Browse Articles

Monitoring sodium content in packaged foods sold in the Americas and compliance with the updated regional sodium reduction targets

Background Sodium reduction is a cost-effective measure to prevent noncommunicable diseases. The World Health Organization (WHO) established a target of a 30% relative reduction in mean population intake of sodium by 2025. The Pan American Health Organization (PAHO) published sodium reduction targets (SRTs) for packaged foods in 2015, expanding and updating the targets in 2021 to help Member States with its efforts in reducing population sodium intake. Objective This study examined the current sodium levels in packaged foods among five countries in the Americas and monitored cross-sectional and longitudinal compliance with the sodium targets from 2015 to 2022. Methods Food labels were systematically collected from the main supermarkets in five countries in the Americas region in 2022. Sodium levels per 100g and per kcal for collected food labels in 16 PAHO categories and 75 subcategories were analyzed and compared against the updated SRTs. Further analysis of three countries that have longitudinal data for 2015–2016, 2017–2018 and 2022 was conducted to compare sodium per 100 g against the 2015 SRTs. Results A total of 25,569 food items were analyzed. Overall, ‘processed meat and poultry’ had the highest sodium levels, although there were large variations within categories. 47% and 45% of products met the sodium per 100g and per kcal 2022 SRTs, respectively. Peru had the highest compliance, whereas Panama had the lowest for both targets. Among Argentina, Costa Rica and Peru, the proportion of foods meeting the 2015 PAHO lower targets were 48, 53 and 61% for 2015–2016, 2017–2018 and 2022, respectively (p < 0.001). Conclusions This study showed that around half of the examined foods met their respective SRTs and there have been small improvements in compliance over time. Further efforts are required to reach the WHO’s global sodium reduction goal by 2025, such as implementation of mandatory SRTs and front-of-pack labelling regulations.

Application Overload — A Call to Reduce the Burden of Applying to Medical School

Possible sarcopenia and depression among middle-aged and older adults in China: A 9-year longitudinal survey

Possible sarcopenia (PS) and depression are prevalent among middle-aged and older adults. However, few studies have evaluated the causal association between depression and PS, as well as its components. This study conducted both cross-sectional and longitudinal analyses to explore the relationship between PS and depression in a population aged 45 and oledr. We evaluated the association between PS and its components with depression using data from the China Health and Retirement Longitudinal Study (CHARLS). PS was assessed according to the Asian Working Group for sarcopenia gudielines established in 2019 (AWGS 2019). Depression was measured by the validated 10-item Center for Epidemiological Studies Depression Scale (CES-D.10), with a cut-off score of 12 or higher indicating the presence of depression. 10,058 participants included in cross-sectional study and 5,726 participants without depression from the same cohort in 2011 were followed through 2020. Logistic regression and Cox proportional hazards models were employed to assess the association between PS and its components with depression. Restricted cubic spline (RCS) model was utilized to evaluate dose-response relationshipbetween muscle strength and physical performance with depression, and subgroup analyses were performed to validate the robustness of the findings. Cross-sectional analysis revealed that the prevalence of PS among middle-aged and older adults was 32.84% (3,303/10,058). Both PS (OR:1.47,95%CI:1.34–1.63), low muscle strength (LMS) (OR:1.46,95%CI:1.24–1.71) and low physical performance (LPP) (OR:1.45,95%CI:1.31–1.61) exhibited higher odds of depression after adjusting covariates. 1515 cases (26.46%) of incident depression were identified during the 9-years follow-up. Subjects with PS (HR:1.10,95%CI:1.01–1.19), LMS (HR:1.16,95%CI:1.01–1.34) and LPP (HR:1.08,95%CI:1.01–1.18) were at an elevated risk of new-onset depression compared to those without these conditions. The RCS analysis demonstrated a non-linear relationship between muscle strength and physical performance with depression (p > 0.05). Participants aged 50–59, married, with education below middle school, living in rural areas, non-smokers or non-drinkers, sleeping less than 8 hours, and classified as obese exhibited an increased risk in subgroup analysis. (all p <  0.05). PS, LMS and LPP were indentified as independent risk factors for new-onset depression. It is essential to assess muscle strength and physical performance in community-dwelling middle-aged and older adults using simple and feasible objective measures to enhance depression screening.

