Weight gain and dietary intake during pregnancy in industrialized countries - a systematic review of observational studies

Background: Gestational weight gain (GWG) above the recently recommended ranges is likely to be related to adverse pregnancy outcomes and therefore a challenge in industrialized countries. Aims: We conducted a systematic review on observational studies in order to gain more evidence on whether diets with lower caloric/protein content or other diets might be associated with lower GWG. Methods: We searched in MEDLINE and EMBASE for observational studies written in English or German reporting associations between diet and GWG in singleton pregnancies of healthy women in industrialized countries. Results: We identified 12 studies which met the inclusion criteria. Five studies suggested significant positive associations between energy intake and GWG, whereas three found no significant association. Further significant positive associations of GWG were reported with respect to protein intake, animal lipids, energy density and a number of different food servings per day, whereas intake of carbohydrates and vegetarian diet were associated with less GWG. Conclusions: We suggest that GWG might be reduced by lower energy intake in pregnancy

Beyond the Refugee Crisis how the UK news media represent asylum seekers across national boundaries

Migration is one of the most pressing, divisive issues in global politics today, and media play a crucial role in how communities understand and respond. This study examines how UK newspapers (n = 974) and popular news websites (n = 1044) reported on asylum seekers throughout 2017. It contributes to previous literature in two important ways. First, by examining the ‘new normal’ of daily news coverage in the wake of the 2015 ‘refugee crisis’ in Europe. Second, by looking at how asylum seekers from different regions are represented. The content analysis finds significant variations in how asylum seekers are reported, including terminology use and topics they are associated with. The paper also identifies important commonalities in how all asylum seekers are represented - most notably, the dominance of political elites as sources across all media content. It argues that Entman’s ‘cascade network model’ can help to explain this, with elites in one country able to influence transnational reports

The Human Fungal Pathogen Cryptococcus neoformans Escapes Macrophages by a Phagosome Emptying Mechanism That Is Inhibited by Arp2/3 Complex-Mediated Actin Polymerisation

The lysis of infected cells by disease-causing microorganisms is an efficient but risky strategy for disseminated infection, as it exposes the pathogen to the full repertoire of the host's immune system. Cryptococcus neoformans is a widespread fungal pathogen that causes a fatal meningitis in HIV and other immunocompromised patients. Following intracellular growth, cryptococci are able to escape their host cells by a non-lytic expulsive mechanism that may contribute to the invasion of the central nervous system. Non-lytic escape is also exhibited by some bacterial pathogens and is likely to facilitate long-term avoidance of the host immune system during latency. Here we show that phagosomes containing intracellular cryptococci undergo repeated cycles of actin polymerisation. These actin ‘flashes’ occur in both murine and human macrophages and are dependent on classical WASP-Arp2/3 complex mediated actin filament nucleation. Three dimensional confocal imaging time lapse revealed that such flashes are highly dynamic actin cages that form around the phagosome. Using fluorescent dextran as a phagosome membrane integrity probe, we find that the non-lytic expulsion of Cryptococcus occurs through fusion of the phagosome and plasma membranes and that, prior to expulsion, 95% of phagosomes become permeabilised, an event that is immediately followed by an actin flash. By using pharmacological agents to modulate both actin dynamics and upstream signalling events, we show that flash occurrence is inversely related to cryptococcal expulsion, suggesting that flashes may act to temporarily inhibit expulsion from infected phagocytes. In conclusion, our data reveal the existence of a novel actin-dependent process on phagosomes containing cryptococci that acts as a potential block to expulsion of Cryptococcus and may have significant implications for the dissemination of, and CNS invasion by, this organism.\ud \u

Patient-level and practice-level factors associated with consultation duration: a cross-sectional analysis of over one million consultations in English primary care

