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Introduction: Stunting and anaemia, two severe public health problems, affect a significant number of children under the age of five. To date, the burden of and predictive factors for coexisting forms of stunting and anaemia in childhood have not been well documented in Ethiopia, where both the conditions are endemic. The primary aims of the present study were to: (i) determine the prevalence of co-morbid anaemia and stunting (CAS); (ii) and identify factors associated with these co-morbid conditions among children aged 6–59 months in Ethiopia. Methods: The study was based on data from the Ethiopian Demographic and Health Survey (EDHS 2005–2016). The EDHS was a cross-sectional study that used a two-stage stratified cluster sampling technique to select households. A total weighted sample of 21,172 children aged 6–59 months was included in the current study (EDHS-2005 (n = 3898), EDHS-2011 (n = 8943), and EDHS-2016 (n = 8332)). Children with height-for-age z-scores (HAZ) less than −2 SD were classified as stunted. Anaemia status was measured by haemoglobin level with readings below 11.0 g/deciliter (g/dL) categorized as anaemic. A multilevel mixed-effects logistic regression model was used to identify the factors associated with CAS. The findings from the models were reported as adjusted odds ratios (AOR) with 95% confidence intervals (CIs). Results: Almost half of the children were males (51.1%) and the majority were from rural areas (89.2%). The prevalence of CAS was 24.4% [95% CI: (23.8–24.9)]. Multivariate analyses revealed that children aged 12–23 months, 24–35 months, and 36–59 months, and children perceived by their mothers to be smaller than normal at birth had higher odds of CAS. The odds of CAS were significantly higher among children born to anaemic mothers [AOR: 1.25, 95% CI: (1.11–1.41)], mothers with very short stature [AOR: 2.04, 95% CI: (1.44–2.91)], children from households which practiced open defecation [AOR: 1.57, 95% CI: (1.27–1.92)], children born to mothers without education [AOR: 3.66, 95% CI: (1.85–7.22)], and those who reside in rural areas [AOR: 1.41, 95% CI: (1.10, 1.82)]. Male children had 19% lower odds of having CAS compared to female children [AOR: 0.81, 95% CI: (0.73–0.91)]. Children born to mothers who had normal body mass index (BMI) [AOR: 0.82, 95%CI: (0.73–0.92)] reported lower odds of CAS. Conclusions: One in four preschool-age children in Ethiopia had co-morbid anaemia and stunting, which is a significant public health problem. Future interventions to reduce CAS in Ethiopia should target those children perceived to be small at birth, anaemic mothers, and mothers with short stature.

Objective: This study aimed to estimate the trends, projections, and determinants of standalone and coexisting forms of malnutrition (CFM) at the global, regional, national, and individual level among children under five in low- and middle-income countries (LMICs). It also assessed the projection trajectory towards the 2030 global nutrition targets (GNTs) for child growth including stunting, wasting, obesity, and CFM. Methods: Data from 48 LMICs were analyzed using the Multiple Indicator Cluster Surveys (MICS) and Demographic and Health Surveys (DHS). Children with complete anthropometry were included for national- and individual-level descriptive analyses. Projected prevalence of each form of malnutrition, including CFM, was calculated using the Annual Rate of Change. Inferential analyses employed generalized linear regression models with two-way interaction terms to identify determinants of each malnutrition type. Findings: By 2030, 22 of 48 LMICs are projected to achieve the GNT of stunting, wasting, and obesity, that is up from 10 countries currently, while Yemen and Zimbabwe are expected to remain off-track. Stunting is the most prevalent form, affecting 42 countries, with nine nations projected to have over 50% of children affected by a form of malnutrition. Wasting, obesity, and CFM are rising in several countries. Maternal education and household wealth were the strongest determinants, with children of uneducated mothers and from poorest households at the highest risk. Inequalities are narrowing slowly by 1–2% per year, and marked regional disparities persist. Conclusions: Many LMICs are off-track to meet child-growth targets when CFM is considered alongside standalone indicators. The government and global health partners must strengthen nutrition surveillance systems and equity-focused policies and programs to routinely capture CFM and prevent as well as manage all forms of malnutrition at the national and individual levels.

