Representation of three-dimensional objects by the rat perirhinal cortex

The perirhinal cortex (PRC) is known to play an important role in object recognition. Little is known, however, regarding the activity of PRC neurons during the presentation of stimuli that are commonly used for recognition memory tasks in rodents, that is, three-dimensional objects. Rats in the present study were exposed to three-dimensional objects while they traversed a circular track for food reward. Under some behavioral conditions, the track contained novel objects, familiar objects, or no objects. Approximately 38% of PRC neurons demonstrated "object fields" (a selective increase in firing at the location of one or more objects). Although the rats spent more time exploring the objects when they were novel compared to familiar, indicating successful recognition memory, the proportion of object fields and the firing rates of PRC neurons were not affected by the rats' previous experience with the objects. Together, these data indicate that the activity of PRC cells is powerfully affected by the presence of objects while animals navigate through an environment; but under these conditions, the firing patterns are not altered by the relative novelty of objects during successful object recognition.

Prevalence of hepatitis C virus infection among high-risk groups in Iran: a systematic review and meta-analysis

OBJECTIVES

Determination of the true burden of hepatitis C virus (HCV) infection among high-risk groups relies heavily on occurrence measures such as prevalence, which are vital for implementation of preventive action plans. Nevertheless, up-to-date data on the prevalence of HCV infection remain scarce in Iran. This study aimed to review the relevant literature systematically and determine the pooled prevalence of HCV infection among high-risk groups in Iran.

STUDY DESIGN

Systematic review & meta-analysis.

METHODS

In 2016, electronic scientific databases including PubMed, Scopus, Web of Science and local databases were searched using a detailed search strategy with language restricted to English and Farsi. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression.

RESULTS

In total, 1817 records were identified in the initial search, and 46 records were included in the meta-analysis. The overall prevalence of HCV among high-risk groups was 32.3%. The prevalence was 41.3% in injection drug users (IDUs), 22.9% in prisoners, 16.2% in drug-dependent individuals and 24.6% in drug-dependent prisoners. Subgroup and meta-regression analyses revealed that geographical location and year of publication were the probable sources of heterogeneity.

CONCLUSION

This meta-analysis found a high prevalence of HCV among high-risk groups in Iran, particularly among IDUs. There is a need for prevention strategies to reduce the burden of HCV infection among high-risk groups, particularly IDUs.

Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the Global Burden of Disease Study 2021

BACKGROUND

Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050.

METHODS

Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline.

FINDINGS

In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8-63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0-45·0] in 2050) and south Asia (31·7% [29·2-34·1] to 15·5% [13·7-17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4-40·3) to 41·1% (33·9-48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6-25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5-43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5-17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7-11·3) in the high-income super-region to 23·9% (20·7-27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5-6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2-26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [-0·6 to 3·6]).

INTERPRETATION

Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions.

FUNDING

Bill & Melinda Gates Foundation.

A Challenging Issue in the Etiology of Speech Problems: The Effect of Maternal Exposure to Electromagnetic Fields on Speech Problems in the Offspring

BACKGROUND

Nowadays, mothers are continuously exposed to different sources of electromagnetic fields before and even during pregnancy.  It has recently been shown that exposure to mobile phone radiation during pregnancy may lead to adverse effects on the brain development in offspring and cause hyperactivity. Researchers have shown that behavioral problems in laboratory animals which have a similar appearance to ADHD are caused by intrauterine exposure to mobile phones.

OBJECTIVE

The purpose of this study was to investigate whether the maternal exposure to different sources of electromagnetic fields affect on the rate and severity of speech problems in their offspring.

METHODS

In this study, mothers of 35 healthy 3-5 year old children (control group) and 77 children and diagnosed with speech problems who had been referred to a speech treatment center in Shiraz, Iran were interviewed. These mothers were asked whether they had exposure to different sources of electromagnetic fields such as mobile phones, mobile base stations, Wi-Fi, cordless phones, laptops and power lines.

RESULTS

We found a significant association between either the call time (P=0.002) or history of mobile phone use (months used) and speech problems in the offspring (P=0.003). However, other exposures had no effect on the occurrence of speech problems. To the best of our knowledge, this is the first study to investigate a possible association between maternal exposure to electromagnetic field and speech problems in the offspring. Although a major limitation in our study is the relatively small sample size, this study indicates that the maternal exposure to common sources of electromagnetic fields such as mobile phones can affect the occurrence of speech problems in the offspring.

