Distinguishing Increased Adiposity and/or Aerobic Deconditioning as Moderators of Low VO2peak in Obese Men

Peak oxygen uptake (V̇O2peak) in a cardiopulmonary exercise test (CPET) is a strong predictor of morbidity, mortality, and quality of life. V̇O2peak in obese individuals is typically below the lower limit of normal (2 transport and utilization, i.e. aerobic deconditioning; or both. We hypothesized a modified CPET, to measure the fraction of maximum isokinetic power that can be supported by aerobic metabolism, will distinguish between adiposity and deconditioning effects on V̇O2peak. PURPOSE: To compare V̇O2peak and isokinetic neuromuscular performance in obese vs non-obese men. METHODS: A modified CPET with maximal (3 s) isokinetic cycling power at baseline and the limit of ramp-incremental (RI) exercise was used to calculate: A) baseline maximum isokinetic power (Piso); B) tolerance index (TI), % of Piso at V̇O2peak; C) fatigue index (FI), % reduction in Piso per RI-watt at V̇O2peak; D) power reserve (PR), isokinetic power available at V̇O2peak expressed as % RI-wattpeak. The FRIEND nomogram was used to predict V̇O2peak. Data are mean(SD) and were assessed by t-test. RESULTS: Compared to controls (n=24), obese men (n=20) were older (32(5) vs 26(7) yr), had greater BMI (38(6) vs 23(2) kg/m2), but were not different in stature (177(5) vs 180(7) cm) or predicted V̇O2peak (3.49(0.49) vs 3.58(0.36) L/min). Obese men had lower V̇O2peak (2.84(0.42) vs 3.71(0.45) L/min, p2peak (82(15) vs 104(12) %, pIndependent of body mass, obese men had preserved leg strength (normal Piso), but the fraction of maximum isokinetic power supported by aerobic metabolism at RI intolerance was reduced (low TI) with greater fatigability (high FI); each consistent with aerobic deconditioning. A modified CPET with maximal isokinetic power measurements can distinguish the effects of increased adiposity from aerobic deconditioning on V̇O2peak in obese men

Construction statistics review for Kenya

Construction is a strategic industry in the developing economies like Kenya. In order for construction to ably perform this role, there is need to provide information on its various economic aspects including raw materials, products, processes, finance, and labour. Construction statistics of Kenya have been evaluated in order to ascertain their adequacy in terms of scope, portrait, reliability and responsiveness in their coverage of the construction industry. Official statistics published in the annual Statistical Abstract were reviewed according to these adequacy criteria. The findings are that: the scope of construction statistics is narrowly defined making the statistical portrait of the sector to be incomplete; the statistics are also unreliable in terms of quality and unresponsive to economical challenges of inflation, structural adjustment policies and the decline of public sector's role in the construction industry. A participatory statistical governance framework is recommended in order to improve the scope of statistics and alleviate the attendant problems like incomplete portrait that come with the narrow scope

Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Methylation at Global LINE-1 Repeats in Human Blood Are Affected by Gender but Not by Age or Natural Hormone Cycles

Previously, we reported on inter-individual and gender specific variations of LINE-1 methylation in healthy individuals. In this study, we investigated whether this variability could be influenced by age or sex hormones in humans. To this end, we studied LINE-1 methylation in vivo in blood-derived DNA from individuals aged 18 to 64 years and from young healthy females at various hormone levels during the menstrual cycle. Our results show that no significant association with age was observed. However, the previously reported increase of LINE-1 methylation in males was reconfirmed. In females, although no correlation between LINE-1 or Alu methylation and hormone levels was observed, a significant stable individual specific level of methylation was noted. In vitro results largely confirmed these findings, as neither estrogen nor dihydrotestosterone affected LINE-1 or Alu methylation in Hek293T, HUVEC, or MDA-kb2 cell lines. In contrast, a decrease in methylation was observed in estrogen-treated T47-Kbluc cell lines strongly expressing estrogen receptor. The very low expression of estrogen receptor in blood cells could explain the observed insensitivity of methylation at LINE-1 to natural hormonal variations in females. In conclusion, neither natural cycle of hormones nor age has a detectable effect on the LINE-1 methylation in peripheral blood cells, while gender remains an important factor

