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

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Développement de nouvelles approches de microscopie correlative AFM-Fluorescence pour l'analyse d'échantillons biologiques

Biological membranes are flexibles barriers that ensure cell permeability, delineating the cell boundaries and the intracellular compartments to organelles within the cell. They are composed mainly by phospholipids and proteins. Those components are the main ones responsible for membrane remodeling. The latter process is highly dynamic and requires observation at high spatial and temporal resolution. This thesis work focused on two main challenges in the study of membranes: i) Softness of biological membranes and their mechanical properties. Membranes are very soft and fragile materials, and determine their real morphology is highly complicated due to their softness. We have studied the maximal force exerted by an AFM tip that supported lipid bilayers can withstand before rupture, as well as their Young’s modulus, both as a function of the tip size. ii) Chemical sensitivity and molecular recognition in microscopy. AFM can achieve the topography of the membrane. However, this technique cannot distinguish the molecule below the AFM tip. In order to overcome this barrier, we worked on developing a new fluorescence super-resolution technique combining AFM and confocal microscopies. First, we developed a correlated and synchronous confocal Fluorescence-lifetime imaging microscope (FLIM)-AFM setup. Finally, we developed a Metal Induced Energy Transfer (MIET)-AFM setup in order to measure molecular recognition, topography, and mechanical properties of biological samples simultaneously.Les membranes biologiques sont des barrières flexibles qui assurent la perméabilité des cellules, délimitant les frontières cellulaires et les compartiments intracellulaires aux organites à l'intérieur de la cellule. Elles sont composées principalement de phospholipides et de protéines. Ces composants sont les principaux responsables du remodelage des membranes. Ce dernier processus est très dynamique et nécessite une observation à haute résolution latérale et temporelle. Ce travail de thèse s'est concentré sur deux défis principaux dans l'étude des membranes : i) Les propriétés mécaniques. Les membranes sont des matériaux très mous et fragiles, et déterminer leur morphologie réelle est très compliqué en raison de leur mollesse. Nous avons étudié la force maximale exercée par une pointe AFM que les bicouches lipidiques supportées peuvent supporter avant la rupture, ainsi que leur module d'Young, tous deux en fonction de la taille de la pointe. ii) Sensibilité chimique lors de l'imagerie des membranes. L'AFM permet d'obtenir la topographie de la membrane. Cependant, cette technique ne peut pas distinguer la molécule située sous la pointe de l'AFM. Afin de surmonter cet obstacle, nous avons travaillé à la mise au point d'une nouvelle technique de fluorescence à super-résolution combinant l'AFM et les microscopies confocales. Tout d'abord, nous avons mis au point un microscope confocal synchrone et corrélé d'imagerie de fluorescence à vie (FLIM)-AFM. Enfin, nous avons mis au point un dispositif de transfert d'énergie induit par les métaux (MIET)-AFM afin de mesurer simultanément la reconnaissance moléculaire, la topographie et les propriétés mécaniques des échantillons biologiques

Contribución al estudio de las revistas de América Latina y el Caribe mediante el mapeo autoorganizado

Starting from the use of neural artificial networks (NAN), and more concretely from the technique of self-organized maps (SOM), also known as Kohonen’s algorithm, the authors try to identify some elements influencing on the position occupied by journals from Latin America and the Caribbean and the effect that certain actions may have on it. As exploratory techniques, they only reveal patterns of behavior (signs) of reality that have to be assessed by experts. On dealing with this topic, there have been considered the results of recent regional efforts (partial results of ongoing projects as LATINDEX and RICYT) that will allow to face in the future more complete tasks

Compression, Rupture, and Puncture of Model Membranes at the Molecular Scale

International audienceElastic properties of biological membranes are involved in a large number of membrane functionalities and activities. Conventionally characterized in terms of Young’s modulus, bending stiffness and stretching modulus, membrane mechanics can be assessed at high lateral resolution by means of atomic force microscopy (AFM). Here we show that the mechanical response of biomimetic model systems such as supported lipid bilayers (SLBs) is highly affected by the size of the AFM tip employed as a membrane indenter. Our study is focused on phase-separated fluid-gel lipid membranes at room temperature. In a small tip radius regime (≈ 2 nm) and in the case of fluid phase membranes, we show that the tip can penetrate through the membrane minimizing molecular vertical compression and in absence of molecular membrane rupture. In this case, AFM indentation experiments cannot assess the vertical membrane Young’s modulus. In agreement with the data reported in the literature, in the case of larger indenters (>2 nm) SLBs can be compressed leading to an evaluation of Young’s modulus and membrane maximal withstanding force before rupture. We show that such force increases with the indenter in agreement with the existing theoretical frame. Finally, we demonstrate that the latter has no influence on the number of molecules involved in the rupture process that is observed to be constant and rather dependent on the indenter chemical composition

A simple approach for controlled deposition of Prussian blue analogue nanoparticles on a functionalised plasmonic gold surface

International audienceWe report here a simple and efficient approach for the controlled deposition of a monolayer of Prussian blue analogue nanoparticles on a gold surface functionalised with amino groups and their characterisation by surface plasmon resonance spectroscopy and atomic force microscopy combined with theoretical modeling