Prevalence of Food Insecurity among Women in Northern Jordan

Food insecurity—not having sufficient quantities of good-quality foods—is inversely related to physical and mental health and directly related to poor dietary intake. The objectives of this research were to (a) measure the prevalence of food insecurity among women in northern Jordan, (b) study the socioeconomic factors associated with an increased risk of food insecurity, and (c) investigate the relationship between household food insecurity and women's reported body-weight. This cross-sectional study was conducted using an interview-based questionnaire. In total, 500 women were interviewed in the waiting rooms of the outpatient clinics of two major public hospitals in northern Jordan. Food insecurity was assessed using the short form of the U.S. food security survey module. The prevalence of food insecurity was 32.4%. Income below the poverty-line, illiteracy, unemployment, rented housing, and woman heading the household were among the socioeconomic factors that increased the probability of food insecurity. No evidence was found to support the relationship between obesity and food insecurity. Except grains, food-insecure women with hunger had lower intake of all food-groups. This study demonstrated that the problem of food insecurity is present in Jordan. Food-insecure women with hunger are at a risk of malnutrition. Interventions that target reduction of the factors associated with food insecurity are necessary

Prevalence of Food Insecurity among Women in Northern Jordan

Food insecurity\u2014not having sufficient quantities of good-quality foods\u2014is inversely related to physical and mental health and directly related to poor dietary intake. The objectives of this research were to (a) measure the prevalence of food insecurity among women in northern Jordan, (b) study the socioeconomic factors associated with an increased risk of food insecurity, and (c) investigate the relationship between household food insecurity and women\u2019s reported body-weight. This cross-sectional study was conducted using an interview-based questionnaire. In total, 500 women were interviewed in the waiting rooms of the outpatient clinics of two major public hospitals in northern Jordan. Food insecurity was assessed using the short form of the U.S. food security survey module. The prevalence of food insecurity was 32.4%. Income below the poverty-line, illiteracy, unemployment, rented housing, and woman heading the household were among the socioeconomic factors that increased the probability of food insecurity. No evidence was found to support the relationship between obesity and food insecurity. Except grains, food-insecure women with hunger had lower intake of all food-groups. This study demonstrated that the problem of food insecurity is present in Jordan. Food-insecure women with hunger are at a risk of malnutrition. Interventions that target reduction of the factors associated with food insecurity are necessary

Normothermic Ex Vivo Lung Perfusion (Novel) as an Assessment of Extended Criteria Donor Lungs: A Prospective Multi-Center Clinical Trial

Purpose: Ex vivo lung perfusion (EVLP) allows re-evaluation of extended criteria/marginal donor lungs. This can increase the number of lung transplants. However, the long-term outcomes of transplanting EVLP-screened lungs in a multicenter setting are unknown. We proposed to evaluate the short- and long-term outcomes of EVLP performed at multiple centers. Methods: This is a prospective, nonrandomized clinical trial. Seventeen lung transplant centers in the United States. Adult patients with end-stage pulmonary disease requiring lung transplant from May 2011 to December 2017 were eligible. Lung allografts initially deemed extended criteria/marginal (n=216) were placed on EVLP and re-evaluated prior to transplant. Patients received either standard donors (n=116) or lungs screened with EVLP (n=110). Results: Half of the lung grafts (110/216, 50.9%) placed on EVLP were transplanted. The incidence of primary graft dysfunction 24 hours post-transplant was higher in the EVLP group (25.5% vs 10.3%, p=0.003), but was not significantly different 48 hours (EVLP: 15.5%, control: 9.5%, p=0.49) and 72 hours (13.6% vs 6.9%, p=0.34) post-transplant. Survival was not significantly different between the 2 groups 1 year (n=226, EVLP: 86%, control: 94%, p=0.06), 3 years (n=226, EVLP: 68%, control: 76%, p=0.16, Figure), or 5 years (n=159, EVLP: 59%, control: 65%, p=0.68) post-transplant. There were also no differences in pulmonary function, the incidence of chronic lung allograft dysfunction or quality of life measures post-transplant. Conclusion: In this multicenter study, recipients of lungs that were re-evaluated on EVLP and deemed suitable for transplant had similar outcomes as a recipients of a standard lung transplants. EVLP offers the opportunity to screen donated lungs initially considered high risk and can safely increase the availability of transplantable lungs without compromising outcomes

Directional uv photoemission from (100) and (110) molybdenum surfaces

A study of the (100) and (110) molybdenum surfaces by directional photoemission spectroscopy is presented. Energy distribution spectra formed by photoelectrons emitted normal to the surfaces have been measured for photon energies between 10.2 and 21.2 eV. The results are discussed in terms of calculated band structure within the framework of the K∥-conservation assumption. A good agreement is found between the main features of the experimental spectra and the emission expected from the band structure along the corresponding symmetry line in the Brillouin zone, assuming essentially direct-transition and surface-emission processes. Two extra structures are interpreted in terms of surface states or resonances: on the (100) surface, 0.5 eV below EF; on the (110) surface, 4.5 eV below EF in the s-d hybridization gap

