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

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Hydraulic interwell connectivity in a carbonate reservoir: Johnson JL "AB" (Grayburg) study area, Ector County, West Texas

Due to the character of the original source materials and the nature of batch digitization, quality control issues may be present in this document. Please report any quality issues you encounter to [email protected], referencing the URI of the item.Includes bibliographical references.Not availabl

Poder judicial y ética pública. La crisis del legislador y de la ciencia penal en Europa

Cap. I. El problema del método penal: de Arturo Rocco al europeísmo judicial* Sumario: 1. La imagen consolidada del tecnicismo jurídico desde la crítica de sus detractores. 2. Si la interpretación del tecnicismo corresponde al Manifiesto (1910) y a la obra de su más original representante: Arturo Rocco. 3. ¿Es la orientación constitucional una forma de positivismo jurídico aplicado a la Constitución? 4. La edad de la alianza entre la dogmática y la política criminal: del desencanto a la pérdida de un rol del saber académico. 5. De la dogmática clásica a la moderna y a la post-constitucional, como un elemento y no un sinónimo de la ciencia penal. 6. La “crisis” de la dogmática en la actualidad. 7. La edad de la democracia penal de los medios masivos de comunicación y del europeísmo judicial y de las fuentes. 8. Los cambios genéticos del discurso penal: la jurisprudencia como fuente y la variedad de los actores jurídicos. 9. ¿Una ciencia exclusivamente de los límites a la intervención punitiva? Punto de vista externo e interno. 10. Más allá de la herencia del iuspositivismo. Por una ciencia penal discursiva y crítica. Cap. 2. El Derecho penal como ética pública Reflexiones acerca del político como “tipo de autor”. Sumario: 1. La sobreexposición de la magistratura penal más allá del republicanismo: especificidad de un fenómeno italiano. 2. El escenario histórico-filosófico de la destrucción de la razón clásica. 3. La búsqueda de valores comunes y la línea Maginot del Derecho “que prohíbe” una violación, en vez de “fijar el precio” para poderla cometer: prohibiting vs. pricing. 4. Hacia la ética pública. ¿Todas las éticas no jurídicas son visiones privadas del mundo? 5. Criminally innocent = politically correct. Si la única ética pública que queda es la penal. 6. Un pluralismo traspasado al proceso penal y fuente de conflictos jurídicos. 7. Incorrupto como competitivo. Cuando la lucha a la corrupción institucional es presentada como un problema utilitarista y condición de eficiencia económica. 8. El corrupto como asociado para delinquir y la exención del político en esta calificación. 9. Las causas no jurídicas de la corrupción institucional. 10. El tipo de autor político, entre valor general de la ley y uso de la pena como instrumento de lucha política. 11. Por qué es necesaria una ética pública no penal. Cap. 3 DISPOSICIÓN Y NORMA EN LA HERMENÉUTICA PENAL CONTEMPORÁNEA* Sumario: 1. La centralidad del Derecho penal en todo análisis de la interpretación jurídica «general». 2. La (pre)supuesta «diversidad» del Derecho penal: verdad y límites de la tesis. 3. La «normalización» del Derecho penal en el universo jurídico. 4. La tesis del «carácter necesariamente judicial del Derecho penal». 5. Problemas de escasa cognoscibilidad ex ante del Derecho casuístico. Interpretaciones analógicas de los «casos» en civil law y en common law: diferencias. 6. Casos fáciles y casos difíciles. 7. La diversidad del juez penal y el problema del juez «de finalidad». 8. La ley penal como «Derecho» y la aplicación a casos como corolario de la división de poderes. 9. La reinterpretación de la ley «general y abstracta» tras la aplicación a casos. Del subsupuesto de hecho (case, example, precedent) al nacimiento de la nueva norma general (rule). 10. Disposición y norma en Derecho penal. 11. La acogida de la distinción entre disposición y norma por parte de los tribunales supremos a nivel europeo (TJUE y TEDH) y nacional (Corte constitucional y Corte de casación) y los arts. 374.3 CPC y 99.3 CPAdm. 12. La fundamental identidad entre doctrina (Juristenrecht) y jurisprudencia (Richterrecht) cuando son generalizadoras y no vinculantes. Del precedente individuado, pero normativo (no mera quaestio facti ni mero ejemplo) al nacimiento de la jurisprudencia-fuente. 13. De la norma «interna» a la norma «externa» a la disposición: la prohibición de analogía como problema del descubrimiento de la criptoanalogía y su sanción. 14. Analogías verdaderas, analogías «inversas», analogías falsas. In dubio pro analogía. 15. Hacia una teoría prescriptiva de la interpretació

