Assessing Disparities about Overweight and Obesity in Pakistani Youth Using Local and International Standards for Body Mass Index.

Background/Objectives: Obesity is currently considered a public health problem in both developed and developing countries. Gender- and age-specific body mass index (BMI) growth standards or references are particularly effective in monitoring the global obesity pandemic. This study aimed to report disparities in age-, gender- and ethnic-specific statistical estimates of overweight and obesity for 2-18 years aged Pakistani children and adolescents using the World Health Organization (WHO), the Center for Disease Control (CDC) 2000 references, the International Obesity Task Force (IOTF) and Pakistani references for BMI. Methods: The study used secondary data of 10,668 pediatric population, aged 2-18 years. Demographic information like age (years), gender, city and anthropometric examinations, i.e., height (cm) and weight (kg) were used in this study. The recommended age- and gender-specific BMI cut-offs of the WHO, CDC 2000 and the IOTF references were used to classify the children sampled as overweight and obese. For the Pakistani reference, overweight and obesity were defined as BMI-for-age ≥ 85th percentile and BMI-for-age ≥ 95th percentile, respectively. Cohen's κ statistic was used to assess the agreement between the international references and local study population references in the classification of overweight/obesity. Results: The statistical estimates (%) of the participants for overweight and obesity varied according to the reference used: WHO (7.4% and 2.2%), CDC (4.9% and 2.1%), IOTF (5.2% and 2.0%) and Pakistan (8.8% and 6.0%), respectively; suggesting higher levels of overweight and obesity prevalence when local study references are used. The Kappa statistic shows a moderate to excellent agreement (κ ≥ 0.6) among three international references when classifying child overweight and obesity and poor agreement between local references and the WHO (0.45, 0.52), CDC (0.25, 0.50) and IOTF references (0.16, 0.31), for overweight and obesity, respectively. Conclusions: The results of the study showed a visible difference in the estimates of excess body weight after applying the WHO, CDC, IOTF and local BMI references to the study population. Based on the disparity results and poor agreement between international references and the local study reference, this study recommends using local BMI references in identifying children with overweight and obesity.

Acceptance, Awareness, Attitude, and Practices Toward Heart Transplantation: A Saudi Based Survey.

Introductions: The awareness of brain death and heart donation (HD) among the Saudi population remains limited, coupled with negative attitudes toward heart donation, resulting in a significant gap between the demand for donor hearts and the available supply. This study aimed to comprehensively understand the current perceptions, attitudes, and practices of the Saudi population regarding HD, as well as identify the obstacles. The ultimate goal was to strengthen the local donor pool. Methods: A cross-sectional study was conducted from March to May 2023, employing a self-administered internet survey. The survey collected demographic information, assessed awareness, attitudes, and practices related to HD, and was completed by 1820 participants from various regions in Saudi Arabia. Data was analyzed using SPSS version 25 (SPSS Inc., Chicago, Illinois, USA). Chi-square test, Independent-samples t-test, one way analysis of variance test (ANOVA) and Spearman correlation coefficient was performed with the significance level set at p < 0.05. Results: A significant portion of the population (out of 1820 participants) lacked organ donation cards and were uncertain about the registration process. Participants displayed a moderate level of knowledge about HD, with roughly half holding unfavorable attitudes toward HD. A considerable percentage of participants 62.0% were unwilling to register as heart donors, but a majority (79.9%) were willing to contribute by disseminating information about HD. The study identified significant associations between knowledge scores and several factors, including age (p = 0.002), career (p = 0.000), possession of an organ donation card (p = 0.000), and a history of transplantation or organ donation among relatives (p = 0.000). A significant relationship was observed between attitude scores and several factors, including career (p = 0.001), Saudi region (p = 0.025), possession of an organ donation card (p = 0.000), and a history of transplantation or organ donation among relatives (p = 0.000). Conclusion: The study highlights the urgent need for increased awareness to bolster the number of local heart donors. The involvement of healthcare professionals and social campaigns is essential to enhance public knowledge and potentially boost the willingness of individuals to become donors.

Improving the durability of cobaltite cathode of solid oxide fuel cells - a review.

