The prevalence of metabolic syndrome parameters and their association with headache characteristics among migraineurs

Background: Migraine is associated with metabolic syndrome (MetS). There are evidences that components of MetS are more prevalent among migraine patients than non migraineurs. Since both migraine and MetS are associated with a high risk of cardiovascular events, it is likely that the parameters of MetS increase the occurrence of cardiovascular disease (CVD) in migraineurs. The present research project was conducted for the purpose of investigating the relationship between MetS parameters and different items of migraine headaches. Methods: This descriptive-analytical, cross-sectional study was performed on 240 migraineurs [according to International Headache Society (HIS) II criteria] within the 17+ age range. The participants were selected via consecutive and convenience sampling method. The evaluated parameters for each subject included 2 arms: migraine characteristics (intensity, frequency of attacks, subtype, duration, and treatment regimen) and indices of MetS according to the National Cholesterol Education Program’s Adult Treatment Panel III (NCEP ATP-III) report criteria [high-density lipoprotein-cholesterol (‎HDL-C), triglyceride (TG), fasting plasma glucose (FPG), height, waist circumference (WC), systolic and diastolic blood pressure (BP), and body mass index (BMI)]. All data were analyzed in SPSS software. Results: Total prevalence of MetS was 16.25% (39 patients). There was a statistically meaningful relationship between hypertriglyceridemia and gender (P = 0.021), hypertriglyceridemia and prophylactic antimigraine regimen (P = 0.022), hyperglycemia and age group (P = 0.010), hyperglycemia and the intensity of headache (P = 0.048), hyperglycemia and prophylactic treatment (P = 0.001), systolic hypertension and migraine subtype (P = 0.004), systolic hypertension and the duration of migraine disease (P = 0.005), diastolic hypertension and migraine subtype (P = 0.002), WC and gender (P = 0.001), WC and the intensity of headache (P = 0.028), WC and prophylactic medication (P = 0.017), HDL and gender (P = 0.001), HDL and the prophylactic regimen (P = 0.023), and MetS and gender (P = 0.005). The prevalence of MetS was increased with increase in the severity of migraine headache. Conclusion: Due to the relative increase in the prevalence of MetS in patients with more severe migraine, an evaluation of the mechanisms of MetS is recommended in this population.

Using Adaptive Capacity to Shift Absorptive Capacity: A Framework of Water Reallocation in Highly Modified Rivers

Damming and water regulation creates highly modified rivers with limited ecosystem integrity and resilience. This, coupled with an ongoing global biodiversity crisis, makes river restoration a priority, which requires water reallocation. Coupled human–natural systems research provides a suitable lens for integrated systems’ analysis but offers limited insight into the governance processes of water reallocation. Therefore, we propose an analytical framework, which combines insight from social–hydrological resilience and water reallocation research, and identifies the adaptive capacity in highly modified rivers as the capacity for water reallocation. We test the framework by conducting an analysis of Sweden, pre- and post-2019, a critical juncture in the governance of the country’s hydropower producing rivers. We identify a relative increase in adaptive capacity post- 2019 since water reallocation is set to occur in smaller rivers and tributaries, while leaving large-scaled rivers to enjoy limited water reallocation, or even increased allocation to hydropower. We contend that the proposed framework is broad enough to be of general interest, yet sufficiently specific to contribute to the construction of middle-range theories, which could further our understanding of why and how governance processes function, change, and lead to outcomes in terms of modified natural resource management and resilience shifts.