Cuestiones constitucionales. Votos del Sr. Lic. D Ignacio L. Vallarta, Presidente que fue de la Suprema Corte de Justicia Nacional, en los negocios más notables resueltos por este tribunal desde mayo de 1878 hasta noviembre de 1892.

Vols. 3-4: Continuada por Agustín Silva y Valencia. México, Impr. y Litografía de I. Paz.Title varies slightly.Mode of access: Internet

Determining the Relative Susceptibility of Four Prion Protein Genotypes to Atypical Scrapie

Atypical scrapie is a sheep prion (PrP^Sc) disease whose epidemiology is consistent with a sporadic origin and is associated with specific polymorphisms of the normal cellular prion protein (PrP^C). To determine the relative amounts of PrP polymorphisms present in atypical scrapie, total PrP was digested with chymotrypsin to generate characteristic peptides spanning relevant polymorphisms at positions 136, 141, 154, 171, and 172 of sheep PrP^C. A multiple reaction monitoring method (MRM), employing ¹⁵N-labeled internal standards, was used to detect and quantify these polymorphisms present in both the PrP^Sc and PrP^C from heterozygous (ALRRY and ALHQY or ALRQD or AFRQY) atypical scrapie-infected or uninfected control sheep. Both polymorphisms of the full length and truncated (C1) natively expressed PrP^C are produced in equal amounts. The overall amount of PrP^C present in the infected or uninfected animals was similar. PrP^Sc isolated from heterozygotes was composed of significant amounts of both PrP polymorphisms, including the ALRRY polymorphism which is highly resistant to classical scrapie. Thus, an atypical scrapie infection does not result from an overexpression of sheep PrP^C. The replication of all atypical scrapie prions occurs at comparable rates, despite polymorphisms at positions 141, 154, 171, or 172

Iodine, a Mild Reagent for the Aromatization of Terpenoids

Efficient procedures based on the use of iodine for the aromatization of a series of terpenoids possessing diene and homoallylic or allylic alcohol functionalities are described. Different examples are reported as a proof-of-concept study. Furthermore, iodine also proved to mediate the dehydrogenation of testosterone

Quantitating PrP Polymorphisms Present in Prions from Heterozygous Scrapie-Infected Sheep

Scrapie is a prion (PrP^Sc) disease of sheep. The incubation period of sheep scrapie is strongly influenced by polymorphisms at positions 136, 154, and 171 of a sheep’s normal cellular prion protein (PrP^C). Chymotrypsin was used to digest sheep recombinant PrP to identify a set of characteristic peptides [M₁₃₂LGS<b><u>X</u></b>MSRPL₁₄₁ (<b><u>X</u></b> = A or V), Y₁₅₃<b><u>X</u></b>ENMY₁₅₈ (<b><u>X</u></b>,= H or R), and Y₁₆₆RPVD<b><u>X</u></b>Y₁₇₂ (<b><u>X</u></b> = H, K, Q, or R)] that could be used to detect and quantitate polymorphisms at positions 136, 154, and 171 of sheep PrP^C or PrP^Sc. These peptides were used to develop a multiple reaction monitoring method (MRM) to detect the amounts of a particular polymorphism in a sample of PrP^Sc isolated from sheep heterozygous for their PrP^C proteins. The limit of detection for these peptides was less than 50 attomole. Spinal cord tissue from heterozygous (ARQ/VRQ or ARH/ARQ) scrapie-infected Rasa Aragonesa sheep was analyzed using this MRM method. Both sets of heterozygotes show the presence of both polymorphisms in PrP^Sc. This was true for samples containing both proteinase K (PK)-sensitive and PK-resistant PrP^Sc and samples containing only the PK-resistant PrP^Sc. These results show that heterozygous animals contain PrP^Sc that is composed of significant amounts of both PrP polymorphisms