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Obesity is one of the major contributors to the excess mortality seen in people with severe mental illness (SMI) and in low- and middle-income countries people with SMI may be at an even greater risk. In this study, we aimed to determine the prevalence of obesity and overweight in people with SMI and investigate the association of obesity and overweight with sociodemographic variables, other physical comorbidities, and health-risk behaviours. This was a multi-country cross-sectional survey study where data were collected from 3989 adults with SMI from three specialist mental health institutions in Bangladesh, India, and Pakistan. The prevalence of overweight and obesity was estimated using Asian BMI thresholds. Multinomial regression models were then used to explore associations between overweight and obesity with various potential determinants. There was a high prevalence of overweight (17·3 %) and obesity (46·2 %). The relative risk of having obesity (compared to normal weight) was double in women (RRR = 2·04) compared with men. Participants who met the WHO recommendations for fruit and vegetable intake had 2·53 (95 % CI: 1·65–3·88) times greater risk of having obesity compared to those not meeting them. Also, the relative risk of having obesity in people with hypertension is 69 % higher than in people without hypertension (RRR = 1·69). In conclusion, obesity is highly prevalent in SMI and associated with chronic disease. The complex relationship between diet and risk of obesity was also highlighted. People with SMI and obesity could benefit from screening for non-communicable diseases, better nutritional education, and context-appropriate lifestyle interventions.
The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS) will be held in Washington DC, USA, from Saturday, 26 August, 2023 to Friday, 1 September, 2023, inclusive. The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery will be the largest and most comprehensive scientific meeting dedicated to paediatric and congenital cardiac care ever held. At the time of the writing of this manuscript, The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery has 5,037 registered attendees (and rising) from 117 countries, a truly diverse and international faculty of over 925 individuals from 89 countries, over 2,000 individual abstracts and poster presenters from 101 countries, and a Best Abstract Competition featuring 153 oral abstracts from 34 countries. For information about the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery, please visit the following website: [www.WCPCCS2023.org]. The purpose of this manuscript is to review the activities related to global health and advocacy that will occur at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery.
Acknowledging the need for urgent change, we wanted to take the opportunity to bring a common voice to the global community and issue the Washington DC WCPCCS Call to Action on Addressing the Global Burden of Pediatric and Congenital Heart Diseases. A copy of this Washington DC WCPCCS Call to Action is provided in the Appendix of this manuscript. This Washington DC WCPCCS Call to Action is an initiative aimed at increasing awareness of the global burden, promoting the development of sustainable care systems, and improving access to high quality and equitable healthcare for children with heart disease as well as adults with congenital heart disease worldwide.
The efficacy of a specialized pediatric cardiac rapid response team is unknown. We hypothesized that a specialized cardiac rapid response team would facilitate team-wide communication between the cardiac stepdown unit and cardiac intensive care unit (ICU) teams and improve patient care.
Materials and methods:
A specialized pediatric cardiac rapid response team was implemented in June 2015. All pediatric cardiac rapid response team activations and outcomes from implementation through December 2018 were reviewed. Cardiac arrests and unplanned transfers to the cardiac ICU were indexed to 1000 patient-days to account for inpatient volume trends and evaluated over time.
There were 202 cardiac rapid response team activations in 108 unique patients during the study period. After implementation of the pediatric cardiac rapid response team, unplanned transfers from the cardiac stepdown unit to the cardiac ICU decreased from 16.8 to 7.1 transfers per 1000 patient days (p = 0.012). The stepdown unit cardiac arrest rate decreased from 1.2 to 0.0 arrests per 1000 patient-days (p = 0.015). There was one death on the cardiac stepdown unit in the 5 years since the implementation of the cardiac rapid response team, compared to four deaths in the previous 5 years.
A reduction in unplanned cardiac ICU transfers, cardiac arrests, and mortality on the cardiac stepdown unit has been observed since the implementation of a specialized pediatric cardiac rapid response team. A specialized cardiac rapid response team may improve communication and empower the interdisciplinary care team to escalate care for patients experiencing clinical decline.
