Perspective: a conceptual framework for adaptive personalized nutrition advice systems (APNASs)

Nearly all approaches to personalized nutrition (PN) use information such as the gene variants of individuals to deliver advice that is more beneficial than a generic one-size-fits-all recommendation. Despite great enthusiasm and the increased availability of commercial services, thus far, scientific studies have only revealed small to negligible effects on the efficacy and effectiveness of personalized dietary recommendations, even when using genetic or other individual information. In addition, from a public health perspective, scholars are critical of PN because it primarily targets socially privileged groups rather than the general population, thereby potentially widening health inequality. Therefore, in this perspective, we propose to extend current PN approaches by creating adaptive personalized nutrition advice systems (APNASs) that are tailored to the type and timing of personalized advice for individual needs, capacities, and receptivity in real-life food environments. These systems encompass a broadening of current PN goals (i.e., what should be achieved) to incorporate individual goal preferences beyond currently advocated biomedical targets (e.g., making sustainable food choices). Moreover, they cover the personalization processes of behavior change by providing in situ, just-in-time information in real-life environments (how and when to change), which accounts for individual capacities and constraints (e.g., economic resources). Finally, they are concerned with a participatory dialogue between individuals and experts (e.g., actual or virtual dieticians, nutritionists, and advisors), when setting goals and deriving measures of adaption. Within this framework, emerging digital nutrition ecosystems enable continuous, real-time monitoring, advice, and support in food environments from exposure to consumption. We present this vision of a novel PN framework along with scenarios and arguments that describe its potential to efficiently address individual and population needs and target groups that would benefit most from its implementation

Gender Monstrosity

Deadgirl (2008) is based around a group of male teens discovering and claiming ownership of a bound female zombie, using her as a sex slave. This narrative premise raises numerous tensions that are particularly amplified by using a zombie as the film’s central victim. The Deadgirl is sexually passive yet monstrous, reifying the horrors associated with the female body in patriarchal discourses. She is objectified on the basis of her gender, and this has led many reviewers to dismiss the film as misogynistic Torture Porn. However, the conditions under which masculinity is formed here – where adolescent males become "men" by enacting sexual violence – are as problematic as the specter of the female zombie. Deadgirl is clearly horrific and provocative: in this article I seek to probe implications arising from the film’s gender conflicts

Phase 3 trials of ixekizumab in moderate-to-severe plaque psoriasis

BACKGROUND Two phase 3 trials (UNCOVER-2 and UNCOVER-3) showed that at 12 weeks of treatment, ixekizumab, a monoclonal antibody against interleukin-17A, was superior to placebo and etanercept in the treatment of moderate-to-severe psoriasis. We report the 60-week data from the UNCOVER-2 and UNCOVER-3 trials, as well as 12-week and 60-week data from a third phase 3 trial, UNCOVER-1. METHODS We randomly assigned 1296 patients in the UNCOVER-1 trial, 1224 patients in the UNCOVER-2 trial, and 1346 patients in the UNCOVER-3 trial to receive subcutaneous injections of placebo (placebo group), 80 mg of ixekizumab every 2 weeks after a starting dose of 160 mg (2-wk dosing group), or 80 mg of ixekizumab every 4 weeks after a starting dose of 160 mg (4-wk dosing group). Additional cohorts in the UNCOVER-2 and UNCOVER-3 trials were randomly assigned to receive 50 mg of etanercept twice weekly. At week 12 in the UNCOVER-3 trial, the patients entered a long-term extension period during which they received 80 mg of ixekizumab every 4 weeks through week 60; at week 12 in the UNCOVER-1 and UNCOVER-2 trials, the patients who had a response to ixekizumab (defined as a static Physicians Global Assessment [sPGA] score of 0 [clear] or 1 [minimal psoriasis]) were randomly reassigned to receive placebo, 80 mg of ixekizumab every 4 weeks, or 80 mg of ixekizumab every 12 weeks through week 60. Coprimary end points were the percentage of patients who had a score on the sPGA of 0 or 1 and a 75% or greater reduction from baseline in Psoriasis Area and Severity Index (PASI 75) at week 12. RESULTS In the UNCOVER-1 trial, at week 12, the patients had better responses to ixekizumab than to placebo; in the 2-wk dosing group, 81.8% had an sPGA score of 0 or 1 and 89.1% had a PASI 75 response; in the 4-wk dosing group, the respective rates were 76.4% and 82.6%; and in the placebo group, the rates were 3.2% and 3.9% (P<0.001 for all comparisons of ixekizumab with placebo). In the UNCOVER-1 and UNCOVER-2 trials, among the patients who were randomly reassigned at week 12 to receive 80 mg of ixekizumab every 4 weeks, 80 mg of ixekizumab every 12 weeks, or placebo, an sPGA score of 0 or 1 was maintained by 73.8%, 39.0%, and 7.0% of the patients, respectively. Patients in the UNCOVER-3 trial received continuous treatment of ixekizumab from weeks 0 through 60, and at week 60, at least 73% had an sPGA score of 0 or 1 and at least 80% had a PASI 75 response. Adverse events reported during ixekizumab use included neutropenia, candidal infections, and inflammatory bowel disease. CONCLUSIONS In three phase 3 trials involving patients with psoriasis, ixekizumab was effective through 60 weeks of treatment. As with any treatment, the benefits need to be weighed against the risks of adverse events. The efficacy and safety of ixekizumab beyond 60 weeks of treatment are not yet known