The Global Spread of Severe Obesity in Toddlers, Children and Adolescents – a Systematic Review & Meta Analysis

Introduction: Severe obesity among children and adolescents has emerged as a public health concern in multiple places around the world. Methods: We searched the Medline database for articles on severe obesity rates in children published between January 1960 and January 2020. For studies with available prevalence rates for an early and a more recent time period, the relative increase in prevalence was imputed. Results: In total, 874 publications were identified, of which 38 contained relevant epidemiological data. Rates of severe obesity varied significantly according to age, gender, geographic area, and the definition of severe obesity. The highest rates of class II and III obesity in the US according to the Centers of Disease Control cutoff were 9.5% and 4.5%, respectively. Seventeen studies reported prevalence rates in at least two time periods. Data for 9,190,718 individuals showed a 1.71 (95%CI, 1.53-1.90) greater odds for severe obesity in 2006-2017 (N=5,029,584) vs. 1967-2007 (N=4,161,134). In an analysis limited to studies from 1980s’ with a minimum follow-up of 20 years, a 9.16(95%CI, 7.76-10.80) greater odds for severe obesity in recent vs. earlier time was found. An analysis limited to studies from 2000, with a follow-up of 5-15 years, a 1.09 (95%CI, 0.99-1.20) greater odds was noted when comparing (2011-2017; N=4,991,831) vs. (2000-2011; N=4,134,340). Conclusion: Severe pediatric obesity is escalating with a marked increase from the1980’s and a slower rate from 2000.

Classifying European cigarette consumption trajectories from 1970 to 2015

ObjectivesTo systematically code and classify longitudinal cigarette consumption trajectories in European countries since 1970.DesignBlinded duplicate qualitative coding of periods of year-over-year relative increase, plateau, and decrease of national per capita cigarette consumption and categorisation of historical cigarette consumption trajectories based on longitudinal patterns emerging from the data.Setting41 countries or former countries in the European region for which data are available between 1970 and 2015.ResultsRegional trends in longitudinal consumption patterns identify stable or decreasing consumption throughout Northern, Western and Southern European countries, while Eastern and Southeastern European countries experienced much greater instability. The 11 emergent classes of historical cigarette consumption trajectories were also regionally clustered, including a distinctive inverted U or sine wave pattern repeatedly emerging from former Soviet and Southeastern European countries.ConclusionsThe open-access data produced by this study can be used to conduct comparative international evaluations of tobacco control policies by separating impacts likely attributable to gradual long-term trends from those more likely attributable to acute short-term events. The complex, regionally clustered historical trajectories of cigarette consumption in Europe suggest that the enduring normative frame of a gently sloping downward curve in cigarette consumption can offer a false sense of security among policymakers and can distract from plausible causal mechanisms among researchers. These multilevel and multisectoral causal mechanisms point to the need for a greater understanding of the political economy of regional and global determinants of cigarette consumption.

Forecasting COVID-19 infection trends and new hospital admissions in England due to SARS-CoV-2 Variant of Concern Omicron

Objectives: On November 26, 2021, WHO designated the variant B.1.1.529 as a new SARS-CoV-2 variant of concern (VoC), named Omicron, originally identified in South Africa. Several mutations in Omicron indicate that it may have an impact on how it spreads, resistance to vaccination, or the severity of illness it causes. We used our previous modelling algorithms to forecast the spread of Omicron in England. Design: We followed EQUATOR TRIPOD guidance for multivariable prediction models. Setting: England. Participants: Not applicable. Interventions: Non-interventional, observational study with a predicted forecast of outcomes. Main outcome measures: Trends in daily COVID-19 cases with a 7-day moving average and of new hospital admissions. Methods: Modelling included a third-degree polynomial curve in existing epidemiological trends on the spread of Omicron and a new Gaussian curve to estimate a downward trend after a peak in England. Results: Up to February 15, 2022, we estimated a projection of 250,000 COVID-19 daily cases of Omicron spread in the worse scenario, and 170,000 in the best scenario. Omicron might represent a relative increase from the background daily rates of COVID-19 infection in England of mid December 2021 of 1.9 to 2.8-fold. With a 5-day lag-time, daily new hospital admissions would peak at around 5,063 on January 23, 2022 in the worse scenario. Conclusion: This warning of pandemic surge of COVID-19 due to Omicron is calling for further reinforcing in England and elsewhere of universal hygiene interventions (indoor ventilation, social distance, and face masks), and anticipating the need of new total or partial lockdowns in England.

