Summary Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. Funding UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union.

The paper describes the factorial design of the experiment with three input factors that change on two levels. For given values of the input parameters, it is shown how to obtain a variance analysis table and which factors and interactions between factors are significant. The example was done in the software intended for the design of the experiment and in the software R. It is shown how to use the software R to arrive at the final solution of the given example.

Introduction: The no-reflow phenomenon (persistent microvascular hypoperfusion despite macrovascular angiographic reperfusion) represents an explanation to poor outcome despite successful thrombectomy. There remains no universally-accepted definition to standardise future studies. We aim to compare the clinical features and outcomes of patients identified as having no-reflow using different perfusion MRI/CT definitions. Methods: We performed a pooled analysis of thrombectomy patients who underwent 24-hour follow-up perfusion MRI or CTs in the EXTEND-IA, EXTEND-IA TNK part 1 and 2 RCT. Presence of no-reflow was defined according to four definitions identified from a meta-analysis of 13 studies (Definition A = eTICI2c-3 and >15% asymmetry in CBV or CBF within the infarct on follow-up perfusion MRI/CT; definition B = mTICI2c-3 and >40% CBF asymmetry, definition C = mTICI2b-3 and presence of a Tmax>6s lesion; Definition D = mTICI2b-3 and >90% reduction of baseline Tmax>6s lesion). Receiver Operating Characteristics (ROC) analysis was performed with the outcome variable being poor functional outcome at 90 days (mRS≥3). Results: Of 325 patients analysed, the prevalence of no-reflow varied between definitions from 1.9 to 29.3% (p<0.001). There was poor agreement between definitions (kappa 0.062-0.745, 5 out 6 comparisons <0.196). Among patients identified as exhibiting no-reflow by any definition, there were significant differences in the intralesional interside differences in CBF (p=0.006), CBV (p<0.001) and MTT (p=0.005). Definition A yielded the highest Area Under the ROC Curve (AUC=0.679) for discrimination of 90-day functional outcome (Definitions C=0.649, D=0.597, B=0.515; p<0.0001). Sensitivity analyses testing across the eTICI≥2b, eTICI≥2c and eTICI3 strata showed consistent results. Conclusions: Existing imaging definitions of no-reflow varied significantly in prevalence and post-treatment perfusion imaging profile, suggesting that patients classified as having no-reflow by various definitions differ in their underlying pathophysiological processes. Definition A (eTICI2c-3 & >15% CBV/CBF asymmetry) discriminated prognostic performance best, supporting its use as the reference no-reflow imaging definition.

Background and Purpose: Cancer increases the risk for acute ischemic stroke (AIS) and deep venous thrombosis. The role of paradoxical embolization as a stroke etiology in patients with cancer is uncertain. Our study investigated the relationship between cancer-related stroke and the presence of a patent foramen ovale (PFO). Methods: We included AIS patients hospitalized at our comprehensive stroke center between January 2015 and December 2020 with available PFO status as detected on transesophageal echocardiography. Active cancer, including cancer known at the time of stroke as well as occult cancer newly diagnosed within one year after stroke, were retrospectively identified. The association between PFO status and active cancer was assessed with multivariable logistic regression and reported using adjusted odds ratios (aOR) and their 95% confidence intervals (CI). Results: Among 2236 AIS patients (median age 68.3 years, female sex 36.4%), 103 (4.6%) had active cancer, of whom 24 (23%) were diagnosed with PFO. This included 32 patients (1.4%) with occult cancer, of whom 19% were diagnosed with PFO. Conversely, among 2133 AIS patients without active cancer, 774 were diagnosed with PFO (36%). In multivariable analysis (Fig 1), the absence of PFO was associated with active cancer (aOR 2.62, 95% CI 1.28-5.38). This association appeared stronger when patients older than 80 years of age were excluded (aOR 3.06, 95% CI 1.42 - 6.58) and persisted among patients with occult cancer at the time of AIS (aOR 5.39, 95% CI 1.18-24.74). Conclusions: In patients with AIS, PFO was diagnosed more commonly among patients without cancer than those with cancer. This might be due to cancer-related stroke being related to arterial coagulopathy rather than paradoxical emboli resulting from venous thrombi. Further studies are needed to confirm these findings and to assess the diagnostic role of PFO in patients with cancer and AIS.

