Body composition and its relationship to metabolic risk factors in Asian children

Obesity is a major public health problem in both developed and developing countries. The body mass index (BMI) is the most common index used to define obesity. The universal application of the same BMI classification across different ethnic groups is being challenged due to the inability of the index to differentiate fat mass (FM) and fat�]free mass (FFM) and the recognized ethnic differences in body composition. A better understanding of the body composition of Asian children from different backgrounds would help to better understand the obesity�]related health risks of people in this region. Moreover, the limitations of the BMI underscore the necessity to use where possible, more accurate measures of body fat assessment in research and clinical settings in addition to BMI, particularly in relation to the monitoring of prevention and treatment efforts. The aim of the first study was to determine the ethnic difference in the relationship between BMI and percent body fat (%BF) in pre�]pubertal Asian children from China, Lebanon, Malaysia, the Philippines, and Thailand. A total of 1039 children aged 8�]10 y were recruited using a non�]random purposive sampling approach aiming to encompass a wide BMI range from the five countries. Percent body fat (%BF) was determined using the deuterium dilution technique to quantify total body water (TBW) and subsequently derive proportions of FM and FFM. The study highlighted the sex and ethnic differences between BMI and %BF in Asian children from different countries. Girls had approximately 4.0% higher %BF compared with boys at a given BMI. Filipino boys tended to have a lower %BF than their Chinese, Lebanese, Malay and Thai counterparts at the same age and BMI level (corrected mean %BF was 25.7�}0.8%, 27.4�}0.4%, 27.1�}0.6%, 27.7�}0.5%, 28.1�}0.5% for Filipino, Chinese, Lebanese, Malay and Thai boys, respectively), although they differed significantly from Thai and Malay boys. Thai girls had approximately 2.0% higher %BF values than Chinese, Lebanese, Filipino and Malay counterparts (however no significant difference was seen among the four ethnic groups) at a given BMI (corrected mean %BF was 31.1�}0.5%, 28.6�}0.4%, 29.2�}0.6%, 29.5�}0.6%, 29.5�}0.5% for Thai, Chinese, Lebanese, Malay and Filipino girls, respectively). However, the ethnic difference in BMI�]%BF relationship varied by BMI. Compared with Caucasians, Asian children had a BMI 3�]6 units lower for a given %BF. More than one third of obese Asian children in the study were not identified using the WHO classification and more than half were not identified using the International Obesity Task Force (IOTF) classification. However, use of the Chinese classification increased the sensitivity by 19.7%, 18.1%, 2.3%, 2.3%, and 11.3% for Chinese, Lebanese, Malay, Filipino and Thai girls, respectively. A further aim of the first study was to determine the ethnic difference in body fat distribution in pre�]pubertal Asian children from China, Lebanon, Malaysia, and Thailand. The skin fold thicknesses, height, weight, waist circumference (WC) and total adiposity (as determined by deuterium dilution technique) of 922 children from the four countries was assessed. Chinese boys and girls had a similar trunk�]to�]extremity skin fold thickness ratio to Thai counterparts and both groups had higher ratios than the Malays and Lebanese at a given total FM. At a given BMI, both Chinese and Thai boys and girls had a higher WC than Malays and Lebanese (corrected mean WC was 68.1�}0.2 cm, 67.8�}0.3 cm, 65.8�}0.4 cm, 64.1�}0.3 cm for Chinese, Thai, Lebanese and Malay boys, respectively; 64.2�}0.2 cm, 65.0�}0.3 cm, 62.9�}0.4 cm, 60.6�}0.3 cm for Chinese, Thai, Lebanese and Malay girls, respectively). Chinese boys and girls had lower trunk fat adjusted subscapular/suprailiac skinfold ratio compared with Lebanese and Malay counterparts. The second study aimed to develop and cross�]validate bioelectrical impedance analysis (BIA) prediction equations of TBW and FFM for Asian pre�]pubertal children from China, Lebanon, Malaysia, the Philippines, and Thailand. Data on height, weight, age, gender, resistance and reactance measured by BIA were collected from 948 Asian children (492 boys and 456 girls) aged 8�]10 y from the five countries. The deuterium dilution technique was used as the criterion method for the estimation of TBW and FFM. The BIA equations were developed from the validation group (630 children randomly selected from the total sample) using stepwise multiple regression analysis and cross�]validated in a separate group (318 children) using the Bland�]Altman approach. Age, gender and ethnicity influenced the relationship between the resistance index (RI = height2/resistance), TBW and FFM. The BIA prediction equation for the estimation of TBW was: TBW (kg) = 0.231�~Height2 (cm)/resistance (ƒ¶) + 0.066�~Height (cm) + 0.188�~Weight (kg) + 0.128�~Age (yr) + 0.500�~Sex (male=1, female=0) . 