Does cash crop adoption detract from childcare provision?

Using data from fieldwork conducted in Nepal, the impact of a project designed to commercialize vegetables and fruits — the Vegetable and Fruit Cash Crop Program (VFC)— on male and female time allocation is examined. Using a rigorous time collection methodology, activity patterns in households that adopt and do not adopt the new technology are profiled. Very few studies examine changing activity patterns of both men and women in response to commercialization of agriculture. Though women's time is valuable in agriculture, it is also valuable in the production of child nutrition. The recent evolution in thinking as to the causes of child malnutrition—the three pillars being food intake, health, and time to care—warrants further analyses of the time trade-offs that women and men face when adopting new agricultural technologies. The VFC program was successful at targeting both men and women farmers in the sense that household participation resulted in increased head male and head female time spent growing vegetables and fruits. The responses varied, however, by the number of preschool children in residence. In households with more than one preschooler, the time trade-offs associated with VFC participation were not sizeable for the care of children under 5 years. In households with just one preschooler, the trade-offs were more important. In these households, preschoolers received less care from the male and female heads, who spent more time in both the cash crop and in the food crop. In these same households, the nonwork (leisure) time of men increased as a result of VFC participation, but for women, leisure time was unaffected. Thus in the short run, there is perhaps scope for protecting childcare time by reducing time to leisure. In the medium run, benefits may well accrue to unborn preschoolers if VFC participation empowers women.Child care. ,Malnutrition Nepal. ,Children Nutrition. ,Cash crops Nepal. ,

Longitudinal associations of leptin and adiponectin with heart rate variability in children

For early prevention of cardiovascular disease, early detection and risk factor insights are necessary. The autonomic balance reflects cardiovascular risk and can be measured by heart rate variability (HRV). Therefore, our purpose is to examine associations between HRV and the energy-related biomarkers leptin and adiponectin in children. Participants of this study were Belgian children recruited for the longitudinal ChiBS study (year 2010-2012). HRV was measured and fasting blood samples were taken in 249 children at baseline (4.4-11.0 y) and 223 children at follow-up (6.7-12.2 y). Cross-sectional and longitudinal linear regression analyses were separated by sex and adjusted for age, socio-economic status, body fat%, negative emotions, puberty, and mean heart rate. Leptin was a negative cross-sectional and longitudinal predictor of parasympathetic activity in boys; while leptin in girls was cross-sectionally associated with higher LF and LF/HF suggesting sympathetic predominance. Adiponectin was a negative cross-sectional and longitudinal predictor of parasympathetic activity in boys; but when adjusting for mean heart rate, this effect disappeared and adiponectin was a positive cross-sectional and longitudinal predictor of parasympathetic activity in girls. These results stress the importance of considering sex differences and adjustment for heart rate in testing HRV predictors. Leptin seemed disadvantageous for the autonomic balance, while adiponectin seemed advantageous for the autonomic balance in girls only. More research is needed to see whether leptin and adiponectin are interesting in cardiovascular screening/prevention or in determining the cardiovascular gain during weight loss follow-up

Dietary management of older people with diabetes

Diabetes UK's revised nutrition guidelines for the prevention and management of diabetes, published recently, encourage education in self-management and include additional guidance for older people with diabetes. The incidence of diabetes in older people is increasing. Many older people with diabetes are healthy and mobile, and live in the community, but a number are frail and living in care homes. Those who are frail are at increased risk of malnutrition from a range of causes. Older people with diabetes should be assessed for malnutrition risk and referred to a dietitian if required. Management of these patients focuses on foods that are high in protein and energy foods. A case study gives an example of how a community nurse may be involved.Peer reviewedFinal Accepted Versio

A review of empirical evidence on gender differences in nonland agricultural inputs, technology, and services in developing countries

