Key messages of the WHO European Regional Obesity Report

Obesity is a complex multifactorial disease defined by excessive adiposity and is linked to an increased risk for many noncommunicable diseases (NCDs). Overweight and obesity affect almost 60% of adults and nearly one in three children in the WHO European Region. Recent estimates suggest that overweight and obesity is the fourth most common risk factor for NCDs in the Region, after high blood pressure, dietary risks and tobacco. It is also the leading risk factor for disability and obesity is linked to greater morbidity and mortality from COVID-19. And obesity is considered a cause of at least 13 different types of cancer including cancers of the breast, colorectum, kidney, liver and ovary, multiple myeloma and meningioma. None of the countries in the Region are on track to achieve the obesity related target set in 2013. Early studies from a number of countries in the Region indicate that the prevalence of overweight and obesity and/or mean body mass index has increased in children and adolescents during the COVID-19 pandemic. This latest WHO European report on obesity examines the growing challenge and impact of obesity in the Region, building on past publications and aligning with initiatives to tackle cancer. The report focuses on managing obesity throughout the life course and tackling obesogenic environments; it also considers more recent challenges, including problematic digital marketing to children and the impact of the COVID-19 pandemic on obesity prevalence. Policy options to prevent obesity are outlined for consideration by Member States together with a suite of population-level approaches. The report highlights the importance of including prevention and control of obesity within measures to build back better in the wake of the COVID-19 pandemic. Whilst highlighting that single intervention will not be sufficient in any country, it examines the challenges faced by countries to implement known interventions to tackle obesity.

Performance analysis method for model-based irrigation strategies under uncertainty

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A Richards equation-based soil water model was combined with an evapotranspiration model to compute drainage and crop water stress resulting from irrigation within a MATLAB programming environment.

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Monte Carlo sampling was used to simulate how uncertainty in soil parameters and evapotranspiration propagates into predictions of drainage, water use and crop water stress.

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Soil water pressure head was used as a threshold value to indicate crop water stress based on soil profile interactions with the crop root zone.

There is a necessity to increase the performance of food production in agriculture, this means, that precise management support in farming systems is required to reduce water use and drainage while avoiding crop stress. Management support based on model predictions is used to increase the performance of food production. However, sources of uncertainty affect the model predictions. Uncertainty in soil properties and uncertain evapotranspiration translate into uncertain predictions, and consequently in risk of performance loss. This paper presents the code and method to analyze performance uncertainty (and risk of performance loss) due to uncertain circumstances. The method is based on using the De Graaf evapotranspiration model and the EMMAN3G model, a Richards equation-based soil water model, as modules to conduct a performance uncertainty study.

Childhood central adiposity at ages 5 and 9 shows consistent relationship with that of the maternal grandmother but not other grandparents

BACKGROUND

The importance of a life course approach to childhood obesity has been emphasized; however, few studies can prospectively investigate relationships in three-generation families.

OBJECTIVE

To prospectively investigate the relationship between grandparental and grandchild waist circumference (WC) at ages 5 and 9 down maternal and paternal lines.

METHODS

At baseline in the Lifeways Cross-Generation Cohort, 1094 children were born to 1082 mothers; 585 were examined at age 5 and 298 at age 9. Of the total 589 children with measured WC, data were also available from 745 grandparents. Child WC was standardized for age and sex, and theory-based hierarchical linear regression was used.

RESULTS

Maternal grandmother (MGM) WC was predictive of grandchild WC at both time points. At age 5, grandchild's standardized birth weight (B = 0.266, p = 0.001), mother's means tested eligibility for free medical care (B = 1.029, p = 0.001) and grandchild seeing maternal grandparents daily (B = 0.312, p = 0.048) were significant alongside MGM WC (B = 0.015, p = 0.019). At age 9, only MGM WC (B = 0.022, p = 0.033) and mother's WC (B = 0.032, p = 0.005) were significant. Mediation analysis with mother's WC showed significant direct relationship of MGM and grandchild WC.

CONCLUSIONS

This prospective cross-generational cohort shows consistent patterns of association between MGM and grandchild WC, not seen in other grandparental lineages.

