Learning our way towards a sustainable agri-food system Three cases from Sweden: Stockholm Farmers market, Ramsjö Community Supported Agriculture and Järna Initiative for Local Production

This research is based on case studies of the Stockholm Farmers Market, Ramsjö Community Supported Agriculture, and Järna Initiative for Local Production. These cases are examples of alternative consumerproducer links in the Swedish agri-food system. An adapted SWOT analysis highlights key strengths, weaknesses, opportunities and constraints in each case from the multiple perspectives of producers, consumers, the organization, as well as the environment and society. Diagrams show where learning opportunities exist in the three systems, and how the structure of the consumer-producer link influences learning processes. Implication assessments consider how each link may affect surrounding ecosystems and social aspects of the agri-food system. A framework for assessing a process of development identifies six components that contribute to agri-food system development. Four key issues are discussed in terms of their potential to significantly affect the development of the agri-food system: the length of the food chain linking producers and consumers, the definition of “local”, learning in the system, and what is really being sold – is it food, or values? Critical research questions are highlighted and recommended for future research

Síndrome metabólico en la edad pediátrica: ¿qué sabemos hasta el momento?

The metabolic syndrome represents a challenge for public health, since it generates an increase in morbidity and mortality in the population and its prevalence is increasing at all ages. It is due to a complex interaction between genetic, behavioral and environmental factors whose harmful effects on the physical health of the individual have been shown to start their affectation from intrauterine life and remain until adulthood. It is a diagnostic challenge in pediatric age, due to lack of consensus in its definition and diagnostic criteria. Regarding the approach, it also poses a challenge due to the multiple factors to be treated, however, the importance of promoting prevention in the first place has been demonstrated, since the younger age and the less advance of the harmful effects, the greater benefit obtained. For this, parents and children are trained to follow healthy habits of physical activity, sleep patterns, breastfeeding and subsequently a healthy diet. There are also options aimed at treating those who already suffer from it, and one of the strategies with the best results is the use of cognitive-behavioral therapy, but in turn there are more objects of study for the future.El síndrome metabólico representa un reto para la salud pública, pues genera un aumento de morbilidad y mortalidad en la población y su prevalencia se encuentra en aumento, en todas las edades. Se debe a una compleja interacción entre factores genéticos, conductuales y ambientales, cuyos efectos nocivos para la salud física del individuo se ha demostrado que inician su afectación desde la vida intrauterina, y se mantienen hasta la edad adulta. Supone un reto diagnóstico en la edad pediátrica, por falta de consenso en su definición y criterios diagnósticos. En cuanto al abordaje también supone un desafío por los múltiples factores a tratar, sin embargo, sí se ha demostrado la importancia de promover en primer lugar la prevención, pues a menor edad y avance de los efectos perjudiciales, mayor es el beneficio que se obtiene, para esto, se entrena a los padres y niños a seguir hábitos saludables de actividad física, patrones de sueño, lactancia materna y posteriormente una dieta saludable. Existen opciones también dirigidas al tratamiento de quien ya lo padece, y una de las estrategias con mejores resultados es el uso de terapia cognitivo-conductual, pero a su vez quedan más objetos de estudio para el futuro

Fibre intake among the Belgian population by sex-age and sex-education groups and its association with BMI and waist circumference

The objectives of the present study were to assess total dietary fibre intake and the main contributors to fibre intake in the Belgian population by sex-age and sex-education groups and to investigate its relationship with BMI and waist circumference (WC). The participants of the Belgian food consumption survey (2004) were randomly selected. Information about food intake was collected using two repeated, non-consecutive 24 h recall interviews. A total of 3083 individuals (>= 15 years; 1546 men and 1537 women) completed both interviews. The main contributors to total fibre intake (17.8 g/d) were cereals and cereal products (34%; 5.9 g/d), potatoes and other tubers (18.6%; 3.3 g/d), fruits (14.7%; 2.8 g/d) and vegetables (14.4%; 2.6 g/d). Legume fibre intake was extremely low (0.672%; 0.139 g/d). In all sex-age and sex-education groups, total fibre intake was below the recommendations of the Belgian Superior Health Council. Men (21 g/d) consumed significantly more fibre than women (17.3 g/d) (P < 0.001). Lower educated men and higher educated women reported the highest fibre intake. A significant inverse association was found between total fibre intake and WC (beta = -0.118, P < 0.001). Fruit-derived fibre was positively associated with WC (beta = 0.731, P=0.001). In summary, total fibre intake was inversely associated with WC, whereas fruit-derived fibre intake was positively associated with WC in the Belgian population

