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1. Impact of Obesity on Timing of Tracheotomy: A Multi‐institutional Retrospective Study

   https://doi.org/10.1002/lary.31586  

   Yousef, Andrew; Soliman, Shady I; Solomon, Isaac; Panuganti, Bharat A; Francis, David O; Pang, John; Klebaner, Dasha; Asturias, Alicia; Alattar, Ali; Wood, Samuel; et al (November 2024, The Laryngoscope)

   ObjectiveTo examine the impact of increased body mass index (BMI) on (1) tracheotomy timing and (2) short‐term surgical complications requiring a return to the operating room and 30‐day mortality utilizing data from the Multi‐Institutional Study on Tracheotomy (MIST). MethodsA retrospective analysis of patients from the MIST database who underwent surgical or percutaneous tracheotomy between 2013 and 2016 at eight institutions was completed. Unadjusted and adjusted logistic regression analyses were used to assess the impact of obesity on tracheotomy timing and complications. ResultsAmong the 3369 patients who underwent tracheotomy, 41.0% were obese and 21.6% were morbidly obese. BMI was associated with higher rates of prolonged intubation prior to tracheotomy accounting for comorbidities, indication for tracheotomy, institution, and type of tracheostomy (p = 0.001). Morbidly obese patients (BMI ≥35 kg/m²) experienced a longer duration of intubation compared with patients with a normal BMI (median days intubated [IQR 25%–75%]: 11.0 days [7–17 days] versus 9.0 days [5–14 days];p < 0.001) but did not have statistically higher rates of return to the operating room within 30 days (p = 0.12) or mortality (p = 0.90) on multivariable analysis. This same finding of prolonged intubation was not seen in overweight, nonobese patients when compared with normal BMI patients (median days intubated [IQR 25%–75%]: 10.0 days [6–15 days] versus 10.0 days [6–15 days];p = 0.36). ConclusionBMI was associated with increased duration of intubation prior to tracheotomy. Although morbidly obese patients had a longer duration of intubation, there were no differences in return to the operating room or mortality within 30 days. Level of Evidence3Laryngoscope, 134:4674–4681, 2024 

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2. Racial Disparities in Methylation of NRF1, FTO, and LEPR Gene in Childhood Obesity

   https://doi.org/10.3390/genes13112030  

   Patel, Priyadarshni; Selvaraju, Vaithinathan; Babu, Jeganathan Ramesh; Wang, Xu; Geetha, Thangiah (November 2022, Genes)

   Childhood obesity has affected the health of millions of children around the world despite vigorous efforts by health experts. The obesity epidemic in the United States has disproportionately afflicted certain racial and ethnic minority groups. African American children are more likely than other children to have obesity-related risk factors such as hyperlipidemia, diabetes, cardiovascular disease, and coronavirus disease (COVID-19). For the reduction in obesity-related health inequalities to be successful, it is essential to identify the variables affecting various groups. A notable advancement in epigenetic biology has been made over the past decade. Epigenetic changes like DNA methylation impact on many genes associated with obesity. Here, we evaluated the DNA methylation levels of the genes NRF1, FTO, and LEPR from the saliva of children using real-time quantitative PCR-based multiplex MethyLight technology. ALU was used as a reference gene, and the Percent of Methylated Reference (PMR) was calculated for each sample. European American children showed a significant increase in PMR of NRF1 and FTO in overweight/obese participants compared to normal weight, but not in African American children. After adjusting for maternal education and annual family income by regression analysis, the PMR of NRF1 and FTO was significantly associated with BMI z-score only in European American children. While for the gene LEPR, African American children had higher methylation in normal weight participants as compared to overweight/obese and no methylation difference in European American children. The PMR of LEPR was significantly negative associated with the obesity measures only in African American children. These findings contribute to a race-specific link between NRF1, FTO, and LEPR gene methylation and childhood obesity. 

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3. Crowd-Sourced Reliability of an Assessment of Lower Facial Aging Using a Validated Visual Scale

   https://doi.org/10.1097/GOX.0000000000003315  

   Kelly, Jason D.; Comstock, Bryan; Kowalewski, Timothy M.; Smartt, James M. (January 2021, Plastic and Reconstructive Surgery - Global Open)