A density functional approach to ferrogels

Ferrogels consist of magnetic colloidal particles embedded in an elastic polymer matrix. As a consequence, their structural and rheological properties are governed by a competition between magnetic particle-particle interactions and mechanical matrix elasticity. Typically, the particles are permanently fixed within the matrix, which makes them distinguishable by their positions. Over time, particle neighbors do not change due to the fixation by the matrix. Here we present a classical density functional approach for such ferrogels. We map the elastic matrix-induced interactions between neighboring colloidal particles distinguishable by their positions onto effective pairwise interactions between indistinguishable particles similar to a 'pairwise pseudopotential'. Using Monte-Carlo computer simulations, we demonstrate for one-dimensional dipole-spring models of ferrogels that this mapping is justified. We then use the pseudopotential as an input into classical density functional theory of inhomogeneous fluids and predict the bulk elastic modulus of the ferrogel under various conditions. In addition, we propose the use of an 'external pseudopotential' when one switches from the viewpoint of a one-dimensional dipole-spring object to a one-dimensional chain embedded in an infinitely extended bulk matrix. Our mapping approach paves the way to describe various inhomogeneous situations of ferrogels using classical density functional concepts of inhomogeneous fluids.

Erratum: Structure and Dynamics of Loosely Cross-Linked Ionic Microgel Dispersions in the Fluid Regime [Phys. Rev. Lett. 109, 048302 (2012)]

This corrects the article DOI: 10.1103/PhysRevLett.109.048302.

Impact of primary healthcare providers' initial role security and therapeutic commitment on implementing brief interventions in managing risky alcohol consumption: a cluster randomised factorial trial

BACKGROUND

Brief interventions in primary healthcare are cost-effective in reducing drinking problems but poorly implemented in routine practice. Although evidence about implementing brief interventions is growing, knowledge is limited with regard to impact of initial role security and therapeutic commitment on brief intervention implementation.

METHODS

In a cluster randomised factorial trial, 120 primary healthcare units (PHCUs) were randomised to eight groups: care as usual, training and support, financial reimbursement, and the opportunity to refer patients to an internet-based brief intervention (e-BI); paired combinations of these three strategies, and all three strategies combined. To explore the impact of initial role security and therapeutic commitment on implementing brief interventions, we performed multilevel linear regression analyses adapted to the factorial design.

RESULTS

Data from 746 providers from 120 PHCUs were included in the analyses. Baseline role security and therapeutic commitment were found not to influence implementation of brief interventions. Furthermore, there were no significant interactions between these characteristics and allocated implementation groups.

CONCLUSIONS

The extent to which providers changed their brief intervention delivery following experience of different implementation strategies was not determined by their initial attitudes towards alcohol problems. In future research, more attention is needed to unravel the causal relation between practitioners' attitudes, their actual behaviour and care improvement strategies to enhance implementation science.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT01501552.

Structure and dynamics of loosely cross-linked ionic microgel dispersions in the fluid regime

We report a comprehensive experimental-theoretical study of the temperature- and concentration-dependent swelling behavior of weakly cross-linked PNiPAm ionic microgel particles in the deionized fluid phase. The particles swell reversibly when the dispersion is cooled from the collapsed state to lower temperatures. While the collapsed state shows no dependence on the microgel number density, the swelling at lower T is more pronounced at lower concentrations. The static pair correlations and short-time diffusion functions, and the concentration and temperature dependence of the microgel radius and effective charge, are studied using static and dynamic light scattering in combination with state-of-the-art analytical theoretical schemes based on a Yukawa-type effective pair potential and a core-shell model. We show that only such a combined, simultaneous fit of static and dynamic scattering functions allows for an unambiguous determination of the microgel radius and effective charge.

Radiation boundary conditions for the numerical solution of the three-dimensional time-dependent Schrödinger equation with a localized interaction

Exact radiation boundary conditions on the surface of a sphere are presented for the single-particle time-dependent Schrödinger equation with a localized interaction. With these boundary conditions, numerical computations of spatially unbounded outgoing wave solutions can be restricted to the finite volume of a sphere. The boundary conditions are expressed in terms of the free-particle Green's function for the outside region. The Green's function is analytically calculated by an expansion in spherical harmonics and by the method of Laplace transformation. For each harmonic number a discrete boundary condition between the function values at adjacent radial grid points is obtained. The numerical method is applied to quantum tunneling through a spherically symmetric potential barrier with different angular-momentum quantum numbers l . Calculations for l=0 are compared to exact theoretical results.

Bridge-bonded formate: active intermediate or spectator species in formic acid oxidation on a Pt film electrode?