Implementation of two-party protocols in the noisy-storage model

The noisy-storage model allows the implementation of secure two-party protocols under the sole assumption that no large-scale reliable quantum storage is available to the cheating party. No quantum storage is thereby required for the honest parties. Examples of such protocols include bit commitment, oblivious transfer and secure identification. Here, we provide a guideline for the practical implementation of such protocols. In particular, we analyze security in a practical setting where the honest parties themselves are unable to perform perfect operations and need to deal with practical problems such as errors during transmission and detector inefficiencies. We provide explicit security parameters for two different experimental setups using weak coherent, and parametric down conversion sources. In addition, we analyze a modification of the protocols based on decoy states.Comment: 41 pages, 33 figures, this is a companion paper to arXiv:0906.1030 considering practical aspects, v2: published version, title changed in accordance with PRA guideline

Post Diagnosis Diet Quality and Colorectal Cancer Survival in Women

Background: Dietary factors are known to influence colorectal cancer (CRC) risk, however, their association with CRC survival is unclear. Therefore, we prospectively examined the association between diet quality scores, dietary patterns and colorectal cancer (CRC) survival. Methods: 1201 women diagnosed with stage I–III CRC between 1986 and 2008, were followed through 2010. Diet was assessed via a food frequency questionnaire administered at least 6 months after diagnosis. We computed the Alternate Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet score (aMED) and Dietary Approaches to Stop Hypertension score (DASH) and derived two dietary patterns, Western (unhealthy) and prudent (healthy), by principal component analysis for each woman. Results: During follow-up, we documented 435 deaths, including 162 from CRC. After adjusting for potential confounders, only a higher AHEI-2010 score was significantly associated with lower overall mortality (HR comparing extreme quintiles = 0.71, 95% CI 0.52–0.98, p trend = 0.01) as well as borderline significantly with lower risk of CRC mortality by the trend test (HR Q5 vs Q1 = 0.72, 95% CI = 0.43–1.21, p trend = 0.07). When AHEI-2010 components were examined separately, inverse associations for overall mortality were primarily accounted for by moderate alcohol intake (HR comparing abstainers vs 5–15 g/d = 1.30, 95%CI = 1.05–1.61) and lower intake of sugar sweetened beverages and fruit juices combined (HR for each additional serving = 1.11, 95% CI = 1.01–1.23). No other diet quality score or dietary pattern was associated with overall or CRC-specific mortality. Conclusion: Higher AHEI-2010 score may be associated with lower overall mortality, moderate alcohol consumption and lower consumption of sugar sweetened beverages and juices combined appeared to account for most of the observed associations

Auto-Conforming Ergonomic Chair

The Auto-Conforming Ergonomic (ACE) Chair is an office chair that will adjust itself to comfortably support anyone that sits in it. By sensing the position of the seated user, the ACE Chair can intelligently adjust the backrest, seat, and armrests to provide the user with unparalleled ergonomic support and seating comfort

Intake of specific fruits and vegetables in relation to risk of estrogen receptor-negative breast cancer among postmenopausal women. Breast Cancer Res

Abstract In previous studies of postmenopausal women, overall intake of fruits and vegetables groups has been inversely associated with estrogen receptor-negative (ER-) breast cancer. In this analysis, we prospectively examined the associations of specific fruits and vegetables with risk of ER-postmenopausal breast cancer among 75,929 women aged 38-63 years at baseline and followed for up to 24 years. Dietary data were collected seven times during this period. Cox proportional hazard models were used, adjusting for potential confounders, including a modified Alternate Mediterranean Diet score. We ascertained 792 incident cases of ER-postmenopausal breast cancer. The multivariate relative risk (RR) for every 2 servings/week consumption for total berries was 0.82 (95 % CI = 0.71-0.96, p = 0.01), and the RR for women who consumed at least one serving of blueberries a week was 0.69 (95 % CI = 0.50-0.95, p = 0.02) compared with non-consumers. Also, the RR for consuming at least 2 servings of peaches/ nectarines per week was 0.59 (95 % CI = 0.37-0.93, p = 0.02). Risk of ER-breast cancer was not associated with intakes of other specific fruits or vegetables. In conclusion, higher intake of berries and peaches was associated with lower risk of ER-breast cancer among postmenopausal women. These results are considered exploratory and need to be confirmed in further studies

Adjunctive PD-1 Inhibitor Versus Standard Chemotherapy in Recurrent or Metastatic Nasopharyngeal Carcinoma: A Systematic Review and Meta-Analysis

