This chapter discusses the concepts of phenotypic induction and programming, which refer to the long-term effects of environmental stimuli during early life periods of development. The chapter presents a model showing how metabolic capacity develops during fetal life and infancy through critical windows, while metabolic load emerges from childhood onwards from traits like tissue mass and diet. A high ratio of metabolic load to capacity increases risk of diseases by altering blood pressure, insulin, and lipid metabolism. Studies show individuals born small who become large as adults have highest risk. Overall growth patterns, not any single period, determine later disease risk as load interacts with capacity throughout life.
The document discusses the relationship between the gut microbiota and obesity. It notes that obesity rates have more than doubled in the past 30 years due to shifts to western diets high in refined carbohydrates and processed foods. Research has found the gut microbiota plays a role in energy harvesting and fat storage, and influences susceptibility to metabolic disorders like diabetes and obesity. Studies show a less diverse gut microbiota, as measured by lower bacterial gene counts, is associated with increased adiposity, insulin resistance, and inflammation - risk factors for obesity and related diseases. Diet-induced changes to the gut microbiota may perpetuate obesity by disturbing host metabolism.
Evolutionary medicine helps explain many mysteries of the human body by considering how our bodies have evolved in response to environmental pressures. It provides insight into why we are vulnerable to diseases and medical issues. For example, it explains why early reproduction occurs even if it leads to lower birth weight offspring, as this represents an evolutionary trade-off. The document also discusses how the battle between mother and fetus for glucose and the hygiene hypothesis help explain medical issues. Overall, evolutionary medicine combined with modern medicine can help discover new treatment options and improve current ones.
This document discusses the relationship between nutritional status and pressure ulcers. It provides epidemiological data showing that malnutrition is associated with increased risk of developing pressure ulcers. Experimental studies in animals also demonstrate impaired wound healing in malnourished subjects. However, clinical studies on the effect of nutritional supplementation on pressure ulcer prevention and treatment have shown mixed results, with some finding no effect of supplementation on ulcer outcomes. Overall, while malnutrition and pressure ulcers often coexist, the relationship is complex and a causal link has not been firmly established.
1. Nutritional programming theories suggest that the prenatal and early life nutritional environment can influence long-term health by permanently programming physiological functions and disease risk.
2. Animal studies demonstrate a direct link between nutrient imbalance during fetal development and later diseases like hypertension, diabetes, and heart disease, independent of growth rates.
3. Exposure to glucocorticoids and alterations in gene expression from nutrient imbalance in early life are thought to be important mechanisms influencing tissue development and function long-term.
Emergency room visit for respiratory conditions in children increased after G...ISAMI1
Emergency room visit for respiratory conditions in children increased after Guagua Pichincha Volcanic eruptions in April 200 in Quito, Ecuador Observational Study: Time Series Analysis
The National Children's Study aims to understand environmental factors contributing to childhood obesity through a large prospective birth cohort study of 100,000 American children. It will address limitations of past studies by following children from before conception through age 21 and collecting extensive data on genetic, behavioral, social, built environment, and chemical exposure factors. This life-course approach will provide insights into obesity origins and allow examination of interactions among multiple influences over time. The study aims to guide evidence-based strategies for obesity prevention.
From metabolic syndrome to cachexia: what’s new about metabolic biomarkers?Bertin Pharma
What does Metabolic Syndrom really mean? What impact on world population? Which biomarkers can serve your studies? What treatments for tomorrow?...
These are just some of the questions Virginie Tolle and Odile Viltart, researchers at the INSERM (The French National Institute for Health and Medical Research ) answered in this very complete article for Bertin Pharma.
Good reading!
ADHD in America: A Bioecological Analysisworldwideww
This document discusses ADHD from a bioecological perspective using Bronfenbrenner's ecological systems theory. It argues that changes in American parenting practices over the last century, including decreased breastfeeding rates and earlier weaning ages, have disrupted the mother-child relationship and altered child development. Specifically, it suggests that reduced breastfeeding has decreased oxytocin levels in mothers and altered their perceptions and behaviors towards their children. This framework challenges the current medical model of ADHD by arguing that normal child behaviors have become pathologized due to changes in family and cultural systems over time.
The document discusses the relationship between the gut microbiota and obesity. It notes that obesity rates have more than doubled in the past 30 years due to shifts to western diets high in refined carbohydrates and processed foods. Research has found the gut microbiota plays a role in energy harvesting and fat storage, and influences susceptibility to metabolic disorders like diabetes and obesity. Studies show a less diverse gut microbiota, as measured by lower bacterial gene counts, is associated with increased adiposity, insulin resistance, and inflammation - risk factors for obesity and related diseases. Diet-induced changes to the gut microbiota may perpetuate obesity by disturbing host metabolism.
Evolutionary medicine helps explain many mysteries of the human body by considering how our bodies have evolved in response to environmental pressures. It provides insight into why we are vulnerable to diseases and medical issues. For example, it explains why early reproduction occurs even if it leads to lower birth weight offspring, as this represents an evolutionary trade-off. The document also discusses how the battle between mother and fetus for glucose and the hygiene hypothesis help explain medical issues. Overall, evolutionary medicine combined with modern medicine can help discover new treatment options and improve current ones.
This document discusses the relationship between nutritional status and pressure ulcers. It provides epidemiological data showing that malnutrition is associated with increased risk of developing pressure ulcers. Experimental studies in animals also demonstrate impaired wound healing in malnourished subjects. However, clinical studies on the effect of nutritional supplementation on pressure ulcer prevention and treatment have shown mixed results, with some finding no effect of supplementation on ulcer outcomes. Overall, while malnutrition and pressure ulcers often coexist, the relationship is complex and a causal link has not been firmly established.
1. Nutritional programming theories suggest that the prenatal and early life nutritional environment can influence long-term health by permanently programming physiological functions and disease risk.
2. Animal studies demonstrate a direct link between nutrient imbalance during fetal development and later diseases like hypertension, diabetes, and heart disease, independent of growth rates.
3. Exposure to glucocorticoids and alterations in gene expression from nutrient imbalance in early life are thought to be important mechanisms influencing tissue development and function long-term.
Emergency room visit for respiratory conditions in children increased after G...ISAMI1
Emergency room visit for respiratory conditions in children increased after Guagua Pichincha Volcanic eruptions in April 200 in Quito, Ecuador Observational Study: Time Series Analysis
The National Children's Study aims to understand environmental factors contributing to childhood obesity through a large prospective birth cohort study of 100,000 American children. It will address limitations of past studies by following children from before conception through age 21 and collecting extensive data on genetic, behavioral, social, built environment, and chemical exposure factors. This life-course approach will provide insights into obesity origins and allow examination of interactions among multiple influences over time. The study aims to guide evidence-based strategies for obesity prevention.
From metabolic syndrome to cachexia: what’s new about metabolic biomarkers?Bertin Pharma
What does Metabolic Syndrom really mean? What impact on world population? Which biomarkers can serve your studies? What treatments for tomorrow?...
These are just some of the questions Virginie Tolle and Odile Viltart, researchers at the INSERM (The French National Institute for Health and Medical Research ) answered in this very complete article for Bertin Pharma.
Good reading!
ADHD in America: A Bioecological Analysisworldwideww
This document discusses ADHD from a bioecological perspective using Bronfenbrenner's ecological systems theory. It argues that changes in American parenting practices over the last century, including decreased breastfeeding rates and earlier weaning ages, have disrupted the mother-child relationship and altered child development. Specifically, it suggests that reduced breastfeeding has decreased oxytocin levels in mothers and altered their perceptions and behaviors towards their children. This framework challenges the current medical model of ADHD by arguing that normal child behaviors have become pathologized due to changes in family and cultural systems over time.
This document summarizes research on factors affecting dietary choices and attitudes towards nutrition among youth in Hong Kong. The researcher conducted surveys of 92 local and international students aged 18-24 in Hong Kong. The surveys found that local Hong Kong students and international students shared similar attitudes towards healthy eating, such as efforts to limit sugar, fat and salt intake, and considering nutrition labels. However, local students seemed uniquely affected by limited nutrition knowledge, inaccurate weight perceptions, and challenges accessing healthy food options. The document concludes stronger nutrition education is needed for Hong Kong youth.
Increase your Understanding of the Pathogenesis of Gluten Spectrum DisordersCell Science Systems
Recently, researchers at Harvard University, Alessio Fasano et. al., and the National Institutes of Health (laboratories of immunology and cellular and molecular biology), reported real-time microscopic observations of gluten-induced neutrophil activation.
According to authors, " To what extent neutrophil function adds to, or protects against, gluten intolerance is currently under vigorous investigation."
This presentation will shed light on this question. It will also review the Fasano study and examine the role of neutrophil function in multiple disease conditions, as well as explore how neutrophil function may also play a dual role in protecting the body from the untoward effects of dietary and environmental agents.
The Department of Nutritional Sciences at UW-Madison has a long history of researching nutrition to improve human and animal health. It was established in 1968 to focus specifically on the study of human nutrition and is now housed in the former Children's Hospital building. The department aims to understand nutrition through research, educate students, and share its findings through outreach. Its work affects communities worldwide by advancing knowledge on topics like preventing chronic diseases and alleviating malnutrition.
Daniel Lee, M.D., of UC San Diego Owen Clinic, presents "Update from the 15th International Workshop on Co-Morbidities and Adverse Drug Reactions in HIV"
This study examined the gut microbiota in a mouse model of autism spectrum disorder (ASD) and found abnormalities in gastrointestinal function and behavior. Treatment with the probiotic Bacteroides fragilis corrected gastrointestinal deficits, improved behavioral symptoms, and normalized metabolite levels. This suggests a connection between the gut microbiome and brain in neurodevelopmental disorders, and that probiotic therapy may help treat symptoms.
The study of how genes and gene products interact with dietary chemicals to alter phenotype and, conversely, how genes and their products metabolize nutrients is called nutritional genomics or “Nutrigenomics”.
Nutrition therapy in sepsis aims to minimize lean body mass loss and maximize recovery. In the acute phase (first 24-96 hours), early enteral nutrition should provide around 1.0 g/kg/day of protein and 15 kcal/kg/day of nonprotein calories. For malnourished patients or those failing enteral nutrition, supplemental parenteral nutrition may be considered to prevent calorie and protein deficits. After resuscitation, increasing protein to 1.5-2.0 g/kg/day and calories is needed to promote recovery, though very high early protein may impair autophagy and require more research. Ongoing nutrition support for months after ICU discharge is often necessary for full recovery of
Nutritional status of boarding and non boarding children in selected schools ...Alexander Decker
This study assessed and compared the nutritional status of boarding and non-boarding children aged 8-10 years in selected private schools in Accra, Ghana. A total of 124 children participated, with 94 being non-boarders and 30 boarders. Anthropometric measurements and 24-hour dietary recalls were collected. The prevalence of stunting and underweight was low at 0.8% each, while overweight and obesity were higher at 12.1% and 11.3%, respectively. Nutrient intakes of calcium and energy were inadequate for many children. No significant differences were found in nutritional status or nutrient intakes between boarding and non-boarding children.
