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1. Anthropometric criteria for best-identifying children at high risk of mortality: a pooled analysis of twelve cohorts

Author

Tanya Khara, Mark Myatt, Kate Sadler, Paluku Bahwere, James A Berkley, Robert E Black, Erin Boyd, Michel Garenne, Sheila Isanaka, Natasha Lelijveld, Christine McDonald, Andrew Mertens, Martha Mwangome, Kieran O’Brien, Heather Stobaugh, Sunita Taneja, Keith P West, André Briend, SOUtenabilité et RésilienCE (SOURCE), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut de Recherche pour le Développement (IRD [France-Nord]), United States Agency for International Development, USAID: 720BHA23CA00001, 720FDA18GROO290, Irish Aid: HQPCR/2022/ENN, HQPU/2021/ENN, and Financial Support: This paper is made possible by the generous support of the American people through the United States Agency for International Development (USAID) (Award No’s 720FDA18GROO290 and 720BHA23CA00001) and of Irish Aid (Grant No’s HQPU/2021/ENN and HQPCR/2022/ENN). The ideas, opinions and comments herein are entirely the responsibility of its authors and do not necessarily represent or reflect the views of USAID or the United States Government or Irish Aid or the Irish Government.

Subjects
Stunting, Nutrition and Dietetics, Anthropometry, Public Health, Environmental and Occupational Health, Medicine (miscellaneous), Therapeutic feeding, Child survival, Wasting, Faculty of Science, Mid-upper arm circumference, Underweight, Mortality, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Abstract

Objective:To understand which anthropometric diagnostic criteria best discriminate higher from lower risk of death in children and explore programme implications.Design:A multiple cohort individual data meta-analysis of mortality risk (within 6 months of measurement) by anthropometric case definitions. Sensitivity, specificity, informedness and inclusivity in predicting mortality, face validity and compatibility with current standards and practice were assessed and operational consequences were modelled.Setting:Community-based cohort studies in twelve low-income countries between 1977 and 2013 in settings where treatment of wasting was not widespread.Participants:Children aged 6 to 59 months.Results:Of the twelve anthropometric case definitions examined, four (weight-for-age Z-score (WAZ) Z-score Conclusions:A combined case definition detects nearly all deaths associated with severe anthropometric deficits suggesting that therapeutic feeding programmes may achieve higher impact (prevent mortality and improve coverage) by using it. There remain operational questions to examine further before wide-scale adoption can be recommended.

Published
2023

2. Procedure-Related Complications of Catheter Ablation for Atrial Fibrillation

Author

Karim Benali, Paul Khairy, Nefissa Hammache, Adrian Petzl, Antoine Da Costa, Atul Verma, Jason G. Andrade, Laurent Macle, Université de Montréal (UdeM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Montreal Heart Institute - Institut de Cardiologie de Montréal, McGill University Health Center [Montreal] (MUHC), Dr Benali has received grant support from the Group of Pacing and Cardiac Electrophysiology of the French Society of Cardiology. Dr Verma has received grant support, advisory board fees, and lecture fees from Bayer, Biosense Webster, and Medtronic, has received grant support from Biotronik, Bristol Myers Squibb, and Boehringer Ingelheim, has received consulting fees from Boston Scientific, MedLumics, and Thermedical, and has received lecture fees from Servier. Dr Andrade has received grant support from Baylis Medical, and and has received lecture fees from Biosense Webster. Dr Macle has received grant support and honoraria from Biosense Webster, Abbott, and Pfizer-Bristol Myers Squibb. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Subjects
meta-analysis, trend, catheter ablation, adverse event, atrial fibrillation, complication, [SDV.IB]Life Sciences [q-bio]/Bioengineering, randomized trials, Cardiology and Cardiovascular Medicine, mortality
Abstract

