METHODS: Using established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021, we modelled overweight and obesity across childhood and adolescence from 1990 to 2021, and then forecasted to 2050. Primary data for our models included 1321 unique measured and self-reported anthropometric data sources from 180 countries and territories from survey microdata, reports, and published literature. These data were used to estimate age-standardised global, regional, and national overweight prevalence and obesity prevalence (separately) for children and young adolescents (aged 5-14 years, typically in school and cared for by child health services) and older adolescents (aged 15-24 years, increasingly out of school and cared for by adult services) by sex for 204 countries and territories from 1990 to 2021. Prevalence estimates from 1990 to 2021 were generated using spatiotemporal Gaussian process regression models, which leveraged temporal and spatial correlation in epidemiological trends to ensure comparability of results across time and geography. Prevalence forecasts from 2022 to 2050 were generated using a generalised ensemble modelling approach assuming continuation of current trends. For every age-sex-location population across time (1990-2050), we estimated obesity (vs overweight) predominance using the log ratio of obesity percentage to overweight percentage.
FINDINGS: Between 1990 and 2021, the combined prevalence of overweight and obesity in children and adolescents doubled, and that of obesity alone tripled. By 2021, 93·1 million (95% uncertainty interval 89·6-96·6) individuals aged 5-14 years and 80·6 million (78·2-83·3) aged 15-24 years had obesity. At the super-region level in 2021, the prevalence of overweight and of obesity was highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and the greatest increase from 1990 to 2021 was seen in southeast Asia, east Asia, and Oceania (eg, Taiwan [province of China], Maldives, and China). By 2021, for females in both age groups, many countries in Australasia (eg, Australia) and in high-income North America (eg, Canada) had already transitioned to obesity predominance, as had males and females in a number of countries in north Africa and the Middle East (eg, United Arab Emirates and Qatar) and Oceania (eg, Cook Islands and American Samoa). From 2022 to 2050, global increases in overweight (not obesity) prevalence are forecasted to stabilise, yet the increase in the absolute proportion of the global population with obesity is forecasted to be greater than between 1990 and 2021, with substantial increases forecast between 2022 and 2030, which continue between 2031 and 2050. By 2050, super-region obesity prevalence is forecasted to remain highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and forecasted increases in obesity are still expected to be largest across southeast Asia, east Asia, and Oceania (eg, Timor-Leste and North Korea), but also in south Asia (eg, Nepal and Bangladesh). Compared with those aged 15-24 years, in most super-regions (except Latin America and the Caribbean and the high-income super-region) a greater proportion of those aged 5-14 years are forecasted to have obesity than overweight by 2050. Globally, 15·6% (12·7-17·2) of those aged 5-14 years are forecasted to have obesity by 2050 (186 million [141-221]), compared with 14·2% (11·4-15·7) of those aged 15-24 years (175 million [136-203]). We forecasted that by 2050, there will be more young males (aged 5-14 years) living with obesity (16·5% [13·3-18·3]) than overweight (12·9% [12·2-13·6]); while for females (aged 5-24 years) and older males (aged 15-24 years), overweight will remain more prevalent than obesity. At a regional level, the following populations are forecast to have transitioned to obesity (vs overweight) predominance before 2041-50: children and adolescents (males and females aged 5-24 years) in north Africa and the Middle East and Tropical Latin America; males aged 5-14 years in east Asia, central and southern sub-Saharan Africa, and central Latin America; females aged 5-14 years in Australasia; females aged 15-24 years in Australasia, high-income North America, and southern sub-Saharan Africa; and males aged 15-24 years in high-income North America.
INTERPRETATION: Both overweight and obesity increased substantially in every world region between 1990 and 2021, suggesting that current approaches to curbing increases in overweight and obesity have failed a generation of children and adolescents. Beyond 2021, overweight during childhood and adolescence is forecast to stabilise due to further increases in the population who have obesity. Increases in obesity are expected to continue for all populations in all world regions. Because substantial change is forecasted to occur between 2022 and 2030, immediate actions are needed to address this public health crisis.
FUNDING: Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council.
METHODS: Leveraging established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study, we estimated the prevalence of overweight and obesity among individuals aged 25 years and older by age and sex for 204 countries and territories from 1990 to 2050. Retrospective and current prevalence trends were derived based on both self-reported and measured anthropometric data extracted from 1350 unique sources, which include survey microdata and reports, as well as published literature. Specific adjustment was applied to correct for self-report bias. Spatiotemporal Gaussian process regression models were used to synthesise data, leveraging both spatial and temporal correlation in epidemiological trends, to optimise the comparability of results across time and geographies. To generate forecast estimates, we used forecasts of the Socio-demographic Index and temporal correlation patterns presented as annualised rate of change to inform future trajectories. We considered a reference scenario assuming the continuation of historical trends.
