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

Métodos de plantio de gliricídia (Gliricidia sepium (Jacq.) Walp.) em estacas para produção de forragem Establishment methods of gliricidia (Gliricidia sepium (Jacq.) Walp.) from stakes for forage production

Gliricídia, uma leguminosa arbórea utilizada no sombreamento de cacaueiros e na produção de forragem, é comumente empregada como cerca viva, madeira e lenha e pode ser multiplicada por sementes e por frações do caule ou de estacas. Conduziu-se este estudo na Escola de Agronomia da UFBA, em Cruz das Almas - Bahia, com o objetivo de avaliar métodos de plantio por estaquia, a fim de se identificar aquele de maior índice de pegamento das estacas, maior produção de forragem e menor custo de implantação. O delineamento experimental foi em blocos casualizados, com cinco tratamentos e cinco repetições. Os tratamentos foram os seguintes: 1) estacas de 1 m de comprimento plantadas verticalmente em covas; 2) estacas de 0,5 m de comprimento plantadas verticalmente em covas; 3) estacas de 0,25 m de comprimento plantadas verticalmente em covas; 4) estacas de 1 m de comprimento plantadas horizontalmente dentro do sulco; 5) estacas de 0,5 m de comprimento plantadas horizontalmente dentro sulco. As estacas de 1,0 m de comprimento plantadas verticalmente dentro de covas (método 1) ou horizontalmente dentro de sulcos (método 4), após 14 dias de colhidas, são os métodos mais recomendáveis por apresentarem menores custos na preparação das estacas e operações de plantio, proporcionando melhores lucros por hectare quando consideradas as receitas das produções de matéria seca.Gliricidia sepium has been used as shade tree in cocoa plantations, living fences, wood, fuel wood and livestock forage. It can be grown from seeds and from cuttings or stakes. This experiment was carried out to evaluate five grown methods from Gliricidia cuttings in other to identify the one showing highest stake sprouting indexes, forage production and least implantation costs. The experiment was in a randomized block design with five treatments and five replications. The treatments were the followings: 1) stakes with 1m in length placed vertically in pits; 2) stakes with .5 m in length placed vertically in pits; 3) stakes with .25 m in length placed vertically in pits; 4) stakes with 1 m in length placed horizontally in furrows; 5) stakes with .5 m in length placed horizontally in furrows. Stakes with 1m in length placed vertically in pits (method 1) or placed horizontally in furrows (method 4), after 14 days from harvesting, are the most recommended methods since they showed the least costs in expending time to prepare the cutting stakes and for planting operations, providing better profits per hectare, when the incomes from dry matter productions are taken into consideration

Laços familiares e aspectos materiais da dinâmica mercantil na cidade de São Paulo (séculos XVIII e XIX)

Based on the family ties established within the active merchant community of the city of São Paulo through the 18th and 19th centuries, the author sets out to tell the life story of nine merchants involved in matrimonial alliances, with a focus on the transactions carried out, their sociopolitical engagement and the fortunes of their descendants. Having done that, she seeks out connections between the urban development of the city center and the activities of these businessmen by means of analyses centered on the material aspects of their lives, particularly those related to their homes and home furniture

ABC₂-SPH risk score for in-hospital mortality in COVID-19 patients

Objectives: The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones. Methods: Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March–July, 2020. The model was validated in the 1054 patients admitted during August–September, as well as in an external cohort of 474 Spanish patients. Results: Median (25–75th percentile) age of the model-derivation cohort was 60 (48–72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO2/FiO2 ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829–0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833–0.885]) and Spanish (0.894 [95% CI 0.870–0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). Conclusions: An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19.</p