Energy availability and sex steroid hormones in physically active females

Sex steroid hormones (i.e., estrogen, progesterone) are major determinants of a women’s health status and play a role in almost every physiological system, including reproductive, endocrine, urinary, nervous, immune, musculoskeletal and cardiovascular. Physically active females have lower estrogen and progesterone when compared to inactive individuals, yet exercise alone does not appear to decrease hormones but alters hormones as a component of energy availability. Energy availability is the amount of energy left after subtracting the energy cost of exercise relative to fat free mass (FFM) from energy intake. When energy availability is inadequate (i.e., low energy availability (LEA)), disruptions to hormonal and metabolic systems occur that can lead to performance decrements and serious psychological and physiological (i.e., menstrual dysfunction) health outcomes. Furthermore, stress can disrupt estrogen and progesterone but how stress affects the relationship between energy availability and sex steroid hormones is unknown. Most research surrounding this topic includes only highly competitive, elite level female athletes and little is known about how energy availability alters hormone levels in physically active females. Since low sex steroid hormone concentrations and LEA are associated with serious health risks, further investigation into the association of energy availability and menstrual cycle hormones in physically active females is warranted. Thus, the purpose of this dissertation was to examine the relationship between energy availability and sex steroid hormones in active females across the menstrual cycle. Healthy, exercising females (n=21; age 21.3 ± 3.1 years) not on oral contraceptives completed measures over two menstrual cycles. Daily saliva measurements were taken across both menstrual cycles to create hormonal profiles of estrogen and progesterone. Energy availability was measured twice within one menstrual cycle, with energy intake recorded for seven days at two timepoints. Participants were all physically active and were asked to continue exercising normally and to record all exercise with a heart rate monitor. The first timepoint (T1) started during menses between day (D) 2-4 and the second timepoint (T2) started between 5-8 days post ovulation. A laboratory visit occurred on the first day of each timepoint, where resting metabolic rate and body composition were measured. Stress was measured with the Acute Recovery and Stress Scale at the beginning and end of each timepoint. Area under the curve (AUC) and range (i.e., difference in minimum and maximum values) for estrogen and progesterone for T1 and T2 was used for analyses. Most of the active females (71%, n = 15) were in a reduced energy state and 23% (n = 6) had subclinical menstrual dysfunction. Energy intake and energy availability remained constant across the two timepoints despite that estrogen and progesterone were significantly different (p = .003, p = .001, respectively). When the components of energy availability and hormones were assessed, progesterone range was positively associated with FFM (T1 p = .015, r=.537; T2 p = .001, r = .674) and RMR (T2 p = .005, r = .605) yet T2 progesterone range, FFM, and RMR were all negatively associated with energy availability (p = .032, r = -.479; p = .001, r = -.672; p = .009, r = -.558). Energy intake was correlated with the progesterone to estrogen ratio (P:E2) (p = .026, r= .321, 95% CI [0.04, 0.55]), but not progesterone or estrogen alone. The results also demonstrated that estrogen, progesterone, and the estrogen progesterone product in T1 exhibited a negative relationship with T2 energy availability ((ß = -.36, p = .009; ß = -.37, p = .008; ß = -.31, p = .029), in active females across a single menstrual cycle. In addition, stress and recovery do not moderate the relationship between hormones and energy availability within a timepoint or across timepoints of one menstrual cycle even though a stress subscale, negative emotional state, was significantly higher post ovulation towards the end of the cycle while recovery and other stress scales remained constant (F (3, 54) = 7.07, p = .000). These data suggest that physically active females are at risk for inadequate energy availability and subclinical menstrual dysfunction. Estrogen and progesterone affect energy intake at the beginning of the cycle and energy availability across timepoints but do not appear to be altered by stress and recovery. A higher progesterone to estrogen ratio was associated with higher energy intake during T1. Furthermore, higher estrogen and progesterone at the beginning of the menstrual cycle are associated with lower energy availability post ovulation. These data highlight the importance of including physically active females in future research on energy availability and emphasizes issues with energy availability are present in physically active females, not just elite athletes. Further investigations are needed to fully elucidate the relationship between energy availability, estrogen and progesterone

PReS-FINAL-2170: Work disability in adult patients with juvenile idiopathic arthritis (JIA)