Solid oxide fuel cells (SOFCs) are highly efficient, low-emission, and fuel-flexible energy conversion devices. However, their commercialization has lagged due to the lack of long-term durability. Among several performance degradation mechanisms, cathode degradation and elemental inter-diffusion of the electrolyte and cathode has been identified as the predominant factors. In the most common SOFC systems, a cobalt-based perovskite material is used, for example LSC or LSCF. These cobalt-based materials offer mixed conductivity and higher concentration of oxygen vacancies as compared to LSM at lower operating temperature leading to favorable reduction kinetics. However, the presence of cobalt results in higher cost, higher thermal expansion co-efficient (TEC) mismatch and most importantly leads to rapid degradation. Various elements like strontium, cobalt, cerium, chromium, or zirconium accumulate or deposit at the electrode-electrolyte interface, which results in sluggish reaction kinetics of the oxygen reduction reaction (ORR). These elements react to form secondary phases that have lower ionic and electronic conductivity, cover active reaction sites, and eventually lead to cell and system deterioration. Over the past decade, several studies have focused on preventative and protective measures to prolong SOFC lifetime which includes novel fabrication techniques, introduction of new layers, addition of thin films to block the cation transport. Such efforts to prevent the formation of insulating phases and decomposition of the cathode have resulted in a remarkable improvement in long-term stability. In this review paper, current research on leading mechanisms responsible for the degradation of cobaltite cathode of solid oxide fuel cell has been summarized and durability improvement strategies of cobalt-based SOFC cathodes have been discussed.

Exploring the therapeutic potential and bio-evaluation of muesli (Chlorophytum borivilianum) for the management of postprandial glucose management in healthy and diabetic female subjects.

Muesli and cereal based breakfast contain generous amounts of fiber that are helpful in the management of blood glucose levels. Muesli contains ß-glucans that ensure gradual rise in blood glucose levels. Muesli also limits the absorption of glucose by making it unavailable. This study explored the effect of muesli in the management of postprandial blood glucose levels. 15 healthy and 15 diabetic females were offered muesli meal after 8h fasting. Fasting blood glucose levels and blood glucose level 30 and 60 minutes after meal were measured. Results of study showed that muesli brought a gradual rise in blood sugar level. Healthy females showed fasting sugar (92.17±11.27), after 30 minutes (110.87±13.85) and after 60 minutes (114.25±15.67) while diabetic females showed fasting sugar (113.25±10.87), after 30 minutes (117.83±18.74) and after 60 minutes (118.26±17.85). The nutritional profile of muesli showed that it contained 202 kcal of energy, 32.7g of carbohydrates, 9g of fiber, 12.4g of protein and 2.5g of fats. It also contained 5.1g of ß-glucans. Muesli found to be effective in the management of postprandial blood glucose levels in healthy and diabetic populations.

Evaluation of two European risk models for predicting medication harm in an Australian patient cohort.

PURPOSE: To externally evaluate the performance of two European risk prediction models, for identifying patients at high-risk of medication harm, in an Australian hospital setting. METHODS: This was a secondary analysis of a pre-existing cohort study described in a recently published study by Falconer et al. (Br J Clin Pharmacol 87(3):1512-1524, 2021) describing the development of a predictive risk model for inpatient medication harm. We retrospectively extracted relevant variables using the electronic health records of general medical and geriatric patients admitted to a quaternary hospital, in Brisbane, over 6 months from July to December 2017. This dataset was used to externally evaluate the two European models, The Brighton Adverse Drug Reaction Risk (BADRI) model by Tangiisuran et al. and a risk model developed by Trivalle et al. The variables were entered into both models and the patients' risk of medication harm was calculated, and compared with actual patient outcomes. Predictive performance was evaluated by measuring area under the receiver operative characteristic (AuROC) curves. RESULTS: The Australian patient cohort included 1982 patients (median age 74 years), of which 136 (7%) patients experienced ≥ 1 medication harm event(s). External evaluation of the two European models identified that both the BADRI and the Trivalle models had reduced predictive performance in an Australian patient cohort, compared with their original studies (AuROC of 0.63 [95% CI: 0.58-0.68] and 0.60 [95% CI: 0.55-0.65], respectively). CONCLUSION: Neither model demonstrated sufficient discrimination to warrant further evaluation in our local setting. This is likely a result of variations between the development and the validation cohorts, and the change in healthcare systems over time, and highlights the need for an up-to-date and context-specific risk prediction model.

