Habitat Suitability in High Andean Butterflies: The Role of Land Cover in the Occurrence and Conservation of Species.

High Andean butterflies in northern South America are subject to landscape change processes. Our study used models to assess the habitat suitability of three Satyrinae species in the Upper Bogotá River Basin, Colombia. These three species include Pedaliodes polla (Thieme), Pedaliodes phaea (Hewitson), and Pedaliodes phaeina (Staudinger), the last two are endemic to Colombia. We used MaxEnt software to assess the habitat quality of these species, analyze the bioclimatic requirements that most influence them, and propose priority conservation areas. Our results indicated that, in most cases, the contribution of cover is more significant than 60%, so this variable determines the habitat capacity to support the species under study. We identified that the areas with suitable habitats are reduced with values less than or equal to 25% and are located in areas with a medium degree of intervention, which allows the species to occur. On the other hand, the climatic variables with the most significant contribution to the models were Temperature Seasonality and Precipitation of Driest Quarter (May-July). Conservation efforts must be focused on the most suitable areas, given the reduction in habitat for these species. Our research emphasizes the need to safeguard well-connected remnants of the high Andean forest and natural cover in agricultural matrices to counter the impact of agricultural expansion.

Industry perspective on regulatory authority (RA) quality reviews of biosimilar applications - an evaluation of RA guidance and expectations for chemical, manufacturing, and controls information through in-depth query analysis.

PURPOSE: Evaluate the type and quantity of quality information (i.e. Chemistry, Manufacturing, and Control) requested by the US FDA and EMA in queries pertaining to biosimilar applications. METHODS: Numbers/types of queries received following regulatory submissions (FDA/EMA, n = 7/n = 5) for seven biosimilars (PF-filgrastim [Nivestym], PF-rituximab [Ruxience®], PF-trastuzumab [Trazimera®], PF-bevacizumab [Zirabev®], PF-pegfilgrastim [Nyvepria®], PF-adalimumab [Abrilada™/Amsparity®], PF-infliximab [Ixifi]) from a single product portfolio were analyzed considering published regulatory authority (RA) guidance and in relation to sections/subsections of Module 3: Quality from the Common Technical Document regulatory dossier and topics based on keyword assignment. RESULTS: Queries were most frequently assigned (FDA/EMA %, range) to Drug Substance Manufacture (subsection 3.2.S.2; 21-35%/13-50%), Control of Drug Substance (3.2.S.4; 3-11%/5-17%), Drug Product Pharmaceutical Development (3.2.P.2; 1-12%/1-15%) and Manufacture (3.2.P.3; 17-41%/2-13%), and Analytical Similarity (3.2.R; 4-21%/4-20%). The proportion of Drug Substance and Drug Product queries was significantly different between RAs (n1 = 952, n2 = 468, p-value <0.001; two-sample proportion z-test). Topic assignments included: Control (12-27%/12-28%), Manufacturing (56-72%/34-66%), Stability (1-12%/2-24%), Biosimilarity (5-16%/5-25%), and Container Closure (0-3%/0-9%). CONCLUSION: The focus of both RAs on topics related to manufacturing and controls is valuable in understanding expectations for scientific and technical content related to gaining biosimilar approval.

Retrospective clinical study of 842 clasp-retained removable partial dentures with a metal framework: survival, maintenance needs, and biologic findings.

OBJECTIVES: To evaluate clasp-retained removable partial dentures (C-RPDs) with a metal framework for survival, maintenance requirements, and biological implications. METHOD AND MATERIALS: C-RPDs were retrospectively analyzed based on patient records. Treatment failure was defined as fracture of a framework component (metal base or connector) or loss of an abutment tooth. Other outcome variables included factors that might conceivably impact C-RPD survival (maxilla vs. mandible, Kennedy classes, opposing dentitions, treatment by students vs. certified dentists), mobility and caries of abutment teeth (in relation to clasp designs), and maintenance requirements (relining, clasp or resin fractures). Differences were evaluated by appropriate statistical tests at the P ≤ .05 level. RESULTS: A total of 612 patients (339 men, 273 women) 60.0 ± 11.5 years old at delivery were included, covering 842 C-RPDs and a mean observation period of 42.1 ± 33.2 months. Kaplan-Meier C-RPD survival was 76.2% after 5 years and 49.5% after 10 years. Biological complications (i.e. loss of abutment teeth) accounted for the vast majority (95.6%) of C-RPDs failures, and Kaplan-Meier C-RPD survival was significantly better in the mandible (P = .015). Some clasp designs contributed significantly to caries and removal of abutment teeth (both P < .05). No other significant differences were noted. CONCLUSION: Tooth loss both emerges as the main cause of C-RPDs failure and might be amenable to careful selection of clasp designs. Overall, better C-RPD survival should be expected in the mandible. A non-contributory role of Kennedy classes and opposing dentitions is tentatively suggested based on numerically heterogeneous subgroups.

