Weight Categories Research Articles

Detection of biventricular volume increase in overweight and obese by using a novel index of the ideal human - a single center non-contrast-enhanced cardiac CT study

Abstract The bi-ventricular volume (BVV) can be measured from non-contrast-enhanced CT images in patients referred for coronary artery calcium (CAC) scoring. Such determined BVV has been found to correlate with left ventricular mass and to predict increased risk of all-cause and CV mortality in patients with type 2 diabetes mellitus. Currently, no data are available that quantifying the effect of body size on BVV using NCE-CT. We used a new indexing parameter that consisted of two parts: height and the difference between numerical values of height and body surface area (BSA). In the "ideal human", the difference is zero. Any deviation from this value determines the share of body mass regardless of height. Aim We hypothesize that a novel indexation way allows for better discrimination of the increased bi-ventricular volume in overweight and obese patients. Method We retrospectively analyzed the CT data from 2466 patients with CAC scoring over the last 15 years. Among them 1606 women and 860 men with an average age of 64 ± 11 years (range 21-93). The fatless bi-ventricular volume was measured manually using commercial software on a dedicated workstation (Vitrea2). Values of the raw (measured, ml) BVV and BVV normalized for height, BSA, and the novel parameter i.e. [h+ (h-BSA)], were compared in patients taking into account body mass index (BMI) categories of normal weight (25% of patients), overweight (40%) and obese (35%). Results Overall, the measured BVV [ml] was significantly greater in males (414±97) than in females (297±66) (p<0.001). BVV decreased non-linearly from before 40ties to mid-60ties, and then remained nearly stable. In normal-weight males, the measured BVV (370±80ml) was greater than in normal-weight females (279±61ml) (p<0.001). In overweight males, the BVV was 411±89ml; in overweight females, the BVV reached 290±59ml (p<0.001). These differences were non-significantly different from the sample of patients with normal BMI. In obese patients, mean values significantly differed between males and females (442±106 vs 321±71 ml, p<0.001). As the absolute value of the BVV should be interpreted in the context of body habitus, normalization for height, BSA, and the novel index were used. The results of these examinations are given in the figure. Conclusions Commonly used methods of indexing the volumetric parameters of the ventricles, as well as the novel indexing approach showed similar results in patients with normal body weight. The proposed indexation allowed for discriminating the increase in BVV that is easy to overlook in overweight. The use of body surface area for volumetric normalization is misleading as it provides similar values in normal, overweight, and obese patients, and should therefore be avoided. We should consider whether ventricular size standards based on a study population under 50 years of age create reliable conditions for detecting ventricular enlargement at an older age.

Blood pressure and cardiovascular risk in relation to birth weight and urinary sodium: an individual-participant meta-analysis of European family-based population studies

Abstract Background While the relation of salt intake with blood pressure (BP) is linear, it is U-shaped for mortality and cardiovascular disease (CVD). Purpose This individual-participant meta-analysis explored whether the relation of hypertension, death or CVD with 24 h urinary sodium excretion (UVNA) or sodium-to-potassium (UNAK) ratio was modified by birth weight. Methods Families were randomly enrolled in the Flemish Study on Genes, Environment and Health Outcomes (1985-2004) and the European Project on Genes in Hypertension (1999-2001). Categories of birth weight, UVNA and UNAK (≤2500, >2500-4000, >4000 g; <2.3, 2.3-4.6 and >4.6 g; and <1, 1-2 , >2, respectively) were coded using deviation-from-mean coding and analyzed by Kaplan-Meier survival functions and linear and Cox regression. Results The study population was subdivided into the Outcome (n=1945), Hypertension (n=1460) and BP cohorts (n=1039) to analyze the incidence of mortality and cardiovascular endpoints, hypertension and BP changes as function of UVNA changes. The prevalence of low/medium/high birth weight in the Outcome Cohort was 5.8/84.5/9.7%. Over 16.7 years (median), rates were 4.9%, 8.0% and 27.1% for mortality, CVD and hypertension, respectively, but were not associated with birth weight. Multivariable-adjusted hazard ratios were not significant for any endpoint in any of the BW, UVNA and UNAK strata. Adult body weight tracked with birth weight (P<0.0001). The partial r in the low birth weight group associating changes from baseline to follow-up in UVNA and systolic BP was 0.68 (P=0.023), but not significant in other birth weight groups. Conclusion This study did not substantiate its prior hypothesis, but showed tracking of adult with birth weight and suggest that low birth weight increases salt sensitivity.Figure 1Figure 2

