Longitudinal physique changes among healthy white veterans at Boston.
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Adult↗
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Change in food intake frequency at five years after baseline in the JACC study.
BACKGROUND: In a cohort study, information on an individual is taken at baseline, after which it usually remains fixed. There is some risk that this will lead to misclassification and cause weakened or biased results. To prevent such distortion, following up of exposure is important, although it is still scarce in practice. METHODS: In the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) sponsored by Monbusho (Ministry of Education, Science, Sports and Culture of Japan), 37,838 (14,531 males and 23,307 females) subjects out of a cohort of 127,477 inhabitants answered an interim questionnaire on food intake frequency consisting of 33 items about five years after registration. The long-term reproducibility was assessed using Spearman's correlation coefficients and agreement. From data at two time points, longitudinal change, age effect, and secular trend were examined. Subjective changes in these items at the time of the interim survey were also compared to longitudinal changes. RESULTS: Spearman's correlation coefficients varied from 0.27 (fruit juice in males) to 0.55 (beef in females and milk in males), and agreement from 29.9% (fruit juice in males) to 61.4% (liver in females). Correlation was relatively stronger in meat and dairy products and weaker in vegetables and fruits. In both males and females, most increased food item was edible wild plants followed by confectioneries (males) and yogurt (females). CONCLUSION: Over five years, food intake was considerably changed. These interim data could be used for a long-term follow-up study to prevent the results becoming weakened or biased.
Adult↗
Concentrations of parathyroid hormone-related protein in rat milk change with duration of lactation and interval from previous suckling, but not with milk calcium.
PTH-related protein (PTHrP) is found in high concentrations in the milk of various mammals. However, little is known about the regulation of PTHrP production or the physiological role(s) of PTHrP in the mammary glands. To address these questions, we examined in lactating rats 1) the longitudinal changes in PTHrP concentrations in milk and PTHrP mRNA levels in the mammary glands throughout lactation, 2) the effects of the nonsuckling interval on milk PTHrP concentration, and 3) the correlation between PTHrP and calcium concentrations in milk. PTHrP concentrations in milk, measured by RIA and in vitro bioassay, increased with the duration of lactation. The maximal concentrations of PTHrP (observed between days 19-21 of lactation in rats milked serially) were 4.8- to 8.0-fold higher than the concentrations on day 7. PTHrP mRNA levels in the mammary glands also increased during the late stages of lactation. The longitudinal changes in calcium concentrations in milk were small and did not parallel the changes in PTHrP. When pups were removed from the mother for 4-24 h, milk PTHrP decreased while calcium increased in a time-dependent manner. As a whole, calcium concentrations in milk did not correlate with PTHrP throughout lactation. These data suggest that the production and secretion of PTHrP into milk are regulated independently of the other major milk proteins by a factor(s) that changes with progression of lactation and in relation to suckling status.
Animals↗
The relationship between peak height velocity and physical performance in youth soccer players.
Longitudinal changes in height, weight and physical performance were studied in 33 Flemish male youth soccer players from the Ghent Youth Soccer Project. The players' ages at the start of the study ranged from 10.4 to 13.7 years, with a mean age of 12.2 +/- 0.7 years. Longitudinal changes were studied over a 5 year period. Peak height velocity and peak weight velocity were determined using non-smoothed polynomials. The estimations of peak height velocity, peak weight velocity and age at peak height velocity were 9.7 +/- 1.5 cm x year-1, 8.4 +/- 3.0 kg x year-1 and 13.8 +/- 0.8 years, respectively. Peak weight velocity occurred, on average, at the same age as peak height velocity. Balance, speed of limb movement, trunk strength, upper-body muscular endurance, explosive strength, running speed and agility, cardiorespiratory endurance and anaerobic capacity showed peak development at peak height velocity. A plateau in the velocity curves was observed after peak height velocity for upper-body muscular endurance, explosive strength and running speed. Flexibility exhibited peak development during the tear after peak height velocity. Trainers and coaches should be aware of the individual characteristics of the adolescent growth spurt and the training load should also be individualized at this time.
Acceleration↗
Longitudinal predictors of airway responsiveness to distilled water: the role of atopy and maternal smoke exposure.