Recently, we found that in ovo feeding of l-leucine (l-Leu) afforded thermotolerance, stimulated lipid metabolism and modified amino acid metabolism in male broiler chicks. However, the effects of in ovo feeding of l-Leu on thermoregulation and growth performance until marketing age of broilers are still unknown. In this study, we investigated the effects of in ovo feeding of l-Leu on body weight (BW) gain under control thermoneutral temperature or chronic heat stress. We measured changes of body temperature and food intake, organ weight, as well as amino acid metabolism and plasma metabolites under acute and chronic heat stress in broilers. A total of 168 fertilized Chunky broiler eggs were randomly divided into 2 treatment groups in experiments. The eggs were in ovo fed with l-Leu (34.5 µmol/500 µl per egg) or sterile water (500 µl/egg) during incubation. After hatching, male broilers were selected and assigned seven to nine replicates (one bird/replicate) in each group for heat challenge experiments. Broilers (29- or 30-day-old) were exposed to acute heat stress (30 ± 1°C) for 120 min or a chronic heat cyclic and continued heat stress (over 30 ± 1°C; ages, 15 to 44 days). In ovo feeding of l-Leu caused a significant suppression of enhanced body temperature without affecting food intake, plasma triacylglycerol, non-esterified fatty acids, ketone bodies, glucose, lactic acid or thyroid hormones under acute heat stress. Daily body temperature was significantly increased by l-Leu in ovo feeding under chronic heat stress. Interestingly, in ovo feeding of l-Leu caused a significantly higher daily BW gain compared with that of the control group under chronic heat stress. Moreover, some essential amino acids, including Leu and isoleucine, were significantly increased in the liver and decreased in the plasma by l-Leu in ovo feeding under acute heat stress. These results suggested that l-Leu in ovo feeding afforded thermotolerance to broilers under acute heat stress mainly through changing amino acid metabolism until marketing age.
High-intensity laser–plasma interactions produce a wide array of energetic particles and beams with promising applications. Unfortunately, the high repetition rate and high average power requirements for many applications are not satisfied by the lasers, optics, targets, and diagnostics currently employed. Here, we aim to address the need for high-repetition-rate targets and optics through the use of liquids. A novel nozzle assembly is used to generate high-velocity, laminar-flowing liquid microjets which are compatible with a low-vacuum environment, generate little to no debris, and exhibit precise positional and dimensional tolerances. Jets, droplets, submicron-thick sheets, and other exotic configurations are characterized with pump–probe shadowgraphy to evaluate their use as targets. To demonstrate a high-repetition-rate, consumable, liquid optical element, we present a plasma mirror created by a submicron-thick liquid sheet. This plasma mirror provides etalon-like anti-reflection properties in the low field of 0.1% and high reflectivity as a plasma, 69%, at a repetition rate of 1 kHz. Practical considerations of fluid compatibility, in-vacuum operation, and estimates of maximum repetition rate are addressed. The targets and optics presented here demonstrate a potential technique for enabling the operation of laser–plasma interactions at high repetition rates.
Patient-reported outcomes and epidemiological studies in adults with tetralogy of Fallot are lacking. Recruitment and longitudinal follow-up investigation across institutions is particularly challenging. Objectives of this study were to assess the feasibility of recruiting adult patients with tetralogy of Fallot for a patient-reported outcomes study, describe challenges for recruitment, and create an interactive, online tetralogy of Fallot registry.
Adult patients living with tetralogy of Fallot, aged 18–58 years, at the University of North Carolina were identified using diagnosis code query. A survey was designed to collect demographics, symptoms, history, and birth mother information. Recruitment was attempted by phone (Part I, n=20) or by email (Part II, n=20). Data analysis included thematic grouping of recruitment challenges and descriptive statistics. Feasibility threshold was 75% for recruitment and for data fields completed per patient.
In Part I, 60% (12/20) were successfully contacted and eight (40%) were enrolled. Demographics and birth mother information were obtained for all enrolled patients. In Part II, 70% (14/20) were successfully contacted; 30% (6/20) enrolled and completed all data fields linked to REDCap database; the median time for survey completion was 8 minutes. Half of the patients had cardiac operations/procedures performed at more than one hospital. Automatic electronic data entry from the online survey was uncomplicated.
Although recruitment (54%) fell below our feasibility threshold, enrolled individuals were willing to complete phone or online surveys. Incorrect contact information, privacy concerns, and patient-reported time constraints were challenges for recruitment. Creating an online survey and linked database is technically feasible and efficient for patient-reported outcomes research.
