Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

モミ・ツガ天然林におけるモミ当年生実生の消長過程と死亡要因

To clarify the demographical traits of current-year seedlings of Abies firma, we examined the emergence and survival processes of seedlings and mortality factors in a total of 213 seedling plots of 1 m[2] inside of a 0.96 ha plot in a natural Abies-Tsuga forest, Wakayama. Seedling emergence started in the middle of April, reached a peak in late April and declined thereafter. The causes of mortality changed seasonally ; herbivory and damping-off prevailed from April to early July, while drought prevailed during summer. Emerged seedlings decreased with time and mortality rate reached 60 % of emerged seedlings at the beginning of December. From the multiple regression analysis, the distance from the nearest conspecific adult negatively affected seedling emergence, while the depth of litter (L) layer affected it positively. Vegetation cover of the ground-layer and the depth of litter (L) promoted the seedling survival rate. Slope angle had a slightly negative effect on seedling survival, although not significant.和歌山演習林のモミ・ツガ天然林において、モミ当年生実生のデモグラフィーを明らかにすることを目的に、0.96ha(80×120m)のプロット内に213個の実生枠(1m[2])を設け実生の消長過程とその死亡要因を調べた。実生の発生は4月中旬から始まり、4月下旬にピークを迎えた後、急激に低下し、6月はじめには停止した。発生した実生は経時的に減少する傾向を示し、成長終了期の12月には死亡率は60%にも達した。死亡をもたらす原因は、動物による被食、菌類などの感染による立ち枯れ、乾燥などであったが、季節的にその度合いは異なっていた。斜面傾斜角度、相対光量子束密度、リター層の厚さ、繁殖成木からの距離、林床植物の被度といった要因を取り上げ、実生の発生と生残率について重回帰分析をおこなった。実生の発生にはリター層の厚さが正に、逆に繁殖成木からの距離が負にそれぞれ有意な影響を及ぼしていることが明らかとなった。生残率にはリター層の厚さと林床層植物の被度がそれぞれ正に有意な影響を、また有意ではなかったものの有意判定基準付近にあった斜面の傾斜角度はわずかに負の影響を及ぼしていることが明らかとなった

Distribución de biomasa aérea en un bosque de Pinus patula bajo gestión forestal en Zacualtipán, Hidalgo, México

La acumulación y distribución de biomasa hacia los componentes estructurales de los árboles es determinante en bosques manejados, tanto en términos de productividad maderable como en la reactivación de diversos procesos ecosistémicos. En el presente estudio se analizó el patrón de acumulación de biomasa aérea total (BAT) y su asignación hacia fuste, ramas, corteza y follaje en una cronosecuencia de un bosque de Pinus patula bajo aprovechamiento forestal en Zacualtipán, Hidalgo. Mediante el uso de ecuaciones alométricas se estimó la BAT y por componente estructural de los árboles en rodales con diferentes años después de la cosecha, en diferentes años de remedición (años 2005, 2008 y 2012). Se encontró que la BAT aumentó con el tiempo después de la cosecha, con diferencias estadísticas significativas (p ramas> corteza> follaje. Esta asignación de BA fue favorecida hacia fuste como un producto maderable comercial, objetivo principal de estos bosques bajo producción. El patrón de asignación de BA entre los componentes estructurales de los árboles puede ser incorporado como base para el diseño de prácticas silvicuturales en los programas de manejo forestal y contribuir en la evaluación de la sustentabilidad de los bosques. Además, puede clarificar el papel de los bosques regenerados después de los aprovechamientos en la fijación y almacenamiento de bióxido de carbono atmosférico

Base de datos de flujos verticales de dioxido de carbono en ecosistemas terrestres y costeros en México

El dióxido de carbono (CO2) es uno de los principales gases de efecto invernadero (GEI) cuyo incremento en la atmósfera está asociado con el calentamiento global. Con el objetivo de promover estudios de síntesis que lleven a un mejor entendimiento de los procesos relacionados con el ciclo del carbono en ecosistemas terrestres y costeros de México, se construyeron bases de datos de flujos verticales de carbono. Se construyó una base de datos con flujos de CO2 a escala anual, para ocho sitios y 30 años por sitio, de la red MexFlux, cuya información se obtuvo de publicaciones en revistas científicas, memorias de resúmenes en extenso y documentos de tesis. Una segunda base se construyó a partir de datos a escala diaria, de los flujos de CO2 de 14 sitios de monitoreo y 53 años/ sitio, que fueron proporcionados directamente por los investigadores principales (PI) de cada sitio y denominada MexFlux_2019 V1. Esta última base de datos, a diferencia de la primera que es de libre acceso, está restringida. Las bases de datos incluyen información del intercambio neto de carbono a nivel ecosistema, la productividad primaria bruta, respiración del ecosistema y de variables meteorológicas y ambientales complementarias