Impacts of Maternal Nutrition on Sow Performance and Potential Positive Effects on Piglet Performance.

The objectives of this review are to identify the nutritional challenges faced by modern sows and present potential solutions to mitigate excessive maternal tissue loss and reproductive failure as it relates to recent genetic improvements. Current feeding programs have limitations to support the rapid genetic improvements in reproductive performance for modern sows. Since 2012, both litter size at birth and fetal weight have increased by 2.26 pigs per litter and 0.22 kg per piglet, respectively, thereby increasing the nutrient needs for sows during gestation and lactation. Prediction models generated in this review predict that modern sows would need 31% more lysine during gestation when compared with current feeding programs. Physiological challenges facing modern sows are also addressed in this review. High oxidative stress, pelvic organ prolapse, and lameness can directly affect the sow, whereas these physiological challenges can have negative impacts on colostrum and milk quality. In response, there is growing interest in investigating the functional roles of select bioactive compounds as feed additives to mitigate the severity of these challenges. Selenium sources, catechins, and select plant extracts have been utilized to reduce oxidative stress, calcium chloride and phytase have been used to mitigate pelvic organ prolapse and lameness, algae and yeast derivatives have been used to improve colostrum and milk quality, and fiber sources and probiotics have been commonly utilized to improve sow intestinal health. Collectively, this review demonstrates the unique challenges associated with managing the feeding programs for modern sows and the opportunities for revision of the amino acid requirements as well as the use of select bioactive compounds to improve reproductive performance.

Methods of Determining Energy Expenditure in Individuals with Prader-Willi Syndrome: A Systematic Literature Review.

Prader-Willi syndrome (PWS) is a rare disorder characterised by varying nutritional phases that occur throughout the lifespan, ranging from failure to thrive to hyperphagia. If uncontrolled, the imbalance between energy intake and expenditure results in obesity development and increased morbidity and mortality risk. Although measures of energy requirements for accurate nutrition assessment are vital, the evidence appears sparse and heterogeneous; hence, the aim of this review was to examine the available literature on energy expenditure predicted or measured using various methods in individuals with PWS. Studies were sought that presented methods and results on resting energy expenditure or basal metabolic rate. A narrative synthesis was completed to present the study characteristics and results. Methods of determining energy requirements included predictive equations and indirect calorimetry. Differences amongst ages, growth hormone therapy, fasting status, and measures in which results were presented were limitations to appropriately summarising and identifying trends in energy expenditure. Indirect calorimetry was identified as the most accurate method; however, it is not widely available in all settings. Further research is encouraged to support the development of valid and reliable predictive equations that will better inform and improve the efficiency of clinical practice in supporting people with PWS.

Cancer Patients' Perspectives and Requirements of Digital Health Technologies: A Scoping Literature Review.

Digital health technologies have the potential to alleviate the increasing cancer burden. Incorporating patients' perspectives on digital health tools has been identified as a critical determinant for their successful uptake in cancer care. The main objective of this scoping review was to provide an overview of the existing evidence on cancer patients' perspectives and requirements for patient-facing digital health technologies. Three databases (CINAHL, MEDLINE, Science Direct) were searched and 128 studies were identified as eligible for inclusion. Web-based software/platforms, mobile or smartphone devices/applications, and remote sensing/wearable technologies employed for the delivery of interventions and patient monitoring were the most frequently employed technologies in cancer care. The abilities of digital tools to enable care management, user-friendliness, and facilitate patient-clinician interactions were the technological requirements predominantly considered as important by cancer patients. The findings from this review provide evidence that could inform future research on technology-associated parameters influencing cancer patients' decisions regarding the uptake and adoption of patient-facing digital health technologies.

