Regulatory and Policy-Related Aspects of Calcium Fortification of Foods. Implications for Implementing National Strategies of Calcium Fortification

Daily calcium intake is well below current recommendations in most low- and middle-income countries (LMICs). Calcium intake is usually related to bone health, however an adequate calcium intake has also been shown to reduce hypertensive disorders of pregnancy, lower blood pressure and cholesterol values, and to prevent recurrent colorectal adenomas. Food fortification of foods has been identified as a cost-effective strategy to overcome micronutrient gaps in public health. This review summarizes regulatory aspects of fortification of commonly consumed foods with micronutrients, with an emphasis on calcium. We selected a convenient sample of 15 countries from differentWHOregions and described the regulatory framework related to calcium fortification of staple foods. We assessed the relevant policies in electronic databases including the WHO Global database on the Implementation of Nutrition Action (GINA) for fortification policies and the Global Fortification Data Exchange Database, a fortification database developed and maintained by Food Fortification Initiative (FFI), Global Alliance for Improved Nutrition (GAIN), Iodine Global Network (IGN), and Micronutrient Forum. Food fortification with micronutrients is widely used in many of the selected countries. Most countries had national legislation for the addition of micronutrients to staple foods, especially wheat flour. These national legislations, that includes regulations and standards, can provide the framework to consider the implementation of adding calcium to the fortification strategies, including the selection of the adequate food vehicle to reach the targeted population at risk safely. The strategy to include calcium in the fortification mix in fortified staple foods seems promising in these countries. However, potential undesired changes on the organoleptic characteristics of fortified foods and products thereof, and operational feasibility at the manufacturing site should be evaluated by the stakeholders during the planning stage. Codex Alimentarius standards should be considered by regulators in order to assure adherence to international standards. While the selected countries already have established national regulations and/or standards for fortification of key staple food vehicles, and there are experiences in the implementation of fortification of some staple foods, national food intake surveys can help plan, design, and modify existing fortification programs as well as monitor food and nutrient consumption to assess risk and benefits.Fil: Cormick, Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina. Universidad Nacional de La Matanza; ArgentinaFil: Betrán, Ana Pilar. Organizacion Mundial de la Salud; ArgentinaFil: Metz, Fletcher. Carleton College; Estados UnidosFil: Palacios, Cristina. Florida International University; Estados UnidosFil: Beltrán Velazquez, Filiberto. Organizacion Mundial de la Salud; ArgentinaFil: de las Nieves García-Casal, María. Organizacion Mundial de la Salud; ArgentinaFil: Peña Rosas, Juan Pablo. Organizacion Mundial de la Salud; ArgentinaFil: Hofmeyr, G. Justus. University Of Fort Hare; SudáfricaFil: Belizan, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentin

Evaluating computer‐aided detection algorithms

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134784/1/mp6289.pd

The soluble form of Toll-like receptor 2 is elevated in serum of multiple sclerosis patients: a novel potential disease biomarker

Multiple sclerosis (MS) is an immune-mediated inflammatory demyelinating disease of the central nervous system. It was previously shown that Toll-like receptor (TLR)-2 signalling plays a key role in the murine experimental autoimmune encephalomyelitis (EAE) model of MS, and that TLR2-stimulation of regulatory T cells (Tregs) promotes their conversion to T helper 17 (Th17) cells. Here, we sought potential sources of TLR2 stimulation and evidence of TLR2 activity in MS patient clinical samples. Soluble TLR2 (sTLR2) was found to be significantly elevated in sera of MS patients (n=21), in both relapse and remission, compared to healthy controls (HC) (n=24). This was not associated with the acute phase reaction (APR) as measured by serum C-reactive protein (CRP) level, which was similarly increased in MS patients compared to controls. An independent validation cohort from a different ethnic background showed a similar upward trend in mean sTLR2 values in relapsing-remitting MS (RRMS) patients, and significant differences in sTLR2 values between patients and healthy controls were preserved when the data from the two cohorts were pooled together (n=41 RRMS and 44 HC, P=0.0006). TLR2-stimulants, measured using a human embryonic kidney (HEK-293) cell transfectant reporter assay, were significantly higher in urine of MS patients than healthy controls. A screen of several common urinary tract infections (UTI)-related organisms showed strong induction of TLR2-signalling in the same assay. Taken together, these results indicate that two different markers of TLR2-activity - urinary TLR2-stimulants, and serum sTLR2 levels - are significantly elevated in MS patients compared to healthy controls

