Central Obesity is an Independent Determinant of Advanced Fibrosis in Lean Patients With Nonalcoholic Fatty Liver Disease.

Background: The current definition of lean is based on body mass index (BMI). However, BMI is an imperfect surrogate for adiposity and provides no information on central obesity (CO). Hence, we explored the differences in clinical profile and liver disease severity in lean patients with nonalcoholic fatty liver disease (NAFLD) with and without CO. Methods: One hundred seventy lean patients with NAFLD (BMI <23 kg/m2) were divided into two groups depending upon the presence or absence of CO (waist circumference ≥80 cm in females and ≥90 cm in males). Noninvasive assessment of steatosis was done by ultrasound and controlled attenuation parameter (CAP), while fibrosis was assessed with FIB-4 and liver stiffness measurement (LSM). FibroScan-AST (FAST) score was used for non-invasive prediction of NASH with significant fibrosis. Results: Of 170 patients with lean NAFLD, 96 (56.5%) had CO. Female gender (40.6% vs. 17.6%, P = 0.001), hypertriglyceridemia (58.3% vs. 39.2%, P = 0.01) and metabolic syndrome (23.9% vs. 4.1%, P < 0.001) were more common in the CO group. There was a poor correlation between BMI and waist circumference (r = 0.24, 95% CI: 0.09-0.38). Grade 2-3 steatosis on ultrasound was significantly more common in CO patients (30% vs. 12.3%, P = 0.007). CAP [312.5 (289.8-341) dB/m vs. 275 (248-305.1) dB/m, P = 0.002], FAST score [0.42 (0.15-0.66) vs. 0.26 (0.11-0.39), P = 0.04], FIB-4 and LSM were higher in those with CO. Advanced fibrosis was more prevalent among CO patients using FIB-4 (19.8% vs 8.1%, P = 0.03) and LSM (9.5% vs. 0, P = 0.04). CO was independently associated with advanced fibrosis after adjusting for BMI and metabolic risk factors (aOR: 3.11 (1.10-8.96), P = 0.03). Among these 170 patients, 142 fulfilled metabolic dysfunction associated steatotic liver disease (MASLD) criteria. CO was also an independent risk factor for advanced fibrosis in MASLD (3.32 (1.23-8.5), P = 0.02). Conclusion: Lean patients with NAFLD or MASLD and CO have more severe liver disease compared to those without CO.

Transvaginal natural orifice transluminal endoscopic surgery hysterectomy in patients with body mass index >50: An Asian experience.

We present two cases of patients with body mass index (BMI) >50 undergoing transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for gynecological indications. Case 1 involves a 52-year-old woman with post-menopausal bleeding and suspicion of ovarian torsion, while case 2 describes a patient with newly diagnosed endometrial adenocarcinoma. Both cases highlight the feasibility and challenges of vNOTES in this patient population. To date, this is the first paper to describe the use of vNOTES in patients of Asian ethnicity, with BMI >50.

Nutrient intake and food selectivity in children with Tourette syndrome.

Objectives: Children with Tourette syndrome (TS) have been shown to exhibit high levels of food selectivity; however, its association with nutritional status has yet to be explored. The current study explored macro and micronutrient intake and food selectivity among children with and without TS, using 24-hour dietary recall and the Child Eating Behaviour Questionnaire.Method: Parents of 43 children diagnosed with TS and 38 age-matched children without a clinical diagnosis completed an online 24-hour food diary.Results: Fifty-eight per cent of children with TS were identified as falling outside of the healthy BMI range (underweight = 24.2%; overweight = 27.3%; obese = 6.1%). Children with TS also consumed fewer portions of fruit and vegetables along with meeting the daily reference nutrient intake guidelines significantly less often for vitamins B3, B6 and C, selenium and phosphorus compared to children without TS.Conclusions: Understanding the nutritional risk of children with TS relative to other children is important to clinicians and health care professionals who oversee nutritional inspection in primary care, and caregivers who are worried about the impact of limited or restricted diets.

Positive serial dependence in ratings of food images for appeal and calories.