International audience; Background: Catheter ablation of atrial fibrillation (AF) is a commonly performed procedure. However, it is associated with potentially significant complications. Reported procedure–related complication rates are highly variable, depending in part on study design. Objectives: The purpose of this systematic review and pooled analysis was to determine the rate of procedure-related complications associated with catheter ablation of AF using data from randomized control trials and to assess temporal trends. Methods: MEDLINE and EMBASE databases were searched from January 2013 to September 2022 for randomized control trials that included patients undergoing a first ablation procedure of AF using either radiofrequency or cryoballoon (PROSPERO, CRD42022370273). Results: A total of 1,468 references were retrieved, of which 89 studies met inclusion criteria. A total of 15,701 patients were included in the current analysis. Overall and severe procedure-related complication rates were 4.51% (95% CI: 3.76%-5.32%) and 2.44% (95% CI: 1.98%-2.93%), respectively. Vascular complications were the most frequent type of complication (1.31%). The next most common complications were pericardial effusion/tamponade (0.78%) and stroke/transient ischemic attack (0.17%). The procedure-related complication rate during the most recent 5-year period of publication was significantly lower than during the earlier 5-year period (3.77% vs 5.31%; P = 0.043). The pooled mortality rate was stable over the 2 time periods (0.06% vs 0.05%; P = 0.892). There was no significant difference in complication rate according to pattern of AF, ablation modality, or ablation strategies beyond pulmonary vein isolation. Conclusions: Procedure-related complications and mortality rates associated with catheter ablation of AF are low and have declined in the past decade. © 2023 American College of Cardiology Foundation

Published
2023

3. Anthropometric deficits and the associated risk of death by age and sex in children aged 6–59 months: A meta‐analysis

Author

Susan Thurstans, Stephanie V. Wrottesley, Bridget Fenn, Tanya Khara, Paluku Bahwere, James A. Berkley, Robert E. Black, Erin Boyd, Michel Garenne, Sheila Isanaka, Natasha Lelijveld, Christine M. McDonald, Andrew Mertens, Martha Mwangome, Kieran S. O'Brien, Heather Stobaugh, Sunita Taneja, Keith P. West, Saul Guerrero, Marko Kerac, André Briend, Mark Myatt, London School of Hygiene and Tropical Medicine (LSHTM), SOUtenabilité et RésilienCE (SOURCE), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut de Recherche pour le Développement (IRD [France-Nord]), Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Université Paris Cité (UPCité)-Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Paris Cité (UPCité)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Epicentre [Paris] [Médecins Sans Frontières], United States Agency for International Development, USAID, Irish Aid: HQPU/2021/ENN, This paper is made possible by the generous support of the American people through the United States Agency for International Development (USAID), and by funding from Irish Aid (grant number (HQPU/2021/ENN). The contents are entirely the responsibility of its authors and do not necessarily reflect the views of USAID or the United States Government or represent or reflect Irish Aid policy., Tampere University, and Clinical Medicine

Subjects
Male, Adolescent, wasting, Thinness, underweight, 3123 Gynaecology and paediatrics, Clinical Research, Prevalence, Humans, sex, Child, Growth Disorders, Pediatric, Nutrition and Dietetics, Anthropometry, Nutrition & Dietetics, Wasting Syndrome, Prevention, Malnutrition, stunting, Public Health, Environmental and Occupational Health, Infant, Obstetrics and Gynecology, mortality, Good Health and Well Being, age, Pediatrics, Perinatology and Child Health, Female, Zero Hunger, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Abstract

Risk of death from undernutrition is thought to be higher in younger than in older children, but evidence is mixed. Research also demonstrates sex differences whereby boys have a higher prevalence of undernutrition than girls. This analysis described mortality risk associated with anthropometric deficits (wasting, underweight and stunting) in children 6–59 months by age and sex. We categorised children into younger (6–23 months) and older (24–59 months) age groups. Age and sex variations in near-term (within 6 months) mortality risk, associated with individual anthropometric deficits were assessed in a secondary analysis of multi-country cohort data. A random effects meta-analysis was performed. Data from seven low-or-middle-income-countries collected between 1977 and 2013 were analysed. One thousand twenty deaths were recorded for children with anthropometric deficits. Pooled meta-analysis estimates showed no differences by age in absolute mortality risk for wasting (RR 1.08, p = 0.826 for MUAC < 125 mm; RR 1.35, p = 0.272 for WHZ < −2). For underweight and stunting, absolute risk of death was higher in younger (RR 2.57, p < 0.001) compared with older children (RR 2.83, p < 0.001). For all deficits, there were no differences in mortality risk for girls compared with boys. There were no differences in the risk of mortality between younger and older wasted children, supporting continued inclusion of all children under-five in wasting treatment programmes. The risk of mortality associated with underweight and stunting was higher among younger children, suggesting that prevention programmes might be justified in focusing on younger children where resources are limited. There were no sex differences by age in mortality risk for all deficits.

Published
2022