A Study of Heavy Road Freight Transport in Poland in the Context of the Pursuit of Sustainable Road Transport

The efficiency of road freight transport determines—to a significant degree—the total environmental footprint and the amount of greenhouse gases and other pollutants released into the atmosphere by inland transport. The rate of empty or partially empty vehicles is one of the key metrics for improvement of the environmental performance of freight road transportation. This paper presents the characteristics of road freight transport in Poland on the basis of data collected by weigh-in-motion stations. Data aggregation for environmental analysis represents a novel aspect of the work. Indicators describing the degree of loading, the share of empty vehicles in traffic, and the share of vehicles of maximum permissible total weight in traffic were determined for a representative group of heavy goods vehicles. Based on the representative load factor value (LFA), a classification of the road section into four groups was proposed. The results obtained show a clear differentiation of the values of the indicators analyzed for individual groups and their variability in the three-year period covered by the analysis. The aggregation method presented can be used to identify the nature of the distribution of the weight categories of the heavy goods vehicles and provide input information for targeted analyses relating to sustainable road transport management and environmental protection. Finally, the grouped LFA values were linked with indicators of energy consumption (ECI) and on-road emissions (EI).

Maternal education and antenatal attendance in Georgia: A cohort study

Abstract Background Antenatal care (ANC) and maternal education are important determinants for maternal and newborn health outcomes. Understanding the impact of maternal education on ANC is crucial. Purpose To examine the association between maternal education and ANC attendance. Methods A retrospective cohort study utilized nationwide electronic medical birth registry data (2020-2022) in Georgia. the study includes pregnant women and their newborns. A randomized sample was selected, and extracted variables included maternal age, parity, body mass index, education, year of delivery, gestational age, infant sex, Apgar score, birth weight, delivery type, and newborn status. Statistical analysis via IBM SPSS v23 involved chi-square, t-tests, and logistic regression. Results The sample size contains 4976 mothers after excluding cases with missing data (n = 25). The mean maternal age was 30.5 years (SD = 5.4), with a mean BMI of 28.0(SD = 4.8), and the mean gestational week was 38.4(SD = 2.0), with a mean birth weight of 3263.0 (SD = 568.0) grams. Highly educated women had more than 3 times higher odds (OR = 3.636,95%CI:2.575-5.134) of having at least one ANC visit compared to those with Unknown education. primiparous women had significantly higher odds of having at least one ANC visit compared to Multiparous women, OR = 1.519, (95%CI:1.081-2.135). The chi-square test showed significant difference between ANC visits and the number of liveborn/stillborn (χ² = 53.026, p < .001). Moreover, there was a significant association between birth weight categories and ANC visits (χ² = 167.095, p < .001). Conclusions Our study emphasizes the role of education in improving access to ANC among women with low education levels. We can increase ANC visits and improve maternal and newborn health outcomes by focusing educational efforts on pregnant women. Additionally, focusing on high-risk populations, and using tailored interventions can further improve ANC attendance along with maternal and neonatal health. Key messages • Boosting ANC access and improving maternal and neonatal health by tailored community programs. • Conservative communities and underrepresented communities require additional resources to promote tailored healthcare. and extra effort in education about ANC.

Obesity and renal impairment in patients with heart failure and reduced ejection fraction: another obesity paradox?

