Utility of waist-to-height ratio, waist circumference and body mass index in predicting clustered cardiometabolic risk factors and subclinical vascular phenotypes in children and adolescents: A pooled analysis of individual data from 14 countries.

AIMS: The clinical utility of waist-to-height ratio (WHtR) in predicting cardiometabolic risk factors (CMRFs) and subclinical markers of cardiovascular disease remains controversial. We aimed to compare the utility of WHtR with waist circumference (WC) and body mass index (BMI) in identifying children and adolescents (youths) at risk for cardiometabolic outcomes, including clustered CMRFs, high carotid intima-media thickness (cIMT), and arterial stiffness (assessed as high pulse wave velocity, PWV). METHODS: We analyzed data from 34,224 youths (51.0 % boys, aged 6-18 years) with CMRFs, 5004 (49.5 % boys, aged 6-18 years) with cIMT measurement, and 3100 (56.4 % boys, aged 6-17 years) with PWV measurement from 20 pediatric samples across 14 countries. RESULTS: WHtR, WC, and BMI z-scores had similar performance in discriminating youths with ≥3 CMRFs, with the area under the curve (AUC) (95 % confidence interval, CI)) ranging from 0.77 (0.75-0.78) to 0.78 (0.76-0.80) using the modified National Cholesterol Education Program (NCEP) definition, and from 0.77 (0.74-0.79) to 0.77 (0.74-0.80) using the International Diabetes Federation (IDF) definition. Similarly, all three measures showed similar performance in discriminating youths with subclinical vascular outcomes, with AUC (95 % CI) ranging from 0.67 (0.64-0.71) to 0.70 (0.66-0.73) for high cIMT (≥P95 values) and from 0.60 (0.58-0.66) to 0.62 (0.58-0.66) for high PWV (≥P95 values). CONCLUSIONS: Our findings suggest that WHtR, WC, and BMI are equally effective in identifying at-risk youths across diverse pediatric populations worldwide. Given its simplicity and ease of use, WHtR could be a preferable option for quickly screening youths with increased cardiometabolic risk in clinical settings.

Incorporation of doxorubicin and CoFe2O4 nanoparticles into the cellulose acetate phthalate / polyvinyl alcohol (core)/ polyurethane (shell) nanofibers against A549 human lung cancer during chemotherapy/hyperthermia combined method.

Cellulose acetate phthalate (CAP)/polyvinyl alcohol (PVA)/polyurethane (PU) nanofibers were synthesized by simple and coaxial electrospinning (ES) processes. Doxorubicin (DOX) and the CoFe2O4 nanoparticles were loaded into the nanofibers. The performance of the prepared nanofibers was investigated for the sustained release of DOX against A541 lung cancer cells under chemotherapy/external magnetic field (EMF) and alternating magnetic field (AMF, hyperthermia treatment) combined methods in both the in vitro and in vivo conditions. The sustained release of DOX from core-shell nanofibers containing 5 wt% cobalt ferrite was obtained within 300, 600 h, at pH of 5.5 and 7.4 without AMF and 168, 360 h, under an alternating magnetic field (AMF). More than 98.3 ± 0.2 % of A549 cancer cells were killed in the presence of core-shell nanofibers containing 100 µg DOX and 5 % cobalt ferrite nanoparticles in the presence of AMF. The flowcytometric results indicated that only 19.1 and 8.85 % cancer cells remained alive under EMF and AMF, respectively. The in vivo results revealed in stopping the growth of tumor volume and decrease in the relative tumor volume up to 0.5 were obtained using magnetic core-shell nanofibers containing 100 µg DOX and 5 % cobalt ferrite nanoparticles in the presence of EMF and AMF, respectively.

Establishing international optimal cut-offs of waist-to-height ratio for predicting cardiometabolic risk in children and adolescents aged 6-18 years.