   Background: Reliable and valid assessments of the visual endpoints of aesthetic surgery procedures are needed. Currently, most assessments are based on the opinion of patients and their plastic surgeons. The objective of this research was to analyze the reliability of crowdworkers assessing de-identified photographs using a validated scale that depicts lower facial aging. Methods: Twenty photographs of the facial nasolabial region of various non-identifiable faces were obtained for which various degrees of facial aging were present. Independent crowds of 100 crowd workers were tasked with assessing the degree of aging using a photograph numeric scale. Independent groups of crowdworkers were surveyed at 4 different times (weekday daytime, weekday nighttime, weekend daytime, weekend nighttime), once a week for 2 weeks. Results: Crowds assessing midface region photographs had an overall correlation of R = 0.979 (weekday daytime R = 0.991; weekday nighttime R = 0.985; weekend daytime R = 0.997; weekend nighttime R = 0.985). Bland−Altman test for test-retest agreement showed a normal distribution of assessments over the various times tested, with the differences in the majority of photographs being within 1 SD of the average difference in ratings. Conclusions: Crowd assessments of facial aging in de-identified photographs displayed very strong concordance with each other, regardless of time of day or week. This shows promise toward obtaining reliable assessments of pre and postoperative results for aesthetic surgery procedures. More work must be done to quantify the reliability of assessments for other pretreatment states or the corresponding results following treatment. 

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4. Effects of Obesity and Fall Risk on Gait and Posture of Community- Dwelling Older Adults

   https://doi.org/10.36001/ijphm.2019.v10i1.2750  

   Lockhart, T.E. (January 2019, International journal of prognostics and health management)

   Epidemiological studies link increased fall risk to obesity in older adults, but the mechanism through which obesity increases falls and fall risks is unknown. This study investigates if obesity (Body Mass Index: BMI>30 kg/m2) influenced gait and standing postural characteristics of community dwelling older adults leading to increased risk of falls. One hundred healthy older adults (age 74.0±7.6 years, range of 56-90 years) living independently in a community participated in this study. Participants' history of falls over the previous two years was recorded, with emphasis on frequency and characteristics of falls. Participants with at least two falls in the prior year were classified as fallers. Each individual was assessed for postural stability during quiet stance and gait stability during 10 meters walking. Fall risk parameters of postural sway (COP area, velocity, path-length) were measured utilizing a standard forceplate coupled with an accelerometer affixed at the sternum. Additionally, parameters of gait stability (walking velocity, double support time, and double support time variability) were assessed utilizing an accelerometer affixed at the participant's sternum. Gait and postural stability analyses indicate that obese older adults who fell have significantly altered gait pattern (longer double support time and greater variability) exhibiting a loss of automaticity in walking and, postural instability as compared to their counterparts (i.e., higher sway area and path length, and higher sway velocity) further increasing the risk of a fall given a perturbation. Body weight/BMI is a risk factor for falls in older adults as measured by gait and postural stability parameters. 

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5. The in vitro Effects of Nutraceutical-Treatment on Human Osteoarthritic Chondrocytes of Females of Different Age and Weight Groups

   Amr, M.; Mallah, A.; Abusharkh, H.; Van Wie, B.; Gozen, A.; Mendenhall, J.; Idone, v.; Tingstad, E.; and Abu-Lail, N. I. (August 2021, Journal of Nutrition Science)

   Trayhurn, Paul (Ed.)

   The in vitro effects of four nutraceuticals, catechin hydrate, gallic acid, alpha tocopherol, and ascorbic acid, on the ability of human osteoarthritic chondrocytes of two female groups to form articular cartilage (AC) tissues and to reduce inflammation were investigated. Group 1 represented 13 females in the 50-69 years old range, average weight of 100 kg, and an average body mass index (BMI) of 34.06 kg/m2 (obese). Group 2 constituted 3 females in the 70-80 years old range, average weight of 75 kg and an average BMI of 31.43 kg/m2 (obese). The efficacy of nutraceuticals was assessed in monolayer cultures using histological, colorimetric and mRNA gene expression analyses. AC engineered-tissues of group 1 produced less total collagen, and COL2A1 (38-fold), and higher COL10A1 (2.7-fold), MMP13 (50-fold), and NOS2 (15-fold) mRNA levels than those of group 2. In comparison, engineered-tissues of group 1 had a significant decrease in NO levels from day 1 to day 21 (2.6-fold), as well as higher mRNA levels of FOXO1(2-fold) and TNFAIP6 (16-fold) compared to group 2. Catechin hydrate decreased NO levels significantly in Group 1 (1.5-fold), while increasing NO levels significantly in group 2 (3.8-fold). No differences from the negative control were observed in the presence of nutraceuticals for either group. In conclusion, engineered-tissues of the younger but heavier patients responded better to nutraceuticals than those from the older but leaner study participants. Finally, group 2 formed better AC tissues with less inflammation and better extracellular matrix than cells from group 1. 

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