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Diets and dietary constituents that we consume have a considerable impact on disease risk. Intriguingly these effects may be modulated to some extent by sex. Lack of female representation in nutritional studies as well as a lack of stratification by sex has and continues to limit our understanding of these sex × diet interactions. Here we provide an overview of the current and available literature describing how exposure to certain dietary patterns (Western-style diet, Mediterranean diet, vegetarian/vegan, ketogenic diet) and dietary constituents (dietary fibre, PUFA and plant bioactive) influences disease risk in a sex-specific manner. Interestingly, these sex differences appear to be highly disease-specific. The identification of such sex differences in response to diet stresses the importance of sex stratification in nutritional research.
Recent excavations at the ancient Maya minor center of Tutu Uitz Na in the Belize River Valley revealed an especially large—about 20 million shells—Middle Preclassic (900–300 BC) shell deposit underlying the plaza. Although marine shell species make up a small percentage of the assemblage, most shells are Pachychilus spp., a common freshwater snail known in the southern Maya Lowlands as jute. This report describes the architectural context and assemblage of the deposit and compares it to similar examples in the region. We propose that the Tutu Uitz Na deposit provides one of the earliest examples of depictions of the Maya primordial sea in an architectural context.
Systems Engineering (SE) is becoming increasingly relevant in industrial application since more stakeholders are involved in engineering activities. To implement SE, companies have to adapt existing engineering processes and methods. This adaption requires knowledge about new methods as well as their integration into the engineering activities. In order to ensure goal-oriented identification of methods for different SE activities in this contribution an action field profile and the Systems Engineering Method Matrix are proposed. The development of both tools is driven by the assumption that most SE activities and methods can be described based on the artefacts the deliver. In order to get feedback about the proposed tools, semi-structured interviews with two industry partners were conducted, focussing on the tool's usability. These interviews underline the basic usability of the tools and their support to identify SE activities to be supported by (new) methods. Moreover, requirements for further development and adaption are derived from the interviews.
The success and longevity of coalition governments depends on the ability to keep conflicts between coalition members at bay. The risk of such conflicts is often assessed by drawing on proxy measures, such as the ideological heterogeneity among government parties. This article presents a new approach to measuring the atmosphere between government parties. The ‘coalition mood’ is a time-varying measure that draws on applause patterns between coalition partners during legislative debates. The article exemplifies the measurement approach based on automated analyses of over 105,000 plenary debates in Germany and Austria. The article then assesses the measure's face, concurrent and predictive validity. It finds the measure well aligned with qualitative evidence, shows that the coalition mood is correlated with poll ratings of the government parties and helps to predict the duration of legislative processes. The conclusion highlights future applications of the coalition mood for research on coalition politics and public policy.
Clays are raw materials with properties that are necessary for the manufacture of ceramic tiles. The characteristics of clay ceramic raw materials may vary within the same mineral deposit. Clay blending promotes better use of clay reserves, thereby increasing the applicability and life cycle of raw materials. Therefore, it is important to understand the mechanisms controlling the firing of ceramic tiles. In this study, three different clays from a clay deposit were assessed and ten formulations were prepared using the mixture design method. The formulations were analysed using differential thermal and thermogravimetric analyses and dilatometric analysis. Subsequently, the most refractory and fluxing formulations were subjected to thermal tests under various heating rates, similar to the process used for the calculation of apparent sintering activation energy for the densification of clays and for pyroplasticity tests. It is suggested that a mineral deposit can be assessed based on activation energy and thermal kinetics, expanding the alternatives available to the miner through the planning of mixtures with various clays and thus reducing the energy costs of the industrial process.
To understand young adults’ perceptions of online and real-life social influences on their food and activity choices.
A qualitative study involving 7 focus groups. Thematic analysis using both deductive and inductive techniques were performed.
A polytechnic and a university in Singapore.
A total of 46 full-time students, 19–24 years of age.
Participants revealed that social media meets multiple needs, contributing to its ubiquitous use and facilitating content spread between social networks. Food-related content shared on social media were mostly commercial posts, marketing foods and eateries showcasing price promotions, emphasising sensory properties of foods or creating narratives that activated trends. Subsequently, real-life social activities frequently revolve around marketed foods that were not necessarily healthy. In contrast, physical activity posts were rarely being followed up in real life. Portrayals describing a toxic gym culture could contribute to negative perceptions of peers’ physical activity posts and a disinclination towards sharing such posts. Participants expressed that close, supportive social networks in real life strongly influenced initiating and maintaining healthy lifestyles. However, in a society that highly values academic achievements, participants prioritised studying and socialising over healthy eating and physical activity.
Overall, our findings reveal that virtual and real-life social influences have complex interactions affecting Asian young adults’ behavioural choices and should be considered when designing interventions for this group. Regulations related to the digital marketing of unhealthy food, and improving the availability, accessibility and affordability of healthier food options, particularly in the foodservice sector, would be of value to consider.
The COVID-19 pandemic has shone a spotlight on how health outcomes are unequally distributed among different population groups, with disadvantaged communities and individuals being disproportionality affected in terms of infection, morbidity and mortality, as well as vaccine access. Recently, there has been considerable debate about how social disadvantage and inequality intersect with developmental processes to result in a heightened susceptibility to environmental stressors, economic shocks and large-scale health emergencies. We argue that DOHaD Society members can make important contributions to addressing issues of inequality and improving community resilience in response to COVID-19. In order to do so, it is beneficial to engage with and adopt a social justice framework. We detail how DOHaD can align its research and policy recommendations with a social justice perspective to ensure that we contribute to improving the health of present and future generations in an equitable and socially just way.
Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
An accurate estimate of the average number of hand hygiene opportunities per patient hour (HHO rate) is required to implement group electronic hand hygiene monitoring systems (GEHHMSs). We sought to identify predictors of HHOs to validate and implement a GEHHMS across a network of critical care units.
Multicenter, observational study (10 hospitals) followed by quality improvement intervention involving 24 critical care units across 12 hospitals in Ontario, Canada.
Critical care patient beds were randomized to receive 1 hour of continuous direct observation to determine the HHO rate. A Poisson regression model determined unit-level predictors of HHOs. Estimates of average HHO rates across different types of critical care units were derived and used to implement and evaluate use of GEHHMS.
During 2,812 hours of observation, we identified 25,417 HHOs. There was significant variability in HHO rate across critical care units. Time of day, day of the week, unit acuity, patient acuity, patient population and use of transmission-based precautions were significantly associated with HHO rate. Using unit-specific estimates of average HHO rate, aggregate HH adherence was 30.0% (1,084,329 of 3,614,908) at baseline with GEHHMS and improved to 38.5% (740,660 of 1,921,656) within 2 months of continuous feedback to units (P < .0001).
Unit-specific estimates based on known predictors of HHO rate enabled broad implementation of GEHHMS. Further longitudinal quality improvement efforts using this system are required to assess the impact of GEHHMS on both HH adherence and clinical outcomes within critically ill patient populations.
Nosocomial transmission of influenza is a major concern for infection control. We aimed to dissect transmission dynamics of influenza, including asymptomatic transmission events, in acute care.
Prospective surveillance study during 2 influenza seasons.
Volunteer sample of inpatients on medical wards and healthcare workers (HCWs).
Participants provided daily illness diaries and nasal swabs for influenza A and B detection and whole-genome sequencing for phylogenetic analyses. Contacts between study participants were tracked. Secondary influenza attack rates were calculated based on spatial and temporal proximity and phylogenetic evidence for transmission.
In total, 152 HCWs and 542 inpatients were included; 16 HCWs (10.5%) and 19 inpatients (3.5%) tested positive for influenza on 109 study days. Study participants had symptoms of disease on most of the days they tested positive for influenza (83.1% and 91.9% for HCWs and inpatients, respectively). Also, 11(15.5%) of 71 influenza-positive swabs among HCWs and 3 (7.9%) of 38 influenza-positive swabs among inpatients were collected on days without symptoms; 2 (12.5%) of 16 HCWs and 2 (10.5%) of 19 inpatients remained fully asymptomatic. The secondary attack rate was low: we recorded 1 transmission event over 159 contact days (0.6%) that originated from a symptomatic case. No transmission event occurred in 61 monitored days of contacts with asymptomatic influenza-positive individuals.
Influenza in acute care is common, and individuals regularly shed influenza virus without harboring symptoms. Nevertheless, both symptomatic and asymptomatic transmission events proved rare. We suggest that healthcare-associated influenza prevention strategies that are based on preseason vaccination and barrier precautions for symptomatic individuals seem to be effective.
To assess influenza symptoms, adherence to mask use recommendations, absenteesm and presenteeism in acute care healthcare workers (HCWs) during influenza epidemics.
The TransFLUas influenza transmission study in acute healthcare prospectively followed HCWs prospectively over 2 consecutive influenza seasons. Symptom diaries asking for respiratory symptoms and adherence with mask use recommendations were recorded on a daily basis, and study participants provided midturbinate nasal swabs for influenza testing.
In total, 152 HCWs (65.8% nurses and 13.2% physicians) were included: 89.1% of study participants reported at least 1 influenza symptom during their study season and 77.8% suffered from respiratory symptoms. Also, 28.3% of HCW missed at least 1 working day during the study period: 82.6% of these days were missed because of symptoms of influenza illness. Of all participating HCWs, 67.9% worked with symptoms of influenza infection on 8.8% of study days. On 0.3% of study days, symptomatic HCWs were shedding influenza virus while at work. Among HCWs with respiratory symptoms, 74.1% adhered to the policy to wear a mask at work on 59.1% of days with respiratory symptoms.
Respiratory disease is frequent among HCWs and imposes a significant economic burden on hospitals due to the number of working days lost. Presenteesm with respiratory illness, including influenza, is also frequent and poses a risk for patients and staff.
This article offers an analysis of the transnational discursive construction processes informing Latin American security governance in the aftermath of 9/11. It demonstrates that the Global War on Terror provided an opportunity for external and aligned local knowledge producers in the security establishments throughout the Americas to reframe Latin America's security problems through the promotion of a militarised security epistemology, and derived policies, centred on the region's ‘convergent threats’. In tracing the discursive repercussions of this epistemic reframing, the article shows that, by tapping into these discourses, military bureaucracies throughout the Americas were able to overcome their previous institutional marginalisation vis-à-vis civilian agencies. This development contributed to the renaissance of counter-insurgency and counter-terrorism discourses and policies in the region, allowing countries such as Colombia and Brazil to reposition themselves globally by exporting their military expertise for confronting post-9/11 threats beyond the region.