Increased fat oxidation in prepubertal obese children: a metabolic defense against further weight gain?

The purpose of this study was to measure postabsorptive fat oxidation at rest and to assess the association between fat mass and fat oxidation rate in prepubertal children, who were assigned to two groups: 35 obese children (weight, 44.5 +/- 9.7 kg; fat mass; 31.7 +/- 5.4%) and 37 nonobese children (weight, 30.8 +/- 6.8 kg; fat mass, 17.5 +/- 6.7%). Postabsorptive fat oxidation expressed in absolute value was significantly higher in obese than in nonobese children (31.4 +/- 9.7 mg/min vs 21.9 +/- 10.2 mg/min; p < 0.001) but not when adjusted for fat-free mass by analysis of covariance with fat-free mass as the covariate (28.2 +/- 10.6 mg/min vs 24.9 +/- 10.5 mg/min). In obese children and in the total group, fat mass and fat oxidation were significantly correlated (r = 0.65; p < 0.001). The slope of the relationship indicated that for each 10 kg additional fat mass, resting fat oxidation increased by 18 gm/day. We conclude that obese prepubertal children have a higher postabsorptive rate of fat oxidation than nonobese children. This metabolic process may favor the achievement of a new equilibrium in fat balance, opposing further adipose tissue gain.

Maintenance of polymorphism : a theoretical approach using multilocus systems

Résumé La thématique de cette thèse peut être résumée par le célèbre paradoxe de biologie évolutive sur le maintien du polymorphisme face à la sélection et par l'équation du changement de fréquence gamétique au cours du temps dû, à la sélection. La fréquence d'un gamète xi à la génération (t + 1) est: !!!Equation tronquée!!! Cette équation est utilisée pour générer des données utlisée tout au long de ce travail pour 2, 3 et 4 locus dialléliques. Le potentiel de l'avantage de l'hétérozygote pour le maintien du polymorphisme est le sujet de la première partie. La définition commune de l'avantage de l'hétérozygote n'etant applicable qu'a un locus ayant 2 allèles, cet avantage est redéfini pour un système multilocus sur les bases de précédentes études. En utilisant 5 définitions différentes de l'avantage de l'hétérozygote, je montre que cet avantage ne peut être un mécanisme général dans le maintien du polymorphisme sous sélection. L'étude de l'influence de locus non-détectés sur les processus évolutifs, seconde partie de cette thèse, est motivée par les travaux moléculaires ayant pour but de découvrir le nombre de locus codant pour un trait. La plupart de ces études sous-estiment le nombre de locus. Je montre que des locus non-détectés augmentent la probabilité d'observer du polymorphisme sous sélection. De plus, les conclusions sur les facteurs de maintien du polymorphisme peuvent être trompeuses si tous les locus ne sont pas détectés. Dans la troisième partie, je m'intéresse à la valeur attendue de variance additive après un goulot d'étranglement pour des traits sélectionés. Une études précédente montre que le niveau de variance additive après goulot d'étranglement augmente avec le nombre de loci. Je montre que le niveau de variance additive après un goulot d'étranglement augmente (comparé à des traits neutres), mais indépendamment du nombre de loci. Par contre, le taux de recombinaison a une forte influence, entre autre en regénérant les gamètes disparus suite au goulot d'étranglement. La dernière partie de ce travail de thèse décrit un programme pour le logiciel de statistique R. Ce programme permet d'itérer l'équation ci-dessus en variant les paramètres de sélection, recombinaison et de taille de populations pour 2, 3 et 4 locus dialléliques. Cette thèse montre qu'utiliser un système multilocus permet d'obtenir des résultats non-conformes à ceux issus de systèmes rnonolocus (la référence en génétique des populations). Ce programme ouvre donc d'intéressantes perspectives en génétique des populations. Abstract The subject of this PhD thesis can be summarized by one famous paradox of evolu-tionary biology: the maintenance of polymorphism in the face of selection, and one classical equation of theoretical population genetics: the changes in gametic frequencies due to selection and recombination. The frequency of gamete xi at generation (t + 1) is given by: !!! Truncated equation!!! This equation is used to generate data on selection at two, three, and four diallelic loci for the different parts of this work. The first part focuses on the potential of heterozygote advantage to maintain genetic polymorphism. Results of previous studies are used to (re)define heterozygote advantage for multilocus systems, since the classical definition is for one diallelic locus. I use 5 different definitions of heterozygote advantage. And for these five definitions, I show that heterozygote advantage is not a general mechanism for the maintenance of polymorphism. The study of the influence of undetected loci on evolutionary processes (second part of this work) is motivated by molecular works which aim at discovering the loci coding for a trait. For most of these works, some coding loci remains undetected. I show that undetected loci increases the probability of maintaining polymorphism under selection. In addition, conclusions about the factor that maintain polymorphism can be misleading if not all loci are considered. This is, therefore, only when all loci are detected that exact conclusions on the level of maintained polymorphism or on the factor(s) that maintain(s) polymorphism could be drawn. In the third part, the focus is on the expected release of additive genetic variance after bottleneck for selected traits. A previous study shows that the expected release of additive variance increases with an increase in the number of loci. I show that the expected release of additive variance after bottleneck increases for selected traits (compared with neutral), but this increase is not a function of the number of loci, but function of the recombination rate. Finally, the last part of this PhD thesis is a description of a package for the statistical software R that implements the Equation given above. It allows to generate data for different scenario regarding selection, recombination, and population size. This package opens perspectives for the theoretical population genetics that mainly focuses on one locus, while this work shows that increasing the number of loci leads not necessarily to straightforward results.

