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Sample records for leg lean mass

  1. Six weeks' aerobic retraining after two weeks' immobilization restores leg lean mass and aerobic capacity but does not fully rehabilitate leg strenght in young and older men

    DEFF Research Database (Denmark)

    Vigelsø Hansen, Andreas; Gram, Martin; Wiuff, Caroline

    2015-01-01

    OBJECTIVE: To determine the effect of aerobic retraining as rehabilitation after short-term leg immobilization on leg strength, leg work capacity, leg lean mass, leg muscle fibre type composition and leg capillary supply, in young and older men. SUBJECTS AND DESIGN: Seventeen young (23 ± 1 years...... immobilization had marked effects on leg strength, and work capacity and 6 weeks' retraining was sufficient to increase, but not completely rehabilitate, muscle strength, and to rehabilitate aerobic work capacity and leg lean mass (in the young men)....

  2. Leg strength and lean mass symmetry influences kicking performance in Australian football.

    Science.gov (United States)

    Hart, Nicolas H; Nimphius, Sophia; Spiteri, Tania; Newton, Robert U

    2014-01-01

    Differential loading patterns during game-based participation may produce or exacerbate strength imbalances between the lower limbs. It is currently unknown whether such imbalances are functionally beneficial or detrimental to performance. This study assessed the influence of lower limb strength and lean mass symmetry on kicking accuracy in Australian Football. Thirty-one Australian footballers were required to perform a kicking assessment, producing ten drop punt kicks over twenty metres to a player target. Athletes were subsequently separated into accurate (n = 15) and inaccurate (n = 16) groups, with lower-body lean mass assessed using whole body DXA scans, and lower-body strength assessed using an isometric protocol. Accurate kickers demonstrated significantly higher relative lean mass (~8% to 16%; p = 0. 001 to 0.004) and significantly lower relative fat mass (~21% to 40%; p = 0.001 to 0.024) than inaccurate kickers. Accurate kickers did not contain any significant difference in lean mass or unilateral strength between lower limbs. Inaccurate kickers displayed significant asymmetry in lean mass (~3%; p ≤ 0.003), producing significant imbalances in strength (~8%; p ≤ 0.002) highlighting a deficiency in their support leg. Greater relative strength and improved lower limb symmetry in strength and muscularity could increase the capacity of an athlete to be technically proficient in favour of greater accuracy. Key PointsStrength deficits in the support leg may lead to inaccurate kicking outcomes.An asymmetry of 3% in lean mass generated an 8% imbalance in leg strength.Greater levels of relative lower-body strength and muscle mass are associated with improved kicking accuracy performance.

  3. TRUNK LEAN DURING A SINGLE-LEG SQUAT IS ASSOCIATED WITH TRUNK LEAN DURING PITCHING.

    Science.gov (United States)

    Plummer, Hillary A; Oliver, Gretchen D; Powers, Christopher M; Michener, Lori A

    2018-02-01

    Impaired trunk motion during pitching may be a risk factor for upper extremity injuries. Specifically, increased forces about the shoulder and elbow have been observed in pitchers with excessive contralateral trunk lean during pitching. Because of the difficulty in identifying abnormal trunk motions during a high-speed task such as pitching, a clinical screening test is needed to identify pitchers who have impaired trunk motion during pitching. The purpose of this study was to determine the relationship between the degree of lateral trunk lean during the single-leg squat and amount of trunk lean during pitching and if trunk lean during pitching can be predicted from lean during the single-leg squat. Controlled Laboratory Study; Cross-sectional. Seventy-three young baseball pitchers (11.4 ± 1.7 years; 156.3 ± 11.9 cm; 50.5 ± 8.8 kg) participated. An electromagnetic tracking system was used to obtain trunk kinematic data during a single-leg squat task (lead leg) and at maximum shoulder external rotation of a fastball pitch. Pearson correlation coefficients for trunk lean during the single-leg squat and pitching were calculated. A linear regression analysis was performed to determine if trunk lean during pitching can be predicted from lean during the single-leg squat. There was a positive correlation between trunk lean during the single-leg squat and trunk lean during pitching (r = 0.53; plean during the single-leg squat predicted the amount of lateral trunk lean during pitching (R 2 = 0.28; p lean during an SLS and pitching. Trunk lean during the single-leg squat explained 28% of the variance in trunk lean during pitching. Diagnosis, level 3.

  4. Relationship between Leg Mass, Leg Composition and Foot Velocity on Kicking Accuracy in Australian Football.

    Science.gov (United States)

    Hart, Nicolas H; Nimphius, Sophia; Spiteri, Tania; Cochrane, Jodie L; Newton, Robert U

    2016-06-01

    Kicking a ball accurately over a desired distance to an intended target is arguably the most important skill to acquire in Australian Football. Therefore, understanding the potential mechanisms which underpin kicking accuracy is warranted. The aim of this study was to examine the relationship between leg mass, leg composition and foot velocity on kicking accuracy in Australian Football. Thirty-one Australian Footballers (n = 31; age: 22.1 ± 2.8 years; height: 1.81 ± 0.07 m; weight: 85.1 ± 13.0 kg; BMI: 25.9 ± 3.2) each performed ten drop punt kicks over twenty metres to a player target. Athletes were separated into accurate (n = 15) and inaccurate (n = 16) kicking groups. Leg mass characteristics were assessed using whole body DXA scans. Foot velocity was determined using a ten-camera optoelectronic, three-dimensional motion capture system. Interactions between leg mass and foot velocity evident within accurate kickers only (r = -0.670 to -0.701). Relative lean mass was positively correlated with kicking accuracy (r = 0.631), while no relationship between foot velocity and kicking accuracy was evident in isolation (r = -0.047 to -0.083). Given the evident importance of lean mass, and its interaction with foot velocity for accurate kickers; future research should explore speed-accuracy, impulse-variability, limb co-ordination and foot-ball interaction constructs in kicking using controlled with-in subject studies to examine the effects of resistance training and skill acquisition programs on the development of kicking accuracy. Key pointsAccurate kickers expressed a very strong inverse relationship between leg mass and foot velocity. Inaccurate kickers were unable to replicate this, with greater volatility in their performance, indicating an ability of accurate kickers to mediate foot velocity to compensate for leg mass in order to deliver the ball over the required distance.Accurate kickers exhibited larger quantities of relative lean mass and lower quantities

  5. Relationship between Leg Mass, Leg Composition and Foot Velocity on Kicking Accuracy in Australian Football

    Directory of Open Access Journals (Sweden)

    Nicolas H. Hart, Jodie L. Cochrane, Tania Spiteri, Sophia Nimphius, Robert U. Newton

    2016-06-01

    Full Text Available Kicking a ball accurately over a desired distance to an intended target is arguably the most important skill to acquire in Australian Football. Therefore, understanding the potential mechanisms which underpin kicking accuracy is warranted. The aim of this study was to examine the relationship between leg mass, leg composition and foot velocity on kicking accuracy in Australian Football. Thirty-one Australian Footballers (n = 31; age: 22.1 ± 2.8 years; height: 1.81 ± 0.07 m; weight: 85.1 ± 13.0 kg; BMI: 25.9 ± 3.2 each performed ten drop punt kicks over twenty metres to a player target. Athletes were separated into accurate (n = 15 and inaccurate (n = 16 kicking groups. Leg mass characteristics were assessed using whole body DXA scans. Foot velocity was determined using a ten-camera optoelectronic, three-dimensional motion capture system. Interactions between leg mass and foot velocity evident within accurate kickers only (r = -0.670 to -0.701. Relative lean mass was positively correlated with kicking accuracy (r = 0.631, while no relationship between foot velocity and kicking accuracy was evident in isolation (r = -0.047 to -0.083. Given the evident importance of lean mass, and its interaction with foot velocity for accurate kickers; future research should explore speed-accuracy, impulse-variability, limb co-ordination and foot-ball interaction constructs in kicking using controlled with-in subject studies to examine the effects of resistance training and skill acquisition programs on the development of kicking accuracy.

  6. Creatine Loading Does Not Preserve Muscle Mass or Strength During Leg Immobilization in Healthy, Young Males

    NARCIS (Netherlands)

    Backx, Evelien M.P.; Hangelbroek, Roland; Snijders, Tim; Verscheijden, Marie Louise; Verdijk, Lex B.; Groot, de Lisette C.P.G.M.; Loon, van Luc J.C.

    2017-01-01

    Background: A short period of leg immobilization leads to rapid loss of muscle mass and strength. Creatine supplementation has been shown to increase lean body mass in active individuals and can be used to augment gains in muscle mass and strength during prolonged resistance-type exercise

  7. Large meta-analysis of genome-wide association studies identifies five loci for lean body mass

    NARCIS (Netherlands)

    Zillikens, M.C.; Demissie, Serkalem; Hsu, Yi Hsiang; Yerges-Armstrong, Laura M.; Chou, Wen Chi; Stolk, Lisette; Livshits, Gregory; Broer, Linda; Johnson, Toby; Koller, Daniel L.; Kutalik, Zoltán; Luan, J.A.; Malkin, Ida; Ried, Janina S.; Smith, Albert V.; Thorleifsson, Gudmar; Vandenput, Liesbeth; Hua Zhao, Jing; Zhang, Weihua; Aghdassi, Ali; Åkesson, Kristina; Amin, Najaf; Baier, Leslie J.; Barroso, Inês; Bennett, David A.; Bertram, Lars; Biffar, Rainer; Bochud, Murielle; Boehnke, Michael; Borecki, Ingrid B.; Buchman, Aron S.; Byberg, Liisa; Campbell, Harry; Campos Obanda, Natalia; Cauley, Jane A.; Cawthon, Peggy M.; Cederberg, Henna; Chen, Zhao; Cho, Nam H.; Jin Choi, Hyung; Claussnitzer, Melina; Collins, Francis; Cummings, Steven R.; Jager, De Philip L.; Demuth, Ilja; Dhonukshe-Rutten, Rosalie A.M.; DIatchenko, Luda; Eiriksdottir, Gudny; Enneman, Anke W.; Erdos, Mike; Eriksson, Johan G.; Eriksson, Joel; Estrada, Karol; Evans, Daniel S.; Feitosa, Mary F.; Fu, Mao; Garcia, Melissa; Gieger, Christian; Girke, Thomas; Glazer, Nicole L.; Grallert, Harald; Grewal, Jagvir; Han, Bok Ghee; Hanson, Robert L.; Hayward, Caroline; Hofman, Albert; Hoffman, Eric P.; Homuth, Georg; Hsueh, Wen Chi; Hubal, Monica J.; Hubbard, Alan; Huffman, Kim M.; Husted, Lise B.; Illig, Thomas; Ingelsson, Erik; Ittermann, Till; Jansson, John Olov; Jordan, Joanne M.; Jula, Antti; Karlsson, Magnus; Khaw, Kay Tee; Kilpelaïnen, Tuomas O.; Klopp, Norman; Kloth, Jacqueline S.L.; Koistinen, Heikki A.; Kraus, William E.; Kritchevsky, Stephen; Kuulasmaa, Teemu; Kuusisto, Johanna; Laakso, Markku; Lahti, Jari; Lang, Thomas; Langdahl, Bente L.; Launer, Lenore J.; Lee, Jong Young; Lerch, Markus M.; Lewis, Joshua R.; Lind, Lars; Lindgren, Cecilia M.; Liu, Yongmei; Liu, Tian; Liu, Youfang; Ljunggren, Östen; Lorentzon, Mattias; Luben, Robert N.; Maixner, William; McGuigan, Fiona E.; Medina-Gomez, Carolina; Meitinger, Thomas; Melhus, Håkan; Mellström, Dan; Melov, Simon; Michaëlsson, Karl; Mitchell, Braxton D.; Morris, Andrew P.; Mosekilde, Leif; Newman, Anne; Nielson, Carrie M.; O'Connell, Jeffrey R.; Oostra, Ben A.; Orwoll, Eric S.; Palotie, Aarno; Parker, Stephan; Peacock, Munro; Perola, Markus; Peters, Annette; Polasek, Ozren; Prince, Richard L.; Raïkkönen, Katri; Ralston, Stuart H.; Ripatti, Samuli; Robbins, John A.; Rotter, Jerome I.; Rudan, Igor; Salomaa, Veikko; Satterfield, Suzanne; Schadt, Eric E.; Schipf, Sabine; Scott, Laura; Sehmi, Joban; Shen, Jian; Soo Shin, Chan; Sigurdsson, Gunnar; Smith, Shad; Soranzo, Nicole; Stančáková, Alena; Steinhagen-Thiessen, Elisabeth; Streeten, Elizabeth A.; Styrkarsdottir, Unnur; Swart, Karin M.A.; Tan, Sian Tsung; Tarnopolsky, Mark A.; Thompson, Patricia; Thomson, Cynthia A.; Thorsteinsdottir, Unnur; Tikkanen, Emmi; Tranah, Gregory J.; Tuomilehto, Jaakko; Schoor, van Natasja M.; Verma, Arjun; Vollenweider, Peter; Völzke, Henry; Wactawski-Wende, Jean; Walker, Mark; Weedon, Michael N.; Welch, Ryan; Wichman, H.E.; Widen, Elisabeth; Williams, Frances M.K.; Wilson, James F.; Wright, Nicole C.; Xie, Weijia; Yu, Lei; Zhou, Yanhua; Chambers, John C.; Döring, Angela; Duijn, Van Cornelia M.; Econs, Michael J.; Gudnason, Vilmundur; Kooner, Jaspal S.; Psaty, Bruce M.; Spector, Timothy D.; Stefansson, Kari; Rivadeneira, Fernando; Uitterlinden, André G.; Wareham, Nicholas J.; Ossowski, Vicky; Waterworth, Dawn M.; Loos, Ruth J.F.; Karasik, David; Harris, Tamara B.; Ohlsson, Claes; Kiel, Douglas P.

    2017-01-01

    Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray

  8. Lean muscle mass in classic or ovulatory PCOS: association with central obesity and insulin resistance.

    Science.gov (United States)

    Mario, F M; do Amarante, F; Toscani, M K; Spritzer, P M

    2012-10-01

    This age-matched case-control study assessed total and segmental lean muscle mass in classic or ovulatory polycystic ovary syndrome (PCOS) patients and investigated whether lean mass is associated with hormone and metabolic features. Participants underwent anthropometric and clinical evaluation. Habitual physical activity was assessed with a digital pedometer, and body composition by dual-energy X-ray absorptiometry. Laboratory measurements included total cholesterol, cholesterol fractions, triglycerides, glucose, total serum testosterone, serum insulin, estradiol, luteinizing hormone, and SHBG. Energy intake was calculated using a food frequency questionnaire. Classic PCOS patients had higher body mass index (BMI), waist circumference, testosterone and lipid accumulation product values than ovulatory PCOS and controls. Energy consumption, homeostasis model assessment index, SHBG, free androgen index and triglycerides, total and trunk lean mass were higher only in classic PCOS women vs. controls. Arm, leg, trunk, total or limb lean masses were not correlated with hormone levels in any of the groups. However, in PCOS women lipid accumulation product was positively correlated with total (r=0.56, p=0.001), trunk (r=0.59, p=0.001), arm (r=0.54, p=0.001), leg (r=0.44, p=0.03) and limb (r=0.48, p=0.001) lean masses. BMI was positively correlated with all lean mass segments and independently associated with total lean mass. Lipid accumulation product and BMI were independently associated with trunk lean mass variation. The increase in lean mass in classic PCOS appears to be associated with insulin resistance and central obesity rather than with energy intake, physical activity or androgens. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  9. Per meal dose and frequency of protein consumption is associated with lean mass and muscle performance.

    Science.gov (United States)

    Loenneke, Jeremy P; Loprinzi, Paul D; Murphy, Caoileann H; Phillips, Stuart M

    2016-12-01

    It has been hypothesized that for older adults evenly distributing consumption of protein at 30-40 g per meal throughout the day may result in more favorable retention of lean mass and muscular strength. Such a thesis has not, to our knowledge, been tested outside of short-term studies or acute measures of muscle protein synthesis. To examine whether the number of times an individual consumed a minimum of 30 g of protein at a meal is associated with leg lean mass and knee extensor strength. Data from the 1999-2002 NHANES were used, with 1081 adults (50-85 y) constituting the analytic sample. A "multiple pass" 24-h dietary interview format was used to collect detailed information about the participants' dietary intake. Knee extensor strength was assessed objectively using the Kin Com MP dynamometer. Leg lean mass was estimated from whole-body dual-energy X-ray absorptiometry (DXA) scans. Participants with 1 vs. 0 (β adjusted  = 23.6, p = 0.002) and 2 vs. 0 (β adjusted  = 51.1, p = 0.001) meals of ≥30 g protein/meal had greater strength and leg lean mass (1 vs. 0, β adjusted  = 1160, p frequency with leg lean mass and strength plateaued at ∼45 g protein/meal for those consuming 2 vs. 0 meals above the evaluated protein/meal threshold. However, for those with only 1 meal at or above the evaluated threshold, the response plateaued at 30 g/meal. Leg lean mass mediated the relationship between protein frequency and strength, with the proportion of the total effect mediated being 64%. We found that more frequent consumption of meals containing between 30 and 45 g protein/meal produced the greatest association with leg lean mass and strength. Thus, the consumption of 1-2 daily meals with protein content from 30 to 45 g may be an important strategy for increasing and/or maintaining lean body mass and muscle strength with aging. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  10. Large meta-analysis of genome-wide association studies identifies five loci for lean body mass.

    Science.gov (United States)

    Zillikens, M Carola; Demissie, Serkalem; Hsu, Yi-Hsiang; Yerges-Armstrong, Laura M; Chou, Wen-Chi; Stolk, Lisette; Livshits, Gregory; Broer, Linda; Johnson, Toby; Koller, Daniel L; Kutalik, Zoltán; Luan, Jian'an; Malkin, Ida; Ried, Janina S; Smith, Albert V; Thorleifsson, Gudmar; Vandenput, Liesbeth; Hua Zhao, Jing; Zhang, Weihua; Aghdassi, Ali; Åkesson, Kristina; Amin, Najaf; Baier, Leslie J; Barroso, Inês; Bennett, David A; Bertram, Lars; Biffar, Rainer; Bochud, Murielle; Boehnke, Michael; Borecki, Ingrid B; Buchman, Aron S; Byberg, Liisa; Campbell, Harry; Campos Obanda, Natalia; Cauley, Jane A; Cawthon, Peggy M; Cederberg, Henna; Chen, Zhao; Cho, Nam H; Jin Choi, Hyung; Claussnitzer, Melina; Collins, Francis; Cummings, Steven R; De Jager, Philip L; Demuth, Ilja; Dhonukshe-Rutten, Rosalie A M; Diatchenko, Luda; Eiriksdottir, Gudny; Enneman, Anke W; Erdos, Mike; Eriksson, Johan G; Eriksson, Joel; Estrada, Karol; Evans, Daniel S; Feitosa, Mary F; Fu, Mao; Garcia, Melissa; Gieger, Christian; Girke, Thomas; Glazer, Nicole L; Grallert, Harald; Grewal, Jagvir; Han, Bok-Ghee; Hanson, Robert L; Hayward, Caroline; Hofman, Albert; Hoffman, Eric P; Homuth, Georg; Hsueh, Wen-Chi; Hubal, Monica J; Hubbard, Alan; Huffman, Kim M; Husted, Lise B; Illig, Thomas; Ingelsson, Erik; Ittermann, Till; Jansson, John-Olov; Jordan, Joanne M; Jula, Antti; Karlsson, Magnus; Khaw, Kay-Tee; Kilpeläinen, Tuomas O; Klopp, Norman; Kloth, Jacqueline S L; Koistinen, Heikki A; Kraus, William E; Kritchevsky, Stephen; Kuulasmaa, Teemu; Kuusisto, Johanna; Laakso, Markku; Lahti, Jari; Lang, Thomas; Langdahl, Bente L; Launer, Lenore J; Lee, Jong-Young; Lerch, Markus M; Lewis, Joshua R; Lind, Lars; Lindgren, Cecilia; Liu, Yongmei; Liu, Tian; Liu, Youfang; Ljunggren, Östen; Lorentzon, Mattias; Luben, Robert N; Maixner, William; McGuigan, Fiona E; Medina-Gomez, Carolina; Meitinger, Thomas; Melhus, Håkan; Mellström, Dan; Melov, Simon; Michaëlsson, Karl; Mitchell, Braxton D; Morris, Andrew P; Mosekilde, Leif; Newman, Anne; Nielson, Carrie M; O'Connell, Jeffrey R; Oostra, Ben A; Orwoll, Eric S; Palotie, Aarno; Parker, Stephen C J; Peacock, Munro; Perola, Markus; Peters, Annette; Polasek, Ozren; Prince, Richard L; Räikkönen, Katri; Ralston, Stuart H; Ripatti, Samuli; Robbins, John A; Rotter, Jerome I; Rudan, Igor; Salomaa, Veikko; Satterfield, Suzanne; Schadt, Eric E; Schipf, Sabine; Scott, Laura; Sehmi, Joban; Shen, Jian; Soo Shin, Chan; Sigurdsson, Gunnar; Smith, Shad; Soranzo, Nicole; Stančáková, Alena; Steinhagen-Thiessen, Elisabeth; Streeten, Elizabeth A; Styrkarsdottir, Unnur; Swart, Karin M A; Tan, Sian-Tsung; Tarnopolsky, Mark A; Thompson, Patricia; Thomson, Cynthia A; Thorsteinsdottir, Unnur; Tikkanen, Emmi; Tranah, Gregory J; Tuomilehto, Jaakko; van Schoor, Natasja M; Verma, Arjun; Vollenweider, Peter; Völzke, Henry; Wactawski-Wende, Jean; Walker, Mark; Weedon, Michael N; Welch, Ryan; Wichmann, H-Erich; Widen, Elisabeth; Williams, Frances M K; Wilson, James F; Wright, Nicole C; Xie, Weijia; Yu, Lei; Zhou, Yanhua; Chambers, John C; Döring, Angela; van Duijn, Cornelia M; Econs, Michael J; Gudnason, Vilmundur; Kooner, Jaspal S; Psaty, Bruce M; Spector, Timothy D; Stefansson, Kari; Rivadeneira, Fernando; Uitterlinden, André G; Wareham, Nicholas J; Ossowski, Vicky; Waterworth, Dawn; Loos, Ruth J F; Karasik, David; Harris, Tamara B; Ohlsson, Claes; Kiel, Douglas P

    2017-07-19

    Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray absorptiometry or bioelectrical impedance analysis, adjusted for sex, age, height, and fat mass. Twenty-one single-nucleotide polymorphisms were significantly associated with lean body mass either genome wide (p lean body mass and in 45,090 (42,360 of European ancestry) subjects from 25 cohorts for appendicular lean body mass was successful for five single-nucleotide polymorphisms in/near HSD17B11, VCAN, ADAMTSL3, IRS1, and FTO for total lean body mass and for three single-nucleotide polymorphisms in/near VCAN, ADAMTSL3, and IRS1 for appendicular lean body mass. Our findings provide new insight into the genetics of lean body mass.Lean body mass is a highly heritable trait and is associated with various health conditions. Here, Kiel and colleagues perform a meta-analysis of genome-wide association studies for whole body lean body mass and find five novel genetic loci to be significantly associated.

  11. High-Intensity Jump Training Is Tolerated during 60 Days of Bed Rest and Is Very Effective in Preserving Leg Power and Lean Body Mass: An Overview of the Cologne RSL Study.

    Science.gov (United States)

    Kramer, Andreas; Kümmel, Jakob; Mulder, Edwin; Gollhofer, Albert; Frings-Meuthen, Petra; Gruber, Markus

    2017-01-01

    Space agencies are looking for effective and efficient countermeasures for the degrading effects of weightlessness on the human body. The aim of this study was to assess the effects of a novel jump exercise countermeasure during bed rest on vitals, body mass, body composition, and jump performance. 23 male participants (29±6 years, 181±6 cm, 77±7 kg) were confined to a bed rest facility for 90 days: a 15-day ambulatory measurement phase, a 60-day six-degree head-down-tilt bed rest phase (HDT), and a 15-day ambulatory recovery phase. Participants were randomly allocated to the jump training group (JUMP, n = 12) or the control group (CTRL, n = 11). A typical training session consisted of 4x10 countermovement jumps and 2x10 hops in a sledge jump system. The training group had to complete 5-6 sessions per week. Peak force for the reactive hops (3.6±0.4 kN) as well as jump height (35±4 cm) and peak power (3.1±0.2 kW) for the countermovement jumps could be maintained over the 60 days of HDT. Lean body mass decreased in CTRL but not in JUMP (-1.6±1.9 kg and 0±1.0 kg, respectively, interaction effect p = 0.03). Resting heart rate during recovery was significantly increased for CTRL but not for JUMP (interaction effect pjump training and maintained high peak forces and high power output during 60 days of bed rest. The countermeasure was effective in preserving lean body mass and partly preventing cardiac deconditioning with only several minutes of training per day.

  12. High-Intensity Jump Training Is Tolerated during 60 Days of Bed Rest and Is Very Effective in Preserving Leg Power and Lean Body Mass: An Overview of the Cologne RSL Study.

    Directory of Open Access Journals (Sweden)

    Andreas Kramer

    Full Text Available Space agencies are looking for effective and efficient countermeasures for the degrading effects of weightlessness on the human body. The aim of this study was to assess the effects of a novel jump exercise countermeasure during bed rest on vitals, body mass, body composition, and jump performance.23 male participants (29±6 years, 181±6 cm, 77±7 kg were confined to a bed rest facility for 90 days: a 15-day ambulatory measurement phase, a 60-day six-degree head-down-tilt bed rest phase (HDT, and a 15-day ambulatory recovery phase. Participants were randomly allocated to the jump training group (JUMP, n = 12 or the control group (CTRL, n = 11. A typical training session consisted of 4x10 countermovement jumps and 2x10 hops in a sledge jump system. The training group had to complete 5-6 sessions per week.Peak force for the reactive hops (3.6±0.4 kN as well as jump height (35±4 cm and peak power (3.1±0.2 kW for the countermovement jumps could be maintained over the 60 days of HDT. Lean body mass decreased in CTRL but not in JUMP (-1.6±1.9 kg and 0±1.0 kg, respectively, interaction effect p = 0.03. Resting heart rate during recovery was significantly increased for CTRL but not for JUMP (interaction effect p<0.001.Participants tolerated the near-daily high-intensity jump training and maintained high peak forces and high power output during 60 days of bed rest. The countermeasure was effective in preserving lean body mass and partly preventing cardiac deconditioning with only several minutes of training per day.

  13. Peak bone mineral density, lean body mass and fractures

    NARCIS (Netherlands)

    Boot, Annemieke M.; de Ridder, Maria A. J.; van der Sluis, Inge M.; van Slobbe, Ingrid; Krenning, Eric P.; Keizer-Schrama, Sabine M. P. F. de Muinck

    Background: During childhood and adolescence, bone mass and lean body mass (LBM) increase till a plateau is reached. In this longitudinal and cross-sectional study, the age of reaching the plateau was evaluated for lumbar spine and total body bone mass measurements and lean body mass. The

  14. Leg mass characteristics of accurate and inaccurate kickers--an Australian football perspective.

    Science.gov (United States)

    Hart, Nicolas H; Nimphius, Sophia; Cochrane, Jodie L; Newton, Robert U

    2013-01-01

    Athletic profiling provides valuable information to sport scientists, assisting in the optimal design of strength and conditioning programmes. Understanding the influence these physical characteristics may have on the generation of kicking accuracy is advantageous. The aim of this study was to profile and compare the lower limb mass characteristics of accurate and inaccurate Australian footballers. Thirty-one players were recruited from the Western Australian Football League to perform ten drop punt kicks over 20 metres to a player target. Players were separated into accurate (n = 15) and inaccurate (n = 16) groups, with leg mass characteristics assessed using whole body dual energy x-ray absorptiometry (DXA) scans. Accurate kickers demonstrated significantly greater relative lean mass (P ≤ 0.004) and significantly lower relative fat mass (P ≤ 0.024) across all segments of the kicking and support limbs, while also exhibiting significantly higher intra-limb lean-to-fat mass ratios for all segments across both limbs (P ≤ 0.009). Inaccurate kickers also produced significantly larger asymmetries between limbs than accurate kickers (P ≤ 0.028), showing considerably lower lean mass in their support leg. These results illustrate a difference in leg mass characteristics between accurate and inaccurate kickers, highlighting the potential influence these may have on technical proficiency of the drop punt.

  15. Serum Predictors of Percent Lean Mass in Young Adults.

    Science.gov (United States)

    Lustgarten, Michael S; Price, Lori L; Phillips, Edward M; Kirn, Dylan R; Mills, John; Fielding, Roger A

    2016-08-01

    Lustgarten, MS, Price, LL, Phillips, EM, Kirn, DR, Mills, J, and Fielding, RA. Serum predictors of percent lean mass in young adults. J Strength Cond Res 30(8): 2194-2201, 2016-Elevated lean (skeletal muscle) mass is associated with increased muscle strength and anaerobic exercise performance, whereas low levels of lean mass are associated with insulin resistance and sarcopenia. Therefore, studies aimed at obtaining an improved understanding of mechanisms related to the quantity of lean mass are of interest. Percent lean mass (total lean mass/body weight × 100) in 77 young subjects (18-35 years) was measured with dual-energy x-ray absorptiometry. Twenty analytes and 296 metabolites were evaluated with the use of the standard chemistry screen and mass spectrometry-based metabolomic profiling, respectively. Sex-adjusted multivariable linear regression was used to determine serum analytes and metabolites significantly (p ≤ 0.05 and q ≤ 0.30) associated with the percent lean mass. Two enzymes (alkaline phosphatase and serum glutamate oxaloacetate aminotransferase) and 29 metabolites were found to be significantly associated with the percent lean mass, including metabolites related to microbial metabolism, uremia, inflammation, oxidative stress, branched-chain amino acid metabolism, insulin sensitivity, glycerolipid metabolism, and xenobiotics. Use of sex-adjusted stepwise regression to obtain a final covariate predictor model identified the combination of 5 analytes and metabolites as overall predictors of the percent lean mass (model R = 82.5%). Collectively, these data suggest that a complex interplay of various metabolic processes underlies the maintenance of lean mass in young healthy adults.

  16. Large meta-analysis of genome-wide association studies identifies five loci for lean body mass

    DEFF Research Database (Denmark)

    Zillikens, M Carola; Demissie, Serkalem; Hsu, Yi-Hsiang

    2017-01-01

    Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray absorpt...... a meta-analysis of genome-wide association studies for whole body lean body mass and find five novel genetic loci to be significantly associated.......-ray absorptiometry or bioelectrical impedance analysis, adjusted for sex, age, height, and fat mass. Twenty-one single-nucleotide polymorphisms were significantly associated with lean body mass either genome wide (p 

  17. Individualisation of Lean Concept in Companies Dealing with Mass Production

    Science.gov (United States)

    Bednár, Roman

    2012-12-01

    The methods of lean manufacturing primarily designed for businesses dealing with serial production, are also used in other types of production. However the concept of lean production was not designed for these types of businesses, they are utilized only partially. Paper focuses on applying methods of lean concept in companies which are dealing with mass production and their options of exchange for other methods in the event of disagreement. Basis of the article is a list of lean methods with its description and its utilization in practice. The questionnaire was utilized to identify information from the practice. Based on this survey were identified the critical methods that are no longer appropriate for companies dealing with mass production. However, there are alternative methods of describing the problem. It is possible to say that companies are trying to get closer to their goal by modification of the basic concepts. And the concept of Lean Enterprise serves as a standard.

  18. Lean Manufacturing, Mass Customization and their relationships - empirical findings

    DEFF Research Database (Denmark)

    Christiansen, Thomas Bøhm

    2004-01-01

    manufacturing companies in 2001-02. This study fills a void in existing research by exploring relationships between bundles of lean manufacturing practices and bundles of mass customization practices. This study is based on a questionnaire that is developed from two existing questionnaires each investigating...... bundles of lean manufacturing practices and bundles of mass customization practices separately. Here, these bundles of practices are related. The results indicate that there are no direct relationships between the lean manufacturing and the mass customization practices, but that the combination of some...... sets of practices can explain differences in performance on important dimensions. The general conclusion, however, is that there are only weak relationships between the two concepts, hence this study suggests that the concepts of lean manufacturing and mass customization at present are more mutually...

  19. LEAN BODY MASS AS A PREDICTOR OF PERFORMANCE OF ...

    African Journals Online (AJOL)

    siahkohian

    literature indicates considerable variations in the LBM of different athletes, with values ranging from a ... Olympic weightlifters are related to and predictive of indirect estimates of absolute and ... Lean body mass & weightlifter performance. 181.

  20. Influence of different sports on fat mass and lean mass in growing girls

    Directory of Open Access Journals (Sweden)

    Esther Ubago-Guisado

    2017-06-01

    Conclusion: Impact sports (football, basketball, and handball and low-impact sports (swimming provide an appropriate development of lean mass in growing girls. We can conclude that people practicing sports at early ages ensure a lower fat mass and higher lean mass compared to those who do not practice. These results may be useful as a preventive method of adult obesity.

  1. Lower Lean Mass Measured by Dual-Energy X-ray Absorptiometry (DXA) is Not Associated with Increased Risk of Hip Fracture in Women: The Framingham Osteoporosis Study.

    Science.gov (United States)

    McLean, Robert R; Kiel, Douglas P; Berry, Sarah D; Broe, Kerry E; Zhang, Xiaochun; Cupples, L Adrienne; Hannan, Marian T

    2018-01-05

    Although muscle mass influences strength in older adults, it is unclear whether low lean mass measured by dual-energy X-ray absorptiometry (DXA) is an independent risk factor for hip fracture. Our objective was to determine the association between DXA lean mass and incident hip fracture risk among 1978 women aged 50 years and older participating in the Framingham Study Original and Offspring cohorts. Leg and total body lean mass (kg) were assessed from whole-body DXA scans collected in 1992-2001. Hip fracture follow-up extended from DXA assessment to the occurrence of fracture, death, drop-out, or end of follow-up in 2007. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) estimating the relative risk of hip fracture associated with a 1-kg increase in baseline lean mass. Mean age was 66 years (range 50-93). Over a median of 8 years of follow-up, 99 hip fractures occurred. In models adjusted for age, height, study cohort, and percent total body fat, neither leg (HR 1.11; 95% CI 0.94, 1.31) nor total body (HR 1.06; 95% CI 0.99, 1.13) lean mass were associated with hip fracture. After further adjustment for femoral neck bone mineral density, leg lean mass results were similar (HR 1.10; 95% CI 0.93, 1.30). In contrast, 1 kg greater total body lean mass was associated with 9% higher hip fracture risk (HR 1.09; 95% CI 1.02, 1.18). Our findings suggest that in women, lower lean mass measured by DXA is not associated with increased risk of hip fracture.

  2. Lean body mass as a determinant of thyroid size

    NARCIS (Netherlands)

    Wesche, M. F.; Wiersinga, W. M.; Smits, N. J.

    1998-01-01

    Males have a larger thyroid gland than females, and this has been related to the difference in body weight. In view of the different body composition of men and women, we hypothesized that lean body mass is a better determinant of thyroid volume than body weight. A cross-sectional study in an area

  3. Perioperative Testosterone Supplementation Increases Lean Mass in Healthy Men Undergoing Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial.

    Science.gov (United States)

    Wu, Brian; Lorezanza, Dan; Badash, Ido; Berger, Max; Lane, Christianne; Sum, Jonathan C; Hatch, George F; Schroeder, E Todd

    2017-08-01

    Rehabilitation after repair of the anterior cruciate ligament (ACL) is complicated by the loss of leg muscle mass and strength. Prior studies have shown that preoperative rehabilitation may improve muscle strength and postoperative outcomes. Testosterone supplementation may likewise counteract this muscle loss and potentially improve clinical outcomes. The purpose was to investigate the effect of perioperative testosterone administration on lean mass after ACL reconstruction in men and to examine the effects of testosterone on leg strength and clinical outcome scores. It was hypothesized that testosterone would increase lean mass and leg strength and improve clinical outcome scores relative to placebo. Randomized controlled trial; Level of evidence, 1. Male patients (N = 13) scheduled for ACL reconstruction were randomized into 2 groups: testosterone and placebo. Participants in the testosterone group received 200 mg of intramuscular testosterone weekly for 8 weeks beginning 2 weeks before surgery. Participants in the placebo group received saline following the same schedule. Both groups participated in a standard rehabilitation protocol. The primary outcome was the change in total lean body mass at 6 and 12 weeks. Secondary outcomes were extensor muscle strength, Tegner activity score, and Knee injury and Osteoarthritis Outcome Score. There was an increase in lean mass of a mean 2.7 ± 1.7 kg at 6 weeks postoperatively in the testosterone group compared with a decrease of a mean 0.1 ± 1.5 kg in the placebo group ( P = .01). Extensor muscle strength of the uninjured leg also increased more from baseline in the testosterone group (+20.8 ± 25.6 Nm) compared with the placebo group (-21.4 ± 36.7 Nm) at 12 weeks ( P = .04). There were no significant between-group differences in injured leg strength or clinical outcome scores. There were no negative side effects of testosterone noted. Perioperative testosterone supplementation increased lean mass 6 weeks after ACL

  4. Chronic exercise preserves lean muscle mass in masters athletes.

    Science.gov (United States)

    Wroblewski, Andrew P; Amati, Francesca; Smiley, Mark A; Goodpaster, Bret; Wright, Vonda

    2011-09-01

    Aging is commonly associated with a loss of muscle mass and strength, resulting in falls, functional decline, and the subjective feeling of weakness. Exercise modulates the morbidities of muscle aging. Most studies, however, have examined muscle-loss changes in sedentary aging adults. This leaves the question of whether the changes that are commonly associated with muscle aging reflect the true physiology of muscle aging or whether they reflect disuse atrophy. This study evaluated whether high levels of chronic exercise prevents the loss of lean muscle mass and strength experienced in sedentary aging adults. A cross-section of 40 high-level recreational athletes ("masters athletes") who were aged 40 to 81 years and trained 4 to 5 times per week underwent tests of health/activity, body composition, quadriceps peak torque (PT), and magnetic resonance imaging of bilateral quadriceps. Mid-thigh muscle area, quadriceps area (QA), subcutaneous adipose tissue, and intramuscular adipose tissue were quantified in magnetic resonance imaging using medical image processing, analysis, and visualization software. One-way analysis of variance was used to examine age group differences. Relationships were evaluated using Spearman correlations. Mid-thigh muscle area (P = 0.31) and lean mass (P = 0.15) did not increase with age and were significantly related to retention of mid-thigh muscle area (P lean mass (P = 0.4) and PT. This study contradicts the common observation that muscle mass and strength decline as a function of aging alone. Instead, these declines may signal the effect of chronic disuse rather than muscle aging. Evaluation of masters athletes removes disuse as a confounding variable in the study of lower-extremity function and loss of lean muscle mass. This maintenance of muscle mass and strength may decrease or eliminate the falls, functional decline, and loss of independence that are commonly seen in aging adults.

  5. Accuracy of Body Mass Index Versus Lean Mass Index for Prediction of Sarcopenia in Older Women.

    Science.gov (United States)

    Benton, M J; Silva-Smith, A L

    2018-01-01

    We compared accuracy of body mass index (BMI) versus lean mass index (LMI) to predict sarcopenia in 58 community-dwelling women (74.1±0.9 years). Lean mass was measured with multi-frequency bioelectrical impedance analysis, and strength was measured with Arm Curl test, Chair Stand test, and handgrip dynamometry. Sarcopenia was defined as low LMI. When categorized by BMI, normal women had less absolute lean mass (37.6±1.0 vs. 42.6±0.9 kg; Plean mass (14.1±0.2 vs. 16.1±0.2 kg/m2; Plean mass (44.0±0.7 vs. 35.7±0.7 kg; Plean mass (16.2±0.2 vs. 13.8±0.2 kg/m2; Plean mass and strength. For clinical assessment, calculation of LMI rather than BMI is appropriate.

  6. Regulation of lean mass, bone mass, and exercise tolerance by the central melanocortin system.

    Directory of Open Access Journals (Sweden)

    Theodore P Braun

    Full Text Available Signaling via the type 4-melanocortin receptor (MC4R is an important determinant of body weight in mice and humans, where loss of function mutations lead to significant obesity. Humans with mutations in the MC4R experience an increase in lean mass. However, the simultaneous accrual of fat mass in such individuals may contribute to this effect via mechanical loading. We therefore examined the relationship of fat mass and lean mass in mice lacking the type-4 melanocortin receptor (MC4RKO. We demonstrate that MC4RKO mice display increased lean body mass. Further, this is not dependent on changes in adipose mass, as MC4RKO mice possess more lean body mass than diet-induced obese (DIO wild type mice with equivalent fat mass. To examine potential sources of the increased lean mass in MC4RKO mice, bone mass and strength were examined in MC4RKO mice. Both parameters increase with age in MC4RKO mice, which likely contributes to increases in lean body mass. We functionally characterized the increased lean mass in MC4RKO mice by examining their capacity for treadmill running. MC4R deficiency results in a decrease in exercise performance. No changes in the ratio of oxidative to glycolytic fibers were seen, however MC4RKO mice demonstrate a significantly reduced heart rate, which may underlie their impaired exercise performance. The reduced exercise capacity we report in the MC4RKO mouse has potential clinical ramifications, as efforts to control body weight in humans with melanocortin deficiency may be ineffective due to poor tolerance for physical activity.

  7. Increased protein intake reduces lean body mass loss during weight loss in athletes.

    Science.gov (United States)

    Mettler, Samuel; Mitchell, Nigel; Tipton, Kevin D

    2010-02-01

    To examine the influence of dietary protein on lean body mass loss and performance during short-term hypoenergetic weight loss in athletes. In a parallel design, 20 young healthy resistance-trained athletes were examined for energy expenditure for 1 wk and fed a mixed diet (15% protein, 100% energy) in the second week followed by a hypoenergetic diet (60% of the habitual energy intake), containing either 15% (approximately 1.0 g x kg(-1)) protein (control group, n = 10; CP) or 35% (approximately 2.3 g x kg(-1)) protein (high-protein group, n = 10; HP) for 2 wk. Subjects continued their habitual training throughout the study. Total, lean body, and fat mass, performance (squat jump, maximal isometric leg extension, one-repetition maximum (1RM) bench press, muscle endurance bench press, and 30-s Wingate test) and fasting blood samples (glucose, nonesterified fatty acids (NEFA), glycerol, urea, cortisol, free testosterone, free Insulin-like growth factor-1 (IGF-1), and growth hormone), and psychologic measures were examined at the end of each of the 4 wk. Total (-3.0 +/- 0.4 and -1.5 +/- 0.3 kg for the CP and HP, respectively, P = 0.036) and lean body mass loss (-1.6 +/- 0.3 and -0.3 +/- 0.3 kg, P = 0.006) were significantly larger in the CP compared with those in the HP. Fat loss, performance, and most blood parameters were not influenced by the diet. Urea was higher in HP, and NEFA and urea showed a group x time interaction. Fatigue ratings and "worse than normal" scores on the Daily Analysis of Life Demands for Athletes were higher in HP. These results indicate that approximately 2.3 g x kg(-1) or approximately 35% protein was significantly superior to approximately 1.0 g x kg(-1) or approximately 15% energy protein for maintenance of lean body mass in young healthy athletes during short-term hypoenergetic weight loss.

  8. Correlates of increased lean muscle mass in women with polycystic ovary syndrome.

    Science.gov (United States)

    Carmina, E; Guastella, E; Longo, R A; Rini, G B; Lobo, R A

    2009-10-01

    Muscle mass plays an important role in determining cardiovascular and metabolic risks in polycystic ovary syndrome (PCOS). In addition, whether lean mass influences carotid intima-media thickness (IMT) in PCOS has not been assessed. Prospective investigation. Ninety-five women with PCOS were age- and weight-matched to 90 ovulatory controls. All women had dual X-ray absorptiometry for lean, fat and bone mass, and bone mass density (BMD). Serum testosterone, sex hormone-binding globulin, insulin, and glucose and carotid IMT were determined. Free androgen index (FAI) and insulin resistance (by QUICKI) were calculated. In PCOS, waist circumference and insulin were higher and QUICKI lower than in controls (Plean mass were higher in PCOS compared to controls (PPCOS (PPCOS patients had abnormal (> or = 0.9 mm) values. Lean mass correlated with fat parameters, insulin, QUICKI, and FAI, but not with total testosterone; and after adjustments for insulin and QUICKI, lean mass still correlated with fat mass (PLean mass correlated with IMT (Plean mass independently of insulin. Bone mass correlated with lean and fat mass, but not with insulin or androgen. PCOS patients with 'pathological' IMT values had higher % trunk fat, lean mass, and insulin, lower QUICKI, and higher testosterone and FAI compared with those with normal IMT. Lean mass is increased in PCOS, while bone mass is similar to that of matched controls. The major correlates of lean mass are fat mass and insulin but not androgen. Lean mass also correlated with IMT, and although influenced by insulin, small changes in IMT may partially reflect changes in muscle mass, while clearly abnormal values relate to more severe abnormalities of PCOS.

  9. Comparison of muscle/lean mass measurement methods: correlation with functional and biochemical testing.

    Science.gov (United States)

    Buehring, B; Siglinsky, E; Krueger, D; Evans, W; Hellerstein, M; Yamada, Y; Binkley, N

    2018-03-01

    DXA-measured lean mass is often used to assess muscle mass but has limitations. Thus, we compared DXA lean mass with two novel methods-bioelectric impedance spectroscopy and creatine (methyl-d3) dilution. The examined methodologies did not measure lean mass similarly and the correlation with muscle biomarkers/function varied. Muscle function tests predict adverse health outcomes better than lean mass measurement. This may reflect limitations of current mass measurement methods. Newer approaches, e.g., bioelectric impedance spectroscopy (BIS) and creatine (methyl-d3) dilution (D3-C), may more accurately assess muscle mass. We hypothesized that BIS and D3-C measured muscle mass would better correlate with function and bone/muscle biomarkers than DXA measured lean mass. Evaluations of muscle/lean mass, function, and serum biomarkers were obtained in older community-dwelling adults. Mass was assessed by DXA, BIS, and orally administered D3-C. Grip strength, timed up and go, and jump power were examined. Potential muscle/bone serum biomarkers were measured. Mass measurements were compared with functional and serum data using regression analyses; differences between techniques were determined by paired t tests. Mean (SD) age of the 112 (89F/23M) participants was 80.6 (6.0) years. The lean/muscle mass assessments were correlated (.57-.88) but differed (p Lean mass measures were unrelated to the serum biomarkers measured. These three methodologies do not similarly measure muscle/lean mass and should not be viewed as being equivalent. Functional tests assessing maximal muscle strength/power (grip strength and jump power) correlated with all mass measures whereas gait speed was not. None of the selected serum measures correlated with mass. Efforts to optimize muscle mass assessment and identify their relationships with health outcomes are needed.

  10. Role of protein and amino acids in promoting lean mass accretion with resistance exercise and attenuating lean mass loss during energy deficit in humans.

    Science.gov (United States)

    Churchward-Venne, Tyler A; Murphy, Caoileann H; Longland, Thomas M; Phillips, Stuart M

    2013-08-01

    Amino acids are major nutrient regulators of muscle protein turnover. After protein ingestion, hyperaminoacidemia stimulates increased rates of skeletal muscle protein synthesis, suppresses muscle protein breakdown, and promotes net muscle protein accretion for several hours. These acute observations form the basis for strategized protein intake to promote lean mass accretion, or prevent lean mass loss over the long term. However, factors such as protein dose, protein source, and timing of intake are important in mediating the anabolic effects of amino acids on skeletal muscle and must be considered within the context of evaluating the reported efficacy of long-term studies investigating protein supplementation as part of a dietary strategy to promote lean mass accretion and/or prevent lean mass loss. Current research suggests that dietary protein supplementation can augment resistance exercise-mediated gains in skeletal muscle mass and strength and can preserve skeletal muscle mass during periods of diet-induced energy restriction. Perhaps less appreciated, protein supplementation can augment resistance training-mediated gains in skeletal muscle mass even in individuals habitually consuming 'adequate' (i.e., >0.8 g kg⁻¹ day⁻¹) protein. Additionally, overfeeding energy with moderate to high-protein intake (15-25 % protein or 1.8-3.0 g kg⁻¹ day⁻¹) is associated with lean, but not fat mass accretion, when compared to overfeeding energy with low protein intake (5 % protein or ~0.68 g kg⁻¹ day⁻¹). Amino acids represent primary nutrient regulators of skeletal muscle anabolism, capable of enhancing lean mass accretion with resistance exercise and attenuating the loss of lean mass during periods of energy deficit, although factors such as protein dose, protein source, and timing of intake are likely important in mediating these effects.

  11. Physical Activity Modifies the Association between Dietary Protein and Lean Mass of Postmenopausal Women.

    Science.gov (United States)

    Martinez, Jessica A; Wertheim, Betsy C; Thomson, Cynthia A; Bea, Jennifer W; Wallace, Robert; Allison, Matthew; Snetselaar, Linda; Chen, Zhao; Nassir, Rami; Thompson, Patricia A

    2017-02-01

    Maintenance of lean muscle mass and related strength is associated with lower risk for numerous chronic diseases of aging in women. Our aim was to evaluate whether the association between dietary protein and lean mass differs by physical activity level, amino acid composition, and body mass index categories. We performed a cross-sectional analysis of a prospective cohort. Participants were postmenopausal women from the Women's Health Initiative with body composition measurements by dual-energy x-ray absorptiometry (n=8,298). Our study measured percent lean mass, percent fat mass, and lean body mass index. Linear regression models adjusted for scanner serial number, age, calibrated energy intake, race/ethnicity, neighborhood socioeconomic status, and recreational physical activity were used to determine the relationship between protein intake and body composition measures. Likelihood ratio tests and stratified analysis were used to investigate physical activity and body mass index as potential effect modifiers. Biomarker-calibrated protein intake was positively associated with percent lean mass; women in the highest protein quintile had 6.3 percentage points higher lean mass than the lowest quintile (Plean body mass index were both inversely related to protein intake (both Plean body mass index (P interaction =0.011). Leucine intake was associated with lean mass, as were branched chain amino acids combined (both Plean mass in postmenopausal women. Importantly, those that also engage in physical activity have the highest lean mass across body mass index categories. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  12. Effect of fat mass and lean mass on bone mineral density in postmenopausal and perimenopausal Thai women

    Directory of Open Access Journals (Sweden)

    Namwongprom S

    2013-02-01

    Full Text Available Sirianong Namwongprom,1 Sattaya Rojanasthien,2 Ampica Mangklabruks,3 Supasil Soontrapa,4 Chanpen Wongboontan,5 Boonsong Ongphiphadhanakul61Clinical Epidemiology Program and Department of Radiology, 2Department of Orthopaedics, 3Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 4Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, 5Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 6Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandBackground: The purpose of this study was to investigate the association between fat mass, lean mass, and bone mineral density (BMD in postmenopausal and perimenopausal Thai women.Methods: A cross-sectional study was conducted in 1579 healthy Thai women aged 40–90 years. Total body, lumbar spine, total femur, and femoral neck BMD and body composition were measured by dual x-ray absorptiometry. To evaluate the associations between fat mass and lean mass and various measures of BMD, multivariable linear regression models were used to estimate the regression coefficients for fat mass and lean mass, first in separate equations and then with both fat mass and lean mass in the same equation.Results: Among the study population, 1448 subjects (91.7% were postmenopausal and 131 (8.3% were perimenopausal. In postmenopausal women, after controlling for age, height, and duration of menopause, both fat mass and lean mass were positively correlated with BMD when they were analyzed independently of each other. When included in the same equation, both fat mass and lean mass continued to show a positive effect, but lean mass had a significantly greater impact on BMD than fat mass at all regions except for total body. Lean mass but not fat mass had a positive effect on BMD at all skeletal sites except the lumbar spine, after controlling for age and height in perimenopausal

  13. Lean body mass and creatine kinase are associated with reduced inflammation in obesity.

    Science.gov (United States)

    Bekkelund, Svein I; Jorde, Rolf

    2017-11-01

    Obesity is associated with inflammation, but the role of lean mass and creatine kinase (CK) on the inflammatory process is less known. We investigated the associations between lean mass, CK and fat mass upon inflammatory parameters in an overweight and obese adult population. Body composition examined by dual-energy X-ray absorptiometry, high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), CK and supplementary clinical parameters were measured in 454 overweight and obese individuals. This is a secondary analysis from a cohort of obese individuals treated with Vitamin D. Mean age was 47·6 ± 11·4 years and mean body mass index 34·6 ± 3·9 kg/m 2 . Lean mass correlated negatively with hs-CRP (r = -0·127, P = 0·042) and ESR (r = -0·381, P lean mass in the lower ESR quartile was significantly higher than in the upper quartile (P lean mass and CK in an overweight and obese population. Hypothetically, lean mass has a favourable effect on obesity-related inflammation, and CK may play a role as an inhibitor of inflammation in obesity. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.

  14. Effects of BMI, Fat Mass, and Lean Mass on Asthma in Childhood: A Mendelian Randomization Study

    Science.gov (United States)

    Granell, Raquel; Henderson, A. John; Evans, David M.; Smith, George Davey; Ness, Andrew R.; Lewis, Sarah; Palmer, Tom M.; Sterne, Jonathan A. C.

    2014-01-01

    Background Observational studies have reported associations between body mass index (BMI) and asthma, but confounding and reverse causality remain plausible explanations. We aim to investigate evidence for a causal effect of BMI on asthma using a Mendelian randomization approach. Methods and Findings We used Mendelian randomization to investigate causal effects of BMI, fat mass, and lean mass on current asthma at age 7½ y in the Avon Longitudinal Study of Parents and Children (ALSPAC). A weighted allele score based on 32 independent BMI-related single nucleotide polymorphisms (SNPs) was derived from external data, and associations with BMI, fat mass, lean mass, and asthma were estimated. We derived instrumental variable (IV) estimates of causal risk ratios (RRs). 4,835 children had available data on BMI-associated SNPs, asthma, and BMI. The weighted allele score was strongly associated with BMI, fat mass, and lean mass (all p-valuesBMI on asthma was 1.55 (95% CI 1.16–2.07) per kg/m2, p = 0.003. This effect appeared stronger for non-atopic (1.90, 95% CI 1.19–3.03) than for atopic asthma (1.37, 95% CI 0.89–2.11) though there was little evidence of heterogeneity (p = 0.31). The estimated causal RRs for the effects of fat mass and lean mass on asthma were 1.41 (95% CI 1.11–1.79) per 0.5 kg and 2.25 (95% CI 1.23–4.11) per kg, respectively. The possibility of genetic pleiotropy could not be discounted completely; however, additional IV analyses using FTO variant rs1558902 and the other BMI-related SNPs separately provided similar causal effects with wider confidence intervals. Loss of follow-up was unlikely to bias the estimated effects. Conclusions Higher BMI increases the risk of asthma in mid-childhood. Higher BMI may have contributed to the increase in asthma risk toward the end of the 20th century. Please see later in the article for the Editors' Summary PMID:24983943

  15. Development of Novel Methods to Define Deficits in Appendicular Lean Mass Relative to Fat Mass.

    Directory of Open Access Journals (Sweden)

    David Weber

    Full Text Available Recent studies suggest that adjustment of measures of lean mass for adiposity improves associations with physical function. Our objective was to develop and test a method to adjust appendicular lean mass for adiposity.Whole-body DXA data in 14,850 adults in the National Health and Nutrition Examination Survey were used to generate sex-, and race-specific standard deviation scores (Z-Scores relative to age and T-scores relative to 25 year-olds for appendicular lean mass index (ALMI, kg/m2 and fat mass index (FMI, kg/m2. Correlations between ALMI and FMI Z- and T-Scores were assessed within demographic categories. Fat-adjusted ALMI (ALMIFMI scores were determined using residual methods. Sarcopenia was defined as a T-Score 0.50; p<0.001 within all demographic categories. The impact of a unit greater FMI Z-score on ALMI Z-score was less in the elderly, men, white subjects, and among individuals with lower FMI (all tests for interaction p<0.001. There was fair agreement between ALMI and ALMIFMI estimates of sarcopenia and low lean for age [Kappa: 0.46, 0.52, respectively (p<0.0001]. Elderly subjects were likely to be re-classified as sarcopenic while young subjects were likely to be re-classified as normal using ALMIFMI. ALMIFMI T-scores resulted in approximately twice the number of subjects defined as sarcopenic, compared with ALMI T-Scores. (1299 v. 534. Among rheumatoid arthritis patients, ALMIFMI Z-scores correlated with physical function (Health Assessment Questionnaire: rho = -0.22, p = 0.04; Short Physical Performance Battery: rho = 0.27, p = 0.01; however, the ALMI Z-Score did not.Adjustment of ALMI for the confounding association with FMI impacts the definition of lean mass deficits. These methods provide a practical tool for investigators and clinicians based on population-based reference data.

  16. Muscle strength and regional lean body mass influence on mineral bone health in young male adults.

    Science.gov (United States)

    Guimarães, Bianca Rosa; Pimenta, Luciana Duarte; Massini, Danilo Alexandre; Dos Santos, Daniel; Siqueira, Leandro Oliveira da Cruz; Simionato, Astor Reis; Dos Santos, Luiz Gustavo Almeida; Neiva, Cassiano Merussi; Pessôa Filho, Dalton Muller

    2018-01-01

    The relationship between muscle strength and bone mineral content (BMC) and bone mineral density (BMD) is supposed from the assumption of the mechanical stress influence on bone tissue metabolism. However, the direct relationship is not well established in younger men, since the enhancement of force able to produce effective changes in bone health, still needs to be further studied. This study aimed to analyze the influence of muscle strength on BMC and BMD in undergraduate students. Thirty six men (24.9 ± 8.6 y/o) were evaluated for regional and whole-body composition by dual energy X-ray absorptiometry (DXA). One repetition maximum tests (1RM) were assessed on flat bench-press (BP), lat-pull down (LPD), leg-curl (LC), knee extension (KE), and leg-press 45° (LP45) exercises. Linear regression modelled the relationships of BMD and BMC to the regional body composition and 1RM values. Measurements of dispersion and error (R2adj and standard error of estimate (SEE)) were tested, setting ρ at ≤0.05. The BMD mean value for whole-body was 1.12±0.09 g/cm2 and BMC attained 2477.9 ± 379.2 g. The regional lean mass (LM) in upper-limbs (UL) (= 6.80±1.21 kg) was related to BMC and BMD for UL (R2adj = 0.74, pBMC and BMD for LL (R2adj = 0.68, pBMC (R2adj = 0.47, pBMC (R2adj = 0.36, pBMC and BMD in young men, strengthening the relationship between force and LM, and suggesting both to parametrizes bone mineral health.

  17. Age-related differences in lean mass, protein synthesis and skeletal muscle markers of proteolysis after bed rest and exercise rehabilitation.

    Science.gov (United States)

    Tanner, Ruth E; Brunker, Lucille B; Agergaard, Jakob; Barrows, Katherine M; Briggs, Robert A; Kwon, Oh Sung; Young, Laura M; Hopkins, Paul N; Volpi, Elena; Marcus, Robin L; LaStayo, Paul C; Drummond, Micah J

    2015-09-15

    Bed rest-induced muscle loss and impaired muscle recovery may contribute to age-related sarcopenia. It is unknown if there are age-related differences in muscle mass and muscle anabolic and catabolic responses to bed rest. A secondary objective was to determine if rehabilitation could reverse bed rest responses. Nine older and fourteen young adults participated in a 5-day bed rest challenge (BED REST). This was followed by 8 weeks of high intensity resistance exercise (REHAB). Leg lean mass (via dual-energy X-ray absorptiometry; DXA) and strength were determined. Muscle biopsies were collected during a constant stable isotope infusion in the postabsorptive state and after essential amino acid (EAA) ingestion on three occasions: before (PRE), after bed rest and after rehabilitation. Samples were assessed for protein synthesis, mTORC1 signalling, REDD1/2 expression and molecular markers related to muscle proteolysis (MURF1, MAFBX, AMPKα, LC3II/I, Beclin1). We found that leg lean mass and strength decreased in older but not younger adults after bedrest (P protein synthesis increased before bed rest in both age groups (P protein synthesis rates and increased MAFBX mRNA, p-AMPKα and the LC3II/I ratio (P protein synthesis and a marginal increase in proteolytic markers. Finally, rehabilitation restored bed rest-induced deficits in lean mass and strength in older adults. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.

  18. Limb/trunk lean mass ratio as a risk factor for mortality in peritoneal dialysis patients

    OpenAIRE

    Hui Kang, Seok; Hyang Cho, Kyu; Won Park, Jong; Woo Yoon, Kyung; Young Do, Jun

    2012-01-01

    Protein energy wasting (PEW) is a common problem in dialysis patients. There have been few reports on the effects of regional lean mass distribution for peritoneal dialysis (PD) patients. We reviewed the medical records and identified all adults who received PD between May 2001 and May 2011. Five hundred thirty four patients were enrolled. The clinical and laboratory data were collected at 1 and 12 months. Regional lean masses were measured by dual-energy X-ray absorptiometry. The limb/trunk ...

  19. Relationship between body mass, lean mass, fat mass, and limb bone cross-sectional geometry: Implications for estimating body mass and physique from the skeleton.

    Science.gov (United States)

    Pomeroy, Emma; Macintosh, Alison; Wells, Jonathan C K; Cole, Tim J; Stock, Jay T

    2018-05-01

    Estimating body mass from skeletal dimensions is widely practiced, but methods for estimating its components (lean and fat mass) are poorly developed. The ability to estimate these characteristics would offer new insights into the evolution of body composition and its variation relative to past and present health. This study investigates the potential of long bone cross-sectional properties as predictors of body, lean, and fat mass. Humerus, femur and tibia midshaft cross-sectional properties were measured by peripheral quantitative computed tomography in sample of young adult women (n = 105) characterized by a range of activity levels. Body composition was estimated from bioimpedance analysis. Lean mass correlated most strongly with both upper and lower limb bone properties (r values up to 0.74), while fat mass showed weak correlations (r ≤ 0.29). Estimation equations generated from tibial midshaft properties indicated that lean mass could be estimated relatively reliably, with some improvement using logged data and including bone length in the models (minimum standard error of estimate = 8.9%). Body mass prediction was less reliable and fat mass only poorly predicted (standard errors of estimate ≥11.9% and >33%, respectively). Lean mass can be predicted more reliably than body mass from limb bone cross-sectional properties. The results highlight the potential for studying evolutionary trends in lean mass from skeletal remains, and have implications for understanding the relationship between bone morphology and body mass or composition. © 2018 The Authors. American Journal of Physical Anthropology Published by Wiley Periodicals, Inc.

  20. The role of lean body mass and physical activity in bone health in children.

    Science.gov (United States)

    Baptista, Fátima; Barrigas, Carlos; Vieira, Filomena; Santa-Clara, Helena; Homens, Pedro Mil; Fragoso, Isabel; Teixeira, Pedro J; Sardinha, Luís B

    2012-01-01

    In the context of physical education curricula, markers of physical fitness (e.g., aerobic capacity, muscular strength, flexibility, and body mass index or body fat) are usually evaluated in reference to health standards. Despite their possible mediating role in the relationship between weight-bearing or muscle forces and features of bone tissue, these attributes of fitness may not be the most relevant to predict skeletal health. It is therefore important to analyze the relative contribution of these factors to the variability in bone tissue of different parts of the skeleton, and to analyze it by gender, as sensitivity to mechanical loading can diverge for boys and girls. We compared the effects of habitual physical activity (PA) and lean mass, as surrogates of weight-bearing and muscle forces, and of physical fitness (aerobic and muscle capacity of lower and upper limbs) on bone mineral content (BMC) and size of total body, lumbar spine, femoral neck, and 1/3 radius in 53 girls and 64 boys from 7.9 to 9.7 years of age. After controlling for bone age, body mass, body height, and calcium intake, lean mass was the most important predictor of bone size and/or mineral in both genders (p  608 counts/min/day (~105 min/day of moderate and vigorous intensity) showed 13-20% more BMC than those with less physical activity, and girls with a lean mass >19 kg showed 12-19% more BMC than those with less lean mass. These findings suggest that lean mass was the most important predictor of bone size and/or mineralization in both genders, while habitual weight-bearing PA appears to positively impact on bone mineral in prepubertal boys and that both lean mass and PA need to be considered in physical education curricula and other health-enhancing programs.

  1. A Combined Training Intervention Programme Increases Lean Mass in Youths with Down Syndrome

    Science.gov (United States)

    Gonzalez-Aguero, Alejandro; Vicente-Rodriguez, German; Gomez-Cabello, Alba; Ara, Ignacio; Moreno, Luis A.; Casajus, Jose A.

    2011-01-01

    Aim: The present study aimed to determine whether youths with Down syndrome (DS) are able to increase lean mass and decrease fat mass, after 21 weeks of conditioning combined with a plyometric jumps training program. Methods: Twenty-six participants with DS (15 males) aged 10-19 years joined the study. Participants were divided into two comparable…

  2. Loss of lean body mass affects low bone mineral density in patients with rheumatoid arthritis - results from the TOMORROW study.

    Science.gov (United States)

    Okano, Tadashi; Inui, Kentaro; Tada, Masahiro; Sugioka, Yuko; Mamoto, Kenji; Wakitani, Shigeyuki; Koike, Tatsuya; Nakamura, Hiroaki

    2017-11-01

    Osteoporosis is one of the complications for patients with rheumatoid arthritis (RA). Rheumatoid cachexia, the loss of lean body mass, is another. However, the relationship between decreased lean body mass and reduced bone mineral density (BMD) in patients with RA has not been well studied. This study included 413 participants, comprising 208 patients with RA and 205 age- and sex-matched healthy volunteers. Clinical data, BMD, bone metabolic markers (BMM) and body composition, such as lean body mass and percent fat, were collected. Risk factors for osteoporosis in patients with RA including the relationship BMD and body composition were analyzed. Patients with RA showed low BMD and high BMM compared with controls. Moreover, lean body mass was lower and percent fat was higher in patients with RA. Lean body mass correlated positively and percent fat negatively with BMD. Lean body mass was a positive and disease duration was a negative independent factor for BMD in multivariate statistical analysis. BMD and lean body mass were significantly lower in patients with RA compared to healthy controls. Lean body mass correlated positively with BMD and decreased lean body mass and disease duration affected low BMD in patients with RA. [UMIN Clinical Trials Registry, http://www.umin.ac.jp/ctr/ , UMIN000003876].

  3. Effect of gender and lean body mass on kidney size in healthy 10-year-old children

    DEFF Research Database (Denmark)

    Schmidt, I. M.; Mølgaard, C.; Main, K. M.

    2001-01-01

    predictor of kidney volume was lean body mass, overruling height, weight, and surface area. When total kidney volume was related to lean body mass as a ratio, the gender difference in kidney size was no longer significant. A strong negative correlation was found between fat body mass and kidney volume...

  4. Age-related differences in lean mass, protein synthesis and skeletal muscle markers of proteolysis after bed rest and exercise rehabilitation

    DEFF Research Database (Denmark)

    Tanner, Ruth E; Brunker, Lucille B; Agergaard, Jakob

    2015-01-01

    during a constant stable isotope infusion in the postabsorptive state and after essential amino acid (EAA) ingestion on three occasions: before (PRE), after bed rest and after rehabilitation. Samples were assessed for protein synthesis, mTORC1 signalling, REDD1/2 expression and molecular markers related...... to muscle proteolysis (MURF1, MAFBX, AMPKα, LC3II/I, Beclin1). We found that leg lean mass and strength decreased in older but not younger adults after bedrest (P protein synthesis increased before bed rest in both age groups...... (P protein synthesis rates and increased MAFBX mRNA, p-AMPKα and the LC3II/I ratio (P

  5. Cull sow knife-separable lean content evaluation at harvest and lean mass content prediction equation development.

    Science.gov (United States)

    Abell, Caitlyn E; Stalder, Kenneth J; Hendricks, Haven B; Fitzgerald, Robert F

    2012-07-01

    The objectives of this study were to develop a prediction equation for carcass knife-separable lean within and across USDA cull sow market weight classes (MWC) and to determine carcass and individual primal cut knife separable lean content from cull sows. There were significant percent lean and fat differences in the primal cuts across USDA MWC. The two lighter USDA MWC had a greater percent carcass lean and lower percent fat compared to the two heavier MWC. In general, hot carcass weight explained the majority of carcass lean variation. Additionally, backfat was a significant variation source when predicting cull sow carcass lean. The findings support using a single lean prediction equation across MWC to assist processors when making cull sow purchasing decisions and determine the mix of animals from various USDA MWC that will meet their needs when making pork products with defined lean:fat content. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Lean mass and insulin resistance in women with polycystic ovary syndrome.

    Science.gov (United States)

    Comerford, Kevin B; Almario, Rogelio U; Kim, Kyoungmi; Karakas, Sidika E

    2012-09-01

    Insulin resistance is common in women with polycystic ovary syndrome (PCOS). Muscle is the major tissue utilizing glucose while excess adipose tissue relates to insulin resistance. Thus, body composition is likely to be an important regulator of insulin sensitivity. Thirty-nine PCOS patients (age: 29.9±1.0 years; BMI: 33.8±1.2 kg/m(2)) participated in a cross sectional study. Body composition was measured by dual energy x-ray absorptiometry (DEXA). Insulin resistance and secretion were assessed using oral glucose tolerance test (OGTT) and frequently sampled intravenous glucose tolerance test (FS-IVGTT). In contrast with the conventional expectations, lean mass correlated directly (Plean mass (52.8±1.8 vs 44.4±1.6 kg), those with higher lean mass had a higher glucose response during OGTT (AUC(Glucose); P=.034). In contrast, 17 pairs matched for lean mass (48.7±1.7 and 48.9±1.6 kg) but discordant for fat mass (43.3±2.6 vs 30.3±8.9 kg) showed no differences in insulin resistance parameters. These novel findings indicate that lean mass relates directly to insulin resistance in PCOS. Published by Elsevier Inc.

