A consensus workshop on low-calorie sweeteners (LCS) was held in November 2018 where seventeen experts (the panel) discussed three themes identified as key to the science and policy of LCS: (1) weight management and glucose control; (2) consumption, safety and perception; (3) nutrition policy. The aims were to identify the reliable facts on LCS, suggest research gaps and propose future actions. The panel agreed that the safety of LCS is demonstrated by a substantial body of evidence reviewed by regulatory experts and current levels of consumption, even for high users, are within agreed safety margins. However, better risk communication is needed. More emphasis is required on the role of LCS in helping individuals reduce their sugar and energy intake, which is a public health priority. Based on reviews of clinical evidence to date, the panel concluded that LCS can be beneficial for weight management when they are used to replace sugar in products consumed in the diet (without energy substitution). The available evidence suggests no grounds for concerns about adverse effects of LCS on sweet preference, appetite or glucose control; indeed, LCS may improve diabetic control and dietary compliance. Regarding effects on the human gut microbiota, data are limited and do not provide adequate evidence that LCS affect gut health at doses relevant to human use. The panel identified research priorities, including collation of the totality of evidence on LCS and body weight control, monitoring and modelling of LCS intakes, impacts on sugar reduction and diet quality and developing effective communication strategies to foster informed choice. There is also a need to reconcile policy discrepancies between organisations and reduce regulatory hurdles that impede low-energy product development and reformulation.

The National Institute for Health and Care Excellence (NICE) has acknowledged the value of waist-to-height ratio (WHtR) as an indicator for ‘early health risk’. We used recent UK data to explore whether classification based on WHtR identifies more adults at cardiometabolic risk than the ‘matrix’ based on BMI and waist circumference, currently used for screening. Data from the Health Survey for England (4112 adults aged 18+ years) were used to identify cardiometabolic risk, indicated by raised glycated Hb, dyslipidaemia and hypertension. HbA1c, total/HDL-cholesterol and systolic blood pressure (BP) were more strongly associated with WHtR than the ‘matrix’. In logistic regression models for HbA1c ≥ 48 mmol/mol, total/HDL-cholesterol > 4 and hypertension (BP > 140/90 mmHg or on medication), WHtR had a higher predictive value than the ‘matrix’. AUC was significantly greater for WHtR than the ‘matrix’ for raised HbA1c and hypertension. Of adults with raised HbA1c, 15 % would be judged as ‘no increased risk’ using the ‘matrix’ in contrast to 3 % using WHtR < 0·5. For hypertension, comparative values were 23 and 9 %, and for total/HDL-cholesterol > 4, 26 and 13 %. Nearly one-third of the ‘no increased risk’ group in the ‘matrix’ had WHtR ≥ 0·5 and hence could be underdiagnosed for cardiometabolic risk. WHtR has the potential to be a better indicator of cardiometabolic risks associated with central obesity than the current NICE ‘matrix’. The cut-off WHtR 0·5 in early screening translates to a simple message, ‘your waist should be less than half your height’, that allows individuals to be aware of their health risks.

Growth patterns are known to differ between breastfed and formula-fed infants, but little is known about the relative impact of maternal smoking in pregnancy v. feeding mode on growth trajectory in infancy. We conducted a secondary analysis of a trial, the Tolerance of Infant Goat Milk Formula and Growth Assessment trial involving 290 healthy infants, to examine whether smoking in pregnancy modified the association between feeding mode and body composition of infants. Fat mass (FM) and fat-free mass (FFM) were estimated at 1, 2, 3, 4, 6 and 12 months of age using bioimpedance spectroscopy. Formula-fed infants (n 190) had a higher mean FFM at 4 months (mean difference (MD) 160 g, 95 % CI 50·4, 269·5 g, P < 0·05)) and 6 months (MD 179 g, 95 % CI 41·5, 316·9 g, P < 0·05) compared with the breastfed infants (n 100). Sub-group analysis of breastfed v. formula-fed infants by maternal smoking status in pregnancy showed that there were no differences in the FM and FFM between the breastfed and formula-fed infants whose mothers did not smoke in pregnancy. Formula-fed infants whose mothers smoked in pregnancy were smaller at birth and had a lower FM% and higher FFM% at 1 month compared with infants of non-smoking mothers regardless of feeding mode, but the differences were not significant at other time points. Adequately powered prospective studies with an appropriate design are warranted to better understand the relative impact of maternal smoking, feeding practice and the growth trajectory of infants.

In her book The Myth of Sacred Prostitution in Antiquity (Cambridge, 2008), Stephanie Budin compiles and analyses an impressive array of literary sources which describe, or have been interpreted as describing, several practices that modern scholars have collectively and variously called sacred, ritual, cultic or temple prostitution. In general, as Budin explains, ‘[s]acred prostitution is the sale of a person's body for sexual purposes where some portion (if not all) of the money or goods received for this transaction belongs to a deity … usually Aphrodite’. Three major subtypes include ‘once-in-a-lifetime prostitution and/or sale of virginity in honor of a goddess’, activity that ‘involves women (and men?) who are professional prostitutes and who are owned by a deity or a deity's sanctuary’, and ‘a temporary type of sacred prostitution, where the women (and men?) are either prostitutes for a limited period of time before being married, or only prostitute themselves during certain rituals’.

A pair of anonymous rhetorical exercises in Greek, dating perhaps to the eleventh century, contain a refutation and a confirmation of the myth of Ganymede, in which the young Trojan shepherd is abducted by Zeus in the form of an eagle to live with him in heaven. This article analyses the opposing arguments about divinity and sexuality in the two exercises, argues that they contain a unique aetiological account of the violet, and situates them in the reception history of Ganymede.

This paper examines the containment and covering of people and objects in burials throughout later prehistory in Britain. Recent analyses of grave assemblages with exceptionally well-preserved organic remains have revealed some of the particular roles played by covers in funerary contexts. Beyond these spectacular examples, however, the objects involved in covering and containing have largely been overlooked. Many of the ‘motley crew’ of pots and stones used to wrap, cover, and contain bodies (and objects) were discarded or destroyed by antiquarian investigators in their quest for more immediately dazzling items. Organic containers and covers – bags, coffins, shrouds, blankets – are rarely preserved. Our study brings together the diverse and often elusive objects that played a part in covering and containing prehistoric burials, including items that directly enclosed bodies and objects, and those that potentially pinned together (now mostly absent) organic wraps. Overall, we contend, wrapping, covering, and containing were significantly more prevalent in prehistoric funerary practices than has previously been recognised.

Falls are a major health concern in older adults. Falls lead to mortality, immobility and high costs to social and health care services. Early detection and classification of falls is imperative for timely and appropriate medical aid response. Traditional machine learning models have been explored for fall classification. While newly developed deep learning techniques have the ability to potentially extract high-level features from raw sensor data providing high accuracy and robustness to variations in sensor position, orientation and diversity of work environments that may skew traditional classification models. However, frequently used deep learning models like Convolutional Neural Networks (CNN) are computationally intensive. To the best of our knowledge, we present the first instance of a Hybrid Multichannel Random Neural Network (HMCRNN) architecture for fall detection and classification. The proposed architecture provides the highest accuracy of 92.23% with dropout regularization, compared to other deep learning implementations. The performance of the proposed technique is approximately comparable to a CNN yet requires only half the computation cost of the CNN-based implementation. Furthermore, the proposed HMCRNN architecture provides 34.12% improvement in accuracy on average than a Multilayer Perceptron.

Dogs harbor numerous zoonotic pathogens, many of which are controlled through vaccination programs. The delivery of these programs can be difficult where resources are limited. We developed a dynamic model to estimate vaccination coverage and cost-per-dog vaccinated. The model considers the main factors that affect vaccination programs: dog demographics, effectiveness of strategies, efficacy of interventions and cost. The model was evaluated on data from 18 vaccination programs representing eight countries. Sensitivity analysis was performed for dog confinement and vaccination strategies. The average difference between modelled vaccination coverage and field data was 3.8% (2.3%–5.3%). Central point vaccination was the most cost-effective vaccination strategy when >88% of the dog population was confined. More active methods of vaccination, such as door-to-door or capture-vaccinate-release, achieved higher vaccination coverage in free-roaming dog populations but were more costly. This open-access tool can aid in planning more efficient vaccination campaigns in countries with limited resources.