Does Occupational Exposure of Shahid Dastghieb International Airport Workers to Radiofrequency Radiation Affect Their Short Term Memory and Reaction Time?

BACKGROUND

Airport workers are continuously exposed to different levels of radiofrequency microwave (RF/MW) radiation emitted by radar equipments. Radars are extensively used in military and aviation industries. Over the past several years, our lab has focused on the health effects of exposure to different sources of electromagnetic fields such as cellular phones, mobile base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons and MRI. The main goal of this study was to investigate if occupational exposure of Shahid Dastghieb international airport workers to radiofrequency radiation affects their short term memory and reaction time.

METHODS

Thirty two airport workers involved in duties at control and approach tower (21 males and 11 females), with the age range of 27-67 years old (mean age of 37.38), participated voluntary in this study. On the other hand, 29 workers (13 males, and 16 females) whose offices were in the city with no exposure history to radar systems were also participated in this study as the control group. The employees' reaction time and short term memory were analyzed using a standard visual reaction time (VRT) test software and the modified Wechsler memory scale test, respectively.

RESULTS

The mean± SD values for the reaction times of the airport employees (N=32) and the control group (N=29) were 0.45±0.12 sec and 0.46±0.17 sec, respectively.  Moreover, in the four subset tests; i.e. paired words, forward digit span, backward digit span and word recognition, the following points were obtained for the airport employees and the control group, respectively: (i) pair words test: 28.00±13.13 and 32.07±11.65, (ii) forward digit span: 8.38±1.40 and 9.03±1.32, (iii) backward digit span: 5.54±1.87 and 6.31±1.46, and (iv) word recognition: 5.73±2.36 and 6.50±1.93. These differences were not statistically significant.

CONCLUSION

The occupational exposure of the employees to the RF radiation in Shahid Dastghieb international airport does not have any significant detrimental effect on their reaction time as well as short term memory.

Pacemaker Implantation in a Patient With Isolated Persistent Left Superior Vena Cava: A Novel Approach

Implanting pacemakers in patients with isolated persistent left superior vena cava (PLSVC) present unique challenges. Recognizing venous anomalies and adapting lead placement techniques are crucial for successful outcomes and stable pacemaker function.

Bariatric surgery mitigated electrocardiographic abnormalities in patients with morbid obesity

Obesity can lead to cardiovascular dysfunctions and cause electrocardiographic disruptions. Bariatric surgery plays a significant role in weight loss. To assess its benefits, this study investigated electrocardiographic changes before and after bariatric surgery. The present article describes a retrospective cohort study with a 6-month follow-up period. Electrocardiograms were interpreted and compared before and six months after surgery. The relationships between weight loss, type of surgery, and electrocardiographic alterations were analyzed. A total of 200 patients participated in the study, with 34 (17%) men and 166 (83%) women. The mean age of the participants was 44.6 ± 8.6, and their mean body mass index was 43.8 ± 5.5 kg/m2. The mean of QTc decreased after the surgery, while the Sokolow-Lyon scores increased. The statistical analysis showed that QTc dispersion (> 40) (P < 0.001), right ventricular hypertrophy (P < 0.001), abnormal R wave progression (P < 0.001), QTc (P < 0.001) and Sokolow-Lyon criteria (P < 0.001) significantly changed postoperatively. In conclusion, bariatric surgery can reduce QTc, correct poor R wave progression, and resolve right ventricular hypertrophy (RVH) in patients with morbid obesity.

Predicting outcomes in patients with low ejection fraction undergoing coronary artery bypass graft

Introduction

Reduced left ventricular ejection fraction (LVEF) is a well-known predictor of adverse events after cardiac surgery. We aimed to assess the outcomes in patients with low LVEF undergoing coronary artery bypass graft.

Methods

In this retrospective cohort, we included all patients with left ventricular ejection fraction ≤ 40 who underwent coronary artery bypass grafting between March 2007 and March 2016 (with a median follow-up of nine years) at Tehran Heart Center. Demographics and clinical characteristics were extracted from the data registry. Akaike information criterion (AIC) was used. The univariate Cox regression was performed. We investigated the predictors of mortality and major adverse cardiac and cerebrovascular events (MACCE) using Cox multivariable regression.