  7. Development of a bedside viable ultrasound protocol to quantify appendicular lean tissue mass.

    Science.gov (United States)

    Paris, Michael T; Lafleur, Benoit; Dubin, Joel A; Mourtzakis, Marina

    2017-10-01

    Ultrasound is a non-invasive and readily available tool that can be prospectively applied at the bedside to assess muscle mass in clinical settings. The four-site protocol, which images two anatomical sites on each quadriceps, may be a viable bedside method, but its ability to predict musculature has not been compared against whole-body reference methods. Our primary objectives were to (i) compare the four-site protocol's ability to predict appendicular lean tissue mass from dual-energy X-ray absorptiometry; (ii) optimize the predictability of the four-site protocol with additional anatomical muscle thicknesses and easily obtained covariates; and (iii) assess the ability of the optimized protocol to identify individuals with low lean tissue mass. This observational cross-sectional study recruited 96 university and community dwelling adults. Participants underwent ultrasound scans for assessment of muscle thickness and whole-body dual-energy X-ray absorptiometry scans for assessment of appendicular lean tissue. Ultrasound protocols included (i) the nine-site protocol, which images nine anterior and posterior muscle groups in supine and prone positions, and (ii) the four-site protocol, which images two anterior sites on each quadriceps muscle group in a supine position. The four-site protocol was strongly associated (R 2  = 0.72) with appendicular lean tissue mass, but Bland-Altman analysis displayed wide limits of agreement (-5.67, 5.67 kg). Incorporating the anterior upper arm muscle thickness, and covariates age and sex, alongside the four-site protocol, improved the association (R 2  = 0.91) with appendicular lean tissue and displayed narrower limits of agreement (-3.18, 3.18 kg). The optimized protocol demonstrated a strong ability to identify low lean tissue mass (area under the curve = 0.89). The four-site protocol can be improved with the addition of the anterior upper arm muscle thickness, sex, and age when predicting appendicular lean tissue mass

  8. An analysis methodology for hot leg break mass and energy release

    International Nuclear Information System (INIS)

    Song, Jin Ho; Kwon, Young Min; Kim, Taek Mo; Chung, Hae Yong; Lee, Sang Jong

    1996-07-01

    An analysis methodology for the hot leg break mass and energy release is developed. For the blowdown period a modified CEFLASH-4A analysis is suggested. For the post-blowdown period a new computer model named COMET is developed. Differently from previous post-blowdown analysis model FLOOD3, COMET is capable of analyzing both cold leg and hot leg break cases. The cold leg break model is essentially same as that of FLOOD3 with some improvements. The analysis results by the newly proposed hot leg break model in the COMET is in the same trend as those observed in scaled-down integral experiment. And the analyses results for the UCN 3 and 4 by COMET are qualitatively and quantitatively in good agreement with those predicted by best-estimate analysis by using RELAP5/MOD3. Therefore, the COMET code is validated and can be used for the licensing analysis. 6 tabs., 82 figs., 9 refs. (Author)

  9. Total and Lower Extremity Lean Mass Percentage Positively Correlates With Jump Performance.

    Science.gov (United States)

    Stephenson, Mitchell L; Smith, Derek T; Heinbaugh, Erika M; Moynes, Rebecca C; Rockey, Shawn S; Thomas, Joi J; Dai, Boyi

    2015-08-01

    Strength and power have been identified as valuable components in both athletic performance and daily function. A major component of strength and power is the muscle mass, which can be assessed with dual-energy x-ray absorptiometry (DXA). The primary purpose of this study was to quantify the relationship between total body lean mass percentage (TBLM%) and lower extremity lean mass percentage (LELM%) and lower extremity force/power production during a countermovement jump (CMJ) in a general population. Researchers performed a DXA analysis on 40 younger participants aged 18-35 years, 28 middle-aged participants aged 36-55 years, and 34 older participants aged 56-75 years. Participants performed 3 CMJ on force platforms. Correlations revealed significant and strong relationships between TBLM% and LELM% compared with CMJ normalized peak vertical ground reaction force (p lean mass percentages. The findings have implications in including DXA-assessed lean mass percentage as a component for evaluating lower extremity strength and power. A paired DXA analysis and CMJ jump test may be useful for identifying neuromuscular deficits that limit performance.

  10. Assessment of nutritional status in adult patients with cystic fibrosis: whole-body bioimpedance vs body mass index, skinfolds, and leg-to-leg bioimpedance

    NARCIS (Netherlands)

    Hollander, F.M.; Roos, de N.M.; Vries, de J.H.M.; Berkhout, van F.T.

    2005-01-01

    Objective: To investigate whether body mass index (BMI) or body fat percentage estimated from BMI, skinfolds, or leg-to-leg bioimpedance are good indicators of nutritional status in adult patients with cystic fibrosis. Body fat percentage measured by whole-body bioimpedance was used as the reference

  11. Weight-adjusted lean body mass and calf circumference are protective against obesity-associated insulin resistance and metabolic abnormalities

    Directory of Open Access Journals (Sweden)

    Toshinari Takamura

    2017-07-01

    Interpretation: Weight-adjusted lean body mass and skeletal muscle area are protective against weight-associated insulin resistance and metabolic abnormalities. The calf circumference reflects lean body mass and may be useful as a protective marker against obesity-associated metabolic abnormalities.

  12. Relation between lean body mass and thyroid volume in competition rowers before and during intensive physical training

    NARCIS (Netherlands)

    Wesche, M. F.; Wiersinga, W. M.

    2001-01-01

    Lean body mass is a better determinant of thyroid size than body weight as demonstrated in a previous crosssectional study. We now evaluated if intra-individual changes in body composition and especially changes in lean body mass, due to physical training, could give rise to changes in thyroid

  13. Limb/trunk lean mass ratio as a risk factor for mortality in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Seok Hui Kang

    2012-06-01

    Full Text Available Protein energy wasting (PEW is a common problem in dialysis patients. There have been few reports on the effects of regional lean mass distribution for peritoneal dialysis (PD patients. We reviewed the medical records and identified all adults who received PD between May 2001 and May 2011. Five hundred thirty four patients were enrolled. The clinical and laboratory data were collected at 1 and 12 months. Regional lean masses were measured by dual-energy X-ray absorptiometry. The limb/trunk lean mass ratio (LTLM was defined as a value on dividing the sum of four limbs by the trunk lean mass. The mean age at the start of PD was 53.2±14.1 years. Diabetes mellitus (DM was most common underlying disease of end-stage renal disease (49.6%. In males, the low LTLM tertile was associated with low body mass index, creatinine, arm muscle circumference, and high C-reactive protein. In females, the low LTLM tertile was associated with low creatinine and normalized protein equivalent of nitrogen appearance. On both univariate and multivariate analysis adjusted for age, Davies risk index, and residual renal function, initial low LTLM tertile and maintenance of low LTLM were associated with mortality in PD patients. Distribution or change of regional lean mass may be more useful for predicting nutritional status. Initial low LTLM and maintenance of low LTLM were associated with mortality in PD patients. LTLM as a new marker would be useful for predicting the nutritional status and the mortality in patients on PD.

  14. A multicenter study of the influence of fat and lean mass on bone mineral content

    DEFF Research Database (Denmark)

    Hla, M M; Davis, J W; Ross, P D

    1996-01-01

    We examined the relative influence of fat and lean mass on bone mineral content (BMC) among 1600 early postmenopausal women aged 45-59 y from four geographical locations (Nottingham, United Kingdom; Portland, OR; Honolulu; and Copenhagen). Bone sites investigated included the major fracture sites...

  15. Anthropometry profiles of elite rugby players: quantifying changes in lean mass.

    Science.gov (United States)

    Duthie, G M; Pyne, D B; Hopkins, W G; Livingstone, S; Hooper, S L

    2006-03-01

    To demonstrate the utility of a practical measure of lean mass for monitoring changes in the body composition of athletes. Between 1999 and 2003 body mass and sum of seven skinfolds were recorded for 40 forwards and 32 backs from one Super 12 rugby union franchise. Players were assessed on 13 (7) occasions (mean (SD)) over 1.9 (1.3) years. Mixed modelling of log transformed variables provided a lean mass index (LMI) of the form mass/skinfolds(x), for monitoring changes in mass controlled for changes in skinfold thickness. Mean effects of phase of season and time in programme were modelled as percentage changes. Effects were standardised for interpretation of magnitudes. The exponent x was 0.13 for forwards and 0.14 for backs (90% confidence limits +/-0.03). The forwards had a small decrease in skinfolds (5.3%, 90% confidence limits +/-2.2%) between preseason and competition phases, and a small increase (7.8%, 90% confidence limits +/-3.1%) during the club season. A small decrease in LMI (approximately 1.5%) occurred after one year in the programme for forwards and backs, whereas increases in skinfolds for forwards became substantial (4.3%, 90% confidence limits +/-2.2%) after three years. Individual variation in body composition was small within a season (within subject SD: body mass, 1.6%; skinfolds, 6.8%; LMI, 1.1%) and somewhat greater for body mass (2.1%) and LMI (1.7%) between seasons. Despite a lack of substantial mean changes, there was substantial individual variation in lean mass within and between seasons. An index of lean mass based on body mass and skinfolds is a potentially useful tool for assessing body composition of athletes.

  16. Serum betaine is inversely associated with low lean mass mainly in men in a Chinese middle-aged and elderly community-dwelling population.

    Science.gov (United States)

    Huang, Bi-Xia; Zhu, Ying-Ying; Tan, Xu-Ying; Lan, Qiu-Ye; Li, Chun-Lei; Chen, Yu-Ming; Zhu, Hui-Lian

    2016-06-01

    Previous studies have demonstrated that betaine supplements increase lean body mass in livestock and improve muscle performance in human beings, but evidence for its effect on human lean mass is limited. Our study assessed the association of circulating betaine with lean mass and its composition in Chinese adults. A community-based study was conducted on 1996 Guangzhou residents (weight/mass: 1381/615) aged 50-75 years between 2008 and 2010. An interviewer-administered questionnaire was used to collect general baseline information. Fasting serum betaine was assessed using HPLC-MS. A total of 1590 participants completed the body composition analysis performed using dual-energy X-ray absorptiometry during a mean of 3·2 years of follow-up. After adjustment for age, regression analyses demonstrated a positive association of serum betaine with percentage of lean mass (LM%) of the entire body, trunk and limbs in men (all Pwomen (P=0·016). Each sd increase in serum betaine was associated with increases in LM% of 0·609 (whole body), 0·811 (trunk), 0·422 (limbs), 0·632 (arms) and 0·346 (legs) in men and 0·350 (trunk) in women. Multiple logistic regression analysis revealed that the prevalence of lower LM% decreased by 17 % (whole body) and 14 % (trunk) in women and 23 % (whole body), 28 % (trunk), 22 % (arms) and 26 % (percentage skeletal muscle index) in men with each sd increment in serum betaine. Elevated circulating betaine was associated with a higher LM% and lower prevalence of lower LM% in middle-aged and elderly Chinese adults, particularly men.

  17. Exercise Preserves Lean Mass and Performance during Severe Energy Deficit: The Role of Exercise Volume and Dietary Protein Content

    Directory of Open Access Journals (Sweden)

    Jose A. L. Calbet

    2017-07-01

    Full Text Available The loss of fat-free mass (FFM caused by very-low-calorie diets (VLCD can be attenuated by exercise. The aim of this study was to determine the role played by exercise and dietary protein content in preserving the lean mass and performance of exercised and non-exercised muscles, during a short period of extreme energy deficit (~23 MJ deficit/day. Fifteen overweight men underwent three consecutive experimental phases: baseline assessment (PRE, followed by 4 days of caloric restriction and exercise (CRE and then 3 days on a control diet combined with reduced exercise (CD. During CRE, the participants ingested a VLCD and performed 45 min of one-arm cranking followed by 8 h walking each day. The VLCD consisted of 0.8 g/kg body weight/day of either whey protein (PRO, n = 8 or sucrose (SU, n = 7. FFM was reduced after CRE (P < 0.001, with the legs and the exercised arm losing proportionally less FFM than the control arm [57% (P < 0.05 and 29% (P = 0.05, respectively]. Performance during leg pedaling, as reflected by the peak oxygen uptake and power output (Wpeak, was reduced after CRE by 15 and 12%, respectively (P < 0.05, and recovered only partially after CD. The deterioration of cycling performance was more pronounced in the whey protein than sucrose group (P < 0.05. Wpeak during arm cranking was unchanged in the control arm, but improved in the contralateral arm by arm cranking. There was a linear relationship between the reduction in whole-body FFM between PRE and CRE and the changes in the cortisol/free testosterone ratio (C/FT, serum isoleucine, leucine, tryptophan, valine, BCAA, and EAA (r = −0.54 to −0.71, respectively, P < 0.05. C/FT tended to be higher in the PRO than the SU group following CRE (P = 0.06. In conclusion, concomitant low-intensity exercise such as walking or arm cranking even during an extreme energy deficit results in remarkable preservation of lean mass. The intake of proteins alone may be associated with greater

  18. [Effect of anticancer treatment on leptin level, fat body mass (FM) and lean body mass (LBM)].

    Science.gov (United States)

    Krawczyk-Rybak, Maryna; Muszyńska-Rosłan, Katarzyna; Konstantynowicz, Jerzy; Solarz, Elzbieta; Wołczynski, Sławomir; Protas, Piotr

    2004-01-01

    Leptin plays an important role in the metabolism of adipose tissue. Considering that malignancy and its treatment cans affect normal development in childhood. We analysed the correlations between serum leptin levels and body composition after anticancer treatment. We studied 33 survivors (24 boys and 9 girls) who before our study, have been treated for acute lymphoblastic leukaemia (ALL) (n=23) and Hodgkin disease (n=10) after 7.15+/-3.5 years. Sixteen patients with ALL received cranial irradiation (12Gy). We measured body mass index (BM1) fat mass (FM) and lean body mass (LBM) using dual energy x-ray absorptiometry (DXA). We compared these results to the results obtained from reference values (SD score). Leptin levels were measured with the RIA method. 1. Mean leptin levels were higher in girls after puberty (10.93 ng/mL+/-8.9) than in boys (3.73 ng/mL+/-3. 7). In boys no differences were found in leptin levels between T2-4 and T5 stages. In girls the leptin values increased after puberty. Leptin SD score levels were higher in boys during (1.55 +/-1.0) and after puberty (1.46+/-0.75) and in girls - after puberty (1.19 +/-1.51). We did not find any influence of cranial irradiation (12Gy) or various methotrexate doses (5 g/m(2) vs. 19/m(2)) leptin values. 2. No difference in BMI SD score was found within the whole study group. 3. FM did not change ill boys during and after puberty, although FM SD score were higher during puberty (2.98 +/-4.8). In girls FM and FM SD score were higher after puberty. In boys and girls LBM augmented with pubertal development but LBM SD score in boys were lower after puberty (-1.67 +/-1.7) in comparison to puberty (0.2 +/-1.7). No differences were found between LBM SD score in girls during and after puberty. 4. We found a correlation between leptin levels and BMI (r=0.59 p=0.001) and FM (r=0.77 p=0.0001). 5. Relation of FM to LBM in boys remained unchanged, however in girls it increased within pubertal development. l. Anticancer

  19. Weight-adjusted lean body mass and calf circumference are protective against obesity-associated insulin resistance and metabolic abnormalities.

    Science.gov (United States)

    Takamura, Toshinari; Kita, Yuki; Nakagen, Masatoshi; Sakurai, Masaru; Isobe, Yuki; Takeshita, Yumie; Kawai, Kohzo; Urabe, Takeshi; Kaneko, Shuichi

    2017-07-01

    To test the hypothesis that preserved muscle mass is protective against obesity-associated insulin resistance and metabolic abnormalities, we analyzed the relationship of lean body mass and computed tomography-assessed sectional areas of specific skeletal muscles with insulin resistance and metabolic abnormalities in a healthy cohort. A total of 195 subjects without diabetes who had completed a medical examination were included in this study. Various anthropometric indices such as circumferences of the arm, waist, hip, thigh, and calf were measured. Body composition (fat and lean body mass) was determined by bioelectrical impedance analysis. Sectional areas of specific skeletal muscles (iliopsoas, erector spinae, gluteus, femoris, and rectus abdominis muscles) were measured using computed tomography. Fat and lean body mass were significantly correlated with metabolic abnormalities and insulin resistance indices. When adjusted by weight, relationships of fat and lean body mass with metabolic parameters were mirror images of each other. The weight-adjusted lean body mass negatively correlated with systolic and diastolic blood pressures; fasting plasma glucose, HbA1c, alanine aminotransferase, and triglyceride, and insulin levels; and hepatic insulin resistance indices, and positively correlated with HDL-cholesterol levels and muscle insulin sensitivity indices. Compared with weight-adjusted lean body mass, weight-adjusted sectional areas of specific skeletal muscles showed similar, but not as strong, correlations with metabolic parameters. Among anthropometric measures, the calf circumference best reflected lean body mass, and weight-adjusted calf circumference negatively correlated with metabolic abnormalities and insulin resistance indices. Weight-adjusted lean body mass and skeletal muscle area are protective against weight-associated insulin resistance and metabolic abnormalities. The calf circumference reflects lean body mass and may be useful as a protective

  20. Influence of lean and fat mass on bone mineral density (BMD) in postmenopausal women with osteoporosis.

    Science.gov (United States)

    Dytfeld, Joanna; Ignaszak-Szczepaniak, Magdalena; Gowin, Ewelina; Michalak, Michał; Horst-Sikorska, Wanda

    2011-01-01

    Despite known positive association between body mass and bone mineral density (BMD), relative contribution of fat and lean tissue to BMD remains under debate. We aimed at investigating the effect of selected anthropometric parameters, including fat content and lean body mass (LBM) on BMD in postmenopausal, osteoporotic women with body mass index (BMI) > 20 kg/m(2). The study involved 92 never-treated women (mean age 69.5 ± 7.3). L1-L4 and femoral neck (FN) BMD were measured by dual energy X-ray absorptiometry (DEXA). Absolute (kg) and relative (%) fat and LBM were assessed by means of electric bioimpedance method. We showed both FN and L1-L4 BMD were positively correlated with body mass, waist circumference (WC), hip circumference (HC) and LBM (kg). Fat content correlated with FN BMD (r = 0.36, p obese. Obese women displayed the highest BMD. Both L1-L4 and FN BMD were higher in women with WC > 80 cm. In postmenopausal osteoporotic women with BMI > 20 kg/m(2) both fat and lean tissue might contribute to BMD. Positive association between body mass and BMD does not make obesity and osteoporosis mutually exclusive. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  1. Development of analysis methodology for hot leg break mass and energy release

    International Nuclear Information System (INIS)

    Song, Jin Ho; Kim, Cheol Woo; Kwon, Young Min; Kim, Sook Kwan

    1995-04-01

    A study for the development of an analysis methodology for hot leg break mass and energy release is performed. For the blowdown period a modified CEFLASH-4A methodology is suggested. For the post blowdown period a modified CONTRAST boil-off model is suggested. By using these computer code improved mass and energy release data are generated. Also, a RELAP5/MOD3 analysis for finally the FLOOD-3 computer code has been modified for use in the analysis of hot leg break. The results of analysis using modified FLOOD-3 are reasonable as we expected and their trends are good. 66 figs., 8 tabs. (Author) .new

  2. Leg blood pressure measured in orthostatic posture is associated with left ventricular mass in normotensive subjects.

    Science.gov (United States)

    Gemignani, Tiago; Matos-Souza, José R; Franchini, Kleber G; Nadruz, Wilson

    2012-10-01

    Changing from a supine to an orthostatic posture is associated with substantial increments in leg blood pressure (BP) levels, which could ultimately influence the hemodynamic burden imposed on the heart. This study investigated the relationship between brachial and leg BP measurements and the left cardiac chamber's structure and assessed the role of body posture changes in this regard. One hundred and thirty normotensive, nondiabetic, nonsmoking, normolipemic subjects were evaluated by a clinical history, anthropometry, the analysis of metabolic parameters, echocardiography, and the measurement of BP in the arm and the calf in both supine and orthostatic positions. Significant correlation coefficients between the leg BP measurements and the cardiac structure were detected, especially between the orthostatic pulse pressure (PP) and the left ventricular (LV) wall thickness (r = 0.38; P < 0.001), the orthostatic PP and the LV mass (r = 0.37; P < 0.001), and the orthostatic systolic BP (SBP) and the left atrial size (r = 0.35; P < 0.001). Stepwise and standard regression analysis adjusted for brachial BP and anthropometric and metabolic variables confirmed that the leg orthostatic PP was independently related to the LV wall thickness and mass. Moreover, the leg orthostatic SBP was associated with the left atrial dimension even after adding the LV mass to the statistical models. Finally, triglyceride levels and body surface area showed significant relationship with leg orthostatic PP and SBP, whereas brachial orthostatic PP and SBP were only associated with age and anthropometric variables. Orthostatic leg BP is independently associated with the cardiac structure in normotensive subjects.

  3. Lean mass predicts conditioned pain modulation in adolescents across weight status.

    Science.gov (United States)

    Stolzman, S; Hoeger Bement, M

    2016-07-01

    There is a wide continuum of conditioned pain modulation (CPM) in adults with older adults experiencing an attenuated CPM response compared with younger adults. Less is known for adolescents and the role of anthropometrics. Fifty-six adolescents (15.1 ± 1.8 years; 32 normal weight and 24 overweight/obese; 27 boys) completed in a CPM session that included anthropometric testing. Pressure pain thresholds were measured at the nailbed and deltoid muscle (test stimuli) with the foot submerged in a cool or ice water bath (conditioning stimulus). Weight status, body composition (Dual-energy X-ray absorptiometry scan), physical activity levels and clinical pain were also evaluated. The CPM response in adolescents was similar across sites (nailbed vs. deltoid), weight status (normal vs. overweight/obese) and sex. CPM measured at the deltoid muscle was positively associated with left arm lean mass but not fat mass; lean mass of the arm uniquely predicted 10% of the CPM magnitude. CPM measured at the nailbed was positively correlated with physical activity levels. These results suggest that lean mass and physical activity levels may contribute to endogenous pain inhibition in adolescents across weight status. © 2016 European Pain Federation - EFIC®

  4. Scaling of avian bipedal locomotion reveals independent effects of body mass and leg posture on gait.

    Science.gov (United States)

    Daley, Monica A; Birn-Jeffery, Aleksandra

    2018-05-22

    Birds provide an interesting opportunity to study the relationships between body size, limb morphology and bipedal locomotor function. Birds are ecologically diverse and span a large range of body size and limb proportions, yet all use their hindlimbs for bipedal terrestrial locomotion, for at least some part of their life history. Here, we review the scaling of avian striding bipedal gaits to explore how body mass and leg morphology influence walking and running. We collate literature data from 21 species, spanning a 2500× range in body mass from painted quail to ostriches. Using dynamic similarity theory to interpret scaling trends, we find evidence for independent effects of body mass, leg length and leg posture on gait. We find no evidence for scaling of duty factor with body size, suggesting that vertical forces scale with dynamic similarity. However, at dynamically similar speeds, large birds use relatively shorter stride lengths and higher stride frequencies compared with small birds. We also find that birds with long legs for their mass, such as the white stork and red-legged seriema, use longer strides and lower swing frequencies, consistent with the influence of high limb inertia on gait. We discuss the observed scaling of avian bipedal gait in relation to mechanical demands for force, work and power relative to muscle actuator capacity, muscle activation costs related to leg cycling frequency, and considerations of stability and agility. Many opportunities remain for future work to investigate how morphology influences gait dynamics among birds specialized for different habitats and locomotor behaviors. © 2018. Published by The Company of Biologists Ltd.

  5. Body size and lean mass of brown bears across and within four diverse ecosystems

    Science.gov (United States)

    Hilderbrand, Grant V.; Gustine, David; Mangipane, Buck A.; Joly, Kyle; Leacock, William; Mangipane, Lindsey S.; Erlenbach, Joy; Sorum, Mathew; Cameron, Matthew; Belant, Jerrold L.; Cambier, Troy

    2018-01-01

    Variation in body size across populations of brown bears (Ursus arctos) is largely a function of the availability and quality of nutritional resources while plasticity within populations reflects utilized niche width with implications for population resiliency. We assessed skull size, body length, and lean mass of adult female and male brown bears in four Alaskan study areas that differed in climate, primary food resources, population density, and harvest regime. Full body-frame size, as evidenced by asymptotic skull size and body length, was achieved by 8 to 14 years of age across populations and sexes. Lean body mass of both sexes continued to increase throughout their life. Differences between populations existed for all morphological measures in both sexes, bears in ecosystems with abundant salmon were generally larger. Within all populations, broad variation was seen in body size measures of adults with females displaying roughly a 2-fold difference in lean mass and males showing a 3- to 4-fold difference. The high level of intraspecific variation seen across and within populations suggests the presence of multiple life-history strategies and niche variation relative to resource partitioning, risk tolerance or aversion, and competition. Further, this level of variation indicates broad potential to adapt to changes within a given ecosystem and across the species’ range.

  6. Whole-body electromyostimulation as a means to impact muscle mass and abdominal body fat in lean, sedentary, older female adults: subanalysis of the TEST-III trial

    Directory of Open Access Journals (Sweden)

    Kemmler W

    2013-10-01

    Full Text Available Wolfgang Kemmler, Simon von StengelInstitute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, GermanyBackground: The primary aim of this study was to determine the effect of 12 months of whole-body electromyostimulation (WB-EMS exercise on appendicular muscle mass and abdominal fat mass in subjects specifically at risk for sarcopenia and abdominal obesity, but unable or unwilling to exercise conventionally.Methods: Forty-six lean, nonsportive (<60 minutes of exercise per week, elderly women (aged 75 ± 4 years with abdominal obesity according to International Diabetes Federation criteria were randomly assigned to either a WB-EMS group (n=23 which performed 18 minutes of intermittent, bipolar WB-EMS (85 Hz three sessions in 14 days or an "active" control group (n=23. Whole-body and regional body composition was assessed by dual energy X-ray absorptiometry to determine appendicular muscle mass, upper leg muscle mass, abdominal fat mass, and upper leg fat mass. Maximum strength of the leg extensors was determined isometrically by force plates.Results: After 12 months, significant intergroup differences were detected for the primary endpoints of appendicular muscle mass (0.5% ± 2.0% for the WB-EMS group versus −0.8% ± 2.0% for the control group, P=0.025 and abdominal fat mass (−1.2% ± 5.9% for the WB-EMS group versus 2.4% ± 5.8% for the control group, P=0.038. Further, upper leg lean muscle mass changed favorably in the WB-EMS group (0.5% ± 2.5% versus −0.9% ± 1.9%, in the control group, P=0.033, while effects for upper leg fat mass were borderline nonsignificant (−0.8% ± 3.5% for the WB-EMS group versus 1.0% ± 2.6% for the control group, P=0.050. With respect to functional parameters, the effects for leg extensor strength were again significant, with more favorable changes in the WB-EMS group (9.1% ± 11.2% versus 1.0% ± 8.1% in the control group, P=0.010.Conclusion: In summary, WB-EMS showed positive effects on the

  7. Efficacy of phosphatidic acid ingestion on lean body mass, muscle thickness and strength gains in resistance-trained men

    Directory of Open Access Journals (Sweden)

    Hoffman Jay R

    2012-10-01

    Full Text Available Abstract Background Phosphatidic acid (PA has been reported to activate the mammalian target of rapamycin (mTOR signaling pathway and is thought to enhance the anabolic effects of resistance training. The purpose of this pilot study was to examine if oral phosphatidic acid administration can enhance strength, muscle thickness and lean tissue accruement during an 8-week resistance training program. Methods Sixteen resistance-trained men were randomly assigned to a group that either consumed 750 mg of PA (n = 7, 23.1 ± 4.4 y; 176.7 ± 6.7 cm; 86.5 ± 21.2 kg or a placebo (PL, n = 9, 22.5 ± 2.0 y; 179.8 ± 5.4 cm; 89.4 ± 13.6 kg group. During each testing session subjects were assessed for strength (one repetition maximum [1-RM] bench press and squat and body composition. Muscle thickness and pennation angle were also measured in the vastus lateralis of the subject’s dominant leg. Results Subjects ingesting PA demonstrated a 12.7% increase in squat strength and a 2.6% increase in LBM, while subjects consuming PL showed a 9.3% improvement in squat strength and a 0.1% change in LBM. Although parametric analysis was unable to demonstrate significant differences, magnitude based inferences indicated that the Δ change in 1-RM squat showed a likely benefit from PA on increasing lower body strength and a very likely benefit for increasing lean body mass (LBM. Conclusions Results of this study suggest that a combination of a daily 750 mg PA ingestion, combined with a 4-day per week resistance training program for 8-weeks appears to have a likely benefit on strength improvement, and a very likely benefit on lean tissue accruement in young, resistance trained individuals.

  8. The role of pyridoxine as a countermeasure for in-flight loss of lean body mass

    Science.gov (United States)

    Gilbert, Joyce A.

    1992-01-01

    Ground based and in flight research has shown that humans, under conditions of microgravity, sustain a loss of lean body tissue (protein) and changes in several biological processes including, reductions in red blood cell mass, and neurotransmitters. The maintenance of muscle mass, the major component of lean body mass, is required to meet the needs of space station EVAs. Central to the biosynthesis of amino acids, the building blocks of protein, is pyridoxine (vitamin B-6). Muscle mass integrity requires the availability of vitamin B-6 for protein metabolism and neurotransmitter synthesis. Furthermore, the formation of red blood cells require pyridoxine as a cofactor in the biosynthesis of hemoglobin, a protein that carries oxygen to tissues. In its active form, pyridoxal-5'-phosphate (PLP), vitamin B-6 serves as a link between amino acid and carbohydrate metabolism through intermediates of glycolysis and the tricarboxylic acid cycle. In addition to its role in energy metabolism, PLP is involved in the biosynthesis of hemoglobin and neurotransmitter which are necessary for neurological functions. Alterations in pyridoxine metabolism may affect countermeasures designed to overcome some of these biochemical changes. The focus of this research is to determine the effects of microgravity on the metabolic utilization of vitamin B-6, integrating nutrition as an integral component of the countermeasure (exercise) to maintain lean body mass and muscle strength. The objectives are: 1) to determine whether microgravity effects the metabolic utilization of pyridoxine and 2) to quantitate changes in B-6 vitamer distribution in tissue and excreta relative to loss of lean body tissue. The rationale for this study encompasses the unique challenge to control biochemical mechanisms effected during space travel and the significance of pyridoxine to maintain and counter muscle integrity for EVA activities. This experiment will begin to elucidate the importance of biochemical

  9. Leg blood flow is impaired during small muscle mass exercise in patients with COPD

    DEFF Research Database (Denmark)

    Iepsen, Ulrik Winning; Munch, Gregers Druedal Wibe; Rugbjerg, Mette

    2017-01-01

    to both endothelium-independent (SNP) and endothelium-dependent (ACh) stimulation. The results suggests that leg muscle blood flow is impaired during small muscle mass exercise in patients with COPD possibly due to impaired formation of prostacyclin and increased levels of endothelin-1.......Skeletal muscle blood flow is regulated to match the oxygen demand and dysregulation could contribute to exercise intolerance in patients with COPD. We measured leg hemodynamics and metabolites from vasoactive compounds in muscle interstitial fluid and plasma at rest, during one-legged knee...... the formation of interstitial prostacyclin (vasodilator) was only increased in the controls. There was no difference between groups in the nitrite/nitrate levels (vasodilator) in plasma or interstitial fluid during exercise. Moreover, patients and controls showed similar vasodilatory capacity in response...

  10. Protein-enriched diet, with the use of lean red meat, combined with progressive resistance training enhances lean tissue mass and muscle strength and reduces circulating IL-6 concentrations in elderly women: a cluster randomized controlled trial.

    Science.gov (United States)

    Daly, Robin M; O'Connell, Stella L; Mundell, Niamh L; Grimes, Carley A; Dunstan, David W; Nowson, Caryl A

    2014-04-01

    Physical inactivity, inadequate dietary protein, and low-grade systemic inflammation contribute to age-related muscle loss, impaired function, and disability. We assessed the effects of progressive resistance training (PRT) combined with a protein-enriched diet facilitated through lean red meat on lean tissue mass (LTM), muscle size, strength and function, circulating inflammatory markers, blood pressure, and lipids in elderly women. In a 4-mo cluster randomized controlled trial, 100 women aged 60-90 y who were residing in 15 retirement villages were allocated to receive PRT with lean red meat (∼160 g cooked) to be consumed 6 d/wk [resistance training plus lean red meat (RT+Meat) group; n = 53] or control PRT [1 serving pasta or rice/d; control resistance training (CRT) group; n = 47)]. All women undertook PRT 2 times/wk and received 1000 IU vitamin D3/d. The mean (± SD) protein intake was greater in the RT+Meat group than in the CRT group throughout the study (1.3 ± 0.3 compared with 1.1 ± 0.3 g · kg⁻¹ · d⁻¹, respectively; P < 0.05). The RT+Meat group experienced greater gains in total body LTM (0.45 kg; 95% CI: 0.07, 0.84 kg), leg LTM (0.22 kg; 95% CI: 0.02, 0.42 kg), and muscle strength (18%; 95% CI: 0.03, 0.34) than did the CRT group (all P < 0.05). The RT+Meat group also experienced a 10% greater increase in serum insulin-like growth factor I (P < 0.05) and a 16% greater reduction in the proinflammatory marker interleukin-6 (IL-6) (P < 0.05) after 4 mo. There were no between-group differences for the change in blood lipids or blood pressure. A protein-enriched diet equivalent to ∼1.3 g · kg⁻¹ · d⁻¹ achieved through lean red meat is safe and effective for enhancing the effects of PRT on LTM and muscle strength and reducing circulating IL-6 concentrations in elderly women. This trial was registered at the Australian Clinical Trials Registry as ACTRN12609000223235.

  11. Lean body mass, interleukin 18, and metabolic syndrome in apparently healthy Chinese.

    Directory of Open Access Journals (Sweden)

    Liang Sun

    Full Text Available OBJECTIVE: We aimed to investigate how lean body mass is related to circulating Interleukin 18 (IL-18 and its association with metabolic syndrome (MetS among apparently healthy Chinese. METHODS: A population-based sample of 1059 Chinese men and women aged 35-54 years was used to measure plasma IL-18, glucose, insulin, lipid profile, inflammatory markers and high-molecular-weight (HMW-adiponectin. Fat mass index (FMI and lean mass index (LMI were measured by dual-energy X-ray absorptiometry. MetS was defined by the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian-Americans. RESULTS: Circulating IL-18 was positively correlated with LMI after adjustment for FMI (correlation coefficient = 0.11, P<0.001. The association with the MetS (odds ratio 3.43, 95% confidence interval 2.01-5.85 was substantially higher in the highest than the lowest quartile of IL-18 after multiple adjustments including body mass index. In the stratified multivariable regression analyses, the positive association between IL-18 and MetS was independent of tertiles of FMI, inflammatory markers and HMW-adiponectin, but significantly interacted with tertile of LMI (P for interaction = 0.010. CONCLUSION: Elevated plasma IL-18 was associated with higher MetS prevalence in apparently healthy Chinese, independent of traditional risk factors, FMI, inflammatory markers and HMW-adiponectin. More studies are needed to clarify the role of lean mass in IL-18 secretion and its associated cardio-metabolic disorders.

  12. Standardized uptake value of FDG corrected by lean body mass measured by DEXA

    International Nuclear Information System (INIS)

    Guirao, M.A.; Sanchez, A.M.; Saravi, F.D.; Mosconi, S.; Frias, L.

    2002-01-01

    Evaluating the metabolic activity of tumor lesion sometimes becomes important to evaluate grading of malignancy, prognosis, or response to therapy. The most used measure of the metabolic activity of [18F]-Fluorodeoxiglucose (FDG) in clinical PET is the Standardized Uptake Value (SUV). It relates the activity measured by the PET scan to the injected dose of FDG divided by the body mass. This approach overestimates SUV in 'heavy' patients, as the proportion of the 'low avid of FDG' fat mass increases. For this reason, different approaches are being evaluated to obtain a more accurate SUV measure. Aims: to compare the measured lean body mass by Dual X-Ray Absorptiometry with the previous methods of correction, to assess the more independent to the body constitution. Material and Methods: FDG metabolism was studied to 15 patients of both sexes, age between 28 and 72 y.o., body weight 55 to 92 Kg. One hour after the IV injection of 0.0045mCi/Kg of FDG, a whole body emission and transmission scan was performed to each subject in a positron emission tomograph (QUEST 250, GE-UGM, USA) for over 1 hour. Body lean mass composition was measured the same or next day by DEXA (Lunar DPX-L, USA.) ROIs were drawn on brain, liver and muscle. SUVbw =[(corrected mCi/g of tissue) / (mCi injected / body weight in grams)] was calculated for each tissue, and then recalculated replacing body weight with the measured lean body mass (SUVlm), calculated lean mass (SUVlc), body mass index (SUVmi) and body surface area (SUVsa). Corrected SUVs were normalized to each SUVbw average for a comparable visualization of results. Results: obtained data was analyzed by linear regression and curve estimation for each case in all tissues with the SPSS statistical software. A positive correlation between SUVbw and subject weight was confirmed for the 3 tissues. In Muscle and liver there was no significant correlation. The liver scanning time was variable ( 90 to 123 minutes after injection). Relating liver

  13. Relative contributions of lean and fat mass to bone strength in young Hispanic and non-Hispanic girls.

    Science.gov (United States)

    Hetherington-Rauth, Megan; Bea, Jennifer W; Blew, Robert M; Funk, Janet L; Hingle, Melanie D; Lee, Vinson R; Roe, Denise J; Wheeler, Mark D; Lohman, Timothy G; Going, Scott B

    2018-05-22

    With the high prevalence of childhood obesity, especially among Hispanic children, understanding how body weight and its components of lean and fat mass affect bone development is important, given that the amount of bone mineral accrued during childhood can determine osteoporosis risk later in life. The aim of this study was to assess the independent contributions of lean and fat mass on volumetric bone mineral density (vBMD), geometry, and strength in both weight-bearing and non-weight-bearing bones of Hispanic and non-Hispanic girls. Bone vBMD, geometry, and strength were assessed at the 20% distal femur, the 4% and 66% distal tibia, and the 66% distal radius of the non-dominant limb of 326, 9- to 12-year-old girls using peripheral quantitative computed tomography (pQCT). Total body lean and fat mass were measured by dual-energy x-ray absorptiometry (DXA). Multiple linear regression was used to assess the independent relationships of fat and lean mass with pQCT bone measures while adjusting for relevant confounders. Potential interactions between ethnicity and both fat and lean mass were also tested. Lean mass was a significant positive contributor to all bone outcomes (p Lean mass is the main determinant of bone strength for appendicular skeletal sites. Fat mass contributes to bone strength in the weight-bearing skeleton but does not add to bone strength in non-weight-bearing locations and may potentially be detrimental. Bone vBMD, geometry, and strength did not differ between Hispanic and non-Hispanic girls; fat mass may be a stronger contributor to bone strength in weight-bearing bones of Hispanic girls compared to non-Hispanic. Copyright © 2018. Published by Elsevier Inc.

  14. Collateral fattening: When a deficit in lean body mass drives overeating.

    Science.gov (United States)

    Dulloo, Abdul G

    2017-02-01

    In his last review entitled "Some Adventures in Body Composition," Gilbert Forbes reminded us that "lean body mass and body fat are in a sense companions." To what extent the lean body mass (or fat-free mass) component in this companionship impacts on energy intake is rarely a topic for discussion, amid a dominant adipocentric view of appetite control. Yet an analysis of the few human studies that have investigated the relationships between objectively measured food intake and body composition reveals a potentially important role for both an increase and a decrease in fat-free mass in the drive to eat. These studies are highlighted here, together with the implications of their findings for research directed as much toward the elucidation of peripheral signals and energy-sensing mechanisms that drive hunger and appetite, as toward understanding the mechanisms by which dieting and sedentariness predispose to fatness. © 2017 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

  15. Lean mass and fat mass predict bone mineral density in middle-aged individuals with noninsulin-requiring type 2 diabetes mellitus.

    Science.gov (United States)

    Moseley, Kendall F; Dobrosielski, Devon A; Stewart, Kerry J; De Beur, Suzanne M Jan; Sellmeyer, Deborah E

    2011-05-01

    Despite high bone mineral density (BMD), persons with type 2 diabetes are at greater risk of fracture. The relationship between body composition and BMD in noninsulin-requiring diabetes is unclear. The aim was to examine how fat and lean mass independently affect the skeleton in this population. Subjects for this cross-sectional analysis were men (n = 78) and women (n = 56) aged 40-65 years (56 ± 6 years) with uncomplicated, noninsulin-requiring type 2 diabetes. Total body fat and lean mass, total body, hip and lumbar spine BMD were measured with dual energy X-ray absorptiometry. Magnetic resonance imaging measured total abdominal, visceral and subcutaneous (SQ) fat. Subjects had normal all-site BMD and were obese to overweight (body mass index 29-41 kg/m(2)) with controlled diabetes (HbA1c women 6·6 ± 1·2%, men 6·7 ± 1·6%). Lean mass was positively associated with total body, hip, femoral neck and hip BMD in both sexes. Fat mass, abdominal total and SQ fat were associated with total body and hip BMD in women. In multivariate analyses adjusted for sex, lean mass significantly predicted total, hip and femoral neck BMD in men and women. In unadjusted models, lean mass continued to predict BMD at these sites in men; fat mass also predicted total body, femoral and hip BMD in women. In men and women with uncomplicated, noninsulin-requiring diabetes, lean mass significantly predicted BMD at the total body, hip and femoral neck. Further research is needed to determine whether acquisition or maintenance of lean mass in T2DM can prevent hip fracture in this at-risk population. © 2011 Blackwell Publishing Ltd.

  16. Association of fat to lean mass ratio with metabolic dysfunction in women with polycystic ovary syndrome.

    Science.gov (United States)

    Ezeh, Uche; Pall, Marita; Mathur, Ruchi; Azziz, Ricardo

    2014-07-01

    Are differences in metabolic dysfunction between polycystic ovary syndrome (PCOS) and control women related to differences in their fat to lean mass (F/L) ratio? Compared with controls of similar body mass index (BMI), women with PCOS demonstrate adverse body composition characterized by increased whole body fat relative to lean mass (i.e. a higher F/L ratio), which is associated with differences in metabolic dysfunction between the two groups. Previous studies examining body composition and insulin resistance (IR) in PCOS have yielded conflicting results. Excess total fat mass (i.e. fat mass index [fat BMI]) correlates with IR, whereas increased total lean mass (i.e. lean BMI) has been associated with higher insulin sensitivity. However, the role of the F/L ratio, which integrates the antagonistic effects of both fat and lean mass depots, on IR in PCOS, has not been investigated. We conducted a prospective cross-sectional study of 120 women between the ages of 22-44 years to study the relation of the F/L ratio with measures of insulin action and secretion in both steady and dynamic states. Sixty PCOS (by NIH, 1990 criteria) and 60 control (age, race and BMI-matched) women were prospectively studied for body composition (by bioelectrical impedance analysis [BIA]) and basal IR and insulin secretion by the homeostasis model assessment (HOMA-IR and HOMA-%β-cell function, respectively) in a tertiary care academic referral center. A subset of 12 PCOS and 12 matched control women also underwent a modified frequently sampled intravenous glucose tolerance test (FSIVGTT) to determine glucose uptake and insulin secretion in dynamic state. Our results indicate that women with PCOS demonstrated greater degrees of hyperandrogenism, and higher waist-to-hip ratio (WHR), %body fat, fat BMI, F/L, fasting insulin levels, and HOMA-IR and HOMA-%β-cell values, than controls. In models adjusted for WHR and free testosterone and diagnostic groups, fasting insulin levels, HOMA-IR, and

  17. Effects of Exercise Training on Fat Loss and Lean Mass Gain in Mexican-American and Korean Premenopausal Women

    Directory of Open Access Journals (Sweden)

    Shenghui Wu

    2017-01-01

    Full Text Available We investigated the effect of exercise training on body composition change in women. Nineteen Mexican-American and 18 Korean premenopausal overweight/obese women were randomized into one of the following groups: control, low-intensity training group (LI, and high-intensity training group (HI. Subjects completed 12 weeks of training at 50–56% maximal oxygen consumption (LI or 65–70% maximal oxygen consumption (HI. Body composition components were measured at baseline and after training using dual-energy X-ray absorptiometry for Mexican-Americans, while whole-body composition was measured by the direct segmental multifrequency bioelectrical impedance analysis and abdominal fat was measured by single-slice computed tomography for Koreans. Data were analyzed using mixed-model repeated measures independent of age, ethnicity, and body mass index (BMI. Exercise training showed a significant effect on BMI, fat percentage, fat mass, lean mass, and visceral adipose tissue area. HI significantly decreased fat mass and fat percentage but increased lean mass (all P<0.05. LI significantly reduced BMI, fat mass, fat percentage, and visceral adipose tissue area but increased lean mass (all P<0.05. Exercise training had a beneficial effect on reducing BMI, fat percentage, fat mass, and visceral adipose tissue area but had no effect on increasing lean mass for Mexican-American and Korean premenopausal overweight/obese women.

  18. In-vivo determination of total body water and lean body mass in subjects by deuterium dilution

    Energy Technology Data Exchange (ETDEWEB)

    Blagojevic, N; Allen, B J; Baur, L; Gaskin, K

    1988-12-01

    Total body water (TBW) estimation is one of a number of basic techniques required for the determination of body composition in normal and malnourished subjects. When combined with total body nitrogen (TBN) analysis by prompt gamma neutron activation, an accurate compartmental model of in vivo body composition can be formed, providing valuable nutritional and other data. This study examines the role of TBW on its own in evaluating lean body mass. Total body water was studied in six male and five female subjects using deuterium oxide and a Fourier transform infrared spectrometer. The lean body mass calculated from the results was compared with the lean body mass deduced from established total body nitrogen measurements. A four-compartment model was also used to calculate lean body mass. Excellent agreement was shown between lean body mass derived from TBW, the four-compartment model and TBN. Hence, TBW can provide a fast, cost-efficient method for evaluating normal subjects. However, for disease-induced malnutrition, or highly developed athletes, both TBN and TBW measurements are essential to establish an accurate picture of their body composition. TBW measurements alone can monitor the hydration state of patients and as such have a useful diagnostic value.

  19. The effect of progressive resistance training on lean body mass in post-treatment cancer patients – A systematic review

    International Nuclear Information System (INIS)

    Lønbro, Simon

    2014-01-01

    Loss of lean body mass is a common problem in many post-treatment cancer patients and may negatively affect physical capacity in terms of maximal muscle strength and functional performance. The purpose of this study was to systematically review the scientific evidence on the effect of progressive resistance training on lean body mass in post-treatment cancer patients. A comprehensive literature search was conducted and ultimately 12 studies were included. Methodological quality of the included studies was evaluated using the PEDro scale and the effect of progressive resistance training was reported as the range of mean changes among RCTs and non-RCTs. Six RCTs and six non-RCTs were included in the study. In the RCTs the change in lean body mass in the progressive resistance training groups relative to control groups ranged from −0.4% to 3.9%, and in four of six trials the training effect was significantly larger than the change in the control groups. In the six non-RCTs, the mean change in lean body mass over time ranged from −0.01 to 11.8% which was significant in two of the trials. The included studies reported no or very limited adverse events following progressive resistance training. Based on 12 heterogenic studies there is moderate evidence supporting a positive effect of progressive resistance training on lean body mass in post-treatment cancer patients

  20. In-vivo determination of total body water and lean body mass in subjects by deuterium dilution

    International Nuclear Information System (INIS)

    Blagojevic, N.; Allen, B.J.; Baur, L.; Gaskin, K.

    1988-01-01

    Total body water (TBW) estimation is one of a number of basic techniques required for the determination of body composition in normal and malnourished subjects. When combined with total body nitrogen (TBN) analysis by prompt gamma neutron activation, an accurate compartmental model of in vivo body composition can be formed, providing valuable nutritional and other data. This study examines the role of TBW on its own in evaluating lean body mass. Total body water was studied in six male and five female subjects using deuterium oxide and a Fourier transform infrared spectrometer. The lean body mass calculated from the results was compared with the lean body mass deduced from established total body nitrogen measurements. A four-compartment model was also used to calculate lean body mass. Excellent agreement was shown between lean body mass derived from TBW, the four-compartment model and TBN. Hence, TBW can provide a fast, cost-efficient method for evaluating normal subjects. However, for disease-induced malnutrition, or highly developed athletes, both TBN and TBW measurements are essential to establish an accurate picture of their body composition. TBW measurements alone can monitor the hydration state of patients and as such have a useful diagnostic value

  1. The Influence of Lower Extremity Lean Mass on Landing Biomechanics During Prolonged Exercise.

    Science.gov (United States)

    Montgomery, Melissa M; Tritsch, Amanda J; Cone, John R; Schmitz, Randy J; Henson, Robert A; Shultz, Sandra J

    2017-08-01

      The extent to which lower extremity lean mass (LELM) relative to total body mass influences one's ability to maintain safe landing biomechanics during prolonged exercise when injury incidence increases is unknown.   To examine the influence of LELM on (1) pre-exercise lower extremity biomechanics and (2) changes in biomechanics during an intermittent exercise protocol (IEP) and (3) determine whether these relationships differ by sex. We hypothesized that less LELM would predict higher-risk baseline biomechanics and greater changes toward higher-risk biomechanics during the IEP.   Cohort study.   Controlled laboratory.   A total of 59 athletes (30 men: age = 20.3 ± 2.0 years, height = 1.79 ± 0.05 m, mass = 75.2 ± 7.2 kg; 29 women: age = 20.6 ± 2.3 years, height = 1.67 ± 0.08 m, mass = 61.8 ± 9.0 kg) participated.   Before completing an individualized 90-minute IEP designed to mimic a soccer match, participants underwent dual-energy x-ray absorptiometry testing for LELM.   Three-dimensional lower extremity biomechanics were measured during drop-jump landings before the IEP and every 15 minutes thereafter. A previously reported principal components analysis reduced 40 biomechanical variables to 11 factors. Hierarchical linear modeling analysis then determined the extent to which sex and LELM predicted the baseline score and the change in each factor over time.   Lower extremity lean mass did not influence baseline biomechanics or the changes over time. Sex influenced the biomechanical factor representing knee loading at baseline (P = .04) and the changes in the anterior cruciate ligament-loading factor over time (P = .03). The LELM had an additional influence only on women who possessed less LELM (P = .03 and .02, respectively).   Lower extremity lean mass influenced knee loading during landing in women but not in men. The effect appeared to be stronger in women with less LELM. Continually decreasing knee loading over time may reflect a

  2. Association between low lean mass and low bone mineral density in 653 women with hip fracture: does the definition of low lean mass matter?

    Science.gov (United States)

    Di Monaco, Marco; Castiglioni, Carlotta; Di Monaco, Roberto; Tappero, Rosa

    2017-12-01

    Loss of both muscle and bone mass results in fragility fractures with increased risk of disability, poor quality of life, and death. Our aim was to assess the association between low appendicular lean mass (aLM) defined according to different criteria and low bone mineral density (BMD) in hip-fracture women. Six hundred fifty-three women admitted to our rehabilitation hospital underwent dual energy X-ray absorptiometry 19.1 ± 4.1 (mean ± SD) days after hip-fracture occurrence. Low aLM was identified according to either Baumgartner's definition (aLM/height 2 less than two standard deviations below the mean of the young reference group) or FNIH criteria: aLM definition, the association between low aLM/height 2 and low BMD was significant: χ 2 (1, n = 653) = 8.52 (p = 0.004), but it was erased by adjustments for age and fat mass. Using the FNIH definition the association between low aLM and low BMD was significant: χ 2 (1, n = 653) = 42.5 (p definition based on aLM/BMI ratio the association between low aLM/BMI ratio and low BMD was nonsignificant: χ 2 (1, n = 653) = 0.003 (p = 0.957). The association between low aLM and low BMD in women with hip fracture dramatically depends on the adopted definition of low aLM. FNIH threshold for aLM (<15.02 kg) emerges as a useful tool to capture women with damage of the muscle-bone unit.

  3. Development and validation of a predictive equation for lean body mass in children and adolescents.

    Science.gov (United States)

    Foster, Bethany J; Platt, Robert W; Zemel, Babette S

    2012-05-01

    Lean body mass (LBM) is not easy to measure directly in the field or clinical setting. Equations to predict LBM from simple anthropometric measures, which account for the differing contributions of fat and lean to body weight at different ages and levels of adiposity, would be useful to both human biologists and clinicians. To develop and validate equations to predict LBM in children and adolescents across the entire range of the adiposity spectrum. Dual energy X-ray absorptiometry was used to measure LBM in 836 healthy children (437 females) and linear regression was used to develop sex-specific equations to estimate LBM from height, weight, age, body mass index (BMI) for age z-score and population ancestry. Equations were validated using bootstrapping methods and in a local independent sample of 332 children and in national data collected by NHANES. The mean difference between measured and predicted LBM was - 0.12% (95% limits of agreement - 11.3% to 8.5%) for males and - 0.14% ( - 11.9% to 10.9%) for females. Equations performed equally well across the entire adiposity spectrum, as estimated by BMI z-score. Validation indicated no over-fitting. LBM was predicted within 5% of measured LBM in the validation sample. The equations estimate LBM accurately from simple anthropometric measures.

  4. Novel Equations for Estimating Lean Body Mass in Peritoneal Dialysis Patients.

    Science.gov (United States)

    Dong, Jie; Li, Yan-Jun; Xu, Rong; Yang, Zhi-Kai; Zheng, Ying-Dong

    2015-12-01

    ♦ To develop and validate equations for estimating lean body mass (LBM) in peritoneal dialysis (PD) patients. ♦ Two equations for estimating LBM, one based on mid-arm muscle circumference (MAMC) and hand grip strength (HGS), i.e., LBM-M-H, and the other based on HGS, i.e., LBM-H, were developed and validated with LBM obtained by dual-energy X-ray absorptiometry (DEXA). The developed equations were compared to LBM estimated from creatinine kinetics (LBM-CK) and anthropometry (LBM-A) in terms of bias, precision, and accuracy. The prognostic values of LBM estimated from the equations in all-cause mortality risk were assessed. ♦ The developed equations incorporated gender, height, weight, and dialysis duration. Compared to LBM-DEXA, the bias of the developed equations was lower than that of LBM-CK and LBM-A. Additionally, LBM-M-H and LBM-H had better accuracy and precision. The prognostic values of LBM in all-cause mortality risk based on LBM-M-H, LBM-H, LBM-CK, and LBM-A were similar. ♦ Lean body mass estimated by the new equations based on MAMC and HGS was correlated with LBM obtained by DEXA and may serve as practical surrogate markers of LBM in PD patients. Copyright © 2015 International Society for Peritoneal Dialysis.

  5. Limb/trunk lean mass ratio as a risk factor for mortality in peritoneal dialysis patients.

    Science.gov (United States)

    Kang, Seok Hui; Park, Jong Won; Yoon, Kyung Woo; Do, Jun Young

    2013-07-01

    This study was performed to determine the clinical relevance of limb/trunk lean mass ratio (LTLM) in continuous ambulatory peritoneal dialysis (CAPD) patients. This retrospective cohort study included 534 CAPD patients. Body compositions were measured using a dual-energy X-ray absorptiometry apparatus. In males, the sensitivity and specificity for the diagnosis of sarcopenia were 70.3% and 85.9%, respectively. Respective values in females were 62.3% and 83.8%. The initial low LTLM tertile was associated with mortality in male CAPD patients and in female CAPD patients. Among patients who maintained CAPD for a year, the maintenance of low LTLM tertile was associated with mortality. LTLM is associated with other lean mass indices, nutritional status, and mortality in CAPD patients. Therefore, LTLM is a novel marker that is useful for the prediction of the nutritional status and mortality in patients with CAPD. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  6. Analysis of Foot Slippage Effects on an Actuated Spring-Mass Model of Dynamic Legged Locomotion

    Directory of Open Access Journals (Sweden)

    Yizhar Or

    2016-04-01

    Full Text Available The classical model of spring-loaded inverted pendulum (SLIP and its extensions have been widely accepted as a simple description of dynamic legged locomotion at various scales in humans, legged robots and animals. Similar to the majority of models in the literature, the SLIP model assumes ideal sticking contact of the foot. However, there are practical scenarios of low ground friction that causes foot slippage, which can have a significant influence on dynamic behaviour. In this work, an extension of the SLIP model with two masses and torque actuation is considered, which accounts for possible slippage under Coulomb's friction law. The hybrid dynamics of this model is formulated and numerical simulations under representative parameter values reveal several types of stable periodic solutions with stick-slip transitions. Remarkably, it is found that slippage due to low friction can sometimes increase average speed and improve energetic efficiency by significantly reducing the mechanical cost of transport.

  7. The effect of progressive resistance training on lean body mass in post-treatment cancer patients - A systematic review

    DEFF Research Database (Denmark)

    Lønbro, Simon

    2014-01-01

    Loss of lean body mass is a common problem in many post-treatment cancer patients and may negatively affect physical capacity in terms of maximal muscle strength and functional performance. The purpose of this study was to systematically review the scientific evidence on the effect of progressive...... resistance training on lean body mass in post-treatment cancer patients. A comprehensive literature search was conducted and ultimately 12 studies were included. Methodological quality of the included studies was evaluated using the PEDro scale and the effect of progressive resistance training was reported...... as the range of mean changes among RCTs and non-RCTs. Six RCTs and six non-RCTs were included in the study. In the RCTs the change in lean body mass in the progressive resistance training groups relative to control groups ranged from -0.4% to 3.9%, and in four of six trials the training effect...

  8. Resistance Exercise Impacts Lean Muscle Mass in Women with Polycystic Ovary Syndrome.

    Science.gov (United States)

    Kogure, Gislaine Satyko; Miranda-Furtado, Cristiana Libardi; Silva, Rafael Costa; Melo, Anderson Sanches; Ferriani, Rui Alberto; De Sá, Marcos Felipe Silva; Dos Reis, Rosana Maria

    2016-04-01

    This study investigated the effects of progressive resistance training (PRT) on lean muscle mass (LMM) in women with or without polycystic ovary syndrome (PCOS) and its effects on metabolic factors and concentrations of related steroid hormones. This was a nonrandomized, therapeutic, open, single-arm study. All in all, 45 sedentary women with PCOS and 52 without (non-PCOS), 18-37 yr of age, with body mass indexes (BMI) of 18-39.9 kg·m(-2) of all races and social status, performed PRT three times a week for 4 months. Before and after PRT, the concentrations of hormones and metabolic factors and waist circumference were measured. LMM and total body fat percentage were determined using dual-energy x-ray absorptiometry. Clinical characteristics, LMM, and fasting glucose were adjusted for confounding covariables and compared using general linear mixed models. Each patient's menstrual history was taken before study enrollment and after PRT. PRT resulted in reduced plasma testosterone and fasting glucose levels. After PRT, the androstenedione concentration increased and the sex hormone-binding globulin concentration decreased in women with PCOS. The waist circumference was reduced (P lean mass (LM)/height2, increased in women with PCOS (P = 0.04). Women with PCOS showed increased muscle mass indexes of appendicular LM/height2 (P = 0.03) and LM/height2 (P women with PCOS (P = 0.01) at the baseline and after PRT. To our knowledge, this is the first report to show that resistance exercise alone can improve hyperandrogenism, reproductive function, and body composition by decreasing visceral fat and increasing LMM, but it has no metabolic impact on women with PCOS.

  9. The effect of boron supplementation on lean body mass, plasma testosterone levels, and strength in male bodybuilders

    Science.gov (United States)

    Ferrando, A. A.; Green, N. R.

    1993-01-01

    The effect of boron supplementation was investigated in 19 male bodybuilders ages 20-27 years. Ten were given a 2.5-mg boron supplement while 9 were given a placebo every day for 7 weeks. Plasma total and free testosterone, plasma boron, lean body mass, and strength measurements were determined on Days 1 and 49 of the study. Plasma boron values were significantly (p bodybuilding can increase total testosterone, lean body mass, and strength in lesser trained bodybuilders, and that boron supplementation had no effect on these measures.

  10. Associations of Bone Mineral Density with Lean Mass, Fat Mass, and Dietary Patterns in Postmenopausal Chinese Women: A 2-Year Prospective Study.

    Directory of Open Access Journals (Sweden)

    Yongjie Chen

    Full Text Available To assess factors associated with bone mineral density (BMD in postmenopausal women in a longitudinal study, and to examine the relative contribution of lean mass, fat mass, dietary patterns, and years since menopause to BMD.Two hundred and eighty-two postmenopausal women were randomly selected from Hongqi Community Health Center, in Harbin City, China. All participants were followed up from 2009 to 2011. Dietary data were collected using a Food Frequency Questionnaire. BMD of the left hip, the lumbar spine, and the total body, and the body composition were measured by dual-energy X-ray absorptiometry at baseline and follow-up.Lean mass and fat mass were positively associated with BMD of the spine, hip, and the total body at both baseline and follow-up. The association between fat mass and BMD at the spine at baseline (P = 0.210 and at the spine (P = 0.116 and hip (P = 0.073 in the second year was not statistically significant when height was adjusted. Six dietary patterns were identified but only cereal grains-fruits pattern (P = 0.001 in the spine, P = 0.037 in hip and milk-root vegetables pattern (P = 0.010 in hip were associated with BMD of the spine and hip. The linear mixed model of follow-up data showed that lean mass, years since menopause, and age of menophania were the significant determinants of BMD of all sites. Moreover, lean mass was the best determinant of BMD (VIP = 1.936.Lean mass, years since menopause, age of menophania and dietary patterns are the important determinants of BMD of the spine, hip, and the total body. Lean mass is the best determinant of BMD.

  11. The relationship between objectively assessed physical activity and bone health in older adults differs by sex and is mediated by lean mass.

    Science.gov (United States)

    McMillan, L B; Aitken, D; Ebeling, P; Jones, G; Scott, D

    2018-03-12

    Relationships between objectively assessed free-living physical activity (PA) and changes in bone health over time are poorly understood in older adults. This study suggests these relationships are sex-specific and that body composition may influence the mechanical loading benefits of PA. To investigate associations of objectively assessed PA and bone health in community-dwelling older adults. This secondary analysis of a subset of the Tasmanian Older Adult Cohort study included participants with PA assessed utilising ActiGraph GT1M accelerometers over 7 days (N = 209 participants, 53% female; mean ± SD age 64.5 ± 7.2 years). Steps/day and PA intensity were estimated via established thresholds. Bone mineral content (BMC) was acquired at the total hip, lumbar spine, legs and whole body by DXA at baseline and approximately 2.2 years later. Relationships between PA and BMC were assessed by multivariable linear regression analyses adjusted for age, smoking status, height and total lean mass. Men with above-median total hip BMC completed significantly less steps per day, but there was no significant difference in PA intensity compared with those with below-median BMC. There were no significant differences in PA in women stratified by median BMC. In women, steps/day were positively associated with leg BMC (B = 0.178; P = 0.017), and sedentary behaviour was negatively associated with leg BMC (- 0.165; 0.016) at baseline. After adjustment for confounders including lean mass and height, higher sedentary behaviour at baseline was associated with declines in femoral neck BMC (- 0.286; 0.011) but also with increases in pelvic BMC (0.246; 0.030) in men and increases in total hip BMC (0.215; 0.032) in women, over 2.2 years. No other significant longitudinal associations were observed after adjustment for body composition. Associations of accelerometer-determined sedentary behaviour and PA with bone health in older adults differ by sex and anatomical

  12. Comparison of SUVs normalized by lean body mass determined by CT with those normalized by lean body mass estimated by predictive equations in normal tissues

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Woo Hyoung; Kim, Chang Guhn; Kim, Dae Weung [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of)

    2012-09-15

    Standardized uptake values (SUVs)normalized by lean body mass (LBM)determined by CT were compared with those normalized by LBM estimated using predictive equations (PEs)in normal liver, spleen, and aorta using {sup 18}F FDG PET/CT. Fluorine 18 fluorodeoxyglucose (F FDG)positron emission tomography/computed tomography (PET/CT)was conducted on 453 patients. LBM determined by CT was defined in 3 ways (LBM{sup CT1}-3). Five PEs were used for comparison (LBM{sup PE1}-5). Tissue SUV normalized by LBM (SUL) was calculated using LBM from each method (SUL{sup CT1}-3, SUL{sup PE1}-5). Agreement between methods was assessed by Bland Altman analysis. Percentage difference and percentage error were also calculated. For all liver SUL{sup CTS} vs. liver SUL{sup PES} except liver SUL{sup PE3}, the range of biases, SDs of percentage difference and percentage errors were -0.17-0.24 SUL, 6.15-10.17%, and 25.07-38.91%, respectively. For liver SUL{sup CTs} vs. liver SUL{sup PE3}, the corresponding figures were 0.47-0.69 SUL, 10.90-11.25%, and 50.85-51.55%, respectively, showing the largest percentage errors and positive biases. Irrespective of magnitudes of the biases, large percentage errors of 25.07-51.55% were observed between liver SUL{sup CT1}-3 and liver SUL{sup PE1}-5. The results of spleen and aorta SUL{sup CTs} and SUL{sup PEs} comparison were almost identical to those for liver. The present study demonstrated substantial errors in individual SUL{sup PEs} compared with SUL{sup CTs} as a reference value. Normalization of SUV by LBM determined by CT rather than PEs may be a useful approach to reduce errors in individual SUL{sup PEs}.

  13. Comparison of SUVs normalized by lean body mass determined by CT with those normalized by lean body mass estimated by predictive equations in normal tissues

    International Nuclear Information System (INIS)

    Kim, Woo Hyoung; Kim, Chang Guhn; Kim, Dae Weung

    2012-01-01

    Standardized uptake values (SUVs)normalized by lean body mass (LBM)determined by CT were compared with those normalized by LBM estimated using predictive equations (PEs)in normal liver, spleen, and aorta using 18 F FDG PET/CT. Fluorine 18 fluorodeoxyglucose (F FDG)positron emission tomography/computed tomography (PET/CT)was conducted on 453 patients. LBM determined by CT was defined in 3 ways (LBM CT1 -3). Five PEs were used for comparison (LBM PE1 -5). Tissue SUV normalized by LBM (SUL) was calculated using LBM from each method (SUL CT1 -3, SUL PE1 -5). Agreement between methods was assessed by Bland Altman analysis. Percentage difference and percentage error were also calculated. For all liver SUL CTS vs. liver SUL PES except liver SUL PE3 , the range of biases, SDs of percentage difference and percentage errors were -0.17-0.24 SUL, 6.15-10.17%, and 25.07-38.91%, respectively. For liver SUL CTs vs. liver SUL PE3 , the corresponding figures were 0.47-0.69 SUL, 10.90-11.25%, and 50.85-51.55%, respectively, showing the largest percentage errors and positive biases. Irrespective of magnitudes of the biases, large percentage errors of 25.07-51.55% were observed between liver SUL CT1 -3 and liver SUL PE1 -5. The results of spleen and aorta SUL CTs and SUL PEs comparison were almost identical to those for liver. The present study demonstrated substantial errors in individual SUL PEs compared with SUL CTs as a reference value. Normalization of SUV by LBM determined by CT rather than PEs may be a useful approach to reduce errors in individual SUL PEs

  14. Ghrelin treatment causes increased food intake and retention of lean body mass in a rat model of cancer cachexia.

    Science.gov (United States)

    DeBoer, Mark D; Zhu, Xin Xia; Levasseur, Peter; Meguid, Michael M; Suzuki, Susumu; Inui, Akio; Taylor, John E; Halem, Heather A; Dong, Jesse Z; Datta, Rakesh; Culler, Michael D; Marks, Daniel L

    2007-06-01

    Cancer cachexia is a debilitating syndrome of anorexia and loss of lean body mass that accompanies many malignancies. Ghrelin is an orexigenic hormone with a short half-life that has been shown to improve food intake and weight gain in human and animal subjects with cancer cachexia. We used a rat model of cancer cachexia and administered human ghrelin and a synthetic ghrelin analog BIM-28131 via continuous infusion using sc osmotic minipumps. Tumor-implanted rats receiving human ghrelin or BIM-28131 exhibited a significant increase in food consumption and weight gain vs. saline-treated animals. We used dual-energy x-ray absorptiometry scans to show that the increased weight was due to maintenance of lean mass vs. a loss of lean mass in saline-treated animals. Also, BIM-28131 significantly limited the loss of fat mass normally observed in tumor-implanted rats. We further performed real-time PCR analysis of the hypothalami and brainstems and found that ghrelin-treated animals exhibited a significant increase in expression of orexigenic peptides agouti-related peptide and neuropeptide Y in the hypothalamus and a significant decrease in the expression of IL-1 receptor-I transcript in the hypothalamus and brainstem. We conclude that ghrelin and a synthetic ghrelin receptor agonist improve weight gain and lean body mass retention via effects involving orexigenic neuropeptides and antiinflammatory changes.

  15. Bio-inspired swing leg control for spring-mass robots running on ground with unexpected height disturbance

    International Nuclear Information System (INIS)

    Vejdani, H R; Hurst, J W; Blum, Y; Daley, M A

    2013-01-01

    We proposed three swing leg control policies for spring-mass running robots, inspired by experimental data from our recent collaborative work on ground running birds. Previous investigations suggest that animals may prioritize injury avoidance and/or efficiency as their objective function during running rather than maintaining limit-cycle stability. Therefore, in this study we targeted structural capacity (maximum leg force to avoid damage) and efficiency as the main goals for our control policies, since these objective functions are crucial to reduce motor size and structure weight. Each proposed policy controls the leg angle as a function of time during flight phase such that its objective function during the subsequent stance phase is regulated. The three objective functions that are regulated in the control policies are (i) the leg peak force, (ii) the axial impulse, and (iii) the leg actuator work. It should be noted that each control policy regulates one single objective function. Surprisingly, all three swing leg control policies result in nearly identical subsequent stance phase dynamics. This implies that the implementation of any of the proposed control policies would satisfy both goals (damage avoidance and efficiency) at once. Furthermore, all three control policies require a surprisingly simple leg angle adjustment: leg retraction with constant angular acceleration. (paper)

  16. Bio-inspired swing leg control for spring-mass robots running on ground with unexpected height disturbance.

    Science.gov (United States)

    Vejdani, H R; Blum, Y; Daley, M A; Hurst, J W

    2013-12-01

    We proposed three swing leg control policies for spring-mass running robots, inspired by experimental data from our recent collaborative work on ground running birds. Previous investigations suggest that animals may prioritize injury avoidance and/or efficiency as their objective function during running rather than maintaining limit-cycle stability. Therefore, in this study we targeted structural capacity (maximum leg force to avoid damage) and efficiency as the main goals for our control policies, since these objective functions are crucial to reduce motor size and structure weight. Each proposed policy controls the leg angle as a function of time during flight phase such that its objective function during the subsequent stance phase is regulated. The three objective functions that are regulated in the control policies are (i) the leg peak force, (ii) the axial impulse, and (iii) the leg actuator work. It should be noted that each control policy regulates one single objective function. Surprisingly, all three swing leg control policies result in nearly identical subsequent stance phase dynamics. This implies that the implementation of any of the proposed control policies would satisfy both goals (damage avoidance and efficiency) at once. Furthermore, all three control policies require a surprisingly simple leg angle adjustment: leg retraction with constant angular acceleration.

  17. Football training improves lean body mass in men with prostate cancer undergoing androgen deprivation therapy

    DEFF Research Database (Denmark)

    Uth, J; Hornstrup, Therese; Schmidt, Jakob Friis

    2014-01-01

    Androgen deprivation therapy (ADT) remains a cornerstone in the management of patients with prostate cancer (PCa) despite adverse effects on body composition and functional parameters. We compared the effects of football training with standard care in PCa patients managed with ADT (> 6 months......). Fifty-seven men aged 67 (range: 43-74) were randomly assigned to a football group (FG, n = 29) or a usual care control group (CON, n = 28). The primary outcome was change in lean body mass (LBM) assessed by dual-energy X-ray absorptiometry scanning. Secondary outcomes included changes in knee.......7%; 95%CI 1.3-0.0; P = 0.06), but these changes were not significantly different from CON. In conclusion, football training over 12 weeks improved LBM and muscle strength compared with usual care in men with prostate cancer receiving ADT....

