The relation between obesity and blood pressure (BP) is well known; however, its relationship with night-time BP and BP variability (BPV) has not been adequately examined. To examine the relationship between obesity and night-time BP/BPV. Data from 6,767 adults (46.4% males), aged 56.0 ±14.0, were collected during their visit to the Outpatient Hypertension Unit of a single institution and had valid ambulatory BP monitoring and anthropometric data. Body mass index (BMI) was estimated by weight and height measurements that took place at the office and categorized as normal weight [<25 kg/m2; 1,719 (25.4%)], overweight [25-29.9 kg/m2; 2,976 (43.0%)] or obesity [≥30 kg/m2; 2,072 (30.6%)]. Standard deviation (SD) and coefficient of variation (CV) of BP were used as indices of BPV. After adjusting for confounders, BMI was significantly related to night-time systolic (b=0.38, 95%CI: 0.31-0.46) and diastolic BP (b =0.10 95%CI: 0.05-0.015). Similarly, after adjusting for confounders, obesity was related to SD (b=0.25, 95%CI: 0.02-0.49) and CV (b = 0.23, 95%CI: 0.03-0.42) of night-time systolic BPV, while a similar pattern was found for diastolic BPV (p < 0.001). Restricted cubic spline models showed a significant joint effect of splines after adjusting for confounders, for all BPV indices (p< 0.05), but a trend for non-linearity found only for systolic BPV indices (χ2 = 3.74, p = 0.053 for SD and χ2 = 3.54, p = 0.060 for CV). In conclusion, the relationship between obesity and both nighttime BP and BPV provides new insights into the possible effects of obesity on the cardiovascular system.

The fatal triad in pcr-negative pediatric autopsies: A focus on aspiration, occult sepsis, and underlying immune dysfunction.

Recurrent weight gain after bariatric surgery (BS) or endoscopic bariatric therapy (EBT) remains a long-term clinical challenge, potentially undermining long-term treatment success. Tirzepatide, a dual agonist of the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors, has shown promising results in obesity treatment, but data regarding its use in post BS or EBT recurrent weight gain are limited. This observational cohort study evaluated the effectiveness and safety of tirzepatide in patients with recurrent weight gain after BS or EBT. Anthropometric data, BMI categories, and adverse events were collected at baseline and after 24 weeks of treatment. A total of 34 patients (26 females, 8 males) who experienced recurrent weight gain after BS (n = 32) or EBT (n = 2) were treated with once-weekly subcutaneous tirzepatide (dosing range 2.5-10mg/week). After 24 weeks, the mean percentage total body weight loss (%TBWL) was 18.1 ± 5.6% (p < 0.0001), with a significant reduction in waist circumference (p < 0.0001). Most patients shifted to lower BMI categories, with the majority reaching overweight or normal weight status. Adverse events were exclusively gastrointestinal (constipation, diarrhea, nausea), generally mild, and did not lead to treatment discontinuation. Preliminary evidence suggests that tirzepatide is associated with significant weight loss and good tolerability in this observational cohort for managing recurrent weight gain after bariatric surgery and endoscopic bariatric therapy. These findings suggest a potential role for tirzepatide as a valuable nonsurgical option in the multidisciplinary management of patients experiencing recurrent weight gain after bariatric procedures.

Risk stratification in early-stage Cardiovascular-Kidney-Metabolic Syndrome: The Potency of visceral adiposity and insulin resistance surrogate indices.

Progressive short stature in Pearson syndrome and the impact of organ failure.

