Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

High-Performance Electrochromic Devices Based on Poly[Ni(<i>salen</i>)]-Type Polymer Films

We report the application of two poly­[Ni­(<i>salen</i>)]-type electroactive polymer films as new electrochromic materials. The two films, poly­[Ni­(3-Mesalen)] (poly[1]) and poly­[Ni­(3-MesaltMe)] (poly[2]), were successfully electrodeposited onto ITO/PET flexible substrates, and their voltammetric characterization revealed that poly[1] showed similar redox profiles in LiClO₄/CH₃CN and LiClO₄/propylene carbonate (PC), while poly[2] showed solvent-dependent electrochemical responses. Both films showed multielectrochromic behavior, exhibiting yellow, green, and russet colors according to their oxidation state, and promising electrochromic properties with high electrochemical stability in LiClO₄/PC supporting electrolyte. In particular, poly[1] exhibited a very good electrochemical stability, changing color between yellow and green (λ = 750 nm) during 9000 redox cycles, with a charge loss of 34.3%, an optical contrast of Δ<i>T</i> = 26.2%, and an optical density of ΔOD = 0.49, with a coloration efficiency of η = 75.55 cm² C^–1. On the other hand, poly[2] showed good optical contrast for the color change from green to russet (Δ<i>T</i> = 58.5%), although with moderate electrochemical stability. Finally, poly[1] was used to fabricate a solid-state electrochromic device using lateral configuration with two figures of merit: a simple shape (typology 1) and a butterfly shape (typology 2); typology 1 showed the best performance with optical contrast Δ<i>T</i> = 88.7% (at λ = 750 nm), coloration efficiency η = 130.4 cm² C^–1, and charge loss of 37.0% upon 3000 redox cycles

Impact of Lignosulfonates on the Thermodynamic and Kinetic Parameters of Malvidin-3‑<i>O</i>‑glucoside in Aqueous Solutions

The interaction of malvidin-3-<i>O</i>-glucoside (<b>1</b>) and a lignosulfonate was studied by UV–visible spectroscopy, and the results obtained showed the formation of a complex between the negatively charged lignosulfonate and the flavylium cation form (AH⁺) of this anthocyanin at pH 1. The thermodynamic and kinetic parameters of <b>1</b> in the presence of a lignosulfonate were determined by UV–visible spectroscopy and stopped-flow techniques. The main differences were observed in the flavylium cation (AH⁺)/quinoidal base (<b>A</b>) equilibrium, the AH^<b>+</b> form being more stabilized than <b>A</b> (p<i>K</i>_a1 = 4.4 ± 0.1) compared with <b>1</b> in the absence of the lignosulfonate (p<i>K</i>_a1 = 3.9 ± 0.1). Furthermore, comparing the hydration (<i>k</i>_h = 0.028 s^–1) and dehydration (<i>k</i>_–h = 40 M^–1 s^–1) processes of <b>1</b> in the presence of the lignosulfonate with the processes of <b>1</b> (<i>k</i>_h = 0.12 s^–1 and <i>k</i>_–h = 35 M^–1 s^–1) show that the hydration process is slower while the dehydration process is practically unaffected in the presence of the lignosulfonate

Caracterização do exometaboloma volátil de linhas celulares de cancro renal com diferentes potenciais metastáticos e subtipos histológicos

O Carcinoma de Células Renais (CCR) representa o terceiro cancro urológico mais frequente e letal em Portugal. Este tipo de cancro inclui vários subtipos histológicos com diferentes potenciais metastáticos, sendo o carcinoma de células claras (ccCCR) e o papilar (pCCR) os mais comuns. É atualmente reconhecida a importância da descoberta de biomarcadores moleculares específicos para o diagnóstico e estadiamento do CCR de forma a superar as limitações dos métodos existentes (ecografia, tomografia computorizada e nefrectomia). O uso da metabolómica constitui uma das abordagens mais promissoras para a identificação de biomarcadores, uma vez que o metabolismo das células tumorais é muito diferente do das células normais. Desta forma, estudos recentes têm mostrado o potencial dos compostos orgânicos voláteis (COVs) e compostos carbonílicos voláteis (CCVs), não só na identificação de novos biomarcadores, mas também na compreensão de vias metabólicas envolvidas na carcinogénese. Objetivos: Este trabalho incluiu o estudo do exometaboloma volátil de linhas celulares dos dois subtipos histológicos mais comuns de CCR (ccCCR e pCCR) com diferentes potenciais metastáticos. Assim, o objetivo principal deste trabalho é identificar os COVs e CCVs, presentes no meio extracelular (exometaboloma), com potencial para serem utilizados como biomarcadores no processo de estadiamento de CCR e consequentemente ajudar na escolha da terapêutica mais dirigida. Material e Métodos: De modo a avaliar as diferenças na composição volátil do exometaboloma de três linhas celulares de ccCCR (não metastáticas: 769-P, 786-O; metastáticas: Caki-1) e duas de pCCR (não metastática: Caki-2; metastática: ACHN), os COVs e CCVs foram extraídos no headspace do meio de cultura por microextração em fase sólida (HS-SPME) e analisados por cromatografia gasosa acoplada à espectrometria de massa (GC-MS). Os dados foram posteriormente tratados através de métodos de análise estatística multivariada e univariada. Resultados: Os resultados obtidos demonstraram que o exometaboloma volátil é mais robusto a discriminar células com diferentes potenciais metastáticos do que a discriminar entre os dois subtipos histológicos. No entanto, foram encontradas diferenças significativas nos níveis de quinze compostos entre ccCCR e pCCR, tais como o 2,4-dimetil-1-hepteno, 3-careno e 4-metilbenzaldeído. Na comparação entre as linhas celulares metastáticas e não metastáticas de ccCCR, foram detetadas alterações nos níveis de diversos alcanos, alcenos e derivados de benzeno, enquanto que nas linhas celulares pCCR, as principais alterações encontradas foram em compostos pertencentes à classe dos aldeídos e cetonas, como o acetaldeído e a 2-pentadecanona. Conclusões: Os resultados obtidos revelaram o potencial do exometaboloma volátil na identificação de biomarcadores promissores para o diagnóstico e estadiamento de CCR.info:eu-repo/semantics/publishedVersio

