Prevalence of thinness, overweight, obesity and central obesity in Finnish school-aged children: a comparison of national and international reference values

Introduction: The global epidemic of obesity concerns children, and monitoring the prevalence is of highest priority. Body mass index (BMI) with age- and sex-specific cut-off values determine weight status in children, although multiple reference systems exist. Our aim was to compare the prevalence for thinness, normal weight, overweight and obesity in Finnish school-aged children according to national and international reference values, as well as to determine which cut-off values for overweight agree with the criteria for central obesity. Methods: This study includes 10 646 children aged 9─12 years from the Finnish Health in Teens (Fin-HIT) cohort. Height, weight and waist circumference were measured in 2011─2014. BMI (weight [kg]/height [m]2) and waist-to-height ratio (WHtR; waist [cm]/height [cm]) were calculated. The WHtR cut-off of > 0.5 indicated central obesity. We compared the sex-specific prevalence of thinness, overweight and obesity using the International Obesity Task Force (IOTF), World Health Organization (WHO) and Finnish (FIN) BMI-for-age reference values, as well as these three against central obesity based on WHtR. Results: The prevalence of thinness, overweight and obesity were 11.0%, 12.7% and 2.6%, respectively, using IOTF; 2.6%, 15.9% and 5.2% using WHO; and 5.1%, 11.4% and 2.2% using FIN. Overweight and obesity were more common in boys than girls using WHO and FIN, while thinness more common in girls using IOTF and FIN. IOTF versus WHO exhibited moderate agreement (κ = 0.59), which improved for IOTF versus FIN (κ = 0.74). Of those classified as overweight by WHO, 37% and 47% were regarded as normal weight according to IOTF and FIN, respectively. The prevalence of central obesity was 8.7%, and it was more common in boys than girls. WHO provided the highest sensitivity: 95% of individuals with central obesity were classified with overweight or obesity. Using FIN provided the highest specificity (93%). Conclusion: Our findings show that WHO overestimates the prevalence of overweight and obesity, while IOTF overrates thinness. Thus, comparing prevalence rates between studies requires caution. The novelty of this study is the comparison of the cut-off values for overweight with central obesity. The choice of reference system affects the generalizability of the research results.

On the Electron Temperature in the Topside Ionosphere as Seen by Swarm Satellites, Incoherent Scatter Radars, and the International Reference Ionosphere Model

The global statistical median behavior of the electron temperature (Te) in the topside ionosphere was investigated through in-situ data collected by Langmuir Probes on-board the European Space Agency Swarm satellites constellation from the beginning of 2014 to the end of 2020. This is the first time that such an analysis, based on such a large time window, has been carried out globally, encompassing more than half a solar cycle, from the activity peak of 2014 to the minimum of 2020. The results show that Swarm data can help in understanding the main features of Te in the topside ionosphere in a way never achieved before. Te data measured by Swarm satellites were also compared to data modeled by the empirical climatological International Reference Ionosphere (IRI) model and data measured by Jicamarca (12.0°S, 76.8°W), Arecibo (18.2°N, 66.4°W), and Millstone Hill (42.6°N, 71.5°W) Incoherent Scatter Radars (ISRs). Moreover, the correction of Swarm Te data recently proposed by Lomidze was applied and evaluated. These analyses were performed for two main reasons: (1) to understand how the IRI model deviates from the measurements; and (2) to test the reliability of the Swarm dataset as a new possible dataset to be included in the underlying empirical dataset layer of the IRI model. The results show that the application of the Lomidze correction improved the agreement with ISR data above all at mid latitudes and during daytime, and it was effective in reducing the mismatch between Swarm and IRI Te values. This suggests that future developments of the IRI Te model should include the Swarm dataset with the Lomidze correction. However, the existence of a quasi-linear relation between measured and modeled Te values was well verified only below about 2200 K, while for higher values it was completely lost. This is an important result that IRI Te model developers should properly consider when using the Swarm dataset.

