Contribution of cod liver oil-related nutrients (vitamins A, D, E and eicosapentaenoic acid and docosahexaenoic acid) to daily nutrient intake and their associations with plasma concentrations in the EPIC-Norfolk cohort

Total nutrient intake (TNI) is intake from food and supplements. This provides an assessment of nutrient adequacy and the prevalence of excessive intake, as well as the response with respect to biomarkers. Cod liver oil (CLO) is the most frequently consumed supplement in the UK, containing nutrients that might have varying influences on health. We calculated TNI for vitamins A, D and E, as well as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and assessed associations with the respective blood concentrations

Spatial confinement of muonium atoms

We report the achievement of spatial confinement of muonium atoms (the bound state of a positive muon and an electron). Muonium emitted into vacuum from mesoporous silica reflects between two SiO$_2$ confining surfaces separated by 1 mm. From the data, one can extract that the reflection probability on the confining surfaces kept at 100 K is about 90% and the reflection process is well described by a cosine law. This technique enables new experiments with this exotic atomic system and is a very important step towards a measurement of the 1S-2S transition frequency using continuous wave laser spectroscopy.Comment: 5 pages, 6 figure

Dietary dairy product intake and incident type 2 diabetes: a prospective study using dietary data from a 7-day food diary

The consumption of specific dairy types may be beneficial for the prevention of diabetes. Abstract: The aim of this study was to investigate the association between total and types of dairy product intake and risk of developing incident type 2 diabetes, using a food diary. Methods: A nested case-cohort within the EPIC-Norfolk Study was examined, including a random subcohort (n=4,000) and cases of incident diabetes (n=892, including 143 cases in the subcohort) followed-up for 11 years. Diet was assessed using a prospective 7-day food diary. Total dairy intake (g/day) was estimated and categorised into high-fat (≥3.9%) and low-fat (<3.9% fat) dairy, and by subtype into yoghurt, cheese and milk. Combined fermented dairy product intake (yoghurt, cheese, sour cream) was estimated and categorised into high- and low-fat. Prentice-weighted Cox regression HRs were calculated. Results: Total dairy, high-fat dairy, milk, cheese and high-fat fermented dairy product intakes were not associated with the development of incident diabetes. Low-fat dairy intake was inversely associated with diabetes in age- and sex-adjusted analyses (tertile [T] 3 vs T1, HR 0.81 [95% CI 0.66, 0.98]), but further adjustment for anthropometric, dietary and diabetes risk factors attenuated this association. In addition, an inverse association was found between diabetes and low-fat fermented dairy product intake (T3 vs T1, HR 0.76 [95% CI 0.60, 0.99]; ptrend=0.049) and specifically with yoghurt intake (HR 0.72 [95% CI 0.55, 0.95]; ptrend=0.017) in multivariable adjusted analyses. Conclusions/interpretation: Greater low-fat fermented dairy product intake, largely driven by yoghurt intake, was associated with a decreased risk of type 2 diabetes development in prospective analyses. These findings suggest that the consumption of specific dairy types may be beneficial for the prevention of diabetes, highlighting the importance of food group subtypes for public health messages

Enhanced Trabeculectomy: The Moorfields Safer Surgery System

Trabeculectomy with antifibrotic treatment is still the most popular incisional procedure for glaucoma filtration surgery (GFS) worldwide. The advent of antifibrotic agents reduced failure due to scarring but resulted in increased complications. Advances in trabeculectomy surgery have been driven by the need to minimise the risk of: (1) complications and (2) surgical failure. This chapter covers preoperative, intraoperative, and postoperative strategies, which improve the outcome of GFS. Strategies to reduce the risk of complications centre on the prevention of postoperative hypotony by minimising the risk of overdrainage, postoperative wound leaks, and poor bleb morphology. Surgical techniques to reduce the risk of postoperative fibrosis by the use of antifibrotic agents (including mitomycin C) are discussed in detail. These techniques are based on a combination of considerable clinical experience, observation, and laboratory research. The need to address pre-, intra-, and postoperative issues in each individual patient is emphasised. These changes are embodied in the system we call the "Moorfields Safer Surgery System." The use of these strategies has considerably reduced the incidence of major complications, including hypotony, cystic blebs, and endophthalmitis in practices around the world. Most of these techniques are simple, require minimal equipment, and can be easily mastered. They are associated with an improvement in overall outcome and it is hoped that this chapter will help the reader benefit from these advances

The Relationship Between Cognitive Performance Using Tests Assessing a Range of Cognitive Domains and Future Dementia Diagnosis in a British Cohort: A Ten-Year Prospective Study.

BACKGROUND: Exploring the domains of cognitive function which are most strongly associated with future dementia may help with understanding risk factors for, and the natural history of dementia. OBJECTIVE: To examine the association of performance on a range of cognitive tests (both global and domain specific) with subsequent diagnosis of dementia through health services in a population of relatively healthy men and women and risk of future dementia. METHODS: We examined the association between performance on different cognitive tests as well as a global score and future dementia risk ascertained through health record linkage in a cohort of 8,581 individuals (aged 48-92 years) between 2004-2019 with almost 15 years follow-up (average of 10 years) before and after adjustment for socio-demographic, lifestyle, and health characteristics. RESULTS: Those with poor performance for global cognition (bottom 10%) were almost four times as likely to receive a dementia diagnosis from health services over the next 15 years than those who performed well HR = 3.51 (95% CI 2.61, 4.71 p < 0.001) after adjustment for socioeconomic, lifestyle, and biological factors and also prevalent disease. Poor cognition performance in multiple tests was associated with 10-fold increased risk compared to those not performing poorly in any test HR = 10.82 (95% CI 6.85, 17.10 p < 0.001). CONCLUSION: Deficits across multiple cognitive domains substantially increase risk of future dementia over and above neuropsychological test scores ten years prior to a clinical diagnosis. These findings may help further understanding of the natural history of dementia and how such measures could contribute to strengthening future models of dementia.This work was supported by the Medical Research Council, UK (MRC) http://www.mrc.ac.uk/ (Ref: MR/N003284/1) Cancer Research UK http://www.cancerresearchuk. org/ (CRUK, Ref: C864/A8257) and NIHR https://www.nihr.ac.uk (Ref: NF-SI-0616-10090 to [CB]). The clinic for EPIC- Norfolk 3HC was funded by Research into Aging, now known as Age UK http://www.ageuk.org.uk/ (Grant Ref: 262). The pilot phase was supported by MRC (Ref: G9502233) and CRUK (Ref: C864/ A2883)