This paper reviews existing microeconomic empirical literature on gender differences in use, access, and adoption of nonland agricultural inputs in developing countries. This review focuses on four key areas: (1) technological resources, (2) natural resources, (3) human resources, and (4) social and political capital. In general, there has been more empirical research on inorganic fertilizer, seed varieties, extension services, and group membership than on tools and mechanization, life-cycle effects, and political participation. Across input areas, generally men have higher input measures than women; however, this finding is often sensitive to the use of models that control for other background factors, as well as the type of gender indicator implemented in the analysis. We find few studies that meet our inclusion criteria outside Sub-Saharan Africa. Finally, future directions, opportunities, and recommendations for microeconomic gender analysis of nonland agricultural inputs are discussed.access to farm inputs, Agricultural inputs, Agriculture, assets, Developing countries, Gender, life-cycle effects, mechanization, Women,

Increased circulating insulin-like growth factor-1 in late-onset Alzheimer's disease

Background: Insulin-like growth factor (IGF)-1 has been implicated in the pathogenesis of Alzheimer's disease ( AD). Methods: We compared the level of circulating total and bioavailable IGF-1, by simultaneous measurements of IGF-1 and IGF binding protein ( IGFBP)-3, between 87 patients diagnosed with AD and 126 age and sex matched control subjects without cognitive impairment. Blood samples were collected and IGF-1 and IGFBP-3 measured by ELISA. Subjects were also genotyped for apolipoprotein E. Results: Total circulating IGF-1 levels were significantly raised in the AD group as compared to the control group (p = 0.022). There was no significant difference in the circulating level of IGFBP-3 between the two groups. When the IGF-1 levels were ratioed against IGFBP-3 levels as an indicator of unbound, bioavailable circulating IGF-1, there was a significant increase in the molar IGF-1:IGFBP-3 ratio in the AD subjects (0.181 +/- 0.006) as compared to the controls (0.156 +/- 0.004) (p < 0.001). Logistic regression analysis revealed that an increase in the IGF-1: IGFBP-3 molar ratio increased the risk of AD significantly. Conclusion: The results of increased total and free circulating IGF-1 support the hypothesis that in its early stages late-onset AD reflects a state of resistance to IGF-1

Outcomes in diabetic patients treated with SGLT2-Inhibitors with acute myocardial infarction undergoing PCI: The SGLT2-I AMI PROTECT Registry

Aims: To investigate in-hospital and long-term prognosis in T2DM patients presenting with acute myocardial infarction (AMI) treated with SGLT2-I versus other oral anti-diabetic agents (non-SGLT2-I users). Methods: In this multicenter international registry all consecutive diabetic AMI patients undergoing percutaneous coronary intervention between 2018 and 2021 were enrolled and, based on the admission anti-diabetic therapy, divided into SGLT-I users versus non-SGLT2-I users. The primary endpoint was defined as a composite of cardiovascular death, recurrent AMI, and hospitalization for HF (MACE). Secondary outcomes included i) in-hospital cardiovascular death, recurrent AMI, occurrence of arrhythmias, and contrast-induced acute kidney injury (CI-AKI); ii) long-term cardiovascular mortality, recurrent AMI, heart failure (HF) hospitalization. Results: The study population consisted of 646 AMI patients (with or without ST-segment elevation): 111 SGLT2-I users and 535 non-SGLT-I users. The use of SGLT2-I was associated with a significantly lower in-hospital cardiovascular death, arrhythmic burden, and occurrence of CI-AKI (all p &lt; 0.05). During a median follow-up of 24 ± 13 months, the primary composite endpoint, as well as cardiovascular mortality and HF hospitalization were lower for SGLT2-I users compared to non-SGLT2-I patients (p &lt; 0.04 for all). After adjusting for confounding factors, the use of SGLT2-I was identified as independent predictor of reduced MACE occurrence (HR=0.57; 95%CI:0.33–0.99; p = 0.039) and HF hospitalization (HR=0.46; 95%CI:0.21–0.98; p = 0.041). Conclusions: In T2DM AMI patients, the use of SGLT2-I was associated with a lower risk of adverse cardiovascular outcomes during index hospitalization and long-term follow-up. Our findings provide new insights into the cardioprotective effects of SGLT2-I in the setting of AMI. Registration: Data are part of the observational international registry: SGLT2-I AMI PROTECT. ClinicalTrials.gov Identifier: NCT05261867

Black Beans, Fiber, and Antioxidant Capacity Pilot Study: Examination of Whole Foods vs. Functional Components on Postprandial Metabolic, Oxidative Stress, and Inflammation in Adults with Metabolic Syndrome.

