Prevalence and trends of thinness, overweight and obesity among children and adolescents aged 3-18 years across Europe: a protocol for a systematic review and meta-analysis

Introduction Increasing prevalence of both thinness and excess weight during childhood and adolescence is a significant public health issue because of short-term health consequences and long-term tracking of weight status. Monitoring weight status in Europe may serve to identify countries and regions where rates of these disorders are either slowing down or increasing to evaluate recent policies aimed at appropriate body weight, and to direct future interventions. This study protocol provides a standardised and transparent methodology to improve estimating trends of thinness, overweight and obesity in children aged 3-18 years and adolescents across the European region between 2000 and 2017. Methods and analysis This protocol is guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and the Cochrane Collaboration Handbook. To identify relevant studies, a search will be conducted in MEDLINE, EMBASE, Cochrane Library, CINAHL and Web of Science databases. From the selected studies, relevant references will be screened as supplemental sources. Finally, open search in websites from health institutions will be conducted to identify weight status data not published in scientific journals. Cross-sectional, follow-up studies and panel surveys reporting weight status (objectively measured height and weight) according to the International Obesity Task Force criteria, and written in English or Spanish will be included. Subgroup analyses will be carried out by gender, age, study year and country or European region. Discussion This study will provide a comprehensive description of weight status of children and adolescents across Europe from 2000 to 2017. The results will be disseminated in a peer-reviewed journal. This study will use data exclusively from published research or institutional literature, so institutional ethical approval is not required

The use of stable isotope ratio analysis to trace European sea bass (D. labrax) originating from different farming systems

This study aimed to determine whether isotopic ratio mass spectrometry (IRMS) can discriminate farmed European sea bass according to different farming systems and geographic origins. Dicentrarchus labrax of commercial size from three different rearing systems (concrete tank inland, sea cages, and extensive methods in valleys or salt works) were collected at the trading period (autumn\u2013winter). For each farming type, different locations spread over Italy were monitored. Once the fish were harvested, the muscle and feed were sampled. For both muscle and feed, \u3b413C and \u3b415N were measured by continuous flow elemental analyzer isotope ratio mass spectrometry (CF-EA-IRMS) with the goal of discriminating samples based on the rearing system. Additional \u3b42H and \u3b418O measurements of fish samples were performed by continuous flow total combustion elemental analyzer isotope ratio mass spectrometry (CF-TC/EA-IRMS) to track the geographical origin. The measurements of \u3b413C and \u3b415N made it possible to discriminate cultured sea bass from different farming systems (extensive vs. intensive) reared at different geographical sites in Italy. Additional information was obtained from \u3b418O and \u3b42H, which enabled the geographical areas of origin of the sea bass farmed extensively and intensively (in cages) to be distinguished

Building and surroundings: thermal coupling

Energy building performance can be different according to outdoor conditions or urban environment, at the same time that this last assess, buildings are also affected by the building envelope, as obvious consequence of the thermal and Aeraulic coupling existing between the indoor and outdoor conditions in buildings. Thus, in this coupling is fundamental to typify the transmission phenomenon through the building envelope. Doing this, it is possible to estimate transmission heating losses and gains and also the superficial temperatures of the envelope. In order to assess the transient behaviour of the building envelope it is necessary to develop a predictive model, precise enough, to be integrated in a simulating tool. Detailed and multidimensional models, based in numerical methods, like Finite Element Method (FEM), has a high precision, but its complexity imply resources consumption and computational time, too high to be integrated in these kind of tools. On the contrary, simplified methods are good enough because they are simple and fast, with an acceptable precision in almost all the situations. The present work is focused: (a) Firstly, to develop a simplified RC-network model. The aim of the model is to characterize and to implement with precision the behaviour of a wall in a simulating software tool based on urban environment, (b) secondly, to express in form of equivalences, the different indoor and outdoor excitations that can exist in the building envelope, and (c) finally, to calibrate the simplified model through its characteristic parameters. For a homogeneous wall and two types of excitations, it has been obtained the characteristic parameters of the model that represent the better adjustment to the real wall. In a first step, it has been obtained the results of the proposal model and a reference model based on FEM, in terms of wall external surface heat flow. Results of both models have been compared, and the resultant characteristic parameters of the model have been obtained through an optimisation method. Results for the wall and for the excitations under analysis show: (1) Characteristic longitude ec, or capacitive node position, it is determined according to a certain value of Fo equal to 2 for both excitations, this value remains constant in time, (2) useful wall thickness, on the contrary, vary as time function, according to a logarithmic law for both excitations, although this function is different depending on the considered excitation, (3) using a constant excitation, coefficients from the previous logarithmic function depends on the range of the excitation, while these are practically independent of the lineal excitation gradient

