Dietary folate intake of female adolescents in New Zealand

Background: Folate plays an important role in DNA synthesis and methylation and thus, dietary inadequacy is of particular concern primarily among reproductive age women. Studies to date show that achieving recommended dietary folate intakes can be difficult, especially in countries without mandatory folate fortification. In an effort to address this nutrient gap, the New Zealand government have instituted voluntary fortification of certain foods with folic acid (bread, breakfast cereals, fruit juice and others) since the mid-1990s. More recently, the New Zealand Association of Bakers have committed to fortifying a minimum of 25 % to 50 % of breads by sales volume, with folic acid. It is unknown whether increased bread fortification and/or changes in dietary patterns over time have influenced dietary folate intakes and the prevalence of inadequacy among the target population. Objective: The aim of the study was to assess dietary folate intakes and major food group contributors of folate among a sample of New Zealand female adolescents aged 15 – 18 years. Design: Healthy, female adolescents were recruited from eight high schools across the country. Sociodemographic data were collected via an online, self-administered questionnaires, and anthropometric data were collected using standardised techniques. Dietary data were collected using two non-consecutive 24-hour recalls. Usual energy and folate intakes, including natural food folate and folic acid, and the prevalence of folate inadequacy were estimated by means of dietary recalls after adjusting for intra-individual variation. Food consumption was also categorised into 33 food groups and the top dietary contributors of total folate intake were calculated. Results: One-hundred and forty-five participants were enrolled in the study, with 132 completing dietary intake data. The average age of participants was 16.7 years, the majority were New Zealand European and Others, and 34.6 % of participants were classified as overweight and obese. Dietary results showed that the median total intake of folate was 347.2 (216.0, 430.3) µg dietary folate equivalents (DFEs)/day, and the prevalence of inadequacy was 41.7 %. A comparison of folate intakes by various socio-demographic subgroups revealed apparent differences with increased risk of inadequate intakes among participants from lower decile schools, and of Maori and Asian descent albeit sample sizes were small. Of the total folate intake in the sample population, median intake of natural food folate and food folic acid was 223.9 (161.7, 263.4) µg/day and 102.5 (75.1, 145.4) µg/day, respectively. Breads (including rolls and specialty breads) represented the top dietary contributor of total folate intake (17.7 %), followed by vegetables (10.9 %) and breakfast cereals (10.8 %). Breads were consumed by the majority of participants (81.8 %) whereas breakfast cereals were consumed less frequently by the sample population (38.6 %). Conclusion: The overall prevalence of inadequate folate intakes was high despite consumption of folic acid fortified foods such as breads and breakfast cereals. Moreover, the results indicate that total folate intakes among reproductive age women have not increased over the last ten years despite increased voluntary folic acid fortification of breads in New Zealand. While further work is needed to recruit a more representative sample of the population, these findings raise concern regarding the effectiveness of the current voluntary folic acid fortification policy in New Zealand to meet the recommended folate requirements of female adolescents

Turner syndrome with ring x chromosome: do they have a distinct phenotype?

In contrast to classic Turner syndrome, Turner patients with ring X chromosome are associated with distinct dysmorphism and are likely to be mentally impaired. Four Turner patients with ring X chromosome were examined for phenotypic features of Turner syndrome and additional dysmorphism. Both patients 1 and 2 are twins with normal intelligence whereas patients 3 and 4 have mental impairment. With the exception of patient 4, the other three patients only have few Turner characteristics. None of the patients have the distinctive dysmorphism previously reported in Turner syndrome with ring X chromosome. Both twins developed spontaneous puberty. Patients 3 and 4 however had no spontaneous puberty. We postulate that this variation may be related to the ring size, the proportion of 45,X and ring X chromosome in cell lines of various body tissues as well as the ability of these rings to be inactivated as a result of lyonisation

Clinical features of girls with turner syndrome in a single centre in Malaysia

Objectives. Diagnosis of Turner syndrome in Malaysia is often late. This may be due to a lack of awareness of the wide clinical variability in this condition. In our study, we aim to examine the clinical features of all our Turner patients during the study period and at presentation. Methodology. This was a cross-sectional study. Thirty-four (34) Turner patients were examined for Turner-specific clinical features. The karyotype, clinical features at presentation, age at diagnosis and physiologic features were retrieved from their medical records. Results. Patients with 45,X presented at a median age of 1 month old with predominantly lymphoedema and webbed neck. Patients with chromosome mosaicism or structural X abnormalities presented at a median age of 11 years old with a broader clinical spectrum, short stature being the most common presenting clinical feature. Cubitus valgus deformity, nail dysplasia and short 4th/5th metacarpals or metatarsals were common clinical features occurring in 85.3%-94.1% of all Turner patients. Almost all patients aged ≥2 years were short irrespective of karyotype. Conclusion. Although short stature is a universal finding in Turner patients, it is usually unrecognised till late. Unlike the 45,X karyotype, non-classic Turner syndrome has clinical features which may be subtle and difficult to discern. Our findings underscore the importance of proper serial anthropometric measurements in children. Awareness for the wide spectrum of presenting features and careful examination for Turner specific clinical features is crucial in all short girls to prevent a delay in diagnosis