Transpiration stimulée afin d'améliorer l'équilibre hydro-sodé chez les patients hémodialysés : à propos d'un cas [Stimulated sweating in order to improve the water-and-salt balance in hemodialysis patients. A case report].

Obtaining the desired dry weight in dialysis patients is challenging once residual diuresis has disappeared, considering the trend of increasing dietary salt intake and shortening dialysis time over the last 40 years. We describe the case of a 55-year-old patient of Sudanese origin, who presented excessive interdialytic weight gain and hypertension on maintenance hemodialysis. After failure of conservative measures, a therapy of daily hot water baths of 30minutes each on non-dialysis days was introduced. All clinical parameters improved, including potassium profile. In this article, we review the history, pathophysiological mechanisms, efficacy and possible side effects of this interesting, somewhat forgotten technique.

Reflective Crack Mitigation Guide for Flexible Pavements, TR-641, 2015

Reflective cracks form in pavements when hot-mix asphalt (HMA) overlays are placed over jointed and/or severely cracked rigid and flexible pavements. In the first part of the research, survival analysis was conducted to identify the most appropriate rehabilitation method for composite pavements and to evaluate the influence of different factors on reflective crack development. Four rehabilitation methods, including mill and fill, overlay, heater scarification (SCR), and rubblization, were analyzed using three performance indicators: reflective cracking, international roughness index (IRI), and pavement condition index (PCI). It was found that rubblization can significantly retard reflective cracking development compared to the other three methods. No significant difference for PCI was seen among the four rehabilitation methods. Heater scarification showed the lowest survival probability for both reflective cracking and IRI, while an overlay resulted in the poorest overall pavement condition based on PCI. In addition, traffic level was found not to be a significant factor for reflective cracking development. An increase in overlay thickness can significantly delay the propagation of reflective cracking for all four treatments. Soil types in rubblization pavement sites were assessed, and no close relationship was found between rubblized pavement performance and subgrade soil condition. In the second part of the research, the study objective was to evaluate the modulus and performance of four reflective cracking treatments: full rubblization, modified rubblization, crack and seat, and rock interlayer. A total of 16 pavement sites were tested by the surface wave method (SWM), and in the first four sites both falling weight deflectometer (FWD) and SWM were conducted for a preliminary analysis. The SWM gave close concrete layer moduli compared to the FWD moduli on a conventional composite pavement. However, the SWM provided higher moduli for the rubblized concrete layer. After the preliminary analysis, another 12 pavement sites were tested by the SWM. The results showed that the crack and seat method provided the highest moduli, followed by the modified rubblization method. The full rubblization and the rock interlayer methods gave similar, but lower, moduli. Pavement performance surveys were also conducted during the field study. In general, none of the pavement sites had rutting problems. The conventional composite pavement site had the largest amount of reflective cracking. A moderate amount of reflective cracking was observed for the two pavement sites with full rubblization. Pavements with the rock interlayer and modified rubblization treatments had much less reflective cracking. It is recommended that use of the modified rubblization and rock interlayer treatments for reflective cracking mitigation are best.

Final Report (SPR Project 90-00-RB10-012) on the Maintenance Asset Management Project Phase I, 2012

This project resulted in the development of a proof of concept for a features inventory process to be used by field staff. The resulting concept is adaptable for different asset classes (e.g. culverts, guardrail) and able to leverage existing DOT resources such as the videolog and LRS and our current technology platforms including Oracle and our GIS web infrastructure. The concept examined the feasibility of newly available technologies, such as mobile devices, while balancing ease of use in the field. Implementation and deployment costs were also important considerations in evaluating the success of the project. These project funds allowed the pilot to address the needs of two DOT districts. A report of findings was prepared, including recommendations for or against full deployment of the pilot solution.