OBJECTIVES: Consultation duration has previously been shown to be associated with patient, practitioner and practice characteristics. However, previous studies were conducted outside the UK, considered only small numbers of general practitioner (GP) consultations or focused primarily on practitioner-level characteristics. We aimed to determine the patient-level and practice-level factors associated with duration of GP and nurse consultations in UK primary care. DESIGN AND SETTING: Cross-sectional data were obtained from English general practices contributing to the Clinical Practice Research Datalink (CPRD) linked to data on patient deprivation and practice staffing, rurality and Quality and Outcomes Framework (QOF) achievement. PARTICIPANTS: 218 304 patients, from 316 English general practices, consulting from 1 April 2013 to 31 March 2014. ANALYSIS: Multilevel mixed-effects models described the association between consultation duration and patient-level and practice-level factors (patient age, gender, smoking status, ethnic group, deprivation and practice rurality, number of full-time equivalent GPs/nurses, list size, consultation rate, quintile of overall QOF achievement and training status). RESULTS: Mean duration of face-to-face GP consultations was 9.24 min and 5.32 min for telephone consultations. Nurse face-to-face and telephone consultations lasted 9.70 and 5.73 min on average, respectively. Longer GP consultation duration was associated with female patient gender, practice training status and older patient age. Shorter duration was associated with higher deprivation and consultation rate. Longer nurse consultation duration was associated with male patient gender, older patient age and ever smoking; and shorter duration with higher consultation rate. Observed differences in duration were small (eg, GP consultations with female patients compared with male patients were 8 s longer on average). CONCLUSIONS: Small observed differences in consultation duration indicate that patients are treated similarly regardless of background. Increased consultation duration may be beneficial for older or comorbid patients, but the benefits and costs of increased consultation duration require further study

Spatial heterogeneity of habitat suitability for Rift Valley fever occurrence in Tanzania: an ecological niche modelling approach

Despite the long history of Rift Valley fever (RVF) in Tanzania, extent of its suitable habitat in the country remains unclear. In this study we investigated potential effects of temperature, precipitation, elevation, soil type, livestock density, rainfall pattern, proximity to wild animals, protected areas and forest on the habitat suitability for RVF occurrence in Tanzania. Presence-only records of 193 RVF outbreak locations from 1930 to 2007 together with potential predictor variables were used to model and map the suitable habitats for RVF occurrence using ecological niche modelling. Ground-truthing of the model outputs was conducted by comparing the levels of RVF virus specific antibodies in cattle, sheep and goats sampled from locations in Tanzania that presented different predicted habitat suitability values. Habitat suitability values for RVF occurrence were higher in the northern and central-eastern regions of Tanzania than the rest of the regions in the country. Soil type and precipitation of the wettest quarter contributed equally to habitat suitability (32.4% each), followed by livestock density (25.9%) and rainfall pattern (9.3%). Ground-truthing of model outputs revealed that the odds of an animal being seropositive for RVFV when sampled from areas predicted to be most suitable for RVF occurrence were twice the odds of an animal sampled from areas least suitable for RVF occurrence (95% CI: 1.43, 2.76, p < 0.001). The regions in the northern and central-eastern Tanzania were more suitable for RVF occurrence than the rest of the regions in the country. The modelled suitable habitat is characterised by impermeable soils, moderate precipitation in the wettest quarter, high livestock density and a bimodal rainfall pattern. The findings of this study should provide guidance for the design of appropriate RVF surveillance, prevention and control strategies which target areas with these characteristics

The Radial Dependence of Proton-scale Magnetic Spectral Break in Slow Solar Wind during PSP Encounter 2

International audienceMagnetic field fluctuations in the solar wind are commonly observed to follow a power-law spectrum. Near proton-kinetic scales, a spectral break occurs that is commonly interpreted as a transition to kinetic turbulence. However, this transition is not yet entirely understood. By studying the scaling of the break with various plasma properties, it may be possible to constrain the processes leading to the onset of kinetic turbulence. Using data from the Parker Solar Probe, we measure the proton-scale break over a range of heliocentric distances, enabling a measurement of the transition from inertial to kinetic-scale turbulence under various plasma conditions. We find that the break frequency f(b) increases as the heliocentric distance r decreases in the slow solar wind following a power law of f(b) similar to r(-1.11). We also compare this to the characteristic plasma ion scales to relate the break to the possible physical mechanisms occurring at this scale. The ratio f(b)/f(c) (f(c) for Doppler-shifted ion cyclotron resonance scale) is close to unity and almost independent of plasma beta(p). While f(b)/f(p) (f(p) for Doppler-shifted proton thermal gyroradius) increases with beta(p) approaching to unity at larger beta(p), f(b)/f(d) (f(d) for Doppler-shifted proton inertial length) decreases with beta(p) from unity at small beta(p). Due to the large comparable Alfven and solar wind speeds, we analyze these results using both the standard and modified Taylor hypotheses, demonstrating the robust statistical results