Objective: To investigate whether Adjunctive PD-1 inhibitors have improved clinical outcomes compared to chemotherapy alone in platinum-pretreated and platinum-naive recurrent or metastatic nasopharyngeal carcinoma (R/M NPCA). Methods: The study involved a literature search from PubMed, Cochrane CENTRAL, and Google Scholar for randomized clinical trials (RCTs) on the use of PD-1 inhibitors versus chemotherapy alone in patients with R/M NPCA. Bias was assessed using Cochrane collaboration\u27s risk of bias tool. Overall Survival (OS) was examined as the primary endpoint. Secondary endpoints were Progression-Free Survival (PFS), Objective Response Rate, Disease Control Rate (DCR), Duration of Response, and Serious/Grade ⩾3 Adverse Events. Outcomes were measured with either Mean Difference, Risk ratio (RR), or Hazard ratios (HRs) at 95% confidence interval. Results: Four RCTs were included in the meta-analysis and systematic review. OS for the monotherapy subgroup was a HR of 0.87 [0.67, 1.13] (p = 0.30) while the combination subgroup had 0.64 [0.45, 0.90] (p = 0.01). The monotherapy subgroup exhibited significantly worse outcomes in PFS (HR 1.31 [1.01, 1.68]) (p = 0.04) and DCR (RR 1.52 [1.12, 2.05]) (p = 0.007) but no significant difference in other outcomes. For combination therapy, a statistically significant benefit can be seen in all outcomes except DCR (RR 0.62 [0.38, 1.01]) (p = 0.06) which was a non-significant benefit favoring PD-1 inhibitors. Conclusion: Combination PD-1 inhibitor + chemotherapy followed by maintenance PD-1 inhibitor therapy is superior to chemotherapy alone in the first-line treatment of R/M NPCA, implying a potential benefit with the use of PD-1 inhibitors + chemotherapy with maintenance PD-1 inhibitors as first-line in R/M NPCA compared to standard chemotherapy alone

Chronic Hepatitis B Finite Treatment: similar and different concerns with new drug classes

Chronic hepatitis B, a major cause of liver disease and cancer, affects over 250 million people worldwide. Currently there is no cure, only suppressive therapies. Efforts to develop finite curative HBV therapies are underway, consisting of combinations of multiple novel agents +/- nucleos(t)ide reverse transcriptase inhibitors. The HBV Forum convened a webinar in July 2021, and subsequent working group discussions to address how and when to stop finite therapy for demonstration of sustained off-treatment efficacy and safety responses. Participants included leading experts in academia, clinical practice, pharmaceutical companies, patient representatives and regulatory agencies. This Viewpoint outlines areas of consensus within our multi-stakeholder group for stopping finite therapies in chronic Hepatitis B investigational studies, including trial design, patient selection, outcomes, biomarkers, pre-defined stopping criteria, pre-defined retreatment criteria, duration of investigational therapies, and follow up after stopping therapy. Future research of unmet needs are discussed

Integrated therapist and online CBT for depression in primary care (INTERACT): study protocol for a multi-centre randomised controlled trial

BACKGROUND: Cognitive behavioural therapy (CBT) is an effective treatment for depression. Self-directed online CBT interventions have made CBT more accessible at a lower cost. However, adherence is often poor and, in the absence of therapist support, effects are modest and short-term. Delivering CBT online using instant messaging is clinically and cost-effective; however, most existing platforms are limited to instant messaging sessions, without the support of between-session "homework" activities. The INTERACT intervention integrates online CBT materials and 'high-intensity' therapist-led CBT, delivered remotely in real-time. The INTERACT trial will evaluate this novel integration in terms of clinical and cost-effectiveness, and acceptability to therapists and clients. METHODS: Pragmatic, two parallel-group multi-centre individually randomised controlled trial, with 434 patients recruited from primary care practices in Bristol, London and York. Participants with depression will be identified via General Practitioner record searches and direct referrals. INCLUSION CRITERIA: aged ≥ 18 years; score ≥ 14 on Beck Depression Inventory (BDI-II); meeting International Classification of Diseases (ICD-10) criteria for depression. EXCLUSION CRITERIA: alcohol or substance dependency in the past year; bipolar disorder; schizophrenia; psychosis; dementia; currently under psychiatric care for depression (including those referred but not yet seen); cannot complete questionnaires unaided or requires an interpreter; currently receiving CBT/other psychotherapy; received high-intensity CBT in the past four years; participating in another intervention trial; unwilling/unable to receive CBT via computer/laptop/smartphone. Eligible participants will be randomised to integrated CBT or usual care. Integrated CBT utilises the standard Beckian intervention for depression and comprises nine live therapist-led sessions, with (up to) a further three if clinically appropriate. The first session is 60-90 min via videocall, with subsequent 50-min sessions delivered online, using instant messaging. Participants allocated integrated CBT can access integrated online CBT resources (worksheets/information sheets/videos) within and between sessions. Outcome assessments at 3-, 6-, 9- and 12-month post-randomisation. The primary outcome is the Beck Depression Inventory (BDI-II) score at 6 months (as a continuous variable). A nested qualitative study and health economic evaluation will be conducted. DISCUSSION: If clinically and cost-effective, this model of integrated CBT could be introduced into existing psychological services, increasing access to, and equity of, CBT provision. TRIAL REGISTRATION: ISRCTN, ISRCTN13112900. Registered on 11/11/2020. Currently recruiting participants. Trial registration data are presented in Table 1