Dietary patterns colorectal cancer risk and survival in Newfoundland, Canada

Diet patterns commonly used in epidemiological research are derived using different methods, yet there have been few studies assessing if and how research results may vary in the same population across diet patterns. This study assesses and compares five different diet patterns identified by Principal Component Analysis (PCA), Cluster Analysis (CA), Alternate Mediterranean Diet (Alt- Med), Dietary Inflammation Index (DII), and Recommended Food Score (RFS). Colorectal cancer risk and patient’s survival is estimated using different patterns as an independent variable. Comparisons are made using hazards ratio, correlation coefficients and distributions of individuals in clusters. Disease outcome estimation varied with diet patterns used and is mainly attributed to differences in its foundation. Hazards ratios for DFS varied from 1.82; (95% CI- 1.07- 3.09) for processed meat pattern identified by PCA to HR 2.19; (95% CI 1.03-4.67) for cluster characterized by meat and dairy products and HR 1.95; (95% CI 1.13-3.37) for cluster characterized by refined grains, sugar, soft drinks. Only cluster characterized by refined grains, sugar, soft drinks had higher risk of OS (HR 2.05; 95% CI 1.18-3.57). All the diet indices showed similar null associations with both DFS and OS except Poor adherence to altMED increased the risk of all-cause mortality (HR 1.62; 95% CI 1.04- 2.56)

Examining the double burden of malnutrition for preschool children and women of reproductive age in low-income and middle-income countries: A scoping review protocol

Introduction The majority of the populations in low-income and middle-income countries (LMICs) are encountering the double burden of malnutrition (DBM): the coexistence of both undernutrition and overnutrition sequalae. With DBM being a new phenomenon in research, little is known about its aetiology, operational definitions and risk factors influencing its manifestation. The proposed scoping review is aimed at mapping literature with regard to the DBM phenomenon among preschool children and women of reproductive age in LMICs who are among the most high-risk groups to encounter DBM. Methods A comprehensive literature search will be conducted in the following electronic databases: MEDLINE, EMBASE, Scopus, CINAHL, LILACS and ProQuest Dissertations and Thesis Global. Additionally, searches in other government and institutional sources (WHO website and university repositories) and forward and backward citation tracking of seminal articles will also be done. Two reviewers will independently conduct title and abstract screening and full-text screening. Similarly, data extraction and coding will independently be done by two reviewers. Information extracted from included literature will be analysed qualitatively using thematic analysis approach and reported as per the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Ethics and dissemination Ethical approval is not required for this study because the review is based on literature from publicly available sources. The dissemination of our findings will be done through presentations in relevant conferences and publication in a peer-reviewed journal

Ramp Tear among Patients Undergoing Arthroscopic Anterior Cruciate Ligament Reconstruction in a Tertiary Care Centre

Introduction: Ramp tear is a specific injury that affects the posterior horn of the medial meniscus and its meniscosynovial or meniscocapsular attachments. The actual prevalence of ramp lesion is unknown due to the high probability of misdiagnosis or underdiagnosis caused by the low sensitivity of imaging modalities and poor visualization during arthroscopy. This study aimed to find out the prevalence of ramp tear among patients undergoing arthroscopic anterior cruciate ligament reconstruction in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients undergoing arthroscopic anterior cruciate ligament reconstruction after getting ethical approval from the Institutional Review Committee. Data from 1 March 2019 to 31 December 2022 was collected between 1 May 2023 to 30 May 2023 from medical records. The study included all patients who underwent arthroscopic anterior cruciate ligament reconstruction. Patients with a previous history of medial meniscus injury or repair and undergoing revision anterior cruciate ligament reconstruction were excluded. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 412 patients who underwent arthroscopic anterior cruciate ligament reconstruction, 53 (12.86%) (9.63-16.09, 95% Confidence Interval) had ramp tears. The mean age of patients with ramp tears was 28.64±7.57 years. Among 53 patients, 42 (79.24%) were male and 11 (20.75%) were female. Conclusions: The prevalence of ramp tears in patients undergoing arthroscopic anterior cruciate ligament reconstruction in a tertiary care centre was found to be lower than other studies done in other international studies

Investigating Health Inequality Using Trend, Decomposition and Spatial Analyses: A Study of Maternal Health Service Use in Nepal

Objectives: (a) To quantify the level and changes in socioeconomic inequality in the utilization of antenatal care (ANC), institutional delivery (ID) and postnatal care (PNC) in Nepal over a 20-year period; (b) identify key drivers of inequality using decomposition analysis; and (c) identify geographical clusters with low service utilization to inform policy.Methods: Data from the most recent five waves of the Demographic Health Survey were used. All outcomes were defined as binary variables: ANC (=1 if ≥4 visits), ID (=1 if place of delivery was a public or private healthcare facility), and PNC (=1 if ≥1 visits). Indices of inequality were computed at national and provincial-level. Inequality was decomposed into explanatory components using Fairile decomposition. Spatial maps identified clusters of low service utilization.Results: During 1996–2016, socioeconomic inequality in ANC and ID reduced by 10 and 23 percentage points, respectively. For PND, the gap remained unchanged at 40 percentage points. Parity, maternal education, and travel time to health facility were the key drivers of inequality. Clusters of low utilization were displayed on spatial maps, alongside deprivation and travel time to health facility.Conclusion: Inequalities in the utilization of ANC, ID and PNC are significant and persistent. Interventions targeting maternal education and distance to health facilities can significantly reduce the gap

