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Background- Both ezetimibe and phytosterols inhibit cholesterol absorption. We tested the hypothesis that the combination of ezetimibe and phytosterols is more effective than ezetimibe alone in altering cholesterol metabolism. Methods [...]

Purpose: Environmental degradation resulting from human activities may adversely affect human health in multiple ways. Until now, policies aimed at mitigating environmental problems such as climate change, environmental pollution and damage to biodiversity have failed to clearly identify and drive the potential benefits of these policies on health. The conducted study assesses and demonstrates how specific environmental policies and instruments influence perceived human health in order to ensure input for a data-driven decision process. Design/methodology/approach: The study was conducted for the 2004–2020 period in European Union (EU) countries with the use of dynamic panel data modeling. Verification of specific policies' impact on dependent variables allows to indicate this their effectiveness and importance. As a result of the computed dynamic panel data models, it has been confirmed that a number of significant and meaningful relationships between the self-perceived health index and environmental variables can be identified. Findings: There is a strong positive impact of environmental taxation on the health index, and the strength of this relationship causes effects to be observed in the very short term, even the following year. In addition, the development of renewable energy sources (RES) and the elimination of fossil fuels from the energy mix exert positive, although milder, effects on health. The reduction of ammonia emissions from agriculture and reducing noise pollution are other health-supporting factors that have been shown to be statistically valid. Results allow to identify the most efficient policies in the analyzed area in order to introduce those with the best results or a mix of such measures. Originality/value: The results of the authors' research clearly indicate the health benefits of measures primarily aimed at improving environmental factors, such as environmental taxes in general. The authors have also discovered an unexpected negative impact of an increase in the share of energy taxes in total taxes on the health index. The presented study opens several possibilities for further investigation, especially in the context of the rapidly changing geopolitical environment and global efforts to respond to environmental and health challenges. The authors believe that the outcome of the authors' study may provide new arguments to policymakers pursuing solutions that are not always easily acceptable by the public. [ABSTRACT FROM AUTHOR]

Background: Establishing and maintaining relationships and ways of connecting and being with others is an important component of health and wellbeing. Harnessing the relational within caring, supportive, educational, or carceral settings as a systems response has been referred to as relational practice. Practitioners, people with lived experience, academics and policy makers, do not yet share a well-defined common understanding of relational practice. Consequently, there is potential for interdisciplinary and interagency miscommunication, as well as the risk of policy and practice being increasingly disconnected. Comprehensive reviews are needed to support the development of a coherent shared understanding of relational practice. Method: This study uses a scoping review design providing a scope and synthesis of extant literature relating to relational practice focussing on organisational and systemic practice. The review aimed to map how relational practice is used, defined and understood across health, criminal justice, education and social work, noting any impacts and benefits reported. Searches were conducted on 8 bibliographic databases on 27 October 2021. English language articles were included that involve/discuss practice and/or intervention/s that prioritise interpersonal relationships in service provision, in both external (organisational contexts) and internal (how this is received by workers and service users) aspects. Results: A total of 8010 relevant articles were identified, of which 158 met the eligibility criteria and were included in the synthesis. Most were opinion-based or theoretical argument papers (n = 61, 38.60%), with 6 (3.80%) critical or narrative reviews. A further 27 (17.09%) were categorised as case studies, focussing on explaining relational practice being used in an organisation or a specific intervention and its components, rather than conducting an evaluation or examination of the effectiveness of the service, with only 11 including any empirical data. Of the included empirical studies, 45 were qualitative, 6 were quantitative, and 9 mixed methods studies. There were differences in the use of terminology and definitions of relational practice within and across sectors. Conclusion: Although there may be implicit knowledge of what relational practice is the research field lacks coherent and comprehensive models. Despite definitional ambiguities, a number of benefits are attributed to relational practices. Systematic review registration: PROSPERO CRD42021295958 [ABSTRACT FROM AUTHOR]

Background: Transportation noise seems to impair self-reported health status (SRHS). However, only a few studies have considered the role of noise annoyance and noise sensitivity in this deleterious effect. This study aims investigating mediator and moderator roles of noise annoyance and noise sensitivity. Methods: In 2013, the DEBATS longitudinal study included 1244 participants aged over 18 years and living around three French airports. These participants were followed up in 2015 and 2017. They self-reported their perceived health status, aircraft noise annoyance, and their noise sensitivity via a questionnaire during the three visits. Noise maps were used to estimate aircraft noise levels at the facade of participants' residence. Generalized linear mixed models with a random intercept at the participant level were used. Results: Aircraft noise levels were associated with severe annoyance. Severe annoyance tent to be associated with impaired SRHS. Aircraft noise levels were associated with impaired SRHS only in men (odds ratio [OR] = 1.47, 95% confidence interval [CI] = [1.02, 2.11], for a 10-dBA Lden increase in aircraft noise levels) with a weaker association adjusted for annoyance (OR = 1.36, 95% CI = [0.94, 1.98]). The association was stronger in men who reported high noise sensitivity (OR = 1.84, 95% CI = [0.92, 3.70], versus OR = 1.39, 95% CI = [0.90, 2.14], for men who were not highly sensitive to noise). Conclusion: From our results, the deleterious effect of aircraft noise on SRHS could be mediated by noise annoyance and moderated by noise sensitivity. Further studies using causal inference methods are needed for identifying causal effect of exposure, mediator, and moderator. [ABSTRACT FROM AUTHOR]

Healthy nutrition contributes to preventing non-communicable and diet-related diseases. Recommender systems, as an integral part of mHealth technologies, address this task by supporting users with healthy food recommendations. However, knowledge about the effects of the long-term provision of health-aware recommendations in real-life situations is limited. This study investigates the impact of a mobile, personalized recommender system named Nutrilize. Our system offers automated personalized visual feedback and recommendations based on individual dietary behaviour, phenotype, and preferences. By using quantitative and qualitative measures of 34 participants during a study of 2–3 months, we provide a deeper understanding of how our nutrition application affects the users' physique, nutrition behaviour, system interactions and system perception. Our results show that Nutrilize positively affects nutritional behaviour (conditional R 2 =. 342 ) measured by the optimal intake of each nutrient. The analysis of different application features shows that reflective visual feedback has a more substantial impact on healthy behaviour than the recommender (conditional R 2 =. 354 ). We further identify system limitations influencing this result, such as a lack of diversity, mistrust in healthiness and personalization, real-life contexts, and personal user characteristics with a qualitative analysis of semi-structured in-depth interviews. Finally, we discuss general knowledge acquired on the design of personalized mobile nutrition recommendations by identifying important factors, such as the users' acceptance of the recommender's taste, health, and personalization. [ABSTRACT FROM AUTHOR]

A polysaccharide is a macromolecule composed of more than ten monosaccharides with a wide distribution and high structural diversity and complexity in nature. Certain polysaccharides are immunomodulators and play key roles in the regulation of immune responses during the progression of some diseases. In addition to stimulating the growth of certain intestinal bacteria, polysaccharides may also promote health benefits by modulating the gut microbiota. In the last years, studies about the triad gut microbiota–polysaccharides–health have increased exponentially. In consequence, in the present review, we aim to summarize recent knowledge about the function of dietary polysaccharides on gut microbiota composition and how these effects affect host health. [ABSTRACT FROM AUTHOR]

