This document discusses the influence of intensive physical training on growth and pubertal development in athletes. It finds that:
1) Intensive training can negatively influence growth, especially in artistic gymnastics where both male and female gymnasts exhibited attenuated growth potential compared to their genetic predisposition and target height.
2) In rhythmic gymnasts, genetic predisposition to growth was preserved and even exceeded, as rhythmic gymnasts continued growing into later ages and achieved heights above their target heights.
3) In most other sports not requiring strict dietary restrictions, no negative impact on growth was found. Intensive training delayed pubertal development and sexual maturation in various sports, especially gymnastics,
Tamara Valovich McLeod, Ph.D. - "The Impact of Sport-Related Injury on Health...youth_nex
The Youth-Nex Conference on Physical Health and Well-Being for Youth, Oct 10 & 11, 2013, University of Virginia
Tamara Valovich McLeod, Ph.D. - "The Impact of Sport-Related Injury on Health-Related Quality of Life"
Valovich McLeod is the John P. Wood, D.O., Endowed Chair for Sports Medicine and a Professor in the Athletic Training Program at A.T. Still University.
Panel 5 -- Injury Prevention and Treatment. While being physically active is important for positive youth development, injuries can result. This panel will discuss ways to minimize injury, particularly concussions, while addressing the impact of sport-related injury on quality of life. The panel will also provide a blueprint for encouraging life-long physical activity.
Website: http://bit.ly/YNCONF13
Tamara Valovich McLeod, Ph.D. - "The Impact of Sport-Related Injury on Health...youth_nex
The Youth-Nex Conference on Physical Health and Well-Being for Youth, Oct 10 & 11, 2013, University of Virginia
Tamara Valovich McLeod, Ph.D. - "The Impact of Sport-Related Injury on Health-Related Quality of Life"
Valovich McLeod is the John P. Wood, D.O., Endowed Chair for Sports Medicine and a Professor in the Athletic Training Program at A.T. Still University.
Panel 5 -- Injury Prevention and Treatment. While being physically active is important for positive youth development, injuries can result. This panel will discuss ways to minimize injury, particularly concussions, while addressing the impact of sport-related injury on quality of life. The panel will also provide a blueprint for encouraging life-long physical activity.
Website: http://bit.ly/YNCONF13
Cognitive Benefits of Exercise for Children and TeensMark Dreher PhD
The brain evolves during our childhood years as it continues to develop and is affected by lifestyle habits such as physical activity, cognitive activity, nutrition and sleep.
Although there is growing scientific evidence that exercise is associated with improved cognitive function, academic performance, and overall health in children, the limited amount of time generally dedicated to physical activity during the school day continues to decline in many schools.
The activity requirements for healthy brain and cognitive function are really relatively modest. For children, moderate aerobic activity of about 60 minutes a day can make a big difference, especially in children that are currently low-performers. There is work to be done in the United States and other countries to meet these activity goals as only about 30% of high school students achieve them.
This presentation provides a current summary of the human research on aerobic exercise and cognitive function in children and teens.
Mark Dreher PhD
A Comprehensive Mixed-Longitudinal Study of Growth in Boys with Autism Spectr...Cherie Green
The first aim in the current study was to replicate previous findings indicating a phase of early overgrowth of HC, height and weight. The second aim was to investigate if growth dysregulation was also apparent in older children and adolescents with ASD. If a general growth dysregulation was found in boys with ASD from birth - 16 years of age, it was hypothesized that this growth dysregulation may be the result of either 1) connective tissue abnormalities, and/or
2) dysregulation of the HPA axis. A further exploratory aim was to identify biologically distinct subgroups within ASD based on specific growth, behavioural, and biological patterns.
The results from both Study 1 and 2 confirmed that an overall growth dysregulation exists in ASD. Boys with ASD are smaller at birth, but then grow at a faster rate, so that by 4 years of age they are larger than TD boys. They then stay larger throughout childhood and adolescence. Although there were no group differences in the overall rate of growth from 4- to 16-years of age, the pattern of growth was visibly different and requires further investigation.
Although the abnormal growth trajectory is clear, the reasoning behind it is less so. Boys with ASD had longer limbs than TD boys, indicating possible connective tissue abnormalities. The HPA axis may also be involved, as more severe autistic symptoms were correlated with a greater CAR and with being large overall. Further research is required to determine if boys who are large overall also have increased CAR and represent a biologically distinct subgroup within ASD.
The impact of physical activity participation on the self esteem of the stude...Dr. Mohammed Abou Elmagd
Positive self-esteem helps people to feel good about themselves and gives them confidence to do things and confront social challenges. Positive self-esteem is improved by certain factors including increased physical activity. This can be utilized in the university age group, especially when considering medical and health sciences colleges where higher stress levels are recorded. Aim: To assess the relationship between physical activity and self-esteem among medical and health sciences students. Methods: an online questionnaire-based cross sectional study involved 198 students from RAK Medical and Health Sciences University was conducted to identify the level of physical activity and self-esteem score. Results were tabulated and analyzed using SPSS. Results: there was significant positive correlation between physical activity and self-esteem (r = 0.604). However, the correlation was higher for female students with no significant difference. Correlation among colleges did not show significant differences.
5 crucial questions you need to answer before choosing a PIM systemPerfion
A guide to a better decision -
for you
Product Information Management – or
PIM – deals with making cumbersome
processes easier and giving you full
control over product data throughout
the entire life of the product and in all
possible channels. A task which is difficult
to understand and time consuming to
handle without central management of
product data.
It is about simplicity, but investing in PIM is still a complex
decision. Mainly, because PIM affects many different
parts of your business. Both in relation to data and the
people who use it.
We have written this guide to help you reach the best
possible basis for your decision before you invest in a PIM
system. If you want to achieve full value out of your investment,
finding a PIM system that matches your needs
in all the key areas is critical
Based on our experience from hundreds of customers
all over the world, we have selected 5 questions that are
essential for a solid identification of needs. The questions
provide you a qualified basis on which to evaluate different
PIM solutions.