Hypothesis and data-driven dietary patterns and colorectal Cancer survival: findings from Newfoundland and Labrador colorectal Cancer cohort

Abstract Background Dietary patterns are commonly used in epidemiological research, yet there have been few studies assessing if and how research results may vary across dietary patterns. This study aimed to estimate the risk of mortality/recurrence/metastasis using different dietary patterns and comparison amongst the patterns. Methods Dietary patterns were identified by Cluster Analysis (CA), Principal Component Analysis (PCA), Alternate Mediterranean Diet score (altMED), Recommended Food Score (RFS) and Dietary Inflammatory Index (DII) scores using a 169-item food frequency questionnaire. Five hundred thirty-two colorectal cancer patients diagnosed between 1999 and 2003 in Newfoundland were followed-up until 2010. Overall Mortality (OM) and combined Mortality, Recurrence or Metastasis (cMRM) were identified. Comparisons were made with adjusted Cox proportional Hazards Ratios (HRs), correlation coefficients and the distributions of individuals in defined clusters by quartiles of factor and index scores. Results One hundred and seventy cases died from all causes and 29 had a cancer recurrence/metastasis during follow-up. Processed meats as classified by PCA (HR 1.82; 95% confidence interval (CI) 1.07–3.09), clusters characterized by meat and dairy products (HR 2.19; 95% CI 1.03–4.67) and total grains, sugar, soft drinks (HR 1.95; 95% CI 1.13–3.37) were associated with a higher risk of cMRM. Poor adherence to AltMED increased the risk of all-cause OM (HR 1.62; 95% CI 1.04–2.56). Prudent vegetable, high sugar pattern, RFS and DII had no significant association with both OM and cMRM. Conclusion Estimation of OM and cMRM varied across dietary patterns which is attributed to the differences in the foundation of each pattern

The double burden of malnutrition among women of reproductive age and preschool children in low- and middle-income countries: A scoping review and thematic analysis of literature.

The aim of this review was to map the literature on the double burden of malnutrition (DBM) among women of reproductive age (WRA) and preschool children in low- and middle-income countries (LMICs). The study aimed to provide an understanding of how DBM construct has been defined in the current literature and to elucidate plausible mechanisms underlying DBM development and its common risk factor among the two subgroups. We systematically searched for literature from the following databases: EMBASE, CINAHL, MEDLINE, LILACS, Scopus and ProQuest Dissertations & Thesis Global and identified articles that specifically reported on the coexistence of undernutrition and overnutrition sequalae at the population, household, or individual levels among WRA and preschool children in LMICs. A thematic analysis using the Braun and Clarke approach was conducted on excerpts from the articles to reveal emerging themes underlying the occurrence of DBM from the included studies. Of the initial 15 112 articles found, 720 met the inclusion criteria. Anthropometric measures for overnutrition and undernutrition including body mass index for WRA and height-for-age, weight-for-age, and weight-for-height Z-scores for preschool children were frequently used indicators for defining DBM across all levels of assessment. In fewer cases, DBM was defined by the pairing of cardiometabolic risk factors (e.g., hypertension) as measures for overnutrition and micronutrient deficiency (e.g., iron deficiency) as measures for undernutrition. The following themes emerged as plausible mechanisms for DBM development: nutrition transition, breastfeeding, diet behavior, biological mechanism, and statistical artifact. Factors such as child age, child sex, maternal age, maternal education, maternal occupation, household food security, household wealth, urbanicity, and economic development were commonly associated with most of the DBM phenotypes. Our review findings showed that the understanding of the DBM in current literature is very ambiguous. There is need for future research to better understand the DBM construct and its etiology

“Make and Use” All Suture Anchor—A Cost-Effective Method of Making an All-Suture Anchor

All-suture anchors (ASA) are newer anchors that anchor soft tissues to the bone. It has several biomechanical and clinical advantages; however, the high cost of this anchor limits its use in low socioeconomic countries. The cost of the anchor dramatically increases the cost of surgery; hence, acceptance of surgery is also affected if patients have to pay their expenditure from their pocket. We have designed a simple, cost-effective method of making an ASA, which can be made instantly and used during surgery; hence, the name “make-and-use anchor.” To make this anchor, few high-strength sutures are required. Over the suture, a sleeve of suture was created using an Ethibond. This sleeve will create a “ball” after deployment under the cortical bone, which provides anchorage to the sutures serving as an anchor. This anchor can be deployed both in the pull-in and push-in methods. This technical note aims to share the technique of making this cost-effective anchor, which is made instantly using locally available suture materials and can be used in various surgeries requiring anchors

Additional file 1: of Hypothesis and data-driven dietary patterns and colorectal Cancer survival: findings from Newfoundland and Labrador colorectal Cancer cohort

Table S1. Food groupings. Table S2. Characteristics of Cluster. Table S3.. Factor loading and explained variances (VAR) for the three major dietary patterns identified from food frequency questionnaire at baseline using the principal component factor analysis, Newfoundland. Table S4. Recommended food Score. Table S5. Alternate Mediterranean Diet Score. (DOCX 23 kb