Artificially sweetened beverages and the response to the global obesity crisis

In March 2015, the World Health Organization (WHO) published revised guidelines on sugar intake that call on national governments to institute policies to reduce sugar intake and increase the scope for regulation of sugar-sweetened beverages (SSBs). • In face of the growing threat of regulatory action on SSBs, transnational beverage companies are responding in multiple ways, including investing in the formulation and sales of artificially sweetened beverages (ASBs), promoted as healthier alternatives to SSBs. • The absence of consistent evidence to support the role of ASBs in preventing weight gain and the lack of studies on other long-term effects on health strengthen the position that ASBs should not be promoted as part of a healthy diet. • The promotion of ASBs must be discussed in a broader context of the additional potential impacts on health and the environment. In addition, a more robust evidence base, free of conflicts of interest, is needed

Cycling in São Paulo, Brazil (1997-2012): Correlates, time trends and health consequences

The purpose of the study was to describe cyclists and cycling trips, and to explore correlates, time trends and health consequences of cycling in São Paulo, Brazil from 1997 to 2012. Cross-sectional analysis using repeated São Paulo Household Travel Surveys (HTS). At all time periods cycling was a minority travel mode in São Paulo (1174 people with cycling trips out of 214,719 people). Poisson regressions for individual correlates were estimated using the entire 2012 HTS sample. Men were six times more likely to cycle than women. We found rates of bicycle use rising over time among the richest quartile but total cycling rates dropped from 1997 to 2012 due to decreasing rates among the poor. Harms from air pollution would negate benefits from physical activity through cycling only at 1997 air pollution levels and at very high cycling levels (≥ 9 h of cycling per day). Exposure-based road injury risk decreased between 2007 and 2012, from 0.76 to 0.56 cyclist deaths per 1000 person-hours travelled. Policies to reduce spatial segregation, measures to tackle air pollution, improvements in dedicated cycling infrastructure, and integrating the bicycle with the public transport system in neighborhoods of all income levels could make cycling safer and prevent more individuals from abandoning the cycling mode in São Paulo.THS acknowledges funding from the Brazilian Science without Borders Scheme (Process number: 200358/2014-6) and the Sao Paulo Research Foundation (Process number: 2012/08565-4). ACD received a postdoctoral research fellowship from the Brazilian National Council for Scientific and Technological Development (249038/2013-7). MT and JW: The work was undertaken by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust (MR/K023187/1), under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged

Ferromagnetic/superconducting proximity effect in La0.7Ca0.3MnO3 / YBa2Cu3O7 superlattices

We study the interplay between magnetism and superconductivity in high quality YBa2Cu3O7 (YBCO) / La0.7Ca0.3MnO3(LCMO)superlattices. We find evidence for the YBCO superconductivity depression in presence of the LCMO layers. We show that due to its short coherence length superconductivity survives in the YBCO down to much smaller thickness in presence of the magnetic layer than in low Tc superconductors. We also find that for a fixed thickness of the superconducting layer, superconductivity is depressed over a thickness interval of the magnetic layer in the 100 nm range. This is a much longer length scale than that predicted by the theory of ferromagnetic/superconducting proximity effect.Comment: 10 pages + 5 figures, submitted to Phys. Rev.

Computer simulation of breast reduction surgery

Background: Plastic surgery of the breast, particularly breast reduction, is considered difficult. It can become a challenge for a less experienced surgeon to understand exactly what to do when facing a particular type of breast and how to avoid unsatisfactory results. Methods: The goal of this study was to create a computer model of the breast that provides a basis for the simulation of breast surgery, particularly breast reduction. The reconstruction of elastic parameters is based on observations of the breast with the patient in different positions. Results: It is shown that several measurements with the patient in different positions allow one to choose the parameters of the model and determine the elastic coefficients of the breast and the skin. The geometry of the breast before and after surgery is simulated. A qualitative study of the incision parameters’ influence on the final geometry of the breast is presented. Conclusion: The developed methodology and software allow one to estimate the form of the breast after the surgery by knowing its form before surgery and taking into consideration the parameters of incision applied by the surgeon at the time of surgery. The described approach can be used for the qualitative and quantitative study of breast reduction surgery with a satisfactory result. Level of Evidence: V (This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.