Remote driving plays an essential role in coordinating automated vehicles in some challenging situations. Due to the changed driving environment, the experiences and behaviors of remote drivers would undergo some changes compared to conventional drivers. To study this, a continuous real-life and remote driving experiment is conducted under different driving conditions. In addition, the effect of steering force feedback (SFF) on the driving experience is also investigated. In order to achieve this, three types of SFF modes are compared. According to the results, no SFF significantly worsens the driving experience in both remote and real-life driving. Additionally, less force and returnability on steering wheel are needed in remote driving, and the steering force amplitude appears to influence the steering velocity of remote drivers. Furthermore, there is an increase in lane following deviation during remote driving. Remote drivers are also prone to driving at lower speeds and have a higher steering reversal rate. They also give larger steering angle inputs when crossing the cones in a slalom manoeuvre and cause the car to experience larger lateral acceleration. These findings provide indications on how to design SFF and how driving behavior and experience change in remote driving.

liver

Aim This study provides a comprehensive review of the current literature on the use of ChatGPT, a generative Artificial Intelligence (AI) tool, in neurosurgery. The study examines potential benefits and limitations of ChatGPT in neurosurgical practice and education. Methods The study involved a systematic review of the current literature on the use of AI in neurosurgery, with a focus on ChatGPT. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to ensure a comprehensive and transparent review process. Thirteen studies met the inclusion criteria and were included in the final analysis. The data extracted from the included studies were analysed and synthesized to provide an overview of the current state of research on the use of ChatGPT in neurosurgery. Results The ChatGPT showed a potential to complement and enhance neurosurgical practice. However, there are risks and limitations associated with its use, including question format limitations, validation challenges, and algorithmic bias. The study highlights the importance of validating machine-generated content for accuracy and addressing ethical concerns associated with AI technologies. The study also identifies potential benefits of ChatGPT, such as providing personalized treatment plans, supporting surgical planning and navigation, and enhancing large data processing efficiency and accuracy. Conclusion The integration of AI technologies into neurosurgery should be approached with caution and careful consideration of ethical and validation issues. Continued research and development of AI tools in neurosurgery can help us further understand their potential benefits and limitations.

UBASH3A and UBASH3B are protein families of atypical protein tyrosine phosphatases that function as regulators of various cellular processes during mammalian development. As UBASH3A has only mild phosphatase activity, its regulatory effects are based on the phosphatase-independent mechanisms. On the contrary, UBASH3B has strong phosphatase activity, and the suppression of its receptor signalling is mediated by Syk and Zap-70 kinases. The regulatory functions of UBASH3A and UBASH3B are particularly evident in the lymphoid tissues and kidney development. These tyrosine phosphatases are also known to play key roles in autoimmunity and neoplasms. However, their involvement in mammalian development and its regulatory functions are largely unknown and are discussed in this review.

Aim To investigate the correlations between tumour characteristics, symptoms, intraoperative findings, and outcomes in patient with meningioma. Methods A retrospective study was conducted on 86 surgically treated patients at Department of Neurosurgery of Cantonal Hospital Zenica from 2010 to 2020. Patients with intracranial meningiomas underwent neurological evaluation and MRI scans to analyse tumour characteristics, including volume (TV), peritumoral brain oedema (PTBE) and oedema index (EI). Surgical treatment was performed, followed by postoperative MRI and outcome assessment. Intraoperatively, the tumour's relationship with cortex, pial membrane, skull bones, and sinuses was evaluated, and the extent of tumour resection was graded. Meningioma samples underwent histopathological analysis to assess the grade and regularity of borders, and Ki-67 labelling index was determined using immunohistochemistry. Results Significant correlations were found between PTBE and Ki67 expression (p<0.001), PTBE and vomiting/nausea (p=0.002), cognitive impairment (p=0.047), venous compression (p=0.001), cortical, pial and dural invasion (p<0.05), and the postoperative presence of oedema (p=0.002). Venous compression, cortical, pial, dural and bone invasion positively correlated with Ki-67 expression (p<0.001). Grade and tumour border positively correlated with Ki-67 expression (p<0.001). Oedema persistence postoperatively showed a positive correlation with Ki-67 expression (p<0.001). Conclusion The study revealed significant correlations between Ki-67 expression and PTBE, with notable associations with clinical symptoms, tumour characteristics, and postoperative oedema presence.

Efficiently mapping quantum circuits onto hardware is integral for the quantum compilation process, wherein a circuit is modified in accordance with a quantum processor’s connectivity. Many techniques currently exist for solving this problem, wherein SWAP-gate overhead is usually prioritized as a cost metric. We reconstitute quantum circuit mapping using tools from quantum information theory, showing that a lower bound, which we dub the lightcone bound, emerges for a circuit executed on hardware. We also develop an initial placement algorithm based on graph similarity search, aiding us in optimally placing circuit qubits onto a device. 600 realistic benchmarks using the IBM Qiskit compiler and a brute-force method are then tested against the lightcone bound, with results unambiguously verifying the veracity of the bound, while permitting trustworthy estimations of minimal overhead in near-term realizations of quantum algorithms. This work constitutes the first use of quantum circuit uncomplexity to practically-relevant quantum computing.

