The effects of dairy foods intakes on weight change and fracture risk during critical life stages in women

Menopause and pregnancy are crucial events in women’s lives because women experience a series of physical and psychological changes at these stages. One of the most critical challenges is excessive weight gain during both of these stages, which could contribute to various adverse health events in their later lives. In addition to weight gain, another critical health concern that women face is fragility-related factures. The rate of fragility fractures begins rising in women during their 40s and increases to the end of life. Fractures result in impaired mobility and hospitalization, which can decrease the life quality of women significantly. Identification of modifiable dietary risk factors for excessive weight gain and fracture risk is crucial. The objectives of this dissertation are to estimate the independent effects of total dairy and individual dairy foods (e.g., yogurt, milk, and cheese), alone and in combination with overall diet patterns, physical activity, and other lifestyle factors, on three outcomes among women: weight change during the menopausal transition, weight retention after pregnancy, and risk of fragility-related fractures throughout mid-life and older adult years. Data from two prospective studies of nurses were used: Nurses’ Health Study I (NHS I) and Nurses’ Health Study II (NHS II). NHS II was used for both weight change analyses, while NHS was used for the fracture analyses. The first specific aim for the analysis of weight change during the menopausal transition was to investigate the effects of total dairy, yogurt, milk, and cheese intakes on menopausal weight change (N = 35,177) and risk of obesity (N = 38,892) among women in NHS II. Weights were self-reported in biennial questionnaires. Diet was assessed with food frequency questionnaires (FFQ) every 4 years. Generalized estimating equations were used to assess the adjusted mean weight change using repeated measures of weight change. Cox proportional hazards models were used to estimate risk of obesity, controlling for confounding. The second specific aim relates to the postpartum weight change analyses and were to investigate the effects of total dairy, yogurt, milk, and cheese intakes on postpartum weight retention (N = 18,366) and risk of postpartum obesity (N = 17,126) among women in the NHS II. Generalized linear models were used to assess postpartum weight change as continuous outcomes and multivariable models with a Poisson distribution were used to estimate risk of postpartum obesity. The third specific aim was for the fragility fracture analyses and included investigating the effects of total dairy, yogurt, milk, and cheese on fragility fractures of the hip, wrist, and vertebrae in women ages 40 years and older in NHS I. In total, there are 99,072 women included. Fractures at the wrist and hip were self-reported. For vertebral fractures, we relied on medical record confirmed cases. Proportional hazards models were used to estimate risk of first fracture (including wrist, hip, or vertebral fractures). Results associated with the first aims suggested that more than 2 servings per week (s/w) of yogurt led to consistently less weight gain than that observed in women consuming less than 1 serving per month (s/m) throughout the menopausal transition. Further, this same yogurt intake was associated with a 31% reduced obesity risk (95% CI: 0.64 - 0.74) after adjusting for potential confounders and baseline body mass index (BMI). Higher total dairy intake was also associated with less obesity risk, but the effect was somewhat weaker than that for yogurt. There was a U-shaped relation between milk consumption and obesity risk during perimenopause. Moderate (0.5 s/d -< 1 s/d vs. < 0.5 s/d) milk consumption reduced obesity risk by 17% (95% CI: 0.78 - 0.89), while higher milk (≥1 s/d vs. < 0.5 s/d) consumption led to a marginally statistically significant 6% higher obesity risk. Cheese intake was not associated with obesity risk in perimenopausal women. In the postpartum weight retention analyses, women who consumed moderate amounts of yogurt (1 s/m -< 2 s/w) and higher amounts of yogurt (≥ 2 s/w) had a 0.38 lb and 0.63 lb reduction in postpartum weight retention, respectively, than those who rarely consumed yogurt (< 1 s/m). Moderate and higher cheese intakes were associated with 0.30 lb and 0.64 lb less postpartum weight retention, respectively, than lower cheese intake (< 2 s/w). In the obesity analysis, moderate (1 s/m -< 2 s/w) and higher yogurt (≥ 2 s/w) intakes were associated with 20% (95%: 0.69 - 0.93) and 16% (95%: 0.69 - 1.02) reduced risks of postpartum obesity, but the association was weakened by adjusting for pre-pregnancy BMI. Women with higher levels of activity and higher yogurt intakes had a 39% (95%: 0.50 - 0.74) lower risk of obesity. Higher Alternative Healthy Eating Index 2010 (AHEI) scores alone were associated with a statistically significantly lower obesity risk. Results from our fracture analyses found that women who consumed more than 2 s/d of total dairy had a 19% (95% CI: 0.67 - 0.98) lower fracture risk than those who consumed less than 1 s/w. In terms of individual dairy products, 2 s/d of milk were associated with a 14% (95% CI: 0.77 - 0.95) reduction in fracture risk compared with lower milk consumption (<1 s/w). Higher cheese (≥ 1 s/d vs. < 1 s/w) intake was associated with a non-statistically significant 9% (95% CI: 0.81 - 1.02) reduction in fracture risk. No association was found between yogurt consumption and fracture. In stratified analysis, the intakes of calcium, vitamin D, and protein from non-dietary sources did not modify the inverse association between total dairy or milk intake and fracture risk. In summary, the findings of this dissertation suggested that greater yogurt consumption was inversely associated with weight change during menopausal transition and after pregnancy while intakes of total dairy and milk had beneficial effects on the risk of fragility fractures among women ages 40 years and older

