Association between Dietary Practice and Gait Speed in Community-Dwelling Older Adults with Overweight and Obesity: A Cross-Sectional Study

: Slow gait speed is associated with poorer clinical outcomes and higher rates of functional limitation and mortality in older adults, especially when combined with overweight or obesity. Aging is also associated with nutritional deficits. The aim of our study was to assess the potential association between dietary practice and gait speed performance in community-dwelling older adults with overweight and obesity. Participants underwent body composition measurement with the Tanita MC-780MA Bioimpedance Analyzer (BIA). Dietary patterns were assessed with the Mini Nutritional Assessment (MNA) questionnaire, and a dietary adequacy (DA) score system was constructed. The four-meter gait speed test was performed in order to assess gait speed. Of 222 participants, aged 67.6 ± 6.6 years, with a body mass index (BMI) of 31.9 ± 4.5 kg/m2, 34.7% had reduced gait speed and lower DA compared to those with normal gait speed (2.99 ± 1.12 vs. 3.37 ± 1.07; p < 0.05). The DA score of participants with slower gait speed was more likely to fall below the median than that of participants with normal gait speed (70.1% vs. 51.7%; p < 0.05). Participants with slower gait speed were more likely to be nutritionally at risk of low DA (22.1% vs. 10.3%; p < 0.05). Logistic regression analysis, after adjustment for confounders, showed that the risk of having a slow gait speed was 75% lower among those with a higher DA score (OR = 0.25; 95% CI = 0.11-0.53). Older adults with overweight or obesity in community dwellings might need to be supported with nutritional interventions that can improve their gait speed

Personalized physical activity programs for the management of knee osteoarthritis in individuals with obesity: a patient-centered approach

Physical activity (PA) plays a vital role in knee osteoarthritis (KOA) management. However, engaging individuals with KOA in regular exercise is challenging, especially when they are affected by obesity. The aim of the current review is to elucidate how to increase adherence to exercise in this population. When implementing a PA program with patients with KOA and obesity, a specific multi-step approach can be adopted. In phase I (the baseline assessment), the patients' eligibility for exercise is ascertained and a physical fitness assessment, sarcopenic obesity screening and quantification of the pain experienced are undertaken. Phase II adopts a patient-centered approach in implementing a PA program that combines an active lifestyle (>6000 steps/day) with land- or water-based exercise programs performed over eight to twelve weeks, with a frequency of three to five sessions per week, each lasting 60 min. In phase III, several strategies can be used to increase the patients' adherence to higher levels of PA, including the following: (i) personalizing PA goal-setting and real-time monitoring; (ii) enhancing physical fitness and the management of sarcopenic obesity; (iii) building a sustainable environment and a supportive social network for an active lifestyle; and (iv) reducing pain, which can ameliorate the clinical severity of KOA and help with weight management in this population

HEALTH-RELATED QUALITY OF LIFE IN TREATMENT-SEEKING ARAB PATIENTSWITH OBESITY

Background & Aim: Health-Related Quality of Life (HRQoL) is an important outcome that reflectsthe impact of chronic diseases on patients’ wellbeing. There is a paucity of studies on HRQoL and obesity in Arab-speaking countries. Therefore we aimed to investigate this outcome in this population. METHODS: The HRQoL was assessed by the validated Arabic version of the ORWELL 97 questionnaire in 116 seeking-treatment patients with obesity referred to the Nutritional and Weight management outpatient clinic of Beirut Arab University (BAU) in Lebanon, matched by age and gender to 116 normal-weight participants. RESULTS: Patients with obesity displayed higher total ORWELL 97 scores when compared with normal-weight controls (52.16 ± 33.34 vs. 13.04 ± 11.36, p \u3c 0.001), and linear regression analysis showed that the increase of Body Mass Index (BMI) among patients with obesity is associated with an increase of ORWELL 97 scores (β= 1.790, 95% CI= 0.808 - 2.772, p \u3c 0.001). Moreover, the logistic regression analysis showed that regardless the class of obesity, the only one-unit increase in BMI may increase the odds of scoring above 71.75 increased by nearly 11% (OR, 95% CI= 1.110, 1.003 - 1.229, p=0.04), which is considered indicative of a clinically significant impairment of HRQoL, especially in those with lower social status (i.e. lower education and unemployed). CONCLUSIONS: Our findings are considered new in an Arab population, and showed that obesity impairs HRQoL in treatment-seeking patients, where higher BMI is associated with more impairment in HRQoL. Moreover, interestingly an only one-unit increase in BMI dramatically increases the risk of HRQoL impairment to become clinically significant. Future studies are needed on larger scale in different Arab countries, to identify factors that are mostly associated with HRQoL, and to detect also changes in the latter in association with obesity treatment

Differentiation of calcified regions and iron deposits in the ageing brain on conventional structural MR images:Calcium and Iron on Conventional MRI

