The relationship between overweight and education revisited: a test of the selection hypothesis based on adolescents' educational aspirations.

OBJECTIVES: This paper examines the selection mechanism underlying the association between overweight/obesity and educational aspirations of adolescents. STUDY DESIGN: This is a cross-sectional study based on a survey conducted in secondary schools in Spain in 2016. METHODS: We estimate linear probability models to determine the association between adolescents' body mass index (BMI) and their expectations to obtain a university degree, as well as their school choices representing the most usual path towards higher studies. To address the potential endogeneity of BMI, we use the instrumental variables (IV) method. Additionally, we account for potential unobserved heterogeneity by including school fixed-effects and a wide set of individual and family characteristics in our analysis. RESULTS: Our results indicate that adolescents with a higher BMI have lower expectations to obtain a university degree and are less likely to enrol in high school with the intention to pursue higher education in the future. The estimated effect is quite sizable and statistically significant only for girls. We estimate that a five-unit increase in BMI (e.g., the change between healthy weight and overweight) reduces girls' expectations to complete higher education by 19 percentage points and odds of enrolling in high school (vs. vocational training) by 21 percentage points. CONCLUSIONS: We provide empirical evidence supporting the selection hypothesis behind the relationship between BMI and adolescents' educational aspirations. That is, unhealthy weight in adolescence is associated with poorer aspirations for further education. Lower educational aspirations during adolescence can lead to lower academic achievement, which in turn, may result in poorer health, labour market outcomes, and well-being during adulthood.

Aseptic meningitis outbreak caused by echovirus 30 in two regions in Bulgaria, May-August 2012.

An aseptic meningitis outbreak emerged in two regions in Bulgaria in 2012 and echovirus 30 (E30) was established as the aetiological agent by cell culture isolation, serological test, and molecular-based techniques. A total of 157 patients with aseptic meningitis were investigated, of which 117 were confirmed as having E30-associated disease. Molecular analysis of 12 E30 isolates revealed 99-100% nucleotide and amino-acid identity between them and a close correlation with a Greek strain involved in an E30 outbreak in 2012. Children aged 5-14 years were mainly affected, which could reflect the absence of E30 epidemics in Bulgaria for a period of 11 years. The first case with E30 isolation (a 2-year-old patient from Plovdiv) was notified at the end of April 2012. This was most likely the index case, from which the spread of the virus started, causing sporadic cases first, which later led to an aseptic meningitis outbreak facilitated by person-to-person viral transmission.

Correlation-induced corrections to the band structure of boron nitride: a wave-function-based approach.

We present a systematic study of the correlation-induced corrections to the electronic band structure of zinc-blende BN. Our investigation employs an ab initio wave-function-based local Hamiltonian approach which offers a rigorous theoretical framework for the calculation of the polarization and local charge redistribution effects around an extra electron or hole placed into the conduction or valence bands of semiconducting and insulating materials. Moreover, electron correlations beyond relaxation and polarization can be readily incorporated. The electron correlation treatment is performed on finite clusters. In conducting our study, we make use of localized Wannier functions and embedding potentials derived explicitly from prior periodic Hartree-Fock calculations. The on-site and nearest-neighbor charge relaxations bring corrections of several eV to the Hartree-Fock band gap. Additional corrections are caused by long-range polarization effects. In contrast, the dispersion of the Hartree-Fock bands is marginally affected by electron correlations. Our final result for the fundamental gap of zinc-blende BN compares well with that derived from soft x-ray experiments at the B and N K-edges.

Risk index score for bacteremia in febrile neutropenic episodes in children with malignancies.

PURPOSE: To prospectively determine risk factors for bacteremia in febrile neutropenic children with malignancies. PATIENTS AND METHODS: We studied 199 episodes of febrile neutropenia in 80 children with malignancies, treated by conventional chemotherapy for a 4-year period (2000 - 2004). A standardized computer database with a set of variables for each febrile neutropenic episode was used. C-reactive protein (CRP) was measured at the first febrile episode and on the 3rd and 5th day from the beginning of antibiotic therapy by immunoturbidimetric method. Blood cultures were taken at the onset of fever and before initiation of antibiotic therapy. RESULTS: Multivariate logistic regression analysis determined 5 variables as independent risk factors for bacteremia: the underlying malignant disease (leukemia, non - Hodgkin's lymphoma / NHL, stage IV), chills, perianal cellulitis, presence of central venous catheter and CRP rise >or=34.5 mg/L between the onset of fever and the 3rd day of empiric antibiotic therapy. Thus we identified a low-risk group for bacteremia of 19.1%. CONCLUSION: Serial measurement of CRP allows for definite risk stratification of febrile neutropenic episodes on the 3rd day from the onset of fever. The low-risk group could be eligible for sequential empiric antibiotic therapy.