Abstract Background Obesity is associated with poor cardiovascular outcomes in patients with HF and reduced ejection fraction (HFrEF). However, whether obesity is associated with worse kidney outcomes in HFrEF has not been evaluated. Purpose To estimate the association between obesity and change in estimated glomerular filtration rate (eGFR) over time in patients with HFrEF. Methods In this post hoc analysis of the PARADIGM-HF trial, body mass index (BMI) and eGFR was collected in 8,389 patients. Change in eGFR over time was assessed according to baseline BMI (normal weight: BMI <25.0, overweight: BMI 25-29.9, and obesity: BMI ≥30). Results The number of patients in each BMI category was: 2,421 (BMI <25.0), 3,249 (BMI 25-29.9), and 2,719 (BMI ≥30), respectively. Patients with obesity were younger but had worse health status (worse NYHA class and KCCQ scores) and had more comorbidities including diabetes mellitus and hypertension. At baseline, eGFR was lower in patients who were overweight (BMI 25-29.9) and obese (BMI ≥30), compared to those with normal weight. Urine albumin-creatinine ratio (UACR) and kidney injury molecule-1 (KIM-1) were also higher in patients with obesity. However, the rate of change in eGFR per year (eGFR "slope") in the overall cohort did not differ according to BMI: change in eGFR per year was -1.8 [-2.1, -1.6] mL/min/1.73m2 for the normal weight category, -1.6 [-1.8, -1.3] mL/min/1.73m2 for those who were overweight, and -1.5 [-1.8, -1.3] mL/min/1.73m2 for those with obesity; P=0.21) (Figure 1). Among those without diabetes at baseline, those who were obese had a significantly less steep eGFR slope compared to patients in the other BMI categories. In those with diabetes at baseline, the eGFR slope was steeper than in patients without diabetes but was similar across all three BMI categories (Figure 2). Conclusions Although baseline kidney function was more impaired in HFrEF patients with obesity, high BMI was not associated with a more rapid subsequent rate of decline in eGFR. Figure 1. eGFR slope over time according to BMI at baseline in patients with HFrEF in PARADIGM-HF Figure 2. eGFR slope over time according to BMI at baseline in patients with HFrEF in PARADIGM-HF with and without diabetes at baselineFigure 1Figure 2-A and 2-B

Exploring UK adult and policy stakeholder perspectives on obesity prevention policy and inequalities

Abstract In England, 14 obesity strategies have been published, including 689 proposed policies, while rates of obesity persist, and inequalities worsen. This study explores adults’ attitudes in relation to food-related obesity policy and how socioeconomic inequalities in obesity are considered throughout the policy process through the perspective of policy stakeholders (PSH). 31 semi-structured interviews with UK-based adults (GPP) (18+) and 14 interviews with PSH categorised as government officials, academics, and advocacy group representatives were conducted and analysed using Braun and Clarke’s thematic analysis. Both PSH and GPP attributed obesity causation primarily to the food environment rather than to individual behaviour. The PSH identified the food industry’s role in shaping the environment. Level of deprivation was believed to exacerbate the barriers to healthy weight in both samples. All participants agreed that, in the UK, there was an unequal opportunity to attain a healthy diet. A disconnect was found between the GPP perspectives towards the barriers to healthy weight and their attitudes towards policy action. The GPP described mistrust in the government’s motives and willingness, fuelling the perspective that policy lacked impact and was disconnected from their lived experiences, particularly among participants of lower socioeconomic status and higher weight classifications. The PSH raised concerns regarding barriers to policy implementation, including inconsistent government commitment, competing priorities, and resistance to state intervention. PSH suggested that it was unfeasible to prioritise inequalities while population rates remain high, and the failure of implement proposed policies continue. This study shows the necessity of incorporating a health equity lens, breaking down policy silos, and amplifying community voices in the policy process to challenge assumptions regarding lived experiences and ensure healthier equitable policy outcomes. Key messages • The study shows the importance of integrating a health equity lens, breaking policy silos, and amplifying community voices to challenge assumptions and achieve more equitable policy outcomes. • Obesity policy requires greater consideration to inequalities to strengthen policy impact as demonstrated by all participants recalling the unequal opportunity to sustain a healthy weight in the UK.