エヌビディアが加速するディープラーニング~進化するニューラルネットワークとその開発方法について~NVIDIA Japan
NVIDIA Deep Learning Institute
2016年4月27日のNVIDIA Deep Learning Day 2016 Springの資料です。
エヌビディア合同会社 プラットフォームビジネス本部
ディープラーニングソリューションアーキテクト 兼
CUDA エンジニア 村上 真奈
[概要]
ディープラーニングは近年、画像認識の分野で、その高い認識精度から大変注目を集めている技術です。音声認識や自動運転など画像認識の分野以外への応用が進んでおり大変期待されています。本セッションは、日々新しい構造のモデルが提案され進化しているディープラーニングの概要とGPUが必要とされている理由について簡単に説明します。
その後に、実際にディープラーニングの開発のイメージを持って戴けるように、いくつかの代表的なディープラーニングのフレームワークを使い、デモしながら各フレームワークの特徴を解説します。ディープラーニングの最新の状況が知りたい、実際の開発の際にどのフレームワークを使うべきか知りたい、開発を始める前に開発のイメージを持ちたいという方に最適です。
Cognitive Benefits of Exercise for Children and TeensMark Dreher PhD
The brain evolves during our childhood years as it continues to develop and is affected by lifestyle habits such as physical activity, cognitive activity, nutrition and sleep.
Although there is growing scientific evidence that exercise is associated with improved cognitive function, academic performance, and overall health in children, the limited amount of time generally dedicated to physical activity during the school day continues to decline in many schools.
The activity requirements for healthy brain and cognitive function are really relatively modest. For children, moderate aerobic activity of about 60 minutes a day can make a big difference, especially in children that are currently low-performers. There is work to be done in the United States and other countries to meet these activity goals as only about 30% of high school students achieve them.
This presentation provides a current summary of the human research on aerobic exercise and cognitive function in children and teens.
Mark Dreher PhD
A Comprehensive Mixed-Longitudinal Study of Growth in Boys with Autism Spectr...Cherie Green
The first aim in the current study was to replicate previous findings indicating a phase of early overgrowth of HC, height and weight. The second aim was to investigate if growth dysregulation was also apparent in older children and adolescents with ASD. If a general growth dysregulation was found in boys with ASD from birth - 16 years of age, it was hypothesized that this growth dysregulation may be the result of either 1) connective tissue abnormalities, and/or
2) dysregulation of the HPA axis. A further exploratory aim was to identify biologically distinct subgroups within ASD based on specific growth, behavioural, and biological patterns.
The results from both Study 1 and 2 confirmed that an overall growth dysregulation exists in ASD. Boys with ASD are smaller at birth, but then grow at a faster rate, so that by 4 years of age they are larger than TD boys. They then stay larger throughout childhood and adolescence. Although there were no group differences in the overall rate of growth from 4- to 16-years of age, the pattern of growth was visibly different and requires further investigation.
Although the abnormal growth trajectory is clear, the reasoning behind it is less so. Boys with ASD had longer limbs than TD boys, indicating possible connective tissue abnormalities. The HPA axis may also be involved, as more severe autistic symptoms were correlated with a greater CAR and with being large overall. Further research is required to determine if boys who are large overall also have increased CAR and represent a biologically distinct subgroup within ASD.
The impact of physical activity participation on the self esteem of the stude...Dr. Mohammed Abou Elmagd
Positive self-esteem helps people to feel good about themselves and gives them confidence to do things and confront social challenges. Positive self-esteem is improved by certain factors including increased physical activity. This can be utilized in the university age group, especially when considering medical and health sciences colleges where higher stress levels are recorded. Aim: To assess the relationship between physical activity and self-esteem among medical and health sciences students. Methods: an online questionnaire-based cross sectional study involved 198 students from RAK Medical and Health Sciences University was conducted to identify the level of physical activity and self-esteem score. Results were tabulated and analyzed using SPSS. Results: there was significant positive correlation between physical activity and self-esteem (r = 0.604). However, the correlation was higher for female students with no significant difference. Correlation among colleges did not show significant differences.
5 crucial questions you need to answer before choosing a PIM systemPerfion
A guide to a better decision -
for you
Product Information Management – or
PIM – deals with making cumbersome
processes easier and giving you full
control over product data throughout
the entire life of the product and in all
possible channels. A task which is difficult
to understand and time consuming to
handle without central management of
product data.
It is about simplicity, but investing in PIM is still a complex
decision. Mainly, because PIM affects many different
parts of your business. Both in relation to data and the
people who use it.
We have written this guide to help you reach the best
possible basis for your decision before you invest in a PIM
system. If you want to achieve full value out of your investment,
finding a PIM system that matches your needs
in all the key areas is critical
Based on our experience from hundreds of customers
all over the world, we have selected 5 questions that are
essential for a solid identification of needs. The questions
provide you a qualified basis on which to evaluate different
PIM solutions.
エヌビディアが加速するディープラーニング~進化するニューラルネットワークとその開発方法について~NVIDIA Japan
NVIDIA Deep Learning Institute
2016年4月27日のNVIDIA Deep Learning Day 2016 Springの資料です。
エヌビディア合同会社 プラットフォームビジネス本部
ディープラーニングソリューションアーキテクト 兼
CUDA エンジニア 村上 真奈
[概要]
ディープラーニングは近年、画像認識の分野で、その高い認識精度から大変注目を集めている技術です。音声認識や自動運転など画像認識の分野以外への応用が進んでおり大変期待されています。本セッションは、日々新しい構造のモデルが提案され進化しているディープラーニングの概要とGPUが必要とされている理由について簡単に説明します。
その後に、実際にディープラーニングの開発のイメージを持って戴けるように、いくつかの代表的なディープラーニングのフレームワークを使い、デモしながら各フレームワークの特徴を解説します。ディープラーニングの最新の状況が知りたい、実際の開発の際にどのフレームワークを使うべきか知りたい、開発を始める前に開発のイメージを持ちたいという方に最適です。
شركة |تراك للحلول التعليمية|، شركة متخصصة في إعداد البرامج المهنية والتعليمية، مقرها الرئيسي في دولة الكويت و فرعها
في دولة الامارات . حيث تعتبر تراك الموزع الوحيد المعتمد لمراكز وهيئات التدريب في الشرق الأوسط و شمال أفريقيا لتقديم برنامج محترف الأعمال المعتمد البرنامج الذي يتصدر لائحة البرامج المهنية والإدارية ،كما تعمل شركة تراك على توفير برامج تعليمية عالية الجودة وتمنح شهاداتها الدولية المعتمدة في جميع أنحاء العالم للمتخصصين في شتى مجالات الأعمال.
