The impact of financial incentives on participants' food purchasing patterns in a supermarket-based randomized controlled trial

Background: The impacts of supermarket-based nutrition promotion interventions might be overestimated if participants shift their proportionate food purchasing away from their usual stores. This study quantified whether participants who received price discounts on fruits and vegetables (FV) in the Supermarket Healthy Eating for Life (SHELf) randomized controlled trial (RCT) shifted their FV purchasing into study supermarkets during the intervention period. Methods: Participants were 642 females randomly assigned to a 1) skill-building (n=160), 2) price reduction (n=161), 3) combined skill-building and price reduction (n=160), or 4) control (n=161) group. Participants self-reported the proportion of FV purchased in study supermarkets at baseline, 3- and 6-months post-intervention. Fisher's exact and ?2 tests assessed differences among groups in the proportion of FV purchased in study supermarkets at each time point. Multinomial logistic regression assessed differences among groups in the change in proportionate FV purchasing over time. Results: Post-intervention, 49% of participants purchased =50% of their FV in study supermarkets. Compared to all other groups, the price reduction group was approximately twice as likely (RRR: 1.8-2.2) to have increased proportionate purchasing of FV in study supermarkets from baseline to post-intervention (p<0.05). Conclusions: Participants who received price reductions on FV were approximately twice as likely to shift their FV purchasing from other stores into study supermarkets during the intervention period. Unless food purchasing data are available for all sources, differential changes in purchasing patterns can make it difficult to discern the true impacts of nutrition interventions. Trial registration: The SHELf trial is registered with Current Controlled Trials Registration ISRCTN39432901, Registered 30 June 2010, Retrospectively registered (http://www.isrctn.com/ISRCTN39432901

Connected healthcare: Improving patient care using digital health technologies

Now more than ever, traditional healthcare models are being overhauled with digital technologies of Healthcare 4.0 being increasingly adopted. Worldwide, digital devices are improving every stage of the patient care pathway. For one, sensors are being used to monitor patient metrics 24/7, permitting swift diagnosis and interventions. At the treatment stage, 3D printers are currently being investigated for the concept of personalised medicine by allowing patients access to on-demand, customisable therapeutics. Robots are also being explored for treatment, by empowering precision surgery or targeted drug delivery. Within medical logistics, drones are being leveraged to deliver critical treatments to remote areas, collect samples, and even provide emergency aid. To enable seamless integration within healthcare, the Internet of Things technology is being exploited to form closed-loop systems that remotely communicate with one another. This review outlines the most promising healthcare technologies and devices, their strengths, drawbacks, and scopes for clinical adoption

Initiation of the West Antarctic Ice Sheet and estimates of total Antarctic ice volume in the earliest Oligocene

Reconstructions of Antarctic paleotopography for the late Eocene suggest that glacial erosion and thermal subsidence have lowered West Antarctic elevations considerably since then, with Antarctic land area having decreased ~20%. A new climate-ice sheet model based on these reconstructions shows that the West Antarctic Ice Sheet first formed at the Eocene-Oligocene transition (33.8–33.5 Ma, E-O) in concert with the continental-scale expansion of the East Antarctica Ice Sheet and that the total volume of East and West Antarctic ice (33.4–35.9 × 106 km3) was >1.4 times greater than previously assumed. This larger modeled ice volume is consistent with a modest cooling of 1–2°C in the deep ocean during the E-O transition, lower than other estimates of ~3°C cooling, and suggests the possibility of substantial ice in the Antarctic interior before the Eocene-Oligocene boundary

Mesoscale subduction at the Almeria-Oran front. Part 2: biophysical interactions.

This paper presents a detailed diagnostic analysis of hydrographic and current meter data from three, rapidly repeated, fine-scale surveys of the Almeria–Oran front. Instability of the frontal boundary, between surface waters of Atlantic and Mediterranean origin, is shown to provide a mechanism for significant heat transfer from the surface layers to the deep ocean in winter. The data were collected during the second observational phase of the EU funded OMEGA project on RRS Discovery cruise 224 during December 1996. High resolution hydrographic measurements using the towed undulating CTD vehicle, SeaSoar, traced the subduction of Mediterranean Surface Water across the Almeria–Oran front. This subduction is shown to result from a significant baroclinic component to the instability of the frontal jet. The Q-vector formulation of the omega equation is combined with a scale analysis to quantitatively diagnose vertical transport resulting from mesoscale ageostrophic circulation. The analyses are presented and discussed in the presence of satellite and airborne remotely sensed data; which provide the basis for a thorough and novel approach to the determination of observational error

The role of immune correlates of protection on the pathway to licensure, policy decision and use of group B Streptococcus vaccines for maternal immunization: considerations from World Health Organization consultations.