Gênero e hidratação como mediadores relevantes para restauração de processos inflamatórios em atletas jovens

Objetivos: Poucos estudos tem dado a devida importância ao estado de hidratação e as alterações hematológicas em menores de 18 anos. O presente estudo investigou estas alterações em menores de 18 anos na prova de 3000 metros para ambos os gêneros. Método: Foram incluídos os seis melhores participantes das Olimpíadas Nacionais do Ensino Médio (menores de 18 anos) no Brasil. Trata-se de um estudo observacional e transversal. Os atletas correram 3.000 metros em uma pista oval de 400 metros. Foi realizado leucograma total e específico, eritrograma e contagem de plaquetas em quatro diferentes tempos (jejum, pré, pós e recuperação). Os cálculos de comparação entre tempos, apresentados, foram adaptados do modelo matemático de variação percentual. Resultados: Quando comparadas as médias em relação a cada tempo, pode-se notar que os eritrócitos, hemoglobina, hematócrito, leucócitos totais e basófilos aumentaram significativamente após a corrida para ambos os gêneros. Além disso, as plaquetas também aumentaram para ambos os gêneros sem significância. O coeficiente de correlação de Pearson mostrou importante interação leucócitos-plaquetas. Os homens recuperaram seu estado de hidratação em quase metade do tempo em relação as mulheres. Em relação ao sistema imune e resposta inflamatória, as atletas do gênero feminino tiveram um aumento relativo de mais que o dobro para leucócitos e não recuperaram estes valores, além de apresentarem um aumento de eosinófilos neste mesmo tempo, enquanto os atletas do gênero masculino apresentaram diminuição. As mulheres apresentaram um aumento de quase o dobro para linfócitos, enquanto os homens tiveram este comportamento para os fagócitos. Conclusões: O exercício induz alteração do estado de hidratação e sistema imune, tendo diferenças em relação ao gênero. Quando bem conduzido, gera efeitos antiinflamatórios a longo prazo. Quando não há controle sobre o volume, intensidade e recuperação pode causar imunossupressão e promover a suceptibilidade para infecções. Foi possível observar que os atletas do gênero masculino tem um menor estresse inflamatório e recuperam o seu estado de hidratação e a resposta inflamatória mais rápido que as meninas após uma corrida de 3000 metros. Objectives: Few studies have given due importance to the hydration status and hematological alterations in children under 18 years of age. The present study investigated these alterations in children under 18 years old in the 3000 meters test for both genders. Method: The six best participants of Brazil's National High School Olympiads (under 18 years old) were included. This is an observational and cross-sectional study. Athletes ran 3,000 meters on a 400 meters oval track. Total and specific white blood cell count, erythrogram, and platelet count were performed four times (fasting, pre, post, and recovery). The time comparison calculations presented were adapted from the percentage variation mathematical model. Results: When comparing the means for each time, it can be noted that erythrocytes, hemoglobin, hematocrit, total leukocytes, and basophils increased significantly after the race for both genders. Furthermore, platelets also increased for both genders without significance. Pearson's correlation coefficient showed a significant leukocyte-platelet interaction. Men regained their hydration status in almost half the time compared to women. Regarding the immune system and inflammatory response, female athletes had a relative increase of more than double for leukocytes and did not recover these values, in addition to showing an increase in eosinophils simultaneously, while male athletes showed a decrease. Women showed an increase of almost double for lymphocytes, while men showed this behavior for phagocytes. Conclusions: Exercise induces changes in hydration status and immune system, with differences concerning gender. When done well, it generates long-term anti-inflammatory effects. When there is no control over volume, intensity, and recovery, it can cause immunosuppression and increase infection susceptibility. It was observed that male athletes have lower inflammatory stress and recover their hydration status and inflammatory response faster than girls after a 3000 meter run.