This document summarizes recent evidence on enteral versus parenteral nutrition in septic shock patients. The largest randomized controlled trial showed no difference in mortality between enteral and parenteral nutrition routes. Enteral nutrition was associated with lower calorie intake and higher rates of hypoglycemia and gastrointestinal complications. Updated guidelines recommend withholding enteral nutrition in hemodynamically unstable shock patients. It remains unclear if parenteral nutrition offers benefits in shock patients, though it may reduce gastrointestinal issues. No guidelines address parenteral nutrition indications in shock patients.
The document discusses enteropathy in children in developing countries. It defines enteropathy as an acquired intestinal change seen in the absence of illness that may increase susceptibility to infection and malnutrition. While studies have found intestinal abnormalities are common, there is no consensus definition and the relationship between enteropathy, diarrhea, and malnutrition is unclear. The document calls for further research to better define enteropathy and understand its role and potential interventions.
This document reviews nutrition therapy in sepsis. It discusses the pathophysiology of sepsis, which involves both excessive inflammation and immune suppression. Nutrition goals aim to support the metabolic response while avoiding harm. Caloric needs should be determined by indirect calorimetry and protein intake increased gradually from 0.8 g/kg/day to 1.3 g/kg/day as shock symptoms improve. Both enteral and parenteral nutrition can be used to meet caloric and protein targets. Low-dose glutamine supplementation may benefit patients on parenteral nutrition. High-quality evidence for other pharmaconutrients is limited. Nutrition stewardship tailored to the individual patient's condition is important for optimal outcomes in sepsis.
The document discusses optimal nutrition for intensive care unit (ICU) patients, specifically the role of protein delivery. It summarizes recent studies showing:
1) Short-term high-level amino acid infusions can change protein balance in critically ill patients from negative to positive.
2) This positive effect on protein balance from supplemental amino acid infusions can last for at least 24 hours.
3) More research is still needed to determine if improving protein balance through nutrition can change patient outcomes and whether the same strategies apply to all heterogeneous ICU patients.
This document is a letter from the Ancestral Health Team thanking attendees of the 2011 Ancestral Health Symposium and providing information about supporting the Ancestry nonprofit organization. It encourages donations to support future symposia and the development of the Ancestral Health Society, including an academic journal. It also provides contact information and websites to stay connected including AncestryFoundation.org, facebook.com/AncestralHealthSymposium, and the email ancestralhealth@gmail.com.
1) The document provides guidance on optimal nutrition therapy for ICU patients, post-ICU patients, and those in long-term recovery.
2) It recommends starting enteral nutrition within 48 hours of ICU admission and gradually increasing calories and proteins to prevent overfeeding and refeeding syndrome.
3) The optimal calorie and protein targets may vary during the different phases of recovery; at least 1.3 g/kg/day of proteins should be targeted after the initial ICU phase.
The document summarizes research into the relationship between gut bacteria, bile acids, and cancer risk. Researchers believe that an imbalance in gut bacteria from conditions like diabetes or a Western diet can increase toxic bile acids, raising cancer risk. The researchers aim to determine bacteria's role in gastrointestinal and liver cancers and whether restoring bacterial balance through probiotics can prevent cancer. They will test if a gut bacterium and milk sugars can lower cancer risk by enriching good bacteria, reducing inflammation and toxic bile acids.
Stress can disrupt the body's homeostasis and lead to psycho-spiritual awakening as the body seeks balance. The human gut microbiome, which outnumbers human cells 10 to 1, plays a key role in this process. Chronic stress and an unhealthy lifestyle can cause chronic inflammation and disease by disrupting the diversity of the gut microbiota. Adopting a diet low in refined carbs and sugar, fasting, probiotic supplementation, spiritual practice, and exercise can help reduce stress, inflammation, and bring the microbiome back into balance.
This study examines the relationship between cesarean birth and childhood body mass in Yucatec Maya subsistence farmers. The researchers collected monthly weight and height measurements on 108 children aged 0-5 to analyze differences in growth trajectories between cesarean-born and vaginally born children. While childhood obesity rates were very low, the study found that cesarean birth was associated with higher weight-for-age and body mass index scores, even after accounting for other factors. Children born by cesarean to mothers with high BMI had the highest weight and BMI of all children. This suggests that cesarean birth may disrupt gut microbiome development and increase risk of heavier body mass, even in populations with minimal obesity-related lifestyle
Irritable Bowel Syndrome (IBS) and Fecal Microbiota Transplant. A new hope fo...Find Good Health
IBDs including irritable bowel syndrome (ibs) or ulcerative colitis (uc) are a set of diseases developing into an epidemic. The unusual and recent rise in these kind of diseases most notably on developed countries point to a recent and area specific etiology, not a better healthcare and diagnosis.
Recent researchs are pointing to a healthier immune system and intestinal flora in undeveloped countries' population and an imbalance in our gut flora caused by excessive use of antibiotics.
For more information about health and wellbeing visit our site at:
http://findgoodhealth.org/
Hacking for Healing at SXSW InteractiveDrBonnie360
This document discusses how lifestyle factors like stress management, social connections, nutrition, exercise, sleep, and mindfulness practices can positively impact health and autoimmune diseases. It promotes participating in a Twitter poll and hackathon called #HacktoHeal to explore how non-medical approaches can restore balance and healing. References are provided on research showing how the mind and body interact, such as how positive emotions, meditation, gratitude, and self-compassion can influence immune function and physical well-being.
The document defines management as the process of planning, organizing, directing, and controlling an organization's resources to achieve its goals. It describes the four functions of management as planning what needs to be done, organizing resources, directing employees, and controlling performance. The document also outlines three types of managers - top managers responsible for overall performance, middle managers who implement strategies, and first-line managers who supervise employees. Finally, it identifies four basic management skills as technical skills, human relations skills, conceptual skills, and decision-making skills.
This document is a curriculum vitae for Ibrahim Osama Ibrahim Mohamed Abu MAATI. It includes his personal details like name, date of birth, place of birth, nationality, marital status and contact information. It also outlines his educational qualifications including a BSc in Chemistry and Botany from Mansoura University in 2015. It lists his work experience as a production chemist and includes his computer skills, languages spoken, and laboratory skills. It provides details on his personal attributes like being optimistic, able to work well under pressure and enjoying reading and sports.
This document summarizes research on factors affecting dietary choices and attitudes towards nutrition among youth in Hong Kong. The researcher conducted surveys of 92 local and international students aged 18-24 in Hong Kong. The surveys found that local Hong Kong students and international students shared similar attitudes towards healthy eating, such as efforts to limit sugar, fat and salt intake, and considering nutrition labels. However, local students seemed uniquely affected by limited nutrition knowledge, inaccurate weight perceptions, and challenges accessing healthy food options. The document concludes stronger nutrition education is needed for Hong Kong youth.
Increase your Understanding of the Pathogenesis of Gluten Spectrum DisordersCell Science Systems
Recently, researchers at Harvard University, Alessio Fasano et. al., and the National Institutes of Health (laboratories of immunology and cellular and molecular biology), reported real-time microscopic observations of gluten-induced neutrophil activation.
According to authors, " To what extent neutrophil function adds to, or protects against, gluten intolerance is currently under vigorous investigation."
This presentation will shed light on this question. It will also review the Fasano study and examine the role of neutrophil function in multiple disease conditions, as well as explore how neutrophil function may also play a dual role in protecting the body from the untoward effects of dietary and environmental agents.
The Department of Nutritional Sciences at UW-Madison has a long history of researching nutrition to improve human and animal health. It was established in 1968 to focus specifically on the study of human nutrition and is now housed in the former Children's Hospital building. The department aims to understand nutrition through research, educate students, and share its findings through outreach. Its work affects communities worldwide by advancing knowledge on topics like preventing chronic diseases and alleviating malnutrition.
Daniel Lee, M.D., of UC San Diego Owen Clinic, presents "Update from the 15th International Workshop on Co-Morbidities and Adverse Drug Reactions in HIV"
This study examined the gut microbiota in a mouse model of autism spectrum disorder (ASD) and found abnormalities in gastrointestinal function and behavior. Treatment with the probiotic Bacteroides fragilis corrected gastrointestinal deficits, improved behavioral symptoms, and normalized metabolite levels. This suggests a connection between the gut microbiome and brain in neurodevelopmental disorders, and that probiotic therapy may help treat symptoms.
The study of how genes and gene products interact with dietary chemicals to alter phenotype and, conversely, how genes and their products metabolize nutrients is called nutritional genomics or “Nutrigenomics”.
Nutrition therapy in sepsis aims to minimize lean body mass loss and maximize recovery. In the acute phase (first 24-96 hours), early enteral nutrition should provide around 1.0 g/kg/day of protein and 15 kcal/kg/day of nonprotein calories. For malnourished patients or those failing enteral nutrition, supplemental parenteral nutrition may be considered to prevent calorie and protein deficits. After resuscitation, increasing protein to 1.5-2.0 g/kg/day and calories is needed to promote recovery, though very high early protein may impair autophagy and require more research. Ongoing nutrition support for months after ICU discharge is often necessary for full recovery of
Nutritional status of boarding and non boarding children in selected schools ...Alexander Decker
This study assessed and compared the nutritional status of boarding and non-boarding children aged 8-10 years in selected private schools in Accra, Ghana. A total of 124 children participated, with 94 being non-boarders and 30 boarders. Anthropometric measurements and 24-hour dietary recalls were collected. The prevalence of stunting and underweight was low at 0.8% each, while overweight and obesity were higher at 12.1% and 11.3%, respectively. Nutrient intakes of calcium and energy were inadequate for many children. No significant differences were found in nutritional status or nutrient intakes between boarding and non-boarding children.
This document summarizes recent evidence on enteral versus parenteral nutrition in septic shock patients. The largest randomized controlled trial showed no difference in mortality between enteral and parenteral nutrition routes. Enteral nutrition was associated with lower calorie intake and higher rates of hypoglycemia and gastrointestinal complications. Updated guidelines recommend withholding enteral nutrition in hemodynamically unstable shock patients. It remains unclear if parenteral nutrition offers benefits in shock patients, though it may reduce gastrointestinal issues. No guidelines address parenteral nutrition indications in shock patients.
The document discusses enteropathy in children in developing countries. It defines enteropathy as an acquired intestinal change seen in the absence of illness that may increase susceptibility to infection and malnutrition. While studies have found intestinal abnormalities are common, there is no consensus definition and the relationship between enteropathy, diarrhea, and malnutrition is unclear. The document calls for further research to better define enteropathy and understand its role and potential interventions.
This document reviews nutrition therapy in sepsis. It discusses the pathophysiology of sepsis, which involves both excessive inflammation and immune suppression. Nutrition goals aim to support the metabolic response while avoiding harm. Caloric needs should be determined by indirect calorimetry and protein intake increased gradually from 0.8 g/kg/day to 1.3 g/kg/day as shock symptoms improve. Both enteral and parenteral nutrition can be used to meet caloric and protein targets. Low-dose glutamine supplementation may benefit patients on parenteral nutrition. High-quality evidence for other pharmaconutrients is limited. Nutrition stewardship tailored to the individual patient's condition is important for optimal outcomes in sepsis.