We present and discuss the results of an in situ IR study on the mechanism and kinetics of formic acid oxidation on a Pt film/Si electrode, performed in an attenuated total reflection (ATR) flow cell configuration under controlled mass transport conditions, which specifically aimed at elucidating the role of the adsorbed bridge-bonded formates in this reaction. Potentiodynamic measurements show a complex interplay between formation and desorption/oxidation of COad and formate species and the total Faradaic current. The notably faster increase of the Faradaic current compared to the coverage of bridge-bonded formate in transient measurements at constant potential, but with different formic acid concentrations, reveals that adsorbed formate decomposition is not rate-limiting in the dominant reaction pathway. If being reactive intermediate at all, the contribution of formate adsorption/decomposition to the reaction current decreases with increasing formic acid concentration, accounting for at most 15% for 0.2 M DCOOH at 0.7 VRHE. The rapid build-up/removal of the formate adlayer and its similarity with acetate or (bi-)sulfate adsorption/desorption indicate that the formate adlayer coverage is dominated by a fast dynamic adsorption-desorption equilibrium with the electrolyte, and that formate desorption is much faster than its decomposition. The results corroborate the proposal of a triple pathway reaction mechanism including an indirect pathway, a formate pathway, and a dominant direct pathway, as presented previously (Chen, Y. X.; et al. Angew. Chem. Int. Ed. 2006, 45, 981), in which adsorbed formates act as a site-blocking spectator in the dominant pathway rather than as an active intermediate.

Immunohistochemical localization of components of the insulin-like growth factor system in human permanent teeth

There is growing evidence that the insulin-like growth factor (IGF) system plays an important role in the biology of oro-dento-facial tissues and organs, including the development, homeostasis and regeneration of the periodontium. To obtain basic data on the occurrence and distribution of IGF components in human permanent teeth we immunohistochemically investigated 25 extracted, decalcified and paraffin-embedded teeth using mono and polyclonal antibodies against the ligands IGF-I and -II, the IGF1 receptor (IGF1R) and all six IGF binding proteins (IGFBP-1 to -6). In the extracellular matrix (ECM) of the adhering periodontal ligament (PDL), immunoreactivity for IGF-I, -II and IGFBP-1 and -6 was observed. PDL fibroblasts showed immunostaining for the IGF1R. For the cementum, in the acellular cementum only IGF-II could be detected, while outer cementum layers with inserting Sharpey's fibers reacted with all antibodies applied except for IGFBP-4 and -6. In the pulp, mainly fibrotic areas and areas around denticles were immunoreactive for IGF-I, IGFBP-1, -3, -5 and -6. Predentin and odontoblastic processes were stained for IGF-I and IGFBP-3. The spatially oriented occurrence of components of the IGF system in human permanent teeth indicates that specific functions of the IGFs may be localized in particular tissue compartments. In the cementum, several IGF components were found indicating roles in tissue homeostasis or attachment. The PDL may function as a reservoir for IGFs probably bound to ECM components. PDL fibroblasts could then respond in a paracrine manner. In the pulp, the IGF system may be involved in odontoblast biology, fibrosis and denticle formation.

St John's wort (Hypericum perforatum) modulates evoked potentials in guinea pig hippocampal slices via AMPA and GABA receptors

The effects of an ethanolic extract of the plant Hypericum perforatum L. (St John's wort) (HYP) and its hydrosoluble fraction (HYPWS) on electrically evoked population spikes and fEPSP were investigated in this study. Concentration dependent (10(-6) to 10(-4) g/l) excitatory effects were found. Above concentrations of 10(-3) g/l, HYP reduced the evoked responses, whereas HYPWS further increased them. Paired pulse facilitation was unaffected with HYPWS (10(-4) to 10(-2) g/l). The excitatory effects of HYPWS were amplified by the GABA(A) and GABA(B) receptor antagonists bicuculline and phaclofen, respectively. These excitations were antagonised by the AMPA receptor antagonist CNQX. Excitations caused by hypericum were not antagonised by the NMDA receptor antagonists D-APV and MK801, the metabotropic glutamate receptor (type I and II) antagonist MCPG, or the L-type calcium channel blocker verapamil. Hypericin and hyperforin, two components of H. perforatum, were found not to be responsible for the excitatory effects of the extract.

Effects of Hypericum perforatum L. on evoked potentials in guinea pig hippocampal slices

Therapeutic uses of Hypericum extracts have been demonstrated as safe and effective in treating mild to moderate depression in numerous clinical trials. To date, however, no definitive statements on their mode of action can be made, and little information on their electrophysiological effects is available. The present communication summarises the results of our efforts directed towards clarifying the effects of an ethanolic Hypericum extract (HYP) and its hydrosoluble fraction (HYPWS), and two of its constituents hypericin and hyperforin on electrically evoked population spikes in guinea pig hippocampal slices. In higher concentrations (>10 microM), the two extract constituents tested revealed inhibitory effects only, whereas concentration-dependent (between 10(-6) to 10(-4) g/l) excitatory effects were observed for HYP and HYPWS. The excitatory effects were strongly amplified by the GABA(B) antagonist phaclofen, whereas the effects of bicucullin, a GABA(A) antagonist, were marginal. The excitations were completely blocked by the AMPA antagonist CNQX, but not by the NMDA antagonists APV and MK801 or the L-type calcium-channel blocker verapamil. This kind of excitatory effect on the hippocampus is unknown in other antidepressants and; indeed, many of the latter reduce neuronal excitability. We conclude, therefore, that the mechanisms involved in the antidepressant activity of Hypericum extracts are different from those of conventional antidepressants, and that identifying their excitatory components may facilitate their more rational standardisation.