Stochastic evolutionary game dynamics

In this review, we summarize recent developments in stochastic evolutionary game dynamics of finite populations.Comment: To appear in "Reviews of Nonlinear Dynamics and Complexity" Vol. II, Wiley-VCH, 2009, edited by H.-G. Schuste

The role of coronary artery calcification score in clinical practice

<p>Abstract</p> <p>Background</p> <p>Coronary artery calcification (CAC) measured by electron-beam computed tomography (EBCT) has been well studied in the prediction of coronary artery disease (CAD). We sought to evaluate the impact of the CAC score in the diagnostic process immediately after its introduction in a large tertiary referral centre.</p> <p>Methods</p> <p>598 patients with no history of CAD who underwent EBCT for evaluation of CAD were retrospectively included into the study. Ischemia detection test results (exercise stress test, single photon emission computed tomography or ST segment analysis on 24 hours ECG detection), as well as the results of coronary angiography (CAG) were collected.</p> <p>Results</p> <p>The mean age of the patients was 55 ± 11 years (57% male). Patients were divided according to CAC scores; group A < 10, B 10 – 99, C 100 – 399 and D ≥ 400 (304, 135, 89 and 70 patients respectively). Ischemia detection tests were performed in 531 (89%) patients; negative ischemia results were found in 362 patients (183 in group A, 87 in B, 58 in C, 34 in D). Eighty-eight percent of the patients in group D underwent CAG despite negative ischemia test results, against 6% in group A, 16% in group B and 29% in group C. A positive ischemia test was found in 74 patients (25 in group A, 17 in B, 16 in C, 16 in D). In group D 88% (N = 14) of the patients with a positive ischemia test were referred for CAG, whereas 38 – 47% in group A-C.</p> <p>Conclusion</p> <p>Our study showed that patients with a high CAC score are more often referred for CAG. The CAC scores can be used as an aid in daily cardiology practice to determine further decision making.</p

A Comprehensive Assessment of Anthropogenic and Natural Sources and Sinks of Australasia's Carbon Budget

Regional carbon budget assessments attribute and track changes in carbon sources and sinks and support the development and monitoring the efficacy of climate policies. We present a comprehensive assessment of the natural and anthropogenic carbon (C-CO2) fluxes for Australasia as a whole, as well as for Australia and New Zealand individually, for the period from 2010 to 2019, using two approaches: bottom-up methods that integrate flux estimates from land-surface models, data-driven models, and inventory estimates; and top-down atmospheric inversions based on satellite and in situ measurements. Our bottom-up decadal assessment suggests that Australasia's net carbon balance was close to carbon neutral (−0.4 ± 77.0 TgC yr−1). However, substantial uncertainties remain in this estimate, primarily driven by the large spread between our regional terrestrial biosphere simulations and predictions from global ecosystem models. Within Australasia, Australia was a net source of 38.2 ± 75.8 TgC yr−1, and New Zealand was a net CO2 sink of −38.6 ± 13.4 TgC yr−1. The top-down approach using atmospheric CO2 inversions indicates that fluxes derived from the latest satellite retrievals are consistent within the range of uncertainties with Australia's bottom-up budget. For New Zealand, the best agreement was found with a national scale flux inversion estimate based on in situ measurements, which provide better constrained of fluxes than satellite flux inversions. This study marks an important step toward a more comprehensive understanding of the net CO2 balance in both countries, facilitating the improvement of carbon accounting approaches and strategies to reduce emissions

