Publications by authors named "JC Wells"

Background: Variability in long-term endovascular treatment outcomes for intracranial aneurysms has prompted questions regarding the effects of these treatments on aneurysm hemodynamics. Endovascular techniques disrupt aneurysmal blood flow and shear, but their influence on intra-aneurysmal pressure remains unclear. A better understanding of aneurysm pressure effects may aid in predicting outcomes and guiding treatment decisions.

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The adaptive and independent interrelationships between different body composition components have been identified as crucial determinants of disease risk. Based on this concept, the load-capacity model of body composition, which utilizes measurements obtained through non-anthropometric techniques such as dual-energy X-ray absorptiometry (DXA), was proposed. This model is typically operationalized as the ratio of metabolic load (adipose mass) to metabolic capacity (lean mass).

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Evolutionary perspectives on obesity have been dominated by genetic frameworks, but plastic responses are also central to its aetiology. While often considered a relatively modern phenomenon, obesity was recorded during the Palaeolithic through small statuettes of the female form (Venus figurines). Even if the phenotype was rare, these statuettes indicate that some women achieved large body sizes during the last glacial maximum, a period of nutritional stress.

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Background: Fat mass (FM) and fat-free mass (FFM) in early life are associated with later obesity and cardiometabolic disease.

Objectives: This study aimed to assess the associations of FM and FFM at birth and conditional FM and FFM accretion from 0 to 5 y with kidney outcomes at the 10-y follow-up.

Methods: The Ethiopian Infant Anthropometry and Body Composition birth cohort included term infants born in Jimma town, with a birth weight ≥1500 g, and having no congenital malformations.

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Background: Impaired fetal and accelerated postnatal growth are associated with cardiometabolic disease. Few studies investigated how recovery from severe acute malnutrition (SAM) is associated with childhood cardiometabolic risk.

Objectives: We evaluated cardiometabolic risk in children with SAM treated through community-based management, relative to controls, 5-y postrecovery.

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Article Synopsis
  • Body composition assessment is crucial for managing health conditions like HIV, especially in resource-limited settings such as Africa.
  • Researchers tested methods like dual-energy X-ray absorptiometry (DXA), bioelectrical impedance (BIA), and various anthropometric measures on 420 HIV-infected adolescents in Zambia.
  • While BIA and anthropometry provided some data, they were not reliable enough for tracking changes in body composition compared to DXA, with BIA potentially being useful for identifying general trends when DXA isn’t available.
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Background: Childhood is a period marked by dynamic growth. Evidence of the association between childhood linear growth and school achievement comes mostly from cross-sectional data. We assessed associations between birth length, childhood linear growth velocities, and stunting with school achievement.

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Background: Few trials have explored long-term effects of interventions designed to reduce child stunting. We evaluated school-age outcomes in rural Zimbabwean children who received cluster-randomised water, sanitation and hygiene (WASH) and/or infant and young child feeding (IYCF) interventions from pregnancy up to 18 months of age.

Methods: The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial enrolled pregnant women from two rural Zimbabwean districts (Chirumanzu and Shurugwi) between 2012 and 2015, and cluster-randomised them using a 2 × 2 factorial design to standard-of-care, WASH, IYCF, or combined WASH & IYCF, with a co-primary outcome of height-for-age Z-score and haemoglobin at 18 months (clinicaltrials.

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Introduction: This pilot study was designed to test the hypothesis that quantitative electroencephalographic (qEEG) measurements reflect physiological adaptations for brain energy reallocation. The study focused on a team of three well-matched male rowers participating in a 30-day, 2,650-mile continuous transatlantic rowing competition, examining the effects of extreme, prolonged stress on brain function and metabolic adaptations.

Methods: Measurements at the start and finish lines included body weight, height, waist circumference, body fat, and a panel of hormones and biochemical markers.

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Early childhood growth is associated with cognitive function. However, the independent associations of fat mass (FM) and fat-free mass (FFM) with cognitive function are not well understood. We investigated associations of FM and FFM at birth and 0-5 years accretion with cognitive function at 10 years.

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The expensive-tissue hypothesis (ETH) posited a brain-gut trade-off to explain how humans evolved large, costly brains. Versions of the ETH interrogating gut or other body tissues have been tested in non-human animals, but not humans. We collected brain and body composition data in 70 South Asian women and used structural equation modelling with instrumental variables, an approach that handles threats to causal inference including measurement error, unmeasured confounding and reverse causality.