Aquatic animals and consumers of aquatic animals are exposed to increasingly complex mixtures of known and as-yet-unknown chemicals with dioxin-like toxicities in the water cycle. Effect- and cell-based bioanalysis can cover known and yet unknown dioxin and dioxin-like compounds as well as complex mixtures thereof but need to be standardized and integrated into international guidelines for environmental testing. In an international laboratory testing (ILT) following ISO/CD 24295 as standard procedure for rat cell-based DR CALUX un-spiked and spiked extracts of drinking-, surface-, and wastewater were validated to generate precision data for the development of the full ISO-standard. We found acceptable repeatability and reproducibility ranges below 36 % by DR CALUX bioassay for the tested un-spiked and spiked water of different origins. The presence of 17 PCDD/Fs and 12 dioxin-like PCBs was also confirmed by congener-specific GC-HRMS analysis. We compared the sum of dioxin-like activity levels measured by DR CALUX bioassay (expressed in 2,3,7,8-TCDD Bioanalytical Equivalents, BEQ) with the obtained GC-HRMS chemical analysis results converted to toxic equivalents (TEQ; van den Berg et al., 2013).

Extract COPD is nowadays considered to be a heterogeneous lung condition characterised by chronic respiratory symptoms caused by airway and/or alveolar abnormalities causing persistent airflow obstruction. This airflow obstruction is defined by a post-bronchodilator forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio lower than 0.7. However, the recent 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines also pointed out that some patients can present with symptoms and/or structural changes such as emphysema and/or physiological abnormalities without airway obstruction, defined as pre-COPD, bearing a higher risk for progression to COPD [1]. Shareable abstract There is a severity dependent increase in the size but not the absolute number of interalveolar pores of Kohn in COPD. In addition, the pore size shows important correlations with pulmonary function testing. https://bit.ly/3HL1GJ8

Background: An intraluminal, non-occlusive thrombus (ILT) is a common feature in an abdominal aortic aneurysm (AAA). This study investigated the relative progression of ILT vs. AAA volume using a novel parameter, the so-called thrombus burden ratio (TBR), in non-treated AAAs. Parameters potentially associated with TBR progression were analyzed and TBR progression in large vs. small and fast- vs. slow-growing AAAs was assessed. Methods: This retrospective, single-center study analyzed sequential contrast-enhanced computed tomography angiography (CTA) scans between 2009 and 2018 from patients with an AAA before surgical treatment. Patients’ medical data and CTA scans were analyzed at two given time points. The TBR was calculated as a ratio of ILT and AAA volume, and relative TBR progression was calculated by normalization for time between sequential CTA scans. Spearman’s correlation was applied to identify morphologic parameters correlating with TBR progression, and multivariate linear regression analysis was used to evaluate the association of clinical and morphological parameters with TBR progression. Results: A total of 35 patients were included. The mean time between CT scans was 16 ± 15.9 months. AAA volume progression was 12 ± 3% and ILT volume progression was 36 ± 13%, resulting in a TBR progression of 11 ± 4%, suggesting overproportioned ILT growth. TBR progression was 0.8 ± 0.8% per month. Spearman’s correlation verified ILT growth as the most relevant parameter contributing to TBR progression (R = 0.51). Relative TBR progression did not differ significantly in large vs. small and fast- vs. slow-growing AAAs. In the multivariate regression analysis, none of the studied factors were associated with TBR progression. Conclusion: TBR increases during AAA development, indicating an overproportioned ILT vs. AAA volume growth. The TBR may serve as a useful parameter, as it incorporates the ILT volume growth relative to the AAA volume, therefore combining two important parameters that are usually reported separately. Yet, the clinical relevance in helping to identify potential corresponding risk factors and the evaluation of patients at risk needs to be further validated in a larger study cohort.

During the 3-year field research in the Sarajevo Canton (from 2019 to 2022), numerous new sites for many alien species were noted. Three of them were covered by this paper. These are: Digitalis purpurea L., Symphyotrichum novi belgii (L.) G. L. Nelson and Armoracia rusticiana Gaertn., Mey et Scherb.. The aim of the research and the paper is to provide new data on these species. This is important for the lack of specific data for alien species about their distribution, environmental conditions in which they develop, which can be very important in fight against them or in their adequate control. For each locality, where the plants were found, number of other parameters were provided, such as: altitude, latitude and longitude, soil type and phytocenological affiliation. Altitude, latitude and longitude were determined by the "MagelaneXplorist 500" GPS. Maps were also done with help of the "ArcGis Pro 2.8.4." program with registered localities. The name of plants were aligned with the www.europlusmed.org. Numerous papers and material from the "Herbarium Collection of the National Museum of BiH – SARA" were reviewed, and yet it was found out that all the localities were new for the researched species. Here we provided all previously published and data on herbarized plants for the whole of BiH.