Noise pollution poses a significant hazard to humans by disrupting the maintenance of the quiet environment that is thought to promote innovation. In this study, the causal relationship between traffic noise and innovation was explored using four models. First, the panel data model with fixed effects was applied to determine the impact of traffic noise on innovation. Second, the interaction model was used to estimate the health regulatory effect. Third, the regression discontinuity model was used to identify the natural experience of the impact of traffic noise on innovation and further determine the causal effect of the noise threshold. Finally, the difference-in-differences model was used to identify the micro impact of traffic noise on innovation. The results show that from macro and micro perspectives, traffic noise suppresses innovation, and that health has a differential impact on the traffic noise–innovation relationship. In addition, we identified the critical point at which the impact of traffic noise on innovation is favorable owing to the white noise effect, providing a quantitative basis for policy implementation. Our results show that current environmental noise regulations must be re-examined to determine new measures for improving the innovative acoustic environment, promoting innovation, and achieving sustainable economic development. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal / Medicinski Časopis is the property of Serbian Medical Society, Section Kragujevac and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This qualitative focus group study aimed to determine how participants responded to a motivational interviewing intervention and to further explore how it impacted whole-person lifestyle of participants with hypertension or type 2 diabetes. Twenty participants attended one of five focus groups. A trained researcher led the one-hour focus groups using a semi-structured question guide. Responses were coded using thematic analysis and were then aggregated into six themes. The following six themes emerged most consistently: (1) the importance of a coach who can connect meaningfully with participants; (2) appreciation of the whole-person approach; (3) the power of "choice" in making health behaviour changes; (4) the effectiveness of goal setting and accountability; (5) the desire for increased contact and follow-up; (6) overall positive experience with mixed clinical results. Focus group themes highlighted that this intervention may empower individuals to feel confident in their choices and attain their goals during their health and wellness journey. [ABSTRACT FROM AUTHOR]

The acoustic environment in an urban dwelling is a key factor in human health, especially in megacities, where there are high levels of traffic noise. This study investigated the effects of various socio-economic indicators (gender, age, roadside residence, average daily time at home) on the subjective evaluation of residential acoustic environments, employing a series of questionnaire surveys and in-depth interviews in two Chinese megacities (Chongqing and Guangzhou). The findings indicate that residents in Chongqing, a typical mountainous city, are less satisfied with their acoustic environment than those in Guangzhou, a city built on a plain. However, there were no significant differences between residents in the two Chinese megacities in terms of their perspectives on their thermal, humid or luminous environments or noise-related health symptoms. Regarding perceptions of acoustic environments, there were significant differences between residents in the mountainous city and the plain city, as well as those in roadside and non-roadside homes, but no significant differences were identified between the views of men and women or the young and the old, and time spent at home appeared to have no impact. Moreover, age and average daily time spent at home are likely to be associated with noise-related health symptoms. [ABSTRACT FROM AUTHOR]

Background: Foodborne diseases non-communicable diseases (NCDs) are the main reason of death, accounting for 38 million (68%) of the 56 million premature deaths worldwide in 2012. Lower-middle and middle-income countries accounted for nearly three-quarters of all NCD fatalities (28 million), as well as the bulk of illness and premature death (82%). An excessive consumption of added sugar is source of worry for its link to unhealthy nutrition quality, overweight, and the risk of NCDs among adolescents. A further source of worry is the link among free sugar consumption and tooth cavities in young adults. Dental infections are the most common NCDs worldwide in young adults, and despite significant advances in management and cure in recent decades, issues remain, resulting in pain, anxiety, functional limitations (which include failing school grades and attendance in children), and social severe disability due to missing teeth.Objectives: The purpose of this report is to give suggestions on how to consume added sugar in order to mitigate the possibility of NCDs in children and young adults, with an emphasis on the care and mitigation of obesity and metabolic syndrome and tooth decay among young adults.Methods and Materials: The Keywords like adolescent, Health, Dental Caries, Obesity, Sugar Intake, Recommendation have been used to evaluate the standard of evidence discovered via current systematic reviews of the scientific literature relating to significance of sugar intake consumption and its effect in young adults.Results: The relevant data from prospective studies was judged to be of good quality, but data from nationwide population-based studies was judged to be of extremely low quality. Free sweeteners should be used in moderation during one's life, according to the World Health Organization (strong recommendation 1). WHO advises limiting natural sugar consumption to very little about 10% of total calorie intake among both grownups and children 2 (strong recommendation).Conclusions: There is a significant association of prevalence of tooth decay, obesity due to sugar consumption at an alarming rate hence regulators as well as curriculum developers can utilize the recommendation reviewed by us to compare current free sugar intake levels in their nations to a benchmark. They may also be used to design ways to reduce free sugar consumption through a wide variety of social health initiatives, if required. [ABSTRACT FROM AUTHOR]

Copyright of Boletín Latinoamericano y del Caribe de Plantas Medicinales y Aromáticas is the property of Universidad de Santiago de Chile and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zywnosc is the property of Polish Society of Food Technologists - Scientific Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Societal Impact Statement: Lentils are not only rich in protein and micronutrients, but they also have significant amounts of prebiotic carbohydrates, which provide benefits to human health. Beneficial microorganisms ferment lentil prebiotic carbohydrates in the colon, which impart gut health benefits to the consumer. In addition, prebiotic carbohydrates provide benefits to lentil plant health through their roles in carbon transport, storage, and abiotic stress tolerance. Advantageous to both human and plant health, prebiotic carbohydrates should be a prominent target for breeding efforts to improve lentil as a crop, as well as its nutritional value to consumers. Summary Diet‐related ailments, such as obesity and micronutrient deficiencies, have global adverse impacts on society. Lentil is an important staple crop, especially in South Asia and Africa, and has been associated with the prevention of chronic illnesses, including type II diabetes, obesity, and cancer. Lentil, a cool‐season food legume, is rich in protein and micronutrients while also containing a range of prebiotic carbohydrates, such as raffinose family oligosaccharides (RFOs), fructooligosaccharides, sugar alcohols (SAs), and resistant starch (RS), which contribute to lentil's health benefits. Prebiotic carbohydrates are fermented by beneficial microorganisms in the colon, which impart health benefits to the consumer. Prebiotic carbohydrates are also vital to lentil plant health, being associated with carbon transport/storage and abiotic stress tolerance. Important to both human and plant health, prebiotic carbohydrates in lentil are a prominent candidate for nutrigenomic breeding efforts. New lentil cultivars could help to combat global health problems, while also proving resilient to climate change. The objectives of this review are to: (a) discuss the benefits lentil prebiotic carbohydrates confer to human and plant health; (b) describe the biosynthesis pathways of two prominent prebiotic carbohydrate families in lentil, RFOs and SAs; and (c) consider the potential of prebiotic carbohydrates in terms of future nutritional breeding efforts. [ABSTRACT FROM AUTHOR]

The purposes of the present study were to analyze the stability of biological risk factors for CVD (blood pressure [BP], percentage of fat mass [%FM], total cholesterol [TC]) and one behavioral/life style risk factor (physical activity [PA]), as well as to study the stability of biological risk factors clustering. The sample comprised 325 males and 367 females, aged 8-15 years old. Participants were classified as being "at risk" according to age and sex adjusted 4th quartile or the first for PA. Three biological risk factors (%FM, SBP and TC) showed higher stability (one-year interval; r = 0.9-0.5) than DBP (r = 0.3) and PAI (r = 0.3). It can be concluded that 46% of subjects with two and/or three biological risk factors at the first measurement remained with the same number of biological risk factors in the second measurement. [ABSTRACT FROM AUTHOR]

