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Two-dimensional (2D) ultra-thin materials are more crucial than their bulk counterparts for the covalent functionalization of their surface owing to atomic thinness, large surface-to-volume ratio, and high reactivity of surface atoms having unoccupied orbitals. Since the surface of a 2D material is composed of atoms having unoccupied orbitals, covalent functionalization enables one to improve or precisely modify the properties of the ultra-thin materials. Chemical functionalization of 2D materials not only modifies their intrinsic properties but also makes them adapted for nanotechnology applications. Such engineered materials have been used in many different applications with their improved properties. In the present Perspective, we begin with a brief history of functionalization followed by the introduction of functionalized 2D materials. Our Perspective is composed of the following sections: the applications areas of 2D graphene and graphene oxide crystals, transition metal dichalcogenides, and in-plane anisotropic black phosphorus, all of which have been widely used in different nanotechnology applications. Finally, our Perspectives on the future directions of applications of functionalized 2D materials are given. The present Perspective sheds light on the current progress in nanotechnological applications of engineered 2D materials through surface functionalization. [ABSTRACT FROM AUTHOR]

Child maltreatment poses not only immediate danger, but as a type of toxic stress, it creates higher risk of biologic dysfunction later in life. Pediatricians are in a unique position to diagnose child maltreatment, but they need evidence-based guidance for when to initiate screening when injury is occult. In this retrospective cohort study of 855 pediatric patients diagnosed with child maltreatment, researchers explored whether type or number of diagnoses was associated with abnormal pediatric weight in either direction. Diagnoses and weight assessed at intake were extracted from medical records for analysis. Statistically significant associations were found between weight classification and child maltreatment type as well as diagnosis count. Neglect was most frequently diagnosed, and children with ≥2 diagnoses were more likely to be classified as underweight, overweight, or obese. Findings support abnormal pediatric weight as a biologic signal of adversity that warrants safety screening in the clinical setting. [ABSTRACT FROM AUTHOR]

Objective: The study investigated interpersonal distance in patients with anorexia nervosa (AN), focussing on the role of other's facial expression and morphology, also assessing physiological and subjective responses. Method: Twenty‐nine patients with AN and 30 controls (CTL) were exposed to virtual characters either with an angry, neutral, or happy facial expression or with an overweight, normal‐weight, or underweight morphology presented either in the near or far space while we recorded electrodermal activity. Participants had to judge their preferred interpersonal distance with the characters and rated them in terms of valence and arousal. Results: Unlike CTL, patients with AN exhibited heightened electrodermal activity for morphological stimuli only, when presented in the near space. They also preferred larger and smaller interpersonal distances with overweight and underweight characters respectively, although rating both negatively. Finally, and similar to CTL, they preferred larger interpersonal distance with angry than neutral or happy characters. Discussion: Although patients with AN exhibited behavioural response to emotional stimuli similar to CTL, they lacked corresponding physiological response, indicating emotional blunting towards emotional social stimuli. Moreover, they showed distinct behavioural and physiological adjustments in response to body shape, confirming the specific emotional significance attached to body shape. Highlights: Patients with anorexia nervosa (AN) show a regulation of interpersonal distances to social emotional stimuli similar to healthy controls (CTL) but lack the corresponding physiological response.Patients with AN, not CTL, prefer shorter interpersonal distance with underweight social stimuli and larger interpersonal distance with overweight ones and show increased physiological response to both of them.Patients with AN show a bias towards morphological rather than emotional cues when processing information to optimise social interaction. [ABSTRACT FROM AUTHOR]

Background: Maternal nutritional status before and during pregnancy is an important determinant of foetal health. In West Africa, maternal and child undernutrition remains a major public health problem and it is important to establish the mechanistic pathway linking the two disorders to help address the problem. We therefore assessed the mediating role of low birth weight (LBW) in the relationship of maternal undernutrition with child undernutrition in West Africa. Methods: We included recent (2010–2019) DHS data from thirteen West African countries. Poisson regression model with robust standard errors was used to assess the relationship between maternal undernutrition (body mass index and anaemia) and child undernutrition (stunting, wasting, underweight, and anaemia). Structural equation modelling was used to conduct the mediation analysis. Results: Prevalence of stunting, wasting, underweight, and anaemia among under-five children in West Africa was found to be 32.4%, 8.1%, 20.1%, and 71.5%, respectively. We found children of underweight mothers to be more likely to be undernourished (stunted, wasted, and underweight) and anaemic compared to children of normal-weight mothers. Also, children of anaemic mothers were more likely to be stunted and anaemic but not wasted compared with children of non-anaemic mothers. LBW mediated the observed relationships between maternal BMI and childhood stunting (22.6%), and maternal anaemia and childhood stunting (24.9%), wasting (11.7), and anaemia (6.6%). Conclusion: We found maternal undernutrition to be associated with child undernutrition in West Africa with LBW noted to be a mediator of the observed relationship. We recommend that, to address the child undernutrition problem in West Africa, governments and policymakers must integrate measures to address the burden of LBW. [ABSTRACT FROM AUTHOR]

This study aimed to identify differences among body mass index (BMI) categories of older family caregivers (=60 years) and their care recipients (=65 years). Secondly, this study aimed to examine group differences and factors associated with weight change during a nutrition and oral health intervention. This secondary analysis of a randomized controlled trial (ClinicalTrial.gov (NCT04003493)) involved individually tailored nutritional guidance from a clinical nutritionist and oral health guidance from a dental hygienist. Baseline BMI differences were analyzed, followed by further analyses of group differences and associated factors of weight change over a 6-month period using generalized estimating equations. Among the participants (113 family caregivers and 107 care recipients), 36.3% and 35.1% were overweight (BMI >29 kg/m²), while 18.6% and 21.6% were underweight (BMI <24 kg/m²) at baseline, respectively. For family caregivers differences in BMI categories included age, mid-arm and calf circumferences, and plasma prealbumin concentration. For care recipients differences were observed in medication use, mid-arm and calf circumferences, Mini Nutritional Assessment scores, physical function, and number of teeth. During the 6-month intervention, there were no differences in weight change between intervention and control groups for both caregivers and care recipients. Factors significantly associated (p < 0.05) with weight loss included female sex for both caregivers and care recipients, and frailty for caregivers. Family caregivers' characteristics were not significantly associated with weight change in their care recipients. In conclusion, being overweight is a prevalent among older family caregivers and care recipients. Factors such as age, medication use, physical function, number of teeth, and Mini Nutritional Assessment scores varied across BMI categories. Female sex was associated with weight loss in both older family caregivers and care recipients, and frailty was associated with weight loss in caregivers. However, the characteristics of family caregivers did not explain the weight loss of their care recipients. [ABSTRACT FROM AUTHOR]

Background: Recognition of atypical anorexia nervosa (AAN) has challenged underweight as a defining factor of illness severity in anorexia nervosa (AN). The present study aimed to compare rates of medical instability in adolescents with underweight (AN) and non‐underweight (AAN) anorexia nervosa. Methods: The study examined assessment data from specialist eating disorder services in the UK between January and December 2022. Participants (n = 205) aged 11–18 years were recruited across eight eating disorder clinics and diagnosed with AN (n = 113) or AAN (n = 92) after clinical assessment. Parameters associated with risk of medical instability were compared between AN and AAN groups, using t tests and regression analysis. Results: Rates of bradycardia and hypotension did not differ significantly between AN and AAN groups (p = 0.239 and p = 0.289). Although white blood cell counts were lower in the AN group, rates of leukopaenia could not be statistically compared as a result of there being too few counts in at least one group. No incidences of hypophosphataemia were found in the sample. A significant regression equation was found for percentage median body mass index, but not rate of weight loss, as a predictor of blood pressure, serum phosphorous and magnesium. Conclusions: Our findings indicate that medical instability occurs across a range of body weights in young people with AN and AAN. Although certain parameters of risk such as blood pressure, serum phosphorous and magnesium may be worsened at lower weight, both AN and AAN are serious mental health conditions that can lead to medical instability. Highlights: The study compared rates of medical instability in adolescents with underweight (AN) and non‐underweight (AAN) anorexia nervosa.The findings support the conclusion that, although certain parameters of risk (e.g., blood pressure) may be worsened by lower weight, both AN and AAN are serious illnesses that can lead to medical compromise. [ABSTRACT FROM AUTHOR]