Final Report (SPR Project 90-00-RB10-012) on the Maintenance Asset Management Project Phase II, 2013

This project resulted in the development of a proof of concept for a features inventory process to be used by field staff. The resulting concept is adaptable for different asset classes (e.g. culverts, guardrail) and able to leverage existing DOT resources such as the videolog and LRS and our current technology platforms including Oracle and our GIS web infrastructure. The concept examined the feasibility of newly available technologies, such as mobile devices, while balancing ease of use in the field. Implementation and deployment costs were also important considerations in evaluating the success of the project. These project funds allowed the pilot to address the needs of two DOT districts. A report of findings was prepared, including recommendations for a full deployment of a field data collection.

Maintenance and Design of Steel Abutment Piles in Iowa Bridges, TR-622, 2014

Soil consolidation and erosion caused by roadway runoff have exposed the upper portions of steel piles at the abutments of numerous bridges, leaving them susceptible to accelerated corrosion rates due to the abundance of moisture, oxygen, and chlorides at these locations. This problem is compounded by the relative inaccessibility of abutment piles for close-up inspection and repair. The objective of this study was to provide bridge owners with recommendations for effective methods of addressing corrosion of steel abutment piles in existing and future bridges A review of available literature on the performance and protection of steel piles exposed to a variety of environments was performed. Eight potential coating systems for use in protecting existing and/or new piles were selected and subjected to accelerated corrosion conditions in the laboratory. Two surface preparation methods were evaluated in the field and three coating systems were installed on three piles at an existing bridge where abutment piles had been exposed by erosion. In addition, a passive cathodic protection (CP) system using sacrificial zinc anodes was tested in the laboratory. Several trial flowable mortar mixes were evaluated for use in conjunction with the CP system. For existing abutment piles, application of a protective coating system is a promising method of mitigating corrosion. Based on its excellent performance in accelerated corrosion conditions in the laboratory on steel test specimens with SSPC-SP3, -SP6, and -SP10 surface preparations, glass flake polyester is recommended for use on existing piles. An alternative is epoxy over organic zinc rich primer. Surface preparation of existing piles should include abrasive blast cleaning to SSPC-SP6. Although additional field testing is needed, based on the results of the laboratory testing, a passive CP system could provide an effective means of protecting piles in existing bridges when combined with a pumped mortar used to fill voids between the abutment footing and soil. The addition of a corrosion inhibitor to the mortar appears to be beneficial. For new construction, shop application of thermally sprayed aluminum or glass flake polyester to the upper portion of the piles is recommended.

Energy gap in the aetiology of body weight gain and obesity: a challenging concept with a complex evaluation and pitfalls.

The concept of energy gap(s) is useful for understanding the consequence of a small daily, weekly, or monthly positive energy balance and the inconspicuous shift in weight gain ultimately leading to overweight and obesity. Energy gap is a dynamic concept: an initial positive energy gap incurred via an increase in energy intake (or a decrease in physical activity) is not constant, may fade out with time if the initial conditions are maintained, and depends on the 'efficiency' with which the readjustment of the energy imbalance gap occurs with time. The metabolic response to an energy imbalance gap and the magnitude of the energy gap(s) can be estimated by at least two methods, i.e. i) assessment by longitudinal overfeeding studies, imposing (by design) an initial positive energy imbalance gap; ii) retrospective assessment based on epidemiological surveys, whereby the accumulated endogenous energy storage per unit of time is calculated from the change in body weight and body composition. In order to illustrate the difficulty of accurately assessing an energy gap we have used, as an illustrative example, a recent epidemiological study which tracked changes in total energy intake (estimated by gross food availability) and body weight over 3 decades in the US, combined with total energy expenditure prediction from body weight using doubly labelled water data. At the population level, the study attempted to assess the cause of the energy gap purported to be entirely due to increased food intake. Based on an estimate of change in energy intake judged to be more reliable (i.e. in the same study population) and together with calculations of simple energetic indices, our analysis suggests that conclusions about the fundamental causes of obesity development in a population (excess intake vs. low physical activity or both) is clouded by a high level of uncertainty.

Deploying the Maintenance Decision Support System (MDSS) in Iowa, 2003

Adverse weather conditions dramatically affect the nation’s surface transportation system. The development of a prototype winter Maintenance Decision Support System (MDSS) is part of the Federal Highway Administration’s effort to produce a prototype tool for decision support to winter road maintenance managers to help make the highways safer for the traveling public. The MDSS is based on leading diagnostic and prognostic weather research capabilities and road condition algorithms, which are being developed at national research centers. In 2003, the Iowa Department of Transportation was chosen as a field test bed for the continuing development of this important research program. The Center for Transportation Research and Education assisted the Iowa Department of Transportation by collecting and analyzing surface condition data. The Federal Highway Administration also selected five national research centers to participate in the development of the prototype MDSS. It is anticipated that components of the prototype MDSS system developed by this project will ultimately be deployed by road operating agencies, including state departments of transportation, and generally supplied by private vendors.