Screening for hepatitis B (HBV) among high-risk young adults can help prevent its transmission and lead to earlier treatment and better long-term health outcomes. Yet few interventions have focused on increasing HBV awareness among young adults. Social media (SM) may be an effective method for disseminating information and engaging young adults about HBV. In this pilot study, qualitative and quantitative methods were applied to collect information on current use and perceptions toward SM through semistructured interviews and focus groups with young Chinese and Vietnamese adults and community leaders from local organizations in Philadelphia. Additionally, survey items were collected during the interviews and focus groups to provide quantitative data. Results from the interviews provided evidence that young adults and local organizations are already using SM and are open to using it to share general health information that is specific to their community. The focus groups suggested that using group pages or chats could be most appropriate for reaching young adults and that credible sources should be used to deliver messages that are tailored to the audience. The findings from this study will support the development of an SM intervention aimed at increasing HBV awareness. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the available evidence on probiotic use in older adults from human studies. Design: systematic review. Methods: The databases Embase, CINAHL and Medline were searched in December of 2017 for studies in humans where probiotics were used to modify a health outcome in older people. The quality of studies was evaluated using the Critical Appraisal Skills Program (CASP) assessment tool and the Cochrane Risk of Bias Assessment tool. Participants: Subjects aged over sixty years either through specified selection criteria or where the mean participant age was greater than sixty. Interventions: Probiotic supplements. Measurements: Pre-specified clinically measurable health outcomes in age related conditions. Results: 1210 articles were identified. After quality assessment and selection criteria were applied, 33 articles were identified to be included for review. As these studies cover a variety of applications and used customised protocols accordingly, meta-analysis was not possible and synthesis is in narrative form. Conclusions: A growing body of research has applied commercially available probiotic preparations across care settings for age related conditions including gut dysmotility, osteoporosis, common infectious diseases and cognitive impairment. Although methodologies vary, randomised controlled trials have reproduced results in these areas, and so warrant consideration of probiotics as a low risk adjuvant treatment for specific indications in the elderly. [ABSTRACT FROM AUTHOR]

India has the dubious distinction of being a hotspot for both diabetes and hypertension. Increased salt and sugar consumption is believed to fuel these two epidemics. This review is an in-depth analysis of current medical literature on salt and sugar being the two white troublemakers of modern society. The PubMed, Medline, and Embase search for articles published in January 2018, using the terms "salt" [MeSH Terms] OR "sodium chloride" [All Fields] OR "sugar" [All Fields]. India is world's highest consumer of sugar with one of the highest salt consumption per day. Increased salt intake is associated with increased risk of hypertension, left ventricular hypertrophy and fibrosis, cardiovascular events, renal stones, proteinuria, and renal failure. Increased sugar intake is directly linked to increased risk of obesity, fatty liver disease, and metabolic syndrome. Also, increased sugar intake may be indirectly related to the increased risk of type 2 diabetes. Both salt and sugar intake is directly linked to increased systemic and hypothalamic inflammation, endothelial dysfunction, microangiopathy, cardiovascular remodelling, cancers, and death. High fructose corn is especially damaging. There is no safe limit of sugar consumption, as the human body can produce its own glucose. Being nature's gift to mankind, there is no harm in moderate consumption of salt and sugar, however, modest reduction in the consumption of both can substantially reduce the burden of non-communicable diseases. Public health interventions to facilitate this behavioural change must be instituted and encouraged. [ABSTRACT FROM AUTHOR]

Objective: To examine the outcomes of a Medicare population who participated in a program combining digital health with human coaching for diabetes risk reduction. Method: People at risk for diabetes enrolled in a program combining digital health with human coaching. Participation and health outcomes were examined at 16 weeks and 6 and 12 months. Results: A total of 501 participants enrolled; 92% completed at least nine of 16 core lessons. Participants averaged 19 of 31 possible opportunities for weekly program engagement. At 12 months, participants lost 7.5% (SD = 7.8%) of initial body weight; among participants with clinical data, glucose control improved (glycosylated hemoglobin [HbA1c] change = -0.14%, p = .001) and total cholesterol decreased (-7.08 mg/dL, p = .008). Self-reported well-being, depression, and self-care improved (p < .0001). Discussion: This Medicare population demonstrated sustained program engagement and improved weight, health, and well-being. The findings support digital programs with human coaching for reducing chronic disease risk among older adults. [ABSTRACT FROM AUTHOR]

The majority of scientific evidence strongly associates a well-planned vegan diet with health, a successful control of body weight, a preventive measure, and, in some cases, with the termination and the reverse of the most common chronic non-communicable diseases, such as cardiovascular diseases, type 2 diabetes, certain cancers, and some other diseases. Numerous athletes have accepted these findings and adopted this lifestyle choice. Furthermore, the athletes choose well-planned vegan diet with the intention of optimizing their athletic abilities. The position of The British Dietetic Association (BDA) and The Academy of Nutrition and Dietetics (AND) on the vegetarian diet states that well-planned vegetarian diets, including the vegan diet, are healthy and nutritionally adequate and appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence and older adulthood. What is more, AND repeats its view from nearly ten years ago on the appropriateness of the vegan diet for the needs of athletes. The aim of this article is to justify the appropriateness of a well-planned vegan diet for the needs for competitive artistic gymnasts and to do so with a relative scientific transparency. [ABSTRACT FROM AUTHOR]

Purpose: Different studies have pointed towards a positive effect of religious fasting on human health. Orthodox fasting (OF) regime could be characterized as a periodical vegetarian diet, demonstrating several common characteristics with the typical Mediterranean diet. The present systematic review aimed to synthesize available results regarding the potential impact of OF on human health. Methods: Key biomedical databases were searched to identify studies examining the effects of OF on humans. Following implementation of specific criteria, ten studies were included in the analysis and their results were systematically reported and critically appraised in this review. Results: According to the available limited results, OF periods are characterized by a restriction in total energy and fat intake, an increase in carbohydrate and fiber consumption, while in terms of protein intake, results are contradictive. The overall effect of OF on lipids profile seems to be optimal, with the reduction of total cholesterol and LDL-C levels, being a consistent finding across studies (up to 17.8 and 31.4%, respectively). However, the effect on HDL-C is still unclear. Conclusions regarding the impact on body weight and glucose homeostasis cannot be drawn, given that relevant data are limited with conflicting results. Any potential negative aspects of OF, mainly attributed to reduced dietary intake of vitamin D and B12 and minerals (mainly calcium), require further investigation. Conclusions: Given the limitations of available evidence, more studies are required before reaching definite conclusions about the effects of OF on human health. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study assessed the knowledge, attitude and consumption of sugar-sweetened beverages (SSBs) and its association with body mass index (BMI) among undergraduate oral health students. Materials and Methods: A cross-sectional design was used and the study was conducted at a South African dental university. Undergraduate dental and oral hygiene students (n = 344) registered in 2015 were invited to participate. A self-administered questionnaire was used to elicit the necessary information. Data analysis included frequencies and correlations using Chi-square tests. Statistical significance was set at P < 0.05. Results: The response rate was 88% (301) and the mean age was 22.3 years (range: 17-42; standard deviation ±3.2). The majority were female (72%) and 70% of respondents had an acceptable level of knowledge on the types of SSBs and possible health conditions if consumed excessively. Almost half (46%) had a positive attitude toward the consumption of SSBs. Clinical students had a significantly higher level of knowledge compared to nonclinical students (P = 0.03). Participants consumed an average of six teaspoons (±9.5) of sugar from SSBs daily. Those with poor knowledge and attitude consumed significantly more SSBs (P < 0.01) than those with higher levels of knowledge and attitude. Males were significantly more obese and overweight than females (P < 0.01). There was no association between the amount of sugar consumed from SSBs and the BMI. Conclusions: The knowledge and attitude toward SSBs was acceptable. Although sugar consumption from SSBs was relatively high, there was no significant correlation between the consumption of SSBs and the BMI. [ABSTRACT FROM AUTHOR]