Electrochemistry and Nanotechnologies: The New Challenges

Digital simulation tools are jointly employed for the design of an existing aircraft engine components manufacturing cell to be enhanced through automated robotic deburring. The application of 3D Motion Simulation is illustrated for layout and material handling system design. Discrete Event Simulation is applied to analyze different scenarios and improve the cell performance with regards to two key objectives: (a) optimization of the batch throughput time for the part number fabricated in the manufacturing cell; (b) utilization increase of the automated deburring station by processing additional part numbers coming from other manufacturing cells in the same production department

Randomized standard-of-care-controlled trial of a silica gel fibre matrix in the treatment of chronic venous leg ulcers

Background: Chronic venous leg ulcers (CVU) are a common, unresolved medical problem. Silica gel fibre (SGF) is a novel biodegradable inorganic material developed to serve as a carrier substrate for the local release of pharmaceutical agents facilitating tissue repair. Objectives: To assess the performance and safety of SGF in subjects with CVU. Methods: Open, randomized, standard-of-care-controlled, multi-centre trial. Subjects (ITT 120 patients) received either SGF in addition to standard treatment or standard-of-care treatment (S-o-C) alone. The primary performance variable was the time to healing of the target ulcer until the end of a 12 week treatment period. Results: SGF was well tolerated. Mean time to healing up to week 12 was 85.62 days for the SGF group (SE +/- 1.5) and 79.66 days for the S-o-C group (SE +/- 1.77) (p-value = 0.217). There was no statistically relevant difference regarding the incidence of complete healing of the target ulcers by weeks 12 and 24 between the SGF and the S-o-C groups (p-value >0.05). Conclusion: SGF is well tolerated and offers a promising perspective as a carrier substrate for the local release of active pharmaceutical agents into the wound site to promote tissue repair

The integration of the princely state of Hyderabad and the making of the postcolonial state in India, 1948-56

This article explores the impact of the police action and the anti-communist struggle in Hyderabad on the formation of the Indian state in the first years after independence. Because of its central location and diverse cultural heritage, the absorption of the princely state of Hyderabad into the Indian Union was an important goal for Nehru's government. However, the task of bringing Hyderabad into the Union was not an easy one. As it entered Hyderabad, the government of independent India had to come to terms with the limitations of the police, military and bureaucracy, which it had inherited from the colonial state; and as it took over the governance of the state, it had to find ways to manage relations between Hindus and Muslims, even as the social order was being transformed. It also had to fight communism in the Telangana region of the state, whilst trying to ensure the loyalty of its new citizens. This article examines the ways in which India's first government confronted these complex problems. The following pages argue that these early years must be seen as a time of great dynamism, rather than as a period of stability inherited from the colonial state