Social, clinical, and policy implications of ultra-processed food addiction

Key messages Ultra-processed foods high in refined carbohydrates and added fats are highly rewarding, appealing, and consumed compulsively and may be addictive Behaviours around ultra-processed food may meet the criteria for diagnosis of substance use disorder in some people •   Ultra-processed food addiction is estimated to occur in 14% of adults and 12% of children and is associated with biopsychological mechanisms of addiction and clinically significant problems Understanding of these foods as addictive could lead to novel approaches in the realm of social justice, clinical care, and policy approache

Face Masks and Cough Etiquette Reduce the Cough Aerosol Concentration of Pseudomonas aeruginosa in People with Cystic Fibrosis

People with cystic fibrosis (CF) generate Pseudomonas aeruginosa in droplet nuclei during coughing. The use of surgical masks has been recommended in healthcare settings to minimize pathogen transmission between patients with CF.To determine if face masks and cough etiquette reduce viable P. aeruginosa aerosolized during coughing.Twenty-five adults with CF and chronic P. aeruginosa infection were recruited. Participants performed six talking and coughing maneuvers, with or without face masks (surgical and N95) and hand covering the mouth when coughing (cough etiquette) in an aerosol-sampling device. An Andersen Cascade Impactor was used to sample the aerosol at 2 meters from each participant. Quantitative sputum and aerosol bacterial cultures were performed, and participants rated the mask comfort levels during the cough maneuvers.During uncovered coughing (reference maneuver), 19 of 25 (76%) participants produced aerosols containing P. aeruginosa, with a positive correlation found between sputum P. aeruginosa concentration (measured as cfu/ml) and aerosol P. aeruginosa colony-forming units. There was a reduction in aerosol P. aeruginosa load during coughing with a surgical mask, coughing with an N95 mask, and cough etiquette compared with uncovered coughing (P

Accuracy of magnetic resonance imaging in detecting lumbo-sacral nerve root compromise: A systematic literature review

Background: MRI is considered to be the diagnostic tool of choice in diagnosing nerve root compromise among patients presenting with clinical suspicion of lumbo-sacral radiculopathy. There exists controversy among researchers and clinicians regarding the diagnostic utility and accuracy of MRI in detecting nerve root compromise and radiculopathy. This review evaluated 4 primary diagnostic accuracy studies that specifically assessed the accuracy of MRI in detecting nerve root compromise, as established in the current literature. Methods: Eight electronic data bases were searched for relevant articles from inception until January 2014. All primary diagnostic studies which investigated the accuracy of MRI in diagnosing nerve root compromise among patients with low back and referred leg symptoms were screened for inclusion. Qualifying studies were retrieved and independently assessed for methodological quality using the 'Quality Assessment of Diagnostic tests Accuracy Studies' criteria. Results: Four studies qualified for inclusion in this review. The sensitivity of MRI in detecting lumbar nerve root compromise was very low at 0.25 (95 % CI) while the specificity was relatively high at 0.92 (95 % CI). Conclusions: There is lack of sufficient high quality scientific evidence in support or against the use of MRI in diagnosing nerve root compression and radiculopathy. Therefore, clinicians should always correlate the findings of MRI with the patients' medical history and clinical presentation in clinical decision making.IS

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Analyzing global research trends in combined cycle power plants: A bibliometric study

Over the last two decades, extensive research has focused on enhancing operational efficiency, emission reduction, and technological advancements in combined cycle power plants. This study conducts a comprehensive bibliometric analysis encompassing over 4100 peer-reviewed publications within the Scopus database (2000–2022) related to combined cycle power plants. The outcomes reveal a burgeoning global research landscape, primarily led by the United States, China, Italy, and the United Kingdom. Encompassing diverse domains such as engineering, energy, environment, and others, this research delves into technical areas like carbon capture, exergy analysis, and optimization, while hinting at emerging research directions involving machine learning and power-to-gas technologies. Renowned authors such as Bolland, Tsatsaronis, and Dincer, alongside influential institutions like Tsinghua University and the Norwegian University of Science and Technology, form significant research networks. International collaboration underscores widespread knowledge exchange, with the United States and China leading in total citations, while Italy boasts the highest average citations per article. A comprehensive analysis of keywords underscores the interdisciplinary nature of research, spanning technical, economic, and environmental dimensions. Further affirmation is found in the extensive publication span across general energy and specialized thermoscience journals. This study offers a comprehensive overview of research productivity, impact, and trends in combined cycle power plant research over the past two decades, providing actionable insights for strategic research planning and global performance enhancement

AN APPROACH FOR MIMICKING ROAD PLANNING AND CIRCULATORY SYSTEM IN HUMAN BODY

The idea of mimicking planning structures and human structure is used in this paper in a detailed way. Roads are one important side in planning as it represents the dynamic system through the circulation system. In this paper, there will be an identification to some definitions, hierarchy, and characteristics concerning the roads and street planning and there will be also an identification for the blood circulation in the human body presenting the definitions and hierarchy of blood in the circulatory system. Also, there will be an analyzed part concerning the Mimics concluded from both sections the blood circulation in the human body and the road planning

Differences in objective balance outcomes between elite female rugby players with and without a history of lateral ankle sprain

This study was conducted to examine differences in objective balance outcomes of female rugby players with (injury group; n = 12) and without (control group: n = 19) a history of lateral ankle sprains. The injured and the uninjured ankles in the previously injured players were also compared. An analytical cross-sectional design was used in this study, which was conducted at the Western Province Rugby Football Union’s (WPRFU) High Performance Centre in Cape Town, South Africa. The Noraxon myoPressureTM (Zebris) pressure plate was used to measure objective dynamic balance using COP (centre of pressure) parameters, namely sway area (SA), COP speed (COP sp), and time-to-boundary (TTB), during single-leg catch-and-throw, single-leg jump landing, and side stepping. The ankle sprain group had statistically significant differences in the SA outcome for the tasks catch-and-throw (p=0.04) and side step (p=0.01) compared with the control group. Regarding the TTB outcome in the treatment category, significant results for catch-and-throw (p=0.02) and side step (0=0.01) tasks were found in contrast to the controls. Further results yielded a substantial difference in COP speed outcome for the side step task (p=0.01) among players with a known history of ankle injury compared with the control category. Rugby players with a history of ankle sprain have altered dynamic balance and poor postural stability. Sway area and COP speed during side-step and catch-and-throw tasks can be used as practical measures of objective dynamic balance in rugby