The present study examined whether the effects of dietary-induced hyperlipidaemia on preimplantation embryo development depend on the predominant fatty acid (FA) type in the diet. In a combined in vivo-in vitro bovine model, two groups of cows (n = 3 in each group) were fed with three diets consecutively (4 weeks feeding for each): (1) a maintenance control diet (CONT); (2) a high-starch diet rich in saturated fat (SAT); and (3) a high-starch diet rich in omega-3 unsaturated fat (UNSAT). Two feeding sequences were used to test for carry-over effects: Group A was fed CONT, SAT1 and then UNSAT2, whereas Group B was fed CONT, UNSAT1 and then SAT2. Serum was collected after each dietary period, analysed and tested in bovine in vitro embryo culture. Introducing SAT and UNSAT diets induced hyperlipidaemia (specifically hypercholesterolaemia and elevated free FAs) and reduced insulin sensitivity. Carry-over effects in serum metabolites and FA profile were dependent on the diet and feeding sequence. SAT1 and SAT2 serum decreased blastocyst rates and altered blastocyst mRNA expression related to apoptosis and oxidative stress. UNSAT1 and UNSAT2 serum resulted in normal embryo development and quality. Other in vitro effects depended on the sequence of feeding. In conclusion, substitution of saturated fat with omega-3 fat in a high-caloric diet induced hyperlipidaemia with an FA profile yielding similar rates and quality of blastocysts compared with normolipidaemic controls. [ABSTRACT FROM AUTHOR]

Interesterified ( IE) fats are used in a wide range of food products and were introduced as a replacement for trans fats, which are known to be detrimental to cardiovascular health. However, the effects of interesterification on metabolism and subsequent effects on cardiovascular health are not understood and previous studies have seldom investigated industrially-relevant IE fats. No legislation currently exists regarding the labelling of IE fats in food products and therefore estimates of average consumption rates in the UK population are currently unavailable. In order to meet the urgent need for a systematic investigation of the health effects of consumer-relevant IE fats, it is essential to estimate current IE fat intakes and to investigate biological mechanisms that might mediate acute and chronic cardiometabolic effects of commercially relevant IE fats. [ABSTRACT FROM AUTHOR]

Importance: Familial hypercholesterolemia (FH) is characterized by elevated cholesterol concentrations early in life. Untreated FH is associated with premature cardiovascular disease in adulthood.Objective: To systematically review the evidence on benefits and harms of screening adolescents and children for heterozygous FH for the US Preventive Services Task Force (USPSTF).Data Sources: MEDLINE, the Cochrane Central Register of Controlled Trials, and PubMed were searched for studies published between January 1, 2005, and June 2, 2015; studies included in a previous USPSTF report were also searched. Surveillance was conducted through April 8, 2016.Study Selection: Fair- and good-quality studies in English with participants 0 to 20 years of age.Data Extraction and Synthesis: Two investigators independently reviewed abstracts and full-text articles and extracted data into evidence tables. Results were qualitatively summarized.Main Outcomes and Measures: Myocardial infarction and ischemic stroke in adulthood; lipid concentrations and atherosclerosis in childhood; diagnostic yield of screening; any harm of screening or treatment.Results: Based on 2 studies (n = 83,241), the diagnostic yield of universal screening for FH in childhood is 1.3 to 4.8 cases per 1000 screened. There was no eligible evidence on the benefits or harms of FH screening in childhood. Eight placebo trials of statin drugs (n = 1071, 6-104 weeks) found low-density lipoprotein cholesterol (LDL-C) decreases of 20% to 40%; 1 trial (n = 214) showed a 2.01% decrease in carotid intima-media thickness with statins, compared with 1.02% with placebo (P = .02). Three placebo trials of bile acid-sequestering agents (n = 332, 8-52 weeks) showed LDL-C reductions of 10% to 20%. In 1 trial (n = 248), ezetimibe with simvastatin resulted in greater LDL-C reductions compared with simvastatin alone at 33 weeks (mean, -54.0% [SD, 1.4%] vs -38.1% [SD, 1.4%]). One trial of ezetimibe monotherapy (n = 138) showed mean LDL-C decreases of 28% (95% CI, -31% to -25%) from baseline and negligible change with placebo at 12 weeks. Eighteen studies found statins generally well tolerated. One observational study found lower, but still normal, dehydroepiandrosterone sulfate concentrations in statin-treated males with FH at 10-year follow-up. Bile acid-sequestering agents were commonly associated with adverse gastrointestinal symptoms and poor palatability. There was no eligible evidence on the effect of FH treatment on myocardial infarction or stroke in adulthood.Conclusions and Relevance: Screening can detect FH in children, and lipid-lowering treatment in childhood can reduce lipid concentrations in the short term, with little evidence of harm. There is no evidence for the effect of screening for FH in childhood on lipid concentrations or cardiovascular outcomes in adulthood, or on the long-term benefits or harms of beginning lipid-lowering treatment in childhood. [ABSTRACT FROM AUTHOR]

The aim of this review was to identify the underlying relationship between preterm birth and the development of cardiovascular diseases. Preterm birth significantly affects the elastin content and viscoelastic properties of the vascular extracellular matrix in human arteries. Inadequate elastin synthesis during early development may cause a permanent increase in arterial stiffness in adulthood. Conclusion Early and permanent alterations in viscoelastic properties may lead to hypertension and cardiovascular disease development in adults born prematurely. [ABSTRACT FROM AUTHOR]

The effects of traditional cooking methods (pan-frying with corn flour, cooking in oven bag, grilling in oven and barbecuing on charcoal fire) on fatty acid composition of bonito were examined. The amount of total saturated fatty acid (SFA)significantly decreased in fried fish. The monounsaturated fatty acid (MUFA) content in all groups significantly decreased. The polyunsaturated fatty acid (PUFA) content in fried fish was higher than other groups. But, the lowesto mega-3 and the highest omega- 6 content were determined in fried fish. The 20:5n3 (EPA) fatty acid was found different in all groups and the highest EPA contents were found in oven bag and barbecued groups, respectively. The 22:6n3 (DHA) fatty acids contents significantly decreased in fried fish while significantly increased in other groups. The lowestn-3/n-6 ratio was found in the method of frying, while the highest rates were found in barbecue. Barbecuing on charcoal fire, cooking in oven bag and grilling in oven were found as the best cooking methods for healthy eating, respectively. [ABSTRACT FROM AUTHOR]