Evaluation of Post-Tension Strengthened Steel Girder Bridge Using FRP Bars, 2003

Many state, county, and local agencies are faced with deteriorating bridge infrastructure composed of a large percentage of relatively short to medium span bridges. In many cases, these older structures are rolled or welded longitudinal steel stringers acting compositely with a reinforced concrete deck. Most of these bridges, although still in service, need some level of strengthening due to increases in legal live loads or loss of capacity due to deterioration. Although these bridges are overstressed in most instances, they do not warrant replacement; thus, structurally efficient but cost-effective means of strengthening needs to be employed. In the past, the use of bolted steel cover plates or angles was a common retrofit option for strengthening such bridges. However, the time and labor involved to attach such a strengthening system can sometimes be prohibitive. This project was funded through the Federal Highway Administration’s Innovative Bridge Research and Construction program. The goal is to retrofit an existing structurally deficient, three-span continuous steel stringer bridge using an innovative technique that involves the application of post-tensioning forces; the post-tensioning forces were applied using fiber reinforced polymer post-tensioning bars. When compared to other strengthening methods, the use of carbon fiber reinforced polymer composite materials is very appealing in that they are highly resistant to corrosion, have a low weight, and have a high tensile strength. Before the post-tensioning system was installed, a diagnostic load test was conducted on the subject bridge to establish a baseline behavior of the unstrengthened bridge. During the process of installing the post-tensioning hardware and stressing the system, both the bridge and the post-tensioning system were monitored. The installation of the hardware was followed by a follow-up diagnostic load test to assess the effectiveness of the post-tensioning strengthening system. Additional load tests were performed over a period of two years to identify any changes in the strengthening system with time. Laboratory testing of several typical carbon fiber reinforced polymer bar specimens was also conducted to more thoroughly understand their behavior. This report documents the design, installation, and field testing of the strengthening system and bridge.

Effectiveness of psychotropic medications in the maintenance phase of bipolar disorder:a meta-analysis of randomized controlled trials

The purpose of this meta-analysis was to examine the efficacy of maintenance treatments for bipolar disorder. Placebo-controlled or active comparator bipolar maintenance clinical trials of ≥6 months' duration with at least 15 patients/treatment group were identified using Medline, EMBASE, clinicaltrials.gov, and Cochrane databases (1993 to July 2010). The main outcome measure was relative risk for relapse for patients in remission. Twenty trials (5,364 patients) were identified. Overall, lithium and quetiapine were the most studied agents (eight and five trials, respectively). The majority of studies included patients who had previously responded to treatment for an acute episode. All interventions, with the exception of perphenazine+mood stabilizer, showed a relative risk for manic/mixed or depressive relapse below 1.0, although there was variation in the statistical significance of the findings vs. placebo. No monotherapy was associated with a significantly reduced risk for both manic/mixed and depressed relapse. Of the combination treatments, only quetiapine+lithium/divalproex, was associated with a significantly reduced risk vs. comparator (placebo+lithium/valproate) for relapse at both the manic/mixed and depressed poles of bipolar illness. Limitations for the analysis include differences in study durations and definitions of relapse. In conclusion, available maintenance therapies show considerable variation in efficacy. The efficacy of lithium and divalproex has been confirmed, but newer therapies, such as a number of atypical antipsychotics were also shown to be effective in bipolar disorder. Efficacy of all maintenance interventions needs to be balanced against the safety and tolerability profiles of individual agents.

Efficacy and safety of aripiprazole in the treatment of bipolar disorder: a systematic review.

Abstract BACKGROUND: The current article is a systematic review concerning the efficacy and safety of aripiprazole in the treatment of bipolar disorder. METHODS: A systematic Medline and repositories search concerning the usefulness of aripiprazole in bipolar disorder was performed, with the combination of the words 'aripiprazole' and 'bipolar'. RESULTS: The search returned 184 articles and was last updated on 15 April 2009. An additional search included repositories of clinical trials and previous systematic reviews specifically in order to trace unpublished trials. There were seven placebo-controlled randomised controlled trials (RCTs), six with comparator studies and one with add-on studies. They assessed the usefulness of aripiprazole in acute mania, acute bipolar depression and during the maintenance phase in comparison to placebo, lithium or haloperidol. CONCLUSION: Aripiprazole appears effective for the treatment and prophylaxis against mania. The data on bipolar depression are so far negative, however there is a need for further study at lower dosages. The most frequent adverse effects are extrapyramidal signs and symptoms, especially akathisia, without any significant weight gain, hyperprolactinaemia or laboratory test changes.

Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area

Background The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity. Methods This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months. Discussion By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting.