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This report presents prevalence estimates for dietary supplement use, number of dietary supplements used, and frequency of use for the most commonly used dietary supplements in the United States.

Background A previous community-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serosurvey in Delhi in January 2021 reported a seroprevalence of 50.52%. We conducted a repeat serosurvey to obtain a recent estimate of the seroprevalence of IgG SARS-CoV-2 in the general population of Delhi, India. Methods This cross-sectional study was conducted from September 24 to October 14, 2021, in 274 wards of Delhi among 27,811 participants through a multistage sampling technique. Results The crude seroprevalence was 89.5% (95% CI 89.1, 89.8), weight for age and sex was 88% (95% CI 87.6, 88.4), and after adjustment for assay performance was estimated as 97.5% (95% CI 97.0, 98.0). On adjusted analysis, the odds of seroconversion in the participants vaccinated with at least one dose of either COVID-19 vaccine (Covishield/Covaxin) was more than four times compared to the unvaccinated ones (aOR 4.2 (3.8, 4.6)). 86.8% of the seropositive individuals had a SARS-CoV-2 signal/cut-off ≥4.0 although it was significantly lower in the pediatric age group. Post-second wave (August to October 2021), on average there were daily 39 new COVID-19 cases and 0.44 deaths which during Omicron driven the third wave in January to March 2022 increased to daily 4,267 cases and 11.6 deaths. Conclusion A high prevalence of IgG antibodies against SARS-CoV-2 with likely higher antibody titres in the vaccinated compared to the unvaccinated groups with evidence of hybrid immunity in a majority of the population was protective against severe disease during transmission of subsequent omicron variants.

To ascertain the COVID-19 vaccination acceptance and the factors contributing to vaccine hesitancy and vaccine confidence in the adult population, and the intention for vaccination of their children.This cross-sectional analysis reports the ancillary results of a population-based SARS-CoV-2 serosurvey conducted in Delhi, India, from September 24 to October 14, 2021. Data were collected from 20312 adult participants through a multistage sampling method from all the 274 wards in the 11 districts of the national capital territory region. We enrolled 12093 (59.3%) females and 8219 (40.5%) male participants with mean (SD) age of 40.3 (14.6) years. The vaccine acceptance rate in the participants was 67.7% (95% CI 67.1, 68.4), with 6031 (43.8%) having received one dose and 7727 (56.2%) having received two vaccine doses. On adjusted analysis, lack of vaccine acceptance was independently associated with female gender aOR 1.15 (95% CI 1.1, 1.23), younger age-group (18-49 years) aOR 1.85 (95% CI 1.71, 2.0), low educational status aOR 1.88 (95% CI 1.77, 2.0), in those with no history of COVID-19 aOR 1.81 (95% CI 1.69, 1.95), non-healthcare workers aOR 2.1 (95% CI 1.7, 2.53), and in the absence of hypertension comorbidity aOR 1.22 (1.1, 1.38). Lack of awareness of COVID-19 vaccines, including doubts on vaccine efficacy and long-term safety, were primary drivers of vaccine hesitancy in the unvaccinated subgroup. Only 35.6% participants reported a positive intention to vaccinate their children.One in three adults lacked vaccine acceptance. High prevalence of delay in second dose vaccination was also observed.

This study (August-September 2021) estimated the seroprevalence of SARS-CoV-2 neutralizing antibodies in the general population of Delhi and correlated it with their anti-SARS-CoV-2 IgG levels. Samples were selected by simple random sampling method. The neutralizing capacity was estimated by performing a surrogate virus neutralization test (sVNT) (GenScript), Piscataway, NJ, USA. A total of 2233 (87.1%, 95% C.I. 85.7, 88.3) of the 2564 SARS-CoV-2 IgG seropositive samples had detectable SARS-CoV-2 neutralizing antibodies. In samples with S/CO ​≥ ​4.00, the neutralizing antibodies ranged from 94.5% to 100%. The SARS-CoV-2 neutralizing antibody seroprevalence strongly correlated with the S/CO range of IgG SARS-CoV-2 (r ​= ​0.62, p ​= ​0.002).

We conducted this study to estimate seroprevalence of neutralizing antibodies in the general population and to further correlate it with the IgG SARS-CoV-2 IgG levels. This present cross-sectional analysis was conducted as a sequel to a state level community-based seroepidemiological study in Delhi, India. A total of 2564 seropositive samples were selected from 25622 seropositive samples through simple random sampling. Neutralizing capacity was estimated by performing a surrogate virus neutralization test with the sVNT (GenScript) assay. Neutralizing antibody against the SARS-CoV-2 virus was operationally considered as detected when the signal inhibition was ≥30%.A total of 2233 (87.1%, 95% C.I. 85.7, 88.3) of the 2564 SARS-CoV-2 seropositive samples had detectable neutralizing antibodies. On bi-variate analysis but not on adjusted analysis, Covid-19 vaccination showed a statistically significant association with the presence of neutralizing antibodies (p

Introduction This study aimed to determine the breakthrough infection rate of coronavirus disease 2019 (COVID-19) (severe acute respiratory syndrome coronavirus 2 {SARS-CoV-2}) infection in healthcare workers (HCWs) vaccinated with either BBV152 or AZD1222 (ChAdOx1-S) vaccine. Methods A cross-sectional analysis was conducted at a medical college and hospital complex in Delhi, India, through telephonic interviews among HCWs who had received at least one dose of a COVID-19 vaccine during January-March 2021. Breakthrough infections were operationally defined as the occurrence of COVID-19 infection >= 14 days after administration of two doses of either COV1D-19 vaccine. Data were entered in Epidata 3.1 (Odense, Denmark: EpiData Association) (single entered) and analyzed with IBM SPSS version 25 (Armonk, NY: IBM Corp.). A p-value < 0.05 was considered statistically significant. Results We enrolled 325 HCWs with a mean (SD) age of 29.1 (9.9) years including 211 (64.9%) males and 114 (35.1%) females. A total of 37 (13.3%, 95% CI 9.8, 17.7) COVID-19 breakthrough infections were observed in the HCWs. Additionally, 20 (6.1%) non-breakthrough infections were reported in the HCWs who were vaccinated with at least a single dose of a COVID-19 vaccine, or both doses, but prior to 14 days since the administration of the second dose. Most breakthrough infections were mild without needing supplemental oxygen for recovery. Conclusion Nearly one in seven HCWs experienced a COVID-19 breakthrough infection in the present study. A history of SARS-CoV-2 natural infection followed by at least one dose of COVID-19 vaccination was associated with significant protection against breakthrough infections.

Background Adult immunization has recently emerged as an area of emphasis in research and policy. Increasing life expectancy, outbreaks like COVID-19, and the endemic nature of diseases like dengue, malaria have underscored its importance. Therefore, this study was carried out with the aim to assess hesitancy and factors influencing the uptake of vaccines in adults. Methods An online cross-sectional study was conducted among adults (age more than 20 years). Data collection was done by convenience sampling in January 2021. Information on awareness and perceptions regarding adult vaccination and immunization status of participants was collected. Data analysis was done using SPSS version 21. Results A total of 461 adults responded to the survey. Among those who had never received any vaccine in adulthood (n = 158), the reasons were lack of recommendation by healthcare providers (38.6%), lack of knowledge of vaccines (15.8%) and fear of adverse effects following vaccination (7.6%). Hesitancy for vaccines among those who were informed by healthcare workers was as follows: shingles (97.8%), human papillomavirus (92.1%), pneumococcal (91.1%), influenza (79.7%), varicella (79.4%) and tetanus (57.6%). Conclusions Reduced vaccine uptake due to vaccine hesitancy in adulthood is a major health concern. Hesitancy was highest for the shingles vaccine and least for the tetanus vaccine. Key messages Coverage of adult vaccination can be improved by formulating national guidelines and encouraging healthcare providers to raise awareness. In-depth qualitative studies are needed to understand the perception of adults towards vaccination.

IntroductionThe study objective was to determine the breakthrough infection rate of Covid-19 (SARS-CoV-2) infection in those vaccinated with either BBV152 or AZD1222 (ChAdOx1-S) vaccine among healthcare workers (HCWs).MethodsA cross-sectional analysis was conducted a medical college and hospital complex in Delhi, India through telephonic interviews among HCWs who had received at-least one dose of a Covid-19 vaccine during January to March’ 2021. Breakthrough infections were operationally defined as occurrence of Covid-19 infection ≥14 days after administration of two doses of either Covid-19 vaccine.ResultsWe enrolled 325 HCWs with mean (SD) age of 29.1 (9.9) years including 211 (64.9%) males. Two seventy nine (85.8%) HCWs were fully vaccinated while 46 (14.2%) were partially vaccinated. There were 168 (51.7%) BBV152 and 157 (48.3%) AZD1222 (ChAdOx1-S) recipients.A total of 37 (11.3%, 95% C.I. 8.3, 15.3) breakthrough infections were observed in the HCWs. The median (IQR) time until incidence of Covid-19 breakthrough infection since receiving second dose of either Covid-19 vaccine was 47 (28.5, 55) days. Additionally, 20 (6.1%) non-breakthrough Covid-19 infections were recorded in the HCWs post vaccination with either a single dose of a Covid-19 vaccine or both doses but prior to a period of 14 days since administration of the second dose.Most breakthrough infection cases (94.4%) were mild and did not require supplemental oxygen therapy. HCWs without a history of natural Covid-19 infection and recovery prior to vaccination were 3.8 times more at risk to contract a Covid-19 infection or reinfection in spite of vaccination with at-least one dose of either Covid-19 vaccine.ConclusionNearly one in nine HCWs experienced a Covid-19 breakthrough infection in the present study.

Dietary supplement use is common in the United States (1). The additional nutrients provided by dietary supplements can help meet recommended nutrient targets but can also potentially lead to excess intakes (2,3). This report describes recent prevalence estimates for dietary supplement use among U.S. adults, the distribution of the number of dietary supplements used, and the most common types of dietary supplements used. Trends in dietary supplement use from 2007-2008 through 2017-2018 are also reported.

Dietary supplement use is common in the United States (1). The additional nutrients provided by dietary supplements can help meet recommended nutrient targets but can also potentially lead to excess intakes (2,3). This report describes recent prevalence estimates for dietary supplement use among U.S. adults, the distribution of the number of dietary supplements used, and the most common types of dietary supplements used. Trends in dietary supplement use from 2007-2008 through 2017-2018 are also reported.

To help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease, the 2015-2020 Dietary Guidelines for Americans recommend following a healthy eating pattern across the lifespan (1). Some people adhere to specific eating patterns, otherwise known as special diets, for the purposes of weight loss or other health-related reasons. This report shows the percentage of U.S. adults who, on a given day, were on any special diet and specific types of special diets in 2015-2018 and trends from 2007-2008 through 2017-2018.

Ultra-high-performance fibre-reinforced concrete (UHPFRC) is a comparatively new generation of fibre-reinforced composites that have been developed to give outstanding material performance than other types of concrete. Such superior properties have been achieved through the use of an optimized combination of its ingredients like cement, fine sand, microsilica, high range water reducing agent, low w/c ratio and fibres. A detailed study on the mechanical properties of UHPFRC, considering various important factors, is authoritative in order to obtain necessary information for its practical application. Therefore, present paper reviewed the mechanical properties and impact resistance of UHPFRC. It is examined whether (1) UHPFRC is able to absorb sufficient mechanical energy under impact loading than that of normal strength concrete with and without fibres; (2) the use of hybrid steel fibre (long + short) is effective in improving the impact resistance of UHPFRC compared to containing single type of fibres.

Evenly distributing daily protein intake at meals has been suggested to improve muscle mass among older adults. The aim of this research is to evaluate protein intake and its distribution across three meal types (breakfast, lunch, and dinner). Nationally representative dietary intake data of adults aged 51 years and older who reported consuming breakfast, lunch, and dinner on the intake day from What We Eat in America, National Health and Nutrition Examination Survey (NHANES) 2011–2012, were analyzed. Total mean daily protein intake and protein intake per meal type were determined. The proportion of individuals consuming ≥25 g protein per meal type and across all three meal types was estimated. Of men and women aged 51 years and over, 64% and 71% consumed three meal types on the intake day, respectively. Men had significantly higher mean daily protein intake than women (84.4 ± 2.33 g vs. 60.9 ± 1.21 g, p

Background: Fruits and vegetables are a rich source of essential micronutrients i.e. vitamins/minerals and dietary fibers required for the normal daily functionality of the body. Young adults such as medical students are a particularly vulnerable population in terms of health issues and adequate diet. Objective of the study was to find the pattern of fruits and vegetables consumption in undergraduate medical students of Delhi.Methods: A cross-sectional study was planned among 300 undergraduate students from medical college in New Delhi. The questionnaire consisted of questions about identification data, pattern of fruit and vegetable consumption. Data was analyzed by SPSS software version 21.0 and for qualitative data analysis chi-square test was used.Results: Mean age of study subjects was 20.82±2.1 years and females (52.7%) were more as compared to (47.3%) males. Out of 300 participants, only one third (33.3%) of study participants consumed more than five servings of fruits and vegetables. More than half of study participants felt that unsafe use of pesticides, difficult to eat five servings in a day, poor handling and poor quality of fruits and vegetables were the most common barriers in consumption of FVs. Age and semester of study participants and education status of mothers were found significant predictors of consumption of recommended number of serving of FVs in day. Conclusions: This study concludes that only one third of study participants consumed more than five servings of fruits and vegetables which is recommended number of serving in a day. So, there is a need to increase awareness about importance of fruits and vegetables consumption among study population.

Background: Scientific research forms an important foundation for producing doctors with an understanding of evidence-based medicine. Medical education in India over a period has largely remained unchanged with a very low emphasis on research and publication. Objective of the study was to assess the knowledge, attitude and practice towards scientific research among undergraduate students of a medical college in Delhi, India.Methods: A cross sectional study was planned among 240 undergraduate students from five semesters of medical college in New Delhi. The questionnaire consisted of questions about identification data, knowledge, attitude and practices of scientific research. Data was analyzed by SPSS software version 21.0 and for qualitative data analysis Chi-square test was used.Results: Mean age of study subjects was 20.68±1.87 years and more than half (59.6%) of them were males and (40.4%) were females. Out of 240 participants, only (13.5%) had excellent knowledge about scientific research. Majority (89.6%) of them felt that research work should be a part of the medical curriculum. About one fourth (22.9%) of study participants had done a scientific research. Age of study participants and better knowledge were found significant predictors of conducting research among study participants.Conclusions: This study concludes that only few study participants had excellent knowledge and practice scientific research but majority of them had positive attitude towards research. So, there is a need to increase awareness about scientific research from an early level in the curriculum among study population.

This research investigated the structural properties (i.e., compressive, tensile, and flexural strength) of different types of ultra-high-performance fiber-reinforced concrete (UHPFRC) with various fibers volume fraction (i.e., 0–4%) and properties compared with a normal strength concrete (NSC) mix. The straight micro steel fibers with aspect ratios (65 and 30) were considered for UHPFRC. The compressive strength exceeded 121 MPa with a water–cementitious material ratio of 0.20 after steam curing. The results of this investigation confirmed that UHPFRC exhibited superior mechanical performance compared to NSC. The increase of fiber volume content showed that mechanical properties of the UHPFRC also increased. It can be seen from the tensile strength tests that NSC and UHPFRC specimen without fiber ended with sudden brittle failure, on the other hand, the specimens made of UHPFRC containing fibers show ductile behaviors. Compressive strength, splitting tensile strength, direct tensile strength, and flexural performance were improved by increasing the fiber volume fraction.