The document discusses optimal nutrition for intensive care unit (ICU) patients, specifically the role of protein delivery. It summarizes recent studies showing:
1) Short-term high-level amino acid infusions can change protein balance in critically ill patients from negative to positive.
2) This positive effect on protein balance from supplemental amino acid infusions can last for at least 24 hours.
3) More research is still needed to determine if improving protein balance through nutrition can change patient outcomes and whether the same strategies apply to all heterogeneous ICU patients.
This document is a letter from the Ancestral Health Team thanking attendees of the 2011 Ancestral Health Symposium and providing information about supporting the Ancestry nonprofit organization. It encourages donations to support future symposia and the development of the Ancestral Health Society, including an academic journal. It also provides contact information and websites to stay connected including AncestryFoundation.org, facebook.com/AncestralHealthSymposium, and the email ancestralhealth@gmail.com.
1) The document provides guidance on optimal nutrition therapy for ICU patients, post-ICU patients, and those in long-term recovery.
2) It recommends starting enteral nutrition within 48 hours of ICU admission and gradually increasing calories and proteins to prevent overfeeding and refeeding syndrome.
3) The optimal calorie and protein targets may vary during the different phases of recovery; at least 1.3 g/kg/day of proteins should be targeted after the initial ICU phase.
The document summarizes research into the relationship between gut bacteria, bile acids, and cancer risk. Researchers believe that an imbalance in gut bacteria from conditions like diabetes or a Western diet can increase toxic bile acids, raising cancer risk. The researchers aim to determine bacteria's role in gastrointestinal and liver cancers and whether restoring bacterial balance through probiotics can prevent cancer. They will test if a gut bacterium and milk sugars can lower cancer risk by enriching good bacteria, reducing inflammation and toxic bile acids.
Stress can disrupt the body's homeostasis and lead to psycho-spiritual awakening as the body seeks balance. The human gut microbiome, which outnumbers human cells 10 to 1, plays a key role in this process. Chronic stress and an unhealthy lifestyle can cause chronic inflammation and disease by disrupting the diversity of the gut microbiota. Adopting a diet low in refined carbs and sugar, fasting, probiotic supplementation, spiritual practice, and exercise can help reduce stress, inflammation, and bring the microbiome back into balance.
This study examines the relationship between cesarean birth and childhood body mass in Yucatec Maya subsistence farmers. The researchers collected monthly weight and height measurements on 108 children aged 0-5 to analyze differences in growth trajectories between cesarean-born and vaginally born children. While childhood obesity rates were very low, the study found that cesarean birth was associated with higher weight-for-age and body mass index scores, even after accounting for other factors. Children born by cesarean to mothers with high BMI had the highest weight and BMI of all children. This suggests that cesarean birth may disrupt gut microbiome development and increase risk of heavier body mass, even in populations with minimal obesity-related lifestyle
Irritable Bowel Syndrome (IBS) and Fecal Microbiota Transplant. A new hope fo...Find Good Health
IBDs including irritable bowel syndrome (ibs) or ulcerative colitis (uc) are a set of diseases developing into an epidemic. The unusual and recent rise in these kind of diseases most notably on developed countries point to a recent and area specific etiology, not a better healthcare and diagnosis.
Recent researchs are pointing to a healthier immune system and intestinal flora in undeveloped countries' population and an imbalance in our gut flora caused by excessive use of antibiotics.
For more information about health and wellbeing visit our site at:
http://findgoodhealth.org/
Hacking for Healing at SXSW InteractiveDrBonnie360
This document discusses how lifestyle factors like stress management, social connections, nutrition, exercise, sleep, and mindfulness practices can positively impact health and autoimmune diseases. It promotes participating in a Twitter poll and hackathon called #HacktoHeal to explore how non-medical approaches can restore balance and healing. References are provided on research showing how the mind and body interact, such as how positive emotions, meditation, gratitude, and self-compassion can influence immune function and physical well-being.
The document defines management as the process of planning, organizing, directing, and controlling an organization's resources to achieve its goals. It describes the four functions of management as planning what needs to be done, organizing resources, directing employees, and controlling performance. The document also outlines three types of managers - top managers responsible for overall performance, middle managers who implement strategies, and first-line managers who supervise employees. Finally, it identifies four basic management skills as technical skills, human relations skills, conceptual skills, and decision-making skills.
This document is a curriculum vitae for Ibrahim Osama Ibrahim Mohamed Abu MAATI. It includes his personal details like name, date of birth, place of birth, nationality, marital status and contact information. It also outlines his educational qualifications including a BSc in Chemistry and Botany from Mansoura University in 2015. It lists his work experience as a production chemist and includes his computer skills, languages spoken, and laboratory skills. It provides details on his personal attributes like being optimistic, able to work well under pressure and enjoying reading and sports.
Berdasarkan dokumen tersebut, ringkasannya adalah:
Penelitian ini membahas penerapan metode bercerita bergambar dalam meningkatkan kecerdasan bahasa anak usia dini di TK Al-Jamiah IAIN STS Jambi. Hasilnya menunjukkan bahwa penerapan metode ini belum sepenuhnya sesuai dengan standar dan masih jarang dilakukan. Guru lebih banyak menggunakan metode ceramah daripada bermain. Pembelaj
This document provides descriptions of several creative and media jobs, including TV presenter, camera operator, film producer, film director, dancer, choreographer, singer, actor, gallery manager, sculptor, and painter. It explains the basic responsibilities and roles within each job such as introducing films, operating cameras, overseeing the filmmaking process, directing actors and crews, using movement to portray concepts, developing dance ideas, producing musical sounds, taking on artistic roles, managing art galleries, making sculptures, and using color to create pictures.
This document discusses nanomaterials for biosensors and implantable biodevices. It describes how nanostructured thin films have enabled the development of more sensitive electrochemical biosensors by increasing detection of specific molecules. Two common techniques for creating nanostructured thin films are discussed - Langmuir-Blodgett films and layer-by-layer films using polyelectrolytes. These techniques allow control over film thickness at the nanoscale and have been used with various biomolecules to create biosensors for applications like glucose detection. Recent advances include using these materials and techniques to create miniaturized and implantable biosensors for real-time monitoring.
As três frases resumem os critérios para submissão de textos à revista literária Buritizeiros: os textos devem ser enviados até 30/07/2012 no formato Wordpad com fonte Times New Roman tamanho 12 justificado, contendo apresentação do autor, títulos publicados, depoimento e o texto; os textos devem ser inéditos até 15/08/2012 e pertencer aos gêneros conto, crônica ou poesia, com cada autor podendo publicar no máximo 4 textos.
Un site map es una página que lista las páginas de un sitio web de forma jerárquica para ayudar a los visitantes y motores de búsqueda a encontrar páginas. Un buen site map debe ser jerárquico con pocos niveles, tener información crucial en los primeros dos niveles, y mejorar la optimización para motores de búsqueda al asegurar que todas las páginas se puedan encontrar. La usabilidad de un sitio web es importante para retener visitantes, por lo que debe ser fácil de usar y navegar desde el
El disco duro es el dispositivo de almacenamiento principal del PC que mantiene los datos incluso sin energía, a diferencia de la RAM. Los discos duros almacenan archivos organizados en carpetas y son más lentos que las memorias SSD. Existen diferentes tipos de discos duros como SATA, SAS y SCSI que se diferencian en velocidad y uso profesional o doméstico.
This document provides a detailed overview of the MRI anatomy of the anorectal region in 3 sentences or less:
The document describes the MRI appearance and anatomy of structures in the anorectal region such as the internal and external anal sphincters, levator ani muscles, and intersphincteric spaces. Key imaging planes such as mid-coronal and mid-sagittal are discussed for visualizing the layers and relationships between anatomical structures in the region. Standardized terminology is introduced for communicating imaging findings, including use of the "anal clock" for describing sites of fistulas and other lesions.
O documento resume o registro de candidatura de Antonio Lopes da Silva, do PHS, concorrendo a vereador em Astorga (PR). Ele tem 58 anos, é casado, tem ensino fundamental completo e trabalha com construção civil. Declarou bens no valor total de R$78.000, incluindo uma Kombi e um lote com casa. Sua candidatura está cadastrada aguardando julgamento.
This document outlines a pantomime scene with 4 characters: Sheldon, an obsessive Victoria Beckham superfan; Eugene, another obsessed fan with a child-like mentality; Victoria Beckham, the self-centered fashion icon; and Sarah, Victoria's indifferent assistant. The plot involves Sheldon and Eugene stalking Victoria in attempts to meet her, which causes Victoria to flee from their strange behavior. Their antics escalate until security arrests Sheldon and Eugene, causing them to realize Victoria is not as great as they thought.
Real time web applications with SignalR (BNE .NET UG)brendankowitz
Static web pages and data don't cut it anymore. Information online is real-time and even web applications should respond to continuous changes. As SignalR has recently been introduced as a component to the ASP.NET runtime there's no better time to start building web application that respond to change. SignalR does all the heavy lifting and makes it easy to introduce into a wide range of projects, so pry your application out of the static mould and start responding to the real dynamic nature of information and changes as they occur.
This document provides contact information for an emcee named Sandip Sharma who is available for booking various events such as weddings, theme parties, fitness challenges, corporate parties, and more. A brief description is given for some of the types of events and examples of past events hosted. Contact information including a phone number and request for booking is provided at the bottom.
Este documento resume las estrategias para optimizar la experiencia del cliente. Explica que la experiencia del cliente no se limita al momento de la compra, sino que abarca toda la relación entre la empresa y el cliente. También destaca la importancia de identificar los "puntos de contacto" con el cliente y mejorar la experiencia en cada uno de ellos para crear clientes leales y defensores de la marca.
This document discusses a drug delivery device to treat diabetic retinopathy, a complication of diabetes that affects the retina. Diabetic retinopathy is classified as either non-proliferative or proliferative and can progress through different stages as the disease worsens over time if not treated. The document outlines the structure and function of the eye, types of diabetes, pathophysiology of diabetic eye disease, and current treatments for diabetic retinopathy which aim to prevent vision loss through early detection and management of risk factors like blood glucose control. A new drug delivery device is proposed to provide an improved treatment option for this condition.
El documento describe las herramientas de comercio electrónico para el éxito de las empresas turísticas. Explica que el turismo es muy importante para la economía mexicana, especialmente en Quintana Roo. Detalla las principales competencias entre destinos turísticos y los visitantes principales desde Europa, América Latina y Estados Unidos. Además, analiza la distribución tradicional frente a la distribución en línea, resaltando las ventajas para los clientes y los hoteles de utilizar el comercio electrónico.
The Journal of NutritionSymposium Nutritional Experiences.docxarnoldmeredith47041
1. Poor growth in utero is associated with increased risk of diseases like type 2 diabetes later in life. Studies in humans and animals provide evidence that early nutrition plays an important role in this relationship.