WISC-III Cognitive Profiles in Children with Developmental Dyslexia: Specific Cognitive Disability and Diagnostic Utility

This study analysed the usefulness of the Wechsler Intelligence Scale for Children-Third Edition in identifying specific cognitive impairments that are linked to developmental dyslexia (DD) and the diagnostic utility of the most common profiles in a sample of 100 Portuguese children (50 dyslexic and 50 normal readers) between the ages of 8 and 12 years. Children with DD exhibited significantly lower scores in the Verbal Comprehension Index (except the Vocabulary subtest), Freedom from Distractibility Index (FDI) and Processing Speed Index subtests, with larger effect sizes than normal readers in Information, Arithmetic and Digit Span. The Verbal-Performance IQs discrepancies, Bannatyne pattern and the presence of FDI; Arithmetic, Coding, Information and Digit Span subtests (ACID) and Symbol Search, Coding, Arithmetic and Digit Span subtests (SCAD) profiles (full or partial) in the lowest subtests revealed a low diagnostic utility. However, the receiver operating characteristic curve and the optimal cut-off score analyses of the composite ACID; FDI and SCAD profiles scores showed moderate accuracy in correctly discriminating dyslexic readers from normal ones. These results suggested that in the context of a comprehensive assessment, the Wechsler Intelligence Scale for Children-Third Edition provides some useful information about the presence of specific cognitive disabilities in DD. Practitioner Points. Children with developmental dyslexia revealed significant deficits in the Wechsler Intelligence Scale for Children-Third Edition subtests that rely on verbal abilities, processing speed and working memory. The composite Arithmetic, Coding, Information and Digit Span subtests (ACID); Freedom from Distractibility Index and Symbol Search, Coding, Arithmetic and Digit Span subtests (SCAD) profile scores showed moderate accuracy in correctly discriminating dyslexics from normal readers. Wechsler Intelligence Scale for Children-Third Edition may provide some useful information about the presence of specific cognitive disabilities in developmental dyslexia

Sea-level rise impacts on transport infrastructure: the notorious case of the coastal railway line at Dawlish, England

Future climate change is likely to increase the frequency of coastal storms and floods, with major consequences for coastal transport infrastructure. This paper assesses the extent to which projected sea-level rise is likely to impact upon the functioning of the Dawlish to Teignmouth stretch of the London to Penzance railway line, in England. Using a semi-empirical modelling approach, we identify a relationship between sea-level change and rail incidents over the last 150 years and then use model-based sea-level predictions to extrapolate this relationship into the future. We find that days with line restrictions (DLRs) look set to increase by up to 1170%, to as many as 84–120 per year, by 2100 in a high sea-level rise scenario (0.55–0.81 m). Increased costs to the railway industry deriving from maintenance and line restrictions will be small (£ millions) in comparison with damage caused by individual extreme events (£10s of millions), while the costs of diversion of the railway are higher still (£100s of millions to billions). Socio-economic costs to the region are likely to be significant although they are more difficult to estimate accurately. Finally, we explain how our methodology is applicable to vulnerable coastal transport infrastructure worldwide

MR imaging of therapy-induced changes of bone marrow

MR imaging of bone marrow infiltration by hematologic malignancies provides non-invasive assays of bone marrow cellularity and vascularity to supplement the information provided by bone marrow biopsies. This article will review the MR imaging findings of bone marrow infiltration by hematologic malignancies with special focus on treatment effects. MR imaging findings of the bone marrow after radiation therapy and chemotherapy will be described. In addition, changes in bone marrow microcirculation and metabolism after anti-angiogenesis treatment will be reviewed. Finally, new specific imaging techniques for the depiction of regulatory events that control blood vessel growth and cell proliferation will be discussed. Future developments are directed to yield comprehensive information about bone marrow structure, function and microenvironment