Food is fundamental to survival, and our brains are highly attuned to rapidly process food stimuli. Neural signals show that foods can be discriminated as edible or inedible as early as 85 ms after stimulus onset,1 distinguished as processed or unprocessed beginning at 130 ms,2 and as high or low density from 165 ms.3 Recent evidence revealed specialized processing of food stimuli in the ventral visual pathway,4,5,6 an area that underlies perception of faces and other important objects. For many visual objects, perception can be biased toward recent perceptual history (known as serial dependence7,8). We examined serial dependence for food in two large samples (n > 300) who rated sequences of food images for either "appeal" or "calories." Ratings for calories were highly correlated between participants and were similar for males and females. Appeal ratings varied considerably between participants, consistent with the idiosyncratic nature of food preferences, and tended to be higher for males than females. High-calorie ratings were associated with high appeal, especially in males. Importantly, response biases showed clear positive serial dependences: higher stimulus values in the previous trials led to positive biases, and vice versa. The effects were similar for males and females and for calories and appeal ratings and were remarkably consistent across participants. These findings square with recently found food selectively in the visual temporal cortex, reveal a new mechanism influencing food decision-making, and suggest a new sensory-level component that could complement cognitive strategies in diet intervention.

Ultraprocessed food intake and body mass index change among youths: a prospective cohort study.

BACKGROUND: Suboptimal diets may promote undesired weight gain in youths, with high ultraprocessed food (UPF) intake becoming a significant concern in the United States. OBJECTIVES: We evaluated the association between UPF intake and body mass index [BMI (in kg/m2)] change in large United States youth cohorts. METHODS: Participants included children and adolescents (7-17 y) from the Growing Up Today Study (GUTS1 and GUTS2) who completed baseline and ≥1 follow-up diet and anthropometrics assessment (GUTS1 1996-2001: N = 15,797; GUTS2 2004-2011: N = 9720). Follow-up years were based on diet assessment availability. UPFs were categorized using the Nova system, with intakes evaluated as the cumulative mean percent energy from UPFs and subgroups. BMI was assessed using self-reported body weight/height. Changes in BMI annually and over 2, 4-5, and 7 y in association with UPF intake were examined using multivariable repeated-measure linear mixed models. RESULTS: At baseline, the mean percentage of energy from UPFs was 49.9% in GUTS1 and 49.5% in GUTS2 participants; mean BMI was 18.7 and 19.8, respectively. After multivariable adjustments for sociodemographic and lifestyle factors, each 10% increment in UPF intake was associated with a 0.01 (95% confidence interval: 0.003, 0.03) increase annually and a 0.07 (0.01, 0.13) increase over 5 y in GUTS1 participants. In GUTS2, increases were 0.02 (0.003, 0.04) annually and 0.09 (0.01, 0.18) over 4 y. Among GUTS1, statistically significant annual BMI increases of 0.02-0.07 were associated with elevated intake of ultraprocessed breakfast cereals, savory snacks, and ready-to-eat/heat foods, especially pizza, burgers, and sandwiches. No association was found between UPF intake and overweight/obesity risk. CONCLUSIONS: A higher UPF intake was associated with a modest yet significant increase in BMI in large prospective cohorts of United States youths, calling for public health efforts to promote healthful food intake among youths to prevent excessive weight gain.

Exploring the longitudinal association between stress and unhealthy eating behaviors: The role of physical activity, BMI, and loneliness.

Previous cross-sectional research indicates a link between stress and unhealthy eating, but the longitudinal association remains unknown. This study examined the longitudinal association between perceived stress over a longer time period and unhealthy eating (i.e., sweet and savory snack intake, uncontrolled eating) in a student population. Moreover, we examined whether physical activity buffers such association, and examined whether this buffering effect is stronger for individuals with higher Body Mass Index (BMI) or greater loneliness. Two timepoints of online survey data (Time 1 Oct-Nov 2021, Time 2 May-July 2022) of Dutch university students (n = 1325, 74.7 % female, mean age 22.45 (SD = 2.31)) were used. Results revealed no longitudinal link between stress and snack intake in the total sample, but this association was found in a subgroup of individuals with a higher BMI. Stress at Time 1 was associated with later uncontrolled eating. Physical activity did not moderate the link between stress and unhealthy eating. However, we found a negative longitudinal link between physical activity and uncontrolled eating among individuals with a higher BMI. Our findings suggest that stress does not play an important role in explaining snack intake in university students, but may be associated with uncontrolled eating. Physical activity seems to be linked with a reduction in uncontrolled eating among individuals with a higher BMI specifically. Replication and extension of current findings in a more diverse (e.g., eating disordered) sample would increase insights into the (combined) effects of stress, BMI and physical activity on uncontrolled eating.