Baricitinib in juvenile idiopathic arthritis: an international, phase 3, randomised, double-blind, placebo-controlled, withdrawal, efficacy, and safety trial

Background Juvenile idiopathic arthritis can be refractory to some or all treatment regimens, therefore new medications are needed to treat this population. This trial assessed the efficacy and safety of baricitinib, an oral Janus kinase 1/2-selective inhibitor, versus placebo in patients with juvenile idiopathic arthritis.Methods This phase 3, randomised, double-blind, placebo-controlled, withdrawal, efficacy, and safety trial was conducted in 75 centres in 20 countries. We enrolled patients (aged 2 to <18 years) with polyarticular juvenile idiopathic arthritis (positive or negative for rheumatoid factor), extended oligoarticular juvenile idiopathic arthritis, enthesitis- related arthritis, or juvenile psoriatic arthritis, and an inadequate response (after =12 weeks of treatment) or intolerance to one or more conventional synthetic or biologic disease-modifying antirheumatic drugs (DMARDs). The trial consisted of a 2-week safety and pharmacokinetic period, a 12-week open-label lead-in period (10 weeks for the safety and pharmacokinetic subcohort), and an up to 32-week placebo-controlled double-blind withdrawal period. After age- based dosing was established in the safety and pharmacokinetic period, patients received a once-daily 4 mg adult- equivalent dose of baricitinib (tablets or suspension) in the open-label lead-in period. Patients meeting Juvenile Idiopathic Arthritis-American College of Rheumatology (JIA-ACR) 30 criteria (JIA-ACR30 responders) at the end of the open-label lead-in (week 12) were eligible for random assignment (1:1) to receive placebo or continue receiving baricitinib, and remained in the double-blind withdrawal period until disease flare or up to the end of the double-blind withdrawal period (week 44). Patients and any personnel interacting directly with patients or sites were masked to group assignment. The primary endpoint was time to disease flare during the double-blind withdrawal period and was assessed in the intention-to-treat population of all randomly assigned patients. Safety was assessed in all patients who received at least one dose of baricitinib throughout the three trial periods. For adverse events in the double-blind withdrawal period, exposure-adjusted incidence rates were calculated. The trial was registered on ClinicalTrials.gov, NCT03773978, and is completed.Findings Between Dec 17, 2018 and March 3, 2021, 220 patients were enrolled and received at least one dose of baricitinib (152 [69%] girls and 68 [31%] boys; median age 14.0 years [IQR 12.0-16.0]). 219 patients received baricitinib in the open-label lead-in period, of whom 163 (74%) had at least a JIA-ACR30 response at week 12 and were randomly assigned to placebo (n=81) or baricitinib (n=82) in the double-blind withdrawal period. Time to disease flare was significantly shorter with placebo versus baricitinib (hazard ratio 0.241 [95% CI 0.128-0.453], p<0.0001). Median time to flare was 27.14 weeks (95% CI 15.29-not estimable) in the placebo group, and not evaluable for patients in the baricitinib group (<50% had a flare event). Six (3%) of 220 patients had serious adverse events during the safety and pharmacokinetic period or open-label lead-in period. In the double-blind withdrawal period, serious adverse events were reported in four (5%) of 82 patients (incidence rate [IR] 9.7 [95% CI 2.7-24.9] per 100 patient-years at risk) in the baricitinib group and three (4%) of 81 (IR 10.2 [2.1-29.7]) in the placebo group.Treatment-emergent infections were reported during the safety and pharmacokinetic or open-label lead-in period in 55 (25%) of 220 patients, and during the double-blind withdrawal period in 31 (38%) of 82 (IR 102.1 [95% CI 69.3-144.9]) in the baricitinib group and 15 (19%) of 81 (IR 59.0 [33.0-97.3]) in the placebo group. Pulmonary embolism was reported as a serious adverse event in one patient (1%; IR 2.4 [95% CI 0.1-13.3]) in the baricitinib group in the double-blind withdrawal period, which was judged to be related to study treatment.Interpretation Baricitinib was efficacious with an acceptable safety profile in the treatment of polyarticular juvenile idiopathic arthritis, extended oligoarticular juvenile idiopathic arthritis, enthesitis-related arthritis, and juvenile psoriatic arthritis, after inadequate response or intolerance to standard therapy