BACKGROUND: Waist-to-height ratio (WHtR) has been proposed as a simple and effective screening tool for assessing central obesity and cardiometabolic risk in both adult and pediatric populations. However, evidence suggests that the use of a uniform WHtR cut-off of 0.50 may not be universally optimal for pediatric populations globally. We aimed to determine the optimal cut-offs of WHtR in children and adolescents with increased cardiometabolic risk across different countries worldwide. METHODS: We used ten population-based cross-sectional data on 24,605 children and adolescents aged 6-18 years from Brazil, China, Greece, Iran, Italy, Korea, South Africa, Spain, the UK, and the USA for establishing optimal WHtR cut-offs. We performed an external independent test (9,619 children and adolescents aged 6-18 years who came from other six countries) to validate the optimal WHtR cut-offs based on the predicting performance for at least two or three cardiometabolic risk factors. RESULTS: Based on receiver operator characteristic curve analyses of various WHtR cut-offs to discriminate those with ≥ 2 cardiometabolic risk factors, the relatively optimal percentile cut-offs of WHtR in the normal weight subsample population in each country did not always coincide with a single fixed percentile, but varied from the 75th to 95th percentiles across the ten countries. However, these relatively optimal percentile values tended to cluster irrespective of sex, metabolic syndrome (MetS) criteria used, and WC measurement position. In general, using ≥ 2 cardiometabolic risk factors as the predictive outcome, the relatively optimal WHtR cut-off was around 0.50 in European and the US youths but was lower, around 0.46, in Asian, African, and South American youths. Secondary analyses that directly tested WHtR values ranging from 0.42 to 0.56 at 0.01 increments largely confirmed the results of the main analyses. In addition, the proposed cut-offs of 0.50 and 0.46 for two specific pediatric populations, respectively, showed a good performance in predicting ≥ 2 or ≥ 3 cardiometabolic risk factors in external independent test populations from six countries (Brazil, China, Germany, Italy, Korea, and the USA). CONCLUSIONS: The proposed international WHtR cut-offs are easy and useful to identify central obesity and cardiometabolic risk in children and adolescents globally, thus allowing international comparison across populations.

Metal organic framework-loaded polyethersulfone/polyacrylonitrile photocatalytic nanofibrous membranes under visible light irradiation for the removal of Cr(vi) and phenol from water.

In this work, various amounts of the UiO-66-NH2 and UiO-66-NH2/TiO2 MOFs have been loaded into polyacrylonitrile (PAN) nanofibers supported on polyethersulfone (PES). The visible light irradiation was used to investigate the influence of pH (2-10), initial concentration (10-500 mg L-1), and time (5-240 min) on the removal efficiency of phenol and Cr(vi) in the presence of MOFs. The reaction time: 120 min, catalyst dosage: 0.5 g L-1, pH: 2 for Cr(vi) ions and pH: 3 for phenol molecules were optimum to degrade phenol and to reduce Cr(vi) ions. The characterization of the produced samples was performed using X-ray diffraction, ultraviolet-visible diffuse reflectance spectroscopy, scanning electron microscopy, and Brunauer-Emmett-Teller analysis. The capability of synthesized photocatalytic membranes was investigated for the removal of phenol and Cr(vi) ions from water. The water flux, Cr(vi) and phenol solutions fluxes and their rejection percentages were evaluated under pressure of 2 bar in the presence of visible light irradiation and in the dark. The best performance of the synthesized nanofibers was obtained for UiO-66-NH2/TiO2 MOF 5 wt% loaded-PES/PAN nanofibrous membranes at temperature of 25 °C and pH of 3. Results demonstrated the high capability of MOFs-loaded nanofibrous membranes for the removal of various contaminants such as Cr(vi) ions and phenol molecules from water.

Paclitaxel-loaded liposome-incorporated chitosan (core)/poly(ε-caprolactone)/chitosan (shell) nanofibers for the treatment of breast cancer.