Risk and determinants of sarcopenia in people with diabetes: a case-control study from Qatar Biobank cohort.

BACKGROUND: Diabetes is associated with impairments in muscle mass and quality increasing the risk of sarcopenia. Thus, this study aimed to investigate the odds of sarcopenia and its associated risk factors among Qatari adults (> 18 years), while exploring the modulating effects of health and lifestyle factors. METHODS: Using a case-control design, data from 767 participants (481 cases with diabetes and 286 controls without diabetes) was collected from Qatar Biobank (QBB). Sociodemographic, lifestyle factors including dietary intake, anthropometric and biochemical measures were analyzed. Handgrip strength, Dual X-ray absorptiometry (DXA), and Bio-impedance were used to assess muscle strength, muscle mass and muscle quality, respectively. The risk of sarcopenia was estimated using the European consensus on definition and diagnosis of sarcopenia. RESULTS: Cases with diabetes were older (55 vs. 36 years; P < 0.001), had higher BMI (31.6 vs. 28.3 kg/m2; P < 0.001), lower cardiorespiratory fitness (50.0% "Moderate" fitness for cases, 62.9% "High" fitness for controls), and consumed less total (59.0 vs. 64.0; P = 0.004) and animal protein (39.0 vs. 42.0; P = 0.001), compared to controls based on a computed score. Participants with diabetes also had lower appendicular lean mass/BMI, handgrip strength, and higher probability of sarcopenia/probable sarcopenia (P < 0.005). Adjusted multiple logistic regression revealed that elevated cardiorespiratory fitness (ß = 0.299, 95%CI:0.12-0.74) and blood triglycerides (ß = 1.475, 95% CI: 1.024-2.124), as well as being a female (ß = 0.086, 95%CI: 0.026-0.288) and having higher BMI (ß = 0.908, 95%CI: 0.852-0.967) and ALM/BMI (ß = 0.000, 95% CI: 0.000-0.007) are independent predictors (p < 0.05) of sarcopenia risk. CONCLUSIONS: This study highlights the intricate relationship between diabetes and sarcopenia, revealing modifiable risk factors. Individuals with diabetes were found to have a higher likelihood of sarcopenia, which was associated with lower fitness levels and higher blood triglycerides. Protective factors against sarcopenia included being female and having higher BMI and ALM/BMI ratios.

Associations between anthropometric indices as complementary predictors and incidence of type 2 diabetes; Panasonic Cohort Study 21.

AIMS: To compare the predictive abilities of body mass index (BMI), waist circumference (WC), waist-corrected BMI (wBMI), a body shape index (ABSI), and waist-to-height ratio (WHtR) for the incidence of type 2 diabetes and determine the practical cut-off values for the Japanese population. METHODS: This study used data from 155,623 participants who had medical checkups with Panasonic Corporation between 2008 and 2021. Predictive abilities of anthropometric indices were evaluated at 13 years using time-dependent receiver operating characteristic (ROC) curve analyses. RESULTS: 8,800 developed type 2 diabetes during the study period. The area under the ROC curve for the WHtR was high (0.717, 95 % confidence interval [CI]: 0.710-0.724), with cut-off value of 0.497 in men, while those for wBMI (0.829, 95 % CI: 0.808-0.848) and WHtR (0.826, 95 % CI: 0.806-0.845) were high in women, with cut-off values of 18.6 kg/m and 0.510, respectively. It was also showed WHtR was the most effective in men, while WHtR and wBMI outperformed WC and were comparable to BMI in women for predicting type 2 diabetes. CONCLUSIONS: WHtR demonstrated superior effectiveness in predicting type 2 diabetes in men, while both WHtR and wBMI showed higher effectiveness than WC and were almost equivalent to BMI in women.