Results

In total, 5,532 cases (79 % male) with a mean age of 65.58 were included in the study. The nine-year overall survival was calculated at 68 %, and more than half of the patients had MACCE (55 %). In adjusted multivariable Cox regression analysis, moderate to severe mitral valve regurgitation, glomerular filtration rate ≤ 60, mild right ventricular dysfunction, and valvular heart disease independently predicted higher mortality. The abovementioned predictors and peripheral vascular disease significantly increased MACCE.

Conclusion

Our study indicates the clinical significance of mitral regurgitation, valvular heart disease, and renal function in patients with low ejection fraction treated by coronary artery bypass grafting surgery. Identifying predictors of adverse events can help with clinical decision-making and risk stratification, ultimately improving patient outcomes.

Blocking Short-Wavelength Component of the Visible Light Emitted by Smartphones' Screens Improves Human Sleep Quality

BACKGROUND

It has been shown that short-wavelength blue component of the visible light spectrum can alter the circadian rhythm and suppress the level of melatonin hormone. The short-wavelength light emitted by smartphones' screens can affect the sleep quality of the people who use these devices at night through suppression of melatonin.

OBJECTIVES

In this study, we examined the effects of covering the screens of smartphones with different filters (changing the effective wavelength of the light) on sleep delay time in 43 healthy students.

MATERIALS AND METHODS

Volunteer students were asked to go to bed at 23:00 and to use their mobile phones in bed for watching a natural life documentary movie for 60 minutes. No filter was used for one night while amber and blue filters were used for other 2 nights. Photospectrometry method was used to determine the output spectrum of the light passing through the filters used for covering the screens of the mobile phones. The order for utilizing amber or blue filters or using no filter was selected randomly. After 1 hour, the participants were asked to record their sleep delay time measured by a modified form of sleep time record sheet.

RESULTS

The mean sleep delay time for the "no-filter" night was 20.84±9.15 minutes, while the sleep delay times for the nights with amber and blue filters were 15.26±1.04 and 26.33±1.59 minutes, respectively.

CONCLUSION

The findings obtained in this study support this hypothesis that blue light possibly suppresses the secretion of melatonin more than the longer wavelengths of the visible light spectrum. Using amber filter in this study significantly improved the sleep quality. Altogether, these findings lead us to this conclusion that blocking the short-wavelength component of the light emitted by smartphones' screens improves human sleep.

Global, regional, and national prevalence of adult overweight and obesity, 1990-2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021

BACKGROUND

Overweight and obesity is a global epidemic. Forecasting future trajectories of the epidemic is crucial for providing an evidence base for policy change. In this study, we examine the historical trends of the global, regional, and national prevalence of adult overweight and obesity from 1990 to 2021 and forecast the future trajectories to 2050.

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.

Evaluation of the Protective Role of Vitamin C on the Metabolic and Enzymatic Activities of the Liver in the Male Rats After Exposure to 2.45 GHz Of Wi-Fi Routers

BACKGROUND

The use of devices emitted microwave radiation such as mobile phones, wireless fidelity (Wi-Fi) routers, etc. is increased rapidly. It has caused a great concern; the researchers should identify its effects on people's health. We evaluated the protective role of Vitamin C on the metabolic and enzymatic activities of the liver after exposure to Wi-Fi routers.

MATERIAL AND METHODS

70 male Wistar rats weighing 200-250 g were randomly divided into 7 groups (10 rats in each group).The first stage one -day test: Group A (received vitamin C 250 mg/kg/day orally together with 8- hour/day Wi-Fi exposure).Group B (exposed to Wi-Fi radiation). Group C (received vitamin C). Group D or Control (was neither exposed to radiation of Wi-Fi modem nor did receive vitamin C). The second phase of experiment had done for five consecutive days. It involved Group E (received vitamin C), Group F (exposed to Wi-Fi radiation), Group G (received vitamin C together with Wi-Fi radiation). The distance between animals' restrainers was 20 cm away from the router antenna. Finally, blood samples were collected and assayed the level of hepatic enzymes including alkaline phosphatase(ALP), alanine amino transferase(ALT) aspartate amino transferase (ASL), gamma glutamyl transferase (GGT) and the concentration of Blood Glucose, Cholesterol , Triglyceride(TG),High density lipoprotein (HDL)and low density lipoprotein (LDL).