This study investigates the impact of Body Mass Index (BMI) on Quality of Life (QoL) and treatment outcomes in breast cancer (BC) patients, particularly focusing on underweight individuals with compromised nutritional status. A nonrandomized prospective study comprising 121 newly diagnosed patients across various BMI categories utilized FACT-B & FACIT-Sp-12 questionnaires. Follow-ups occurred at baseline, during (3rd and 6th), and after (12th month) anthracycline-taxane chemotherapy, either sequentially or concomitantly. Patients with low BMI (<18.5 kg/m2; 53.7%) exhibited significantly poorer QoL, marked by compromised nutritional indicators (low MUAC and SFT). Repeated measures ANOVA identified significant correlations between BMI groups in functional, social, and emotional QoL aspects (p < 0.05), with no notable differences in other domains. A Chi-square (ꭓ2) test underscored a significant link between BMI and treatment response (p < 0.0001), showing higher rates of non-responders among underweight patients (p = 4.259e−14). The study advocates pretreatment consultation with a dietitian as standard care for Indian BC patients, offering complimentary nutritional support for improved QoL outcomes and treatment responses. [ABSTRACT FROM AUTHOR]

Objectives: To examine the association between life‐course body silhouette changes and oral conditions in adulthood. Methods: At study recruitment (2008–2012), 5430 adults underwent a full‐mouth clinical examination and recalled their body silhouettes at ages 8, 15, 25, 35 and 45. Life‐course trajectories of body silhouettes were computed using group‐based trajectory modelling. Gingival inflammation, dental plaque, masticatory units, numbers of healthy, missing, decayed and filled teeth at study recruitment were clustered. The associations between body silhouette trajectories and clusters of oral conditions were assessed by multinomial logistic regression. Results: The final analysis included 4472 participants. Five body silhouette trajectories were established: lean‐stable (30.0%), lean‐increased (19.3%), moderate stable (18.1%), lean‐marked increased (25.8%) and heavy stable (6.7%). Three clusters of oral conditions were identified: optimal oral health and preserved masticatory capacity (70.0%, cluster 1), moderate oral health and moderately impaired masticatory capacity (25.4%, cluster 2) and poor oral health and severely impaired masticatory capacity (4.7%, cluster 3). Participants with a lean‐increased trajectory were 58% more likely than those with a lean‐stable trajectory to be in cluster 3 (aOR 1.58 [95% CI 1.07; 2.35]) relative to cluster 1, independently of covariates measured at study recruitment and including age, sex, smoking, socioeconomic status, BMI, hypertension, type 2 diabetes, cholesterol and triglycerides. Conclusions: A life‐course lean‐increased body silhouette trajectory is associated with higher likelihood of poor oral health and severely impaired masticatory capacity in adulthood. [ABSTRACT FROM AUTHOR]

Aims: To examine physical activity patterns over 34 years in a representative adult population in Norway. Methods: Longitudinal data were obtained from the Helseundersøkelsen i Trøndelag (HUNT) study, performed in 1984–1986 (HUNT1), 2006–2008 (HUNT3) and 2017–2019 (HUNT4). There were a total 123,005 participants across all four studies. Physical activity patterns over time are described, in relation to age, gender and body mass index (BMI). Multiple imputation was used to handle missing data. Results: The proportion of adults estimated (using a proxy measure) as being physically active 1 h or more per week increased from 32% in 1984–1986 (HUNT1) to 64% in 2017–2019 (HUNT4). The most frequent pattern was being inactive at HUNT1, becoming active at HUNT3 and staying active (until HUNT4). From HUNT3 to HUNT4, the most frequent pattern was being active at both time points. The adults >50 years old had a similar physical activity pattern from HUNT3 to HUNT4 and were more active than those >50 years. During the period, men were more active than woman, but difference was reduced over time. Both for persons being underweight (BMI ⩽ 18.5) or obese (BMI > 30), the proportion being active at multiple time points was lower than for persons at normal weight. Conclusions: The data indicate a noticeable increase in being physically active for 1 h or more per week during the 34-year study period. Relatively stable patterns of physical activity were identified, with some variations according to age, gender and BMI. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study aimed to investigate the association of body mass index (BMI) with the weekly frequency of moderate-intensity physical activity, eating behavior, and the use of the Internet or games among Korean middle school students. Methods: The data of 23,583 Korean middle school students were collected from the 2023 Korean Student Health Examination. The collected data were analyzed using frequency, chi-square, and multivariate logistic regression analyses. Results: The results also showed that the higher the BMI, the greater the likelihood of moderate-intensity physical activity. The likelihood of breakfast intake reduced as the BMI increased. However, the likelihood of using the Internet or games increased with an increase in BMI. The results revealed that 28% (6594 of 23,583) of middle school students rarely participate in moderate-intensity physical activity, while 32% (7553 of 23,583) participate only once or twice a week. The results also showed that the higher the BMI, the higher the likelihood of moderate-intensity physical activity. Among those who were underweight, the odds ratio (OR) of 3–4 days of participation in moderate-intensity physical activity was 0.764 (95% confidence interval [CI]: 0.664–0.880; p < 0.001). Among those who were healthy, the OR of more than 5 days of participation was 1.279 (95% CI: 1.131–1.446; p < 0.001). Among those who were overweight, the OR of 3–4 days and more than 5 days of participation was 1.172 (95% CI: 1.019–1.348; p = 0.026) and 1.181 (95% CI: 1.011–1.380; p = 0.036), respectively. The likelihood of the use of the Internet or games increased with an increase in BMI. The OR of the use of the Internet or games was 0.876 (95% CI: 0.806–0.952; p = 0.002) and 0.824 (95% CI: 0.743–0.913; p < 0.001) among those who were healthy and those who were overweight, respectively. However, the likelihood of breakfast intake reduced as the BMI increased. Among those who were underweight, the OR of always eating breakfast and mostly eating breakfast was 1.299 (95% CI: 1.114–1.515; p < 0.001) and 1.236 (95% CI: 1.045–1.461; p = 0.013), respectively. Among those who were healthy, the OR of always eating breakfast was 1.157 (95% CI: 1.026–1.305; p = 0.018). Among those who were overweight, the OR of mostly eating breakfast was 1.215 (95% CI: 1.030–1.433; p = 0.021). Conclusions: Given this, outdoor sports may increase adolescents' participation in physical activities by helping them break away from repetitive ball games and increasing their overall interest and participation in physical activities. Overall, our results suggest the need to move away from traditional physical education and develop engaging physical activity programs that motivate students to participate in moderate-intensity physical activities. [ABSTRACT FROM AUTHOR]

Longitudinal studies on chronic loneliness and before and during the COVID-19 pandemic are lacking in Africa. The study aimed to estimate the prevalence and associated factors of loneliness and chronic loneliness using cross-sectional and longitudinal data from middle-aged and older adults from rural South Africa. The analysis utilized data from the South African 7-year longitudinal Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) (analytic sample: n = 3,418, aged 40 years and older). Loneliness was assessed with a single and 3-item measure. The proportion of loneliness was 19.5% in the 2021/2022 survey, the incidence of chronic loneliness (having loneliness in wave 2 and 3, and free of loneliness in wave 1) was 18.9%, and the 7-year incidence of loneliness was 41.0%. Comparing the 2019 (pre-COVID-19) to 2021/2022 (during COVID-19 pandemic) surveys participants experienced a significant reduction of loneliness. In cross-sectional and/or longitudinal analyses, we found that younger age, living alone, food insecurity, lack of social engagement, depressed mood, poor life satisfaction, poor sleep quality, impaired cognition, poor self-rated health, functional disability, underweight, obesity, and not living with HIV were associated with a higher prevalence, incidence and/or increases in loneliness. One in five aging adults had acute or chronic loneliness. Several social, mental, and physical health factors were identified as associated with loneliness. [ABSTRACT FROM AUTHOR]

Background: Considering the higher prevalence of psychological problems in patients with Celiac disease (CD), the current study aims to assess the prevalence of eating disorders (EDs) and body image disturbance in patients with CD and examine the possible correlation between EDs, body image dissatisfaction and distortion, and gluten-free diet (GFD) adherence in these patients. Methods: In this cross-sectional study, 217 patients with CD (18–55 years old) were recruited randomly from the CD registry database. EDs and body image issues were assessed using the 26-item Eating Attitude Test (EAT-26) and Stunkard Figure Rating Scale (FRS), respectively. Adherence to GFD was evaluated by the Celiac Dietary Adherence Test (CDAT) questionnaire. Results: The prevalence of EDs was 43.5%. Furthermore, the prevalence of body dissatisfaction and distortion was 65.9% and 41.1%, respectively. The logistic regression demonstrated a significant negative association between adherence to the GFD and EDs (OR = 2.09, 95% CI: 1.11–3.91, P = 0.022). However, there was no significant association between following GFD and body image dissatisfaction (OR = 1.70, CI: 0.92–3.17, P = 0.090), and distortion (OR = 0.65, CI: 0.36–1.18, P = 0.163). Conclusion: Considering the high prevalence of EDs in patients with CD and owing to the inverse association between EDs and GFD adherence, nutritionists should consider the psychological barriers in adhering to a GFD when consulting patients with CD. Highlights: we determined the association between eating disorders (EDs), body image dissatisfaction with adherence to gluten free diet (GFD) in patients with celiac disease. The prevalence of EDs was 43.5%. The prevalence of body image dissatisfaction and distortion was 65.9% and 41.1%, respectively. We observed a significant negative association between adherence to the GFD and EDs. There was no significant association between following the GFD with body image dissatisfaction and distortion. [ABSTRACT FROM AUTHOR]