Association between serum iron levels and atherosclerotic cardiovascular diseases among American older adults: a cross-sectional study based on the National Health and Nutrition Examination Survey, 2009-2018.

Background: There is controversy regarding the relationship between serum iron levels and atherosclerotic cardiovascular disease (ASCVD). Objective: To investigate the relationship between serum iron levels and ASCVD among older adults using data from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). Methods: We performed a cross-sectional analysis involving 8,682 participants aged 60 years and older, with complete data on serum iron levels and confirmed ASCVD status, sourced from the 2009-2018 National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression models were used to examine the association between serum iron levels and ASCVD. To assess the consistency of this association across different demographic groups, subgroup analyses, and interaction tests were performed. Results: The group with the highest serum iron levels (fourth quartile, 100-369 µg/dL) exhibited several distinct characteristics: they were the youngest on average (69.57 ± 6.91 years), had the highest proportion of males (61.42%), and the highest hemoglobin levels (14.43 ± 1.33 g/dL). This group also showed the lowest iron supplement usage (19.71 ± 12.85 mg/30 days), white blood cell counts (6.73 ± 2.41 1,000 cells/µL), and serum creatinine levels (0.98 ± 0.45 mg/dL). Moreover, they had higher levels of education and income, a higher likelihood of being married, and a lower body mass index (BMI). Additionally, they had significantly lower rates of diabetes, hypertension, stroke, and heart attacks (all p < 0.05). After adjusting for potential confounders, a linear relationship between serum iron levels and ASCVD was initially observed (OR = 0.97; 95% CI, 0.95-0.99, p < 0.05). However, further analysis using a two-part logistic regression model with an inflection point at 131 µg/dL revealed more nuanced results. For serum iron levels below 131 µg/dL, each 10 µg/dL increase was associated with a 4% decrease in the odds of ASCVD (OR = 0.96; 95% CI, 0.93-0.98, p < 0.001). Conversely, for serum iron levels above 131 µg/dL, each 10 µg/dL increase corresponded to a 1% increase in the odds of ASCVD, though this finding was not statistically significant (OR = 1.01; 95% CI, 0.98-1.08, p > 0.05). Conclusion: In the US elderly population, serum iron levels are negatively associated with ASCVD, particularly when serum iron levels are below 131 µg/dL.

Body Mass Index Combined With Inflammatory Factors Can Better Predict Varicocele.

Most patients with VC have no symptoms, so they are often discovered due to male infertility. Early identification of them is a matter of concern for clinicians. A retrospective analysis of clinical data from patients between January 1, 2021, and February 1, 2024, was conducted. Patients were divided into VC and non-VC groups. Propensity score matching (PSM) was performed at a ratio of 1:1, and two cohorts with homogeneous baseline status were selected. Multivariate binary logistic regression and receiver operating characteristic (ROC) curve were used to analyze independent risk factors and protective factors and to evaluate their diagnostic value individually and in combination. A p-value <0.05 was considered statistically significant. A total of 256 patients with similar clinical characteristics were further analyzed after PSM in a 1:1 ratio of the 423 patients included in the study. The two groups had statistically significant differences in systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and body mass index (BMI) (p<0.05). Multivariate binary logistic regression analysis showed that SII and NLR were independent risk factors for VC, while high BMI could reduce the prevalence of VC. The PLR differences were not significant. The ROC analysis showed that BMI, SII, and NLR could predict VC, with areas under the curve of 68.3% (cut-off value 22.32), 83.4% (cut-off value 357.57), and 83.2% (cut-off value 1.8), respectively. The combination of BMI and inflammatory factors was more accurate for predicting VC than BMI alone (87.5% vs. 68.3%, p=0.0001), SII (87.5% vs. 83.4%, p=0.0106), and NLR (87.5% vs 83.2%, p=0.0058). Both SII and NLR are independent risk factors for VC while BMI is an independent protective factor. The BMI, SII, and NLR values have the potential to predict VC. The BMI combined with these inflammatory factors can improve the accuracy of prediction.