Modest Blood Pressure Increase with Age in Adults with Down’s Syndrome

The evolution of bone-eating worm diversity in the Upper Cretaceous Chalk Group of the United Kingdom

The bone-eating worm Osedax is today a member of the highly adapted invertebrate assemblages associated with whale carcasses on the ocean floor. The worm has also been found in a variety of other vertebrates in marine environments. Osedax borings are represented by the trace fossil Osspecus, which has been identified in fossil whales and marine reptiles, with the earliest occurrence in the Albian. In studies of present-day whale bones it has been found that individual species of Osedax create distinct boring morphologies. The diversity of boring geometries therefore provides a proxy for species diversity that can be applied to the fossil record to better understand the diversity, ecology, and evolution of extinct Osedax species. We examined marine reptile fossils from the Upper Cretaceous Chalk Group of the United Kingdom, and found five previously undocumented boring morphologies. These results, coupled with a re-examination of previous records of Osspecus, led to the naming of seven new ichnospecies. Using nannofossil biostratigraphy from the chalk, we constrained the ages of these occurrences and found a high species diversity in the early Late Cretaceous, indicating either a rapid diversification or an earlier origin for Osedax than previously estimated. Furthermore, we recognise five Cretaceous ichnospecies that are also found in the Cenozoic, three of which are also found in present-day whale bones.

Association between Wealth and Mortality in the United States and Europe

The supplemental nutrition assistance program and older adults: A scoping review protocol

Objective The objective of this scoping review is to describe the scope of original published research on SNAP and older adults. Introduction Food insecurity among older adults in the United States is a significant public health issue. Participation in the Supplemental Nutrition Assistance Program (SNAP), the largest nutrition assistance program in the United States, by older adults is lower than the overall participation rate. Inclusion criteria This scoping review will include original research focused on older adults (aged 60 years and older) and participation in SNAP. Studies should address at least one of the following: examining one or more outcomes related to participation in SNAP, facilitators or barriers to SNAP participation, and/or evaluation of a program, policy or other strategy for influencing SNAP participation. Methods Databases to be searched include PubMed, Scopus, CINAHL, and ProQuest. Sciwheel will be used for deduplicating references that will be imported into Covidence for screening and extracting data. Two independent reviewers will screen titles/abstracts followed by full-text articles to assess whether articles meet inclusion criteria and then complete a data extraction template for each included article. A third reviewer will resolve any discrepancies. The findings will be summarized and presented in tables and narrative form.

Cervical Cancer

Study protocol: LIAM Mc trial (Linking In with Advice and supports for Men impacted by Metastatic cancer)

Background The significant increase in cancer survivorship rates necessitates a comprehensive, multidisciplinary approach to supportive care services. This study seeks to assess the feasibility of introducing a Men’s Health Initiative supportive care intervention program in Ireland. Methods This is a single-arm feasibility study involving a 12-week men’s cancer survivorship programme alongside routine follow-up care in patients with advanced genitourinary malignancies. Men with advanced/metastatic genitourinary cancer (including prostate, kidney, urothelial tract, testicular or penile cancer), are eligible to enrol, with a target of 72 participants over a 2-year period. The intervention programme entails a twice-weekly physiotherapy-led exercise programme, along with dietetics, nursing, and psychosocial components, and regular signposting to additional available services. A Pilot Phase involving analysis of data from the first group of 6 participants to complete the programme is planned, before an Expansion Phase. Assessments will occur at baseline, on completion of the 12-week intervention, and 3 months post-intervention, and will include analyses of exercise/activity levels, body composition, muscle strength, psychological wellbeing, quality of life and resources utilised. The primary endpoints are to determine the feasibility and acceptability of introducing a men’s cancer survivorship intervention programme into routine follow-up care in patients with advanced genitourinary malignancies. Secondary endpoints include impact of the intervention programme on quality of life, cancer-related fatigue, maintenance of weight, changes in body composition and changes in dietary intake and diet quality over the study period, as well as self-care agency and its relationship to quality of life and symptoms experienced. A qualitative process evaluation will be undertaken to explore participants’ experiences, while an economic analysis will examine the healthcare resource utilization and costs associated with the intervention. The trial was peer-reviewed by the Irish Cancer Society. Discussion The programme described in this protocol provides a supportive and safe environment for the introduction of self-care interventions using a small group-based format supported by individualised counselling according to the participant’s identified needs. The development and implementation of future supportive care programmes for men’s cancer survivorship will be guided by the findings of this study. Trial registrartion ClinicalTrials.gov NCT05946993

