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BackgroundThe COVID-19 pandemic had a global impact on people life, notably because of lockdown periods. This could particularly affected patients suffering from hip fracture, who could have been more isolated during these periods. We aim at evaluating the impact of the COVID-19 period (including lockdown periods) on quality of life (QOL) in older adult patients 90 days after a surgery for a hip fracture.Subject and methodsAncillary study of the prospective randomized controlled HiFIT study. We compared the QOL measured at 90 days after a hip fracture surgery using the EuroQOL-5 dimensions 3 levels (EQ-5D), the Perceived Quality of life (PQOL) and the Instrumental Activities of Daily Living (IADL) in patients included in the Hifit study before and during the COVID-19 pandemic.ResultsThe characteristics of the 161 patients included before and of the 213 included during the COVID period (including 122 (57%) during COVID with containment periods and 91 (43%) during COVID without containment periods) were similar (mean age 84 ± 10 years; 282 (75%) women). The majority (81%) of the patients alive at 90 days had returned to their previous place of residence in both periods. During the COVID period, EQ-5D showed better patient pain/discomfort and anxiety/depression levels. The PQOL happiness was not different, with around 81% of the patient being “happy” or “very happy” during the two periods and the IADL was also similar during the two periods. In the multivariate analysis odd ratios of having poorer outcomes were increased before COVID for pain/discomfort (OR 2.38, 95%CI [1.41–4.15], p = 0.001), anxiety (OR 1.89 [1.12–3.21], p = 0.017) and mobility (1.69 [1.02–2.86], p = 0.044).ConclusionPatient’s quality of life measured using different scales was not altered during the COVID period compared to before COVID, 90 days after a hip fracture. Surprisingly, the Pain/Discomfort and Anxiety dimensions of the EQ-5D questionnaires were even better during the COVID period.Clinical trial registration:https://clinicaltrials.gov/ (NCT02972294).

Dermatomyofibromas are a rare, benign, acquired neoplasm with less than 150 reported cases worldwide. The etiologic factors that contribute to the development of these lesions are currently unknown. To our knowledge, there have been only six previously reported cases of patients presenting with multiple dermatomyofibromas, and in each of these cases, there were less than ten lesions present. Herein, we describe a patient who developed more than 100 dermatomyofibromas over a period of years, and we argue that the patient’s concurrent Ehlers-Danlos syndrome could have contributed to this unique presentation by inducing an increased fibroblast-to-myofibroblast transition.

Abstract Background The valuable clinical data, specimens, and assay results collected during a primary clinical trial or observational study can enable researchers to answer additional, pressing questions with relatively small investments in new measurements. However, management of such follow-on, “ancillary” studies is complex. It requires coordinating across institutions, sites, repositories, and approval boards, as well as distributing, integrating, and analyzing diverse data types. General-purpose software systems that simplify the management of ancillary studies have not yet been explored in the research literature. Methods We have identified requirements for ancillary study management primarily as part of our ongoing work with a number of large research consortia. These organizations include the Center for HIV/AIDS Vaccine Immunology (CHAVI), the Immune Tolerance Network (ITN), the HIV Vaccine Trials Network (HVTN), the U.S. Military HIV Research Program (MHRP), and the Network for Pancreatic Organ Donors with Diabetes (nPOD). We also consulted with researchers at a range of other disease research organizations regarding their workflows and data management strategies. Lastly, to enhance breadth, we reviewed process documents for ancillary study management from other organizations. Results By exploring characteristics of ancillary studies, we identify differentiating requirements and scenarios for ancillary study management systems (ASMSs). Distinguishing characteristics of ancillary studies may include the collection of additional measurements (particularly new analyses of existing specimens); the initiation of studies by investigators unaffiliated with the original study; cross-protocol data pooling and analysis; pre-existing participant consent; and pre-existing data context and provenance. For an ASMS to address these characteristics, it would need to address both operational requirements (e.g., allocating existing specimens) and data management requirements (e.g., securely distributing and integrating primary and ancillary data). Conclusions The scenarios and requirements we describe can help guide the development of systems that make conducting ancillary studies easier, less expensive, and less error-prone. Given the relatively consistent characteristics and challenges of ancillary study management, general-purpose ASMSs are likely to be useful to a wide range of organizations. Using the requirements identified in this paper, we are currently developing an open-source, general-purpose ASMS based on LabKey Server (http://www.labkey.org) in collaboration with CHAVI, the ITN and nPOD.