Prevalence and associated risk factors of post-COVID-19 syndrome in healthcare workers.

Given the global burden of COVID-19 among healthcare workers (HCWs), it is expected that they face an elevated risk of developing post-COVID-19 syndrome. The objectives of this study were to evaluate the prevalence of post-COVID-19 syndrome and associated risk factors in HCWs followed for a median time of 18 months by conducting a retrospective cohort study. All HCWs with confirmed COVID-19 during the period from January 2021 to December 2022 were included in the study. HCWs were regularly assessed after COVID-19 diagnosis, so post-COVID-19 syndrome data could be collected. During the study period, 463 HCWs were included in the study, 227 (49.0%) of which experienced post-COVID-19 syndrome. The most common persistent symptoms were fatigue (n = 147 [32.5%]), memory disorders (n = 98 [21.5%]), dyspnea (n = 73 [16.0%]), anxiety/depression (n = 69 [15.0%]), and cough (n = 43 [9.4%]). Female sex and obesity were statistically associated with the development of post-COVID-19 syndrome. A high prevalence of post-COVID-19 syndrome in HCWs was found. Female sex and obesity appear to be risk factors associated with a higher prevalence of post-COVID-19 syndrome. Special attention should be given to these patients with risk factors during follow-up in the COVID-19 recovery period.

Secular trends of physical fitness in Austrian children attending sports schools: An analysis of repeated cross-sections from 2006 to 2023.

BACKGROUND: Physical fitness (PF) offers numerous physical and mental health benefits, especially during childhood. Previous studies investigating trends in children's PF over the years reported contradictory findings. OBJECTIVE: To identify and analyse secular trends in PF among Austrian schoolchildren from 2006 to 2023. METHOD: A repeated cross-sections design was used to examine the PF of children enrolling in sports schools between 2006 and 2023. During this period, a standardized eight-item motor performance testing battery was administered yearly to capture markers of strength, speed, endurance, agility and reaction time in Austrian schools. RESULTS: A total of n = 3827 children (996 girls) with a mean age of 9.9 ±â€¯1.0 years were included. Linear mixed models indicated significant declines in sprint performance (5, 10, 20 m), tapping, jump (long jump and drop jump), throwing (medicine ball), and agility (snake run). No changes were observed in cardiorespiratory fitness (8 min run) or reaction time. CONCLUSION: There has been a steady decline in PF among Austrian children attending sports schools. This finding underscores the need for enhanced PF monitoring and training in schools to improve public health outcomes.

A 1024-Channel 268 nW/pixel 36×36 µm2/channel Data-Compressive Neural Recording IC for High-Bandwidth Brain-Computer Interfaces.

This paper presents a data-compressive neural recording IC for single-cell resolution high-bandwidth brain-computer interfaces. The IC features wired-OR lossy compression during digitization, thus preventing data deluge and massive data movement. By discarding unwanted baseline samples of the neural signals, the output data rate is reduced by 146× on average while allowing the reconstruction of spike samples. The recording array consists of pulse position modulation-based active digital pixels with a global single-slope analog-to-digital conversion scheme, which enables a low-power and compact pixel design with significantly simple routing and low array readout energy. Fabricated in a 28-nm CMOS process, the neural recording IC features 1024 channels (i.e., 32 × 32 array) with a pixel pitch of 36 µm that can be directly matched to a high-density microelectrode array. The pixel achieves 7.4 µVrms input-referred noise with a -3 dB bandwidth of 300-Hz to 5-kHz while consuming only 268 nW from a single 1-V supply. The IC achieves the smallest area per channel (36 × 36 µm2) and the highest energy efficiency among the state-of-the-art neural recording ICs published to date.

An exploratory examination of medical and nursing students' intentions to discuss body image, weight, and eating disorders with their patients.