In Pakistan, malnutrition is a chronic issue. Concerns regarding coexisting forms of malnutrition (CFM) in an individual child are emerging, as children suffering from CFM have a 4 to 12-fold higher risk of death compared with healthy children. This study assessed the prevalence, trends, and socioeconomic determinants of various types of CFM using Pakistan Demographic and Health Survey (PDHS) datasets. Data from children aged 0–5 years old, with complete height and weight information, and valid anthropometry, from all regions of Pakistan (except residents of Azad Jammu Kashmir (AJK) and Federally Administered Tribal Areas (FATA), and non-de jure residents), were included. The prevalence of CFM was 30.6% in 2012–2013 and 21.5% in 2017–2018 PDHS. Both PDHSs reported a significantly higher prevalence of CFM in Sindh and Baluchistan compared with other regions of Pakistan. Improved socioeconomic status significantly reduced the odds of various types of CFM, except the coexistence of underweight with wasting. The high prevalence of CFM in Pakistan can be averted by multisectoral collaboration and by integrating nutrition-sensitive and nutrition-specific interventions.

Management of undernourished children depends only on wasting yet it can coexist with underweight and/or stunting. Among children admitted to hospital with acute illness, we determined the proportion with wasting coexisting with underweight and/or stunting and their risk factors. A retrospective review of hospital records of children 6‒59 months old admitted at Garissa County referral hospital, Kenya, from January 2017 to December 2019 was conducted. Using World Health Organization 2006 growth standards, undernutrition were defined: wasting as Weight‐for‐height Z‐score < −2, stunting Height‐for‐age Z‐score < −2 and underweight Weight‐for‐age Z‐score < −2. We studied wasting coexisting with underweight and/or stunting. Among 624 children recruited, 347 (56%) were males and 511 (82%) <24 months old. Diarrhoea 210 (34%) and pallor/anaemia 310 (50%) were the most frequent admission diagnosis. HIV infection was present among 8 (1.3%) children. Wasting, underweight and stunting were present among 595 (95%), 518 (83%) and 176 (28%) children respectively. 161 (26%), 506 (81%) and 161 (26%) children had wasting coexisting with stunting, underweight and both stunting and underweight respectively. In the multivariable regression, diarrhoea was positively associated with wasting coexisting with stunting (adjusted risk ratio [aRR = 2.96] [95% CI = 2.06‒4.23]) and anaemia with wasting coexisting with underweight (aRR = 1.23) (95% CI = 1.03‒1.47). Overall, 343 (55%) children were discharged alive, 67 (11%) absconded from the wards, 164 (26%) were transferred to another hospital and 50 (8.0%) died before discharge. The risk of inpatient death was 10.3%, 7.9%, 8.4% and 6.8% among children not wasted, wasted only, wasted & underweight, and wasted and underweight and stunted respectively (Chi‐square p = 0.60). The study reports an unacceptably high levels of undernourishment, including coexisting forms of undernutrition among hospitalised children. This highlights a public health priority for current nutrition therapeutic care and need of continuity of care among those children discharged alive in the community‐based management of acute malnutrition programmes. In this population of hospitalised children, we found critically high levels of wasting and underweight. The most frequent form of undernutrition coexistence was wasting and underweight. Early detection and effective treatment of hospitalised children with coexisting forms of undernutrition deserves more attention in the current nutrition therapeutic care and those discharged alive linked with community‐based management of acute malnutrition programmes. Key messages In this population of hospitalised children, we found critically high levels of wasting and underweight. The most frequent form of undernutrition coexistence was wasting and underweight. Early detection and effective treatment of hospitalised children with coexisting forms of undernutrition (CFU) deserves more attention in the current nutrition therapeutic treatment programmes. Routine reporting of CFU in hospital settings should be encouraged. Future research to increase our understanding of its mechanism and need for robust interventions should be prioritised.

Objectives To estimate Global, Regional, and National prevalence of Malnutrition, specifically Coexisting forms of malnutrition (CFM) and its various types: Coexistence of underweight with stunting (CUS), Coexistence of underweight with wasting (CUW), Coexistence of underweight with wasting & stunting (CUWS), Coexistence of stunting with overweight/obesity (CSO) among children under five years in low- and middle-income countries (LMICs). Methods This cross-sectional observational study utilized latest nationally representative Demographic and Health Surveys (DHS) datasets of 62 LMICs corresponding to six global regions from 2006 to 2024. Data of 541,707 children aged 0 to 59 months with complete anthropometry were analysed descriptively (prevalence estimates) and inferentially (multivariate logistic regression). Results The global malnutrition prevalence among children was 43.9%, of which CFM was observed among 20.9% children. Among various CFM types, CUS was highly prevalent (11.8%), followed by CUW (4.2%), CUWS (3.2%), and CSO (2.1%). South & Southeast Asian had highest CFM prevalence of 29.6%, while Central Asia and Latin America & Caribbean reported the lowest CFM prevalence of 8.1% and 6.2%, respectively. Among all the LMIC included, Timor-Leste exhibited the highest CFM at 41.8%. In general, children aged between 12 to 35 months had 2-3 times higher odds of various forms of CFM. However, female sex, maternal education, improvement in socioeconomic status, medium to large family size showed significantly lower odds with various forms of CFM. Conclusions This study advances the understanding of CFM’s prevalence, determinants, and regional variations, filling a critical gap in global nutrition research. The findings serve as a reminder to reinvest in efforts to protect children from malnutrition during their early years of life. Governments and other global health sector must invest in a well-established system of nutrition surveillance for addressing CFM, informing targeted interventions to improve child health outcomes in LMICs.