0.316�~Ethnicity (Thai ethnicity=1, others=0) �] 4.574, and for the estimation of FFM: FFM (kg) = 0.299�~Height2 (cm)/resistance (ƒ¶) + 0.086�~Height (cm) + 0.245�~Weight (kg) + 0.260�~Age (yr) + 0.901�~Sex (male=1, female=0) �] 0.415�~Ethnicity (Thai ethnicity=1, others=0) �] 6.952. The R2 was 88.0% (root mean square error, RSME = 1.3 kg), 88.3% (RSME = 1.7 kg) for TBW and FFM equation, respectively. No significant difference between measured and predicted TBW and between measured and predicted FFM for the whole cross�]validation sample was found (bias = �]0.1�}1.4 kg, pure error = 1.4�}2.0 kg for TBW and bias = �]0.2�}1.9 kg, pure error = 1.8�}2.6 kg for FFM). However, the prediction equation for estimation of TBW/FFM tended to overestimate TBW/FFM at lower levels while underestimate at higher levels of TBW/FFM. Accuracy of the general equation for TBW and FFM compared favorably with both BMI�]specific and ethnic�]specific equations. There were significant differences between predicted TBW and FFM from external BIA equations derived from Caucasian populations and measured values in Asian children. There were three specific aims of the third study. The first was to explore the relationship between obesity and metabolic syndrome and abnormalities in Chinese children. A total of 608 boys and 800 girls aged 6�]12 y were recruited from four cities in China. Three definitions of pediatric metabolic syndrome and abnormalities were used, including the International Diabetes Federation (IDF) and National Cholesterol Education Program (NCEP) definition for adults modified by Cook et al. and de Ferranti et al. The prevalence of metabolic syndrome varied with different definitions, was highest using the de Ferranti definition (5.4%, 24.6% and 42.0%, respectively for normal�]weight, overweight and obese children), followed by the Cook definition (1.5%, 8.1%, and 25.1%, respectively), and the IDF definition (0.5%, 1.8% and 8.3%, respectively). Overweight and obese children had a higher risk of developing the metabolic syndrome compared to normal�]weight children (odds ratio varied with different definitions from 3.958 to 6.866 for overweight children, and 12.640�]26.007 for obese children). Overweight and obesity also increased the risk of developing metabolic abnormalities. Central obesity and high triglycerides (TG) were the most common while hyperglycemia was the least frequent in Chinese children regardless of different definitions. The second purpose was to determine the best obesity index for the prediction of cardiovascular (CV) risk factor clustering across a 2�]y follow�]up among BMI, %BF, WC and waist�]to�]height ratio (WHtR) in Chinese children. Height, weight, WC, %BF as determined by BIA, blood pressure, TG, high�]density lipoprotein cholesterol (HDL�]C), and fasting glucose were collected at baseline and 2 years later in 292 boys and 277 girls aged 8�]10 y. The results showed the percentage of children who remained overweight/obese defined on the basis of BMI, WC, WHtR and %BF was 89.7%, 93.5%, 84.5%, and 80.4%, respectively after 2 years. Obesity indices at baseline significantly correlated with TG, HDL�]C, and blood pressure at both baseline and 2 years later with a similar strength of correlations. BMI at baseline explained the greatest variance of later blood pressure. WC at baseline explained the greatest variance of later HDL�]C and glucose, while WHtR at baseline was the main predictor of later TG. Receiver�]operating characteristic (ROC) analysis explored the ability of the four indices to identify the later presence of CV risk. The overweight/obese children defined on the basis of BMI, WC, WHtR or %BF were more likely to develop CV risk 2 years later with relative risk (RR) scores of 3.670, 3.762, 2.767, and 2.804, respectively. The final purpose of the third study was to develop age�] and gender�]specific percentiles of WC and WHtR and cut�]off points of WC and WHtR for the prediction of CV risk in Chinese children. Smoothed percentile curves of WC and WHtR were produced in 2830 boys and 2699 girls aged 6�]12 y randomly selected from southern and northern China using the LMS method. The optimal age�] and gender�]specific thresholds of WC and WHtR for the prediction of cardiovascular risk factors clustering were derived in a sub�]sample (n=1845) by ROC analysis. Age�] and gender�]specific WC and WHtR percentiles were constructed. The WC thresholds were at the 90th and 84th percentiles for Chinese boys and girls, respectively, with sensitivity and specificity ranging from 67.2% to 83.3%. The WHtR thresholds were at the 91st and 94th percentiles for Chinese boys and girls, respectively, with sensitivity and specificity ranging from 78.6% to 88.9%. The cut�]offs of both WC and WHtR were age�] and gender�]dependent. In conclusion, the current thesis quantifies the ethnic differences in the BMI�]%BF relationship and body fat distribution between Asian children from different origins and confirms the necessity to consider ethnic differences in body composition when developing BMI and other obesity index criteria for obesity in Asian children. Moreover, ethnicity is also important in BIA prediction equations. In addition, WC and WHtR percentiles and thresholds for the prediction of CV risk in Chinese children differ from other populations. Although there was no advantage of WC or WHtR over BMI or %BF in the prediction of CV risk, obese children had a higher risk of developing the metabolic syndrome and abnormalities than normal�]weight children regardless of the obesity index used.