BACKGROUND: Although many people have concerns about their body image, weight, and eating behaviors these issues are not usually discussed in a productive manner with medical providers. Thus, we examined nursing and medical students' willingness to discuss patients' weight, body image, and eating disorders and reasons why they may do so. METHOD: One hundred and eighty-three nursing and medical students (Mage = 25.06, SD = 5.43) participated in this study. Participants completed open-ended questions pertaining to their willingness to discuss body image, eating, and weight-related issues with future patients. We further queried students' perspective on body mass index (BMI) as a measure of weight status and sought to determine if participants' own weight, weight concerns, appearance evaluation, body appreciation, and experiences of stigma were associated with their willingness to discuss weight-related issues with prospective patients. RESULTS: Coding of qualitative data indicated that nursing and medical students were "sometimes" willing to discuss prospective patients' weight, body image, and eating disorders, especially if a health concern was evident. Nursing students seemed somewhat more willing to discuss weight issues than medical students and willingness to discuss one of these issues (e.g., body image) was positively associated with willingness discuss the others. Plans for future discussions of body image and weight were marginally associated with personal experiences of weight stigma. The majority of participants indicated that BMI was not a valid measure of health. CONCLUSIONS: Taken together, findings suggest that future providers' conversations with patients about these sensitive topics are less likely to be associated with their own experiences and more with the relevance of these topics to specific patients.

The aim of this study was to better understand nursing and medical students' interest and willingness to discuss body image, eating behaviors, and weight with their patients. Although medical organizations and training suggest the importance of talking with patients about these issues, providers often do not feel comfortable doing so or do not know how to best broach these sensitive topics. Our results revealed that nursing students seemed somewhat more comfortable discussing these issues with patients than medical students. Nursing and medical students were more apt to feel they would discuss these issues if a patient had an obvious health concern that was relevant (e.g., sudden weight loss). Medical and nursing students who had experiences with weight stigma were more apt to try to discuss these issues with patients.

Application value of individualized tube voltage, contrast injection, and adaptive statistical iterative reconstruction V algorithm based on body mass index in renal computed tomography angiography for radiation and iodinated contrast dose reduction.

OBJECTIVES: To explore the application value of body mass index (BMI)-based kilovoltage peak (kVp) selection and contrast injection protocol combined with different adaptive statistical iterative reconstruction V (ASIR-V) strengths in renal computed tomography angiography (CTA) in reducing radiation and contrast medium (CM) doses. METHODS: One-hundred renal CTA patients were prospectively enrolled and were divided into individualized kVp group (group A, n = 50) and conventional 100 kVp group (group B, n = 50), both with automatic tube current modulation and CM of Iohexol at 350 mgI/mL concentration. Group A: 70 kVp, noise index (NI) of 18 and CM dose rate of 17 mgI/kg/s for 10 s for BMI <25 kg/m2 patients; 80 kVp, NI = 17, and CM dose rate of 19 mgI/kg/s for 10 s for 25 kg/m2≤BMI≤30 kg/m2 patients. Group B: 100 kVp, 50 mL of CM at the flow rate of 4.5 mL/s. The objective image quality, effective radiation dose, CM dose, injection rate, and image quality were compared between the 2 groups. RESULTS: There was no significant difference in patient characteristics between the 2 groups (P > .05). Compared to group B, group A significantly reduced effective radiation dose by 28.4%, CM dose by 27.2%, and injection rate by 22.7% (all P < .001). The 2 groups had similar SD values in erector spine (P > .05). Group A had significantly higher CT values, SNR, and CNR values of the renal arteries than group B (all P < .001). The 2 radiologists had excellent agreement (Kappa value > 0.8) in the subjective scores of renal CTA images and showed no statistically significant difference between the 2 groups (4.57 ± 0.42 vs 4.41 ± 0.49) (P > .05). CONCLUSIONS: BMI-based scan and reconstruction protocol in renal CTA significantly reduces radiation and contrast doses while maintaining diagnostic image quality. ADVANCES IN KNOWLEDGE: (i) BMI-based individualized tube voltage selection and contrast injection protocol in renal CTA reduces both radiation and contrast doses over conventional protocol. (ii) The combination of lower kVp and higher weight ASIR-V maybe used to improve image quality in terms of contrast enhancement and image noise under lower radiation and contrast dose conditions. (iii) Renal CTA of normal size (BMI ≤ 30 kg/m2) patients acquired at low radiation dosage and low iodine contrast dose through the combination of low tube voltage and ASIR-V algorithm achieves excellent diagnostic image quality with a good inter-rater agreement.