Contemporary Management of Ischemic Mitral Regurgitation at Coronary Artery Bypass Grafting

BACKGROUND: Recent guidelines for the treatment of moderate or severe ischemic mitral regurgitation (IMR) in patients undergoing coronary artery bypass grafting (CABG) have changed. This study assessed the real-world impact of changing guidelines on the management of IMR during CABG over time. We hypothesized that the utilization of mitral valve repair for IMR would decrease over time, whereas mitral valve replacement for severe IMR would increase. METHODS: Patients undergoing CABG in a statewide collaborative database (2011-2020) were stratified by severity of IMR. Trends in mitral valve repair or replacement were evaluated. To account for differences of the patients, propensity score-matched analyses were used to compare patients with and without mitral intervention. RESULTS: A total of 11,676 patients met inclusion criteria, including 1355 (11.6%) with moderate IMR and 390 (3.3%) with severe IMR. The proportion of patients undergoing mitral intervention for moderate IMR decreased over time (2011, 17.7%; 2020, 7.5%; P(trend) = .001), whereas mitral replacement for severe IMR remained stable (2011, 11.1%; 2020, 13.3%; P(trend) = .14). Major morbidity was higher for patients with moderate IMR who underwent mitral intervention (29.1% vs 19.9%; P = .005). In a propensity analysis of 249 well-matched pairs, there was no difference in major morbidity (29.3% with mitral intervention vs 23.7% without; P = .16) or operative mortality (1.2% vs 2.4%; P = .5). CONCLUSIONS: Consistent with recent guideline updates, patients with moderate IMR were less likely to undergo mitral repair. However, the rate of replacement for severe IMR did not change. Mitral intervention during CABG did not increase operative mortality or morbidity

Ventricular Assist Device Patient Phenotypes: What Attributes Describe Long Term Survival?

Purpose: Presently, 50% of patients on LVAD support are alive on therapy at 5 years. While preoperative (preop) variables can predict short term (ST) survival, correlates of long term (LT) survival remain poorly characterized. Using Intermacs-STS, we aim to identify preop and postoperative correlates of LT survival. Methods: Patients (n=16474) undergoing LVAD implant (2012-18) in Intermacs-STS were categorized as ST (survival ≤1 year postoperative, n=7483), mid-term (MT, 1-3 years, n=5976) and LT (\u3e3 years, n=3015) survivors. Pre-implant characteristics and events during support were compared between the three groups to identify mortality correlates. Results: Compared with patients dying in the ST, LT survivors were more likely to be younger, not listed for transplant, with higher BSA and VAS scores and several lower risk preop characteristics but differences between MT and LT survivors were not clinically significant (table). On multi-variable analysis, patients suffering post-LVAD stroke (HR 1.42, image), any major infection (HR 1.13), pump related infection (HR 1.19), and/or device malfunction (HR=1.22) (all p\u3c0.001) were less likely to live \u3e1 year, as were patients with a history of pulmonary disease (HR 1.19, 0.01), cancer (HR 1.26, p=0.01), CABG (HR 1.24, p\u3c0.001), hepatitis (HR 1.54, p=0.002) and active smoking (1.44, p \u3c0.001). Conclusion: The preop clinical features of ST and LT survivors vary significantly. Preop characteristics mainly select out early deaths, failing to accurately characterize survival after 1 year. LT survival is heavily influenced by device complications and pre-existing medical co-morbidities

The NOVEL Study: A Multi-Center Clinical Trial Studying the Safety of Ex Vivo Lung Perfusion

Purpose: lung transplantation continues to be a life saving therapy for patients with end stage lung disease. In a donor restrictive environment and with only 22% of donor lungs currently being transplanted ex vivo lung perfusion can increase donor use and transplantation preserving safety and good outcomes Methods: the NOVEL study is a prospective, multi-center, controlled clinical trial. Seventeen US lung transplant centers evaluated the safety of screening donors initially considered unacceptable for transplant with normothermic ex vivo lung perfusion (EVLP). Results: from 2011 to 2017 seventeen lung transplant centers evaluated 216 donors with EVLP. 110 were transplanted for a 50.9% conversion rate. Early and long-term outcomes were compared to 116 control patients that underwent transplantation using standard criteria lungs. The primary endpoints for this study were Primary Graft Dysfunction (PGD) grade 3 at 72 hours and 1-year survival. The rate of PGD grade 3 at 72 hrs. was non-inferior between the ELVP and Control group (8.9% vs 9.5%, p 0.12). The 1-year survival for the EVLP group was 93.2% vs. 96.5% for the Control group, p 0.84. Secondary endpoints such as ICU length of stay, 9.9 vs 9.8 days, hospital length of stay, 23.9 vs 28.5 days, duration of mechanical ventilation, 7.0 vs 5.7 days, were also not significantly different between the EVLP and Control groups. Median FEV 1 was also no different between the EVLP and Control groups 12 months post transplant 65 vs 70 %. Conclusion: data from this multi-center, controlled clinical trial demonstrates that the use of ex vivo lung perfusion to screen for viable grafts within the unused donor pool is safe and provides equal short and long therm outcomes to standard criteria donor lungs