The challenge of paediatric obesity: More rhetoric than action

A growing body of knowledge clearly shows a rapid increase in the prevalence of childhood obesity. But in spite of the many empirically-driven research projects and more laissez-faire initiatives intent on finding ways to ensure the healthy development of our young people, translating what we know into appropriate behaviour in the home, school, and community is more difficult than it sounds. It is, therefore, not surprising this concern is attracting the attention of politicians, health professionals, and educators. This article reflects on the paediatric obesity research and argues for a more coordinated effort in addressing what could (but need not) become a major public health issue

Alteration and recovery of arm usage in daily activities after rotator cuff surgery.

BACKGROUND: The objective measurement of dominant/nondominant arm use proportion in daily life may provide relevant information on healthy and pathologic arm behavior. This prospective case-control study explored the potential of such measurements as indicators of upper limb functional recovery after rotator cuff surgery. METHODS: Data on dominant/nondominant arm usage were acquired with body-worn sensors for 7 hours. The postsurgical arm usage of 21 patients was collected at 3, 6, and 12 months after rotator cuff surgery in the sitting, walking, and standing postures and compared with a reference established with 41 healthy subjects. The results were calculated for the dominant and nondominant surgical side subgroups at all stages. The correlations with clinical scores were calculated. RESULTS: Healthy right-handed and left-handed dominant arm usage was 60.2% (±6.3%) and 53.4% (±6.6%), respectively. Differences in use of the dominant side were significant between the right- and left-handed subgroups for sitting (P = .014) and standing (P = .009) but not for walking (P = .328). The patient group showed a significant underuse of 10.7% (±8.9%) at 3 months after surgery (P < .001). The patients recovered normal arm usage within 12 months, regardless of surgical side. The arm underuse measurement was weakly related to function and pain scores. CONCLUSION: This study provided new information on arm recovery after rotator cuff surgery using an innovative measurement method. It highlighted that objective arm underuse measurement is a valuable indicator of upper limb postsurgical outcome that captures a complementary feature to clinical scores

Bioimpedance spectroscopy for swelling evaluation following total knee arthroplasty: a validation study

BACKGROUND: The evaluation of swelling is important for the outcome of total knee arthroplasty (TKA) surgery. The circumference or volume measurements are applicable at the bedside of the patient but are altered by muscular atrophy and the post-surgical dressing. Bioimpedance spectroscopy might overcome these limitations; however, it should be validated. This study aimed to explore the validity, the reliability and the responsiveness of bioimpedance spectroscopy for measuring swelling after TKA. METHODS: The degree of swelling in 25 patients undergoing TKA surgery was measured using bioimpedance spectroscopy (BIS R0), knee circumference and limb volume. The measurements were performed on D-1 (day before surgery), D + 2 (2 days after surgery) and D + 8 (8 days after surgery). The BIS R0 measurements were repeated twice, alternating between two evaluators. The percentage of the difference between the limbs was calculated for BIS R0, circumference and volume. The intra- and inter-observer intraclass correlation coefficients (ICCs), limits of agreement (LOA), effect size (Cohen's d), correlations between the methods and diagnostic sensitivity were calculated. RESULTS: BIS R0, circumference and volume detected swelling < 3.5% at D-1. The swelling at D2 and D8 was greater with BIS R0 [mean (SD) 29.9% (±9.8) and 38.27 (±7.8)] than with volume [14.7 (±9.5) and 14.9 (±8.2)] and circumference [11.1 (±5.7) and 11.7 (±4.1)]. The BIS R0 intra- and inter-evaluator ICCs ranged from 0.89 to 0.99, whereas the LOA were < 5.2%. The BIS R0 correlation was 0.73 with volume and 0.75 with circumference. The BIS R0 Cohen's d was 3.32 for the D-1-D2 evolution. The diagnostic sensitivity was 83% D2 and 96% at D8. CONCLUSION: Bioimpedance is a valid method for the evaluation of swelling following TKA. BIS R0 also demonstrated excellent intra- and inter-evaluator reliability. The diagnostic sensitivity and responsiveness is superior to that of concurrent methods. BIS R0 is an efficient method for post-surgical follow up at the bedside of the patient. The measurement of BIS R0 is a straightforward, valid, reliable and responsive method for lower limb swelling following TKA surgery that could be used in clinics and research. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00627770

Endocrine disrupting chemicals removal in an aerobic granular sludge reactor treating simulated saline wastewater