This study aimed to examine the association between iron deficiency (ID) and thyroid dysfunction among Jordanian adults. A cross-sectional analysis was conducted using data from 3,605 participants in a 2017 nationwide survey covering all 12 Jordanian governorates. Sociodemographic, anthropometric, and biochemical data were collected, including serum ferritin, thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4). Participants were categorized as having iron deficiency (ID), iron deficiency anemia (IDA), or control group (CG). Kruskal-Wallis and chi-square tests were used, with p < 0.05 considered significant. Individuals with ID and IDA had significantly lower FT3 and FT4 levels and higher TSH levels compared to CG. The prevalence of hypothyroidism and combined hypothyroidism plus subclinical hypothyroidism was higher in the IDA group (p = 0.0011 and p = 0.0126, respectively). No significant associations were observed for hyperthyroidism or subclinical hyperthyroidism. Iron deficiency, particularly IDA, was associated with an increased prevalence of hypothyroidism among Jordanian adults. These findings highlight the importance of thyroid function screening in individuals with low iron status and underline the need for longitudinal studies to clarify causal pathways.

Obesity is a risk factor for hypercholesterolemia; however, evidence of obesity among Orang Asli (OA) adults remains limited. Lifestyle changes, including unhealthy diets and sedentary behavior, may increase vulnerability to noncommunicable diseases. This study examined the sex-specific associations between body mass index (BMI) and hypercholesterolemia using data from the OA Health Survey 2022. A total of 8160 adults aged ≥18 years with complete questionnaires, anthropometric data, and blood data were analyzed. The prevalence of hypercholesterolemia among OA adults was 47.6%; of these, 41.5% were previously undiagnosed. Compared with normal BMI, overweight and obesity were associated with a higher odds of hypercholesterolemia in both sexes. Older age, Senoi tribe affiliation, and diabetes were associated with hypercholesterolemia in both sexes. These findings highlight the need for culturally tailored interventions to strengthen obesity prevention and cholesterol testing in primary care and outreach services to reduce cardiovascular risk in OA communities.

Insulin resistance arises from impaired insulin signaling, leading to reduced glucose uptake and the progression of type 2 diabetes mellitus. Experimental evidence indicates that lithium modulates insulin signaling pathways; however, its role in the development of insulin resistance remains poorly defined. Anthropometric, biochemical, and lifestyle data were collected. IR was assessed via HOMA-IR, and insulin processing/clearance was evaluated by insulin to c-peptide ratio (ICPR). Univariate and multivariate logistic regression identified independent predictors of IR. ROC analysis assessed the diagnostic performance of Li. Linear regression examined associations between biochemical parameters and IR. A cross-sectional study was conducted among 211 adults with T2D attending AIIMS Raebareli; of these, 172 participants with complete data constituted the final analytical cohort, including 122 (70.9%) with insulin resistance (IR). The IR group exhibited significantly higher fasting and postprandial glucose, insulin, C-peptide, ICPR, total cholesterol, and TyG index, and lower serum lithium levels than the non-IR group. Multivariate logistic regression analyses identified ICPR, TyG index, and serum lithium (OR = 3.69, 95% CI: 1.190-11.437, P = 0.024) as independent predictors of IR. ROC analysis showed that a lithium cutoff of 0.1 mmol/L predicted IR, with 81.9% sensitivity and 56.5% specificity (AUC = 0.863). Lower lithium levels were associated with higher insulin, C-peptide, and ICPR, and linear regression revealed a significant inverse association between lithium and HOMA-IR (β = -0.233, p = 0.007). Lower serum lithium levels independently predict insulin resistance in T2DM, alongside ICPR and TyG index. This association with hyperinsulinemia and impaired insulin processing/clearance suggests a potential mechanistic role for lithium in metabolic dysregulation.

A body shape index is a better predictor of overall and cardiovascular mortality than body mass index: Results from the ENAH study.

