Body mass index estimation and measurement by healthcare professionals

Background: Severe obesity has increased more than three-fold in prevalence over the past fifteen years in Europe and the United States. Correctly identifying severe obesity permits access to mortality-reducing interventions. We aimed to determine the accuracy of healthcare professionals (HCPs) in recognising severe obesity and the frequency of body mass index (BMI) assessment by HCPs. Methods: We performed two cross-sectional surveys: one of 206 HCPs in Ireland and Canada and another of 515 Irish hospital healthcare records. The first survey evaluated BMI estimation from photographs and the second examined recording of weight and height during outpatient clinic visits. Results: HCPs underestimated the BMI of severely obese people by an average of 22% to 39%. For a patient with a BMI of 52 kg/m2, 35.4% of family physicians appreciated that the patient was severely obese (BMI > 40 kg/m2) compared with 81.0% of endocrinologists. During clinic visits only 18.1% (n = 75), 1% (n = 4) and 0% (n = 0) of patients had their respective weights, heights and BMIs recorded. Conclusions: HCPs frequently fail to recognise severe obesity from photographs and, in our centre, do not routinely record weight or height. Whether patient outcomes can be improved by measuring weight and height during every HCP encounter warrants further study.

EVI1 Mediated Stimulation of 3T3-L1 Preadipocyte Differentiation Is CtBP Dependent

Myelodysplasia syndrome 1 (MDS1) and Ecotropic viral integration site 1 (EVI1) complex (MECOM) locus encode multiple isoforms of the EVI1 protein that are essential for normal vertebrate development and when inappropriately expressed play a significant role in malignancy and in particular leukaemias. However, the function of individual EVI1 isoforms is not fully understood. Recently, EVI1 or PRDM3, which is structurally closely related to the brown adipose tissue determining factor PRDM16, was shown to be required for differentiation of adipocytes. In this study, we show that 3T3-L1 preadipocytes sustain expression of all Evi1 isoforms examined, including Mds1-Evi1, Evi1FL, Evi1Δ324, Evi1FL + 9 and Evi1Δ105 throughout the adipogenesis differentiation programme. We also show that differentiation markers are enhanced by enforced expression of either Evi1, Evi1FL + 9 or Evi1Δ105 isoforms. Interestingly 3T3-L1 differentiation markers are also moderately enhanced by enforced expression of Evi1Δ324, which lacks part of the N-ter-minal zinc finger domain (ZF1), demonstrating a biological activity for this particular isoform. Enforced expression of an Evi1 mutant lacking C-terminal binding protein (CtBP) co-repressor protein binding activity fails to stimulate 3T3-L1 differentiation markers and may have dominant negative activity, causing partial inhibition of this developmental programme. These studies show that multiple EVI1 isoforms are expressed in adipocytes and can stimulate adipogenic markers in a manner that is partially independent of the ZF1 DNA binding domain but fully dependent upon interaction with co-repressor CtBP proteins.

Use of Medicinal Plant and Its Vulnerability Due to Climate Change in Northern Part of Bangladesh

Medicinal plants are playing an important role to human livelihood. Bangladesh is well recognized of medicinal plants wealth as unique and globally rich. The studies demonstrate about the value of traditional systems of medicine as economically useful plants and possible effects of climate change on medicinal plants. It is true that climate change is causing noticeable effects on life cycles and distribution of the plant species. However, climate change effects on medicinal plants are widely unclear in Bangladesh. At present, a huge number of populations in Bangladesh are directly dependent on the healthcare treatment by medicinal plants that is why it is an emerging concern in Bangladesh. It is a crying need to improve our understanding the effects on medicinal plants by various researches is stressed in the present article. To know the present condition of medicinal plants and effects of climate change on medicinal plants in northern part of Bangladesh an attempt is being taken here. The study also added the optimum use of medicinal plants and their conservation in northern part of Bangladesh.