The occurrence of Endocrine disrupting chemicals (EDCs) in the environment is a topic of concern. It is commonly accepted that the major source of EDCs to the environment is wastewater treatment plants effluents. Salinity is an additional common stress factor in wastewater treatment. Aerobic granular sludge (AGS) has a number of properties that make it more attractive than conventional biological systems for treatment of wastewater containing EDCs. In the present study, an AGS sequencing batch reactor adapted to salinity was operated for 140 days for treating synthetic saline wastewater containing 17β–estradiol (E2), 17α–ethinylestradiol (EE2) and bisphenol-A (BPA). E2 was removed by biodegradation. EE2 adsorption/desorption to the aerobic granules was observed. The increasing of BPA removal efficiency after bioaugmentation with a degrading bacterial strain shows that biodegradation was the removal mechanism. COD removal was not significantly affected by EDCs shock loads. Activity of ammonia oxidizing bacteria and nitrite oxidizing bacteria did not seem to be inhibited by the presence of EDCs. The activity of phosphate accumulating organisms was affected.info:eu-repo/semantics/publishedVersio

Effect of different salt adaptation strategies on the microbial diversity, activity, and settling of nitrifying sludge in sequencing batch reactors

The effect of salinity on the activity of nitrifying bacteria, floc characteristics, and microbial community structure accessed by fluorescent in situ hybridization and polymerase chain reaction–denaturing gradient gel electrophoresis techniques was investigated. Two sequencing batch reactors (SRB1 and SBR2) treating synthetic wastewater were subjected to increasing salt concentrations. In SBR1, four salt concentrations (5, 10, 15, and 20 g NaCl/L) were tested, while in SBR2, only two salt concentrations (10 and 20 g NaCl/L) were applied in a more shock-wise manner. The two different salt adaptation strategies caused different changes in microbial community structure, but did not change the nitrification performance, suggesting that regardless of the different nitrifying bacterial community present in the reactor, the nitrification process can be maintained stable within the salt range tested. Specific ammonium oxidation rates were more affected when salt increase was performed more rapidly and dropped 50% and 60% at 20 g NaCl/L for SBR1 and SBR2, respectively. A gradual increase in NaCl concentration had a positive effect on the settling properties (i.e., reduction of sludge volume index), although it caused a higher amount of suspended solids in the effluent. Higher organisms (e.g., protozoa, nematodes, and rotifers) as well as filamentous bacteria could not withstand the high salt concentrations

Rhodococcus sp. ED55: a bacterial strain with ability to degrade endocrine disrupting chemicals and potential for bioaugmentation

The occurrence of Endocrine disrupting chemicals (EDCs) in the environment is a topic of concern. It is commonly accepted that the major source of EDCs to the environment is wastewater treatment plants (WWTPs’) effluents, due to the inefficiency of WWTPs to remove this kind of pollutants. A bacterial strain – Rhodococcus sp. ED55 was isolated from the sediments of a discharge point of a WWTP in Coloane, Macau, for its ability to degrade EDCs. The bacterium was able to biodegrade 17β–estradiol (E2), 17α–ethinylestradiol (EE2), bisphenol-A (BPA) and bisphenol-S (BPS) at different extents. Strain ED55 was able to completely degrade the supplied amount of E2 in few hours, both in synthetic medium and in real wastewater from a municipal WWTP (Parada, Maia – Portugal). Estrone (E1), 4OH-E1 and 4OH-E2 were identified as intermediate degradation metabolites and the metabolic pathway is under elucidation. Bioaugmentation with Rhodococcus sp. ED 55 significantly improved the natural attenuation of the compound in municipal wastewater in batch assays. The acute test with luminescent marine bacterium Vibrio fischeri revealed elimination of the toxicity of the treated effluent and the standardized yeast estrogenic (S-YES) assay with the recombinant strain of Saccharomyces cerevisiae revealed decrease of estrogenic activity of samples. Rhodococcus sp. ED55 was applied in a strategy of an AGS sequencing batch reactor adapted to salinity, which was operated for treating a synthetic saline wastewater containing E2, EE2 and BPA. E2 was no longer detected in the bulk liquid after 10 min of aerobic reaction throughout reactor operation, suggesting that this compound was quickly removed by biodegradation. EE2 adsorption/desorption to the aerobic granules was observed. Removal of BPA significantly increased after bioaugmentation with Rhodococcus sp. ED55, showing that biodegradation was the governing removal mechanism. COD removal was not significantly affected by EDCs shock loads. Rhodococcus sp. ED55 can potentially be applied in bioaugmentation strategies for ameliorating treatment of wastewater contaminated with EDCs.info:eu-repo/semantics/publishedVersio

Bacterial strain rhodococcus sp. ED55 degrades endocrine disrupring chemicals in wastewater

info:eu-repo/semantics/publishedVersio

Rhodococcus sp. ED55: a bacterial strain with potential for application in wastewater treatment for effective removal of endocrine disruptors

info:eu-repo/semantics/publishedVersio