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 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 https://researchonline.ljmu.ac.uk/images/research_banner_face_lab_290.jpgunderweight 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 obesity

Resistencia de varios cultivares de fresa frente a tres patógenos diferentes

In addition to the agronomical characteristics of strawberries (Fragaria ×ananassa Duch.), strawberry breeding programs should take into account its resistance to pathogens. The main goal of this study was to evaluate the resistance of strawberry cultivars against crown and root rot caused by Phytophthora cactorum (Lebert & Cohn) J. Schröt., Verticillium wilt caused by Verticillium dahliae Kleb. and V. albo-atrum Reinke et Berth., and angular leaf spot caused by Xanthomonas fragariae Kennedy and King, all of which are important diseases in strawberry plant nurseries in Spain. Ten strawberry cultivars were used for resistance testing against P. cactorum; nine cultivars were used for resistance testing against V. dahliae and V. albo-atrum; and eight strawberry cultivars were used for resistance testing against two strains of X. fragariae, IVIA349.9a and NCPPB 1469. These assays were conducted under greenhouse conditions for P. cactorum, and under growth chamber conditions for V.dahliae and V. albo-atrum and X. fragariae. ‘Sabrosa’, was classified as being resistant to P. cactorum and V.dahliae and V. albo-atrum and only ‘Sieger’ was classified as being resistant to both strains of X. fragariae. These results emphasize the importance of screening for disease resistance before using strawberry cultivars in commercial strawberry production in Spain.Los programas de mejora de la fresa (Fragaria ×ananassa Duch.) deberían tener en cuenta, además de las características agronómicas de la fresa, su resistencia a patógenos. El objetivo principal de este estudio fue evaluar la resistencia de varios cultivares de fresa contra la podredumbre de corona y radicular causada por Phytophthora cactorum (Lebert and Cohn) J. Schröt., la Verticilosis causada por Verticillium dahliae Kleb. y V. albo-atrum Reinke et Berth., y la mancha angular causada por Xanthomonas fragariae Kennedy and King, todas las cuales son importantes enfermedades en los viveros de fresa en España. Diez cultivares de fresa, se utilizaron para evaluar la resistencia frente a P. cactorum; nueve cultivares se utilizaron para evaluar la resistencia frente a V. dahliae y V. albo-atrum y ocho cultivares fueron utilizados para probar la resistencia frente a dos cepas de X. fragariae, IVIA349.9a y NCPPB 1469. Estos ensayos se realizaron en condiciones de invernadero en el caso de P. cactorum, y en condiciones de cámara de crecimiento en los casos de V.dahliae y V. albo-atrum y X. fragariae. 'Sabrosa' fue clasificada como resistente a P. cactorum y V.dahliae y V. albo-atrum, mientras que sólo 'Sieger' se clasificó como resistente a ambas cepas de X. fragariae. Estos resultados señalan la importancia de evaluar la resistencia de los cultivares de fresa a las diferentes enfermedades presentes en España antes de utilizarlos en la producción comercial de fresas en España