RESULTS

Data obtained from the One day test showed an increase in concentration of blood glucose, decrease in Triglyceride level and GGT factor (P<0.05), however no observed significant difference on the Cholesterol , HDL , LDL level and hepatic enzymes activities in compare to control group. Groups of the five-day test showed reduction in the amount of blood glucose, elevation of cholesterol level and LDL relative to control group(P<0.05).

CONCLUSION

WiFi exposure may exert alternations on the metabolic parameters and hepatic enzymes activities through stress oxidative and increasing of free radicals, but the use of vitamin C protects them from changing induced. Also taking optimum dose of vitamin C is essential for radioprotective effect and maintaining optimum health.

The status of sodium intake and excretion and the primary dietary sources of sodium in Iranian adults, a comprehensive pilot study

Background

Coronary artery disease and hypertension are the leading causes of death and disability worldwide, primarily due to high sodium intake. Therefore, accurate assessment of the status of sodium intake and excretion is crucial. The present study aimed to assess the dietary sodium intake and excretion in Iranian population.

Methods

This cross-sectional study was carried out on 150 adults aged 20-65 years in Tehran, Iran. A 24-h dietary recall was used to measure the intake of sodium. A food frequency questionnaire was also used to identify the food items that contributed the highest amount of sodium in the diet. A 24-h urine collection was applied to assess the amount of sodium excretion.

Results

The mean of dietary sodium intake and sodium excreted in 24-h urine collections were 3888 ± 2931 mg/day and 125.2 ± 49 mmol/dl, respectively. Sodium intake and sodium excretion were significantly higher in men compared to women (P = 0.012 and P = 0.004, respectively). Traditional flatbreads were identified as the two main food sources contributing to dietary sodium intake, accounting for 31.2% of the total sodium intake from food sources. The average daily salt intake exceeded the recommended amount (5 g/day) in over 80% of the participants.

Conclusion

Sodium intake in a wide range of Iranian adults may be higher than the recommended values. Iranian flatbreads are the primary source of sodium intake In Iranian diets. If be confirmed in future studies, these results could help policymakers make decisions on reducing salt intake to prevent diseases associated with high salt consumption.

Association between mitral annulus calcification and severity of coronary artery disease assessed by SYNTAX score in patients presented with acute coronary syndrome

Objectives

Mitral annulus calcification (MAC) has been linked to cardiovascular disease severity, but its relationship with the SYNTAX score (SS) in acute coronary syndrome (ACS) patients remains unclear. This study aimed to investigate the association between MAC and SS in ACS patients to explore the role of MAC in predicting cardiovascular disease severity.

Methods

We conducted a cross-sectional study of 233 ACS patients at Tehran Heart Center, Tehran, Iran, from December 2021 to August 2022. Patients with prior coronary artery disease (CAD) were excluded. Demographic data, risk factors, and medical history were extracted from clinical files. SS was determined using coronary angiography, and MAC was assessed via two-dimensional transthoracic echocardiography.

Results

The study population had a mean age of 58.79 years, with 74.7% male. MAC was present in 24.9% of participants, and 57% of those with MAC had an SS above 23. Univariate analysis revealed a significant association between MAC and higher SSs (odds ratio: 1.84, 95% CI: 1.02-3.39; P = 0.046). However, multivariable analysis showed that only left ventricular ejection fraction (LVEF) was independently associated with SS (odds ratio: 0.94, 95% CI: 0.89-0.99; P = 0.015).

Conclusion

While MAC was initially associated with higher SSs in ACS patients, only LVEF emerged as an independent predictor in the multivariable analysis. Although MAC may not be independently associated with SS, it may serve as a useful echocardiographic indicator of more severe CAD in ACS.

Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990-2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021

BACKGROUND

Despite the well documented consequences of obesity during childhood and adolescence and future risks of excess body mass on non-communicable diseases in adulthood, coordinated global action on excess body mass in early life is still insufficient. Inconsistent measurement and reporting are a barrier to specific targets, resource allocation, and interventions. In this Article we report current estimates of overweight and obesity across childhood and adolescence, progress over time, and forecasts to inform specific actions.

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.