Abstract Background Multiple types of assays allow sensitive detection of virus-specific neutralizing antibodies. For example, the extent of antibody neutralization of HIV-1, SIV and SHIV can be measured in the TZM-bl cell line through the degree of luciferase reporter gene expression after infection. In the past, neutralization curves and titers for this standard assay have been calculated using an Excel macro. Updating all instances of such a macro with new techniques can be unwieldy and introduce non-uniformity across multi-lab teams. Using Excel also poses challenges in centrally storing, sharing and associating raw data files and results. Results We present LabKey Server's NAb tool for organizing, analyzing and securely sharing data, files and results for neutralizing antibody (NAb) assays, including the luciferase-based TZM-bl NAb assay. The customizable tool supports high-throughput experiments and includes a graphical plate template designer, allowing researchers to quickly adapt calculations to new plate layouts. The tool calculates the percent neutralization for each serum dilution based on luminescence measurements, fits a range of neutralization curves to titration results and uses these curves to estimate the neutralizing antibody titers for benchmark dilutions. Results, curve visualizations and raw data files are stored in a database and shared through a secure, web-based interface. NAb results can be integrated with other data sources based on sample identifiers. It is simple to make results public after publication by updating folder security settings. Conclusions Standardized tools for analyzing, archiving and sharing assay results can improve the reproducibility, comparability and reliability of results obtained across many labs. LabKey Server and its NAb tool are freely available as open source software at http://www.labkey.com under the Apache 2.0 license. Many members of the HIV research community can also access the LabKey Server NAb tool without installing the software by using the Atlas Science Portal (https://atlas.scharp.org). Atlas is an installation of LabKey Server.

Abstract Background Broad-based collaborations are becoming increasingly common among disease researchers. For example, the Global HIV Enterprise has united cross-disciplinary consortia to speed progress towards HIV vaccines through coordinated research across the boundaries of institutions, continents and specialties. New, end-to-end software tools for data and specimen management are necessary to achieve the ambitious goals of such alliances. These tools must enable researchers to organize and integrate heterogeneous data early in the discovery process, standardize processes, gain new insights into pooled data and collaborate securely. Results To meet these needs, we enhanced the LabKey Server platform, formerly known as CPAS. This freely available, open source software is maintained by professional engineers who use commercially proven practices for software development and maintenance. Recent enhancements support: (i) Submitting specimens requests across collaborating organizations (ii) Graphically defining new experimental data types, metadata and wizards for data collection (iii) Transitioning experimental results from a multiplicity of spreadsheets to custom tables in a shared database (iv) Securely organizing, integrating, analyzing, visualizing and sharing diverse data types, from clinical records to specimens to complex assays (v) Interacting dynamically with external data sources (vi) Tracking study participants and cohorts over time (vii) Developing custom interfaces using client libraries (viii) Authoring custom visualizations in a built-in R scripting environment. Diverse research organizations have adopted and adapted LabKey Server, including consortia within the Global HIV Enterprise. Atlas is an installation of LabKey Server that has been tailored to serve these consortia. It is in production use and demonstrates the core capabilities of LabKey Server. Atlas now has over 2,800 active user accounts originating from approximately 36 countries and 350 organizations. It tracks roughly 27,000 assay runs, 860,000 specimen vials and 1,300,000 vial transfers. Conclusions Sharing data, analysis tools and infrastructure can speed the efforts of large research consortia by enhancing efficiency and enabling new insights. The Atlas installation of LabKey Server demonstrates the utility of the LabKey platform for collaborative research. Stable, supported builds of LabKey Server are freely available for download at http://www.labkey.org. Documentation and source code are available under the Apache License 2.0.