The role of the laboratory in disease surveillance

Laboratory information is critical for disease surveillance and control programmes. Before an outbreak, laboratory-supported surveillance allows early detection of cases. During an outbreak a sample of cases should be laboratory confirmed to assess changes in the etiological agent and to guide decisions about the allocation of resources. Support is provided by laboratories of differing capabilities. Field laboratories are useful in areas where resources are limited or nonexistent. More complete testing is usually done in regional laboratories. International reference laboratories may identify rare or dangerous pathogens, identify newly described organisms, and provide uncommon diagnostic reagents. Laboratory information must be accurate, timely and subjected to quality assurance procedures

Prediction Equation for Spirometric Parameters in Cairo Governorate Adult Population

Context: Spirometry is the most common one used in assessing, diagnosing, and managing patients with different lung diseases. Prediction equations developed in one set of the population may not apply to a different set of populations. Aim: This work aimed to develop prediction equations for spirometry pulmonary function parameters in a sample of the adult Egyptian population in the Cairo governorate. The secondary aim was to compare our derived equations of pulmonary function with international reference figures used in our spirometric lab facilities. Methods: This observational cross-sectional population-based study was carried out at Embaba Chest Hospital upon 610 normal healthy subjects, aged between 20 - 45 years old. All subjects were subjected to history, clinical examination, and pulmonary function tests. These subjects were randomly selected in a cluster from registration records in different official health care facilities or community health centers. Subjects from records were invited by calling through land phone, cell phone, or e-mails. This study compared the international reference figures of mean predicted spirometry values with our derived predicted values of lung function parameters. Results: The predicted equations for FEV1 were [(3.429+(-0.028*Age)+(-0.017*weight)+(0.018*height)], and [1.238+(-0.005*Age)+(-0.006*weight)+(0.014*height)] for males and females respectively. The predicted equations for FVC were [4.556+(-0.016*Age)+(-0.012*weight)+(0.01*height)], and [2.494+(-0.009*Age)+(-0.005*weight)+(0.0100*height)] for males and females respectively. It was found that the Egyptian predicted mean values were within the lower limit of normal LLN and upper limit normal ULN when each of these prediction equations was used. These results were higher than US population with regards to FEV1 4.089(0.498) Vs 3.88(0.04) [p<0.001] in males, but non-significant in females 2.865 (0.171) Vs2.85 (0.33) [p0.449]. FVC was found statistically higher in Egyptian population in female gender 3.513(0.164) Vs 3.36(0.33) [p<0.001] and non-significant difference in males 4.743(0.31) Vs 4.74(0.36) [p0.932] compared to US population. Besides, there were considerable differences between Omani and Jordanian populations and Egyptian populations, on the other hand regarding FEV1 and FEF 25-75% in the male gender. Conclusion: The Linear regression equations had a direct linear correlation with height and inverse linear correlation with age. The implemented reference values utilized in our lab's facilities are particularly suited with the present study’s derived predicted lung function equation. In addition, equations had diverse determination coefficients from those reported by authors in adult Omani and Jordanian populations.

A Global Empirical Model of the Ion Temperature in the Ionosphere for the International Reference Ionosphere

This study presents a suggestion for improvement of the ion temperature (Ti) model in the International Reference Ionosphere (IRI). We have re-examined ion temperature data (primarily available from NASA’s Space Physics Data Facility (SPDF)from older satellites and combined them with newly available data from the Defense Meteorological Satellite Program (DMSP), the Communication Navigation Outage Forecasting System (C/NOFS), and from the recently launched Ionospheric Connection Explorer (ICON). We have compiled these data into a unified database comprising in total Ti data from 18 satellites. By comparisons with long term records of ion temperature from the three incoherent scatter radars (ISRs) (Jicamarca, Arecibo, and Millstone Hill), it was found that an intercalibration is needed to achieve consistency with the ISR data and among individual satellite data sets. This database with thus corrected data has been used for the development of a new global empirical model of Ti with inclusion of solar activity variation. This solar activity dependence is represented by an additive correction term to the Ti global pattern. Due to the limited data coverage at altitudes above 1000 km, the altitude range described by the model ranges from 350 km to 850 km covering only the region where generally Ti is higher than the neutral temperature (Tn) and lower than the electron temperature (Te). This approach is consistent with the current description of Ti in the IRI model. However, instead of one anchor point at 430 km altitude as in the current IRI, our approach includes anchor points at 350, 430, 600, and 850 km. At altitudes above 850 km Ti is merged using a gradient derived from the model at 600 and 850 km, with the electron temperature described by the IRI-2016/TBT-2012 option. Comparisons with the ISR data (Jicamarca, Arecibo, Millstone Hill, and Kharkiv) for high and low solar activity and equinox show that the proposed Ti model captures local time variation of Ti at different altitudes and latitudes better than the current IRI-2016 Ti model.