The development of a group B Streptococcus (GBS) vaccine for maternal immunization constitutes a global public health priority, to prevent GBS-associated early life invasive disease, stillbirth, premature birth, maternal sepsis, adverse neurodevelopmental consequences, and to reduce perinatal antibiotic use. Sample size requirements for the conduct of a randomized placebo-controlled trial to assess vaccine efficacy against the most relevant clinical endpoints, under conditions of appropriate ethical standards of care, constitute a significant obstacle on the pathway to vaccine availability. Alternatively, indirect evidence of protection based on immunologic data from vaccine and sero-epidemiological studies, complemented by data from opsonophagocytic in vitro assays and animal models, could be considered as pivotal data for licensure, with subsequent confirmation of effectiveness against disease outcomes in post-licensure evaluations. Based on discussions initiated by the World Health Organization we present key considerations about the potential role of correlates of protection towards an accelerated pathway for GBS vaccine licensure and wide scale use. Priority activities to support progress to regulatory and policy decision are outlined

CCL2-CCR2 axis promotes metastasis of nasopharyngeal carcinoma by activating ERK1/2-MMP2/9 pathway

Distant metastasis remains the major failure of nasopharyngeal carcinoma (NPC). In this study, the roles of chemokine C-C motif ligand 2 (CCL2), and its receptor chemokine C-C motif receptor type 2 (CCR2) on NPC metastasis were investigated. Serum CCL2 and CCL2/CCR2 expression level were remarkably increased in NPC patients compared to non-tumor patients by ELISA and IHC analyses. High expressions of CCL2/CCR2 were significantly associated with NPC metastasis and poor overall survival (OS). High expression of CCR2 is an independent adverse prognostic factor of OS and distant metastasis free survival (DMFS). Overexpressions of CCL2 and CCR2 were detected in high-metastatic NPC cell lines. Upregulating CCL2 and CCR2 respectively in low-metastatic NPC cell lines could promote cell migration and invasion, and exogenous CCL2 enhanced the motility in CCR2-overexpressing cells. On the other hand, downregulating CCL2 and CCR2 respectively in high-metastatic NPC cell lines by shRNA could decrease cell migration and invasion. However, exogenous CCL2 could not rescue the weaken ability of motility of CCR2-silencing cells. In nude mouse model, distant metastasis was significantly facilitated in either CCL2-overexpressing or CCR2-overexpressing groups, which was more obvious in CCR2-overexpressing group. Also, distant metastasis was considerably inhibited in either CCL2-silencing or CCR2-silencing groups. Dual overexpression of CCL2/CCR2 could activate extracellular signal-regulated kinase (ERK1/2) signaling pathway, which sequentially induced matrix metalloproteinase (MMP) 2 and 9 upregulations in the downstream. In conclusion, CCL2-CCR2 axis could promote NPC metastasis by activating ERK1/2-MMP2/9 pathway. This study helps to develop novel therapeutic targets for distant metastasis in NPC

Uncertainty in climate change projections

Twentieth century climate exhibits a strong warming trend. There is a broad scientific consensus that the warming contains a significant contribution from enhanced atmospheric greenhouse gas (GHG) concentrations due to anthropogenic emissions. The climate will continue to warm during the 21st century due to the large inertia of the Earth System and in response to additional GHG emissions, but by how much remains highly uncertain. This is mainly due to three factors: natural variability, model uncertainty, and GHG emission scenario uncertainty. Uncertainty due to natural variability dominates at short time scales of a few years up to a few decades, while at the longer centennial time scales scenario uncertainty provides the largest contribution to the total uncertainty. Model uncertainty is important at all lead times. Furthermore, our understanding of the Earth System dynamics is incomplete. Potentially important feedbacks such as the carbon cycle feedback are not well understood and not even taken into account in many model projections. Yet the scientific evidence is overwhelming that global mean surface temperature will exceed a level toward the end of the 21st century that will be unprecedented during the history of mankind, even if strong measures are taken to reduce global GHG emissions. It is this long-term perspective that demands immediate political action

Thermohaline structure, ageostrophic vertical velocity fields and phytoplankton distribution and production in the northeast Atlantic subtropical front

Author Posting. © American Geophysical Union, 2004. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 109 (2004): C04020, doi:10.1029/2003JC001990.Two oceanographic cruises were carried out in the Azores Current/Subtropical Front region in July 1997 and April 1999 to study the seasonal and mesoscale spatial variability in the relationship between the hydrodynamic characteristics of the water column and the distribution of nutrients, phytoplankton biomass, and production. Both the magnitude of chlorophyll-a values and primary production rates as well as their vertical distribution varied sharply associated with subtle changes in seasonal thermal stratification. Successive upwelling and downwelling regions were detected along the track of a cyclonic meander, with maximum ageostrophic vertical velocities of 3 m d−1 and −4 m d−1, respectively, at 375 dbar. Relatively high nitrate concentrations (>3.5 μM) were found associated with denser waters at the center of the meander, where the deep chlorophyll maximum (DCM) uplifted ~20 dbar. Chlorophyll-a concentrations ranged from 0.1 to 0.4 mg m−3, with slightly higher values (>0.35 mg m−3) at the northern side of the current. A significant relationship was not detected between the vertical ageostrophic velocity field and nitrate and chlorophyll-a distributions, which were significantly correlated with the depth of the 16°C isotherm. Vertical advective fluxes of nitrate across the base of the DCM were about 2 orders of magnitude higher than vertical diffusive nitrate transport (−6.6 to 3.7 mmol m−2 d−1 versus 0.01 to 0.07 mmol m−2 d−1). Diffusive nitrate fluxes only account for <10% of the total primary production rates measured in the region.This study was funded by the European Commission under the CANIGO contract MAS3CT960060 and CICYT. B. Mourin˜o was supported by a FPU fellowship from the Ministerio de Educacio´n y Cultura (Spain)

Actin filament severing by cofilin is more important for assembly than constriction of the cytokinetic contractile ring

When fission yeast express mutant cofilin that is inefficient at actin filament severing, cytokinetic contractile ring formation is severely impaired, but ring contraction proceeds efficiently