Development and validation of anthropometric prediction equations for estimation of body fat in Indonesian men

Body composition of 292 males aged between 18 and 65 years was measured using the deuterium oxide dilution technique. Participants were divided into development (n=146) and cross-validation (n=146) groups. Stature, body weight, skinfold thickness at eight sites, girth at five sites, and bone breadth at four sites were measured and body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-stature ratio (WSR) calculated. Equations were developed using multiple regression analyses with skinfolds, breadth and girth measures, BMI, and other indices as independent variables and percentage body fat (%BF) determined from deuterium dilution technique as the reference. All equations were then tested in the cross-validation group. Results from the reference method were also compared with existing prediction equations by Durnin and Womersley (1974), Davidson et al (2011), and Gurrici et al (1998). The proposed prediction equations were valid in our cross-validation samples with r=0.77- 0.86, bias 0.2-0.5%, and pure error 2.8-3.6%. The strongest was generated from skinfolds with r=0.83, SEE 3.7%, and AIC 377.2. The Durnin and Womersley (1974) and Davidson et al (2011) equations significantly (p<0.001) underestimated %BF by 1.0 and 6.9% respectively, whereas the Gurrici et al (1998) equation significantly (p<0.001) overestimated %BF by 3.3% in our cross-validation samples compared to the reference. Results suggest that the proposed prediction equations are useful in the estimation of %BF in Indonesian men.

Some practical advice on polynomial regression analysis from blocked response surface designs

It is often necessary to run response surface designs in blocks. In this paper the analysis of data from such experiments, using polynomial regression models, is discussed. The definition and estimation of pure error in blocked designs are considered. It is recommended that pure error is estimated by assuming additive block and treatment effects, as this is more consistent with designs without blocking. The recovery of inter-block information using REML analysis is discussed, although it is shown that it has very little impact if thc design is nearly orthogonally blocked. Finally prediction from blocked designs is considered and it is shown that prediction of many quantities of interest is much simpler than prediction of the response itself.

Optimum design of experiments for statistical inference

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Otimização da desidratação osmótica de filés de mapará (Hypophthalmus edentatus) através da metodologia de superfície de resposta

A desidratação osmótica de filés de mapará tem sido utilizada como pré-tratamento antes da secagem e refrigeração de alimentos como um meio de reduzir a umidade dos produtos. O objetivo do trabalho foi otimizar a transferência de massa ocorrida durante a desidratação osmótica de mapará através da metodologia de superfície de resposta. A desidratação osmótica foi realizada de acordo com um planejamento fatorial completo 2³, com oito pontos fatoriais, três centrais e seis axiais, totalizando 17 ensaios, em que o valor das variáveis dependentes, a perda de peso (PP), a perda de água (PA), o ganho de sólidos (GS), GS/PA e ácido tiobarbitúrico (TBA), são funções das variáveis independentes, temperatura, concentração de NaCl e tempo de imersão. A análise estatística aplicada aos dados experimentais foi realizada através do erro puro e pelo SS residual. Aplicando a metodologia de superfície de resposta, a condição ótima de convergência de menor perda de peso, maior perda de água e menor ganho de sal correspondeu a uma concentração de cloreto de sódio de 22%, temperatura de 46 °C e tempo de 7 horas.

Quantum Error Correction via Codes over GF(2)

It is well known that n-length stabilizer quantum error correcting codes (QECCs) can be obtained via n-length classical error correction codes (CECCs) over GF(4), that are additive and self-orthogonal with respect to the trace Hermitian inner product. But, most of the CECCs have been studied with respect to the Euclidean inner product. In this paper, it is shown that n-length stabilizer QECCs can be constructed via 371 length linear CECCs over GF(2) that are self-orthogonal with respect to the Euclidean inner product. This facilitates usage of the widely studied self-orthogonal CECCs to construct stabilizer QECCs. Moreover, classical, binary, self-orthogonal cyclic codes have been used to obtain stabilizer QECCs with guaranteed quantum error correcting capability. This is facilitated by the fact that (i) self-orthogonal, binary cyclic codes are easily identified using transform approach and (ii) for such codes lower bounds on the minimum Hamming distance are known. Several explicit codes are constructed including two pure MDS QECCs.

