Association of early childhood abdominal circumference and weight gain with blood pressure at 36 months of age: secondary analysis of data from a prospective cohort study

To assess whether changes in measures of fat distribution and body size during early life are associated with blood pressure at 36 months of age.

Evidence for the existence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) with and without abdominal discomfort (irritable bowel) syndrome.

There is evidence that Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is accompanied by gastro-intestinal symptoms; and IgA and IgM responses directed against lipopolysaccharides (LPS) of commensal bacteria, indicating bacterial translocation.

Aortic intima-media thickness measured by trans-abdominal ultrasound as an early life marker of subclinical atherosclerosis

Atherosclerosis is a chronic inflammatory process that begins in early life. Improved identification of markers of early atherosclerosis via neonatal aortic intima-media thickness (aIMT) measurement may allow the development of interventions to prevent or reduce later cardiovascular disease.

The influence of fiber diameter, fabric attributes and environmental conditions on wetness sensations of next-to-skin knitwear

This study investigated the relationships between the sensations of sweaty, damp, muggy and clingy, as assessed by human response from wearer trial garment assessment, and fiber type, fiber, yarn and fabric properties and instrumental fabric measurements of next-to-skin knitwear. Wearer trial assessment of 48 fabrics followed a strict 60 minute protocol including a range of environmental conditions and levels of exercise. Adjusted mean weighted scores were determined using linked garments. Instrumental fabric handle measurements were determined with the Wool HandleMeter (WHM) and Wool ComfortMeter. Data were analyzed using forward stepwise general linear modeling. Mean fiber diameter (MFD) affected the sweaty, damp, muggy and clingy sensation responses accounting for between 23.5% and 56.2% of the variance of these sensations. In all cases, finer fibers were associated with lower sensation scores (preferred). There were also effects of fiber type upon sweaty, muggy and clingy scores, with polyester fiber fabrics having higher scores (less preferred) compared with fabrics composed of wool, particularly for peak sweaty scores in hot and active environments. Attributes such as fabric density, yarn linear density, knitting structure and finishing treatments, but not fabric thickness, accounted for some further variance in these attributes once MFD had been taken into account. This is explained as finer fibers have a greater surface area for any given mass of fiber and so finer fibers can act as a more effective sink for moisture compared with coarser fibers. No fabric handle parameter or other attribute of fiber diameter distribution was significant in affecting these sensation scores.

Resistive simulated weightbearing exercise with whole body vibration reduces lumbar spine deconditioning in bed-rest

STUDY DESIGN: Randomized controlled trial. OBJECTIVE: Determine the effectiveness a resistive exercise countermeasure with whole-body vibration in relation to lumbo-pelvic muscle and spinal morphology changes during simulated spaceflight (bed-rest). SUMMARY OF BACKGROUND DATA: Spinal lengthening, flattening of the spinal curves, increases in disc size, and muscle atrophy are commonly seen in spaceflight simulation. This may represent a risk for low back injury. Consideration of exercise countermeasures against these changes is critical for success of long-term spaceflight missions. METHODS: Twenty healthy male subjects underwent 8-weeks of bed-rest with 6-months follow-up and were randomly allocated to an inactive control or countermeasure exercise group. Magnetic resonance imaging of the lumbo-pelvic region was conducted at regular time-points during and after bed-rest. Using uniplanar images at L4, cross-sectional areas of the multifidus, lumbar erector spinae, quadratus lumborum, psoas, anterolateral abdominal, and rectus abdominis muscles were measured. Sagittal scans were used to assess lumbar spine morphology (length, sagittal disc area and height, and intervertebral angles). RESULTS: The countermeasure group exhibited less multifidus muscle atrophy (P = 0.024) and its atrophy did not persist long-term as in the control group (up to 3-months; P < 0.006). Spinal lengthening (P = 0.03) and increases in disc area (P = 0.041) were also reduced. Significant partial correlations (P < 0.001) existed between spinal morphology and muscle cross-sectional area changes. CONCLUSION: The resistive vibration exercise countermeasure reduced, but did not entirely prevent, multifidus muscle atrophy and passive spinal tissue deconditioning during bed-rest. Atrophy of the multifidus muscles was persistent long-term in the inactive subjects. Future work could consider closer attention to spinal posture during exercise and optimizing exercise dose.

Altered response of the anterolateral abdominal muscles to simulated weight-bearing in subjects with low back pain

An important aspect of neuromuscular control at the lumbo-pelvic region is stabilization. Subjects with low back pain (LBP) have been shown to exhibit impairments in motor control of key muscles which contribute to stabilization of the lumbo-pelvic region. However, a test of automatic recruitment that relates to function has been lacking. A previous study used ultrasound imaging to show that healthy subjects automatically recruited the transversus abdominis (TrA) and internal oblique (IO) muscles in response to a simulated weight-bearing task. This task has not been investigated in subjects with LBP. The aim of this study was to compare the automatic recruitment of the abdominal muscles among subjects with and without LBP in response to the simulated weight-bearing task. Twenty subjects with and without LBP were tested. Real-time ultrasound imaging was used to assess changes in thickness of the TrA and internal oblique IO muscles as well as lateral movement ("slide") of the anterior fascial insertion of the TrA muscle. Results showed that subjects with LBP showed significantly less shortening of the TrA muscle (P < 0.0001) and greater increases in thickness of the IO muscle (P = 0.002) with the simulated weight-bearing task. There was no significant difference between groups for changes in TrA muscle thickness (P = 0.055). This study provides evidence of changes in motor control of the abdominal muscles in subjects with LBP. This test may provide a functionally relevant and non-invasive method to investigate the automatic recruitment of the abdominal muscles in people with and without LBP.

Extended studies on fibre diameter measurement with OFDA instrument

OFDA 2000 is a widely used fibre diameter measurement instrument. The instrument can provide improved statistical accuracy measurements in comparison with traditional technology. In this paper, a new technique has been developed to enable fibre diameters to be measured in an aqueous environment using the OFDA 2000 instrument. This new technique was utilised to assess the effects of pH and temperature on the diameters of Merino wool fibres in aqueous environments. Significant changes in fibre diameter under aqueous conditions were found as a function of pH and temperature. It is also demonstrated in this paper that the fibre diameter measurement results can be affected by fibre colour. In both dry and aqueous conditions, variation in fibre diameter was observed on fibres with different colours. This could be due to an optical effect or more likely due to physical changes in the dyed fibres as a result of the presence of dyes. Apart from their physical bulk, dyes may also affect the water content of fibres and hence have an influence on the swelling of fibres when they are measured under ambient regain and wet conditions.

Changes in abdominal obesity and age-related macular degeneration: the atherosclerosis risk in communities study

OBJECTIVE: To examine the association between changes in waist-hip ratio (WHR), a measure of abdominal obesity, and age-related macular degeneration (AMD). METHODS: A total of 12 515 persons from a population-based cohort study, aged 45 to 64 years in 1987 to 1989, were followed up over 6 years. The percentage change in WHR during follow-up was ranked into sex-specific deciles; an increase in WHR was defined as the top 10% of change and a decrease in WHR as the bottom 10%. The association of increased or decreased WHR and presence of AMD at follow-up was determined using logistic regression adjusting for potential confounders. RESULTS: The average change in WHR was an increase of 2%, ranging from a decrease of 44% to an increase of 102%. A decrease in WHR of 3% or more was associated with 29% lower odds of any AMD (odds ratio = 0.71; 95% confidence interval, 0.52-0.97). This effect was most pronounced among obese participants at baseline, where a decrease in WHR was associated with 59% lower odds of AMD (odds ratio = 0.41; 95% confidence interval, 0.20-0.82). CONCLUSIONS: Middle-aged persons who had a 3% or greater reduction in WHR over time were less likely to have AMD, particularly among those who were initially obese.

