Estimating safe maximum levels of vitamins and minerals in fortified foods and food supplements.

Purpose: To show how safe maximum levels (SML) of vitamins and minerals in fortified foods and supplements may be estimated in population subgroups. Methods: SML were estimated for adults and 7- to 10-year-old children for six nutrients (retinol, vitamins B6, D and E, folic acid, iron and calcium) using data on usual daily nutrient intakes from Irish national nutrition surveys. Results: SML of nutrients in supplements were lower for children than for adults, except for calcium and iron. Daily energy intake from fortified foods in high consumers (95th percentile) varied by nutrient from 138 to 342 kcal in adults and 40–309 kcal in children. SML (/100 kcal) of nutrients in fortified food were lower for children than adults for vitamins B6 and D, higher for vitamin E, with little difference for other nutrients. Including 25 % ‘overage’ for nutrients in fortified foods and supplements had little effect on SML. Nutritionally significant amounts of these nutrients can be added safely to supplements and fortified foods for these population subgroups. The estimated SML of nutrients in fortified foods and supplements may be considered safe for these population subgroups over the long term given the food composition and dietary patterns prevailing in the respective dietary surveys. Conclusions: This risk assessment approach shows how nutrient intake data may be used to estimate, for population subgroups, the SML for vitamins and minerals in both fortified foods and supplements, separately, each taking into account the intake from other dietary sources

Embedding Session Types in HML

Recent work on the enhancement of multiparty session types with logical annotations enable the effective verification of properties on (1) the structure of the conversations, (2) the sorts of the messages, and (3) the actual values exchanged. In [3] we extend this work to enable the specification and verification of mutual effects of multiple cross-session interactions. Here we give a sound and complete embedding into the Hennessy-Milner logic to justify the expressiveness of the approach in [3] and to provide it with a logical background that will enable us to compare it with similar approaches

Comparison of Multiple Imputation Methods for Categorical Survey Items with High Missing Rates: Application to the Family Life, Activity, Sun, Health and Eating (FLASHE) Study

Two multiple imputation methods, the Sequential Regression Multivariate Imputation Algorithm and the Cox-Lannacchione Weighted Sequential Hotdeck, were examined and compared to impute highly missing categorical variables from the Family Life, Activity, Sun, Health and Eating (FLASHE) study. This paper describes the imputation approaches and results from the study

Safe and effective prescribing with dyslexia

Background: The term ‘dyslexia’ refers to a condition that impacts upon reading and writing abilities whilst not altering intelligence. Individuals with dyslexia may have difficulties with the speed and accuracy and their reading and writing, amongst other issues. Dyslexia is not automatically considered a disability but is a protected characteristic under the UK Equality Act (2010), and therefore employers and educational institutions are required to provide ‘reasonable adjustments’ in order to allow individuals to reach their full potential. There is a lack of research on this issue, but what little there is suggests that doctors feel as though any support they received ended when they graduated from medical school. Main body: A core distinction between medical school and medical practice is the requirement to prescribe medicines as registered medical practitioners. Junior doctors have to master this complex and potentially hazardous skill “on the job”, with a perceived lack of support. Here, we open up a debate about the potential impact of dyslexia on prescribing, and the need to find supports that may be effective in enabling doctors with dyslexia prescribe medicines safely and effectively – and thus reach their full potential as medical practitioners and promote patient safety. Conclusion: We argue that medical schools and hospitals could immediately provide dyslexia awareness training in both undergraduate and postgraduate settings. We discuss electronic prescribing systems, and conclude that research is required to identify effective supports for junior doctors with dyslexia

Transgender health in medical education

No description supplie

Targeting the Epidermal Growth Factor Receptor in Epithelial Ovarian Cancer: Current Knowledge and Future Challenges

