Liver Adiposity and Metabolic Profile in Individuals with Chronic Spinal Cord Injury

Purpose. To quantify liver adiposity using magnetic resonance imaging (MRI) and to determine its association with metabolic profile in men with spinal cord injury (SCI). Materials and Methods. MRI analysis of liver adiposity by fat signal fraction (FSF) and visceral adipose tissue (VAT) was completed on twenty participants. Intravenous glucose tolerance test was conducted to measure glucose effectiveness (g) and insulin sensitivity (i ). Lipid panel, fasting glucose, glycated hemoglobin (HbA1c), and inflammatory cytokines were also analyzed. Results. Average hepatic FSF was 3.7% ± 2.1. FSF was positively related to TG, non-HDL-C, fasting glucose, HbA1c, VAT, and tumor necrosis factor alpha (TNF-). FSF was negatively related to i and testosterone. FSF was positively related to VAT ( = 0.48, = 0.032) and TNF- ( = 0.51, = 0.016) independent of age, level of injury (LOI), and time since injury (TSI). The associations between FSF and metabolic profile were independent of VAT. Conclusions. MRI noninvasively estimated hepatic adiposity in men with chronic SCI. FSF was associated with dysfunction in metabolic profile, central adiposity, and inflammation. Importantly, liver adiposity influenced metabolic profile independently of VAT. These findings highlight the significance of quantifying liver adiposity after SCI to attenuate the development of metabolic disorders

Influenza, Campylobacter and Mycoplasma Infections, and Hospital Admissions for Guillain-Barré Syndrome, England

TOC Summary line: Campylobacter, Mycoplasma pneumoniae, and influenza (or influenza vaccination) act as infectious triggers for Guillain-Barré syndrome

Fruit and vegetable intakes, sources and contribution to total diet in very young children (1–4 years): the Irish National Pre-School Nutrition Survey

Although the importance of fruit and vegetable (F&V) intakes in the prevention of chronic diseases is well established, there are limited data on intakes in very young children. This study estimates F&V intakes and sources and the contribution to the total diet using data from the National Pre-School Nutrition Survey, a nationally representative sample (n 500) of Irish children aged 1–4 years. A 4-d weighed food record was used to collect food intake data. Of 1652 food codes consumed, 740 had a fruit/vegetable component. The percentage of edible fruits and/or vegetables in each food code was calculated. Intakes (g/d), sources (g/d) and the contribution of F&V to the weight of the total diet (%) were estimated, split by age. All children consumed F&V. Intakes of total fruits, in particular fruit juice, increased with age. The contribution to total fruit intake was discrete fruits (47–56 % range across age), 100 % fruit juice, smoothies and pureés (32–45 %) as well as fruits in composite dishes (7–13 %). Total vegetable intake comprised of discrete vegetables (48–62 % range across age) and vegetables in composite dishes (38–52 %). F&V contributed on average 20 % (15 % fruit; 5 % vegetables) to the weight of the total diet and was <10 % in sixty-one children (12 %). F&V contributed 50 % of vitamin C, 53 % of carotene, 34 % of dietary fibre and 42 % of non-milk sugar intakes from the total diet. F&V are important components of the diet of Irish pre-school children; however, some aspects of F&V intake patterns could be improved in this age group

Editorial: Marine Pollution - Emerging Issues and Challenges

publishedVersio

Estimating the incidence of acute infectious intestinal disease in the community in the UK:A retrospective telephone survey

Objectives: To estimate the burden of intestinal infectious disease (IID) in the UK and determine whether disease burden estimations using a retrospective study design differ from those using a prospective study design. Design/Setting: A retrospective telephone survey undertaken in each of the four countries comprising the United Kingdom. Participants were randomly asked about illness either in the past 7 or 28 days. Participants: 14,813 individuals for all of whom we had a legible recording of their agreement to participate Outcomes: Self-reported IID, defined as loose stools or clinically significant vomiting lasting less than two weeks, in the absence of a known non-infectious cause. Results: The rate of self-reported IID varied substantially depending on whether asked for illness in the previous 7 or 28 days. After standardising for age and sex, and adjusting for the number of interviews completed each month and the relative size of each UK country, the estimated rate of IID in the 7-day recall group was 1,530 cases per 1,000 person-years (95% CI: 1135 – 2113), while in the 28-day recall group it was 533 cases per 1,000 person-years (95% CI: 377 – 778). There was no significant variation in rates between the four countries. Rates in this study were also higher than in a related prospective study undertaken at the same time. Conclusions: The estimated burden of disease from IID varied dramatically depending on study design. Retrospective studies of IID give higher estimates of disease burden than prospective studies. Of retrospective studies longer recall periods give lower estimated rates than studies with short recall periods. Caution needs to be exercised when comparing studies of self-reported IID as small changes in study design or case definition can markedly affect estimated rates

Cost-Effectiveness of Treating Upper Limb Spasticity Due to Stroke with Botulinum Toxin Type A: Results from the Botulinum Toxin for the Upper Limb after Stroke (BoTULS) Trial

Stroke imposes significant burdens on health services and society, and as such there is a growing need to assess the cost-effectiveness of stroke treatment to ensure maximum benefit is derived from limited resources. This study compared the cost-effectiveness of treating post-stroke upper limb spasticity with botulinum toxin type A plus an upper limb therapy programme against the therapy programme alone. Data on resource use and health outcomes were prospectively collected for 333 patients with post-stroke upper limb spasticity taking part in a randomized trial and combined to estimate the incremental cost per quality adjusted life year (QALY) gained of botulinum toxin type A plus therapy relative to therapy alone. The base case incremental cost-effectiveness ratio (ICER) of botulinum toxin type A plus therapy was £93,500 per QALY gained. The probability of botulinum toxin type A plus therapy being cost-effective at the England and Wales cost-effectiveness threshold value of £20,000 per QALY was 0.36. The point estimates of the ICER remained above £20,000 per QALY for a range of sensitivity analyses, and the probability of botulinum toxin type A plus therapy being cost-effective at the threshold value did not exceed 0.39, regardless of the assumptions made

Linking migration to community resilience in the receiving basin of a large-scale water transfer project

Large-scale water transfer projects (LWTPs) transfer water to urban and agricultural areas. The Majes-Siguas canal, established in 1983, is an LWTP that created a thriving agricultural area through irrigating the Majes district in the Atacama Desert of Peru. Like other LWTP receiving basins, the project has attracted an influx of migrants who work on the farms. At the same time, the Majes LWTP is the district’s only source of water and has an aging infrastructure which presents significant risks. While many studies critically analyze the consequences of LWTPs in water supply basins, few evaluate the resilience of communities living in LWTP receiving basins. In this study, we ask: what factors stifle or enable resilience of the agricultural community in the Majes-Siguas receiving basin? In 2019, we conducted semi-structured interviews with migrant and residents and water authorities, collected and reviewed historical documents, and conducted participant observations. Using this data, we analyze community resilience by identifying perceived risks, stressors, and vulnerabilities among and between groups of agricultural actors, their adaptations, and their perceptions of water management organizations’ responses. Results show that a single source of water, differential vulnerabilities between groups of agricultural actors, and limited organizational responsiveness stifled community resilience, while communal pooling and self-organization enabled community resilience. Attention to increasing inclusion of migrants in water management decision-making, addressing differential water and land rights, and cultivating space for migrant self-organization could enable the agricultural community to be more resilient