Early outcome of a 31-gene expression profile test in 86 AJCC stage IB-II melanoma patients. A prospective multicentre cohort study

Background: The clinical and pathological features of primary melanoma are not sufficiently sensitive to accurately predict which patients are at a greater risk of relapse. Recently, a 31-gene expression profile (DecisionDx-Melanoma) test has shown promising results. Objectives: To evaluate the early prognostic performance of a genetic signature in a multicentre prospectively evaluated cohort. Methods: Inclusion of patients with AJCC stages IB and II conducted between April 2015 and December 2016. All patients were followed up prospectively to assess their risk of relapse. Prognostic performance of this test was evaluated individually and later combined with the AJCC staging system. Prognostic accuracy of disease-free survival was determined using Kaplan-Meier curves and Cox regression analysis. Results of the gene expression profile test were designated as Class 1 (low risk) and Class 2 (high risk). Results: Median follow-up time was 26 months (IQR 22-30). The gene expression profile test was performed with 86 patients; seven had developed metastasis (8.1%) and all of them were in the Class 2 group, representing 21.2% of this group. Gene expression profile was an independent prognostic factor for relapse as indicated by multivariate Cox regression analysis, adjusted for AJCC stages and age. Conclusions: This prospective multicentre cohort study, performed in a Spanish Caucasian cohort, shows that this 31-gene expression profile test could correctly identify patients at early AJCC stages who are at greater risk of relapse. We believe that gene expression profile in combination with the AJCC staging system could well improve the detection of patients who need intensive surveillance and optimize follow-up strategies

Oxidative Stress Mediates Physiological Costs of Begging in Magpie (Pica pica) Nestlings

[Background] Theoretical models predict that a cost is necessary to guarantee honesty in begging displays given by offspring to solicit food from their parents. There is evidence for begging costs in the form of a reduced growth rate and immunocompetence. Moreover, begging implies vigorous physical activity and attentiveness, which should increase metabolism and thus the releasing of pro-oxidant substances. Consequently, we predict that soliciting offspring incur a cost in terms of oxidative stress, and growth rate and immune response (processes that generate pro-oxidants substances) are reduced in order to maintain oxidative balance. [Methodology/Principal Findings] We test whether magpie (Pica pica) nestlings incur a cost in terms of oxidative stress when experimentally forced to beg intensively, and whether oxidative balance is maintained by reducing growth rate and immune response. Our results show that begging provokes oxidative stress, and that nestlings begging for longer bouts reduce growth and immune response, thereby maintaining their oxidative status. [Conclusions/Significance] These findings help explaining the physiological link between begging and its associated growth and immunocompetence costs, which seems to be mediated by oxidative stress. Our study is a unique example of the complex relationships between the intensity of a communicative display (begging), oxidative stress, and life-history traits directly linked to viability.GM-R was supported by the Spanish Government (Ministerio de Ciencia y Tecnología, “Juan de la Cierva” program), and TR was supported by the Consejo Superior de Investigaciones Científicas (CSIC; Proyectos Intramurales Especiales)

Television watching, videogames, and excess of body fat in Spanish adolescents: the AVENA study

Abstract OBJECTIVE: We assessed the individual association of sedentary behaviors with the risk of overweight and excess body fat (overfat) in adolescents. METHODS: A representative sample (1960 subjects, 1012 males, age 13-18.5 y) of Spanish adolescents was studied within the framework of the Alimentación y Valoración del Estado Nutricional de los Adolescentes (AVENA) study. Television (TV) watching, videogame and computer usage, doing homework, and the way students got to school, physical activity, and socioeconomic status were analyzed. Anthropometrics were measured to describe overweight (International Obesity Task Force cutoffs for body mass index) and overfat (body fat percentage >85th percentile). RESULTS: When all subjects were considered as an entire group, the overweight risk increased by 15.8% (P < 0.05) per increasing hour of TV watching. The overweight risks decreased by 32.5% in females, 22% per increasing year of age, and 12.5% by increasing socioeconomic status by 1 U (all Ps < 0.05). The obesity risks decreased with age by 17.8% per year in males and 27.1% in females (both Ps < 0.05). The overfat risks increased by 26.8% and 9.4% per increasing hour of TV and weekend videogame usage, respectively (both Ps < 0.05). In males, the overfat risk increased by 21.5% per increasing hour in weekend videogame usage (P < 0.05). Each hour of TV use increased the overfat risks by 22% in males and 28.3% in females (both Ps < 0.05). CONCLUSIONS: Time spent watching TV increased the risk of overweight and obesity in Spanish adolescents, but the effect was influenced by age, sex, and socioeconomic status. Moreover, an excess of body fat was more directly explained by the time spent watching TV and playing videogames during the weekend.Peer Reviewe