Coordinating Pricing and Empty Container Repositioning in Two-Depot Shipping Systems

This paper studies joint decisions on pricing and empty container repositioning in two- depot shipping services with stochastic shipping demand. We formulate the problem as a stochastic dynamic programming (DP) model. The exact DP may have a high-dimensional state space due to in-transit containers. To cope with the curse of dimensionality, we develop an approximate model where the number of in-transit containers on each vessel is approxi- mated with a fixed container flow predetermined by solving a static version of the problem. Moreover, we show that the approximate value function is L♮-concave, thereby characterizing the structure of the optimal control policy for the approximate model. With the upper bound obtained by solving the information relaxation-based dual of the exact DP, we numerically show that the control policies generated from our approximate model are close to optimal when transit times span multiple periods

Antioxidant, α-glucosidase inhibitory activities, and HPLC quantitative analysis of phenolic compounds isolated from Neptunia oleracea Lour.

Neptunia oleracea Lour. is a tropical plant cultivated in Southeast Asia. It is consumed as vegetable and traditional herb for the treatment of several disorders. The objective of the present work was to isolate the phenolic compounds from N. oleracea, followed by their bioactivity evaluation and quantitative analysis. The ethyl acetate (EtOAc) and methanol (MeOH) fractions of N. oleracea were subjected to various chromatographic techniques to isolate the phenolic compounds. The isolated phenolic compounds were characterised by several spectroscopic methods, including mass spectrometry (MS) and nuclear magnetic resonance (NMR). Then, these compounds were subjected to DPPH free radical scavenging as α-glucosidase inhibitory assays for the evaluation of their activities. Their contents in the fractions were analysed via high performance liquid chromatography (HPLC) quantitative analysis. Five phenolic compounds including quercetin-3-O-β-D-xylopyranoside (1), quercetin-3-O-α-L-arabinopyranoside (2), quercetin-3-O-α-L-rhamnoside (3), methylgallate (4) and rutin (5) were isolated from N. oleracea for the first time. Evaluation on the DPPH free radical scavenging and α-glucosidase inhibitory activities of these compounds showed that methylgallate (4) was the most potent antioxidant and α-glucosidase inhibitors among them, with IC50 values of 17.25 and 50.76 μM, respectively. The HPLC quantitative analysis revealed the high content of the quercetin derivatives (compounds 1, 2 and 3) in the EtOAc fraction (ranging from 125.68 to 157.55 μg/mg) and methylgallate (4) in the MeOH fraction (75.25 μg/mg). Comparison of the bioactivities of the isolated phenolic compounds with the fractions indicated their significant contribution for the DPPH free radical scavenging of N. oleracea; while they might be working synergistically for the α-glucosidase inhibitory activity. The results of the present work could help to validate the contribution of phenolic compounds for the studied bioactivities of N. oleracea

Association between knowledge, attitude, and practice of nutrition and food labels among selected higher educational institution students in Klang Valley

Nutrition information on food labels guides consumers to purchase healthier food choices. Besides nutrition information, other factors influence a purchase. This study aims to determine the association between the knowledge, attitude, and practice (KAP) among tertiary students on nutrition and food labels. In this cross-sectional study, a total of 190 students from three tertiary institutions within Klang Valley completed an online survey. Self-administered questionnaires on sociodemographic profiles and KAP questions, available in Malay and English, were distributed. Association between KAP was determined using Spearman's Rho test, while multiple linear regression was used to assess predictors of KAP scores. Mean body mass index (BMI) of the respondents were 20.8 kg/m2. The total mean score for knowledge on food labels was 8.93, followed by attitude and practice with 3.86 and 3.11, respectively. There was a significant correlation between attitude and practice (p<0.005). Nutrient and total calorie information on food labels influenced purchases, with 56.3% of respondents reported looking at the total calorie content, followed by 55.7% and 49.5% checking on sugar and fats, respectively. In addition, other factors such as expiry date (60.9%) and price (59.9%) also influenced purchases. Overall, respondents have a positive attitude on food selection, but male respondents have better knowledge levels than females. However, female respondents interpret food labelling effectively compared to male respondents. Despite having good knowledge and attitude towards nutrition, respondents were still making poor choices. A more extensive range of healthier food options and targeted healthy eating campaigns may empower students to choose more nutritious foods

Medical record abstraction in a hospital with paper-based records: experience of early career psychiatrists in northern Borneo

We used medical record abstraction to conduct research in a psychiatric hospital with paper-based medical records. The challenges we encountered included: the difficulty in retrieving files; the extensive effort and time needed to extract clinical information; the lack of a standardised documentation system of medical records; and the need for advanced computer literacy. To promote future research using electronic medical records, potential solutions include creating a registry of all patients receiving treatment, as well as equipping busy clinicians with computer skills