Colour effect on fibre diameter measurement with OFDA 2000

In this study, wool samples from Merino, Corriedale and Lincoln sheep with a wide range of fibre diameters have been dyed and measured for fibre diameter using OFDA 2000 in both dry and conditioned states. Variation in fibre diameter is observed on fibres with different colours in both dry and aqueous conditions. This could be due to an optical effect or more likely due to physical changes in the dyed fibres owing to the presence of dyes. Apart from their physical bulk, dyes may also affect the owing water content of fibres and hence have an influence on the swelling of fibres when they are measured under ambient regain and wet conditions.

Coarser wool is not a necessary consequence of sheep aging: allometric relationship between fibre diameter and fleece-free liveweight of Saxon Merino sheep

The mean fibre diameter (MFD) of wool is the primary determinant of price, processing performance and textile quality. This study determines the primary influences on MFD as Saxon Merino sheep age, by allometrically relating MFD to fleece-free liveweight (FFLwt). In total, 79 sheep were grazed in combinations of three stocking rates and two grazing systems (GS: sheep only; mixed with Angora goats) and studied over 3 years. Measurements were made over 14 consecutive periods (Segments), including segments of FFLwt gain or FFLwt loss. Using shearing and liveweight records and dye-bands on wool, the FFLwt and average daily gain (ADG) of each sheep were determined for each segment. The mean and range in key measurements were as follows: FFLwt, 40.1 (23.1 to 64.1) kg; MFD, 18.8 (12.7 to 25.8) μm. A random coefficient restricted maximum likelihood (REML) regression mixed model was developed to relate the logarithm of MFD to the logarithm of FFLwt and other effects. The model can be written in the form of ${\rm MFD}\,{\equals}\,\rkappa \left( {{\rm GS,}\,{\rm A}{\rm ,}\,{\rm Segment}{\rm .Plot,}\,{\rm Segment,}\,{\rm ADG}} \right){\times}{\rm FFLwt}^{{\left( {\ralpha \left( {{\rm GS}} \right){\plus}\rbeta \left(\rm A \right){\plus}\rgamma \left( {{\rm Segment}{\rm .Plot}} \right)} \right)}} $ , where $\ralpha \left( {{\rm GS}} \right)\,{\equals}\,\;\left\{ {\matrix{\!\! {0.32\left( {{\rm SE}\,{\equals}\,{\rm 0}{\rm .038}} \right)\,{\rm when}\,{\rm sheep}\,{\rm are}\,{\rm grazed}\,{\rm alone}} \hfill \cr \!\!\!\!{0.49\left( {{\rm SE}\,{\equals}\,{\rm 0}{\rm .049}} \right)\,{\rm when}\,{\rm sheep}\,{\rm are}\,{\rm mixed}\,{\rm with}\,{\rm goats}} \hfill \cr } } \right.$ β(A) is a random animal effect, γ(Segment.Plot) a random effect associated with Segment.plot combinations, and κ a constant that depends on GS, random animal effects, random Segment.plot combination effects, Segment and ADG. Thus, MFD was allometrically related to the cube root of FFLwt over seasons and years for sheep, but to the square root of FFLwt for sheep grazed with goats. The result for sheep grazed alone accords with a primary response being that the allocation of nutrients towards the cross-sectional growth of wool follicles is proportional to the changes in the skin surface area arising from changes in the size of the sheep. The proportionality constant varied systematically with ADG, and in sheep only grazing, was about 5 when sheep lost 100 g/day and about 6 when sheep gained 100 g/day. The proportionality constant did not systematically change with chronological age. The variation in the allometric coefficient between individual sheep indicates that some sheep were more sensitive to changes in FFLwt than other sheep. Key practical implications include the following: (a) the reporting of systematic increases in MFD with age is likely to be a consequence of allowing sheep to increase in size during shearing intervals as they age; (b) comparisons of MFD between sheep are more likely to have a biological basis when standardised to a common FFLwt and not just to a common age;

