Endoscopically Assisted LeFort I Osteotomy for Minimally Invasive Orthognathic Surgery: A Technical Note.

Minimally invasive surgery in orthognathic surgery has gained popularity in recent years. This is mainly due to the benefit to the patient of achieving a better postoperative period and a faster recovery. However, one of the main difficulties is the lack of direct vision, which is a concern for the surgeon. For this reason, this technical note aims to propose endoscopically assisted LeFort I osteotomy for MI orthognathic surgery.

A Novel Method for Lengthening Iliac Crest Grafts for Mandibular Reconstruction.

The objective of this article is to propose a technique for mandibular reconstructions of up to 17 cm, in order to obtain anterior iliac crest grafts smaller than those required, and then lengthen them using corticotomies. This technique has been performed in 5 patients with an indication for reconstruction after partial mandibulectomy due to pathology. Reconstruction of the body of the mandible, including the angle in some cases, was performed using nonvascularized anterior iliac crest grafts. These were elongated using corticotomies and fixed to cover the defect using reconstruction plates and screws (2.4 system). The wedge spaces that were formed by lengthening the bone block were grafted with autologous medullary bone and platelet-rich plasma. There was no loss of any of the grafts and there was no need for second surgical times to place more grafts. All cases were able to be rehabilitated with removable prostheses or dental implants. This method optimizes the amount of graft obtained, favors revascularization of the graft, reduces hypoxia times and allows the placement of osteoconductive and/or osteoinductive grafts directly on the exposed medullary areas, with the aim of promoting integration and reducing the resorption rate in large grafts.

Loss of the psychiatric risk factor SLC6A15 is associated with increased metabolic functions in primary hippocampal neurons.

Major depressive disorder (MDD) is one of the most severe global health problems with millions of people affected, however, the mechanisms underlying this disorder is still poorly understood. Genome-wide association studies have highlighted a link between the neutral amino acid transporter SLC6A15 and MDD. Additionally, a number of preclinical studies support the function of this transporter in modulating levels of brain neurotransmitters, stress system regulation and behavioural phenotypes related to MDD. However, the molecular and functional mechanisms involved in this interaction are still unresolved. Therefore, to investigate the effects of the SLC6A15 transporter, we used hippocampal tissue from Slc6a15-KO and wild-type mice, together with several in-vitro assays in primary hippocampal neurons. Utilizing a proteomics approach we identified differentially regulated proteins that formed a regulatory network and pathway analysis indicated significantly affected cellular domains, including metabolic, mitochondrial and structural functions. Furthermore, we observed reduced release probability at glutamatergic synapses, increased mitochondrial function, higher GSH/GSSG redox ratio and an improved neurite outgrowth in primary neurons lacking SLC6A15. In summary, we hypothesize that by controlling the intracellular concentrations of neutral amino acids, SLC6A15 affects mitochondrial activity, which could lead to alterations in neuronal structure and activity. These data provide further indication that a pharmacological or genetic reduction of SLC6A15 activity may indeed be a promising approach for antidepressant therapy.

Childhood adversity and sleep are associated with symptom severity in perinatal women presenting for psychiatric care.

This study leverages psychiatric intake data from treatment-seeking perinatal women aiming to explore the understudied associations between childhood adversity, sleep quality, and severity of perinatal mental illness in this population. The sample is 578 perinatal women presenting for initial evaluation to a university-based perinatal psychiatry clinic. At intake, we collected demographics, adverse childhood experiences (ACEs), sleep quality, and diagnosis and symptom severity of depression, anxiety, and posttraumatic stress disorder (PTSD). Clinician-rated diagnoses showed that 65% of women met criteria for major depression, 23% for generalized anxiety disorder and 4% for PTSD; almost 30% of women had childhood adversity and 98.2% reported poor perinatal sleep quality. Regression analyses revealed differential associations between ACEs and sleep quality and perinatal mood symptoms; ACEs were significantly associated with pregnancy and postpartum PTSD, whereas sleep quality was associated with perinatal depression and generalized anxiety. Screening for ACEs and sleep quality during perinatal intake has high clinical utility, as these two factors significantly contribute to symptom severity across peripartum.

Prevalence of overweight and obesity and associations with socioeconomic indicators: the study of health and activity among adolescents in Kuwait.

