The objective of this study was to determine the effects of a structured weight loss program that included hypocaloric diet, exercise and dietary supplementation, on weight loss, metabolic syndrome risk factors and antioxidant levels in healthy overweight and obese females. Thirty-seven healthy overweight and obese women (BMI 29.5 ± 2.3 kg/m2, 41.1 ± 7.1 yrs) participated in this study. The subjects were randomized into one of two groups: an exercise, hypocaloric diet and antioxidant supplement (LifePak®; LSANT group, n=20) or an exercise, hypocaloric diet and appetite suppression supplement (HTP Complex® and TēGreen®; LSAS group, n=17). A significant weight loss occurred in both groups after 12 weeks (LSANT: -2.8 ± 2.8 kg and LSAS: -4.3 ± 2.7 kg, p < 0.001). Body fat mass, percent body fat, and waist circumference significantly improved in both groups (p < 0.05). No significant difference was found between the groups for weight loss (p > 0.05). However, a significant difference was found between the groups for body fat mass (LSANT: -1.8 ± 2.6 kg; LSAS: -3.4 ± 2.4 kg, p ≤ 0.05). Glucose, insulin and insulin resistance (HOMA-IR) were significantly decreased in the LSAS group (glucose: -5.0 ± 6.8 mg/dl, p=0.008; insulin: -2.6 ± 3.8 uIU/dl, p=0.013; and HOMA-IR: -0.7 ± 1.0, p=0.012) but not in the LSANT group (p > 0.05). There were no significant differences (p > 0.05) observed within or between the groups for cholesterol, triglycerides or LDL-c. HDL-c decreased significantly in the LSANT group (-2.9 ± 5.3 mg/dl, p=0.024) but not in the LSAS group (p > 0.05). Skin carotenoid scores (SCS) increased significantly within the LSANT group (LSANT: 10950 ± 8395 SCS, p < 0.001) but not the LSAS group (p > 0.05). Lifestyle intervention that involves a structured hypocaloric diet and increased physical activity results in weight loss and improvements in body composition. However, supplementation with an appetite suppressant (HTP Complex®) did not enhance weight loss beyond what was achieved with a structured lifestyle intervention. Antioxidant supplementation may be of benefit during a weight loss program that incorporates physical activity and a low energy diet.

Thesis (M.A.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Increasing evidence indicates that the sooner treatment begins for patients with Alzheimer's Disease (AD), the better the chance of delaying progression of the disease. As a result, studies have begun focusing on risk factors for AD with the goal of identifying individuals with AD at the earliest possible stage. Such studies have found that individuals with Mild Cognitive Impairment (MCI) are at increased risk for AD and other forms of dementia. This study examines the potential mediating effect of a set of prospective risk factors, smoking and ApolipoproteinE (ApoE) genotype, on the incidence of MCI and AD. Although results of this study provide some preliminary evidence of an interaction, the study models presented here fail to reach significance. Additional studies are needed to confirm the hypothesis of an ApoE mediated relationship of smoking on MCI and AD. / 2031-01-01

Globally, the prevalence of diabetes has seen a significant increase, rising from 211 million in 1990 (3.96% of the global population at that time) to 476 million in 2017 (6.31% of the global population in 2017). Extensive research has been conducted to study the causes of diabetes from a data-driven approach, leading to the development of prospective models for predicting future diabetes risks. These studies have highlighted the strong correlation between diabetes and various biomarker factors, such as BMI, age, and certain blood test measures. However, there is a lack of research that focuses on building prospective models to predict future diabetes risks based on lifestyle factors. Therefore, this thesis aims to employ popular machine learning methods to investigate whether it is possible to predict future diabetes using prospective models that incorporate self-controllable lifestyle factors. Our analysis produced remarkable results, with the biomarker model achieving an average validation AUC score of 0.78, while the lifestyle model reached 0.70. Notably, lifestyle features demonstrate a greater predictive capacity for short-term new-onset diabetes when compared to the long-term endpoint. The biomarker model identified visceral fat as the most significant risk factor, whereas income level and employment emerged as the top risk factors in the lifestyle model. This thesis represents an innovative approach to diabetes prediction by leveraging lifestyle factors, providing valuable data-driven insights into the root causes of diabetes. It addresses a critical research gap by highlighting the significant role of lifestyle factors in predicting the future onset of diabetes, particularly within the context of parametric modeling. / Thesis / Master of Science (MSc)

The risk for upper extremity lymphedema post-mastectomy in women surgically treated for breast cancer is a concern since it is often painful, aesthetically displeasing, and can increase the risk of infection. However, there is a paucity of data examining if diagnostic procedures performed in the ipsilateral arm post-mastectomy increases the risk of lymphedema. The purpose of this research is to examine the relationship between diagnostic procedures performed in the ipsilateral arm post-mastectomy and the occurrence of lymphedema with or without related complications. A systematic review of the literature was conducted from multiple, online databases available from 1992 through 2014, and included CINAHL, MedLine, PsychInfo, and ERIC. Search terms included lymphedema, breast cancer, mastectomy, blood pressure, and infection. Exclusion criteria comprised articles focused on male gender, primary lymphedema, metastases, survival, quality of life studies, reoccurrence breast cancer, breast conservation, lymphedema management, lymphedema, and lymphoma. The results of this study were inconclusive concerning a relationship between upper extremity lymphedema and procedures performed in the ipsilateral arm after mastectomy. This literature review outlines gaps in the data showing a need for more focused research on the causes of secondary lymphedema after breast cancer surgery with lymph node removal. Further research on the impact of diagnostic and other invasive procedures on the ispilateral arm after mastectomy should be considered.