Consumer taste preference can be influenced by visual preference. To eliminate the influence of visual preference in the sensory evaluation of whole grain wheat, a reproducible method to eliminate color differences between Whole Grain breads prepared from hard white wheat (HWW) and hard red wheat (HRW) was evaluated. Response surface methodology (RSM) was used to match the color of HWW to HRW with the addition of commercially available dye solutions: McCormick black (red #40, yellow #5, blue #1), red (red #40, red #3, yellow #6), and yellow (yellow #5). Bread color was assessed by L * , a * , and b * color parameters according to the CIELAB international system of color measurement. Four replicates of the control and dye treated breads were analyzed. Initial color values for HRW were L * = 56.8 ± 0.40; a * = 8.04 ± 0.44; b * = 21.34 ± 0.46. RSM was used to predict dye addition levels to match color between HWW and HRW. With the addition of black (0.457 µL/mL), red (0.574 µL/mL), and yellow (1.165 µL/mL) dye to HWW, breads could be produced with L * , a * , and b * values of no statistical difference to the HRW (P < 0.05). A timed storage trail demonstrated the need to standardize the time between bread production and feeding studies. Visual bias can hinder assessment of wheat varieties in sensory studies. A reproducible method of dying wheat was developed that can be used to reduce this bias in sensory studies. PRACTICAL APPLICATIONS: The ability to control color variability is a critical tool in determining perceived quality in sensory analysis of breads. In this study, a method to reduce or eliminate visual bias between breads made from different varieties of wheat was developed. This method is applicable to any foods where dye could be added to reduce or eliminate color bias in sensory studies., (© 2019 Institute of Food Technologists®.)

Background/objectives: Breakfast consumption has been shown to impact children's growth and development, but the influence of breakfast skipping on total daily intakes is not known. The purpose of this study was to examine the differences in nutritional intakes and food consumption between children who consume breakfast versus those who do not., Subjects/methods: Dietary recall data were assessed for 2-year-old to 5-year-old children (n = 3443) and 6-year-old to 12-year-old children (n = 5147) from NHANES 2005-2012. Dietary intakes and diet quality scores were compared across breakfast consumption and skipping with means and 95% confidence interval., Results: Children who skipped breakfast on the day of intake had significantly lower energy intakes for the total day (5911 vs 6723 kJ) but had greater energy intakes from non-breakfast meals and snacks. Children who skipped breakfast consumed nearly 40% of the day's intake (2332 kJ of 5911 kJ) from snacks, with 586 kJ from snacks as added sugars. Breakfast skipping was also related to significantly lower intakes of fiber, folate, iron, and calcium intakes. Overall diet quality scores, as well as fruit, whole fruit, whole grains, dairy and empty calorie subscale scores were significantly better in children who ate breakfast., Conclusions: Children who skipped breakfast presented poorer overall diet quality and lower total intakes commonly obtained at breakfast. To address missed opportunities, nutrition professionals should encourage children's consumption of a nutritious breakfast to support overall diet quality.

Nutritional quality of children's diets is a public health priority in the fight against childhood obesity and chronic diseases. The main purpose of this study was to determine contribution of snacks to energy and nutrient intakes and to identify leading snack food sources of energy, total fat, and added sugars amongst young children in the United States. Using the 2005-2012 NHANES data, dietary intakes of 2- to 5-year-old children were analysed from a parent-reported 24-hour dietary recall (n = 3,429). Snacking occasions were aggregated to determine the proportion of total food/beverage intake obtained from snacks, estimate energy, and nutrient intakes, and identify the leading snack food sources of energy, added sugars, and total fat. Nearly all children consumed a snack on the reported day (62% morning, 84% afternoon, and 72% evening). Snacks accounted for 28% of total energy intake, 32% of carbohydrates, 39% of added sugars, and 26% of total fat and dietary fiber intakes for the day. Snacking occasions accounted for 46.6% of all beverages consumed on the reported day. Snacks and sweets food category (i.e., cookies and pastries) were the leading sources of energy (44%), total fat (52%), and added sugars (53%) consumed during snacking occasions. Sweetened beverages (e.g., fruit and sport drinks) contributed 1-quarter of all added sugars obtained from snacks. Snacks contribute considerable amount of energy and nutrients to young children's diets, with a heavy reliance on energy-dense foods and beverages. Targeted interventions are needed to improve the nutritional quality of snacks consumed by young children., (© 2017 John Wiley & Sons Ltd.)