BACKGROUND: Kuwait is one of the Arab countries with the highest prevalence of overweight or obesity. However, few studies have described the prevalence of obesity in this country. The aim of this study is to describe the prevalence of overweight and obesity among Kuwaiti adolescents; and to examine the association of overweight and obesity status with familial socioeconomic status (SES). METHODS: Cross-sectional data from 591 adolescent students (47% boys, median age: 16 years) from the Study of Health and Activity among Adolescents in Kuwait in 2012 and 2013. Body weight status was determined using the International Obesity Task Force (IOTF) body mass index standards. SES was based on parental education. Odds ratio for overweight and obesity were calculated using multiple logistic regression. RESULTS: In our study, over half of the adolescents were overweight or obese 54.3% (95% CI: 49.9-58.4). The prevalence of overweight (including obesity) was higher in boys (59.8%, 95% CI: 54.3-66.3) than girls (49.2%, 95% CI: 43.5-54.8). No association between parental education and the risk of overweight/obesity was found. CONCLUSIONS: There is an alarmingly high rate of overweight/obesity among Kuwaiti adolescents, but we did not find evidence of a social gradient in obesity risk. Urgent actions are needed to reverse this epidemic across all social groups.

Molecular convergence of neurodevelopmental disorders.

Neurodevelopmental disorders (NDDs) are caused by mutations in diverse genes involved in different cellular functions, although there can be crosstalk, or convergence, between molecular pathways affected by different NDDs. To assess molecular convergence, we generated human neural progenitor cell models of 9q34 deletion syndrome, caused by haploinsufficiency of EHMT1, and 18q21 deletion syndrome, caused by haploinsufficiency of TCF4. Using next-generation RNA sequencing, methylation sequencing, chromatin immunoprecipitation sequencing, and whole-genome miRNA analysis, we identified several levels of convergence. We found mRNA and miRNA expression patterns that were more characteristic of differentiating cells than of proliferating cells, and we identified CpG clusters that had similar methylation states in both models of reduced gene dosage. There was significant overlap of gene targets of TCF4 and EHMT1, whereby 8.3% of TCF4 gene targets and 4.2% of EHMT1 gene targets were identical. These data suggest that 18q21 and 9q34 deletion syndromes show significant molecular convergence but distinct expression and methylation profiles. Common intersection points might highlight the most salient features of disease and provide avenues for similar treatments for NDDs caused by different genetic mutations.

Effects of Eight Months of Whole-Body Vibration Training on the Muscle Mass and Functional Capacity of Elderly Women.

Few intervention studies have used whole-body vibration (WBV) training in the elderly, and there is inconclusive evidence about its health benefits. We examined the effect of 8 months of WBV training on muscle mass and functional capacity in elderly women. A total of 37 women (aged 82.4 ± 5.7 years) voluntarily participated in this study. Subjects were randomly assigned to a vibration group (n = 19) or a control group (n = 18). The vibration group trained on a vertical vibration platform twice a week. The control group was requested not to change their habitual lifestyle. The quadriceps femoris muscle cross-sectional area was determined by magnetic resonance imaging. All participants were evaluated by a battery of tests (Senior Fitness Test) to determine their functional capacity, as well as handgrip strength and balance/gait. General linear repeated-measure analysis of variance (group by time) was performed to examine the effect of the intervention on the outcomes variables. After 8 months, nonstatistically significant differences in the quadriceps CSA (pre-training: 8,516.16 ± 1,271.78 mm² and post-training: 8,671.63 ± 1,389.03 mm²) (p > 0.05) were found in the WBV group (Cohen's d: -0.12), whereas the CON group significantly decreased muscle mass (pre-training: 9,756.18 ± 1,420.07 mm² and post-training: 9,326.82 ± 1,577.53 mm²), with moderate effect size evident (Cohen's d: 0.29). In both groups, no changes were observed in the functional capacity, handgrip strength and balance/gait. The WBV training could prevent the loss of quadriceps CSA in elderly women.

A New Ready-to-Eat Product Based on Enzymatically Peeled 'Hernandina' Clementine Segments and Citrus Syrup.

Ready-to-eat fresh fruit have an increasing presence in international markets due to their convenience and health benefits. However, these products are highly perishable and efficient technologies to increase their shelf life are needed. In the present research, different citrus fruit species and cultivars from organic farming were assessed to obtain enzymatically peeled citrus segments. The best results in terms of segment quality were observed for 'Hernandina' clementine, which was chosen to make a new ready-to-eat product based on peeled citrus segments that were packaged in glass jars with a light syrup made of citrus juice and organic sugar cane. Different citrus juice mixtures were assayed and the most appreciated syrup, based on the sensory scores given by panellists, was that containing 50-50 (v/v) of 'Fino' lemon and 'Hernandina' clementine juices. In addition, different pasteurization treatments were assessed for their effects on conserving the safety, nutritional quality and sensory properties of the product during cold storage. The results show that pasteurization treatment at 50 °C for 45 min was sufficient to prevent microbial contamination with mesophilic and psychrophilic aerobic bacteria or yeast and mould and to maintain sensory properties until five weeks of storage at 4 °C. In addition, only a 10% reduction in vitamin C concentrations was observed in fresh-segments or syrup until the end of the storage period, showing that a high bioactive compound content and health benefits were conserved in the new ready-to-eat product after pasteurization and prolonged cold storage.