Gestión de la invasión de la especie invasora Spartina Densiflora en las marismas del Golfo de Cádiz. Implicaciones del cambio climático sobre sus respuestas ecofisiológicas

Las marismas son ecosistemas frontera entre los medios terrestre y costero, que se distribuyen a lo largo de los estuarios de latitudes medias y altas de todo el mundo. Se trata de ecosistemas de gran importancia tanto ecológica como medioambiental y socio-económica. A pesar de la importancia de las marismas, son ecosistemas con graves problemas de conservación, derivados principalmente de la actividad humana. Actualmente, la introducción de especies exóticas invasoras está adquiriendo gran peso en la problemática de la conservación de las marismas. La introducción de seres vivos fuera de su área de distribución natural supone, tras la destrucción de los hábitats, el segundo problema ambiental por orden de magnitud que afecta a la Biosfera a escala global. Spartina densiflora, es una gramínea de origen sudamericano, que está invadiendo marismas del norte de América, del norte de África y el suroeste de Europa. En Europa, la presencia de esta especie se restringe al Golfo de Cádiz donde invade muchos estuarios con diferente grado e intensidad de invasión. La invasión de S. densiflora en el Golfo de Cádiz es uno de los problemas de conservación más graves a los que se enfrentan las marismas andaluzas, ya que los efectos deletéreos que se derivan de la invasión de esta especie sobre estos ecosistemas son muy variados: (1) la alteración de la red de drenaje; (2) se dan pérdidas de hábitats debido a su forma de crecimiento; (3) esta pérdida de hábitats incide directamente en la pérdida de riqueza específica y diversidad genotípica. (4) Interfiere en los procesos de sucesión primaria y secundaria; (5) se da la disminución de la tasa de descomposición, de la productividad y de la producción y (6) se ha descrito en especies del género Spartina la intervención en procesos de hibridación con especies nativas, que suponen un grave riesgo ecológico para el ecosistema al generarse híbridos fértiles, de gran capacidad competitiva. En vista de toda la problemática que subyace a la invasión de S. densiflora en los complejos marismeños del Golfo de Cádiz es necesario elaborar un plan de gestión dirigido a luchar eficazmente contra la invasión de esta especie en las marismas andaluzas. Para la elaboración de cualquier programa de gestión de una especie invasora, se marcan diferentes objetivos. Uno de ellos es profundizar en el conocimiento de la biología, ecología y fisiología de la especie objeto de los diferentes programas de gestión. Uno de los aspectos fundamentales a dilucidar es como el Cambio Climático puede afectar a la invasión de esta especie y en que medida las nuevas condiciones ambientales que se darán podrán alterar los patrones de invasión y tolerancia de esta especie. Para lo cual se ha propuesto un trabajo en el que se ha analizado el efecto del incremento del CO2 atmosférico sobre el crecimiento y la fisiología de esta especie invasora. Nuestros resultados mostraron como el incremento del CO2 tendrá un efecto positivo sobre el desarrollo de esta especie lo que supondrá un favorecimiento del potencial invasor de S. densiflora en las marismas del Golfo de Cádiz. Esta información es de gran utilidad para los gestores de los Espacios Naturales Protegidos la cual se tendrá que tener en cuenta en los futuros planes de gestión de las especies exóticas invasoras a la hora de la priorización en la asignación de recursos para el control o erradicación de dichas especies

Pre-exposure prophylaxis with hydroxychloroquine for COVID-19 : a double-blind, placebo-controlled randomized clinical trial