Purpose. To determine whether a plant-based nutrition program in a multicenter, corporate setting improves depression, anxiety, and productivity. Design. A quasi-experimental study examined the impact of diet on emotional well-being and productivity. Setting. The study was conducted in 10 corporate sites of a major U.S. insurance company. Subjects. There were 292 participants (79.8% women, 20.2% men), with body mass index ≥25 kg/m2 and/or previous diagnosis of type 2 diabetes. Intervention. Either weekly instruction in following a vegan diet or no instruction was given for 18 weeks. Measures. Depression and anxiety were measured using the Short Form-36 questionnaire. Work productivity was measured using the Work Productivity and Activity Impairment questionnaire. Analysis. Baseline characteristics were examined by t-test for continuous variables and χ2 test for categorical variables. Analysis of covariance models were adjusted for baseline covariates. Paired t-tests were used to determine within-group changes and t-tests for between-group differences. Results. In an intention-to-treat analysis, improvements in impairment because of health (p < .001), overall work impairment because of health (p = .02), non-work-related activity impairment because of health (p < .001), depression (p = .02), anxiety (p = .04), fatigue (p < .001), emotional well-being (p = .01), daily functioning because of physical health (p = .01), and general health (p = 0.02) in the intervention group were significantly greater than in the control group. Results were similar for study completers. Conclusion. A dietary intervention improves depression, anxiety, and productivity in a multicenter, corporate setting.

Introduction Distributing daily protein intake evenly across meals (∼25–30g/meal) has been suggested to improve muscle mass. The aim of this research is to examine the association between grip strength, total protein intake and its distribution across day’s meals in older adults. Methods Nationally representative dietary intake data of adults aged 51 years and older (n = 4,123) who participated in What We Eat in America, NHANES 2011–2014 were analyzed. Protein intake per day and per eating occasion (breakfast, lunch, dinner, and snack) were determined. Combined grip strength was calculated and expressed in kilograms. Grip strength of individuals consuming ≥25g protein at 1 eating occasion was compared with those consuming same level of protein at 2 and 3 or more eating occasions. Grip strength of individuals in quartile 1 of daily protein intake was compared to those in the other quartiles. All associations were examined without and with adjustment for age, race/ethnicity, physical activity, health status, and smoking status. The comparison involving eating occasions and protein intake quartiles were further adjusted for daily protein intake and energy intake, respectively. Results Only 33% of men and 19% of women had protein intake of ≥25g at 2 or more eating occasions. These individuals also had higher grip strength and daily protein intake. Grip strength was positively associated with consumption of ≥25g protein at 2 eating occasions as compared to consumption of same level of protein at 1 eating occasion (p

Background/objectives: To assess the effects on macro- and micronutrient intake of a nutrition intervention program in corporate settings across the United States. Subjects/methods: Two hundred and ninety-two individuals who were overweight or had type 2 diabetes were recruited from 10 sites of a US insurance company. Two hundred and seventy-one participants completed baseline diet recalls, and 183 participants completed dietary recalls at 18 weeks. Sites were randomly assigned to an intervention group (five sites) or to a control group (five sites) for 18 weeks. At intervention sites, participants were asked to follow a low-fat vegan diet and attend weekly group meetings. At control sites, participants continued their usual diets. At baseline and 18 weeks, participants completed 2-day diet recalls. Between-group differences in changes in nutrient intake were assessed using an analysis of covariance. Results: Compared with those in the control group, intervention-group participants significantly reduced the reported intake of total fat (P=0.02), saturated (P=0.006) and monounsaturated fats (P=0.01), cholesterol (P=0.009), protein (P=0.03) and calcium (P=0.02), and increased the intake of carbohydrate (P=0.006), fiber (P=0.002), β-carotene (P=0.01), vitamin C (P=0.003), magnesium (P=0.04) and potassium (P=0.002). Conclusions: An 18-week intervention program in a corporate setting reduces intake of total fat, saturated fat and cholesterol and increases the intake of protective nutrients, particularly fiber, β-carotene, vitamin C, magnesium and potassium. The reduction in calcium intake indicates the need for planning for this nutrient.