2. A study of twins found that the twin with lower birth weight was more likely to develop type 2 diabetes, indicating the importance of prenatal environmental factors over genetics. Studies of people born during the Dutch famine linked maternal malnutrition to impaired glucose tolerance in offspring.
3. In animal models, maternal protein restriction in rats leads to low birth weight offspring that develop insulin resistance and type 2 diabetes. This is associated with changes in the expression of genes related to insulin signaling and may represent an early risk factor for metabolic
This article discusses the increasing prevalence of type 2 diabetes in adolescents and the role of sleep. It notes that while genetics play a role, lifestyle changes like decreased sleep have contributed to rising obesity and diabetes rates. Sleep is influenced by biological and social factors in adolescents. Short sleep duration is linked to increased insulin resistance and BMI. The article reviews studies showing that sleep education and advice programs can improve sleep habits and duration in teens, with some evidence they may also positively impact metabolic health and weight. Larger and longer trials are still needed.
This document discusses the role of maternal nutrition in the development of the fetal cardiovascular system. It begins by outlining Barker's hypothesis that heart disease may originate during fetal development due to nutritional inadequacies altering cardiac physiology and increasing risk of cardiovascular disease later in life. It then examines how nutrition affects fetal development through the placenta and fetal programming, discussing specific nutrients' impacts on the developing heart and gene expression changes from maternal nutrient restriction. The goal is to understand these relationships to improve fetal nutrition and prevent cardiovascular disease.
This document discusses how prenatal nutrition can impact the risk of adult obesity through long-term effects on epigenetic mechanisms regulating gene expression. Nutrition during early development can influence DNA methylation patterns and histone modifications, which are epigenetic regulators of gene expression. This epigenetic programming during prenatal development and infancy may underlie the developmental origins of adult diseases like obesity and cardiovascular disease.
This document discusses the high rates of low birth weight (LBW) babies in South Asia and its link to increased risk of developing cardio-metabolic disorders later in life. It notes that over 30% of births in India are LBW, and cohort studies from hospitals in India have found that these LBW babies often develop elevated blood pressure, obesity, diabetes and cardiovascular diseases as adults. The document advocates for early prevention strategies before conception to address this issue and its contribution to the "fetal origin of adult disease" hypothesis whereby adverse fetal environments can program future disease risk.
Assignment #1 – This assignment should help you to organize your t.docxdavezstarr61655
Assignment #1 – This assignment should help you to organize your thoughts about your research. Take time to really think about the questions – this effort will make writing the actual paper much easier. Please complete this worksheet and submit on Bb. You need to submit only once per pair (make sure I know who you are working with!).
1. With your partner, develop a research question. Write your research question here:
*Please ensure that the question is not answered by the book’s author.
Question is. "How has the development in human society led to the increased frequency of obesity?"
2. Why do you have this question? Please write a paragraph or two explaining your interest in this question. Give specific information from the book that leads you to ask this question (include page numbers). Explain how this information relates to your question.
Obesity in the whole world has become a public health problem in that it has raised concern. About 700 million people aged 15 years and above in the entire world are obese. The prevalence rate of based on years past shows a rapid increase of obesity in developed countries mainly Pacific region. Various cancers, cardiovascular diseases-morbidities, type II diabetes are some of the factors which lead to morbidity and mortality; this is based on literature on body exhaustive.
A public health strategy is, therefore, to be developed based on prevention of obesity rate of increase. The development and also the process of policies on preventing obesity should target factors which tend to contribute to obesity. Moreover, it should target barriers to lifestyle changes which are personal and also environmental and levels socioeconomic.
There are etiologies which contribute to obesity in which this etiologies are multifactorial,some if these factors include sedentary lifestyle, adverse socio-economic conditions which are there in developed countries, high rate of energy dense food, rigid restraint, alcohol, large portion sizes and food ratio which are prepared outside home (mostly in developed countries) page 70 (International journal of environmental research and public health).
There is a proposed framework by sacks (2009) where a suggestion is made that there should be policy actions and implementation of health strategies to preventing obesity. These factors target environments, behaviors directly influencing people, physical activity settings, food environments and also the socioeconomic environments.
3. What do you need to learn as a biologist to understand your question in the context of human evolution?
Obesity, diabetes and also metabolic syndrome has become a worldwide health concern due to that they are growing rapidly, and their causes are not fully understood. Therefore a research into the obesity epidemic etiology is highly appreciated depending on the evolutionary roots of metabolic control. Thrifty gene hypothesis argues that obesity is an evolutionary roots of metabolic control .
Bisphenol A and obesity, the estrogenic endocrine disrupting chemicalricguer
This document discusses how exposure to the estrogenic endocrine disrupting chemical bisphenol A (BPA) during fetal and early life development can lead to obesity later in life. It proposes that BPA exposure can cause epigenetic changes through DNA methylation that program genes involved in metabolic processes and weight regulation. This fetal programming may contribute to the current obesity epidemic by permanently altering the body's ability to maintain a normal weight. The document also discusses how factors like reduced placental blood flow can further interact with BPA exposure to influence fetal growth and the development of metabolic abnormalities and obesity.
This document discusses the natural history of disease and fetal origins of adult disease. It provides background on how diseases progress over time without treatment and the importance of understanding this progression. It then discusses the theory that nutritional deprivation of the fetus during critical periods of development can force adaptations that become maladaptive when faced with different postnatal nutritional circumstances, potentially leading to adult health disorders. Factors like low birth weight, infant growth, and prenatal exposures are associated with increased risk of adult obesity, cardiovascular disease, and other issues. The document emphasizes that fetal development can permanently affect body structure and function in ways that manifest as disease later in life.
The National Children's Study aims to understand environmental factors contributing to childhood obesity through a large prospective birth cohort study of 100,000 American children. It will address limitations of past studies by following children from before conception through age 21 and collecting extensive data on genetics, behaviors, social environment, chemical exposures, and health outcomes. This life-course approach will provide insights into early-life and community-level influences on obesity risk and their interactions. The study aims to guide evidence-based strategies for obesity prevention.
Epidemiological studies are applicable to communicable and non-com.docxSALU18
Epidemiological studies are applicable to communicable and non-communicable diseases. Childhood obesity is an area that is receiving more attention in public health due to the multiple morbidities that emerge as a result of this condition. Below are links to a cross-sectional study and a case-control study. Imagine that you are interested in conducting a case-control or cross-sectional study proposal of childhood obesity vs. birth weight (prenatal and early life influences). Both articles below address prenatal influences on childhood obesity and birth weight using different approaches.
Article 1 -attached
Article 2-attached
Using the information in the articles, answer the following questions using AMA format.
1. How would you select cases and controls for this study and how would you define exposure and outcome variables for a case-control study design? What other factors would you control for?
2. How would you design a proposal measuring the effect of birthweight on childhood obesity for a cross-sectional study design? What other factors would you control for?
BioMed CentralBMC Public Health
ss
Open AcceStudy protocol
Cross sectional study of childhood obesity and prevalence of risk
factors for cardiovascular disease and diabetes in children aged 11–
13
Anwen Rees*1, Non Thomas1, Sinead Brophy2, Gareth Knox1 and
Rhys Williams2
Address: 1Cardiff School of Sport, University of Wales Institute Cardiff, Wales, UK and 2School of Medicine, Swansea University, Wales, UK
Email: Anwen Rees* - [email protected]; Non Thomas - [email protected]; Sinead Brophy - [email protected];
Gareth Knox - [email protected]; Rhys Williams - [email protected]
* Corresponding author
Abstract
Background: Childhood obesity levels are rising with estimates suggesting that around one in
three children in Western countries are overweight. People from lower socioeconomic status and
ethnic minority backgrounds are at higher risk of obesity and subsequent CVD and diabetes.
Within this study we examine the prevalence of risk factors for CVD and diabetes (obesity,
hypercholesterolemia, hypertension) and examine factors associated with the presence of these
risk factors in school children aged 11–13.
Methods and design: Participants will be recruited from schools across South Wales. Schools
will be selected based on catchment area, recruiting those with high ethnic minority or deprived
catchment areas. Data collection will take place during the PE lessons and on school premises. Data
will include: anthropometrical variables (height, weight, waist, hip and neck circumferences, skinfold
thickness at 4 sites), physiological variables (blood pressure and aerobic fitness (20 metre multi
stage fitness test (20 MSFT)), diet (self-reported seven-day food diary), physical activity (Physical
Activity Questionnire for Adolescents (PAQ-A), accelerometery) and blood tests (fasting glucose,
insulin, lipids, fibrinogen (Fg), adiponectin (high molecular weight), C-react ...
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 document discusses how changes in modern life have disrupted the developmental equilibrium between the human microbiome and physiology. Factors like C-sections, antibiotic use, and formula feeding have led to the loss of microbial taxa and a less diverse microbiome being vertically and horizontally transmitted between generations. This is theorized to alter the immunological development setting of early life and increase the risk of inflammatory and autoimmune diseases by reducing tolerance to commensal bacteria. Understanding and restoring the lost microbiota is proposed as a way to reverse disease epidemics.
This paper investigates the causal effect of education on various health outcomes and behaviors in Italy, exploiting a 1963 reform that raised compulsory schooling by three years. The reform provides exogenous variation in education levels needed for causal identification. Using survey data on Italians, the paper analyzes effects on chronic diseases, BMI, smoking, physical activity, preventive health behaviors, and more. Considering multiple outcomes simultaneously allows for a more comprehensive assessment than prior studies examining only one or a few measures. The results provide new causal evidence on how education impacts health in Italy.
Who this is for: Health professionals.
Description: Dr. Sheila Bushkin-Bedient will be speaking on the prenatal origins of disease and why we should be focusing on studying possible connections between unconventional natural gas extraction and diabetes, obesity, and cancer.
About the Speaker: Sheila Bushkin is a member of the Institute of Health and the Environment at the State University at Albany, and Concerned Health Professionals of New York. She has been a member of the Medical Society of the State of New York for 15 years. Her specific areas of interest involve environmental health issues, chronic diseases, health concerns of older adults, and CME for physicians.
This document summarizes evidence that breastfeeding can help combat childhood obesity. It finds that exclusive breastfeeding for at least one year is associated with lower rates of childhood obesity compared to formula feeding. This is because breastmilk regulates appetite and promotes healthy weight through hormones. While breastfeeding rates have increased in the US, rates of exclusive breastfeeding at 6 and 12 months have remained low. Increasing exclusive breastfeeding could help address the epidemic of childhood obesity and subsequent risks of adult obesity and related diseases.
Aene project a medium city public students obesity studyCIRINEU COSTA
Identifying undernutrition and obesity on students and propose public policies of health are urgent issues. This paper presents a study with weight and stature from students collected by physical education teachers (PEF) in schools of a city near São Paulo. The PEF collected the data and they were inserted in a program especially developed for each school Department (AENE Project). The datas were analyzed by software and evaluation done based on a World Health Organization (WHO_2007) table, that develops health programs worldwide. The results evaluations were used to raise the students and family, teachers and responsibles for treatment search (when required).