Evidence from previous studies suggests a strong association between pediatric undernutrition and maternal stature. However, there's a scarcity of evidence regarding the relationship between maternal stature and pediatric coexisting forms of malnutrition (CFM). This study examined the prevalence and trends of CFM at the individual, household, and community levels, using data from the Demographic & Health Surveys (DHS) of Pakistan. Furthermore, this study assessed the association between pediatric CFM and short maternal stature while adjusting for multiple covariates. A panel cross‐sectional analysis was conducted using data from the 2012–2013 and 2017–2018 Pakistan Demographic & Health Survey (PDHS). We included data from 6194 mother–child dyads aged 15–49 years and 0–59 months, respectively, while excluding data from pregnant mothers and dyads with incomplete anthropometric variables and anthropometric outliers. Across the two survey periods, our findings reveal a significant decline in pediatric malnutrition, including CFM, alongside a concurrent increase in maternal overweight/obesity. Three out of four households had either a malnourished mother, and/or a malnourished child, and/or both. Our study demonstrates that short maternal stature increased the odds of various forms of pediatric undernutrition by two‐to‐threefolds (p < .041), but we did not find an association with wasting, overweight/obesity, and nutritional paradox. This underscores the heightened vulnerability of children born to short‐stature mothers to various forms of pediatric undernutrition. Addressing the high prevalence of pediatric undernutrition among children of short‐stature mothers necessitates a comprehensive approach that considers an individual's nutritional status throughout their entire life cycle. Children living in most of the Asian and African countries are at highly vulnerable to various types of nutritional adversities, including undernutrition. Undernutrition during early infancy and childhood laid the foundation for intergenerational undernutrition. Maternal short stature (<145 cm) is an irreversible type of undernutrition, which is associated with various types of nutritional adversities, such as intrauterine fetal growth retardation, small‐for‐gestational age (SGA), low birth weight (LBW), and undernutrition. This study reported a high prevalence of malnutrition across Pakistan, where three out of every four households had either a malnourished child, and/or malnourished mother, and/or a malnourished mother–child dyad. The relationship of maternal short stature with CFM is not yet assessed, but this study measured significantly two‐to‐threefold higher odds of pediatric undernutrition (standalone forms and coexisting forms of undernutrition) compared with children of normal/tall heighted mothers. Tackling the pediatric undernutrition requires a life‐cycle approach, with special emphasis on all adolescent girls and expecting mothers, so that issues related to nutritional disorders that may develop in adolescent girls, expecting mothers, developing fetuses, and newborns can be curtailed early. This study investigates the link between maternal stature and pediatric coexisting forms of malnutrition (CFM) using Pakistan Demographic & Health Surveys (PDHS) data. Results indicate a decline in pediatric malnutrition and an increase in maternal overweight/obesity over time. About 75% of households of Pakistan have either a malnourished mothers and/or child and/or both. Evidence of a relationship between maternal short stature with CFM is scarce, but it showed two‐to‐threefold higher odds of pediatric undernutrition in children born to short‐stature mothers.

Background and objective: Paediatric malnutrition has a synergistic relationship with diarrhoea. In children under two years of age, diarrhoea occurs in more than half of malnutrition cases and is associated with increased duration of illness, increased length of hospital stays, increased morbidity, and mortality. A well-established relationship exists between diarrhoeal and various standalone forms of malnutrition, but their association with coexisting forms of malnutrition (CFM) has not yet been investigated. Thus, this study assessed the association of CFM with diarrhoea among Pakistani children using datasets retrieved from Demographic Health & Survey and UNICEF. Study design: A pooled analysis of datasets of Pakistan Demographic & Health Surveys (PDHS) and Multiple Indicator Cluster Surveys (MICS) from the year 2010 to 2018 was conducted. Methods: Data of 70,723 children aged below two years were analysed after excluding those with incomplete anthropometry and outliers. Findings: Of the total study population, this study reported the presence of either diarrhoea or malnutrition or both in over half of Pakistani children aged between 0 and 23.9 months. Both standalone forms of undernutrition and coexisting forms of undernutrition were significantly associated with increased odds of diarrhoea by 1.07 (1.02 to 1.12) and 1.21 (1.16 to 1.27) times. The practice of breastfeeding, secondary/higher level of maternal education, and improvement in socioeconomic status reduced the risk of diarrhoea, while the children aged between 6 and 23.9 months residing in urban areas showed a high risk of diarrhoea. Conclusions: The presence of any type of undernutrition, i.e., standalone and/or coexisting forms were associated with increased risk of diarrhoeal diseases in children. An improvement in socioeconomic status, adherence to the continuation of breastfeeding, and maternal education are keys to reducing the burden of diarrhoea among children.