  18. The effects of dietary protein intake on appendicular lean mass and muscle function in elderly men

    DEFF Research Database (Denmark)

    Mitchell, Cameron J; Milan, Amber M; Mitchell, Sarah M

    2017-01-01

    Background: The Recommended Daily Allowance (RDA) for protein intake in the adult population is widely promoted as 0.8 g · kg-1 · d-1 Aging may increase protein requirements, particularly to maintain muscle mass.Objective: We investigated whether controlled protein consumption at the current RDA...... or twice the RDA (2RDA) affects skeletal muscle mass and physical function in elderly men.Design: In this parallel-group randomized trial, 29 men aged >70 y [mean ± SD body mass index (in kg/m2): 28.3 ± 4.2] were provided with a complete diet containing either 0.8 (RDA) or 1.6 (2RDA) g protein · kg-1 · d-1...... energy balance (mean ± SD RDA: 209 ± 213 kcal/d; 2RDA 145 ± 214 kcal/d; P= 0.427 for difference between the groups). In comparison with RDA, whole-body lean mass increased in 2RDA (P = 0.001; 1.49 ± 1.30 kg, P

  19. Eight weeks of pre- and postexercise whey protein supplementation increases lean body mass and improves performance in Division III collegiate female basketball players.

    Science.gov (United States)

    Taylor, Lemuel W; Wilborn, Colin; Roberts, Michael D; White, Andrew; Dugan, Kristen

    2016-03-01

    We examined if 8 weeks of whey protein (WP) supplementation improved body composition and performance measures in NCAA Division III female basketball players. Subjects were assigned to consume 24 g WP (n = 8; age, 20 ± 2 years; height, 170 ± 6 cm; weight, 66.0 ± 3.1 kg) or 24 g of maltodextrin (MD) (n = 6; age, 21 ± 3 years; height, 169 ± 6 cm; weight, 68.2 ± 7.6 kg) immediately prior to and following training (4 days/week anaerobic and resistance training) for 8 weeks. Prior to (T1) and 8 weeks following supplementation (T2), subjects underwent dual X-ray absorptiometry body composition assessment as well as performance tests. The WP group gained lean mass from T1 to T2 (+1.4 kg, p = 0.003) whereas the MD group trended to gain lean mass (+0.4 kg, p = 0.095). The WP group also lost fat mass from T1 to T2 (-1.0 kg, p = 0.003) whereas the MD group did not (-0.5 kg, p = 0.41). The WP group presented greater gains in 1-repetition maximum (1RM) bench press (+4.9 kg) compared with the MD group (+2.3 kg) (p agility from T1 to T2 (p = 0.001) whereas the MD group did not (p = 0.38). Both groups equally increased leg press 1RM, vertical jump, and broad jump performances. This study demonstrates that 8 weeks of WP supplementation improves body composition and select performance variables in previously trained female athletes.

  20. Psoas muscle cross-sectional area as a measure of whole body lean muscle mass in maintenance hemodialysis patients

    Science.gov (United States)

    Morrell, Glen R.; Ikizler, Talat A.; Chen, Xiaorui; Heilbrun, Marta E.; Wei, Guo; Boucher, Robert; Beddhu, Srinivasan

    2016-01-01

    Objective We investigate whether psoas or paraspinous muscle area measured on a single L4–5 image is a useful measure of whole lean body mass compared to dedicated mid-thigh magnetic resonance imaging (MRI). Design Observational study. Setting Outpatient dialysis units and a research clinic. Subjects 105 adult participants on maintenance hemodialysis. No control group was used. Exposure variables Psoas muscle area, paraspinous muscle area, and mid-thigh muscle area (MTMA) were measured by MRI. Main outcome measure Lean body mass was measured by dual-energy absorptiometry (DEXA) scan. Results In separate multivariable linear regression models, psoas, paraspinous, and mid-thigh muscle area were associated with increase in lean body mass. In separate multivariate logistic regression models, c-statistics for diagnosis of sarcopenia (defined as lean body mass) were 0.69 for paraspinous muscle area, 0.81 for psoas muscle area, and 0.89 for mid-thigh muscle area. With sarcopenia defined as lean body mass, the corresponding c-statistics were 0.71, 0.92, and 0.94. Conclusions We conclude that psoas muscle area provides a good measure of whole body muscle mass, better than paraspinous muscle area but slightly inferior to mid thigh measurement. Hence, in body composition studies a single axial MR image at the L4–L5 level can be used to provide information on both fat and muscle and may eliminate the need for time-consuming measurement of muscle area in the thigh. PMID:26994780

  1. Oral Supplementation with Beta-Hydroxy-Beta-Methylbutyrate, Arginine, and Glutamine Improves Lean Body Mass in Healthy Older Adults.

    Science.gov (United States)

    Ellis, Amy C; Hunter, Gary R; Goss, Amy M; Gower, Barbara A

    2018-04-19

    Oral intake of beta-hydroxy-beta-methylbutyrate (HMB), arginine, and glutamine may ameliorate muscle loss by stimulating protein synthesis and decreasing protein degradation while simultaneously decreasing inflammation. Previous studies provide evidence for improvement in body composition with dietary supplementation of these ingredients among patients with muscle-wasting diseases. The objectives of this study were to examine the effects of this amino acid mixture on lean body mass, muscle volume, and physical function among healthy older adults. Thirty-one community-dwelling men and women, aged 65-89 years, were randomized to either two oral doses of the amino acid supplement (totaling 3 g HMB, 14 g arginine, 14 g glutamine) or placebo daily for six months. At baseline and month six, lean body mass was measured by air displacement plethysmography, dual-energy X-ray absorptiometry (DXA), and four-compartment model. Muscle volume of quadriceps was quantified by magnetic resonance imaging (MRI), and participants performed a battery of tests to assess physical function. As compared to the placebo group, the treatment group exhibited improvement in a timed stair climb (p =.016) as well as significant increases in lean body mass by all methods of assessment (p lean mass in the supplement group only (p =.035). However, no change was observed in MRI-derived quadriceps volume. Dietary supplementation with HMB, arginine, and glutamine improved total body lean mass among a small sample of healthy older adults. Further research is indicated to elucidate mechanisms of action and to determine whether supplementation may benefit frail elders. Registered under ClinicalTrials.gov identifier no. NCT01057082.

  2. Low lean tissue mass can be a predictor of one-year survival in hemodialysis patients.

    Science.gov (United States)

    Rymarz, Aleksandra; Gibińska, Julia; Zajbt, Maria; Piechota, Wiesław; Niemczyk, Stanisław

    2018-11-01

    Nutritional status has a significant impact on the outcomes in the dialysis population. The aim of this study was to evaluate the association between body composition and a one-year survival of hemodialysis patients. Forty-eight patients with chronic kidney disease stage V treated with hemodialysis for more than three months were included. Body composition was assessed by bioimpedance spectroscopy (Body Composition Monitor, Fresenius Medical Care). Blood samples for serum creatinine, serum albumin, serum prealbumin, high sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), insulin-like growth factor 1(IGF-1) concentrations were taken before the midweek dialysis session. Over the course of a one-year observation, seven patients died. We observed a significantly lower lean tissue index (LTI) (p = .013) and higher IL-6 (p = .032) and hsCRP levels (p = .011) among the patients who died. The remaining biochemical markers did not differ between these two groups. Kapplan-Meier analysis revealed a worse survival rate in patients with sarcopenia (lower than the 10th percentile for their age and gender) in comparison with those with normal LTI. However, it was not of statistical significance (p = .055). LTI inversely correlated with age and IL-6 and positively with IGF-1. Sarcopenia defined as decreased LTI, is a relatively common condition among patients undergoing maintenance hemodialysis, it can also be associated with a lower one-year survival rate. Decreased lean tissue mass can be associated with old age, lower IGF-1 levels and higher IL-6 levels. Body composition assessment may provide prognostic data for hemodialysis patients.

  3. Increased rate of osteoporosis, low lean mass, and fragility fractures in COPD patients: association with disease severity.

    Science.gov (United States)

    Graumam, R Q; Pinheiro, M M; Nery, L E; Castro, C H M

    2018-03-21

    A very high rate of osteoporosis, fractures, and low lean mass was observed in patients with chronic obstructive pulmonary disease (COPD). Disease severity was associated with bone and muscle adverse outcomes, while age ≥ 63.5 years old, low lean mass, higher iPTH, and a T-score below - 2.5 were all associated with higher risk of fracture. Osteoporosis is frequently neglected in patients with COPD. We aimed at evaluating the rate of osteoporosis, fractures, and low lean mass in patients with COPD. Ninety-nine patients with COPD (53 women, 64.5 ± 9.6 years old, and 46 men, 65.9 ± 8.0 years old) underwent bone densitometry (DXA) with body composition analyses. Healthy individuals (N = 57) not exposed to tobacco matched by sex, age, and body mass index (BMI) were used as controls. Spirometry, routine laboratory workout, and conventional thoracolumbar radiography surveying for vertebral deformities were performed in all patients. Osteoporosis was found in 40.4% of the COPD patients against only 13.0% of the healthy controls (p = 0.001). Vertebral fractures were seen in 24.4% of the men and 22.0% of the women with COPD. Disease severity (GOLD 3 and 4) was significantly associated with higher risk of vitamin D deficiency (p = 0.032), lower BMD (both men and women at all sites), higher frequency of osteoporosis (in women at all sites), lower skeletal mass index, and higher rate of low lean mass (in both men and women) than healthy controls and COPD patients with milder disease (GOLD 1 and 2). Age was a main predictor of vertebral fractures (OR = 1.164 (1.078-9.297); p lean mass were associated with FEV 1% lean mass, high iPTH, and low bone mass were all significantly associated with fractures in COPD patients.

  4. Contribution of Myostatin gene polymorphisms to normal variation in lean mass, fat mass and peak BMD in Chinese male offspring

    Institute of Scientific and Technical Information of China (English)

    Hua YUE; Miao LI; Yu-juan LIU; Song-hua WU; Zhen-lin ZHANG; Jin-wei HE; Hao ZHANG; Chun WANG; Wei-wei HU; Jie-mei GU; Yao-hua KE; Wen-zhen FU; Yun-qiu HU

    2012-01-01

    Myostatin gene is a member of the transforming growth factor-β (TGF-β) family that negatively regulates skeletal muscle growth.Genetic polymorphisms in Myostatin were found to be associated with the peak bone mineral density (BMD) in Chinese women.The purpose of this study was to investigate whether Myostatin played a role in the normal variation in peak BMD,lean mass (LM),and fat mass (FM) of Chinese men.Methods:Four hundred male-offspring nuclear families of Chinese Han ethnic group were recruited.Anthropometric measurements,includingthe peak BMD,body LM and FM were measured using dual-energy X-ray absorptiometry (DXA).The single nucleotide polymorphisms (SNPs) studied were tag-SNPs selected by sequencing.Both rs2293284 and +2278G>A were genotyped using TaqMan assay,and rs3791783 was genotyped with PCR-restriction fragment length polymorphism (RFLP) analysis.The associations of the SNPs with anthropometfic variations were analyzed using the quantitative transmission disequilibrium test (QTDT).Results:Using QTDT to detect within-family associations,neither single SNP nor haplotype was found to be associated with peak BMD at any bone site.However,rs3791783 was found to be significantly associated with fat mass of the trunk (P<0.001).Moreover,for within-family associations,haplotypes AGG,AAA,and TGG were found to be significantly associated with the trunk fat mass (all P<0.001).Conclusion:Our results suggest that genetic variation within Myostatin may play a role in regulating the variation in fat mass in Chinese males.Additionally,the Myostatin gene may be a candidate that determines body fat mass in Chinese men.

  5. Lean maturity, lean sustainability

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Matthiesen, Rikke; Nielsen, Jacob

    2007-01-01

    . A framework for describing levels of lean capability is presented, based on a brief review of the literature and experiences from 12 Danish companies currently implementing lean. Although still in its emerging phase, the framework contributes to both theory and practice by describing developmental stages......Although lean is rapidly growing in popularity, its implementation is far from problem free and companies may experience difficulties sustaining long term success. In this paper, it is suggested that sustainable lean requires attention to both performance improvement and capability development...... that support lean capability development and consequently, lean sustainability....

  6. Risk stratification using lean body mass in patients undergoing transcatheter aortic valve replacement.

    Science.gov (United States)

    Hioki, Hirofumi; Watanabe, Yusuke; Kozuma, Ken; Yamamoto, Masanori; Naganuma, Toru; Araki, Motoharu; Tada, Norio; Shirai, Shinichi; Yamanaka, Futoshi; Higashimori, Akihiro; Mizutani, Kazuki; Tabata, Minoru; Takagi, Kensuke; Ueno, Hiroshi; Hayashida, Kentaro

    2018-02-22

    The prognostic impact of skeletal muscle mass, assessed using lean body mass (LBM), remain unclear in patients who underwent transcatheter aortic valve replacement (TAVR). The aim of this study to assess prognostic impact of LBM on mortality after TAVR. We assessed 1,613 patients (median age 85 years, 70% female) who underwent TAVI from October 2013 to April 2016 using OCEAN (Optimized transCathEter vAlvular interveNtion)-TAVI registry data. LBM was calculated using the James formula. The primary endpoint was all-cause death after TAVR. Median follow-up period was 287 days (interquartile range 110-462). The Kaplan-Meier analysis demonstrated that patients with low LBM had significantly higher incidence of all-cause death than those with high LBM in male (32.3% vs. 9.9%, log rank P LBM was an independent predictor of all-cause death in male (Hazard ratio [HR] 0.93; 95% confidence interval [CI] 0.89-0.98) and female (HR 0.94; 95% CI 0.89-0.99). Inversely, the assessment using BMI could not identify the high-risk population in a female. The patients with low LBM had the higher incidence of all-cause death after TAVR than those with high LBM, regardless of gender. Thus, the risk stratification using LBM might provide further insight to identify the high-risk TAVR population, compared to conventional risk stratification using BMI. © 2018 Wiley Periodicals, Inc.

  7. Bone Turnover Markers and Lean Mass in Pubescent Boys: Comparison Between Elite Soccer Players and Controls.

    Science.gov (United States)

    Nebigh, Ammar; Abed, Mohamed Elfethi; Borji, Rihab; Sahli, Sonia; Sellami, Slaheddine; Tabka, Zouhair; Rebai, Haithem

    2017-11-01

    The aim of this study was to examine the relationship between bone mass and bone turnover markers with lean mass (LM) in pubescent soccer players. Two groups participated in this study, which included 65 elite young soccer players who trained for 6-8 hours per week and 60 controls. Bone mineral density; bone mineral content in the whole body, lower limbs, lumbar spine, and femoral neck; biochemical markers of osteocalcin; bone-specific alkaline phosphatase; C-telopeptide type I collagen; and total LM were assessed. Young soccer players showed higher bone mineral density and bone mineral content in the whole body and weight-bearing sites (P soccer players compared with the control group, but no significant difference in C-telopeptide type I collagen was observed between the 2 groups. This study showed a significant positive correlation among bone-specific alkaline phosphatase, osteocalcin, and total LM (r = .29; r = .31; P soccer players. Findings of this study highlight the importance of soccer practice for bone mineral parameters and bone turnover markers during the puberty stage.

  8. Genome-wide association study identified copy number variants important for appendicular lean mass.

    Science.gov (United States)

    Ran, Shu; Liu, Yong-Jun; Zhang, Lei; Pei, Yufang; Yang, Tie-Lin; Hai, Rong; Han, Ying-Ying; Lin, Yong; Tian, Qing; Deng, Hong-Wen

    2014-01-01

    Skeletal muscle is a major component of the human body. Age-related loss of muscle mass and function contributes to some public health problems such as sarcopenia and osteoporosis. Skeletal muscle, mainly composed of appendicular lean mass (ALM), is a heritable trait. Copy number variation (CNV) is a common type of human genome variant which may play an important role in the etiology of many human diseases. In this study, we performed genome-wide association analyses of CNV for ALM in 2,286 Caucasian subjects. We then replicated the major findings in 1,627 Chinese subjects. Two CNVs, CNV1191 and CNV2580, were detected to be associated with ALM (p = 2.26×10(-2) and 3.34×10(-3), respectively). In the Chinese replication sample, the two CNVs achieved p-values of 3.26×10(-2) and 0.107, respectively. CNV1191 covers a gene, GTPase of the immunity-associated protein family (GIMAP1), which is important for skeletal muscle cell survival/death in humans. CNV2580 is located in the Serine hydrolase-like protein (SERHL) gene, which plays an important role in normal peroxisome function and skeletal muscle growth in response to mechanical stimuli. In summary, our study suggested two novel CNVs and the related genes that may contribute to variation in ALM.

  9. Genome-wide association study identified copy number variants important for appendicular lean mass.

    Directory of Open Access Journals (Sweden)

    Shu Ran

    Full Text Available Skeletal muscle is a major component of the human body. Age-related loss of muscle mass and function contributes to some public health problems such as sarcopenia and osteoporosis. Skeletal muscle, mainly composed of appendicular lean mass (ALM, is a heritable trait. Copy number variation (CNV is a common type of human genome variant which may play an important role in the etiology of many human diseases. In this study, we performed genome-wide association analyses of CNV for ALM in 2,286 Caucasian subjects. We then replicated the major findings in 1,627 Chinese subjects. Two CNVs, CNV1191 and CNV2580, were detected to be associated with ALM (p = 2.26×10(-2 and 3.34×10(-3, respectively. In the Chinese replication sample, the two CNVs achieved p-values of 3.26×10(-2 and 0.107, respectively. CNV1191 covers a gene, GTPase of the immunity-associated protein family (GIMAP1, which is important for skeletal muscle cell survival/death in humans. CNV2580 is located in the Serine hydrolase-like protein (SERHL gene, which plays an important role in normal peroxisome function and skeletal muscle growth in response to mechanical stimuli. In summary, our study suggested two novel CNVs and the related genes that may contribute to variation in ALM.

  10. Lean mass influences overnight changes in hydration, blood pressure and strength in community-dwelling older women.

    Science.gov (United States)

    Benton, Melissa J; Schlairet, Maura C

    2016-10-01

    We evaluated the hypothesis that greater lean mass promotes better overnight hydration, improved postural blood pressure and greater strength. Thirty women, aged 71 ± 0.9 years (mean ± SE), completed one measurement in a euhydrated state and another the following morning after an overnight fast. Measurements included hydration, lean mass, orthostatic blood pressure and strength. Participants were grouped by fat-free mass index (FFMI), with cut-points defined as low (blood pressure. On day 1, women with low FFMI experienced significant postural systolic blood pressure changes from sitting to standing (-11.3 ± 4.0 mmHg, p postural blood pressure and loss of strength that increases the risk for early morning falls.

  11. The prediction of lean body mass and fat mass from arm anthropometry at diagnosis in children with cancer.

    Science.gov (United States)

    Webber, Colin; Halton, Jacqueline; Walker, Scott; Young, Andrea; Barr, Ronald D

    2013-10-01

    Maintenance of adequate nutrition is important in the care of children with cancer. In clinical practice, determination of nutritional status can be accomplished with measurement of body composition by dual-energy x-ray absorptiometry (DXA). However, DXA is seldom available in low-income countries where most children with cancer live. This study sought to provide predictive equations for lean body mass and fat mass, measured by DXA, on the basis of simple arm anthropometry providing measures of mid-upper arm circumference and triceps skin-fold thickness in a population (N=99) of children diagnosed with cancer. Such equations were derived successfully with the inclusion of absolute body weight, the body weight Z-score, and the predicted whole-body bone mineral content on the basis of age and sex. Attempted validation in a small sample (N=7) of children who completed therapy for acute lymphoblastic leukemia revealed disparities reflective of the prevalence of obesity in such survivors. Further validation must be undertaken in large samples of children with a variety of malignant diseases to assess the robustness of the equations predictive of body composition.

  12. Patient-specific lean body mass can be estimated from limited-coverage computed tomography images.

    Science.gov (United States)

    Devriese, Joke; Beels, Laurence; Maes, Alex; van de Wiele, Christophe; Pottel, Hans

    2018-06-01

    In PET/CT, quantitative evaluation of tumour metabolic activity is possible through standardized uptake values, usually normalized for body weight (BW) or lean body mass (LBM). Patient-specific LBM can be estimated from whole-body (WB) CT images. As most clinical indications only warrant PET/CT examinations covering head to midthigh, the aim of this study was to develop a simple and reliable method to estimate LBM from limited-coverage (LC) CT images and test its validity. Head-to-toe PET/CT examinations were retrospectively retrieved and semiautomatically segmented into tissue types based on thresholding of CT Hounsfield units. LC was obtained by omitting image slices. Image segmentation was validated on the WB CT examinations by comparing CT-estimated BW with actual BW, and LBM estimated from LC images were compared with LBM estimated from WB images. A direct method and an indirect method were developed and validated on an independent data set. Comparing LBM estimated from LC examinations with estimates from WB examinations (LBMWB) showed a significant but limited bias of 1.2 kg (direct method) and nonsignificant bias of 0.05 kg (indirect method). This study demonstrates that LBM can be estimated from LC CT images with no significant difference from LBMWB.

  13. Lean body mass in small for gestational age and appropriate for gestational age infants

    International Nuclear Information System (INIS)

    Petersen, S.; Gotfredsen, A.; Knudsen, F.U.

    1988-01-01

    Dual photon absorptiometry using 153 Gd in a whole-body scanner was used to measure lean body mass (LBM) in 51 newborn infants. LBM% decreased exponentially with increasing gestational age in both small for gestational age (SGA) and appropriate for gestational age (AGA) infants. In preterm SGA and AGA infants LBM was 104% and 103%, respectively, indicating that no fat was detectable. In term SGA infants LBM was 98%, which corresponded to 48 gm fat on average, and in term AGA infants LBM was 87%, which corresponded to 452 gm fat on average. The LBM%, ponderal index, and skinfold thickness were significantly different between AGA and SGA infants. Infants with clinical signs of intrauterine wastage had significantly higher LBM% than did infants without signs of weight loss. Our results on LBM% by dual photon absorptiometry agree with earlier dissection data; the clinically applicable methods of (1) height combined with weight (i.e., ponderal index), (2) skinfold thickness, and (3) scoring by clinical observations are useful for the estimation of lack of fat as an indicator of intrauterine growth retardation

  14. Review of clinically accessible methods to determine lean body mass for normalization of standardized uptake values

    International Nuclear Information System (INIS)

    DEVRIESE, Joke; POTTEL, Hans; BEELS, Laurence; MAES, Alex; VAN DE WIELE, Christophe; GHEYSENS, Olivier

    2016-01-01

    With the routine use of 2-deoxy-2-[ 18 F]-fluoro-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scans, metabolic activity of tumors can be quantitatively assessed through calculation of SUVs. One possible normalization parameter for the standardized uptake value (SUV) is lean body mass (LBM), which is generally calculated through predictive equations based on height and body weight. (Semi-)direct measurements of LBM could provide more accurate results in cancer populations than predictive equations based on healthy populations. In this context, four methods to determine LBM are reviewed: bioelectrical impedance analysis, dual-energy X-ray absorptiometry. CT, and magnetic resonance imaging. These methods were selected based on clinical accessibility and are compared in terms of methodology, precision and accuracy. By assessing each method’s specific advantages and limitations, a well-considered choice of method can hopefully lead to more accurate SUVLBM values, hence more accurate quantitative assessment of 18F-FDG PET images.

  15. Dietary Supplementation at Home Improves the Regain of Lean Body Mass After Surgery

    DEFF Research Database (Denmark)

    Jensen, Martin Bach; Hessov, Ib

    1997-01-01

    Little is known about nutritional intake after discharge though it takes months to regain preoperative weight after gastrointestinal surgery. We studied whether a 4-mo intervention with dietary advice and protein-rich supplements would increase nutritional intake and gain in lean body mass (LBM...... with the intake of the general population that did not increase further. During the 4 m, the intervention patients had an increased intake of protein (+22%) and energy (+16%), and an enhanced gain of LBM after 2 mo (control 0.8 kg versus intervention 2.1 kg; P = 0.009). After the 4-mo intervention, both LBM...... and fat were gained (control 1.7 kg LBM and 0.2 kg fat versus intervention 3.1 kg LBM and 1.5 kg fat; LBM: P = 0.029 and fat: P = 0.056). At discharge patients should increase protein intake to 1.5 g·kg−1·d−1 for 2 mo, e.g., by taking protein-rich liquid supplements....

  16. Simulation of lean NOx trap performance with microkinetic chemistry and without mass transfer.

    Energy Technology Data Exchange (ETDEWEB)

    Larson, Rich; Daw, C. Stuart (Oak Ridge National Laboratory, Knoxville, TN); Pihl, Josh A. (Oak Ridge National Laboratory, Knoxville, TN); Chakravarthy, V. Kalyana (Oak Ridge National Laboratory, Knoxville, TN)

    2011-08-01

    A microkinetic chemical reaction mechanism capable of describing both the storage and regeneration processes in a fully formulated lean NO{sub x} trap (LNT) is presented. The mechanism includes steps occurring on the precious metal, barium oxide (NO{sub x} storage), and cerium oxide (oxygen storage) sites of the catalyst. The complete reaction set is used in conjunction with a transient plug flow reactor code to simulate not only conventional storage/regeneration cycles with a CO/H{sub 2} reductant, but also steady flow temperature sweep experiments that were previously analyzed with just a precious metal mechanism and a steady state code. The results show that NO{sub x} storage is not negligible during some of the temperature ramps, necessitating a re-evaluation of the precious metal kinetic parameters. The parameters for the entire mechanism are inferred by finding the best overall fit to the complete set of experiments. Rigorous thermodynamic consistency is enforced for parallel reaction pathways and with respect to known data for all of the gas phase species involved. It is found that, with a few minor exceptions, all of the basic experimental observations can be reproduced with these purely kinetic simulations, i.e., without including mass-transfer limitations. In addition to accounting for normal cycling behavior, the final mechanism should provide a starting point for the description of further LNT phenomena such as desulfation and the role of alternative reductants.

  17. Lean Body Mass Harbors Sensing Mechanisms that Allow Safeguarding of Methionine Homeostasis

    Directory of Open Access Journals (Sweden)

    Yves Ingenbleek

    2017-09-01

    Full Text Available Protein-depleted states generate allosteric inhibition of liver cystathionine β-synthase (CBS, which governs the first enzymatic step of the transsulfuration cascade, resulting in upstream accretion of homocysteine (Hcy in body fluids. A similar Hcy increase may arise from normal hepatocytes undergoing experimentally-induced impairment of betaine-homocysteine methyltransferase (BHTM activity or from components of lean body mass (LBM submitted to any inflammatory disorder. LBM comprises a composite agglomeration of extrarenal tissues characterized by naturally occurring BHTM inactivity. As a result of cellular injury, LBM releases high concentrations of Hcy into the extracellular space, contrasting with the disruption of normal remethylation pathways. Hyperhomocysteinemia acts as a biomarker, reflecting the severity of insult and operating as an alarm signal. Elevated Hcy levels constitute a precursor pool recognized by a CBS coding region that reacts to meet increased methionine requirements in LBM tissues, using its enhanced production in hepatocytes. Preservation of methionine homeostasis benefits from its high metabolic priority and survival value.

  18. Lean Body Mass Harbors Sensing Mechanisms that Allow Safeguarding of Methionine Homeostasis.

    Science.gov (United States)

    Ingenbleek, Yves

    2017-09-20

    Protein-depleted states generate allosteric inhibition of liver cystathionine β-synthase (CBS), which governs the first enzymatic step of the transsulfuration cascade, resulting in upstream accretion of homocysteine (Hcy) in body fluids. A similar Hcy increase may arise from normal hepatocytes undergoing experimentally-induced impairment of betaine-homocysteine methyltransferase (BHTM) activity or from components of lean body mass (LBM) submitted to any inflammatory disorder. LBM comprises a composite agglomeration of extrarenal tissues characterized by naturally occurring BHTM inactivity. As a result of cellular injury, LBM releases high concentrations of Hcy into the extracellular space, contrasting with the disruption of normal remethylation pathways. Hyperhomocysteinemia acts as a biomarker, reflecting the severity of insult and operating as an alarm signal. Elevated Hcy levels constitute a precursor pool recognized by a CBS coding region that reacts to meet increased methionine requirements in LBM tissues, using its enhanced production in hepatocytes. Preservation of methionine homeostasis benefits from its high metabolic priority and survival value.

  19. Downsizing of lean body mass is a key determinant of Alzheimer's disease.

    Science.gov (United States)

    Ingenbleek, Yves; Bernstein, Larry H

    2015-01-01

    Lean body mass (LBM) encompasses all metabolically active organs distributed into visceral and structural tissue compartments and collecting the bulk of N and K stores of the human body. Transthyretin (TTR) is a plasma protein mainly secreted by the liver within a trimolecular TTR-RBP-retinol complex revealing from birth to old age strikingly similar evolutionary patterns with LBM in health and disease. TTR is also synthesized by the choroid plexus along distinct regulatory pathways. Chronic dietary methionine (Met) deprivation or cytokine-induced inflammatory disorders generates LBM downsizing following differentiated physiopathological processes. Met-restricted regimens downregulate the transsulfuration cascade causing upstream elevation of homocysteine (Hcy) safeguarding Met homeostasis and downstream drop of hydrogen sulfide (H2S) impairing anti-oxidative capacities. Elderly persons constitute a vulnerable population group exposed to increasing Hcy burden and declining H2S protection, notably in plant-eating communities or in the course of inflammatory illnesses. Appropriate correction of defective protein status and eradication of inflammatory processes may restore an appropriate LBM size allowing the hepatic production of the retinol circulating complex to resume, in contrast with the refractory choroidal TTR secretory process. As a result of improved health status, augmented concentrations of plasma-derived TTR and retinol may reach the cerebrospinal fluid and dismantle senile amyloid plaques, contributing to the prevention or the delay of the onset of neurodegenerative events in elderly subjects at risk of Alzheimer's disease.

  20. Plasma Transthyretin as a Biomarker of Lean Body Mass and Catabolic States.

    Science.gov (United States)

    Ingenbleek, Yves; Bernstein, Larry H

    2015-09-01

    Plasma transthyretin (TTR) is a plasma protein secreted by the liver that circulates bound to retinol-binding protein 4 (RBP4) and its retinol ligand. TTR is the sole plasma protein that reveals from birth to old age evolutionary patterns that are closely superimposable to those of lean body mass (LBM) and thus works as the best surrogate analyte of LBM. Any alteration in energy-to-protein balance impairs the accretion of LBM reserves and causes early depression of TTR production. In acute inflammatory states, cytokines induce urinary leakage of nitrogenous catabolites, deplete LBM stores, and cause an abrupt decrease in TTR and RBP4 concentrations. As a result, thyroxine and retinol ligands are released in free form, creating a second frontline that strengthens that primarily initiated by cytokines. Malnutrition and inflammation thus keep in check TTR and RBP4 secretion by using distinct and unrelated physiologic pathways, but they operate in concert to downregulate LBM stores. The biomarker complex integrates these opposite mechanisms at any time and thereby constitutes an ideally suited tool to determine residual LBM resources still available for metabolic responses, hence predicting outcomes of the most interwoven disease conditions. © 2015 American Society for Nutrition.

  1. Hubungan tingkat kecukupan zat gizi, lean body mass, dan aktivitas fisik dengan kepadatan tulang pada mahasiswa Universitas Udayana Denpasar

    Directory of Open Access Journals (Sweden)

    Ni Putu Puspita Adhytiarini Dewi

    2016-12-01

    Full Text Available Background: Bone formation and peak bone mass determine with bone density in adulthood related with osteopenia or osteoporosis. It could be influenced by nutrition intakes, lean body mass, and physical activity. Objective: to analyze the correlation between nutritional adequacy, lean body mass, physical activity and bone mineral density in Udayana University Economic’s students, Denpasar. Methods: Cross-sectional study design was done to female students of Faculty of Economic and Business, Udayana University, Denpasar. Seventy five subjects were choosen by simple random sampling. Results: Research subjects were aged 20-25 years old. The mean t-score of bone mineral density is -0,363 ± 1,057. Research subjects were classified as low bone density (osteopenia 26,7% and 73,3% are normal. Intakes of animal protein (p = 0,042 and lean body mass (p = 0,011 are related with bone mineral density protein (p = 0,955 but not on intakes of vitamin A (p = 0,249, vitamin C (p = 0,632, vitamin D (p = 0,864, calcium (p = 0,724, iron (p = 0,768, magnesium (p = 0,689, phosphorus (p = 0,716, and physical activity (p = 0,254. There were a positive trend on the level of protein, vitamin A, vitamin C, vitamin D, calcium, iron, magnesium and phosphorus sufficiency. Conclusions: Intakes of Animal protein, lean body mass and physical activity related with bone mineral density but not on protein, vitamin A, vitamin C, vitamin D, calcium, iron, magnesium, and phosphorus intake.

  2. Lean body mass and muscle function in head and neck cancer patients and healthy individuals - results from the DAHANCA 25 study

    DEFF Research Database (Denmark)

    Lønbro, Simon; Dalgas, Ulrik; Primdahl, Hanne

    2013-01-01

    Abstract Introduction. Loss of lean body mass is common following radiotherapy in patients with head and neck squamous cell carcinoma (HNSCC) and may reduce maximal muscle strength and functional performance. However, the associations between lean body mass, muscle strength and functional...... m max gait speed, 30 s chair rise, 30 s arm curl, stair climb) from HNSCC patients from the DAHANCA 25 trials and data from 24 healthy individuals were included. Results. Lean body mass and maximal muscle strength were significantly associated according to the gender and age-adjusted linear...... regression model (p regression analyses showed that HNSCC patients expressed significant lower levels of the investigated variables after radiotherapy...

  3. Nutritional Status of Maintenance Dialysis Patients: Low Lean Body Mass Index and Obesity Are Common, Protein-Energy Wasting Is Uncommon.

    Directory of Open Access Journals (Sweden)

    Mette Koefoed

    Full Text Available Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean body mass index and obesity in maintenance dialysis patients, and compared different methods of nutritional assessment.In a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip circumferences, and determined plasma albumin and normalized protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients.Seventy-nine eligible maintenance dialysis patients participated. The prevalence of protein-energy wasted patients was 4% (95% CI: 2-12 as assessed by the coexistence of low lean body mass index and low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22-44. Obesity prevalence as assessed from fat mass index was 43% (95% CI: 32-55. Coexistence of low lean body mass index and obesity was seen in 10% (95% CI: 5-19. The prevalence of protein-energy wasting and obesity varied considerably, depending on nutritional assessment methodology.Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in the future. In order to clearly distinguish between shortage, sufficiency and abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest the simple measurements of lean body mass index and fat mass index.

  4. Nutritional Status of Maintenance Dialysis Patients: Low Lean Body Mass Index and Obesity Are Common, Protein-Energy Wasting Is Uncommon.

    Science.gov (United States)

    Koefoed, Mette; Kromann, Charles Boy; Juliussen, Sophie Ryberg; Hvidtfeldt, Danni; Ekelund, Bo; Frandsen, Niels Erik; Marckmann, Peter

    2016-01-01

    Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean body mass index and obesity in maintenance dialysis patients, and compared different methods of nutritional assessment. In a cross-sectional study conducted in 2014 at Roskilde Hospital, Denmark, we performed anthropometry (body weight, skinfolds, mid-arm, waist, and hip circumferences), and determined plasma albumin and normalized protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients. Seventy-nine eligible maintenance dialysis patients participated. The prevalence of protein-energy wasted patients was 4% (95% CI: 2-12) as assessed by the coexistence of low lean body mass index and low fat mass index. Low lean body mass index was seen in 32% (95% CI: 22-44). Obesity prevalence as assessed from fat mass index was 43% (95% CI: 32-55). Coexistence of low lean body mass index and obesity was seen in 10% (95% CI: 5-19). The prevalence of protein-energy wasting and obesity varied considerably, depending on nutritional assessment methodology. Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase and preserve lean body mass in dialysis patients is suggested in the future. In order to clearly distinguish between shortage, sufficiency and abundance of protein and/or fat deposits in maintenance dialysis patients, we suggest the simple measurements of lean body mass index and fat mass index.

  5. Novel Equations for Estimating Lean Body Mass in Patients With Chronic Kidney Disease.

    Science.gov (United States)

    Tian, Xue; Chen, Yuan; Yang, Zhi-Kai; Qu, Zhen; Dong, Jie

    2018-05-01

    Simplified methods to estimate lean body mass (LBM), an important nutritional measure representing muscle mass and somatic protein, are lacking in nondialyzed patients with chronic kidney disease (CKD). We developed and tested 2 reliable equations for estimation of LBM in daily clinical practice. The development and validation groups both included 150 nondialyzed patients with CKD Stages 3 to 5. Two equations for estimating LBM based on mid-arm muscle circumference (MAMC) or handgrip strength (HGS) were developed and validated in CKD patients with dual-energy x-ray absorptiometry as referenced gold method. We developed and validated 2 equations for estimating LBM based on HGS and MAMC. These equations, which also incorporated sex, height, and weight, were developed and validated in CKD patients. The new equations were found to exhibit only small biases when compared with dual-energy x-ray absorptiometry, with median differences of 0.94 and 0.46 kg observed in the HGS and MAMC equations, respectively. Good precision and accuracy were achieved for both equations, as reflected by small interquartile ranges in the differences and in the percentages of estimates that were 20% of measured LBM. The bias, precision, and accuracy of each equation were found to be similar when it was applied to groups of patients divided by the median measured LBM, the median ratio of extracellular to total body water, and the stages of CKD. LBM estimated from MAMC or HGS were found to provide accurate estimates of LBM in nondialyzed patients with CKD. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  6. Survival predictability of lean and fat mass in men and women undergoing maintenance hemodialysis.

    Science.gov (United States)

    Noori, Nazanin; Kovesdy, Csaba P; Dukkipati, Ramanath; Kim, Youngmee; Duong, Uyen; Bross, Rachelle; Oreopoulos, Antigone; Luna, Amanda; Benner, Debbie; Kopple, Joel D; Kalantar-Zadeh, Kamyar

    2010-11-01

    Larger body size is associated with greater survival in maintenance hemodialysis (MHD) patients. It is not clear how lean body mass (LBM) and fat mass (FM) compare in their associations with survival across sex in these patients. We examined the hypothesis that higher FM and LBM are associated with greater survival in MHD patents irrespective of sex. In 742 MHD patients, including 31% African Americans with a mean (± SD) age of 54 ± 15 y, we categorized men (n = 391) and women (n = 351) separately into 4 quartiles of near-infrared interactance-measured LBM and FM. Cox proportional hazards models estimated death hazard ratios (HRs) (and 95% CIs), and cubic spline models were used to examine associations with mortality over 5 y (2001-2006). After adjustment for case-mix and inflammatory markers, the highest quartiles of FM and LBM were associated with greater survival in women: HRs of 0.38 (95% CI: 0.20, 0.71) and 0.34 (95% CI: 0.17, 0.67), respectively (reference: first quartile). In men, the highest quartiles of FM and percentage FM (FM%) but not of LBM were associated with greater survival: HRs of 0.51 (95% CI: 0.27, 0.96), 0.45 (95% CI: 0.23, 0.88), and 1.17 (95% CI: 0.60, 2.27), respectively. Cubic spline analyses showed greater survival with higher FM% and higher "FM minus LBM percentiles" in both sexes, whereas a higher LBM was protective in women. In MHD patients, higher FM in both sexes and higher LBM in women appear to be protective. The survival advantage of FM appears to be superior to that of LBM. Clinical trials to examine the outcomes of interventions that modify body composition in MHD patients are indicated.

  7. Lean body mass predicts long-term survival in Chinese patients on peritoneal dialysis.

    Directory of Open Access Journals (Sweden)

    Jenq-Wen Huang

    Full Text Available BACKGROUND: Reduced lean body mass (LBM is one of the main indicators in malnutrition inflammation syndrome among patients on dialysis. However, the influence of LBM on peritoneal dialysis (PD patients' outcomes and the factors related to increasing LBM are seldom reported. METHODS: We enrolled 103 incident PD patients between 2002 and 2003, and followed them until December 2011. Clinical characteristics, PD-associated parameters, residual renal function, and serum chemistry profiles of each patient were collected at 1 month and 1 year after initiating PD. LBM was estimated using creatinine index corrected with body weight. Multiple linear regression analysis, Kaplan-Meier survival analysis, and Cox regression proportional hazard analysis were used to define independent variables and compare survival between groups. RESULTS: Using the median LBM value (70% for men and 64% for women, patients were divided into group 1 (n = 52; low LBM and group 2 (n = 51; high LBM. Group 1 patients had higher rates of peritonitis (1.6 vs. 1.1/100 patient months; p<0.05 and hospitalization (14.6 vs. 9.7/100 patient months; p<0.05. Group 1 patients also had shorter overall survival and technique survival (p<0.01. Each percentage point increase in LBM reduced the hazard ratio for mortality by 8% after adjustment for diabetes, age, sex, and body mass index (BMI. Changes in residual renal function and protein catabolic rate were independently associated with changes in LBM in the first year of PD. CONCLUSIONS: LBM serves as a good parameter in addition to BMI to predict the survival of patients on PD. Preserving residual renal function and increasing protein intake can increase LBM.

  8. Correction of Hypothyroidism Leads to Change in Lean Body Mass without Altering Insulin Resistance.

    Science.gov (United States)

    Sirigiri, Sangeetha; Vaikkakara, Suresh; Sachan, Alok; Srinivasarao, P V L N; Epuri, Sunil; Anantarapu, Sailaja; Mukka, Arun; Chokkapu, Srinivasa Rao; Venkatanarasu, Ashok; Poojari, Ravi

    2016-12-01

    Hypothyroidism is associated with insulin resistance, dyslipidemia, and abnormal body composition. This study assessed changes in body composition and insulin resistance after thyroxine (T 4 ) replacement in overt hypothyroidism. In this prospective longitudinal study carried out in a tertiary care center, adult nondiabetic patients with overt hypothyroidism were rendered euthyroid on T 4 . Anthropometry including skinfold thickness (SFT) at the triceps and subscapularis was recorded. Patients underwent testing for fasting plasma glucose, creatinine, serum insulin, T 4 , thyrotropin (TSH) and body composition analysis by dual-energy X-ray absorptiometry (DEXA) both before and at 2 months after restoration to the euthyroid state. Twenty-seven patients (20 female and 7 male) aged 35.3 ± 11.0 years (min-max: 17-59 years) with overt hypothyroidism were recruited. Serum T 4 at the time of recruitment was 48.9 ± 24.6 nmol/l (normal range = 64.4-142 nmol/l). All patients had TSH ≥50 µIU/l. Following treatment, there was a mean body weight reduction of 1.7 kg (p = 0.01). Waist circumference as well as triceps and subscapularis SFT decreased significantly (p change in fat mass (FM), percentage of fat (%FM) or bone mineral content in any of the specified regions or in the body as a whole. In contrast, mean lean body mass (LBM) decreased significantly by 0.8 kg (p resistance and level of glycemia were not affected by treatment with T 4 . LBM decreases significantly without affecting FM after correction of hypothyroidism. Insulin resistance was not influenced by T 4 treatment.

  9. Cytogenetic support for primacy prostatic cancer in a patient presenting with a soft tissue mass in the leg

    NARCIS (Netherlands)

    Molenaar, WM; Stoepker, MEJ; deRuiter, AJ; Hoekstra, HJ; vandenBerg, E

    A 65-year-old man presented with a soft tissue mass in the leg, clinically suspect of a sarcoma. Histologic examination suggested a metastatic adenocarcinoma of the prostate, which could not be confirmed by immunohistologic studies. However, cytogenetic analysis strongly supported this diagnosis. A

  10. Lean body mass change over 6 years is associated with dietary leucine intake in an older Danish population

    DEFF Research Database (Denmark)

    McDonald, Cameron Keith; Ankarfeldt, Mikkel Z.; Capra, Sandra

    2016-01-01

    Higher protein intake, and particularly higher leucine intake, is associated with attenuated loss of lean body mass (LBM) over time in older individuals. Dietary leucine is thought to be a key mediator of anabolism. This study aimed to assess this relationship over 6 years among younger and older...... corroborates findings from laboratory investigations in relation to protein and leucine intakes and LBM change. A more diverse and larger sample is needed for confirmation of these results....

  11. Increasing Lean Mass and Strength: A Comparison of High Frequency Strength Training to Lower Frequency Strength Training.

    Science.gov (United States)

    Thomas, Michael H; Burns, Steve P

    The purpose of this study was to determine the effect strength training frequency has on improvements in lean mass and strength. Participants were 7 women and 12 men, age ( χ̄ = 34.64 years ± 6.91 years), with strength training experience, training age ( χ̄ = 51.16 months ± 39.02 months). Participants were assigned to one of two groups to equal baseline group demographics. High frequency training group (HFT) trained each muscle group as the agonist, 3 times per week, exercising with 3 sets per muscle group per session (3 total body workouts). Low frequency training group (LFT) trained each muscle group as the agonist one time per week, completing all 9 sets during that one workout. LFT consisted of a routine split over three days: 1) pectoralis, deltoids, and triceps; 2) upper back and biceps; 3) quadriceps, hamstrings, calves, and abdominals. Following eight weeks of training, HFT increased lean mass by 1.06 kg ± 1.78 kg, (1.9%), and LFT increased lean mass by .99 kg ± 1.31 kg, (2.0%). HFT strength improvements on the chest press was 9.07 kg ± 6.33 kg, (11%), and hack squat 20.16 kg ± 11.59 kg, (21%). LFT strength improvements on chest press was 5.80kg ± 4.26 kg, (7.0%), and hack squat 21.83 kg ± 11.17 kg, (24 %). No mean differences between groups were significant. These results suggest that HFT and LFT of equal set totals result in similar improvements in lean mass and strength, following 8 weeks of strength training.

  12. Relationship between body mass index, fat mass and lean mass with SF-36 quality of life scores in a group of fibromyalgia patients.

    Science.gov (United States)

    Arranz, Laura; Canela, Miguel Angel; Rafecas, Magda

    2012-11-01

    Patients suffering from fibromyalgia (FM) had widespread musculoskeletal pain and stiffness, fatigue, sleep disorders, cognitive impairment and other symptoms, which seriously affects their quality of life (QoL), making it difficult to perform normal activities. Moreover, FM has been associated with a higher prevalence of overweight and obesity than in the general population. Weight reduction has been beneficial in both FM and other rheumatic patients. Obesity and overweight have been pointed as playing a relevant role in FM symptoms; however, it is necessary to find out more about this relationship. The objective of this study was to evaluate the relationship between body mass index (BMI), fat mass (fM) and lean mass (lM) with quality of life in a group of FM patients. 103 women, with a mean age of 53.74 ± 7.81, and members of different FM patient associations from Spain participated in our study. Some anthropometric measures were taken like weight, height, BMI, body fat mass and lean mass. FM patients QoL was assessed by the Short-Form Health Survey, SF-36 questionnaire. Statistical reports were based on mean, standard deviation and correlation, but significance was tested by nonparametric methods. BMI, fM and lM correlated differently with the specific SF-36 scores. BMI had a high negative correlation with emotional role, fM with bodily pain and lM almost with all scores but specially with emotional role, vitality and physical role. The outcome of this study reveals some interesting relationships, which need to be further investigated to improve the management of FM patients.

  13. Soy versus whey protein bars: Effects on exercise training impact on lean body mass and antioxidant status

    Directory of Open Access Journals (Sweden)

    Babaknia Ari

    2004-12-01

    Full Text Available Abstract Background Although soy protein may have many health benefits derived from its associated antioxidants, many male exercisers avoid soy protein. This is due partly to a popular, but untested notion that in males, soy is inferior to whey in promoting muscle weight gain. This study provided a direct comparison between a soy product and a whey product. Methods Lean body mass gain was examined in males from a university weight training class given daily servings of micronutrient-fortified protein bars containing soy or whey protein (33 g protein/day, 9 weeks, n = 9 for each protein treatment group. Training used workouts with fairly low repetition numbers per set. A control group from the class (N = 9 did the training, but did not consume either type protein bar. Results Both the soy and whey treatment groups showed a gain in lean body mass, but the training-only group did not. The whey and training only groups, but not the soy group, showed a potentially deleterious post-training effect on two antioxidant-related related parameters. Conclusions Soy and whey protein bar products both promoted exercise training-induced lean body mass gain, but the soy had the added benefit of preserving two aspects of antioxidant function.

  14. Evaluating the contribution of differences in lean mass compartments for resting energy expenditure in African American and Caucasian American children.

    Science.gov (United States)

    Broadney, M M; Shareef, F; Marwitz, S E; Brady, S M; Yanovski, S Z; DeLany, J P; Yanovski, J A

    2018-04-26

    Resting energy expenditure (REE), adjusted for total lean mass (LM), is lower in African American (AA) than Caucasian American (CA) children. Some adult studies suggest that AA-CA differences in lean mass compartments explain this REE difference. Similar data are limited in children. To evaluate differences in compartment-specific lean mass between AA and CA children and examine the individual contributions of high-metabolic rate-at-rest trunk lean mass (TrLM) and low-metabolic-rate-at-rest appendicular lean mass (AppLM) for AA-CA differences in REE. We studied a convenience sample of 594 AA (n = 281) and CA (n = 313) children. REE was measured by using indirect calorimetry; dual-energy X-ray absorptiometry was used to assess body composition. ANCOVAs were performed to examine AA-CA differences in TrLM, AppLM and REE. After accounting for age, sex, height, pubertal development, bone mass and adiposity, REE was evaluated adjusting for total LM (model A) and separately adjusting for TrLM and AppLM (model B). African American children had greater adjusted AppLM (17.8 ± 0.2 [SE] vs. 16.0 ± 0.2 kg, p < 0.001) and lower TrLM (17.2 ± 0.2 vs. 17.7 ± 0.2 kg, p = 0.022) than CA children. REE adjusted for total LM was 77 ± 16 kcal/d lower in AA than CA (p < 0.001). However, after accounting separately for AppLM and TrLM, the discrepancy in REE between the groups declined to 28 ± 19 kcal/d (p = 0.14). In the adjusted model, both TrLM (p < 0.001) and AppLM (p < 0.027) were independently associated with REE. In children, AA-CA differences in REE appear mostly attributable to differences in body composition. Lower REE in AA children is likely due to lower TrLM and greater AppLM. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

  15. Lean body mass-based levothyroxine replacement in young athyrotic patients with differentiated carcinoma of thyroid

    Directory of Open Access Journals (Sweden)

    Fatima Begum

    2013-01-01

    Full Text Available Objective: The objective of this study was to optimize dose of levothyroxine (LT4 based on lean body mass (LBM in young athyrotic patients with differentiated carcinoma of thyroid (DCT which has not been properly addressed in Bangladesh before. Materials and Methods: Sixty patients with DCT (age, range: 20-39 years having total thyroidectomy followed by radioiodine ablative therapy (RIT and 23 euthyroid volunteers were recruited. Clinical, biochemical parameters were obtained from all patients after 2 months of RIT and on LT4 replacement at a dose of 200 μg/day as first follow up visit and also from control subjects. Then 60 patients were divided into two groups consisting of 30 patients each. Patients of Group-I received LT4 replacement based on LBM measured by dual energy X-ray absorptiometry (DXA and Group-II continued LT4 replacement in conventional dose. Patients of both groups were assessed again for same parameters at 6 to 12 months at the second visit. Results: Optimized dose of LT4 based on LBM by DXA (131 ±23 μg/day significantly reduced thyroid hormones and kept thyroid stimulating hormone (TSH in expected levels in patients of Group-I at the second visit compared to patients of Group-II who continued conventional LT4 dose (200 μg/day. Hyperthyroid symptom scale (HSS was significantly reduced to 2 ± 1 in patients of Group-I but not in patients of Group-II, HSS, 8 ±1 ( P < 0.001. Conclusion: Optimization of LT4 dose based on LBM can avoid chronic exposure of mild excess of thyroid hormone in young patients with low risk DCT.

  16. Mechanical muscle function and lean body mass during supervised strength training and testosterone therapy in aging men with low-normal testosterone levels

    DEFF Research Database (Denmark)

    Kvorning, Thue; Christensen, Louise L; Madsen, Klavs

    2013-01-01

    To examine the effect of strength training and testosterone therapy on mechanical muscle function and lean body mass (LBM) in aging men with low-normal testosterone levels in a randomized, double-blind, placebo-controlled 24-week study.......To examine the effect of strength training and testosterone therapy on mechanical muscle function and lean body mass (LBM) in aging men with low-normal testosterone levels in a randomized, double-blind, placebo-controlled 24-week study....

  17. Relationship Between Changes in Fat and Lean Depots Following Weight Loss and Changes in Cardiovascular Disease Risk Markers.

    Science.gov (United States)

    Clifton, Peter M

    2018-04-04

    Gluteofemoral fat mass has been associated with improved cardiovascular disease risk factors. It is not clear if loss of this protective fat during weight loss partially negates the effect of loss of visceral fat. The aim of this study was to examine regional fat loss in a large weight-loss cohort from one center and to determine if fat loss in the leg and total lean tissue loss is harmful. We combined the data from 7 of our previously published 3-month weight-loss studies and examined the relationship between regional fat and lean tissue loss and changes in cardiovascular disease risk factors in 399 participants. At baseline, leg fat was positively associated with high-density lipoprotein cholesterol in women and inversely with fasting triglyceride level in both sexes. Abdominal lean tissue was also related to systolic blood pressure in men. Changes in regional fat and lean tissue were positively associated with changes in glucose, insulin, total cholesterol, triglycerides, low-density lipoprotein cholesterol and systolic and diastolic blood pressure ( r =0.11-0.22, P lean tissue dominating in multivariate regression. After adjustment for total weight or total fat change, these relationships disappeared except for a positive relationship between arm and lean leg mass loss and changes in triglycerides and systolic blood pressure. Loss of leg fat and leg lean tissue was directly associated with beneficial changes in cardiovascular disease risk markers. Loss of lean tissue may not have an adverse effect on cardiovascular disease risk, and measures to retain lean tissue during weight loss may not be necessary. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  18. The effect of sex, carcass mass, back fat thickness and lean meat content on pork ham and loin characteristics

    Directory of Open Access Journals (Sweden)

    D. Knecht

    2016-01-01

    P  ≤ 0.01. Half-carcass mass showed a strong negative correlation with bone content in ham and loin (r = −0.35 and r = −0.21, respectively. Back fat thickness and meat content strongly and inversely correlated with the content of ham and loin in half-carcasses (r = −0.41 and r = 0.59 for back fat thickness; r = 0.66 and r = −0.57 for lean meat content. Close and inverse correlations of back fat thickness and lean meat content were observed with regard to their content in ham and loin (P  ≤ 0.01.

  19. Increased prevalence of malnutrition and reduced lean body mass in overweight/obese kidney transplant recipients

    Directory of Open Access Journals (Sweden)

    Sylwia Małgorzewicz

    2012-06-01

    Full Text Available Overweight and obesity are common in subjects after kidney transplantation. On the other hand, features of malnutrition are also frequently recognized in this group of patients. The aim of the study was to evaluate the prevalence of both abnormalities in a cohort of stable kidney recipients and to assess whether obesity precludes malnutrition in transplanted patients. We also investigated associations between the nutritional status, graft function and adipokines concentrations. The study was performed in 80 prevalent kidney transplant patients and in a control group which consisted of 23 healthy volunteers. Body composition (% of fat, lean body mass (LBM, water content was measured by multifrequency bioelectrical impedance (Body Composition Manager. Nutritional status was determined by a 7–point Subjective Global Assessment (SGA, anthropometric measurements and s-albumin concentration. C–reactive protein (CRP, Il–6 and plasminogen activator inhibitor–1 (PAI–1 were used as markers of inflammatory status. Concentration of leptin, adiponectin and visfatin were measured by ELISA. Results: Mean age was 52.4±13.9 years (45 men and 35 women. Diabetes mellitus was present in 29% (n=23 of them. Mean time after transplantation (transplantation vintage was 82.5±56.5 months (median=73 months. Mean eGFR was 41.7±14.9 ml/min (4 points MDRD, BMI was 25.7±4.2. Overweight was present in 41% of the patients and obesity in 14%. On the basis of SGA evaluation, signs of malnutrition were observed in 48% of the subjects. Malnutrition was present in 64% (21/33 of the overweight patients and in 91% (10/11 of the obese patients. Transplantation vintage was directly associated with fat mass and inversely associated with LBM. Malnourished patients (SGA had a longer transplantation vintage. Adiponectin levels were significantly lower in transplanted patients as compared to controls. In multivariate analysis, leptin was an independent predictor of serum

  20. Novel equations to estimate lean body mass in maintenance hemodialysis patients.

    Science.gov (United States)

    Noori, Nazanin; Kovesdy, Csaba P; Bross, Rachelle; Lee, Martin; Oreopoulos, Antigone; Benner, Deborah; Mehrotra, Rajnish; Kopple, Joel D; Kalantar-Zadeh, Kamyar

    2011-01-01

    Lean body mass (LBM) is an important nutritional measure representing muscle mass and somatic protein in hemodialysis patients, for whom we developed and tested equations to estimate LBM. A study of diagnostic test accuracy. The development cohort included 118 hemodialysis patients with LBM measured using dual-energy x-ray absorptiometry (DEXA) and near-infrared (NIR) interactance. The validation cohort included 612 additional hemodialysis patients with LBM measured using a portable NIR interactance technique during hemodialysis. 3-month averaged serum concentrations of creatinine, albumin, and prealbumin; normalized protein nitrogen appearance; midarm muscle circumference (MAMC); handgrip strength; and subjective global assessment of nutrition. LBM measured using DEXA in the development cohort and NIR interactance in validation cohorts. In the development cohort, DEXA and NIR interactance correlated strongly (r = 0.94, P < 0.001). DEXA-measured LBM correlated with serum creatinine level, MAMC, and handgrip strength, but not with other nutritional markers. Three regression equations to estimate DEXA-measured LBM were developed based on each of these 3 surrogates and sex, height, weight, and age (and urea reduction ratio for the serum creatinine regression). In the validation cohort, the validity of the equations was tested against the NIR interactance-measured LBM. The equation estimates correlated well with NIR interactance-measured LBM (R² ≥ 0.88), although in higher LBM ranges, they tended to underestimate it. Median (95% confidence interval) differences and interquartile range for differences between equation estimates and NIR interactance-measured LBM were 3.4 (-3.2 to 12.0) and 3.0 (1.1-5.1) kg for serum creatinine and 4.0 (-2.6 to 13.6) and 3.7 (1.3-6.0) kg for MAMC, respectively. DEXA measurements were obtained on a nondialysis day, whereas NIR interactance was performed during hemodialysis treatment, with the likelihood of confounding by volume status

  1. Connective Tissue Growth Factor Transgenic Mouse Develops Cardiac Hypertrophy, Lean Body Mass and Alopecia.

    Science.gov (United States)

    Nuglozeh, Edem

    2017-07-01

    compelled us to work at the level of hemizygosity. The histological characterisation of left ventricle shows cardiac hypertrophy together with decrease in body mass and alopecia, this compared to the wild type. The immunohistochemical staining of aorta root showed hyperplasia with increased expression and colocalisation of renin and CTGF demonstrating that CTGF may be involved in vascular tone control. Genetic engineering is a noble avenue to investigate the function of new or existing genes. Our data have shown that CTGF transgenic mouse has cardiac and aorta root hypertrophy and abnormal renin accumulation in aorta root as compared to the wild-type animals. The transgenic animals developed alopecia and lean body mass adding two new functions on pre-existing CTGF multiple functions.

  2. The relationship of endogenous plasma concentrations of β-Hydroxy β-Methyl Butyrate (HMB) to age and total appendicular lean mass in humans.

    Science.gov (United States)

    Kuriyan, Rebecca; Lokesh, Deepa P; Selvam, Sumithra; Jayakumar, J; Philip, Mamatha G; Shreeram, Sathyavageeswaran; Kurpad, Anura V

    2016-08-01

    The maintenance of muscle mass and muscle strength is important for reducing the risk of chronic diseases. The age- related loss of muscle mass and strength is associated with adverse outcomes of physical disability, frailty and death. β-Hydroxy β-Methyl Butyrate (HMB), a metabolite of leucine, has beneficial effects on muscle mass and strength under various catabolic conditions. The objectives of the present study were to determine if age- related differences existed in endogenous plasma HMB levels, and to assess if HMB levels correlated to total appendicular lean mass and forearm grip strength. Anthropometry, dietary and physical activity assessment, and the estimation of fasting plasma HMB concentrations and handgrip strength were performed on the 305 subjects (children, young adults and older adults). Lean mass, which serves as a surrogate for muscle mass was measured using dual energy X-ray absorptiometry (DEXA). Mean plasma HMB concentrations were significantly lower with increasing age groups, with children having highest mean HMB concentration (pHMB concentrations. A significant positive correlation between HMB concentrations and appendicular lean mass normalized for body weight (%), appendicular lean mass (r=0.37; pHMB concentrations in young adults (r=0.58; pHMB concentrations in humans and the HMB concentrations were positively correlated with appendicular lean mass and hand grip strength in young adults and older adults group. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Resistance Training Combined With Diet Decreases Body Fat While Preserving Lean Mass Independent of Resting Metabolic Rate: A Randomized Trial.

    Science.gov (United States)

    Miller, Todd; Mull, Stephanie; Aragon, Alan Albert; Krieger, James; Schoenfeld, Brad Jon

    2018-01-01

    The purpose of this study was to determine the effects of resistance training only (RT; n = 10), dietary intervention only (DIET; n = 10), resistance training plus diet (RT+DIET; n = 10), and control (CON; n = 10) on body composition and resting metabolic rate (RMR) in a cohort of 40 premenopausal female volunteers. Subjects in DIET and RT+DIET were provided with daily macronutrient and calorie goals based on DXA and RMR tests, with protein maintained at 3.1 g/kg/day. Subjects in the RT and RT+DIET groups performed a supervised progressive RT program consisting of exercises for all the major muscle groups of the body. Results showed a significant month-by-group interaction for change in fat mass with no significant linear trend for control. The three treatment groups all showed significant linear decreases in fat mass, but the slope of the decrease became progressively steeper from the RT, to DIET, to RT+DIET. A significant linear increase for lean mass was seen for resistance training only. There was a nonsignificant increase in RMR in all groups from Month 0 to Month 4 but no significant month by group interaction. In conclusion, significant reductions in fat mass were achieved by all experimental groups, but results were maximized by RT+DIET. Only the RT group showed significant increases in lean mass.

  4. Peak lean tissue mass accrual precedes changes in bone strength indices at the proximal femur during the pubertal growth spurt.

    Science.gov (United States)

    Jackowski, Stefan A; Faulkner, Robert A; Farthing, Jonathan P; Kontulainen, Saija A; Beck, Thomas J; Baxter-Jones, Adam D G

    2009-06-01

    We examined the timing of the age and the magnitude of peak lean tissue mass accrual (PLTV) relative to the age and magnitude of two variables of bone strength [peak cross sectional area velocity (PCSAV), and peak section modulus velocity, (PZV)] at the proximal femur in males and females during the adolescent growth spurt. We hypothesized that the age of PLTV would precede the ages of PCSAV and PZV and that there is a positive relationship between the magnitude of PLTV and both PCSAV and PZV in both genders. 41 males and 42 females aged 8-18 years were selected from the Saskatchewan Pediatric Bone Mineral Accrual Study (1991-2005). Participants' total body lean tissue mass was assessed annually for 6 consecutive years using DXA. Narrow neck and femoral shaft cross sectional areas (CSA) and section modulus (Z) were determined using the hip structural analysis (HSA) program. Participants were aligned by maturational age (years from peak height velocity). Lean tissue mass, CSA, and Z were converted into whole year velocities and the maturational age of peak tissue velocities was determined using a cubic spline curve fitting procedure. A 2 x 3 (gender x tissue) factorial MANOVA with repeated measures was used to test for differences between age of PLTV and the ages of PCSAV and PZV between genders. Multiple regression analyses were used to examine the relationship between PLTV and both PCSAV and PZV. There were no sex differences in the ages at which tissue peaks occurred when aligned by maturational age. There were significant differences between the age of PLTV and both PCSAV and PZV at the narrow neck (p=0.001) and femoral shaft (p=0.03), where the age of PLTV preceded both PCSAV and PZV when pooled by gender. PLTV was a significant predictor of the magnitude of both PCSAV and PZV at all sites (ptheory that muscle development is an important factor in affecting bone strength.

  5. A Comparison of Vertical Stiffness Values Calculated from Different Measures of Center of Mass Displacement in Single-Leg Hopping.

    Science.gov (United States)

    Mudie, Kurt L; Gupta, Amitabh; Green, Simon; Hobara, Hiroaki; Clothier, Peter J

    2017-02-01

    This study assessed the agreement between K vert calculated from 4 different methods of estimating vertical displacement of the center of mass (COM) during single-leg hopping. Healthy participants (N = 38) completed a 10-s single-leg hopping effort on a force plate, with 3D motion of the lower limb, pelvis, and trunk captured. Derived variables were calculated for a total of 753 hop cycles using 4 methods, including: double integration of the vertical ground reaction force, law of falling bodies, a marker cluster on the sacrum, and a segmental analysis method. Bland-Altman plots demonstrated that K vert calculated using segmental analysis and double integration methods have a relatively small bias (0.93 kN⋅m -1 ) and 95% limits of agreement (-1.89 to 3.75 kN⋅m -1 ). In contrast, a greater bias was revealed between sacral marker cluster and segmental analysis (-2.32 kN⋅m -1 ), sacral marker cluster and double integration (-3.25 kN⋅m -1 ), and the law of falling bodies compared with all methods (17.26-20.52 kN⋅m -1 ). These findings suggest the segmental analysis and double integration methods can be used interchangeably for the calculation of K vert during single-leg hopping. The authors propose the segmental analysis method to be considered the gold standard for the calculation of K vert during single-leg, on-the-spot hopping.

  6. In healthy elderly postmenopausal women variations in BMD and BMC at various skeletal sites are associated with differences in weight and lean body mass rather than by variations in habitual physical activity, strength or VO2max.

    Science.gov (United States)

    Schöffl, I; Kemmler, W; Kladny, B; Vonstengel, S; Kalender, W A; Engelke, K

    2008-01-01

    The objective of this study was an integrated cross-sectional investigation for answering the question whether differences in bone mineral density in elderly postmenopausal women are associated with differences in habitual physical activity and unspecific exercise levels. Two hundred and ninety nine elderly women (69-/+3 years), without diseases or medication affecting bone metabolism were investigated. The influence of weight, body composition and physical activity on BMD was measured at multiple sites using different techniques (DXA, QCT, and QUS). Physical activity and exercise level were assessed by questionnaire, maximum strength of the legs and aerobic capacity. Variations in physical activity or habitual exercise had no effect on bone. The only significant univariate relation between strength/VO(2)max and BMD/BMC that remained after adjusting for confounding variables was between arm BMD (DXA) and hand-grip strength. The most important variable for explaining BMD was weight and for cortical BMC of the femur (QCT) lean body mass. Weight and lean body mass emerge as predominant predictors of BMD in normal elderly women, whereas the isolated effect of habitual physical activity, unspecific exercise participation, and muscle strength on bone parameters is negligible. Thus, an increase in the amount of habitual physical activity will probably have no beneficial impact on bone.

  7. Effect of low appendicular lean mass, grip strength, and gait speed on the functional outcome after surgery for distal radius fractures.

    Science.gov (United States)

    Roh, Young Hak; Noh, Jung Ho; Gong, Hyun Sik; Baek, Goo Hyun

    2017-12-01

    Patients with low appendicular lean mass plus slow gait speed or weak grip strength are at risk for poor functional recovery after surgery for distal radius fracture, even when they have similar radiologic outcomes. Loss of skeletal muscle mass and consequent loss in muscle function associate with aging, and this condition negatively impacts the activities of daily living and increases elderly individuals' frailty to falls. Thus, patients with low appendicular lean mass would show different functional recovery compared to those without this condition after surgery for distal radius fracture (DRF). This study compares the functional outcomes after surgery for DRF in patients with or without low appendicular lean mass plus slowness or weakness. A total of 157 patients older than 50 years of age with a DRF treated via volar plate fixation were enrolled in this prospective study. A definition of low appendicular lean mass with slowness or weakness was based on the consensus of the Asian Working Group for Sarcopenia. The researchers compared functional assessments (wrist range of motion and Michigan Hand Questionnaire [MHQ]) and radiographic assessments (radial inclination, volar tilt, ulnar variance, and articular congruity) 12 months after surgery between patients with and without low appendicular lean mass plus slowness or weakness. Multivariable regression analyses were performed to determine whether appendicular lean mass, grip strength, gait speed, patient demographic, or injury characteristics accounted for the functional outcomes. Patients with low appendicular lean mass plus slowness or weakness showed a significantly lower recovery of MHQ score than those in the control group throughout 12 months. There was no significant difference in the range of motion between the groups. The radiologic outcomes showed no significant difference between groups in terms of volar tilt, radial inclination, or ulnar variance. According to multivariable regression analysis

  8. Engineering Probiotics that Improve Warfighter Performance by Maintaining Lean Body Mass and Inhibiting Anxiety

    Science.gov (United States)

    2017-10-03

    From - To) 03/10/2017 Final Technical Report 15-05-14 to 14-05-17 4. TITLE AND SUBTITLE Sa. CONTRACT NUMBER Engineering probiotics that improve...ABSTRACT The overall goal of this work is to engineer "synthetic probiotics": orally-administered gut bacteria that sense and compute the metabolic...Final Technical Report Grant number: ONR N00014-14-1-0487 Title: Engineering probiotics that improve warfighter performance by maintaining lean body

  9. A selective androgen receptor modulator with minimal prostate hypertrophic activity restores lean body mass in aged orchidectomized male rats.

    Science.gov (United States)

    Allan, George; Sbriscia, Tifanie; Linton, Olivia; Lai, Muh-Tsann; Haynes-Johnson, Donna; Bhattacharjee, Sheela; Ng, Raymond; Sui, Zhihua; Lundeen, Scott

    2008-06-01

    Androgens are required for the maintenance of normal sexual activity in adulthood and for enhancing muscle growth and lean body mass in adolescents and adults. Androgen receptor (AR) ligands with tissue selectivity (selective androgen receptor modulators, or SARMs) have potential for treating muscle wasting, hypogonadism of aging, osteoporosis, female sexual dysfunction, and other indications. JNJ-37654032 is a nonsteroidal AR ligand with mixed agonist and antagonist activity in androgen-responsive cell-based assays. It is an orally active SARM with muscle selectivity in orchidectomized rat models. It stimulated growth of the levator ani muscle with ED(50) 0.8 mg/kg, stimulating maximal growth at a dose of 3mg/kg. In contrast, it stimulated ventral prostate growth to 21% of its full size at 3mg/kg. At the same time, JNJ-37654032 reduced prostate weight in intact rats by 47% at 3mg/kg, while having no inhibitory effect on muscle. Using magnetic resonance imaging to monitor body composition, JNJ-37654032 restored about 20% of the lean body mass lost following orchidectomy in aged rats. JNJ-37654032 reduced follicle-stimulating hormone levels in orchidectomized rats and reduced testis size in intact rats. JNJ-37654032 is a potent prostate-sparing SARM with the potential for clinical benefit in muscle-wasting diseases.

