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The aim is to determine the disparity between the overweight and obesity prevalence of Chinese American school-aged children and adolescents as measured by the Centers for Disease Control and Prevention (CDC) growth reference and the prevalence as measured by international and ethnic-specific-growth references.
This retrospective, cross-sectional study measured overweight and obesity prevalence among a paediatric population using the CDC, International Obesity Task Force (IOTF), World Health Organization (WHO) and an ethnic Chinese growth curve.
A community health centre in New York City, USA.
Chinese American children aged 6–17 years in 2017 (N 9160).
The overweight prevalence was 24 % (CDC), 23 % (IOTF), 30 % (WHO) and 31 % (China). The obesity prevalence was 10 % (CDC), 5 % (IOTF), 10 % (WHO) and 10 % (China). When disaggregated by age and sex, the difference was the most prominent in girls; using the China reference compared with using the CDC reference almost doubles the overweight prevalence (school-aged: 31 v. 17 %, P < 0·001, adolescent: 27 v. 14 %, P < 0·001) and the obesity prevalence (school-aged: 11 v. 5 %, P < 0·001, adolescent: 7 v. 4 %, P < 0·001).
Use of the CDC reference compared with the Chinese ethnic-specific reference results in lower overweight and obesity prevalence in Chinese American girls. Almost half of the girls who were overweight and half of the girls who were obese were not identified using the CDC reference. Using ethnic-specific references or ethnic-specific cut-points may help improve overweight identification for Chinese American children.
Introduction: Emergency Department (ED) utilization during pregnancy may be common, but data specific to universal healthcare systems like Canada are lacking, where pregnancy care is supposed to be standardized. The objective of this study was to quantify and characterize ED utilization among all Ontarian women who had a recognized pregnancy, including by trimester and within 42 days after pregnancy, and further stratified by pregnancy outcome. Methods: Utilizing provincial administrative health databases, this retrospective population-based cohort study included all recognized pregnancies in Ontario conceived between April 1, 2002 and March 31, 2017. Peri-pregnancy ED utilization was defined as any ED visit from 0-42 weeks’ gestation, or within 42 days after the end of pregnancy. Modified Poisson regression was used to generate relative risks (RR) and 95% confidence intervals (CI) for the outcome of any peri-pregnancy ED utilization in association with maternal characteristics. Results: Peri-pregnancy ED utilization occurred among 1,075,991 of 2,728,236 recognized pregnancies (39.4%), including among 35.8% of livebirths, 47.3% of stillbirths, 73.7% of miscarriages, and 84.8% of threatened abortions. There were 22,802 (0.84%) ectopic pregnancies among all pregnancies in the cohort. ED utilization peaked in the first trimester and in the first week postpartum. A dose-response effect was seen in the number of peri-pregnancy ED visits in relation to certain maternal characteristics. Women residing in rural areas had an odds ratio (OR) of 3.44 (95% CI 3.39 to 3.49) for ≥ 3 ED visits, compared to those in urban areas. Women with 3-5 (OR 1.99 95% CI 1.97-2.01), 5-6 (OR 3.55, 95% CI 3.49 to 3.61), or ≥ 7 (OR 7.59, 95% CI 7.39 to 7.78) pre-pregnancy comorbidities were more likely to have ≥ 3 peri-pregnancy ED visits than those with 0-2 comorbidities. Of all recognized pregnancies in the cohort, only 106,989 (3.9%) had an injury-related ED visit. Conclusion: Peri-pregnancy ED utilization occurs in nearly 40% of pregnancies, notably in the first trimester and immediately postpartum. Efforts are needed to streamline rapid access to ambulatory obstetrical care during these peak periods, when women are vulnerable to either a miscarriage, or a complication after a livebirth.
Acute change in mental status (ACMS), defined by the Confusion Assessment Method, is used to identify infections in nursing home residents. A medical record review revealed that none of 15,276 residents had an ACMS documented. Using the revised McGeer criteria with a possible ACMS definition, we identified 296 residents and 21 additional infections. The use of a possible ACMS definition should be considered for retrospective nursing home infection surveillance.
Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available.
Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.