No description available.

Non-suicidal self-injury (NSSI) and suicidal behavior are prevalent problems, particularly among young adults. However, previous research on factors that might impact the severity of NSSI is limited, with no studies examining concurrently demographic and psychological risk factors, along with how reasons for engaging in, and emotional states surrounding, NSSI might impact its course. Furthermore, no studies to date have examined how these variables may be associated with laboratory-based behavioral indicators of NSSI severity. Similarly, the relationship between NSSI and suicide has been largely unexplored until recently. The few studies that have been conducted to date have relied primarily on self-report batteries of symptoms, largely neglecting interview and performance-based methodologies. The current study used a multi-method approach to elucidate factors associated with: 1) co-morbid suicidal behavior and 2) NSSI severity among a sample of young adults who engage in NSSI. Finally, the current study sought to develop an algorithm for predicting suicidal behavior among self-injurers by simultaneously examining all study variables to determine which variables best differentiated between those with and without a history of suicidal behavior. Hypotheses: It was hypothesized that: 1) greater endorsement of self-punishment, emotion regulation, sensation seeking, and addiction functions of NSSI, along with decreases in negative affect and increases in positive affect during NSSI, would be independently associated with a history of suicidal behavior after controlling for relevant demographic and diagnostic characteristics, and 2) greater endorsement of self-punishment, emotion regulation, sensation seeking, and addiction functions, along with decreases in negative affect and increases in positive affect during NSSI, each would be independently associated with a more severe course of NSSI as indicated by a greater number of self-reported acts and methods of NSSI, stronger implicit associations with NSSI, and higher levels of behavioral self-aggression. Methods: Participants were 68 undergraduates aged 18-26 who had engaged in at least 5 acts of NSSI, with at least one in the past six months. Twenty-eight participants endorsed little or no previous suicidal ideation and were in the NSSI Only group. Forty participants endorsed clinical levels of suicidal behavior (plans or attempts) in their lifetime and were in the NSSI+Suicidal Behavior group. Participants completed a screening procedure during which they completed self-report measures of lifetime history of NSSI and suicidal behavior, as well as self-report measures of impulsivity and affect regulation. Participants who met inclusion criteria were enrolled in the full study during which they completed diagnostic interviews for Axis I and II psychopathology, structured interviews to assess detailed lifetime self-injurious and suicidal behavior, self-report measures to assess current mood, and behavioral tasks assessing implicit associations with NSSI and self-aggression. Results: In terms of predicting group membership, mean level of behavioral self-aggression in the lab and engaging in NSSI for the purpose of emotion regulation significantly predicted membership in the NSSI+S study group. Regarding NSSI severity, engaging in NSSI because one feels addicted, significantly predicted more self-reported lifetime acts and methods of NSSI. Engaging in NSSI in order to meet interpersonal needs was significantly associated with implicit associations with NSSI, and increases in positive affect during NSSI were significantly associated with greater mean behavioral self-aggression in the lab. Finally, a simple algorithm was developed that correctly classified 87% of study participants into their correct study groups. This algorithm included only four variables: a history of suicidal ideation, trait sensation seeking, mean level of behavioral self-aggression in the lab, and current alcohol abuse. Conclusions: The current study revealed that although NSSI and suicidal behavior have several similarities, they are distinct in several ways and many self-injurious individuals are not suicidal. Furthermore, the two study groups did not differ significantly on any Axis I or II diagnosis, suggesting that focusing primarily on diagnostic differentiators between NSSI and suicide may be misguided. Rather, the current study found that reasons for engaging in NSSI, affective states surrounding NSSI, and behavioral self-aggression, contribute significantly to NSSI severity and the relation between NSSI and suicide. / Psychology

Resilience is a phenomenon that refers to the ability to overcome risk factors that increase the likelihood of academic or social failure. Considerable research has been conducted to determine what may enhance or hinder the ability of individuals to overcome adversity. Unfortunately, much of the research has focused primarily on factors that place individuals at greater risk of failure. Today in the United States, a number of students experience academic failure due to multiple risk factors. However, the research is clear that there are individuals referred to as resilient who are able to achieve at high levels in spite of many of the same risk factors. This heuristic phenomenological study provides insight, based on interviews with high risk, African-American, young adults, into those factors that enabled them to exhibit behaviors consistent with resilience in spite of risk factors in the home, school or community. The study helps to illuminate their challenges and the reasons for their success. / Ed. D.