ABSTRACT This paper enriches the literature on the debate regarding the relationship between maternal employment and child malnutrition. Some argue that maternal employment is associated with an increase in child malnutrition, while others contend that it leads to a decrease in child malnutrition. The debate centers on the trade-off between time spent working versus caring for children (substitution effect) and the income gained from employment (income effect). The substitution and income effects have opposite impacts on child malnutrition. The substitution effect may increase child malnutrition, while the income effect may reduce it. This paper contributes new empirical evidence of the association between maternal employment and child malnutrition, measured with stunting and wasting in Indonesia, where child malnutrition remains one of the challenges in development. It addresses potential endogeneity concerns through the use of the IV-2SLS approach and utilizes data from the 2021 ‘Indonesian Nutrition Status Study’ data, a nationally representative survey noteworthy for its anthropometric data. It concludes that maternal employment is related to lower malnutrition indicating that the income effect is greater than the substitution effect. Policymakers can therefore focus on improvements in infrastructure, including healthcare facilities and community education, as they are essential and needed to increase women's income.

Urinary screening is a useful and non-invasive tool for identifying occult kidney disease in asymptomatic children and may be an important initial step in preventing progressive kidney disease. However, this screening is not commonly performed in children living in low-resource countries, including the Democratic Republic of the Congo (DRC). This study aimed to determine the prevalence of albuminuria and its associated factors among healthy school children living in DRC. In addition, the study examined the prevalence of urinary abnormalities detected by dipstick in this population. This cross-sectional study was conducted in 17 schools in Kinshasa. A multistage sampling procedure was applied, and 497 healthy school children aged 6 to 16 were randomly recruited. Anthropometric and clinical data were collected. Using a single-sample measurement, urinary albumin-to-creatinine ratio (ACR) was determined by an immunoturbidimetric method, and dipstick tests were performed to detect other urinary abnormalities (leukocyturia, nitrituria, proteinuria, hematuria). Albuminuria was defined as ACR ≥ 30mg/g. Logistic regression was used to identify clinical factors associated with albuminuria. Among the 497 school children (208 boys and 289 girls), 58 had single-sample albuminuria, corresponding to a prevalence of 11.7%. There was no significant association between albuminuria and clinical variables based on univariate logistic regression analysis. Dipstick urinary abnormalities were present in 113 children (22.7%). Specifically, leukocyturia, nitrituria, proteinuria, and hematuria were detected in 14.3%, 1.6%, 8.2%, and 1.6% of participants, respectively. Leukocyturia and nitrituria were significantly more common among girls (p < 0.001). Urinary abnormalities are common among asymptomatic school children in the DRC. Although a single measurement was performed, these results raise the relevant question of the usefulness of urinary screening in children living in resource-limited settings. However, the feasibility, cost, and potential benefits of such a program warrant further evaluation in these settings.

Urban-rural disparities in physical fitness during early childhood remain insufficiently characterized. This study aimed to identify physical fitness phenotypes among preschool children in urban and rural settings and evaluate their predictability using anthropometric and demographic features. A total of 1049 children aged 3-6 years were assessed using standardized fitness tests. K-means clustering identified latent fitness profiles separately in urban and rural groups. Logistic regression, random forest, and XGBoost models were trained to predict cluster membership using anthropometric and demographic variables. Two distinct fitness phenotypes were consistently identified, with Cluster1 demonstrating superior strength, power, and coordination ([Formula: see text]). Supervised models achieved moderate predictive performance (accuracy ≈ 0.79-0.80; AUC ≈ 0.85-0.86). Model interpretation indicated that age and height were the most influential predictors, while body composition and demographic variables contributed less. Preschool children exhibit distinct, region-dependent fitness phenotypes. While these phenotypes are primarily defined by motor performance, their prediction based on anthropometric data alone is moderate, highlighting the importance of functional assessments for early fitness evaluation.