Objective Despite an increase in twin pregnancies in recent decades, the Institute of Medicine twin weight gain recommendations remain provisional and provide no guidance for the pattern or timing of weight change. We sought to characterize gestational weight change trajectory patterns and examine associations with birth outcomes in a cohort of twin pregnancies. Study Design Prenatal and delivery records were examined for 320 twin pregnancies from a maternal–fetal medicine practice in Austin, TX 2011-2019. Prenatal weights for those with >1 measured weight in the first trimester and ≥3 prenatal weights were included in analyses. Trajectories were estimated to 32 weeks (mean delivery: 33.7 ± 3.3 weeks) using flexible latent class mixed models with low-rank thin-plate splines. Associations between trajectory classes and infant outcomes were analyzed using multivariable Poisson or linear regression. Results Weight change from prepregnancy to delivery was 15.4 ± 6.3 kg for people with an underweight body mass index, 15.4 ± 5.8 kg for healthy weight, 14.7 ± 6.9 kg for overweight, and 12.5 ± 6.4 kg for obesity. Three trajectory classes were identified: low (Class 1), moderate (Class 2), or high gain (Class 3). Class 1 (24.7%) maintained weight for 15 weeks and then gained an estimated 6.6 kg at 32 weeks. Class 2 (60.9%) exhibited steady gain with 13.5 kg predicted total gain, and Class 3 (14.4%) showed rapid gain across pregnancy with 21.3 kg predicted gain. Compared to Class 1, Class 3 was associated with higher birth weight z -score (β = 0.63, 95% confidence interval [CI]: 0.31,0.96), increased risk for large for gestational age (IRR = 5.60, 95% CI: 1.59, 19.67), and birth <32 weeks (IRR = 2.44, 95% CI: 1.10, 5.4) that was attenuated in sensitivity analyses. Class 2 was associated with moderately elevated birth weight z -score (β = 0.24, 95% CI: 0.00, 0.48, p = 0.050). Conclusion Gestational weight change followed a low, moderate, or high trajectory; both moderate and high gain patterns were associated with increased infant size outcomes. Optimal patterns of weight change that balance risk during the prenatal, perinatal, and neonatal periods require further investigation, particularly in high-risk twin pregnancies. Key Points A majority gained weight below IOM twin recommendations. Three patterns of GWC across pregnancy were identified. Moderate or high GWC was associated with infant size. [ABSTRACT FROM AUTHOR]

Background Children with human immunodeficiency virus (HIV, CWH) are at high risk of tuberculosis (TB) and face poor outcomes, despite antiretroviral therapy (ART). We evaluated outcomes in CWH and children not living with HIV treated for nonsevere TB in the SHINE trial. Methods SHINE was a randomized trial that enrolled children aged <16 years with smear-negative, nonsevere TB who were randomized to receive 4 versus 6 months of TB treatment and followed for 72 weeks. We assessed TB relapse/recurrence, mortality, hospitalizations, grade ≥3 adverse events by HIV status, and HIV virological suppression in CWH. Results Of 1204 children enrolled, 127 (11%) were CWH, of similar age (median, 3.6 years; interquartile range, 1.2, 10.3 versus 3.5 years; 1.5, 6.9; P =.07) but more underweight (weight-for-age z score, −2.3; (3.3, −0.8 versus −1.0; −1.8, −0.2; P <.01) and anemic (hemoglobin, 9.5 g/dL; 8.7, 10.9 versus 11.5 g/dL; 10.4, 12.3; P <.01) compared with children without HIV. A total of 68 (54%) CWH were ART-naive; baseline median CD4 count was 719 cells/mm3 (241–1134), and CD4% was 16% (10–26). CWH were more likely to be hospitalized (adjusted odds ratio, 2.4; 1.3–4.6) and to die (adjusted hazard ratio [aHR], 2.6; 95% confidence interval [CI], 1.2 to 5.8). HIV status, age <3 years (aHR, 6.3; 1.5, 27.3), malnutrition (aHR, 6.2; 2.4, 15.9), and hemoglobin <7 g/dL (aHR, 3.8; 1.3,11.5) independently predicted mortality. Among children with available viral load (VL), 45% and 61% CWH had VL <1000 copies/mL at weeks 24 and 48, respectively. There was no difference in the effect of randomized treatment duration (4 versus 6 months) on TB treatment outcomes by HIV status (P for interaction = 0.42). Conclusions We found no evidence of a difference in TB outcomes between 4 and 6 months of treatment for CWH treated for nonsevere TB. Irrespective of TB treatment duration, CWH had higher rates of mortality and hospitalization than their counterparts without HIV. Clinical Trials Registration.  ISRCTN63579542. [ABSTRACT FROM AUTHOR]

When restricted to alternating links, both Heegaard Floer and Khovanov homology concentrate along a single diagonal $\delta$ -grading. This leads to the broader class of thin links that one would like to characterize without reference to the invariant in question. We provide a relative version of thinness for tangles and use this to characterize thinness via tangle decompositions along Conway spheres. These results bear a strong resemblance to the L-space gluing theorem for three-manifolds with torus boundary. Our results are based on certain immersed curve invariants for Conway tangles, namely the Heegaard Floer invariant $\operatorname {HFT}$ and the Khovanov invariant $\widetilde {\operatorname {Kh}}$ that were developed by the authors in previous works. [ABSTRACT FROM AUTHOR]

Background: Abdominal fat necrosis is mostly an incidental finding during rectal examination manifested by the presence of hard necrotic masses of different sizes. Differential diagnosis includes gastrointestinal neoplasia, abdominal abscessation and mummified fetuses. This report describes the clinical, hematological, biochemical, sonographic, and pathologic findings in a female Arabian camel (Camelus dromedaries) with abdominal fat necrosis. Case Description: A 7-year-old female dromedary camel was presented for examination because of weakness and progressive weight loss since months ago. Anthelmintics, analgesics, broad-spectrum antimicrobials, anti-inflammatories and stomachics were administered, but did not result in significant improvement. Preliminary examination of the case revealed emaciation with a body condition score of 2.5 (scale 1-5). The cardiopulmonary, digestive, and urinary systems were evaluated transcutaneously by sonography in the recumbent position. Multiple echogenic masses--located within the intestinal loops were observed alongside few hypoechogenic masses. A hyperechogenic peritoneal effusion and enlarged mesenteric lymph nodes were also detected. Decreased hematocrit value, normocytic normochromic anemia, neutrophilic leukocytosis, hypoalbuminemia, hhyperglobulinemia, hyperglycemia, hyponatremia, and hyperkalemia were detected. A free-hand, ultrasound-guided biopsy was examined histopathologically and revealed multiple abdominal fat necrosis, severe fibrosis, and pancreatitis. Conclusion: It is concluded that, transabdominal ultrasonography in camels was valuable for suspicious of abdominal mesenteric masses and helpful in sampling of a representative biopsy specimen However, histological examination of the biopsy remains the final diagnostic method. [ABSTRACT FROM AUTHOR]

Early childhood development (ECD) is crucial for better health and well‐being throughout life, but few studies have examined how ECD relates to child malnutrition. This is mainly due to lack of reliable and disaggregated data on ECD. We estimated the prevalence of ECD delays (communication, fine motor, gross motor, problem‐solving and personal–social) and examined how different ECD domains were associated with child nutritional status in urban Ethiopia. Using a community‐based cross‐sectional survey design, 627 mother–child (12–36 months old) pairs were included in the study. The ECD was assessed using the Age and Stage Questionnaire (ASQ‐3), and the nutritional status was assessed using anthropometric measurements. The association between the ECD domains and nutritional status was analysed using ordinal logistic regression, adjusting for confounding variables. Delays in ECD domains were common, especially in fine motor domain (41.9%); and more than half of the children were stunted (52.8%). Stunting and underweight were associated with ECD delays, while wasting was not. Accordingly, stunted children were more likely to have worst ECD delays in fine motor (odds ratios [OR] = 1.54; 95% confidence interval [CI]: 1.11; 2.15), gross motor (OR = 1.47; 95% CI: 1.05; 2.04) and problem‐solving (OR = 1.41; 95% CI: 1.02; 1.96) domains compared to non‐stunted children. Similarly, underweight children were more likely to have worse ECD delays in gross motor (OR = 1.91; 95% CI: 1.20; 3.04) and fine motor (OR = 1.90; 95% CI: 1.15; 3.15) domains compared to normal children. Coordinated and targeted ECD interventions, such as nurturing care, should be promoted and implemented widely to improve ECD outcomes and child nutrition. Key messages: Studies examining early childhood development (ECD) and child nutrition are scarce in Ethiopia, mainly due to lack of reliable and disaggregated ECD data.We estimated the prevalence of ECD delays and examined how different ECD domains were associated with child nutrition in urban Ethiopia using a direct ECD measure.Our study revealed that stunted and underweight children had a higher likelihood of ECD delays. To address these issues, we recommend coordinated efforts across key sectors, such as health, education, women's affairs and social protection, to promote and implement ECD interventions, such as nurturing care. [ABSTRACT FROM AUTHOR]

