Mass index

Obesity is defined by the body mass index (BMI), measured as body weight in kilograms divided by the squared height in metres (kg/m2). A BMI of 30 or more is a commonly-used criterion for defining obesity and a BMI between 25 and 30 is considered overweight. 

Cell BR, Cote CG, Marin JM et al (2004) The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. New Engl J Med 350 1005-1012... 

TSCHOPP O, BOEHLER A, SPEICH R, WEDER W, SEIFERT B, RUSSI E W and SCHMID C (2002) OsteoporOsis before lung transplantation association with low body mass index, but not with imderlying disease. Am J Transplant. 2 (2) 167-72. 

Yield and other mass-related metrics such as atom economy, reaction mass efficiency and mass intensity have been examined by Constable et al with regard to their significance concerning greenness and costs. The importance of using a (product) concentration term, which can be mass intensity or mass index, is additionally emphasized by Laird et al This is in compliance with Winterton, who in his twelve more green chemistry principles demands the establishment of full mass balances. 

The research chemist both in academia and in industry profits from the application of metrics such as mass index (equation (5.1)), environmental factor (equation (5.2)) and cost index (equation (5.3)). Therefore, one purpose of this chapter is to demonstrate how to apply such metrics and what kind of information can be obtained from them. Some of their potential application areas are indicated in Box 5.1. 

The biocatalytic reduction step B in synthetic route B demands more raw materials (mass index S , see equation (5.1)) and generates more waste (environmental factor , see equation (5.2)) as compared to reduction step C (Figure 5.1). Solvents used to perform the extraction of the product from the aqueous phase in reduction step B are denoted as auxiliaries in Figure 5.1. These solvents and the aqueous phase dominate the mass balances as well as the environmental scores in Figure 5.2 (M4, M8). 

Inputs and outputs assessed in mass balancing are shown in Figure 5.3. The software EATOS was used to calculate all mass balances of processes. Outputs of EATOS are the mass index (equation (5.1), mass of raw material per mass of product output), and the environmental factor (equation (5.2), mass of waste output per mass of product output). EATOS also allows the calculation of cost indices (e.g., reference [15]) (equation (5.3), cost of raw material per mass of product output). 

Only a little effort is necessary to reduce solvent 1 demand used during reaction scale-up. The quantity used in the laboratory stage was reduced to 59% in the operation stage (Table 5.1). However, related to substrate 2, 96% of solvent 1 is still used. Thus, 87% of the original quantity of solvent will be fed to the incinerator for disposal, while the recycle rate is only 9.1% (from 96% to 87%, Table 5.1). Considering that there is a factor of five difference in solvent 1 demand between the operation scale and the literature procedure (see the segments Solvent of the mass index, in Figure 5.10), the potential for optimiz-... 

In contrast to the quantity of solvent 1 used during the reaction, the quantity of extraction solvent 2 (work up) increases during scale up (Laboratory 100% Operation 103%), especially when it is related to substrate 2 (Laboratory 100% Operation 169%). Compared to the yield obtained from the literature protocol in which an extraction procedure is missing, an efficient extraction seems to be important in order to achieve sufficient product accumulation. However, as the mass index and the environmental factor demonstrate with respect to the possibility for reducing the volume of water used (see above), solvent 2 demand should be able to be reduced as well, since less water use means less solvent is required for extraction. StiU, at least the recycle rate of solvent 2 is as high as 72.8% (from 169% to 46%, Table 5.1), regarding the current data of the technical operation scale. 

Loft, S., Vistisen, K., Ewertz, M., Tjonneland, A., Overvad, K. and Poulsen, H.E. (1992). Oxidative DNA damage estimated by 8-hydroxydeoxyguanosine excretion in humans influence of smoking, gender and body mass index. Carcinogenesis 13, 2441-2447. 

Assess body mass index (weight in kg/height in m2)... 

Weight reduction Maintain normal body weight (body mass index 18.5-24.9 kg/m2) 5-20 mm Hg/10 kg... 

Diabetes mellitus Hypertension Physical inactivity Obesity (body mass index greater than or equal to 30 kg/m2)... 

Weight loss, through caloric restriction and increased physical activity, should be encouraged in patients who have a body mass index greater than 25 kg/m2. Dietary modification is important for risk factor management, and dietary counseling... 

BMI body mass index PAI-1 plasminogen activator inhibitor-1... 

MMRC dyspnea scale Body mass index (kg/m2) 0-1 Greater than 21 2 Less than or equal to 21 3 4... 

Monitor short- and long-term nutritional status through evaluation of height, weight, and body mass index. Ideally, parameters should be near the normals for non-CF patients. 

Atypical antipsychotics Monitor for increased appetite with weight gain (primarily in patients with initial low or normal body mass index) monitor closely if rapid or significant weight gain... 

Testing should be considered for persons younger than 45 years of age or more frequently in individuals who are overweight (body mass index greater than or equal to 25 kg/m2) and have additional risk factors ... 

---