Peripheral venous congestion causes time- and dose-dependent release of endothelin-1 in humans

Endothelin-1 (ET-1) is a pivotal mediator of vasoconstriction and inflammation in congestive states such as heart failure (HF) and chronic kidney disease (CKD). Whether peripheral venous congestion (VC) increases plasma ET-1 at pressures commonly seen in HF and CKD patients is unknown. We seek to characterize whether peripheral VC promotes time- and dose-dependent increases in plasma ET-1 and whether these changes are sustained after decongestion. We used a randomized, cross-over design in 20 healthy subjects (age 30 ± 7 years). To experimentally model VC, venous pressure was increased to either 15 or 30 mmHg (randomized at first visit) above baseline by inflating a cuff around the subject\u27s dominant arm; the nondominant arm served as a noncongested control. We measured plasma ET-1 at baseline, after 20, 60 and 120 min of VC, and finally at 180 min (60 min after cuff release and decongestion). Plasma ET-1 progressively and significantly increased over 120 min in the congested arm relative to the control arm and to baseline values. This effect was dose-dependent: ET-1 increased by 45% and 100% at VC doses of 15 and 30 mmHg, respectively

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

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

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

The impacts of perceived overqualification on employee performance: a case of chefs

There are many variables that affect employee performance in working life. Some of these variables originate from individuals, while others are caused by external factors. One of the individual factors that affects employee performance is perceived overqualification. The purpose of this study is to reveal the effect of perceived overqualification on employee performance. That's why in this research, the effect of perceived overqualification in the hospitality industry on employee performance is discussed. The data of the current study, which utilized 138 usable questionnaires, were collected from the kitchen staff of 4- and 5-star hotels in Nevşehir. As a result of the analysis made with the data collected, it was found that perceived overqualification negatively and significantly affects employee performance. In this context, as a result of this study, it can be said that employee performance may increase or decrease if the overqualification observed in chefs increases or decreases. In light of the results obtained as a result of the study, practical implications and suggestions have been made for future studies

The impact of internal marketing on employee competency: A case of in the hotel businesses in Nevsehir

Bu çalışmanın amacı, Nevşehir' deki üç, dört ve beş yıldızlı otel işletmelerindeki içsel pazarlama faaliyetlerinin işgören yetkinliği üzerindeki etkisini araştırmaktır. Bu amaçla, içsel pazarlama faaliyetlerinin boyutlarının işgören yetkinliği üzerindeki etkisini belirlemeye yönelik bir model önerilmiş ve bu model çoklu regresyon analizi ile test edilmiştir. Otel işletmelerindeki içsel pazarlama faaliyetlerini ölçmek için daha önce geliştirilen bir ölçek kullanılmıştır. Otel işletmelerinde işgören yetkinliğini ölçmek için önceden geliştirilmiş bir ölçek bulunmaması nedeniyle bu çalışma için bir işgören yetkinliği ölçeği oluşturulmuştur. Örnekleme yöntemi olarak yargısal örnekleme tercih edilmiş ve araştırmanın kapsamına Nevşehir'deki üç, dört ve beş yıldızlı otellerdeki işgörenler dahil edilmiştir. Veriler anket yöntemi ile toplanmıştır. Araştırma sonucunda içsel pazarlama faaliyetlerinin işgören yetkinliğini pozitif ve anlamlı yönde etkilediği görülmüştür. Vizyon geliştirme işgören yetkinliğini negatif ve anlamsız bir şekilde etkilemektedir. Buna karşılık kişisel gelişim ve ödüllendirme boyutlarının yapılan çoklu regresyon analizi sonucunda işgören yetkinliğini pozitif ve anlamlı yönde etkilediği ortaya çıkmıştır.The purpose of this study is to examine the impact of three, four, and five-star hotel businesses' internal marketing activities on employee competence. With this end in view, a model for determining the impact of dimensions of internal marketing on employee competence was proposed and this model was tested through multiple regression analysis. A previously developed scale was used in order to measure internal marketing activities in hotel businesses. Since no scale to measure employee competence was found in hotel businesses, employee competence scale was developed for this study. As sampling method, judgmental sampling was preferred and employees of three, four, and five-star hotels in Nevsehir were included in the study. Data were collected via questionnaires. In the result of the research, it was discovered that internal marketing activities had a positive and significant impact on employee competence. Vision development affected employee competence negatively and insignificantly. On the other hand, in the result of multiple regression analysis done, it was discovered that personal development and reward dimensions affected employee competence positively and significantl