FINDINGS: Rates of overweight and obesity increased at the global and regional levels, and in all nations, between 1990 and 2021. In 2021, an estimated 1·00 billion (95% uncertainty interval [UI] 0·989-1·01) adult males and 1·11 billion (1·10-1·12) adult females had overweight and obesity. China had the largest population of adults with overweight and obesity (402 million [397-407] individuals), followed by India (180 million [167-194]) and the USA (172 million [169-174]). The highest age-standardised prevalence of overweight and obesity was observed in countries in Oceania and north Africa and the Middle East, with many of these countries reporting prevalence of more than 80% in adults. Compared with 1990, the global prevalence of obesity had increased by 155·1% (149·8-160·3) in males and 104·9% (95% UI 100·9-108·8) in females. The most rapid rise in obesity prevalence was observed in the north Africa and the Middle East super-region, where age-standardised prevalence rates in males more than tripled and in females more than doubled. Assuming the continuation of historical trends, by 2050, we forecast that the total number of adults living with overweight and obesity will reach 3·80 billion (95% UI 3·39-4·04), over half of the likely global adult population at that time. While China, India, and the USA will continue to constitute a large proportion of the global population with overweight and obesity, the number in the sub-Saharan Africa super-region is forecasted to increase by 254·8% (234·4-269·5). In Nigeria specifically, the number of adults with overweight and obesity is forecasted to rise to 141 million (121-162) by 2050, making it the country with the fourth-largest population with overweight and obesity.
INTERPRETATION: No country to date has successfully curbed the rising rates of adult overweight and obesity. Without immediate and effective intervention, overweight and obesity will continue to increase globally. Particularly in Asia and Africa, driven by growing populations, the number of individuals with overweight and obesity is forecast to rise substantially. These regions will face a considerable increase in obesity-related disease burden. Merely acknowledging obesity as a global health issue would be negligent on the part of global health and public health practitioners; more aggressive and targeted measures are required to address this crisis, as obesity is one of the foremost avertible risks to health now and in the future and poses an unparalleled threat of premature disease and death at local, national, and global levels.
FUNDING: Bill & Melinda Gates Foundation.
AIM: The aim of this study was to examine the differential expression of miRNAs in 80 patients with gastric cancer, specifically in connection to the presence of H. pylori and its cag pathogenicity island (cagPAI).
METHODS: Biopsies of 80 gastric cancer patients were collected and used for H. pylori DNA isolation and tissue miRNA isolation, and further analyzed for cagPAI and miRNA expression and their association.
RESULTS: Elevated levels of miR-21, miR-155, and miR-223 were detected in malignant tissues. The expression of miR-21 and miR-223 was considerably elevated in biopsies that tested positive for H. pylori, whereas the expression of miR-34a was reduced. H. pylori cagPAI samples that are functionally intact exhibit greater expression of miR-21 and miR-223 compared to cagPAI samples that are partially deleted, in both normal and malignant tissues.
CONCLUSION: Thus, the novelty of our study lies in its focus on the differential expression of specific miRNAs in relation to the functional integrity of the cagPAI in H. pylori-infected gastric cancer patients, offering a more detailed understanding of the interplay between H. pylori virulence factors and miRNA regulation than previous studies.
METHODS: Retrospective cohort study in a tertiary center from May 2021-December 2022 included 150 patients with symptomatic anterior or apical POP stage III and IV, who underwent pelvic reconstructive surgery with Surelift-A mesh combined with SSF. All completed a 72-h voiding diary, urodynamic study (UDS), and multiple validated QoL questionnaires at baseline, 6 and 12 months postoperatively. Primary outcomes were the development of post operative de novo stress urinary incontinence (SUI), objectively via cough stress test and UDS, and subjectively by evaluation of UDI-6, question 3 score >1 and IIQ-7, QoL and surgical complications. Secondary outcomes were the objective cure of POP, defined as anterior and apical prolapse Pelvic Organ Prolapse Quantification System ≤ stage I, and subjective cure based on negative answers to Pelvic Organ Prolapse Distress Inventory 6, quality of life, sexual function, major and minor complications.
RESULT: At one-year follow-up, the objective cure rate was 96.7 %, whereas the subjective cure rate was 93.3 %, with favorable anatomical outcomes. Significant QoL improvements were observed. Among those without mid-urethral sling (MUS), a (60.0 %) improvement in SUI occurred. De novo SUI emerged in 10.5 % objectively and 12 % subjectively. Mesh exposure rate was 1.3 %.
CONCLUSION: The Combined Surelift-A and SSF approach shows effective cure rates with minimal complications, and a slight risk of de novo SUI.