Ontogenetically distinct neutrophils differ in function and transcriptional profile in zebrafish.

The current view of hematopoiesis considers leukocytes on a continuum with distinct developmental origins, and which exert non-overlapping functions. However, there is less known about the function and phenotype of ontogenetically distinct neutrophil populations. In this work, using a photoconvertible transgenic zebrafish line; Tg(mpx:Dendra2), we selectively label rostral blood island-derived and caudal hematopoietic tissue-derived neutrophils in vivo during steady state or upon injury. By comparing the migratory properties and single-cell expression profiles of both neutrophil populations at steady state we show that rostral neutrophils show higher csf3b expression and migration capacity than caudal neutrophils. Upon injury, both populations share a core transcriptional profile as well as subset-specific transcriptional signatures. Accordingly, both rostral and caudal neutrophils are recruited to the wound independently of their distance to the injury. While rostral neutrophils respond uniformly, caudal neutrophils respond heterogeneously. Collectively, our results reveal that co-existing neutrophils populations with ontogenically distinct origin display functional differences.

Sedentary behaviours and its association with bone mass in adolescents: the HELENA Cross-Sectional Study.

BACKGROUND: We aimed to examine whether time spent on different sedentary behaviours is associated with bone mineral content (BMC) in adolescents, after controlling for relevant confounders such as lean mass and objectively measured physical activity (PA), and if so, whether extra-curricular participation in osteogenic sports could have a role in this association. METHODS: Participants were 359 Spanish adolescents (12.5-17.5 yr, 178 boys,) from the HELENA-CSS (2006-07). Relationships of sedentary behaviours with bone variables were analysed by linear regression. The prevalence of low BMC (at least 1SD below the mean) and time spent on sedentary behaviours according to extracurricular sport participation was analysed by Chi-square tests. RESULTS: In boys, the use of internet for non-study was negatively associated with whole body BMC after adjustment for lean mass and moderate to vigorous PA (MVPA). In girls, the time spent studying was negatively associated with femoral neck BMC. Additional adjustment for lean mass slightly reduced the negative association between time spent studying and femoral neck BMC. The additional adjustment for MVPA did not change the results at this site. The percentage of girls having low femoral neck BMC was significantly smaller in those participating in osteogenic sports (≥ 3 h/week) than in the rest, independently of the cut-off selected for the time spent studying. CONCLUSIONS: The use of internet for non-study (in boys) and the time spent studying (in girls) are negatively associated with whole body and femoral neck BMC, respectively. In addition, at least 3 h/week of extra-curricular osteogenic sports may help to counteract the negative association of time spent studying on bone health in girls.

Reliability and validity of a screen time-based sedentary behaviour questionnaire for adolescents: The HELENA study.

BACKGROUND: Although there is a growing interest in the epidemiology of sedentary behaviours, it is unknown whether sedentary behaviour questionnaires are broad markers of sedentary time. The aims of this study were to determine the: (i) reliability of the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) screen time-based sedentary behaviour questionnaire; and (ii) its validity, i.e. the ability of the questionnaire to correctly rank adolescents according to the objectively measured sedentary time. METHODS: A total of 183 adolescents (104 females aged 12.5-17.5 years) were involved in the reliability study. Participants completed the HELENA sedentary questionnaire twice (1 week apart). The validity study comprised 2048 (1212 females) adolescents (12.5-17.5 years of age) included in the HELENA cross-sectional study. Questions included television viewing, computer games, console games, Internet for study and non-study reasons and study during week and weekend days. We compared median values of sedentary time, using accelerometers, by tertiles of self-reported sedentary behaviours and their sum (composite sedentary score). RESULTS: Reliability study: κ-values showed a good agreement (>0.7), except for Internet for study reasons (0.46 weekdays, 0.33 weekend). The questionnaire correctly classified boys' sedentary time when analysed by specific behaviours and by a composite sedentary score. In girls, median values of objectively measured sedentary time were not different across tertiles of self-reported sedentary behaviours or the composite sedentary score. CONCLUSION: The HELENA sedentary questionnaire is reliable, yet only correctly classifies objectively measured sedentary time in boys.

