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Introduction: Tuberous sclerosis complex (TSC) is a genetic disease caused by pathogenetic variants in either the TSC1 or TSC2 genes. Consequently, the mechanistic target of the rapamycin complex 1 (mTORC1) pathway, a regulator of cell growth, metabolism, and survival, becomes inappropriately activated, leading to the development of benign tumors in multiple organs. The role of mTORC1 in lipid metabolism and liver steatosis in TSC patients has not been well-studied, and clinical data on liver involvement in this population are scarce. Methods: We conducted a retrospective, cross-sectional study to compare liver steatosis in TSC patients with age-, sex-, BMI-, and diabetes status-matched controls. Participants with a definite diagnosis of TSC were recruited from the TSC clinic at UZ Brussel. Liver steatosis was quantified using the fat signal fraction from in-phase and out-of-phase MRI, with a threshold of ≥5% defining the presence of steatosis. We also evaluated the prevalence of liver angiomyolipomata in the TSC group and analyzed risk factors for both liver steatosis and angiomyolipomata. Results: The study included 59 TSC patients and 59 matched controls. The mean fat signal fraction was 4.0% in the TSC group and 3.9% in the controls, showing no significant difference (two-tailed Wilcoxon signed ranks test, p = 0.950). Liver steatosis was observed in 15.3% of TSC patients compared to 23.7% of the controls, which was not statistically significant (two-tailed McNemar test, p = 0.267). Liver angiomyolipomata were identified in 13.6% of the TSC cohort. Conclusions: Our study, describing in detail the liver phenotype of TSC patients, did not reveal a significant difference in the prevalence of MRI-assessed liver steatosis in a large cohort of TSC patients compared to a closely matched control group.

The current society consists of an increasing number of people vulnerable to infections. For certain people with severe immunodeficiency, a neutropenic or low-microbial diet is being prescribed, which substitutes high-risk foods that are more likely to contain human (opportunistic) pathogens with lower-risk alternatives. These neutropenic dietary guidelines are typically set up from a clinical and nutritional perspective, rather than from a food processing and food preservation perspective. In this study, the current guidelines in use by the Ghent University Hospital were evaluated based on the current knowledge of food processing and preservation technologies and the scientific evidence on microbiological quality, safety, and hygiene of processed foods. Three criteria are identified to be important: (1) the microbial contamination level and composition; (2) the potential presence of established foodborne pathogens such as Salmonella spp. (to which a zero-tolerance policy is recommended); and (3) an increased vigilance for L. monocytogenes as an opportunistic foodborne pathogen with a high mortality rate in immunocompromised individuals (to which a zero-tolerance policy should apply). A combination of these three criteria was used as a framework for the evaluation of the suitability of foodstuffs to be included in a low-microbial diet. Differences in processing technologies, initial contamination of products, etc., however, lead to a high degree of variability in microbial contamination and make it difficult to unambiguously accept or reject a certain type of foodstuff without prior knowledge of the ingredients and the processing and preservation technologies applied during manufacturing and subsequent storage conditions. A restricted screening on a selection of (minimally processed) plant-based foodstuffs on the retail market in Flanders, Belgium supported decision-making on the inclusion of these food types in a low-microbial diet. Still, when determining the suitability of a foodstuff to be included in a low-microbial diet, not only the microbiological status but also nutritional and sensorial properties should be assessed, which requires multidisciplinary communication and collaboration., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 De Bock, Jacxsens, Maes, Van Meerhaeghe, Reygaerts and Uyttendaele.)

Background: Sport-for-All emphasizes that every individual has the right to participate in sport. Despite all efforts to deliver Sport-for-All during the past decades, studies indicate that sport participation rates have been stagnating, whereas social inequalities in sport continue to exist. By applying an institutional theory lens, this study sheds light on how the dual mission of sport federations, i.e., providing Sport-for-All and high performance sport, affects the Sport-for-All projects of Flemish sport federations (e.g., amount of projects and target groups). In particular, Sport-for-All projects have to reduce barriers to engage in the sport system and be supported by a sport federation. Furthermore, this study seeks to better understand the impact of the underlying institutional logic on the institutional pressure and legitimacy of the sport federations., Method: This study implemented a cross-sectional field study in sport federations. In particular, the sport federations selected for our study are the 47 Flemish sport federations. Both qualitative (i.e., document analysis) and quantitative research methods (i.e., a new questionnaire was developed based on institutional theory) were applied in the study., Results: Results indicated that sport federations are important partners in support of Sport-for-All projects, but also suggested that there is a discrepancy between the projects of the high performance-oriented and the Sport-for-All-oriented federations. Specifically, the high performance-oriented federations were targeting youth participants, whereas Sport-for-all-oriented federations aimed to reach disadvantaged groups. Furthermore, the results indicated that high performance-oriented federations endured more institutional pressure than Sport-for-All-oriented federations., Conclusion: The results of our study indicated that the Sport-for-All projects of performance-oriented federations are often more superficial compared to Sport-for-All oriented federations, and that the latter federations play an important role in attaining public health targets. Moreover, policymakers should consider how they can optimize the role of the performance-oriented federations in the Sport-for-All delivery (e.g., they could function as a bridge to guide participants who prefer a less competitive setting towards Sport-for-All oriented federations)., (© 2022. The Author(s).)