We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but without PVCR-BSI was 6.67%, and mortality was 18% in patients with PVC and PVCR-BSI. The length of stay of patients with PVC but without PVCR-BSI was 4.83 days, and the length of stay was 9.85 days in patients with PVC and PVCR-BSI. Among these infections, the microorganism profile showed 58% gram-negative bacteria: Escherichia coli (16%), Klebsiella spp (11%), Pseudomonas aeruginosa (6%), Enterobacter spp (4%), and others (20%) including Serratia marcescens. Staphylococcus aureus were the predominant gram-positive bacteria (12%).
PVCR-BSI rates in INICC ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs in resource-limited countries.
In this work, we report a preliminary study, based on molecular dynamics simulations, about 3D carbon nanotube networks that could be formed inside the beta zeolites. We investigated their structural stability and mechanical properties. Our results show that from all possible carbon nanotubes that can be embedded inside the channels of the beta zeolite, the one with chirality (6,0) is the most stable. Using the carbon nanotube (6,0), it is possible to build 3D structures with both all (higher density) and only partially (lower density) filled zeolite channels. Under tensile uniaxial force, the 3D low-density carbon nanotube networks are anisotropic and can be stretched along the direction in which all nanotubes are perpendicular up to 130% of strain without fracture. Also, the porosity and network stiffness can be tuned depending on the amount of carbon nanotubes filling the channels of the zeolites.
The study area belongs to the Singhbhum metamorphic belt of Jharkhand, situated in the eastern part of India. The spatial distribution of the index minerals in the pelitic schists of the area shows Barrovian type of metamorphism. Three isograds, viz. garnet, staurolite and sillimanite, have been delineated and the textural study of the schists has revealed a time relation between crystallization and deformation. Series of folds with shifting values of plunges in the supracrustal rocks having axial-planar schistosity to the folds have been widely cited. Development of these folds could be attributed to the second phase of deformation. In total, two phases of deformation, D1 and D2, in association with two phases of metamorphism, M1 and M2, have been lined up in the study area. Chemographic plots of reactant and product assemblages corresponding to various metamorphic reactions suggest that the pattern of metamorphic zones mapped in space is in coherence with the temporal-sequential change during prograde metamorphism. The prograde P–T evolution of the study area has been obtained using conventional geothermobarometry, internally consistent winTWQ program and Perple_X software in the MnNCKFMASHTO model system. Our observations suggest that the progressive metamorphism in the area is not related to granitic intrusion or migmatization but that it was possibly the ascending plume that resulted in the M1 phase of metamorphism followed by D1 deformation. The second and prime metamorphic phase, M2, with its possible heat source generated by crustal overloading, was preceded by D1 and it lasted until late- to post-D2 deformation.
Consumption of sugar-sweetened beverages (SSB) by infants and young children are less explored in Asian populations. The Growing Up in Singapore Towards healthy Outcomes cohort study examined associations between SSB intake at 18 months and 5 years of age, with adiposity measures at 6 years of age. We studied Singaporean infants/children with SSB intake assessed by FFQ at 18 months of age (n 555) and 5 years of age (n 767). The median for SSB intakes is 28 (interquartile range 5·5–98) ml at 18 months of age and 111 (interquartile range 57–198) ml at 5 years of age. Association between SSB intake (100 ml/d increments and tertile categories) and adiposity measures (BMI standard deviation scores (sd units), sum of skinfolds (SSF)) and overweight/obesity status were examined using multivariable linear and Poisson regression models, respectively. After adjusting for confounders and additionally for energy intake, SSB intake at age 18 months were not significantly associated with later adiposity measures and overweight/obesity outcomes. In contrast, at age 5 years, SSB intake when modelled as 100 ml/d increments were associated with higher BMI by 0·09 (95 % CI 0·02, 0·16) sd units, higher SSF thickness by 0·68 (95 % CI 0·06, 1·44) mm and increased risk of overweight/obesity by 1·2 (95 % CI 1·07, 1·23) times at age 6 years. Trends were consistent with SSB intake modelled as categorical tertiles. In summary, SSB intake in young childhood is associated with higher risks of adiposity and overweight/obesity. Public health policies working to reduce SSB consumption need to focus on prevention programmes targeted at young children.