Early life social conditions and adverse experiences are associated with childhood BMI and perceived overeating.

BACKGROUND: Early life socioeconomic disadvantage and adverse experiences may lead to overeating, which is in turn associated with increased body mass index (BMI). However, recent evidence indicated that the association between childhood BMI and overeating might be bidirectional. This bidirectionality prompts the need for further investigation of early life predictors of BMI in childhood. OBJECTIVES: To longitudinally assess the directionality of the association between childhood BMI and perceived overeating and to investigate their antecedent early life predictors. METHODS: The sample included data from 5151 children from the ELSPAC study, collected between 18 months and 11 years of child age. The outcomes were child BMI and mother-reported overeating, assessed at the age of 3, 5, 7 and 11 years. Predictors included maternal BMI, maternal education, single parenthood, financial difficulties and adverse childhood experiences (ACEs) reported by parents and paediatricians. The random intercept cross-lagged panel model was applied. RESULTS: The mean child's BMI at age 3 was 15.59 kg/m2 and increased to 17.86 kg/m2 at age 11. The percentage of parent-reported overeating increased in the following period, from about 12% at age 3 to 17% at age 11. The results showed temporal stability in perceived overeating and BMI, with a bidirectional relationship strengthening over time. The child's BMI was associated with maternal BMI. Maternal BMI was positively associated with child-perceived overeating, but a stronger effect was found for ACEs. ACEs mediated the impact of maternal education, financial difficulties and single parenthood on overeating. CONCLUSIONS: We observed stable bidirectional associations between BMI and perceived overeating. The results indicated two main pathways: one linked to maternal BMI and early childhood BMI increase followed by perceived overeating and the second associated with ACEs mediating the effect of early childhood social factors on perceived overeating, leading to gradual BMI gain.

Hyponatremia Prevalence in Decompensated Chronic Liver Disease: Insights from a Tertiary Care Hospital.

BACKGROUND: Liver cirrhosis is a prominent global contributor to mortality, and hyponatremia is a common complication in patients with decompensated chronic liver disease (DCLD). Hyponatremia is characterized by kidney impairment when eliminating solute-free water. The presence of contradictory findings in existing literature prompted this study. OBJECTIVE: The objective of this study was to determine the prevalence of hyponatremia in patients with DCLDs presenting at a tertiary care hospital. METHODOLOGY:  This six-month cross-sectional study was performed at the Allied Institute of Medical Sciences Teaching Hospital in Gujranwala, Pakistan, from January 2022 to June 2022. A total of 133 patients were selected as subjects. Researchers took blood samples from these patients and sent the samples to the hospital pathology lab for evaluation of serum sodium levels. If sodium levels were ≤130 mmol/L, the patient was considered to have hyponatremia. All information was recorded on proforma. RESULTS:  The mean age of patients was 47.68 ± 12.89 years. Overall, 80 (60.15%) were male, and 53 (39.85%) female. The mean BMI of patients was 23.20 ± 3.11 kg/m2 and the average duration of DCLD was 7.24 ± 4.12 years. Among participants, 48 (36.09%) patients had hyponatremia, whereas 85 (63.91%) did not have hyponatremia. The mean sodium level was 132.39 ± 11.37 mEq/L. Stratified analysis based on patient age revealed that among patients aged 21-45 years, 27 (45.8%) had hyponatremia, whereas, in the group aged 46-70 years, 21 (28.4%) had hyponatremia with a p-value < 0.05. Stratification of the basis of BMI, among underweight patients, all eight (100%) had hyponatremia, whereas of overweight patients, 14 (31.1%) had hyponatremia. This difference was statistically significant (p < 0.05). CONCLUSION: The prevalence of hyponatremia was notably elevated among individuals suffering from DCLD. Age and BMI were the most common risk factors for hyponatremia among subjects with DCLD. This study recommends that patients with DCLD should have their serum sodium levels screened at regular intervals to prevent complications, including encephalopathy, which occurs particularly in younger and underweight DCLD patients.

Mortality and rate of hospitalization stratified by patients' BMI in a colonoscopy screening - a cross sectional analysis of data from Polish Colonoscopy Screening Platform.