Analytical growth equations and their Genstat 5 equivalents

Two ways of representing some of the existing growth functions, (the exponential, the monomolecular or Mitscherlich, the logistic or autocatalytic, the Gompertz, and the Richards equations) are compared. In the first, growth is expressed in the parameters mass at time zero W0, mass at time infinity Wf, and a measure for the relative growth rate k. In the second, different parameters are used because of robust parameter optimization (e.g., by the statistical software package Genstat). The relationships between these fitted parameters and the parameters W0, Wf and k are demonstrated. The properties of these models, such as physical meaning of the parameters, properties at the point of inflection (if it exists), and the growth rate at a limit W -> 0, are examined. The second order exponential polynomial was rewritten in such a way that use was made of a proportionality constant, equal to the relative growth rate at the point of inflection. Application of the growth models is demonstrated using data for lettuce grown in a nutrient film system. Finally, it is shown that, except for the exponential polynomial, all growth equations originate from one single equation.

[True splenic cysts. Two clinical cases]

Two case reports of epidermoid cyst of the spleen are presented. Only 700 cases have been reported so far. Although splenic cysts are benign lesions and could involve spontaneously, the risk of rupture of a large cyst is high, so a diameter of 5 cm was suggested as the higher limit for nonsurgical treatment. For many years the surgical treatment of splenic epidermoid cysts was splenectomy: however recognition of the short and long-term complications of radical splenectomy had led to the practice of splenic preservation (partial splenectomy, total cystectomy, laparoscopic cyst decapsulation).

[A retrospective examination of the acceptance of removable appliances]

In order to study the subjective attitudes of patients and their parents to orthodontic treatment questionnaires were handed out to both groups. One hundred and forty five patient questionnaires and those answered by 114 parents formed the base of the study. The majority of the patients were only able to provide partial answers to precise questions about their treatment. Speech impairment, pressure, and salivation were given as being the most vexatious aspects of the treatment. The majority of the patients and the majority of parents favored removable appliances over fixed appliances. The patients' social environment did not negatively influence their attitude to orthodontic treatment.

[Caudal anesthesia for hypospadias operations in children]

Bupivacaine induced caudal block as unique anaesthetic procedure in 80 children who underwent surgical correction of hypospadias, resulted of great efficacy and easy employment. Furthermore, the method permitted to avoid intubation and the use of general anaesthetic drugs with their relative complications and provided a great postoperative analgesia.

[Perioperative water-electrolyte therapy in urologic surgery in childhood]

Renal function was evaluated before and after introduction of different intraoperatory methods of hydroelectrolytic re-equilibrium in 172 children who underwent urological surgery. 24 h postoperatory renal function resulted not affected in the treated group, while significantly reduced in untreated patients.

[The Lester Martin operation in an infant]

A case of Lester Martin repair for total colonic and distal ileal aganglionosis in an infant of 3.4 Kg is reported. The Authors consider and discuss the possibility of application of this operation at a younger age than normally performed considering the satisfactory result obtained in this case.

[An alternative method of percutaneous introduction of central venous catheters: experience in 20 cases in pediatric surgery]

An alternative method of percutaneous introduction of a central venous catheter through a periferal antecubital vein, in neonates and infants, is presented. The AA. prefers this method beeing safer, less traumatic and easier to performe than the other commonly used techniques.

[Studies on investigation of primary pathologic deterioration of the lower limbs. Calcific deposits in the veins (author's transl)]

Veins of the limbs of 193 sudden deaths are examined concerning the frequency, extent and localisation of sclerosis. The macroscopic process of preparation has been satisfactory. Correlations to several factors, especially age and diseases of heart and arteries, are presented and discussed.

[Studies on investigation of primary pathologic deterioration of the lower limbs. (author's transl)]

Veins of the limbs of 193 sudden deaths are examined under aspects of frequency, extent and localisation of sclerosis. Macroscopic process of preparation has approved. Correlations to several factors, especially age and affections of heart and arteries, are represented and discussed.