The document discusses how adverse childhood experiences (ACEs) like abuse, neglect, and household dysfunction can disrupt normal energy storage mechanisms in children and potentially lead to obesity. It explores the relationship between stress, hormones like insulin and leptin, and the hypothalamic-pituitary-adrenal axis in regulating weight gain. When a child experiences stress from ACEs, their stress response is activated, altering these biological processes and potentially causing excessive fat storage and weight gain over time. The document aims to further examine how external stress from ACEs can immediately and long-term impact children's health, obesity risk, and neurodevelopment through disruption of normal metabolic functioning.
The document summarizes 5 research articles related to diabetes. It discusses the purpose, background, methods, subjects, data collection and analysis, and conclusions of each study. The first study examined pregnant women's knowledge of gestational diabetes prevention. The second looked at factors influencing insulin initiation in UK adults with diabetes. The third evaluated the relationship between continuous glucose monitoring and type 1 diabetes management. The fourth assessed the link between vitamin D intake and risk of type 1 diabetes in infants. The fifth studied the association between erectile dysfunction and glycemic control in men with type 2 diabetes.
Running head METABOLIC DISEASE RISK .docxcowinhelen
Running head: METABOLIC DISEASE RISK 1
METABOLIC DISEASE RISK 8
Metabolic Disease Risk in Children
Name:
Institutional Affiliation:
Instructor:
Course:
Date:
Metabolic Disease Risk in Children
Summary
The metabolic process allows the breakdown of foods into small compounds. It is essential to note that disorder in the normal metabolism of the body normally leads to metabolic disease. Moreover, disruptions or abnormalities in the biochemical reactions lead to metabolism errors; hence, it is important to determine the exact cause of metabolic disease. Most people construe that hereditary factors cause metabolic disease in children alone, but the fact is wrong since other factors such as obesity and insulin resistance also cause the disease. The metabolic disease is usually inherited as an autosomal condition, which means that two copies of defective genes from both parents must exist for the disease to develop. Hoffmann (2002) contends that there is always a 25 percent chance that will inherit two defective gene copies from the carrier parents. It is also important to note that the hereditary argument is inconclusive since studies have shown that other factors such as mitochondrial overload, insulin resistance, and accumulation of fats also lead to a metabolic disorder. Insulin resistance leads to metabolic disease because the human body responds to physiological insulin level through the reduction of glucose uptake. The primary target of insulin action is the liver because it plays a major role when it comes to substrate metabolism. On the other hand, global concern about the increase in metabolic dysregulation among children has increased lately especially after some studies illustrated that there exists a positive correlation between metabolic disease and obesity. A recent survey has revealed that pediatric obesity is the leading risk factor for metabolic disease contrary to earlier assertions that the metabolic disease is purely hereditary. Obese children have a high chance of developing the metabolic disease as compared to other children.
Introduction
Metabolism is a very important process in the human body because the biochemical reactions and interconversions are what produce energy and other important compounds for the body. For the body to take up food, the food must be broken down into simple compounds through the metabolic process. Therefore, a disruption in the normal metabolism of the body is what normally leads to metabolic disease. According to Chen, Srinivasan, and Berenson (2008), enzymes play a critical role in the metabolic process because they speed up the biochemical reactions taking place at the cellular level. Any abnormality or disruption in the biochemical reactions and interconversions leads to metabolism ...
The chemistry of the actinide and transactinide elements (set vol.1 6)Springer
Actinium is the first member of the actinide series of elements according to its electronic configuration. Actinium closely resembles lanthanum chemically. The three most important isotopes of actinium are 227Ac, 228Ac, and 225Ac. 227Ac is a naturally occurring isotope in the uranium-actinium decay series with a half-life of 21.772 years. 228Ac is in the thorium decay series with a half-life of 6.15 hours. 225Ac is produced from 233U with applications in medicine.
Transition metal catalyzed enantioselective allylic substitution in organic s...Springer
This document provides an overview of computational studies of palladium-mediated allylic substitution reactions. It discusses the history and development of quantum mechanical and molecular mechanical methods used to study the structures and reactivity of allyl palladium complexes. In particular, density functional theory methods like B3LYP have been widely used to study reaction mechanisms and factors controlling selectivity. Continuum solvation models have also been important for properly accounting for reactions in solvent.
1) Ranchers in Idaho observed lambs born with cyclopia (one eye) due to ewes grazing on corn lily plants. Cyclopamine was identified as the compound responsible and was later found to inhibit the Hedgehog signaling pathway.
2) Nakiterpiosin and nakiterpiosinone were isolated from cyanobacterial sponges and shown to inhibit cancer cell growth. Their unique C-nor-D-homosteroid skeleton presented synthetic challenges.
3) The authors developed a convergent synthesis of nakiterpiosin involving a carbonylative Stille coupling and a photo-Nazarov cyclization. Model studies led them to propose a revised structure for n
This document reviews solid-state NMR techniques that have been used to determine the molecular structures of amyloid fibrils. It discusses five categories of NMR techniques: 1) homonuclear dipolar recoupling and polarization transfer via J-coupling, 2) heteronuclear dipolar recoupling, 3) correlation spectroscopy, 4) recoupling of chemical shift anisotropy, and 5) tensor correlation methods. Specific techniques described include rotational resonance, dipolar dephasing, constant-time dipolar dephasing, REDOR, and fpRFDR-CT. These techniques have provided insights into the hydrogen-bond registry, spatial organization, and backbone torsion angles of amyloid fibrils.
This document discusses principles of ionization and ion dissociation in mass spectrometry. It covers topics like ionization energy, processes that occur during electron ionization like formation of molecular ions and fragment ions, and ionization by energetic electrons. It also discusses concepts like vertical transitions, where electronic transitions occur much faster than nuclear motions. The document provides background information on fundamental gas phase ion chemistry concepts in mass spectrometry.
Higher oxidation state organopalladium and platinumSpringer
This document discusses the role of higher oxidation state platinum species in platinum-mediated C-H bond activation and functionalization. It summarizes that the original Shilov system, which converts alkanes to alcohols and chloroalkanes under mild conditions, involves oxidation of an alkyl-platinum(II) intermediate to an alkyl-platinum(IV) species by platinum(IV). This "umpolung" of the C-Pt bond facilitates nucleophilic attack and product formation rather than simple protonolysis back to alkane. Subsequent work has validated this mechanism and also demonstrated that platinum(IV) can be replaced by other oxidants, as long as they rapidly oxidize the
Principles and applications of esr spectroscopySpringer
- Electron spin resonance (ESR) spectroscopy is used to study paramagnetic substances, particularly transition metal complexes and free radicals, by applying a magnetic field and measuring absorption of microwave radiation.
- ESR spectra provide information about electronic structure such as g-factors and hyperfine couplings by measuring resonance fields. Pulse techniques also allow measurement of dynamic properties like relaxation.
- Paramagnetic species have unpaired electrons that create a magnetic moment. ESR detects transition between spin energy levels induced by microwave absorption under an applied magnetic field.
This document discusses crystal structures of inorganic oxoacid salts from the perspective of periodic graph theory and cation arrays. It analyzes 569 crystal structures of simple salts with the formulas My(LO3)z and My(XO4)z, where M are metal cations, L are nonmetal triangular anions, and X are nonmetal tetrahedral anions. The document finds that in about three-fourths of the structures, the cation arrays are topologically equivalent to binary compounds like NaCl, NiAs, and FeB. It proposes representing these oxoacid salts as a quasi-binary model My[L/X]z, where the cation arrays determine the crystal structure topology while the oxygens play a
Field flow fractionation in biopolymer analysisSpringer
This document summarizes a study that uses flow field-flow fractionation (FlFFF) to measure initial protein fouling on ultrafiltration membranes. FlFFF is used to determine the amount of sample recovered from membranes and insights into how retention times relate to the distance of the sample layer from the membrane wall. It was observed that compositionally similar membranes from different companies exhibited different sample recoveries. Increasing amounts of bovine serum albumin were adsorbed when the average distance of the sample layer was less than 11 mm. This information can help establish guidelines for flow rates to minimize fouling during ultrafiltration processes.
1) The document discusses phonons, which are quantized lattice vibrations in crystals that carry thermal energy. It describes modeling crystal vibrations using a harmonic lattice approach.
2) Normal modes of the lattice vibrations can be described as a set of independent harmonic oscillators. Quantum mechanically, these normal modes are quantized as phonons with discrete energy levels.
3) Phonons can be thought of as quasiparticles that carry momentum and energy in the crystal lattice. Their propagation is described using a phonon field approach rather than independent normal modes.
This chapter discusses 3D electroelastic problems and applied electroelastic problems. For 3D problems, it presents the potential function method for solving problems involving a penny-shaped crack and elliptic inclusions. It derives the governing equations and introduces potential functions to obtain the general static and dynamic solutions. For applied problems, it discusses simple electroelastic problems, laminated piezoelectric plates using classical and higher-order theories, and piezoelectric composite shells. It also presents a unified first-order approximate theory for electro-magneto-elastic thin plates.
Tensor algebra and tensor analysis for engineersSpringer
This document discusses vector and tensor analysis in Euclidean space. It defines vector- and tensor-valued functions and their derivatives. It also discusses coordinate systems, tangent vectors, and coordinate transformations. The key points are:
1. Vector- and tensor-valued functions can be differentiated using limits, with the derivatives being the vector or tensor equivalent of the rate of change.
2. Coordinate systems map vectors to real numbers and define tangent vectors along coordinate lines.
3. Under a change of coordinates, components of vectors and tensors transform according to the Jacobian of the coordinate transformation to maintain geometric meaning.
This document provides a summary of carbon nanofibers:
1) Carbon nanofibers are sp2-based linear filaments with diameters of around 100 nm that differ from continuous carbon fibers which have diameters of several micrometers.
2) Carbon nanofibers can be produced via catalytic chemical vapor deposition or via electrospinning and thermal treatment of organic polymers.
3) Carbon nanofibers exhibit properties like high specific area, flexibility, and strength due to their nanoscale diameters, making them suitable for applications like energy storage electrodes, composite fillers, and bone scaffolds.
Shock wave compression of condensed matterSpringer
This document provides an introduction and overview of shock wave physics in condensed matter. It discusses the assumptions made in treating one-dimensional plane shock waves in fluids and solids. It briefly outlines the history of the field in the United States, noting that accurate measurements of phase transitions from shock experiments established shock physics as a discipline and allowed development of a pressure calibration scale for static high pressure work. It describes some of the practical applications of shock wave experiments for providing high-pressure thermodynamic data, understanding explosive detonations, calibrating pressure scales, and enabling studies of materials under extreme conditions.
Polarization bremsstrahlung on atoms, plasmas, nanostructures and solidsSpringer
This document discusses the quantum electrodynamics approach to describing bremsstrahlung, or braking radiation, of a fast charged particle colliding with an atom. It derives expressions for the amplitude of bremsstrahlung on a one-electron atom within the first Born approximation. The amplitude has static and polarization terms. The static term corresponds to radiation from the incident particle in the nuclear field, reproducing previous results. The polarization term accounts for radiation from the atomic electron and contains resonant denominators corresponding to intermediate atomic states. The full treatment allows various limits to be taken, such as removing the nucleus or atomic electron, reproducing known results from quantum electrodynamics.