We investigated factors associated with military personnel success in Special Operations courses (course pass or fail). A systematic search was conducted across eight databases using the keywords "Special Operations" and "attrition." Sample size and profile data, course characteristics, predictive factors, follow-up, and results were extracted from the studies. We compared the means of the variables associated with success between the groups that completed and did not complete the courses. A meta-analysis was conducted for factors assessed by two or more studies, pooling standardized or weighted mean differences using fixedor random-effects models. A total of 23 studies were included. They were published between 1990 and 2022, included samples from 10 nations, lasted between 5 days and 12 months, and ranged from 11 to 1,138 individuals. VO2max, pull-ups, push-ups, and marching performance showed consistent positive associations with course success, while body fat percentage and sit-up performance did not. Certainty of evidence was rated as low to very low using the Grading of Recommendations Assessment, Development, and Evaluation. The factors that increased the probability of success in Special Operations courses were character strengths, recidivism in the course, anthropometric data, performance on physical assessment tests, psychological dissociation, psychosocial resources, blood markers, smoking/alcohol consumption, personality, and psychological strength. These findings support the inclusion of aerobic capacity, muscular endurance, and psychological resilience in early screening and preparatory selection processes.

Maternal and neonatal morbidity and mortality have declined dramatically during the last century. Historical data are therefore important sources to study the evolutionary selection pressures related to childbirth and how they have fluctuated over time. We analyzed birth records detailing 17,473 births of the years 1896 to 1944 from the maternal hospital Basel, Switzerland. This enabled the evaluation of changes in anthropometric data across several generations during times of varying socioeconomic stress. Our results revealed very weak correlations (r< 0.2) of maternal measurements such as stature and pelvic size with the size of the newborn (birth weight, head circumference). Maternal pelvic size was weakly correlated with stature (r = 0.33). While mean maternal stature showed a clear secular trend, increasing steadily by 5%, that is, from 153 cm for mothers born 1850 to 161 cm for mothers born 1923, birth weight fluctuated slightly during economically demanding periods, with an overall increase of only 3.8% from 3160 g in 1896 to 3280 g in 1944. In contrast, virtually no changes were found in pelvic size and newborn head circumference, implying the existence of strong stabilizing selection pressures on maternal pelvic dimensions and neonatal head circumference. We conclude that the resulting constant cephalopelvic proportion guarantees obstetric sufficiency as predicted by the obstetrical dilemma.

Prevalence of metabolic syndrome among family farmers in Southern Brazil chronically exposed to pesticides.

Type 2 diabetes mellitus is a complex metabolic disorder with rising prevalence in Nigeria. APOL1 and NOTCH2 have been implicated in glucose metabolism, adiposity, and diabetic complications, necessitating comparison of APOL1 and NOTCH2 gene expression in patients with T2DM and healthy controls. A case-control study was conducted among 50 participants attending Babcock University Teaching Hospital, Nigeria. Participants were consecutively recruited based on eligibility and sample availability during the study period. Sociodemographic, anthropometric, and clinical data were collected. Biochemical analyses included fasting plasma glucose, lipid profile, urea, creatinine, glycated haemoglobin, serum insulin, and insulin resistance estimated using Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Gene expression of APOL1 and NOTCH2 in peripheral blood mononuclear cells was quantified using real-time reverse transcription quantitative PCR. Group comparisons and correlation analyses were performed using parametric or non-parametric statistical methods, including Pearson's or Spearman's correlation tests, depending on data distribution. Participants with T2DM demonstrated significantly higher fasting glucose, HbA1c, triglycerides, urea, and HOMA-IR compared with controls (p < 0.05). Cases exhibited significantly higher fasting glucose, HbA1c, triglycerides, urea, and HOMA-IR, indicating poor glycaemic control and increased insulin resistance. APOL1 expression was significantly lower in T2DM cases compared with controls (p < 0.05), whereas NOTCH2 expression did not differ significantly between groups. APOL1 expression correlated positively with adiposity measures but showed significant inverse associations with fasting glucose, HbA1c, and urea. NOTCH2 expression was negatively associated with age and fasting glucose and positively correlated with hip circumference. A moderate positive correlation was observed between APOL1 and NOTCH2 expression. These findings highlight the importance of integrating molecular markers with clinical and biochemical data to improve understanding of T2DM in African populations.