Clustering patterns of physical activity, sedentary and dietary behavior among European adolescents: The HELENA study.

BACKGROUND: Evidence suggests possible synergetic effects of multiple lifestyle behaviors on health risks like obesity and other health outcomes. A better insight in the clustering of those behaviors, could help to identify groups who are at risk in developing chronic diseases. This study examines the prevalence and clustering of physical activity, sedentary and dietary patterns among European adolescents and investigates if the identified clusters could be characterized by socio-demographic factors. METHODS: The study comprised a total of 2084 adolescents (45.6% male), from eight European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Physical activity and sedentary behavior were measured using self-reported questionnaires and diet quality was assessed based on dietary recall. Based on the results of those three indices, cluster analyses were performed. To identify gender differences and associations with socio-demographic variables, chi-square tests were executed. RESULTS: Five stable and meaningful clusters were found. Only 18% of the adolescents showed healthy and 21% unhealthy scores on all three included indices. Males were highly presented in the cluster with high levels of moderate to vigorous physical activity (MVPA) and low quality diets. The clusters with low levels of MVPA and high quality diets comprised more female adolescents. Adolescents with low educated parents had diets of lower quality and spent more time in sedentary activities. In addition, the clusters with high levels of MVPA comprised more adolescents of the younger age category. CONCLUSION: In order to develop effective primary prevention strategies, it would be important to consider multiple health indices when identifying high risk groups.

Sedentary behaviours and socio-economic status in Spanish adolescents: the AVENA study.

BACKGROUND: This study aimed to describe the influence of socio-economic status (SES) on the prevalence sedentary behaviours among Spanish adolescents. METHODS: Cross-sectional data from Spanish adolescents from the Alimentación y Valoración del Estado Nutricional de los Adolescentes (AVENA) Study (2002). A national representative sample of 1776 adolescents aged 13-18.5 years provided information about time spent watching television (TV), playing with computer or videogames and studying. Parental education and occupation were assessed as SES. Participants were categorized by gender, age, parental education and occupation. Logistic regression models were used. RESULTS: No gender differences were found for TV viewing. For computer and videogames use (weekdays), more boys played >3 h/day (P < 0.001), whereas a higher percentage of girls reported studying >3 h/day (P < 0.001). Among boys, parental education and occupation were inversely associated with TV viewing, parental occupation directly associated with study and maternal education inversely with computer and videogames use during weekdays (all P < 0.05). For girls, parental occupation was inversely associated with TV viewing. CONCLUSION: Spanish adolescents presented different sedentary patterns according to age, gender and SES. Boys reported more time engaged in electronic games, whereas girls reported more time studying. Parental occupation had more influence than parental education on the time spent in sedentary behaviours.

Interrater reliability and time measurement validity of speed-agility field tests in adolescents.

The aim of this study was to examine the interrater reliability (trained vs. untrained raters) and criterion-related validity (manual vs. automatic timing) of the 4 × 10-m shuttle run and 30-m running speed tests (times measured). The study comprised 85 adolescents (38 girls) aged 13.0-16.9 years from the Healthy Lifestyle in Europe by Nutrition in Adolescence study. The time required to complete the 4 × 10-m shuttle run and 30-m running tests was simultaneously measured (a) manually with a stopwatch by both trained and untrained raters (for interrater reliability analysis), and (b) by using photoelectric cells (for validity analysis). Systematic error, random error, and heteroscedasticity were studied with repeated-measured analysis of variance and Bland-Altman plots. The systematic error for untrained vs. trained raters and the untrained raters vs. photoelectric cells were in all cases ∼0.1 seconds (p < 0.01), that is, untrained raters recorded higher times. No systematic error was found between trained raters and photoelectric cells (p > 0.05). No heteroscedasticity was shown in any case (p > 0.05). The findings indicate that manual measurements by a trained rater, using a stopwatch, seem to be a valid method to assess speed and agility fitness testing in adolescents. Researchers must be trained to minimize the measurement error.

Sedentary patterns and media availability in European adolescents: The HELENA study.