The epidermal growth factor receptor is overexpressed in up to 60% of ovarian epithelial malignancies. EGFR regulates complex cellular events due to the large number of ligands, dimerization partners, and diverse signaling pathways engaged. In ovarian cancer, EGFR activation is associated with increased malignant tumor phenotype and poorer patient outcome. However, unlike some other EGFR-positive solid tumors, treatment of ovarian tumors with anti-EGFR agents has induced minimal response. While the amount of information regarding EGFR-mediated signaling is considerable, current data provides little insight for the lack of efficacy of anti-EGFR agents in ovarian cancer. More comprehensive, systematic, and well-defined approaches are needed to dissect the roles that EGFR plays in the complex signaling processes in ovarian cancer as well as to identify biomarkers that can accurately predict sensitivity toward EGFR-targeted therapeutic agents. This new knowledge could facilitate the development of rational combinatorial therapies to sensitize tumor cells toward EGFR-targeted therapies

The learning experiences of dyslexic medical students during the COVID‑19 pandemic: a phenomenological study

Dyslexia is a Specific Learning Difficulty that impacts on reading and writing abilities. During the COVID-19 pandemic, medical schools have been forced to undertake distance learning and assessment. The wider literature suggested that e-learning might pose additional challenges for dyslexic students. Here we explore their overall experiences of learning/studying during this time in a phenomenological study. Five medical students were interviewed in depth and the audio-recordings were transcribed verbatim. Transcripts then underwent an interpretive phenomenological analysis. Our results highlighted a largely positive experience, with an improved culture of togetherness, freedom and sense of control. They also revealed issues with a lack of clinical exposure, potential negative impacts on ranking positions for those with dyslexia, and possible cheating in exams. There are some surprising results—in particular the positive responses to how remote learning was delivered. These seemed to put our participants more on a par with their non-dyslexic colleagues—except in some examinations. It is our hope that medical educators may resist a return to ‘the way things have always been done’ when the pandemic has resolved, and by doing so, continue to foster this new, positive culture and paradigm shift

Medical students’ attitudes towards and beliefs about dyslexia: a single-centre survey study

Dyslexia impacts upon reading and writing, but not upon intelligence. Little research has explored dyslexia in medicine. An online questionnaire was emailed to all medical students within a single medical school, inviting them to participate. Results were analysed using descriptive statistics. Statistical significance was calculated for any differences between gender, age group, or year-group cohorts. 123 individuals responded. Most reported a good understanding of dyslexia, and feelings that their peers with it should be supported. However, a minority reported feelings of jealously, and dissatisfaction – feeling that students with dyslexia should not be supported, as this gives them an unfair advantage. In some, this seemed to stem from a belief that dyslexia were not real, or that their peers were “faking it”. “I think it is a poor excuse for students to be favoured advantageously and receive tremendous benefits. It is certainly not a medical problem.

Organizing a System-Wide Effort on Ventilator Supply Management during COVID-19

We developed a concise definition of ventilators to accurately represent them in all reports across the enterprise, and a ventilator deployment plan

Magnetic resonance imaging detects placental hypoxia and acidosis in mouse models of perturbed pregnancies

Endothelial dysfunction as a result of dysregulation of anti-angiogenic molecules secreted by the placenta leads to the maternal hypertensive response characteristic of the pregnancy complication of preeclampsia. Structural abnormalities in the placenta have been proposed to result in altered placental perfusion, placental oxidative stress, cellular damage and inflammation and the release of anti-angiogenic compounds into the maternal circulation. The exact link between these factors is unclear. Here we show, using Magnetic Resonance Imaging as a tool to examine placental changes in mouse models of perturbed pregnancies, that T2 contrast between distinct regions of the placenta is abolished at complete loss of blood flow. Alterations in T2 (spin-spin or transverse) relaxation times are explained as a consequence of hypoxia and acidosis within the tissue. Similar changes are observed in perturbed pregnancies, indicating that acidosis as well as hypoxia may be a feature of pregnancy complications such as preeclampsia and may play a prominent role in the signalling pathways that lead to the increased secretion of anti-angiogenic compounds