muCool: A novel low-energy muon beam for future precision experiments

Experiments with muons ($\mu^{+}$) and muonium atoms ($\mu^{+}e^{-}$) offer several promising possibilities for testing fundamental symmetries. Examples of such experiments include search for muon electric dipole moment, measurement of muon $g-2$ and experiments with muonium from laser spectroscopy to gravity experiments. These experiments require high quality muon beams with small transverse size and high intensity at low energy. At the Paul Scherrer Institute, Switzerland, we are developing a novel device that reduces the phase space of a standard $\mu^{+}$ beam by a factor of $10^{10}$ with $10^{-3}$ efficiency. The phase space compression is achieved by stopping a standard $\mu^{+}$ beam in a cryogenic helium gas. The stopped $\mu^{+}$ are manipulated into a small spot with complex electric and magnetic fields in combination with gas density gradients. From here, the muons are extracted into the vacuum and into a field-free region. Various aspects of this compression scheme have been demonstrated. In this article the current status will be reported.Comment: 8 pages, 5 figures, TCP 2018 conference proceeding

A Mediterranean Diet Is Positively Associated with Bone and Muscle Health in a Non-Mediterranean Region in 25,450 Men and Women from EPIC-Norfolk.

Research on Mediterranean diet (MD) adherence and musculoskeletal health is limited. The current study determined if adherence to the alternative MD score (aMED) and MD score (MDS), quantified from 7-d food diaries, was associated with fracture incidence, bone density (calcaneal broadband ultrasound attenuation (BUA)) and fat free mass (expressed over BMI (FFMBMI) using bioelectrical impedance) in 25,450 men and women recruited to the European Prospective Investigation into Cancer study in Norfolk, UK. During 17.4 years of follow up (443,178 total person years) 2195 incident fractures occurred. Higher aMED adherence was associated with 23% reduced total (Q5-Q1 HR 0.77; 95% CI 0.67, 0.88; p-trend < 0.01) and 21% reduced hip (Q5-Q1 HR 0.79; 95% CI 0.65, 0.96; p-trend = 0.01) fracture incidence, and significantly higher BUA (Q5-Q1 1.0 dB/MHz 95% CI 0.2, 1.9; p-trend < 0.01) and FFMBMI (Q5-Q1 0.05 kg/(kg/m2) 95% CI 0.04, 0.06; p-trend < 0.01), comparing extreme adherence quintiles. Higher MDS was also associated with reduced total fractures (Q5-Q1 HR 0.83; 95% CI 0.71, 0.96; p-trend = 0.03) and significantly higher BUA (Q5-Q1 1.4 dB/MHz 95% CI 0.5, 2.3; p-trend < 0.01) and FFMBMI (Q5-Q1 0.03 kg/(kg/m2) 95% CI 0.01, 0.04; p-trend < 0.01). This evidence supports the need to develop interventions to enhance MD adherence, particularly in women, where evidence for associations was stronger

Contribution of cod liver oil-related nutrients (vitamins A, D, E and eicosapentaenoic acid and docosahexaenoic acid) to daily nutrient intake and their associations with plasma concentrations in the EPIC-Norfolk cohort.

BACKGROUND: Total nutrient intake (TNI) is intake from food and supplements. This provides an assessment of nutrient adequacy and the prevalence of excessive intake, as well as the response with respect to biomarkers. Cod liver oil (CLO) is the most frequently consumed supplement in the UK, containing nutrients that might have varying influences on health. We calculated TNI for vitamins A, D and E, as well as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and assessed associations with the respective blood concentrations. METHODS: Seven-day diet diaries and blood samples were taken from two subsets of the European Prospective Investigation into Cancer (EPIC-Norfolk) cohort (age range 39-79 years; n = 1400 for vitamin D; n = 6656 for remaining nutrients). TNI was calculated for the subgroups: nonsupplement users, those consuming the nutrient in supplement form and those consuming a supplement without this nutrient. RESULTS: CLO-related nutrients were supplemented by 15%-33%, which approximately doubled median intakes. Almost everyone in the supplement + vitamin A group reached the estimated average requirement; however, guideline levels were likely to be exceeded. Partial correlations between intake of vitamins A and D and biomarkers were low and modestly strengthened by the inclusion of supplement sources (correlation = 0.01-0.13). Correlations between biomarker and TNI of vitamin E and EPA+DHA were in the range 0.40-0.46; however, vitamin E exceeding food intake resulted in attenuated coefficients. Linear associations between food or TNI EPA+DHA and plasma were weak but consistent across subgroups. CONCLUSIONS: CLO-related nutrients contribute substantially to nutrient intake, with a risk of over-consumption. Apart from EPA+DHA, biomarker data suggest that CLO-related nutrients in supplements are not linearly associated with vitamin status.All authors report grants from Cancer Research UK and grants from the Medical Research Council (MRC) during the study.This is the final published manuscript, first published by Wiley in the Journal of Human Nutrition and Dietetics here: http://dx.doi.org/10.1111/jhn.1227