Despite being classed as an asocial species, aggregations of sea anemones can be common in abundant species. UK populations of the geographically common aggressive intertidal sea anemone Actinia equina, form clustered aggregations notwithstanding a violent nature towards neighbours and relatives. Smaller in body size, and more abundant than those found in warmer climates, little research has been undertaken to discover what factors affect body size. This study investigates whether aggregation, distance to neighbour, submergence at low tide or pH in rock pools affect body size of A. equina in their natural habitat. Populations were investigated at five sites on the Yorkshire coast during August and September 2016. A total of 562 anemones were recorded revealing that solitary anemones were significantly larger than those found in clustered aggregations. In addition, anemones found submerged in rock pools at low tide were significantly larger than those found on emergent rock, and smaller anemones were found in significantly higher pH conditions (8.5+) than larger anemones. Anemones submerged at low tide are constantly able to feed and not subject to harsh conditions such as wind exposure and temperature, hence they can achieve larger sizes. Consequently, the size of the anemones may reflect a trade-off between the benefits of aggregating in exposed environments and the costs of competition for a reduced food resource.
The Maghrib has a rich tradition of archaeological studies. However, this research has been biased from the chronological and cultural points of view. This is due to different reasons, relating to both the nature of the archaeological record and the ideological and political circumstances that developed successively under colonial rule and, from the mid-twentieth century, in the modern independent states of the area.
In general, comparatively little attention has been paid to the indigenous cultures of the pre-Roman period, in particular as regards dwelling sites, which generally underlie thick stratigraphic deposits of later periods. The situation is somewhat different with regard to funerary archaeology, as North Africa, especially its eastern portion, is characterised by the existence of a surprising number and diversity of pre-Roman sepulchral monuments.
The previous chapter introduced the Garamantes, an ancient Saharan people, whose story can be traced archaeologically through the first millennium BC and first millennium AD (see also Figs 1.1and 1.2 for location maps). This chapter presents evidence on the funerary practices of the Garamantian heartlands in the Wadi al-Ajal in the Libyan Fazzan (Central Sahara). The Wadi al-Ajal is a long and thin oasis depression running for c.150 km from al-Abyad (to the south-west of Fazzan’s modern capital at Sabha) to Ubari. Our work has been particularly focused on the area around Jarma (ancient Garama, the Garamantian capital about 40 km east of Ubari). The burials in these Garamantian heartlands differ in certain significant ways from those recorded by the Italian mission at Aghram Nadharif and Fewet, and an interesting aspect of the discussion we shall develop below seeks to explain this difference.
Despite more than 150 years of archaeological research in the Maghrib and the Sahara, it is still difficult to establish a universally accepted chronological framework for Moroccan protohistory. While it is generally agreed that its beginning corresponds with the appearance of metal objects around the start of the third millennium BC, its end is much more imprecise, vague and uncertain. The Mediterranean littoral and its hinterland first entered written history around the eighth century BC, at the date of the earliest evidence for a Phoenician presence. However, the other continental regions of Morocco were not part of this schema. These areas were at the margins of ancient knowledge. During the centuries of the ‘Phoenician presence’, only the urban centres changed their character; the countryside, on the other hand, retained a protohistoric lifestyle.
Situated in the hinterland of the eastern Niger Bend in north-east Burkina Faso (Fig. 12.1), in the so-called Gourma area (that is, the bush-land on the right bank of the Niger River), the archaeological site of Kissi consists of an extensive cluster of adjacent settlement areas, including several burial grounds (Fig. 12.2). Its occupation during almost the whole Iron Age (c.third century BC to twelfth century AD) provides the opportunity to follow certain developments that local society underwent over more than a millennium. Spreading over an area of more than 300 hectares, the archaeological site lies on the northern shore of the Mare de Kissi (see Fig. 12.2), a small rainwater-fed lake, similar to – though smaller than – several other lakes in this region (that is, Mare d’Oursi c.35 km to the west, Mare de Darkoy c.6 km to the north, or Mare de Markoye c.15 km to the east, to name but the largest).