BACKGROUND: Currently, it remains unknown whether there is an association between body mass index (BMI) and complications during screening colonoscopy; hence, it remains unclear whether BMI should be considered a risk factor in pre-procedural assessments. The aim of this study was to compare mortality and unplanned hospitalization rates before and after colonoscopy stratified by patients' BMI. MATERIAL AND METHODS: This was a retrospective cohort study of individuals who underwent screening colonoscopy as part of the Polish Colonoscopy Screening Program (PCSP). The included individuals were followed up for mortality and hospitalization episodes from 42 days prior to colonoscopy to 30 days after the procedure. Rates for the endpoints were calculated, compared, and adjusted for available data. Weighted averages of stratum-specific rates were calculated. Additional subanalyses were performed for sex and procedure type (screening colonoscopy without biopsy, colonoscopy with biopsy, or colonoscopy with polypectomy). RESULTS: A total of 55390 individuals who underwent colonoscopy between years 2012-2015 were included. Obese individuals had significantly more hospitalizations than non-obese patients (1.94% versus 0%, p = .038). Analysis of adjusted hospitalization rates stratified by sex revealed that obese males had significantly higher related hospitalizations' rates before or after and after colonoscopy. Unadjusted and adjusted mortality rates after screening colonoscopy did not reveal significant differences between BMI categories. CONCLUSIONS: Overweight and obesity are not clinically relevant risk factors for mortality and hospitalization six weeks before or 30 days after screening colonoscopy. Obese males may be more likely to require hospital care after colonoscopy.

Exploring adverse effects of deep brain stimulation: the need for personalized care and long-term monitoring.

Deep Brain Stimulation (DBS), an FDA-approved treatment for movement disorders such as Parkinson's Disease (PD), is increasingly used for various neurological and neuropsychiatric conditions. A recent systematic review and meta-analysis by Bahadori et al. highlighted a significant increase in Body Mass Index (BMI) among patients post-DBS, with most participants having PD. The study, however, noted moderate heterogeneity (I² = 67.566%) without thoroughly addressing its potential causes or proposing strategies to mitigate it. The review's limited patient diversity and short follow-up period also challenge its generalizability and long-term implications. In addition to BMI changes, DBS has been linked to motor, cognitive, and psychiatric side effects. Patients undergoing subthalamic nucleus (STN) stimulation, for example, face risks of motor complications, including speech and gait issues, while cognitive declines, particularly in verbal fluency and executive function, are also concerning. Psychiatric side effects such as depression, anxiety, and psychosis further complicate treatment outcomes. These findings underscore the importance of personalized treatment strategies, preoperative assessments, and ongoing patient education to minimize adverse effects and optimize the therapeutic potential of DBS.

Dual Cross-Linked Networks Reinforced Polyimide Foams with Outstanding Piezoelectric Properties and Heat Resistance Performance.

The application of traditional isocyanate-based polyimide (PI) foams is highly hindered due to limited flame retardancy, poor mechanical properties, and relatively single functionality. Herein, we propose an effective method to fabricate dual cross-linked polyimide/bismaleimide (PI-BMI) foams with outstanding heat resistance and enhanced mechanical properties by incorporating bis(3-ethyl-5-methyl-4-maleimidophenyl)methane (ME-BMI) as the interpenetrating network. The results show that the prepared PI-BMI composite foams exhibit enhanced mechanical properties with lightweight characteristics (23-80 kg·m-3). When the ME-BMI loading reached 120 wt %, the tensile and compressive strength of PI-BMI composite foam can reach 1.9 and 7.8 MPa, which are 9.6 and 63.3 times higher than that of pure PI foam, respectively. In comparison with PIF-0, the 10% heat loss temperature (Td,10%) of PIF-90 improved by 156 °C. Moreover, the PI-BMI foam piezoelectric sensor containing fluorine groups presents a short response time (14.22 ms), high sensitivity (0.266 V/N), and outstanding stability (10 000 cycles). Besides, the sensor can accurately monitor human activity in different states. This work provides a promising strategy for designing multifunctional PI foams, making them suitable for applications in aerospace and microelectronics.