A “Hot” Cardiomyopathy

Stable topical application of antimicrobials using plumbing rings in an ex vivo porcine corneal infection model

Microbial keratitis (MK) is a substantial cause of clinical blindness worldwide. Pseudomonas aeruginosa is an opportunistic Gram-negative bacterium and is the leading cause of MK. Infection models are vital tools in understanding host-pathogen interactions and the development of novel therapies. As well as ethical and practical advantages, ex vivo infection models enable researchers to study host-pathogen interactions with greater accuracy and physiological relevance compared to traditional cell culture systems. The versatility of porcine corneal ex vivo models have been employed to study various pathogens (for example Staphylococcus aureus and Acanthamoeba) and has enabled innovation of novel MK therapies. Here, we describe an improved porcine corneal ex vivo protocol, which uses plumbing rings and medical adhesive to circumvent several distinct limitations and challenges. The application of a 10 mm plumbing ring to the center of the cornea allows localized inoculation of pathogens of interest, maintaining them at the site of infection, rather than running the risk of “run off” of topically added aqueous solutions. The second important advantage is that topically applied therapeutic agents can be properly maintained on the cornea within the plumbing ring reservoir, allowing more accurate study of antimicrobial effects. In this contextualized protocol, we infected porcine corneas with the P. aeruginosa strain PA103 with topical treatments of moxifloxacin. PA103 colony-forming unit (CFU) quantification, spectrophotometric measurement of corneal opacity, and histological analysis of stromal edema using hematoxylin and eosin staining were employed to assess infection over 48 hours. Moxifloxacin treatment demonstrated a dose-dependent reduction in infection and corneal damage. These findings have contributed to the development of an improved and standardized ex vivo infection model for evaluating therapeutic interventions, potentially supporting clinical translation to alleviate the burden of microbial keratitis.

A Letter of Recommendation Regarding Impersonal Personal Statements

Millimetre-scale bioresorbable optoelectronic systems for electrotherapy

Sub-sector, property rights system, and performance of China’s tourism enterprises: DEA and Luenberger approach

This study is designed to delve into the efficiency and total factor productivity (TFP) of tourism enterprises, aiming to uncover the sources of variation in these metrics. To meet this objective, we have employed the data envelopment analysis (DEA) approach and the Luenberger index—making it the inaugural application within the tourism industry—to assess efficiency and TFP. Our findings indicate that the tourism industry boasts high efficiency, with progress in TFP and its component factors. In our quest to identify the determinants of efficiency and TFP, the research has taken into account sub-sectors and the property rights system. It has been revealed that there are notable efficiency disparities among different sub-sectors, while differences in TFP are not significant. When examining the property rights system, we found significant efficiency and TFP differences between state-owned enterprises (SOEs) and non-SOEs. To the best of our knowledge, this research pioneers the application of nonparametric analysis to differentiate the performance disparities in tourism enterprises attributable to the property rights system. Furthermore, we have constructed a decision-making matrix that incorporates an enterprise’s efficiency, TFP, and scale. This matrix allows each enterprise to precisely pinpoint its position, enabling managers to formulate targeted strategies for performance enhancement.

Neonatal Lupus

RUNX2 promotes fibrosis via an alveolar-to-pathological fibroblast transition

Elucidating the impact of Hypericum alpestre extract and L-NAME on the PI3K/Akt signaling pathway in A549 lung adenocarcinoma and MDA-MB-231 triple-negative breast cancer cells