Anopheles salivary antigens as serological biomarkers of vector exposure and malaria transmission: A systematic review with multilevel modelling

<b>Background:</b> Entomological surveillance for malaria is inherently resource-intensive and produces crude population-level measures of vector exposure which are insensitive in low-transmission settings. Antibodies against Anopheles salivary proteins measured at the individual-level may serve as proxy biomarkers for vector exposure and malaria transmission, but their relationship is yet to be quantified. <b>Methods:</b> A systematic review of studies measuring antibodies against Anopheles salivary antigens (PROSPERO: CRD42020185449). Multilevel modelling (to account for multiple study-specific observations (level-one), nested within study (level-two), and study nested within country (level-three)) estimated associations between seroprevalence with Anopheles human biting rate (HBR) and malaria transmission measures. <b>Results:</b> From 3981 studies identified in literature searches, 42 studies across 16 countries were included contributing 393 study-specific observations of anti-Anopheles salivary antibodies determined in 42,764 samples. A positive association between HBR (log transformed) and seroprevalence was found; overall a 2-fold (100% relative) increase in HBR was associated with a 23% increase in odds of seropositivity (OR: 1.23, 95%CI: 1.10-1.37, p<0.001). The association between HBR and Anopheles salivary antibodies was strongest with concordant, rather than discordant Anopheles species. Seroprevalence was also significantly positively associated with established epidemiological measures of malaria transmission: entomological inoculation rate, Plasmodium spp. prevalence, and malarial endemicity class. <b>Conclusions:</b> Anopheles salivary antibody biomarkers can serve as a proxy measure for HBR and malaria transmission, and could monitor malaria receptivity of a population to sustain malaria transmission. Validation of Anopheles species-specific biomarkers are important given the global heterogeneity in the distribution of Anopheles species. Salivary biomarkers have the potential to transform surveillance by replacing impractical, inaccurate entomological investigations, especially in areas progressing towards malaria elimination. <b>Funding:</b> Australian National Health and Medical Research Council, Wellcome Trust.

Microdosimetric Investigation and a Novel Model of Radiosensitization in the Presence of Metallic Nanoparticles

Auger cascades generated in high atomic number nanoparticles (NPs) following ionization were considered a potential mechanism for NP radiosensitization. In this work, we investigated the microdosimetric consequences of the Auger cascades using the theory of dual radiation action (TDRA), and we propose the novel Bomb model as a general framework for describing NP-related radiosensitization. When triggered by an ionization event, the Bomb model considers the NPs that are close to a radiation sensitive cellular target, generates dense secondary electrons and kills the cells according to a probability distribution, acting like a “bomb.” TDRA plus a distance model were used as the theoretical basis for calculating the change in α of the linear-quadratic survival model and the relative biological effectiveness (RBE). We calculated these quantities for SQ20B and Hela human cancer cells under 250 kVp X-ray irradiation with the presence of gadolinium-based NPs (AGuIXTM), and 220 kVp X-ray irradiation with the presence of 50 nm gold NPs (AuNPs), respectively, and compared with existing experimental data. Geant4-based Monte Carlo (MC) simulations were used to (1) generate the electron spectrum and the phase space data of photons entering the NPs and (2) calculate the proximity functions and other related parameters for the TDRA and the Bomb model. The Auger cascade electrons had a greater proximity function than photoelectric and Compton electrons in water by up to 30%, but the resulting increases in α were smaller than those derived from experimental data. The calculated RBEs cannot explain the experimental findings. The relative increase in α predicted by TDRA was lower than the experimental result by a factor of at least 45 for SQ20B cells with AGuIX under 250 kVp X-ray irradiation, and at least four for Hela cells with AuNPs under 220 kVp X-ray irradiation. The application of the Bomb model to Hela cells with AuNPs under 220 kVp X-ray irradiation indicated that a single ionization event for NPs caused by higher energy photons has a higher probability of killing a cell. NPs that are closer to the cell nucleus are more effective for radiosensitization. Microdosimetric calculations of the RBE for cell death of the Auger electron cascade cannot explain the experimentally observed radiosensitization by AGuIX or AuNP, while the proposed Bomb model is a potential candidate for describing NP-related radiosensitization at low NP concentrations.