Objective: To examine the nutrition and young child feeding (YCF) education and training of nurses in public health clinics of Ghana's Komenda-Edina-Eguafo-Abrem region (KEEA) in relation to global health guidelines, and how nurses served as educators for caregivers with children aged 0-5 years., Design: A qualitative study of semi-structured one-on-one and group interviews (n 21) following a questionnaire of closed- and open-ended questions addressing child feeding, nutrition and global health recommendations. Interviews were conducted in English, audio-recorded, transcribed and coded. Descriptive data were tabulated. Content analysis identified themes from open-ended questions., Setting: KEEA public health clinics (n 12)., Subjects: Nurses (n 41) purposefully recruited from KEEA clinics., Results: A model capturing nurses' nutrition and YCF education emerged with five major themes: (i) adequacy of nurses' basic knowledge in breast-feeding, complementary feeding, iron-deficiency anaemia, YCF and hygiene; (ii) nurses' delivery of nutrition and YCF information; (iii) nurses' evaluation of children's health status to measure education effectiveness; (iv) nurses' perceived barriers of caregivers' ability to implement nutrition and YCF education; and (v) a gap in global health recommendations on YCF practices for children aged 2-5 years., Conclusions: Nurses demonstrated adequate nutrition and YCF knowledge, but reported a lack of in-depth nutrition knowledge and YCF education for children 2-5 years of age, specifically education and knowledge of YCF beyond complementary feeding. To optimize child health outcomes, a greater depth of nutrition and YCF education is needed in international health guidelines.

Objectives: Fruit and vegetable intake (FVI) is below recommendations and fruit and vegetable liking (FVL) is associated with intake. Greater understanding of college student FVL and FVI is needed; therefore, the study objectives were to compare reported FVL and frequency of FVI in adulthood to recollection of FVL and frequency of fruit and vegetable offering (FVO) in childhood and identify factors related to FVL and FVI in college students., Methods: A retrospective survey was administered via e-mail to randomly selected college students (18-25 years) from 2 Northwestern universities (n = 676). McNemar's chi-square tests were used to evaluate differences in FVL and FVI scores. Spearman's rank identified an association between current FVL and FVI scores and their recollection of FVO as a child. Pearson's chi-square tests were used to examine differences in FVL and FVI scores within the demographic factors age, gender, year in school, urban/rural, body mass index (BMI), childhood overweight, breastfed, and forced to eat fruits or vegetables., Results: FVL was more frequent in adulthood, but college students reported FVO as a child more frequently than their current FVI. Females reported greater FVL and FVI. Upperclassmen and the 21-25 age group reported greater frequency of vegetable liking and intake compared to underclassmen and the 18-20 age group. Lower vegetable liking and fruit intake were reported for those identifying as overweight, and recollection of FVO in childhood was associated with increased FVL and FVI scores in adulthood. Individuals forced by caregivers to eat vegetables as a child reported a lower vegetable liking than those not forced., Conclusions: FVL increased from childhood to adulthood, demonstrating a progression; however, recollection of childhood offering was higher than FVI in young adulthood. Results indicate a need for behavioral strategies to increase FVI in college students and encourage offering fruit and vegetables but refrain from forcing children to eat vegetables.

Children are encouraged to eat a specific amount of fruits and vegetables to optimize health. The purpose of this study was to assess whether consumption of a variety of fruits and vegetables, respectively, was associated with a greater diet quality among preschool-aged children. Analyses were performed using a cross-sectional, nationally representative sample of US children. Dietary intakes from 24-h dietary recalls of two-five year old children ( n  = 2595) in 2005-2010 NHANES were examined. Diet quality was evaluated using MyPlate equivalents and the Healthy Eating Index 2010 (HEI-2010). Variety categories were determined based on children's fruit, fruit juice, and vegetable consumption on the recalled day. Differences in diet quality were examined using t -tests. Variety of fruits and vegetables was linked to higher overall diet quality. Children who consumed whole fruit had better diet quality scores for total fruit, whole fruit, whole grains, dairy, seafood, refined grains, sodium, and empty calories ( P  ≤ 0.018). Significantly higher HEI-2010 scores for total fruit, whole fruit, fatty acids, sodium, and empty calories, but a lower dairy HEI-2010 score, were identified in children who drank fruit juice ( P  ≤ 0.038). Vegetable consumption was significantly associated with higher total vegetables, greens/beans, and empty calories, but a lower sodium score ( P  ≤ 0.027). Children who consumed whole fruit, fruit juice and non-starchy vegetables ( P  ≤ 0.017), but not white potatoes, had significantly higher total HEI-2010 scores. Reinforcing fruit and 100% fruit juice consumption may indirectly support healthier diets among children. However, underlying associations between fruit and vegetable intakes and overall diet quality should be examined further.

