mediterranean diet (MD) and depressive, anxiety, and stress symptoms in adolescents. This cross-sectional study included a sample of 698 adolescent students from a region of Spain (mean age of 13.9 ± 1.5 years; 56.2% girls). Adherence to the MD was evaluated with the Mediterranean Diet Quality Index in children and adolescents (KIDMED). Mental health symptoms were measured with the Depression, Anxiety, and Stress Scale (DASS-21). Logistic regression models were performed, including a wide range of potential confounders. Compared to individuals with low adherence to the MD, those with moderate and high adherence had lower odds of experiencing depressive symptoms (odds ratio [OR] = 0.40, 95% confidence interval [CI] 0.24–0.65 and OR = 0.33, 95% CI 0.20–0.55, respectively), which were statistically significant even after adjustment. No significant associations were found regarding anxiety or stress symptoms. Therefore, according to our results, higher adherence to the MD is inversely related to having depressive symptoms among adolescents, regardless of socioeconomic, anthropometric, and lifestyle factors. Considering the deleterious effects of mental health problems in youths, further research on the role of nonpharmacological strategies for the prevention and treatment of depressive symptoms in adolescence is essential. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: To investigate the relationship between adductor pollicis muscle thickness (AMPT) and physical frailty. Findings: Adductor pollicis muscle thickness was statistically lower in frail patients and the negative predictive values were identified as 89.5% for women and 93.2% for men. Message: Further prospective cohort studies should investigate the potential value of using APMT to diagnose frailty. Purpose: There is a need for an easily measurable and reliable surrogate marker for physical frailty. This study aims to investigate the predictive capacity of adductor pollicis muscle thickness (AMPT), which can be easily measured externally and minimally influenced by subcutaneous adipose tissue, for physical frailty. Methods: A total of 589 patients (16.3% physically frail, 54.7% pre-frail, 29% robust) were included. Comprehensive geriatric assessments and anthropometric measurements of the patients were performed. APMT was assessed with a skinfold caliper. Physical frailty was diagnosed using the fried frailty phenotype. The predictive ability of APMT for the diagnosis of frailty was examined. Results: Of all the participants, 64.3% were women, and the average age was 74 ± 5.9 years. There was no significant difference in waist and hip circumference, or body mass index between the frail and non-frail groups. APMT, handgrip strength, gait speed, and calf circumference were significantly lower in frail patients than in non-frail ones (p < 0.01). The area under the curve (AUC) of APMT for physical frailty was determined to be 0.627 (95% confidence interval [CI] 0.58–0.66; p < 0.001). The best cut-off value for APMT was ≤ 18.5 mm for all individuals. Conclusion: Adductor pollicis muscle thickness can be a useful anthropometric marker for evaluating the risk of physical frailty. [ABSTRACT FROM AUTHOR]

Background/Objectives: Type 1 diabetes (T1D) is associated with an increase in resting metabolic rate (RMR), but the impact of T1D on other components of 24-h energy expenditure (24-h EE) is not known. Also, there is a lack of equations to estimate 24-h EE in patients with T1D. The aims of this analysis were to compare 24-h EE and its components in young adults with T1D and healthy controls across the spectrum of body mass index (BMI) and derive T1D-specific equations from clinical variables. Subjects/Methods: Thirty-three young adults with T1D diagnosed ≥1 year prior and 33 healthy controls matched for sex, age and BMI were included in this analysis. We measured 24-h EE inside a whole room indirect calorimeter (WRIC) and body composition with dual x-ray absorptiometry. Results: Participants with T1D had significantly higher 24-h EE than healthy controls (T1D = 2047 ± 23 kcal/day vs control= 1908 ± 23 kcal/day; P < 0.01). We derived equations to estimate 24-h EE with both body composition (fat free mass + fat mass) and anthropometric (weight + height) models, which provided high coefficients of determination (R2 = 0.912 for both). A clinical model that did not incorporate spontaneous physical activity yielded high coefficients of determination as well (R2 = 0.897 and R2 = 0.880 for body composition and anthropometric models, respectively). Conclusion: These results confirm that young adults with established T1D have increased 24-h EE relative to controls without T1D. The derived equations from clinically available variables can assist clinicians with energy prescriptions for weight management in patients with T1D. [ABSTRACT FROM AUTHOR]