Protein intake and requirements in children and adolescents undergoing Hematopoietic Stem Cell Transplant (HSCT): An international benchmarking survey and a scoping review.

BACKGROUND & AIMS: For children and adolescents undergoing hematopoietic stem cell transplant (HSCT), adequate protein and energy intake is essential to mitigate malnutrition risk. However, little is known about optimal requirements, including adequate dietary protein intake in this population. We conducted an international benchmarking survey and a scoping review to explore current practices in determining protein requirements (PR) and examine existing evidence for PR and dietary protein intake in pediatric HSCT. METHODS: Twelve pediatric oncology centers were surveyed to elicit current practices in determining PR in pediatric HSCT. A scoping review then collected sources of evidence from six databases (MEDLINE, Embase, CINAHL, PubMed, Cochrane Library and Web of Science) and grey literature (Google Scholar). RESULTS: Survey data revealed variable practices in determining PR for pediatric HSCT patients. Four centers (44%) used the American Society for Parenteral and Enteral Nutrition (ASPEN) Nutrition Support in Pediatric Critically Ill Patient Guidelines 2009 and four (44%) used local guidelines or their national nutrient reference values (NRV). The scoping review included nineteen studies. The review highlighted a broad range of PR used in this population, ranging from 0.8 to 3.0 g/kg/d. Practices regarding the documentation and frequency of collecting protein intake data varied. Only five studies reported estimated protein requirement (EPR) status and just two studies met EPR. No clinical guidelines on PR in pediatric HSCT were identified. CONCLUSIONS: Given the existing gap in evidence, the optimal amount of protein required for children and adolescents undergoing HSCT remains unknown. To establish specific, evidence-based PR guidelines, comprehensive research is needed. Future investigations should prioritize evaluating current clinical practices, assessing the gap between actual protein intake and EPR, and understanding the relationship between protein intake, protein status, and the impact on treatment outcomes. Addressing these research priorities is crucial for bridging the current evidence gap, thereby enabling the development of enhanced and personalized nutritional support for children and adolescents undergoing HSCT.

User Requirements and Perceptions of a Sensor System for Early Stress Detection in People With Dementia and People With Intellectual Disability: Qualitative Study.

BACKGROUND: Timely detection of stress in people with dementia and people with an intellectual disability (ID) may reduce the occurrence of challenging behavior. However, detecting stress is often challenging as many long-term care (LTC) residents with dementia and residents with ID have communication impairments, limiting their ability to express themselves. Wearables can help detect stress but are not always accepted by users and are uncomfortable to wear for longer periods. Integrating sensors into clothing may be a more acceptable approach for users in LTC. To develop a sensor system for early stress detection that is accepted by LTC residents with dementia and residents with ID, understanding their perceptions and requirements is essential. OBJECTIVE: This study aimed to (1) identify user requirements for a garment-integrated sensor system (wearable) for early stress detection in people with dementia and people with ID, (2) explore the perceptions of the users toward the sensor system, and (3) investigate the implementation requirements in LTC settings. METHODS: A qualitative design with 18 focus groups and 29 interviews was used. Focus groups and interviews were conducted per setting (dementia, ID) and target group (people with dementia, people with ID, family caregivers, health care professionals). The focus groups were conducted at 3 time points within a 6-month period, where each new focus group built on the findings of previous rounds. The data from each round were used to (further) develop the sensor system. A thematic analysis with an inductive approach was used to analyze the data. RESULTS: The study included 44 participants who expressed a positive attitude toward the idea of a garment-integrated sensor system but also identified some potential concerns. In addition to early stress detection, participants recognized other potential purposes or benefits of the sensor system, such as identifying triggers for challenging behavior, evaluating intervention effects, and diagnostic purposes. Participants emphasized the importance of meeting specific system requirements, such as washability and safety, and user requirements, such as customizability and usability, to increase user acceptance. Moreover, some participants were concerned the sensor system could contribute to the replacement of human contact by technology. Important factors for implementation included the cost of the sensor system, added value to resident and health care professionals, and education for all users. CONCLUSIONS: The idea of a garment-integrated sensor system for early stress detection in LTC for people with dementia and people with ID is perceived as positive and promising by stakeholders. To increase acceptability and implementation success, it is important to develop an easy-to-use, customizable wearable that has a clear and demonstrable added value for health care professionals and LTC residents. The next step involves pilot-testing the developed wearable with LTC residents with dementia and residents with ID in clinical practice.