The beneficial effects of consuming omega-3 polyunsaturated fatty acids (n-3 PUFAs), specifically eicosapentaenoic acid ( EPA) and docosahexaenoic acid ( DHA), on cardiovascular health have been studied extensively. To date, there is no dietary reference intake ( DRI) for EPA and DHA, although many international authorities and expert groups have issued dietary recommendations for them. Given the substantial new evidence published since the last Institute of Medicine ( IOM) report on energy and macronutrients, released in 2002, there is a pressing need to establish a DRI for EPA and DHA. In order to set a DRI, however, more information is needed to define the intakes of EPA and DHA required to reduce the burden of chronic disease. Information about potential gender- or race-based differences in requirements is also needed. Given the many health benefits of EPA and DHA that have been described since the 2002 IOM report, there is now a strong justification for establishing a DRI for these fatty acids. [ABSTRACT FROM AUTHOR]

Oxidative stress is a condition in which oxidant metabolites exert their toxic effect because of an increased production or an altered cellular mechanism of protection; oxidative stress is rapidly gaining recognition as a key phenomenon in chronic diseases. Antioxidants terminate these chain reactions by removing free radical intermediates, and inhibit other oxidation reactions by being oxidized themselves. Endogenous defence mechanisms are inadequate for the complete prevention of oxidative damage, and different sources of dietary antioxidants may be especially important. This article calls attention to the dietary antioxidants, such as vitamins A, C, and E and polyphenols. Compelling evidence has led to the conclusion that diet is a key environmental factor and a potential tool for the control of chronic diseases. More specifically, fruits and vegetables have been shown to exert a protective effect. The high content of minerals and natural antioxidant as vitamins A, C, and E and polyphenols in fruits and vegetables may be a main factor responsible for these effects. [ABSTRACT FROM AUTHOR]

Background:Dietary habits and smoking are recognised as important gastric cancer determinants. However, their impact on prognosis remains poorly understood. We aimed to quantify the association between lifestyles and survival of gastric cancer patients.Methods:In 2001-2006, 568 patients were recruited in the two major public hospitals in the north of Portugal. Participants were inquired about smoking and dietary habits regarding the year preceding the diagnosis. The vital status of all participants, up to 2011 (maximum follow-up: 10 years), was assessed through the North Region Cancer Registry. Cox proportional hazards regression models were used to estimate adjusted (at least for age, sex and education) hazard ratios (HR) and 95% confidence intervals (95% CI).Results:No significant differences in gastric cancer survival were observed according to smoking status (current vs never smokers, HR=1.00, 95% CI: 0.72-1.38) or alcohol intake (current vs never consumers, HR=0.87, 95% CI: 0.61-1.25). Only a dietary pattern (high consumptions of most food groups and low vegetable soup intake) was significantly associated with a better prognosis among patients with the extent of disease classified as regional spread (HR=0.45, 95% CI: 0.22-0.93).Conclusion:This study shows that prediagnosis lifestyles have a small impact in the survival of gastric cancer patients. [ABSTRACT FROM AUTHOR]

Milk is the most nourishing natural biofluid and almost an ideal functional food for humans of all ages. The objective of this review article is to delineate global nutritional and health implications of main live-stock dairy products for optimum postmodern life quality. Milk bioactives contribute considerably to meeting nutrient requirements while offering potentials to reduce risks of cancers, traumas and metabolic disorders. Milk functions beyond its nutritive worth. Cow milk intake by lactating mothers enriches breast milk β-lactoglobulin and ovalbumin. Milk intake leads to more standard body frame structure and bone health. Milk immunoglobulins act against Enterotoxigenic Escherichia coli. Casomorphins, immunostimulating peptides, and ACE-inhibitory peptides modulate the gut nutrient assimilation. Whey proteins are insulinotropic and medium chain fatty acids improve insulin action. Peptides along with calcium may reduce blood pressure and cholesterol. Milk improves folate availability, and reduces homocysteinemia and heart infarcts. Ewe milk is richer than cow milk in riboflavin, thiamine, niacin, pantothenic acid, vitamin B, vitamin B and biotin. Goat milk has less α-s-1-casein, β-carotene, agglutinin; and is lower in citric acid, Na, Fe, S, Zn, Mo, ribonuclease, alkaline phosphatase, lipase, xanthine oxidase, N-acetylneuraminic acid, orotic acid, pyridoxine, folate, vitamin B, and vitamin C than cow milk. Goat milk is richer in Ca, K, Mg, P, Cl, Mn, vitamins A and D, nicotinic acid, choline, inositol, medium-chain FA, small diameter fat globules than cow milk. Goat milk is a suitable substitute in allergies, and with low orotic acid might prevent fatty liver. Lysozyme-rich milk has been produced with transgenic dairy goats to prevent intestinal disorders in infants. Donkey and horse milks are considered optimal substitutes for human and cow milk in minimizing allergies and hyperlipidemia related complexities. Effective education and data dissemination are the ongoing obligations for unbiased milk science to be adequately perceived and applied by postmodern human populations. [ABSTRACT FROM AUTHOR]

Aim: To evaluate social and behavioural determinants of alcohol consumption in an urban sample of Portuguese adults. Subjects and methods: Participants were randomly selected within the non-institutionalized adult population of Porto (1489 women, 925 men). A questionnaire on socio-demographic (age, education and employment status) and behavioural characteristics (smoking, physical exercise and fruit and vegetable intake) was applied; alcohol consumption and alcoholic beverage types were assessed using a validated food frequency questionnaire covering the previous year. Odds ratios and 95% confidence intervals (OR; 95%CI) were computed using logistic regression models. Results: The prevalence of current alcohol drinking was 65.6% (53.3% in women; 85.5% in men). From those, 15.6% of women and 40.1% of men were high-intake drinkers (>15 g/day in women and >30 g/day in men). In multivariate analysis, high-intake drinkers compared to non-drinkers were significantly older (40--59 vs 18--39 years: OR  ==  3.86; 95%CI: 2.24--6.63 in women; OR  ==  5.30; 95%CI: 3.01--9.35 in men), less educated (  ≥≥  12 vs ≤≤  4 years: OR  ==  0.46; 95%CI: 0.30--0.71 in women; OR  ==  0.43; 95%CI: 0.24--0.76 in men) and more frequently smokers (OR  ==  1.51; 95%CI: 0.93--2.46 in women; OR  ==  2.08; 95%CI: 1.23--3.52 in men). A negative association was found between high-intake drinking and fruit and vegetable consumption (  ≥≥  5 vs <  5 portions/day: OR  ==  0.68; 95%CI: 0.50--0.93 in women; OR  ==  0.56; 95%CI: 0.34--0.79 in men). Less educated men reported a higher consumption of wine, but lower of beer and spirits. Among women, beer and spirits consumption was positively associated with regular physical exercise (OR  ==  1.59; 95%CI: 1.18--2.13). Conclusions: Current and high-intake drinkers were more frequently men, older and less educated subjects, smokers and lower fruit and vegetable consumers, compared with non-drinkers. [ABSTRACT FROM AUTHOR]