Social exchange theory: Systematic review and future directions.

Social exchange theory (SET) is one of the most influential theories in social sciences, which has implications across various fields. Despite its usefulness being a typical social transaction, there is a need to look at it from the lens of psychological transactions to further its evolution and to identify future directions. After generally reviewing 3,649 articles from the Social Science Citation Index and Scopus, a total of 46 articles were selected for final review using a comprehensive systematic review approach. We have highlighted the need for further research in psychological transactions, reciprocity principles, exchange relations, and the impact of various factors on the exchange process. Among other exchange rules (social, economic, and psychological) and transactions (social, economic, and psychological), this research provides an elevation platform for the less explored exchange rules in psychological transactions. Among other theories in the social sciences, social exchange theory is a theory that shadows many other theories under its umbrella.

Moringa Oleifera in Malnutrition: A Comprehensive Review.

Nutritional deficiency is a major concern in developing countries, resulting in serious health consequences like mental and physical growth retardation. Moringa oleifera (Moringa), a nutritious plant growing in tropical regions of developing countries, is a candidate for overcoming nutritional deficiency. Moringa leaves are rich in protein including sulphur containing amino acids. It contains high amounts of vitamin C than oranges, a higher concentration of vitamin A than carrots, higher calcium content than milk and more potassium than bananas. Moreover, there is 9 times more iron in moringa than spinach and 4 times more fiber than oats. This review enlightens and explores the nutritional diversification of Moringa oleifera and other benefits which make it a better choice to use in our daily diet to combat malnutrition.

Effect of integration of oxalic acid and hot water treatments on postharvest quality of rambutan (Nephelium lappaceum L. cv. Anak Sekolah) under modified atmosphere packaging.

The shelf life of rambutan is often limited due to rapid water loss from the spinterns and browning of the pericarp. An integrated approach, which combined hot water treatment (HWT) (56 °C for 1 min), oxalic acid (OA) dip (10% for 10 min) and modified atmosphere packaging (MAP), was used to study their effectiveness on the quality of rambutan during storage (10 °C, 90-95% relative humidity). Significant differences were observed in rambutan quality with the combination of MAP + HWT + OA after 20 days of storage. This treatment combination resulted into better retention of firmness and colour (L and a* values) than in the control. Change in the total soluble solid content was significantly delayed however the titratable acidity showed no significant change in comparison to the control at the end of storage.

Is the Future of Coronary Arterial Revascularization a Hybrid Approach?: The Canadian Experience Across Three Centers.

OBJECTIVE: Hybrid coronary revascularization offers and combines the advantages of both surgical and percutaneous revascularization and eliminates at the same time the disadvantages of both procedures. The objective of this study was to assess graft and stent patency at 6 months, rate of bleeding, intensive care unit and hospital stay, rate of reintervention, and long-term clinical follow-up. METHODS: From March 2004 to November 2015, a total of 203 patients underwent robotic-assisted minimally invasive direct coronary artery bypass graft of the left internal thoracic artery to the left anterior descending artery and PCI of a non-left anterior descending vessel in a single or two stage, at three different centers. Patients underwent 6-month angiographic follow-up. The mean ± SD clinical follow-up was 77.82 ± 41.4 months. RESULTS: Successful hybrid coronary revascularization occurred in 196 of the 203 patients. One hundred forty-six patients underwent simultaneous surgical and percutaneous intervention. Nineteen patients underwent PCI before surgery, and 38 patient underwent PCI after surgery. No in-hospital mortality occurred. The mean ± SD ICU stay was 1 ± 1 days and the mean ± SD hospital stay was 5 ± 2 days. Only 13.3% of the patients required a blood transfusion. Six-month angiographic follow-up has been performed in the 95 patients, and it demonstrated a left internal thoracic artery anastomotic patency of 97.9% and stent patency of 92.6%. A total of 77.8 ± 41.4-month clinical follow-up demonstrated 95.1% survival, 92.6% freedom from angina, and 90.7% freedom from any form of coronary revascularization. CONCLUSIONS: Hybrid coronary revascularization seems to be a promising and safe revascularization strategy. It provides selected patients with an alternative, functionally complete revascularization with minimal surgical trauma and good long-term clinical outcomes.