Towards a Real-Time Description of the Ionosphere: A Comparison between International Reference Ionosphere (IRI) and IRI Real-Time Assimilative Mapping (IRTAM) Models

This paper focuses on a detailed comparison, based on the F2-layer peak characteristics foF2 and hmF2, between the International Reference Ionosphere (IRI), which is a climatological empirical model of the terrestrial ionosphere, and the IRI Real-Time Assimilative Mapping (IRTAM) procedure, which is a real-time version of IRI based on data assimilation from a global network of ionosondes. To perform such a comparison, two different kinds of datasets have been considered: (1) foF2 and hmF2 as recorded by 40 ground-based ionosondes spread all over the world from 2000 to 2019; (2) foF2 and hmF2 from space-based COSMIC/FORMOSAT-3 radio occultation measurements recorded from 2006 to 2018. The aim of the paper is to understand whether and how much IRTAM improves IRI foF2 and hmF2 outputs for different locations and under different diurnal, seasonal, solar and magnetic activity conditions. The main outcomes of the study are: (1) when ionosonde observations are considered for validation, IRTAM significantly improves the IRI foF2 modeling both in accuracy and precision, while a slight improvement in the IRI hmF2 modeling is observed for specific locations and conditions; (2) when COSMIC observations are considered for validation, no noticeable improvement is observed from the IRTAM side for both foF2 and hmF2. Indeed, IRTAM can improve the IRI foF2 description only nearby the assimilated ionosonde locations, while the IRI hmF2 description is always more accurate and precise than IRTAM one.

Cardiometabolic risk factors in children and adolescents from southern Brazil: comparison to international reference values

Objectives To compare cardiometabolic risk factors of Brazilian children and adolescents with international reference values. Cardiometabolic risk factors constitute the Metabolic Syndrome, whose evaluation is important to assess pediatric populations’ health and potential to experience metabolic disorders. Methods Cross-sectional study that included 2,250 randomly selected children and adolescents (55.6% girls), aged 6 to 17. Cardiometabolic parameters (body mass index [BMI], waist circumference [WC], systolic and diastolic blood pressures [SBP and DBP], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], TC:HDL-C ratio, triglycerides [TG], glucose and peak oxygen uptake [VO2peak]), and clustered risk scores were compared to international age- and sex-specific reference values. A clustered risk score was calculated by summing the WC, glucose, SBP, TG, and the TC:HDL-C ratio Z-scores divided by five. A second clustered was calculated including VO2peak (inverted) Z-score, but divided by six. Results The clustered risk score, considering the all ages sample, was better in the Brazilian boys (−0.20 [−0.41;0.01] and −0.18 [−0.37;0.01], including or not VO2peak, respectively) but not significantly, and worse in girls (0.24 [0.05;0.43] and 0.28 [0.11;0.44], including or not VO2peak, respectively) than the international reference. Additionally, Brazilian youth had a statistically better profile in TC, LDL-C, HDL-C, TC:HDL-C ratio, and VO2peak (only girls) as well as a worse profile in BMI, WC, SBP, DBP, TG (only girls), and VO2peak (only boys). Conclusions The clustered cardiometabolic risk score (including or not VO2peak), considering the all ages sample, was better in the Brazilian boys, but not significantly, and worse in girls compared to the international reference.