  10. The interaction effect of body mass index and age on fat-free mass, waist-to-hip ratio, and soft lean mass

    Directory of Open Access Journals (Sweden)

    Alireza Shahab Jahanlou

    2017-01-01

    Full Text Available Background: Research has shown that body mass index (BMI does not take into consideration the gender and ethnicity. The primary purpose of this study was to examine the interaction effect of the BMI and age on fat-free mass (FFM, waist-to-hip ratio (WHR, and soft lean mass (SLM. The secondary purpose was to evaluate the practical significance of the findings by examining effect sizes. Materials and Methods: The study was comparative in nature and employed a factorial design. Due to nonexperimental nature of the investigation, no causal inferences were drawn. The nonprobability sample consisted of 19,356 adults. Analysis of the data included factorial analysis of variance, analysis of simple effects, calculation of mean difference effect sizes, and data transformation. The Statistical Package for the Social Sciences version 22 was employed for the purpose of data manipulation and analysis. Results: The BMI by age interaction effects on FFM, F (10, 19,338 = 28.26, P < 0.01, on WHR, F (10, 19,338 = 18.46, P < 0.01, and on SLM, F (10, 19,338 = 14.65, P < 0.01, was statistically significant and ordinal in nature. Analysis of the effect sizes, ranging from 0.30 to 1.20, showed that the BMI and age influenced the WHR but their interaction effects on FFM and SLM, ranging from 0.04 to 0.36 and 0.03 to 0.33, respectively, were mainly negligible. Conclusion: Based on the examination of the statistical and practical significance of the results, it is concluded that the BMI and age together can influence the WHR but their interaction effect on the FFM and SLM is questionable.

  11. Progressive resistance training rebuilds lean body mass in head and neck cancer patients after radiotherapy – Results from the randomized DAHANCA 25B trial

    International Nuclear Information System (INIS)

    Lønbro, Simon; Dalgas, Ulrik; Primdahl, Hanne; Johansen, Jørgen; Nielsen, Jakob Lindberg; Aagaard, Per; Hermann, Anne Pernille; Overgaard, Jens; Overgaard, Kristian

    2013-01-01

    Purpose: The critical weight loss observed in head and neck squamous cell carcinoma (HNSCC) patients following radiotherapy is mainly due to loss of lean body mass. This is associated with decreases in muscle strength, functional performance and Quality of Life (QoL). The present study investigated the effect of progressive resistance training (PRT) on lean body mass, muscle strength and functional performance in HNSCC patients following radiotherapy. Patients and methods: Following radiotherapy HNSCC patients were randomized into two groups: Early Exercise (EE, n = 20) initiated 12 weeks of PRT followed by 12 weeks of self-chosen physical activity. Delayed Exercise (DE, n = 21) initiated 12 weeks of self-chosen physical activity followed by 12 weeks of PRT. Lean body mass, muscle strength, functional performance and QoL were evaluated at baseline and after week 12 and 24. Results: In the first 12 weeks lean body mass increased by 4.3% in EE after PRT and in the last 12 weeks by 4.2% in DE after PRT. These increases were significantly larger than the changes after self-chosen physical activity (p ⩽ 0.005). Regardless of PRT start-up time, the odds ratio of increasing lean body mass by more than 4% after PRT was 6.26 (p < 0.05). PRT significantly increased muscle strength, whereas functional performance increased significantly more than after self-chosen physical activity only after delayed onset of PRT. Overall QoL improved significantly more in EE than DE from baseline to week 12. Conclusion: PRT effectively increased lean body mass and muscle strength in HNSCC patients following radiotherapy, irrespectively of early or delayed start-up

  12. Effect of body mass index and fat mass on balance force platform measurements during a one-legged stance in older adults.

    Science.gov (United States)

    Pereira, Camila; Silva, Rubens A da; de Oliveira, Marcio R; Souza, Rejane D N; Borges, Renata J; Vieira, Edgar R

    2018-05-01

    The purpose of this study was to evaluate the impact of body mass index (BMI) and fat mass on balance force platform measurements in older adults. The sample consisted of 257 participants who were stratified into four groups by BMI: low weight, normal weight, pre-obesity and obesity. For fat mass variables, older individuals were classified into low and high-fat mass. All groups investigated performed three trials of one-legged stance balance on a force platform. Center of pressure (COP) domain parameters were computed from the mean across trials. Analysis of variance results revealed no significant interactions for groups and sexes for all COP parameters. Comparable balance results were found for BMI and fat groups for all COP parameters. A statistical effect (P < 0.05) was only reported for sex differences for COP parameters, regardless of BMI and fat mass variables. Overall, women presented better balance than men. In conclusion, BMI and fat mass do not seem to influence the balance of older adults during a one-leg stance task.

  13. Catàleg dels Miridae (Heteroptera) del Massís del Garraf

    OpenAIRE

    Goula Goula, Marta

    1989-01-01

    Per a la redacció d'aquest catàleg, s'aporten dades d'observació pròpia al llarg dels anys 1980-1984, així com les troballes publicades per CUNI (1889a,1889b,1889c,1891) i per RIBES (1978a,1978b,1980,1984). Totes aquestes observacions s'han fet en localitats del Massis del Garraf, que será objecte d'una curta descripció.

  14. A 5-year cohort study of the effects of high protein intake on lean mass and BMC in elderly postmenopausal women.

    Science.gov (United States)

    Meng, Xingqiong; Zhu, Kun; Devine, Amanda; Kerr, Deborah A; Binns, Colin W; Prince, Richard L

    2009-11-01

    Long-term effects of high dietary protein intake on muscle and bone structure in the elderly are not clear. The aim of this study was to investigate the relationship between baseline protein intake and lean mass and BMC 5 yr later in a cohort of elderly postmenopausal women. A total of 862 community-dwelling women 75 +/- 3 yr of age provided baseline data including nutrient intake assessed by a food frequency questionnaire. At 5 yr, upper arm muscle area (UAMA) and body composition using DXA were measured. Baseline protein intake was 81 +/- 28 g/d (1.2 +/- 0.4 g/kg/d), contributing 19 +/- 3% of total energy intake. There were positive correlations between baseline protein intake and whole body and appendicular bone-free lean mass and BMC (r = 0.14-0.18, p 87 g/d) had 5.4-6.0% higher whole body and appendicular lean mass and UAMA and 5.3-6.0% higher whole body and appendicular BMC. These effects remained after adjusting for potential confounders. However, the effect on BMC disappeared after further adjustment for lean mass. This study shows that high protein intake is associated with long-term beneficial effects on muscle mass and size and bone mass in elderly women. The protein effect on bone may be partly mediated by its effects on muscle.

  15. DXA, bioelectrical impedance, ultrasonography and biometry for the estimation of fat and lean mass in cats during weight loss

    Directory of Open Access Journals (Sweden)

    Borges Naida C

    2012-07-01

    Full Text Available Abstract Background Few equations have been developed in veterinary medicine compared to human medicine to predict body composition. The present study was done to evaluate the influence of weight loss on biometry (BIO, bioimpedance analysis (BIA and ultrasonography (US in cats, proposing equations to estimate fat (FM and lean (LM body mass, as compared to dual energy x-ray absorptiometry (DXA as the referenced method. For this were used 16 gonadectomized obese cats (8 males and 8 females in a weight loss program. DXA, BIO, BIA and US were performed in the obese state (T0; obese animals, after 10% of weight loss (T1 and after 20% of weight loss (T2. Stepwise regression was used to analyze the relationship between the dependent variables (FM, LM determined by DXA and the independent variables obtained by BIO, BIA and US. The better models chosen were evaluated by a simple regression analysis and means predicted vs. determined by DXA were compared to verify the accuracy of the equations. Results The independent variables determined by BIO, BIA and US that best correlated (p r2, 19 equations were selected (12 for FM, 7 for LM; however, only 7 equations accurately predicted FM and one LM of cats. Conclusions The equations with two variables are better to use because they are effective and will be an alternative method to estimate body composition in the clinical routine. For estimated lean mass the equations using body weight associated with biometrics measures can be proposed. For estimated fat mass the equations using body weight associated with bioimpedance analysis can be proposed.

  16. Measurement of body potassium with a whole-body counter: relationship between lean body mass and resting energy expenditure

    International Nuclear Information System (INIS)

    Jensen, M.D.; Braun, J.S.; Vetter, R.J.; Marsh, H.M.

    1988-01-01

    We conducted studies to determine whether the Mayo whole-body counter could be used to measure body potassium, and thus lean body mass (LBM), and whether moderate obesity alters resting energy expenditure when corrected for LBM. Twenty-four nonobese and 18 moderately obese adults underwent body potassium (40K) counting, as well as tritiated water space measurement and indirect calorimetry. LBM values predicted from 40K counting and tritiated water space measurements were highly correlated (P = 0.001; r = 0.88). Resting energy expenditure was closely related to LBM (P less than 0.0001; r = 0.78): kcal/day = 622 kcal + (LBM.20.0 kcal/kg LBM). In this relationship, the obese subjects did not differ from nonobese subjects. In summary, the Mayo whole-body counter can accurately measure LBM, and moderate obesity has no detectable effect on corrected resting energy expenditure

  17. Comparison of nodal staging with lean body mass based and with total body weight based in lung cancer

    International Nuclear Information System (INIS)

    Lee, H. Y.; Chung, J. K.; Kang, W. J.; So, Y.; Lee, D. S.; Lee, M. C.

    2004-01-01

    The standardized uptake (SUV) is semiquantitative evaluation parameter in positron emission tomography (PET). But there is no consensus about the application or process of SUV measurement. In this study, we used measured lean body mass (LBM) and total weight for application in SUV measurement. Also we compared the each nodal staging with SUV between measured LBM, and total weight, in non small cell lung cancer (NSCLC). Total 21 patients with lung cancer were enrolled (M:F=17:4, age 45[+-]8 years). PET-CT was done before operation with Gemini (Philips, Milpitas, U.S.). Each image was reconstructed twice with measured weight and lean body mass. Maximum SUVs of 103 dissected lymph nodes were measured and compared with histological result. For the deciding on the cut off value, receiver operating characteristic (ROC) analysis was done. 14 lymph nodes in the 103 dissected lymph nodes were metastatic lesions. From the ROC analysis, the cut off value of SUV was 1.7 with measured LBM and 2.3 with total weight. With measured LBM, Sensitivity and specificity were 92.5%. 78.2% and area under curve was 0.881. With total weight, sensitivity and specificity was 92.5% and 77%, Area under curve was 0.859. The normalization of SUV could be done with measured LBM. With the normalization of SUV with LBM, the nodal staging of NSCLC using SUV could be more accurate than using total weight in the reconstruction and measurement of SUV for lymph node lesions

  18. Lean body mass correction of standardized uptake value in simultaneous whole-body positron emission tomography and magnetic resonance imaging

    Science.gov (United States)

    Jochimsen, Thies H.; Schulz, Jessica; Busse, Harald; Werner, Peter; Schaudinn, Alexander; Zeisig, Vilia; Kurch, Lars; Seese, Anita; Barthel, Henryk; Sattler, Bernhard; Sabri, Osama

    2015-06-01

    This study explores the possibility of using simultaneous positron emission tomography—magnetic resonance imaging (PET-MRI) to estimate the lean body mass (LBM) in order to obtain a standardized uptake value (SUV) which is less dependent on the patients' adiposity. This approach is compared to (1) the commonly-used method based on a predictive equation for LBM, and (2) to using an LBM derived from PET-CT data. It is hypothesized that an MRI-based correction of SUV provides a robust method due to the high soft-tissue contrast of MRI. A straightforward approach to calculate an MRI-derived LBM is presented. It is based on the fat and water images computed from the two-point Dixon MRI primarily used for attenuation correction in PET-MRI. From these images, a water fraction was obtained for each voxel. Averaging over the whole body yielded the weight-normalized LBM. Performance of the new approach in terms of reducing variations of 18F-Fludeoxyglucose SUVs in brain and liver across 19 subjects was compared with results using predictive methods and PET-CT data to estimate the LBM. The MRI-based method reduced the coefficient of variation of SUVs in the brain by 41  ± 10% which is comparable to the reduction by the PET-CT method (35  ± 10%). The reduction of the predictive LBM method was 29  ± 8%. In the liver, the reduction was less clear, presumably due to other sources of variation. In conclusion, employing the Dixon data in simultaneous PET-MRI for calculation of lean body mass provides a brain SUV which is less dependent on patient adiposity. The reduced dependency is comparable to that obtained by CT and predictive equations. Therefore, it is more comparable across patients. The technique does not impose an overhead in measurement time and is straightforward to implement.

  19. Fat Mass Is Positively Associated with Estimated Hip Bone Strength among Chinese Men Aged 50 Years and above with Low Levels of Lean Mass.

    Science.gov (United States)

    Han, Guiyuan; Chen, Yu-Ming; Huang, Hua; Chen, Zhanyong; Jing, Lipeng; Xiao, Su-Mei

    2017-04-24

    This study investigated the relationships of fat mass (FM) and lean mass (LM) with estimated hip bone strength in Chinese men aged 50-80 years (median value: 62.0 years). A cross-sectional study including 889 men was conducted in Guangzhou, China. Body composition and hip bone parameters were generated by dual-energy X-ray absorptiometry (DXA). The relationships of the LM index (LMI) and the FM index (FMI) with bone phenotypes were detected by generalised additive models and multiple linear regression. The associations between the FMI and the bone variables in LMI tertiles were further analysed. The FMI possessed a linear relationship with greater estimated hip bone strength after adjustment for the potential confounders ( p maintenance of adequate FM could help to promote bone acquisition in relatively thin men.

  20. Depression-related differences in lean body mass distribution from National Health and Nutrition Examination Survey 2005-2006.

    Science.gov (United States)

    Li, Ying; Meng, Lu; Li, Yue; Sato, Yasuto

    2014-03-01

    Although the association between depression and body composition has been widely discussed, the effects of depression on lean body mass (LBM) are unclear. The present study aimed to investigate the association of depression with LBM. The study included 2406 participants aged 18-69 years. The sex and body mass index (BMI) stratified analysis of covariance was performed to compare total LBM and percentage LBM (%LBM) in subjects with different depression score levels. Multiple linear regression analysis was conducted to estimate the association between depression score and serum albumin level. An analysis of covariance stratified by sex showed that participants with moderate-to-severe depression had significantly decreased total LBM and total and regional %LBM in men, except for total LBM and percentage gynoid LBM, which was observed in women. In the BMI stratified analysis of covariance, depression was significantly associated with decreased total and regional %LBM and with increased total and regional percentage fat body mass. In people with BMI≥25kg/m(2), the associations between depression or depressive syndrome and LBM, and total and regional %LBM are stronger compared to those with BMILBM and serum albumin level. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Leg muscle mass and composition in relation to lower extremity performance in men and women aged 70 to 79 : the health, aging and body composition study

    NARCIS (Netherlands)

    Visser, Marjolein; Kritchevsky, Stephen B; Goodpaster, Bret H; Newman, Anne B; Nevitt, Michael; Stamm, Elizabeth; Harris, Tamara B

    OBJECTIVES: The loss of muscle mass with aging, or sarcopenia, is hypothesized to be associated with the deterioration of physical function. Our aim was to determine whether low leg muscle mass and greater fat infiltration in the muscle were associated with poor lower extremity performance (LEP).

  2. Cross-sex hormone therapy in transgender persons affects total body weight, body fat and lean body mass: a meta-analysis.

    Science.gov (United States)

    Klaver, M; Dekker, M J H J; de Mutsert, R; Twisk, J W R; den Heijer, M

    2017-06-01

    Weight gain and body fat increase the risk of cardiometabolic disease. Cross-sex hormone therapy in transgender persons leads to changes in body weight and body composition, but it is unclear to what extent. We performed a meta-analysis to investigate the changes in body weight, body fat and lean body mass during cross-sex hormone therapy in transgender persons. We searched the PubMed database for eligible studies until November 2015. Ten studies reporting changes in body weight, body fat or lean mass in hormone naive transgender persons were included, examining 171 male-to-female and 354 female-to-male transgender people. Pooled effect estimates in the male-to-female group were +1.8 kg (95% CI: 0.2;3.4) for body weight, +3.0 kg (2.0;3.9) for body fat and -2.4 kg (-2.8; -2.1) for lean body mass. In the female-to-male group, body weight changed with +1.7 kg (0.7;2.7), body fat with -2.6 kg (-3.9; -1.4) and lean body mass with +3.9 kg (3.2;4.5). Cross-sex hormone therapy increases body weight in both sexes. In the male-to-female group, a gain in body fat and a decline in lean body mass are observed, while the opposite effects are seen in the female-to-male group. Possibly, these changes increase the risk of cardiometabolic disease in the male-to-female group. © 2016 Blackwell Verlag GmbH.

  3. Healthcare Lean.

    Science.gov (United States)

    Long, John C

    2003-01-01

    Lean Thinking is an integrated approach to designing, doing and improving the work of people that have come together to produce and deliver goods, services and information. Healthcare Lean is based on the Toyota production system and applies concepts and techniques of Lean Thinking to hospitals and physician practices.

  4. Relationships between central arterial stiffness, lean body mass, and absolute and relative strength in young and older men and women.

    Science.gov (United States)

    Fahs, Christopher A; Thiebaud, Robert S; Rossow, Lindy M; Loenneke, Jeremy P; Bemben, Debra A; Bemben, Michael G

    2017-08-16

    Relationships between muscular strength and arterial stiffness as well as between muscle mass and arterial stiffness have been observed suggesting a link between the neuromuscular system and vascular health. However, the relationship between central arterial stiffness and absolute and relative strength along with muscle mass has not been investigated in both sexes across a broad age range. The purpose of this study was to examine the relationship between central arterial stiffness and absolute and relative strength as well as between central arterial stiffness and lean body mass (LBM) in men and women across a broad age range. LBM, central arterial stiffness and strength were measured on 36 men and 35 women between the ages of 18 and 75 years. Strength was measured on five machine resistance exercises and summed as one measure of overall strength (absolute strength). Relative strength was calculated as total strength divided by LBM (relative strength). Central arterial stiffness was inversely related to both absolute (r = -0·230; P = 0·029) and relative strength (r = -0·484; P LBM (r = 0·097; P = 0·213). The relationship between central arterial stiffness and relative strength was attenuated but still present when controlling for either age, per cent body fat, LBM or mean arterial pressure. These results suggest that, across a wide age range, the expression of relative muscular strength has a stronger relationship with central arterial stiffness compared to either LBM or absolute strength. This suggests that muscle function more than muscle mass may be coupled with vascular health. © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  5. A controlled trial of protein enrichment of meal replacements for weight reduction with retention of lean body mass

    Directory of Open Access Journals (Sweden)

    Bowerman Susan

    2008-08-01

    Full Text Available Abstract Background While high protein diets have been shown to improve satiety and retention of lean body mass (LBM, this study was designed to determine effects of a protein-enriched meal replacement (MR on weight loss and LBM retention by comparison to an isocaloric carbohydrate-enriched MR within customized diet plans utilizing MR to achieve high protein or standard protein intakes. Methods Single blind, placebo-controlled, randomized outpatient weight loss trial in 100 obese men and women comparing two isocaloric meal plans utilizing a standard MR to which was added supplementary protein or carbohydrate powder. MR was used twice daily (one meal, one snack. One additional meal was included in the meal plan designed to achieve individualized protein intakes of either 1 2.2 g protein/kg of LBM per day [high protein diet (HP] or 2 1.1 g protein/kg LBM/day standard protein diet (SP. LBM was determined using bioelectrical impedance analysis (BIA. Body weight, body composition, and lipid profiles were measured at baseline and 12 weeks. Results Eighty-five subjects completed the study. Both HP and SP MR were well tolerated, with no adverse effects. There were no differences in weight loss at 12 weeks (-4.19 ± 0.5 kg for HP group and -3.72 ± 0.7 kg for SP group, p > 0.1. Subjects in the HP group lost significantly more fat weight than the SP group (HP = -1.65 ± 0.63 kg; SP = -0.64 ± 0.79 kg, P = 0.05 as estimated by BIA. There were no significant differences in lipids nor fasting blood glucose between groups, but within the HP group a significant decrease in cholesterol and LDL cholesterol was noted at 12 weeks. This was not seen in the SP group. Conclusion Higher protein MR within a higher protein diet resulted in similar overall weight loss as the standard protein MR plan over 12 weeks. However, there was significantly more fat loss in the HP group but no significant difference in lean body mass. In this trial, subject compliance with both the

  6. Health issues of whey proteins: 1. Protection of lean body mass

    NARCIS (Netherlands)

    Schaafsma, G.

    2006-01-01

    Loss of muscle mass as a consequence of changes in protein metabolism during periods of catabolic stress is a serious complication in a variety of conditions. These conditions are weight loss programs, sarcopenia in the elderly and several clinical states. It appears from many studies that improved

  7. Associations between ACE-Inhibitors, Angiotensin Receptor Blockers, and Lean Body Mass in Community Dwelling Older Women.

    Science.gov (United States)

    Bea, Jennifer W; Wassertheil-Smoller, Sylvia; Wertheim, Betsy C; Klimentidis, Yann; Chen, Zhao; Zaslavsky, Oleg; Manini, Todd M; Womack, Catherine R; Kroenke, Candyce H; LaCroix, Andrea Z; Thomson, Cynthia A

    2018-01-01

    Studies suggest that ACE-inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) may preserve skeletal muscle with aging. We evaluated longitudinal differences in lean body mass (LBM) among women diagnosed with hypertension and classified as ACE-I/ARB users and nonusers among Women's Health Initiative participants that received dual energy X-ray absorptiometry scans to estimate body composition ( n =10,635) at baseline and at years 3 and 6 of follow-up. Of those, 2642 were treated for hypertension at baseline. Multivariate linear regression models, adjusted for relevant demographics, behaviors, and medications, assessed ACE-I/ARB use/nonuse and LBM associations at baseline, as well as change in LBM over 3 and 6 years. Although BMI did not differ by ACE-I/ARB use, LBM (%) was significantly higher in ACE-I/ARB users versus nonusers at baseline (52.2% versus 51.3%, resp., p =0.001). There was no association between ACE-I/ARB usage and change in LBM over time. Reasons for higher LBM with ACE-I/ARB use cross sectionally, but not longitundinally, are unclear and may reflect a threshold effect of these medications on LBM that is attenuated over time. Nevertheless, ACE-I/ARB use does not appear to negatively impact LBM in the long term.

  8. Existing equations to estimate lean body mass are not accurate in the critically ill: Results of a multicenter observational study.

    Science.gov (United States)

    Moisey, Lesley L; Mourtzakis, Marina; Kozar, Rosemary A; Compher, Charlene; Heyland, Daren K

    2017-12-01

    Lean body mass (LBM), quantified using computed tomography (CT), is a significant predictor of clinical outcomes in the critically ill. While CT analysis is precise and accurate in measuring body composition, it may not be practical or readily accessible to all patients in the intensive care unit (ICU). Here, we assessed the agreement between LBM measured by CT and four previously developed equations that predict LBM using variables (i.e. age, sex, weight, height) commonly recorded in the ICU. LBM was calculated in 327 critically ill adults using CT scans, taken at ICU admission, and 4 predictive equations (E1-4) that were derived from non-critically adults since there are no ICU-specific equations. Agreement was assessed using paired t-tests, Pearson's correlation coefficients and Bland-Altman plots. Median LBM calculated by CT was 45 kg (IQR 37-53 kg) and was significantly different (p LBM (error ranged from 7.5 to 9.9 kg), compared with LBM calculated by CT, suggesting insufficient agreement. Our data indicates a large bias is present between the calculation of LBM by CT imaging and the predictive equations that have been compared here. This underscores the need for future research toward the development of ICU-specific equations that reliably estimate LBM in a practical and cost-effective manner. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  9. Using Lean Six Sigma Methodology to Improve a Mass Immunizations Process at the United States Naval Academy.

    Science.gov (United States)

    Ha, Chrysanthy; McCoy, Donald A; Taylor, Christopher B; Kirk, Kayla D; Fry, Robert S; Modi, Jitendrakumar R

    2016-06-01

    Lean Six Sigma (LSS) is a process improvement methodology developed in the manufacturing industry to increase process efficiency while maintaining product quality. The efficacy of LSS application to the health care setting has not been adequately studied. This article presents a quality improvement project at the U.S. Naval Academy that uses LSS to improve the mass immunizations process for Midshipmen during in-processing. The process was standardized to give all vaccinations at one station instead of giving a different vaccination at each station. After project implementation, the average immunizations lead time decreased by 79% and staffing decreased by 10%. The process was shown to be in control with a capability index of 1.18 and performance index of 1.10, resulting in a defect rate of 0.04%. This project demonstrates that the LSS methodology can be applied successfully to the health care setting to make sustainable process improvements if used correctly and completely. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  10. Role of cytokines and testosterone in regulating lean body mass and resting energy expenditure in HIV-infected men.

    Science.gov (United States)

    Roubenoff, Ronenn; Grinspoon, Steven; Skolnik, Paul R; Tchetgen, Eric; Abad, Leslie; Spiegelman, Donna; Knox, Tamsin; Gorbach, Sherwood

    2002-07-01

    Although catastrophic weight loss is no longer common in HIV-infected men, we hypothesized that a more gradual process of cachexia [loss of lean body mass (LBM) without severe weight loss, often accompanied by elevated resting energy expenditure (REE)] is still common and is driven by excessive production of the catabolic cytokines tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta). We performed a longitudinal analysis of an ongoing cohort study of nutritional status in 172 men with HIV infection. LBM loss of >1 kg occurred in 35% of the cohort, and LBM loss of >5% occurred in 12.2% over 8 mo of observation, but classical wasting (loss of approximately 10% of weight) was rare (2%). Both TNF-alpha (-150 g LBM. ng(-1) x ml(-1), P production (-130 g LBM x ng(-1) x ml(-1), P 200 kcal/day was found in 17.7% of the subjects regardless of weight change. IL-1 beta (+9 kcal/day per ng/ml, P production predicted Delta REE. Serum free testosterone was inversely associated with TNF-alpha production and was not an independent predictor of either Delta LBM or Delta REE after adjustment for cytokine production. Even though weight loss was rare in this cohort of patients treated with highly active antiretroviral therapy, loss of LBM was common and was driven by catabolic cytokines and not by inadequate dietary intake or hypogonadism.

  11. Lean production

    OpenAIRE

    Veselková, Jana

    2011-01-01

    The goal of this Bachelor's Thesis is to describe the general principles of lean production and afterwards apply these principles in a particular company. Due to the changing conditions on the world market is among companies growing concern about such innovative business systems. The theoretical part of this work deals with the general characteristics of lean production, including their history and focus on Toyota, as the originator of most lean systems. Mentioned are also the economic aspect...

  12. Androgen receptor agonists increase lean mass, improve cardiopulmonary functions and extend survival in preclinical models of Duchenne muscular dystrophy.

    Science.gov (United States)

    Ponnusamy, Suriyan; Sullivan, Ryan D; You, Dahui; Zafar, Nadeem; He Yang, Chuan; Thiyagarajan, Thirumagal; Johnson, Daniel L; Barrett, Maron L; Koehler, Nikki J; Star, Mayra; Stephenson, Erin J; Bridges, Dave; Cormier, Stephania A; Pfeffer, Lawrence M; Narayanan, Ramesh

    2017-07-01

    Duchenne muscular dystrophy (DMD) is a neuromuscular disease that predominantly affects boys as a result of mutation(s) in the dystrophin gene. DMD is characterized by musculoskeletal and cardiopulmonary complications, resulting in shorter life-span. Boys afflicted by DMD typically exhibit symptoms within 3-5 years of age and declining physical functions before attaining puberty. We hypothesized that rapidly deteriorating health of pre-pubertal boys with DMD could be due to diminished anabolic actions of androgens in muscle, and that intervention with an androgen receptor (AR) agonist will reverse musculoskeletal complications and extend survival. While castration of dystrophin and utrophin double mutant (mdx-dm) mice to mimic pre-pubertal nadir androgen condition resulted in premature death, maintenance of androgen levels extended the survival. Non-steroidal selective-AR modulator, GTx-026, which selectively builds muscle and bone was tested in X-linked muscular dystrophy mice (mdx). GTx-026 significantly increased body weight, lean mass and grip strength by 60-80% over vehicle-treated mdx mice. While vehicle-treated castrated mdx mice exhibited cardiopulmonary impairment and fibrosis of heart and lungs, GTx-026 returned cardiopulmonary function and intensity of fibrosis to healthy control levels. GTx-026 elicits its musculoskeletal effects through pathways that are distinct from dystrophin-regulated pathways, making AR agonists ideal candidates for combination approaches. While castration of mdx-dm mice resulted in weaker muscle and shorter survival, GTx-026 treatment increased the muscle mass, function and survival, indicating that androgens are important for extended survival. These preclinical results support the importance of androgens and the need for intervention with AR agonists to treat DMD-affected boys. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Efficacy of a novel formulation of L-Carnitine, creatine, and leucine on lean body mass and functional muscle strength in healthy older adults: a randomized, double-blind placebo-controlled study.

    Science.gov (United States)

    Evans, Malkanthi; Guthrie, Najla; Pezzullo, John; Sanli, Toran; Fielding, Roger A; Bellamine, Aouatef

    2017-01-01

    Progressive decline in skeletal muscle mass and function are growing concerns in an aging population. Diet and physical activity are important for muscle maintenance but these requirements are not always met. This highlights the potential for nutritional supplementation. As a primary objective, we sought to assess the effect of a novel combination of L-Carnitine, creatine and leucine on muscle mass and performance in older subjects. Forty-two healthy older adults aged 55-70 years were randomized to receive either a novel L-Carnitine (1500 mg), L-leucine (2000 mg), creatine (3000 mg), Vitamin D3 (10 μg) (L-Carnitine-combination) product ( n  = 14), L-Carnitine (1500 mg) ( n  = 14), or a placebo ( n  = 14) for eight weeks. We evaluated body mass by DXA, upper and lower strength by dynamometry, and walking distance by a 6-min walk test at baseline and after eight weeks of intervention. These measures, reflecting muscle mass, functional strength and mobility have been combined to generate a primary composite score. Quality of life, blood safety markers, and muscle biopsies for protein biomarker analysis were also conducted at baseline and the end of the study. The primary composite outcome improved by 63.5 percentage points in the L-Carnitine-combination group vs. placebo ( P  = 0.013). However, this composite score did not change significantly in the L-Carnitine group ( P =  0.232), and decreased slightly in the placebo group ( P =  0.534). Participants supplemented with the L-Carnitine-combination showed a 1.0 kg increase in total lean muscle mass ( P  = 0.013), leg lean muscle mass (0.35 kg, P =  0.005), and a 1.0 kg increase in lower leg strength ( P  = 0.029) at week 8. In addition, these increases were significant when compared to the placebo group (P =  0.034, P =  0.026, and P =  0.002, respectively). Total mTOR protein expression was increased in participants in the L-Carnitine-combination group at the end of

  14. Fat Mass Is Positively Associated with Estimated Hip Bone Strength among Chinese Men Aged 50 Years and above with Low Levels of Lean Mass

    Directory of Open Access Journals (Sweden)

    Guiyuan Han

    2017-04-01

    Full Text Available This study investigated the relationships of fat mass (FM and lean mass (LM with estimated hip bone strength in Chinese men aged 50–80 years (median value: 62.0 years. A cross-sectional study including 889 men was conducted in Guangzhou, China. Body composition and hip bone parameters were generated by dual-energy X-ray absorptiometry (DXA. The relationships of the LM index (LMI and the FM index (FMI with bone phenotypes were detected by generalised additive models and multiple linear regression. The associations between the FMI and the bone variables in LMI tertiles were further analysed. The FMI possessed a linear relationship with greater estimated hip bone strength after adjustment for the potential confounders (p < 0.05. Linear relationships were also observed for the LMI with most bone phenotypes, except for the cross-sectional area (p < 0.05. The contribution of the LMI (4.0%–12.8% was greater than that of the FMI (2.0%–5.7%. The associations between the FMI and bone phenotypes became weaker after controlling for LMI. Further analyses showed that estimated bone strength ascended with FMI in the lowest LMI tertile (p < 0.05, but not in the subgroups with a higher LMI. This study suggested that LM played a critical role in bone health in middle-aged and elderly Chinese men, and that the maintenance of adequate FM could help to promote bone acquisition in relatively thin men.

  15. Effect of Protein Intake on Lean Body Mass in Functionally Limited Older Men: A Randomized Clinical Trial.

    Science.gov (United States)

    Bhasin, Shalender; Apovian, Caroline M; Travison, Thomas G; Pencina, Karol; Moore, Lynn L; Huang, Grace; Campbell, Wayne W; Li, Zhuoying; Howland, Andrew S; Chen, Ruo; Knapp, Philip E; Singer, Martha R; Shah, Mitali; Secinaro, Kristina; Eder, Richard V; Hally, Kathleen; Schram, Haley; Bearup, Richelle; Beleva, Yusnie M; McCarthy, Ashley C; Woodbury, Erin; McKinnon, Jennifer; Fleck, Geeta; Storer, Thomas W; Basaria, Shehzad

    2018-04-01

    The Institute of Medicine set the recommended dietary allowance (RDA) for protein at 0.8 g/kg/d for the entire adult population. It remains controversial whether protein intake greater than the RDA is needed to maintain protein anabolism in older adults. To investigate whether increasing protein intake to 1.3 g/kg/d in older adults with physical function limitations and usual protein intake within the RDA improves lean body mass (LBM), muscle performance, physical function, fatigue, and well-being and augments LBM response to a muscle anabolic drug. This randomized clinical trial with a 2 × 2 factorial design was conducted in a research center. A modified intent-to-treat analytic strategy was used. Participants were 92 functionally limited men 65 years or older with usual protein intake less thanor equal to 0.83 g/kg/d within the RDA. The first participant was randomized on September 21, 2011, and the last participant completed the study on January 19, 2017. Participants were randomized for 6 months to controlled diets with 0.8 g/kg/d of protein plus placebo, 1.3 g/kg/d of protein plus placebo, 0.8 g/kg/d of protein plus testosterone enanthate (100 mg weekly), or 1.3 g/kg/d of protein plus testosterone. Prespecified energy and protein contents were provided through custom-prepared meals and supplements. The primary outcome was change in LBM. Secondary outcomes were muscle strength, power, physical function, health-related quality of life, fatigue, affect balance, and well-being. Among 92 men (mean [SD] age, 73.0 [5.8] years), the 4 study groups did not differ in baseline characteristics. Changes from baseline in LBM (0.31 kg; 95% CI, -0.46 to 1.08 kg; P = .43) and appendicular (0.04 kg; 95% CI, -0.48 to 0.55 kg; P = .89) and trunk (0.24 kg; 95% CI, -0.17 to 0.66 kg; P = .24) lean mass, as well as muscle strength and power, walking speed and stair-climbing power, health-related quality of life, fatigue, and well-being, did not differ between men

  16. Aerobic power and lean mass are indicators of competitive sprint performance among elite female cross-country skiers

    Directory of Open Access Journals (Sweden)

    Carlsson T

    2016-11-01

    Full Text Available Tomas Carlsson, Michail Tonkonogi, Magnus Carlsson School of Education, Health and Social Studies, Dalarna University, Falun, SwedenAbstract: The purpose of this study was to establish the optimal allometric models to predict International Ski Federation’s ski-ranking points for sprint competitions (FISsprint among elite female cross-country skiers based on maximal oxygen uptake (V̇O2max and lean mass (LM. Ten elite female cross-country skiers (age: 24.5±2.8 years [mean ± SD] completed a treadmill roller-skiing test to determine V̇O2max (ie, aerobic power using the diagonal stride technique, whereas LM (ie, a surrogate indicator of anaerobic capacity was determined by dual-emission X-ray anthropometry. The subjects’ FISsprint were used as competitive performance measures. Power function modeling was used to predict the skiers’ FISsprint based on V̇O2max, LM, and body mass. The subjects’ test and performance data were as follows: V̇O2max, 4.0±0.3 L min-1; LM, 48.9±4.4 kg; body mass, 64.0±5.2 kg; and FISsprint, 116.4±59.6 points. The following power function models were established for the prediction of FISsprint: 3.91×105 ∙ VO -6.00 2max and 6.95×1010 ∙ LM-5.25; these models explained 66% (P=0.0043 and 52% (P=0.019, respectively, of the variance in the FISsprint. Body mass failed to contribute to both models; hence, the models are based on V̇O2max and LM expressed absolutely. The results demonstrate that the physiological variables that reflect aerobic power and anaerobic capacity are important indicators of competitive sprint performance among elite female skiers. To accurately indicate performance capability among elite female skiers, the presented power function models should be used. Skiers whose V̇O2max differs by 1% will differ in their FISsprint by 5.8%, whereas the corresponding 1% difference in LM is related to an FISsprint difference of 5.1%, where both differences are in favor of the skier with

  17. Negotiating Lean

    DEFF Research Database (Denmark)

    Rahbek Pedersen, Esben; Muniche, Mahad

    2011-01-01

    Purpose – The purpose of this paper is to analyse how negotiations between the constituencies affect the processes and outcomes of lean projects in Danish public sector organisations. Design/methodology/approach – The paper is based on a qualitative analysis of interviews with managers...... projects in the Danish public sector. It cannot be concluded that the findings can be generalised to reflect all types of lean projects across organisational and geographical settings. Originality/value – The paper adds value to the relatively scarce literature on lean management in the public sector...... and employees who have participated in lean projects in the Danish public sector. Negotiated order theory serves as the overarching theoretical framework for the analysis. Findings – The paper concludes that the processes and outcomes of lean depend not only on the technology itself, but also the negotiation...

  18. Lean body mass change over 6 years is associated with dietary leucine intake in an older Danish population.

    Science.gov (United States)

    McDonald, Cameron Keith; Ankarfeldt, Mikkel Z; Capra, Sandra; Bauer, Judy; Raymond, Kyle; Heitmann, Berit Lilienthal

    2016-05-01

    Higher protein intake, and particularly higher leucine intake, is associated with attenuated loss of lean body mass (LBM) over time in older individuals. Dietary leucine is thought to be a key mediator of anabolism. This study aimed to assess this relationship over 6 years among younger and older adult Danes. Dietary leucine intake was assessed at baseline and after 6 years in men and women, aged 35-65 years, participating in the Danish cohort of the WHO-MONICA (Multinational MONItoring of trends and determinants in CArdiovascular disease) study (n 368). Changes in LBM over the 6 years were measured by bioelectrical impedance using equations developed for this Danish population. The association between leucine and LBM changes was examined using multivariate linear regression and ANCOVA analyses adjusted for potential confounders. After adjustment for baseline LBM, sex, age, energy intake and physical activity, leucine intake was associated with LBM change in those older than 65 years (n 79), with no effect seen in those younger than 65 years. Older participants in the highest quartile of leucine intake (7·1 g/d) experienced LBM maintenance, whereas lower intakes were associated with LBM loss over 6 years (for trend: β=0·434, P=0·03). Sensitivity analysis indicated no effect modification of sex or the presence of CVD. Greater leucine intake in conjunction with adequate total protein intake was associated with long-term LBM retention in a healthy older Danish population. This study corroborates findings from laboratory investigations in relation to protein and leucine intakes and LBM change. A more diverse and larger sample is needed for confirmation of these results.

  19. Liver-derived IGF-I contributes to GH-dependent increases in lean mass and bone mineral density in mice with comparable levels of circulating GH.

    Science.gov (United States)

    Nordstrom, Sarah M; Tran, Jennifer L; Sos, Brandon C; Wagner, Kay-Uwe; Weiss, Ethan J

    2011-07-01

    The relative contributions of circulating and locally produced IGF-I in growth remain controversial. The majority of circulating IGF-I is produced by the liver, and numerous mouse models have been developed to study the endocrine actions of IGF-I. A common drawback to these models is that the elimination of circulating IGF-I disrupts a negative feedback pathway, resulting in unregulated GH secretion. We generated a mouse with near total abrogation of circulating IGF-I by disrupting the GH signaling mediator, Janus kinase (JAK)2, in hepatocytes. We then crossed these mice, termed JAK2L, to GH-deficient little mice (Lit). Compound mutant (Lit-JAK2L) and control (Lit-Con) mice were treated with equal amounts of GH such that the only difference between the two groups was hepatic GH signaling. Both groups gained weight in response to GH but there was a reduction in the final weight of GH-treated Lit-JAK2L vs. Lit-Con mice. Similarly, lean mass increased in both groups, but there was a reduction in the final lean mass of Lit-JAK2L vs. Lit-Con mice. There was an equivalent increase in skeletal length in response to GH in Lit-Con and Lit-JAK2L mice. There was an increase in bone mineral density (BMD) in both groups, but Lit-JAK2L had lower BMD than Lit-Con mice. In addition, GH-mediated increases in spleen and kidney mass were absent in Lit-JAK2L mice. Taken together, hepatic GH-dependent production of IGF-I had a significant and nonredundant role in GH-mediated acquisition of lean mass, BMD, spleen mass, and kidney mass; however, skeletal length was dependent upon or compensated for by locally produced IGF-I.

  20. Effects of testosterone treatment on body fat and lean mass in obese men on a hypocaloric diet: a randomised controlled trial.

    Science.gov (United States)

    Ng Tang Fui, Mark; Prendergast, Luke A; Dupuis, Philippe; Raval, Manjri; Strauss, Boyd J; Zajac, Jeffrey D; Grossmann, Mathis

    2016-10-07

    Whether testosterone treatment has benefits on body composition over and above caloric restriction in men is unknown. We hypothesised that testosterone treatment augments diet-induced loss of fat mass and prevents loss of muscle mass. We conducted a randomised double-blind, parallel, placebo controlled trial at a tertiary referral centre. A total of 100 obese men (body mass index ≥ 30 kg/m 2 ) with a total testosterone level of or below 12 nmol/L and a median age of 53 years (interquartile range 47-60) receiving 10 weeks of a very low energy diet (VLED) followed by 46 weeks of weight maintenance were randomly assigned at baseline to 56 weeks of 10-weekly intramuscular testosterone undecanoate (n = 49, cases) or matching placebo (n = 51, controls). The main outcome measures were the between-group difference in fat and lean mass by dual-energy X-ray absorptiometry, and visceral fat area (computed tomography). A total of 82 men completed the study. At study end, compared to controls, cases had greater reductions in fat mass, with a mean adjusted between-group difference (MAD) of -2.9 kg (-5.7 to -0.2; P = 0.04), and in visceral fat (MAD -2678 mm 2 ; -5180 to -176; P = 0.04). Although both groups lost the same lean mass following VLED (cases -3.9 kg (-5.3 to -2.6); controls -4.8 kg (-6.2 to -3.5), P = 0.36), cases regained lean mass (3.3 kg (1.9 to 4.7), P dieting men receiving placebo lost both fat and lean mass, the weight loss with testosterone treatment was almost exclusively due to loss of body fat. clinicaltrials.gov, identifier NCT01616732 , registration date: June 8, 2012.

  1. The Effect of Upper Body Mass and Initial Knee Flexion on the Injury Outcome of Post Mortem Human Subject Pedestrian Isolated Legs.

    Science.gov (United States)

    Petit, Philippe; Trosseille, Xavier; Dufaure, Nicolas; Dubois, Denis; Potier, Pascal; Vallancien, Guy

    2014-11-01

    In the ECE 127 Regulation on pedestrian leg protection, as well as in the Euro NCAP test protocol, a legform impactor hits the vehicle at the speed of 40 kph. In these tests, the knee is fully extended and the leg is not coupled to the upper body. However, the typical configuration of a pedestrian impact differs since the knee is flexed during most of the gait cycle and the hip joint applies an unknown force to the femur. This study aimed at investigating the influence of the inertia of the upper body (modelled using an upper body mass fixed at the proximal end of the femur) and the initial knee flexion angle on the lower limb injury outcome. In total, 18 tests were conducted on 18 legs from 9 Post Mortem Human Subjects (PMHS). The principle of these tests was to impact the leg at 40 kph using a sled equipped with 3 crushing steel tubes, the stiffness of which were representative of the front face of a European sedan (bonnet leading edge, bumper and spoiler). The mass of the equipped sled was 74.5 kg. The test matrix was designed to perform 4 tests in 4 configurations combining two upper body masses (either 0 or 3 kg) and two knee angles (0 or 20 degrees) at 40 kph (11 m/s) plus 2 tests at 9 m/s. Autopsies were performed on the lower limbs and an injury assessment was established. The findings of this study were first that the increase of the upper body mass resulted in more severe injuries, second that an initial flexion of the knee, corresponding to its natural position during the gait cycle, decreased the severity of the injuries, and third that based on the injury outcome, a test conducted with no upper body mass and the knee fully extended was as severe as a test conducted with a 3 kg upper body mass and an initial knee flexion of 20°.

  2. Lean body mass-based standardized uptake value, derived from a predictive equation, might be misleading in PET studies

    International Nuclear Information System (INIS)

    Erselcan, Taner; Turgut, Bulent; Dogan, Derya; Ozdemir, Semra

    2002-01-01

    The standardized uptake value (SUV) has gained recognition in recent years as a semiquantitative evaluation parameter in positron emission tomography (PET) studies. However, there is as yet no consensus on the way in which this index should be determined. One of the confusing factors is the normalisation procedure. Among the proposed anthropometric parameters for normalisation is lean body mass (LBM); LBM has been determined by using a predictive equation in most if not all of the studies. In the present study, we assessed the degree of agreement of various LBM predictive equations with a reference method. Secondly, we evaluated the impact of predicted LBM values on a hypothetical value of 2.5 SUV, normalised to LBM (SUV LBM ), by using various equations. The study population consisted of 153 women, aged 32.3±11.8 years (mean±SD), with a height of 1.61±0.06 m, a weight of 71.1±17.5 kg, a body surface area of 1.77±0.22 m 2 and a body mass index of 27.6±6.9 kg/m 2 . LBM (44.2±6.6 kg) was measured by a dual-energy X-ray absorptiometry (DEXA) method. A total of nine equations from the literature were evaluated, four of them from recent PET studies. Although there was significant correlation between predicted and measured LBM values, 95% limits of agreement determined by the Bland and Altman method showed a wide range of variation in predicted LBM values as compared with DEXA, no matter which predictive equation was used. Moreover, only one predictive equation was not statistically different in the comparison of means (DEXA and predicted LBM values). It was also shown that the predictive equations used in this study yield a wide range of SUV LBM values from 1.78 to 5.16 (29% less or 107% more) for an SUV of 2.5. In conclusion, this study suggests that estimation of LBM by use of a predictive equation may cause substantial error for an individual, and that if LBM is chosen for the SUV normalisation procedure, it should be measured, not predicted. (orig.)

  3. A 7-day high protein hypocaloric diet promotes cellular metabolic adaptations and attenuates lean mass loss in healthy males

    Directory of Open Access Journals (Sweden)

    Matthew Furber

    2017-08-01

    Full Text Available Mitochondrial quantity and density are associated with increased oxidative metabolism. It has been demonstrated that a hypocaloric high fat/low carbohydrate (HF/LC diet can up-regulate transcriptional markers of mitochondrial biogenesis; this was yet to be explored in vivo subsequent to a high protein/low carbohydrate (HP/LC diet. Thus the aims of the study were to explore such diets on transcriptional markers or mitochondrial biogenesis, body composition and resting metabolic rate (RMR. Forty-five healthy male participants were randomly assigned one of four intervention diets: eucaloric high protein low carbohydrate (PRO-EM, hypocaloric high protein low carbohydrate (PRO-ER, eucaloric high carbohydrate (CHO-EM or hypocaloric high carbohydrate (CHO-ER. The macronutrient ratio of the high protein diet and high carbohydrate diets was 40:30:30% and 10:60:30% (PRO:CHO:FAT respectively. Energy intake for the hypocaloric diets were calculated to match resting metabolic rate. Participants visited the laboratory on 3 occasions each separated by 7 days. On each visit body composition, resting metabolic rate and a muscle biopsy from the vastus lateralis was collected. Prior to visit 1 and 2 habitual diet was consumed which was used as a control, between visit 2 and 3 the intervention diet was consumed continuously for 7-days. No group × time effect was observed, however in the PRO-ER group a significant increase in AMPK, PGC-1α, SIRT1 and SIRT3 mRNA expression was observed post diet intervention groups (p < 0.05. No change was observed in any of the transcriptional markers in the other 3 groups. Despite ∼30% reduction in calorie intake no difference in lean mass (LM loss was observed between the PRO-ER and CHO-EM groups. The results from this study suggest that a 7-day a high protein low carbohydrate hypocaloric diet increased AMPK, SIRT1 and PGC-1 α mRNA expression at rest, and also suggest that increased dietary protein may attenuate LM mass

  4. Case Study: The Effect of 32 Weeks of Figure-Contest Preparation on a Self-Proclaimed Drug-Free Female's Lean Body and Bone Mass.

    Science.gov (United States)

    Petrizzo, John; DiMenna, Frederick J; Martins, Kimberly; Wygand, John; Otto, Robert M

    2017-12-01

    To achieve the criterion appearance before competing in a physique competition, athletes undergo preparatory regimens involving high-volume intense resistance and aerobic exercise with hypocaloric energy intake. As the popularity of "drug-free" competition increases, more athletes are facing this challenge without the recuperative advantage provided by performance-enhancing drugs. Consequently, the likelihood of loss of lean body and/or bone mass is increased. The purpose of this investigation was to monitor changes in body composition for a 29-year-old self-proclaimed drug-free female figure competitor during a 32-week preparatory regimen comprising high-volume resistance and aerobic exercise with hypocaloric energy intake. We used dual-energy x-ray absorptiometry (DXA) to evaluate regional fat and bone mineral density. During the initial 22 weeks, the subject reduced energy intake and engaged in resistance (4-5 sessions/week) and aerobic (3 sessions/week) training. During the final 10 weeks, the subject increased exercise frequency to 6 (resistance) and 4 (aerobic) sessions/week while ingesting 1130-1380 kcal/day. During this 10-week period, she consumed a high quantity of protein (~55% of energy intake) and nutritional supplements. During the 32 weeks, body mass and fat mass decreased by 12% and 55%, respectively. Conversely, lean body mass increased by 1.5%, an amount that exceeded the coefficient of variation associated with DXA-derived measurement. Total bone mineral density was unchanged throughout. In summary, in preparation for a figure competition, a self-proclaimed drug-free female achieved the low body-fat percentage required for success in competition without losing lean mass or bone density by following a 32-week preparatory exercise and nutritional regimen.

  5. Variation in C-reactive protein following weight loss in obese insulin resistant postmenopausal women: is there an independent contribution of lean body mass?

    Science.gov (United States)

    Barsalani, R; Riesco, É; Perreault, K; Imbeault, P; Brochu, M; Dionne, I J

    2015-03-01

    We showed that obese insulin resistant postmenopausal women are characterized by higher lean body mass and elevated C-reactive protein. Although counterintuitive, we hypothesized that losses in muscle mass following caloric restriction and increase in muscle quality will be associated with improvements in glucose homeostasis through decreases in C-reactive protein. To determine 1) if improvements in C-reactive protein concentrations occurs through losses in lean body mass; and 2) if decreases in C-reactive protein levels contribute to improvements in insulin sensitivity. 50 postmenopausal women (body mass index>26 kg/m(²)) with impaired glucose disposal (program. Outcome measures were: Glucose disposal rate: M value (by hyperinsulinemic-euglycemic clamp), body composition (total, trunk, and appendicluar). LBM and FM by DXA), LBM index (LBM (kg)/height (m(2)), body fat distribution (VAT and SAT by CT scan) and plasma high-sensitive C-reactive protein (hsCRP) and interleukin-6 (Il-6). Significant correlations were observed between Δ hsCRP levels with Δ Il-6 (r=0.33, p≤0.05), Δ total LBM index (r=0.44, p≤0.01), Δ trunk LBM (r=0.38, p≤0.01) Δ SAT (r=0.35, p≤0.05) and ∆ glucose disposal rate (r=- 0.44, p≤0.01). After including all the correlated variables in Stepwise linear regression model, Δ LBM index was the only independent predictor of the reduction in hsCRP levels (R(2)=0.20, p≤0.01). Losses in total lean body mass are independently associated with improvements in inflammatory state (CRP levels) in obese postmenopausal women with impaired glucose disposal. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Lean Management

    OpenAIRE

    Picot, Arnold

    1994-01-01

    In this article the possibility of increase of competitiveness of the domestic enterprises by means of Lean management system is considered, and also the analysis of introduction of the mentioned system at the Russian enterprises is carried out. Besides, the key conditions necessary for successful introduction of system are presented. Lean management is a world-spread way of solving the problems, aimed at making the company competitive; it is the organized activity of staff of the company, fo...

  7. Changes in Lean Mass and Serum Myostatin with Habitual Protein Intake and High-Velocity Resistance Training.

    Science.gov (United States)

    Binns, A; Gray, M; Henson, A C; Fort, I L

    2017-01-01

    Examine the associations between dietary protein intake, lean mass (LM), and serum myostatin (Mstn) levels among community-dwelling older adults participating in a 20-week high-velocity resistance training (HVRT) program. This longitudinal study consisted of 33 community-dwelling, older adults (mean age 77.0 years, SD = 6.4); all of which obtained physician clearance prior to study participation. Twenty-five females and eight males were randomized to a control (CON) or HVRT group. Anthropometric measures were obtained via dual energy x-ray absorptiometry (DXA) and peripheral venous blood draw used for serum myostatin analysis. Exercise was performed twice per week for 20 consecutive weeks. Food intake estimation with a diet history questionnaire (DHQ) was used for protein intake comparison to the recommended dietary allowance (RDA). All measures were recorded both prior to and following study participation. Altogether, protein was consumed in amounts more generous (1.01 ± 0.47 g·kg-1·d-1) than that of the RDA (0.8 g·kg-1·d-1). As a result of significant LM differences among men and women (p myostatin was greater among females (6681.8 ± 3155.0 pg·mL-1) than males (5560.0 ± 2946.1 pg·mL-1); however, these values were not significantly different (p = 0.39). Combined, protein consumption and serum myostatin did not significantly influence LM among males (p = 0.09) or females (p = 0.71). Irrespective of training group, significant changes were not exhibited in dietary intake patterns, LM, or serum myostatin. Contrary to the proposed hypothesis, results suggest protein consumption and circulating serum myostatin levels did not significantly influence LM among older adults. Although HVRT positively impacts LM, neither exercise group displayed significant changes in LM. Therefore, further research is needed examining dietary intake, exercise modality, and myostatin downregulation as non-pharmacological approaches to combating sarcopenia.

  8. Creation of a predictive equation to estimate fat-free mass and the ratio of fat-free mass to skeletal size using morphometry in lean working farm dogs.

    Science.gov (United States)

    Leung, Y M; Cave, N J; Hodgson, B A S

    2018-06-27

    To develop an equation that accurately estimates fat-free mass (FFM) and the ratio of FFM to skeletal size or mass, using morphometric measurements in lean working farm dogs, and to examine the association between FFM derived from body condition score (BCS) and FFM measured using isotope dilution. Thirteen Huntaway and seven Heading working dogs from sheep and beef farms in the Waikato region of New Zealand were recruited based on BCS (BCS 4) using a nine-point scale. Bodyweight, BCS, and morphometric measurements (head length and circumference, body length, thoracic girth, and fore and hind limb length) were recorded for each dog, and body composition was measured using an isotopic dilution technique. A new variable using morphometric measurements, termed skeletal size, was created using principal component analysis. Models for predicting FFM, leanST (FFM minus skeletal mass) and ratios of FFM and leanST to skeletal size or mass were generated using multiple linear regression analysis. Mean FFM of the 20 dogs, measured by isotope dilution, was 22.1 (SD 4.4) kg and the percentage FFM of bodyweight was 87.0 (SD 5.0)%. Median BCS was 3.0 (min 1, max 6). Bodyweight, breed, age and skeletal size or mass were associated with measured FFM (pFFM and measured FFM (R 2 =0.96), and for the ratio of predicted FFM to skeletal size and measured values (R 2 =0.99). Correlation coefficients were higher for the ratio FFM and leanST to skeletal size than for ratios using skeletal mass. There was a positive correlation between BCS-derived fat mass as a percentage of bodyweight and fat mass percentage determined using isotope dilution (R 2 =0.65). As expected, the predictive equation was accurate in estimating FFM when tested on the same group of dogs used to develop the equation. The significance of breed, independent of skeletal size, in predicting FFM indicates that individual breed formulae may be required. Future studies that apply these equations on a greater population of

  9. A 4-week, lifestyle-integrated, home-based exercise training programme elicits improvements in physical function and lean mass in older men and women: a pilot study.

    Science.gov (United States)

    Cegielski, Jessica; Brook, Matthew S; Quinlan, Jonathan I; Wilkinson, Daniel J; Smith, Kenneth; Atherton, Philip J; Phillips, Bethan E

    2017-01-01

    Developing alternative exercise programmes that can alleviate certain barriers to exercise such as psychological, environmental or socio-economical barriers, but provide similar physiological benefits e.g. increases in muscle mass and strength, is of grave importance. This pilot study aimed to assess the efficacy of an unsupervised, 4-week, whole-body home-based exercise training (HBET) programme, incorporated into daily living activities, on skeletal muscle mass, power and strength. Twelve healthy older volunteers (63±3 years, 7 men: 5 women, BMI: 29±1 kg/m²) carried out the 4-week "lifestyle-integrated" HBET of 8 exercises, 3x12 repetitions each, every day. Before and after HBET, a number of physical function tests were carried out: unilateral leg extension 1-RM (one- repetition maximum), MVC (maximal voluntary contraction) leg extension, lower leg muscle power (via Nottingham Power Rig), handgrip strength and SPPBT (short physical performance battery test). A D 3 -Creatine method was used for assessment of whole-body skeletal muscle mass, and ultrasound was used to measure the quadriceps cross-sectional area (CSA) and vastus lateralis muscle thickness. Four weeks HBET elicited significant (p<0.05) improvements in leg muscle power (276.7±38.5 vs. 323.4±43.4 W), maximal voluntary contraction (60°: 154.2±18.4 vs. 168.8±15.2 Nm, 90°: 152.1±10.5 vs. 159.1±11.4 Nm) and quadriceps CSA (57.5±5.4 vs. 59.0±5.3 cm 2 ), with a trend for an increase in leg strength (1-RM: 45.7±5.9 vs. 49.6±6.0 kg, P=0.08). This was despite there being no significant differences in whole-body skeletal muscle mass, as assessed via D 3 -Creatine. This study demonstrates that increases in multiple aspects of muscle function can be achieved in older adults with just 4-weeks of "lifestyle-integrated" HBET, with a cost-effective means. This training mode may prove to be a beneficial alternative for maintaining and/or improving muscle mass and function in older adults.

  10. Characterization of Athabasca lean oil sands and mixed surficial materials: Comparison of capillary electrophoresis/low-resolution mass spectrometry and high-resolution mass spectrometry.

    Science.gov (United States)

    MacLennan, Matthew S; Peru, Kerry M; Swyngedouw, Chris; Fleming, Ian; Chen, David D Y; Headley, John V

    2018-05-15

    Oil sands mining in Alberta, Canada, requires removal and stockpiling of considerable volumes of near-surface overburden material. This overburden includes lean oil sands (LOS) which cannot be processed economically but contain sparingly soluble petroleum hydrocarbons and naphthenic acids, which can leach into environmental waters. In order to measure and track the leaching of dissolved constituents and distinguish industrially derived organics from naturally occurring organics in local waters, practical methods were developed for characterizing multiple sources of contaminated water leakage. Capillary electrophoresis/positive-ion electrospray ionization low-resolution time-of-flight mass spectrometry (CE/LRMS), high-resolution negative-ion electrospray ionization Orbitrap mass spectrometry (HRMS) and conventional gas chromatography/flame ionization detection (GC/FID) were used to characterize porewater samples collected from within Athabasca LOS and mixed surficial materials. GC/FID was used to measure total petroleum hydrocarbon and HRMS was used to measure total naphthenic acid fraction components (NAFCs). HRMS and CE/LRMS were used to characterize samples according to source. The amounts of total petroleum hydrocarbon in each sample as measured by GC/FID ranged from 0.1 to 15.1 mg/L while the amounts of NAFCs as measured by HRMS ranged from 5.3 to 82.3 mg/L. Factors analysis (FA) on HRMS data visually demonstrated clustering according to sample source and was correlated to molecular formula. LRMS coupled to capillary electrophoresis separation (CE/LRMS) provides important information on NAFC isomers by adding analyte migration time data to m/z and peak intensity. Differences in measured amounts of total petroleum hydrocarbons by GC/FID and NAFCs by HRMS indicate that the two methods provide complementary information about the nature of dissolved organic species in a soil or water leachate samples. NAFC molecule class O x S y is a possible tracer for LOS

  11. Differences in Adipose Tissue and Lean Mass Distribution in Patients with Collagen VI Related Myopathies Are Associated with Disease Severity and Physical Ability.

    Science.gov (United States)

    Rodríguez, M A; Del Rio Barquero, Luís M; Ortez, Carlos I; Jou, Cristina; Vigo, Meritxell; Medina, Julita; Febrer, Anna; Ramon-Krauel, Marta; Diaz-Manera, Jorge; Olive, Montse; González-Mera, Laura; Nascimento, Andres; Jimenez-Mallebrera, Cecilia

    2017-01-01

    Mutations in human collagen VI genes cause a spectrum of musculoskeletal conditions in children and adults collectively termed collagen VI-related myopathies (COL6-RM) characterized by a varying degree of muscle weakness and joint contractures and which include Ullrich Congenital Muscular Dystrophy (UCMD) and Bethlem Myopathy (BM). Given that collagen VI is one of the most abundant extracellular matrix proteins in adipose tissue and its emerging role in energy metabolism we hypothesized that collagen VI deficiency might be associated with alterations in adipose tissue distribution and adipokines serum profile. We analyzed body composition by means of dual-energy X-ray absorptiometry in 30 pediatric and adult COL6-RM myopathy patients representing a range of severities (UCMD, intermediate-COL6-RM, and BM). We found a distinctive pattern of regional adipose tissue accumulation which was more evident in children at the most severe end of the spectrum. In particular, the accumulation of fat in the android region was a distinguishing feature of UCMD patients. In parallel, there was a decrease in lean mass compatible with a state of sarcopenia, particularly in ambulant children with an intermediate phenotype. All children and adult patients that were sarcopenic were also obese. These changes were significantly more pronounced in children with collagen VI deficiency than in children with Duchenne Muscular Dystrophy of the same ambulatory status. High molecular weight adiponectin and leptin were significantly increased in sera from children in the intermediate and BM group. Correlation analysis showed that the parameters of fat mass were negatively associated with motor function according to several validated outcome measures. In contrast, lean mass parameters correlated positively with physical performance and quality of life. Leptin and adiponectin circulating levels correlated positively with fat mass parameters and negatively with lean mass and thus may be relevant to

  12. Differences in Adipose Tissue and Lean Mass Distribution in Patients with Collagen VI Related Myopathies Are Associated with Disease Severity and Physical Ability

    Directory of Open Access Journals (Sweden)

    M. A. Rodríguez

    2017-08-01

    Full Text Available Mutations in human collagen VI genes cause a spectrum of musculoskeletal conditions in children and adults collectively termed collagen VI-related myopathies (COL6-RM characterized by a varying degree of muscle weakness and joint contractures and which include Ullrich Congenital Muscular Dystrophy (UCMD and Bethlem Myopathy (BM. Given that collagen VI is one of the most abundant extracellular matrix proteins in adipose tissue and its emerging role in energy metabolism we hypothesized that collagen VI deficiency might be associated with alterations in adipose tissue distribution and adipokines serum profile. We analyzed body composition by means of dual-energy X-ray absorptiometry in 30 pediatric and adult COL6-RM myopathy patients representing a range of severities (UCMD, intermediate-COL6-RM, and BM. We found a distinctive pattern of regional adipose tissue accumulation which was more evident in children at the most severe end of the spectrum. In particular, the accumulation of fat in the android region was a distinguishing feature of UCMD patients. In parallel, there was a decrease in lean mass compatible with a state of sarcopenia, particularly in ambulant children with an intermediate phenotype. All children and adult patients that were sarcopenic were also obese. These changes were significantly more pronounced in children with collagen VI deficiency than in children with Duchenne Muscular Dystrophy of the same ambulatory status. High molecular weight adiponectin and leptin were significantly increased in sera from children in the intermediate and BM group. Correlation analysis showed that the parameters of fat mass were negatively associated with motor function according to several validated outcome measures. In contrast, lean mass parameters correlated positively with physical performance and quality of life. Leptin and adiponectin circulating levels correlated positively with fat mass parameters and negatively with lean mass and thus may

  13. Stable walking with asymmetric legs

    International Nuclear Information System (INIS)

    Merker, Andreas; Rummel, Juergen; Seyfarth, Andre

    2011-01-01

    Asymmetric leg function is often an undesired side-effect in artificial legged systems and may reflect functional deficits or variations in the mechanical construction. It can also be found in legged locomotion in humans and animals such as after an accident or in specific gait patterns. So far, it is not clear to what extent differences in the leg function of contralateral limbs can be tolerated during walking or running. Here, we address this issue using a bipedal spring-mass model for simulating walking with compliant legs. With the help of the model, we show that considerable differences between contralateral legs can be tolerated and may even provide advantages to the robustness of the system dynamics. A better understanding of the mechanisms and potential benefits of asymmetric leg operation may help to guide the development of artificial limbs or the design novel therapeutic concepts and rehabilitation strategies.

  14. A selective androgen receptor modulator with minimal prostate hypertrophic activity enhances lean body mass in male rats and stimulates sexual behavior in female rats.

    Science.gov (United States)

    Allan, George F; Tannenbaum, Pamela; Sbriscia, Tifanie; Linton, Olivia; Lai, Muh-Tsann; Haynes-Johnson, Donna; Bhattacharjee, Sheela; Zhang, Xuqing; Sui, Zhihua; Lundeen, Scott G

    2007-08-01

    Androgen receptor (AR) ligands with tissue selectivity (selective androgen receptor modulators, or SARMs) have potential for treating muscle wasting, hypogonadism of aging, osteoporosis, female sexual dysfunction, and other indications. JNJ-28330835 is a nonsteroidal AR ligand with mixed agonist and antagonist activity in androgen-responsive cell-based assays. It is an orally active SARM with muscle selectivity in orchidectomized rat models. It stimulated growth of the levator ani muscle, stimulating maximal growth at a dose of 10 mg/kg. At the same time, JNJ-28330835 reduced prostate weight in intact rats by a mean of 30% at 10 mg/kg, while having no inhibitory effect on muscle. Using magnetic resonance imaging (MRI) to monitor body composition, it prevented half of the loss of lean body mass associated with orchidectomy, and restored about 30% of lost lean mass to aged orchidectomized rats. It had agonist effects on markers of both osteoclast and osteoblast activity, suggesting that it reduces bone turnover. In a model of sexual behavior, JNJ-28330835 enhanced the preference of ovariectomized female rats for sexually intact male rats over nonsexual orchidectomized males. JNJ-28330835 is a prostate-sparing SARM with the potential for clinically beneficial effects in muscle-wasting diseases and sexual function disorders.

  15. Massage therapy during early postnatal life promotes greater lean mass and bone growth, mineralization, and strength in juvenile and young adult rats.

    Science.gov (United States)

    Chen, H; Miller, S; Shaw, J; Moyer-Mileur, L

    2009-01-01

    The objects of this study were to investigate the effects of massage therapy during early life on postnatal growth, body composition, and skeletal development in juvenile and young adult rats. Massage therapy was performed for 10 minutes daily from D6 to D10 of postnatal life in rat pups (MT, n=24). Body composition, bone area, mineral content, and bone mineral density were measured by dual energy X-ray absorptiometry (DXA); bone strength and intrinsic stiffness on femur shaft were tested by three-point bending; cortical and cancellous bone histomorphometric measurements were performed at D21 and D60. Results were compared to age- and gender-matched controls (C, n=24). D21 body weight, body length, lean mass, and bone area were significantly greater in the MT cohort. Greater bone mineral content was found in male MT rats; bone strength and intrinsic stiffness were greater in D60 MT groups. At D60 MT treatment promoted bone mineralization by increasing trabecular mineral apposition rate in male and endosteal mineral surface in females, and also improved micro-architecture by greater trabeculae width in males and decreasing trabecular separation in females. In summary, massage therapy during early life elicited immediate and prolonged anabolic effects on postnatal growth, lean mass and skeletal developmental in a gender-specific manner in juvenile and young adult rats.

  16. Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial123

    Science.gov (United States)

    de Souza, Russell J; Carey, Vincent J; Hall, Kevin D; LeBoff, Meryl S; Loria, Catherine M; Laranjo, Nancy M; Sacks, Frank M; Smith, Steven R

    2012-01-01

    Background: Weight loss reduces body fat and lean mass, but whether these changes are influenced by macronutrient composition of the diet is unclear. Objective: We determined whether energy-reduced diets that emphasize fat, protein, or carbohydrate differentially reduce total, visceral, or hepatic fat or preserve lean mass. Design: In a subset of participants in a randomized trial of 4 weight-loss diets, body fat and lean mass (n = 424; by using dual-energy X-ray absorptiometry) and abdominal and hepatic fat (n = 165; by using computed tomography) were measured after 6 mo and 2 y. Changes from baseline were compared between assigned amounts of protein (25% compared with 15%) and fat (40% compared with 20%) and across 4 carbohydrate amounts (35% through 65%). Results: At 6 mo, participants lost a mean (±SEM) of 4.2 ± 0.3 kg (12.4%) fat and 2.1 ± 0.3 kg (3.5%) lean mass (both P fat (P ≥ 0.34), or 65% and 35% carbohydrate (P ≥ 0.27). Participants lost 2.3 ± 0.2 kg (13.8%) abdominal fat: 1.5 ± 0.2 kg (13.6%) subcutaneous fat and 0.9 ± 0.1 kg (16.1%) visceral fat (all P fat than did men relative to total-body fat loss. Participants regained ∼40% of these losses by 2 y, with no differences between diets (P ≥ 0.23). Weight loss reduced hepatic fat, but there were no differences between groups (P ≥ 0.28). Dietary goals were not fully met; self-reported contrasts were closer to 2% protein, 8% fat, and 14% carbohydrate at 6 mo and 1%, 7%, and 10%, respectively, at 2 y. Conclusion: Participants lost more fat than lean mass after consumption of all diets, with no differences in changes in body composition, abdominal fat, or hepatic fat between assigned macronutrient amounts. This trial was registered at clinicaltrials.gov as NCT00072995. PMID:22258266

  17. Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial.