Influence of soil microplastic contamination on maize (Zea mays) development and microbial dynamics

BackgroundMicroplastics are contaminants in soil ecosystems that alter biophysical processes, affect plant growth, ecosystems and humans in the long run. This study was conducted to investigate the influence of soil microplastic contamination on the growth, development, and microbial dynamics of maize (Zea mays).Composite soil samples were collected from the farm from 0 to 10 cm depth. Physicochemical properties were assessed before maize seed sowing. Three soil weight categories were treated with 30 g, 20 g and 10 g microplastics. Soil physicochemical properties and heavy metal content in maize plants were analyzed. Morphological parameters, microbial counts, and microorganism identification were conducted. FTIR analysis was carried out in selected plant parts.ResultsThe study revealed a pH range of 5.00–6.70, electrical conductivity of 70–158 µS/cm, organic carbon and organic matter, total nitrogen, average phosphorus content, clay and silt content. The concentrations of heavy metals in plant parts were within WHO standard limits of 425.5 and 500 mg/kg for iron and manganese, but above the limits of 40, 60, and 350 mg/kg for copper, zinc and magnesium. The plant had various leaf sizes and heights, with chlorosis and necrotic activity ranging from 0.33 to 2.67, and a range of 1.33 to 6.33, respectively. Soil samples showed a total bacterial count (TBC) of 2.00 × 103 cfu/g to 7.60 × 104 cfu/g and a total fungal count (TFC) of 4.00 × 103 cfu/g to 2.20 × 104 cfu/g. Pseudomonas aeruginosa, Bacillus subtilis, Escherichia coli, Staphylococcus epidermidis, Proteus mirabilis and Bacillus cereus had percentage occurrences of 44.31, 21.17, 9.12, and 3.26%, respectively. Penicillium notatum was the most prevalent, while Fusarium spp. was the least prevalent. The FTIR analysis of maize seeds from soil samples A, B, and C revealed various organic compounds, with opium powder and streptomycin sulphate being the most abundant. The study revealed that pot B had the highest microplastic concentration at 1 WAS, while pot C had the lowest at 0.10 mg/kg, indicating a differential soil microplastic accumulation.ConclusionMicroplastics impact soil health, plant growth, and nutrient cycling, necessitating sustainable agriculture. Long-term research is needed to understand ecological and physiological impacts and explore remediation techniques.

An Analysis Through to Congruence Between Real and Self-Perceived Body Mass Index in Nursing Students.

Overweight and obesity are growing concerns that also affect nursing staff, healthcare professionals that play a critical role in public health awareness and intervention. This study aimed to define the health parameters associated with body weight, analyze if there is an erroneous self-perception of overweight/obesity through the distortion of body weight perception, and determine the predictive factors of body weight distortion. A cross-sectional study of 224 nursing students gathered anthropometric and demographic data. Self-perceived body weight was assessed using Stunkard and Stellar's scale. Descriptive statistics and multinomial logistic regression identified significant predictors of weight distortion. The analysis found that men reported greater weight discrepancies than women. Specifically, 57% of the men (28 of 49 participants) underestimated their real BMI, while only 23% of the women (40 of 175 participants) did so. Age, sex, and weight classification emerged as significant explanatory variables for the distortion of body weight perception. The findings indicate a significant vulnerability among nursing students to the misperception of their own body weight status, highlighting the need for targeted training strategies. These strategies should focus on correcting misperceptions of obesity among health professionals throughout their working life to improve future obesity prevention efforts for society.

Association between BMI and increased time-to-pregnancy in planned pregnancy couples: a cohort study in Guangzhou, China

BackgroundThis study examines the relationship between overweight and obesity and fertility in the context of China’s fertility. Given the inconsistent results in previous research, which mostly focused on females, our study targets couples in Guangzhou. We investigate the relationship between Body Mass Index (BMI) and time-to-pregnancy (TTP) to provide evidence-based strategies for enhancing reproductive outcomes in China.MethodsThis cohort study, utilizing the National Free Pre-pregnancy Checkups Project (NFPCP), employs a Cox regression model to assess the associations between different BMI categories and TTP. Heatmaps are utilized to investigate the association between various BMI combinations of couples and TTP. Additionally, restricted cubic spline (RCS) curves were used to explore the impact of different ranges of male and female BMI on TTP.ResultsThe results showed that females and males classified as overweight and obese (fecundability ratios (FR) 0.78, 95% CI 0.64, 0.95 for females; FR 0.86, 95% CI 0.76, 0.97 for males) had longer TTP compared with those in the normal weight category, regardless of controlled covariates, while those classified as underweight also had longer TTP, but the difference was not statistically significant (P > 0.05). Across all BMI combinations, couples in the overweight and obese groups exhibited the longest TTP, experiencing a 34% increase in TTP compared to couples in the normal BMI combination (FR 0.66; 95% CI 0.50, 0.85). After adjusting for all covariates in the RCS model, a male BMI within the range of 23.40 to 29.44 was significantly associated with an increase in TTP (FR<1).ConclusionsIncreased BMI in both females and males is associated with a certain predictive effect on prolonged TTP. Scientific BMI management is crucial for couples preparing to conceive.