The Integrated Child Development Services (ICDS) programme has been the central focus of the POSHAN Abhiyaan to combat maternal and child malnutrition under the national nutrition mission in India. This paper examined the linkages between utilization of ICDS and underweight among children aged 6–59 months. The study utilized data from two recent rounds of the National Family Health Survey (NFHS‐4 [2015–2016] and NFHS‐5 [2019–2021]). Descriptive analyses were used to assess the change in utilization of ICDS and the prevalence of underweight at the national and state levels. Multivariable logistic regressions were performed to examine factors associated with the utilization of ICDS and underweight. Linkages between utilization of ICDS and underweight were examined using the difference‐in‐differences (DID) approach. Utilization of ICDS increased from 58% in 2015–2016 to 71% in 2019–2021. The prevalence of underweight decreased from 37% to 32% in the same period. Changes in ICDS utilization and underweight prevalence varied considerably across states, socioeconomic and demographic characteristics. Results from decomposition of DID models suggest that improvements in ICDS explained 9%–12% of the observed reduction in underweight children between 2016 and 2021, suggesting that ICDS made a modest but meaningful contribution in addressing undernutrition among children aged 6–59 months in this period. Key messages: Utilization of ICDS services among children aged 6–59 months increased from 58% (2015–2016) to 71% (2019–2021) nationally. The programme's expansion was prominent in urban areas, showcasing progress across states.The prevalence of underweight among children in India declined by 5 percentage points from 2016 to 2021, but almost one‐third of children are still underweight.Increase in coverage and service delivery strengthening of ICDS explained 9%–12% of the observed reduction in underweight between 2016 and 2021.The findings suggest that optimizing quality of interventions under ICDS can have a modest but meaningful contribution in reducing childhood underweight in India. [ABSTRACT FROM AUTHOR]

Child malnutrition remains a significant concern in the Asia‐Pacific region, with short birth intervals recognised as a potential risk factor. However, evidence of this association is inconclusive. This study aimed to systematically review the existing evidence and assess the summary effects of short birth interval on child malnutrition in the Asia‐Pacific region. Five electronic databases were searched in May 2023 to identify relevant studies reporting the association between short birth interval and child malnutrition, including stunting, wasting, underweight, anaemia and overall malnutrition, in Asia‐Pacific region between September 2000 and May 2023. Fixed‐effects or random‐effects meta‐analysis was performed to estimate the summary effects of short birth interval on child malnutrition. Out of 56 studies meeting the inclusion criteria, 48 were included in quantitative synthesis through meta‐analysis. We found a slightly higher likelihood of stunting (n = 25, odds ratio [OR] = 1.13; 95% confidence interval [CI]: 0.97–1.32) and overall malnutrition (n = 3, OR = 2.42; 95% CI: 0.88–6.65) among children born in short birth intervals compared to those with nonshort intervals, although the effect was not statistically significant. However, caution is warranted due to identified heterogeneity across studies. Subgroup analysis demonstrated significant effects of short birth intervals on child malnutrition in national‐level studies and studies with larger sample sizes. These findings underscore short birth intervals as a significant contributor to child malnutrition in the Asia‐Pacific region. Implementing effective policies and programs is vital to alleviate this burden, ultimately reducing child malnutrition and associated adverse outcomes, including child mortality. Key messages: Short interval pregnancies pose a persistent public health threat in the South Asian region.While a potential link with child malnutrition exists, reported associations often conflict.Our findings suggest that short interval births slightly increase the risk of child malnutrition.Addressing short interval pregnancies is crucial to mitigate the ongoing nutritional burden in South Asian countries. [ABSTRACT FROM AUTHOR]

Small and nutritionally at‐risk infants aged under 6 months (<6 months) are at high risk of death, but important evidence gaps exist on how to best identify them. We aimed to determine associations between anthropometric deficits and mortality among infants <6 months admitted to inpatient therapeutic care. A secondary analysis of 2002–2008 data included 5034 infants aged <6 months from 12 countries. We estimated the prevalence, concurrence, and severity of wasted, stunted, and underweight, as stand‐alone indicators, and using the Composite Index of Anthropometric Failure (CIAF), which combines these indicators into six subgroups of single and multiple anthropometric deficits and into one combined indicator called CIAF. We used logistic regression to examine the association of different anthropometric deficits with in‐programme mortality. Among 3692 infants aged <6 months with complete data, 3539 (95.8%) were underweight, 3058 (82.8%) were wasted, 2875 (77.8%) were stunted and 3575 (96.8%) had CIAF. Infants with multiple anthropometric deficits were presented with significantly lower anthropometric indices, that is, they were more severely wasted, stunted and underweight. A total of 141 infants died during inpatient therapeutic care. Among these, severely wasted (116) and severely underweight (138) infants had higher odds of mortality than normal infants (odds ratio [OR] = 2.1, 95% confidence interval [CI]: 1.2–2.7, p = 0.009, and OR = 3.3, 95% CI: 0.8–13.6, p = 0.09, respectively). Boys had higher odds of inpatient mortality than girls (OR = 1.40, 95% CI: 1.02–1.92, p = 0.03). Mortality was only observed in infants <6 months presenting multiple anthropometric deficits, although their odds of mortality were not significant, for example, OR = 2.4, 95% CI: 0.5–10.0, p = 0.21 for stunted, wasted and underweight infants <6 months. In conclusion, multiple anthropometric deficits (CIAF) is common among infants <6 months and may be reported in nutrition care programmes and surveys. Both weight‐for‐length/height z‐score and weight‐for‐age z‐score were found to be useful indicators for programme admission and in‐programme prognosis. Future work needs to explore which better accounts for admission bias. Boys appear to be most at‐risk of dying while receiving malnutrition therapeutic care. Programmes should ensure that all infants receive timely, evidence‐based, effective care. Key messages: Infants aged <6 months with multiple anthropometric deficits present more severely wasted, stunted, and underweight. Prevalence of concurrent deficits increases with age within this group.In inpatient therapeutic care, low weight‐for‐length/height z‐score (WLZ) and weight‐for‐age z‐score (WAZ) strongly correlate with mortality. In contrast, associations with low length‐for‐age z‐score (LAZ) are the weakest.Boys had a higher prevalence of anthropometric deficits and a higher mortality risk than girls.Future work is needed to see if these risk profiles also apply to the general population or infants <6 months admitted to newer feeding programmes using other criteria. [ABSTRACT FROM AUTHOR]

Objective: Binge‐eating spectrum disorders (BESD) involve large eating episodes accompanied by a sense of loss of control that occur in individuals with body weights spanning the full body mass index (BMI) spectrum. While research links BESD with peripheral inflammation, this literature is limited by underpowered studies and a failure to control for confounding variables that could promote inflammation independent of dysregulated eating, specifically elevated body adiposity and depression. Our study examined plasma interleukin‐6 (IL‐6), a marker of peripheral inflammation, in a sample of women with BESD and non‐eating disorder controls, controlling for BMI, body adiposity, and depression. Method: Participants (N = 94) included women with BESD (n = 73) or no eating disorder (n = 21) who completed structured clinical interviews in a larger study, selected to represent BMI categories ranging from underweight to obese in both groups. Fasting blood samples were processed for plasma IL‐6 concentration via enzyme‐linked immunosorbent assays. In addition to assessing group differences in plasma IL‐6, exploratory analyses examined associations between IL‐6 and biological and clinical markers of BESD. Results: Significantly elevated plasma IL‐6 was found in women with BESD, relative to controls, that was not accounted for by BMI, adiposity, or depression. Plasma IL‐6 was positively correlated with plasma leptin concentration, clinical assessments of eating disorder severity, and participants' largest self‐reported eating episode. Discussion: Peripheral inflammation is specifically linked to presence of dysregulated eating independently from weight, adiposity, and depression in BESD. Future research should probe the potential role of neuroinflammation in altered eating behavior. Public Significance: This study provides the first demonstration that inflammation, characterized by elevated plasma IL‐6 concentration, is uniquely associated with dysregulated eating in a transdiagnostic group of individuals with BESD. A better understanding of whether immune factors contribute to dysregulated eating could help identify novel biological targets for intervention. [ABSTRACT FROM AUTHOR]