Michael Balint's word trail: The ‘Ocnophil’, the ‘Philobat’ and creative dyads

In this paper, I discuss how Michael Balint arrived at the concepts of ‘ocnophil’ and ‘philobat’, which refer to two kinds of object relations. I look at the correspondence between Balint and the classical scholar David Eichholz. The two crafted these words together in a passionate exchange of letters. By recognizing the importance of creative dyads in psychoanalysis, we gain more insight into the creation of psychoanalytic knowledge beyond the frame of individual authorship. I read the collaboration between Balint and Eichholz in its historical and theoretical context, particularly in relation to the Budapest School of psychoanalysis, where intellectual collaborations had an important place. The Budapest School was Michael Balint's first home, and it shaped his epistemic and psychoanalytic style. Balint constructed his psychoanalytic theories in a spirit of openness, maintaining a commitment to conversations between psychoanalysis and other disciplines

A Validated Age-Related Normative Model for Male Total Testosterone Shows Increasing Variance but No Decline after Age 40 Years

The diagnosis of hypogonadism in human males includes identification of low serum testosterone levels, and hence there is an underlying assumption that normal ranges of testosterone for the healthy population are known for all ages. However, to our knowledge, no such reference model exists in the literature, and hence the availability of an applicable biochemical reference range would be helpful for the clinical assessment of hypogonadal men. In this study, using model selection and validation analysis of data identified and extracted from thirteen studies, we derive and validate a normative model of total testosterone across the lifespan in healthy men. We show that total testosterone peaks [mean (2.5-97.5 percentile)] at 15.4 (7.2-31.1) nmol/L at an average age of 19 years, and falls in the average case [mean (2.5-97.5 percentile)] to 13.0 (6.6-25.3) nmol/L by age 40 years, but we find no evidence for a further fall in mean total testosterone with increasing age through to old age. However we do show that there is an increased variation in total testosterone levels with advancing age after age 40 years. This model provides the age related reference ranges needed to support research and clinical decision making in males who have symptoms that may be due to hypogonadism.Publisher PDFPeer reviewe

Testosterone Replacement Therapy

Male hypogonadism (HG) can be defined according to its etiology as primary (pHG) when caused by any diseases affecting the testes, or as secondary (sHG) when due to a pituitary or hypothalamic dysfunction. Both fertility and testosterone (T) can be theoretically restored in sHG by removing the precipitating cause and/or by appropriate endocrine therapy. Conversely, only T treatment can be offered to patients with pHG. Symptoms and signs are quite similar independent of the underlying causes. Conversely, the phenotype of the hypogonadal patient is more often affected by the age of hypogonadism onset. Late-onset hypogonadism (LOH) that occurs in adulthood is probably the most common form of HG. In this chapter, the criteria defining LOH and the available T formulations along with their outcomes and main important side effects are analyzed in detail

Computer-Aided Architectural Design Research: Summary of Proposed Research Plan

The potentials of recent advancements in computer-driven, information-rich technologies have begun to effect the disciplines of architecture, planning, and design. The roles of computer-aided design tools are, however, still not completely specified, and it is the responsibility of research institutes, and in particular schools of architecture and design, to explore, define, and develop the uses of computers in architecture, planning, and design. The CAD program at the School of Architecture and Planning is based on the premise that research and education are both essential and interdependent components which provide students with necessary technical skills, improve methods of teaching fundamental design knowledge, and foster the exploration and development of new technologies and methodologies for computers in design. The program has been implemented in what the authors have termed the'Triad Methodology'of computer-aided architectural design: the teaching of CAD principles to students, the development of a strong research program, and the use of computer tools to enhance the school's general curriculum. The CAD Lab functions as a conduit for basic and advanced research intended to enhance architecture and planning through the use of computers. The faculty and graduate students have already demonstrated their interest and ability to undertake state of the art research in CAD. It is expected that these interests will continue and proliferate in the future. This paper briefly outlines the direction, scope, and required resources for computer related research at the School of Architecture and Planning in Buffal