Airway responsiveness is an objectively measurable clinical trait related to the presence of asthma. Although risk factors for this trait have been evaluated cross-sectionally, little is known about its longitudinal predictors. A population cohort of 539 children, aged 8 yrs at the start of follow-up, underwent 3-7 bronchial challenge tests spaced at 3-9 month intervals. Airway responsiveness was assessed by a single-step distilled water challenge. To investigate responsiveness as a continuous trait, the ratio of the postchallenge to prechallenge forced expiratory volume in one second was calculated. A child's repeated ratios were then regressed on the time of follow-up. The resulting child-specific regression coefficient was the outcome variable to assess longitudinal predictors of airway responsiveness (AR). Results were based on 2,267 repeated challenge tests, and indicated an overall decrease in responsiveness. Children with a diagnosis of asthma (mean+/-SD, longitudinal change in AR + yr(-1): -0.060+/-0.149), those with a positive skin-prick test (-0.018+/-0.106) and those with reported exposure to maternal smoking (-0.004+/-0.083) demonstrated increased airway responsiveness over time. All of these changes in airway responsiveness were found to be significant in multiple linear regression analysis (p<0.05). Stratified analysis further indicated that the effect of maternal smoking was observed primarily in nonatopic children and was greatest at an exposure level of > or =10 cigarettes x day(-1). In conclusion, atopy and exposure to maternal smoking can predict longitudinal change in childhood airway responsiveness.
Air Pollutants↗
Longitudinal and secular trends in physical activity and sedentary behavior during adolescence.
OBJECTIVE: There is little epidemiologic research on longitudinal and secular trends in weight-related health behaviors throughout the stages of adolescence. In particular, few data are available to assess secular trends in various sedentary behaviors. The objective of this research was to investigate longitudinal and secular trends in physical activity and sedentary behavior in a large, diverse cohort of adolescents. METHODS: Project EAT-II is a 5-year longitudinal study (N = 2516) that includes 2 cohorts that allow for the observation of longitudinal changes from early to midadolescence (junior high to high school; n = 806; mean baseline age: 12.8 +/- 0.8 years) and mid- to late adolescence (high school to post-high school; n = 1710; mean baseline age: 15.8 +/- 0.8 years). EAT-II also examined secular trends in health behavior from 1999 to 2004 in midadolescence. The main outcome measures of the mixed-model regression analyses used in this research were self-reported weekly hours of moderate to vigorous physical activity, television/video viewing, and leisure-time computer use. RESULTS: Our findings indicate substantial longitudinal changes in moderate to vigorous physical activity, particularly among girls (decreasing 5.9-4.9 hours/week from early to midadolescence and 5.1-3.5 hours/week from mid- to late adolescence), and leisure-time computer use, particularly among boys (increasing 11.4-15.2 hours/week from early to midadolescence and 10.4-14.2 hours/week from mid- to late adolescence). Secular trends further indicate dramatic increases in midadolescent computer use from 1999 to 2004; girls increased from 8.8 to 11.1 hours/week, and boys increased from 10.4 to 15.2 hours/week. CONCLUSIONS: These adolescents experienced unfavorable shifts in activity patterns, such as longitudinal decreases in moderate to vigorous physical activity, coupled with longitudinal and secular increases in leisure-time computer use. Developing effective health promotion strategies that address a wide array of changing behavioral patterns will be important in promoting long-term health and active lifestyles among adolescents and young adults.
Adolescent↗
Ultrasound biomicroscopy of conventional and sutureless pars plana sclerotomies: a comparative and longitudinal study.
PURPOSE: To report the rate of ultrasonically visible vitreous incarceration and longitudinal changes of incarcerated vitreous in pars plana sclerotomies after conventional suturing or sutureless technique using ultrasound biomicroscopy. METHODS: Twenty-five consecutive eyes (25 patients) undergoing primary three-port pars plana vitrectomy participated. The first 16 pars plana vitrectomies were performed with standard conventional sutured sclerotomies, and the following nine pars plana vitrectomies were performed with modified sutureless sclerotomies. Patient demographics, diagnoses, procedures, and complications were recorded. Each patient had ultrasound biomicroscopy performed 1 week before surgery, and also after surgery at 1 week, 2 weeks, 3 weeks, 4 weeks, 2 months, 3 months, and 6 months. Visible vitreous incarceration was graded as 0 to 3. RESULTS: Vitreous incarceration was seen in 41 of 48 sclerotomies (85.4%) in the conventionally sutured group, and in 23 of 27 sclerotomies (85.2%) in the sutureless group, with no significant difference in severity among sclerotomies within each group and between the two groups. There was a significant difference in the rate of vitreous incarceration between diabetic patients with proliferative retinopathy and others (P =.002). No progressive change of visible vitreous incarceration was noted in any eye during the 6-month postoperative period. No sclerotomy-related complications occurred during the study period. CONCLUSIONS: Ultrasound biomicroscopy showed no difference in the amount of visible vitreous incarceration in conventionally sutured or sutureless sclerotomies. There was no visible longitudinal change in the incarcerated vitreous during the 6 months of follow-up in uncomplicated cases.