Sampling Strategies for Experimentally Mapping Molecular Fitness Landscapes Using High-Throughput Methods.

Empirical studies of genotype-phenotype-fitness maps of proteins are fundamental to understanding the evolutionary process, in elucidating the space of possible genotypes accessible through mutations in a landscape of phenotypes and fitness effects. Yet, comprehensively mapping molecular fitness landscapes remains challenging since all possible combinations of amino acid substitutions for even a few protein sites are encoded by an enormous genotype space. High-throughput mapping of genotype space can be achieved using large-scale screening experiments known as multiplexed assays of variant effect (MAVEs). However, to accommodate such multi-mutational studies, the size of MAVEs has grown to the point where a priori determination of sampling requirements is needed. To address this problem, we propose calculations and simulation methods to approximate minimum sampling requirements for multi-mutational MAVEs, which we combine with a new library construction protocol to experimentally validate our approximation approaches. Analysis of our simulated data reveals how sampling trajectories differ between simulations of nucleotide versus amino acid variants and among mutagenesis schemes. For this, we show quantitatively that marginal gains in sampling efficiency demand increasingly greater sampling effort when sampling for nucleotide sequences over their encoded amino acid equivalents. We present a new library construction protocol that efficiently maximizes sequence variation, and demonstrate using ultradeep sequencing that the library encodes virtually all possible combinations of mutations within the experimental design. Insights learned from our analyses together with the methodological advances reported herein are immediately applicable toward pooled experimental screens of arbitrary design, enabling further assay upscaling and expanded testing of genotype space.

Effects of Feed Moisture Content on the Physical and Nutritional Quality Attributes of Sunflower Meal-based High-Moisture Meat Analogues.

Adding value to food industry by-products, like sunflower meal (SFM), through their utilization as ingredients in new food products can improve sustainability of food systems. This research investigated extrusion cooking to produce high-moisture meat analogues (HMMAs) made from blends of soy protein isolate and expeller-pressed SFM. The effects of feed moisture content [FMC] (60, 65, and 70%, wet basis) and SFM concentration (37.5, 50, and 62.5%, total blend weight basis) on physical and protein nutritional quality attributes of HMMAs were investigated. The processing temperatures (including cooling die), screw speed and feed rate were kept constant at 60-80-115-125-50-25 °C (from feeder to the die end), 200 rpm and 0.5 kg/h (dry basis), respectively. An increase in SFM concentration and FMC significantly (p < 0.05) reduced the mechanical energy requirements for extrusion. Cutting strength and texture profile analysis of HMMAs indicated softer texture with increases in SFM and FMC. X-ray microcomputed tomography analysis revealed that the microstructure of the HMMAs at the centre and towards the surface was different and affected by SFM concentration and FMC. The in vitro-protein digestibility corrected amino acid score of the HMMAs ranged between 85 and 91% and did not show significant (p < 0.05) changes as a function of FMC or SFM concentration. HMMAs produced from 37.5% SFM at 70% FMC showed no deficiency in essential amino acids for all age categories except for infants, suggesting the high potential of SFM and soy protein blends for creating nutritious meat alternative products. Overall, this work provided valuable insights regarding the effects of soy protein replacement by SFM on the textural, microstructural and nutritional quality of HMMA applications, paving the way for value-addition to this underutilized food industry by-product.

An increasing proportion of the population is not covered by the current RDA for vitamin C - interrogation of EPIC-Norfolk and NHANES 2017/2018 cohorts.

With the rising prevalence of obesity globally, increasing proportions of the population may not be covered by current recommended daily allowances (RDAs) that are supposed to provide 97.5% of the population with a sufficient nutrient status but are typically based on a healthy young 70 kg male reference person. Using the EPIC-Norfolk (UK) and the NHANES (US) cohorts, we estimated the effect of body weight on the dose-concentration relationship to derive weight-based requirements to achieve an 'adequate' plasma concentration of vitamin C estimated to be 50 µmol/L. Inverse correlations between body weight and vitamin C were observed in both cohorts (p < 0.0001). Moreover, only about 2/3 of the cohorts achieved an adequate plasma vitamin C status by consuming the RDA or above, while only 1/3 to 1/2 of the cohorts achieved adequacy by an intake of the local RDA ± 10%. Using vitamin C as an example, the present data demonstrate that a considerable and expectedly increasing proportion of the world population is unable to achieve an adequate target plasma concentration with the current recommended daily intakes of vitamin C. This needs to be considered in future public health recommendations.