. هذا وتعمل أيضا على مساعدة شركائها في المنطقة وذلك عبر التواصل والدعم المستمر.
Help, what content does my ecommerce site need? - SEMRush webinar January 2016Charlie Williams
The slides from a webinar delivered for SEMrush on 28th January 2016 on the challenges of creating, managing & optimising product page content.
Always one of search marketing’s biggest challenges, content is doubly so for e-commerce websites with a big list of products to create content for. Often we have to create content when we don’t have direct access to the products themselves or the manufacturer’s range of expert knowledge. But we’re constantly told that in the modern search landscape, content is a key ingredient.
We’ll dive into the common content questions: What does Google want? What content mistakes get made? How do we know what our audience needs? And how do we become experts and create content that will stand out in the ever-increasingly crowded market?
POSITION STATEMENTOveruse Injuries and Burnout in Youth Sp.docxharrisonhoward80223
POSITION STATEMENT
Overuse Injuries and Burnout in Youth Sports:
A Position Statement from the American Medical Society for
Sports Medicine
John P. DiFiori, MD,* Holly J. Benjamin, MD,† Joel Brenner, MD, MPH,‡ Andrew Gregory, MD,§
Neeru Jayanthi, MD,¶ Greg L. Landry, MD,∥ and Anthony Luke, MD, MPH**
(Clin J Sport Med 2014;24:3–20)
Executive Summary
BACKGROUND
• Youth sport participation offers many benefits including
the development of self-esteem, peer socialization, and
general fitness.
• However, an emphasis on competitive success, often driven
by goals of elite-level travel team selection, collegiate schol-
arships, Olympic and National team membership, and even
professional contracts, has seemingly become widespread.
• This has resulted in increased pressure to begin high-
intensity training at young ages.
• Such an excessive focus on early intensive training and
competition at young ages rather than skill development
can lead to overuse injury and burnout.
PURPOSE
• To provide a systematic, evidenced-based review that will:
∘ Assist clinicians in recognizing young athletes at risk
for overuse injuries and burnout.
∘ Delineate the risk factors and injuries that are unique to
the skeletally immature young athlete.
∘ Describe specific high-risk overuse injuries that present
management challenges and/or can lead to long-term
health consequences.
∘ Summarize the risk factors and symptoms associated
with burnout in young athletes.
∘ Provide recommendations on overuse injury prevention.
METHODOLOGY
• Medical Subject Headings (MeSHs) and text words were
searched on March 26, 2012, for MEDLINE, CINAHL,
and PsychINFO.
• Nine hundred fifty-three unique articles were initially
identified. Additional articles were found using cross-
referencing. The process was repeated July 10, 2013,
to review any new articles since the original search.
• Screening by the authors yielded a total of 208 relevant
sources that were used for this paper.
• Recommendations were classified using the Strength of
Recommendation Taxonomy (SORT) grading system.
DEFINITION OF OVERUSE INJURY
• Overuse injuries occur due to repetitive submaximal
loading of the musculoskeletal system when rest is not
adequate to allow for structural adaptation to take place.
• Injury can involve the muscle-tendon unit, bone, bursa,
neurovascular structures, and the physis.
• Overuse injuries unique to young athletes include apoph-
yseal injuries and physeal stress injuries.
EPIDEMIOLOGY
• It is estimated that 27 million US youth between 6 to 18
years of age participate in team sports.
• The National Council of Youth Sports survey found that
60 million children aged 6 to 18 years participate in some
Submitted for publication November 2, 2013; accepted November 6, 2013.
From the *Division of Sports Medicine and Non-Operative Orthopaedics, Depart-
ments of Family Medicine and Orthopaedics, University of California, Los
Angeles, California; †Departments of Pediatrics an.
Nutrition, Sports, and Covid-19 Lockdown Impact on Young Competitive Artistic...Austin Publishing Group
COVID-19 lockdown has highlighted a worrying discrepancy among macronutrients intake during the training period and the suggested ratio of macronutrients for healthy nutrition, with an inverted ratio fat/protein, and lower energy intake in respect to the consumed.
Abstract—
A birth weight that is too small could signal the occurrence of growth disorders or even growth deficiency, as well as a variety of disorders of bodily functions, including impaired glucose tolerance, insulin resistance and hypertension. However, so far the relation between birth weight and aerobic capacity has not been studied.
Objective: To compare the aerobic capacity of physically active young adults with different birth weights.
Methods: 159 people born at full term of a single pregnancy (F: 45%, n = 71; M: n = 88), first-year students studying Physical Education. In all cases the subjects’ body composition was estimated, height and weight (BW) was measured, and the maximal oxygen uptake during exercises performed on an ergometer bicycle was established.
Results: the smallest birth body weight (BBW) was 2200 g; 3% of students (n = 5) were born with a BBW of less than 2500 g, and only 2% were born with BBW deficiency (<2><1> 2 s);
2. We suggest that when enrolling women for sports disciplines requiring their best aerobic capacity, birth weight should be taken into consideration, and based on the observations from the study it is furthermore suggested that a search for talent should be conducted among girls with BBW between 2300 and 3800 g.
The impact of physical activity on academic performance among medical and hea...Dr. Mohammed Abou Elmagd
Physical activity is a crucial component of school curricula as it is suggested to increase the students’ academic performance. This may be applied in the university age group, especially when considering medical and health sciences colleges where higher stress levels are recorded. Aim: To assess the relationship between physical activity and academic performance among medical and health sciences students. Methods: an online questionnaire-based cross sectional study involved 198 students from RAK Medical and Health Sciences University was conducted to identify the level of physical activity and academic performance. Results were tabulated and analyzed using SPSS. Results: there was significant positive correlation between physical activity and academic performance (r = 0.208). However, the correlation was higher for BDS College with no significant difference with regard to nationality, age and gender.