Nanostructured materials for magnetoelectronicsSpringer
This document discusses experimental approaches to studying magnetization and spin dynamics in magnetic systems with high spatial and temporal resolution.
It describes using time-resolved X-ray photoemission electron microscopy (TR-XPEEM) to image the temporal evolution of magnetization in magnetic thin films with picosecond time resolution. Results are presented showing the changing domain structure in a Permalloy thin film following excitation with a magnetic field pulse. Different rotation mechanisms are observed depending on the initial orientation of the magnetization with respect to the applied field.
A novel pump-probe magneto-optical Kerr effect technique using higher harmonic generation is also discussed for addressing spin dynamics in magnetic systems with femtosecond time resolution and element selectivity.
This document discusses nanomaterials for biosensors and implantable biodevices. It describes how nanostructured thin films have enabled the development of more sensitive electrochemical biosensors by improving the detection of specific molecules. Two common techniques for creating nanostructured thin films are described - Langmuir-Blodgett films and layer-by-layer films. These techniques allow for the precise control of film thickness at the nanoscale and have been used to immobilize biomolecules like enzymes to create biosensors. Recent research is also exploring how these nanostructured films and biomolecules can be used to create implantable biosensors for real-time monitoring inside the body.
Modern theory of magnetism in metals and alloysSpringer
This document provides an introduction to magnetism in solids. It discusses how magnetic moments originate from electron spin and orbital angular momentum at the atomic level. In solids, electron localization determines whether magnetic properties are described by localized atomic moments or collective behavior of delocalized electrons. The key concepts of metals and insulators are introduced. The document then presents the basic Hamiltonian used to describe magnetism in solids, including terms for kinetic energy, electron-electron interactions, spin-orbit coupling, and the Zeeman effect. It also discusses how atomic orbitals can be used as a basis set to represent the Hamiltonian and describes the symmetry properties of s, p, and d orbitals in cubic crystals.
This chapter introduces and classifies various types of damage that can occur in structures. Damage can be caused by forces, deformations, aggressive environments, or temperatures. It can occur suddenly or over time. The chapter discusses different damage mechanisms including corrosion, excessive deformation, plastic instability, wear, and fracture. It also introduces concepts that will be covered in more detail later such as damage mechanics, fracture mechanics, and the influence of microstructure on damage and fracture. The chapter aims to provide an overview of damage types before exploring specific mechanisms and analyses in later chapters.
This document summarizes research on identifying spin-wave eigen-modes in a circular spin-valve nano-pillar using Magnetic Resonance Force Microscopy (MRFM). Key findings include:
1) Distinct spin-wave spectra are observed depending on whether the nano-pillar is excited by a uniform in-plane radio-frequency magnetic field or by a radio-frequency current perpendicular to the layers, indicating different excitation mechanisms.
2) Micromagnetic simulations show the azimuthal index φ is the discriminating parameter, with only φ=0 modes excited by the uniform field and only φ=+1 modes excited by the orthogonal current-induced Oersted field.
3) Three indices are used to label resonance
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfrightmanforbloodline
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
2. 14 J.C.K. Wells
2.1 Introduction
Until the 1980s, the degenerative diseases most responsible for morbidity and mortality in indus-
trialised populations were generally attributed to the combination of genetic risk factors and adult
lifestyle. Indeed they were often termed ‘lifestyle diseases’, considered to derive from poor diets,
inadequate physical activity levels and unhealthy behaviours such as smoking or excessive alcohol
consumption.
This perspective changed profoundly following pioneering work by Barker and colleagues, study-
ing the epidemiology of degenerative diseases in those for whom early life experience could be
reconstructed (Barker, 1998). Interest in the possible early origins of adult diseases initially arose
following observations that adult mortality was often correlated with infant mortality, suggesting a
possible long-term influence of conditions during early life. When the first longitudinal analyses on
this issue were conducted, the results were provocative. The earliest work consistently showed that
low birth weight was a strong predictor of diseases such as stroke, hypertension, type 2 diabetes and
ischaemic heart disease (Barker, 1998). These results would subsequently be replicated in numerous
cohorts and settings. For example, whilst initial work tended to use data from other industrialised
populations, cohorts in India and Brazil also replicated the same findings. Subsequently, postnatal
growth also became implicated in the risk of the same diseases.
At the end of the first decade of the 21st century, the ‘developmental origins of adult health and
disease’ (DOHaD) hypothesis has become a mainstream theme within paediatric research. Central
to this hypothesis is the notion that growth rates in early life are predictive of later disease risk
(Forsen et al., 2000; Barker et al., 2005). This work has thus introduced a novel issue to the pae-
diatrician in highlighting that nutritional management not only impacts on short-term outcomes but
also has profound longer term consequences. Yet despite compelling evidence that early experience
is critical for later health, there remain several controversies concerning which developmental peri-
ods are important, what environmental cues are relevant and whether there is a common human
physiological response or whether it differs within and between populations. These questions must
be addressed in order to develop coherent public health policies and appropriate guidelines for the
clinical management of individuals.
2.2 The Concepts of Phenotypic Induction and Programming
Early work on the developmental origins of adult disease comprised epidemiological analyses rather
than theoretical exploration, and a clear theoretical basis for this component of development is still
consolidating.
In fact, independent of the epidemiological cohort studies, nutritional scientists had been investi-
gating the process of growth in animal studies for several decades. In the 1960s, two British scientists
showed that the effect of malnutrition on rats differed markedly according to the period of growth
affected. Whereas malnutrition during the period of gestation or lactation permanently reduced size,
malnutrition following infancy only slowed growth temporarily, such that the trajectory of growth
was restored rapidly following a resumption of normal food supplies (Widdowson and McCance,
1960). This work, complemented by similar work on the development of the brain (Davison and
Dobbing, 1968), indicated the possibility of ‘sensitive’ or ‘critical’ periods in development. Such
critical periods apply to many aspects of development and are well known in non-human species
such as the behavioural imprinting characteristic of some birds, but their sensitivity to nutrition had
received little attention.
3. 2 The Concept of Phenotypic Induction (‘Programming’) and Implications for Growth 15
Such work suggested that whereas growth rates in early life in mammals are relatively plastic,
around the time of weaning canalisation tends to occur, with growth trajectory becoming ‘self-
righting’ following nutritional insult (Tanner, 1963; Smith et al., 1976). This work is fundamental to
current work on the early origins of later disease risk, focusing in particular on what happens during
early windows of plasticity and what the long-term effects are. Some of the first studies to reveal the
long-term effects of early nutritional variability were conducted on baboons. Lewis and colleagues
(1986, 1988) showed that infant nutrition was associated with both adiposity and cardiovascular risk
in adulthood. Significantly, the enhanced fatness of adults overfed in infancy developed post-puberty.
Building on this animal work, Lucas and colleagues initiated a series of trials in humans, ran-
domising infants in the postnatal period to different diets (Lucas et al., 1984). This work emphasised
the concept of ‘programming’, which Lucas (1991) defined as the capacity of environmental stimuli
during critical developmental periods to exert long-term or permanent effects on subsequent struc-
ture and function of the organism. The terminology of programming has subsequently entered into
widespread use amongst the medical community. However, it has been criticised by the evolution-
ary biologist Bateson (2001), on the grounds that it incorrectly suggests that early life experience
contains ‘instructions’ for later disease states. Many authors for example refer to the programming
of obesity or hypertension; yet, these diseases are in fact complex composite traits responding to
numerous exposures across different developmental periods.
Bateson (2001) proposed instead the term ‘phenotypic induction’, as a broader phrase appropriate
for application across a wide range of biological disciplines. To some extent, the two terms can be
used interchangeably; however, phenotypic induction is in my view preferable because it facilitates
the incorporation of different stimuli impacting on phenotype throughout development. Whereas
the programming approach places particular emphasis on those expressing ill health in later life,
the broader approach regards all individuals as responding to their successive environments. The
benefits of this approach may become apparent during the discussions that follow.
The concept of phenotypic induction is illustrated in Fig. 2.1. This schematic diagram shows
that phenotypic variability can develop in response to environmental stimuli during early sensitive
periods. In postnatal life, these plastic periods terminate, such that whatever variability is present
tends to track on through adolescence into adult life. However, only some traits may be considered to
be induced in this way. As will be discussed in greater detail below, other components of physiology
retain plasticity and hence mediate the impact of subsequent environmental conditions.
Fig. 2.1 Schematic diagram illustrating the concepts of phenotypic induction (programming) and tracking.
Phenotypic induction occurs through developmental plasticity during early ‘critical windows’ of physiological sen-
sitivity, when environmental factors induce variability in a range of phenotypic traits such as the size and structure
of organs. As the windows of sensitivity close, these traits tend to track onwards into adulthood, such that the early
environmental factors exert long-term phenotypic effects. The body accommodates these long-term effects in some
traits (e.g. nephron number) by maintaining plasticity in others (e.g. blood pressure)
4. 16 J.C.K. Wells
2.3 The Classic Study of the Dutch ‘Hunger Winter’
Perhaps the first study in humans which drew attention to the potential importance of early life expe-
rience for later health was a follow-up of adults exposed to malnutrition in utero during the Second
World War. During the ‘Dutch hunger winter’, a portion of the Dutch population was suddenly
exposed to a drastic reduction in food rations. Some months later, the famine ended and adequate
food supplies were rapidly restored (Ravelli et al., 1976). Detailed studies have illustrated the conse-
quences of this experience for those gestated during the famine, both in terms of birth weight and in
terms of adult phenotype. Of particular scientific interest, it has been possible to differentiate those
who were exposed to maternal famine during specific trimesters of pregnancy. A landmark publi-
cation showed that compared with young adult men who had not experienced maternal famine in
utero, those who had been exposed had higher adult BMI if they had experienced maternal famine
in the first trimester of pregnancy, but lower BMI if they had experienced maternal famine in the
third trimester (Ravelli et al., 1976). These data were collectively suggested to indicate the induction
of either adipocyte number or appetite regulation, depending on when the malnutrition exposure
occurred. Longer term follow-up studies reported similar associations between early pregnancy
exposure to maternal famine and markers of obesity in middle-aged women, but did not reproduce
the earlier findings in middle-aged men.
The notion that fetal nutrition might be the critical underlying mechanism in such associations
appeared to be supported by birth weight data. Compared to those not experiencing maternal famine,
those exposed to famine in the third trimester had significantly reduced birth weight. However, those
exposed to famine in the first trimester did not have reduced birth weight (Stein et al., 2004).
Paradoxically, these findings were not replicated in a very similar cohort, who had been exposed
to famine during the siege of Leningrad, also during the Second World War. In this population, no
association was observed between maternal malnutrition in utero and subsequent phenotype, despite
an even bigger deficit in birth weight (Stanner and Yudkin, 2001). An important difference between
these populations is that whereas the Dutch population experienced a sudden relief from famine, the
Leningrad population continued to experience malnutrition for several years. As discussed in greater
detail below, this indicates that the association between fetal nutrition and adult health profile is
mediated by patterns of postnatal growth.