A small but growing body of research in pediatric feeding disorders asserts the importance of comprehensively measuring social significance of goals, procedures, and effects of intervention, and incorporating social validity into practice to inform treatment. This report sought to extend this literature by detailing procedures to measure and improve social validity during a clinical case of a 3.5‐year‐old during a home‐based intensive feeding program. A multiple baseline design demonstrated effectiveness of nonremoval and re‐presentation added to a treatment package. Repeated choice via direct child preference assessments informed demand fading and gradual progression across six feeding skill domains (medication, cup drinking, independence, texture, volume, variety) and arrangements of response effort (preference, skill) with layers of reinforcer parameters (quality, magnitude, rate, immediacy). Indices of happiness definitions were modified, and extinction bursts examined. Fostering a collaborative approach, caregivers provided detailed input on social validity measures pretreatment, at discharge, and long‐term follow‐up (6‐month, 1‐year), inclusive of both qualitative and quantitative responses, written and verbal communication, and permanent product data. Further implications for practitioners included detailing the process for caregiver training and generalization to family meals with siblings and community settings, and providing adaptable full‐text guidelines for free access/choice contexts. [ABSTRACT FROM AUTHOR]

Introduction: The impact of young child formula (YCF) consumption on children's growth, particularly under suboptimal conditions, has scarcely been studied. In the current study, weight-for-age (WAZ), length-for-age (LAZ), and BMI-for-age (BAZ) z-score development was evaluated in children from five different countries (n = 668) who participated in a double-blind, randomized, controlled trial. Methods: The children (1–3 years old) were randomized to one of two intervention YCFs (with presence or absence of prebiotics and n-3 LCPUFAs) during 52 weeks of intervention. Additional stratified analyses evaluated the growth patterns of underweight, overweight, or stunted children. Results: No apparent differences in anthropometric measurements were observed between the intervention groups. In both YCF intervention groups, mean WAZ, LAZ and BAZ development was indicative of adequate growth during the intervention period. Stratified analyses showed stable WAZ and BAZ development among children with a healthy weight or overweight at baseline. Among underweight and stunted children, normalization in mean weight (∼1 SD) and length (∼0.8 SD) gain, respectively, was observed. Conclusion: The current study suggests that consumption of YCF, either or not containing prebiotics and n-3 LCPUFAs, is associated with adequate growth among young children. This association may depend on the child's baseline nutritional status. Future studies to assess the potential role of YCF in supporting adequate weight/length gain among children at risk for undernutrition are warranted. [ABSTRACT FROM AUTHOR]

Background: Patients with anorexia nervosa (AN) show overgeneralization of memory (OGM) when generating autobiographical episodes related to food and body shape. These memories are central for the construction of a coherent self‐concept, interpersonal relationships, and problem‐solving abilities. The current study aims to investigate changes in autobiographical memory following weight gain. Methods: OGM was assessed with an adapted version of the Autobiographical Memory Test including food‐, body‐, depression‐related, and neutral cues. N = 41 female patients with AN (28 restricting‐, 13 binge‐eating/purging‐subtype; mean disease duration: 4.5 years; mean BMI: 14.5 kg/m2) and N = 27 healthy controls (HC) were included at baseline. After inpatient treatment (mean duration: 11 weeks), 24 patients with AN and 24 age‐matched HC were reassessed. Group differences were assessed using independent samples t‐tests for cross‐sectional comparisons and repeated measures ANOVAs for longitudinal data. Results: At baseline, patients with AN generated significantly fewer specific memories than HC, independent of word category (F(1.66) = 27.167, p < 0.001). During inpatient stay, the average weight gain of patients with AN was 3.1 body mass index points. At follow‐up, patients with AN showed a significant improvement in the number of specific memories for both depression‐related and neutral cues, but not for food‐ and body‐related cues. Conclusions: Generalised OGM (i.e., independent of word category) in patients with AN before weight restoration may be a general incapacity to recall autobiographical memory. After weight gain, the previously well‐studied pattern of eating disorder‐related OGM emerges. The clinical relevance of the continuing disorder‐related OGM in patients with AN after weight gain is discussed. Highlights: 'Overgeneral Memory' (OGM) in severely underweight patients (mean body mass index = 14.5 kg/m2) with anorexia nervosa (AN) might be a state marker in the form of a general incapacity to recall autobiographical memories, regardless of emotional valence.Reduced symptoms of depression in patients with AN after weight gain, compared with the beginning of inpatient treatment, may be an indication of an overall improvement in mental health as negative memories become more specific.The persisting eating disorder‐related OGM after weight gain might be a maintaining factor of AN facilitating relapse and could also reflect increased dysfunctional emotion processing despite decreased eating disorder symptoms: functional avoidance might be a protective mechanism in the form of less confrontation with eating disorder‐related content through generalised memories. [ABSTRACT FROM AUTHOR]

Background: Adverse childhood experiences (ACEs) are elevated in individuals with eating disorders (EDs), but how the neurobiology of EDs and ACEs interact is unclear. Methods: Women 18–45 years old with anorexia nervosa (AN, n = 38), bulimia nervosa (BN, n = 32), or healthy controls (n = 60) were assessed for ACEs and ED behaviours and performed a taste‐conditioning task during brain imaging. Mediation analyses tested relationships between ACE score, self‐esteem, and ED behaviours. Results: ACE scores were elevated in EDs and correlated positively with body mass index (p = 0.001), drive for thinness (p = 0.001), and body dissatisfaction (p = 0.032); low self‐esteem mediated the relationship between ACEs and body dissatisfaction, drive for thinness, and bulimia severity. ACE scores correlated negatively (FDR‐corrected) with unexpected, salient stimulus receipt in AN (substantia nigra) and BN (anterior cingulate, frontal and insular cortex, ventral striatum, and substantia nigra). When ACE scores were included in the model, unexpected stimulus receipt brain response was elevated in EDs in the anterior cingulate and ventral striatum. Conclusions: ACEs attenuate unexpected salient stimulus receipt response, which may be a biological marker for altered valence or hedonic tone perception in EDs. Low self‐esteem mediates the relationships between ACEs and ED behaviours. Adverse childhood experiences should be assessed in biological studies, and their effects targeted in treatment. Highlights: The study replicates that low self‐esteem mediates the effects of adverse childhood experiences (ACEs) on drive for thinness, body dissatisfaction, and the tendency to binge eat.This study provides a neurobiological mechanism for how ACEs affect stimulus valence or hedonic tone processing long after the trauma has occurred.Assessing ACEs is important to control for their effects when studying salient stimulus responses in eating disorders (EDs), and low self‐esteem and the effects of ACEs should be targeted in treatment. [ABSTRACT FROM AUTHOR]

Background Underweight is a significant symptom in alcohol-dependent patients, yet few studies have examined underweight in Chinese male patients. The current study aimed to identify the prevalence, sociodemographic, and clinical correlates of underweight in Chinese male patients with alcohol dependency. Methods In this cross-sectional study, 405 male inpatients with alcohol dependence and 383 healthy male controls were recruited. Participants' demographic and clinical data, including anthropometric data, were collected. We first conducted univariate analysis to identify seven variables with significant differences between groups: smoking behavior, hospitalization, alcohol consumption, cerebral infarction, hypertension, Hamilton Depression Scale (HAMD) score, and Scale for Assessment of Negative Symptom (SANS) score. Then, binary logistic regression was used to assess their relationship with underweight, with a significance level of.05. Results The prevalence of underweight was significantly higher in the study population than in the control group (2.99% vs. 2.87%; P  < .001). Patients with underweight had significantly higher rates of smoking behavior and cerebral infarction, as well as higher scores of SANS and HAMD than non-underweight patients. The non-underweight patients had higher daily alcohol consumption and times of hospitalization. Furthermore, logistic regression analysis showed that smoking behavior [odds ratio (OR) = 2.84, 95% confidence interval (CI) = 1.03–7.80, P  = .043)], cerebral infarction (OR = 5.20, 95% CI = 1.13–23.85, P  = .036), SANS score (OR = 1.22, 95% CI = 1.16–1.28, P  < .001), and HAMD score (OR = 1.06, 95% CI = 1.02–1.11, P  = .005) were associated with underweight. Conclusions More than 20% of male alcohol-dependent patients in a Chinese sample were underweight. Some demographic and clinical variables independent correlates for underweight in alcohol-dependent patients. We need to focus on alcohol-dependent patients with smoking, cerebral infarction, depression, and more prominent negative symptoms. [ABSTRACT FROM AUTHOR]