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Article Synopsis
  • Doubly labeled water is the most reliable method for measuring total energy expenditure (TEE), but its accuracy can be affected by the isotope dilution space ratio (DSR).
  • This study explored factors like age, sex, ethnicity, body composition, and geographical elevation to see how they influence DSR, using various statistical analysis methods.
  • Results showed that while DSR decreased with age in individuals 60 and older, no significant effects were found from other variables, suggesting that previous estimates of TEE might be overestimating values for older individuals, especially those around 90 years old.
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Article Synopsis
  • - Over 16 million children were born HIV-free despite exposure during pregnancy by 2022, but those who are HIV-free exhibit worse health and development outcomes, leading to the need for further research on their long-term effects compared to unexposed children.
  • - The SHINE trial in rural Zimbabwe tracked growth and cognitive development in children born HIV-free compared to unexposed children, evaluating participants at age 7 using a variety of assessments that included measurements of height, haemoglobin, cognitive abilities, and physical fitness.
  • - The study aimed to understand the differences in health outcomes between the two groups and utilized advanced statistical methods to analyze the collected data, considering various demographic and socioeconomic factors affecting the children's development.
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Maternal/caregivers' mental health (MMH) and child nutrition are both poor in low- and middle-income countries. Links between the two are plausible but poorly researched. Our aim was to inform future malnutrition management programmes by better understanding associations between MMH and nutritional status of infants aged under six month (u6m).

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Objectives: The aim of this study was to evaluate body composition variability assessed by bioimpedance in relation to nutritional status assessed by anthropometry in children and adolescents living in countries characterized by contrasting nutritional conditions.

Methods: The sample was comprised of 8614 children (4245 males; 4369 females), aged 3 to 19 years, from Nepal (477 children), Uganda (488 children and adolescents), UK (297 children and adolescents) and US (7352 children and adolescents). Height-for-age (HAZ) and body mass index-for-age (BAZ) z-scores were calculated according to WHO growth references.

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Introduction: In the context of adverse in utero environments, the fetal brain might be preserved at the expense of other tissues. This trade-off, brain sparing, has not been studied in the context of maternal infection. We investigated cases of maternal syphilis in the early 20th century and influenza during the 1918-1920 pandemic, in the Swiss city of Lausanne, a relatively high-income setting.

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Background: Women's underage marriage (<18 years) is associated with adverse maternal and child health outcomes. Poverty in the natal household has been widely considered to be a key risk factor for underage marriage, but the evidence base is unreliable. When investigating this issue, most studies use marital wealth inappropriately, as a proxy for wealth in the natal household.

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Background: Development of body composition (BC) may be disrupted in children with stunting. Such disruption may affect the later risk of excess adiposity and metabolic health, yet few studies have investigated correlates of BC in children with stunting.

Objectives: We aimed to investigate nutritional status, infection and inflammation, breastfeeding behaviors, and other factors as correlates of BC in children with stunting.

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Background: Breast milk is the gold standard for infant feeding. It is a dynamic biological fluid rich in numerous bioactive components. Emerging research suggests that these components, including hormones, may serve as signals between mother and offspring.

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Background: In 2020, the global COVID-19 pandemic caused educational disruptions to many medical students nationally. Societal and hospital guidelines, including social distancing protocols, resulted in the cancellation or postponement of many elective procedures. A shortage in personal protective equipment also contributed to restrictions in clinical experiences for trainees.

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Background: Many studies have documented the epidemic of mental ill-being among resident physicians, but fewer have focused on mental well-being or on guiding intervention design to make progress toward positive change in residency programs to support resident thriving. Informed by the job demands-resources model (JD-R) and positive psychology, the current study examines 4 potential predictors of residents' ill-being (burnout, depression) and well-being (engagement, stay intent) that are malleable and thus capable of change through intervention: psychological capital (PsyCap), supervising physicians' autonomy-supportive leadership style (ASL), social support, and meaningful work.

Methods: Three waves of data were collected between November 2017 and September 2018 at a large hospital system in the United States.

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Background: This study evaluated wellness programs in a large hospital network to determine residency program directors' (PDs) perspectives on their wellness programs' state, including wellness prioritization, frequency of wellness activities, and wellness' influence on decision-making across organizational levels.

Methods: In 2021, 211 PDs were sent surveys on program policies, program implementation frequency, perceptions of the administration's ability to prioritize wellness, funding sources, and perceptions of resident wellness' impact on decision-making.

Results: Among 211 contacted programs, 148 surveys were completed (70.

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Background: The current research used a qualitative approach to understand which factors facilitate and hinder wellness programming in residency programs.

Methods: Program directors identified from a previous quantitative study as having residency programs with notably more or less resident wellness programming than others (ie, high- and low-exemplars, respectively) were contacted. In total, semi-structured interviews were conducted over Zoom with 7 low-exemplars and 9 high-exemplars.

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Background: Lymphocytes are closely linked to mechanisms of action of immuno-oncology (IO) agents. We aimed to assess the prognostic significance of absolute lymphocyte count (ALC) in patients with metastatic renal cell carcinoma (mRCC).

Patients And Methods: Using the International mRCC Database Consortium (IMDC), patients receiving first-line IO-based combination therapy were analysed.

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