MEASURED AND PREDICTED RESTING ENERGY EXPENDITURE IN OVERWEIGHT BLACK AND WHITE YOUNG ADULT WOMEN

Daishan Johnson, Ronald Evans, FACSM, Autumn Lanoye, Jessica LaRose. Virginia Commonwealth University, Richmond, VA. BACKGROUND: Resting energy expenditure (REE) is the major determinant of total energy expenditure and is reported to be reduced in Black compared to White individuals. This study aims to assess and evaluate the relationship between REE and body composition (BC) measures in overweight Black and White young adult women and explore the accuracy of common REE prediction equations. METHODS: Weight (WT), height (HT), measured REE (REEM; Fitmate GS, Cosmed USA Inc.), and BC (BC-418, Tanita Corp.) were assessed in Black (n=79) and White (n=96) non-hispanic women (age=22.2 ± 2.1; BMI≥25 kg/m2) enrolling in a behavioral weight loss (BWL) program. In addition to REEM, the accuracy of 4 common REE prediction (REEP) equations was evaluated: Harris-Benedict, Mifflin-St. Jeur, Owen, and World Health Organization. RESULTS: Black women had significantly (p\u3c0.05) higher WT, BMI, and % fat and significant correlations were observed between REEM and all BC variables in both groups. No significant differences were observed in unadjusted REEM (1534±240 vs. 1525±274 kcals/day; p=0.82); however, REEM adjusted for WT was significantly lower in Black women (1492±201 vs. 1561±201 kcals/day; p=0.028). The Owen equation demonstrated the highest accuracy in both groups with ~63% of REEP values within ±10% of REEM. CONCLUSIONS: The observed difference in weight adjusted REEM between the groups has implications for caloric intake and physical activity goal setting in BWL. Further research is needed to determine if the observed difference in REEM impacts weight loss outcomes and weight loss maintenance. This work was supported by NIH R01DK103668 to JGL

Use of a wave based method to calculate the sound field above a patchwork of absorbing materials

status: publishe

Wave Intensity Analysis of Left Ventricular Filling

Wave intensity analysis (WIA) is a powerfu

Secondary data analysis from a randomized trial examining the effects of small financial incentives on intrinsic and extrinsic motivation for weight loss

The purpose of this study was to examine whether (a) an obesity treatment involving financial incentives yields higher levels of extrinsic motivation for weight management compared to an identical intervention without incentives, (b) extrinsic motivation for weight management mediates, or accounts for, the difference in weight loss outcomes between the two interventions, and (c) there is any evidence that financial incentives and associated extrinsic motivation “crowd out” intrinsic motivation for weight control. Participants (N = 153, 80.4% female; body mass index [BMI] = 33.2 ± 5.9) were randomly assigned to a 3-month Web-based behavioral weight loss program (WBWL) or the same program plus small financial incentives delivered consistent with behavioral economics and behavior change theories (WBWL + $). Weight was objectively assessed at baseline, post-treatment (month 3), and after a 9-month no-treatment follow-up phase (month 12). Intrinsic and extrinsic motivation for weight management were assessed at months 3 and 12 using a modified version of the Treatment Self-Regulation Questionnaire (TSRQ), with questions added to specifically target extrinsic motivation related to incentives. Compared to WBWL alone, WBWL +$ had better weight loss and higher levels of both extrinsic and intrinsic motivation for weight management (p-values ≤ .02). Moreover, during the no-treatment follow-up phase, the trajectories of weight regain did not significantly differ between WBWL and WBWL + $ (p = .58). Extrinsic motivation was not a significant mediator of treatment outcomes. These results suggest that modest financial incentives delivered consistent with behavioral economics and behavior change theories do not undermine intrinsic motivation for weight management during obesity treatment; in fact, they yield higher levels of both extrinsic and intrinsic motivation. Additional research is needed to better understand the mechanisms by which incentives improve outcomes in health behavior change interventions. Clinicaltrials.gov number: NCT01560130

Effect of an abdominal aortic aneurysm on wave reflection in the aorta

Despite extensive attention to abdominal aortic aneurysm (AAA) in the biomedical engineering community, its effect on aortic hemodynamics and arterial wave reflection has not been addressed before. We used experimental and numerical methods, relying on a realistic AAA geometry constructed from patient computer tomography scans (CT-scans), to study this issue. Pressure and flow waves were measured and simulated before and after AAA repair, and wave reflections were analyzed using linear wave separation and wave intensity analysis. With AAA, pronounced reflections were present in the pressure and flow waveforms. The reflection coefficient measured experimentally in the upper aorta was negative with AAA (-0.10) versus 0.47 without AAA. Wave intensity analysis confirmed the presence of a backward expansion wave caused by sudden expansion of the aorta; this was absent without AAA. These results were confirmed using a 1-D numerical model. A parameter study using this model demonstrated that dominant factors are diameter and compliance of the aneurysm, with larger diameters and more compliant AAA generating more negative reflections. Finally, a preliminary noninvasive study in three patients before and after AAA repair demonstrated that AAA-repair increased the reflection coefficient. In conclusion, the presence of AAA significantly alters wave reflection and hemodynamics in the aorta, with apparently measurable effects in humans

Study protocol for Cognitive Behavioral Therapy for Insomnia in patients with primary brain tumor: A single-arm phase 2a proof-of-concept trial

Background: Sleep disturbance is among the most common symptoms endorsed by patients with primary brain tumor (PwPBT), with many reporting clinically elevated insomnia and poor management of their sleep-related symptoms by their medical team. Though Cognitive Behavioral Therapy for Insomnia (CBT-I) remains the front-line treatment for sleep disturbance, CBT-I has yet to be evaluated in PwPBT. Thus, it is unknown whether CBT-I is feasible, acceptable, or safe for patients with primary brain tumors. Methods: PwPBT (N = 44) will enroll and participate in a six-week group-based CBT-I intervention delivered via telehealth. Feasibility will be based on pre-determined metrics of eligibility, rates and reasons for ineligibility, enrollment, and questionnaire completion. Acceptability will be measured by participant retention, session attendance, satisfaction ratings, and recommendation to others. Safety will be assessed by adverse event reporting. Sleep will be measured both objectively via wrist-worn actigraphy and subjectively via self-report. Participants will also complete psychosocial questionnaires at baseline, post-intervention, and three-month follow-up. Conclusion: CBT-I, a non-pharmacological treatment option for insomnia, has the potential to be beneficial for an at-risk, underserved population: PwPBT. This trial will be the first to assess feasibility, acceptability, and safety of CBT-I in PwPBT. If successful, this protocol will be implemented in a more rigorous phase 2b randomized feasibility pilot with the aim of widespread implementation of CBT-I in neuro-oncology clinics