Polyunsaturated fatty acids intake and risk of all-cause mortality, cardiovascular disease, breast cancer, mental health, and type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies

Objective: To systematically review prospective cohort studies and quantify associations between polyunsaturated fatty acids (PUFA) and all-cause mortality, cardiovascular disease (CVD), breast cancer, mental health, inflammatory bowel disease and type 2 diabetes. Design: Systematic review and meta-analysis of prospective cohort studies. Data Sources: MEDLINE (from 1946), EMBASE (from 1974), Cochrane Central Registry of Controlled Trials (from 1996), Evidence Based Medicine Reviews (from 1996) and CINAHL (from 1983) were searched through 19 December 2019. Reference lists of retrieved articles and previous systematic and narrative reviews were hand searched. Eligibility criteria for selecting studies: Prospective cohort studies reporting associations between PUFA and all-cause mortality, CVD, breast cancer, mental health or type 2 diabetes were eligible. Data extraction and synthesis: Two reviewers independently abstracted design features, participant characteristics, exposures and outcomes, and assessed risk of bias. Multivariable risk ratios were pooled using inverse-variance random-effects models. Heterogeneity was assessed (Q statistic) and quantified (I2). Potential publication bias was assessed (funnel plots) and subgroup analyses were undertaken (meta-regression). Results: A total of 4015 potentially eligible articles were identified; after full-text review, 170 primary reports of associations between PUFA and the health outcomes in prospective cohort studies (published between 1981 and 2020) provided 719 comparisons. In prospective cohort studies (considered the highest quality observational evidence available), higher intake of total and various subtypes of PUFA, compared with lower intake varied in terms of associations with chronic diseases. Higher intakes of total PUFA were associated with a 14% reduced risk of all-cause mortality (16 studies with 960 538 participants), 9% reduced risk of fatal CVD (13 studies with 907 721 participants) and 27% reduced risk of sudden cardiac death (1 study with 91 981 participants). Total omega-3 fatty acids were associated with a 6% reduced risk of fatal CVD (10 studies with 872 029 participants), 17% reduced risk of fatal coronary heart disease (CHD) (4 studies with 238 990 participants), 35% reduced risk of sudden cardiac death (2 studies with 149 953 participants), 57% reduced risk of myocardial infarction (1 study with 41 578 participants), 15% reduced risk of fatal stroke (2 studies with 82 122 participants), and 21% reduced risk of cognitive decline in older age (1 study with 4809 participants). Higher intakes of long-chain omega-3 fatty acids were associated with a 9% reduced risk of all-cause mortality (15 studies with 1 033 235 participants), 12% reduced risk of fatal CVD (18 studies with 1 070 906 participants), 20% reduced risk of fatal CHD (16 studies with 461 060 participants), 59% reduced risk of fatal myocardial infarction (2 studies with 39 586 participants), 45% reduced risk of haemorrhagic stroke (4 studies with 94 687 participants) and 28% reduced risk of ulcerative colitis (1 study with 170 805 participants). Higher intakes of total n-6 fatty acids were associated with a 9% reduced all-cause mortality (9 studies with 768 475 participants) but a 31% increased risk of postmenopausal breast cancer (6 studies with 174 816 participants). Higher intakes of arachidonic acid were associated with a 5% increased risk of breast cancer (3 studies with 180 342 participants). Higher intakes of linoleic acid were associated with a 16% reduced risk of all-cause mortality (9 studies with 706 400 participants), 17% reduced risk of fatal CVD (7 studies with 692 243 participants), 21% reduced risk of fatal CHD (13 studies with 306 050 participants), 32% reduced risk of sudden cardiac death (1 study with 91 181 participants) and 14% reduced risk of total CHD (14 studies with 267 201 participants), but a 26% increased risk of depression (3 studies with 57 538 participants). Higher intakes of alpha-linolenic acid were associated with a 7% reduced all-cause mortality (10 studies with 714 634 participants), 9% reduced risk of fatal CVD (11 studies with 800 724 participants), 18% reduced risk of fatal CHD (9 studies with 252 010 participants), 46% reduced risk of sudden cardiac death (2 studies with 99 183 participants) and 15% reduced risk of fatal stroke (3 studies with 103 532 participants). A higher polyunsaturated:saturated fat ratio was associated with an 18% increased risk of fatal CVD (3 studies with 65 598 participants) and 86% increased risk of postmenopausal breast cancer (1 study with 910 participants). A high omega-6:omega-3 ratio was associated with a 25% increased risk of cognitive decline and 45% increased risk of ulcerative colitis (1 study with 170 805 participants). A high omega-3:omega-6 ratio was associated with a 26% reduced risk of depression (3 studies with 57 538 participants), The confidence in the estimates for the association between PUFA and all outcomes using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach ranged from very low to moderate. Conclusions: On balance, higher intakes of PUFA are associated with reduced risks of all-cause and cardiovascular mortality, but the quality of the evidence is mostly very low. The benefits of n-3 fatty acids appear to be specific for CVDs, but few observational studies have directly observed or otherwise modelled the effects of replacing saturated or trans-unsaturated fats with PUFA on health outcomes. The interaction between different types of PUFA requires further research

Excitatory-inhibitory balance within EEG microstates and resting-state fMRI networks: assessed via simultaneous trimodal PET-MR-EEG imaging