ORIGINALARTICLESEVIDENCE BASED PHYSICAL ACTIVITY FOR SCH.docxalfred4lewis58146
ORIGINAL
ARTICLES
EVIDENCE BASED PHYSICAL ACTIVITY FOR SCHOOL-AGE YOUTH
WILLIAM B. STRONG, MD,* ROBERT M. MALINA, PHD,* CAMERON J. R. BLIMKIE, PHD, STEPHEN R. DANIELS, MD, PHD,
RODNEY K. DISHMAN, PHD, BERNARD GUTIN, PHD, ALBERT C. HERGENROEDER, MD, AVIVA MUST, PHD, PATRICIA A. NIXON, PHD,
JAMES M. PIVARNIK, PHD, THOMAS ROWLAND, MD, STEWART TROST, PHD, AND FRANCxOIS TRUDEAU, PHD
Objectives To review the effects of physical activity on health and behavior outcomes and develop evidence-based
recommendations for physical activity in youth.
Study design A systematic literature review identified 850 articles; additional papers were identified by the expert
panelists. Articles in the identified outcome areas were reviewed, evaluated and summarized by an expert panelist. The strength
of the evidence, conclusions, key issues, and gaps in the evidence were abstracted in a standardized format and presented and
discussed by panelists and organizational representatives.
Results Most intervention studies used supervised programs of moderate to vigorous physical activity of 30 to 45 minutes
duration 3 to 5 days per week. The panel believed that a greater amount of physical activity would be necessary to achieve similar
beneficial effects on health and behavioral outcomes in ordinary daily circumstances (typically intermittent and unsupervised
activity).
Conclusion School-age youth should participate daily in 60 minutes or more of moderate to vigorous physical activity that
is developmentally appropriate, enjoyable, and involves a variety of activities. (J Pediatr 2005;146:732-7)
R
ecommendations for appropriate amounts of physical activity for the US
population, including school-age youth, have been developed by several
organizations and agencies.1 Although recent reviews have summarized the
benefits of regular physical activity on the health of youth and its potential for reducing the
incidence of chronic diseases that are manifested in adulthood,
2-5
a more systematic
approach is indicated. This report presents results of a systematic evaluation of evidence
dealing with the effects of regular physical activity on several health and behavioral
outcomes in US school-age youth, with the goal of developing a recommendation for the
amount of physical activity deemed appropriate to yield beneficial health and behavioral
outcomes.
METHOD
Under a contract with the Divisions of Nutrition and Physical Activity and
Adolescent and School Health of the Centers for Disease Control and Prevention and the
Constella Group, an expert panel was convened to review and evaluate available evidence
on the influence of physical activity on several health and behavioral outcomes in youth
aged 6 to 18 years. The co-chairs of the panel selected panelists on the basis of expertise in
specific areas: adiposity, cardiovascular health (lipids and lipoproteins, blood pressure, the
metabolic syndrome, type 2 diabetes mellitus, cardiovascular reactivity, heart rate
variab.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Are There Any Natural Remedies To Treat Syphilis.pdf
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES
1. Ann. N.Y. Acad. Sci. ISSN 0077-8923
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES
Issue: Women’s Health and Disease
The influence of intensive physical training on growth
and pubertal development in athletes
Neoklis A. Georgopoulos,1
Nikolaos D. Roupas,1
Anastasia Theodoropoulou,2
Athanasios Tsekouras,2
Apostolos G. Vagenakis,2
and Kostas B. Markou2
1
Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School,
University Hospital, Patras, Greece. 2
Division of Endocrinology, Department of Medicine, University of Patras Medical School,
University Hospital, Patras, Greece
Address for correspondence: Neoklis A. Georgopoulos, Division of Reproductive Endocrinology, Department of Obstetrics
and Gynecology, University of Patras Medical School, University Hospital, Rio-26500, Patras, Greece. neoklisg@hol.gr
Genetic potential for growth can be fully expressed only under favorable environmental conditions. Although
moderate physical activity has beneficial effects on growth, excessive physical training may negatively affect it. Sports
favoring restricted energy availability, in the presence of high energy expenditure, are of particular concern. In
gymnastics, a different pattern in skeletal maturation and linear growth was observed, resulting in an attenuation
of growth potential in artistic gymnasts (AG), more pronounced in males than in females. In female rhythmic
gymnasts (RG), the genetic predisposition to growth was preserved owing to a late catchup growth phenomenon.
In all other sports not requiring strict dietary restrictions, no deterioration of growth has been documented so
far. Intensive physical training and negative energy balance alter the hypothalamic pituitary set point at puberty,
prolong the prepubertal stage, and delay pubertal development and menarche in a variety of sports. In elite RG and
AG, prepubertal stage is prolonged and pubertal development is entirely shifted to a later age, following the bone
maturation rather than the chronological age.
Keywords: athletes; gymnasts; growth; pubertal development; skeletal maturation; bone acquisition
Introduction
Somatic growth and biological maturation are dy-
namic processes regulated by a variety of genetic and
environmental factors. Changes in body composi-
tion, in body proportions, in skeletal maturation,
and in pubertal development constitute indispens-
able components in the evaluation of the growth
process,complementingthetraditionalaspectofthe
assessment of stature as the main focus of growth
evaluation. Thus, growth and physical maturation
should be regarded as a complex, and dynamic pro-
cess, including a large variety of molecular and so-
matic changes.
Genetic predisposition to growth can be fully
expressed only under favorable environmental
conditions.1
Environmental factors can act inde-
pendently or in combination to modify the individ-
ual genetic potential. Athletic training when exerted
during childhood and adolescence has a huge im-
pact on physical growth and pubertal maturation.