Are We Dosing Correctly? Population Pharmacokinetics of Cefepime in Critically Ill Pediatric Patients

Abstract Background Dosing guidelines of cefepime are well defined in healthy pediatric and adult populations but have not been extensively studied in critically ill pediatric patients. Patients who are critically ill may have significant alterations in antibiotic pharmacokinetics (PK) and pharmacodynamics (PD) due to many factors. Receipt of ECMO or CRRT may further alter PK/PD due to changes in clearance and volume of distribution and the depletion of plasma proteins. Since critically ill pediatric patients are likely to receive multiple courses of antimicrobials, optimization of drug dosing and delivery is critically important for individual patient outcomes. This study will test the hypothesis that the PK of cefepime is substantially altered in critically ill pediatric patients. Methods We prospectively enrolled patients in VUMC pediatric ICUs receiving cefepime, including those receiving ECMO or CRRT. Plasma samples were collected at opportune timepoints enriched for specific PK/PD metrics. Cefepime plasma concentrations were measured by LC-MS/MS. Weight, dose, interval, and administration time were extracted from the medical record. Monolix was used to fit population PK models using one and two-compartment models with a proportional error model. Covariate modeling was performed with a priori selected covariates: ECMO, CRRT, sex, race, ethnicity, gestational age, and creatinine clearance (CrCl). The final covariate model was used to perform probability of target attainment (PTA) analysis using Monte Carlo simulation. 6,000 subjects were simulated for each dosing regimen, with 3 weight categories (≤9 kg, 9-25 kg, and &amp;gt;25 kg) and 2 CrCl categories (≤90 mL/min and &amp;gt;90 mL/min). PTA was calculated over a grid of possible MIC values based on three targets, 65% fT&amp;gt;MIC, 100% fT&amp;gt;MIC, and 100% fT&amp;gt;4×MIC. Results Preliminary data from 84 pediatric participants receiving cefepime were analyzed. Of these, 9 received CRRT and 10 received ECMO. An average of 3 samples were collected per participant. A two compartment with proportional error model was selected as the base model. Population PK parameter estimates for the base model, base model with weight, and final covariate model were calculated. Inclusion of weight and CrCl significantly improved model fit. CRRT, ethnicity, and gestational age did significantly improve model fit, but their inclusion in the model did not provide evidence of being significantly better than the model with only weight and CrCl. The results from the PTA analysis are seen in Figure 1. We observed an overall ordering of PTA by dosing regimen across all three targets, with q8h 3-hour infusion having the highest PTA and q12h 30-minute infusion having the lowest PTA. Increased CrCl led to reduced PTA and as weight increased, PTA also increased. Conclusion This study will be among the first and largest to characterize cefepime PK in the critically ill pediatric population. Clinicians should incorporate local antibiograms with these population PK models to determine optimal dosing in critically ill pediatric patients. The use of extended infusions may be beneficial for PK/PD target achievement, particularly for resistant pathogens. Since clinical covariates affect PK parameters, this population may also benefit from therapeutic drug monitoring. Figure 1. Comparison of PTA among four dosing regimens of cefepime at targets of 65% fT&amp;gt;MIC, 100% fT&amp;gt;MIC, and 100% fT&amp;gt;4×MIC.