Avocado dieback caused by Neofusicoccum parvum in Andalucia region, Spain

From 2002 to 2006, adult avocado trees, Persea americana Miller cv. Hass, located in the subtropical-fruit-producing area of Andalucia (southern Spain) developed symptoms of dieback characterized by death of twigs and branches in the tree canopy. Sections of surface-disinfested, necrotic branch tissues were plated on Difco potato dextrose agar (PDA) (Sparks, NV) and a Neofusicoccum-like fungus was isolated. On PDA, the isolates had white, appressed mycelium that turned dull gray as the colony aged, although conidia were not formed. Abundant pycnidia and conidia developed when isolates were cultured on 2% water agar with sterilized pine needles as substratum at 25°C under near-UV light for 2 weeks. Conidia were hyaline, unicellular, ellipsoid with an obtuse apex and subtruncate base, averaged 16.2 ¿m long by 5.8 ¿m wide and ranged from 12.0 to 20.0 by 4.0 to 8.0 ¿m, and becoming brown with one or two septa with age. Sequenced rDNA fragments (ITS1, 5.8S rDNA, and ITS2, amplified with ITS1 and ITS4 primers) of two avocado isolates were 100% homologous with Neofusicoccum parvum (Pennycook & Samuels) Crous, Slippers, & A.J.L. Phillips (1) (GenBank Accession Nos. AM410965 and AM410966). Morphological and molecular results confirmed this species as N. parvum, reported as the anamorph of Botryosphaeria parva (1). A pathogenicity test was conducted using two isolates on sets of five 2-year-old avocado plants produced from seeds of cv. Topa-Topa growing in 5-liter pots with soil. Unwounded and wounded plants were used for inoculations. Plants were wounded 2 to 3 cm below the apical tip with a lance (4 mm long and 1 mm deep). For inoculation, 4-mm 2-week-old PDA culture plugs were placed in contact with wounded tissues and covered with Parafilm. Five noninoculated plants treated similarly served as controls. Plants were maintained in the greenhouse with a temperature range of 18 to 26°C, and 1 month later, brown stem lesions, as much as 5 cm, originating from the inoculation site followed by dieback of branches were observed. Reisolations from necrotic branches were successful, and both isolates with identical morphology to those used for inoculations were recovered. Pathogenicity tests of seedlings using the same methods also caused stem lesions on unwounded plants and the pathogen was reisolated. To our knowledge, this is the first report of N. parvum causing dieback of avocado trees in Spain. Previously, B. parva has been reported causing stem-end rot of avocado fruit in New Zealand (2). In Spain, since diseased orchards are increasing rapidly, this pathogen could be efficiently distributed by pruning activities (tools and vegetal debris) as observed with other diseases (3). The presence of N. parvum in this subtropical area presents a serious disease problem not only to avocado but also to mango (Mangifera indica L.), which is another susceptible host (4).Peer Reviewe

Resistance of several strawberry cultivars against three different pathogens

In addition to the agronomical characteristics of strawberries (Fragaria ×ananassa Duch.), strawberry breeding programs should take into account its resistance to pathogens. The main goal of this study was to evaluate the resistance of strawberry cultivars against crown and root rot caused by Phytophthora cactorum (Lebert & Cohn) J. Schröt., Verticillium wilt caused by Verticillium dahliae Kleb. and V. albo-atrum Reinke et Berth., and angular leaf spot caused by Xanthomonas fragariae Kennedy and King, all of which are important diseases in strawberry plant nurseries in Spain. Ten strawberry cultivars were used for resistance testing against P. cactorum; nine cultivars were used for resistance testing against V. dahliae and V. albo-atrum; and eight strawberry cultivars were used for resistance testing against two strains of X. fragariae, IVIA349.9a and NCPPB 1469. These assays were conducted under greenhouse conditions for P. cactorum, and under growth chamber conditions for V.dahliae and V. albo-atrum and X. fragariae. �Sabrosa�, was classified as being resistant to P. cactorum and V.dahliae and V. albo-atrum and only �Sieger� was classified as being resistant to both strains of X. fragariae. These results emphasize the importance of screening for disease resistance before using strawberry cultivars in commercial strawberry production in Spain

Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry

Objective. Digital ulcers (DUs) are frequent manifestations of systemic scleroderma (SSc). This study assessed functional limitations due to DUs among patients enrolled in the Digital Ulcer Outcome (DUO) Registry, an international, multicentre, observational registry of SSc patients with DU disease. Methods. Patients completed at enrolment a DU-specific functional assessment questionnaire with a 1-month recall period, measuring impairment in work and daily activities, and hours of help needed from others. Physician-reported clinical parameters were used to describe the population. For patients who completed at least part of the questionnaire, descriptive analyses were performed for overall results, and stratified by number of DUs at enrolment. Results. This study included 2327 patients who completed at least part of the questionnaire. For patients with 0, 1-2, and DUs at enrolment, mean overall work impairment during the prior month among employed/self-employed patients was 28\%, 42\%, and 48\%, respectively. Across all included patients, ability to perform daily activities was impaired on average by 35\%, 54\%, and 63\%, respectively. Patients required a mean of 2.0, 8.7, and 8.8 hours of paid help and 17.0, 35.9, and 63.7 hours of unpaid help, respectively, due to DUs in the prior month. Patients with DUs had more complications and medication use than patients with no DUs. Conclusion. With increasing number of DUs, SSc patients reported more impairment in work and daily activities and required more support from others