There is strong evidence that regular physical ac-
tivity is important for good body function and de-
velopment. At the same time, there is a growing
concern regarding the influence of stress and inten-
sivephysicaltrainingongeneralhealth.Beginningat
an early age, athletes performing at a high compet-
itive level are exposed to high levels of physical and
psychological stress resulting from many hours of
intense training and competitions. The damaging
effects of these factors on somatic growth, skele-
tal, and pubertal maturation, have been described
in individuals performing a variety of sports. Indi-
vidual sports exert unique influences on biological
maturation, depending on the sport-related specific
character, technical skills and training methods and
the stage of growth and sexual maturation of the
individual athlete. Therefore, the whole picture is
doi: 10.1111/j.1749-6632.2010.05677.x
Ann. N.Y. Acad. Sci. 1205 (2010) 39–44 c 2010 New York Academy of Sciences. 39
2. Growth in athletes Georgopoulos et al.
extremely complex and should be approached with
extreme caution and responsibility.
Somatic growth in athletes
The major factor influencing linear growth is ge-
netic predisposition. Both adult final height and the
rate of growth are greatly influenced by genetic fac-
tors.2
Studies involving twins, revealed that the aver-
age difference in final height between monozygotic
twins was less than 3 cm, compared to 12 cm for
dizygotic twins.3
Final height is best correlated to
target height (midparental height) especially when
parents are not of disparate heights.4
Environment
and heredity continuously interact throughout the
entire period of growth. Children with similar ge-
netic potential are expected to reach comparable
final height under optimal environmental condi-
tions. On the other hand, children with the same
genetic background exposed to entirely different en-
vironmental conditions, can end up with a different
adult height. Furthermore, children of parents from
underdeveloped areas, born and raised in industri-
alized countries, present taller as adults, compared
to their target height. In industrialized countries, an
increase in height has been documented, attributed
to the improvement in socioeconomic conditions.1
Growth and maturation are complex processes
and genetic predisposition is achieved only when
favorable conditions exist during the entire period
of growth. Major environmental factors that may
alter somatic growth are intensive physical exercise
and stress. The impact of stress and intensive phys-
ical training on growth depends on the combined
effects of intensity, frequency, and duration of exer-
cise. Intensive athletic training of 18 hours per week
is capable of attenuating growth.5
Although moder-
ate physical activity has beneficial effects on growth,
as it is associated with cardiovascular benefits and
favorable changes in body composition, extensive
physical training may negatively affect growth, es-
pecially during puberty.6
The effect of intense phys-
ical training on growth and maturation depends
on a variety of factors, including the type of phys-
ical training, the age of training initiation, and the
intensity of training. Each sport requires a spe-
cific type of exercise and is characterized by unique
athletic demands that favor a particular optimal
somatotype.
The period of maximum training during the
growth process is of particular importance. For ex-
ample, in female gymnasts, the greatest physical ex-
ertion coincides with the period of pubertal devel-
opment, whereas in male gymnasts, the maximum
training is required toward the end of puberty. Over
the past few decades, the demands of high compe-
tition level have increased the intensity of training
within the same sport. For example, it is known that
gymnasts are trained much more intensely nowa-
days than previously, usually 26–32 hours per week
compared to 15 h during the seventies and 20 h
during the eighties.
Sports that require a strict control of energy in-
put in combination with a high energy output are of
particular concern. Thus, it is not reasonable to gen-
eralize when trying to evaluate the particular effects
of the activity of each sport on somatic growth. The
major sports that require intensive physical training
during childhood and adolescence are mainly gym-
nastics (both Rhythmic and Artistic), and to a lesser
extent swimming, rowing, wrestling, track and field
athletism, and tennis.
Rhythmic gymnasts (RG) and artistic gymnasts
(AG)aretwodistinctgroupswithinthefieldofgym-
nastics. They include different training methods,
athleticperformanceobjectives,andrequirespecial-
ized and distinct skills. Each sport is characterized
by specific athletic requirements that favor a partic-
ularoptimalsomatotype.Ashort-limbedindividual
would have a greater mechanical advantage in artis-
tic gymnastic performance, whereas a long-limbed
individual could benefit from a similar advantage in
rhythmic gymnastics. Indeed, performance scores
in elite female artistic gymnasts are negatively cor-
related with the degree of fatness or endomorphy
of the individual.7
Therefore, trainers (coaches) ex-
pectedly select individuals that best match certain
anthropometric criteria for each sport. The sport-
specific selection criteria for artistic gymnastics im-
ply that a short stature with relatively short limbs,
broad shoulders, and narrow hips is due to deter-
mined genetic predisposition, rather than a result
of the specific sport training and performance.8
Thus, genetic predisposition should always be con-
sidered when studying the impact of gymnastics on
growth.
Artistic gymnasts
Until recently, AG anthropometric measurements
andprospectivegrowthpredictionsappearedwithin
normal limits.9–12
In all these reports, the adult
40 Ann. N.Y. Acad. Sci. 1205 (2010) 39–44 c 2010 New York Academy of Sciences.
3. Georgopoulos et al. Growth in athletes
height of AG remained proportional for the re-
ported target height despite the method used to
estimate predicted adult height. Another prospec-
tive study documented a reduction of growth po-
tential and a decrease in mean height predictions
over time, in a smaller group of AG.13
However,
in another study by the same group evidence was
provided that the predicted adult height was not
reduced in AG, demonstrating the inherent inac-
curacy of height predictions.14
Although these data
provide useful information, no definite conclusions
should be made until adult height has been attained.
In a large cross-sectional study, we have shown
that female AG were shorter and lighter than aver-
age, with mean height and weight SD scores below
0 (the 50% percentile), following their respective
target height SD score, which was also below 0.15
However, the actually measured height was lower
than their target height. The major factors nega-
tively affecting height in AG were low weight, low
body fat, and intensity of training.
The majority of previously reported data referred
only to female AG. We, therefore, evaluated compar-
atively both male and female AG.16
At the time of ex-
amination, although both female and male AG were
shorter than their age-related population mean, fe-
male AG showed a greater height deviation from
their age-related population mean. Male AG pre-
senting with a height closer to their age-related pop-
ulation mean, had a genetic predisposition toward
a much higher final height than female AG. As a re-
sult, the difference between target height and actual
height SD score ( Target height − Actual height SD
score) was greater in males than in females. Consid-
eringthesedata,itisreasonabletoassumethatinAG
the growth process in males might be more suscep-
tible to the detrimental effects of intensive physical
training.