A qualitative study of culturally embedded factors in complementary and alternative medicine use

Abstract Background Within the intercultural milieu of medical pluralism, a nexus of worldviews espousing distinct explanatory models of illness, our research aims at exploring factors leading to complementary and alternative medicine (CAM) use with special attention to their cultural context. Methods The results are based on medical anthropological fieldwork (participant observation and in-depth interviews) spanning a period from January 2015 to May 2017 at four clinics of Traditional Chinese Medicine in Budapest, Hungary. Participant observation involved 105 patients (males N = 42); in-depth interviews were conducted with patients (N = 9) and practitioners (N = 9). The interviews were coded with Interpretative Phenomenological Analysis; all information was aggregated employing Atlas.ti software. Results In order to avoid the dichotomization of “push and pull factors,” results obtained from the fieldwork and interviews were structured along milestones of the patient journey. These points of reference include orientation among sources of information, biomedical diagnosis, patient expectations and the physician-patient relationship, the biomedical treatment trajectory and reasons for non-adherence, philosophical congruence, and alternate routes of entry into the world of CAM. All discussed points which are a departure from the strictly western therapy, entail an underlying socio-cultural disposition and must be scrutinized in this context. Conclusions The influence of one’s culturally determined explanatory model is ubiquitous from the onset of the patient journey and exhibits a reciprocal relationship with subjective experience. Firsthand experience (or that of the Other) signifies the most reliable source of information in matters of illness and choice of therapy. Furthermore, the theme of (building and losing) trust is present throughout the patient journey, a determining factor in patient decision-making and dispositions toward both CAM and biomedicine

Human pancreatic islet transplantation: an update and description of the establishment of a pancreatic islet isolation laboratory

Type 1 diabetes mellitus (T1DM) is associated with chronic complications that lead to high morbidity and mortality rates in young adults of productive age. Intensive insulin therapy has been able to reduce the likelihood of the development of chronic diabetes complications. However, this treatment is still associated with an increased incidence of hypoglycemia. In patients with "brittle T1DM", who have severe hypoglycemia without adrenergic symptoms (hypoglycemia unawareness), islet transplantation may be a therapeutic option to restore both insulin secretion and hypoglycemic perception. The Edmonton group demonstrated that most patients who received islet infusions from more than one donor and were treated with steroid-free immunosuppressive drugs displayed a considerable decline in the initial insulin independence rates at eight years following the transplantation, but showed permanent C-peptide secretion, which facilitated glycemic control and protected patients against hypoglycemic episodes. Recently, data published by the Collaborative Islet Transplant Registry (CITR) has revealed that approximately 50% of the patients who undergo islet transplantation are insulin independent after a 3-year follow-up. Therefore, islet transplantation is able to successfully decrease plasma glucose and HbA1c levels, the occurrence of severe hypoglycemia, and improve patient quality of life. The goal of this paper was to review the human islet isolation and transplantation processes, and to describe the establishment of a human islet isolation laboratory at the Endocrine Division of the Hospital de Clínicas de Porto Alegre - Rio Grande do Sul, Brazil

Spatial Evaluation and Modeling of Dengue Seroprevalence and Vector Density in Rio de Janeiro, Brazil

Dengue is a major public health problem in many tropical regions of the world, including Brazil, where Aedes aegypti is the main vector. We present a household study that combines data on dengue fever seroprevalence, recent dengue infection, and vector density, in three neighborhoods of Rio de Janeiro, Brazil, during its most devastating dengue epidemic to date. This integrated entomological–serological survey showed evidence of silent transmission even during a severe epidemic. Also, past exposure to dengue virus was highly associated with age and living in areas of high movement of individuals and social/commercial activity. No association was observed between household infestation index and risk of dengue infection in these areas. Our findings are discussed in the light of current theories regarding transmission thresholds and relative role of mosquitoes and humans as vectors of dengue viruses

Neuroprotection by adenosine in the brain: From A1 receptor activation to A2A receptor blockade

Adenosine is a neuromodulator that operates via the most abundant inhibitory adenosine A1 receptors (A1Rs) and the less abundant, but widespread, facilitatory A2ARs. It is commonly assumed that A1Rs play a key role in neuroprotection since they decrease glutamate release and hyperpolarize neurons. In fact, A1R activation at the onset of neuronal injury attenuates brain damage, whereas its blockade exacerbates damage in adult animals. However, there is a down-regulation of central A1Rs in chronic noxious situations. In contrast, A2ARs are up-regulated in noxious brain conditions and their blockade confers robust brain neuroprotection in adult animals. The brain neuroprotective effect of A2AR antagonists is maintained in chronic noxious brain conditions without observable peripheral effects, thus justifying the interest of A2AR antagonists as novel protective agents in neurodegenerative diseases such as Parkinson’s and Alzheimer’s disease, ischemic brain damage and epilepsy. The greater interest of A2AR blockade compared to A1R activation does not mean that A1R activation is irrelevant for a neuroprotective strategy. In fact, it is proposed that coupling A2AR antagonists with strategies aimed at bursting the levels of extracellular adenosine (by inhibiting adenosine kinase) to activate A1Rs might constitute the more robust brain neuroprotective strategy based on the adenosine neuromodulatory system. This strategy should be useful in adult animals and especially in the elderly (where brain pathologies are prevalent) but is not valid for fetus or newborns where the impact of adenosine receptors on brain damage is different