Background: There is an abundance of studies explaining the separate impact of female employment and household wealth status in reducing malnutrition. However, our study has unraveled the combined impact of maternal employment and household wealth on undernutrition among children under three in Pakistan. Methods: Using a sample of 1093 children under three years of age from the Pakistan Demographic and Health Survey 2017–2018, a binary logistic model was employed to gauge factors influencing the children's undernutrition. Results: Our results indicated that children up to a certain age (three years old) with residence in certain regions (Pakistan) and recent episodes of diarrhea had an increased risk of undernutrition. Conversely, secondary and higher maternal education, access to improved water sources, and sanitation facilities lowered the chances of undernutrition in children under three in Pakistan. The interaction between maternal employment and household wealth showed that maternal employment significantly lowered the risk of stunting, being underweight, and wasting among the average, rich, and richest households; however, it did not contribute to child nutrition among the poorer and poor households. Notably, regardless of whether the mother was employed, the wealth status of being rich and richest reduced the risk of stunting, being underweight, and wasting. Conclusions: In overcoming undernutrition, maternal employment significantly contributed to middle-income households. However, in the richer and richest households, the wealth status played a more crucial role compared to the maternal employment. This indicates that while employment plays a supportive role in household resources, the wealth status is overall more influential in reducing undernutrition. [ABSTRACT FROM AUTHOR]

Background: Food insecurity significantly impacts children's health, affecting their development across cognitive, physical, and socio-emotional dimensions. This study explores the impact of food insecurity among children aged 6 months to 5 years, focusing on nutrient intake and its relationship with various forms of malnutrition. Methods: Utilizing machine learning algorithms, this study analyzed data from 819 children in the West Bank to investigate sociodemographic and health factors associated with food insecurity and its effects on nutritional status. The average age of the children was 33 months, with 52% boys and 48% girls. Results: The analysis revealed that 18.1% of children faced food insecurity, with household education, family income, locality, district, and age emerging as significant determinants. Children from food-insecure environments exhibited lower average weight, height, and mid-upper arm circumference compared to their food-secure counterparts, indicating a direct correlation between food insecurity and reduced nutritional and growth metrics. Moreover, the machine learning models observed vitamin B1 as a key indicator of all forms of malnutrition, alongside vitamin K1, vitamin A, and zinc. Specific nutrients like choline in the "underweight" category and carbohydrates in the "wasting" category were identified as unique nutritional priorities. Conclusion: This study provides insights into the differential risks for growth issues among children, offering valuable information for targeted interventions and policymaking. [ABSTRACT FROM AUTHOR]

* OBJECTIVE: To examine the associations between (1) various types of physical activity and the risk of back pain incidence, and (2) the influence of substituting sedentary behaviors with physical activities on back pain incidence. * DESIGN: A prospective cohort study. * METHODS: We analyzed UK Biobank data collected from 365 307 participants who were free of back pain at baseline. The exposures were total, light, moderate, and vigorous physical activity, and sedentary behaviors. The outcome was back pain incidence. The main statistical models were the Cox proportional hazard model and the isotemporal substitution model. * RESULTS: In the follow-up time (median, 12.97 years; interquartile range, 12.10-13.71), 25 189 individuals developed back pain. The associations between all types of physical activity and incident back pain were significantly nonlinear (P<.001) among the general population and other subgroups. High physical activity was associated with a decreased risk of back pain compared with no physical activity. The lowest risk occurred in the 1801-to-2400 MET-min/week (metabolic-equivalent minutes per week) subgroup of total physical activity (hazard ratio [HR] = 0.64; 95% CI: 0.59, 0.69), approximately consisting of 1200, 600, and 600 MET-min/week of light, moderate, and vigorous physical activity, respectively. Extremely high vigorous physical activity was related to high risk, specifically in males (HR = 1.13; 95% CI: 1.02, 1.25). Replacing 1 hour/day of sedentary behaviors with an equal time of physical activity reduced the risk of incident back pain by 2% to 8% (P<.05). * CONCLUSION: Physical activity was related to a reduced risk of back pain incidence (except over high vigorous physical activity). Substituting sedentary behaviors with physical activities reduced the risk of future back pain. [ABSTRACT FROM AUTHOR]

Background: Three indicators of early childhood undernutrition and associated factors are evaluated among under-5 children in five National Family Health Surveys in India spanning 1992 to 2021. Methods: Data for 533,495 children under 5 years of age (U–5) were analysed in the context of three commonly used indicators of early childhood undernutrition – wasting, stunting and underweight. In addition to descriptive and inferential statistics, binary logistic regression was used to estimate the effects of specific explanatory factors on the three indicators using adjusted odds ratios. Results: Over the three-decade interval, stunting was reduced by 22.1% in boys and 20.9% in girls, followed by underweight, 19.3% in boys and 17.4% in girls; wasting, in contrast, was reduced to a considerably lesser extent, 2.8% in boys and 0.9% in girls. Demographic, maternal and socioeconomic factors were associated with the incidence of early childhood undernutrition, specifically among young mothers and those with less education in low-income families, and among children from Scheduled Tribes or Scheduled Castes. Stunting and underweight declined significantly over the past three decades while wasting changed negligibly. The disparity in the occurrence of early childhood undernutrition was apparent throughout socioeconomic categories and regions of India. Conclusions: The results highlight the need for special programs aimed at reducing waste among children and also the need for customized initiatives focused on the improvement of maternal education and wealth in addition to other ancillary factors related to regional variation. [ABSTRACT FROM AUTHOR]

Purpose: This study examined metabolic flexibility with respect to fat metabolism during exercise in children who are lean (n=11; 10.9[0.9] y) and overweight/obese (OW/OB; n=9; 10.3[1.2] y). Method: Participants were grouped based on body mass index percentiles for age and sex. Groups were mixed in age and sex. Participants completed two 20-minute exercise bouts on a cycle ergometer, separated by a 10-minute rest. Bout 1 consisted of 10 minutes at 50% VO2peak and 10 minutes at 75% VO2peak. Bout 2 was 20 minutes at 50% VO2peak. Absolute fat oxidation rate (FOR), FOR relative to body mass, FOR relative to fat-free mass, and proportional fat use were measured at 10 minutes of bout 1 and 5, 10, 15, and 20 minutes of bout 2. Results: Absolute FOR was higher in the OW/OB group (range: 117.8 [55.1]–206.2 [48.3] mg·min−1) than in the lean group (81.1 [32.2]–152.2 [38.2] mg·min−1); however, there were no significant main effects for group or significant interactions for proportional fat use, FOR relative to body mass, or FOR relative to fat-free mass. Conclusion: Children in this age range who are overweight/obese do not display impaired metabolic flexibility with respect to fat metabolism during exercise. [ABSTRACT FROM AUTHOR]

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Introduction: The importance of body composition and sarcopenia is wellrecognized in cancer patient outcomes and treatment tolerance, yet routine evaluations are rare due to their time-intensive nature. While CT scans provide accurate measurements, they depend on manual processes. We developed and validated a deep learning algorithm to automatically select and segment abdominal muscles [SM], visceral fat [VAT], and subcutaneous fat [SAT] on CT scans. Materials and Methods: A total of 352 CT scans were collected from two cancer centers. The detection of the third lumbar vertebra and three different body tissues (SM, VAT, and SAT) were annotated manually. The 5-fold cross-validation method was used to develop the algorithm and validate its performance on the training cohort. The results were validated on an external, independent group of CT scans. Results: The algorithm for automatic L3 slice selection had a mean absolute error of 4 mm for the internal validation dataset and 5.5 mm for the external validation dataset. The median DICE similarity coefficient for body composition was 0.94 for SM, 0.93 for VAT, and 0.86 for SAT in the internal validation dataset, whereas it was 0.93 for SM, 0.93 for VAT, and 0.85 for SAT in the external validation dataset. There were high correlation scores with sarcopenia metrics in both internal and external validation datasets. Conclusions: Our deep learning algorithm facilitates routine research use and could be integrated into electronic patient records, enhancing care through better monitoring and the incorporation of targeted supportive measures like exercise and nutrition. [ABSTRACT FROM AUTHOR]

This study aimed to identify critical risk factors for childhood malnutrition and inform targeted interventions. Childhood malnutrition remains a pressing concern in the coastal regions of Bangladesh. Data were extracted from the latest Bangladesh Demographic and Health Survey 2017–2018 and children aged 0–59 months and their mothers aged 15–49 years from 17 coastal districts were included as study population in this study. We performed multivariable logistic regression model to determine the risk factors and a total 2153 children were eligible for the analysis. Stunting, wasting and underweight prevalence was 31.4%, 8.5% and 21.1% respectively. Stunting was more common in children aged 24–35 months with compared to their younger counterparts [adjusted odds ratio (AOR) = 3.32, 95% confidence interval (CI): 2.35–4.67]. Children to mothers with higher education exhibited 69% (AOR = 0.31, 95% CI: 0.18–0.52) lower risk of stunting compared to those with no education. Similarly, children in poorest and poorer households had 2.2 and 1.83 times higher odds of stunting respectively than those in the richest households. Children born to obese mothers (compared to normal) were 34% less likely to be stunted (AOR = 0.66, 95% CI: 0.51–0.85). Children who had fever and underweight mothers reported wasting. Increasing child age, low maternal education, poorest wealth index, unimproved toilet facilities and childhood morbidity were identified as significant risk factors for underweight. Results support the requirement of effective and appropriate interventions for this particular region considering the identified risk factors to reduce childhood malnutrition in Bangladesh. [ABSTRACT FROM AUTHOR]