Adult↗
The effects of habitual caffeine use on cognitive change: a longitudinal perspective.
The efficiency of higher cortical functions, such as memory and speed of complex information processing, tends to decrease with advancing age in normal healthy individuals. Recently, a high habitual intake of caffeine was found associated with better verbal memory performance and psychomotor speed in several cross-sectional population studies. We tested the hypothesis that habitual caffeine intake can reduce or postpone age-related cognitive decline in healthy adults. For this purpose, the cognitive performance of all participants in the Maastricht Aging Study (MAAS), aged between 24 and 81 years, was reassessed after 6 years. Information on the intake of caffeine-containing beverages was available from the baseline questionnaire. After 6 years, 1376 (75.6%) individuals were available for reassessment. After correction for demographic characteristics, baseline performance and health status, there were small albeit significant associations between the overall estimated caffeine intake at baseline and the 6-year change in complex motor speed (motor choice reaction time). The earlier found association between caffeine intake and verbal memory performance was not apparent in this longitudinal study. These results imply that the longitudinal effect of habitual caffeine intake is limited and will not promote a substantial reduction in age-related cognitive decline at a population level.
Adult↗
ECG abnormalities in the elderly: prevalence, time and generation trends and association with mortality.
BACKGROUND AND AIMS: Electrocardiographic (ECG) abnormalities are often found in older patients but relatively few epidemiological studies have been performed. This study describes: a) cross-sectional differences in ECG abnormalities among three 70-year-old cohorts born over a period of 30 years; b) longitudinal changes in ECG abnormalities from the age of 70 to 85; and c) the relationship between ECG abnormalities at age 70 and subsequent 10- and 15-year mortality in men and women. METHODS: Trends in the prevalence of ECG abnormalities were investigated among 2100 70-year olds (994 men, 1106 women) from three cohorts born in 1901/02 (I), 1911/12 (III) and 1930 (VI). Longitudinal changes and mortality risks were investigated among 973 70-year olds (449 men and 524 women) from cohort I, which was followed from 1971 until 2001. RESULTS: In both sexes, the prevalence of ECG abnormalities was significantly lower in the later-born cohorts. From age 70 to 85, there was an increase in both men and women of large or intermediate Q-waves, left axis deviation, negative T-waves (0-5 mm), complete right bundle branch block (RBBB), and atrial fibrillation or flutter. Compared with those with no ECG abnormalities, the mortality risk was higher among individuals with large and intermediate Q-waves and negative T-waves (> or = 1 mm) in both sexes, and STJ depression > or = 0.5 mm and complete LBBB together with complete RBBB and intraventricular block; QRS > or = 0.12 sec in men only. CONCLUSIONS: ECG abnormalities are frequent in the elderly, they increase with age, and are associated with increased mortality.
Aged↗
Multiple imputation compared with some informative dropout procedures in the estimation and comparison of rates of change in longitudinal clinical trials with dropouts.
Statistical analysis based on multiple imputation (MI) of missing data when analyzing data with missing observations is gaining popularity among statisticians because of availability of computing softwares; it might be tempting to use MI whenever data is missing. An important assumption behind MI is the "ignorability of missingness." In this paper, we demonstrate the use of MI in conjunction with random effects models and several other methods that are devised to handle nonignorable missingness (informative dropouts). We then compare the results to assess sensitivity to underlying assumptions. Our focus is primarily to estimate and compare rates of change (of a primary variable). The application dataset has a high dropout rate and has features to suggest informativeness of the dropout process. The estimates obtained under random effects modeling with multiple imputation were found to differ substantially from those obtained by methods devised to handle informative dropouts.