published_or_final_version / abstract / Social Work and Social Administration / Doctoral / Doctor of Philosophy

From this series of studies, we conclude that microalbuminuria may represent a novel risk factor in SLE, and lupus patients are more susceptible to endothelial dysfunction caused by hyperhomocysteinemia. The use of antimalarial agents is beneficial for lupus patients with active disease on corticosteroid, and antioxidant vitamins are useful in lowering the oxidative stress markers but do not affect the endothelial function. The results highlight the importance of targeting the known modifiable risk factors in order to prevent premature atherosclerosis in SLE patients. / My first step was to elucidate the prevalence and metabolic abnormalities in SLE patients with microalbuminuria. Twenty percent of patients were found to have microalbuminuria, which was associated with higher mean arterial pressure, total plasma antioxidant and homocysteine levels. / Next, we recruited 12 SLE patients and 15 controls and gave them oral methionine loading to achieve acute hyperhomocysteinemia. After oral methionine loading, von Willebrand factor (vWF) levels increased significantly in both groups. The increase in vWF was apparently more pronounced in SLE (20%) compared to controls (8%). Fibrinogen binding to platelets increased significantly only in SLE patients. / Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disease of unknown cause which can affect any organs. Studies have reported an increased prevalence of cardiovascular disease (CVD) in these patients. We performed a series of studies to elucidate the interaction between microalbuminuria, dyslipidaemia, hyperhomocysteinemia, oxidative stress and immune dysregulation from the underlying disease in order to understand the accelerated atherosclerotic process in SLE. / We then evaluated the effects of long-term antioxidant vitamins. The plasma malondialdehyde level was significantly decreased after treatment in the vitamin group. Other oxidative stress markers and antioxidant levels and endothelial function remained unchanged in both groups. / We then proceeded to study the relative effect of antimalarial agents on fasting lipid fractions in patients with active SLE. Total cholesterol, very low-density lipoprotein cholesterol, and low density lipoprotein cholesterol levels were significantly lower in patients taking antimalarial agents, particularly for those patients taking concomitant prednisone. In the last study, we demonstrated that hydroxychloroquine had no significant effect on the serum lipid profile in these lupus patients with mild or inactive disease. / Tam Lai Shan. / Adviser: Edmund K. Li. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1550. / Thesis (M.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 178-214). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / School code: 1307.

As the prevalence of atherosclerosis has risen to an alarming level throughout the world, this thesis investigated: (1) the effects of type 2 diabetes mellitus on the risk factors for atherosclerosis and the intima-media thickness (IMT) of the common carotid arteries (a surrogate marker for atherosclerosis), (2) the contribution of various risk factors to the IMT of the common carotid arteries and (3) the interrelationship between the risk factors. / Atherosclerosis is the process by which the inner lining of a large or medium artery is deposited with lipids, cellular waste and other substances. It reduces the vessel's elasticity, lumen size and blood flow. Atherosclerosis is the primary underlying mechanism leading to cardiovascular and cerebrovascular diseases, the second and third leading causes of death in Hong Kong. / Both traditional and emerging risk factors for atherosclerosis were studied: traditional risk factors include age, blood pressure, indices of glycaemia control (fasting glucose, insulin and haemoglobin-Alc), and fasting lipids, while the emerging risk factors include, abdominal fat volume (subcutaneous and visceral), inflammatory markers (interleukin-6 (IL-6), interleukin-8 (IL-8) and high sensitivity c-reactive protein (hsCRP)), adiponectin, stress hormones (24 hr urinary noradrenaline and adrenaline, and plasma cortisol), and occupational stress (measured by a effort-reward imbalance questionnaire). / Starting with 204 subjects recruited from three different studies, data from 84 normoglycaemic subjects, 23 patients with impaired glucose tolerance (IGT) and 77 patients with diabetes mellitus (DM) were included in the analysis. When the IMT of the common carotid arteries and various risk factors were compared between normoglycaemic, IGT and DM subjects: (1) the IMT of the common carotid arteries showed an increasing trend with the worsening of glycaemia control (normal&lt;IGT&lt;DM), (2) increased prevalence of hypertension, dyslipidaemia, and obesity were observed among DM patients, and (3) increased levels of inflammatory markers, reduced concentration of adiponectin (a anti-inflammatory substance), and increased plasma cortisol concentration were also found among DM subjects. As the studies were limited by sample size, only a few risk factors were found significantly related to the carotid IMT. Age was the only common risk factor which was found to be correlated to the IMT of both the normoglycaemic and the DM/IGT subjects. (Abstract shortened by UMI.) / Fok Siu Pong. / "June 2005." / Adviser: Lester A. H. Critchley. / Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0173. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 200-228). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.