Association between cannabis use and physical activity in the United States based on legalization and health status

BackgroundStudies investigating the association between cannabis use and physical activity have had mixed results. This study provided a population-based assessment while determining how the relationship is affected by variables such as cannabis legalization status and chronic medical conditions.MethodsBehavior Risk Factor Surveillance System (BRFSS) data were used to evaluate the association between cannabis use and physical activity among adults ages 18 years and older in several states and territories of the U.S. during 2016–2022. Adjusted odds ratios (ORs) measuring the relationship between physical activity in the past 30 days (yes vs. no) and cannabis use in the past 30 days (yes vs. no) based on legalization and health status were estimated using logistic regression.ResultsPhysical activity increased from 73.16% in 2016 to 75.72% in 2022 (3.5% increase) and current cannabis use increased from 7.48% in 2016 to 14.71% in 2022 (96.7% increase). Current cannabis use was 6.5% higher in areas of legalized recreational cannabis (vs. not legal) and 0.7% higher in areas of legalized medical cannabis (vs. not legal). For the combined years, the OR measuring the association between cannabis use and physical activity was 1.24 (95% CI 1.10–1.41), after adjusting for age, sex, race/ethnicity, marital status, employment status, education, smoking status, weight classification, legal status, and chronic medical condition. The adjusted OR was 1.47 (95% CI 1.34–1.62) in areas with legalized recreational and medical cannabis (vs. illegal) and 1.05 (95% CI 0.98–1.12) in areas with legalized medical cannabis only (vs. illegal). Having a medical condition was significantly associated with lower prevalence of physical activity in the adjusted models (overall adjusted OR = 0.79, 95% CI 0.73–0.85). However, this significantly lower odds ratio was insignificant for current cannabis users.ConclusionsPublic policy and personal health behaviors may improve with the findings that legal medical cannabis promotes greater physical activity in those experiencing chronic medical conditions and legal recreational cannabis promotes (even more so) greater physical activity in those not experiencing chronic medical conditions.

Weight perception and mental health disorders among adolescents of central-eastern Tunisia: A cross-sectional study.

The physical changes that accompany the onset of puberty demand a constant restructuring of the adolescent's perception of their body and may influence adolescents' mental health. To describe weight status perception and its association with socio-demographic characteristics (SDC) and mental health disorders among adolescents in a low and middle-income country (LMIC). We conducted a cross-sectional study in high schools in the urban area of the governorate of Sousse, Tunisia in 2018. We included in our study all students studying in selected classes in selected public high schools and who are consented to participate. Multinomial logistic regression was used to assess the associated factors to weight perception categories. The total number of students participating was 1399 with a response rate of 86.68%. The female sex was predominant (60.5% versus 39.5%). The mean age was of 17.03 ± 1.51 years. According to multivariate analysis, perceived weight categories were associated with sociodemographic factors such as gender and maternal educational level. Adolescents perceiving themselves as obese were at risk for severe depression (aOR = 0.40; p = 0.033). The BMI was associated with weight misperception: adolescents with normal weight tend to overestimate their weight (obesity aOR = 0.13, p = 0.017; overweight aOR = 0.1, p = 0.001). There was a clear discrepancy between the actual weight status of the teens and their self-perceived weight. Adolescents are still growing both physically and mentally, and forming their self-image. Thus, health promotion practices designed to create accurate perceptions of current body weight need to be part of prevention efforts.

Golden score period in high-level judo competitions: the effect of the scores and penalties at the real contest time

ABSTRACT This study investigated the effect of scores and penalties in real contest time on the contest results in the golden score period. Of 6872 official contests at 10 different high-level competitions, 1414 contests with a golden score (21%) were included. Analyses for sex, weight category and rounds were performed with total match duration. Scores and penalties were recorded separately for real contest time and golden score period. Mutual waza-ari at real time (first 4 min) caused the high rate of matches ending with a score (p < 0.05). The rate of receiving a shido was higher among defeated athletes during the real contest time (p < 0.05). The rate of winning a contest with score during the golden score period was lower than winning a contest with hansoku-make in heavyweight categories. The contests more likely ended with scores and less likely ended with hansoku-make for men than women (p < 0.05). The results showed that the way the contest ended was different between sexes and among weight categories during the golden score period. Receiving a shido during the real contest time can lead to defeat in the golden score, thus athletes should be careful of presenting active judo and refraining from any action leading to penalties.