Algorithms↗
Longitudinal effects of estrogen replacement therapy on PET cerebral blood flow and cognition.
Observational studies suggest that estrogen replacement therapy (ERT) may protect against age-related memory decline and lower the risk of Alzheimer's disease (AD). This study aimed to characterize the neural substrates of those effects by comparing 2-year longitudinal changes in regional cerebral blood flow (rCBF) in 12 ERT users and 16 nonusers. Positron emission tomography (PET) measurements of rCBF were obtained under three conditions: rest, and verbal and figural recognition memory tasks. Groups showed different patterns of change in rCBF over time in a number of brain areas. These group differences, for the most part, reflected regions of increased rCBF over time in users compared to nonusers. The greatest differences between ERT users and nonusers were in the hippocampus, parahippocampal gyrus, and temporal lobe, regions that form a memory circuit and that are sensitive to preclinical AD. Across a battery of standardized neuropsychological tests of memory, users obtained higher scores than did nonusers of comparable intellect. Group differences in longitudinal change in rCBF patterns may reflect one way through which hormones modulate brain activity and contribute to enhanced memory performance among ERT users.
Aged↗
Genetic evidence that advanced COVID-19 accelerates longitudinal brain atrophy: A Mendelian randomization study.
Coronavirus disease 2019 (COVID-19) was reported to persist long-term in the brain and leave several long-term neurologic sequelae. However, the causal relationship between COVID-19 and brain aging is still unknown. The genome-wide association study (GWAS) data on COVID-19 phenotypes (susceptibility, hospitalization, and severity), involving a total of 5,779,391 participants, were collected from the COVID-19 Host Genetics Initiative. In addition, GWAS data on longitudinal changes in 15 brain structures, assessed via magnetic resonance imaging across the lifespan, were sourced from the ENIGMA Consortium and involved 15,640 participants. Two-sample Mendelian randomization was conducted to infer the causal relationship between COVID-19 and longitudinal brain changes. Multi-trait GWAS meta-analysis, colocalization, and fine-mapping analyses were performed to identify shared genetic etiologies. H3K27me3 ChIP-seq was used to evaluate the regulatory effect of colocalized loci. Two-step Mendelian randomization was applied to explore potential mediating mechanisms across multi-omics layers, including proteomics, metabolomics, and immunomics. Our results showed that COVID-19 hospitalization (β = -262.405, P = .041) and severity (β = -177.676, P = .049) were genetically associated with atrophied volume of total brain during longitudinal change. This suggests that individuals with advanced COVID-19 may be more susceptible to accelerated global brain aging. Caudate was genetically affected by all COVID-19 phenotypes. Seven variants were shared between advanced COVID-19 and global brain aging. rs117169628 was colocalized between advanced COVID-19 and global brain aging, and exerted an inhibitory effect on CDH15 expression, further strengthening the causality. Six metabolites, 1 protein, and 1 immune trait were identified as potential mediators. Our study indicates that advanced COVID-19 might be genetically associated with accelerated brain aging. Brain health should be paid more attention in long COVID-19.
Humans↗
Comorbidities in stroke patients as assessed with a newly developed comorbidity scale.
We previously reported reliability and validity of our newly developed comorbidity scale (CS) for stroke outcome research based on a retrospective sample. The objectives of this study were to cross-validate the comorbidity scale in a new prospective sample and to investigate longitudinal changes of the comorbidity scale during hospitalization. In a prospective sample of 175 stroke patients admitted to five nonacute rehabilitation hospitals in Japan, we analyzed the frequency and grading of comorbidities and compared the comorbidity scale with demographic data, impairment as assessed with the Stroke Impairment Assessment Set (SIAS), and disability as measured with the Functional Independence Measure (FIM(SM)). The results were compared with our previous retrospective study. We also studied longitudinal changes by measuring the comorbidity scale on admission, 2 wk later, and at discharge of 67 patients. As a result, the comorbidity scaling was significantly lower in the prospective sample, and it increased at the second measurement and then plateaued. Among the comorbidities, hypertension ranked first, followed by shoulder pain, and diabetes mellitus. Similar to our previous retrospective study, the comorbidity scale correlated positively with age and length of stay and correlated negatively with the SIAS motor item scores and the FIM scores. In conclusion, the present study suggested concurrent and predictive validity of the comorbidity scale in a prospective sample as well and clarified the comorbidity characteristics of stroke inpatients.