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy with multifactorial etiologies. We intended in this case–control study to identify, out of a comprehensive set of risk factors, the relatively important ones and develop a quantitative risk assessment model for this disorder. It was also legitimate to define the hazard of those factors in a dose-related manner and the acceptable safe limit especially for work-related stresses. Results: Age and female predominance were comparable between the 60 patients (89 hands with electrophysiologically confirmed CTS) and 50 controls (100 hands). Occupation of the studied sample varied between housewives only, employed housewives, and manual workers with a distribution that differed significantly between patients and controls. Significantly higher body mass index (BMI) and mean wrist depth were found in patients than controls. Wrist ratio (clinically or sonographically) was significantly squarer in patients than controls. Overall workload and number of hours spent daily performing work with repeated hand movements or awkward hand position were significantly higher among patients than controls. ROC curves were constructed for wrist measurements and occupational stresses. Cut-off points of wrist ratio and internal carpal tunnel ratio (by ultrasound) to discriminate subjects with CTS were > 0.68 and ≤ 1.854, respectively. The best cut-off value for number of hours spent daily performing work with repeated hand movements was 3 h/ day. As for working with awkward hand position or cold exposure, cut-off value was 0.6 h/day for both. Two logistic regression models were conducted to investigate nonoccupational and occupational predictors of CTS. The independent predictors concluded from the first model were BMI, positive family history of CTS, wrist ratio, and decrease grip strength. As for the occupational model, predictors were tasks requiring awkward hand position and cold exposure. Conclusion: Occupational risk assessment by clinical, anthropometric, and ultrasonographic measurement should be used in professions requiring repetitive or awkward hand movements, so that in overweight persons with square wrists appropriate workplace setup measures or assistive technology at work or home could be taken to prevent or decrease the impact of work hazards or help choose individuals with low risk for appropriate jobs. [ABSTRACT FROM AUTHOR]

Background: Obesity and its related medical conditions are well-established contributors to the development of chronic kidney disease (CKD). Metabolic and bariatric surgery (MBS), including procedures such as sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), is a potential intervention for these individuals. However, the heightened risk of postoperative complications casts doubts on the suitability of MBS in this population. Our aim is to evaluate the long-term safety, anthropometric and renal outcomes of MBS in patients with CKD. Methods: A retrospective review of patients who underwent primary laparoscopic MBS with a BMI ≥ 35 kg/m2 and a preoperative diagnosis of stage 2 to 5 CKD. Criteria for CKD diagnosis and staging were based on estimated glomerular filtration rate measurements in accordance with established guidelines. Anthropometric and renal outcomes were measured at 3-, 6-, 12-, 24- and 60-months postoperatively. Results: A total of 302 patients (177 SG, 125 RYGB) were included. RYGB was preferred for patients with stage 3 CKD, while SG was more common in stages 4 and 5. At 5-year follow-up, percentage of total weight loss was higher in the RYGB cohort compared to SG (25.1% vs. 18.6%, p = 0.036). Despite SG patients having more advanced CKD, the incidence of late complications was significantly higher following RYGB, with 11 incidents (8.8%), compared to the SG cohort with only 4 cases (2.3%) (p = 0.014). In those with preoperative CKD stage 3, 76 patients (43.2%) improved to stage 2, with another 9 patients (5.1%) improving further to stage 1. Of all patients, 63 (20.8%) eventually received a successful renal transplant. Conclusions: MBS is an effective strategy for sustained weight loss in patients with CKD with acceptable complications rates. RYGB leads to a higher percentage of overall weight loss, albeit with an elevated likelihood of late surgical complications. Future studies are needed to determine the safety of MBS in this demographic. [ABSTRACT FROM AUTHOR]