An increased prothrombotic state is a major risk factor for the development of heart attacks, strokes, and venous thromboembolism. Platelet activation and aggregation play an important role in determining a prothrombotic state. Although pharmaceutical agents such as aspirin, heparin, and warfarin are able to reduce prothrombotic tendency, long-term drug treatment may produce a variety of side effects, including bleeding. Diet is generally recognized to be significantly involved in modifying the individual risk for the development of thrombotic diseases, although its influence during the treatment of these disorders is probably less important. Dietary intervention has proven effective in lowering serum lipid levels, which are otherwise essential elements in the pathogenesis of cardio-vascular disease. Likewise, certain dietary components have also been proven effective in decreasing platelet activation through various mechanisms and therefore may contribute to attenuating the future risk of thrombosis. This article provides an up-to-date review of the role of nutrient and nonnutrient supplements on platelet aggregation and risk of thrombosis. [ABSTRACT FROM AUTHOR]

The article focuses on the role of caloric restriction (CR) to improve health and to extend lifespan in human beings and animals. CR refers to the reduction of caloric intake, while maintaining adequate nutrient intake. CR, when combined with exercise, results in decreased caloric intake and increased caloric expenditure. Dietary restriction (DR) is the restriction of one or more components of food intake, with minimal reduction in total caloric intake.

Background: There is substantial published evidence that warfarin reduces the risk of stroke in patients with atrial fibrillation (AF). However, the current literature suggests that not all patients who could benefit from warfarin receive the drug. Objective: To evaluate patient-related demographic and clinical factors that could influence warfarin use or other anticoagulant use in hospitalized patients with AF. Study Design: Retrospective observational study using claims data from the Wolters Kluwer Pharma Solutions Hospital Patient Level Database, evaluating characteristics of patients hospitalized in the US between 1 November 2003 and 31 October 2004. Setting: Hospital care. Patients: The study included 44 193 patients aged ≥40 years who were hospitalized between 1 November 2003 and 31 October 2004 and had a diagnosis of AF during hospitalization (AF did not need to be the cause of hospitalization). Interventions: Use of warfarin or other anticoagulants (unfractionated heparin [UFH] or low-molecular-weight heparin [LMWH]) was evaluated. Main Outcome Measures: A logistic regression model was used to identify factors associated with warfarin use, international normalized ratio (INR) monitoring, or the use of anticoagulants (UFH or LMWH). Results: In this analysis of hospitalized patients with AF in the real-world setting, about 56% of patients received anticoagulation therapy with warfarin. Elderly patients aged ≥75 years were less likely to be treated with warfarin than younger patients, but patients between the ages of 60 and 74 years were more likely to use warfarin than their younger counterparts. Except for patients with congestive heart failure or vascular malformation, patients with other bleeding risk factors (hepatic disease, renal disease, aspirin use, and fractures) were significantly less likely to receive warfarin than those without these risk factors. CHADS2 scores for stroke risk of 2 and 3 were associated with a significantly higher likelihood of warfarin treatment than scores of 0 or 1. Patients admitted through a routine admission (an outpatient department) were significantly more likely to be prescribed warfarin than patients admitted through an emergency room. Patients aged ≥75 years and aspirin users were more likely to have their INR monitored during hospitalization. With respect to other anticoagulant use, females and older patients (≥65 years) were less likely to use UFH or LMWH, and patients with renal disease or vascular malformation and those receiving aspirin were more likely to use UFH or LMWH than patients without these conditions/not receiving aspirin. Patients admitted through the emergency room were more likely to receive an anticoagulant than patients admitted through an outpatient department, an inpatient transfer, or any other source. Conclusions: Older age, female sex, and certain risk factors for bleeding, including hepatic disease, renal disease, aspirin use, and fractures, were associated with a lower likelihood of warfarin treatment, while a higher stroke risk (as indicated by CHADS2 scores) was associated with a higher likelihood of warfarin treatment, in hospitalized patients with a diagnosis of AF. The likelihood of INR being monitored increased for patients aged ≥75 years and for aspirin users. Older patients and female patients were less likely to be prescribed other anticoagulants (UFH or LMWH) also. [ABSTRACT FROM AUTHOR]

Dramatic advances in understanding mechanisms of aging have recently been made in model systems. Interventions have been devised that successfully enhance survival. Major issues still in need of resolution include whether these interventions not only increase survival but also enhance function, delay frailty, and can be translated into clinical application. It seems there are basic biologic findings close to being ready for translation. However, a number of barriers exist to translating these findings into realistic clinical interventions. Steps and resources needed include measuring not only survival but also impact of interventions on age-related disability, frailty, and onset of disease in model systems; development of clinically relevant measures of disability, frailty, and disease for each animal model and genetically tractable animal models of frailty; training and career-long funding mechanisms for geriatricians in basic science research and for basic scientists in geriatric issues; translationally capable review and funding mechanisms; emphasis on studies of interventions that can be initiated in later life for preventing or reversing disability; genetic association studies in humans to identify new candidate genes and pathways that correlate with disability, frailty, and age-related disease onset as well as longevity; study of exposure to environmental agents or toxins early in life on survival, disability, frailty, and disease in later life. [ABSTRACT FROM AUTHOR]

The global incidence of diabetes is increasing at epidemic rates. Estimates suggest there are currently 150 million people with diabetes and this number is expected to double in the next 20 years. Type 2 diabetes accounts for 95% of all cases and is characterized in part by impaired sensitivity to insulin or 'insulin resistance'. Defects in the insulin signalling pathways underpin this resistance. In the current article we discuss the regulation of Insulin Receptor Substrate-1 (IRS-1), a protein that plays a pivotal role in insulin signalling and whose function is impaired in subjects with insulin resistance. Coordination of IRS-1 function is multi-faceted, involving phosphorylation of IRS-1 at multiple serine/threonine residues. This controls many aspects of IRS-1, including its interaction with the insulin receptor and subsequent tyrosine phosphorylation, as well as its subcellular distribution and targeting for degradation by the proteasome. Such tight control ensures appropriate transduction and attenuation of the insulin signal, thereby regulating insulin action in healthy individuals. Emerging evidence indicates that 'diabetogenic factors' associated with insulin resistance, such as TNFα and elevated circulating fatty acids, impact on insulin signalling at the level of IRS-1 serine/threonine phosphorylation. The expression and/or activity of several kinases, such as IκB kinase β (IKKβ) and salt-induced kinase 2 (SIK2), and the phosphorylation of IRS-1 at key sites, such as Ser307 and Ser789, are increased in states of insulin resistance. Identifying the pathways by which such factors activate these and other kinases, and defining the precise roles of specific serine/threonine phosphorylation events in IRS-1 regulation, represent important goals which may eventually provide a rationale for therapeutic intervention. IUBMB Life, 55: 367-374, 2003 [ABSTRACT FROM AUTHOR]

Presents information on a study which determined the serum cholesterol, apolipoproteins and low density lipoproteins oxidizability in Japanese men and women during walnut consumption. Review of related literature; Characteristics of the subjects; Data and methods used; Results and conclusions.

Examines the psychometric properties of a disease-specific health locus of control scale. Presentation of the factor structure of a modified version of the scale; Assessment of the general health locus of control measure; Classification of individuals according to control orientation.

Focuses on research done on the relationships of major types of stressors and anxiety along with maternal, fetal and neonatal complications. Main components of stress; How the systems for reproduction are linked to the stress system.