The symbiosis of neuronal activities and glucose energy metabolism is reflected in the generation of functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) signals. However, their association with the balance between neuronal excitation and inhibition (E/I-B), which is closely related to the activities of glutamate and γ-aminobutyric acid (GABA) and the receptor availability (RA) of GABAA and mGluR5, remains unexplored. This research investigates these associations during the resting state (RS) condition using simultaneously recorded PET/MR/EEG (trimodal) data. The trimodal data were acquired from three studies using different radio-tracers such as, [11C]ABP688 (ABP) (N = 9), [11C]Flumazenil (FMZ) (N = 10) and 2-[18F]fluoro-2-deoxy-D-glucose (FDG) (N = 10) targeted to study the mGluR5, GABAA receptors and glucose metabolism respectively. Glucose metabolism and neuroreceptor binding availability (non-displaceable binding potential (BPND)) of GABAA and mGluR5 were found to be significantly higher and closely linked within core resting-state networks (RSNs). The neuronal generators of EEG microstates and the fMRI measures were most tightly associated with the BPND of GABAA relative to mGluR5 BPND and the glucose metabolism, emphasising a predominance of inhibitory processes within in the core RSNs at rest. Changes in the neuroreceptors leading to an altered coupling with glucose metabolism may render the RSNs vulnerable to psychiatric conditions. The paradigm employed here will likely help identify the precise neurobiological mechanisms behind these alterations in fMRI functional connectivity and EEG oscillations, potentially benefitting individualised healthcare treatment measures

Successful treatment of Candida parapsilosis mural endocarditis with combined caspofungin and voriconazole

BACKGROUND: Fungal mural endocarditis is a rare entity in which the antemortem diagnosis is seldom made. Seven cases of mural endocarditis caused by Candida spp. have been collected from literature and six of these patients died after treatment with amphotericin B. CASE PRESENTATION: We report a case of mural endocarditis diagnosed by transesophageal echocardiogram and positive blood cultures to Candida parapsilosis. Because blood cultures continued to yield C. parapsilosis despite caspofungin monotherapy, treatment with voriconazole was added. CONCLUSION: This is the first description of successful treatment of C. parapsilosis mural endocarditis with caspofungin and voriconazole

Temple building on the Egyptian margins: the geopolitical issues behind Seti II and Ramesses IX’s activity at Amheida

Middle Eastern Studie

Work Value Preferences of Generation Z in the United States

This study examined the work value preferences of Generation Z (Gen Z) in the United States. The literature indicated that each generational cohort demonstrated a unique set of values, beliefs, and attitudes, which has implications in the workplace. As the most recent generational cohort to enter the workplace, Gen Z’s work values needed to be better understood to develop effective management strategies. Work values can influence motivation, employee performance, job satisfaction, and organizational commitment. This study’s main research question was which work values Gen Z rated as most important. This was achieved through a cross-sectional, quantitative, descriptive research design using an online survey questionnaire. Participants rated the importance of 25 individual work value items on the revised Lyons Work Values Survey (Lyons, 2003; Lyons et al., 2010). These were used to identify the importance Gen Z placed on four dimensions of work values (cognitive, instrumental, social/altruistic, and prestige). Participants consisted of adult Gen Z members aged 18–26 residing in the United States. The results from the study demonstrated that Gen Z (n= 440) rated instrumental work values the highest, followed by cognitive, social/altruistic, and prestige. The results from the independent t test and one-way analysis of variance indicated no significant differences in work values between men and women or based on ethnic background. Differences based on employment status were found between employed and unemployed participants on cognitive, social/altruistic, and prestige work values. This may be worth exploring for future research, along with longitudinal studies on Gen Z. A confirmatory factor analysis supported the four-factor work values model. Recommendations from this study included offering Gen Z competitive compensation, good work–life balance, and flexibility in the workplace. It is also important to provide them with opportunities for growth, advancement, and stimulating work. The study results will aid in creating effective strategies to better recruit, retain, and motivate Gen Z and assist leaders, managers, and human resource practitioners in understanding their work values

Work Value Preferences of Generation Z in the United States

This study examined the work value preferences of Generation Z (Gen Z) in the United States. The literature indicated that each generational cohort demonstrated a unique set of values, beliefs, and attitudes, which has implications in the workplace. As the most recent generational cohort to enter the workplace, Gen Z’s work values needed to be better understood to develop effective management strategies. Work values can influence motivation, employee performance, job satisfaction, and organizational commitment. This study’s main research question was which work values Gen Z rated as most important. This was achieved through a cross-sectional, quantitative, descriptive research design using an online survey questionnaire. Participants rated the importance of 25 individual work value items on the revised Lyons Work Values Survey (Lyons, 2003; Lyons et al., 2010). These were used to identify the importance Gen Z placed on four dimensions of work values (cognitive, instrumental, social/altruistic, and prestige). Participants consisted of adult Gen Z members aged 18–26 residing in the United States. The results from the study demonstrated that Gen Z (n= 440) rated instrumental work values the highest, followed by cognitive, social/altruistic, and prestige. The results from the independent t test and one-way analysis of variance indicated no significant differences in work values between men and women or based on ethnic background. Differences based on employment status were found between employed and unemployed participants on cognitive, social/altruistic, and prestige work values. This may be worth exploring for future research, along with longitudinal studies on Gen Z. A confirmatory factor analysis supported the four-factor work values model. Recommendations from this study included offering Gen Z competitive compensation, good work–life balance, and flexibility in the workplace. It is also important to provide them with opportunities for growth, advancement, and stimulating work. The study results will aid in creating effective strategies to better recruit, retain, and motivate Gen Z and assist leaders, managers, and human resource practitioners in understanding their work values