Gap between words and action: empirical study on the consistency of farmers supporting green vegetable production practices

The increasing interest on the quality and safety of vegetables has focused much attention to the words (willingness) and action (behavior) of farmers toward the production of safe vegetables. However, the majority of studies typically focus on willingness or behavior, ignoring the interactions between the two. Moreover, there exists a wide gap between farmers’ actual behavior and their willingness to support green production practices of vegetable. Thus, in order to explore the key factors of farmers’ willingness, behavior, and their consistency to adopt green vegetable production vegetable practices, we performed bivariate probit modeling and binary logistic regression based on a survey of 452 farmers in Beijing, China. Results demonstrate the number of farmers willing to adopt green vegetable production practices to exceed those who do not by 65.5%. In particular, 73.9% of farmers adopt green vegetable production practices, while 67.5% of farmers exhibit an adoption willingness that is consistent with the adoption behavior. A positive correlation is observed between the willingness and behavior to adopt green production practices of vegetable, while the key influencing factors of the willingness, behavior, and consistency of green production practices are distinct. For example, cooperatives, neighboring farmers, and government regulation exert a significant positive impact on consistency, while family labor force, vegetable income, and the media have a significant negative impact. Moreover, cooperatives are identified as the most important influencing factor. Our work offers guidance in understanding the influencing factors of the willingness and behavior to adopt green vegetable production practices, and can provide a policy basis for governments to promote such practices

A QoS-Based Fairness-Aware BBR Congestion Control Algorithm Using QUIC

Congestion control is a fundamental technology to balance the traffic load and the network. The Internet Engineering Task Force (IETF) Quick UDP Internet Connection (QUIC) protocol has flexible congestion control and at the same time possesses the advantages of high efficiency, low latency, and easy deployment at the application layer. Bottleneck bandwidth and round-trip propagation time (BBR) is an optional congestion control algorithm adopted by QUIC. BBR can significantly increase throughput and reduce latency, in particular over long-haul paths. However, BBR results in high packet loss in low bandwidth and low fairness in multi-stream scenarios. In this article, we propose the enhanced BBR congestion control (eBCC) algorithm, which improves the BBR algorithm in two aspects: (1) 10.87% higher throughput and 74.58% lower packet loss rate in the low-bandwidth scenario and (2) 8.39% higher fairness in the multi-stream scenario. This improvement makes eBCC very suitable for IoT communications to provide better QoS services

Dietary fat intakes, lipid profiles, adiposity, inflammation, and glucose in women and men in the Framingham Offspring Cohort