Impact of the early COVID-19 pandemic on outcomes in a rural Ugandan neonatal unit: A retrospective cohort study

Background During the early COVID-19 pandemic travel in Uganda was tightly restricted which affected demand for and access to care for pregnant women and small and sick newborns. In this study we describe changes to neonatal outcomes in one rural central Ugandan newborn unit before and during the early phase of the COVID-19 pandemic. Methods We report outcomes from admissions captured in an electronic dataset of a well-established newborn unit before (September 2019 to March 2020) and during the early COVID-19 period (April–September 2020) as well as two seasonally matched periods one year prior. We report excess mortality as the percent change in mortality over what was expected based on seasonal trends. Findings The study included 2,494 patients, 567 of whom were admitted during the early COVID-19 period. During the pandemic admissions decreased by 14%. Patients born outside the facility were older on admission than previously (median 1 day of age vs. admission on the day of birth). There was an increase in admissions with birth asphyxia (22% vs. 15% of patients). Mortality was higher during COVID-19 than previously [16% vs. 11%, p = 0.017]. Patients born outside the facility had a relative increase of 55% above seasonal expected mortality (21% vs. 14%, p = 0.028). During this period patients had decreased antenatal care, restricted transport and difficulty with expenses and support. The hospital had difficulty with maternity staffing and supplies. There was significant community and staff fear of COVID-19. Interpretation Increased newborn mortality during the early COVID-19 pandemic at this facility was likely attributed to disruptions affecting maternal and newborn demand for, access to and quality of perinatal healthcare. Lockdown conditions and restrictions to public transit were significant barriers to maternal and newborn wellbeing, and require further focus by national and regional health officials.

Hormonal Regulatory Patterns of LaKNOXs and LaBEL1 Transcription Factors Reveal Their Potential Role in Stem Bulblet Formation in LA Hybrid Lily

In lily reproduction, the mechanism of formation of bulbs has been a hot topic. However, studies on stem bulblet formation are limited. Stem bulblets, formed in the leaf axils of under- and above-ground stems, provide lilies with a strong capacity for self-propagation. First, we showed that above-ground stem bulblets can be induced by spraying 100 mg/L 6-BA on the LA hybrid lily ‘Aladdin’, with reduced endogenous IAA and GA4 and a higher relative content of cytokinins. Then, expression patterns of three potential genes (two KNOTTED1-like homeobox (KNOX) and one partial BEL1-like homeobox (BELL)), during stem bulblet formation from our previous study, were determined by RT-qPCR, presenting a down-up trend in KNOXs and a rising tendency in BELL. The partial BELL gene was cloned by RACE from L. ‘Aladdin’ and denoted LaBEL1. Physical interactions of LaKNOX1-LaBEL1 and LaKNOX1-LaKNOX2 were confirmed by yeast two-hybrid and bimolecular fluorescence complementation assays. Furthermore, hormonal regulatory patterns of single LaKNOX1, LaKNOX2, LaBEL1, and their heterodimers, were revealed in transgenic Arabidopsis, suggesting that the massive mRNA accumulations of LaKNOX1, LaKNOX2 and LaBEL1 genes during stem bulblet formation could cause the dramatic relative increase of cytokinins and the decline of GAs and IAA. Taken together, a putative model was proposed that LaKNOX1 interacts with LaKNOX2 and LaBEL1 to regulate multiple phytohormones simultaneously for an appropriate hormonal homeostasis, which suggests their potential role in stem bulblet formation in L. ‘Aladdin’.