We present a complete spatial and dynamical study of the poorly populated stellar system ESO65SC03. The radial distribution of the system gives a core and cluster radii of 1.10±0.63 and 5.36±0.24 arcmin, respectively. The SNDP does not show any clear enhancement of the surface stellar number density between the stars of the system and the field regions. We derive the optimum isochrone solution for a particular grid size in the CMD using the statistical cleaning procedure. Using the statistically cleaned CMDs, we find the distance modulus, (m − M)0, and reddening, E(B − V), of the system to be 11.8±0.2 and 0.45 mag, respectively. The mean proper motion of this system is − 5.37±0.81 mas yr−1 and 0.31±0.40 in RA and DEC directions, respectively. The mean proper motion of this system is found to be almost similar to the field region. The mass function for the brighter stars is found to be too high for the system to be an open cluster. These combined results place constraints on whether stellar system ESO65SC03 is a POCR or an Asterism. Our understanding is that the ESO65SC03 is in a stage of POCR by losing their main-sequence stars in the dynamic evolution processes.
In experiments harvested in 1985 and 1986 the grain yields of 61 F1 hybrids among winter wheat varieties and advanced breeding lines were 5·9% greater than the yields of the best parents. In a trial with 430 hybrids in 1986, the hybrids yielded 3·6% more grain than the best parents. Among these 430 hybrids heterosis for yield was greatest for those from the lowest yielding parents. This result is taken to indicate that among these genotypes most genes for high yield have been fixed in the highest yielding parents.
The hybrids had slightly fewer ears/m2, but more grains per ear and heavier grains than the highest yielding parents. They yielded more straw as well as more grain.
The results are compared with those from other studies and it is concluded that yield advantage of F1 hybrids so far tested is not generally sufficient to justify their introduction into U.K. agriculture.
The effects of selected socioeconomic factors on basic competencies of children in Bangladesh were studied using primary data on 2520 children from all over the country. The residence of the child, years of schooling, parental education and economic status of the household were found to be important determinants of basic competencies of children.
The 1981 Bangladesh Contraceptive Prevalence Survey found that 55% of ever-married women had some knowledge of traditional methods of contraception and the overall level of ever use was 23%. There was a positive relationship between use and socioeconomic variables. Current use of traditional methods at 7·7% was only slightly below the figure for modern methods (10·9%). It is suggested that traditional methods still have an important role in family planning and that this should not be disregarded.
Recent data from Bangladesh reveal evidence of some fertility decline. Although fertility increased among younger age groups between 1975 and 1983, it was offset by a decrease in fertility in the older age groups, resulting in a slight overall decrease in total fertility in 1983. Fertility was lower among urban residents, educated mothers and contraceptive users than among rural residents, uneducated mothers and contraceptive non-users, respectively, particularly in 1983.
A quantum magnetohydrodynamic model is used to investigate the nonlinear propagation of dust ion-acoustic waves in a three-component quantum plasma composed of electrons, positively charged ions and immobile charged dust grains. Using the standard reductive perturbation technique, a Korteweg–de Vries equation is derived containing the quantum statistical and diffraction effects. There exists a critical value of the non-dimensional parameter H, proportional to the quantum diffraction, beyond which the bright soliton propagation is not possible with positive phase velocity. The effects of obliqueness, charged dust impurity and external magnetic field as well as the quantum mechanical effects are investigated numerically on the profiles of the amplitude and width of the solitary waves.
An epidemiological study was carried out to find out the aetiological agent for diarrhoeal disorders in the cyclone and flood affected areas of Orissa, India. Rectal swabs collected from 107 hospitalized diarrhoea patients were bacteriologically analysed to isolate and identify the various enteropathogens. Detection of toxic genes among E. coli and V. cholerae was carried out by polymerase chain reaction (PCR) assay. Of the 107 rectal swabs analysed, 72·3% were positive for V. cholerae O1 Ogawa, 7·2% for V. cholerae O139, 1·2% for E. coli (EAggEC) and 1·2% for Shigella flexneri type 6. Using multiplex PCR assay it was found that all V. cholerae isolates were ctxA positive and El Tor biotype. Strains of V. cholerae O1 were observed to be resistant to nalidixic acid, furazolidone, streptomycin, co-trimoxazole and ampicillin. Except for nalidixic acid, the resistance pattern for O139 was identical to that of O1 strains. Representative strains of V. cholerae were further characterized by randomly amplified polymorphic DNA (RAPD) analysis and ribotyping. Both O1 and O139 V. cholerae strains exhibited the R3 pattern of ribotype and belonged to a similar pattern of RAPD compared with that of Calcutta strains. Early bacteriological and epidemiological investigations have revealed the dominance of V. cholerae O1 among the hospitalized patients in cyclone affected areas of Orissa. Drinking water scarcity and poor sanitation were thought to be responsible for these diarrhoeal outbreaks. Timely reporting and implementation of appropriate control measures could contain a vital epidemic in this area.