Activities of Daily Living↗
Plasminogen activator inhibitor-1 4G/5G genetic polymorphism does not affect peritoneal transport characteristic.
There is evidence that type 1 plasminogen activator inhibitor (PAI-1) may have an important role in peritoneal function. We studied the effect of physiologically relevant PAI-1 promotor polymorphisms on peritoneal permeability. We performed a standard peritoneal equilibration test (PET) in 100 new continuous ambulatory peritoneal dialysis (CAPD) patients. We studied another 48 prevalent CAPD patients who had a baseline PET performed 2 years before; a standard PET was repeated on enrollment. The PAI-1 promotor polymorphism was examined. All patients then were followed up for 16.7 +/- 15.0 months. Prevalences of 4G/4G, 4G/5G, and 5G/5G genotypes were 31.8%, 46.6%, and 21.6%, respectively. Of the 100 new CAPD patients, there was no difference in net ultrafiltration (UF), dialysate-plasma (D/P) creatinine ratio at 4 hours, or mass transfer area coefficient (MTAC) of creatinine among the three genotype groups. D/P creatinine ratios at 4 hours were 0.595 +/- 0.133, 0.607 +/- 0.137, and 0.627 +/- 0.142 for the 4G/4G, 4G/5G, and 5G/5G groups, respectively (one way analysis of variance, P = 0.715). Of the 48 prevalent patients, PAI-1 genotype did not affect the longitudinal change in net UF, D/P creatinine ratio at 4 hours, or MTAC of creatinine. During follow-up, 16 patients developed peritonitis episodes that required Tenckhoff catheter removal. One patient died, 8 patients returned to long-term CAPD therapy after peritonitis resolved, and the other 7 patients developed peritoneal failure and were switched to long-term hemodialysis therapy. PAI-1 promotor genotype did not predict peritoneal failure after an episode of severe peritonitis (chi-square test, P = 0.328). We conclude that PAI-1 promotor polymorphism is not associated with peritoneal transport characteristics in stable peritoneal dialysis patients, longitudinal change in peritoneal transport, or development of peritoneal failure after an episode of severe peritonitis.
Biological Transport↗
[Smoking and asthma].
Cigarette smoking is a well-known health hazard, probably not least for patients suffering from asthma. This review gives a short overview of the effects of passive and active smoking on the inception and outcome with of longitudinal changes in the lung function and mortality of patients with asthma. Substantial evidence suggests that smoking affects asthma adversely. Exposure to environmental tobacco smoke, especially maternal smoking in children, may be a significant risk factor for asthma. Such exposure in patients with established asthma is not only associated with more severe symptoms, but also with a poorer quality of life, reduced lung function, and increased utilisation of health care including hospital admissions. Active smoking does not appear to be a significant risk factor for asthma, but is associated with a worse outcome with regard to both longitudinal changes in lung function and asthma-related mortality. Based on current knowledge, it is therefore of utmost importance to encourage patients with asthma not to smoke, and accordingly these patients should be given full support in their right to a smoke-free environment.
Asthma↗
A longitudinal study of behavioral pathology across five levels of dementia severity in Alzheimer's disease: the CERAD Behavior Rating Scale for Dementia. The Alzheimer's Disease Cooperative Study.
As part of the Alzheimer's Disease Cooperative Study (ADCS) Instrument Development Project, the CERAD Behavior Rating Scale for Dementia (BRSD) was examined for its sensitivity to degree of cognitive impairment, its test-retest reliability, and its sensitivity to longitudinal change. Sixty-four normal elderly participants and 261 patients with AD stratified into severity groups based on Mini-Mental State Exam (MMSE) scores were rated on the BRSD at baseline and 12-month follow-up visits. A subset of subjects was evaluated at a 1-month follow-up visit. Baseline BRSD Total Score discriminated the normal group from each AD group, and mean Total Score significantly increased with increasing dementia severity. Test-retest reliability between baseline and 1-month Total Scores was satisfactory for all AD groups. Longitudinal change was evaluated by 12-month change scores, which were significant in only the normal and in one AD group. From the results, we argue that the value of behavioral pathology assessment in clinical trials would be enhanced if additive scores were based on groups of correlated items rather than on a broad array of behaviors, some of which may increase and others may decrease in frequency as AD progresses.