Background/objectives: To determine the effects of a low-fat plant-based diet program on anthropometric and biochemical measures in a multicenter corporate setting. Subjects/methods: Employees from 10 sites of a major US company with body mass index ⩾25 kg/m2 and/or previous diagnosis of type 2 diabetes were randomized to either follow a low-fat vegan diet, with weekly group support and work cafeteria options available, or make no diet changes for 18 weeks. Dietary intake, body weight, plasma lipid concentrations, blood pressure and glycated hemoglobin (HbA1C) were determined at baseline and 18 weeks. Results: Mean body weight fell 2.9 kg and 0.06 kg in the intervention and control groups, respectively (P

Objective Elevated levels of serum leptin are associated with increased adiposity and production of pro-inflammatory cytokines. Both cytokines and body adiposity have been shown to predict cardiovascular events and mortality. The primary objective of the present study is to explore the associations between serum leptin and all-cause mortality and mortality from cardiovascular disease (CVD) over a span of 10 years, controlling for body adiposity and proinflammatory cytokines. Methods The Health, Aging and Body Composition (Health ABC) study is a prospective cohort of 3,075 older adults aged 70 to 79 years. This analysis includes 2,919 men and women with complete serum leptin and vital status data. Data on all-cause mortality and incident cardiovascular events (including Coronary Heart Disease and Congestive Heart Failure) were collected over 10 years of follow-up (mean 8.4 years). Results Women with leptin in quartile 2 and 3 were at lower risk of all-cause mortality, and those with leptin in quartile 2 were at lower risk of mortality from CVD as compared to women with lowest leptin values when adjusted for age, race, site, years of education, alcohol use, smoking, and physical activity. When these associations were additionally adjusted for body fat, C-reactive protein and pro-inflammatory cytokines, women with leptin values in quartile 3 were at lower risk of all-cause mortality and women with leptin in quartile 2 and 3 were at lower risk of mortality from CVD than women with lowest leptin values. These associations were not significant among men after adjusting for body fat and cytokines. Conclusions The present study suggests that moderately elevated concentrations of serum leptin are independently associated with lower risk of all-cause mortality and CVD-related mortality among older women. Among men, serum leptin is not associated with reduced risk of all-cause and CVD mortality after controlling for body fat and cytokines.

Background. Abdominal adiposity and serum leptin increase with age as does risk of metabolic syndrome. This study investigates the prospective association between leptin and metabolic syndrome risk in relation to adiposity and cytokines.Methods. The Health, Aging, and Body Composition study is a prospective cohort of older adults aged 70 to 79 years. Baseline measurements included leptin, cytokines, BMI, total percent fat, and visceral and subcutaneous fat. Multivariate logistic regression was used to determine the association between leptin and metabolic syndrome (defined per NCEP ATP III) incidence after 6 years of follow-up among 1,120 men and women.Results. Leptin predicted metabolic syndrome in men (Pfor trend = 0.0002) and women (Pfor trend = 0.0001). In women, risk of metabolic syndrome increased with higher levels of leptin (compared with quintile 1, quintile 2 RR = 3.29, CI = 1.36, 7.95; quintile 3 RR = 3.25, CI = 1.33, 7.93; quintile 4 RR = 5.21, CI = 2.16, 12.56; and quintile 5 RR = 7.97, CI = 3.30, 19.24) after adjusting for potential confounders. Leptin remained independently associated with metabolic syndrome risk after additional adjustment for adiposity, cytokines, and CRP. Among men, this association was no longer significant after controlling for adiposity.Conclusion. Among older women, elevated concentrations of leptin may increase the risk of metabolic syndrome independent of adiposity and cytokines.