In this paper, we highlight the inverse association between body weight and vitamin C status. Our study strongly suggests that a large proportion of the population is not covered by the current recommended intakes of vitamin C.

Developing CBTC system safety requirement hierarchy through STPA methodology.

Safety-critical systems, such as the railway signal system, are subject to potentially high costs from failures, including loss of life and property damage. The use of new technology, including communication-based train control (CBTC) systems with software and computers, has changed the types of accidents that occur. Software-related issues and dysfunctional interactions between system components controlled by the software are increasingly the cause of incidents. Developing a "safe" safety-critical system requires accurate and complete safety requirements, which are the foundation of system development. Traditional hazard analysis techniques are insufficient for identifying the causes of accidents in modern railway signaling systems. Systems-Theoretic Process Analysis (STPA) is a powerful new hazard analysis method designed to address these limitations. Building upon this foundation, a hierarchical approach to safety requirement development has been further developed. This approach combines STPA analysis with a hierarchical modeling approach to establish traceability links from safety requirements to specific architectures, refine and allocate system-level safety requirements to relevant subsystems, and abstract safety requirements at higher hierarchical levels to enable easy changes to lower-level implementations. This paper employs the aforementioned methodology within the context of the CBTC system, thereby enhancing risk management and hazard analysis, enabling early insights, and facilitating the generation of safety requirements of CBTC System.

Fat-free mass derived from bioimpedance spectroscopy and computed tomography are in good agreement in patients with chronic kidney disease.

OBJECTIVE: Malnutrition is highly prevalent in patients with kidney failure. Since body weight does not reflect body composition, other methods are needed to determine muscle mass, often estimated by fat-free mass (FFM). Bioimpedance spectroscopy (BIS) is frequently used for monitoring body composition in patients with kidney failure. Unfortunately, BIS-derived lean tissue mass (LTMBIS) is not suitable for comparison with FFM cut-off values for the diagnosis of malnutrition, or for calculating dietary protein requirements. Hypothetically, FFM could be derived from BIS data (FFMBIS). This study aims to compare FFMBIS and LTMBIS with computed tomography (CT) derived FFM (FFMCT). Secondarily, we aimed to explore the impact of using different methods on calculated protein requirements. METHODS: CT scans of 60 patients with CKD stage 4-5 were analyzed at the L3 level for muscle cross-sectional area, which was converted to FFMCT. Spearman rank correlation coefficient and 95% limits of agreement (LoA) were calculated to compare FFMBIS and LTMBIS with FFMCT. Dietary protein requirements were determined based on FFMCT, FFMBIS and adjusted body weight. Deviations over 10% were considered clinically relevant. RESULTS: FFMCT correlated most strongly with FFMBIS (r=0.78, p<0.001), in males (r=0.72, p<0.001) and in females (r=0.60, p<0.001). A mean difference of -0.54 kg was found between FFMBIS and FFMCT (LoA: -14.88 to 13.7 kg, p=0.544). Between LTMBIS and FFMCT a mean difference of -12.2 kg was apparent (LoA: -28.7 to 4.2 kg, p<0.001). Using FFMCT as a reference, FFMBIS best predicted protein requirements. The mean difference between protein requirements according to FFMBIS and FFMCT was -0.7 ± 9.9 grams in males and -0.9 ± 10.9 grams in females. CONCLUSION: FFMBIS correlates well with FFMCT at a group level, but still shows large variation within individuals. As expected, large clinically relevant differences were observed in calculated protein requirements.

How to obtain product green design requirements based on sentiment analysis and topic analysis: Using washing machine online reviews as an example.

Green design involves the entire life cycle of a product, including stages such as raw material acquisition, production and manufacturing, sales and transportation, use, recycling, and disposal. Extracting customer requirements (CRs) related to product green design (PGD) is one of the necessary conditions for achieving the dual carbon goal. However, only a few studies have evaluated CRs for PGD from a full life cycle perspective. This study obtained 20,000 online reviews of washing machines from e-commerce platforms. The customers' sentiment tendencies toward the requirements of washing machines at various stages of their life cycle are analyzed and evaluated. The CRs contained in online washing machine reviews were identified through cluster analysis. Based on the life cycle theory, the product green design requirements (PGDRs) of CRs were extracted and analyzed. This study can provide theoretical and methodological support for green product design.