Aged↗
Mandibular alveolar bone mass, structure and thickness in relation to skeletal bone density in dentate women.
The aim of this series of studies was to investigate the relationship between skeletal bone mineral density (BMD) and mandibular alveolar bone mass (MABM), structure, and thickness, as well as to evaluate the possible effect of local functional factors on MABM and alveolar thickness. A further aim was to elucidate whether longitudinal changes in mandibular radiographic characteristics and the bucco-lingual dimension of the alveolar process were related to alterations of BMD. BMD was measured in 160 dentate women using dual X-ray absorptiometry of the forearm. On periapical radiographs MABM was estimated using densitometry and the grey-level value. The alveolar bone structure was evaluated with a visual index and by examining the bone texture on periapical radiographs. The thickness of the masseter was assessed with ultrasound imaging to estimate the masticatory functional factor, and the bucco-lingual alveolar thickness was measured on casts. MABM and alveolar structure were significantly correlated to BMD. The best correlation was found between BMD and trabecular pattern evaluated with the visual index (r = 0.62, p < 0.001). The alveolar thickness was correlated to BMD, and to masseter thickness. MABM was influenced of age, the alveolar thickness, the number of occluding teeth, and the masseter muscle thickness but these factors had no effect on the trabecular structure. After five years, all measurements except the ultrasound imaging of the masseter muscle were repeated in 136 women. The mean BMD, MABM, and alveolar thickness decreased significantly during this period, whereas no significant change was found in the bone structure. In posterior region, the alterations in alveolar bone thickness, radiographic grey-level value, and bone texture were significantly correlated to the changes in BMD. In the anterior region, the alterations in alveolar thickness were not correlated with the changes in BMD. Furthermore, no correlation was found between alterations in MABM, estimated by densitometry, and changes in BMD. In conclusion, a significant relationship exists between BMD and mandibular alveolar bone mass, structure, and thickness. The local functional factors mainly influence MABM and the alveolar thickness in the molar region, whereas BMD influences the trabecular structure. Dense trabeculation is a strong indicator of high BMD, whereas sparse trabeculation predicts low bone mass. In peri- and postmenopausal women the alveolar shape in the premolar region can be used to predict BMD level. In the lower premolar region, the longitudinal alterations in BMD are related to longitudinal changes in grey-level value, bone texture and alveolar thickness. The decrease in bucco-lingual alveolar thickness may be due to periosteal resorption related to skeletal bone loss.
Absorptiometry, Photon↗
Response of cortical bone to antiresorptive treatment.
A total of 113 postmenopausal women (69 controls, 33 using hormone replacement therapy (HRT), and 11 using bisphosphonate) were evaluated twice over 2 years with a new noninvasive, radiogrammetry-based technique called digital X-ray radiogrammetry (DXR) and conventional bone densitometry of the spine, hip, and forearm. Longitudinal changes in bone densitometry were compared with changes captured by DXR: BMD evaluated by DXR (BMDDXR), cortical thickness of the second metacarpal (CTMC2), and porosity of cortical bone. The expected annual postmenopausal reduction in BMD in the control group was detected by BMDspine (-0.8%, P < 0.01), BMDhip (-1.6%, P < 0.001), BMDforearm (-1.5%, P < 0.001), DXR-BMD (-0.8%, P < 0.001), and CTMC2 (-1.1%, P < 0.001). In the HRT group, smaller reductions were seen in BMDDXA, but only significant at the hip (-1.0%, P < 0.01) and distal forearm (-1.0%, P < 0.02). In the bisphosphonate group, cortical porosity was significantly reduced (P < 0.025). Comparing longitudinal changes in age-matched subsamples of controls and bisphosphonate treated, BMDDXR, CTMC2, and porosity of cortical bone all differed significantly (P < 0.01, P < 0.05, P < 0.05, respectively), whereas the BMDDXA measurements did not. In conclusion, DXR provides a densitometry equivalent measurement of the distal forearm and hand and seems to offer new information on the porosity of cortical bone. This may prove useful in the evaluation of bone loss and offer new insight into the effects of different antiresorptive treatment regimens used in the prevention of osteoporosis.
Absorptiometry, Photon↗