8137 Prevalence Of Overweight And Obesity In Dominican Children With Congenital Heart Disease

Abstract Disclosure: L.D. Rojas Rodríguez: None. M.J. Mateo Pérez: None. L.C. López Sención: None. V.T. San Martin: None. A. Grullón: None. Background: Overweight and obesity can be detrimental to the health of children with congenital heart disease, potentially leading to or contributing to other chronic medical conditions such as hypertension. This, in turn, may increase the cardiovascular demands of these patients whose lives are already affected by a defective heart anatomy. Objective: To determine the prevalence of overweight and obesity in Dominican children with congenital heart disease. Methods: An observational cross-sectional study was conducted to determine the prevalence of overweight and obesity in children with congenital heart disease attending the Pediatric Cardiology Department at Children's Hospital (Santo Domingo, Dominican Republic), from July to December 2022. The study population was classified into categories of underweight, normal weight, overweight or obesity using the CDC Body Mass Index-for-age growth chart (2022), based on their age, weight, height, and sex. The parents of the patients were interviewed to gather information about their children’s medical history, as well as their diet type and level of physical activity. Diet type was assessed through a questionnaire about daily meals; diets in which processed foods and simple carbohydrates were predominant were categorized as unhealthy, while those with a predominance of proteins and complex carbohydrates were categorized as healthy. Physical activity levels were measured using the Assessment of Physical Activity Level Questionnaire (APALQ). Additionally, blood pressure values were categorized as normal or elevated/high based on the American Academy of Pediatrics Clinical Practice Guidelines for Screening and Management of High Blood Pressure in Children and Adolescents (2017). Results: A total of 84 patients with congenital heart disease were analyzed, with 11.9% (10/84) categorized as having overweight and 23.8% (20/84) categorized as having obesity. Among patients with overweight or obesity, unhealthy eating habits predominated in 66.7% (20/30), while a sedentary level of physical activity was reported in 56.7% (17/30). Additionally, among patients with overweight or obesity, 36.7% (11/30) had elevated/high blood pressure. Conclusion: About one-third of Dominican patients with congenital heart disease were found to have overweight or obesity. Additionally, about one-third of those with excess weight were found to have elevated/high blood pressure. These findings stress the need for urgent implementation of personalized interventions and educational programs focused on fostering healthier lifestyles. The ultimate goal is to reduce cardiovascular risks and improve the overall well-being of children living with congenital heart disease. Presentation: 6/1/2024

Monitoring The Effort Curve In Physical Education For Normal And Overweight Students Using Smartwatches And Mobile Applications

Study purpose. In physical education and sports lessons, correctly dosing effort is essential for optimising physical performance and adapting effort parameters, including breaks, in line with physiological principles. The study hypothesises that using smart-watches and mobile apps to monitor effort in middle school physical education lessons will reveal significant differences in effort and heart rate between overweight and average BMI students. Modern technology is expected to enhance understanding of students' physical exertion, facilitating adjustments to programs based on health status and fitness level. Material and method. The study involved 45 students (average age 13.5 years) using 15 Xiaomi 8 smart-watches, phones, Wi-Fi, the Mi Fit app, and other devices to analyse body composition. Data on heart rate and BMI were collected during lessons, which followed the same theme and effort dosage. The Mi Fit app provided detailed aerobic and anaerobic exertion analyses. Parental consent was obtained, and data collection was done under routine lesson conditions. The technology aimed to improve performance and customise programs, offering a personalised approach to physical education. Real-time data transfer enabled accurate analysis of physical effort, promoting healthier lifestyles and better lesson adaptation by teachers. Results. A significant interaction between heart rate and BMI steps (p &lt; 0.01) shows different cardiovascular adaptations to exercise based on BMI. MANOVA confirmed the significant impact of these variables on heart rate, and post hoc comparisons showed differences between weight categories, except between overweight and extremely obese groups. These results highlight the need to tailor physical education programs to BMI categories to optimise cardiovascular health and performance. Conclusion. Results suggest that monitoring the effort curve using modern technologies, such as smart-watches and mobile apps, provides valuable information for adjusting and optimising physical education lessons, especially for overweight and obese students.

