Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: a pooled analysis of 1018 population-based measurement studies with 88.6 million participants

Background Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20–29?years to 70–79?years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results In 2005–16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

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

A list of authors and their affiliations appears online. A supplementary appendix is herewith attached.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 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 obesity.peer-reviewe

Small Signal Stability Analysis of Multi-Area Power System

This paper focuses on methodologies for calculation and examination of oscillatory security of interconnected power system network against constant disturbances. For instance, voltage soundness, transient dependability and oscillatory behaviors are also the measure of power system stability, which must be evaluated. For that proposed strategies based on proportional integral and fuzzy logic controlling techniques are implemented. The integral controller-based technique provides the zero steady-state error and with adequate damping, time to reach steady state can be reduced, on the cost of oscillation in frequency and tie-line power. On the contrary, fuzzy logic has demonstrated that strategies of computational intelligence can alleviate the quick appraisal of oscillatory solidness with less time to reach steady state. Furthermore, Eigenvalues are constructed for small signal stability analysis, utilizing a parallel variation of Arnoldi technique, reducing the time essential for calculation of vast Multi-Area power frameworks. For exhibit purposes, models have been composed utilizing MATLAB/SIMULINK and with the assistance of the fuzzy logic.</jats:p

Parameter-uniform approximation on equidistributed meshes for singularly perturbed parabolic reaction-diffusion problems with Robin boundary conditions.

[EN]In this work we develop a parameter-uniform numerical method on equidistributed meshes for solving a class of singularly perturbed parabolic reaction-diffusion problems with Robin boundary conditions. The discretization consists of a modified Euler scheme in time, a central difference scheme in space, and a special finite difference scheme for the Robin boundary conditions. A uniform mesh is used in the time direction while the mesh in the space direction is generated via the equidistribution of a suitably chosen monitor function. We discuss error analysis and prove that the method is parameter-uniformly convergent of order two in space and order one in time. To support the theoretical result, some numerical experiments are performed

Macrophage Activation Syndrome - An Unusual Complication Of SLE

Macrophage Activation Syndrome (MAS) is a rare and potentially fatal condition that can complicate many autoimmune diseases. It is a type of Hemophagocytic Lymphohistiocytosis (HLH). HLH is a potentially fatal disease of normal but overactive histiocytes and lymphocytes commonly occurring in infancy but can occur in all age groups. There are two types of HLH: Familial and acquired. Familial HLH is an autosomal recessive disorder and accounts for 25% of the cases. Acquired type is secondary to drugs, malignancies, rheumatological disorders. There are five subtypes of inherited HLH: familial HLH and types 1-5. HLH may result from an inappropriate immune response to a viral illness like EBV. It may be due to X-linked Lymphoproliferative Disease (XLP) caused by a mutation in SH2D1A or XIAP gene. Usually, MAS term is used for HLH secondary to rheumatological disorders that occur mostly in individuals with Systemic Juvenile Idiopathic Arthritis (SJIA) and those with adult-onset Still disease. The condition is thought to be caused due to excessive activation and expansion of T lymphocytes and macrophage histiocytes that show hemophagocytic activity. The expansion of these cells leads to a massive systemic inflammatory response associated with three cardinal features: cytopenias, liver dysfunction, and coagulopathy, resembling Disseminated Intravascular Coagulation (DIC). MAS incidence in SLE patients is estimated to be 0.9% - 4.6%, and it is widely under recognized and underreported. In this report, we enumerate one such case with their clinical presentation, evaluation, and management.</jats:p

Study of Nanotechnology and Its Application

Nanotechnology is new frontiers of this century. The world is facing great challenges in meeting rising demands for basic commodities(e.g., food, water and energy), finished goods (e.g., cellphones, cars and airplanes) and services (e.g., shelter, healthcare and employment) while reducing and minimizing the impact of human activities on Earth’s global environment and climate. Nanotechnology has emerged as a versatile platform that could provide efficient, cost-effective and environmentally acceptable solutions to the global sustainability challenges facing society. In recent years there has been a rapid increase in nanotechnology in the fields of medicine and more specifically in targeted drug delivery. Opportunities of utilizing nanotechnology to address global challenges in (1) water purification, (2) clean energy technologies, (3) greenhouse gases management, (4) materials supply and utilization, and (5) green manufacturing and hemistry. Smart delivery of nutrients, bio-separation of proteins, rapid sampling of biological and chemical contaminants, and nano encapsulation of nutraceuticals are some of the emerging topics of nanotechnology for food and agriculture. Nanotechnology is helping to considerably improve, even revolutionize, many technology and Industry sectors: information technology, energy, environmental science, medicine, homeland security, food safety, and transportation, among many others. Today’s nanotechnology harnesses current progress in chemistry, physics, materials science, and biotechnology to create novel materials that have unique properties because their structures are determined on the nanometer scale. This paper summarizes the various applications of nanotechnology in recent decades Nanotechnology is one of the leading scientific fields today since it combines knowledge from the fields of Physics, Chemistry, Biology, Medicine, Informatics, and Engineering. It is an emerging technological field with great potential to lead in great breakthroughs that can be applied in real life. Novel Nano and biomaterials, and Nano devices are fabricated and controlled by nanotechnology tools and techniques, which investigate and tune the properties, responses, and functions of living and non-living matter, at sizes below100 nm. The application and use of Nano materials in electronic and mechanical devices, in optical and magnetic components, quantum computing, tissue engineering, and other biotechnologies, with smallest features, widths well below 100 nm, are the economically most important parts of the nanotechnology nowadays and presumably in the near future. The number of Nano products is rapidly growing since more and more Nano engineered materials are reaching the global market the continuous revolution in nanotechnology will result in the fabrication of nanomaterial with properties and functionalities which are going to have positive changes in the lives of our citizens, be it in health, environment, electronics or any other field. In the energy generation challenge where the conventional fuel resources cannot remain the dominant energy source, taking into account the increasing consumption demand and the CO2 .Emissions alternative renewable energy sources based on new technologies have to be promoted. Innovative solar cell technologies that utilize nanostructured materials and composite systems such as organic photovoltaic offer great technological potential due to their attractive properties such as the potential of large-scale and low-cost roll-to-roll manufacturing processes</jats:p