Introduction: The role of dietary fat in the evolution of cardiometabolic disorders is highly controversial. As both dietary intake and the development of cardiometabolic risk differ by sex, we evaluated sex-specific differences in the associations between dietary fats (saturated and unsaturated) and four key cardiometabolic risk factors—lipid profiles, body fat, inflammation, and glucose regulation.Methods: We included 2391 women and men aged ≥30 years in the prospective Framingham Offspring Cohort. Weight-adjusted dietary fats (saturated, monounsaturated, and polyunsaturated fats, including omega-3 and omega-6) were derived from 3-day dietary records. Analysis of covariance was used to derive adjusted mean levels of all outcomes.Results: In both men and women, intakes of saturated and monounsaturated fats were inversely associated with TG:HDL ratio (p &lt; 0.02 for both types of fat). In women, higher omega-3 and omega-6 PUFAs were also inversely associated with TG:HDL (p &lt; 0.05 for both), but for men, only omega-3 PUFAs were associated (p = 0.026). All types of dietary fat were beneficially associated with larger HDL particle sizes in both men and women, while only saturated and monounsaturated fats were associated with larger LDL particles in men. In addition, saturated and monounsaturated fats were associated with statistically significantly higher concentrations of HDL and lower concentrations of LDL and VLDL particles in both sexes, while polyunsaturated fat had favorable associations in women only. Saturated fat also had beneficial associations with three measures of body fat. For example, women with the highest (vs. lowest) saturated fat intake had a lower BMI (27.7 ± 0.25 vs. 26.2 ± 0.36 kg/m2, p = 0.001); findings were similar in men (28.2 ± 0.25 vs. 27.1 ± 0.20, p = 0.002). Unsaturated fats had beneficial associations with body fat primarily in women. Finally, omega-3 PUFAs among women were inversely associated with interleukin-6 levels. There was no association between dietary fat intake and fasting glucose levels in either women or men.Discussion: In sum, we found no evidence of an adverse association between dietary fats and several surrogate markers of cardiometabolic health. This study suggests that different dietary fats may have divergent associations with cardiometabolic risk in women and men, perhaps owing to differences in food sources of the same dietary fats

Dynamical Jumping Real-Time Fault-Tolerant Routing Protocol for Wireless Sensor Networks

In time-critical wireless sensor network (WSN) applications, a high degree of reliability is commonly required. A dynamical jumping real-time fault-tolerant routing protocol (DMRF) is proposed in this paper. Each node utilizes the remaining transmission time of the data packets and the state of the forwarding candidate node set to dynamically choose the next hop. Once node failure, network congestion or void region occurs, the transmission mode will switch to jumping transmission mode, which can reduce the transmission time delay, guaranteeing the data packets to be sent to the destination node within the specified time limit. By using feedback mechanism, each node dynamically adjusts the jumping probabilities to increase the ratio of successful transmission. Simulation results show that DMRF can not only efficiently reduce the effects of failure nodes, congestion and void region, but also yield higher ratio of successful transmission, smaller transmission delay and reduced number of control packets.Comment: 22 pages, 9 figure

Clinicopathological Features and Prognostic Factors of Colorectal Neuroendocrine Neoplasms

Background. Limited research is available regarding colorectal NENs and the prognostic factors remain controversial. Materials and Methods. A total of 68 patients with colorectal NENs were studied retrospectively. Clinical characteristics and prognosis between colonic and rectal NENs were compared. The Cox regression models were used to evaluate the predictive capacity. Results. Of the 68 colorectal NENs patients, 43 (63.2%) had rectal NENs, and 25 (36.8%) had colonic NENs. Compared with rectal NENs, colonic NENs more frequently exhibited larger tumor size (P<0.0001) and distant metastasis (P<0.0001). Colonic NENs had a worse prognosis (P=0.027), with 5-year overall survival rates of 66.7% versus 88.1%. NET, NEC, and MANEC were noted in 61.8%, 23.5%, and 14.7% of patients, respectively. Multivariate analyses revealed that tumor location was not an independent prognostic factor (P=0.081), but tumor size (P=0.037) and pathological classification (P=0.012) were independent prognostic factors. Conclusion. Significant differences exist between colonic and rectal NENs. Multivariate analysis indicated that tumor size and pathological classification were associated with prognosis. Tumor location was not an independent factor. The worse outcome of colonic NENs observed in clinical practice might be due not only to the biological differences, but also to larger tumor size in colonic NENs caused by the delayed diagnosis

A real-world clinicopathological model for predicting pathological complete response to neoadjuvant chemotherapy in breast cancer