OBJECTIVE: To describe sedentary behaviors in adolescents and to examine the influence of media availability on TV viewing. METHOD: The study assessed 3278 adolescents (1537 males and 1741 females, 12.5-17.5 years) involved in the HELENA study (2007). Adolescents reported hours of TV viewing, computer games, console, internet for study and non-study reasons, and study, as well as availability of TVs, computers and consoles. RESULTS: Time spent in sedentary behaviors was higher during weekends (all p<0.001). Males spent more hours on TV viewing (for > or = 15 years at weekends), playing computer games and console games while females spent more time studying and surfing for non-study reasons. During weekdays, one third of adolescents exceeded the screen time guidelines (>2h/day) based solely on TV viewing, whereas around 60% exceeded it at weekends. Having a TV or a console in the bedroom was associated with higher TV viewing (OR=2.66; 95% CI 2.23-3.18; and OR=1.92; 95% CI 1.61-2.28, respectively) whereas the presence of computer reduced it (OR=0.57; 95% CI 0.48-0.68). CONCLUSION: Adolescents living in Europe are not meeting media recommendations, especially during weekend. The absence of a TV in the adolescents' bedroom might reduce TV viewing. Further studies are needed to confirm or contrast our findings.

Association of physical activity with muscular strength and fat-free mass in adolescents: the HELENA study.

The objective of this study is to analyse the association of objectively assessed physical activity (PA) with muscular strength and fat-free mass in adolescents, and to determine whether meeting the current PA recommendations is associated with higher levels of muscular strength and fat-free mass. The present cross-sectional study comprised 363 Spanish adolescents (180 females) aged 12.5-17.5 years. PA was assessed by accelerometry and expressed as average PA (counts/min), and min/day of inactive, light, moderate, vigorous and moderate to vigorous PA (MVPA). MVPA was dichotomized into < 60 min/day and > or = 60. Upper body muscular strength was measured with the handgrip strength test, and lower body muscular strength was measured with the standing broad jump, squat jump, counter movement jump and Abalakov tests. Fat-free mass was measured by DXA. We observed positive associations between vigorous PA and all the lower body muscular strength tests except for the counter movement jump in males. PA was not associated with fat-free mass in both males and females. Male adolescents engaged in at least 60 min/day MVPA performed better in the standing broad jump test. In conclusion, the findings of the present study suggest that only vigorous PA is associated with muscular strength, particularly lower-body muscular strength in male adolescents.

Extra-curricular participation in sports and socio-demographic factors in Spanish adolescents: the AVENA study.

The aims of this study were to identify differences between the sexes in extra-curricular participation in sports and to determine its association with body fat and socio-demographic factors in Spanish adolescents. A total of 2165 adolescents (1124 males and 1041 females) aged 13.0-18.5 years from the AVENA Study participated. Participants filled in an ad hoc questionnaire for extra-curricular participation in sports, which was the dependent variable. Independent variables were: age, percent body fat, and father's and mother's educational level and occupation. Chi-square tests and logistic regression were applied. Bivariate analysis showed for male adolescents that age and father's occupation were related to extra-curricular participation in sports. In addition, body fat and mother's education and occupation (all P < 0.05) were related to extra-curricular participation of in sports for female adolescents. Logistic regression analysis showed that the likelihood of involvement in extra-curricular participation in sports was 5.3-fold (3.86-7.38) higher for males than females. Age and father's education in both males and females were independently associated with extra-curricular participation in sports. In summary, Spanish male adolescents were shown to engage in more extra-curricular sports than females. In addition, age and father's education (in both sexes) were associated with the participation of their offspring in extra-curricular sports during adolescence.

Intestinal Inflammation Induced by Soybean Meal Ingestion Increases Intestinal Permeability and Neutrophil Turnover Independently of Microbiota in Zebrafish.

Intestinal inflammation is a condition shared by several intestinal chronic diseases, such as Crohn's disease and ulcerative colitis, with severely detrimental consequences in the long run. Current mammalian models have considerably increased understanding of this pathological condition, highlighting the fact that, in most of the cases, it is a highly complex and multifactorial problem and difficult to deal with. Thus, there is an increasingly evident need for alternative animal models that could offer complementary approaches that have not been exploited in rodents, thereby contributing to a different view on the disease. Here, we report the effects of a soybean meal-induced intestinal inflammation model on intestinal integrity and function as well as on neutrophil recruitment and microbiota composition in zebrafish. We find that the induced intestinal inflammation process is accompanied by an increase in epithelial permeability in addition to changes in the mRNA levels of different tight junction proteins. Conversely, there was no evidence of damage of epithelial cells nor an increase in their proliferation. Of note, our results show that this intestinal inflammatory model is induced independently of the presence of microbiota. On the other hand, this inflammatory process affects intestinal physiology by decreasing protein absorption, increasing neutrophil replacement, and altering microbiota composition with a decrease in the diversity of cultivable bacteria.