2.4 The Fetal Versus Postnatal Growth Controversy
Whilst the Dutch hunger winter study provided the first significant data set on the long-term con-
sequences of early nutrition, the issue had already attracted attention elsewhere. Epidemiologists
observed that adult mortality tended to be positively associated with infant mortality, even though
the causes of death differed across the lifespan. This indicated that tough conditions early in life
might have long-term effects on survivability. From the late 1980s, epidemiologists began to study
data sets collected during the early to mid-20th century, in order to explore in more detail associ-
ations between early experience and subsequent health outcomes. The first results to be published
came from the Hertfordshire cohort, born in the 1930s in the UK and followed up 50 years later
(Barker, 1998).
Perhaps the key finding to emerge from such early analyses was the strong inverse association
between birth weight and subsequent disease risk (Barker, 1998; Barker et al., 2002). Although
attention focused in particular on the enhanced disease risk of those born small, studies repeatedly
5. 2 The Concept of Phenotypic Induction (‘Programming’) and Implications for Growth 17
Fig. 2.2 Standardised mortality ratios according to birth weight in the Hertfordshire cohort. The figure shows an
inverse association, indicating that taking into account current weight, mortality increases with decreasing weight
across the range of birth weight (Barker, 1998)
demonstrated a negative dose–response association between birth weight and subsequent risk across
the range of birth weight (Barker, 1998; Barker et al., 2002). Figure 2.2 shows for example the asso-
ciation between birth weight and risk of ischaemic heart disease in the Hertfordshire cohort study.
Initial interpretation of these findings focused on the apparent importance of fetal nutrition for adult
health, and though this issue has subsequently become a topic of fierce debate, the findings were
sufficiently robust to challenge the prevailing view that differences in cardiovascular risk were pri-
marily attributable to genetic factors or adult lifestyle. Hales and Barker (1992) proposed the ‘thrifty
phenotype hypothesis’, arguing that low birth weight should be considered a ‘survival phenotype’
induced by poor fetal nutrition. The survival phenotype would be beneficial in early life, but would
predispose to metabolic costs in later life, especially if challenged by a high-quality diet. Their
model attributed these long-term effects to the fact that the structure of most vital organs develops
in utero or during infancy, such that it is not possible for the effects of early malnutrition to be fully
compensated for during later periods of growth.
As the inverse association between birth weight and cardiovascular risk became replicated across
diverse cohorts, both in industrialised populations and in developing countries, it came to attention
that the link emerged most strongly, or in some cases only, following statistical adjustment for current
weight (Lucas et al., 1999). In other words, holding current adult weight constant, disease risk was
found to be greatest in those born small, though once again the effect was discernible across the
range of birth weight.
Lucas and colleagues (1999) argued that a more appropriate interpretation of such statistical
models was that variability in disease risk could be attributed to change in size between birth and
adulthood. This approach focuses attention on postnatal rather than fetal growth, in other words the
trajectory of weight gain during infancy and childhood. Subsequently, Singhal and Lucas (2004)
argued that variability in disease risk could be attributed entirely to postnatal growth patterns. Their
‘growth acceleration hypothesis’ stemmed from their work on randomised trials of infant diets,
which showed long-term effects of early growth variability independent of size at birth.
To some extent, these perspectives do not actually differ. A large number of studies have now con-
verged on the hypothesis that disease risk is greatest in those born small who subsequently become
6. 18 J.C.K. Wells
Table 2.1 Studies demonstrating high risk of the metabolic syndrome in those born small who become large
Population Disease trait or marker Author
Filipino adolescents Blood pressure Adair and Cole (2003)
Indian children CVD risk (insulin resistance, blood pressure,
glucose tolerance and plasma lipids)
Joglekar et al. (2007)
Indian adolescents Glucose tolerance Bhargava et al. (2004)
Swedish adult men Blood pressure Leon et al. (1996)
Finnish adults Type 2 diabetes Forsen et al. (2000)
Finnish adults Coronary events Barker et al. (2005)
large, as shown in Table 2.1. A particularly informative study was conducted by Leon and colleagues
(1996), who focused on the disparity between adult height and birth weight. Those with the greatest
deficit of size at birth relative to adult height were considered to have undergone poor fetal growth,
and these individuals had the greatest risk of cardiovascular disease. Nevertheless, in some studies
an association of low birth weight with later health outcomes is apparent without any adjustment
for later size, and as discussed below, it is helpful to consider the complementary contributions of
growth during different developmental periods to disease risk.
The area of greatest controversy comprises infancy, where both slow and rapid growth appear to
be associated with increased disease risk in later life. In the Hertfordshire cohort, body weight at
1 year of age showed the same inverse association with adult cardiovascular risk as birth weight,
indicating that both fetal life and infancy are periods when poor growth induces ill health in later life
(Hales et al., 1991). Conversely, in their randomised controlled trials, Singhal and colleagues demon-
strated adverse effects of rapid infant growth, as indexed by childhood proxies for cardiovascular risk
such as split proinsulin, lipid metabolism or blood pressure (Singhal and Lucas, 2004).
These findings are less contradictory than might appear to be the case. One of the challenges of
integrating the data is that the studies have focused on different ages, used different designs and
assessed different outcomes. Close attention to these differences allows the findings to be integrated
successfully within a single model of disease aetiology (Wells, 2009a).
2.5 A Physiological Model of the Development of Metabolic Phenotype
As recognised by Hales and Barker (1992), the structure of vital organs develops primarily during
fetal life, the period of growth when the vast majority of the rounds of cell division occur (hyper-
plasia) (Bogin, 1988). Organ phenotype is therefore highly sensitive to fetal nutritional experience.
Physiological traits such as nephron number, cardiac structure and pancreatic beta-cell mass are
strongly (although not necessarily exclusively) associated with fetal nutritional experience. I have
referred to such traits as ‘metabolic capacity’ (Wells, 2009a), which may be considered a collec-
tive term describing the capability to maintain homeostasis. Control of blood sugar levels and blood
pressure is closely associated with these physiological traits, especially in relation to the pattern of
postnatal growth. However, metabolic capacity does not develop exclusively during fetal life. Some
such traits continue to maintain sensitivity to nutritional experience during infancy. For example,
beta-cell mass continues to increase during infancy and is therefore predicted to reflect the magnitude
of nutritional intake and hence track weight gain during this period.
After infancy, growth is dominated by hypertrophy, an increase in cell size rather than cell num-
ber (Bogin, 1988). As discussed above, linear growth becomes canalised after weaning (Smith et al.,
1976), and the relative size of different organs tends to remain broadly constant, linked to overall
7. 2 The Concept of Phenotypic Induction (‘Programming’) and Implications for Growth 19
height (Weder and Schork, 1994). Thus, whereas nutrition exerts profound impacts on organ pheno-
type during the period of hyperplasia, this impact becomes minimal during the period of hypertrophy.
Nevertheless, other traits remain more sensitive to nutrition, including in particular adiposity, and to
a lesser extent lean mass as well as the rate of maturation. Thus, greater rates of weight gain can
increase tissue mass without inducing matching increases in organ mass. I have therefore referred to
hypertrophic growth and its causative processes as ‘metabolic load’, which refers to the homeostatic
burden imposed by total tissue masses on metabolic capacity (Wells, 2009a). A larger muscle mass
in itself increases metabolic load, whilst increased fat mass also exacerbates it (e.g. blood pressure
and insulin resistance), due in part to the harmful endocrine products secreted by adipose tissue.
This load may be further exacerbated by sedentary behaviour, which reduces metabolic flexibility
(the ability to balance alternative fuel sources at the cellular level) and a diet high in carbohydrates,
each of which challenges the ongoing regulation of blood sugar content and cellular metabolism.
Thus, metabolic load refers to the sum total of tissue masses and fuel metabolism which derive from
the interactions between past and current dietary and activity patterns.
Risk of the metabolic syndrome and cardiovascular disease can then be attributed to the ratio of
metabolic load to metabolic capacity, as now demonstrated by numerous studies. Using this model,
it is now possible to understand the apparently contradictory epidemiological evidence, which has
emerged from contrasting study designs. The logic of the approach may be expressed in purely phys-
ical terms, using the analogy of the car. According to this approach, metabolic capacity is represented
by the engine and metabolic load by the total weight of the vehicle. A high ratio of vehicle weight to
engine size increases the risk of mechanical failure; however, this situation can arise from variability
in both engine size and total car size (Fig. 2.3). Holding the size of the car constant, the risk of
mechanical breakdown is increased for smaller engines. Holding the size of the engine constant, the
risk of mechanical breakdown is increased for larger cars. This model translates directly into human
physiology: holding metabolic load constant, the risk of disease is increased for smaller metabolic
Fig. 2.3 Schematic diagram using the analogy of automobile design to illustrate the complementary contributions
of engine size and total car size to the risk of breakdown. Both reduced engine size and larger car size contribute
independently to the risk of mechanical failure, and their interaction is therefore derived from taking both components
of design into account. This model replicates the scenario of the human body, where the engine symbolises ‘metabolic
capacity’ and the size of the car symbolises ‘metabolic load’
8. 20 J.C.K. Wells
Fig. 2.4 Schematic 3-D diagram illustrating the complementary contributions of ‘metabolic capacity’ and ‘metabolic
load’ to the risk of metabolic disease. For any given metabolic load, disease risk increases with decreased metabolic
capacity. For any metabolic capacity, disease risk increases with increasing metabolic load. Metabolic capacity is
indexed by fetal and infant size, which in turn indexes developmental traits such as nephron number and pancreatic
B-cell mass. Metabolic load is indexed by the sum total of tissue masses, along with the metabolic stress induced by
past and current patterns of food intake and physical activity
capacity; in turn, holding the size of metabolic capacity constant, disease risk is increased with
greater metabolic load. This is illustrated in Fig. 2.4, which includes reference to various parameters
of metabolic capacity and load.
This model can therefore explain why the epidemiological studies following cohorts into late
adult life consistently associate, holding current weight constant, low birth weight (poor metabolic
capacity) with an increased risk of cardiovascular disease, diabetes, hypertension and stroke (Barker,
1998; Barker et al., 2002; Hales et al., 1991). It can also explain why randomised trials associate rapid
childhood growth rates (increased metabolic load) with indices of cardiovascular risk (Singhal and
Lucas, 2004), with obesity exerting similar effects. Finally, it can explain the paradoxical findings
for infancy, where both low and high rates of growth appear detrimental to later health. It is plausible
that low rates of infant weight gain continue to constrain metabolic capacity, whereas high rates of
infant weight gain represent an early induction of increased metabolic load (Wells, 2009a). Infancy
is thus an unusual period of growth, during which both metabolic capacity and metabolic load are
sensitive to nutritional experience.