For both sexes, current measured height was cor-
related positively to target height, indicating that
genetic predisposition to growth, although altered,
was not disrupted. In the group of athletes—of both
sexes—that have reached their final adult height, fi-
nalheightfailedtomeettheirgeneticpredisposition,
providing additional evidence for growth attenua-
tion in AG.
Rhythmic gymnasts
In RG, female RG were taller and thinner than av-
erage for age, with height velocity SD score for each
age group above 0 (50% percentile) for all ages.17,18
Interestingly, although linear growth in normal girls
comes to an end by the year of 15, in RG growth con-
tinued up to the age of 18. Their final adult height
was identical to the estimated predicted height at
first evaluation, and higher than the genetically de-
termined target height, denoting that genetic po-
tentials to final height was not only achieved, but
even exceeded. Furthermore, target height was the
only independent parameter proved to positively
influence height velocity, therefore genetic predis-
position remained the main driving force for the
observed efficient catch-up growth. Comparing AG
with RG leads to the conclusion that their reported
target height SD score was similar to their own mea-
sured heights (above 0 for the RG and below 0 for
the AG), indicating once more the determining role
of genetic predisposition and preselection. RG fol-
lowed a growth pattern that was higher than their
reportedtargetheight,whereasAGexhibitedalower
growth pattern.
In conclusion, studies in gymnasts performing at
thehighestcompetitivelevel,documentedadeterio-
ration of growth potential in AG, more pronounced
in males than in females; whereas, in female RG,
the genetic predisposition to growth was not only
preserved, but even exceeded.
Other sports
In all other sports, no deterioration of growth has
been reported. In swimmers, probably due both to
preselection bias by trainers and to high energy in-
put, the currently measured height was well above
the population mean.19–21
Another longitudinal
study, found no impact of regular intensive physical
training on the final height of female swimmers and
tennis players.22
In young distance runners, mean
height for both males and females approximates the
reference medians and estimated height velocities
are, on average, similar to age and sex-specific pop-
ulation means.23
Girls training for approximately 12
hours per week in sports including rowing, track,
and swimming for an average of 4 years during
puberty, revealed no difference in height velocity
compared to the population means, although a ten-
dency towarda slightly laterpeakheightvelocity was
noted.24
Female swimmers training for 8 hours per
week presented, after a follow-up of 2–3 years, nor-
mal heights and normal height velocities compared
to their population means, whereas AG training
Ann. N.Y. Acad. Sci. 1205 (2010) 39–44 c 2010 New York Academy of Sciences. 41
4. Growth in athletes Georgopoulos et al.
for 22 hours per week showed significantly lower
growth velocities.13
Assessment of anthropometric
data of elite junior tennis players, revealed signifi-
cantly taller top ranked, compared to lower ranked,
female tennis players.25
No difference in growth has
been found between seasonal wrestlers and controls
as all changes in dietary intake, body composition,
and muscular strength were reversed during the
post seasonal period.26
Growth rate was assessed
as normal in a large cohort of school wrestlers, al-
though no information was provided whether or
not a lower growth rate was observed during the
sport season followed by a catch-up growth during
the nontraining season.27
Anthropometric charac-
teristics showed that male rowers were similar in
most aspects to a student control sample, whereas
data on a large sample of elite junior rowers showed
a tendency toward a taller height, more pronounced
among finalists compared to nonfinalists, indicating
the influence of preselection bias.28,29
Inconclusion,intensivephysicaltrainingandath-
letic performance at high level did not negatively af-
fect somatic growth in all sports not requiring strict
dietaryrestrictionsleadingtoenergyimbalance.The
attention should be drawn to elite AG of both sexes,
engaged in highly strenuous competitions.
Pubertal development in athletes
Growth specifically refers to increase in body size,
whereas maturation includes the progress leading to
the biologically mature state. Thus, growth cannot
be fully evaluated without determining the timing
and tempo of biological maturation. Puberty is a
dynamic period of development with rapid changes
in body size, shape, and composition. The onset of
puberty corresponds to a specific biological age, as
determined by skeletal maturation, and namely, a
bone age of 13 years for boys and 11 years for girls.30
Prolonged intensive physical training has great im-
pact on skeletal maturation, leading to a signifi-
cant delay in bone age compared to chronological
age. As in the general population, pubertal devel-
opment in highly trained athletes seems to follow
bone age rather than chronological age.31
However,
genetic predisposition and variation among indi-
viduals should always be considered. Specific sports
favor the early matures, whereas others, such as
gymnastics, offer advantage to the later develop-
ing individuals. Therefore, any assessment of sexual
maturation must take into account the biological
indicators of bone age and peak height velocity.
Delayed pubertal development and sexual mat-
uration has been observed in a variety of sports,
mainly gymnastics, dancing, and long-distance run-
ning.32
The documented delay is determined by the
type, the frequency, the intensity, and the duration
of exercise and is more pronounced in sports requir-
ing strict dietary restrictions that result in higher
energy expenditure in the presence of a deficient
energy input. In the case of gymnasts performing
in the high competitive level of the Olympic games,
delayedmenarchehasbeennoted, comparedtohigh
school, college, and club-level athletes.7
Young girls
or adolescents engaged in sports requiring training
less than 15 hours per week do not show menstrual
disturbances or delay in sexual maturation.33
In elite RG and AG, the prepubertal stage was
prolonged and pubertal development was shifted to
a later age, retaining a normal progression rate.15–18
Expectedly, the progression of puberty followed the
bone age rather than the chronological age.16,17
It
is to be underlined that for both RG and AG, pu-
bertal progression, although delayed, was not pro-
longed. Normal girls require an average of 1.96 ±
0.93 years (mean±SD) for their breast development
toprogressfromTannerstageIItoTannerstageIV.34
A comparable period of time was observed for both
RG and AG in our study. Therefore, pubertal matu-
ration was entirely shifted to a later age, maintaining
a normal rate of progression.
The major factor responsible for the delay in the
onset of breast and pubic hair development in both
sports was low body weight. Low body weight re-
flects an energy deficit, prominent in both sports, as
a result of intensive physical training (high energy
expenditure) on the one side and caloric under-
nutrition (low energy input) on the other. Gym-
nasts indeed are subject to a significant energy
drain, occurring early in prepubertal age, and are
highly motivated to achieve low body weight con-
sistent with their sports requirements for a thin
somatotype.