The aim of this study was to evaluate whether machine learning models comprising anthropometric, physical fitness, and sport-specific performance data from young canoe sprint athletes can predict their senior performance level (SPL). Between 1992 and 2019, anthropometric (e.g. body mass/height), physical fitness (e.g. 800 m/1500 m run, 2min bench press/pull), and sport-specific performance (e.g. 250 m/2000m on-water canoe sprint) data as well as age (i.e. U13 to U16) and sport discipline were annually examined in young male and female canoe sprint athletes (n = 729, male: 495, female: 234). A benchmark experiment was conducted to evaluate and compare multiple classification models and to use the final model to predict SPL (national vs. international) on three validation datasets (n = 103, U13 to U17, 2021 to 2023) with ground-truth labels from 2025. Findings revealed that an XGBoost model achieved acceptable discrimination (AUC = 0.81) and balanced accuracy (BACC = 0.73) for predicting SPL in young canoe sprint athletes. However, precision for the international class was low (PRAUC = 0.35, PPV = 0.20), indicating many false-positive international predictions. The most important feature was 2000m on-water canoe sprint test. Furthermore, predictions on the three external validation datasets showed limited temporal generalizability, with moderate discrimination (AUC: 0.68 to 0.73), modest but consistently above-chance balanced accuracy (BACC: 0.59 to 0.63), and moderate but variable sensitivity (0.20 to 0.67). However, precision for identifying international athletes was low across the external validation datasets, indicating a high false-positive rate. Therefore, the model should be interpreted as an acceptable screening tool. However, low precision and variable sensitivity limit its practical utility as a stand alone selection instrument. The present findings may help practitioners involved in talent selection and development in Olympic canoe sprinting and may inform the development of future prediction models for young canoeists based on anthropometric, physical fitness, and sport-specific performance data.

Objective: This study aims to investigate the relationship between triglyceride-based indices (lipid accumulation product (LAP), triglyceride-glucose (TyG) index, and visceral adiposity index (VAI)) and glycated hemoglobin A (HbA1c) levels in atherosclerosis patients. Materials and Methods: The retrospective cross-sectional analysis was performed using recorded demographic, anthropometric, and laboratory data of 113 patients diagnosed with atherosclerosis. The TyG, LAP, and VAI indices were computed using standard formulas derived from available anthropometric and biochemical measurements. Participants were classified considering HbA1c levels as normoglycemic (&amp;lt;5.7%), prediabetic (5.7-6.4%), or diabetic (≥6.5%). Correlation analyses, group comparisons (ANOVA or Kruskal-Wallis tests), and multivariable logistic regression models adjusted for body mass index (BMI), waist-to-height ratio (WHtR), high-density lipoprotein cholesterol (HDL-C), sex, and age were applied. Results: HbA1c levels showed significant positive correlations with TyG (r = 0.32, p = 0.009), LAP (r = 0.47, p &amp;lt; 0.001), and VAI (r = 0.36, p = 0.004). All indices increased significantly across HbA1c categories (p &amp;lt; 0.001). In multivariable analysis, only the TyG index remained independently related with elevated HbA1c levels (OR = 21.57, 95% CI: 6.53-71.24, p &amp;lt; 0.001). Receiver operating characteristic (ROC) analysis yielded good discriminatory performance for the TyG index (AUC = 0.83), and the optimal cut-off value was 9.0. Conclusion: Among triglyceride-based metabolic indices, the TyG index demonstrated the strongest independent relationship with elevated HbA1c levels, highlighting its potential clinical utility as a simple marker of glycemic dysregulation in patients with atherosclerosis.