Measurement of vein diameter for peripherally inserted central catheter (PICC) insertion: an observational study

Choosing an appropriately sized vein reduces the risk of venous thromboembolism associated with peripherally inserted central catheters. This observational study described the diameters of the brachial, basilic, and cephalic veins and determined the effect of patient factors on vein size. Ultrasound was used to measure the veins of 176 participants. Vein diameter was similar in both arms regardless of hand dominance and side. Patient factors-including greater age, height, and weight, as well as male gender-were associated with increased vein diameter. The basilic vein tended to have the largest diameter statistically. However, this was the case in only 55% of patients.

‘Care in a chair’ – The impact of an overcrowded emergency department on the time to treatment and length of stay of self-presenting patients with abdominal pain

Objectives The aim in this study was to investigate the impact of overcrowding on the Australasian Triage Score’s (ATS) time to treatment target and the National Emergency Access Target (NEAT) for patients who self-present to the Emergency Department (ED) with abdominal pain. Background The causes and effects of ED overcrowding have been well described in the literature. It is a widespread phenomenon throughout the world and it can cause serious harm to patients and have a negative impact on access to emergency care. There is however, little research investigating the effect of overcrowding when patients self-present to the ED and experience a delay in being allocated a cubicle. Methods A retrospective analysis of 12-months of computerised records was carried out in order to determine if self-presenting patients with abdominal pain allocated a category 3 triage score who were required to ‘queue’ for a cubicle would meet ATS target and NEAT requirements. A multiple regression analysis was used to determine whether or not queuing for an ED cubicle, age and gender were predictors of meeting the ATS guidelines and NEAT requirements. Results Three hundred and five patients met the inclusion criteria and were included in the study. Of these 149 patients waited more than 15 min to be allocated a cubicle while 156 did not experience any delay. A multiple regression analysis revealed that gender and age were not predictive of meeting the ATS target and NEAT requirements, while delay in allocation to a cubicle was a significant predictor of not being assessed within 30 min and discharged within 4 h. Furthermore, 61.2% of patients allocated to the waiting room queue for any amount of time were admitted to the ward. Conclusion Queuing in the waiting room for an ED bed was a significant predictor of whether or not category three patients with abdominal pain had treatment commenced within 30 min of presentation and was associated with a longer total ED length of stay.

Vein diameter for peripherally inserted cathether insertion: a scoping review

Background: The risk of venous thromboembolism (VTE) may be reduced if a vein of appropriate diameter is used forperipherally inserted central catheter (PICC) insertion. However, clinicians may have predilections to cannulate certainvein types and use particular insertion sites (eg, right or left arm) and therefore do not necessarily assess all veinsavailable to determine the most optimal vessel to introduce a catheter. It is important that clinicians have anunderstanding of the diameter of veins used for PICC insertion and the effect of patient factors such as hand dominanceon vein size to determine whether their clinical practice is appropriate.

Methods: A scoping review of published literature was performed to determine existing knowledge regarding thediameters of veins used for PICC insertion and the influence of patient factors such as hand dominance and laterality(left or right arm) on vein size.

Results: There was limited published research about the diameters of the basilic, brachial, and cephalic veins at themidupper arm, with only 6 studies identified. Three of the 6 selected articles focused on vein diameter measurement toinform arteriovenous fistula development. Only 1 study included participants undergoing PICC insertion. Scant researchexamined the effect of laterality on vein diameter and 1 study was identified that reported the influence of handdominance or vein type on the diameter of veins used for PICC insertion.

Conclusions: This review found that there is a paucity of studies that have examined the veins used for PICC insertion.Nevertheless, it appears that the basilic vein has the largest diameter (with smaller brachial and cephalic veins),although this is not always the case. Laterality and hand dominance does not seem to influence vein diameter. Furtherresearch about the vasculature used for PICC insertion is needed to inform clinical practice.