On the other hand, in ballet dancers under high-
energy drain and low-diet intake, a delayed the-
larche and a normal pubarche were noted.35
This
implies that independent central mechanisms are
involved in triggering these aspects of pubertal de-
velopment. Indeed, breast development and sub-
sequently menarche are related to estrogen levels,
42 Ann. N.Y. Acad. Sci. 1205 (2010) 39–44 c 2010 New York Academy of Sciences.
5. Georgopoulos et al. Growth in athletes
whereas pubarche is mainly related to adrenal an-
drogen production.36
In conditions of energy im-
balance and consequent reduction in adipose tissue
mass, estrogen production is decreased and breast
development and menarche are delayed. It is the on-
set,theduration,andtheextentofenergydeficitthat
determine the degree of involvement in all aspects of
pubertal development. Indeed, ballet dancers with
a normal pubarche start their training at the age of
8–9 years of age with only 3.5–7.3 hours per week,
whereas the RG and AG we examined started their
training at the age of 6.4–7.7 years of age with more
than 30 hours of training per week.35
Female athletes involved in a large variety of
sports, including runners, swimmers, tennis play-
ers, ballet dancers, and gymnasts, present a well-
documented delayed menarche.22,35,36–38
In RG,
menarche was significantly delayed compared to
their mothers and not trained sisters, an observa-
tion arguing against a genetic predisposition toward
delayed menarche.18
It is well known that a minimum weight, for,
height and a critical lean, to, fat mass ratio is re-
quired for menarche. According to Frisch theory,
the attainment of a critical percentage of body fat
lowers the metabolic rate and induces a sensitization
of the hypothalamus to gonadal steroids.39
Indeed,
leptin and estrogen production by the adipose tissue
play a central role in triggering menarche.40
These
adjustments reflect a natural adaptation of the body
to high energy demands. In AG and RG, low body
fat, low body weight (low energy input), and pro-
longed intensive physical training (high energy out-
put) were the major factors influencing menarche.
Low body weight, however, remained the most sig-
nificant factor in delaying the onset of puberty. It is
to be noted that in both RG and AG, older athletes
without menarche presented lower height, weight,
and BMI compared to their contemporaries with
menarche.
In conclusion, in RG and AG intensive physical
training and negative energy balance prolong the
prepubertal stage and delay pubertal development,
by regulating the hypothalamic pituitary set point
at puberty, without affecting the duration of the
pubertal process.
Conclusions
Genetic predisposition to growth can be fully ex-
pressed only under favorable environmental con-
ditions. Moderate physical exercise has beneficial
effects on growth as it is associated with cardiovas-
cularbenefitsandfavorablechangesinbodycompo-
sition. Conversely, extensive physical training may
attenuate growth, especially during puberty.
The effect of stress and intensive physical training
on growth and maturity is related to the combined
effects of age of exercise onset, exercise intensity,
exercise frequency, and exercise duration.
Sports that require a strict control of energy con-
sumption, combined with a high-energy expendi-
ture, are of particular concern. In gymnastics of the
highest competitive level, a delay in skeletal mat-
uration was observed, leading to a deterioration of
growth potential in AG, more pronounced for males
than for females, whereas in female RG the genetic
potential for growth was finally achieved by com-
pensation via a late catch-up growth phenomenon.
In all other sports not requiring strict dietary re-
strictions, no deterioration of growth has been
documented.
Intensive physical training and negative energy
balance, by modulating the hypothalamic pituitary
set point at the expected time of puberty, prolong
theprepubertalstageanddelaypubertalprogression
in a variety of sports.
In elite RG and AG, prepubertal stage was pro-
longed and pubertal development was entirely
shifted to a later age, following the bone age
rather than the chronological age and maintain-
ing a normal rate of progression. Female ath-
letespresentawell-documenteddelayedmenarcheal
age, compared to their mothers and nontrained
sisters.
Conflicts of interest
The authors declare no conflicts of interest.
References
1. Tanner,J.M.1989.FetusintoMan:PhysicalGrowthfromCon-
ception to Maturity. Harvard University Press. Cambridge,
MA.
2. Sinclair, D. 1978. Human Growth After Birth. Oxford Uni-
versity Press. London, pp. 140–159.
3. Rogol, A.D., J.N. Roemmich & P.A. Clark. 2002. Growth at
puberty. J. Adol. Health 31: 192–200.
4. Smith, D.W. 1977. Growth and its Disorders. WB Saunders
Co. Philadelphia.
5. Tanner, J.M. ed. 1962. Growth at Adolescence, 2nd Ed. Black-
well. Oxford.
6. Tanner,J.M.1986.Growthasatarget-seekingfunction:catch
up and catch down growth in man. In: Human Growth. F.
Ann. N.Y. Acad. Sci. 1205 (2010) 39–44 c 2010 New York Academy of Sciences. 43
6. Growth in athletes Georgopoulos et al.
Falkner & J.M. Tanner, Eds.: 167–179, vol. 1. Plenum Press.
New York.
7. Claessens, A., J. Lefevre, G. Beunen & R.M. Malina. 1999.
The contribution of anthropometric characteristics to per-
formance scores in elite female gymnasts. J. Sports Med. Phys.
Fitness 39: 355–360.
8. Buckler, J. & D. Brodie. 1977. Growth and maturity charac-
teristics of schoolboy gymnasts. Annals Hum. Biol. 4: 455–
463.
9. Caldarone, G., M. Leglise, M. Giampietro & G. Berlutti.
1986. Anthropometric measurements, body composition,
biological maturation and growth predictions in young fe-
male gymnasts of high agonistic level. J. Sports Med. 26:
263–273.
10. Claessens, A.L., R.M. Malina, J. Lefevre, et al. 1992. Growth
and menarcheal status of elite female gymnasts. Med. Sci.
Sports Exerc. 24: 755–763.
11. Jost-Relyveld, A. & M. Sempe. 1982. Analyse de la croissance
et de la maturation squelettique de 80 jeunes gymnasts in-
ternationaux. Pediatrie 37: 247–262.