Background: Pre-exposure prophylaxis (PrEP) is a promising strategy to break COVID-19 transmission. Although hydroxychloroquine was evaluated for treatment and post-exposure prophylaxis, it is not evaluated for COVID-19 PrEP yet. The aim of this study was to evaluate the efficacy and safety of PrEP with hydroxychloroquine against placebo in healthcare workers at high risk of SARS-CoV-2 infection during an epidemic period. Methods: We conducted a double-blind placebo-controlled randomized clinical trial in three hospitals in Barcelona, Spain. From 350 adult healthcare workers screened, we included 269 participants with no active or past SARS-CoV-2 infection (determined by a negative nasopharyngeal SARS-CoV-2 PCR and a negative serology against SARS-CoV-2). Participants allocated in the intervention arm (PrEP) received 400 mg of hydroxychloroquine daily for the first four consecutive days and subsequently, 400 mg weekly during the study period. Participants in the control group followed the same treatment schedule with placebo tablets. Results: 52.8% (142/269) of participants were in the hydroxychloroquine arm and 47.2% (127/269) in the placebo arm. Given the national epidemic incidence decay, only one participant in each group was diagnosed with COVID-19. The trial was stopped due to futility and our study design was deemed underpowered to evaluate any benefit regarding PrEP efficacy. Both groups showed a similar proportion of participants experiencing at least one adverse event (AE) (p=0.548). No serious AEs were reported. Almost all AEs (96.4%, 106/110) were mild. Only mild gastrointestinal symptoms were significantly higher in the hydroxychloroquine arm compared to the placebo arm (27.4% (39/142) vs 15.7% (20/127), p=0.041). Conclusions: Although the efficacy of PrEP with hydroxychloroquine for preventing COVID-19 could not be evaluated, our study showed that PrEP with hydroxychloroquine at low doses is safe. Trial registration: ClinicalTrials.govNCT04331834. Registered on April 2, 2020

RANK links senescence to stemness in the mammary epithelia, delaying tumor onset but increasing tumor aggressiveness

Rank signaling enhances stemness in mouse and human mammary epithelial cells (MECs) and mediates mammary tumor initiation. Mammary tumors initiated by oncogenes or carcinogen exposure display high levels of Rank and Rank pathway inhibitors have emerged as a new strategy for breast cancer prevention and treatment. Here, we show that ectopic Rank expression in the mammary epithelia unexpectedly delays tumor onset and reduces tumor incidence in the oncogene-driven Neu and PyMT models. Mechanistically, we have found that ectopic expression of Rank or exposure to Rankl induces senescence, even in the absence of other oncogenic mutations. Rank leads to DNA damage and senescence through p16/p19. Moreover, RANK-induced senescence is essential for Rank-driven stemness, and although initially translates into delayed tumor growth, eventually promotes tumor progression and metastasis. We uncover a dual role for Rank in the mammary epithelia: Rank induces senescence and stemness, delaying tumor initiation but increasing tumor aggressiveness

Design and evaluation of a treatment programme for Spanish adolescents with overweight and obesity. The EVASYON Study

Background The prevalence of overweight and obesity (OW/OB) among adolescents worldwide has increased since the 60 s. Spain has reached one of the highest OW/OB prevalence rates among adolescents from European countries. The aim of this methodological paper is to describe the design and evaluation in the EVASYON study (Development, implementation and evaluation of the efficacy of a therapeutic programme for adolescents with OW/OB: integral education on nutrition and physical activity). Methods/Design The EVASYON was planned by a multidisciplinary team to treat OW/OB in Spanish adolescents. The EVASYON is a multi-centre study conducted in 5 hospitals in 5 Spanish cities (Granada, Madrid, Pamplona, Santander and Zaragoza) and two hundred and four OW/OB Spanish adolescents were recruited for this intervention. The treatment was implemented for approximately one-year follow-up. The adolescents were treated in groups of a maximum of 10 subjects; each group had 20 visits during the treatment period in two phases: intensive during the first 2 months (1st to 9th visits), and extensive during the last 11 months (10th to 20th visits). In order to assess the efficacy of the treatment, 8 dimensions were measured: diet; physical activity and fitness; eating behaviour; body composition; haematological profile; metabolic profile; minerals and vitamins; immuno-inflammatory markers. Moreover, genetic polymorphisms were also determined. Discussion The treatment programme developed in the EVASYON study was designed as a national pilot study to be implemented as an effective treatment for adolescents with OW/OB into the Spanish Health Care Service