Eco-compatible oxides enabling energy storage via Li+/Mg2+ co-intercalation.

The storage of energy by means of reversible intercalation of bivalent magnesium ions represents, nowadays, the shortest route for doubling the energy density of conventional lithium ion batteries. Contrary to the intercalation of monovalent lithium ions, the intercalation of Mg2+ is a kinetically limited process. Herein we demonstrate a new approach for improving Mg2+ intercalation, which is based on dual intercalation of Li+ and Mg2+ ions with a synergic effect. The concept is proved on the basis of eco-compatible oxides such as magnesium manganate spinels, MgMn2O4, and lithium titanates Li2TiO3 and Li4Ti5O12 with a monoclinic and spinel structure. These two types of oxides are selected since they exhibit high and low potentials of ion intercalation due to the redox couples Mn2,3+/Mn3,4+ and Ti3+/Ti4+, respectively. Through a newly developed method of synthesis, we succeeded in the preparation of well-crystallized nanosized spinels with a specific cationic distribution. The intercalation properties of MgMn2O4, Li2TiO3 and Li4Ti5O12 are first examined in model cells versus the metallic Li anode. The Li+ and Mg2+ intercalation is directed by the kind of the used electrolyte: a lithium electrolyte consisting of 1 M LiPF6 solution in EC : DMC and a magnesium electrolyte consisting of 0.5 Mg(TFSI)2 solution in diglyme. The mechanism of Li+ and Mg2+ co-intercalation is assessed by ex situ X-ray diffraction and high-resolution transmission electron microscopy (HR-TEM). Finally, a new type of hybrid Li-Mg ion cell combining MgMn2O4 and Li4Ti5O12 oxides as electrodes is constructed. The cell configuration allows reaching an operating voltage of around 1.7 V by using an electrolyte containing 0.5 M LiTFSI in diglyme.

Interleukin-6, interleukin-8, interleukin-10, and C-reactive protein in febrile neutropenia in children with malignant diseases.

AIM: To compare serum levels of interleukin-6, interleukin-8 and interleukin-10 in bacteremic and non-bacteremic episodes of febrile neutropenia in children with malignant diseases, and determine their changes and correlation with C-reactive protein (CRP). MATERIAL AND METHODS: Between January 2003 and June 2004, we examined 41 episodes of febrile neutropenia in 24 children with malignant diseases who were receiving polychemotherapy. C-reactive protein was measured at the onset of febrile episodes and on days 3 and 5 from beginning of therapy. The soluble interleukins-6, -8, and -10 were determined in the serum using enzyme bound immunosorbent analysis at the onset of fever and at 24 and 72 hours after initiation of an empiric antibiotic therapy. RESULTS: The CRP baseline levels differentiated the patients with unexplained fever from those with local infection but did not differentiate them from those with bacteremia. Interleukin-8 at 24 hours differentiated bacteremic from non-bacteremic episodes (P < 0.05) and at a cut-off value of 130 pg/ml it had a sensitivity of 72% and a specificity of 84% to differentiate bacteremia. Interleukin-10 at 24 hours yielded higher values in Gram (-) bacteremia in comparison with the non-bacteremic episodes (P < 0.001) and Gram (+) bacteremia (P < 0.05). Interleukin-6 at 24 hours had significantly higher values in febrile episodes of more than 3 days duration (P < 0.05). CONCLUSIONS: Interleukin-8 could differentiate in the first 24 hours bacteremic from non-bacteremic episodes in febrile neutropenia, while interleukin-10 is perhaps a more accurate marker for Gram (-) bacteremia.

Solid tumours in newborns and infants.