The results of studying silicon concentrations and coexisting forms in surface water bodies of Ukraine with different hydrological regime, hydrophysical and hydrochemical characteristics are presented. Silicon distribution between its dissolved and suspended forms, as well as the relationship between the concentration of suspended silicon and the weight of suspended matter and its nature are discussed. The dominating form of silicon migration is shown to be its dissolved form (70.1–99.4% of its total content), while suspended form of silicon dominates in river waters with higher concentration of suspended matter of mineral origin, (56.1–81.5%). The results of studying silicon distribution between abiotic and biotic components of suspended matter, as well as between its dissolved forms with different charge signs are given. Dissolved silicon in the water bodies under study is shown to account for 93.0–99.0% of neutral fraction, where its compounds with molecular weight <0.2 kDa dominate.

This paper analyzes complex dynamics of the generalized Langford system (GLS) with five parameters. First, some important local dynamics such as the Hopf bifurcations and the stabilities of hyperbolic and zero/double-zero equilibrium are investigated using normal form theory, center manifold theory and bifurcation theory. Besides, an accurate expression of a periodic orbit and some approximate expressions of bifurcating limit cycles by Hopf bifurcation are obtained. Second, by using averaging theory, the zero-Hopf bifurcation at the origin is analyzed and also the stability of the bifurcating limit cycle is obtained. Of particular interest is that one numerically finds an annulus in three-dimensional space which appears nearby the bifurcating limit cycle under proper conditions. If an amplitude system of GLS has a center, its suspension may lead the GLS to exhibit such annulus. Third, it is proved rigorously that there exist two heteroclinic cycles and the coexistence of such two heteroclinic cycles and a periodic orbit under some conditions. This implies system has no chaos in the sense Shil’nikov heteroclinic criterion. Finally, by further numerical observation, it is shown that three different types of attractors exist simultaneously, such as two kinds of periodic orbits, periodic orbit and invariant torus.

Bicapite, KNa2Mg2(H2PV145+O42)·25H2O, is a new mineral species (IMA2018-048) discovered at the Pickett Corral mine, Montrose County, Colorado, U.S.A. Bicapite occurs as square tablets up to about 0.2 mm on edge on montroseite-corvusite-bearing sandstone. Crystals are dark red-brown, often appearing black. The streak is orange, and the luster is vitreous. Bicapite is brittle, has a Mohs hardness of 11/2, and displays one excellent cleavage on {100}. The measured density is 2.44(2) g/cm3. Bicapite is uniaxial (+), ω=1.785(5), ε≈1.81 (white light); pleochroism is red-brown; E>O, slight. The electron probe microanalysis and results of the crystal structure determination provided the empirical formula (based on 67 O apfu) (K1.23Na2.23Mg1.48)Σ4.94 [H2.51P1.02(V13.915+Mo0.076+)Σ13.98O42]·25H2O. Bicapite is tetragonal, I4/m, with a=11.5446(12) Å, c=20.5460(14) Å, V=2738.3(6) Å3, and Z=2. The strongest four lines in the diffraction pattern are [d in Å (I) (hkl)]: 10.14 (100) (002,101); 2.978 (29) (134,206); 2.809 (11) (305); and 2.583 (11) (420,008). The atomic arrangement of bicapite was solved and refined to R1=0.0465 for 1008 independent reflections with I>2σI. The structural unit is a [H2PV125+O40(V5+O)2]7- heteropolyanion composed of 12 distorted VO6 octahedra surrounding a central PO4 tetrahedron and capped on opposite sides by two VO5 square pyramids; the structural unit is a modification of the α-isomer of the Keggin anion, [XM12O40]n-. Charge balance in the structure is maintained by the [KNa2Mg2(H2O)25]7+ interstitial complex. The name bicapite is in recognition of this being the only known mineral with a structure based on a bicapped Keggin anion. The discovery of bicapite and numerous other natural polyoxometalate compounds in the Colorado Plateau uranium/vanadium deposits make that the most productive region found to date for naturally occurring polyoxometalate compounds.