Liposomes and nanofibers have been introduced as effective drug delivery systems of anticancer drugs. The performance of chitosan (core)/poly(ε-caprolactone) (PCL)/paclitaxel simple nanofibers, chitosan/paclitaxel (core)/PCL/chitosan (shell) nanofibers and paclitaxel-loaded liposome-incorporated chitosan (core)/PCL-chitosan (shell) nanofibers was investigated for the controlled release of paclitaxel and the treatment of breast cancer. The synthesized formulations were characterized using polydispersity index, dynamic light scattering, zeta potential, scanning electron microscopy, transmission electron microscopy, and Fourier transform infrared analysis. The sustained release of paclitaxel from liposome-loaded nanofibers was achieved within 30 days. The release data was best described using Korsmeyer-Peppas pharmacokinetic model. The cell viabilities of synthesized nanofibrous samples were higher than 98 % ± 1 % toward L929 normal cells after 168 h. The maximum cytotoxicity against MCF-7 breast cancer cells was 85 % ± 2.5 % using liposome-loaded core-shell nanofibers. The in vivo results indicated the reduction of tumor weight from 1.35 ± 0.15 g to 0.65 ± 0.05 g using liposome-loaded core-shell nanofibers and its increasing from 1.35 ± 0.15 g to 3.2 ± 0.2 g using pure core-shell nanofibers. The three-stage drug release behavior of paclitaxel-loaded liposome-incorporated core-shell nanofibers and the high in vivo tumor efficiency suggested the development of these formulations for cancer treatment in the future.

Adsorption, and controlled release of doxorubicin from cellulose acetate/polyurethane/multi-walled carbon nanotubes composite nanofibers.

The cellulose acetate (CA)/poly (ε-caprolactone diol)/poly (tetramethylene ether) glycol-polyurethane (PCL-Diol/PTMG-PU)/multi-walled carbon nanotubes (MWCNTs) composite nanofibers were prepared via two-nozzle electrospinning on both counter sides of the collector. The performance of synthesized composite nanofibers was investigated as an environmental application and anticancer delivery system for the adsorption/release of doxorubicin (DOX). The synergic effect of MWCNTs and DOX incorporated into the nanofibers was investigated against LNCaP prostate cancer cells. The status of MWCNTs and DOX in composite nanofibers was demonstrated by SEM, FTIR and UV-vis determinations. The adsorption tests using nanofibrous adsorbent toward DOX sorption was evaluated under various DOX initial concentrations (100-2000 mg l-1), adsorption times (5-120 min), and pH values (pH:2-9). Due to the fitting of isotherm and kinetic data with Redlich-Peterson and pseudo-second order models, both chemisorption and surface adsorption of DOX molecules mechanisms have been predicted. The drug release from both nanofibers and MWCNTs-loaded nanofibers was compared. The better drug sustained release profiles verified in the presence of composite nanofibers. LNCaP prostate cancer and L929 normal cells were treated to investigate the cytotoxicity and compatibility of synthesized composite nanofibers. The apoptosis/necrosis of hybrid nanofibers and MWCNTs loaded-nanofibers was investigated. The obtained results demonstrated the synergic effects of MWCNTs and DOX loaded-nanofibers on the LNCaP prostate cancer cells death.

Incorporation of magnetic NaX zeolite/DOX into the PLA/chitosan nanofibers for sustained release of doxorubicin against carcinoma cells death in vitro.

In the present study, the magnetic NaX nanozeolites were synthesized via microwave heating method and loaded into the PLA/chitosan solution. Doxorubicin (DOX) as an anticancer drug was simultaneously incorporated into the PLA/chitosan solution and the electrospinning process was used to fabricate the PLA/chitosan/NaX/Fe3O4/DOX nanofibers for sustained release of DOX against carcinoma cells death. The synthesized nanozeolites were characterized using X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM) and energy dispersive X-ray spectroscopy (EDX) analysis. The scanning electron microscopy (SEM) was used to determine the morphology and fiber diameter distribution of synthesized nanofibers. The DOX loading efficiency and in vitro DOX release profiles from nanofibers were investigated. The kinetic models including zero-order, Higuchi and Korsmeyer-Peppas were used to analyze the release mechanism of DOX from nanofibers. The effect of ferrite nanoparticles on the DOX release from chitosan/PLA/NaX/DOX and chitosan/PLA/NaX/Fe3O4/DOX nanofibers have been investigated in the presence of magnetic field and without magnetic field. The antitumor activity of synthesized nanofibers was also investigated on the carcinoma cells death. The maximum killing percentage of H1355 cells was found to be 82% using DOX loaded chitosan/PLA/NaX/ferrite in the presence of external magnetic field after 7 days of treatment.