12. Smit, P.J. 1973. Anthropometric observations on South
African gymnasts. Afr. Med. J. 47: 480–485.
13. Theintz, G.E., H. Howald, U. Weiss & P.C. Sizonenko. 1993.
Evidence for a reduction of growth potential in adolescent
female gymnasts. J. Pediatr. 122: 306–313.
14. Theintz, G.E., H. Howald, Y. Allemann & P.C. Sizonenko.
1989. Growth and pubertal development of young female
gymnasts and swimmers: a correlation with parental data.
Int. J. Sports Med. 10: 87–91.
15. Georgopoulos,N.A,K.B.Markou,A.Theodoropoulou,etal.
2002. Growth retardation in artistic compared to rhythmic
elite female gymnasts. J. Clin. Endocrinol. Metab. 87: 3169–
3173.
16. Georgopoulos, N.A., A. Theodoropoulou, M. Leglise, et al.
2004. Growth and skeletal maturation in male and female
artistic gymnasts. J. Clin. Endocrinol. Metab. 89: 4377–4382
17. Georgopoulos, N., K. Markou, A. Theodoropoulou, et al.
1999. Growth and pubertal development in elite female
rhythmic gymnasts. J. Clin. Endocrinol. Metab. 84: 4525–
4530.
18. Georgopoulos, N.A., K. Markou, A. Theodoropoulou, et al.
2001. Height velocity and skeletal maturation in elite female
rhythmic gymnasts. J. Clin. Endocrinol. Metab. 86: 5159–
5164.
19. Bernink, M.J.E., W.B.M. Erich, A.L. Peltenburg, et al. 1983.
Height, body composition, biological maturation and train-
ing in relation to socio-economic status in girl gymnasts,
swimmers and controls. Growth 47: 1–12.
20. Peltenburg, A.L., W.B.M. Erich, M.J.E. Bernink, et al. 1984.
Biological maturation, body composition and growth of fe-
male gymnasts and control groups of schoolgirls and girls
swimmers, aged 8 to 14 years: a cross-sectional survey of
1064 girls. Int. J. Sports Med. 5: 36–42.
21. Peltenburg,A.L.,W.B.M.Erich,M.L.Zonderland,etal.1984.
A retrospective growth study of female gymnasts and girl
swimmers. Int. J. Sports Med. 5: 262–267.
22. Erladson, M.C., L.B. Sherar, R.L. Milwald, et al. 2008.
Growth and maturation of adolescent female gymnasts,
swimmers, and tennis players. Med. Sci. Sports Exerc. 40:
34–42
23. Eisenmann, J.C. & R.M. Malina. 2002. Growth status and es-
timated growth rate of young distance runners. Int. J. Sports
Med. 23: 168–173.
24. Geithner, C.A., B. Woynarowska & R.M. Malina. 1998. The
adolescent spurt and sexual maturation in girls active and
not active in sport. Ann. Hum. Biol. 25: 415–423.
25. Sanchez-Munoz, C., D. Sanz & M. Zabala. 2007. Anthropo-
metric characteristics, body composition and somatotype of
elite junior tennis players. Br. J. Sports Med. 41: 793–799.
26. Roemmich, J.N. & W.E. Sinning. 1997. Weight loss and
wrestling training: effects on nutrition, growth, maturation,
body composition and strength. J. Appl. Physiol. 82: 1751–
1759.
27. Housh, T.J., G.O. Johnson, J. Stout & D.J. Housh. 1993.
Anthropometric growth patterns of high school wrestlers.
Med. Sci. Sports Exerc. 25: 1141–1151.
28. DeRose, E.H., S.M. Crawford, D.A. Kerr, et al. 1989.
Physique characteristics of Pan American Games lightweight
rowers. Int. J. Sports Med. 10: 292–297.
29. Bourgois, J., A.L. Claessens, J. Vrijens, et al. 2000. Anthro-
pometric characteristics of elite male junior rowers. Br. J.
Sports Med. 34: 216–217.
30. Tanner, J.M., R.H. Whitehous, W.A. Marsall & B.S. Carter.
1975. Prediction of adult height, bone age, and occurrence
of menarche, at age 4 to 16 with allowance for midparental
height. Arch. Dis. Child. 50: 14–26.
31. Rogol, A.D., P.A. Clark & J.N. Roemmich. 2000. Growth and
pubertal development in children and adolescents: effects
of diet and physical activity. Ann. J. Clin. Nutr. 72(Suppl.):
521S–528S.
32. Malina, R.M. 1994. Physical growth and biological matura-
tion of young athletes. Exerc. Sport Sci. Rev. 22: 389–433.
33. Bonen, A. 1992. Recreatinal exercise does not impair men-
strual cycles: a prospective study. Int. J. Sports Med. 13: 10–
120.
34. Marshall, W.A. & J.M. Tanner. 1969. Variations in pattern of
pubertal changes in girls. Arch. Dis. Child. 44: 291–303.
35. Warren, M.P. 1980. The effects of exercise on pubertal pro-
gression and reproductive function in girls. J. Clin. En-
docrinol. Metab. 51: 1150–1157.
36. Zacharias, L., R.J. Wurtman & M. Shatzoff. 1970. Sexual
maturation in contemporary American girls. Am. J. Obstet.
Gynecol. 108: 833–846.
37. Marcus, R., C. Cann, P. Madvij, et al. 1985. Menstrual func-
tion and bone mass in elite women distance runners. Ann.
Intern. Med. 102: 158–163.
38. Baxter-Jones,A.D.G.,P.Helms,J.Baines-Preece&M.Preece.
1994. Menarche in intensively trained gymnasts, swimmers
and tennis players. Ann. Hum. Biol. 21: 407–415.
39. Frisch, R.E. & J.W. McArthur. 1974. Menstrual cycles; fatness
as a determinant of minimum weight for height necessary
for their maintenance or onset. Science 185: 949–951.
40. Moschos, S., J.L. Chen & C.S. Mantzoros. 2002. Leptin and
reproduction; a review. Fertil. Steril. 77: 433–444.
44 Ann. N.Y. Acad. Sci. 1205 (2010) 39–44 c 2010 New York Academy of Sciences.