Purpose: In the human brain, minerals such as iron and calcium accumulate increasingly with age. They typically appear hypointense on T2*‐weighted MRI sequences. This study aims to explore the differentiation and association between calcified regions and noncalcified iron deposits on clinical brain MRI in elderly, otherwise healthy subjects. Materials and Methods: Mineral deposits were segmented on co‐registered T1‐ and T2*‐weighted sequences from 100 1.5 Tesla MRI datasets of community‐dwelling individuals in their 70s. To differentiate calcified regions from noncalcified iron deposits we developed a method based on their appearance on T1‐weighted images, which was validated with a purpose‐designed phantom. Joint T1‐ and T2*‐weighted intensity histograms were constructed to measure the similarity between the calcified and noncalcified iron deposits using a Euclidean distance based metric. Results: We found distinct distributions for calcified regions and noncalcified iron deposits in the cumulative joint T1‐ and T2*‐weighted intensity histograms across all subjects (correlations ranging from 0.02 to 0.86; mean = 0.26 ± 0.16; t = 16.93; P < 0.001) consistent with differences in iron and calcium signal in the phantom. The mean volumes of affected tissue per subject for calcified and noncalcified deposits were 236.74 ± 309.70 mm3 and 283.76 ± 581.51 mm3; respectively. There was a positive association between the mineral depositions (β = 0.32, P < 0.005), consistent with existing literature reports. Conclusion: Calcified mineral deposits and noncalcified iron deposits can be distinguished from each other by signal intensity changes on conventional 1.5T T1‐weighted MRI and are significantly associated in brains of elderly, otherwise healthy subjects

Contribuição ao estudo da interrelação flúor-manganês em ratos

Devido a numerosas discrepâncias nos resultados de estudos experimentais relativos à interação flúor-manganês, propusemo-nos a verificar se a adição de manganês 5 água fluoretada (1 ppm), em diferentes proporções fluor-manganês, levaria a uma diferente fixaçao do halogênio. Para tanto, 24 ratos Wistar, recém-desmamados, foram mantidos em dieta padrão de caseína a 27%, recebendo na sua água de consumo: 1) H2O destilada (controle); 2) 1,0 ppm de flúor: 3) 1,0 ppm de flúor + 0,5 ppm de manganês (F:Mn = 2,0); 4) 1,0 ppm de flúor +1,0 ppm de manganês (F: Mn = 1,0). Foram anotados o peso ganho e o consumo de alimento e água, durante os 60 dias de experimento, após o qual as patas traseiras, dos animais sacrificados, foram autoclavadas e desossadas, e os femures retirados. Posteriormente, foram estes submetidos à secagem, extração da gordura, pulverização e analise do flúor fixado. Também foram efetuadas analises da composição centesimal da ração e de flúor e manganês nesta e nas diferentes águas de consumo. Os resultados de percentagem do flúor ingerido fixado nos femures, foram analisados estatisticamente pelo teste não-paramétrico de Kruskal-Wallis (níveis de 1% e 5%) mostrando que, para as proporções consideradas, o flúor na taxa de 1 ppm, o manganês, quando administrado após o desmame, parece não afetar a fixaçao do flúor. Contudo, faz-se necessário dar continuidade aos estudos com novas proporções e taxas mais elevadas de flúor e manganês.An experiment to determine the effects of varying the manganese concentration of the diet on the fluorine retention in the femur of rats was made. Four groups of weaning rats were fed ad libitum a 27% casein synthetic diet and were provided with water as follows: 1) distilled (control); 2) containing 1 ppm of fluorine (F); 3) 1,0 ppm F + 0,5 ppm Mn; 4) 1 ppm F + 1 ppm Mn. The weight gain and food and water consumption were measured during 60 days. The results indicated that manganese does not seem to affect the proportional fixation of fluorine in the femur. The authors think that more data should be available before a definite conclusion on the influence of the ratio F:Mn on the fluorine retention could be drawn

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

New Realities: The Story of an International Art Education Student on the Frontline of COVID-19

This research investigates how my experience at the front line during a global pandemic has changed me as an artist, researcher, and teacher. Based on my experiences, I shared a description of the adaptation process during the COVID-19 pandemic and translate my story into a graphic novel. This study is an in-depth inquiry, designed to show how art teachers as individuals can adapt to unexpected situations. This research further presents the importance of art in the process of personal and professional adaptation. This study informs art education because of my frontline experience in the community, especially working with seniors, from which I draw out practices grounded in the health and well-being that have a relevance to teaching and learning as part of the new reality going forward. This pathway suggests to me that oscillating between art and health sectors may offer alternate ways of thinking about pedagogic and artistic practice. My story is written in a brief narrative, using accessible language and natural tone to keep the authenticity of the story and invite readers to plunge into my personal experience. Building on my story, I created a graphic novel as an approach to connect my story with the arts and to visually represent my experience. By doing so, I also investigate the importance of art making and promoting the visual aspect of research. I want to explore the importance of art as a space in relation to the chaos of the world around us. Adding to that, I want to share how my experience at the front line has affected my formal/informal learning journey and focus on how the a/r/t/ographic activities has helped me escape and manage the reality of this pandemic