Thirty two cases of solid tumours in newborns and infants were observed by the authors over a 15 year period. The most common type of tumours were soft tissue tumours (n = 8), neuroblastomas (n = 7), nephroblastomas (n = 5) and germ cell tumours (n = 5). Other types of embryonal tumours such as retinoblastoma and hepatoblastoma were observed in four children and non-Hodgkin's lymphomas in three children. Of 25 children followed up 18 survived. Five children died of their tumours and two children died of causes unrelated to their basic disease. Analysis of the fate of the patients and the effect of the therapy is made. It is concluded that malignant tumours prevail in infancy (90.6% of all cases). The percentage of patients treated successfully with insignificant risk for consequences from radiotherapy and chemotherapy is also high (72%).

Glanzmann's thrombasthenia in 11 cases of one family.

We report here the largest family in Bulgaria with Glanzmann's thrombasthenia which is inherited in an autosomal recessive manner. Eleven children in four successive generations were followed up. Clinically, the disease manifested in mucocutaneous haemorrhages. Five of the children died due to severe haemorrhagic episodes. The diagnosis was confirmed by haemostasic investigation; in some of the children the thrombocytes were examined by electron microscopy. Necessity of prenatal diagnosis is suggested.

Secondary diabetes in children with thalassaemia major (homozygous thalassaemia).

Life expectancy of patients suffering from homozygous beta-thalassaemia has been improved due to the modern treatment of this disease. This has allowed development of late hemosiderosis-related complications and disturbances of the endocrine and exocrine functions of the pancreas. Carbohydrate metabolism of 16 patients with thalassaemia major was studied. Three of them presented with a pronounced clinical picture and biochemical constellations of a severe diabetes mellitus. The remainder had no clinical symptoms of carbohydrate metabolism disorders. The pancreatic beta-cell function of the patients was assessed by measuring the serum concentrations of immunoreactive insulin and by a glucose tolerance test. Most patients showed very low basal insulin levels while glucose tolerance was reduced in only one of them. In this patient we also established delayed insulin response after an intravenous glucose load. We concluded that the disturbed insulin secretion found in the children studied is most likely the earliest manifestation of the pancreatic beta-cell insufficiency which precedes the changes in the glucose tolerance.

A case of undifferentiated (embryonal) sarcoma of the liver: fine needle aspiration cytology diagnosis by one cell type.

We present the first case in Bulgaria of cytologically verified undifferentiated (embryonal) sarcoma of the liver. A 10-year-old girl was admitted to the hospital with abdominal pain, extreme hepatomegaly, one-month fever, anemia and highly elevated erythrocyte sedimentation rate (95 mm). A large formation was found in the right liver lobe on ultrasound examination, which was polycystic on CT scan. Neither bone marrow abnormalities nor elevation of serum alpha-fetoprotein was found. In the scanty specimen obtained by fine-needle aspiration biopsy under ultrasound control a characteristic prevalence of polygonal cells within mesenchyme tissue was found. The cells had eccentric hyperchromic nuclei which were pushed to the periphery by large clusters of PAS-positive, diastase-resistant granules. Vimentin and alpha 1-antitrypsyn were expressed immunohistochemically. The cells are pathognomonic of undifferentiated (embryonal) sarcoma of the liver. After preoperative chemotherapy with ifosfamide, vincristine and actinomycin D (CEVAIE, CWS--96) resection of the tumor including IV, V, VI and VII liver segments was performed. A 30 x 30-cm soft gray-whitish tumor with fine capsule was found. The cytological diagnosis was histologically verified. The patient had a mechanical subileus episode after the 6th course of chemotherapy. One year after the surgery she is in good condition. The histogenesis of this rare tumor is discussed regarding its unique cytology, immunohistochemical constellation and ultrastructure. A literature review is presented. The case indicates that the unique cell appearance in embryonal sarcoma of the liver provides a correct diagnosis even in a scanty specimen.

Three-dimensional analysis of combination effect of ellagitannins and acyclovir on herpes simplex virus types 1 and 2.

The effects of combinations of three nonahydroxyterphenoyl-bearing C-glucosidic ellagitannins (castalagin, vescalagin and grandinin) with acyclovir (ACV) on the replication of type-1 and type-2 herpes simplex viruses in MDBK cells were tested by the focus-forming units reduction test. Ellagitannins included in these combinations possess a high individual antiviral activity: selectivity index of castalagin and vescalagin versus HSV-1 was similar to that of ACV, and relatively lower against HSV-2. The three-dimensional analytical approach of Prichard and Shipman was used to evaluate the impact of drug-drug interactions. The combination effects of ellagitannins with acyclovir were markedly synergistic.