Understanding the Role of Galectin-1 in Heart Failure: A Comprehensive Narrative Review

Heart failure (HF) is the fastest-growing cardiovascular condition worldwide. The immune system may play a role in the development of HF since this condition is associated with elevated pro-inflammatory cytokine levels. HF is a life-threatening disease, and there is an increasing demand for diagnostic biomarkers, prognostic factors, and therapeutic agents that can help treat it. Galectin-1 (Gal-1) is the prototype galectin of the lectin family. Multiple signal transduction pathways are regulated by Ras proteins, which act as a molecular switch in cells. Gal-1 regulates T and B cell activation, differentiation, and survival. Gal-1 has been linked to inflammation. Activated T cells produce Gal-1 through an autocrine apoptotic mechanism involving MEK1/ERK and p38 MAPK. In the cardiovascular system, atherosclerosis is facilitated by Gal-1. Heart disease, myocardial infarction, hypertension, and stroke can be caused by atherosclerotic plaque. HF and heart hypertrophy are caused by decreased cardiac L-type Ca2+ channel activity. Deregulation of Gal-1 and CaV1.2 in pathological cardiac hypertrophy suggests a possible target for anti-hypertrophic therapy. Rat hypertrophic cardiomyocytes express Gal-1 and CaV1.2 channels simultaneously. It has been reported that diastolic dysfunction (DD) is associated with elevated Gal-1 levels. The high Gal-1 level in subjects led to the lowest cumulative survival as a composite endpoint. Incidences of HF, DD, and serum Gal-1 levels correlated significantly. The ejection fraction was negatively correlated with Gal-1 and CRP concentrations. Based on two different approaches in mice and humans, Gal-1 was identified as a potential mediator of HF.

Cucumber mosaic virus subgroup IA frequently occurs in the northwest Iran

To monitor genetic variation between Cucumber mosaic virus (CMV) isolates of northwest Iran, samples of cucurbitaceous plants expressing symptoms similar to those caused by CMV were collected. The samples were first screened by ELISA to detect CMV and to determine its subgroup. All detected CMV isolates appeared to be subgroup I (S-I). When total RNA from the samples was subjected to RT-PCR with a pair of primers corresponding to the CMV coat protein (CP) flanking regions, the expected ~870 bp DNA fragment was amplified at 18 samples of 34 tested. MspI restriction analysis of 18 amplified products produced two DNA fragments with sizes about 530 and 330 bp corresponding to MspI profile of CMV S-I. The amplification products of four representative samples were cloned and nucleotide sequences of 1-5 clones from each isolate were determined. The clones from each isolate were over 99% identical and also the isolates themselves were only up to 2% divergent. These isolates clustered in subgroup IA clade on a consensus phylogenetic tree and formed a distinct subclade suggesting that the isolates have originated from a common source.

Investigating the relationship between opium use and coronary slow flow: a propensity score matched case-control study

OBJECTIVES

Recent studies have suggested a potential link between opium consumption and microvascular dysfunction in coronary arteries, which may contribute to the development of coronary slow-flow syndrome. This study aims to investigate the relationship between opium use and coronary slow-flow syndrome.

DESIGN AND SETTING

This retrospective study analysed medical records of patients who underwent coronary angiography at the Tehran Heart Center from 2006 to 2020. It focused on those with coronary slow flow phenomenon (CSFP) or non-obstructive coronary artery disease, excluding patients with significant left ventricular dysfunction (left ventricular ejection fraction <40%), previous coronary revasculariation, arrhythmias or coronary artery ectasia. The coronary slow flow was assessed using thrombolysis in myocardial infarction flow grade and frame count. Propensity score matching and inverse probability weighting were applied to minimise confounding variables. Conditional logistic regression and logistic regression models were then used to examine the association between opium use and coronary slow flow, controlling for potential confounders.

RESULTS

Among 21 835 patients with normal coronary angiograms, 767 were identified with CSFP and matched with 3068 controls. The mean age of CSFP patients was 51.59 years, with 64.6% male. Opium use was similar, reported in 8.9% of CSFP patients and 9.5% of controls (p=0.96). Within the CSFP group, opium use was associated with more extensive coronary artery involvement (33.3% vs 18.9%, p=0.03). Initial analysis indicated a higher risk for CSFP in opium users (OR: 1.74, p=0.001), but after adjustments, no significant association was found (OR: 1.06, p=0.70; OR: 1.15, p=0.55).

CONCLUSION

Our study indicates that opium use is not an independent risk factor for CSFP but may exacerbate the severity of coronary artery involvement, noted by a higher incidence of multivessel disease among users. This suggests that opium may affect the extent of coronary artery issues rather than cause CSFP directly.