    Science.gov (United States)

    de Souza, Russell J; Bray, George A; Carey, Vincent J; Hall, Kevin D; LeBoff, Meryl S; Loria, Catherine M; Laranjo, Nancy M; Sacks, Frank M; Smith, Steven R

    2012-03-01

    Weight loss reduces body fat and lean mass, but whether these changes are influenced by macronutrient composition of the diet is unclear. We determined whether energy-reduced diets that emphasize fat, protein, or carbohydrate differentially reduce total, visceral, or hepatic fat or preserve lean mass. In a subset of participants in a randomized trial of 4 weight-loss diets, body fat and lean mass (n = 424; by using dual-energy X-ray absorptiometry) and abdominal and hepatic fat (n = 165; by using computed tomography) were measured after 6 mo and 2 y. Changes from baseline were compared between assigned amounts of protein (25% compared with 15%) and fat (40% compared with 20%) and across 4 carbohydrate amounts (35% through 65%). At 6 mo, participants lost a mean (±SEM) of 4.2 ± 0.3 kg (12.4%) fat and 2.1 ± 0.3 kg (3.5%) lean mass (both P fat (P ≥ 0.34), or 65% and 35% carbohydrate (P ≥ 0.27). Participants lost 2.3 ± 0.2 kg (13.8%) abdominal fat: 1.5 ± 0.2 kg (13.6%) subcutaneous fat and 0.9 ± 0.1 kg (16.1%) visceral fat (all P fat than did men relative to total-body fat loss. Participants regained ~40% of these losses by 2 y, with no differences between diets (P ≥ 0.23). Weight loss reduced hepatic fat, but there were no differences between groups (P ≥ 0.28). Dietary goals were not fully met; self-reported contrasts were closer to 2% protein, 8% fat, and 14% carbohydrate at 6 mo and 1%, 7%, and 10%, respectively, at 2 y. Participants lost more fat than lean mass after consumption of all diets, with no differences in changes in body composition, abdominal fat, or hepatic fat between assigned macronutrient amounts. This trial was registered at clinicaltrials.gov as NCT00072995.

  18. Lean healthcare.

    Science.gov (United States)

    Weinstock, Donna

    2008-01-01

    As healthcare organizations look for new and improved ways to reduce costs and still offer quality healthcare, many are turning to the Toyota Production System of doing business. Rather than focusing on cutting personnel and assets, "lean healthcare" looks to improve patient satisfaction through improved actions and processes.

  19. Exercise is More Effective at Altering Gut Microbial Composition and Producing Stable Changes in Lean Mass in Juvenile versus Adult Male F344 Rats.

    Directory of Open Access Journals (Sweden)

    Agnieszka Mika

    Full Text Available The mammalian intestine harbors a complex microbial ecosystem that influences many aspects of host physiology. Exposure to specific microbes early in development affects host metabolism, immune function, and behavior across the lifespan. Just as the physiology of the developing organism undergoes a period of plasticity, the developing microbial ecosystem is characterized by instability and may also be more sensitive to change. Early life thus presents a window of opportunity for manipulations that produce adaptive changes in microbial composition. Recent insights have revealed that increasing physical activity can increase the abundance of beneficial microbial species. We therefore investigated whether six weeks of wheel running initiated in the juvenile period (postnatal day 24 would produce more robust and stable changes in microbial communities versus exercise initiated in adulthood (postnatal day 70 in male F344 rats. 16S rRNA gene sequencing was used to characterize the microbial composition of juvenile versus adult runners and their sedentary counterparts across multiple time points during exercise and following exercise cessation. Alpha diversity measures revealed that the microbial communities of young runners were less even and diverse, a community structure that reflects volatility and malleability. Juvenile onset exercise altered several phyla and, notably, increased Bacteroidetes and decreased Firmicutes, a configuration associated with leanness. At the genus level of taxonomy, exercise altered more genera in juveniles than in the adults and produced patterns associated with adaptive metabolic consequences. Given the potential of these changes to contribute to a lean phenotype, we examined body composition in juvenile versus adult runners. Interestingly, exercise produced persistent increases in lean body mass in juvenile but not adult runners. Taken together, these results indicate that the impact of exercise on gut microbiota

  20. Effect of Leg Dominance on The Center-of-Mass Kinematics During an Inside-of-the-Foot Kick in Amateur Soccer Players.

    Science.gov (United States)

    Zago, Matteo; Motta, Andrea Francesco; Mapelli, Andrea; Annoni, Isabella; Galvani, Christel; Sforza, Chiarella

    2014-09-29

    Soccer kicking kinematics has received wide interest in literature. However, while the instep-kick has been broadly studied, only few researchers investigated the inside-of-the-foot kick, which is one of the most frequently performed techniques during games. In particular, little knowledge is available about differences in kinematics when kicking with the preferred and non-preferred leg. A motion analysis system recorded the three-dimensional coordinates of reflective markers placed upon the body of nine amateur soccer players (23.0 ± 2.1 years, BMI 22.2 ± 2.6 kg/m2), who performed 30 pass-kicks each, 15 with the preferred and 15 with the non-preferred leg. We investigated skill kinematics while maintaining a perspective on the complete picture of movement, looking for laterality related differences. The main focus was laid on: anatomical angles, contribution of upper limbs in kick biomechanics, kinematics of the body Center of Mass (CoM), which describes the whole body movement and is related to balance and stability. When kicking with the preferred leg, CoM displacement during the ground-support phase was 13% higher (p<0.001), normalized CoM height was 1.3% lower (p<0.001) and CoM velocity 10% higher (p<0.01); foot and shank velocities were about 5% higher (p<0.01); arms were more abducted (p<0.01); shoulders were rotated more towards the target (p<0.01, 6° mean orientation difference). We concluded that differences in motor control between preferred and non-preferred leg kicks exist, particularly in the movement velocity and upper body kinematics. Coaches can use these results to provide effective instructions to players in the learning process, moving their focus on kicking speed and upper body behavior.

  1. Effects of elastic band exercise on lean mass and physical capacity in older women with sarcopenic obesity: A randomized controlled trial.

    Science.gov (United States)

    Liao, Chun-De; Tsauo, Jau-Yih; Huang, Shih-Wei; Ku, Jan-Wen; Hsiao, Dun-Jen; Liou, Tsan-Hon

    2018-02-02

    Sarcopenia is associated with loss of muscle mass as well as an increased risk of physical disability in elderly people. This study was aimed to investigate the effect of elastic band resistance training (ERT) on muscle mass and physical function in older women with sarcopenic obesity. A randomized controlled trial with an intention-to-treat analysis was conducted. A total of 56 women (mean ± SD age 67.3 ± 5.1 years) were randomly assigned to the experimental group receiving 12 weeks of ERT and to the control group receiving no exercise intervention. Lean mass (measured using a dual-energy X-ray absorptiometer), physical capacity (assessed using the global physical capacity score), and a 36-item short form questionnaire were conducted at the baseline examination (T 0 ), as well as the 3-month (T 1 ) and 9-month followups (T 2 ). At T 1 and T 2 , the between-group difference was measured in total skeletal mass relative to T 0 , with mean differences of 0.70 kg (95% CI 0.12-1.28; P physical capacity, and physical function outcomes. The ERT exerted a significant beneficial effect on muscle mass, muscle quality, and physical function in older women with sarcopenic obesity.

  2. Lean consumption.

    Science.gov (United States)

    Womack, James P; Jones, Daniel T

    2005-03-01

    During the past 20 years, the real price of most consumer goods has fallen worldwide, the variety of goods and the range of sales channels offering them have continued to grow, and product quality has steadily improved. So why is consumption often so frustrating? It doesn't have to be--and shouldn't be--the authors say. They argue that it's time to apply lean thinking to the processes of consumption--to give consumers the full value they want from goods and services with the greatest efficiency and the least pain. Companies may think they save time and money by off-loading work to the consumer but, in fact, the opposite is true. By streamlining their systems for providing goods and services, and by making it easier for customers to buy and use those products and services, a growing number of companies are actually lowering costs while saving everyone time. In the process, these businesses are learning more about their customers, strengthening consumer loyalty, and attracting new customers who are defecting from less user-friendly competitors. The challenge lies with the retailers, service providers, manufacturers, and suppliers that are not used to looking at total cost from the standpoint of the consumer and even less accustomed to working with customers to optimize the consumption process. Lean consumption requires a fundamental shift in the way companies think about the relationship between provision and consumption, and the role their customers play in these processes. It also requires consumers to change the nature of their relationships with the companies they patronize. Lean production has clearly triumphed over similar obstacles in recent years to become the dominant global manufacturing model. Lean consumption, its logical companion, can't be far behind.

  3. [Overweight and obesity in young adults: relevance of job-related changes of exercise on fat, lean body and body mass in students].

    Science.gov (United States)

    Kemmler, Wolfgang; Kohl, Matthias; Bebenek, Michael; von Stengel, Simon

    2015-03-01

    Early adulthood is related to changes in lifestyle that negatively affect body weight and health. The aim of the study was to determine the effect of exercise changes on the development of weight and body composition in college students.Sixty-one randomly selected dental (ZMS) and 53 sport students (SLS) were accompanied over 5 years. Body mass, fat and lean body mass (LBM) were determined via DXA-technique. Exercise and physical activity were assessed by questionnaires and interviews.All exercise indices significantly increased in the SLS and significantly decreased in the ZMS. Physical activity slightly increased in both groups. Both cohorts comparably gained body mass, however, the increase in the SLS group can be attributed to LBM-changes with minor changes of fat-mass (2.4 % ± 3.3 % vs. 0.1 ± 1.0 %) whereas ZMS gained fat and LBM in a proportion of 2:1.Maintenance/increase of exercise compensate the negative effects of lifestyle changes on body composition during young adulthood.

  4. Moderately Low Magnesium Intake Impairs Growth of Lean Body Mass in Obese-Prone and Obese-Resistant Rats Fed a High-Energy Diet

    Directory of Open Access Journals (Sweden)

    Jesse Bertinato

    2016-04-01

    Full Text Available The physical and biochemical changes resulting from moderately low magnesium (Mg intake are not fully understood. Obesity and associated co-morbidities affect Mg metabolism and may exacerbate Mg deficiency and physiological effects. Male rats selectively bred for diet-induced obesity (OP, obese-prone or resistance (OR, obese-resistant were fed a high-fat, high-energy diet containing moderately low (LMg, 0.116 ± 0.001 g/kg or normal (NMg, 0.516 ± 0.007 g/kg Mg for 13 weeks. The growth, body composition, mineral homeostasis, bone development, and glucose metabolism of the rats were examined. OP and OR rats showed differences (p < 0.05 in many physical and biochemical measures regardless of diet. OP and OR rats fed the LMg diet had decreased body weight, lean body mass, decreased femoral size (width, weight, and volume, and serum Mg and potassium concentrations compared to rats fed the NMg diet. The LMg diet increased serum calcium (Ca concentration in both rat strains with a concomitant decrease in serum parathyroid hormone concentration only in the OR strain. In the femur, Mg concentration was reduced, whereas concentrations of Ca and sodium were increased in both strains fed the LMg diet. Plasma glucose and insulin concentrations in an oral glucose tolerance test were similar in rats fed the LMg or NMg diets. These results show that a moderately low Mg diet impairs the growth of lean body mass and alters femoral geometry and mineral metabolism in OP and OR rats fed a high-energy diet.

  5. Increased Leg Bone Mineral Density and Content During the Initial Years of College Sport.

    Science.gov (United States)

    Scerpella, John J; Buehring, Bjoern; Hetzel, Scott J; Heiderscheit, Bryan C

    2018-04-01

    Scerpella, JJ, Buehring, B, Hetzel, SJ, and Heiderscheit, BC. Increased leg bone mineral density and content during the initial years of college sport. J Strength Cond Res 32(4): 1123-1130, 2018-Bone mineral density (BMD) and bone mineral content (BMC) data are useful parameters for evaluating how training practices promote bone health. We used dual-energy X-ray absorptiometry (DXA) to longitudinally assess sport-specific growth in leg and total body BMD/BMC over the initial 2 years of collegiate training. Eighty-five Division 1 collegiate basketball, hockey, and soccer athletes (50 males and 35 females; age 19.0 [0.8] years) underwent annual DXA scans. Leg and total body BMD/BMC were compared within and across two 1-year intervals (periods 1 and 2) using repeated-measures analysis of variance, adjusting for age, sex, race, and sport. Leg BMD, leg BMC, and total body BMC all increased over period 1 (0.05 g·cm [p = 0.001], 0.07 kg [p = 0.002], and 0.19 kg [p BMC (p BMC (p = 0.005). Leg lean mass increased more during period 2 than period 1 (p = 0.018). Sports participation was the only significant predictor of change in leg BMD. Significant increases in both leg BMD and BMC were demonstrated over both 2-year periods, with greater gains during period 1. These gains highlight the importance of attentive training procedures, capitalizing on attendant physical benefits of increased BMD/BMC. Additional research in young adults, evaluating bone mass acquisition, will optimize performance and decrease risk of bone stress injury among collegiate athletes.

  6. Leg pain

    Science.gov (United States)

    ... in the blood Medicines (such as diuretics and statins) Muscle fatigue or strain from overuse, too much exercise, or holding a muscle in the same position for a long time An injury can also cause leg pain from: A torn or overstretched muscle ( strain ) Hairline ...

  7. Broken Leg

    Science.gov (United States)

    ... the leg, which can result in a fracture. Stress fractures outside of sport situations are more common in people who have: ... shoes. Choose the appropriate shoe for your favorite sports or activities. And ... can prevent stress fractures. Rotate running with swimming or biking. If ...

  8. The increase in physical performance and gain in lean and fat mass occur in prepubertal children independent of mode of school transportation. One year data from the prospective controlled Pediatric Osteoporosis Prevention (POP) Study

    Science.gov (United States)

    2009-01-01

    Background The aim of this 12-month study in pre-pubertal children was to evaluate the effect of school transportation on gain in lean and fat mass, muscle strength and physical performance. Methods Ninety-seven girls and 133 boys aged 7-9 years from the Malmö Pediatric Osteoporosis Prevention Study were included. Regional lean and fat mass were assessed by dual energy X-ray absorptiometry, isokinetic peak torque of knee extensors and flexors by a computerised dynamometer and physical performance by vertical jump height. Level of physical activity was assessed by accelerometers. The 12-month changes in children who walked or cycled to school were compared with changes in those who travelled by bus or car. Results There were no differences in baseline or annual changes in lean or fat mass gain, muscle strength or physical performance between the two groups. All children reached the internationally recommended level of 60 minutes per day of moderate or high physical activity by accelerometers. Conclusion The choice of school transportation in pre-pubertal children seems not to influence the gain in lean and fat mass, muscle strength or functional ability, probably as the everyday physical activity is so high that the mode of school transportation contributes little to the total level of activity.

  9. High Whey Protein Intake Delayed the Loss of Lean Body Mass in Healthy Old Rats, whereas Protein Type and Polyphenol/Antioxidant Supplementation Had No Effects

    Science.gov (United States)

    Mosoni, Laurent; Gatineau, Eva; Gatellier, Philippe; Migné, Carole; Savary-Auzeloux, Isabelle; Rémond, Didier; Rocher, Emilie; Dardevet, Dominique

    2014-01-01

    Our aim was to compare and combine 3 nutritional strategies to slow down the age-related loss of muscle mass in healthy old rats: 1) increase protein intake, which is likely to stimulate muscle protein anabolism; 2) use leucine rich, rapidly digested whey proteins as protein source (whey proteins are recognized as the most effective proteins to stimulate muscle protein anabolism). 3) Supplement animals with a mixture of chamomile extract, vitamin E, vitamin D (reducing inflammation and oxidative stress is also effective to improve muscle anabolism). Such comparisons and combinations were never tested before. Nutritional groups were: casein 12% protein, whey 12% protein, whey 18% protein and each of these groups were supplemented or not with polyphenols/antioxidants. During 6 months, we followed changes of weight, food intake, inflammation (plasma fibrinogen and alpha-2-macroglobulin) and body composition (DXA). After 6 months, we measured muscle mass, in vivo and ex-vivo fed and post-absorptive muscle protein synthesis, ex-vivo muscle proteolysis, and oxidative stress parameters (liver and muscle glutathione, SOD and total antioxidant activities, muscle carbonyls and TBARS). We showed that although micronutrient supplementation reduced inflammation and oxidative stress, the only factor that significantly reduced the loss of lean body mass was the increase in whey protein intake, with no detectable effect on muscle protein synthesis, and a tendency to reduce muscle proteolysis. We conclude that in healthy rats, increasing protein intake is an effective way to delay sarcopenia. PMID:25268515

  10. Male sex, height, weight, and body mass index can increase external pressure to calf region using knee-crutch-type leg holder system in lithotomy position.

    Science.gov (United States)

    Mizuno, Ju; Takahashi, Toru

    2016-01-01

    Well-leg compartment syndrome (WLCS) is one of the catastrophic complications related to prolonged surgical procedures performed in the lithotomy position, using a knee-crutch-type leg holder (KCLH) system, to support the popliteal fossae and calf regions. Obesity has been implicated as a risk factor in the lithotomy position-related WLCS during surgery. In the present study, we investigated the relationship between the external pressure (EP) applied to the calf region using a KCLH system in the lithotomy position and selected physical characteristics. Twenty-one young, healthy volunteers (21.4±0.5 years of age, eleven males and ten females) participated in this study. The KCLH system used was Knee Crutch(®). We assessed four types of EPs applied to the calf region: box pressure, peak box pressure, contact pressure, and peak contact pressure, using pressure-distribution measurement system (BIG-MAT(®)). Relationships between these four EPs to the calf regions of both lower legs and a series of physical characteristics (sex, height, weight, and body mass index [BMI]) were analyzed. All four EPs applied to the bilateral calf regions were higher in males than in females. For all subjects, significant positive correlations were observed between all four EPs and height, weight, and BMI. EP applied to the calf region is higher in males than in females when the subject is supported by a KCLH system in the lithotomy position. In addition, EP increases with the increase in height, weight, and BMI. Therefore, male sex, height, weight, and BMI may contribute to the risk of inducing WLCS.

  11. Skeletal muscle mass and exercise performance in stable ambulatory patients with heart failure.

    Science.gov (United States)

    Lang, C C; Chomsky, D B; Rayos, G; Yeoh, T K; Wilson, J R

    1997-01-01

    The purpose of this study was to determine whether skeletal muscle atrophy limits the maximal exercise capacity of stable ambulatory patients with heart failure. Body composition and maximal exercise capacity were measured in 100 stable ambulatory patients with heart failure. Body composition was assessed by using dual-energy X-ray absorption. Peak exercise oxygen consumption (VO2peak) and the anaerobic threshold were measured by using a Naughton treadmill protocol and a Medical Graphics CardioO2 System. VO2peak averaged 13.4 +/- 3.3 ml.min-1.kg-1 or 43 +/- 12% of normal. Lean body mass averaged 52.9 +/- 10.5 kg and leg lean mass 16.5 +/- 3.6 kg. Leg lean mass correlated linearly with VO2peak (r = 0.68, P < 0.01), suggesting that exercise performance is influences by skeletal muscle mass. However, lean body mass was comparable to levels noted in 1,584 normal control subjects, suggesting no decrease in muscle mass. Leg muscle mass was comparable to levels noted in 34 normal control subjects, further supporting this conclusion. These findings suggest that exercise intolerance in stable ambulatory patients with heart failure is not due to skeletal muscle atrophy.

  12. Effects of Whey Protein Alone or as Part of a Multi-ingredient Formulation on Strength, Fat-Free Mass, or Lean Body Mass in Resistance-Trained Individuals: A Meta-analysis.

    Science.gov (United States)

    Naclerio, Fernando; Larumbe-Zabala, Eneko

    2016-01-01

    Even though the positive effects of whey protein-containing supplements for optimizing the anabolic responses and adaptations process in resistance-trained individuals have been supported by several investigations, their use continues to be controversial. Additionally, the administration of different multi-ingredient formulations where whey proteins are combined with carbohydrates, other protein sources, creatine, and amino acids or derivatives, has been extensively proposed as an effective strategy to maximize strength and muscle mass gains in athletes. We aimed to systematically summarize and quantify whether whey protein-containing supplements, administered alone or as a part of a multi-ingredient, could improve the effects of resistance training on fat-free mass or lean body mass, and strength in resistance-trained individuals when compared with other iso-energetic supplements containing carbohydrates or other sources of proteins. A structured literature search was conducted on PubMed, Science Direct, Web of Science, Cochrane Libraries, US National Institutes of Health clinicaltrials.gov, SPORTDiscus, and Google Scholar databases. Main inclusion criteria comprised randomized controlled trial study design, adults (aged 18 years and over), resistance-trained individuals, interventions (a resistance training program for a period of 6 weeks or longer, combined with whey protein supplementation administered alone or as a part of a multi-ingredient), and a calorie equivalent contrast supplement from carbohydrates or other non-whey protein sources. Continuous data on fat-free mass and lean body mass, and maximal strength were pooled using a random-effects model. Data from nine randomized controlled trials were included, involving 11 treatments and 192 participants. Overall, with respect to the ingestion of contrast supplements, whey protein supplementation, administered alone or as part of a multi-ingredient, in combination with resistance training, was associated

  13. Appendicular and whole body lean mass outcomes are associated with finite element analysis-derived bone strength at the distal radius and tibia in adults aged 40years and older.

    Science.gov (United States)

    Gibbs, Jenna C; Giangregorio, Lora M; Wong, Andy K O; Josse, Robert G; Cheung, Angela M

    2017-10-01

    The purpose of this cross-sectional study was to determine how appendicular lean mass index (ALMI), and whole body lean (LMI) and fat mass indices (FMI) associate with estimated bone strength outcomes at the distal radius and tibia in adults aged 40 years and older. Dual energy X-ray absorptiometry (DXA) scans were performed to determine body composition, including whole body lean and fat mass, and appendicular lean mass. ALMI (appendicular lean mass/height 2 ), LMI (lean tissue mass/height 2 ) and FMI (fat mass/height 2 ) were calculated. High-resolution peripheral quantitative computed tomography (HRpQCT) scans were performed to assess bone structural properties at the distal radius and tibia. Using finite element analysis, failure load (N), stiffness (N/mm), ultimate stress (MPa), and cortical-to-trabecular load ratio were estimated from HRpQCT scans. The associations between body composition (ALMI, LMI, FMI) and estimated bone strength were examined using bivariate and multivariable linear regression analyses adjusting for age, sex, and other confounding variables. In 197 participants (127 women; mean±SD, age: 69.5±10.3y, body mass index: 27.95±4.95kg/m 2 , ALMI: 7.31±1.31kg/m 2 ), ALMI and LMI were significantly associated with failure load at the distal radius and tibia (explained 39%-48% of the variance) and remained significant after adjusting for confounding variables and multiple testing (R 2 =0.586-0.645, p<0.001). ALMI, LMI, and FMI did not have significant associations with ultimate stress in our multivariable models. FMI was significantly associated with cortical-to-trabecular load ratio at the distal radius and tibia (explained 6%-12% of the variance) and remained significant after adjusting for confounders and multiple testing (R 2 =0.208-0.243, p<0.001). FMI was no longer significantly associated with failure load after adjusting for confounders. These findings suggest that ALMI and LMI are important determinants of estimated bone strength

  14. Association of lean body mass with nutritional parameters and mortality in hemodialysis patients: A long-term follow-up clinical study.

    Science.gov (United States)

    Zhou, Dong Chi; Yang, Xiu Hong; Zhan, Xiao Li; Gu, Yan Hong; Guo, Li Li; Jin, Hui Min

    2018-06-01

    This study aimed to evaluate the correlation between lean body mass (LBM) and nutritional status in hemodialysis (HD) patients to better predict their long-term prognosis. Anthropometric body measurements and biochemical parameters were recorded from 222 patients on maintenance hemodialysis (MHD) at the Shanghai Pudong Hospital Hemodialysis Center. LBM was calculated using the serum creatinine index (LBM-SCR), mid-arm muscle circumference (LBM-MAMC), and dominant-arm hand-grip strength (LBM-HGS). Patient mortality and hospitalization were observed after 24 months. LBMs measured from LBM-SCR and LBM-MAMC were associated with sex, body mass index (BMI), serum albumin, and serum creatinine (SCR) ( p LBM evaluation, low LBM was shown to be associated with a higher mortality in patients undergoing HD ( p LBM-SCR and LBM-HGS are strongly associated with hospitalization and mortality in HD patients, indicating LBM is an important factor in prediction of outcomes in those patients. LBM is associated with nutritional parameters in HD patients, and LBM-SCR, HGS, and MAMC are simple approaches for accurately predicting the patient's risk of hospitalization and/or death.

  15. Dietary restraint partially mediates the relationship between impulsivity and binge eating only in lean individuals: The importance of accounting for body mass in studies of restraint

    Directory of Open Access Journals (Sweden)

    Jaime Ashley Coffino

    2016-10-01

    Full Text Available Binge eating is characteristic of eating and weight-related disorders such as binge eating disorder, bulimia nervosa, and obesity. In light of data that suggests impulsivity is associated with overeating specifically in restrained eaters, this study sought to elucidate the exact nature of the associations between these variables, hypothesizing that the relationship between impulsivity and binge eating is mediated by restrained eating. We further hypothesized that the role of dietary restraint as a mediator would be moderated by body mass index (BMI. Study participants (n = 506, 50.6% female were categorized based on self-reported BMI as under- and normal weight (BMI < 25, 65.8%, n = 333 or overweight and obese (BMI ≥ 25, 34.2%, n = 173 and completed the restrained eating subscale of the Dutch Eating Behavior Questionnaire, the difficulties with impulse control subscale of the Difficulties with Emotion Regulation Scale, and the Binge Eating Scale. Findings provide initial evidence for the hypothesized moderated mediation model, with dietary restraint partially mediating the relationship between impulsivity and binge eating severity only in lean respondents. In respondents with overweight or obesity, impulsivity was significantly correlated with binge eating severity, but dietary restraint was not. Findings inform our conceptualization of dietary restraint as a possible risk factor for binge eating and highlight the importance of accounting for body mass in research on the impact of dietary restraint on eating behaviors.

  16. Psoas Muscle Cross-sectional Area as a Measure of Whole-body Lean Muscle Mass in Maintenance Hemodialysis Patients.

    Science.gov (United States)

    Morrell, Glen R; Ikizler, Talat A; Chen, Xiaorui; Heilbrun, Marta E; Wei, Guo; Boucher, Robert; Beddhu, Srinivasan

    2016-07-01

    We investigate whether psoas or paraspinous muscle area measured on a single L4-L5 image is a useful measure of whole lean body mass (LBM) compared to dedicated midthigh magnetic resonance imaging (MRI). Observational study. Outpatient dialysis units and a research clinic. One hundred five adult participants on maintenance hemodialysis. No control group was used. Psoas muscle area, paraspinous muscle area, and midthigh muscle area (MTMA) were measured by magnetic resonance imaging. LBM was measured by dual-energy absorptiometry scan. In separate multivariable linear regression models, psoas, paraspinous, and MTMA were associated with increase in LBM. In separate multivariate logistic regression models, C statistics for diagnosis of sarcopenia (defined as <25th percentile of LBM) were 0.69 for paraspinous muscle area, 0.81 for psoas muscle area, and 0.89 for MTMA. With sarcopenia defined as <10th percentile of LBM, the corresponding C statistics were 0.71, 0.92, and 0.94. We conclude that psoas muscle area provides a good measure of whole-body muscle mass, better than paraspinous muscle area but slightly inferior to midthigh measurement. Hence, in body composition studies a single axial MR image at the L4-L5 level can be used to provide information on both fat and muscle and may eliminate the need for time-consuming measurement of muscle area in the thigh. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  17. Lean years

    Energy Technology Data Exchange (ETDEWEB)

    Barnet, R J

    1982-01-01

    The author attempts to take stock of five critical systems of resources: Energy, mineral resources, food, water, and human abilities. All five systems have been integrated, to an ever-increasing extent in global control systems. These control systems determine how many people, in what parts of the world, will be faced with hunger, cold, or unemployment. The author tries to find out who is in charge of these control systems, how they have come into existence, and on what strategies they are based. In the final chapter, ''Policy of survival'', the author states that the secret of survival in the lean years to come is still in the dark. Man's most fundamental desire is to be human, i.e. to be in harmony with nature both psychologically and biologically. Politics should take account of this and provide us with the means for doing what is necessary.

  18. Direct Determination of Lean Body Mass by CT in F-18 FDG PET/CT Studies: Comparison with Estimates Using Predictive Equations.

    Science.gov (United States)

    Kim, Chang Guhn; Kim, Woo Hyoung; Kim, Myoung Hyoun; Kim, Dae-Weung

    2013-06-01

    The purpose of this study was to estimate lean body mass (LBM) using CT (LBM CTs) and compare the results with LBM estimates of four different predictive equations (LBM PEs) to assess whether LBM CTs and LBM PEs can be used interchangeably for SUV normalization. Whole-body F-18 FDG PET/CT studies were conducted on 392 patients. LBM CT1 is modified adipose tissue-free body mass, and LBM CT2 is adipose tissue-free body mass. Four different PEs were used for comparison (LBM PE1-4). Agreement between the two measurement methods was assessed by Bland-Altman analysis. We calculated the difference between two methods (bias), the percentage of difference, and the limits of agreement, expressed as a percentage. For LBM CTs vs. LBM PEs, except LBM PE3, the ranges of biases and limits of agreement were -3.77 to 3.81 kg and 26.60-35.05 %, respectively, indicating the wide limits of agreement and differing magnitudes of bias. For LBM CTs vs. LBM PE3, LBM PE3 had wider limits of agreement and greater positive bias (44.28-46.19 % and 10.49 to 14.04 kg, respectively), showing unacceptably large discrepancies between LBM CTs and LBM PE3. This study demonstrated that there are substantial discrepancies between individual LBM CTs and LBM PEs, and this should be taken into account when LBM CTs and LBM PEs are used interchangeably between patients.

  19. Accuracy and Utility of Estimating Lean Body Mass and Nutritional Status in Patients with Chronic Kidney Disease on Long-Term Hemodialysis Using Anthropometric Skinfold Thickness Measurements.

    Science.gov (United States)

    Leong, Khai Gene; Chee, Jia Lian; Karahalios, Amalia; Skelley, Annabelle; Wong, Kim

    2018-01-01

    Malnutrition is common in patients on hemodialysis (prevalence of 30% to 50%) and is associated with higher mortality. Lean body mass (LBM) assessment is an accurate way of assessing nutritional status. The dual-energy X-ray absorptiometry (DEXA) scan is a reliable method in assessing body compositions and LBM; however, it is expensive and largely inaccessible. Anthropometric skinfold thickness measurement (ASFM) is useful in assessing LBM. It is cheaper and accessible, but underutilized clinically. The subjective global score (SGA) is a well-established method of assessing nutritional status. All three methods of assessing nutritional status were compared. In this pilot observational study, there was a significant correlation between LBM% estimated by DEXA and ASFM (mean difference -1.46% [95% CI -4.09 to 1.18]; LOA -14.0 to 11.1). Nutritional status by SGA could only detect those severely malnourished when using LBM% by ASFM as comparison. Our study demonstrated that ASFM is a useful method of assessing LBM and nutritional status, which can be easily utilized clinically. Copyright© by the American Nephrology Nurses Association.

  20. Association of protein intake with the change of lean mass among elderly women: The Osteoporosis Risk Factor and Prevention - Fracture Prevention Study (OSTPRE-FPS).

    Science.gov (United States)

    Isanejad, Masoud; Mursu, Jaakko; Sirola, Joonas; Kröger, Heikki; Rikkonen, Toni; Tuppurainen, Marjo; Erkkilä, Arja T

    2015-01-01

    Low protein intake can lead to declined lean mass (LM) in elderly. We examined the associations of total protein (TP), animal protein (AP) and plant protein (PP) intakes with LM. The association of TP intake with LM change was further evaluated according to weight change status. This cross-sectional and prospective cohort study included 554 women aged 68 (sd 1·9) years from the Osteoporosis Risk Factor and Prevention - Fracture Prevention Study (OSTPRE-FPS). The intervention group (n 270) received daily cholecalciferol (800 IU; 20 μg) and Ca (1000 mg) for 3 years while the control group received neither supplementation nor placebo (n 282). Participants filled out a questionnaire on lifestyle factors and a 3-d food record in 2002 and underwent dual-energy X-ray absorptiometry for body composition measurements at baseline and 3 years. Multiple linear regressions evaluated the association between protein intake and LM, adjusting for relevant covariates. At the baseline TP and AP intakes were positively associated with LM and trunk LM, TP was associated also with appendicular LM (aLM). Follow-up results showed that in the total population and the intervention group, higher TP and AP were associated with increased LM and aLM (P ≤ 0·050). No such associations were observed in the control group. PP intake was also associated with aLM change in the total population. Overall, the associations were independent of fat mass. Further, among weight maintainers, TP intake was positively associated with LM, aLM and trunk LM changes (P ≤ 0·020). In conclusion, dietary TP, especially AP, intake may be a modifiable risk factor for sarcopenia by preserving LM in the elderly.

  1. Induction of IL-6 by Cytotoxic Chemotherapy Is Associated With Loss of Lean Body and Fat Mass in Tumor-free Female Mice.

    Science.gov (United States)

    Elsea, Collin R; Kneiss, Janet A; Wood, Lisa J

    2015-10-01

    Cancer patients treated with cytotoxic chemotherapy experience fatigue and changes in body composition that can impact physical functioning and quality of life during and after treatment. Interleukin-6 (IL-6) is associated with fatigue in cancer survivors and plays an important role in the regulation of body composition. The purpose of the present study was to determine the specific role of IL-6 in cyclophosphamide-doxorubicin-5-fluorouracil (CAF)-induced changes in fatigue, food intake, and body composition using mice lacking IL-6. Female wild-type (WT) and IL-6 (-/-) mice were injected with four cycles of CAF or normal saline (NS) administered at 21-day intervals. Daily voluntary wheel-running activity (VWRA), used as a proxy for fatigue, and food intake were monitored daily up to 21 days after the fourth dose. Dual-energy X-ray absorptiometry (DEXA) was used to assess treatment-related changes in lean body mass (LBM), fat mass (FM), and bone mineral content (BMC). Patterns of change in fatigue and food intake did not differ between CAF-treated WT and IL-6 (-/-) mice. However, a Genotype × Drug interaction was observed for LBM (p = 0.047) and FM (p = 0.035) but not BMC (p = .569). Whereas WT mice lost LBM and FM during CAF treatment, IL-6-deficient mice did not. Treatment-related decreases in levels of the anabolic hormone insulin-like growth factor-1 (IGF-1) may contribute to LBM and FM loss since CAF decreased IGF-1 levels in an IL-6-dependent manner. These findings implicate IL-6 and possibly IGF-1 in the regulation of body composition in breast cancer patients exposed to cytotoxic chemotherapy. © The Author(s) 2014.

  2. Quantification of trunk and android lean mass using dual energy x-ray absorptiometry compared to magnetic resonance imaging after spinal cord injury.

    Science.gov (United States)

    Rankin, Kathleen C; O'Brien, Laura C; Gorgey, Ashraf S

    2018-02-20

    To determine whether dual energy x-ray absorptiometry (DXA) compared to magnetic resonance imaging (MRI) may accurately quantify trunk lean mass (LM) after chronic spinal cord injury (SCI) and to investigate the relationships between trunk LM, visceral adiposity, trunk fat mass and basal metabolic rate (BMR). Cross-sectional design and correlational analysis. Research setting in a medical center. Twenty-two men with motor complete paraplegia (n = 14; T4-T11) and tetraplegia (n = 8; C5-C7) were recruited as part of a clinical trial. Not applicable. Trunk and android LM were measured using DXA. The volume of six trunk muscle groups were then measured using MRI to quantify trunk LM-MRI. Subcutaneous and visceral adipose tissue (VAT) cross-sectional areas were also measured using MRI. After overnight fast, BMR was evaluated using indirect calorimetry. Trunk LM-DXA (24 ± 3.3 kg) and android LM-DXA (3.6 ± 0.7 kg) overestimated (P android LM-DXA + 0.126; r 2 =0.26, SEE= 0.21 kg, P = 0.018. Percentage trunk LM-MRI was inversely related to VAT (r=-0.79, P android LM-DXA overestimated trunk LM-MRI. Percentage trunk LM-MRI, but not LM-DXA, was inversely related to trunk central adiposity. The findings highlight the importance of exercising trunk LM to attenuate cardio-metabolic disorders after SCI.

  3. Trunk lean mass and its association with 4 different measures of thoracic kyphosis in older community dwelling persons.

    Directory of Open Access Journals (Sweden)

    J Yamamoto

    Full Text Available The causes of age-related hyperkyphosis (HK include osteoporosis, but only 1/3 of those most severely affected have vertebral fractures, suggesting that there are other important, and potentially modifiable causes. We hypothesized that muscle mass and quality may be important determinants of kyphosis in older persons.We recruited 72 persons >65 years to participate in a prospective study designed to evaluate kyphosis and fall risk. At the baseline visit, participants had their body composition measures completed using Dual Energy X-ray Absorptiometry (DXA. They had kyphosis measured in either the standing [S] or lying [L] position: 1 Cobb angle from DXA [L]; 2 Debrunner kyphometer [S]; 3 architect's flexicurve ruler [S]; and 4 blocks method [L]. Multivariable linear/logistic regression analyses were done to assess the association between each body composition and 4 kyphosis measures.Women (n = 52 were an average age of 76.8 (SD 6.7 and men 80.5 (SD 7.8 years. They reported overall good/excellent health (93%, the average body mass index was 25.3 (SD 4.6 and 35% reported a fall in the past year. Using published cut-offs, about 20-30% were determined to have HK. For the standing assessments of kyphosis only, after adjusting for age, sex, weight and hip BMD, persons with lower TLM were more likely to be hyperkyphotic.Lower TLM is associated with HK in older persons. The results were stronger when standing measures of kyphosis were used, suggesting that the effects of muscle on thoracic kyphosis are best appreciated under spinal loading conditions.

  4. Whole-body bone mineral content, lean body mass, and fat mass measured by dual-energy x-ray absorptiometry in a population of normal Canadian children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Sala, A. [McMaster Children' s Hospital, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Pediatrics, Hamilton, Ontario (Canada); Univ. of Milan-Bicocca, Monza (Italy); Webber, C.E. [Hamilton Health Sciences, Dept. of Nuclear Medicine, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Radiology, Hamilton, Ontario (Canada)]. E-mail: webber@hhsc.ca; Morrison, J. [McMaster Children' s Hospital, Hamilton, Ontario (Canada); Beaumont, L.F. [Hamilton Health Sciences, Dept. of Nuclear Medicine, Hamilton, Ontario (Canada); Barr, R.D. [McMaster Children' s Hospital, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Pediatrics, Hamilton, Ontario (Canada)

    2007-02-15

    Measurements of body composition have evident value in evaluating growing children and adolescents, and dual-energy X-ray absorptiometry (DXA) is a tool that provides accurate measurements of whole-body bone mineral content (WBBMC), lean body mass (LBM), and fat mass (FM). To interpret such measurements in the context of ill health, normative values must be available. Such information could be expected to be regionally specific because of differences in ethnic, dietary, and physical activity determinants. In this study, DXA was performed with Hologic densitometers in normal girls (n = 91) and boys (n 88) between 3 and 18 years of age. The derivation of normal ranges is presented for boys and girls. The correlation of the sum of WBBMC, LBM, and FM with directly measured body weight was almost perfect (r > 0.997). As expected, FM and body mass index correlated strongly. The normal values for WBBMC, LBM, and FM from this study are compared with other Canadian data and with published normative data from Argentina and the Netherlands, all of which use different densitometers. The results of this study allow the calculation of z scores for each facet of body composition and facilitate the use of DXA to report routine evaluations of body composition in children and adolescents. (author)

  5. Whole-body bone mineral content, lean body mass, and fat mass measured by dual-energy x-ray absorptiometry in a population of normal Canadian children and adolescents

    International Nuclear Information System (INIS)

    Sala, A.; Webber, C.E.; Morrison, J.; Beaumont, L.F.; Barr, R.D.

    2007-01-01

    Measurements of body composition have evident value in evaluating growing children and adolescents, and dual-energy X-ray absorptiometry (DXA) is a tool that provides accurate measurements of whole-body bone mineral content (WBBMC), lean body mass (LBM), and fat mass (FM). To interpret such measurements in the context of ill health, normative values must be available. Such information could be expected to be regionally specific because of differences in ethnic, dietary, and physical activity determinants. In this study, DXA was performed with Hologic densitometers in normal girls (n = 91) and boys (n 88) between 3 and 18 years of age. The derivation of normal ranges is presented for boys and girls. The correlation of the sum of WBBMC, LBM, and FM with directly measured body weight was almost perfect (r > 0.997). As expected, FM and body mass index correlated strongly. The normal values for WBBMC, LBM, and FM from this study are compared with other Canadian data and with published normative data from Argentina and the Netherlands, all of which use different densitometers. The results of this study allow the calculation of z scores for each facet of body composition and facilitate the use of DXA to report routine evaluations of body composition in children and adolescents. (author)

  6. Effect of β-hydroxy-β-methylbutyrate (HMB) on lean body mass during 10 days of bed rest in older adults.

    Science.gov (United States)

    Deutz, Nicolaas E P; Pereira, Suzette L; Hays, Nicholas P; Oliver, Jeffery S; Edens, Neile K; Evans, Chris M; Wolfe, Robert R

    2013-10-01

    Loss of muscle mass due to prolonged bed rest decreases functional capacity and increases hospital morbidity and mortality in older adults. To determine if HMB, a leucine metabolite, is capable of attenuating muscle decline in healthy older adults during complete bed rest. A randomized, controlled, double-blinded, parallel-group design study was carried out in 24 healthy (SPPB ≥ 9) older adult subjects (20 women, 4 men), confined to complete bed rest for ten days, followed by resistance training rehabilitation for eight weeks. Subjects in the experimental group were treated with HMB (calcium salt, 1.5 g twice daily - total 3 g/day). Control subjects were treated with an inactive placebo powder. Treatments were provided starting 5 days prior to bed rest till the end rehabilitation phase. DXA was used to measure body composition. Nineteen eligible older adults (BMI: 21-33; age: 60-76 year) were evaluable at the end of the bed rest period (Control n = 8; Ca-HMB n = 11). Bed rest caused a significant decrease in total lean body mass (LBM) (2.05 ± 0.66 kg; p = 0.02, paired t-test) in the Control group. With the exclusion of one subject, treatment with HMB prevented the decline in LBM over bed rest -0.17 ± 0.19 kg; p = 0.23, paired t-test). There was a statistically significant difference between treatment groups for change in LBM over bed rest (p = 0.02, ANOVA). Sub-analysis on female subjects (Control = 7, HMB = 8) also revealed a significant difference in change in LBM over bed rest between treatment groups (p = 0.04, ANOVA). However, differences in function parameters could not be observed, probably due to the sample size of the study. In healthy older adults, HMB supplementation preserves muscle mass during 10 days of bed rest. These results need to be confirmed in a larger trial. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  7. Lean body mass as an independent determinant of dose-limiting toxicity and neuropathy in patients with colon cancer treated with FOLFOX regimens

    International Nuclear Information System (INIS)

    Ali, Raafi; Sawyer, Michael B.; Bianchi, Laurent; Roberts, Sarah; Mollevi, Caroline; Senesse, Pierre; Baracos, Vickie E.; Assenat, Eric

    2016-01-01

    Evidence suggests that lean body mass (LBM) may be useful to normalize chemotherapy doses. Data from one prospective and one retrospective study were used to determine if the highest doses of oxaliplatin/kg LBM within FOLFOX regimens would be associated with dose-limiting toxicity (DLT) in colon cancer patients. Toxicity over four cycles was graded according to NCI Common Toxicity Criteria V2 or V3 (Common Terminology Criteria for Adverse Events, National Cancer Institute, Bethesda, MD). Muscle tissue was measured by computerized tomography (CT) and used to evaluate the LBM compartment of the whole body. In prospective randomized clinical trials conducted in France (n = 58), for patients given FOLFOX-based regimens according to body surface area, values of oxaliplatin/kg LBM were highly variable, ranging from 2.55 to 6.6 mg/kg LBM. A cut point of 3.09 mg oxaliplatin/kg LBM for developing toxicity was determined by Receiver Operating Characteristic (ROC) analysis, below this value 0/17 (0.0%) of patients experienced DLT; in contrast above this value 18/41 (44.0%) of patients were dose reduced or had treatment terminated owing to toxicity (≥Grade 3 or neuropathy ≥Grade 2); for 9/41 the DLT was sensory neuropathy. These findings were validated in an independent cohort of colon cancer patients (n = 80) receiving FOLFOX regimens as part of standard care, in Canada. Low LBM is a significant predictor of toxicity and neuropathy in patients administered FOLFOX-based regimens using conventional body surface area (BSA) dosing

  8. Relationship of low lean body mass with body weight increase until one year of age and current lifestyles in Japanese young women.

    Science.gov (United States)

    Miyamoto, Shoji; Murotani, Kenta; Yanagawa, Takashi; Kato, Atsushi; Matsunaga, Satoshi

    2010-06-01

    To investigate factors affecting the low lean body mass (LBM) of young women, we focused on the increase in body weight until one year of age and current lifestyles. In 442 young women, the increase in body weight from birth until one year of age, breast-feeding method in infancy, current physique index and body composition, and physique and lifestyles were investigated using a questionnaire. Subjects with an LBM percentile of less than 33.3 (less than 36.8 kg) were classified as having a low LBM (n = 150), and those with a 33.3 or higher LBM percentile as the control (n = 293). Based on body weight changes from birth to days 3 and 7, the subjects were divided into a rapid weight gain group and two non-rapid weight gain groups (groups 1-3). To analyze factors involved in a low LBM, multivariate analysis using a logistic model was employed. The prevalence of a low LBM in the rapid weight gain group was 0.41 times higher than in the others. The prevalence of a low LBM with a low birth weight was 0.58 times higher, indicating that a low birth weight is likely to result in a low LBM. Regarding the lifestyles, the prevalence of a low LBM in subjects with a current breakfasting habit was 0.60 times higher than in those without one. These findings suggest that the thinness of young women characterized by a low LBM is associated with the increase in body weight until one year of age and current lifestyles.

  9. Intermittent Fasting Promotes Fat Loss With Lean Mass Retention, Increased Hypothalamic Norepinephrine Content, and Increased Neuropeptide Y Gene Expression in Diet-Induced Obese Male Mice.

    Science.gov (United States)

    Gotthardt, Juliet D; Verpeut, Jessica L; Yeomans, Bryn L; Yang, Jennifer A; Yasrebi, Ali; Roepke, Troy A; Bello, Nicholas T

    2016-02-01

    Clinical studies indicate alternate-day, intermittent fasting (IMF) protocols result in meaningful weight loss in obese individuals. To further understand the mechanisms sustaining weight loss by IMF, we investigated the metabolic and neural alterations of IMF in obese mice. Male C57/BL6 mice were fed a high-fat diet (HFD; 45% fat) ad libitum for 8 weeks to promote an obese phenotype. Mice were divided into four groups and either maintained on ad libitum HFD, received alternate-day access to HFD (IMF-HFD), and switched to ad libitum low-fat diet (LFD; 10% fat) or received IMF of LFD (IMF-LFD). After 4 weeks, IMF-HFD (∼13%) and IMF-LFD (∼18%) had significantly lower body weights than the HFD. Body fat was also lower (∼40%-52%) in all diet interventions. Lean mass was increased in the IMF-LFD (∼12%-13%) compared with the HFD and IMF-HFD groups. Oral glucose tolerance area under the curve was lower in the IMF-HFD (∼50%), whereas the insulin tolerance area under the curve was reduced in all diet interventions (∼22%-42%). HPLC measurements of hypothalamic tissue homogenates indicated higher (∼55%-60%) norepinephrine (NE) content in the anterior regions of the medial hypothalamus of IMF compared with the ad libitum-fed groups, whereas NE content was higher (∼19%-32%) in posterior regions in the IMF-LFD group only. Relative gene expression of Npy in the arcuate nucleus was increased (∼65%-75%) in IMF groups. Our novel findings indicate that intermittent fasting produces alterations in hypothalamic NE and neuropeptide Y, suggesting the counterregulatory processes of short-term weight loss are associated with an IMF dietary strategy.

  10. The effects of a high dosage of creatine and caffeine supplementation on the lean body mass composition of rats submitted to vertical jumping training

    Directory of Open Access Journals (Sweden)

    Carneiro-Junior Miguel A

    2011-03-01

    Full Text Available Abstract Background The influences of creatine and caffeine supplementation associated with power exercise on lean body mass (LBM composition are not clear. The purpose of this research was to determine whether supplementation with high doses of creatine and caffeine, either solely or combined, affects the LBM composition of rats submitted to vertical jumping training. Methods Male Wistar rats were randomly divided into 8 groups: Sedentary (S or Exercised (E [placebo (Pl, creatine (Cr, caffeine (Caf or creatine plus caffeine (CrCaf]. The supplemented groups received creatine [load: 0.430 g/kg of body weight (BW for 7 days; and maintenance: 0.143 g/kg of BW for 35 days], caffeine (15 mg/kg of BW for 42 days or creatine plus caffeine. The exercised groups underwent a vertical jump training regime (load: 20 - 50% of BW, 4 sets of 10 jumps interspersed with 1 min resting intervals, 5 days/wk, for 6 weeks. LBM composition was evaluated by portions of water, protein and fat in the rat carcass. Data were submitted to ANOVA followed by the Tukey post hoc test and Student's t test. Results Exercised animals presented a lower carcass weight (10.9%; P = 0.01, as compared to sedentary animals. However, no effect of supplementation was observed on carcass weight (P > 0.05. There were no significant differences among the groups (P > 0.05 for percentage of water in the carcass. The percentage of fat in the group SCr was higher than in the groups SCaf and ECr (P Conclusions High combined doses of creatine and caffeine does not affect the LBM composition of either sedentary or exercised rats, however, caffeine supplementation alone reduces the percentage of fat. Vertical jumping training increases the percentages of water and protein and reduces the fat percentage in rats.

  11. Internal lean practitioner's challenges in lean principles ...

    African Journals Online (AJOL)

    The approach to this paper is to answer the questions such as “how does internal management commitment impact the Lean principles?”, “how does Supply Chain Management practices impact the lean principles?”, “can Supply Chain Management practices be embedded with internal management commitment?

  12. Magnetic resonance imaging findings of the lumbar spine in elite horseback riders: correlations with back pain, body mass index, trunk/leg-length coefficient, and riding discipline.

    Science.gov (United States)

    Kraft, Clayton N; Pennekamp, Peter H; Becker, Ute; Young, Mei; Diedrich, Oliver; Lüring, Christian; von Falkenhausen, Makus

    2009-11-01

    Most orthopaedic problems experienced by competitive horseback riders are related to pain in the lower back, hip joint, and hamstring muscles. Riders-especially, show jumpers-are frequently hampered in their performance because of lumbar pain. To date, there has been no research into lumbar disk degeneration in elite competitive riders. Competitive horseback riding accelerates lumbar disk degeneration. Cross-sectional study; Level of evidence, 3. Fifty-eight elite riders (18 men, 40 women; mean age, 32.4 years) and a control group of 30 nonriding volunteers (17 men, 13 women; mean age, 28.7 years) were evaluated for lumbar disk degeneration, cross-sectional area of paraspinal muscles, spondylolysis, and spondylolisthesis, using magnetic resonance imaging (MRI). The prevalence of disk degeneration between the 2 groups was compared, and the relationship was investigated between low back pain (LBP), riding discipline, body mass index (BMI), trunk/leg-length coefficient, and MRI results. Eighty-eight percent of elite riders (n = 51) had a history of LBP, versus 33% of the controls (P back pain. Although riders have a high prevalence of LBP, there is no conclusive MRI evidence to suggest that the cause lies in undue disk degeneration, spondylolysis, spondylolisthesis, or pathologic changes of the paraspinal muscles of the lumbar spine.

  13. Implementation of lean leadership

    Directory of Open Access Journals (Sweden)

    Trenkner Małgorzata

    2016-12-01

    Full Text Available The Toyota case proves that lean leadership is of critical importance for the successful implementation and permanent functioning of Lean Production System. There is no ready formula for developing Toyota style lean leadership. However, one may gain inspiration from its experience.

  14. Lean information management

    NARCIS (Netherlands)

    Hammer, D.K.

    1997-01-01

    The concept of a Lean Enterprise has proven to be extremely valuable for making companies fit for today's competitive business environment. Lean Information Management denotes the type of information management that is appropriate for such all organization. According to the paradigm of a Lean

  15. Does a crouched leg posture enhance running stability and robustness?

    Science.gov (United States)

    Blum, Yvonne; Birn-Jeffery, Aleksandra; Daley, Monica A; Seyfarth, Andre

    2011-07-21

    Humans and birds both walk and run bipedally on compliant legs. However, differences in leg architecture may result in species-specific leg control strategies as indicated by the observed gait patterns. In this work, control strategies for stable running are derived based on a conceptual model and compared with experimental data on running humans and pheasants (Phasianus colchicus). From a model perspective, running with compliant legs can be represented by the planar spring mass model and stabilized by applying swing leg control. Here, linear adaptations of the three leg parameters, leg angle, leg length and leg stiffness during late swing phase are assumed. Experimentally observed kinematic control parameters (leg rotation and leg length change) of human and avian running are compared, and interpreted within the context of this model, with specific focus on stability and robustness characteristics. The results suggest differences in stability characteristics and applied control strategies of human and avian running, which may relate to differences in leg posture (straight leg posture in humans, and crouched leg posture in birds). It has been suggested that crouched leg postures may improve stability. However, as the system of control strategies is overdetermined, our model findings suggest that a crouched leg posture does not necessarily enhance running stability. The model also predicts different leg stiffness adaptation rates for human and avian running, and suggests that a crouched avian leg posture, which is capable of both leg shortening and lengthening, allows for stable running without adjusting leg stiffness. In contrast, in straight-legged human running, the preparation of the ground contact seems to be more critical, requiring leg stiffness adjustment to remain stable. Finally, analysis of a simple robustness measure, the normalized maximum drop, suggests that the crouched leg posture may provide greater robustness to changes in terrain height

  16. Structural imaging of the brain reveals decreased total brain and total gray matter volumes in obese but not in lean women with polycystic ovary syndrome compared to body mass index-matched counterparts.

    Science.gov (United States)

    Ozgen Saydam, Basak; Has, Arzu Ceylan; Bozdag, Gurkan; Oguz, Kader Karli; Yildiz, Bulent Okan

    2017-07-01

    To detect differences in global brain volumes and identify relations between brain volume and appetite-related hormones in women with polycystic ovary syndrome (PCOS) compared to body mass index-matched controls. Forty subjects participated in this study. Cranial magnetic resonance imaging and measurements of fasting ghrelin, leptin and glucagon-like peptide 1 (GLP-1), as well as GLP-1 levels during mixed-meal tolerance test (MTT), were performed. Total brain volume and total gray matter volume (GMV) were decreased in obese PCOS compared to obese controls (p lean PCOS and controls did not show a significant difference. Secondary analyses of regional brain volumes showed decreases in GMV of the caudate nucleus, ventral diencephalon and hippocampus in obese PCOS compared to obese controls (p lean patients with PCOS had lower GMV in the amygdala than lean controls (p PCOS, suggests volumetric reductions in global brain areas in obese women with PCOS. Functional studies with larger sample size are needed to determine physiopathological roles of these changes and potential effects of long-term medical management on brain structure of PCOS.

  17. Nine weeks of supplementation with a multi-nutrient product augments gains in lean mass, strength, and muscular performance in resistance trained men

    Directory of Open Access Journals (Sweden)

    Lemieux Robert

    2010-12-01

    Full Text Available Abstract Background The purpose of this study was to compare the effects of supplementation with Gaspari Nutrition's SOmaxP Maximum Performance™ (SOmaxP versus a comparator product (CP containing an equal amount of creatine (4 g, carbohydrate (39 g maltodextrin, and protein (7 g whey protein hydrolysate on muscular strength, muscular endurance, and body composition during nine weeks of intense resistance training. Methods Using a prospective, randomized, double-blind design, 20 healthy men (mean ± SD age, height, weight, % body fat: 22.9 ± 2.6 y, 178.4 ± 5.7 cm, 80.5 ± 6.6 kg, 16.6 ± 4.0% were matched for age, body weight, resistance training history, bench press strength, bench press endurance, and percent body fat and then randomly assigned via the ABBA procedure to ingest 1/2 scoop (dissolved in 15 oz water of SOmaxP or CP prior to, and another 1/2 scoop (dissolved in 15 oz water during resistance exercise. Body composition (DEXA, muscular performance (1-RM bench press and repetitions to failure [RTF: 3 sets × baseline body weight, 60-sec rest between sets], and clinical blood chemistries were measured at baseline and after nine weeks of supplementation and training. Subjects were required to maintain their normal dietary habits and follow a specific, progressive overload resistance training program (4-days/wk, upper body/lower body split during the study. An intent-to-treat approach was used and data were analyzed via ANCOVA using baseline values as the covariate. Statistical significance was set a priori at p ≤ 0.05. Results When adjusted for initial differences, significant between group post-test means were noted in: 1-RM bench press (SOmaxP: 133.3 ± 1.3 kg [19.8% increase] vs. CP: 128.5 ± 1.3 kg [15.3% increase]; p Conclusions These data indicate that compared to CP, SOmaxP administration augments and increases gains in lean mass, bench press strength, and muscular performance during nine weeks of intense resistance training

  18. Predictive performance of the 'Minto' remifentanil pharmacokinetic parameter set in morbidly obese patients ensuing from a new method for calculating lean body mass.

    Science.gov (United States)

    La Colla, Luca; Albertin, Andrea; La Colla, Giorgio; Porta, Andrea; Aldegheri, Giorgio; Di Candia, Domenico; Gigli, Fausto

    2010-01-01

    In a previous article, we showed that the pharmacokinetic set of remifentanil used for target-controlled infusion (TCI) might be biased in obese patients because it incorporates flawed equations for the calculation of lean body mass (LBM), which is a covariate of several pharmacokinetic parameters in this set. The objectives of this study were to determine the predictive performance of the original pharmacokinetic set, which incorporates the James equation for LBM calculation, and to determine the predictive performance of the pharmacokinetic set when a new method to calculate LBM was used (the Janmahasatian equations). This was an observational study with intraoperative observations and no follow-up. Fifteen morbidly obese inpatients scheduled for bariatric surgery were included in the study. The intervention included manually controlled continuous infusion of remifentanil during the surgery and analysis of arterial blood samples to determine the arterial remifentanil concentration, to be compared with concentrations predicted by either the unadjusted or the adjusted pharmacokinetic set. The statistical analysis included parametric and non-parametric tests on continuous variables and determination of the median performance error (MDPE), median absolute performance error (MDAPE), divergence and wobble. The median values (interquartile ranges) of the MDPE, MDAPE, divergence and wobble for the James equations during maintenance were -53.4% (-58.7% to -49.2%), 53.4% (49.0-58.7%), 3.3% (2.9-4.7%) and 1.4% h(-1) (1.1-2.5% h(-1)), respectively. The respective values for the Janmahasatian equations were -18.9% (-24.2% to -10.4%), 20.5% (13.3-24.8%), 2.6% (-0.7% to 4.5%) and 1.9% h(-1) (1.4-3.0% h(-1)). The performance (in terms of the MDPE and MDAPE) of the corrected pharmacokinetic set was better than that of the uncorrected one. The predictive performance of the original pharmacokinetic set is not clinically acceptable. Use of a corrected LBM value in morbidly obese

  19. The effects of a high dosage of creatine and caffeine supplementation on the lean body mass composition of rats submitted to vertical jumping training.

    Science.gov (United States)

    Franco, Frederico Sc; Costa, Neuza Mb; Ferreira, Susana A; Carneiro-Junior, Miguel A; Natali, Antônio J

    2011-03-01

    The influences of creatine and caffeine supplementation associated with power exercise on lean body mass (LBM) composition are not clear. The purpose of this research was to determine whether supplementation with high doses of creatine and caffeine, either solely or combined, affects the LBM composition of rats submitted to vertical jumping training. Male Wistar rats were randomly divided into 8 groups: Sedentary (S) or Exercised (E) [placebo (Pl), creatine (Cr), caffeine (Caf) or creatine plus caffeine (CrCaf)]. The supplemented groups received creatine [load: 0.430 g/kg of body weight (BW) for 7 days; and maintenance: 0.143 g/kg of BW for 35 days], caffeine (15 mg/kg of BW for 42 days) or creatine plus caffeine. The exercised groups underwent a vertical jump training regime (load: 20 - 50% of BW, 4 sets of 10 jumps interspersed with 1 min resting intervals), 5 days/wk, for 6 weeks. LBM composition was evaluated by portions of water, protein and fat in the rat carcass. Data were submitted to ANOVA followed by the Tukey post hoc test and Student's t test. Exercised animals presented a lower carcass weight (10.9%; P = 0.01), as compared to sedentary animals. However, no effect of supplementation was observed on carcass weight (P > 0.05). There were no significant differences among the groups (P > 0.05) for percentage of water in the carcass. The percentage of fat in the group SCr was higher than in the groups SCaf and ECr (P < 0.05). A higher percentage of protein was observed in the groups EPl and ECaf when compared to the groups SPl and SCaf (P < 0.001). The percentage of fat in the carcass decreased (P < 0.001), while those of water and protein increased (P < 0.05) in exercised animals, compared to sedentary animals. Caffeine groups presented reduced percentage of fat when compared to creatine supplemented groups (P < 0.05). High combined doses of creatine and caffeine does not affect the LBM composition of either sedentary or exercised rats, however, caffeine

  20. Lang vej endnu før bilindustrien er Lean

    DEFF Research Database (Denmark)

    Christiansen, Thomas Bøhm

    2005-01-01

    Anmeldelse og diskussion af bogen "The Second Century: Reconnecting Customer and Value Chain through Build-to-order - Moving beyond Mass and Lean Production in the Auto Industry......Anmeldelse og diskussion af bogen "The Second Century: Reconnecting Customer and Value Chain through Build-to-order - Moving beyond Mass and Lean Production in the Auto Industry...

  1. A 4-week, lifestyle-integrated, home-based exercise training programme elicits improvements in physical function and lean mass in older men and women: a pilot study [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Jessica Cegielski

    2017-09-01

    Full Text Available Background: Developing alternative exercise programmes that can alleviate certain barriers to exercise such as psychological, environmental or socio-economical barriers, but provide similar physiological benefits e.g. increases in muscle mass and strength, is of grave importance. This pilot study aimed to assess the efficacy of an unsupervised, 4-week, whole-body home-based exercise training (HBET programme, incorporated into daily living activities, on skeletal muscle mass, power and strength. Methods: Twelve healthy older volunteers (63±3 years, 7 men: 5 women, BMI: 29±1 kg/m² carried out the 4-week “lifestyle-integrated” HBET of 8 exercises, 3x12 repetitions each, every day. Before and after HBET, a number of physical function tests were carried out: unilateral leg extension 1-RM (one- repetition maximum, MVC (maximal voluntary contraction leg extension, lower leg muscle power (via Nottingham Power Rig, handgrip strength and SPPBT (short physical performance battery test. A D3-Creatine method was used for assessment of whole-body skeletal muscle mass, and ultrasound was used to measure the quadriceps cross-sectional area (CSA and vastus lateralis muscle thickness. Results: Four weeks HBET elicited significant (p<0.05 improvements in leg muscle power (276.7±38.5 vs. 323.4±43.4 W, maximal voluntary contraction (60°: 154.2±18.4 vs. 168.8±15.2 Nm, 90°: 152.1±10.5 vs. 159.1±11.4 Nm and quadriceps CSA (57.5±5.4 vs. 59.0±5.3 cm2, with a trend for an increase in leg strength (1-RM: 45.7±5.9 vs. 49.6±6.0 kg, P=0.08. This was despite there being no significant differences in whole-body skeletal muscle mass, as assessed via D3-Creatine. Conclusions: This study demonstrates that increases in multiple aspects of muscle function can be achieved in older adults with just 4-weeks of “lifestyle-integrated” HBET, with a cost-effective means. This training mode may prove to be a beneficial alternative for maintaining and/or improving

  2. Performance effect of Lean

    DEFF Research Database (Denmark)

    Kristensen, Thomas Borup; Israelsen, Poul

    2016-01-01

    To understand how the practices of Lean affect performance, we tested and validated a system-wide approach using mediating relationships in a structural equation model. We used a cross-sectional survey of 200 Danish companies that indicated that they used Lean. Thus, this study is especially...... relevant to Denmark, but the approach is empirically more generalizable. We show that the effect of Lean standardized flow production practices on performance is mediated by analytical continuous improvement empowerment practices and by delegation of decision rights practices. Thus, standardized flow...... of decision rights. The paper provides evidence that supports the view that middle managers’ actions further enhance performance in Lean companies. The right Lean behavior by middle managers increases the level of analytical continuous improvement empowerment. In total, high-performing Lean companies...

  3. LEAN dig ikke tilbage

    DEFF Research Database (Denmark)

    Weirsøe, Mathilde

    2011-01-01

    Fit, slankere, hurtigst. Lean-konceptet ruller ind over de offentlige institutioner, hvor det skal trimme og effektivisere arbejdsprocesser. Men hvor er den maksimale grænse for effektivitet? Er der et ’tipping point’, hvor Lean ikke længere motiverer, men snarere udmatter......Fit, slankere, hurtigst. Lean-konceptet ruller ind over de offentlige institutioner, hvor det skal trimme og effektivisere arbejdsprocesser. Men hvor er den maksimale grænse for effektivitet? Er der et ’tipping point’, hvor Lean ikke længere motiverer, men snarere udmatter...

  4. Sources of variation in estimates of lean body mass by creatinine kinetics and by methods based on body water or body mass index in patients on continuous peritoneal dialysis.

    Science.gov (United States)

    Tzamaloukas, Antonios H; Murata, Glen H; Piraino, Beth; Raj, Dominic S C; VanderJagt, Dorothy J; Bernardini, Judith; Servilla, Karen S; Sun, Yijuan; Glew, Robert H; Oreopoulos, Dimitrios G

    2010-03-01

    We identified factors that account for differences between lean body mass computed from creatinine kinetics (LBM(cr)) and from either body water (LBM(V)) or body mass index (LBM(BMI)) in patients on continuous peritoneal dialysis (CPD). We compared the LBM(cr) and LBM(V) or LBM(BMI) in hypothetical subjects and actual CPD patients. We studied 439 CPD patients in Albuquerque, Pittsburgh, and Toronto, with 925 clearance studies. Creatinine production was estimated using formulas derived in CPD patients. Body water (V) was estimated from anthropometric formulas. We calculated LBM(BMI) from a formula that estimates body composition based on body mass index. In hypothetical subjects, LBM values were calculated by varying the determinants of body composition (gender, diabetic status, age, weight, and height) one at a time, while the other determinants were kept constant. In actual CPD patients, multiple linear regression and logistic regression were used to identify factors associated with differences in the estimates of LBM (LBM(cr)LBM(V), or LBM(cr)LBM(BMI)). We sought predictors of the differences LBM(V) - LBM(cr) and LBM(BMI) - LBM(cr). Both LBM(V) (regardless of formula used to estimate V) and LBM(BMI) exceeded LBM(cr) in hypothetical subjects with average body compositions. The sources of differences between LBM estimates in this group involved differences in the coefficients assigned to gender, age, height, weight, presence or absence of diabetes, and serum creatinine concentration. In CPD patients, mean LBM(V) or LBM(BMI) exceeded mean LBM(cr) by 6.2 to 6.9 kg. For example, the LBM(V) obtained from one anthropometric formula was 50.4+/-10.4 kg and the LBM(cr) was 44.1+/-13.6 kg (P LBM(cr)>LBM(V). The differences in determinants of body composition between groups with high versus low LBM(cr) were similar in hypothetical and actual CPD patients. Multivariate analysis in actual CPD patients identified serum creatinine, height, age, gender, weight, and body mass

  5. Leg Injuries and Disorders

    Science.gov (United States)

    ... are important for motion and standing. Playing sports, running, falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures. ...

  6. Lean Production : Werkzeuge zur Realisierung

    OpenAIRE

    Binner, Hartmut F.

    2008-01-01

    INHALT: l. Einleitung und Standortbestimmung 2. Japanische Wertvorstellungen 3. Inhalte der Lean Production 4. Fertigungssegmentierung 5. Informationsmanagement mit CIM- und Logistik-Komponenten 6. Logistikgerechte Strukturen der Lean Production 7. Realisierung der Lean Production 8. Zusammenfassung

  7. Lean and Information Technology Toolkit

    Science.gov (United States)

    The Lean and Information Technology Toolkit is a how-to guide which provides resources to environmental agencies to help them use Lean Startup, Lean process improvement, and Agile tools to streamline and automate processes.

  8. Analysis The Leanness of The Supply Chain By Fuzzy QFD

    OpenAIRE

    Mukesh Singh Baghel; Pavan Agrawal

    2014-01-01

    The new systems of doing business in manufacturing have evolved in recent decades Lean production. Lean production can be traced to the 1960s in Japan, when Toyota Motors started innovating changes in mass production to deal with its domestic automotive market. The term “Lean production” was coined around 1989 with the popularity of the book, the machine that can change the world written by researchers at the Massachusetts Institute of Technology (MIT). The term itself was coined ...

  9. Identification of Lean Implementation Hurdles in Indian Industries

    OpenAIRE

    Bhim Singh

    2016-01-01

    Due to increased pressure from global competitors, manufacturing organizations are switching over to lean philosophies from traditional mass production. Lean manufacturing is a manufacturing philosophy which focuses on elimination of various types of wastes and creates maximum value for the end customers. Lean thinking aims to produce high quality products and services at the lowest possible cost with maximum customer responsiveness. Indian Industry is facing lot of problems in this transform...

  10. Moving on - beyond lean thinking

    OpenAIRE

    Koskela, Lauri

    2004-01-01

    Lean Thinking is currently often positioned as the underlying theory of lean production among practitioners and academics, although its originators, Womack and Jones, seem not to have presented it as a theory. This paper endeavors to analyze whether Lean Thinking can be viewed as a theory of lean production. For this purpose, a critical assessment of Lean Thinking is carried out. Lean Thinking is argued to lack an adequate conceptualization of production, which has led to imprecise concepts, ...

  11. lean-ISD.

    Science.gov (United States)

    Wallace, Guy W.

    2001-01-01

    Explains lean instructional systems design/development (ISD) as it relates to curriculum architecture design, based on Japan's lean production system. Discusses performance-based systems; ISD models; processes for organizational training and development; curriculum architecture to support job performance; and modular curriculum development. (LRW)

  12. Healthy Lean Through HRD

    DEFF Research Database (Denmark)

    Jørgensen, Frances

    2008-01-01

    The paper reports on findings from the initial, exploratory phase of a longitudinal research study aimed at developing a framework for implementing lean while ensuring employee well-being. Data from observations and in-depth dialogues with persons involved in lean implementation, along...