PURPOSE: This review examines the complex host-parasite interactions, focusing on the immune evasion mechanisms used by EHP. The study explores how EHP manipulates host immune pathways, including NF-κB, JAK/STAT, Toll, and IMD, to suppress immune responses, inhibit antimicrobial peptide production, and avoid detection, thus ensuring its persistence in the host.
METHODS: The authors reviewed recent research from databases like PubMed, Scopus, and Web of Science, including studies up to 2024. The keywords Ecytonucleospora hepatopenaei, immune evasion, EHP treatment, and associated words with topics were used in this search.
RESULTS: EHP induces oxidative stress, which weakens the host immune system while simultaneously upregulating antioxidant responses to favor its survival. The parasite also alters the gut microbiota and disrupts key cellular processes, such as cell cycle regulation, further enhancing its ability to sustain infection.
CONCLUSION: This review highlights the need for integrated management strategies, including disease-resistant breeding, microbiota modulation, and advanced diagnostics, to combat EHP. By providing an overview of EHP's immune evasion tactics, this study aims to advance knowledge in the field and support efforts to improve shrimp health and aquaculture sustainability.
METHODOLOGY: Patients with AD aged 65 and above accompanied with primary caregivers were recruited in 6 tertiary care hospitals. A structured interview was conducted to collect sociodemographic, clinical and resource use information using an adapted questionnaire. Direct medical cost, direct non-medical cost and indirect cost were annualised and categorised by severity level. Generalised linear models were applied to investigate predictors of costs.
RESULTS: Among 135 patient-caregiver dyads, the annual economic burden of AD from a societal perspective was USD 8618.83 ± USD 6740.79 per capita. The societal cost of severe AD patients (USD11943.19 ± USD6954.17) almost doubled those in mild AD (USD6281.10 ± USD6879.83). IDC was the primary cost driver (77.7%) which represented the impact of productivity loss due to informal care. Besides disease severity, time spent in informal care, caregivers' employment and use of special accommodation were predictors of AD cost. This neurodegenerative disorder is estimated to impose a burden of USD1.9 billion in 2022, which represents 0.47% of Malaysia's GDP.
CONCLUSION: This study provided real-world empirical cost estimates of AD burden in Malaysia. Informal care is a significant contributor to the societal cost of AD. Optimal healthcare resource allocation is essential in the decision making of healthcare stakeholders to address rising demands.
METHODS: This was a single-blinded randomized controlled trial. 30 participants were randomly assigned into 3 equal groups; FROM, PROM, and control (CON). Triceps strength training was carried out using an adjustable overhead cable crossover machine. With shoulders over-head flexed to 160-180° for both experimental groups, the FROM group performed strength training from full elbow flexion to full extension. In contrast, the PROM group worked at a restricted range, between 60°-110° elbow flexion/extension. Both groups engaged in 4 sets of 10 repetitions, 2 sessions/week for 4-weeks at 67% of 1 repetition maximum, while the CON group did not participate in any exercise program. S3P was assessed at baseline and at the end of 4-weeks intervention.
RESULTS: Participants mean age (20.20 ± 1.54 years), height (1.74 ± 0.61 m), and body mass index (22.55 ± 3.31) were descriptively analysed. Within group analysis showed a significant improvement of S3P in both FROM (p = 0.0345, 95% CI = -1.50 to -0.07, ES = 0.81) and PROM (p = 0.005, 95% CI = -2.44 to -0.97, ES = 2.40) compared to CON group (p = 0.8995, 95% CI = -0.61 to 0.68, ES = 0.05). Group-by-time interaction demonstrated PROM to be more promising (p = 0.0102, 95% CI = -1.70 to 0.21) than the FROM and CON groups.
CONCLUSIONS: PROM triceps strength training improves shooting accuracy and is a time-efficient technique highly recommended for basketball players.
TRIAL REGISTRATION: clinicaltrials.gov, NCT04128826, registered on 14/10/2019 - retrospectively, https://clinicaltrials.gov/study/NCT04128826 .
OBJECTIVES: QoL studies in patients with HAE have not been carried out in the Indian subcontinent. Hence, we carried out this study to assess the QoL and to identify factors associated with impaired QoL in patients with HAE.
METHODS: This was a cross-sectional observational study carried out in confirmed cases of HAE, aged >18 years, using angioedema QoL score and angioedema control test.
RESULTS: We enrolled 135 patients with HAE (aged 18-80 years) with a mean age of 40.93 years. We observed that the QoL directly correlates with angioedema control and is also affected by other factors such as gender, duration of follow-up, and the frequency of episodes. Genitalia swelling, positive family history, and presence of mortality due to HAE in the family also significantly impact the QoL of patients with HAE. In addition, patients with type 1 HAE reported a poorer QoL as compared to patients with type 2 HAE.
CONCLUSION: We report the QoL of patients with HAE from settings where none of the first-line medications are available. Results of the study suggest that disease control is the most important factor that influences the QoL.