Objective To explore the definition and operationalization of resilience in health system performance assessments in European Union countries. Methods We conducted multiple empirical case study analyses. We identified relevant cases through a literature review from 2014 to 2023 using Google Scholar and through a snowball technique to retrieve additional information. We included only documents that explicitly mentioned resilience in health system performance assessments. We performed a content analysis to identify common patterns in defining resilience. Findings The final sample consisted of six countries: Belgium, Croatia, Czechia, Estonia, Ireland and Italy. Each country adopted a distinct approach to conceptualizing resilience, with countries prioritizing specific aspects based on lessons learnt from the coronavirus disease 2019 (COVID-19) pandemic. Some countries focused on maintaining essential health-care services and protecting vulnerable groups. Other countries prioritized management capacity, staff preparedness, digital health utilization and strengthening of primary health care. Content analysis revealed six resilience definitions derived from the key performance indicators: addressing unmet needs and maintaining outcomes; protecting vulnerable groups; acquiring and using resources; having trained and prepared staff in place; using digital health; and strengthening primary health care. Conclusion Integration of resilience into the health profiles of European Union countries preceded its inclusion in national health system performance assessments, the latter of which became more prominent after the COVID-19 pandemic. Variations in interpretations within health system performance assessments reflect differences in indicators and policy responses. [phrase omitted] [phrase omitted] Objectif Explorer la definition et la mise en reuvre de la resilience dans l'evaluation des performances des systemes de sante au sein des pays de l'Union europeenne. Methodes Nous avons effectue plusieurs analyses d'etudes de cas empiriques. Nous avons identifie les cas pertinents en procedant a une revue de la litterature publiee entre 2014 et 2023 sur Google Scholar et en appliquant la technique de type <> pour obtenir des informations supplementaires. Nous n'avons retenu que les documents qui mentionnaient explicitement la resilience dans les evaluations des performances des systemes de sante. Enfin, nous avons examine les contenus afin de reperer les modeles les plus courants dans la definition de la resilience. Resultats Lechantillon final etait compose de six pays : la Belgique, la Croatie, l'Estonie, l'Irlande, l'Italie et la Republique tcheque. Chacun de ces pays a adopte une approche differente dans sa conceptualisation de la resilience, certains ayant donne la priorite a des aspects specifiques en fonction des lecons qu'ils ont tirees de la pandemie de maladie a coronavirus 2019 (COVID-19). Quelques-uns se sont concentres sur le maintien des services de sante essentiels et la protection des groupes vulnerables. D'autres ont privilegie les capacites de gestion, la preparation du personnel, l'utilisation des technologies numeriques et le renforcement des soins de sante primaires. Lanalyse des contenus a revele six definitions de la resilience derivees des indicateurs cles de performance : repondre aux besoins non satisfaits et assurer le maintien des resultats ; proteger les groupes vulnerables ; acquerir et exploiter les ressources ; disposer de personnel forme et prepare ; deployer des technologies numeriques ; et enfin, consolider les soins de sante primaires. Conclusion La resilience figurait dans les profils sanitaires de certains pays de l'Union europeenne avant d'etre integree dans les mecanismes d'evaluation des performances des systemes de sante nationaux, ayant gagne en importance apres la pandemie de COVID-19. Les divergences d'interpretation observees dans le cadre de ces evaluations refletent les variations au niveau des indicateurs et des solutions politiques. [phrase omitted] Objetivo Explorar la definicion y la puesta en practica de la resiliencia en las evaluaciones del rendimiento de los sistemas sanitarios en los paises de la Union Europea. Metodos Se realizaron multiples analisis de estudios de casos empiricos. Se identificaron casos relevantes mediante una revision bibliografica de 2014 a 2023 utilizando Google Scholar y mediante una tecnica de bola de nieve para recuperar informacion adicional. Se incluyeron solo los documentos que mencionaban explicitamente la resiliencia en las evaluaciones del rendimiento del sistema sanitario. Se realizo un analisis de contenido para identificar patrones comunes en la definicion de resiliencia. Resultados La muestra final estaba formada por seis paises: Belgica, Croacia, Chequia, Estonia, Irlanda e Italia. Cada pais adopto un enfoque distinto para conceptualizar la resiliencia, dando prioridad a aspectos especificos basados en las lecciones aprendidas de la pandemia de la enfermedad por coronavirus de 2019 (COVID-19). Algunos paises se centraron en mantener los servicios sanitarios esenciales y proteger a los grupos vulnerables. Otros paises priorizaron la capacidad de gestion, la preparacion del personal, la utilizacion de la salud digital y el fortalecimiento de la atencion primaria. El analisis de contenido revelo seis definiciones de resiliencia derivadas de los indicadores clave de rendimiento: abordar las necesidades insatisfechas y mantener los resultados; proteger a los grupos vulnerables; adquirir y utilizar recursos; contar con personal capacitado y preparado; utilizar la salud digital; y fortalecer la atencion primaria de salud. Conclusion La integracion de la resiliencia en los perfiles sanitarios de los paises de la Union Europea precedio a su inclusion en las evaluaciones del rendimiento de los sistemas sanitarios nacionales, estas ultimas mas destacadas tras la pandemia de la COVID-19. Las variaciones en las interpretaciones dentro de las evaluaciones del rendimiento de los sistemas sanitarios reflejan diferencias en los indicadores y las respuestas politicas., Introduction The coronavirus disease 2019 (COVID-19) pandemic posed a considerable challenge for governments, affecting health, the economy and citizens' well-being. (1) The pandemic exposed weaknesses in health systems, such as [...]

BACKGROUND: Nighttime aircraft noise may affect people's sleep, yet large-scale evidence using objective and subjective measures remains limited. OBJECTIVE: Our aim was to investigate associations between nighttime aircraft noise exposure and objectively measured sleep disturbance using a large UK cohort. METHODS: We used data from 105,770 UK Biobank cohort participants exposed and unexposed to aircraft noise who lived in 44 local authority districts near 4 international airports in England. We used a generalized linear regression model to examine cross-sectional associations between aircraft noise [L.sub.night] (23:00 hours-07:00 hours) and 7-d actimetric measures collected 2013-2015 (n = 22,102). We also used Logit and generalized estimating equations models to examine associations between [L.sub.night] and self-reported sleep measures at enrollment (2006-2010) and follow-up (2012-2013). This approach allowed us to compare and contrast the results and support potential future meta-analyses on noise-related sleep disturbance. RESULTS: Cross-sectional analyses of actimetric data suggested sleep disturbance associated with [L.sub.night], showing higher level of movements during the least active continuous 8-h time period [[beta]: 0.12 milligravitational units; 95% confidence interval (CI): 0.013, 0.23]. We also saw disrupted sleepwake cycles as indicated by index scores of lower relative amplitude ([beta]: -0:006; 95% CI: -0:007, -0:005), poorer interdaily stability ([beta]: -0:010; 95% CI: -0:014, -0:006), and greater intradaily variability ([beta]: 0.021; 95% CI: 0.019, 0.023), comparing [L.sub.night] [greater than or equal to]55 dB with 65 y of age and those with diabetes or dementia. CONCLUSION: Individuals exposed to higher levels of aircraft noise experienced objectively higher levels of sleep disturbance and changes in sleepwake cycle. https://doi.org/10.1289/EHP14156, Introduction The World Health Organization (WHO) Environmental Noise Guidelines for the European Region published in 2018 recommended reducing the noise levels produced by aircraft during nighttime to below 40 dB [...]