Introduction: Body image distortion and/or dissatisfaction may occur primarily due to body fat accumulation and/or distribution. The aim of this study was to evaluate the frequency of body image perception and (dis)satisfaction categories in adult men and women according to the adiposity classification. Methods: This is a cross-sectional study (n = 514; 33–79 years; 265 women) that is part of a prospective cohort (Pró-Saúde study). Adiposity measurements were determined by two methods: anthropometry, used to calculate the body mass index (BMI) and dual-energy X-ray absorptiometry (DXA), to estimate body fat percentage. Participants were grouped as "no excess adiposity" and "excess adiposity", considering BMI and body fat percentage (>30% for men, >40% for women). Perception and (dis)satisfaction with body image were evaluated using the Kakeshita scale, composed by 15 silhouettes, developed for the Brazilian population. Degree of distortion (perceived BMI ‐ real BMI) and dissatisfaction (perceived BMI ‐ desired BMI) were calculated. Results: A high proportion of men (58.6%; 74.3%), and especially of women (82.6%; 86.8%), presented body size overestimation and dissatisfaction due to excess weight, respectively. A relevant fraction of the women (32.6%) and men (30.8%) who were dissatisfied due to excess weight did not present excess adiposity, especially if classified by DXA. Variability in degree of distortion was hardly explained by anthropometric and DXA variables in women (<5%) and men (∼22%). Both anthropometric and DXA measurements accounted for ∼30% and ∼50% of the variability in degree of dissatisfaction among women and men, respectively. Conclusion: Our results suggest a high frequency of body image distortion in Brazilian adult individuals, as well as dissatisfaction with excess weight, especially among women with excess adiposity. The findings indicate that anthropometric measurements explain much of the variability in degree of body image dissatisfaction in men, with no apparent advantage of the use of more refined DXA measurements. [ABSTRACT FROM AUTHOR]

Summary: Background: Obesity is prevalent among children and adults. Yet, understanding the relationship between parent and child weight trajectories is limited. Objective: (1) Examine the association between parent/child undesirable body mass index (BMI) category change. (2) Assess whether parental BMI category predicts child modified BMI z‐score (mBMIz) annual change. Methods: We conducted a cross‐sectional study of weight trajectories of 3821 parent–child dyads between March 2020 and December 2021 within the NYC Health + Hospitals system. Undesirability of child and parental BMI category change and the magnitude of mBMIz change by parental BMI are analysed. Results: Of 3821 children (mean [SD] baseline age, 9.84 [3.51]), 1889 were female. Of the 3220 parents (mean [SD] baseline age, 39.9 [8.51]), 2988 were female. Most children (53.52%) and parents (81.94%) presented with overweight and obesity. Undesirable BMI change in children was associated with concordant change in parents (adjusted OR: 1.7, 95% CI [1.45, 2.01], adjusted p < 0.001). Children of parents with obesity (adjusted coef: 0.076, 95% CI [0.004, 0.147], p < 0.038) and severe obesity (adjusted coef: 0.1317, 95% CI [0.024, 0.239], adjusted p < 0.016) demonstrated greater change in mBMIz than those of parents with normal weight or underweight. Conclusion: Parents and children have concordant weight trajectories, and public health interventions targeting both populations are essential. [ABSTRACT FROM AUTHOR]

We aimed to explore and analyse the dietary intake patterns of 3‐6 year‐old children left behind by one or both parents and to assess their associations with body mass index (BMI) and the prevalence of childhood anaemia in rural Anhui, eastern China. We used random cluster sampling to recruit rural children aged 3–6 years in two rural areas in Anhui province. Sociodemographic information and dietary intake were collected by self‐reported questionnaires. Height, weight and prevalence of anaemia were measured by trained nurses blinded to parental migration status. Factor analysis was applied to determine that major dietary patterns, binary logistic regression and generalised linear regression were used to explore the associations between anaemia and BMI Z‐score with dietary patterns. Of 1720 children aged 3–6 years, 236 were left by both parents and 388 were left by a single parent. The prevalence of stunting and underweight among left‐behind children with migration of both parents (BLBC) was significantly higher than that of non‐left‐behind children (NLBC). Three dietary patterns—"grain–vegetable," "meat–egg" and "fast food–sweet"—were identified in our study, and the total variance explained was 46.9%. The meat–egg dietary pattern was associated with a decreased risk of anaemia after adjustment for confounding factors in the left‐behind children with migration of both parents (BLBC), left‐behind children with single parent migration (SLBC) and non‐left‐behind children (NLBC) groups. After adjusting for confounding factors, the fast food–sweet dietary pattern was found to be associated with an increased risk of anaemia (OR [95% CI]: Q4: 2.21 [1.14, 4.57], p = 0.034). In addition, children with obesity had a lower intake of vegetables and fruits (β = −0.08, 95% CI: −0.13, −0.02) compared with children with a normal weight. In conclusion, there are correlations between different types of parental migration and children's nutritional status in rural Anhui. The meat–egg dietary pattern may have a preventive effect on anaemia in comparison with other dietary patterns, irrespective of whether children are left behind or not. Children with overweight and obesity had a higher intake of pork and red meat and snacks compared with children with normal BMI. [ABSTRACT FROM AUTHOR]

The literature on the nutritional needs and outcomes of critically ill children is scarce, especially on those with critical neurological illnesses (CNIs). Current evidence shows a lower mortality in patients who achieve two-thirds of their nutritional needs during the first week of pediatric intensive care unit (PICU) admission. We hypothesized that achieving 60% of the recommended dietary intake during the first week of a PICU stay is not feasible in patients with CNI. We designed an observational retrospective cohort study where we included all index admissions to the PICU in our institution of children (1 month to 18 years) with CNI from January 2018 to June 2021. We collected patient demographics, anthropometric measures, and caloric and protein intake (enteral and parenteral) information during the first week of PICU admission. Goal adequacy for calories and protein was defined as [(intake/recommended) × 100] ≥ 60%. A total of 1112 patients were included in the nutrition assessment, 12% of whom were underweight (weight for age z score < −2). Of this group, 180 met the criteria for nutrition support evaluation. On the third day of admission, 50% of the patients < 2 years achieved caloric and protein goal adequacy, compared to 25% of patients > 2 years, with p-values of 0.0003 and 0.0004, respectively. Among the underweight patients, 60% achieved both caloric and protein goal adequacy by day 3 vs. 30% of non-underweight patients with p-values of 0.0006 and 0.002, respectively. The results show that achieving 60% of the recommended dietary intake by days 5 and 7 of admission was feasible in more than half of the patients in this cohort. Additionally, children who were evaluated by a clinical dietician during the first 48 h of PICU admission reached higher nutrition adequacy. [ABSTRACT FROM AUTHOR]

Objectives: The current study aimed to investigate the impact of oxytocin on emotion recognition, trust, body image, affect, and anxiety and whether eating disorder (ED) symptoms moderated any of these relationships. Method: Participants (n = 149) were female university students, who were randomly allocated to receive in a double-blind nature, a single dose of oxytocin intranasal spray (n = 76) or a placebo (saline) intranasal spray (n = 73). Participants were asked to complete an experimental measure of emotion recognition and an investor task aimed to assess trust. Results: The oxytocin group exhibited better overall performance on the emotion recognition task (especially with recognising positive emotions), and a decline in state positive affect than the control group at post-intervention. However, these effects were not moderated by ED symptom severity, nor were effects found for state anxiety, negative affect, body image and recognising negative emotions in the emotion recognition task. Conclusion: The current findings contribute to the growing literature on oxytocin, emotion recognition and positive affect and suggest that ED pathology does not moderate these relationships. Future research would benefit from examining the efficacy of an oxytocin intervention using a within-subjects, cross-over design, in those with sub-clinical and clinical EDs, as well as healthy controls. [ABSTRACT FROM AUTHOR]