Effects of Noise and Detection Error in a Dynamic Adaptive Optics System

It is well known that noise and detection error can affect the performances of an adaptive optics (AO) system. Effects of noise and detection error on the phase compensation effectiveness in a dynamic AO system are investigated by means of a pure numerical simulation in this paper. A theoretical model for numerically simulating effects of noise and detection error in a static AO system and a corresponding computer program were presented in a previous article. A numerical simulation of effects of noise and detection error is combined with our previous numeral simulation of a dynamic AO system in this paper and a corresponding computer program has been compiled. Effects of detection error, readout noise and photon noise are included and investigated by a numerical simulation for finding the preferred working conditions and the best performances in a practical dynamic AO system. An approximate model is presented as well. Under many practical conditions such approximate model is a good alternative to the more accurate one. A simple algorithm which can be used for reducing the effect of noise is presented as well. When signal to noise ratio is very low, such method can be used to improve the performances of a dynamic AO system.

Energy inequalities and error estimates for axisymmetric torsion of thin elastic shells of revolution

The problem motivating this investigation is that of pure axisymmetric torsion of an elastic shell of revolution. The analysis is carried out within the framework of the three-dimensional linear theory of elastic equilibrium for homogeneous, isotropic solids. The objective is the rigorous estimation of errors involved in the use of approximations based on thin shell theory.

The underlying boundary value problem is one of Neumann type for a second order elliptic operator. A systematic procedure for constructing pointwise estimates for the solution and its first derivatives is given for a general class of second-order elliptic boundary-value problems which includes the torsion problem as a special case.

The method used here rests on the construction of “energy inequalities” and on the subsequent deduction of pointwise estimates from the energy inequalities. This method removes certain drawbacks characteristic of pointwise estimates derived in some investigations of related areas.

Special interest is directed towards thin shells of constant thickness. The method enables us to estimate the error involved in a stress analysis in which the exact solution is replaced by an approximate one, and thus provides us with a means of assessing the quality of approximate solutions for axisymmetric torsion of thin shells.

Finally, the results of the present study are applied to the stress analysis of a circular cylindrical shell, and the quality of stress estimates derived here and those from a previous related publication are discussed.

Pure-phase plates for super-Gaussian focal-plane irradiance profile generations of extremely high order

A set of recursive formulas for diffractive optical plates design is described. The pure-phase plates simulated by this method homogeneously concentrate more than 96% of the incident laser energy in the desired focal-plane region. The intensity focal-plane profile fits a lath-order super-Gaussian function and has a nearly perfect flat top. Its fit to the required profile measured in the mean square error is 3.576 x 10(-3). (C) 1996 Optical Society of America

The effect of the product cost factor on error handling in industrial robots

N.W. Hardy and M.H. Lee. The effect of the product cost factor on error handling in industrial robots. In Maria Gini, editor, Detecting and Resolving Errors in Manufacturing Systems. Papers from the 1994 AAAI Spring Symposium Series, pages 59-64, Menlo Park, CA, March 1994. The AAAI Press. Technical Report SS-94-04, ISBN 0-929280-60-1.

Research into error recovery for sensory robots

Lee, M., Barnes, D. P., Hardy, N. (1985). Research into error recovery for sensory robots. Sensor Review, 5 (4), 194-197.

Research into automatic error recovery

Lee, M., Hardy, N., & Barnes, D. P. (1984). Research into automatic error recovery. 65-69. Paper presented at 4th International Conference on Robot Vision and Sensory Controls, London, London, United Kingdom.

Error recovery in robot applications

Lee, M., Hardy, N., & Barnes, D. P. (1983). Error recovery in robot applications. 217-222. Paper presented at 6th British Robot Association Annual Conference, Birmingham, Birmingham, United Kingdom.

Knowledge based error recovery in industrial robots

M. H. Lee, D. P. Barnes, and N. W. Hardy. Knowledge based error recovery in industrial robots. In Proc. 8th. Int. Joint Conf. Artificial Intelligence, pages 824-826, Karlsruhe, FDR., 1983.

Automatic Error Recovery in Behaviour-Based Assistive Robots with Learning from Experience

Meng Q. and Lee M.H., Automatic Error Recovery in Behaviour-Based Assistive Robots with Learning from Experience, in Proc. INES 2001, 5th IEEE Int. Conf. on Intelligent Engineering Systems, Helsinki, Finland, Sept 2001, pp291-296.