  13. LEAN and energy efficiency; Lean og energieffektivisering

    Energy Technology Data Exchange (ETDEWEB)

    Jespersen, Per T; Vesterager Christensen, D; Andersen, Hans [Teknologisk Institut, Energi og Klima, Taastrup (Denmark); Dam Wied, M; Dam, M [NRGi Raadgivning, Aarhus (Denmark); Thorndahl, M [Horsens Kommune, Horsens (Denmark); Weldingh, P [Lokal Energi, Viby J. (Denmark); Maagoee, P; Kristensen, Kenneth T [Viegand og Maagoee, Copenhagen (Denmark); Kirketerp Friis, A [Novozymes, Bagsvaerd (Denmark)

    2010-03-15

    By means of theoretical reports and three specific cases, the project showed how Lean principles can improve energy consulting efficiency, thus making it easier for end-users and energy consultants to record and document energy savings achieved. The three cases documented various types of extra benefits of integrating energy efficiency improvement in Lean processes. As a result of process optimisation, one manufacturing company successfully reduced both staffing and energy consumption, thus making production in Denmark competitive with out-sourced production in Asia. (LN)

  14. Foot, leg, and ankle swelling

    Science.gov (United States)

    Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... Foot, leg, and ankle swelling is common when the person also: Is overweight Has a blood clot in the leg Is older Has ...

  15. Body fat mass, lean body mass and associated biomarkers as determinants of bone mineral density in children 6-8years of age - The Physical Activity and Nutrition in Children (PANIC) study.

    Science.gov (United States)

    Soininen, Sonja; Sidoroff, Virpi; Lindi, Virpi; Mahonen, Anitta; Kröger, Liisa; Kröger, Heikki; Jääskeläinen, Jarmo; Atalay, Mustafa; Laaksonen, David E; Laitinen, Tomi; Lakka, Timo A

    2018-03-01

    Lean body mass (LM) has been positively associated with bone mineral density (BMD) in children and adolescents, but the relationship between body fat mass (FM) and BMD remains controversial. Several biomarkers secreted by adipose tissue, skeletal muscle, or bone may affect bone metabolism and BMD. We investigated the associations of LM, FM, and such biomarkers with BMD in children. We studied a population sample of 472 prepubertal Finnish children (227 girls, 245 boys) aged 6-8years. We assessed BMD, LM, and FM using whole-body dual-energy x-ray absorptiometry and analysed several biomarkers from fasting blood samples. We studied the associations of LM, FM, and the biomarkers with BMD of the whole body excluding the head using linear regression analysis. LM (standardized regression coefficient β=0.708, p<0.001), FM (β=0.358, p<0.001), and irisin (β=0.079, p=0.048) were positive correlates for BMD adjusted for age, sex, and height in all children. These associations remained statistically significant after further adjustment for LM or FM. The positive associations of dehydroepiandrosterone sulphate (DHEAS), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), leptin, free leptin index, and high-sensitivity C-reactive protein and the negative association of leptin receptor with BMD were explained by FM. The positive associations of DHEAS and HOMA-IR with BMD were also explained by LM. Serum 25-hydroxyvitamin D was a positive correlate for BMD adjusted for age, sex, and height and after further adjustment for FM but not for LM. LM and FM were positive correlates for BMD also in girls and boys separately. In girls, insulin, HOMA-IR, leptin, and free leptin index were positively and leptin receptor was negatively associated with BMD adjusted for age, height, and LM. After adjustment for age, height, and FM, none of the biomarkers was associated with BMD. In boys, leptin and free leptin index were positively and leptin receptor was negatively

  16. Diccionario Lean Manufacturing

    OpenAIRE

    Muñoz Ellner, Sarah María

    2016-01-01

    El Diccionario Bilingüe de Lean Manufacturing pretende ser un instrumento de apoyo a todo aquel que tenga la responsabilidad de planear, ejecutar o simplemente algún interés con las actividades de Lean Manufacturing, aportando así también conceptos claros tanto en castellano como en inglés, con el fin de entender de forma integral el alcance mismo que puede llegar a tener dicha filosofía, al igual que se proporcionara una serie de siglas y herramientas para la implementación del Lean Manufact...

  17. Lean og arbejdsmiljø

    DEFF Research Database (Denmark)

    Jensen, Kenneth

    Bogen tager udgangspunkt i en undersøgelse af 10 private og offentlige virksomheders erfaringer med lean. Undersøgelsen viser at der ikke findes entydige sammenhænge mellem lean og det psykosociale arbejdsmiljø. Bogen forholder sig til sammenhængen mellem lean og ledelse, lean og medarbejderens...... rolle, lean og lean og forandringsprocessen. Bogen kommer desuden med anbefalinger til hvorledes virksomheden kan gribe dialogen an for at opnå et godt lean forløb der inddrager hensynet til og effekterne af et godt psykosocialt arbejdsmiljø....

  18. Orchestrating Lean Implementation

    DEFF Research Database (Denmark)

    Riis, Jens Ove; Mikkelsen, Hans; Andersen, Jesper Rank

    2008-01-01

    The notion of Lean Manufacturing is not merely confined to a set of well defined techniques, but represents a broad approach to managing a company. Working with lean entails many aspects, such as production planning and control, production engineering, product development, supply chain......, and organizational issues. To become effective, many functional areas and departments must be involved. At the same time companies are embedded in a dynamic environment. The aim of the paper is to propose a comprehensive approach to better implementation of lean initiatives, based on two empirical studies. The paper...... will discuss how a concerted effort can be staged taking into account the interdependencies among individual improvement initiatives. The notion of orchestration will be introduced, and several means for orchestration will be presented. Critical behavioral issues for lean implementation will be discussed....

  19. Lean Government Methods Guide

    Science.gov (United States)

    This Guide focuses primarily on Lean production, which is an organizational improvement philosophy and set of methods that originated in manufacturing but has been expanded to government and service sectors.

  20. Lean Enterprise Value Phase

    National Research Council Canada - National Science Library

    Shields, John T

    2005-01-01

    ... using a philosophy called "lean." LAl's mission is to research, develop, and promulgate practices, tools, and knowledge that enable and accelerate the envisioned transformation of the greater US aerospace enterprise through people and processes...

  1. Clinical effectiveness of protein and amino acid supplementation on building muscle mass in elderly people: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Zhe-rong Xu

    Full Text Available A major reason for the loss of mobility in elderly people is the gradual loss of lean body mass known as sarcopenia. Sarcopenia is associated with a lower quality of life and higher healthcare costs. The benefit of strategies that include nutritional intervention, timing of intervention, and physical exercise to improve muscle loss unclear as finding from studies investigating this issue have been inconsistent. We have performed a systematic review and meta-analysis to assess the ability of protein or amino acid supplementation to augment lean body mass or strength of leg muscles in elderly patients.Nine studies met the inclusion criteria of being a prospective comparative study or randomized controlled trial (RCT that compared the efficacy of an amino acid or protein supplement intervention with that of a placebo in elderly people (≥ 65 years for the improvement of lean body mass (LBM, leg muscle strength or reduction associated with sarcopenia.The overall difference in mean change from baseline to the end of study in LBM between the treatment and placebo groups was 0.34 kg which was not significant (P = 0.386. The overall differences in mean change from baseline in double leg press and leg extension were 2.14 kg (P = 0.748 and 2.28 kg (P = 0.265, respectively, between the treatment group and the placebo group.These results indicate that amino acid/protein supplements did not increase lean body mass gain and muscle strength significantly more than placebo in a diverse elderly population.

  2. The lean service machine.

    Science.gov (United States)

    Swank, Cynthia Karen

    2003-10-01

    Jefferson Pilot Financial, a life insurance and annuities firm, like many U.S. service companies at the end of the 1990s was looking for new ways to grow. Its top managers recognized that JPF needed to differentiate itself in the eyes of its customers, the independent life-insurance advisers who sell and service policies. To establish itself as these advisers' preferred partner, it set out to reduce the turnaround time on policy applications, simplify the submission process, and reduce errors. JPF's managers looked to the "lean production" practices that U.S. manufacturers adopted in response to competition from Japanese companies. Lean production is built around the concept of continuous-flow processing--a departure from traditional production systems, in which large batches are processed at each step. JPF appointed a "lean team" to reengineer its New Business unit's operations, beginning with the creation of a "model cell"--a fully functioning microcosm of JPF's entire process. This approach allowed managers to experiment and smooth out the kinks while working toward an optimal design. The team applied lean-manufacturing practices, including placing linked processes near one another, balancing employees' workloads, posting performance results, and measuring performance and productivity from the customer's perspective. Customer-focused metrics helped erode the employees' "My work is all that matters" mind-set. The results were so impressive that JPF is rolling out similar systems across many of its operations. To convince employees of the value of lean production, the lean team introduced a simulation in which teams compete to build the best paper airplane based on invented customer specifications. This game drives home lean production's basic principles, establishing a foundation for deep and far-reaching changes in the production system.

  3. Lyden-af-Leg

    DEFF Research Database (Denmark)

    Toft, Herdis

    Præsentation af seniorforsker-projekt Lyden-af-Leg i et traderingsperspektiv og med indledende fokus på YouTube som traderings-platform.......Præsentation af seniorforsker-projekt Lyden-af-Leg i et traderingsperspektiv og med indledende fokus på YouTube som traderings-platform....

  4. Low-fat, high-carbohydrate (low-glycaemic index) diet induces weight loss and preserves lean body mass in obese healthy subjects: results of a 24-week study.

    Science.gov (United States)

    Bahadori, B; Yazdani-Biuki, B; Krippl, P; Brath, H; Uitz, E; Wascher, T C

    2005-05-01

    The traditional treatment for obesity which is based on a reduced caloric diet has only been partially successful. Contributing factors are not only a poor long-term dietary adherence but also a significant loss of lean body mass and subsequent reduction in energy expenditure. Both low-fat, high-carbohydrate diets and diets using low-glycaemic index (GI) foods are capable of inducing modest weight loss without specific caloric restriction. The purpose of this study was to investigate the feasibility and medium-term effect of a low-fat diet with high (low GI) carbohydrates on weight loss, body composition changes and dietary compliance. Obese patients were recruited from two obesity outpatient clinics. Subjects were given advise by a dietician, then they attended biweekly for 1-hour group meetings. Bodyweight and body composition were measured at baseline and after 24 weeks. One hundred and nine (91%) patients completed the study; after 24 weeks the average weight loss was 8.9 kg (98.6 vs. 89.7 kg; p fat mass (42.5 vs. 36.4 kg; p vs. 53.3 kg; p low-fat, low-GI diet led to a significant reduction of fat mass; adherence to the diet was very good. Our results suggest that such a diet is feasible and should be evaluated in randomized controlled trials.

  5. EPA Lean Government Initiative: How to Replicate Lean Successes

    Science.gov (United States)

    This Lean Replication Primer describes how EPA Offices and Regions can identify and adapt successful practices from previous Lean projects to “replicate” their successes and generate further improvements.

  6. Use of Novel High-Protein Functional Food Products as Part of a Calorie-Restricted Diet to Reduce Insulin Resistance and Increase Lean Body Mass in Adults: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Carol S. Johnston

    2017-10-01

    Full Text Available Significant reductions in insulin resistance (IR can be achieved by either calorie restriction or by the increase of lean mass. However, calorie restriction usually results in significant loss of lean mass. A 6-week randomized controlled feeding trial was conducted to determine if a calorie-restricted, high-protein diet (~125 g protein/day consumed evenly throughout the day using novel functional foods would be more successful for reducing IR in comparison to a conventional diet (~80 g protein/day with a similar level of calorie restriction. Healthy adults (age 20–75 years; body mass index, 20–42 kg/m2 with raised triglyceride/high-density lipoprotein ratios were randomly assigned to the control group (CON: test foods prepared using gluten-free commercial pasta and cereal or to the high-protein group (HPR: test foods prepared using novel high-protein pasta and cereal both rich in wheat gluten. Mean weight loss did not differ between groups (−2.7 ± 2.6 and −3.2 ± 3.0 kg for CON (n = 11 and HPR (n = 10 respectively, p = 0.801; however, the 6-week change in fat-free mass (FFM differed significantly between groups (−0.5 ± 1.5 and +1.5 ± 3.8 kg for CON and HPR respectively, p = 0.008. IR improved in HPR vs. CON participants (homeostasis model assessment-estimated insulin resistance [HOMAIR] change: −1.7 ± 1.4 and −0.7 ± 0.7 respectively; p = 0.020. The change in HOMA-IR was related to the change in FFM among participants (r = −0.511, p = 0.021. Thus, a high-protein diet using novel functional foods combined with modest calorie restriction was 140% more effective for reducing HOMA-IR in healthy adults compared to a lower protein, standard diet with an equal level of calorie restriction.

  7. Can lean save lives?

    Science.gov (United States)

    Fillingham, David

    2007-01-01

    The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare. This paper is a viewpoint. One's early experience is that lean really can save lives. The Toyota Production System is an amazingly successful way of manufacturing cars. It cannot be simply translated unthinkingly into a hospital but lessons can be learned from it and the method can be adapted and developed so that it becomes owned by healthcare staff and focused towards the goal of improved patient care. Working in healthcare is a stressful and difficult thing. Everyone needs a touch of inspiration and encouragement. Applying lean to healthcare in Bolton seems to be achieving just that for those who work there.

  8. Rethinking Lean Service

    Science.gov (United States)

    Seddon, John; O'Donovan, Brendan; Zokaei, Keivan

    Ever since Levitt's influential Harvard Business Review article 'Production-Line Approach to Service' was published in 1972, it has been common for services to be treated like production lines in both the academic literature and more widely in management practice. The belief that achieving economies of scale will reduce unit costs is a common feature of management decision-making. As technological advancement has produced ever more sophisticated IT and telephony, it has become increasingly easier for firms to standardise and off-shore services. The development of the 'lean' literature has only helped to emphasise the same underlying management assumptions: by managing cost and workers' activity, organisational performance is expected to improve. This chapter argues that through misinterpretation of the core paradigm 'lean' has become subsumed into the 'business as usual' of conventional service management. As a result, 'lean' has become synonymous with 'process efficiency' and the opportunity for significant performance improvement - as exemplified by Toyota - has been missed.

  9. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on the substantiation of health claims related to very low calorie diets (VLCDs) and reduction in body weight (ID 1410), reduction in the sense of hunger (ID 1411), reduction in body fat mass while maintaining lean

    DEFF Research Database (Denmark)

    Tetens, Inge

    claims in relation to very low calorie diets (VLCDs) and reduction in body weight, reduction in the sense of hunger, reduction in body fat mass while maintaining lean body mass, reduction of post-prandial glycaemic responses, and maintenance of normal blood lipid profile. The scientific substantiation...... that whereas the diet that is the subject of the claim, very low calorie diet, is sufficiently characterised in relation to the following claimed effects: reduction in body weight (ID 1410), reduction in the sense of hunger (ID 1411), and reduction in body fat mass while maintaining lean body mass (ID 1412...... that formula foods for use in very low calorie diets should contain. The Panel concludes that a cause and effect relationship cannot be established between the consumption of a very low calorie diet and reduction of post-prandial glycaemic responses (ID 1414) and maintenance of normal blood lipid profile (ID...

  10. Lean Management Genesis

    Directory of Open Access Journals (Sweden)

    Parkes Aneta

    2015-12-01

    Full Text Available Lean Management is a philosophy and management concept, based on reduction of the waste and resources used in the process of producing goods and providing services. Lean Management genesis dates back to scientific management in America (for example concepts of H. Ford and F.W. Taylor and quality management, including development of TQM concept. Japanese Toyota Production System has been inspired by chosen elements of these concepts, and then it evolved towards global concept called Toyota Way (which connects production rules with values and work attitude.

  11. Improving Healthcare through Lean Management

    DEFF Research Database (Denmark)

    Nielsen, Anders Paarup; Edwards, Kasper

    2011-01-01

    The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare....... The paper concludes by discussing the implications of hypothesis two, three, and four for the successful application of lean management within healthcare. Is it concluded that this requires a transformative and contingent approach to lean management where the universal principles of the lean philosophy...

  12. Lean in Air Permitting Guide

    Science.gov (United States)

    The Lean in Air Permitting Guide is designed to help air program managers at public agencies better understand the potential value and results that can be achieved by applying Lean improvement methods to air permitting processes.

  13. The Lean and Environment Toolkit

    Science.gov (United States)

    This Lean and Environment Toolkit assembles practical experience collected by the U.S. Environmental Protection Agency (EPA) and partner companies and organizations that have experience with coordinating Lean implementation and environmental management.

  14. Android subcutaneous adipose tissue topography in lean and obese women suffering from PCOS: comparison with type 2 diabetic women.

    Science.gov (United States)

    Horejsi, R; Möller, R; Rackl, S; Giuliani, A; Freytag, U; Crailsheim, K; Sudi, K; Tafeit, E

    2004-07-01

    The new optical device, the lipometer, enables the noninvasive, quick, safe, and precise determination of the thickness of subcutaneous adipose tissue (SAT) layers at any given site of the human body. Fifteen anatomically well-defined body sites from neck to calf describe a SAT topography (SAT-Top) like an individual "fingerprint" of a subject. This SAT-Top was examined in 16 women with polycystic ovary syndrome (PCOS) and compared to the body fat distribution of 87 age-matched healthy controls and 20 type-2 diabetic women. SAT-Top differences of these three groups were described and, to render the possibility of visual comparison, the 15-dimensional body fat information was condensed to a two-dimensional factor plot by factor analysis. All PCOS patients had an android body fat distribution with significantly thinner SAT layers on the legs as compared to healthy controls. Moreover, a hierarchical cluster analysis resulted in two distinctly different groups of PCOS women, a lean (PCOSL) and an obese (PCOSO) cluster: compared to healthy women, lean PCOS patients had significantly lower total SAT development, even though height, weight, and body mass index did not deviate significantly. Especially on the legs, their SAT layers were significantly lowered, indicating a more "apple-like" fat distribution type. Obese PCOS women showed a SAT-Top pattern very similar to that of women with type-2 diabetes, although the mean age difference between these groups was more than 30 years. Compared to healthy controls, the SAT-Top of these obese PCOS patients was strongly shifted into the android direction, appearing as "super-apples" with a significantly increased upper trunk obesity to 237.8% and a significantly decreased leg SAT development to 79.8%. Copyright 2004 Wiley-Liss, Inc.

  15. Lean leadership: an ethnographic study

    NARCIS (Netherlands)

    Aij, K.H.; Visse, M.A.; Widdershoven, G.A.M.

    2015-01-01

    Purpose – The purpose of this study is to provide a critical analysis of contemporary Lean leadership in the context of a healthcare practice. The Lean leadership model supports professionals with a leading rolein implementing Lean.This article presents a case study focusing specifcally on

  16. Lean With a Human Face

    DEFF Research Database (Denmark)

    Hasle, Peter; Jensen, Per Langaa

    2008-01-01

    The consequences for quality of work of lean manufacturing is discussed in the international litterature, and several authors suggest increased work speed, stress, and muscoskeletal diseases as a consequence of lean. The Danish experience with lean has been studied through interviews with managers...

  17. RESTLESS LEGS SYNDROME

    Directory of Open Access Journals (Sweden)

    Dmitriy Valer'evich Artem'ev

    2009-01-01

    Full Text Available The paper describes the epidemiology, etiology, pathogenesis, clinical picture, diagnosis, differential diagnosis, and treatment of restless legs syndrome. Recommendations are given how to choose therapeutic modalities and drugs in relation to different factors.

  18. Design thinking & lean

    DEFF Research Database (Denmark)

    Bravos, Cynthia; Adler, Isabel K.

    2015-01-01

    This paper aims at presenting how a Brazilian innovation consultancy guided a collaborative development of a mobile solution using the Design Thinking approach (Vianna et al, 2012) and Lean principles (Ries, 2011). It will describe tools and methods used and how it was applied to requirement gath...

  19. Increasing trunk flexion transforms human leg function into that of birds despite different leg morphology.

    Science.gov (United States)

    Aminiaghdam, Soran; Rode, Christian; Müller, Roy; Blickhan, Reinhard

    2017-02-01

    Pronograde trunk orientation in small birds causes prominent intra-limb asymmetries in the leg function. As yet, it is not clear whether these asymmetries induced by the trunk reflect general constraints on the leg function regardless of the specific leg architecture or size of the species. To address this, we instructed 12 human volunteers to walk at a self-selected velocity with four postures: regular erect, or with 30 deg, 50 deg and maximal trunk flexion. In addition, we simulated the axial leg force (along the line connecting hip and centre of pressure) using two simple models: spring and damper in series, and parallel spring and damper. As trunk flexion increases, lower limb joints become more flexed during stance. Similar to birds, the associated posterior shift of the hip relative to the centre of mass leads to a shorter leg at toe-off than at touchdown, and to a flatter angle of attack and a steeper leg angle at toe-off. Furthermore, walking with maximal trunk flexion induces right-skewed vertical and horizontal ground reaction force profiles comparable to those in birds. Interestingly, the spring and damper in series model provides a superior prediction of the axial leg force across trunk-flexed gaits compared with the parallel spring and damper model; in regular erect gait, the damper does not substantially improve the reproduction of the human axial leg force. In conclusion, mimicking the pronograde locomotion of birds by bending the trunk forward in humans causes a leg function similar to that of birds despite the different morphology of the segmented legs. © 2017. Published by The Company of Biologists Ltd.

  20. Gender-specific association between dietary acid load and total lean body mass and its dependency on protein intake in seniors

    Science.gov (United States)

    Background: Sarcopenia, the age-related decline of muscle mass, is one of the most important causes of loss of physical function and falls in seniors. Causes of sarcopenia are multiple, but there is evidence that diet-related mild metabolic acidosis may play a role in the development of skeletal mus...

  1. Efficacy of whey protein supplementation on resistance exercise-induced changes in muscle strength, lean mass, and function in mobility-limited older adults

    Science.gov (United States)

    Whey protein supplementation may augment resistance exercise-induced increases in muscle strength and mass. Further studies are required to determine whether this effect extends to functionally compromised older adults. The objectives of the study were to compare the effects of whey protein concent...

  2. Collagen fragment biomarkers as serological biomarkers of lean body mass – a biomarker pilot study from the DAHANCA25B cohort and matched controls

    DEFF Research Database (Denmark)

    Nedergaard, Anders; Dalgas, Ulrik; Primdahl, Hanne

    2015-01-01

    Background Loss of muscle mass and function is an important complication to ageing and a range of pathologies, including, but not restricted to, cancer, organ failures, and sepsis. A number of interventions have been proposed ranging from exercise to anabolic pharmacological therapy, with varying...

  3. A longitudinal study of systemic inflammation and recovery of lean body mass among malnourished HIV-infected adults starting antiretroviral therapy in Tanzania and Zambia

    DEFF Research Database (Denmark)

    PrayGod, George; Blevins, M; Woodd, Susannah

    2016-01-01

    BACKGROUND/OBJECTIVES: The effects of inflammation on nutritional rehabilitation after starting antiretroviral therapy (ART) are not well understood. We assessed the relationship between inflammation and body composition among patients enrolled in the Nutritional Support for African Adults Starting...... gains. Further studies are warranted to determine whether interventions to reduce systemic inflammation will enhance gains in fat-free mass.European Journal of Clinical Nutrition advance online publication, 20 January 2016; doi:10.1038/ejcn.2015.221....

  4. The Effect of Special Operations Training on Testosterone, Lean Body Mass, and Strength and the Potential for Therapeutic Testosterone Replacement: A Review of the Literature

    Science.gov (United States)

    2016-07-01

    low bone mass, and physical frailty. J Am Geriatr Soc. 2010; 58(6):1134-1143. 22. Hildreth KL, Barry DW, Moreau KL, Vande Griend J, Meacham RB, et...88PA, Case # 2016-0120, 15 Jan 2016. 14. ABSTRACT Special Operations Forces (SOF) are routinely exposed to physically demanding missions that...deprivation, and decreased testosterone. A secondary purpose is to summarize the effects of exogenous testosterone therapy in healthy males as well as to

  5. Lean start-up

    DEFF Research Database (Denmark)

    Rasmussen, Erik Stavnsager; Tanev, Stoyan

    2016-01-01

    The risk of launching new products and starting new firms is known to be extremely high. The Lean Start-up approach is a way of reducing these risks and enhancing the chances for success by validating the products and services in the market with customers before launching it in full scale. The ma...... and the final business model. In other words: The start-up must first nail the problem together with the customers, then develop the solution and test, and then in the end scale it to a full-grown business model.......The risk of launching new products and starting new firms is known to be extremely high. The Lean Start-up approach is a way of reducing these risks and enhancing the chances for success by validating the products and services in the market with customers before launching it in full scale. The main...

  6. Green and lean management

    CERN Document Server

    Davim, J

    2017-01-01

    This book focusses on the challenges and changes organizational management faces in an era when the need to develop environmentally aware processes meets high levels of competition. It covers the synergetic effects, how re-use, recycling, waste reduction, and other sustainable production strategies can add value, low costs and time of production. Sustainable business behavior is not only an environmental perspective on management, but more and more contains an organizational perspective. Taking into account these issues, green and lean management appears as the way managers can drive their employees to continuously improve the management processes that add value to the organization and costumers. This book provides information on principles, strategies, models, and applications of green and lean management, and at the same time communicates the latest research activity relating to this scientific field world-wide.

  7. Efeito da fisioterapia contra-resistida com relação à massa corporal magra em pacientes no pós-operatório de cirurgia bariátrica Effect of counter resisted physiotherapy in relationship to the lean body mass after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Denise Serpa Bopp Nassif

    2011-09-01

    Full Text Available RACIONAL: Cálculos metabólicos e de atividade física são realizados a partir do tecido ativo presente no corpo, conhecido como massa corporal magra, que resulta da soma da massa magra isenta de gordura com a gordura essencial. A cinesioterapia é a musculação terapêutica que auxilia na força e flexibilidade. OBJETIVOS: No paciente submetido a tratamento cirúrgico para obesidade mórbida: 1 avaliar o efeito da fisioterapia contra-resistida na massa magra; 2 avaliar os fatores associados às variações de massa corporal magra com tratamento fisioterapêutico; 3 comparar o grupo de pacientes que perdeu com o que ganhou massa magra com o tratamento fisioterapêutico, analisando as co-morbidades que interferiram para esses resultados. MÉTODO: Foram incluídos 100 pacientes operados pela técnica de Fobi-Capella, ou derivação em Y-de-Roux, sem anel e divididos em grupo A composto por pacientes que perderam massa corporal magra nos dois períodos avaliados (entre 30 dias e três meses e entre três meses e seis meses e o grupo B pelos demais pacientes que apresentaram ganho de massa corporal magra em pelo menos um dos períodos avaliados. A coleta de dados foi realizada através do Protocolo Eletrônico Multiprofissional em Cirurgia Bariátrica e Metabólica com Ênfase em Fisioterapia, identificado pela siga SINPE© (Sistema Integrado de Protocolos Eletrônicos. Os pacientes realizaram avaliação fisioterapêutica pré-operatória e foram acompanhados no período pós-operatório em quatro fases: na internação hospitalar, submetidos à musculação terapêutica em 30 dias após a operação, aos três meses e aos seis meses do pós-operatório. RESULTADOS: Houve diferença significativa entre as três avaliações (pBACKGROUND: Calculations of metabolic and physical activity are carried out from the active tissue in the body, known as lean body mass, which is the sum of fat-free lean mass to essential fat. Kinesiotherapy helps in

  8. Lean Leadership - Organizational Buy - Ins

    Directory of Open Access Journals (Sweden)

    Dr. Revathi Iyer

    2017-05-01

    Full Text Available Great organizations have become leaders due to their leadership and sustainable initiatives. One such initiative is adoption of lean leadership to align core strategies with all functional areas of business. Leadership is likely to take place in a lean environment because improvements that happen are continual and can only be supported by leadership which understands this important aspect. The topic of lean leadership organizational buy ins speaks on how lean leadership could affect organizations that adopt lean and other quality tools. Purpose of the study This study has been undertaken to understand When leadership more of is likely to take place in lean . Leadership plays a very important role while adopting lean processes and how lean leadership can address the process problem. Application of leadership lenses to lean processes needs great foresight thought and creativity. It has been also observed that lean management and lean processes can happen only if leadership is able to effectively communicate the thought of continual improvement to bring in a lean organization and a future state of processes where everything of a firm process and procedure is continually improving and the best strategies to manage this change becomes a philosophy. Lean leadership is associated with such a change. This enables leadership vision to be clear as it paves the way for current state and is clear to everyone. It is this leadership vision which enables employees to think and act in a way that perpetrates continual improvement. Hence leadership buys ins for lean are very necessary. The purpose of the study is also to understand how leaders can not only use cost reduction but also reducing time-to-market improving service quality and reducing risk exposure by adopting lean methods . it has been also seen that there is overall productivity and efficiency in organizations holistically when leadership endorses lean methodology. Radnor Z. and Bucci G. 2007

  9. Robust and efficient walking with spring-like legs

    Energy Technology Data Exchange (ETDEWEB)

    Rummel, J; Blum, Y; Seyfarth, A, E-mail: juergen.rummel@uni-jena.d, E-mail: andre.seyfarth@uni-jena.d [Lauflabor Locomotion Laboratory, University of Jena, Dornburger Strasse 23, 07743 Jena (Germany)

    2010-12-15

    The development of bipedal walking robots is inspired by human walking. A way of implementing walking could be performed by mimicking human leg dynamics. A fundamental model, representing human leg dynamics during walking and running, is the bipedal spring-mass model which is the basis for this paper. The aim of this study is the identification of leg parameters leading to a compromise between robustness and energy efficiency in walking. It is found that, compared to asymmetric walking, symmetric walking with flatter angles of attack reveals such a compromise. With increasing leg stiffness, energy efficiency increases continuously. However, robustness is the maximum at moderate leg stiffness and decreases slightly with increasing stiffness. Hence, an adjustable leg compliance would be preferred, which is adaptable to the environment. If the ground is even, a high leg stiffness leads to energy efficient walking. However, if external perturbations are expected, e.g. when the robot walks on uneven terrain, the leg should be softer and the angle of attack flatter. In the case of underactuated robots with constant physical springs, the leg stiffness should be larger than k-tilde = 14 in order to use the most robust gait. Soft legs, however, lack in both robustness and efficiency.

  10. Robust and efficient walking with spring-like legs

    International Nuclear Information System (INIS)

    Rummel, J; Blum, Y; Seyfarth, A

    2010-01-01

    The development of bipedal walking robots is inspired by human walking. A way of implementing walking could be performed by mimicking human leg dynamics. A fundamental model, representing human leg dynamics during walking and running, is the bipedal spring-mass model which is the basis for this paper. The aim of this study is the identification of leg parameters leading to a compromise between robustness and energy efficiency in walking. It is found that, compared to asymmetric walking, symmetric walking with flatter angles of attack reveals such a compromise. With increasing leg stiffness, energy efficiency increases continuously. However, robustness is the maximum at moderate leg stiffness and decreases slightly with increasing stiffness. Hence, an adjustable leg compliance would be preferred, which is adaptable to the environment. If the ground is even, a high leg stiffness leads to energy efficient walking. However, if external perturbations are expected, e.g. when the robot walks on uneven terrain, the leg should be softer and the angle of attack flatter. In the case of underactuated robots with constant physical springs, the leg stiffness should be larger than k-tilde = 14 in order to use the most robust gait. Soft legs, however, lack in both robustness and efficiency.

  11. Approach to leg edema

    Directory of Open Access Journals (Sweden)

    Fulvio Pomero

    2017-09-01

    Full Text Available Edema is defined as a palpable swelling caused by an increase in interstitial fluid volume. Leg edema is a common problem with a wide range of possible causes and is the result of an imbalance in the filtration system between the capillary and interstitial spaces. Major causes of edema include venous obstruction, increased capillary permeability and increased plasma volume secondary to sodium and water retention. In both hospital and general practice, the patient with a swollen leg presents a common dilemma in diagnosis and treatment. The cause may be trivial or life-threatening and it is often difficult to determine the clinical pathway. The diagnosis can be narrowed by categorizing the edema according to its duration, distribution (unilateral or bilateral and accompanying symptoms. This work provides clinically oriented recommendations for the management of leg edema in adults.

  12. Leg som ustyrlig deltagelseskultur

    DEFF Research Database (Denmark)

    Toft, Herdis

    2017-01-01

    - og spilteoretikere Johan Huizinga og Roger Caillois. Deres teorier og begrebsdannelser har været brugt til at påpege leg dels som et æstetisk baseret betydningssystem, dels som et affektivt og stemningsbaseret oplevelsessystem samt endelig som et socialt baseret relationssystem. I artiklen vælger vi...... at fokusere på leg som et socialt baseret relationssystem og yderligere zoome ind på et af legens systemiske væsenstræk, nemlig brugen af regulerbare regelsæt, som legerne uden ’politi’ forhandler sig frem til før, under og efter legen. Fælles for Huizinga og Caillois er, at de knytter leg uløseligt sammen...

  13. Lean leadership: an ethnographic study.

    Science.gov (United States)

    Aij, Kjeld Harald; Visse, Merel; Widdershoven, Guy A M

    2015-01-01

    The purpose of this study is to provide a critical analysis of contemporary Lean leadership in the context of a healthcare practice. The Lean leadership model supports professionals with a leading role in implementing Lean. This article presents a case study focusing specifically on leadership behaviours and issues that were experienced, observed and reported in a Dutch university medical centre. This ethnographic case study provides auto-ethnographic accounts based on experiences, participant observation, interviews and document analysis. Characteristics of Lean leadership were identified to establish an understanding of how to achieve successful Lean transformation. This study emphasizes the importance for Lean leaders to go to the gemba, to see the situation for one's own self, empower health-care employees and be modest. All of these are critical attributes in defining the Lean leadership mindset. In this case study, Lean leadership is specifically related to healthcare, but certain common leadership characteristics are relevant across all fields. This article shows the value of an auto-ethnographic view on management learning for the analysis of Lean leadership. The knowledge acquired through this research is based on the first author's experiences in fulfilling his role as a health-care leader. This may help the reader examining his/her own role and reflecting on what matters most in the field of Lean leadership.

  14. High-intensity intermittent "5-10-15" running reduces body fat, and increases lean body mass, bone mineral density, and performance in untrained subjects

    DEFF Research Database (Denmark)

    Ravnholt, Tanja Højegaard; Tybirk, Jonas; Jørgensen, Niklas Rye

    2018-01-01

    treadmill running (P running at 85% of maximal aerobic speed was lower (P beneficial changes and better performance......The present study examined the effect of intense intermittent running with 5 s sprints on body composition, fitness level, and performance in untrained subjects aged 36-53 years. For 7 weeks, the subjects carried out 3 days a week 5-10-15 training consisting of 3-9 blocks of 4 repetitions of 15, 10......, and 5 s low-, moderate-, and high-speed running, respectively. Body fat mass was 4.3% lower (P 

  15. High-intensity intermittent "5-10-15" running reduces body fat, and increases lean body mass, bone mineral density, and performance in untrained subjects

    DEFF Research Database (Denmark)

    Ravnholt, Tanja Højegaard; Tybirk, Jonas; Jørgensen, Niklas Rye

    2018-01-01

    , and 5 s low-, moderate-, and high-speed running, respectively. Body fat mass was 4.3% lower (P bone mineral density was 1.1 and 0.9% higher (P bone turnover markers osteocalcin......The present study examined the effect of intense intermittent running with 5 s sprints on body composition, fitness level, and performance in untrained subjects aged 36-53 years. For 7 weeks, the subjects carried out 3 days a week 5-10-15 training consisting of 3-9 blocks of 4 repetitions of 15, 10...

  16. Leg og dannelse

    DEFF Research Database (Denmark)

    Skovbjerg, Helle Marie

    2017-01-01

    lederen i det pædagogiske tidskrift Asterisk: ”Leg i skolen, leg i klasserummet, ja legende læring i skolen udgør derimod en enorm, seriøs og ubrugt læringsressource – ikke alene med effekter på kreativiteten, men også på den faglige læring” (Holm, 2015, p. 2). Legens værdi gøres altså først og fremmest...

  17. Venous leg ulcers

    Science.gov (United States)

    2008-01-01

    Introduction Leg ulcers usually occur secondary to venous reflux or obstruction, but 20% of people with leg ulcers have arterial disease, with or without venous disorders. Between 1.5 and 3.0/1000 people have active leg ulcers. Prevalence increases with age to about 20/1000 in people aged over 80 years. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of standard treatments, adjuvant treatments, and organisational interventions for venous leg ulcers? What are the effects of interventions to prevent recurrence of venous leg ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2007 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 80 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: compression bandages and stockings, cultured allogenic (single or bilayer) skin replacement, debriding agents, dressings (cellulose, collagen, film, foam, hyaluronic acid-derived, semi-occlusive alginate), hydrocolloid (occlusive) dressings in the presence of compression, intermittent pneumatic compression, intravenous prostaglandin E1, larval therapy, laser treatment (low-level), leg ulcer clinics, multilayer elastic system, multilayer elastomeric (or non-elastomeric) high-compression regimens or bandages, oral treatments (aspirin, flavonoids, pentoxifylline, rutosides, stanozolol, sulodexide, thromboxane alpha2 antagonists, zinc), peri

  18. Indian girls have higher bone mineral content per unit of lean body than boys through puberty.

    Science.gov (United States)

    Khadilkar, Anuradha V; Sanwalka, Neha; Mughal, M Zulf; Chiplonkar, Shashi; Khadilkar, Vaman

    2018-05-01

    Our aim is to describe changes in the muscle-bone unit assessed as a ratio of bone mineral content (BMC) to lean body mass (LBM) through puberty at total body and various skeletal sites in Indian boys and girls. A cross-sectional study was conducted (888 children, 480 boys, aged 5-17 years) in Pune, India. Pubertal staging was assessed. BMC, LBM and fat percentage at the arms, legs, android, gynoid and total body (less the head) were assessed by dual energy X-ray absorptiometry. The amount of BMC per unit LBM (BMC/LBM) was computed. Changes in mean BMC/LBM at 5 Tanner (pubertal) stages after adjustment for age and fat percentage were calculated. In boys, adjusted BMC/LBM was significantly higher with successive Tanner stages [legs (TS-II vs TS-I), android (TS-III vs TS-II, TS-IV vs TS-III) and gynoid region (TS-III vs TS-II and TS-II vs TS-I) (p LBM was significantly higher with successive Tanner stages at total body, legs and gynoid (TS-III vs TS-II; TS-II vs TS-I; TS-V vs TS-IV), arms (TS-I to TS-V) and android regions (TS-V vs TS-IV) (p LBM than girls at earlier Tanner stages (TS-I to TS-III), whereas girls had significantly higher adjusted BMC/LBM than boys at later Tanner stages (TS-IV, TS-V) (p LBM with successive pubertal stages. Girls had higher BMC/LBM than boys which may possibly act as a reservoir for later demands of pregnancy and lactation.

  19. Creatinine index as a surrogate of lean body mass derived from urea Kt/V, pre-dialysis serum levels and anthropometric characteristics of haemodialysis patients.

    Directory of Open Access Journals (Sweden)

    Bernard Canaud

    Full Text Available BACKGROUND AND OBJECTIVES: Protein-energy wasting is common in long-term haemodialysis (HD patients with chronic kidney disease and is associated with increased morbidity and mortality. The creatinine index (CI is a simple and useful nutritional parameter reflecting the dietary skeletal muscle protein intake and skeletal muscle mass of the patient. Because of the complexity of creatinine kinetic modeling (CKM to derive CI, we developed a more simplified formula to estimate CI in HD patients. DESIGN, SETTING, PARTICIPANTS & MEASUREMENTS: A large database of 549 HD patients followed over more than 20 years including monthly CKM-derived CI values was used to develop a simple equation based on patient demographics, predialysis serum creatinine values and dialysis dose (spKt/V using mixed regression models. RESULTS: The equation to estimate CI was developed based on age, gender, pre-dialysis serum creatinine concentrations and spKt/V urea. The equation-derived CI correlated strongly with the measured CI using CKM (correlation coefficient  = 0.79, p-value <0.001. The mean error of CI prediction using the equation was 13.47%. Preliminary examples of few typical HD patients have been used to illustrate the clinical relevance and potential usefulness of CI. CONCLUSIONS: The elementary equation used to derive CI using demographic parameters, pre-dialysis serum creatinine concentrations and dialysis dose is a simple and accurate surrogate measure for muscle mass estimation. However, the predictive value of the simplified CI assessment method on mortality deserves further evaluation in large cohorts of HD patients.

  20. Organizational change through Lean Thinking.

    Science.gov (United States)

    Tsasis, Peter; Bruce-Barrett, Cindy

    2008-08-01

    In production and manufacturing plants, Lean Thinking has been used to improve processes by eliminating waste and thus enhancing efficiency. In health care, Lean Thinking has emerged as a comprehensive approach towards improving processes embedded in the diagnostic, treatment and care activities of health-care organizations with cost containment results. This paper provides a case study example where Lean Thinking is not only used to improve efficiency and cost containment, but also as an approach to effective organizational change.

  1. Restless Legs Syndrome

    Science.gov (United States)

    ... disorder, particularly if they experience onset at an early age; many years may pass before symptoms occur regularly. top What causes restless legs syndrome? In most cases, the cause of RLS is unknown (called primary RLS). However, RLS has a genetic component and ...

  2. The mangled lower leg

    NARCIS (Netherlands)

    Hoogendoorn, Jochem Maarten

    2002-01-01

    A surgeon faced with a patient presenting with an open tibial/fibular fracture in combination with severe damage of the surrounding soft tissues, has to make the difficult decision whether to attempt salvage or to perform an immediate amputation of the leg. Until late in the nineteenth century the

  3. Applying lean thinking in construction

    Directory of Open Access Journals (Sweden)

    Remon Fayek Aziz

    2013-12-01

    Full Text Available The productivity of the construction industry worldwide has been declining over the past 40 years. One approach for improving the situation is using lean construction. Lean construction results from the application of a new form of production management to construction. Essential features of lean construction include a clear set of objectives for the delivery process, aimed at maximizing performance for the customer at the project level, concurrent design, construction, and the application of project control throughout the life cycle of the project from design to delivery. An increasing number of construction academics and professionals have been storming the ramparts of conventional construction management in an effort to deliver better value to owners while making real profits. As a result, lean-based tools have emerged and have been successfully applied to simple and complex construction projects. In general, lean construction projects are easier to manage, safer, completed sooner, and cost less and are of better quality. Significant research remains to complete the translation to construction of lean thinking in Egypt. This research will discuss principles, methods, and implementation phases of lean construction showing the waste in construction and how it could be minimized. The Last Planner System technique, which is an important application of the lean construction concepts and methodologies and is more prevalent, proved that it could enhance the construction management practices in various aspects. Also, it is intended to develop methodology for process evaluation and define areas for improvement based on lean approach principles.

  4. Lean software development in action

    CERN Document Server

    Janes, Andrea

    2014-01-01

    This book illustrates how goal-oriented, automated measurement can be used to create Lean organizations and to facilitate the development of Lean software, while also demonstrating the practical implementation of Lean software development by combining tried and trusted tools. In order to be successful, a Lean orientation of software development has to go hand in hand with a company's overall business strategy. To achieve this, two interrelated aspects require special attention: measurement and experience management. In this book, Janes and Succi provide the necessary knowledge to establish "

  5. Creatine monohydrate supplementation does not increase muscle strength, lean body mass, or muscle phosphocreatine in patients with myotonic dystrophy type 1.

    Science.gov (United States)

    Tarnopolsky, Mark; Mahoney, Douglas; Thompson, Terry; Naylor, Heather; Doherty, Timothy J

    2004-01-01

    Creatine monohydrate (CrM) supplementation may increase strength in some types of muscular dystrophy. A recent study in myotonic muscular dystrophy type 1 (DM1) did not find a significant treatment effect, but measurements of muscle phosphocreatine (PCr) were not performed. We completed a randomized, double-blind, cross-over trial using 34 genetically confirmed adult DM1 patients without significant cognitive impairment. Participants received CrM (5 g, approximately 0.074 g/kg daily) and a placebo for each 4-month phase with a 6-week wash-out. Spirometry, manual muscle testing, quantitative isometric strength testing of handgrip, foot dorsiflexion, and knee extension, handgrip and foot dorsiflexion endurance, functional tasks, activity of daily living scales, body composition (total, bone, and fat-free mass), serum creatine kinase activity, serum creatinine concentration and clearance, and liver function tests were completed before and after each intervention, and muscle PCr/beta-adenosine triphosphate (ATP) ratios of the forearm flexor muscles were completed at the end of each phase. CrM supplementation did not increase any of the outcome measurements except for plasma creatinine concentration (but not creatinine clearance). Thus, CrM supplementation at 5 g daily does not have any effects on muscle strength, body composition, or activities of daily living in patients with DM1, perhaps because of a failure of the supplementation to increase muscle PCr/beta-ATP content.

  6. First Lean, then modularisation

    DEFF Research Database (Denmark)

    Petersen, Kristian R.; Madsen, Erik Skov; Bilberg, Arne

    2016-01-01

    of Europe’s leading offshore wind power operators with more than 1,000 wind turbine generators in operation. By focusing on this company, in-depth insights into its operations and maintenance processes are investigated. Findings – Lean is identified to constitute an important first step before...... and resources can take place. The authors also establish a foundation for the development of a software tool to support the development of the modularisation of maintenance tasks. Originality/value – The present study contributes to the rather immature field of research on the operations and maintenance...

  7. Design of a Single Motor Based Leg Structure with the Consideration of Inherent Mechanical Stability

    Science.gov (United States)

    Taha Manzoor, Muhammad; Sohail, Umer; Noor-e-Mustafa; Nizami, Muhammad Hamza Asif; Ayaz, Yasar

    2017-07-01

    The fundamental aspect of designing a legged robot is constructing a leg design that is robust and presents a simple control problem. In this paper, we have successfully designed a robotic leg based on a unique four bar mechanism with only one motor per leg. The leg design parameters used in our platform are extracted from design principles used in biological systems, multiple iterations and previous research findings. These principles guide a robotic leg to have minimal mechanical passive impedance, low leg mass and inertia, a suitable foot trajectory utilizing a practical balance between leg kinematics and robot usage, and the resultant inherent mechanical stability. The designed platform also exhibits the key feature of self-locking. Theoretical tools and software iterations were used to derive these practical features and yield an intuitive sense of the required leg design parameters.

  8. Lean approach in knowledge work

    Directory of Open Access Journals (Sweden)

    Hanna Kropsu-Vehkapera

    2018-05-01

    Full Text Available Purpose: Knowledge work productivity is a key area of improvement for many organisations. Lean approach is a sustainable way to achieve operational excellence and can be applied in many areas. The purpose of this novel study is to examine the potential of using lean approach for improving knowledge work practices. Design/methodology/approach: A systematic literature review has been carried out to study how lean approach is realised in knowledge work. The research is conceptual in nature and draws upon earlier research findings. Findings: This study shows that lean studies’ in knowledge work is an emerging research area. This study documents the methods and practices implemented in knowledge work to date, and presents a knowledge work continuum, which is an essential framework for effective lean approach deployment and to frame future research focus in knowledge work productivity. Research limitations/implications: This study structures the concept of knowledge work and outlines a concrete concept derived from earlier literature. The study summarises the literature on lean in knowledge work and highlights, which methods are used. More research is needed to understand how lean can be implemented in complex knowledge work environment and not only on the repetitive knowledge work. The limitations of this research are due to the limited availability of previous research. Practical implications: To analyse the nature of knowledge work, we implicate the areas where lean methods especially apply to improving knowledge work productivity. When applying lean in knowledge work context the focus should be using the people better and improving information flow. Originality/value: This study focuses on adapting lean methods into a knowledge work context and summarises earlier research done in this field. The study discusses the potential to improve knowledge work productivity by implementing lean methods and presents a unique knowledge work continuum to

  9. EDUCATION FOR LEAN & LEAN FOR EDUCATION: A LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    Saveta Vukadinovic

    2017-03-01

    Full Text Available The purpose of this paper is to investigate and understand how tools and principles of Lean philosophy can be adopted to improve the effectiveness of engineering education by providing services beyond the competition and costs below the competition, and how engineering education can provide better prepared engineering professionals capable to work in dynamic Lean environments by developing multidisciplinary knowledge and skills. Paper will be based on analysis of relevant scientific and professional literature sources, including certain elements of description, classification, explanation and prediction. The authors will use detailed literature review to explain complex relationship and interdependence between Lean philosophy and engineering education and answer the question what benefits modern Lean enterprises may expect from properly educated and qualified engineers and how application of Lean tools and principles can improve the system of engineering education.

  10. Early-stage primary school children attending a school in the Malawian School Feeding Program (SFP) have better reversal learning and lean muscle mass growth than those attending a non-SFP school.

    Science.gov (United States)

    Nkhoma, Owen W W; Duffy, Maresa E; Cory-Slechta, Deborah A; Davidson, Philip W; McSorley, Emeir M; Strain, J J; O'Brien, Gerard M

    2013-08-01

    In developing countries, schoolchildren encounter a number of challenges, including failure to complete school, poor health and nutrition, and poor academic performance. Implementation of school feeding programs (SFPs) in less developed countries is increasing and yet there is mixed evidence regarding their positive effects on nutrition, education, and cognition at the population level. This study evaluated cognitive and anthropometric outcomes in entry-level primary school children in Malawi with the aim of generating evidence for the ongoing debate about SFPs in Malawi and other developing countries. A total of 226 schoolchildren aged 6-8 y in 2 rural Malawian public primary schools were followed for one school year. Children attending one school (SFP school) received a daily ration of corn-soy blend porridge, while those attending the other (non-SFP school) did not. Baseline and post-baseline outcomes included the Cambridge Neurological Test Automated Battery cognitive tests of paired associate learning, rapid visual information processing and intra-extra dimensional shift, and anthropometric measurements of weight, height, and mid-upper arm circumference (MUAC). At follow-up, the SFP subcohort had a greater reduction than the non-SFP subcohort in the number of intra-extra predimensional shift errors made (mean 18.5 and 24.9, respectively; P-interaction = 0.02) and also showed an increase in MUAC (from 16.3 to 17.0; P-interaction learning and catch-up growth in lean muscle mass in children in the SFP school compared with children in the non-SFP school. These findings suggest that the Malawian SFP, if well managed and ration sizes are sustained, may have the potential to improve nutritional and cognitive indicators of the most disadvantaged children.

  11. Ares Launch Vehicles Lean Practices Case Study

    Science.gov (United States)

    Doreswamy, Rajiv, N.; Self, Timothy A.

    2008-01-01

    This viewgraph presentation describes test strategies and lean philisophies and practices that are applied to Ares Launch Vehicles. The topics include: 1) Testing strategy; 2) Lean Practices in Ares I-X; 3) Lean Practices Applied to Ares I-X Schedule; 4) Lean Event Results; 5) Lean, Six Sigma, and Kaizen Practices in the Ares Projects Office; 6) Lean and Kaizen Success Stories; and 7) Ares Six Sigma Practices.

  12. LEAN thinking in Finnish healthcare.

    Science.gov (United States)

    Jorma, Tapani; Tiirinki, Hanna; Bloigu, Risto; Turkki, Leena

    2016-01-01

    Purpose - The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes. Design/methodology/approach - A mixed-method approach incorporating the Webropol survey was used. Findings - LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN. Originality/value - This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

  13. Dynamically Stable Legged Locomotion.

    Science.gov (United States)

    1983-01-27

    digitai~y thro)ugh a ribbon cable. lhe dcsign effort required to mount power sources and computing u(m board would hive distracted us fiorn our main...angular momentum. "The model used in this paper, shown in Fig. 6-1, has 3 single springy leg that articular •s ,ith respect to a body about a simple hince

  14. Two Legged Walking Robot

    OpenAIRE

    Kraus, V.

    2015-01-01

    The aim of this work is to construct a two-legged wirelessly controlled walking robot. This paper describes the construction of the robot, its control electronics, and the solution of the wireless control. The article also includes a description of the application to control the robot. The control electronics of the walking robot are built using the development kit Arduino Mega, which is enhanced with WiFi module allowing the wireless control, a set of ultrasonic sensors for detecting obstacl...

  15. Dynamically Stable Legged Locomotion

    Science.gov (United States)

    1981-11-30

    the laboratory. Harry Asada, Wayne Book, Nancy Cornelius, Sesh Murthy and Ivan Sutherland read various drafts of this report, for which we are...particularly helpful in providing an atmosphere where things could get started. Craig Fields and Clint Kelly deserve special credit for letting the idea of...legged technology capture their imaginations, even before we could show them tangible results. We are especially indebted to Ivan Sutherland for his

  16. Legāti

    OpenAIRE

    Segliņa, Aiga

    2010-01-01

    Autore teorētiski analizē legāta jēdzienu testamentārās mantošanas ietvaros un atspoguļo praktiska pētījuma rezultātus. Teorētiskā daļa apskata legāta nodibināšanas formu un spēkā esamību, tā iegūšanu un atraidīšanu, izpildi un zaudēšanu, novēlējuma robežas un aprobežojumus. Pētījums veikts aptaujas veidā ar mērķi noskaidrot, cik liela Latvijas iedzīvotāju daļa apzinās legāta nodrošinātās priekšrocības testamentārajā mantošanā. Apskatīts notāra neitralitātes jautājums attiecībā pret mantošana...

  17. Prediction equation for lower limbs lean soft tissue in circumpubertal boys using anthropometry and biological maturation.

    Directory of Open Access Journals (Sweden)

    João Valente-dos-Santos

    Full Text Available Lean soft tissue (LST, a surrogate of skeletal muscle mass, is largely limited to appendicular body regions. Simple and accurate methods to estimate lower limbs LST are often used in attempts to partition out the influence of body size on performance outputs. The aim of the current study was to develop and cross-validate a new model to predict lower limbs LST in boys aged 10-13 years, using dual-energy X-ray absorptiometry (DXA as the reference method. Total body and segmental (lower limbs composition were assessed with a Hologic Explorer-W QDR DXA scanner in a cross-sectional sample of 75 Portuguese boys (144.8±6.4 cm; 40.2±9.0 kg. Skinfolds were measured at the anterior and posterior mid-thigh, and medial calf. Circumferences were measured at the proximal, mid and distal thigh. Leg length was estimated as stature minus sitting height. Current stature expressed as a percentage of attained predicted mature stature (PMS was used as an estimate of biological maturity status. Backward proportional allometric models were used to identify the model with the best statistical fit: ln (lower limbs LST  = 0.838× ln (body mass +0.476× ln (leg length - 0.135× ln (mid-thigh circumference - 0.053× ln (anterior mid-thigh skinfold - 0.098× ln (medial calf skinfold - 2.680+0.010× (percentage of attained PMS (R = 0.95. The obtained equation was cross-validated using the predicted residuals sum of squares statistics (PRESS method (R2PRESS = 0.90. Deming repression analysis between predicted and current lower limbs LST showed a standard error of estimation of 0.52 kg (95% limits of agreement: 0.77 to -1.27 kg. The new model accurately predicts lower limbs LST in circumpubertal boys.

  18. Lean management beyond manufacturing a holistic approach

    CERN Document Server

    Bhasin, Sanjay

    2015-01-01

    Exploring Lean manufacturing in a holistic manner, this book helps organizations to implement Lean principles successfully by offering theoretical, empirical and practical knowledge. It empirically demonstrates how a successful Lean initiative can improve organizational efficiency, and incorporates valuable primary research to substantiate findings. It argues that Lean principles need to be applied throughout the value chain in order to be successful , and suggests that these tools need to be aligned with culture and change management. Chapters examine issues including Lean cultures, impediments to Lean, Lean and performance measurement, and the impact of Lean. Viewing Lean as a never-ending journey, this book provides a valuable resource to practising Lean managers, and specialist researchers and students, and also offers an important reference for organizations embarking on their Lean voyage.

  19. VLCD compliance and lean body mass

    DEFF Research Database (Denmark)

    Astrup, A; Quaade, F

    1989-01-01

    Very low calorie diets (VLCD) have many advantages, as they are inexpensive, safe and easy to comply with, and give rapid and encouraging weight loss. On the other hand, many patients complain of hunger and constipation. We have shown that these drawbacks can be reduced by the supplementation of ...

  20. Lean Startup and Lean Canvas Using for Innovative Product Development

    Directory of Open Access Journals (Sweden)

    Alena Buchalcevová

    2016-06-01

    Full Text Available Recently, new approaches to product development have emerged that focus on idea generation techniques and customer itself. One of them is the Lean Startup method that is described in this article along with the Lean Canvas method. The main goal of the article is to demonstrate the application of both methods to an innovative product development focused on providing interactive trips for families with children. The development of the product during individual phases is described and application of the Lean Startup and Lean Canvas principles is demonstrated. Finally, benefits of both methods contributing to the product success are discussed. Similar case studies start emerging worldwide, however in the Czech context are quite rare.

  1. Clinically lean; "cutting the crap".

    Science.gov (United States)

    Caldwell, G

    2012-01-01

    Proponents of Lean Philosophy believe that successful businesses must reduce waste in working time and resources to a minimum, and maximise their use in productive work. The productive work of the Acute Medical Unit is to provide effective clinical management to a daily cohort of acutely ill patients. Many Clinicians are cynical about Lean. In this article, Dr Caldwell discusses how many clinicians complain of too much crap in the workplace, which gets in the way of swift, safe high quality clinical care. He argues that "Cutting the Crap" in the Acute Medical Unit is entirely consistent with Lean approaches to management of complex systems.

  2. Improving healthcare using Lean processes.

    Science.gov (United States)

    Baker, G Ross

    2014-01-01

    For more than a decade, healthcare organizations across Canada have been using Lean management tools to improve care processes, reduce preventable adverse events, increase patient satisfaction and create better work environments. The largest system-wide effort in Canada, and perhaps anywhere, is currently under way in Saskatchewan. The jury is still out on whether Lean efforts in that province, or elsewhere in Canada, are robust enough to transform current delivery systems and sustain new levels of performance. This issue of Healthcare Quarterly features several articles that provide a perspective on Lean methods in healthcare. Copyright © 2014 Longwoods Publishing.

  3. LEGS data acquisition facility

    International Nuclear Information System (INIS)

    LeVine, M.J.

    1985-01-01

    The data acquisition facility for the LEGS medium energy photonuclear beam line is composed of an auxiliary crate controller (ACC) acting as a front-end processor, loosely coupled to a time-sharing host computer based on a UNIX-like environment. The ACC services all real-time demands in the CAMAC crate: it responds to LAMs generated by data acquisition modules, to keyboard commands, and it refreshes the graphics display at frequent intervals. The host processor is needed only for printing histograms and recording event buffers on magnetic tape. The host also provides the environment for software development. The CAMAC crate is interfaced by a VERSAbus CAMAC branch driver

  4. Lean Manufacturing measurement: The relationships between Lean activities and Lean metrics

    Directory of Open Access Journals (Sweden)

    Diego Fernando Manotas Duque

    2007-01-01

    Full Text Available Medición en Lean Manufacturing: Relaciones entre Actividades Lean y Métricas Lean Lean Manufacturing fue desarrollada por Toyota para satisfacer sus necesidades específicas en un mercado restringido y en tiempos de estrechez económica. Estos conceptos han sido estudiados y se ha comprobado su aplicabilidad en una amplia variedad de industrias. El objetivo de este artículo es el de integrar un conjunto de métricas que han sido propuestas por diferentes autores, de tal manera que sean consistentes con las etapas y elementos de implementaciones de Lean Manufacturing. Para lograrlo se presentan dos marcos de referencia para implementaciones Lean y los principales factores de éxito se utilizan como base para proponer métricas que identifiquen el avance en estos factores. Posteriormente se propone una tabla que cruza el impacto de las “Actividades Lean” sobre las métricas, postulando que muchos de los supuestos a priori sobre estos impactos deberían ser precisos. Finalmente se proponen algunas ideas para proyectos de investigación hacia el futuro y posibles extensiones de las aplicaciones propuestas aquí.

  5. Can adaptive threshold-based metabolic tumor volume (MTV) and lean body mass corrected standard uptake value (SUL) predict prognosis in head and neck cancer patients treated with definitive radiotherapy/chemoradiotherapy?

    Science.gov (United States)

    Akagunduz, Ozlem Ozkaya; Savas, Recep; Yalman, Deniz; Kocacelebi, Kenan; Esassolak, Mustafa

    2015-11-01

    To evaluate the predictive value of adaptive threshold-based metabolic tumor volume (MTV), maximum standardized uptake value (SUVmax) and maximum lean body mass corrected SUV (SULmax) measured on pretreatment positron emission tomography and computed tomography (PET/CT) imaging in head and neck cancer patients treated with definitive radiotherapy/chemoradiotherapy. Pretreatment PET/CT of the 62 patients with locally advanced head and neck cancer who were treated consecutively between May 2010 and February 2013 were reviewed retrospectively. The maximum FDG uptake of the primary tumor was defined according to SUVmax and SULmax. Multiple threshold levels between 60% and 10% of the SUVmax and SULmax were tested with intervals of 5% to 10% in order to define the most suitable threshold value for the metabolic activity of each patient's tumor (adaptive threshold). MTV was calculated according to this value. We evaluated the relationship of mean values of MTV, SUVmax and SULmax with treatment response, local recurrence, distant metastasis and disease-related death. Receiver-operating characteristic (ROC) curve analysis was done to obtain optimal predictive cut-off values for MTV and SULmax which were found to have a predictive value. Local recurrence-free (LRFS), disease-free (DFS) and overall survival (OS) were examined according to these cut-offs. Forty six patients had complete response, 15 had partial response, and 1 had stable disease 6 weeks after the completion of treatment. Median follow-up of the entire cohort was 18 months. Of 46 complete responders 10 had local recurrence, and of 16 partial or no responders 10 had local progression. Eighteen patients died. Adaptive threshold-based MTV had significant predictive value for treatment response (p=0.011), local recurrence/progression (p=0.050), and disease-related death (p=0.024). SULmax had a predictive value for local recurrence/progression (p=0.030). ROC curves analysis revealed a cut-off value of 14.00 mL for

  6. Lean Architecture for Agile Software Development

    CERN Document Server

    Coplien, James O

    2010-01-01

    More and more Agile projects are seeking architectural roots as they struggle with complexity and scale - and they're seeking lightweight ways to do it: Still seeking? In this book the authors help you to find your own path; Taking cues from Lean development, they can help steer your project toward practices with longstanding track records; Up-front architecture? Sure. You can deliver an architecture as code that compiles and that concretely guides development without bogging it down in a mass of documents and guesses about the implementation; Documentation? Even a whiteboard diagram, or a CRC

  7. Researching Lean: Methodological Implications of Loose Definitions

    Directory of Open Access Journals (Sweden)

    Mikael Brännmark

    2012-12-01

    Full Text Available Recently, Lean Production (Lean has become a prevailing management concept in Sweden. However, previous research seems to show that the Lean concept and the impact of Lean vary considerably between organizations. This paper illustrates some key methodological issues that need to be considered when researching loosely defined management concepts such as Lean. The paper is based on a review of the literature and five comparative Swedish cases studies. Our study indicates that Lean has changed over time and that operationalization and interpretations of the concept vary considerably. This study concludes that future Lean studies should include a thorough assessment of the Lean interventions, study settings, and in particular non-Lean factors mediating the outcomes of Lean-inspired change programs.

  8. Parametric study of turbine NGV blade lean and vortex design

    Directory of Open Access Journals (Sweden)

    Zhang Shaowen

    2016-02-01

    Full Text Available The effects of blade lean and vortex design on the aerodynamics of a turbine entry nozzle guide vane (NGV are considered using computational fluid dynamics. The aim of the work is to address some of the uncertainties which have arisen from previous studies where conflicting results have been reported for the effect on the NGV. The configuration was initially based on the energy efficient engine turbine which also served as the validation case for the computational method. A total of 17 NGV configurations were evaluated to study the effects of lean and vortex design on row efficiency and secondary kinetic energy. The distribution of mass flow ratio is introduced as an additional factor in the assessment of blade lean effects. The results show that in the turbine entry NGV, the secondary flow strength is not a dominant factor that determines NGV losses and therefore the changes of loading distribution due to blade lean and the associated loss mechanisms should be regarded as a key factor. Radial mass flow redistribution under different NGV lean and twist is demonstrated as an addition key factor influencing row efficiency.

  9. Lean Design and Management for Manufactoring

    OpenAIRE

    NIU, Zhanwen

    2009-01-01

    Most enterprises inducting lean production were confined by the innate limitations of existing production systems, which make it difficult to fulfill lean production comprehensively. To solve this problem, the theory of lean design and management for the manufacturing enterprise lifecycle was proposed. First, the necessities of lean design were analyzed and its theoretical system was established; second, the principles, process, methods and tools for lean design was introduced. Techniques and...

  10. The evolution of Lean organizations

    OpenAIRE

    Serafinas, Dalius; Ruželė, Darius

    2014-01-01

    Remiantis evoliucijos tyrimų modeliais bei autorių sudarytu evoliucionuojančios organizacijos modeliu,straipsnyje analizuojama Lean vadybos metodologija ir tiriama, kaip evoliucionuoja ją įgyvendinančios Lietuvosgamybinės organizacijos. The purpose of this paper is to examine the evolution of Lean organizations.Design/methodology/approach: a conceptual literature on the evolution of species, organisms and organizations was reviewed and an original model (framework) of the evolution of orga...

  11. Buildings Lean Maintenance Implementation Model

    Science.gov (United States)

    Abreu, Antonio; Calado, João; Requeijo, José

    2016-11-01

    Nowadays, companies in global markets have to achieve high levels of performance and competitiveness to stay "alive".Within this assumption, the building maintenance cannot be done in a casual and improvised way due to the costs related. Starting with some discussion about lean management and building maintenance, this paper introduces a model to support the Lean Building Maintenance (LBM) approach. Finally based on a real case study from a Portuguese company, the benefits, challenges and difficulties are presented and discussed.

  12. Lean Transformation of Multinational Concerns

    DEFF Research Database (Denmark)

    Matthiesen, Rikke Vestergaard; Johansen, John

    2008-01-01

    triggered. This paper reports on exploratory studies from a multinational company adopting centrally managed pilot projects as a transformation mechanism for continuous change towards a lean business system and an organizational culture of continuous improvements (CI). Competitive pressure demands...... from a multinational company adopting centrally managed pilot projects as a transformation mechanism for continuous change towards a lean business system and an organizational culture of continuous improvements (CI)....

  13. Lean manufacturing measurement: the relationship between lean activities and lean metrics

    Directory of Open Access Journals (Sweden)

    Manotas Duque Diego Fernando

    2007-10-01

    Full Text Available Lean Manufacturing was developed by Toyota Motor company to address their specific needs in a restricted market in times of economic trouble. These concepts have been studied and proven to be transferrable and applicable to a wide variety of industries. This paper aims to integrate a set of metrics that have been proposed by different authors in such a way that they are consistent with the different stages and elements of Lean Manufacturing implementations. To achieve this, two frameworks for Lean implementations are presented and then the main factors for success are used as the basis to propose metrics that measure the advance in these factors. A tabular display of the impact of “Lean activities” on the metrics is presented, proposing that many a priori assumptions about the benefits on many different levels of improvement should be accurate. Finally, some ideas for future research and extension of the applications proposed on this paper are presented as closing points.

  14. Don't break a leg: running birds from quail to ostrich prioritise leg safety and economy on uneven terrain.

    Science.gov (United States)

    Birn-Jeffery, Aleksandra V; Hubicki, Christian M; Blum, Yvonne; Renjewski, Daniel; Hurst, Jonathan W; Daley, Monica A

    2014-11-01

    Cursorial ground birds are paragons of bipedal running that span a 500-fold mass range from quail to ostrich. Here we investigate the task-level control priorities of cursorial birds by analysing how they negotiate single-step obstacles that create a conflict between body stability (attenuating deviations in body motion) and consistent leg force-length dynamics (for economy and leg safety). We also test the hypothesis that control priorities shift between body stability and leg safety with increasing body size, reflecting use of active control to overcome size-related challenges. Weight-support demands lead to a shift towards straighter legs and stiffer steady gait with increasing body size, but it remains unknown whether non-steady locomotor priorities diverge with size. We found that all measured species used a consistent obstacle negotiation strategy, involving unsteady body dynamics to minimise fluctuations in leg posture and loading across multiple steps, not directly prioritising body stability. Peak leg forces remained remarkably consistent across obstacle terrain, within 0.35 body weights of level running for obstacle heights from 0.1 to 0.5 times leg length. All species used similar stance leg actuation patterns, involving asymmetric force-length trajectories and posture-dependent actuation to add or remove energy depending on landing conditions. We present a simple stance leg model that explains key features of avian bipedal locomotion, and suggests economy as a key priority on both level and uneven terrain. We suggest that running ground birds target the closely coupled priorities of economy and leg safety as the direct imperatives of control, with adequate stability achieved through appropriately tuned intrinsic dynamics. © 2014. Published by The Company of Biologists Ltd.

  15. Estimation of lean and fat composition of pork ham using image processing measurements

    Science.gov (United States)

    Jia, Jiancheng; Schinckel, Allan P.; Forrest, John C.

    1995-01-01

    This paper presents a method of estimating the lean and fat composition in pork ham from cross-sectional area measurements using image processing technology. The relationship between the quantity of ham lean and fat mass with the ham lean and fat areas was studied. The prediction equations for pork ham composition based on the ham cross-sectional area measurements were developed. The results show that ham lean weight was related to the ham lean area (r equals .75, P lean weight was highly related to the product of ham total weight times percentage ham lean area (r equals .96, P product of ham total weight times percentage ham fat area (r equals .88, P lean weight was trimmed wholesale ham weight and percentage ham fat area with a coefficient of determination of 92%. The best combination of independent variables for estimating ham fat weight was trimmed wholesale ham weight and percentage ham fat area with a coefficient of determination of 78%. Prediction equations with either two or three independent variables did not significantly increase the accuracy of prediction. The results of this study indicate that the weight of ham lean and fat could be predicted from ham cross-sectional area measurements using image analysis in combination with wholesale ham weight.

  16. Clinical and biochemical profile of lean type 2 diabetes mellitus

    OpenAIRE

    Barma, Punyakrit Deb; Ranabir, Salam; Prasad, Lallan; Singh, Thangjam Premchand

    2011-01-01

    Background: Type 2 diabetes mellitus is the most prevalent form of diabetes worldwide. In western countries majority of the cases are obese. The scenario may be different in certain parts of India. Various studies have reported a high prevalence of lean type 2 diabetes mellitus with a body mass index < 19 kg/m 2 . Materials and Methods: We evaluated 100 cases of lean type 2 diabetes mellitus (62 males and 38 females). Results and Conclusion: The mean duration of diabetes was 51.7 months (rang...