Cross Helicity Reversals in Magnetic Switchbacks

International audienceWe consider 2D joint distributions of normalized residual energy, sigma(r)(s, t), and cross helicity, sigma(c)(s, t), during one day of Parker Solar Probe's (PSP's) first encounter as a function of wavelet scale s. The broad features of the distributions are similar to previous observations made by Helios in slow solar wind, namely well-correlated and fairly Alfvenic wind, except for a population with negative cross helicity that is seen at shorter wavelet scales. We show that this population is due to the presence of magnetic switchbacks, or brief periods where the magnetic field polarity reverses. Such switchbacks have been observed before, both in Helios data and in Ulysses data in the polar solar wind. Their abundance and short timescales as seen by PSP in its first encounter is a new observation, and their precise origin is still unknown. By analyzing these MHD invariants as a function of the wavelet scale, we show that magnetohydrodynamic (MHD) waves do indeed follow the local mean magnetic field through switchbacks, with a net Elsasser flux propagating inward during the field reversal and that they, therefore, must be local kinks in the magnetic field and not due to small regions of opposite polarity on the surface of the Sun. Such observations are important to keep in mind as computing cross helicity without taking into account the effect of switchbacks may result in spurious underestimation of sigma(c) as PSP gets closer to the Sun in later orbits

Kinetic-scale Spectral Features of Cross Helicity and Residual Energy in the Inner Heliosphere

In this work, we present the first results from the flux angle (FA) operation mode of the Faraday Cup instrument on board the Parker Solar Probe (PSP). The FA mode allows rapid measurements of phase space density fluctuations close to the peak of the proton velocity distribution function with a cadence of 293 Hz. This approach provides an invaluable tool for understanding kinetic-scale turbulence in the solar wind and solar corona. We describe a technique to convert the phase space density fluctuations into vector velocity components and compute several turbulence parameters, such as spectral index, residual energy, and cross helicity during two intervals when the FA mode was used in PSP's first encounter at 0.174 au distance from the Sun

Randomized trial of tapas acupressure technique for weight loss maintenance

<p>Abstract</p> <p>Background</p> <p>Obesity is an urgent public health problem, yet only a few clinical trials have systematically tested the efficacy of long-term weight-loss maintenance interventions. This randomized clinical trial tested the efficacy of a novel mind and body technique for weight-loss maintenance.</p> <p>Methods</p> <p>Participants were obese adults who had completed a six-month behavioral weight-loss program prior to randomization. Those who successfully lost weight were randomized into either an experimental weight-loss maintenance intervention, Tapas Acupressure Technique (TAT^®), or a control intervention comprised of social-support group meetings (SS) led by professional facilitators. TAT combines self-applied light pressure to specific acupressure points accompanied by a prescribed sequence of mental steps. Participants in both maintenance conditions attended eight group sessions over six months of active weight loss maintenance intervention, followed by an additional 6 months of no intervention. The main outcome measure was change in weight from the beginning of the weight loss maintenance intervention to 12 months later. Secondary outcomes were change in depression, stress, insomnia, and quality of life. We used analysis of covariance as the primary analysis method. Missing values were replaced using multiple imputation.</p> <p>Results</p> <p>Among 285 randomized participants, 79% were female, mean age was 56 (standard deviation (sd) = 11), mean BMI at randomization was 34 (sd = 5), and mean initial weight loss was 9.8 kg (sd = 5). In the primary outcome model, there was no significant difference in weight regain between the two arms (1.72 kg (se 0.85) weight regain for TAT and 2.96 kg (se 0.96) weight regain for SS, p < 0.097) Tests of between- arm differences for secondary outcomes were also not significant. A secondary analysis showed a significant interaction between treatment and initial weight loss (p < .036), with exploratory <it>post hoc </it>tests showing that greater initial weight loss was associated with more weight regain for SS but less weight regain for TAT.</p> <p>Conclusions</p> <p>The primary analysis showed no significant difference in weight regain between TAT and SS, while secondary and post hoc analyses indicate direction for future research.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00526565">NCT00526565</a></p