Feed balances for ruminant livestock: gridded estimates for data-constrained regions.

Demand for animal-source foods and livestock feed are forecast to increase across sub-Saharan Africa. In this context, there is a need to estimate the availability of livestock feed to support decision-making at local, sub-national and national levels. In this study, we assess feed balances for ruminant livestock in Ethiopia and Burkina Faso. Feed availability was estimated using remotely sensed products and detailed feed composition data. Feed requirements were estimated for maintenance, growth, lactation, gestation and locomotion using a data-intensive model. Biomass available as animal feed was estimated to be 8.6 tonnes of DM per hectare in the Ethiopian highlands and midlands, 3.2 tonnes DM per hectare in the Ethiopian lowlands, 2.9 tonnes DM per hectare in Burkina Faso's Sudanian agro-ecological zone and 1.0 tonne DM per hectare in the Sahel. The energy requirements of lactating cows were estimated to be 62.1 Megajoules (MJs) per animal per day in the Ethiopian highlands and midlands, 62.7 MJ in the Ethiopian lowlands, 88.5 MJ in Burkina Faso's Sudanian agro-ecological zone and 53.1 MJ per animal per day in the Sahel. Feed scarcity hotspots are most prominently located in the Ethiopian highlands and the Sahelian agro-ecological zone of Burkina Faso. Demand-side policy and investment initiatives can address hotspots by influencing herd sizes, nutritional requirements and herd mobility. Supply-side policy and investment initiatives can secure existing feed resources, develop new sources of feed and incentivise trade in feed resources. Improving feed balances will be of value to decision-makers with the aims of optimising livestock productivity, minimising exposure to climatic shocks and minimising greenhouse gas emission intensity.

Normative challenges in data governance: insights from global health research.

Many important questions in health professions education require datasets that are built from several sources, in some cases using data collected for a different purpose. In building and maintaining these datasets, project leaders will need to make decisions about the data. While such decisions are often construed as technical, there are several normative concerns, such as who should have access, how the data will be used, how products resulting from the data will be shared, and how to ensure privacy of the individuals the data is about is respected, etc. Establishing a framework for data governance can help project leaders in avoiding problems, related to such matters, that could limit what can be learned from the data or that might put the project (or future projects) at risk. In this paper, we highlight several normative challenges to be addressed when determining a data governance framework. Drawing from lessons in global health, we illustrate three kinds of normative challenges for projects that rely on data from multiple sources or involved partnerships across institutions or jurisdictions: (1) legal and regulatory requirements, (2) consent, and (3) equitable sharing and fair distribution.

The art of establishing mineral tolerances of dogs and cats.

For over six decades, nutritional science has provided well-developed, peer-reviewed nutrient recommendations to support the health of dogs and cats. These guidelines are updated based on new scientifically valid research and appropriate peer-review. Recent regulatory and scientific positions around health issues have resulted in strong opinions and desires for rapid regulatory action surrounding mineral nutrition, but with limited and conflicting scientific evidence. Pet Food Institute nutrition experts have come together to jointly author an article on the complexities of establishing mineral tolerances of dogs and cats to illustrate the limitations in defining mineral tolerances. This discussion covers how mineral requirements were determined, including the opportunities and pitfalls encountered. Scientific councils must review and clarify any proposed changes in conducting mineral nutrition research that might impact complete and balanced foods and surrounding regulations. It is important to clarify the multiple issues in mineral nutrition research and the necessity for thorough evaluation of data while avoiding arbitrary and potentially harmful guidelines.

Dogs and cats are living longer and healthier lives due, in part, to the scientific development of nutritional information. This information has allowed the building of many new types of foods, treats, and supplements that promote life, health, and enjoyment by the pet. There are several organizations that have provided helpful reviews of nutritional data through scientific councils that help identify safe and healthy criteria for all pet food products. These are readily available for those who want to learn more about pet nutrition. For many nutrients, there is a large database of information to help build products. Nutrients that are called macro- or micro-/trace minerals (e.g., sodium, potassium, zinc, copper, etc.) often have more limited information. Recently, strong opinions about pet health as related to mineral nutrition have been shared and robustly communicated without adequate scientific research to support the hypotheses. This has led to misinformation, concerns, and fear. To safeguard the health of companion animals and provide assistance to regulatory bodies regarding the nutritional welfare of dogs and cats, scientific panels have come together from industry, government, and academia to review, approve, and challenge nutritional guidelines. This overview provides the reader context into the rigor needed to establish safe mineral tolerances for dogs and cats.