Plants of the Hypericaceae family have been traditionally used for their medicinal properties, including antibacterial, antiviral, and antioxidant activities. Among these, Hypericum alpestre (HA) extracts have shown notable cytotoxicity against various cancer cell lines, drawing attention to their phenolic compounds as potential anticancer agents. Similarly, N(G)-Nitro-L-arginine methyl ester (L-NAME), an inhibitor of nitric oxide synthase (NOS) activity, has emerged as a promising candidate in cancer therapy. However, the precise molecular mechanisms underlying the anticancer effects of both HA and L-NAME remain unclear. This study aimed to clarify the impact of HA and L-NAME on the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt)/ mammalian target of rapamycin (mTOR) signaling pathway in A549 human lung adenocarcinoma and MDA-MB-231 breast cancer triple-negative cells, with particular emphasis on the tumor necrosis factor-alpha (TNFα)/cyclooxygenase-2 (COX-2) and vascular endothelial growth factor A (VEGFα)/matrix metalloproteinase-2 (MMP-2) pathways. In silico analyses identified compounds within HA extracts with the highest affinity for PI3K/Akt, a finding subsequently confirmed by in vitro experiments. Notably, the combination of HA and L-NAME demonstrated greater efficacy than the combination of HA and 5-fluorouracil (5-FU), as evidenced by enhanced apoptotic activity. Both HA alone and in combination with L-NAME inhibited the TNFα/COX-2 and VEGFα/MMP-2 pathways. These results suggest that the therapeutic effects of HA, especially in combination with L-NAME, may be mediated through the PI3K/Akt signaling pathway. A better understanding of the interaction between HA polyphenols and PI3K/Akt signaling could pave the way for novel therapeutic strategies against cancer, including drug-resistant tumors.

Clearance of Driver Mutations in Myelofibrosis

Productivity and stress recollection inaccuracy: Anchoring effects in work-from-home evaluation

Self-reported productivity and satisfaction have become central metrics in evaluating work-from-home (WFH) policies, yet their reliability remains largely unexamined. Despite growing scrutiny of WFH efficacy, assessments continue to rely heavily on subjective evaluations, creating a persistent gap between perceived and objective productivity measures within the working-from-home literature. This study investigates whether retrospective self-reports of productivity during WFH are systematically biased due to recollection inaccuracy, particularly through anchoring biases in memory recall. A two-wave survey data sample consisting of 772 home-workers during the 2020 shift to the home office examines recollection accuracy as well as the underlying mechanism. Using a five-factor productivity scale, within-subject analyses explore consistency within and between multiple waves and evaluate the predictive value of the targeted score compared to the current (inaccurate) score. The signed rank test shows that recollection scores consistently underestimate past scores (one factor: p < .002; four factors: p < 0.0004). The recollected scores are closer to the current score than the targeted score (for all factors: p < .0004) and have a greater magnitude impact on the recollection scores than the targeted score (difference in OLS coefficients ranging from.164 to.606). Exploration of trends additionally suggests that, although the absolute scores are influenced by the current reference point, the relative changes seem consistent over time. These findings highlight the risks of relying on self-reported retrospective productivity measures in shaping WFH policies. The observed biases help contextualize the ongoing discrepancy between optimistic self-reports and more pessimistic objective measures of WFH productivity. Without accounting for recollection biases, assessments of WFH effectiveness may be flawed, potentially leading to suboptimal or counterproductive policy decisions.

Could optical coherence tomography detect monosodium urate crystal deposition at artery walls? An exploratory, phantom-based study

Objective Some reports suggest monosodium urate (MSU) crystals may deposit in artery walls. This exploratory study evaluated the capacity of optical coherence tomography (OCT) to detect MSU crystals in vessel phantoms. Methods We used 3D-printed blood vessel phantoms made of photosensitive acrylic resins, with varying compliances. 0.1cc volume injections of centrifugated human synovial fluids containing MSU crystals, calcium pyrophosphate crystals or 0.9% saline were performed in four predefined locations in the phantoms. OCT was subsequently performed in a blinded manner by two cardiologists, experts in the technique. Two exploratory definitions for MSU crystal deposits were used, depicting a lesion with high attenuation (#1) or also with a linear morphology (#2). Diagnostic properties of both definitions were studied building 2x2 tables. Results Definition #1 was found by OCT in 3/8 (37.5%) of MSU injections and in 3/16 (18.8%) of controls, what yielded a sensitivity of 37.5%, specificity of 81.3%, positive and predictive values of 50.0% and 72.2% respectively, and positive and negative likelihood ratios of 2 and 0.77. Definition #2 was only seen in 2 cases, both with MSU crystals (8.3%); this definition showed a sensitivity of 25.0%, specificity of 100%, positive and predictive values of 100.0% and 72.7%, a negative likelihood ratio of 0.8, while the positive ratio could not be calculated. Data seemed to be slightly better with Semirigid phantoms. Conclusion This preliminary, preclinical data suggest OCT could detect MSU crystals deposits in vessel walls.