Introduction Approximately 20% JIA patients enters adulthood with clinically active disease and disabled, therefore work condition may be affected. Objectives To assess the prevalence of work disability among adult patients with JIA regularly attending a tertiary heumatology center and to determine possible associated risk factors.\ud Methods This was a cross-sectional study that enrolled 43 JIA patients according to 2004 revised ILAR criteria. A questionnaire was developed in order to evaluate working status and labor activity: occupation, current/previous work, employment status and withdrawal rate were actively searched. Demographic data, JIA characteristics, clinical activity (DAS28>2.6), therapeutic intervention, comorbidities, physical activity, sedentarism (WHO definitions), functional class (1991 ACR criteria), HAQ and SF-36 were recorded. The prevalence of work disability was calculated using 95% confidence interval, and compared to all parameters; qualitative variables were analyzed using tests of association (chi-square test) and quantitative variables by Mann-Whitney or student test. Results\ud Patients' mean age was 29+7.4 yrs (range 19-41) with mean JIA duration = 17.2+12.3 yrs (range 3-33); 63% were males and 37% females. JIA subtypes were 64% polyarticular, 11% oligoarticular, 9% systemic, 9% ERA, 2% extended oligoarticular, 2% psoriatic arthritis; 7% had uveitis. Serum RF was positive in 21% and ANA in 21%. The majority (72%, n = 31) of JIA patients were employed, whereas 28% (n = 12) were currently not working. In the latter group, 83% (10/12) were retired due to JIA related disability. Further analysis comparing those currently working vs. Those not working revealed similar age (25,3 yrs vs.29,5 yrs, p = 0,09). Although not significantly, most patients currently working had Poly onset JIA (22 vs. 6 p = 0,37), higher frequencies of good education level >12 yrs of school (31 vs.9, p = 0,38), functional class I (p = 0,96), practiced regular physical activity (9 vs. 0, p = 0,89), were singles (26 vs. 8, p = 0,15). Both groups had comparable HAQ and DAS 28 scores (0,62 vs. 0.59, p = 0,47 and 2,51 vs.2,07, p = 0,64) and similar arthroplasty rate (8 vs. 4, p = 0,427). Frequencies of hypertension (3 vs.1, p = 0,999), dyslipidemia (1 vs. 1, p = 0,125), diabetes (1 vs. 0 p = 0,999), depression (1 vs. 0, p = 0,999) and smokers (3 vs. 1, p = 0,99) were alike in both groups. Remarkably, employed patients had higher SF 36 mental health component (84.0 vs. 70.42, P = 0.01). Conclusion\ud High prevalence of almost 1/3 work disability and of retirement due to disease related incapacity remain major problems for adult JIA individuals. We also identified worse mental health in employed patients indicating that further research is needed, in addition to intense affirmative disability actions in order to remove possible disabling barriers and to adapt restrictive environments for these patients. Moreover, enhanced strategies and policy for inclusion of JIA patients in the job market is urged

Automatic 3D Facial Expression Analysis in Videos

We introduce a novel framework for automatic 3D facial expression analysis in videos. Preliminary results demonstrate editing facial expression with facial expression recognition. We first build a 3D expression database to learn the expression space of a human face. The real-time 3D video data were captured by a camera/projector scanning system. From this database, we extract the geometry deformation independent of pose and illumination changes. All possible facial deformations of an individual make a nonlinear manifold embedded in a high dimensional space. To combine the manifolds of different subjects that vary significantly and are usually hard to align, we transfer the facial deformations in all training videos to one standard model. Lipschitz embedding embeds the normalized deformation of the standard model in a low dimensional generalized manifold. We learn a probabilistic expression model on the generalized manifold. To edit a facial expression of a new subject in 3D videos, the system searches over this generalized manifold for optimal replacement with the 'target' expression, which will be blended with the deformation in the previous frames to synthesize images of the new expression with the current head pose. Experimental results show that our method works effectively

Haptoglobin Phenotype, Preeclampsia Risk and the Efficacy of Vitamin C and E Supplementation to Prevent Preeclampsia in a Racially Diverse Population

Haptoglobin's (Hp) antioxidant and pro-angiogenic properties differ between the 1-1, 2-1, and 2-2 phenotypes. Hp phenotype affects cardiovascular disease risk and treatment response to antioxidant vitamins in some non-pregnant populations. We previously demonstrated that preeclampsia risk was doubled in white Hp 2-1 women, compared to Hp 1-1 women. Our objectives were to determine whether we could reproduce this finding in a larger cohort, and to determine whether Hp phenotype influences lack of efficacy of antioxidant vitamins in preventing preeclampsia and serious complications of pregnancy-associated hypertension (PAH). This is a secondary analysis of a randomized controlled trial in which 10,154 low-risk women received daily vitamin C and E, or placebo, from 9-16 weeks gestation until delivery. Hp phenotype was determined in the study prediction cohort (n = 2,393) and a case-control cohort (703 cases, 1,406 controls). The primary outcome was severe PAH, or mild or severe PAH with elevated liver enzymes, elevated serum creatinine, thrombocytopenia, eclampsia, fetal growth restriction, medically indicated preterm birth or perinatal death. Preeclampsia was a secondary outcome. Odds ratios were estimated by logistic regression. Sampling weights were used to reduce bias from an overrepresentation of women with preeclampsia or the primary outcome. There was no relationship between Hp phenotype and the primary outcome or preeclampsia in Hispanic, white/other or black women. Vitamin supplementation did not reduce the risk of the primary outcome or preeclampsia in women of any phenotype. Supplementation increased preeclampsia risk (odds ratio 3.30; 95% confidence interval 1.61-6.82, p<0.01) in Hispanic Hp 2-2 women. Hp phenotype does not influence preeclampsia risk, or identify a subset of women who may benefit from vitamin C and E supplementation to prevent preeclampsia