Associations between Intake of Dietary Sugars and Diet Quality: A Systematic Review of Recent Literature.

Understanding the relationship between the intake of sugars and diet quality can inform public health recommendations. This systematic review synthesized recent literature on associations between sugar intake and diet quality in generally healthy populations aged 2 years or older. We searched databases from 2010 to 2022 for studies of any design examining associations between quantified sugar intake in the daily diet and dietary indexes (DIs) or micronutrient intakes. Different sugar types and diet quality measures were analyzed separately. We converted DI results to Pearson's r correlations and grouped indexes with or without a free or added sugar component to facilitate cross-study comparisons. Meta-analysis was deemed inappropriate. From 13,869 screened records, we included 27 cross-sectional studies. NUQUEST risk of bias ratings were neutral (n = 18 studies) or poor (n = 9), and strength of evidence by the GRADE approach was very low due to study design. Most studies reported negative associations for added and free sugars with diet quality indexes (r ranging from -0.13 to -0.42) and nutrients of public health concern (fiber, vitamin D, calcium, potassium), while associations with total sugars were mixed. Due to cross-sectional study designs, the clinical relevance of these findings is unclear. Prospective studies are needed to minimize confounding and inform causal relationships.

Stigma and the use of umbrellas, hiking poles and walking sticks to aid walking in Hong Kong.

Background: The use of walking aids is widely acknowledged as one of the most relied-on forms of assistive technology. Using stick-shaped devices, such as a cane, is often the entrance for many people to the world of assistive technologies, often accompanied by the negative stigma associated with ageing and disability. Objectives: This study investigated the perception of disability and needs of the Hong Kong population using walking aids, aiming to inform device design and service provision. Methods: We observed 391 individuals using cane-like devices in their natural environment and conducted semi-structured interviews with 28 participants to understand stigma, barriers to acquisition, training, and design requirements. Results: Half of the interviewees (50%, n = 14) did not feel disabled when using a walking stick, while 39% felt slightly disabled. 56% of the observed sample used non-medical-looking aids like hiking poles or umbrellas. Most interviewees (79%) purchased off-the-shelf devices, but less than half received seller support in choosing appropriate aids. Conclusion: The feelings associated with using walking sticks and similar devices are mostly positive. There is a preference in Hong Kong for using devices without a medical appearance to aid walking, such as umbrellas and hiking poles. There is a need to raise awareness of the risks of using umbrellas to aid walking and empower the user to make informed decisions when purchasing walking aid devices. In addition, there is a need to support the supply chain of walking aids, including umbrellas and hiking poles, to provide more information on device use, misuse, training, and maintenance.

Impact of metabolic and bariatric surgery on weight loss and insulin requirements in type 1 and insulin-treated type 2 diabetes.

Metabolic and Bariatric Surgery (MBS) is effective in improving metabolic outcomes and reducing weight in patients with obesity and diabetes, with less explored benefits in type 1 diabetes (T1D). This study aimed to evaluate the impact of MBS on weight loss and insulin requirements in T1D patients compared to insulin-treated type 2 diabetes (T2D) patients over a 5-year period. This retrospective analysis included patients who underwent primary sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) with a confirmed preoperative diagnosis of either T1D or insulin-treated T2D. Primary endpoints focusing on weight loss and secondary outcomes assessing changes in insulin dosage and glycemic control. After 5 years, weight loss was similar across groups, with total weight loss at 14.2% for T1D and 17.6% for insulin-treated T2D in SG, and 22.6% for T1D vs. 26.8% for insulin-treated T2D in RYGB. Additionally, there was a significant reduction in median daily insulin doses from 140.5 units at baseline to 77.5 units at 1 year postoperatively, sustained at 90 units at 5 years. The differential impact of MBS procedure was also highlighted, where RYGB patients showed a more pronounced and enduring decrease in insulin requirements compared to SG.