Background: Recent guidelines recommend using direct oral anticoagulants (DOACs) as first-line agents in patients with non-valvular atrial fibrillation (NVAF). Research is currently investigating the use of Apixaban in underweight patients, with some results suggesting altered pharmacokinetics, decreased drug absorption, and potential overdosing in this population. This study examined the effectiveness and safety of standard Apixaban dosing in adult patients with atrial NVAF weighing less than 50 kg. Methods: This is a retrospective cohort study conducted at King Abdulaziz Medical City (KAMC); adult patients with a body mass index (BMI) below 25 who received a standard dose of Apixaban (5 mg twice daily) were categorized into two sub-cohorts based on their weight at the time of Apixaban initiation. Underweight was defined as patients weighing ≤ 50 kg, while the control group (Normal weight) comprised patients weighing > 50 kg. We followed the patients for at least one year after Apixaban initiation. The study's primary outcome was the incidence of stroke events, while secondary outcomes included bleeding (major or minor), thrombosis, and venous thromboembolism (VTE). Propensity score (PS) matching with a 1:1 ratio was used based on predefined criteria and regression model was utilized as appropriate. Results: A total of 1,433 patients were screened; of those, 277 were included according to the eligibility criteria. The incidence of stroke events was lower in the underweight than in the normal weight group at crude analysis (0% vs. 9.1%) p-value = 0.06), as well in regression analysis (OR (95%CI): 0.08 (0.001, 0.76), p-value = 0.002). On the other hand, there were no statistically significant differences between the two groups in the odds of major and minor bleeding (OR (95%CI): 0.39 (0.07, 2.03), p-value = 0.26 and OR (95%CI): 1.27 (0.56, 2.84), p-value = 0.40, respectively). Conclusion: This exploratory study revealed that underweight patients with NVAF who received standard doses of Apixaban had fewer stroke events compared to normal-weight patients, without statistically significant differences in bleeding events. To confirm these findings, further randomized controlled trials with larger sample sizes and longer observation durations are required. [ABSTRACT FROM AUTHOR]

Background: This study sought to compare the prevalence of underweight and overweight among ever-married, non-pregnant women of reproductive age in Bangladesh by urban or rural residency status. Methods: This study used Bangladesh Demographic and Health Survey (BDHS), 2017 data. Cross-sectional study design with two-stage stratified sampling method was employed. A sample of ever-married non-pregnant women of reproductive age was selected and multinomial logistic regression was utilised in analysis. Results: It was found that around half of rural women (45.0%, N = 4,934) and more than half of urban women (60.3%, n = 3,913) were overweight. Nearly one in seven rural women (14.0%, n = 1,537) and 1 in 12 urban women (9.0%, n = 564) were reported as underweight. Our analyses revealed that being overweight was substantially connected with age, husband's occupation, economic status, television access, and division for both urban and rural areas. Women from poor households were significantly more likely to be underweight than women from middle- income households for both urban (P < 0.05; OR: 1.41; 95% CI: 1.03, 1.94) and rural (P < 0.05; OR: 1.23; 95% CI: 1.04, 1.46) areas. Interestingly, women without television access both in urban (P < 0.001; OR = 0.78; 95% CI: 0.67, 0.91) and rural (P < 0.001; OR = 0.75; 95% CI: 0.68, 0.84) areas had an inverse association with overweight/obesity compared to women with television access. In both areas, women in Sylhet and Mymensingh had higher likelihood of being underweight than Barisal division. Additionally, in both residential zones, women in Sylhet had lower likelihood of being overweight than Barisal division. Conclusion: This study reveals that multiple characteristics are linked to both overweight and underweight among ever-married, non-pregnant women of reproductive age in Bangladesh. Addressing these variables should be a priority in public health efforts to combat the dual challenge of malnutrition in Bangladesh. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate the effect of physical activity, body mass index (BMI), and levels of prostaglandins (PGF2α) urine on the occurrence of dysmenorrhea in adolescents. Methods: A total of 128 female students included in the study. The study was conducted from January to March 2023 using a cross‐sectional design. This study utilized the Menstrual Symptom Questionnaire (MSQ) and gynecological examination with ultrasonography. The urinary prostaglandin (PGF2α) was measured using the enzyme linked immuno sorbent assay (ELISA). Data were analyzed using the chi‐square test and logistic regression test. Results: The age range of the participants included in the study was 14–17, with a mean age of 15.85 ± 0.65. There was an correlation between physical activity, BMI, and urinary prostaglandin (PGF2α) levels with the incidence of dysmenorrhea in adolescents (p < 0.001). In multivariate analysis, it revealed that underweight, and had a high urinary prostaglandin significant correlated to primary dysmenorrhea with odds ratio 4.78 (95% confidence interval [CI] 1.98–11.54) and 4.88 (95% CI 1.98–12.08), respectively. High physical activity and overweight was not associated with incidence of dysmenorrhea in adolescents. Conclusion: This study provides valuable insights into the correlation between physical activity, BMI, and levels of prostaglandins (PGF2α) in urine. A high level of urinary prostaglandin was found to be the most influential factor in the incidence of primary dysmenorrhea in adolescents. By addressing factors associated with dysmenorrhea in adolescents, healthcare professionals can potentially enhance well‐being by reducing menstrual pain and encouraging a healthy lifestyle to prevent dysmenorrhea. [ABSTRACT FROM AUTHOR]

The present investigation was executed at Department of Veterinary Medicine and Dr. I. P. Singh Veterinary Clinical Complex and Trauma Centre, College of Veterinary and Animal Sciences, G.B.P.U.A. & T, Pantnagar U.S. Nagar, Uttarakhand, India during the period of September, 2021 to April, 2022. The present study aimed to diagnose hepatic dysfunction in dogs presented to Dr. I.P. Singh Veterinary Clinical Complex and Trauma Centre, Pantnagar. Eighteen dogs presented with varied symptoms of hepatic dysfunction such as fever, anorexia, vomition, emaciation, polydipsia, polyuria, dullness, diarrhoea, icterus and nervous signs indicating hepatic affections were selected irrespective of their age breed, sex and were subjected to haematological, biochemical, radiographic and ultrasonographic examination. Alterations in hematobiochemical parameters of dogs with hepatic dysfunction were compared with healthy dogs. Findings of haematological examination revealed significant decrease in Hb, PCV, TEC, platelets, lymphocytes whereas there was significant increase in neutrophils in dogs with hepatic dysfunction as compared to healthy dogs. Findings of biochemical parameter revealed significant increase in total bilirubin ALT, AST, GGT, ALP whereas there was significant decrease in total protein, albumin, A:G ratio, blood glucose of dogs with hepatic dysfunction as compared to healthy dogs. Radiography and ultrasonography were found useful in diagnosis of canine hepatic dysfunction. Ultrasonography offers additional advantages over radiography by allowing for the evaluation of echogenicity, echotexture, size, shape, and margins of the liver. From the study it was concluded that combination of diagnostic test is reliable to diagnose hepatic dysfunction in dogs and single diagnostic test can be misleading. [ABSTRACT FROM AUTHOR]

Nicotinamide phosphoribosyltransferase (Nampt) is an adipocytokine that is elevated in obesity, type 2 diabetes and increased levels are associated with inflammatory processes. Nampt serum concentrations have been suggested to follow a diurnal rhythm peaking in the afternoon in lean males. However, no data exists regarding the effects of gender and body weight. We measured Nampt serum levels over 24 h in a cohort of healthy individuals living with either normal weight or obesity. Furthermore, effects of meals, oral glucose tolerance test and physical exercise on Nampt concentrations were evaluated. Correlation analyses to other hormonal- and lab parameters and anthropometric measurements were performed. Nampt showed a diurnal rhythm with increased levels at daytime and a peak in the early afternoon. This diurnal rhythm was significant for all groups but obese males. The Nampt amplitude, measured both relatively and absolutely, was significantly higher in females than in males. Meals did not influence Nampt serum levels, whereas physical exercise and an OGTT did significantly influence Nampt serum levels. In conclusion, we found gender specific differences in Nampt amplitude and coefficient variation with both being higher in females. The circadian rhythm of Nampt was independent of gender in healthy lean individuals, whereas it was disturbed in men with obesity. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Brasileira de Nutrição e Esportiva is the property of Instituto Brasileiro de Pesquisa e Ensino em Fisiologia do Exercicio and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the context of advanced nanoelectronics, two-dimensional semiconductors such as transition metal dichalcogenides (TMDs) are gaining considerable interest due to their ultimate thinness, clean surface and high carrier mobility. The engineering prospects offered by those materials are further enlarged by the recent realization of atomically sharp TMD-based lateral junctions, whose electronic properties are governed by strain effects arising from the constituents lattice mismatch. Although most theoretical studies considered only misfit strain, first-principles simulations are employed here to investigate the transport properties under external deformation of a three-terminal device constructed from a MoS2/WSe2/MoS2 junction. Large modulation of the current is reported owing to the change in band offset, illustrating the importance of strain on the p–n junction characteristics. The device operation is demonstrated for both local and global deformations, even for ultra-short channels, suggesting potential applications for ultra-thin body straintronics. [ABSTRACT FROM AUTHOR]