Exactly how growth rates during childhood exacerbate metabolic load is becoming clear from
studies of physiology. Traits such as blood pressure are sensitive to weight gain, because they play a
key role in normalising the metabolic load exerted by the tissue masses on metabolic capacity. Blood
pressure increases naturally during adolescence, because as body size increases whilst nephron num-
ber remains constant, a larger pressure is required to supply the tissues (Weder and Schork, 1994).
Thus, whilst for a given nephron number, increased tissue mass requires greater blood pressure, so
for a given tissue mass, lower nephron number will also increase blood pressure because the relative
9. 2 The Concept of Phenotypic Induction (‘Programming’) and Implications for Growth 21
load will be greater. The greatest blood pressures are thus found in those born small who become
large (Adair and Cole, 2003).
A similar pattern of normalisation is apparent for other traits relative to metabolic phenotype. For
example, insulin resistance and insulin secretion are closely related, such that in healthy individu-
als insulin resistance interacts with insulin secretion to maintain glycaemic control (Bergman et al.,
2002). Insulin resistance may initially arise to protect tissues from the effects of hyperinsulinaemia,
reflecting high dietary load. However, reduced beta-cell mass reduces the capacity to secrete suffi-
cient insulin and hence eventually reduces tolerance of insulin resistance. Both low birth weight and
high current weight therefore predict glucose intolerance and diabetes (Hales et al., 1991; Bhargava
et al., 2004; Joglekar et al., 2007), but again their combination generates the strongest risk.
Whilst increased metabolic load at any time throughout postnatal life is assumed by this model
to increase disease risk, the emergence of metabolic load in infancy may be especially important.
Epigenetic effects are generated primarily within the window of plasticity and then continue to
influence phenotype thereafter. This scenario can explain why rapid infant growth in industrialised
populations tends to have long-term effects on obesity risk, as discussed below.
2.6 The Variable Impact of Catch-Up Growth
This model of disease development places particular emphasis on the contribution of catch-up growth
during infancy. As is well established, infants born small tend to undergo catch-up growth during the
first few months of life (Ong et al., 2000). In developing countries, this catch-up growth pattern is
associated with improved survival (Victora et al., 2001), and promotion of infant weight gain has long
been regarded an important public health policy. Recent studies, however, have demonstrated strong
associations of rapid childhood weight gain with increased cardiovascular risk profile. Thus, one key
issue is when catch-up growth should occur, in order to maximise its benefits and minimise its costs.
The disease implications of catch-up growth also appear to differ markedly between populations
from industrialised and developing countries, and this issue is likewise of critical importance for
public health policies.
In industrialised populations, rapid infant growth has been associated with increased risk of obe-
sity (Stettler et al., 2002) and cardiovascular risk (Ekelund et al., 2007). However, in a comprehensive
analysis of data from five birth cohorts in Brazil, Guatemala, India, South Africa and the Philippines,
greater infant growth was found to impact beneficially on a wide range of outcomes, without sub-
stantially increasing risk of later disease (Victora et al., 2008). In both types of population, however,
rapid childhood growth is directly increased with later disease risk.
Data from India illustrate this scenario particularly well. Indian neonates tend to have substantially
lower birth weight than those in the UK, with an average deficit of almost a kilogram (Yajnik et al.,
2003). This reduced birth weight is associated with altered body composition, with much greater
deficits in lean mass than in fat mass, whilst low birth weight Indian neonates are also hyperinsuli-
naemic (Yajnik et al., 2003). During infancy, greater rates of weight gain are associated primarily
with increased levels of lean mass in adulthood, considered beneficial for health and metabolic phe-
notype (Sachdev et al., 2005). In contrast, greater rates of weight gain from childhood are associated
with greater adiposity in adulthood and with poorer metabolic phenotype (Sachdev et al., 2005).
A similar pattern of growth has been observed in Brazilian cohorts, where again infant growth was
associated most strongly with later lean mass, but childhood growth with later fat mass (Victora
et al., 2008).
10. 22 J.C.K. Wells
These findings thus suggest that catch-up growth in developing countries, where low birth weight
remains common, may be beneficial if it occurs within the first 2 years of life (although the exact
duration of the beneficial window and the optimal magnitude of catch-up should be established with
more confidence). The key question is therefore how to target growth at the specific developmental
periods where it is most beneficial. A solution to this dilemma may be emerging following improved
understanding of the hormonal regulation of early growth.
Leptin acts as a signal of energy stores to the brain. During pregnancy and lactation, maternal
leptin passes to the offspring and hence ‘overestimates’ the offspring’s own energy reserves, thus
encouraging it to deposit lean rather than fat (Wells, 2009b). Administration of leptin to small infants
may therefore promote healthier weight gain during infancy, with long-term beneficial effects.
Likewise, the rapid infant growth of small-for-gestational age babies appears to be driven by high
levels of insulin secretion (Soto et al., 2003), which favours increased rates of linear growth during
infancy. Around the time of 2 years, if rapid weight gain continues, insulin resistance develops along
with an increased rate of central fat deposition (Ibanez et al., 2006). This central fat then plays a key
role in the emergence of other detrimental traits such as greater blood pressure, adverse lipoprotein
profile and reduced glycaemic control. According to this perspective, the early childhood diet is a
key mediating factor linking child growth with adverse metabolic profile and is the ideal target for
intervention. The obesogenic niche effectively acts as a magnifying lens, providing a high level of
energy intake during a period of growth when, prior to the invention of modern energy-dense foods,
low energy intake would have been the norm.
2.7 An Evolutionary Perspective
Up to now, this chapter has considered phenotypic induction as a process occurring in each gener-
ation. Growth patterns induce later phenotype and hence health, with low birth weight associated
with poorer phenotype and health in adult life. Whilst this perspective is valuable for identifying the
key period of sensitivity, and hence the optimum time points for specific interventions, it artificially
isolates within a single generation a process which actually occurs across generations. Phenotypic
plasticity evolved in order to protect the genome from selective pressures and allow development to
adapt to more recent or prevailing ecological conditions.
The patterns of fetal growth that initiate the process of phenotypic induction in each generation
are largely the product of the nutritional experience of the prior generation. Nutritionists have long
been aware of secular trends in growth that occur across generations, most notably upwards in recent
decades in industrialised populations, but in other global regions downwards in response to deteri-
orating ecological conditions (Wells, 2010). Phenotypic plasticity allows each generation to ‘guide’
the development of the next one. Much of this guiding occurs during pregnancy, when uterine pheno-
type impacts strongly on the development of the fetus. Greater flexibility characterises infancy, such
that the small baby may be able to catch-up following fetal growth restraint if adequate nutrition is
available.
This trans-generational plasticity allows human populations to adapt to changing levels of
nutritional supply. Body size decreases when energy availability falls and increases when energy
availability improves. However, when this trans-generational process is compressed into within-
generational time spans, the metabolic costs are exacerbated (Wells, 2010). Fetal life and infancy
are the primary periods during which nutritional supply can induce a larger body size. From early
childhood onwards, because height is canalised, increased nutritional supply primarily affects weight
rather than height and exacerbates metabolic load. It is the emergence of the obesogenic niche with
11. 2 The Concept of Phenotypic Induction (‘Programming’) and Implications for Growth 23
Table 2.2 Key points
1. Compelling evidence now links early and childhood growth rates with later disease risk
2. The paediatrician must now consider that growth has both benefits and costs, and that these benefits and costs
may be realised in different periods of the life course. This has implications for nutritional interventions in both
infancy and childhood
3. The impacts of infant catch-up growth appear to differ by population, and it remains uncertain what the optimum
rate of infant weight gain is, how long growth should be promoted in any given population and what
characteristics of populations should be taken into account when making such decisions
4. One particularly intriguing issue comprises ethnicity, as ethnic groups appear to differ in their associations
between nutritional status and disease risk
5. Future research should establish how much of this differential disease risk can be explained by the model
described here focusing on metabolic plasticity and metabolic load (which would implicate past patterns of
growth in recent generations) and how much can be explained by genetic factors (which would implicate deeper
ancestral experience)
6. Public health policies need to take into account the fact that metabolic risk is the consequence of accumulating
exposures across the life course
7. There is a need for coherent policies that, at any given life-course period, complement those impacting other
periods
8. Traditionally, policies in developing countries have promoted growth throughout infancy and childhood. Recent
comprehensive analyses indicate, however, that the benefits of increased growth are limited to within the first 2
years of life (Victora et al., 2008)
9. Studies are now required to determine how to capture the benefits of this early growth whilst avoiding
detrimental rapid child weight gain
unprecedented high levels of calories and little demand for physical activity that is facilitating the
exacerbation of metabolic load, particularly in those whose metabolism predisposes them to this on
account of their upregulated infant growth.
In this context, ethnicity emerges as a particularly important factor. Ethnic groups are known to
differ in the disease risks associated with particular levels of nutritional status. This differential dis-
ease risk may in part derive from recent ancestral variability in growth patterns. For example, the
lower average birth weight and reduced metabolic capacity of south Asians may derive from poor
nutrition in recent generations (Wells, 2010), rather than genetic adaptations in more distant ances-
tors. Testing these ideas, to understand the contribution of plasticity to ethnic variability, is critical
for formulating appropriate public health policies for developing countries, as well as managing
individual patients.
Growth is now a well-established determinant of later health, and several issues are critical for
paediatricians (Table 2.2). Paediatricians must also be aware that the optimal pattern of growth at
any age is a compromise between health costs and benefits realised at different times through the
life course. Key questions meriting further attention are how to boost metabolic capacity with-
out exacerbating metabolic load and how to limit metabolic load without constraining metabolic
capacity.
2.8 Applications to Other Areas of Health and Disease
The developmental origins of adult disease hypothesis are increasingly considered integral to many
areas of human health and have particular importance as discussed above for understanding the
life-course emergence of disease profile and the trans-generational nature of this life-course pro-
gression. Many areas of adult health increasingly take early life factors into account, for both
12. 24 J.C.K. Wells
non-communicable and infectious diseases. Furthermore, the implications of research in this area
apply not only to public health nutrition policies and clinical paediatrics but also to policy relating to
agriculture and the food industry, as well as social issues relating to the pattern of sexual maturation.
Summary Points
• There is now compelling evidence linking growth patterns in early life and childhood with the
risk of metabolic disease (type 2 diabetes, hypertension, stroke and coronary heart disease) in
later life.
• Holding current size constant, poor growth in fetal life and early infancy is strongly associated
with increased disease risk. Holding birth size constant, increased childhood growth rates are
associated with risk of the same diseases.
• A physiological model based on metabolic capacity (directly associated with early life growth)
and metabolic load (directly associated with weight gain, rich diet and physical inactivity from
childhood onwards) can explain these observations. A high ratio of load to capacity increases
disease risk.
• The effects of growth in infancy appear to vary between industrialised and developing countries.
This may relate to differences in birth weight and the magnitude and duration of infant catch-
up growth. Studies from industrialised countries are not appropriate for generating public health
policies for developing countries.
• The induction of phenotype occurs across as well as between generations. The most success-
ful health policies are likely to be those that provide coherent benefits across generations and
life courses. The model used here indicates that the promotion of metabolic capacity should be
complemented by the reduction of metabolic load.
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