In Patients Presenting with an ST-Elevation Myocardial Infarction, Overweight and Obese Patients Have the Lowest Inpatient Mortality whereas Cachexia Patients Have the Highest Inpatient Mortality Followed by Patients with Morbid Obesity

Introduction: The obesity paradox has been observed in patients with cardiovascular disease. The goal of this study was to evaluate whether obesity has a protective effect in patients presenting with an ST elevation myocardial infarction (STEMI). Method: Using the large Nationwide Inpatient (NIS) sample database, we evaluated the mortality in patients with a STEMI based on weight categories. Results: A total of 2,161,640 STEMI patients were found in the database over age 18. We found that overweight and obesity had the lowest mortality using univariate (overweight mortality of 5% vs. obesity mortality of 6.5% vs. 10.9% for normal weights) and multivariate analyses (overweight OR: 0.52, CI: 0.43–063; p &lt; 0.001 and obesity OR: 0.7, CI: 0.67–0.74; p &lt; 0.001), whereas cachexia was associated with the highest mortality in the univariate (cachexia 24.5%) and multivariate (OR: 2.28, CI: 2.13–2.44; p &lt; 0.001) analyses, followed by morbid obesity in the multivariate analysis (OR: 1.07, CI: 1.02–1.12; p = 0.004). Conclusions: We observed a partial obesity paradox in patients with a STEMI showing that overweight have the best survival rates followed by obesity. Cachexia followed by morbid obesity had the lowest survival rates.

Association between body mass index and urinary tract infections: A cross-sectional investigation of the PERSIAN Guilan cohort study.

There is a relationship between excess body weight and the risk of a number of infectious diseases, including urinary tract infections (UTIs). This study aimed to investigate the correlation between body mass index (BMI) and UTIs among Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study (PGCS) population. This cross-sectional study was conducted on 10,520 individuals aged 35-70 years from PGCS. The demographical data and clinical characteristics of the participants were recorded. Microscopic examination of the urine samples was performed to detect the presence of bacteria or white blood cells (WBC) as indicators of infection. UTI was defined as the presence of bacteria in the urine (Few, moderate, and many) and a value of ≥10 WBC/high power field (HPF) by light microscopy. The prevalence of UTIs in this study was 8.8%, with a higher incidence in females compared to males (12.2% vs. 4.7%, p<0.001). Among participants, the prevalence of UTIs across different weight categories was as follows: underweight/normal weight, 7.1%; overweight, 8.1%; and obesity, 10.9%. According to the unadjusted model, subjects with obesity were at significantly higher odds for UTIs than subjects with underweight/normal BMI (OR=1.62, 95% CI: 1.35-1.93, p<0.001). However, this association was no longer significant after adjusting for demographic and clinical variables. The findings of this study provide evidence supporting a higher prevalence of UTIs among individuals with obesity.

Exploring the relationship of building area and GHGe: a mitigation strategy?

Abstract Greenhouse gas emissions (GHGe) from new constructions must be reduced to address the climate change crisis. Life cycle assessment (LCA) is widely applied to document the environmental impacts of buildings, often reporting results by dividing the total emissions over the measured building area, such as the gross floor area. The appropriateness of this approach has been debated in the building LCA research community and the construction industry, with concerns about the potential consequence of designing larger buildings to reduce emissions over the buildings’ life cycle and if this entails easier compliance with limit values in regulations. With a large collection of 291 case studies divided into four weight categories, potential correlations between constructing larger areas and GHGe are explored by fitting linear models. The results show that theoretically, GHGe reported per area can be decreased due to increased building area. However, this requires significant increases in area, which realistically results in increased costs, resource use, and related environmental impacts, which is not feasible. Therefore, the findings do not support the notion that interpreting LCA results per square meter encourages the enlargement of buildings to reduce emissions over their life cycle. It should be noted that the study’s conclusions are drawn from the end results of individual LCAs. The potential decrease in GHGe by enlarging the building area during the design process is not possible to derive without involving stakeholders. Thus, this study underlines the need for future research to achieve a nuanced relationship between building size, design choices, and environmental impacts.

Prevalence of physiological and perceptual markers of low energy availability in male academy football players: a study protocol for a cross-sectional study

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