Beans (Phaseolus vulgaris) contain bioactive components with functional properties that may modify cardiovascular risk. The aims of this pilot study were to evaluate the ability of black beans to attenuate postprandial metabolic, oxidative stress, and inflammatory responses and determine relative contribution of dietary fiber and antioxidant capacity of beans to the overall effect. In this randomized, controlled, crossover trial, 12 adults with metabolic syndrome (MetS) consumed one of three meals (black bean (BB), fiber matched (FM), and antioxidant capacity matched (AM)) on three occasions that included blood collection before (fasting) and five hours postprandially. Insulin was lower after the BB meal, compared to the FM or AM meals (p &lt; 0.0001). A significant meal × time interaction was observed for plasma antioxidant capacity (p = 0.002) revealing differences over time: AM &gt; BB &gt; FM. Oxidized LDL (oxLDL) was not different by meal, although a trend for declining oxLDL was observed after the BB and AM meals at five hours compared to the FM meal. Triglycerides and interleukin-6 (IL-6) increased in response to meals (p &lt; 0.0001). Inclusion of black beans with a typical Western-style meal attenuates postprandial insulin and moderately enhances postprandial antioxidant endpoints in adults with MetS, which could only be partly explained by fiber content and properties of antioxidant capacity

Cardiac Magnetic Resonance to Predict Cardiac Mass Malignancy: The CMR Mass Score

Background: Multimodality imaging is currently suggested for the noninvasive diagnosis of cardiac masses. The identification of cardiac masses' malignant nature is essential to guide proper treatment. We aimed to develop a cardiac magnetic resonance (CMR)-derived model including mass localization, morphology, and tissue characterization to predict malignancy (with histology as gold standard), to compare its accuracy versus the diagnostic echocardiographic mass score, and to evaluate its prognostic ability. Methods: Observational cohort study of 167 consecutive patients undergoing comprehensive echocardiogram and CMR within 1-month time interval for suspected cardiac mass. A definitive diagnosis was achieved by histological examination or, in the case of cardiac thrombi, by histology or radiological resolution after adequate anticoagulation treatment. Logistic regression was performed to assess CMR-derived independent predictors of malignancy, which were included in a predictive model to derive the CMR mass score. Kaplan-Meier curves and Cox regression were used to investigate the prognostic ability of predictors. Results: In CMR, mass morphological features (non-left localization, sessile, polylobate, inhomogeneity, infiltration, and pericardial effusion) and mass tissue characterization features (first-pass perfusion and heterogeneity enhancement) were independent predictors of malignancy. The CMR mass score (range, 0-8 and cutoff, ≥5), including sessile appearance, polylobate shape, infiltration, pericardial effusion, first-pass contrast perfusion, and heterogeneity enhancement, showed excellent accuracy in predicting malignancy (areas under the curve, 0.976 [95% CI, 0.96-0.99]), significantly higher than diagnostic echocardiographic mass score (areas under the curve, 0.932; P=0.040). The agreement between the diagnostic echocardiographic mass and CMR mass scores was good (κ=0.66). A CMR mass score of ≥5 predicted a higher risk of all-cause death (P&lt;0.001; hazard ratio, 5.70) at follow-up. Conclusions: A CMR-derived model, including mass morphology and tissue characterization, showed excellent accuracy, superior to echocardiography, in predicting cardiac masses malignancy, with prognostic implications