Objective Appropriate and timely complementary feeding practices are fundamental to a child's growth, health, and development during the first 2 years of life. This study aimed to understand (1) Ghanaian mother's complementary feeding practices, and (2) their perceived and observed impacts of complementary feeding on their children. Methods Ghanaian mothers with children 4-24 months of age were recruited from four communities in the Komenda Edina Eguafo Abrem district in the Central Region of Ghana (n = 99). A qualitative methodological approach with focus group interview discussions was used. Eleven focus group interviews were conducted, and were audio recorded and transcribed. The audio transcriptions were coded and analyzed into pertinent themes, meta-themes, and theoretical concepts. Results Over 80 % (85) of mothers reported poor knowledge about the effects of complementary feeding on their children and 45 % (45) of the children were undernourished, indicating inappropriate complementary feeding practices. Some mothers held misconceptions about the effect of food on children's health. Four overarching themes were identified: (1) mothers' background knowledge about food, child health and growth outcomes, (2) mothers' motivation in feeding their children, (3) barriers to feeding, (4) foods mothers offered their children. Conclusion for Practice Nutrition education on complementary feeding is needed for Ghanaian mothers. Health facilities and community outreach programs could be a venue to provide education to mothers regarding infant and young child feeding practices in Ghana.

The communication component of the Child Care MAPP Web site was designed according to an established theoretical base, and was critically reviewed. The communication materials were targeted for use by trainers who educate child care providers, and may be incorporated into higher education curricula to guide nutrition educators who will be working in child nutrition and child feeding programs. Evaluation of the impact of the communication materials on a group of trainers demonstrated a significant increase in participant confidence to communicate about nutrition. In particular, the child- and adult-centered phrases developed as a novel and developmentally appropriate approach to nutrition education were evaluated by respondents as useful, and were found to increase confidence to communicate with children. Future research should further examine the use of child-centered and adult-centered nutrition phrases in nutrition education and higher education, to determine whether the way in which adults talk with children improves children’s knowledge about nutrition, and whether use of the phrases can positively affect children’s nutrition behaviors.

Objective: To identify characteristics in nutrition education video vignettes that support learning and motivation to learn about feeding children., Methods: Nine focus group interviews were conducted with child care providers in child care settings from 4 states in the western United States: California, Idaho, Oregon, and Washington. At each focus group interview, 3-8 participants (n = 37) viewed video vignettes and participated in a facilitated focus group discussion that was audiorecorded, transcribed, and analyzed., Results: Primary characteristics of video vignettes child care providers perceived as supporting learning and motivation to learn about feeding young children were identified: (1) use real scenarios; (2) provide short segments; (3) present simple, single messages; (4) convey a skill-in-action; (5) develop the videos so participants can relate to the settings; and (6) support participants' ability to conceptualize the information., Conclusions and Implications: These 6 characteristics can be used by nutrition educators in selecting and developing videos in nutrition education., (Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Background: Adults often ask health professionals for guidance on offering the appropriate serving sizes for young children and little research is available on whether serving size approaches meet children's nutrient needs., Objective: Determine whether three serving size approaches for young children meet dietary standards for nutrient adequacy., Design: We examined nutrient contents of three serving size approaches for children ages 2-5 years of age: 1 tablespoon per year of age (T/y), MyPyramid, and Child and Adult Care Food Program. Nutrient content of the three approaches were compared to the Estimated Energy Requirements (EER), Estimated Average Requirement (EAR), or Adequate Intake (AI) for each year of age for males and females; Analysis of Variance identified differences in nutrient content among the three approaches., Results: Young children's nutrient requirements were met for most nutrients by all approaches. However, the recommendation for vitamin E, potassium, and fat were not met by any approach, for any year, for either girls or boys. Energy content of the T/y serving size approach was below the EER for each year of age and for both sexes but still met minimal vitamin and mineral needs., Conclusion: Health professionals can feel comfortable using any of the three approaches. However, the T/y approach is a more graduated serving size approach, may be more consistently age appropriate for young children, and may be implemented more easily by adults., (Published by Elsevier Ltd.)