Investigations of CT Dose with Contrast Agent and Its Effects on the CTDI

Purpose: Computed tomography is a leading imaging technique for head & neck and brain and most of these imaging protocols iodine-based contrast media are utilised. The chief aim of this research is to utilize the effects of the contrast media “CM” used in computed tomography “CT” which is used to enhance subject contrast on the delivered CT via its inclusion into the CT dose index “CTDI”, and to introduce a simple method to determine this effect via the available CT numbers at the imaged targets. Method: The CT dose increase is estimated theoretically and measured experimentally and then related to the average CT number in the volume of CM uptake. A factor dependent on CM concentration and beam energy is added to the CTDI equation to represent the increased dose burden. A simple holed Perspex phantom was built to measure the variation of imaged CT number. CT Gafchromic type film was alternately imaged in a reservoir of CM and water. The relative difference in the dose burden as obtained by scanning the two films represents the dose difference and hence the CM dependent increase. Results: Measured dose effects due to the inclusion of the CM varied depending on the concentration. The increase in dose is estimated to be about 17% for 20% contrast media in the target while that for 10% by volume is around 6.6%. These are estimated from the CT numbers. Patients’ data also shows influence of the CM on the CTDI values. Conclusion: The dosimetric effects of the contrast media are included into the CTDI and can be estimated by using the CT numbers obtained.

瞬态诱发耳声发射在农村学龄儿童听力筛查中的应用

目的探讨瞬态诱发耳声发射（transient evoked otoaeoustic emission，TEOAE）应用于中国农村学龄儿童听力筛查的意义和可行性。方法用Madsen Celesta 503耳声发射仪对317例（634耳）正常农村小学1-6年级学生进行听力筛查，并用耳镜、纯音测听和鼓室导抗图系列检查作为“金标准”，验证其结果。结果317例（634耳）儿童TEOAE的通过率为94．64％（600／634），金标准的通过率为94．48％（599／634）。TEOAE测试中，一致百分率为96．69％±0．71％，灵敏度为0．69±0．078（69％±7．8％），特异度为0．98±0．0052（98％±0．52％），漏诊率β=0．31，误诊率α=0．02，Youden指数J=0．67±0．078，阳性似然比LR＋=34．5，阴性似然比LR_=0．32，阳性预报值PV＋=0．71（71％），阴性预报值PV_=0．98（98．％），AZ=0．8。结论TEOAE测试具有方便、快速、无创、灵敏、客观等优点，是较好的中国农村学龄儿童听力筛查的方法。

Osteoarthritis and Articular Cartilage: Biomechanics and Novel Treatment Paradigms

Background: Osteoarthritis is a widespread highly painful disabling age-related disease with no known cure. Although novel strategies for ameliorating osteoarthritic damage abound, it is likely that none will be successful over time if the entire spectrum of the disease and the effects of joint biomechanics on joint tissues are not carefully considered. Objectives: 1) To detail the structure of healthy articular cartilage, the key tissue affected by osteoarthritis. 2) To detail what aspects of cartilage damage best characterize osteoarthritis. 3) To consider the role of biomechanical factors in developing solutions to treat osteoarthritic joint damage. Methods: Literature sources from 1980 onwards that have contributed to our knowledge of the topics relevant to this paper were accessed and retrieved. The data were categorized into four predominant themes and conclusions about the state of our knowledge and future directives were formulated. Conclusions: Osteoarthritis prevalence remains high, and a cure appears elusive. A rich body of data has helped us to better understand the key tissue involved, and suggests a repair process might be feasible, if the basic collective information on the role of biomechanics in mediating or moderating articular cartilage integrity and function is forthcoming.

Carbonic Anhydrase III S-Glutathionylation Is Necessary for Anti-Oxidant Activity

Carbonic anhydrase isozyme CA3 protects cells against oxidative stress. Ectopic expression of murine Ca3, but not Ca2, protects proto-oncogene Evi1 expressing Rat1 fibroblast cells (ca3low) against hydrogen peroxide (H2O2) induced stress. Ca3 is S-glutathionylated via glutathione adducts with cysteines 181 and 186. Substitution of both Ca3 cysteines with serine fails to protect cells from oxidative stress. Insertion of cysteine at 181 and 186 in Ca2 is insufficient for conferring efficient anti-oxidant activity. This shows for the first time that S-glutathionylation of cys181 and cys186 residues is required for Ca3 anti-oxidant activity but that additional factors are also required.