Anthropometric indices as screening tools for cardiovascular risk factors in Singaporean women

Previous studies have suggested the need to revise the World Health Organization (WHO) cut-off values for the various indices of obesity and fat distribution in Singapore. The purpose of this study was to delineate cut-off points of body mass index (BMI), waist-hip ratio (WHR), waist circumference (WC), and waist-stature ratio (WSR) as screening tools for cardiovascular risk factors in Singaporean women. Anthropometric indices were measured in a cross sectional survey of 566 subjects (60% Chinese individuals, 28% Malay individuals and 12% Indian individuals). Cardiovascular risk factors were determined by measuring blood pressure, serum lipids, and fasting blood glucose levels. Receiver Operating Characteristic (ROC) curves were constructed to determine cut-off points. Forward logistic regression and area under curves (AUC) were used to determine the best anthropometric index. For at least one cardiovascular risk factor (hypertension, dyslipidaemia and diabetes mellitus), the cut-off points for BMI, WHR, WC and WSR were around 23.6kg/m 2 , 0.80, 77.8cm and 0.48 for Singaporean females. The AUC of WSR was the highest for all three risk factors in females (0.79 for hypertension, 0.70 for dyslipidaemia, 0.88 for diabetes mellitus). Regression analyses revealed that WSR was independently associated with all risk factors. For Singaporean female adults, the cut-off points were lower than the criteria suggested by the WHO, but were in agreement with those reported for Asians. BMI, WHR, WC and WSR may be used as screening tools for cardiovascular risk factors, of which WSR may be the best anthropometric index

Genetic and Proteomic Approaches to Identify Cancer Drug Targets

While target-based small-molecule discovery has taken centre-stage in the pharmaceutical industry, there are many cancer-promoting proteins not easily addressed with a traditional target-based screening approach. In order to address this problem, as well as to identify modulators of biological states in the absence of knowing the protein target of the state switch, alternative phenotypic screening approaches, such as gene expression-based and high-content imaging, have been developed. With this renewed interest in phenotypic screening, however, comes the challenge of identifying the binding protein target(s) of small-molecule hits. Emerging technologies have the potential to improve the process of target identification. In this review, we discuss the application of genomic (gene expression-based), genetic (short hairpin RNA and open reading frame screening), and proteomic approaches to protein target identification

Evaluation of the Wii Balance Board for Walking Aids Prediction: Proof-of-Concept Study in Total Knee Arthroplasty

<div><p>Background and Objectives</p><p>To provide proof-of-concept for the validity of the Wii Balance Board (WBB) measures to predict the type of walking aids required by inpatients with a recent (≤4days) total knee arthroplasty (TKA).</p><p>Methods</p><p>A cross-sectional sample of 89 inpatients (mean age, 67.0±8years) with TKA was analyzed. A multivariable proportional odds prediction model was constructed using 8 pre-specified predictors – namely, age, sex, body mass index, knee pain, knee range-of-motion, active knee lag, and WBB-derived standing balance. The type of walking aids prescribed on day 4 post-surgery was the outcome of interest – an ordinal variable with 4 categories (walking stick, narrow- and broad-base quadstick, and walking frame).</p><p>Results</p><p>Women, increasing body mass index, and poorer standing balance were independently associated with greater odds for requiring walking aids with a larger base-of-support. The concordance-index of the prediction model was 0.74. The model comprising only WBB-derived standing balance had nearly half (44%) the explanatory power of the full model. Adding WBB-derived standing balance to conventional demographic and knee variables resulted in a continuous net reclassification index of 0.60 (95%CI,0.19-1.01), predominantly due to better identification of patients who required walking aids with a large base-of-support (sensitivity gain).</p><p>Conclusions</p><p>The WBB was able to provide quantitative measures of standing balance which could assist healthcare professionals in prescribing the appropriate type of walking aids for patients. Further investigation is needed to assess whether using the WBB could lead to meaningful changes in clinical outcomes such as falls.</p></div

Comparison of predictive value of (i) the full model which comprised CoP ML-SD and conventional measures (demographic and knee variables) and (ii) two nested models which comprised CoP ML-SD or conventional measures.

<p>The predictive value is represented by the likelihood ratio <i>χ</i>² statistic. The model comprising CoP ML-SD alone had 44% of the explanatory power of the full model. Put otherwise, nearly half the prognostic information of the full model (comprising conventional and ML-SD variables) may be attributed to ML-SD. Furthermore, ML-SD added statistically significant predictive information (<i>P</i><0.001) to a model that comprised only conventional measures.</p

Screenshot of the spreadsheet with calculations of predicted probabilities for each type of walking aid.

<p>Screenshot of the spreadsheet with calculations of predicted probabilities for each type of walking aid.</p

Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis

Objective. Knee extensor strength is an important correlate of physical function in patients with knee osteoarthritis; however, it remains unclear whether standing balance is also a correlate. The purpose of this study was to evaluate the cross-sectional associations of knee extensor strength, standing balance, and their interaction with physical function. Methods. One hundred four older adults with end-stage knee osteoarthritis awaiting a total knee replacement (mean ± SD age 67 ± 8 years) participated. Isometric knee extensor strength was measured using an isokinetic dynamometer. Standing balance performance was measured by the center of pressure displacement during quiet standing on a balance board. Physical function was measured by the self-report Short Form 36 (SF-36) questionnaire and by the 10-meter fast-pace gait speed test. Results. After adjustment for demographic and knee pain variables, we detected significant knee strength by standing balance interaction terms for both SF-36 physical function and fast-pace gait speed. Interrogation of the interaction revealed that standing balance in the anteroposterior plane was positively related to physical function among patients with lower knee extensor strength. Conversely, among patients with higher knee extensor strength, the standing balance-physical function associations were, or tended to be, negative. Conclusion. These findings suggest that although standing balance was related to physical function in patients with knee osteoarthritis, this relationship was complex and dependent on knee extensor strength level. These results are of importance in developing intervention strategies and refining theoretical models, but they call for further study. © 2011, American College of Rheumatology

Functional heterogeneity and outcomes in community-dwelling women with osteoporosis, with and without a history of falls

Falls leading to osteoporotic fracture is a substantial issue clinically. By inference from the literature, women with osteoporosis who are classified as having a history of falls may not represent a distinct homogeneous population. However, studies exploring the potential heterogeneity within fallers in women with osteoporosis are scarce. The objective of this study was to better understand the physical function characteristics of women with osteoporosis, with and without a previous history of falls, by further stratifying them based on their single-leg stance (SLS) performance. Eighty-seven consecutive, community-dwelling women with osteoporosis were recruited from the Endocrinology Clinic at Singapore General Hospital. Laboratory-based and clinic-based standing balance tests, a lower limb strength test, and the 6-min walk test (6MWT) were measured. Fallers and non-fallers did not differ in standing balance, lower limb strength nor the 6MWT (P's > 0.08). SLS performance was an independent predictor of the various functional measures, after adjusting for age and body mass index. Specifically, an increase in SLS time was associated with lower standing center-of-pressure velocities, greater lower limb strength, and greater 6-min walking distance. When the two groups were stratified based on their recent history of falls and clinic-based standing balance performance (SLS time), fallers with good SLS time (>30 s) showed better functional outcomes than did non-fallers with poor SLS time (≤30 s) (P's 0.11). The results indicate an important heterogeneity within fallers and non-fallers with osteoporosis and they argue for a individualized approach to rehabilitation

Falls among Asians living in small apartments designed for older adults in Singapore

10.1080/02763893.2019.1627265Journal of Aging and Environment34131-4