: BACKGROUND: Sedation is fundamental to the management of patients in the intensive care unit (ICU). Its indications in the ICU are vast, including the facilitating of mechanical ventilation, permitting invasive procedures, and managing anxiety and agitation. Inhaled sedation with halogenated agents, such as isoflurane or sevoflurane, is now feasible in ICU patients using dedicated devices/systems. Its use may reduce adverse events and improve ICU outcomes compared to conventional intravenous (IV) sedation in the ICU. This review examined the effectiveness of inhalational sedation using the anesthetic conserving device (ACD) compared to standard IV sedation for adult patients in ICU and highlights the technical aspects of its functioning. METHODS: We searched the PubMed, Cochrane Central Register of Controlled Trials, The Cochrane Library, MEDLINE, Web of Science, and Sage Journals databases using the terms 'anesthetic conserving device,' 'Anaconda,' 'sedation' and 'intensive care unit' in randomized clinical studies that were performed between 2012 and 2022 and compared volatile sedation using an ACD with IV sedation in terms of time to extubation, duration of mechanical ventilation, and lengths of ICU and hospital stay. RESULTS: Nine trials were included. Volatile sedation (sevoflurane or isoflurane) administered through an ACD shortened the awakening time compared to IV sedation (midazolam or propofol). CONCLUSION: Compared to IV sedation, volatile sedation administered through an ACD in the ICU shortened the awakening and extubation times, ICU length of stay, and duration of mechanical ventilation. More clinical trials that assess additional clinical outcomes on a large scale are needed. Keywords: Anesthetic conserving device, inhalation sedation, intensive care unit, intravenous sedation, length of stay, Author(s): Zohair Al Aseri (corresponding author) [1,2,3]; Mariam Ali Alansari [4]; Sara Ali Al-Shami [2]; Bayan Alaskar [2]; Dhuha Aljumaiah [2]; Alyaa Elhazmi [5] Sedation is essential to provide comfort [...]

Context.--In 2019, papillary renal neoplasm with reverse polarity (PRNRP) was defined as a new neoplasm because it has a predominately tubulopapillary pattern lined by a single layer of cuboidal and eosinophilic cells with apically located round nuclei. Immunohistochemically, this neoplasm showed expression of GATA-3 and L1CAM and had recurrent KRAS mutations. Objective.--To estimate the incidence of PRNRP and provide 8 additional cases with some variations in the morphology. Design.--We reviewed 1627 renal tumors from our hospital during a 21-year period (2000-2020). We reexamined 196 papillary renal cell carcinomas and selected those that met the diagnostic criteria for PRNRP. Results.--We found 8 cases consistent with PRNRP. The median age of the patients was 64.75 years; 7 patients were male, and 1 was female. Two patients had end-stage renal disease. No recurrence, metastasis, or tumor-related death occurred in a mean follow-up period of 67.62 months. Tumor size ranged from 1.6 to 3.7 cm. All cases were (7 of 8; 87.5%) had predominantly cystic changes, and 1 had solid architecture. No foamy cells, clear cell change, or psammoma bodies were seen in any cases. All cases were positive for CK7, EMA, GATA3, and L1CAM. KRAS gene mutation was detected in 5 cases (5 of 8; 62.5%). Conclusions.--PRNRP represents 4.08% (8 of 196 cases) of papillary renal cell carcinomas and 0.49% (8 of 1627 cases) of all renal tumors in the 21-year period in our series. In our study, all cases exhibited an indolent clinical course. This supports that PRNRP has characteristic morphologic and molecular features. (Arch Pathol Lab Med. 2023;147:692-700; doi: 10.5858/arpa.2022-0156-OA), Papillary renal cell carcinoma (PRCC) is the second most frequent histologic type of renal cell carcinoma. Since 1997, it has been classified into type 1 and type 2 according to [...]

PURPOSE The US Preventive Services Task Force (USPSTF) is an independent body that makes evidence-based recommendations regarding preventive services to improve health for people nationwide. Here, we summarize current USPSTF methods, describe how methods are evolving to address preventive health equity, and define evidence gaps for future research. METHODS We summarize current USPSTF methods as well as ongoing methods development. RESULTS The USPSTF prioritizes topics on the basis of disease burden, extent of new evidence, and whether the service can be provided in primary care and going forward will increasingly consider health equity. Analytic frameworks specify the key questions and linkages connecting the preventive service to health outcomes. Contextual questions provide information on natural history, current practice, health outcomes in high-risk groups, and health equity. The USPSTF assigns a level of certainty to the estimate of net benefit of a preventive service (high, moderate, or low). The magnitude of net benefit is also judged (substantial, moderate, small, or zero/negative). The USPSTF uses these assessments to assign a letter grade from A (recommend) to D (recommend against). I statements are issued when evidence is insufficient. CONCLUSIONS The USPSTF will continue to evolve its methods for simulation modeling and to use evidence to address conditions for which there are limited data for population groups who bear a disproportionate burden of disease. Additional pilot work is underway to better understand the relations of the social constructs of race, ethnicity, and gender with health outcomes to inform the development of a USPSTF health equity framework. Key words: preventive medicine; clinical practice guidelines; methodology; health equity https://doi.org/10.1370/afm.2946, INTRODUCTION The US Preventive Services Task Force (USPSTF) is an independent body formed in 1984 to make evidence-based recommendations regarding preventive services including screening, behavioral counseling, and preventive drugs. The [...]

Background: Evidence of the negative impacts of contemporary use insecticides on sperm concentration has increased over the last few decades; however, meta-analyses on this topic are rare. OBJECTIVES: This investigation assessed the qualitative and quantitative strength of epidemiological evidence regarding adult exposure to two classes of contemporary use insecticides--organophosphates (OPs) and N-methyl carbamates (NMCs)--and sperm concentration using robust and reproducible systematic review and meta-analysis methods. Methods: Three scientific databases (PubMed, Scopus, and Web of Science), two U.S. government databases (NIOSHTIC- 2 and Science.gov), and five nongovernmental organization websites were searched for relevant primary epidemiological studies published in any language through 11 August 2022. Risk of bias and strength of evidence were evaluated according to Navigation Guide systematic review methodology. Bias-adjusted standardized mean difference effect sizes were calculated and pooled using a three-level, multivariate random-effect meta- analysis model with cluster-robust variance estimation. Results: Across 20 studies, 21 study populations, 42 effect sizes, and 1,774 adult men, the pooled bias-adjusted standardized mean difference in sperm concentration between adult men more- and less-exposed to OP and NMC insecticides was -0.30 (95% CI: -0.49, - 0.10; [P.sub.Satt] Discussion: This comprehensive investigation found sufficient evidence of an association between higher OP and NMC insecticide exposure and lower sperm concentration in adults. Although additional cohort studies can be beneficial to fill data gaps, the strength of evidence warrants reducing exposure to OP and NMC insecticides now to prevent continued male reproductive harm. https://doi.org/10.1289/EHP12678, Introduction Studies conducted across a wide range of populations have found significant decreases in average sperm concentrations over the last century, (1-6) and the prospect of further declines threatens population-wide [...]