PurposeThis study aimed to develop and validate a clinicopathological model to predict pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer patients and identify key prognostic factors.MethodsThis retrospective study analyzed data from 279 breast cancer patients who received NAC at Zhejiang Provincial People’s Hospital from 2011 to 2021. Additionally, an external validation dataset, comprising 50 patients from Lanxi People’s Hospital and Second Affiliated Hospital, Zhejiang University School of Medicine from 2022 to 2023 was utilized for model verification. A multivariate logistic regression model was established incorporating clinical, ultrasound features, circulating tumor cells (CTCs), and pathology variables at baseline and post-NAC. Model performance for predicting pCR was evaluated. Prognostic factors were identified using survival analysis.ResultsIn the 279 patients enrolled, a pathologic complete response (pCR) rate of 27.96% (78 out of 279) was achieved. The predictive model incorporated independent predictors such as stromal tumor-infiltrating lymphocyte (sTIL) levels, Ki-67 expression, molecular subtype, and ultrasound echo features. The model demonstrated strong predictive accuracy for pCR (C-statistics/AUC 0.874), especially in human epidermal growth factor receptor 2 (HER2)-enriched (C-statistics/AUC 0.878) and triple-negative (C-statistics/AUC 0.870) subtypes, and the model performed well in external validation data set (C-statistics/AUC 0.836). Incorporating circulating tumor cell (CTC) changes post-NAC and tumor size changes further improved predictive performance (C-statistics/AUC 0.945) in the CTC detection subgroup. Key prognostic factors included tumor size &gt;5cm, lymph node metastasis, sTIL levels, estrogen receptor (ER) status and pCR. Despite varied pCR rates, overall prognosis after standard systemic therapy was consistent across molecular subtypes.ConclusionThe developed predictive model showcases robust performance in forecasting pCR in NAC-treated breast cancer patients, marking a step toward more personalized therapeutic strategies in breast cancer

Weight self-misperception and Obesity-related Knowledge, Attitudes, Lifestyle Behaviors and Cardio-metabolic Markers among Chinese School-aged Children and Adolescents

Abstract Objective: The relationships between childhood weight self-misperception and obesity-related factors particularly health markers have not been extensively discussed. This study aims to examine the associations between weight self-misperception and obesity-related knowledge, attitudes, lifestyles and cardio-metabolic markers among Chinese pediatric population. Design: Cross-sectional study. Setting: Data sourced from a national survey in Chinese seven provinces in 2013. Participants: Children and adolescents aged 5-19 years. Results: Of the total 14079 participants, there were 14.5% and 2.2% participants over-estimated and under-perceived their weight, respectively. Multi-variable logistic regression was applied to calculate odds ratio (OR) and 95% confidence interval (95% Cl) of obesity-related behaviors and cardio-metabolic markers by actual and perceived weight status. Individuals who perceived themselves as overweight/obese were more likely to have prolonged screen time, insufficient dairy intake, and over sugar-sweetened beverages consumption (all P<0.05), regardless of their weight. Furthermore, actual overweight/obese individuals had higher odds of abnormal cardio-metabolic markers, but a smaller magnitude of association was found among weight under-estimators. Among non-overweight/obese individuals, weight over-estimation was positively associated with abdominal obesity (OR: 10.49, 95% CI: 7.45, 14.76), elevated blood pressure (OR: 1.30, 95% CI: 1.12, 1.51), and dyslipidemia (OR: 1.43, 95% CI: 1.29, 1.58). Conclusions: Weight over-perception was more prevalent than under-estimation, particularly in girls. Weight over-estimators tended to master better knowledge but behave more unhealthily, both weight over-perception and actual overweight/obesity status were associated with poorer cardio-metabolic markers. Future obesity intervention programs should additionally pay attention to the population with inaccurate estimation of weight who were easily overlooked

Motivations of Enterprise Social Media Feature Set Usage

Enterprise social media (ESM) are widely adopted in the organizations with the aim of improving employees\u27 work performance. The purpose of this paper is to investigate the moderating effects of work context characteristics on the relationships between proactive motivations and usage behaviors of ESM communication and task collaboration feature sets.Design/methodology/approachQuestionnaire surveys were used to gather data from 307 randomly chosen Chinese employees, who were also ESM users. The research model was examined using linear regression methods with the SPSS 24 software package.FindingsThe results indicate that work context characteristics (i.e. task interdependence and perceived organizational support) had significant moderating effects on the relationships between proactive motivations and usage behaviors.Originality/valueBy extending the model of proactive motivation to the ESM context, this study directly addresses how users can be energized to use ESM features