Maids, machines and morality in Brazilian homes

This paper engages with debates about the increasing use of paid domestic labour in Europe and the USA contributing with a reflection about the case of Brazil. Relations of gender, class and race are considered in the deployment of maids for housework, the patterns of consumption of household technologies and the moral reasoning of daily living with hierarchical divisions within the home. The paper considers some parallels between the Brazilian context and that of more developed countries and also the specificity of Brazil. Based on participant observation, secondary data and an ethnographic study, rich empirical data are weaved through to discuss material and moral dimensions of domestic labour and care. How does the availability of cheap domestic labour configure relations of inequality? How are social differences in the home lived with and justified? The exploration of the Brazilian case illuminates some of the problems, contradictions and possible consequences of wealthier households benefitting from the displacement of poor women that is currently happening through international migration. The paper argues that in Brazil the deflecting of tensions in gender divisions of labour in households onto a subordinate person has affected relations of equality between women and men and also the patterns of technological innovation to facilitate housework. These are outcomes to be guarded against in Europe and the United States in face of the current trends in 'global woman' relations

"Outroduction":A research agenda on collegiality in university settings

Collegiality is the modus operandi of universities. Collegiality is central to academic freedom and scientific quality. In this way, collegiality also contributes to the good functioning of universities’ contribution to society and democracy. In this concluding paper of the special issue on collegiality, we summarize the main findings and takeaways from our collective studies. We summarize the main challenges and contestations to collegiality and to universities, but also document lines of resistance, activation, and maintenance. We depict varieties of collegiality and conclude by emphasizing that future research needs to be based on an appreciation of this variation. We argue that it is essential to incorporate such a variation-sensitive perspective into discussions on academic freedom and scientific quality and highlight themes surfaced by the different studies that remain under-explored in extant literature: institutional trust, field-level studies of collegiality, and collegiality and communication. Finally, we offer some remarks on methodological and theoretical implications of this research and conclude by summarizing our research agenda in a list of themes

PReS-FINAL-2177: Safety and lack of autoantibody production following influenza H1N1 vaccination in patients with juvenile idiopathic arthritis (JIA)

Introduction Vaccination is an effective tool against several infectious agents including influenza. In 2010, the Advisory Committee on Immunization Practices (ACIP) recommended influenza A H1N1/2009 immunization for high risk groups, including juvenile idiopathic arthritis (JIA) patients and more recently the EULAR task force reinforced the importance of vaccination in immunosuppressed pediatric rheumatologic patients. We have recently shown that Influenza A H1N1/2009 vaccination generated protective antibody production with short-term safety profile among 93 JIA patients, but the possible impact of the vaccine in autoimmune response in JIA have not been studied. Therefore, we aimed to assess the production of some autoantibodies generated following influenza H1N1 vaccination in JIA patients. Objectives To assess the autoimmune response and H1N1 serology following influenza H1N1 vaccination in patients with JIA. Methods Cepa A/California/7/2009 (NYMC X-179A) anti-H1N1 was used to vaccinate JIA patients: 1 dose of immunization was given to all participants and those <9yrs of age received a second booster 3 weeks apart. Sera were analyzed before and 3 weeks following complete vaccination. Serology against H1N1 virus was performed by hemagglutination inhibition antibody assay, rheumatoid factor (RF) by latex fixation test, antinuclear antibodies (ANA) by IIF, IgM and IgG anticardiolipin (aCL) by ELISA.Results Among 98 JIA patients that were vaccinated, 58 sera were available for this study. Mean age of 58 JIA patients was 23.9 ± 9.5 yrs, 38 were females and 20 males with mean disease duration of 14.7 ± 10.1 yrs. JIA subtypes were: 33 (57%) poliarticular, 10 (17%) oligoarticular, 6 (10%) systemic and 9 (16%) other. Sixteen patients were off drugs while 42 (72%) were under different pharmacotherapy: 32 (55%) were on 1 DMARD/IS, 10 (17%) on 2 DMARDs/IS, 19 (33%) antimalarials, 29 (50%) MTX, 8(14%) sulfasalazine, 6 (10%) anti-TNFs, 4 (7%) abatacept; no patient was using prednisone >0.5 mg/kg/d. Seroprotection rates against H1N1 influenza increased from 23 to 83% and seroconversion rates were achieved in 78% JIA. Prior to vaccination, 31(53.4%) JIA patients were ANA+, 6(10.3%) RF+, and 4 (7%) IgM + IgG aCL+. After complete H1N1 vaccination, positivity for ANA remained the same whereas 1 patient became negative for IgG aCL, and another for RF, IgM and IgG aCL. One (1.7%) patient turned low titer IgG aCL+. Conclusion Vaccination of JIA patients against pandemic influenza A (H1N1) generated successful protective antibody production without the induction of autoantibody production, except for 1 patient that became positive for low titer IgG aCL, supporting its safety