Active surveillance of Vibrio parahaemolyticus infection among hospitalized patients in
Calcutta, India, showed the appearance of the O4[ratio ]K68 serovar for the first time in March 1998
alongside the continued predominant incidence of the O3[ratio ]K6 serovar. Strains belonging to both
these serovars have been reported to possess pandemic potential. The genomes of O3[ratio ]K6 and
O4[ratio ]K68 strains and for comparison, non-O3[ratio ]K6 and non-O4[ratio ]K68 strains isolated from two
different countries, India and Thailand, were examined by different molecular techniques to
determine their relatedness. The O3[ratio ]K6 and O4[ratio ]K68 strains from Calcutta and Bangkok
carried the tdh gene but not the trh gene. Characterization of representative strains of these
two serovars by ribotyping and by arbitrarily primed-polymerase chain reaction (AP-PCR)
showed that the isolates had identical ribotype and DNA fingerprint. Pulsed-field gel
electrophoresis (PFGE) performed with the same set of strains yielded nearly similar restriction
fragment length polymorphism (RFLP) patterns for the O3[ratio ]K6 and O4[ratio ]K68 isolates from
Calcutta and Thailand. Phylogenetic analysis of the NotI RFLP showed that the O3[ratio ]K6 and
O4[ratio ]K68 strains formed a cluster with 78–91% similarity thus indicating close genetic
relationship between the two different serovars isolated during the same time-frame but from
widely separated geographical regions. The non-O3[ratio ]K6 and non-O4[ratio ]K68, in contrast, showed
different ribotype, AP-PCR and PFGE patterns.
The effect of body fat content on the protein metabolism of energy-restricted sheep has been studied in two experiments. In the first experiment, six Suffolk-cross wether sheep, three weighing about 39 kg and three of about 61 kg, were given progressively increasing amounts of casein-N from 0 to 3000 mg N/kg metabolic body weight (W0·75) daily with constant energy, 91 kJ/kg W0·75 daily, from a high-propionic acid mixture of volatile fatty acids (VFA). In the second experiment, two lean and two fat sheep of similar body weights were given progressively increasing amounts of casein with the same VFA mixture. All the animals attained a positive N balance when they were in negative energy balance. N balance was not affected by body fatness of the magnitude studied, although lean animals utilized increasing levels of standard VFA (acetate-propionate-butyrate 65:25:10, molar proportions) infusion for N accretion more efficiently than fat animals. Endogenous energy was utilized for protein accretion with an efficiency of 0·56. Supply of glucogenic VFA equivalent to 28 mmol glucose/kg W0·75 reduced fasting N excretion by 39%. Fasting heat production decreased from 335 to 300 kJ/kg W0·75 with the infusion of casein and glucogenic VFA. It is argued that fasting induces additional heat losses due to raised protein metabolism and is unsuited as a baseline for dietary assessment.
Utilization of endogenous and exogenous energy for protein accretion during energy undernutrition has been studied. Nine lambs nourished by intragastric infusion were given either progressively increasing or decreasing amounts of casein-N up to 2550 mg/kg metabolic weight (W0·75), with or without 250 kJ/kg W0·75 of volatile fatty acids daily. Energy balance (respiration calorimetry) and N balance were measured. While all experimental animals were in negative energy balance, N balance increased curve-linearly with the increase in casein-N infusion and attained positive N balance. Endogenous energy (presumably body fat) was found to meet the energy needs for protein accretion during energy undernutrition. It is concluded that body fat can be effectively utilized to support lean-tissue growth during energy undernutrition, so that the classical nutritional concept of dietary energy:protein ratio is only meaningful when both endogenous and exogenous energy are considered.
Using both XRD and HRTEM lattice imaging, we have shown that CO2 laser pyrolysis (LP) produces nanoscale transition metal carbide and nitride catalysts, including cubic Mo2C, Mo2N, and W2N, which possess highly crystalline structures in their as-synthesized form In contrast, LP-produced W2C in its hexagonal phase is disordered. Clear lattice expansion, induced by the small crystallite size of the nanoparticles has been observed for LP-produced Mo2C particles, which have a typical crystallite size of 2 nm. No carbon coating was observed in HRTEM for LP-produced Mo2C particles. Furthermore, Mo=N and Mo=C bonding in Mo2N and Mo2C, respectively, were identified by an XPS measurement, which also reveals the presence of a thin oxide layer formed on the particle surface during the passivation process. Finally, the average crystallite sizes determined from HRTEM and XRD are in good agreement, indicating that the line broadening observed in XRD is due to the small crystallite size of the nanoparticles.