Investigation of dietary patterns provides an integrative model for examining the role of diet in chronic diseases. In this context, this study evaluated dietary patterns and their association with metabolic syndrome (MetS) and its components among quilombola women. A population-based cross-sectional study was conducted with women aged 19 to 59 years living in quilombola communities in Alagoas, Brazil. Socioeconomic, demographic, anthropometric, clinical, and dietary intake data were collected using a 24-hour dietary recall. Metabolic syndrome was defined according to the Joint Interim Statement criteria (abdominal obesity, hypertriglyceridemia, low HDL cholesterol, hypertension, and hyperglycemia assessed by HbA1c instead of fasting plasma glucose). Dietary patterns were identified by factor analysis and classified into quartiles. Associations were estimated using prevalence ratios obtained by Poisson regression with robust variance. The sample included 895 women (mean age: 38.9 ± 11.0 years), of whom 48.3% had MetS. Seven dietary patterns were identified, none of which were associated with MetS. Moderate adherence to the "meat and beans" pattern was associated with a lower prevalence of hypertriglyceridemia (PR = 0.76; 95% CI: 0.58-0.99). The "dairy and soups" pattern was associated with a lower prevalence of hyperglycemia (PR = 0.68; 95% CI: 0.49-0.93) and low HDL cholesterol (PR = 0.89; 95% CI: 0.80-0.99). Higher adherence to the "cereals/roots, oils, and infusions" pattern (PR = 1.10; 95% CI: 1.01-1.19) and higher adherence to the "fruits" pattern in the second quartile (Q2) (PR = 1.10; 95% CI: 1.02-1.20) were associated with abdominal obesity. No dietary pattern was directly associated with metabolic syndrome; however, relevant associations were observed with specific metabolic components - particularly hypertriglyceridemia, hyperglycemia, low HDL cholesterol, and abdominal obesity -, highlighting the importance of dietary profiles in the metabolic health of quilombola women.

Sleep terror (ST) is a common NREM parasomnia in early childhood and may be associated with broader emotional and behavioral dysregulation. However, its links with psychopathological symptoms and nutritional biomarkers remain unclear. This study compared children with ST and healthy controls (HC) in terms of psychopathology, sleep features, and biochemical markers, and explored short-term changes in a subgroup of children with ST receiving supplementation for documented micronutrient deficiencies. Forty-eight children aged 24-60 months with ST and 48 HC were evaluated for sociodemographic, sleep, biochemical, anthropometric, and standardized scale data obtained from electronic medical records. A subset of 25 children with ST with documented micronutrient deficiencies received guideline-based supplementation and had biochemical and scale reassessments after a mean interval of 90.6 days, as part of routine clinical follow-up. Children with ST showed shorter sleep duration and higher rates of bedtime resistance at the nominal level, but these differences did not survive FDR correction (FDR p = .092 and 0.069, respectively). Only nocturnal awakenings remained significant after FDR correction (FDR p = .028). In contrast, total anxiety, behavioral dysregulation, and sleep disturbance scores were markedly higher in the ST group and remained significant after FDR correction (all FDR p < .001). Vitamin D (20.4 vs. 25.8 ng/mL; p = .015, FDR p = .026), vitamin B12 (231.7 vs. 309.4 pg/mL; p = .002, FDR p = .003), and folate (11.3 vs. 13.1 ng/mL; p = .016, FDR p = .028) levels were lower in the ST group. At follow-up, vitamin B12 increased significantly (201.8→281.1 pg/mL; p = .006, FDR p = .009; r = .631, 95% CI [0.237, 0.926]), whereas other biomarkers did not change significantly after FDR correction. Anxiety, behavioral dysregulation, and sleep disturbance scores decreased substantially; however, change-score analyses did not show statistically robust associations between vitamin B12 change and symptom change after FDR correction. ST in early childhood was associated with a multidimensional profile of anxiety, behavioral dysregulation, parent-rated sleep disturbance, and lower vitamin D, vitamin B12, and folate levels. Clinical symptom differences remained robust after FDR correction. During naturalistic follow-up, vitamin B12 increased and symptom scores decreased, but change-score analyses did not support a direct biomarker-symptom association. These findings should be interpreted as hypothesis-generating. Larger prospective, controlled studies are needed to clarify the role of micronutrient status in early childhood ST.