  17. Leptin production during early starvation in lean and obese women.

    Science.gov (United States)

    Klein, S; Horowitz, J F; Landt, M; Goodrick, S J; Mohamed-Ali, V; Coppack, S W

    2000-02-01

    We evaluated abdominal adipose tissue leptin production during short-term fasting in nine lean [body mass index (BMI) 21 +/- 1 kg/m(2)] and nine upper body obese (BMI 36 +/- 1 kg/m(2)) women. Leptin kinetics were determined by arteriovenous balance across abdominal subcutaneous adipose tissue at 14 and 22 h of fasting. At 14 h of fasting, net leptin release from abdominal adipose tissue in obese subjects (10.9 +/- 1.9 ng x 100 g tissue x (-1) x min(-1)) was not significantly greater than the values observed in the lean group (7.6 +/- 2.1 ng x 100 g(-1) x min(-1)). Estimated whole body leptin production was approximately fivefold greater in obese (6.97 +/- 1.18 microg/min) than lean subjects (1.25 +/- 0.28 microg/min) (P production rates decreased in both lean and obese groups (to 3.10 +/- 1.31 and 10.5 +/- 2.3 ng x 100 g adipose tissue(-1) x min(-1), respectively). However, the relative declines in both arterial leptin concentration and local leptin production in obese women (arterial concentration 13.8 +/- 4.4%, local production 10.0 +/- 12.3%) were less (P lean women (arterial concentration 39.0 +/- 5.5%, local production 56.9 +/- 13.0%). This study demonstrates that decreased leptin production accounts for the decline in plasma leptin concentration observed after fasting. However, compared with lean women, the fasting-induced decline in leptin production is blunted in women with upper body obesity. Differences in leptin production during fasting may be responsible for differences in the neuroendocrine response to fasting previously observed in lean and obese women.

  18. Lean versus Quick Response Manufacturing og andre koncepter - er Lean den eneste ene?

    DEFF Research Database (Denmark)

    Michelsen, Aage U

    2005-01-01

    Begrebet Lean har gennem de senere år vundet en enorm udbredelse. Antallet af publikationer om Lean har været eksplosivt stigende, og mange virksomheder har gennemført eller gennemfører Lean-projekter. Er Lean et nyt koncept? Er Lean den eneste løsning? Kan Lean kombineres med tankegange og princ...... løsning af en anden produktionsopgave. I fjerde afsnit skitseres kort relationerne mellem Lean og to andre begreber, Six Sigma og TPM, der begge har samme mål som Lean, men forskellige udgangspunkter og forskellige indfaldsvinkler....

  19. Lean Production Applications in a Manufacturing Company

    OpenAIRE

    Ali Görener; Humeyra Baser; Ali Turkyilmaz

    2013-01-01

    Lean production is a production model which comes about the pursuit of companies to be able to meet competition and make effective production. The main purpose of lean production is to get control about the wastage. This study includes the requirements for the success of the lean production and how the lean production system can be established. In this paper, lean production techniques were applied to the electric water heater line. Measurements using lean initiatives were made, operation cyc...

  20. Muscle quality, aerobic fitness and fat mass predict lower-extremity physical function in community-dwelling older adults.

    Science.gov (United States)

    Misic, Mark M; Rosengren, Karl S; Woods, Jeffrey A; Evans, Ellen M

    2007-01-01

    Muscle mass, strength and fitness play a role in lower-extremity physical function (LEPF) in older adults; however, the relationships remain inadequately characterized. This study aimed to examine the relationships between leg mineral free lean mass (MFLM(LEG)), leg muscle quality (leg strength normalized for MFLM(LEG)), adiposity, aerobic fitness and LEPF in community-dwelling healthy elderly subjects. Fifty-five older adults (69.3 +/- 5.5 years, 36 females, 19 males) were assessed for leg strength using an isokinetic dynamometer, body composition by dual energy X-ray absorptiometry and aerobic fitness via a treadmill maximal oxygen consumption test. LEPF was assessed using computerized dynamic posturography and stair ascent/descent, a timed up-and-go task and a 7-meter walk with and without an obstacle. Muscle strength, muscle quality and aerobic fitness were similarly correlated with static LEPF tests (r range 0.27-0.40, p < 0.05); however, the strength of the independent predictors was not robust with explained variance ranging from 9 to 16%. Muscle quality was the strongest correlate of all dynamic LEPF tests (r range 0.54-0.65, p < 0.001). Using stepwise linear regression analysis, muscle quality was the strongest independent predictor of dynamic physical function explaining 29-42% of the variance (p < 0.001), whereas aerobic fitness or body fat mass explained 5-6% of the variance (p < 0.05) depending on performance measure. Muscle quality is the most important predictor, and aerobic fitness and fat mass are secondary predictors of LEPF in community-dwelling older adults. These findings support the importance of exercise, especially strength training, for optimal body composition, and maintenance of strength and physical function in older adults.

  1. Mass

    International Nuclear Information System (INIS)

    Quigg, Chris

    2007-01-01

    In the classical physics we inherited from Isaac Newton, mass does not arise, it simply is. The mass of a classical object is the sum of the masses of its parts. Albert Einstein showed that the mass of a body is a measure of its energy content, inviting us to consider the origins of mass. The protons we accelerate at Fermilab are prime examples of Einsteinian matter: nearly all of their mass arises from stored energy. Missing mass led to the discovery of the noble gases, and a new form of missing mass leads us to the notion of dark matter. Starting with a brief guided tour of the meanings of mass, the colloquium will explore the multiple origins of mass. We will see how far we have come toward understanding mass, and survey the issues that guide our research today.

  2. Lean computing for the cloud

    CERN Document Server

    Bauer, Eric

    2016-01-01

    Applies lean manufacturing principles across the cloud service delivery chain to enable application and infrastructure service providers to sustainably achieve the shortest lead time, best quality, and value This book focuses on lean in the context of cloud computing capacity management of applications and the physical and virtual cloud resources that support them. Lean Computing for the Cloud considers business, architectural and operational aspects of efficiently delivering valuable services to end users via cloud-based applications hosted on shared cloud infrastructure. The work also focuses on overall optimization of the service delivery chain to enable both application service and infrastructure service providers to adopt leaner, demand driven operations to serve end users more efficiently. The book’s early chapters analyze how capacity management morphs with cloud computing into interlocked physical infrastructure capacity management, virtual resou ce capacity management, and application capacity ma...

  3. An Explanatory Study of Lean Practices in Job Shop Production/ Special Job Production/ Discrete Production/ Batch Shop Production Industries

    OpenAIRE

    Lavlesh Kumar Sharma; Ravindra Mohan Saxena

    2014-01-01

    In this paper, the study explores the benefits and advantages of Lean Practices or Lean Thinking in Job shop production/ Special job production/ Discrete production/ Batch shop production industries. The Lean Practices have been applied more compatible in Job shop production than in the continuous/ mass production because of several barriers and hurdles in the industrial context that influence the whole processes again and again, this happens due to the lack of knowledge about...

  4. IMPLEMENTATION OF LEAN MANUFACTURING IN FISH CANNING COMPANY: A CASE STUDY OF A CANNED SARDINES PRODUCTION COMPANY IN MOROCCO

    OpenAIRE

    I. Idrıssi; A. Mesfioui; I. Aftais; B. Benazzouz

    2015-01-01

    Lean is a powerful tool, which can bring significant benefit to manufacturing industries by creating value through reduction of waste. Although the lean concept has become very popular in mass production industries such as the automotive industry, more recently the concept has been adopted in different batch processing industries and service sectors. The application of lean tools into the food processing industry has not received the same level of attention compared...

  5. Lean management in academic surgery.

    Science.gov (United States)

    Collar, Ryan M; Shuman, Andrew G; Feiner, Sandra; McGonegal, Amy K; Heidel, Natalie; Duck, Mary; McLean, Scott A; Billi, John E; Healy, David W; Bradford, Carol R

    2012-06-01

    Lean is a management system designed to enhance productivity by eliminating waste. Surgical practice offers many opportunities for improving efficiency. Our objective was to determine whether systematic implementation of lean thinking in an academic otolaryngology operating room improves efficiency and profitability and preserves team morale and educational opportunities. In an 18-month prospective quasi-experimental study, a multidisciplinary task force systematically implemented lean thinking within an otolaryngology operating room of an academic health system. Operating room turnover time and turnaround time were measured during a baseline period; an observer-effect period in which workers were made aware that their efficiency was being measured but before implementing lean changes; and an intervention period after redesign principles had been used. The impact on teamwork, morale, and surgical resident education were measured during the baseline and intervention periods through validated surveys. A profit model was applied to estimate the financial implications of the study. There was no difference between the baseline and observer-effect periods of the study for turnover time (p = 0.98) or turnaround time (p = 0.20). During the intervention period, the mean turnover time and turnaround time were significantly shorter than during the baseline period (29 vs 38 minutes; p improved morale after implementation (p = 0.011). Educational metrics were unchanged before and after implementation. The annual opportunity revenue for the involved operating room is $330,000; when extrapolated throughout the operating rooms, lean thinking could create 6,500 hours of capacity annually. Application of lean management techniques to a single operating room and surgical service improved operating room efficiency and morale, sustained resident education, and can provide considerable financial gains when scaled to an entire academic surgical suite. Copyright © 2012. Published by

  6. Lean spare parts delivery chain

    OpenAIRE

    Sjöstrand, Niklas; Larsson, Mona-Liza

    2015-01-01

    AbstractWhen a product has been sold to a customer a new market arises for the company to earn profit from and to differentiate itself within. According to Bartwal, et al. (2010) the after sales market generally does not provide great revenues but good profits of the total revenue. In order to gain competiveness and live up to customer’s expectations a company needs to be efficient (Atkinson, 2004). He continuous that this can be accomplished if companies implement Lean. Lean is different too...

  7. 'Lean' approach gives greater efficiency.

    Science.gov (United States)

    Call, Roger

    2014-02-01

    Adapting the 'Lean' methodologies used for many years by many manufacturers on the production line - such as in the automotive industry - and deploying them in healthcare 'spaces' can, Roger Call, an architect at Herman Miller Healthcare in the US, argues, 'easily remedy many of the inefficiencies' found within a healthcare facility. In an article that first appeared in the September 2013 issue of The Australian Hospital Engineer, he explains how 'Lean' approaches such as the 'Toyota production system', and 'Six Sigma', can be harnessed to good effect in the healthcare sphere.

  8. A Simulation of Lean Manufacturing: The Lean Lemonade Tycoon 2

    Science.gov (United States)

    Ncube, Lisa B.

    2010-01-01

    This article discusses the functions and effectiveness of games and simulations in the learning processes, in particular as an experiential learning methodology. The application of the game Lemonade Tycoon in the development of lean manufacturing concepts is described. This article addresses the use of the game to teach the principles of lean…

  9. Learning Lean: A Survey of Industry Lean Needs

    Science.gov (United States)

    Fliedner, Gene; Mathieson, Kieran

    2009-01-01

    The authors examined business practitioners' preferences for higher education curricula design in general and for what graduates should know about Lean, or waste-reduction efforts. The authors conducted a Web-based survey and found that practitioners are not as concerned about graduates' possessing specific technical skills as they are about them…

  10. Lean Application to Manufacturing Ramp-Up

    DEFF Research Database (Denmark)

    Christensen, Irene; Rymaszewska, Anna

    2016-01-01

    . Abstracting from the extant literature, the authors considered the competitiveness of manufacturing companies from two principal perspectives: the leanness of the ramp-up process and the new-value creation of quality managers. While much of the literature fails to acknowledge that the roots of lean actually......This article provides a theoretical overview of the concepts of lean and manufacturing ramp-up in an attempt to conceptualize the strategic areas in which lean philosophy and principles can be applied for continuous improvements. The application of lean principles during the final stage of a new...... product development process, that is, the ramp-up process, is a critical, early enabler of lean manufacturing. The manufacturing strategy literature conceptualizes a state of “leanness in operations,” which can consolidate both the concepts of lean and manufacturing ramp-up, providing a dual perspective...

  11. Readiness for change and job satisfaction in a case of lean management application - a comparative study.

    Science.gov (United States)

    Lipińska-Grobelny, Agnieszka; Papieska, Ewelina

    2012-09-01

    This current study investigates the effect of lean management system on work attitudes of workers of two manufacturing companies. "Lean management" is a concept of work processes and human relations that determines company's productivity and profitability. Workers of two enterprises, the first one with lean production and the second one with old mass production, were compared for their readiness for change and job satisfaction (both emotional and cognitive aspect). The sample of 102 employees completed a battery of instruments such as: the Job Description Inventory by Neuberger and Allerbeck, the Job Affect Scale by Burke et al. and the Change-Readiness Scale by Kriegel and Brandt. Individuals from the lean manufacturing company were characterized by higher level of readiness for change, positive affect at work, and cognitive job satisfaction. In this approach the introduction of lean production positively affected company's human resource attitudes.

  12. Dynamic stability of running: The effects of speed and leg amputations on the maximal Lyapunov exponent

    International Nuclear Information System (INIS)

    Look, Nicole; Arellano, Christopher J.; Grabowski, Alena M.; Kram, Rodger; McDermott, William J.; Bradley, Elizabeth

    2013-01-01

    In this paper, we study dynamic stability during running, focusing on the effects of speed, and the use of a leg prosthesis. We compute and compare the maximal Lyapunov exponents of kinematic time-series data from subjects with and without unilateral transtibial amputations running at a wide range of speeds. We find that the dynamics of the affected leg with the running-specific prosthesis are less stable than the dynamics of the unaffected leg and also less stable than the biological legs of the non-amputee runners. Surprisingly, we find that the center-of-mass dynamics of runners with two intact biological legs are slightly less stable than those of runners with amputations. Our results suggest that while leg asymmetries may be associated with instability, runners may compensate for this effect by increased control of their center-of-mass dynamics

  13. A Sand Cone Model of Lean Implementation

    OpenAIRE

    Yestemessov, Azamat

    2011-01-01

    Over the past 20 years Lean Production system has been a focus of researches by different academicians. A numerous works have been written in the field of Lean implementation in manufacturing companies. However, as shown, most of the academic topics relate to the issues of implementing Lean tools and techniques. Critical Success Factors have been also described widely; however, no efforts in systematization have been made. Only several works have a focus on integration of Lean implementation ...

  14. Performance Improvement through Implementation of Lean Maintenance

    OpenAIRE

    S. Kolanjiappan; Dr. K. Maran

    2011-01-01

    Lean Maintenance is a relatively new term, invented in the last decade of the twentieth century, but the principles are well established in Total Productive Maintenance (TPM). Lean Maintenance—taking its lead from Lean Manufacturing—applies some new techniques to TPM concepts to render a more structured implementation path. Tracing its roots back to Henry Ford with modern refinements born in Japanese manufacturing, specifically the Toyota Production System (TPS). Lean seeks to eliminate a...

  15. Training for successful lean manufacturing implementation

    OpenAIRE

    Ichimura, Maki; Jahankhani, Hamid; Arunachalam, Subramaniam

    2006-01-01

    Implementing lean manufacturing is a complex and everlasting task. The workers involving in production processes are the pivot of the lean manufacturing implementation. Training is known as a vehicle to assist the implementation process. Despite awareness of the training importance, so far, a little is available to assist to organise an efficient training. This paper summarises the overview of lean manufacturing and discuss the importance of human resource within lean implementation process. ...

  16. Dynamic legged locomotion in robots and animals

    Science.gov (United States)

    Raibert, Marc; Playter, Robert; Ringrose, Robert; Bailey, Dave; Leeser, Karl

    1995-01-01

    This report documents our study of active legged systems that balance actively and move dynamically. The purpose of this research is to build a foundation of knowledge that can lead both to the construction of useful legged vehicles and to a better understanding of how animal locomotion works. In this report we provide an update on progress during the past year. Here are the topics covered in this report: (1) Is cockroach locomotion dynamic? To address this question we created three models of cockroaches, each abstracted at a different level. We provided each model with a control system and computer simulation. One set of results suggests that 'Groucho Running,' a type of dynamic walking, seems feasible at cockroach scale. (2) How do bipeds shift weight between the legs? We built a simple planar biped robot specifically to explore this question. It shifts its weight from one curved foot to the other, using a toe-off and toe-on strategy, in conjunction with dynamic tipping. (3) 3D biped gymnastics: The 3D biped robot has done front somersaults in the laboratory. The robot changes its leg length in flight to control rotation rate. This in turn provides a mechanism for controlling the landing attitude of the robot once airborne. (4) Passively stabilized layout somersault: We have found that the passive structure of a gymnast, the configuration of masses and compliances, can stabilize inherently unstable maneuvers. This means that body biomechanics could play a larger role in controlling behavior than is generally thought. We used a physical 'doll' model and computer simulation to illustrate the point. (5) Twisting: Some gymnastic maneuvers require twisting. We are studying how to couple the biomechanics of the system to its control to produce efficient, stable twisting maneuvers.

  17. Lean and psychosocial work environment in manufacturing

    DEFF Research Database (Denmark)

    Edwards, Kasper; Thye, Nina; Nielsen, Anders P.

    2011-01-01

    Lean is currently the rationalization method of choice in the Danish manufacturing industry. This paper reports finding from three lean implementation cases. All cases are manufacturing companies focusing on upmarket products produced in small series. Prior to lean production was organized as sel...

  18. Lean - set i et historisk perspektiv

    DEFF Research Database (Denmark)

    Michelsen, Aage U

    2006-01-01

    I kapitlet redegøres for, hvordan begrebet Lean opstod som en karakteristik af Toyota Production System (TPS), der igen har sin rod i scientific management. Gennem eksempler illustreres det, at centrale Lean-principper således har været anvendt i årtier. Der argumenteres for, at Lean i mange...

  19. Lean Six Sigma in financial services

    NARCIS (Netherlands)

    de Koning, H.; Does, R.J.M.M.; Bisgaard, S.

    2008-01-01

    Lean Thinking and Six Sigma are typically considered as separate approaches to process innovation, with complementary strengths. When combined as Lean Six Sigma, this approach provides a unified framework for systematically developing innovations. Lean Six Sigma can also bring about significant

  20. Assessing Children's Legs and Feet

    OpenAIRE

    Wedge, John H.

    1985-01-01

    Shoes are necessary for protection and warmth. Normal children do not require shoes for support. There is no scientific evidence that shoes—‘orthopedic’ or otherwise—influence or alter the growth or shape of the normal child's foot except, perhaps, adversely if they fit poorly. Family physicians must understand common variations of normal foot and leg development if they are to effectively advise and reassure parents about appropriate footwear. Flat feet, knock knees, bow legs, in-toeing, and...

  1. Improving venous leg ulcer management

    OpenAIRE

    Weller, Carolina Dragica

    2017-01-01

    This thesis reports several different methods to develop and evaluate complex interventions designed to improve venous leg ulcer management. Chronic venous leg ulcers (VLU) are the most common chronic wound problem in the community. Its health and economic burden is predicted to increase due to ageing of the community and increase in prevalence of diabetes and obesity. Although many patients seek health care for VLU, most do not receive the most effective management. Patients with this condi...

  2. Change management in lean enterprise

    Directory of Open Access Journals (Sweden)

    Furman Joanna

    2016-06-01

    Full Text Available The main purpose of the paper is the analysis of a process of change focusing particularly on the concept of slimmed production (Lean and its implementation in the enterprise. A case study method was chosen as a research tool because it offers wide array of techniques and means of gaining and analysing data.

  3. Analysis Of Lean Accounting JIT And Balance Scorecard In The Companys Lean Manufacturing

    OpenAIRE

    Irwan Sutirman Wahdiat

    2015-01-01

    This research purpose to analyze the concept of Lean Manufacturing which is influenced by the role of JIT. This research uses a theoretical approach. This study portrait thinking companies that have yet to implement lean manufacturing and after doing the concept of lean manufacturing. This study shows that the concept of lean manufacturing can make the company more efficient and effective. This paper shows some lean manufacturing dimensions of the researchers previous researchers. This study ...

  4. Comparative Analysis between Lean, Six Sigma and Lean Six Sigma Concepts

    OpenAIRE

    Alexandra Mirela Cristina MUNTEANU

    2017-01-01

    This paper analyzes the benefits of Lean Six Sigma in comparison with Lean and Six Sigma, traditional improvement methodologies. The introduction highlights the appearance of Lean Six Sigma, early 2000s, as well as the benefits brought by the integrated approach. The following parts of the study emphasize the main differences between methodologies and their commonalities based on their synergy. Finally the advantages of Lean Six Sigma versus Lean and Six Sigma are analyzed and systematized by...

  5. Exploiting HRM in support of lean manufacturing

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Matthiesen, Rikke

    The purpose of this paper is to investigate the ways in HRM practices are-and could potentially be-exploited to support lean manufacturing in practice. First, a review of the pertinent literature regarding HRM, SHRM, and lean manufacturing is presented to provide an understanding of the mechanisms...... by which HRM practices could, theoretically, be used to support a lean implementation. Data presented in the paper are derived from 1) a longitudinal case study on lean implementation and 2) from managers currently involved with lean manufacturing in a second company. The relevant literature and the data...... depicting the potential role in supporting HRM/lean integrated practices. The analysis of the model with respect to the theoretical background emphasizes a number of areas in which HRM could be more fully exploited in order to more successfully support lean implementation, for example, by stressing HRM...

  6. Lean manufacturing in Indian context: A survey

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar

    2015-04-01

    Full Text Available This paper is an attempt to examine the implementation of Lean Manufacturing system in the Indian industries. Predominant elements of Lean Manufacturing, benefits gained after its implementation and obstacles observed by Indian Industry have been recognized. The results of this survey support the opinion that Lean Manufacturing had potential to improve the organizational performance of Indian industries. Nevertheless, Indian industries are required to be passionate to transform their manufacturing by adopting Lean manufacturing to gain the full benefits. A large numbers of literature papers are available on the better side of Lean manufacturing approach and its benefits gained by manufacturing organizations after implementation. But the adverse impacts of Lean manufacturing are not discussed to a great extent. Some drawbacks of Lean manufacturing are also highlighted in this paper.

  7. Lean Production Applications in a Manufacturing Company

    Directory of Open Access Journals (Sweden)

    Ali Görener

    2016-01-01

    Full Text Available Lean production is a production model which comes about the pursuit of companies to be able to meet competition and make effective production. The main purpose of lean production is to get control about the wastage. This study includes the requirements for the success of the lean production and how the lean production system can be established. In this paper, lean production techniques were applied to the electric water heater line. Measurements using lean initiatives were made, operation cycle times were determined, and Kaizen improvement methods and line balancing methods were applied according to the results. And the last section of study showed conclusion of lean implementation.

  8. Effect of obesity on oxygen uptake and cardiovascular dynamics during whole-body and leg exercise in adult males and females.

    LENUS (Irish Health Repository)

    Green, Simon

    2018-05-01

    Obesity has been associated with a slowing of V˙O2 dynamics in children and adolescents, but this problem has not been studied in adults. Cardiovascular mechanisms underlying this effect are not clear. In this study, 48 adults (18 males, 30 females) grouped according to body mass index (BMI) (lean < 25 kg·m-2 , overweight = 25-29.9 kg·m-2 , obese ≥30 kg·m-2 ) provided a fasting blood sample, completed a maximal graded exercise test and six bouts of submaximal exercise on a cycle ergometer, and performed two protocols of calf exercise. Dynamic response characteristics of V˙O2 and leg vascular conductance (LVC) were assessed during cycling (80% ventilatory threshold) and calf exercise (30% MVC), respectively. Dynamic responses of cardiac output, mean arterial pressure and total systemic vascular conductance were also assessed during cycling based on measurements at 30 and 240 sec. The time constant of the second phase of the V˙O2 response was significantly greater in obese than lean subjects (39.4 (9.2) vs. 29.1 (7.6) sec); whereas dynamic responses of cardiac output and systemic vascular conductance were not affected by BMI. For calf exercise, the time constant of the second growth phase of LVC was slowed significantly in obese subjects (22.1 (12.7) sec) compared with lean and overweight subjects (11.6 (4.5) sec and 13.4 (6.7) sec). These data show that obesity slows dynamic responses of V˙O2 during cycling and the slower phase of vasodilation in contracting muscles of male and female adults.

  9. Immobilization increases interleukin-6, but not tumour necrosis factor-a, release from the leg during exercise in humans

    DEFF Research Database (Denmark)

    Reihmane, Dace; Hansen, Andreas Vigelsø; Jensen, Martin Gram

    2013-01-01

    have now studied the temporal relationship of leg IL-6 and TNF-a release before and during isolated two-legged exercise after 14 days of one-leg immobilization (IM) while the other leg served as the control (CON) leg. Fifteen healthy male subjects (mean ± SEM age, 23 ± 1 years; body mass index, 23.......6 ± 0.7 kg m; and maximal oxygen uptake, 46.8 ± 1.4 ml kg min) performed 45 min of two-legged dynamic knee-extensor exercise at 19.6 ± 0.8 W. Arterial and femoral venous blood samples from the CON and the IM leg were collected every 15 min during exercise, and leg blood flow was measured with Doppler...

  10. Leg-adjustment strategies for stable running in three dimensions

    International Nuclear Information System (INIS)

    Peuker, Frank; Maufroy, Christophe; Seyfarth, André

    2012-01-01

    The dynamics of the center of mass (CoM) in the sagittal plane in humans and animals during running is well described by the spring-loaded inverted pendulum (SLIP). With appropriate parameters, SLIP running patterns are stable, and these models can recover from perturbations without the need for corrective strategies, such as the application of additional forces. Rather, it is sufficient to adjust the leg to a fixed angle relative to the ground. In this work, we consider the extension of the SLIP to three dimensions (3D SLIP) and investigate feed-forward strategies for leg adjustment during the flight phase. As in the SLIP model, the leg is placed at a fixed angle. We extend the scope of possible reference axes from only fixed horizontal and vertical axes to include the CoM velocity vector as a movement-related reference, resulting in six leg-adjustment strategies. Only leg-adjustment strategies that include the CoM velocity vector produced stable running and large parameter domains of stability. The ability of the model to recover from perturbations along the direction of motion (directional stability) depended on the strategy for lateral leg adjustment. Specifically, asymptotic and neutral directional stability was observed for strategies based on the global reference axis and the velocity vector, respectively. Additional features of velocity-based leg adjustment are running at arbitrary low speed (kinetic energy) and the emergence of large domains of stable 3D running that are smoothly transferred to 2D SLIP stability and even to 1D SLIP hopping. One of the additional leg-adjustment strategies represented a large convex region of parameters where stable and robust hopping and running patterns exist. Therefore, this strategy is a promising candidate for implementation into engineering applications, such as robots, for instance. In a preliminary comparison, the model predictions were in good agreement with the experimental data, suggesting that the 3D SLIP is an

  11. Caloric Restriction in Lean and Obese Strains of Laboratory ...

    Science.gov (United States)

    NEW FINDINGS: What is the central question of this study? How do lean and obese rats respond physiologically to caloric restriction? What is the main finding and its importance? Obese rats show marked benefits compared with lean animals. Reduced body fat is associated with improved longevity with caloric restriction (CR) in rodents. Little is known regarding effects of CR in genetically lean versus obese strains. Long-Evans (LE) and Brown Norway (BN) rats make an ideal comparison for a CR study because the percentage body fat of young adult LE rats is double that of BN rats. Male LE and BN rats were either fed ad libitum (AL) or were caloricallyrestricted to 80 or 90% of their AL weight. The percentages of fat, lean and fluid mass were measured non-invasively at 2- to 4-week intervals. Metabolic rate and respiratory quotient were measured after 3, 6, 9 and 12 months of CR. Overall health was scored monthly. The percentage of fat of the LE strain decreased with CR, whereas the percentage of fat of the BN strain remained above the AL group for several months. The percentage of lean mass increased above the AL for both strains subjected to CR. The percentage offluid was unaffected by CR. The average metabolic rate over 22 h of the BN rats subjected to CR was reduced, whereas that of LE rats was increased slightly above the AL group. The respiratory quotient of BN rats wasdecreased with CR. Overall health of the CR LE group was significantly improved compared with t

  12. Predicting a 10 repetition maximum for the free weight parallel squat using the 45 degrees angled leg press.

    Science.gov (United States)

    Willardson, Jeffrey M; Bressel, Eadric

    2004-08-01

    The purpose of this research was to devise prediction equations whereby a 10 repetition maximum (10RM) for the free weight parallel squat could be predicted using the following predictor variables: 10RM for the 45 degrees angled leg press, body mass, and limb length. Sixty men were tested over a 3-week period, with 1 testing session each week. During each testing session, subjects performed a 10RM for the free weight parallel squat and 45 degrees angled leg press. Stepwise multiple regression analysis showed leg press mass lifted to be a significant predictor of squat mass lifted for both the advanced and the novice groups (p squat mass lifted for the novice group and 55% of the variance in squat mass lifted for the advanced group. Limb length and body mass were not significant predictors of squat mass lifted for either group. The following prediction equations were devised: (a) novice group squat mass = leg press mass (0.210) + 36.244 kg, (b) advanced group squat mass = leg press mass (0.310) + 19.438 kg, and (c) subject pool squat mass = leg press mass (0.354) + 2.235 kg. These prediction equations may save time and reduce the risk of injury when switching from the leg press to the squat exercise.

  13. Spring-like leg behaviour, musculoskeletal mechanics and control in maximum and submaximum height human hopping

    NARCIS (Netherlands)

    Bobbert, M.F.

    2011-01-01

    The purpose of this study was to understand how humans regulate their 'leg stiffness' in hopping, and to determine whether this regulation is intended to minimize energy expenditure. 'Leg stiffness' is the slope of the relationship between ground reaction force and displacement of the centre of mass

  14. Pipe crawler with extendable legs

    International Nuclear Information System (INIS)

    Zollinger, W.T.

    1992-01-01

    A pipe crawler for moving through a pipe in inchworm fashion having front and rear leg assemblies separated by air cylinders to increase and decrease the spacing between assemblies. Each leg of the four legs of an assembly is moved between a wall-engaging, extended position and a retracted position by a separate air cylinder. The air cylinders of the leg assemblies are preferably arranged in pairs of oppositely directed cylinders with no pair lying in the same axial plane as another pair. Therefore, the cylinders can be as long as a leg assembly is wide and the crawler can crawl through sections of pipes where the diameter is twice that of other sections. The crawler carries a valving system, a manifold to distribute air supplied by a single umbilical air hose to the various air cylinders in a sequence controlled electrically by a controller. The crawler also utilizes a rolling mechanism, casters in this case, to reduce friction between the crawler and pipe wall thereby further extending the range of the pipe crawler. 8 figs

  15. Pipe crawler with extendable legs

    Science.gov (United States)

    Zollinger, W.T.

    1992-06-16

    A pipe crawler for moving through a pipe in inchworm fashion having front and rear leg assemblies separated by air cylinders to increase and decrease the spacing between assemblies. Each leg of the four legs of an assembly is moved between a wall-engaging, extended position and a retracted position by a separate air cylinder. The air cylinders of the leg assemblies are preferably arranged in pairs of oppositely directed cylinders with no pair lying in the same axial plane as another pair. Therefore, the cylinders can be as long as a leg assembly is wide and the crawler can crawl through sections of pipes where the diameter is twice that of other sections. The crawler carries a valving system, a manifold to distribute air supplied by a single umbilical air hose to the various air cylinders in a sequence controlled electrically by a controller. The crawler also utilizes a rolling mechanism, casters in this case, to reduce friction between the crawler and pipe wall thereby further extending the range of the pipe crawler. 8 figs.

  16. Leaning in to "muddy" interviews

    DEFF Research Database (Denmark)

    Lippke, Lena; Tanggaard, Lene

    2014-01-01

    Over the last few decades, qualitative research has been acknowledged as a peopled practice in which subjectivities come into play. The main argument presented in this article is that qualitative research involves “muddy,” troublesome, interactional passages, because of a complex interplay between...... situated identities among the participants cross each other. We emphasize the value of daring to lean in to the muddiness of peopled research, use it as an analytical tool and present it in its imperfect form. This approach contributes to transparency in qualitative research, opens up the data in a new way...... subjectivities, situated identities, emotions, and conversational genres. Based on ethnographic fieldwork at a Danish Vocational Educational Training College, we introduce the concept of “leaning in” to provide an analytical grasp of the “muddy” interactional tension field in an interview situation, in which...

  17. A Hybrid Fuzzy Model for Lean Product Development Performance Measurement

    Science.gov (United States)

    Osezua Aikhuele, Daniel; Mohd Turan, Faiz

    2016-02-01

    In the effort for manufacturing companies to meet up with the emerging consumer demands for mass customized products, many are turning to the application of lean in their product development process, and this is gradually moving from being a competitive advantage to a necessity. However, due to lack of clear understanding of the lean performance measurements, many of these companies are unable to implement and fully integrated the lean principle into their product development process. Extensive literature shows that only few studies have focus systematically on the lean product development performance (LPDP) evaluation. In order to fill this gap, the study therefore proposed a novel hybrid model based on Fuzzy Reasoning Approach (FRA), and the extension of Fuzzy-AHP and Fuzzy-TOPSIS methods for the assessment of the LPDP. Unlike the existing methods, the model considers the importance weight of each of the decision makers (Experts) since the performance criteria/attributes are required to be rated, and these experts have different level of expertise. The rating is done using a new fuzzy Likert rating scale (membership-scale) which is designed such that it can address problems resulting from information lost/distortion due to closed-form scaling and the ordinal nature of the existing Likert scale.

  18. Lean six sigma in healthcare.

    Science.gov (United States)

    de Koning, Henk; Verver, John P S; van den Heuvel, Jaap; Bisgaard, Soren; Does, Ronald J M M

    2006-01-01

    Healthcare, as with any other service operation, requires systematic innovation efforts to remain competitive, cost efficient, and up-to-date. This article outlines a methodology and presents examples to illustrate how principles of Lean Thinking and Six Sigma can be combined to provide an effective framework for producing systematic innovation efforts in healthcare. Controlling healthcare cost increases, improving quality, and providing better healthcare are some of the benefits of this approach.

  19. Leg ulcers due to hyperhomocysteinemia

    Directory of Open Access Journals (Sweden)

    Krupa Shankar D

    2006-01-01

    Full Text Available Chronic leg ulcers are rare in young adults and generally indicate a vascular cause. We report a case of a 26-year-old man with leg ulcers of eight months duration. Doppler study indicated venous incompetence and a postphlebitic limb. However, as the distribution and number of ulcers was not consistent with stasis alone and no features of collagen vascular disease were noted, a hyperviscosity state was considered and confirmed with significantly elevated homocysteine level in the serum. Administration of vitamins B1, B2, B6 and B12, trimethyl-glycine, mecobalamine, folic acid and povidone iodine dressings with culture-directed antibiotic therapy led to a satisfactory healing of ulcers over a period of one month. Hyperhomocysteinemia must be considered in the differential diagnosis of leg ulcers in young individuals.

  20. Promethus Hot Leg Piping Concept

    International Nuclear Information System (INIS)

    AM Girbik; PA Dilorenzo

    2006-01-01

    The Naval Reactors Prime Contractor Team (NRPCT) recommended the development of a gas cooled reactor directly coupled to a Brayton energy conversion system as the Space Nuclear Power Plant (SNPP) for NASA's Project Prometheus. The section of piping between the reactor outlet and turbine inlet, designated as the hot leg piping, required unique design features to allow the use of a nickel superalloy rather than a refractory metal as the pressure boundary. The NRPCT evaluated a variety of hot leg piping concepts for performance relative to SNPP system parameters, manufacturability, material considerations, and comparison to past high temperature gas reactor (HTGR) practice. Manufacturability challenges and the impact of pressure drop and turbine entrance temperature reduction on cycle efficiency were discriminators between the piping concepts. This paper summarizes the NRPCT hot leg piping evaluation, presents the concept recommended, and summarizes developmental issues for the recommended concept

  1. Dynamic Behavior of Reverse Flow Reactor for Lean Methane Combustion

    OpenAIRE

    Yogi W. Budhi; M. Effendy; Yazid Bindar; Subagjo

    2014-01-01

    The stability of reactor operation for catalytic oxidation of lean CH4 has been investigated through modeling and simulation, particularly the influence of switching time and heat extraction on reverse flow reactor (RFR) performance. A mathematical model of the RFR was developed, based on one-dimensional pseudo-homogeneous model for mass and heat balances, incorporating heat loss through the reactor wall. The configuration of the RFR consisted of inert-catalyst-inert, with or without heat ext...

  2. Comparative Analysis between Lean, Six Sigma and Lean Six Sigma Concepts

    Directory of Open Access Journals (Sweden)

    Alexandra Mirela Cristina MUNTEANU

    2017-06-01

    Full Text Available This paper analyzes the benefits of Lean Six Sigma in comparison with Lean and Six Sigma, traditional improvement methodologies. The introduction highlights the appearance of Lean Six Sigma, early 2000s, as well as the benefits brought by the integrated approach. The following parts of the study emphasize the main differences between methodologies and their commonalities based on their synergy. Finally the advantages of Lean Six Sigma versus Lean and Six Sigma are analyzed and systematized by author in order to reveal Lean Six Sigma’s benefits.

  3. Effects of Eating Fresh Lean Pork on Cardiometabolic Health Parameters

    Directory of Open Access Journals (Sweden)

    Peter R. C. Howe

    2012-07-01

    Full Text Available High protein meat-based diets are commonly promoted for weight loss, supposedly by increasing satiety and energy expenditure. Pork is a good source of protein however little information on the metabolic effects of pork consumption exists. This pilot study aimed to examine whether regular consumption of fresh lean pork could improve body composition and cardiovascular risk factors in a 6 month parallel intervention trial. 164 overweight adults (mean BMI 32 were randomly assigned to incorporate up to 1 kg pork/week by substituting for other foods or maintain their habitual diet (control. Plasma levels of lipids, glucose and insulin, BMI, waist/hip circumference, blood pressure, heart rate and arterial compliance were measured at baseline and 3 and 6 months. Body composition was determined using dual energy X-ray absorptiometry. A total of 144 volunteers completed and volunteers in the pork group increased their intake 10 fold by substituting pork for mainly beef and chicken. After 3 months, there were significant (p ≤ 0.01 reductions in weight, BMI, waist circumference, % body fat, fat mass and abdominal fat in the pork group relative to controls, which persisted for 6 months. There was no change in lean mass, indicating that the reduction in weight was due to loss of fat mass. There were no significant effects on other metabolic parameters. Regular consumption of lean fresh pork may improve body composition.

  4. The one-leg standing radiograph

    OpenAIRE

    Pinsornsak, P.; Naratrikun, K.; Kanitnate, S.; Sangkomkamhang, T.

    2016-01-01

    Objectives The purpose of this study was to compare the joint space width between one-leg and both-legs standing radiographs in order to diagnose a primary osteoarthritis of the knee. Methods Digital radiographs of 100 medial osteoarthritic knees in 50 patients were performed. The patients had undergone one-leg standing anteroposterior (AP) views by standing on the affected leg while a both-legs standing AP view was undertaken while standing on both legs. The severity of the osteoarthritis wa...

  5. The maintenance management for lean organization

    Directory of Open Access Journals (Sweden)

    Daniel D. GEORGESCU

    2010-12-01

    Full Text Available The goal of lean maintenance approach is to maintain organization international competitiveness. In the spirit of continuously improvement, in the paper it is shown how by adjusting some Lean manufacturing specific techniques for Total Productive Maintenance (TPM system, was born new maintenance system named Lean TPM. This is a systemic approach with three techniques, which don’t exclude specific techniques of TPM pillars, but complete them: the 7Ss as a critical first step in any improvement program; instantaneous maintenance; improvement setup operations. In the spirit of Lean principle, Lean TPM adjusts overall equipment effectiveness concept for all supply-chain from supplier to customer. Maintaining equipment in its optimal state and continually improving its productivity is the whole strategy behind Lean TPM.

  6. Trunk lean gait decreases multi-segmental coordination in the vertical direction.

    Science.gov (United States)

    Tokuda, Kazuki; Anan, Masaya; Sawada, Tomonori; Tanimoto, Kenji; Takeda, Takuya; Ogata, Yuta; Takahashi, Makoto; Kito, Nobuhiro; Shinkoda, Koichi

    2017-11-01

    [Purpose] The strategy of trunk lean gait to reduce external knee adduction moment (KAM) may affect multi-segmental synergy control of center of mass (COM) displacement. Uncontrolled manifold (UCM) analysis is an evaluation index to understand motor variability. The purpose of this study was to investigate how motor variability is affected by using UCM analysis on adjustment of the trunk lean angle. [Subjects and Methods] Fifteen healthy young adults walked at their preferred speed under two conditions: normal and trunk lean gait. UCM analysis was performed with respect to the COM displacement during the stance phase. The KAM data were analyzed at the points of the first KAM peak during the stance phase. [Results] The KAM during trunk lean gait was smaller than during normal gait. Despite a greater segmental configuration variance with respect to mediolateral COM displacement during trunk lean gait, the synergy index was not significantly different between the two conditions. The synergy index with respect to vertical COM displacement during trunk lean gait was smaller than that during normal gait. [Conclusion] These results suggest that trunk lean gait is effective in reducing KAM; however, it may decrease multi-segmental movement coordination of COM control in the vertical direction.

  7. Sleep apnea in patients reporting insomnia or restless legs symptoms.

    Science.gov (United States)

    Bianchi, M T; Goparaju, B; Moro, M

    2016-01-01

    Insomnia and restless legs syndrome (RLS) are defined by self-reported symptoms, and polysomnography (PSG) is not routinely indicated. Occult obstructive sleep apnea (OSA), common even in asymptomatic adults, may complicate management of patients presenting with insomnia or restless legs. To this end, we investigated objective sleep apnea metrics in a large retrospective cohort according to self-reported symptom profiles. We compared sleep apnea findings in patients referred to our center according to self-reported symptoms associated with insomnia, sleep apnea, and restless legs. The cohort included over 1900 adults who underwent diagnostic (n = 1418) or split-night (n = 504) PSGs and completed a symptom and medical history questionnaire. More than 30% of patients who did not endorse any OSA symptoms, but did endorse insomnia or restless legs symptoms, were found to have OSA based on apnea-hypopnea index (AHI) >5 during overnight laboratory testing. Regression models of the full cohort showed that the risk of OSA was related, as expected, to older age, male sex, elevated body mass index, and presence of OSA symptoms. The presence of insomnia symptoms did not alter the risk of OSA. The presence of restless legs symptoms showed a small odds ratio for lowered OSA risk. Objective evidence of OSA occurs similarly in those with insomnia or restless legs symptoms, even among those without self-reported OSA symptoms. Providers should be aware of the potential for occult OSA in populations with insomnia and restless legs, which may complicate their management in addition to presenting an independent medical risk itself. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Cultural Aspects when Implementing Lean Production and Lean Product Development – Experiences from a Swedish Perspective

    Directory of Open Access Journals (Sweden)

    Promporn Wangwacharakul

    2014-07-01

    Full Text Available Lean principles and methods, originating in a Japanese cultural context, have spread to a large number of companies throughout the world. The aim of this case study research is to identify and compare national cultural aspects that influence Lean Production and Lean Product Development implementation in Swedish companies. Data were collected through questionnaires, interviews and an industrial workshop with Swedish Lean practitioners. The study shows that some sub-areas in Lean, such as value definition, control systems, leadership, team development, knowledge management, and strategies, are highly dependent on contextual factors related to human, cultural and organizational aspects. These are related to the national culture and should be considered to a higher extent for successful sustainable implementation of Lean in different cultural contexts. As for implementing Lean in Sweden, national cultural characteristics, such as individualism, autonomy and supportive management style fit well with Lean thinking.

  9. Gene expression microarray profiles of cumulus cells in lean and overweight-obese polycystic ovary syndrome patients.

    Science.gov (United States)

    Kenigsberg, Shlomit; Bentov, Yaakov; Chalifa-Caspi, Vered; Potashnik, Gad; Ofir, Rivka; Birk, Ohad S

    2009-02-01

    The aim of this work was to study gene expression patterns of cultured cumulus cells from lean and overweight-obese polycystic ovary syndrome (PCOS) patients using genome-wide oligonucleotide microarray. The study included 25 patients undergoing in vitro fertilization and intra-cytoplasmic sperm injection: 12 diagnosed with PCOS and 13 matching controls. Each of the groups was subdivided into lean (body mass index (BMI) 27) subgroups. The following comparisons of gene expression data were made: lean PCOS versus lean controls, lean PCOS versus overweight PCOS, all PCOS versus all controls, overweight PCOS versus overweight controls, overweight controls versus lean controls and all overweight versus all lean. The largest number of differentially expressed genes (DEGs), with fold change (FC) |FC| >or= 1.5 and P-value lean PCOS versus lean controls comparison (487) with most of these genes being down-regulated in PCOS. The second largest group of DEGs originated from the comparison of lean PCOS versus overweight PCOS (305). The other comparisons resulted in a much smaller number of DEGs (174, 109, 125 and 12, respectively). In the comparison of lean PCOS with lean controls, most DEGs were transcription factors and components of the extracellular matrix and two pathways, Wnt/beta-catenin and mitogen-activated protein kinase. When comparing overweight PCOS with overweight controls, most DEGs were of pathways related to insulin signaling, metabolism and energy production. The finding of unique gene expression patterns in cumulus cells from the two PCOS subtypes is in agreement with other studies that have found the two to be separate entities with potentially different pathophysiologies.

  10. Lean Construction Supply Chain : A Literature Review

    OpenAIRE

    Ren, Jiamei

    2012-01-01

    The aim of this thesis is to enhance the management of supply systems in construction industry using lean principles. This study is an attempt to identify what kind of activities causes’ construction process delay and how to perform lean concept into supply chain in practice. The objective is to assure on-time delivery of information and materials to construction sites at lowest cost and maximum value for the customer. These study problems have been analysed from a lean construction supply ch...

  11. The maintenance management for lean organization

    OpenAIRE

    Daniel D. GEORGESCU

    2010-01-01

    The goal of lean maintenance approach is to maintain organization international competitiveness. In the spirit of continuously improvement, in the paper it is shown how by adjusting some Lean manufacturing specific techniques for Total Productive Maintenance (TPM) system, was born new maintenance system named Lean TPM. This is a systemic approach with three techniques, which don’t exclude specific techniques of TPM pillars, but complete them: the 7Ss as a critical first step in any improvemen...

  12. Apply Lean Thinking in Project Management

    OpenAIRE

    Pham Ngoc, Lan

    2015-01-01

    The purpose of this thesis was to study the effects of Lean Thinking in Project Management and how applying Lean Project Management could enhance the productivity of project work. The study was carried using theoretical research and collecting empirical data from three interviews and one case study at a local company. At the end of the study, the major project management problems at the company were identified and analyzed following Lean Principles. It was also pointed out where there...

  13. Lean Six Sigma in financial services

    OpenAIRE

    de Koning, H.; Does, R.J.M.M.; Bisgaard, S.

    2008-01-01

    Lean Thinking and Six Sigma are typically considered as separate approaches to process innovation, with complementary strengths. When combined as Lean Six Sigma, this approach provides a unified framework for systematically developing innovations. Lean Six Sigma can also bring about significant results and breakthrough improvements in financial services, as demonstrated with four case studies from Dutch multinational insurance companies. These cases demonstrate the importance of incremental i...

  14. Fat mass measured by DXA varies with scan velocity

    DEFF Research Database (Denmark)

    Black, Eva; Petersen, Liselotte; Kreutzer, Martin

    2002-01-01

    To study the influence of scan velocities of DXA on the measured size of fat mass, lean body mass, bone mineral content and density, and total body weight.......To study the influence of scan velocities of DXA on the measured size of fat mass, lean body mass, bone mineral content and density, and total body weight....

  15. Lean and the quality of work

    DEFF Research Database (Denmark)

    Jensen, Per Langaa

    2008-01-01

    Lean has for the last decade developed as the dominating model for developing productions processes not only within industry but also in health care, administration and service industries in general. With this development a discussion on human factors aspects of lean has developed internationally....... Literature studies documents that it is not possible to establish a clear relation between lean and the psychosocial aspects of work. The studies also indicate that the context and the implementations process play a dominating role in how lean is experienced. This has been the basis for establishing...

  16. Lean education an overview of current issues

    CERN Document Server

    Flumerfelt, Shannon; Kahlen, Franz-Josef

    2017-01-01

    This edited volume presents a structured approach to a new lean education curriculum, implemented for the education of engineers, managers, administrators as well as human resources developers. The authorship comprises professors and lecturers, trainers and practitioners who educate future professionals in Lean Thinking principles and tools. This edited book provides a platform for authors to share their efforts in building a Body of Knowledge (BoK) for Lean Education. The topical spectrum is state-of-the-art in this field, but the book also includes a glimpse into future developments. This is a highly informative and carefully presented book, providing valuable insight for scholars with an interest in Lean Education.

  17. Doppler ultrasound exam of an arm or leg

    Science.gov (United States)

    Peripheral vascular disease - Doppler; PVD - Doppler; PAD - Doppler; Blockage of leg arteries - Doppler; Intermittent claudication - Doppler; Arterial insufficiency of the legs - Doppler; Leg pain and ...

  18. A Methodology for the Assessment of Experiential Learning Lean: The Lean Experience Factory Study

    Science.gov (United States)

    De Zan, Giovanni; De Toni, Alberto Felice; Fornasier, Andrea; Battistella, Cinzia

    2015-01-01

    Purpose: The purpose of this paper is to present a methodology to assess the experiential learning processes of learning lean in an innovative learning environment: the lean model factories. Design/methodology/approach: A literature review on learning and lean management literatures was carried out to design the methodology. Then, a case study…

  19. Lean programm as a method of managing lean changes in the company

    Directory of Open Access Journals (Sweden)

    Suetina Tatiana Aleksandrovna

    2012-12-01

    Full Text Available This article is about methods and ways of providing changes on enterprices which introduce instruments of lean production. The main accent is how to use metodology of the project management by providing lean-changes. Lean program is proposed as a program of strategic developement of enterprices.

  20. Lean and Green Hand Surgery.

    Science.gov (United States)

    Van Demark, Robert E; Smith, Vanessa J S; Fiegen, Anthony

    2018-02-01

    Health care in the United States is both expensive and wasteful. The cost of health care in the United States continues to increase every year. Health care spending for 2016 is estimated at $3.35 trillion. Per capita spending ($10,345 per person) is more than twice the average of other developed countries. The United States also leads the world in solid waste production (624,700 metric tons of waste in 2011). The health care industry is second only to the food industry in annual waste production. Each year, health care facilities in the United States produce 4 billion pounds of waste (660 tons per day), with as much as 70%, or around 2.8 billion pounds, produced directly by operating rooms. Waste disposal also accounts for up to 20% of a hospital's annual environmental services budget. Since 1992, waste production by hospitals has increased annually by a rate of at least 15%, due in part to the increased usage of disposables. Reduction in operating room waste would decrease both health care costs and potential environmental hazards. In 2015, the American Association for Hand Surgery along with the American Society for Surgery of the Hand, American Society for Peripheral Nerve Surgery, and the American Society of Reconstructive Microsurgery began the "Lean and Green" surgery project to reduce the amount of waste generated by hand surgery. We recently began our own "Lean and Green" project in our institution. Using "minor field sterility" surgical principles and Wide Awake Local Anesthesia No Tourniquet (WALANT), both surgical costs and surgical waste were decreased while maintaining patient safety and satisfaction. As the current reimbursement model changes from quantity to quality, "Lean and Green" surgery will play a role in the future health care system. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  1. Clinical and Metabolic Characterization of Lean Caucasian Subjects With Non-alcoholic Fatty Liver.

    Science.gov (United States)

    Feldman, Alexandra; Eder, Sebastian K; Felder, Thomas K; Kedenko, Lyudmyla; Paulweber, Bernhard; Stadlmayr, Andreas; Huber-Schönauer, Ursula; Niederseer, David; Stickel, Felix; Auer, Simon; Haschke-Becher, Elisabeth; Patsch, Wolfgang; Datz, Christian; Aigner, Elmar

    2017-01-01

    Non-alcoholic fatty liver disease (NAFLD) is closely linked to obesity; however, 5-8% of lean subjects also have evidence of NAFLD. We aimed to investigate clinical, genetic, metabolic and lifestyle characteristics in lean Caucasian subjects with NAFLD. Data from 187 subjects allocated to one of the three groups according to body mass index (BMI) and hepatic steatosis on ultrasound were obtained: lean healthy (BMI≤25 kg/m 2 , no steatosis, N=71), lean NAFLD (BMI≤25 kg/m 2 , steatosis, N=55), obese NAFLD (BMI≥30 kg/m 2 , steatosis; N=61). All subjects received a detailed clinical and laboratory examination including oral glucose tolerance test. The serum metabolome was assessed using the Metabolomics AbsoluteIDQ p180 kit (BIOCRATES Life Sciences). Genotyping for single-nucleotide polymorphisms (SNPs) associated with NAFLD was performed. Lean NAFLD subjects had fasting insulin concentrations similar to lean healthy subjects but had markedly impaired glucose tolerance. Lean NAFLD subjects had a higher rate of the mutant PNPLA3 CG/GG variant compared to lean controls (P=0.007). Serum adiponectin concentrations were decreased in both NAFLD groups compared to controls (Pphosphatidylcholines (PCaa C36:3; false discovery rate (FDR)-corrected P-value<0.001) as well as lysine, tyrosine, and valine (FDR<0.001). Lean subjects with evidence of NAFLD have clinically relevant impaired glucose tolerance, low adiponectin concentrations and a distinct metabolite profile with an increased rate of PNPLA3 risk allele carriage.

  2. Lean production of intensive cities

    DEFF Research Database (Denmark)

    Ratner, Helene Gad; Bojesen, Anders; Bramming, Pia

    2014-01-01

    turnover. This is analysed in terms of Italo Calvino's Invisible cities. It is argued that Calvino's themes and prose help us understand change as a multiplicity of temporal intensities producing ambivalence and affect. We describe this use of literary abstractions as a ‘hyperbolic social epistemology......’. Through the depiction of four intensifications of Lean Production, the metaphors of Calvino's cities show how reality and illusion; hope and poverty; dreams and death and utopia and dystopia are intricately mingled and produce temporary and equally ambivalent affects of alienation, hypocrisy, self...

  3. Plasma Amino Acids Stimulate Uncoupled Respiration of Muscle Subsarcolemmal Mitochondria in Lean but Not Obese Humans.

    Science.gov (United States)

    Kras, Katon A; Hoffman, Nyssa; Roust, Lori R; Patel, Shivam H; Carroll, Chad C; Katsanos, Christos S

    2017-12-01

    Obesity is associated with mitochondrial dysfunction in skeletal muscle. Increasing the plasma amino acid (AA) concentrations stimulates mitochondrial adenosine triphosphate (ATP) production in lean individuals. To determine whether acute elevation in plasma AAs enhances muscle mitochondrial respiration and ATP production in subsarcolemmal (SS) and intermyofibrillar (IMF) mitochondria in obese adults. Assessment of SS and IMF mitochondrial function during saline (i.e., control) and AA infusions. Eligible participants were healthy lean (body mass index, mass index >30 kg/m2; age 35 ± 3 years; n = 11) subjects. Single trial of saline infusion followed by AA infusion. SS and IMF mitochondria were isolated from muscle biopsies collected at the end of the saline and AA infusions. Mitochondrial respiration and ATP production. AA infusion increased adenosine 5'-diphosphate (ADP)-stimulated respiration and ATP production rates of SS mitochondria in the lean (P lean subjects only (P lean or obese subjects (P > 0.05). Increasing the plasma AA concentrations enhances the capacity for respiration and ATP production of muscle SS, but not IMF, mitochondria in lean individuals, in parallel with increases in uncoupled respiration. However, neither of these parameters increases in muscle SS or IMF mitochondria in obese individuals. Copyright © 2017 Endocrine Society

  4. Adipocyte triglyceride turnover and lipolysis in lean and overweight subjects.

    Science.gov (United States)

    Rydén, Mikael; Andersson, Daniel P; Bernard, Samuel; Spalding, Kirsty; Arner, Peter

    2013-10-01

    Human obesity is associated with decreased triglyceride turnover and impaired lipolysis in adipocytes. We determined whether such defects also occur in subjects with only moderate increase in fat mass. Human abdominal subcutaneous adipose tissue was investigated in healthy, nonobese subjects [body mass index (BMI) > 17 kg/m(2) and BMI lean subjects (P = 0.017) with triglyceride T1/2 of 14 and 9 months, respectively (P = 0.04). Triglyceride age correlated positively with BMI (P = 0.002) but not with adipocyte volume (P = 0.2). Noradrenaline-, isoprenaline- or dibutyryl cyclic AMP-induced lipolysis was inversely correlated with triglyceride age (P maintenance of excess body fat.

  5. H:q ratios and bilateral leg strength in college field and court sports players.

    Science.gov (United States)

    Cheung, Roy T H; Smith, Andrew W; Wong, Del P

    2012-06-01

    One of the key components in sports injury prevention is the identification of imbalances in leg muscle strength. However, different leg muscle characteristics may occur in large playing area (field) sports and small playing area (court) sports, which should be considered in regular injury prevention assessment. This study examined the isokinetic hamstrings-to-quadriceps (H:Q) ratio and bilateral leg strength balance in 40 male college (age: 23.4 ± 2.5 yrs) team sport players (field sport = 23, soccer players; court sport = 17, volleyball and basketball players). Five repetitions of maximal knee concentric flexion and concentric extension were performed on an isokinetic dynamometer at two speeds (slow: 60°·s(-1) and fast: 300°·s(-1)) with 3 minutes rest between tests. Both legs were measured in counterbalanced order with the dominant leg being determined as the leg used to kick a ball. The highest concentric peak torque values (Nm) of the hamstrings and quadriceps of each leg were analyzed after body mass normalization (Nm·kg(-1)). Court sport players showed significantly weaker dominant leg hamstrings muscles at both contraction speeds (P Sport-specific leg muscle strength was evident in college players from field and court sports. These results suggest the need for different muscle strength training and rehabilitation protocols for college players according to the musculature requirements in their respective sports.

  6. The LEAN Payload Integration Process

    Science.gov (United States)

    Jordan, Lee P.; Young, Yancy; Rice, Amanda

    2011-01-01

    It is recognized that payload development and integration with the International Space Station (ISS) can be complex. This streamlined integration approach is a first step toward simplifying payload integration; making it easier to fly payloads on ISS, thereby increasing feasibility and interest for more research and commercial organizations to sponsor ISS payloads and take advantage of the ISS as a National Laboratory asset. The streamlined integration approach was addressed from the perspective of highly likely initial payload types to evolve from the National Lab Pathfinder program. Payloads to be accommodated by the Expedite the Processing of Experiments for Space Station (EXPRESS) Racks and Microgravity Sciences Glovebox (MSG) pressurized facilities have been addressed. It is hoped that the streamlined principles applied to these types of payloads will be analyzed and implemented in the future for other host facilities as well as unpressurized payloads to be accommodated by the EXPRESS Logistics Carrier (ELC). Further, a payload does not have to be classified as a National Lab payload in order to be processed according to the lean payload integration process; any payload that meets certain criteria can follow the lean payload integration process.

  7. Lean production and business performance: influences of ...

    African Journals Online (AJOL)

    Hence, this study aims to examine the influence of leadership style in the implementation of lean production. Data were gathered from randomly selected Malaysian manufacturing firms. Findings reveal a positive relationship between lean production and business performance. Specifically, democratic leadership style was ...

  8. Just-in-Time og Lean Manufacturing

    DEFF Research Database (Denmark)

    Michelsen, Aage U.

    2004-01-01

    Filosofi, principper og teknikker i JIT. Princip i Kanban-styring og dimensionering af et Kanban-system. Lean Thinking og Value Stream Mapping.......Filosofi, principper og teknikker i JIT. Princip i Kanban-styring og dimensionering af et Kanban-system. Lean Thinking og Value Stream Mapping....

  9. Indførelse af Lean principper

    DEFF Research Database (Denmark)

    Balmer, Christian; Michelsen, Aage U

    2004-01-01

    I artiklen beskrives, hvorledes lean-principper er indført i en forsikringsvirksomhed samt de opnåede resultater.......I artiklen beskrives, hvorledes lean-principper er indført i en forsikringsvirksomhed samt de opnåede resultater....

  10. Principles of lean planning and control

    NARCIS (Netherlands)

    Riezebos, J.

    2015-01-01

    Lean production systems use teams instead of functional departments as well as simple shop floor control methods to manage the flow of orders at the shop floor. Lean shop floor control focuses on robust and visual methods that are able to cope with variation in processing times, routing sequences,

  11. De praktijk van Lean Six Sigma

    NARCIS (Netherlands)

    Does, R.J.M.M.; de Koning, H.

    2008-01-01

    Zowel Lean als Six Sigma zijn benaderingen van kwaliteits- en efficiëntieverbetering die op dit moment sterk in de belangstelling staan van zowel de industrie als de dienstverlening. Lean Six Sigma integreert beide benaderingen. Ze wordt door sommigen gezien als panacee voor alle mogelijke

  12. Disturbing Practices: Training Workers to Be Lean

    Science.gov (United States)

    Yasukawa, Keiko; Brown, Tony; Black, Stephen

    2014-01-01

    Purpose: The purpose of this paper is to explore the possibilities for expansive learning during organisational change. It considers the introduction of "lean production" as a disturbance to the existing work practices. Design/methodology/approach: The paper considers two case studies of "lean production" training with…

  13. Advancing lean manufacturing, the role of IT

    NARCIS (Netherlands)

    Riezebos, J.; Klingenberg, W.

    This introduction to the special issue discusses the changing role of information technology (IT) in advancing lean production. Lean principles and techniques have been applied in a wide variety of organisations, from make-to-stock to engineer-to-order industries, and even in typical service

  14. Lean in healthcare from employees' perspectives.

    Science.gov (United States)

    Drotz, Erik; Poksinska, Bozena

    2014-01-01

    The purpose of this paper is to contribute toward a deeper understanding of the new roles, responsibilities, and job characteristics of employees in Lean healthcare organizations. The paper is based on three cases studies of healthcare organizations that are regarded as successful examples of Lean applications in the healthcare context. Data were collected by methods including interviews, observations, and document studies. The implementation of Lean in healthcare settings has had a great influence on the roles, responsibilities, and job characteristics of the employees. The focus has shifted from healthcare professionals, where clinical autonomy and professional skills have been the guarding principles of patient care, to process improvement and teamwork. Different job characteristics may make it difficult to implement certain Lean practices in healthcare. Teamwork and decentralization of authority are examples of Lean practices that could be considered countercultural because of the strong professional culture and uneven power distribution, with doctors as the dominant decision makers. Teamwork, value flow orientation, and company-wide involvement in CI were associated with positive effects on the organizations' working environment, staff development, and organizational performance. In order to succeed with Lean healthcare, it is important to understand and recognize the differences in job characteristics between Lean manufacturing and healthcare. This paper provides insights into how Lean implementation changes the roles, responsibilities, and job characteristics of healthcare staff and the challenges and implications that may follow from this.

  15. Lean Six Sigma in a hospital

    NARCIS (Netherlands)

    van den Heuvel, J.; Does, R.J.M.M.; de Koning, H.

    2006-01-01

    Abstract Hospitals today face major challenges. Patients demand quality of care to be improved continuously. Health insurance companies demand the lowest possible prices. Lean Six Sigma is a program that can help healthcare providers to achieve these (seemingly) conflicting goals. Lean Six Sigma is

  16. [Etiological diagnosis of leg ulcers].

    Science.gov (United States)

    Debure, Clélia

    2010-09-20

    Etiological diagnosis of leg ulcers must be the first step of treatment, even if we know that veinous disease is often present. We can build a clinical decisional diagram, which helps us to understand and not forget the other causes of chronic wounds and choose some basic examination, like ultrasound and histological findings. This diagnosis helps to choose the right treatment in order to cure even the oldest venous ulcers. Educational programs should be improved to prevent recurrence.

  17. Differential Risk of Hypertension Among Lean and Nonlean Rural Subjects in Relation to Decadal Changes in Anthropometry.

    Science.gov (United States)

    Deshpande-Joshi, Sayali S; Rao, Shobha

    2018-02-09

    Assessing risk of hypertension in relation to decadal changes in anthropometry among cohort of young rural Indian men. Subjects (n = 140) were measured in 2005 and 2015 for blood pressure, body mass index (BMI), body fat (BF), waist circumference (WC), waist-to-hip ratio (WHR), and additionally for visceral fat (VF) at follow-up. Decadal changes showed significant (p lean (baseline BMI lean but was not significant among nonlean subjects. This was also true for change in other adiposity indicators, indicating greater vulnerability of lean subjects. Further, among lean subjects, ORs reduced considerably after adjusting for VF, whereas among nonlean subjects ORs continued to remain nonsignificant but showing independent significance for VF. For similar level of change in adiposity indicators, lean subjects were at greater risk of hypertension than nonlean subjects, probably due to higher VF deposition.

  18. Skaber lean bedre arbejdsmiljø?

    DEFF Research Database (Denmark)

    Hansen, Nanette Juhler

    2007-01-01

    rationalization strategies, among others Lean, claim to improve working conditions. The aim of this thesis is to identify whether the application of Lean strategies leads to a reduction of the occupational health and safety problem repetitive work. Repetitive work is a problem created by the Taylorisation of work......, and therefore it is to be expected that a break with one or more of the Tayloristic principles can lead to a reduction of repetitive work. This thesis points out a number of areas within which Lean breaks with Tayloristic principles, whilst other principles are maintained. These breaks between Lean...... and Taylorism are also found in the study of the case company. By linking breaks with Taylorism with solutions for the reduction of repetitive work, I point out a number of openings in Lean that may lead to a reduction of repetitive work. By using the concept of openings I present the possibilities offered...

  19. THE LEAN AND SIX SIGMA SINERGY

    Directory of Open Access Journals (Sweden)

    Mirko Sokovic

    2008-12-01

    Full Text Available Many organizations, dealing with continuous improvement methods, have realized that Lean and Six Sigma methodologies complement each other. Lean manufacturing focuses on the remova l of waste so that all processes in the total system add value from the customers' perspectives. The main emphasis of Six Sigma is the application of statistical tools in a disciplined manner, which requires data-driven decision-making. The integration of Lean and Six Sigma provides a synergetic effect, a rapid process improvement strategy for attaining organizational goals. When separated, Lean manufacturing cannot bring a process under statistical control, and Six Sigma cannot dramatically improve cycle time or reduce invested capital. Together, synergistic qualities are created to maximize the potential for a process improvement. The paper deals with Lean and Six Sigma principles and approaches used in modern manufacturing for process improvements, and bring forward benefits that are gained when these two methodologies are integrated.

  20. Lean thinking for a maintenance process

    Directory of Open Access Journals (Sweden)

    Sherif Mostafa

    2015-01-01

    Full Text Available The maintenance process shares significant operating costs in an organisation. Lean thinking can be incorporated into maintenance activities through applying its principles and practices/tools. Lean maintenance (LM is a prerequisite for lean manufacturing systems. This research proposes a new structure for LM process based on a systematic literature review of a significant number of related articles that were published on LM. The process structure is designed based on the five lean principles to guide and support organisations to pursue maintenance excellence. This study establishes a scheme for LM tools that are structured into 2 level 4 bundles and 26 lean practices/tools and develops a House of Waste (HoW to demonstrate the association between maintenance wastes and the LM tools. With a successful accomplishment of the proposed scheme, the performance of a maintenance department can create more improvement opportunities over time to reach the maintenance excellence status.

  1. Researching Lean: Methodological implications of loose definitions

    DEFF Research Database (Denmark)

    Brännmark, Mikael; Langstrand, Jostein; Johansson, Stina

    2012-01-01

    practices seem to overlap with other popular management concepts, such as High Performance Work Systems, World Class Manufacturing and Total Quality Management. This confusion, combined with different methodological and theoretical traditions, has led to much debate and contradictory conclusions regarding...... Lean. The purpose of the paper is to illustrate some key methodological issues that need to be considered in future Lean research to allow increased understanding of Lean effects for different stakeholders, primarily meaning the customer, employer and employees. Design/methodology/approach – The paper...... on the case studies, we suggest that future investigations describe the Lean interventions in more detail. General descriptions or analogies, e.g. ‘learning organizations’, presumably increase the present confusion regarding Lean impact on different stakeholders. The case studies also illustrate...

  2. Transferring lean management infrastructure for increasing productivity

    Directory of Open Access Journals (Sweden)

    Ph.D.Daniel Georgescu

    2010-12-01

    Full Text Available These years, manufacturing function have been transferred rapidly and globally from matured countries to emerging countries. In this paper is about the critical elements for successful transfer of lean management among sites and countries. Based on this general descriptive analysis, current global transfer activity of Lean as well as its future direction is also described. According to the gradual progress of lean management transfer, necessity of its refinement/reinforcement is recognized and some research subjects are proposed for contributing further encouragement of its global activities. In this paper, based on this understanding, requisites for transfer of lean management are discussed through investigating global activity of Lean and specification of infrastructure enabling its smooth transfer is examined

  3. Modelling Lean and Green Supply Chain

    Science.gov (United States)

    Duarte, Susana Carla Vieira Lino Medina

    The success of an organization depends on the effective control of its supply chain. It is important to recognize new opportunities for organization and its supply chain. In the last few years the approach to lean, agile, resilient and green supply chain paradigms has been addressed in the scientific literature. Research in this field shows that the integration of these concepts revealed some contradictions among so many paradigms. This thesis is mainly focused on the lean and green approaches. Thirteen different management frameworks, embodied in awards, standards and tools were studied to understand if they could contribute for the modelling process of a lean and green approach. The study reveals a number of categories that are common in most management frameworks, providing adequate conditions for a lean and green supply chain transformation. A conceptual framework for the evaluation of a lean and green organization`s supply chain was proposed. The framework considers six key criteria, namely, leadership, people, strategic planning, stakeholders, processes and results. It was proposed an assessment method considering a criteria score for each criterion. The purpose is to understand how lean and green supply chain can be compatible, using principles, practices, techniques or tools (i.e. elements) that support both, a lean and a green approach, in all key criteria. A case study in the automotive upstream supply chain was performed to understand more deeply if the elements proposed for the conceptual framework could be implemented in a real-scenario. Based on the conceptual framework and the case study, a roadmap to achieve a lean-green transformation is presented. The proposed roadmap revealed its contribution to the understanding on how and when an organization`s supply chain should apply the lean and green elements. This study is relevant to practice, as it may assist managers in the adoption of a lean and green supply chain approach, giving insights for the

  4. An empirical review of lean manufacturing and their strategies

    Directory of Open Access Journals (Sweden)

    Virender Chahal

    2017-07-01

    Full Text Available The theory of lean manufacturing provides the quality of the products in minimum cost and pro-vides customer satisfaction. Today, the competition level is very high and every industry tries to supply high quality products in nominal cost, so lean is the latest tool to achieve. The objective of this paper is to study different lean concepts under various lean strategies. This study helps to find out the status of lean manufacturing and its ways of implementation. Also in this paper, there is a discussion about lean manufacturing concept, lean waste, lean strategies, lean barriers and cycle of lean implementation. This paper presents a literature review to clear the status of lean manufacturing and their strategies with help of collection of relevant papers.

  5. IMPLEMENTATION OF LEAN MANUFACTURING IN FISH CANNING COMPANY: A CASE STUDY OF A CANNED SARDINES PRODUCTION COMPANY IN MOROCCO

    Directory of Open Access Journals (Sweden)

    I. Idrıssi

    2015-12-01

    Full Text Available Lean is a powerful tool, which can bring significant benefit to manufacturing industries by creating value through reduction of waste. Although the lean concept has become very popular in mass production industries such as the automotive industry, more recently the concept has been adopted in different batch processing industries and service sectors. The application of lean tools into the food processing industry has not received the same level of attention compared to the traditional manufacturing industries. The paper discusses how the lean concept could be applied to a fish manufacturing company. The paper first presents the lean concept tools. The empirical section discusses how a case company, operating as a contract manufacturer in the food industry, has applied the lean production concept and tools. In the case study, three analysis tools are examined and the structures of demand chains of different customers are presented. The delivery times will decrease and more flexibility will be needed from the contract manufacturer. The case study shows that much movement is possible toward the lean supply chain and partnership-based cooperation. By implementing the lean concept, food companies can increase customer value through cost reduction or through provision of additional value-enhanced services.

  6. Adapting lean to histology laboratories.

    Science.gov (United States)

    Buesa, René J

    2009-10-01

    Histology laboratories (histolabs) can increase productivity and reduce turnaround time and errors by using any one of several available management tools. After a few years of operation, all histolabs develop workflow problems. Histology laboratories handling more than 20,000 cases per year benefit the most from implementing management tools, as occurred in the 25 facilities summarized in this article. Discontinuous workflow, lack of "pulling" between steps, accepting unavoidable waiting times while working with small batches within work cells, and a workflow with an uneven rate of completion, are some of the adaptations required by the Lean system when it is used in histology because 70% of the tasks are manual and the flow has to be interrupted to add value to the pieces of tissue during tissue processing, no matter how short that step is. After all these adaptations are incorporated, the histolab becomes as "Lean" as it can be, and the qualifier is also a recognition of the effort and personnel involvement in the implementation. Given its service nature, productivity increments do not expand the histolab customer base and could lead to staffing reductions. This is one of the causes of reluctance by some employees for implementing these techniques which are mostly driven by cost reductions sought by insurance companies and administrators, and not necessarily because of a real medical need to reduce the turnaround time. Finally, any histolab wanting to improve its workflow can follow some easy steps presented here as a guide to accomplish that objective. These steps stress the need for the supervisors to insure that the personnel in the histology laboratory are being paid at a comparable rate as other histolabs in the area.

  7. Should insulin resistance be screened in lean hirsute women?

    Science.gov (United States)

    Arduc, Ayse; Sarıcam, Orkun; Dogan, Bercem Aycicek; Tuna, Mazhar Muslum; Tutuncu, Yasemin Ates; Isik, Serhat; Berker, Dilek; Sennaroglu, Engin; Guler, Serdar

    2015-04-01

    The role of insulin resistance (IR) is well-documented in obese women with polycystic ovary syndrome (PCOS). Controversies exist concerning the presence of IR in idiopathic hirsutism (IH) or if it is a manifestation of high body mass index (BMI). We aimed to investigate the presence/absence of IR in lean hirsute women. One-hundred fifty-one lean women with hirsutism [96 PCOS (group 1) and 55 IH (group 2)] and 58 age-and BMI-matched healthy controls (group 3) were recruited in the study (mean age 25.21 ± 6.1 versus 26.26 ± 4.6years; BMI 21.79 ± 1.7 versus 22.02 ± 2.2 kg/m(2), respectively). Significantly higher insulin and HOMA-IR, and significantly lower fasting glucose insulin ratio (FGIR), quantitative insulin sensitivity check index (QUICKI), reciprocal insulin, and Raynaud index were detected in groups 1 and 2 than in group 3 (p  2, FGIR lean hirsute women regardless of they having PCOS or IH. IR may contribute to aetiopathogenesis of IH, or may cause some metabolic abnormalities in these patients.

  8. On the quantum analogue of Galileo's leaning tower experiment

    International Nuclear Information System (INIS)

    Ali, Md Manirul; Majumdar, A S; Home, Dipankar; Pan, Alok Kumar

    2006-01-01

    The quantum analogue of Galileo's leaning tower experiment is revisited using wave packets evolving under the gravitational potential. We first calculate the position detection probabilities for particles projected upwards against gravity around the classical turning point and also around the point of initial projection, which exhibit mass dependence at both these points. We then compute the mean arrival time of freely falling particles using the quantum probability current, which also turns out to be mass dependent. The mass dependence of both the position detection probabilities and the mean arrival time vanish in the limit of large mass. Thus, compatibility between the weak equivalence principle and quantum mechanics is recovered in the macroscopic limit of the latter

  9. Lean Six Sigma implementation and organizational culture.

    Science.gov (United States)

    Knapp, Susan

    2015-01-01

    The purpose of this paper is to examine the relationship between four organizational cultural types defined by the Competing Values Framework and three Lean Six Sigma implementation components - management involvement, use of Lean Six Sigma methods and Lean Six Sigma infrastructure. The study involved surveying 446 human resource and quality managers from 223 hospitals located in Maine, New Hampshire, Vermont, Massachusetts and Rhode Island using the Organizational Culture Assessment Instrument. Findings - In total, 104 completed responses were received and analyzed using multivariate analysis of variance. Follow-up analysis of variances showed management support was significant, F(3, 100)=4.89, p cultures having significant interactions with management support. The relationship between organizational culture and Lean Six Sigma in hospitals provides information on how specific cultural characteristics impact the Lean Six Sigma initiative key components. This information assists hospital staff who are considering implementing quality initiatives by providing an understanding of what cultural values correspond to effective Lean Six Sigma implementation. Managers understanding the quality initiative cultural underpinnings, are attentive to the culture-shared values and norm's influence can utilize strategies to better implement Lean Six Sigma.

  10. Lean in healthcare: the unfilled promise?

    Science.gov (United States)

    Radnor, Zoe J; Holweg, Matthias; Waring, Justin

    2012-02-01

    In an effort to improve operational efficiency, healthcare services around the world have adopted process improvement methodologies from the manufacturing sector, such as Lean Production. In this paper we report on four multi-level case studies of the implementation of Lean in the English NHS. Our results show that this generally involves the application of specific Lean 'tools', such as 'kaizen blitz' and 'rapid improvement events', which tend to produce small-scale and localised productivity gains. Although this suggests that Lean might not currently deliver the efficiency improvements desired in policy, the evolution of Lean in the manufacturing sector also reveals this initial focus on the 'tool level'. In moving to a more system-wide approach, however, we identify significant contextual differences between healthcare and manufacturing that result in two critical breaches of the assumptions behind Lean. First, the customer and commissioner in the private sector are the one and the same, which is essential in determining 'customer value' that drives process improvement activities. Second, healthcare is predominantly designed to be capacity-led, and hence there is limited ability to influence demand or make full use of freed-up resources. What is different about this research is that these breaches can be regarded as not being primarily 'professional' in origin but actually more 'organisational' and 'managerial' and, if not addressed could severely constrain Lean's impact on healthcare productivity at the systems level. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. The human side of lean teams.

    Science.gov (United States)

    Wackerbarth, Sarah B; Strawser-Srinath, Jamie R; Conigliaro, Joseph C

    2015-05-01

    Organizations use lean principles to increase quality and decrease costs. Lean projects require an understanding of systems-wide processes and utilize interdisciplinary teams. Most lean tools are straightforward, and the biggest barrier to successful implementation is often development of the team aspect of the lean approach. The purpose of this article is to share challenges experienced by a lean team charged with improving a hospital discharge process. Reflection on the experience provides an opportunity to highlight lessons from The Team Handbook by Peter Scholtes and colleagues. To improve the likelihood that process improvement initiatives, including lean projects, will be successful, organizations should consider providing training in organizational change principles and team building. The authors' lean team learned these lessons the hard way. Despite the challenges, the team successfully implemented changes throughout the organization that have had a positive impact. Training to understand the psychology of change might have decreased the resistance faced in implementing these changes. © 2014 by the American College of Medical Quality.

  12. Assessment of insulin resistance and impaired glucose tolerance in lean women with polycystic ovary syndrome.

    Science.gov (United States)

    Stovall, Dale William; Bailey, Amelia Purser; Pastore, Lisa M

    2011-01-01

    To analyze insulin resistance (IR) and determine the need for a 2-hour oral glucose tolerance test (OGTT) for the identification of IR and impaired glucose tolerance (IGT) in lean nondiabetic women with polycystic ovary syndrome (PCOS). This was a cross-sectional analysis of treatment-naive women with PCOS who enrolled in a university-based clinical trial. Nondiabetic women with PCOS based on the Eunice Kennedy Shriven National Institute of Child Health and Human Development (NICHD) definition, aged 18-43 years and weighing ≤113 kg, were evaluated. Glucose and insulin levels were assessed at times 0, 30, 60, 90, and 120 minutes after a 75-g glucose load. Lean was defined as body mass index (BMI) women was studied. The prevalence of IR was 0% among lean women vs. 21% among nonlean subjects based on fasting insulin I(0) and 40%-68% based on two different homeostatic model assessment (HOMA) cutoff points (p women with IR had a BMI ≥ 28. Controlling for age and race, BMI explained over 57% of the variation in insulin fasting (I(o)), glucose fasting/Io (G(o)/I(o)), the qualitative insulin sensitivity check index (QUICKI), and HOMA and was a highly significant predictor of these outcomes (p lean PCOS women had IGT based on a 2-hour OGTT, and no lean subjects had IGT based on their fasting blood glucose. Diabetes mellitus, IGT, and IR are far less common in young lean women with PCOS compared with obese women with PCOS. These data imply that it is unnecessary to routinely perform either IR testing or 2-hour OGTT in lean women with PCOS; however, greater subject accumulation is needed to determine if OGTT is necessary in lean women with PCOS. BMI is highly predictive of both insulin and glucose levels in women with PCOS.

  13. Antihypertensive effect of alpha- and beta-adrenergic blockade in obese and lean hypertensive subjects.

    Science.gov (United States)

    Wofford, M R; Anderson, D C; Brown, C A; Jones, D W; Miller, M E; Hall, J E

    2001-07-01

    The purpose of this study was to determine the contribution of the adrenergic system in mediating hypertension in obese and lean patients. Thirteen obese, hypertensive patients with a body mass index (BMI) > or =28 kg/m2 (obese) and nine lean patients with a BMI lean) were recruited. After a 1-week washout period, participants underwent daytime ambulatory blood pressure monitoring (ABPM). Participants were then treated with the alpha-adrenergic antagonist doxazosin, titrating to 4 mg QHS in 1 week. In the next week, the beta-adrenergic antagonist atenolol was added at an initial dose of 25 mg/day and titrated to 50 mg/day within 1 week. One month after the addition of atenolol, all patients underwent a second ABPM session. There were no differences between the obese and lean subjects in baseline systolic (SBP), diastolic (DBP), or mean arterial pressures (MAP) measured by office recording or ABPM. However, obese subjects had higher heart rates than lean subjects (87.5+/-2.4 v 76.8+/-4.9 beats/min). After 1 month of treatment with the adrenergic blockers, obese patients had a significantly lower SBP (130.0+/-2.5 v 138.9+/-2.1 mm Hg, P = .02) and MAP (99.6+/-2.3 v 107.0+/-1.5 mm Hg, P = .02) than lean patients. Obese patients also tended to have a lower DBP than lean patients (84.3+/-2.5 v 90.9+/-1.6 mm Hg, P = .057), but there was no significant difference in heart rate after 1 month of adrenergic blockade. These results indicate that blood pressure is more sensitive to adrenergic blockade in obese than in lean hypertensive patients and suggest that increased sympathetic activity may be an important factor in the maintenance of hypertension in obesity.

  14. Effects of fasting on insulin action and glucose kinetics in lean and obese men and women.

    Science.gov (United States)

    Bergman, Bryan C; Cornier, Marc-Andre; Horton, Tracy J; Bessesen, Daniel H

    2007-10-01

    The development of insulin resistance in the obese individual could impair the ability to appropriately adjust metabolism to perturbations in energy balance. We investigated a 12- vs. 48-h fast on hepatic glucose production (R(a)), peripheral glucose uptake (R(d)), and skeletal muscle insulin signaling in lean and obese subjects. Healthy lean [n = 14; age = 28.0 +/- 1.4 yr; body mass index (BMI) = 22.8 +/- 0.42] and nondiabetic obese (n = 11; age = 34.6 +/- 2.3 yr; BMI = 36.1 +/- 1.5) subjects were studied following a 12- and 48-h fast during 2 h of rest and a 3-h 40 mUxm(-2)xmin(-1) hyperinsulinemic-euglycemic clamp (HEC). Basal glucose R(a) decreased significantly from the 12- to 48-h fast (lean 1.96 +/- 0.23 to 1.63 +/- 0.15; obese 1.23 +/- 0.07 to 1.07 +/- 0.07 mgxkg(-1)xmin(-1); P = 0.004) and was equally suppressed during the HEC after both fasts. The increase in glucose R(d) during the HEC after the 12-h fast was significantly decreased in lean and obese subjects after the 48-h fast (lean 9.03 +/- 1.17 to 4.16 +/- 0.34, obese 6.10 +/- 0.77 to 3.56 +/- 0.30 mgxkg FFM(-1)xmin(-1); P lean than obese subjects. We conclude that 1) 48 h of fasting produces a marked decline in peripheral insulin action, while suppression of hepatic glucose production is maintained in lean and obese men and women; and 2) the magnitude of this decline is greater in lean vs. obese subjects.

  15. Efficacy of a novel formulation of L-Carnitine, creatine, and leucine on lean body mass and functional muscle strength in healthy older adults: a randomized, double-blind placebo-controlled study

    Science.gov (United States)

    Background: Progressive decline in skeletal muscle mass and function are growing concerns in an aging population. Diet and physical activity are important for muscle maintenance but these requirements are not always met. This highlights the potential for nutritional supplementation. As a primary obj...

  16. Leading Lean: a Canadian healthcare leader's guide.

    Science.gov (United States)

    Fine, Benjamin A; Golden, Brian; Hannam, Rosemary; Morra, Dante

    2009-01-01

    Canadian healthcare organizations are increasingly asked to do more with less, and too often this has resulted in demands on staff to simply work harder and longer. Lean methodologies, originating from Japanese industrial organizations and most notably Toyota, offer an alternative - tried and tested approaches to working smarter. Lean, with its systematic approaches to reducing waste, has found its way to Canadian healthcare organizations with promising results. This article reports on a study of five Canadian healthcare providers that have recently implemented Lean. We offer stories of success but also identify potential obstacles and ways by which they may be surmounted to provide better value for our healthcare investments.

  17. PWR hot leg natural circulation modeling with MELCOR code

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hong; Lee, Jong In [Korea Institute of Nuclear Safety, Taejon (Korea, Republic of)

    1997-12-31

    Previous MELCOR and SCDAP/RELAP5 nodalizations for simulating the counter-current, natural circulation behavior of vapor flow within the RCS hot legs and SG U-tubes when core damage progress can not be applied to the steady state and water-filled conditions during the initial period of accident progression because of the artificially high loss coefficients in the hot legs and SG U-tubes which were chosen from results of COMMIX calculation and the Westinghouse natural circulation experiments in a 1/7-scale facility for simulating steam natural circulation behavior in the vessel and circulation modeling which can be used both for the liquid flow condition at steady state and for the vapor flow condition at the later period of in-vessel core damage. For this, the drag forces resulting from the momentum exchange effects between the two vapor streams in the hot leg was modeled as a pressure drop by pump model. This hot leg natural circulation modeling of MELCOR was able to reproduce similar mass flow rates with those predicted by previous models. 6 refs., 2 figs. (Author)

  18. PWR hot leg natural circulation modeling with MELCOR code

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jae Hong; Lee, Jong In [Korea Institute of Nuclear Safety, Taejon (Korea, Republic of)

    1998-12-31

    Previous MELCOR and SCDAP/RELAP5 nodalizations for simulating the counter-current, natural circulation behavior of vapor flow within the RCS hot legs and SG U-tubes when core damage progress can not be applied to the steady state and water-filled conditions during the initial period of accident progression because of the artificially high loss coefficients in the hot legs and SG U-tubes which were chosen from results of COMMIX calculation and the Westinghouse natural circulation experiments in a 1/7-scale facility for simulating steam natural circulation behavior in the vessel and circulation modeling which can be used both for the liquid flow condition at steady state and for the vapor flow condition at the later period of in-vessel core damage. For this, the drag forces resulting from the momentum exchange effects between the two vapor streams in the hot leg was modeled as a pressure drop by pump model. This hot leg natural circulation modeling of MELCOR was able to reproduce similar mass flow rates with those predicted by previous models. 6 refs., 2 figs. (Author)

  19. A Hydroxyurea-induced Leg Ulcer

    OpenAIRE

    Hwang, Seon-Wook; Hong, Soon-Kwon; Kim, Sang-Hyun; Seo, Jong-Keun; Lee, Deborah; Sung, Ho-Suk

    2009-01-01

    Hydroxyurea is a cytostatic agent that has recently become the drug of choice in the treatment of various myeloproliferative diseases. The cutaneous side effects of hydroxyurea include xerosis, hyperpigmentation, nail discoloration, and scaling. Leg ulcers have only rarely been reported in association with hydroxyurea treatment. A 75-year-old woman presented with leg ulcers, nail discoloration, and xerosis. The leg ulcers were refractory to conventional treatment. She had been taking oral hyd...

  20. Making it lean applying lean practices to the work of it

    CERN Document Server

    Williams, Howard

    2013-01-01

    Making IT Lean: Applying Lean Practices to the Work of IT presents Lean concepts and techniques for improving processes and eliminating waste in IT operations and IT Service Management, in a manner that is easy to understand. The authors provide a context for discussing several areas of application within this domain, allowing you to quickly gain insight into IT processes and Lean principles.The text reviews IT Service Management, with reference to the IT Infrastructure Library (ITIL®) as a framework for best practices-explaining how to use it to accommod

  1. LEAN SIX SIGMA – MULTIPLE CASE STUDY

    Directory of Open Access Journals (Sweden)

    Delvio Venanzi

    2017-12-01

    Full Text Available Lean Six Sigma é uma gestão focada na qualidade e desempenho produtivo em sistemas operacionais. Este artigo discute os fundamentos desta metodologia através de duas diferentes concepções de gestão, Lean Manufacturing e Six Sigma. Primeiro, o artigo explica o DMAIC (definir, medir, analisar, melhorar e controlar e suas respectivas fases, após a filosofia Lean com o sipoc e técnicas de mapeamento de fluxo de valor. O artigo pretende mostrar a integração destes dois conceitos e seus resultados. A metodologia consistiu em uma teoria baseada em uma pesquisa bibliográfica de pesquisa exploratória que consistiu de três estudos de caso em empresas de diferenças localizadas em Sorocaba, São Paulo. Neste artigo estuda a aplicação de Lean Seis Sigma e seus resultados.

  2. Lean Construction Applications for Bridge Inspection

    Science.gov (United States)

    2017-10-01

    Lean philosophy was used to analyze the efficiency of bridge inspection. Emphasis was put on identifying activities that add value to the final output, an owner approved bridge inspection report. 26 bridge inspections were shadowed. Time spent on bri...

  3. Lean in service industries: A literature review

    Science.gov (United States)

    V, Vignesh; Suresh, M.; Aramvalarthan, S.

    2016-09-01

    Lean service is an amalgamation of tools and practices which, if applied appropriately, would definitely improve the existing quality of operations and ensure the generation of a large amount of favourable financial and economic outcomes and improve the behaviour of the workforce. As a result, it assumes of great significance in the fiercely competitive modern world. This article presents a comprehensive bibliographic study about the various lean service practices through a variety of approaches like service improvement, manufacturing, supply chain, market and retailing approaches, etc. Thus it gives a clear view on how the lean services are implemented in various sectors and the contribution of lean service towards improving the quality in the services provided while reducing the costs.

  4. Implementation of Lean Manufacturing in Romanian Organisations

    Directory of Open Access Journals (Sweden)

    Ucenic Camelia Ioana

    2017-01-01

    Full Text Available The implementation of lean manufacturing is one of the main tools for attaining a higher performance level in the Romanian organisations. The study uses data collected at middle management level from organisations located in Transylvania. The organisations come from different fields of activity and are in different stages of lean implementation. The article makes use of quantitative and qualitative instruments for the evaluation of lean in the above mentioned companies. Characteristics as waste reduction, cost, quality, product design have different approaches in the companies. Their way of approach gives useful information regarding the type of company from the point of view of lean manufacturing implementation. This knowledge provides a useful support at different managerial levels in the process of decision making.

  5. Lean six sigma application to transportation logistics

    Directory of Open Access Journals (Sweden)

    Simone Tavares Fernandes

    2012-06-01

    Full Text Available This work presents the application of Lean Six Sigma in a case study of a metallurgic industry. The Six Sigma and the Lean are two processes used by enterprises in Brazil and worldwide. Currently the integration of these processes is a challenge for these companies, which search a way more efficient to reduce their wastes and to adapt to the needs of their markets. The paper had as purpose to demonstrate the applicability of the Lean Six Sigma in a real logistical problem related to the transportation of goods among units of a metallurgic industry. The stages used for the solution of the problem follow the DMAIC cycle – Define, Measure, Analyze, Improve and Control. The paper presents in details the integrated approach of the improvement processes Lean and Six Sigma, their tools set, as well the excellent results obtained in the case study.

  6. LEAN Tools in the IT Sector

    Directory of Open Access Journals (Sweden)

    Zoltan VAJNA

    2015-05-01

    Full Text Available Nowadays the LEAN tools with their proven efficiency are indispensable parts of the production management. I think there is no producing enterprise that cannot utilize a wide variety of these LEAN tools. The question now is how these tools can support companies in increasing the efficiency of their supporting IT processes. In this study I will demonstrate how these well-known LEAN tools from production management can be used in IT management to create more cost-effective, efficient and transparent solutions during the IT system development and IT operation activities. I will show respectively without attempting to be comprehensive the most important tools of the LEAN management and I will analyse how these tools can be used in the IT sector. At the end of this study I will demonstrate what the IT managers think about the practical use of these tools.

  7. A case study of lean, sustainable manufacturing

    Directory of Open Access Journals (Sweden)

    Geoff Miller

    2010-06-01

    Full Text Available A small furniture production company has integrated lean tools and sustainability concepts with discrete event simulation modeling and analysis as well as mathematical optimization to make a positive impact on the environment, society and its own financial success. The principles of lean manufacturing that aid in the elimination of waste have helped the company meet ever increasing customer demands while preserving valuable resources for future generations. The implementation of lean and sustainable manufacturing was aided by the use of discrete event simulation and optimization to overcome deficits in lean’s traditional implementation strategies. Lean and green manufacturing can have a more significant, positive impact on multiple measures of operational performance when implemented concurrently rather than separately. These ideas are demonstrated by three applications.

  8. A Web-Based Lean Simulation Game for Office Operations: Training the Other Side of a Lean Enterprise

    Science.gov (United States)

    Kuriger, Glenn W.; Wan, Huang-da; Mirehei, S. Moussa; Tamma, Saumya; Chen, F. Frank

    2010-01-01

    This research proposes a Web-based version of a lean office simulation game (WeBLOG). The game is designed to be used to train lean concepts to office and administrative personnel. This group belongs to the frequently forgotten side of a lean enterprise. Over four phases, the game presents the following seven lean tools: one-piece flow,…

  9. The Finnish healthcare services lean management.

    Science.gov (United States)

    Hihnala, Susanna; Kettunen, Lilja; Suhonen, Marjo; Tiirinki, Hanna

    2018-02-05

    Purpose The purpose of this paper is to discuss health services managers' experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers' work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews. The participants were nurse managers ( n = 7) and medical managers ( n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis. Findings A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills. Practical implications Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care. Originality/value The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers' experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used

  10. Lean Implementation : the significance of people and dualism

    OpenAIRE

    Bengt, Halling

    2013-01-01

    Lean, with its origins at the Toyota Motor Company, is a concept that is known to increase effectiveness in manufacturing. The Lean concept is now argued to be relevant not only in manufacturing but in service and health-care delivery as well. The reported results of Lean implementation efforts are divided. There are reports that most of the Lean implementation efforts are not reaching the goal; on the other hand, there are reports of promising results. The divided results from Lean implement...

  11. Lean in the supply chain : research and practice

    OpenAIRE

    Ugochukwu, Paschal

    2012-01-01

    Lean is a management philosophy that enhances customer value through waste elimination and continuous improvement in a system by applying lean principles, practices, and techniques. The focus on lean implementations and research had been typically a single company without extension to the entire supply chain. When the concept of lean is implemented across the entire supply chain, however, it is referred to as lean supply chain. The purpose of this thesis is to create a structure from theory a...

  12. Lean in healthcare: A comprehensive review.

    Science.gov (United States)

    D'Andreamatteo, Antonio; Ianni, Luca; Lega, Federico; Sargiacomo, Massimo

    2015-09-01

    Lean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and adopted in healthcare. Accordingly, Lean healthcare has been developing into a major strand of research since the early 2000s. The aim of this work is to present a comprehensive overview of the main issues highlighted by research on implementation of Lean in a complex contest such as the healthcare one. Comprehensive literature review was conducted in order to identify empirical and theoretical articles published up to September 2013. Thematic analysis was performed in order to extract and synthesis data. 243 articles were selected for analysis. Lean is best understood as a means to increase productivity. Hospital is the more explored setting, with emergency and surgery as the pioneer departments. USA appears to be the leading country for number of applications. The theoretical works have been focused mainly on barriers, challenges and success factors. Sustainability, framework for measurement and critical appraisal remain underestimated themes. Evaluations of "system wide approach" are still low in number. Even though Lean results appear to be promising, findings so far do not allow to draw a final word on its positive impacts or challenges when introduced in the healthcare sector. Scholars are called to explore further the potentiality and the weaknesses of Lean, above all as for the magnitude of investments required and for the engagement of the whole organization it represents increasingly strategic choice, whilst health professionals, managers and policy makers could and should learn from research how to play a pivotal role for a more effective implementation of lean in different health contexts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Lean tool used in the automotive industry

    Directory of Open Access Journals (Sweden)

    Manuela Ingaldi

    2014-10-01

    Full Text Available In the paper basic concepts of Lean Manufacturing were presented. A company specializing in the development of vehicle dynamics, driver assistance systems, brake systems, seat belt sand electronics technology was characterized. The company is engaged in designing and manufacturing world-class products for the automotive market. The Lean tools used in the production hall, such as Yamazumi chart, machine motion analysis, MTM method and timing, were presented.

  14. Lean tool used in the automotive industry

    OpenAIRE

    Manuela Ingaldi; Marta Jagusiak-Kocik

    2014-01-01

    In the paper basic concepts of Lean Manufacturing were presented. A company specializing in the development of vehicle dynamics, driver assistance systems, brake systems, seat belt sand electronics technology was characterized. The company is engaged in designing and manufacturing world-class products for the automotive market. The Lean tools used in the production hall, such as Yamazumi chart, machine motion analysis, MTM method and timing, were presented.

  15. Implementing lean manufacturing system: ISM approach

    Directory of Open Access Journals (Sweden)

    Naveen Kumar

    2013-09-01

    Full Text Available Purpose: Lean Manufacturing System has emerged as an important area of research in Indian context. The requirement of Lean Manufacturing has increased due to defects in products (semi finished and finished and subsequent increase in cost. In this context, this study is an attempt to develop a structural model of the variables, important to implement Lean Manufacturing System in Indian automobile industry. Design/Methodology/Approach: Various variables of lean manufacturing system implementation have been identified from literature review and experts’ opinions. Contextual relationship among these identified variables has been set after carrying out brainstorming session. Further, classification of the variables has been carried out based upon the driving power and dependence. In addition to this, a structural model of variables to implement lean concept in Indian automobile industry has also been developed using Interpretive Structural Modeling (ISM technique. Questionnaire based survey has also been conducted to rank these variables. Findings: Eighteen variables have been identified from the literature and subsequent discussions with experts. Out of which, nine variables have been identified as dependent and nine variables have been identified as driver. No variable has been identified as linkage variable and autonomous variable. From the model developed, ‘Relative cost benefits’ has been identified as top level dependent variable and top management commitment as bottom level most independent variable. Research limitations/Implications: The model so developed is a hypothetical model based upon experts’ opinions. The conclusions so drawn may be further modified to apply in real situation. Practical implication: Clear understanding of interactions among these variables will help organizations to prioritize and manage these variables more effectively and efficiently to draw advantage from lean manufacturing system implementation

  16. INNOVATION LEAN PRINCIPLES IN AUTOMOTIVE GREEN MANUFACTURING

    Directory of Open Access Journals (Sweden)

    Dušan Sabadka

    2014-12-01

    Full Text Available Today, industries such as automotive and manufacturing industries deal with a lot of environmental regulations. Lean is a production strategy whose fundamental principles drive the industry towards a more effective production of goods and services. The eco-efficiency concept is primary to sustainable development and intends to provide more value with less environmental impact. The aim of this study is to identify and explore the contributions of Lean to reduce environmental impacts that naturally result from industrial activity.

  17. High-speed Dynamic Gait Generation Based on Asymmetrization of Impact Posture Using Telescopic Legs

    OpenAIRE

    浅野, 文彦

    2011-01-01

    This paper proposes a novel method for generating a dynamic gait based on anterior-posterior asymmetric impact posture tilting the robo's center of mass forward. The primary purpose of this method is to asymmetrize the impact posture by actuating the robot's telescopic-legs to make overcoming the potential barrier at mid-stance easy, and the mechanical energy is accordingly restored. First, we introduce a planar rimless wheel model with telescopic legs, and investigate the validity of the sta...

  18. The promise of Lean in health care.

    Science.gov (United States)

    Toussaint, John S; Berry, Leonard L

    2013-01-01

    An urgent need in American health care is improving quality and efficiency while controlling costs. One promising management approach implemented by some leading health care institutions is Lean, a quality improvement philosophy and set of principles originated by the Toyota Motor Company. Health care cases reveal that Lean is as applicable in complex knowledge work as it is in assembly-line manufacturing. When well executed, Lean transforms how an organization works and creates an insatiable quest for improvement. In this article, we define Lean and present 6 principles that constitute the essential dynamic of Lean management: attitude of continuous improvement, value creation, unity of purpose, respect for front-line workers, visual tracking, and flexible regimentation. Health care case studies illustrate each principle. The goal of this article is to provide a template for health care leaders to use in considering the implementation of the Lean management system or in assessing the current state of implementation in their organizations. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  19. Lean healthcare from a change management perspective.

    Science.gov (United States)

    van Rossum, Lisa; Aij, Kjeld Harald; Simons, Frederique Elisabeth; van der Eng, Niels; Ten Have, Wouter Dirk

    2016-05-16

    Purpose - Lean healthcare is used in a growing number of hospitals to increase efficiency and quality of care. However, healthcare organizations encounter problems with the implementation of change initiatives due to an implementation gap: the gap between strategy and execution. From a change management perspective, the purpose of this paper is to increase scientific knowledge regarding factors that diminish the implementation gap and make the transition from the "toolbox lean" toward an actual transformation to lean healthcare. Design/methodology/approach - A cross-sectional study was executed in an operating theatre of a Dutch University Medical Centre. Transformational leadership was expected to ensure the required top-down commitment, whereas team leadership creates the required active, bottom-up behavior of employees. Furthermore, professional and functional silos and a hierarchical structure were expected to impede the workforce flexibility in adapting organizational elements and optimize the entire process flow. Findings - The correlation and regression analyses showed positive relations between the transformational leadership and team leadership styles and lean healthcare implementation. The results also indicated a strong relation between workforce flexibility and the implementation of lean healthcare. Originality/value - With the use of a recently developed change management model, the Change Competence Model, the authors suggest leadership and workforce flexibility to be part of an organization's change capacity as crucial success factor for a sustainable transformation to lean healthcare.

  20. Implementing Lean Health Reforms in Saskatchewan

    Directory of Open Access Journals (Sweden)

    Greg Marchildon

    2013-07-01

    Full Text Available Saskatchewan has gone further than any other Canadian province in implementing health system process improvements using Lean, a production line discipline that originated with the automobile industry. The goal of the Lean reform is to reduce waste and improve quality and overall health system performance by long-term changes in behaviour. Lean enjoys a privileged position on the provincial government’s agenda because of the policy’s championing by the Deputy Minister of Health and the policy’s fit with the government’s patient-centred care agenda. The implementation of reform depends on a major investment of time in the training and Lean-certification of key leaders and managers in the provincial health system. The Saskatchewan Union of Nurses, the union representing the single largest group of health workers in the province, has agreed to co-operate with the provincial government in implementing Lean-type reforms. Thus far, the government has had limited independent evaluation of Lean while internal evaluations claim some successes.

  1. Visual communication in lean organizations

    Directory of Open Access Journals (Sweden)

    Iuga Maria Virginia

    2017-01-01

    Full Text Available Many researchers have studied the role and importance of communication and communication types for organizations and their work force. The topic of organizational communication is a constantly changing one. The thing that remains stable throughout this very wide topic is its purpose: communication is vital for the effectiveness and success of organizations of all sizes, types and cultures. In terms of type, one could split up topic by type as followed: verbal, visual and written. This research paper focuses on the visual component at shop floor within automotive organizations. It aims at giving the reader a structured overview on the most appropriate but also lean visual communication practices. In order to establish these methods at shop floor, a survey was conducted among nine big automotive companies in Romania. It was then followed up by a second survey dedicated to check the effectiveness of implementation of these methods in a big automotive organization. The paper presents the analyses, results and the conclusions of this surveys.

  2. Epilepsy and restless legs syndrome.

    Science.gov (United States)

    Geyer, James D; Geyer, Emery E; Fetterman, Zachary; Carney, Paul R

    2017-03-01

    Restless legs syndrome (RLS) is a common neurological movement disorder occurring in approximately 10% of the general population. The prevalence of moderately severe RLS is 2.7% overall (3.7% for women and 1.7% for men). Epilepsy is also a common neurological disorder with significant associated morbidity and impact on quality of life. We evaluated the severity and frequency of primary RLS in patients with localization-related temporal lobe epilepsy (TLE) and investigated the role of prodromal RLS symptoms as a warning sign and lateralizing indicator. All epilepsy patients seen in the outpatient clinic were screened for movement disorders from 2005 to 2015. Ninety-eight consecutive patients with localization-related TLE (50 right TLE and 48 left TLE) who met inclusion criteria were seen in the outpatient clinic. The control group consisted of 50 individuals with no history or immediate family history of epilepsy. Each patient was evaluated with the International Restless Legs Study Group (IRLSSG) questionnaire, NIH RLS diagnostic criteria, ferritin level, and comprehensive sleep screening including polysomnography. Furthermore, patients with obstructive sleep apnea or a definite cause of secondary restless legs syndrome such as low serum ferritin or serum iron levels were also excluded from the study. There was a significant association between the type of epilepsy and whether or not patients had RLS χ 2 (1)=10.17, p<.01, using the χ 2 Goodness of Fit Test. Based on the odds ratio, the odds of patients having RLS were 4.60 times higher if they had right temporal epilepsy than if they had left temporal epilepsy, serving as a potential lateralizing indicator. A prodromal sensation of worsening RLS occurred in some patients providing the opportunity to intervene at an earlier stage in this subgroup. We identified frequent moderate to severe RLS in patients with epilepsy. The frequency of RLS was much more common than would typically be seen in patients of similar

  3. The Relationship among Leg Strength, Leg Power and Alpine Skiing Success.

    Science.gov (United States)

    Gettman, Larry R.; Huckel, Jack R.

    The purpose of this study was to relate leg strength and power to alpine skiing success as measured by FIS points. Isometric leg strength was represented by the knee extension test described by Clarke. Leg power was measured by the vertical jump test and the Margaria-Kalamen stair run. Results in the strength and power tests were correlated with…

  4. L-carnitine increases body lean in adult dogs and cats

    OpenAIRE

    Jewell, D.

    2010-01-01

    L-carnitine has been shown to be a repartitioning agent (i.e.,setting metabolism toward more protein and less fat accretion) in animals used for food production. The purpose of this study was to determine the effects on body composition repartitioning (i.e.,increasing lean body mass) of added dietary L-carnitine in adult dogs and cats.

  5. Leg ischemia post-varicocelectomy

    Directory of Open Access Journals (Sweden)

    Al-Wahbi AM

    2016-03-01

    Full Text Available Abdullah M Al-Wahbi1, Shaza Elmoukaied2 1Division of Vascular Surgery, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2Department of Surgery, Dr Sulaiman Al Habib Hospital, Riyadh, Saudi Arabia Abstract: Varicocelectomy is the most commonly performed operation for the treatment of male infertility. Many surgical approaches are used as each of them has advantages over the other and is preferred by surgeons. Vascular injury has never been reported as a complication of varicocelectomy apart from testicular artery injury. We present a 36-year-old male who developed leg ischemia post-varicocelectomy due to common femoral artery injury. He was successfully treated by using a vein graft. Keywords: varicocele, varicocelectomy, complications, vascular injuries

  6. Lean i Norge : opplever norske bedrifter som er mer lean, større økning i kundetilfredshet enn de som er mindre lean?

    OpenAIRE

    Fagereng, Hanne Eline; Askevold, Elisabeth Cathrine

    2010-01-01

    Vi ønsker å måle i hvor stor grad norske bedrifter har implementert lean, og for å måle grad av lean har vi utviklet et rammeverk basert på lean teori. Hovedformålet med lean er å øke kundeverdi med minst mulig ressursbruk, anstrengelse, energi, utstyr, tid, plass, material og kapital (Womack, Roos and Jones 2007). Vi vil utforske om høyere grad av lean fører til mer tilfredse kunder enn de som har lavere grad av lean. Altså om hovedformålet med lean blir oppnådd hvis man implementerer lean i...

  7. Intensive treatment of leg lymphedema

    Directory of Open Access Journals (Sweden)

    Pereira de Godoy Jose

    2010-01-01

    Full Text Available Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value < 0.05 being considered significant. Results: All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value < 0.001. Losses of more than 90% of the lymphedema occurred in 9 (39.13% patients; losses of more than 80% in 13 (56.52%, losses of more than 70% in 17 (73.91% and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9% of the edema. Conclusion: The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees.

  8. Børns leg og eksperimenterende virksomhed

    DEFF Research Database (Denmark)

    Damgaard Warrer, Sarah; Broström, Stig

    Børns leg og eksperimenterende virksomhed er et rigt felt med mange perspektiver, indgangsvinkler og nuancer. I denne bog kædes leg og det eksperimenterende og skabende sammen som to gensidigt forbundne fænomener og belyses i pædagogisk og didaktisk perspektiv. Desuden beskrives potentialet i båd...

  9. Clinical quality indicators of venous leg ulcers

    DEFF Research Database (Denmark)

    Kjaer, Monica L; Mainz, Jan; Soernsen, Lars T

    2005-01-01

    In the clinical setting, diagnosis and treatment of venous leg ulcers can vary considerably from patient to patient. The first step to reducing this variation is to document venous leg ulcer care through use of quantitative scientific documentation principles. This requires the development of val...

  10. Using Dynamic Value Stream Mapping and Lean Accounting Box Scores to Support Lean Implementation

    Science.gov (United States)

    Woehrle, Stephen L.; Abou-Shady, Louay

    2010-01-01

    Lean has proven to be an effective management philosophy for improving businesses in a competitive market by eliminating waste and improving operations. An impact of implementing lean projects is the rapid reduction in inventory levels, which gives management the false impression that profits are decreasing while workers on the shop floor observe…

  11. Efeitos da suplementação de creatina e do treinamento de potência sobre a performance e a massa corporal magra de ratos Effects of creatine supplementation and power training on performance and lean body mass of rats

    Directory of Open Access Journals (Sweden)

    Frederico S.C. Franco

    2007-10-01

    Full Text Available INTRODUÇÃO: A creatina é um dos suplementos mais usados por atletas para incrementar a síntese protéica e aumentar a massa e força muscular. OBJETIVO: Investigou-se os efeitos da suplementação de creatina associada a um programa de treinamento de potência (saltos verticais sobre a performance e a composição da massa corporal magra de ratos Wistar. MÉTODOS: Ratos Wistar adultos foram distribuídos em quatro grupos: SSC (sedentário sem creatina; SC (sedentário com creatina; ESC (exercício sem creatina e EC (exercício com creatina. Os animais receberam água e ração ad libitum. Os grupos SC e EC ingeriam dose de creatina diariamente, adotando o procedimento de carga (0,430g/kg p.c. por 7 dias e manutenção (0,070g/kg p.c. por 6 semanas. Os grupos EC e ESC foram submetidos a um regime progressivo de saltos verticais (5x10 saltos com 1 min de intervalo em tanque com água, 5 dias/semana, durante 7 semanas. A performance foi avaliada pelo tempo de execução das 5 séries de 10 saltos verticais e a composição da massa corporal magra (músculos e ossos foi avaliada pelas porções: água, proteína e gordura. RESULTADOS: A performance não foi afetada pela ingestão de creatina (p > 0,05. Os animais suplementados tiveram o percentual de proteína elevado e o de gordura reduzido (p 0,05. CONCLUSÃO: A suplementação de creatina não afetou a performance dos animais, mas alterou a massa corporal magra. A suplementação de creatina e o programa de treinamento de potência, de forma independente, elevaram o percentual de proteína dos músculos e ossos e reduziram o percentual de gordura, sem alterar o percentual de água.INTRODUCTION: Creatine is one of the supplements most used by athletes in order to increase protein synthesis and consequently muscle mass and strength. OBJECTIVE: This study investigated the effects of creatine intake on the performance and lean body mass of Wistar rats. METHODS: Male Wistar rats were allocated

  12. Convergence in insulin resistance between very severely obese and lean women at the end of pregnancy.

    Science.gov (United States)

    Forbes, Shareen; Barr, Sarah M; Reynolds, Rebecca M; Semple, Scott; Gray, Calum; Andrew, Ruth; Denison, Fiona C; Walker, Brian R; Norman, Jane E

    2015-11-01

    Disrupted intermediary metabolism may contribute to the adverse pregnancy outcomes in women with very severe obesity. Our aim was to study metabolism in such pregnancies. We recruited a longitudinal cohort of very severely obese (n = 190) and lean (n = 118) glucose-tolerant women for anthropometric and metabolic measurements at early, mid and late gestation and postpartum. In case-control studies of very severely obese and lean women we measured glucose and glycerol turnover during low- and high-dose hyperinsulinaemic-euglycaemic clamps (HEC) at early and late pregnancy and in non-pregnant women (each n = 6-9) and body fat distribution by MRI in late pregnancy (n = 10/group). Although greater glucose, insulin, NEFA and insulin resistance (HOMA-IR), and greater weight and % fat mass (FM) was observed in very severely obese vs lean participants, the degree of worsening was attenuated in the very severely obese individuals with advancing gestation, with no difference in triacylglycerol (TG) concentrations between very severely obese and lean women at term. Enhanced glycerol production was observed in early pregnancy only in very severely obese individuals, with similar intrahepatic FM in very severely obese vs lean women by late gestation. Offspring from obese mothers were heavier (p = 0.04). Pregnancies complicated by obesity demonstrate attenuation in weight gain and insulin resistance compared with pregnancies in lean women. Increased glycerol production is confined to obese women in early pregnancy and obese and lean individuals have similar intrahepatic FM by term. When targeting maternal metabolism to treat adverse pregnancy outcomes, therapeutic intervention may be most effective applied early in pregnancy.

  13. The relationships between Lean manufacturing, management accounting and firm performance

    DEFF Research Database (Denmark)

    Kristensen, Thomas Borup; Nielsen, Henrik; Grasso, Lawrency

    2016-01-01

    with management accounting practices. Specifically, we document that Lean manufacturing is positively associated with Value Stream Costing, Lean visual controls and, more importantly, measures of labor and materials efficiency. Lean manufacturing is positively related to Lean thinking and both are positively...... associated with operational performance and so are Lean visual controls. We also document that the management accounting practices intervene affecting operational performance and they intervene with Lean thinking as well. Lastly, the relationship between Lean manufacturing and measures of labor and materials......Lean manufacturing has been adopted by numerous western companies as an answer to an increasing competitive environment. Lean manufacturing is seen as an enterprise-wide strategy encompassing a transformation of manufacturing practices, affecting companies’ management accounting practices and...

  14. Implementing lean in Malaysian universities: Lean awareness level in an engineering faculty of a local university

    Science.gov (United States)

    Azim Khairi, M.; Rahman, Mohamed Abd

    2018-01-01

    Many academic articles were published in Malaysia promoting the goodness of lean in manufacturing and industrial sectors but less attention was apparently given to the possibility of obtaining the same universal benefits when applying lean in non-manufacturing sectors especially higher education. This study aims to determine the level of lean awareness among a local university’s community taking its Faculty of Engineering (FoE) as the case study. It also seeks to identify typical FoE’s staff perception on lean regarding its benefits and the obstacles in implementing it. A web-based survey using questionnaires was carried out for 215 respondents consisting of academic and administrative staff of the faculty. Statistical Package for the Social Science (SPSS) was used to analyze the survey data collected. A total of 13.95% of respondents returned the forms. Slightly more than half of those responded (56.7%) have encountered some of the lean terms with mean 1.43 and standard deviation 0.504. However, the large amount of standard deviation somewhat indicates that the real level of lean awareness of FoE as a group was low. In terms of lean benefits, reduction of waste was favored (93.3%) by the respondents with mean 0.93 and standard deviation 0.254. For obstacles in implementing lean, lack of knowledge was selected by most respondents (86.7%) to be the major factor with mean 0.87 and standard deviation 0.346. Through the analysis done, the study may conclude that level of lean awareness among the university‘s community was low thus may hinder implementation of lean concept.

  15. Assessment of circulating betatrophin concentrations in lean glucose-tolerant women with polycystic ovary syndrome.

    Science.gov (United States)

    Erol, Onur; Özel, Mustafa Kemal; Ellidağ, Hamit Yaşar; Toptaş, Tayfun; Derbent, Aysel Uysal; Yılmaz, Necat

    2017-07-01

    The aims of the current study were to investigate the betatrophin levels in lean glucose-tolerant women with polycystic ovary syndrome (PCOS), and to explore the relationships between these levels and antropometric, hormonal and metabolic parameters. The study population consisted of 50 lean (body mass index [BMI] production and improved glucose tolerance. Few studies have investigated the association between PCOS and betatrophin. However, in contrast to our study, the authors included overweight/obese patients and glucose tolerance was not evaluated before recruitment. What the results of this study add: Our results showed that serum betatrophin levels were significantly higher in lean glucose-tolerant PCOS women than in age- and BMI-matched healthy controls. What are the implications of these findings for clinical practice and/or further research: Elevated betatrophin levels in PCOS women, in the absence of obesity and glucose intolerance, may reflect a compensatory mechanism in order to counteract metabolic syndrome-related risk factors.

  16. Optimization of large scale food production using Lean Manufacturing principles

    DEFF Research Database (Denmark)

    Engelund, Eva Høy; Friis, Alan; Breum, Gitte

    2009-01-01

    This paper discusses how the production principles of Lean Manufacturing (Lean) can be applied in a large-scale meal production. Lean principles are briefly presented, followed by a field study of how a kitchen at a Danish hospital has implemented Lean in the daily production. In the kitchen...... not be negatively affected by the rationalisation of production procedures. The field study shows that Lean principles can be applied in meal production and can result in increased production efficiency and systematic improvement of product quality without negative effects on the working environment. The results...... show that Lean can be applied and used to manage the production of meals in the kitchen....

  17. Lean Manufacturing Auto Cluster at Chennai

    Science.gov (United States)

    Bhaskaran, E.

    2012-10-01

    Due the presence of lot of automotive Industry, Chennai is known as Detroit of India, that producing over 40 % of the Indian vehicle and components. Lean manufacturing concepts have been widely recognized as an important tool in improving the competitiveness of industries. This is a continuous process involving everyone, starting from management to the shop floor. Automotive Component Industries (ACIs) in Ambattur Industrial Estate, Chennai has formed special purpose vehicle (SPV) society namely Ambattur Industrial Estate Manufacturers Association (AIEMA) Technology Centre (ATC) lean manufacturing cluster (ATC-LMC) during July 2010 under lean manufacturing competitiveness scheme, that comes under National Manufacturing Competitiveness Programme of Government of India. The Tripartite Agreement is taken place between National Productivity Council, consultants and cluster (ATC-LMC). The objective is to conduct diagnostic study, study on training and application of various lean manufacturing techniques and auditing in ten ACIs. The methodology adopted is collection of primary data/details from ten ACIs. In the first phase, diagnostic study is done and the areas for improvement in each of the cluster member companies are identified. In the second phase, training programs and implementation is done on 5S and other areas. In the third phase auditing is done and found that the lean manufacturing techniques implementation in ATC-LMC is sustainable and successful in every cluster companies, which will not only enhance competitiveness but also decrease cost, time and increase productivity. The technical efficiency of LMC companies also increases significantly.

  18. Lean oncology: a new model for oncologists

    Directory of Open Access Journals (Sweden)

    Montesarchio Vincenzo

    2012-04-01

    Full Text Available Abstract The history of the term Lean is relatively recent and originates from the Toyota Production System (TPS. The term "Lean" means "thin", which refers to a mental process, operational, productive, no-frills, quick but not hasty, consequential to the previous event. The Lean process flows seamlessly into the result, eliminates unnecessary complications to the effect, prevents unnecessary equipment processes. The idea is to 'do more with less', like using the (few available resources in the most productive way possible, through the elimination of all types of waste that inevitably accompanies every stage of a production process. Lean management is primarily a management philosophy, a system of values and behaviors that goes beyond the mere application of the instrument and that, once internalized, will form the nucleus of the corporate culture. "Lean Oncology" is a term coined to identify a methodology of care and treatment to cancer patients, consisting on process simplification, streamlining of the organizational and routes of drug treatment, detection and elimination of waste. Its main objective is the centrality of the patient.

  19. Lean oncology: a new model for oncologists.

    Science.gov (United States)

    Montesarchio, Vincenzo; Grimaldi, Antonio Maria; Fox, Bernard A; Rea, Antonio; Marincola, Francesco M; Ascierto, Paolo A

    2012-04-25

    The history of the term Lean is relatively recent and originates from the Toyota Production System (TPS). The term "Lean" means "thin", which refers to a mental process, operational, productive, no-frills, quick but not hasty, consequential to the previous event. The Lean process flows seamlessly into the result, eliminates unnecessary complications to the effect, prevents unnecessary equipment processes. The idea is to 'do more with less', like using the (few) available resources in the most productive way possible, through the elimination of all types of waste that inevitably accompanies every stage of a production process. Lean management is primarily a management philosophy, a system of values and behaviors that goes beyond the mere application of the instrument and that, once internalized, will form the nucleus of the corporate culture. "Lean Oncology" is a term coined to identify a methodology of care and treatment to cancer patients, consisting on process simplification, streamlining of the organizational and routes of drug treatment, detection and elimination of waste. Its main objective is the centrality of the patient.

  20. LEAN PRACTICES FOR PRODUCT DEVELOPMENT PROCESS

    Directory of Open Access Journals (Sweden)

    Guilherme Luz Tortorella

    2015-06-01

    Full Text Available Lean product development (LPD is an approach that comprises lean principles and management practices that aim to reduce waste and improve operational effectiveness throughout the entire value stream in continuous improvement endless journey. Due to that, the ability to innovate, change and learn continuously is a key element in order to minimize product development problems. Several LPD techniques are presented in the literature as possible enablers for lean implementation. However, little has been known about the impact of these enablers on the problems related to product development processes. Thus, this paper aims to examine the relationship between five LPD practices’ constructs and the occurrence frequency of eleven LPD problems’ constructs in companies that are implementing lean. Moreover, the identification of relevant relationships between LPD practices’ and problems’ constructs may contribute to specify the contexts in which problems are expected to occur. The study sample comprises sixty four companies already undergoing lean implementation both in shop floor and offices area. The results indicate that the same practices’ constructs, which are deemed as influential for minimizing LPD problems, present different relationship intensities among them.

  1. Using Lean to Advance Quality Improvement Research.

    Science.gov (United States)

    Blackmore, Christopher Craig; Williams, Barbara L; Ching, Joan M; Chafetz, Lynne A; Kaplan, Gary S

    2016-01-01

    Quality improvement research skills are not commonplace among quality improvement practitioners, and research on the effectiveness of quality improvement has not always kept pace with improvement innovation. However, the Lean tools applied to quality improvement should be equally relevant to the advancement of quality improvement research. We applied the Lean methods to develop a simplified quality improvement publication pathway enabling a small research methodology group to increase quality improvement research throughout the institution. The key innovations of the pathway are horizontal integration of the quality improvement research methods group across the institution, implementation of a Lean quality improvement research pathway, and application of a just-in-time quality improvement research toolkit. This work provides a road map and tools for the acceleration of quality improvement research. At our institution, the Lean quality improvement research approach was associated with statistically significant increases in the number (annual mean increase from 3.0 to 8.5, p = .03) and breadth of published quality improvement research articles, and in the number of quality improvement research projects currently in process. Application of Lean methods to the quality improvement research process can aid in increasing publication of quality improvement articles from across the institution.

  2. Bevezetés a lean menedzsmentbe – a lean stratégiai alapjai = Introduction to lean management – basic strategic elements of lean

    OpenAIRE

    Losonci, Dávid

    2010-01-01

    A lean menedzsment az értékteremtő folyamatok stratégiai és operatív szintjének meghatározó formálójává vált az elmúlt évtizedekben. Jelen tanulmány stratégiai nézőpontból tárgyalja a lean menedzsment teljes bevezetését. Részletes áttekintést ad a Womack és Jones (2003) által lefektetett lean alapelvekről. Az operatív teljesítményjavulásból származó vevői értékteremtés mellett foglalkozik a tulajdonosi értékteremtéssel, az MRP és a lean szinergikus összekapcsolásával, valamint a lean ideális ...

  3. Detailed characterization of particulate matter emitted by lean-burn gasoline direct injection engine

    Energy Technology Data Exchange (ETDEWEB)

    Zelenyuk, Alla [Pacific Northwest National Laboratory, Richland, WA, USA; Wilson, Jacqueline [Pacific Northwest National Laboratory, Richland, WA, USA; Imre, Dan [Imre Consulting, Richland, WA, USA; Stewart, Mark [Pacific Northwest National Laboratory, Richland, WA, USA; Muntean, George [Pacific Northwest National Laboratory, Richland, WA, USA; Storey, John [Oak Ridge National Laboratory, Knoxville, TN, USA; Prikhodko, Vitaly [Oak Ridge National Laboratory, Knoxville, TN, USA; Lewis, Samuel [Oak Ridge National Laboratory, Knoxville, TN, USA; Eibl, Mary [Oak Ridge National Laboratory, Knoxville, TN, USA; Parks, Jim [Oak Ridge National Laboratory, Knoxville, TN, USA

    2016-11-10

    This study presents detailed characterization of the chemical and physical properties of PM emitted by a 2.0L BMW lean-burn turbocharged GDI engine operated under a number of combustion strategies that include lean homogeneous, lean stratified, stoichiometric, and fuel rich conditions. We characterized PM number concentrations, size distributions, and the size, mass, compositions, and effective density of fractal and compact individual exhaust particles. For the fractal particles, these measurements yielded fractal dimension, average diameter of primary spherules, and number of spherules, void fraction, and dynamic shape factors as function of particle size. Overall, the PM properties were shown to vary significantly with engine operation condition. Lean stratified operation yielded the most diesel-like size distribution and the largest PM number and mass concentrations, with nearly all particles being fractal agglomerates composed of elemental carbon with small amounts of ash and organics. In contrast, stoichiometric operation yielded a larger fraction of ash particles, especially at low speed and low load. Three distinct forms of ash particles were observed, with their fractions strongly dependent on engine operating conditions: sub-50 nm ash particles, abundant at low speed and low load, ash-containing fractal particles, and large compact ash particles that significantly contribute to PM mass loadings

  4. Cycling peak power in obese and lean 6- to 8-year-old girls and boys.

    Science.gov (United States)

    Aucouturier, Julien; Lazaar, Nordine; Doré, Eric; Meyer, Martine; Ratel, Sebastien; Duché, Pascale

    2007-06-01

    The purpose of this study was to investigate the possible effect of the difference in percentage body fat (%BF) and fat-free mass (FFM) on cycling peak power (CPP) in 6- to 8-year-old obese and lean untrained girls and boys. Obese (35 girls, 35 boys) and lean (35 girls, 35 boys) children were measured for obesity, %BF, calculated from skinfold measurements. FFM was calculated as body mass (BM) minus body fat. A force-velocity test on a cycle ergometer was used to measure CPP. CPP was related to anthropometric variables using standard and allometric models. CPP in absolute terms was higher in obese children than in lean children irrespective of gender. BM-related CPP was significantly lower in obese children than in lean ones, whereas no effect of obesity appeared on FFM-related CPP. Velocity at CPP (Vopt) was significantly lower and force at CPP (Fopt) was significantly higher in girls than in boys. Muscle power production was unaffected by obesity in children. Low BM-related CPP could explain the difficulty of taking up physical activities that are body-mass related in obese children. Gender difference for Vopt and Fopt shows that girls and boys may have different maturation patterns affecting CPP.

  5. The impact of insulin resistance on clinical, hormonal and metabolic parameters in lean women with polycystic ovary syndrome.

    Science.gov (United States)

    Yildizhan, Begum; Anik Ilhan, Gokce; Pekin, Tanju

    2016-10-01

    This study was performed to assess insulin resistance (IR) in lean women with polycystic ovary syndrome (PCOS). Retrospective analysis of 100 consecutive lean (body mass index PCOS subjects was performed. Subjects were divided into two groups according to homeostasis model assessment IR index (HOMA-IR), as IR + and IR-. A HOMA-IR value >2.5 was used to indicate IR. A total of 100 lean PCOS subjects were enrolled in the study, of which 47% were insulin resistant. Comparison of group means showed significantly higher values for waist-to-hip ratio (WHR), diastolic blood pressure and Ferriman-Gallwey score (FGS) in IR + group. HOMA-IR values were found to be positively correlated with WHR (r = 0.500, p PCOS subjects, the insulin resistant group should be separated as unique and IR should also be evaluated in lean women with PCOS.

  6. Hot Leg Piping Materials Issues

    International Nuclear Information System (INIS)

    V. Munne

    2006-01-01

    With Naval Reactors (NR) approval of the Naval Reactors Prime Contractor Team (NRPCT) recommendation to develop a gas cooled reactor directly coupled to a Brayton power conversion system as the space nuclear power plant (SNPP) for Project Prometheus (References a and b) the reactor outlet piping was recognized to require a design that utilizes internal insulation (Reference c). The initial pipe design suggested ceramic fiber blanket as the insulation material based on requirements associated with service temperature capability within the expected range, very low thermal conductivity, and low density. Nevertheless, it was not considered to be well suited for internal insulation use because its very high surface area and proclivity for holding adsorbed gases, especially water, would make outgassing a source of contaminant gases in the He-Xe working fluid. Additionally, ceramic fiber blanket insulating materials become very friable after relatively short service periods at working temperatures and small pieces of fiber could be dislodged and contaminate the system. Consequently, alternative insulation materials were sought that would have comparable thermal properties and density but superior structural integrity and greatly reduced outgassing. This letter provides technical information regarding insulation and materials issues for the Hot Leg Piping preconceptual design developed for the Project Prometheus space nuclear power plant (SNPP)

  7. The Development Of A Theoretical Lean Culture Causal Framework To Support The Effective Implementation Of Lean In Automotive Component Manufacturers

    Directory of Open Access Journals (Sweden)

    Van der Merwe, Karl Robert

    2014-05-01

    Full Text Available Although it is generally accepted that lean manufacturing improves operational performance, many organisations are struggling to adapt to the lean philosophy. The purpose of this study is to contribute to a more effective strategy for implementing the lean manufacturing improvement philosophy. The study sets out both to integrate well-researched findings and theories related to generic organisational culture with more recent research and experience related to lean culture, and to examine the role that culture plays in the effective implementation of lean manufacturing principles and techniques. The ultimate aim of this exercise is to develop a theoretical lean culture causal framework.

  8. Stiffness characteristics of compliant three segment leg with the self-stable region in slow and fast running

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Oh Seok; Ha, Sung Mok; Lee, Dong Ha [Convergence Research Center for WellnessDaegu Gyeongbuk Institute of Science and TechnologyDaegu (Korea, Republic of)

    2016-12-15

    In this paper, we propose the stiffness characteristics of compliant three segment leg that can have a self-stable region in slow and fast running. This proposition can contribute to reducing the control effort and enhancing the locomotion energy efficiency for the compliant three segment legged robot in slow and fast running. Previous research indicated that the running self-stable region of the spring-mass system is located in a relatively fast running region and that of the two segment leg is located in a relatively slow running region. In this paper, we analyze the stiffness characteristics of the spring-mass system and the two segment leg to explain the previous research results. From this analysis, we propose the stiffness characteristics of the compliant three segment leg with a self-stable region in slow and fast running. We further design the compliant three segment leg based on this proposition and check its structural stability. We examine the running self-stable region of this compliant three segment leg to determine whether it has a self-stable region in slow and fast running. We also examine the walking self-stable region of this compliant three segment leg.

  9. Lean for Government: Eliminating the Seven Wastes

    Science.gov (United States)

    Shepherd, Christena C.

    2012-01-01

    With shrinking budgets and a slow economy, it is becoming increasingly important for all government agencies to become more efficient. Citizens expect and deserve efficient and effective services from federal, state and local government agencies. One of the best methods to improve efficiency and eliminate waste is to institute the business process improvement methodologies known collectively as Lean; however, with reduced budgets, it may not be possible to train everyone in Lean or to engage the services of a trained consultant. It is possible, however, to raise awareness of the "Seven Wastes" of Lean in each employee, and encourage them to identify areas for improvement. Management commitment is vital to the success of these initiatives, and it is also important to develop the right metrics that will track the success of these changes.

  10. Contribution of Lean Management to Excellence

    Directory of Open Access Journals (Sweden)

    López-Fresno Palmira

    2014-11-01

    Full Text Available To continuously and systematically improve efficiency and efficacy of processes, organizations need the implication of all employees in continuous improvement and innovation through suitable Quality Management Programs (QMPs. Effectiveness of these programs is directly linked to the requirement employees understand the methodologies and tools used for QM and the benefits that will derivate from their implementation, individually and collectively, so they can commit and implicate. Lean Management is a friendly methodology to continuously and systematically achieve process improvement, so helping the organization seeking operational excellence that contributes to overall excellence. This paper identifies Critical Success Factors (CSFs for an effective implementation of QMPs, suggests Lean Management as an easy-to-understand, powerful and friendly methodology for operational excellence and overall excellence, and presents a case experience of implementation of Lean Management in a health care organization that applies the EFQM model, and the lessons learnt.

  11. Lean Start-up in Established Companies

    DEFF Research Database (Denmark)

    Goduscheit, René Chester

    2018-01-01

    Lean start-up is an emergent perspective on how entrepreneurs can bring new products and services to the market. This approach challenges the dominant role of lengthy business plans, linear product development processes, and seeking complete overview of the potential of the new products....../services before market launch. Instead it suggests that start-ups could benefit from a ‘minimum-viable product’ approach where products and services are launched when they contain critical features. The emphasis in the lean start-up approach is on business models rather than the elaborate business plan...... at the companies (strategy meetings, development workshops etc.). The aim is to shed light on the implications for companies that seek to employ lean start-up. These implications will be aimed at aspects like innovation management, organizational structure, customer relations etc....

  12. Theories of lean management: an empirical evaluation.

    Science.gov (United States)

    Handel, Michael J

    2014-03-01

    Debates within organization theory traditionally argued the relative merits of bureaucracy but today there is broad agreement across different perspectives that bureaucratic organization is inefficient and outmoded. Despite their differences, post-bureaucratic and neo-liberal theories argue that organizations with relatively flat hierarchies and low management overhead are better adapted to current market requirements. Post-bureaucratic theory also argues that employees, as well as firms, benefit from leaner management structures. This paper investigates trends in managerial leanness, proposed explanations for such trends, and the consequences of leanness for firms and employees. Although there is a trend toward flatter management hierarchies, there is only weak support for current claims regarding both the causes and consequences of lean management. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Quantifying Leg Movement Activity During Sleep.

    Science.gov (United States)

    Ferri, Raffaele; Fulda, Stephany

    2016-12-01

    Currently, 2 sets of similar rules for recording and scoring leg movement (LM) exist, including periodic LM during sleep (PLMS) and periodic LM during wakefulness. The former were published in 2006 by a task force of the International Restless Legs Syndrome Study Group, and the second in 2007 by the American Academy of Sleep Medicine. This article reviews the basic recording methods, scoring rules, and computer-based programs for PLMS. Less frequent LM activities, such as alternating leg muscle activation, hypnagogic foot tremor, high-frequency LMs, and excessive fragmentary myoclonus are briefly described. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Waste Measurement Techniques For Lean Companies

    Directory of Open Access Journals (Sweden)

    Maciej Pieńkowski

    2014-12-01

    Full Text Available The paper is dedicated to answer the problem of measuring waste in companies, which are implementing Lean Manufacturing concept. Lack of complex identification, quantification an visualization of waste significantly impedes Lean transformation efforts. This problem can be solved by a careful investigation of Muda, Muri and Mura, which represent the essence of waste in the Toyota Production System. Measuring them facilitates complete and permanent elimination of waste in processes. The paper introduces a suggestion of methodology, which should enable company to quantify and visualize waste at a shop floor level.

  15. A Lean Six Sigma journey in radiology.

    Science.gov (United States)

    Bucci, Ronald V; Musitano, Anne

    2011-01-01

    The department of radiology at Akron Children's Hospital embarked on a Lean Six Sigma mission as part of a hospital wide initiative to show increased customer satisfaction, reduce employee dissatisfaction and frustration, and decrease costs. Three processes that were addressed were reducing the MRI scheduling back-log, reconciling discrepancies in billing radiology procedures, and implementing a daily management system. Keys to success is that managers provide opportunities to openly communicate between department sections to break down barriers. Executive leaders must be engaged in Lean Six Sigma for the company to be successful.

  16. The Lean and Global Start-up

    DEFF Research Database (Denmark)

    Tanev, Stoyan; Rasmussen, Erik Stavnsager

    For several decades researchers have studied start-up companies with a focus on international markets, suppliers and networks from their inception and on companies that are establishing new, agile business models. This has resulted in two streams of research: The Born Global and International New...... Ventures research and research with a focus on the Lean Start-up company. It is our intention in this paper to give a short presentation of the two research streams and show how they can be merged into one with a focus on newly established technology oriented firms that are lean and global from...

  17. Leg ulcer in Werner syndrome (adult progeria): a case report.

    Science.gov (United States)

    Fumo, Giuseppe; Pau, Monica; Patta, Federico; Aste, Nicola; Atzori, Laura

    2013-03-15

    Werner syndrome (WS; MIM#277700) or adult progeria, is a rare disease, associated with mutations of a single gene (RECQL2 or WRN), located on chromosome 8 (8p12). It codes a DNA-helicase, whose defects cause genomic instability. The highest incidences are reported in Japan and Sardinia (Italy). On this major island of the Mediterranean Basin, the WS cases have been observed in the northern areas. The authors describe the apparently first case reported in southern Sardinia, a 51-year-old woman, who was born in and resides in the province of Cagliari. She presented with a 9-year history of an intractable leg ulcer and other characteristic symptoms, including "bird-like" face, high-pitched voice, premature greying, short stature, abdominal obesity in contrast with thin body type, scleroderma-like legs, decreased muscle mass, diabetes, atherosclerosis, and premature menopause. A specialized genetic Institute of Research (IRCCS-IDI, Rome) confirmed the clinical diagnosis. There is no cure or specific treatment and patients must be periodically screened for an increased risk of cardiovascular and cerebrovascular disease and malignancies. Among the many findings, leg ulcers significantly affect the patient's quality of life. This problem may send the patient to the dermatologist, who finally suspects the diagnosis. Poor response to medical treatment may require aggressive repeated surgery, with poor or temporary results.

  18. Diet-induced obesity, energy metabolism and gut microbiota in C57BL/6J mice fed Western diets based on lean seafood or lean meat mixtures.

    Science.gov (United States)

    Holm, Jacob Bak; Rønnevik, Alexander; Tastesen, Hanne Sørup; Fjære, Even; Fauske, Kristin Røen; Liisberg, Ulrike; Madsen, Lise; Kristiansen, Karsten; Liaset, Bjørn

    2016-05-01

    High protein diets may protect against diet-induced obesity, but little is known regarding the effects of different protein sources consumed at standard levels. We investigated how a mixture of lean seafood or lean meat in a Western background diet modulated diet-induced obesity, energy metabolism and gut microbiota. Male C57BL/6J mice fed a Western diet (WD) containing a mixture of lean seafood (seafood WD) for 12weeks accumulated less fat mass than mice fed a WD containing a mixture of lean meat (meat WD). Meat WD-fed mice exhibited increased fasting blood glucose, impaired glucose clearance, elevated fasting plasma insulin and increased plasma and liver lipid levels. We observed no first choice preference for either of the WDs, but over time, mice fed the seafood WD consumed less energy than mice fed the meat WD. Mice fed the seafood WD exhibited higher spontaneous locomotor activity and a lower respiratory exchange ratio (RER) than mice fed the meat WD. Thus, higher activity together with the decreased energy intake contributed to the different phenotypes observed in mice fed the seafood WD compared to mice fed the meat WD. Comparison of the gut microbiomes of mice fed the two WDs revealed significant differences in the relative abundance of operational taxonomic units (OTUs) belonging to the orders Bacteroidales and Clostridiales, with genes involved in metabolism of aromatic amino acids exhibiting higher relative abundance in the microbiomes of mice fed the seafood WD. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Lean Transformation Guidance: Why Organizations Fail To Achieve and Sustain Excellence Through Lean Improvement

    OpenAIRE

    Mohammed Hamed Ahmed

    2013-01-01

    Many companies are complaining that lean didn’t achieve their long-term goals, and the improvement impact was very short-lived. 7 out of each 10 lean projects fail as companies try to use lean like a toolkit, copying and pasting the techniques without trying to adapt the employee’s culture, manage the improvement process, sustain the results, and develop their leaders. When the Toyota production system was created, the main goal was to remove wastes from the shop floor us...

  20. Development of framework for sustainable Lean implementation: an ISM approach

    Science.gov (United States)

    Jadhav, Jagdish Rajaram; Mantha, S. S.; Rane, Santosh B.

    2014-07-01

    The survival of any organization depends upon its competitive edge. Even though Lean is one of the most powerful quality improvement methodologies, nearly two-thirds of the Lean implementations results in failures and less than one-fifth of those implemented have sustained results. One of the most significant tasks of top management is to identify, understand and deploy the significant Lean practices like quality circle, Kanban, Just-in-time purchasing, etc. The term `bundle' is used to make groups of inter-related and internally consistent Lean practices. Eight significant Lean practice bundles have been identified based on literature reviewed and opinion of the experts. The order of execution of Lean practice bundles is very important. Lean practitioners must be able to understand the interrelationship between these practice bundles. The objective of this paper is to develop framework for sustainable Lean implementation using interpretive structural modelling approach.