Algorithm-based mapping of products in a branded Canadian food and beverage database to their equivalents in Health Canada's Canadian Nutrient File.

Introduction: There is increasing recognition of the value of linking food sales databases to national food composition tables for population nutrition research. Objectives: Expanding upon automated and manual database mapping approaches in the literature, our aim was to match 1,179 food products in the Canadian data subset of Euromonitor International's Passport Nutrition to their closest respective equivalents in Health Canada's Canadian Nutrient File (CNF). Methods: Matching took place in two major steps. First, an algorithm based on thresholds of maximal nutrient difference (between Euromonitor and CNF foods) and fuzzy matching was executed to offer match options. If a nutritionally appropriate match was available among the algorithm suggestions, it was selected. When the suggested set contained no nutritionally sound matches, the Euromonitor product was instead manually matched to a CNF food or deemed unmatchable, with the unique addition of expert validation to maximize meticulousness in matching. Both steps were independently performed by at least two team members with dietetics expertise. Results: Of 1,111 Euromonitor products run through the algorithm, an accurate CNF match was offered for 65% of them; missing or zero-calorie data precluded 68 products from being run in the algorithm. Products with 2 or more algorithm-suggested CNF matches had higher match accuracy than those with one (71 vs. 50%, respectively). Overall, inter-rater agreement (reliability) rates were robust for matches chosen among algorithm options (51%) and even higher regarding whether manual selection would be required (71%); among manually selected CNF matches, reliability was 33%. Ultimately, 1,152 (98%) Euromonitor products were matched to a CNF equivalent. Conclusion: Our reported matching process successfully bridged a food sales database's products to their respective CNF matches for use in future nutritional epidemiological studies of branded foods sold in Canada. Our team's novel utilization of dietetics expertise aided in match validation at both steps, ensuring rigor and quality of resulting match selections.

Pregnant Individuals' Views on Fetal Tissue Research in the United States.

OBJECTIVE: Fetal tissue research has driven significant medical advances but remains publicly contentious in the United States. The views of pregnant individuals in the United States regarding the donation of fetal tissue offer an important and previously unexplored perspective on this issue. METHODS: We conducted a secondary analysis of data from two separate, broader qualitative studies. Pregnant and recently pregnant individuals (N=79) from clinical sites at the University of North Carolina at Chapel Hill, Johns Hopkins University, and Massachusetts General Hospital were interviewed individually using a semi-structured guide addressing a range of issues related to infectious disease research and pregnancy, including the acceptability of fetal tissue research. Interviews were transcribed, coded, and analyzed for emergent themes. RESULTS: Among this sample of predominantly Black (61%), reproductive-aged pregnant and recently pregnant participants, the majority (72%) generally supported fetal tissue research. The following three themes were identified: choice, respect, and meaning. Respondents discussed the deeply personal nature of decisions surrounding fetal tissue research, emphasizing the importance of informed consent and respect for the person's emotional state when approaching for consent. The ways in which participants regarded how to respectfully handle fetal tissue also shaped views about the acceptability of donation, both for and against. For many participants, fetal tissue donation to research represented one way of ascribing meaning to pregnancy termination or loss. CONCLUSION: Among this diverse sample of pregnant and recently pregnant individuals, most were supportive of fetal tissue donation for research. A better understanding of pregnant individuals' views on this topic may lead to policies and practices that are congruent with the needs and values of people facing decisions regarding the disposition of fetal remains.

Advancing HIV research with pregnant women: navigating challenges and opportunities.

OBJECTIVE: Concerns about including pregnant women in research have led to a dearth of evidence to guide safe and effective treatment and prevention of HIV in pregnancy. To better understand why these evidence gaps persist and inform guidance for responsible inclusion of pregnant women in the HIV research agenda, we aimed to learn what HIV experts perceive as barriers and constraints to conducting this research. METHODS: We conducted a series of group and one-on-one consultations with 62 HIV investigators and clinicians to elicit their views and experiences conducting HIV research involving pregnant women. Thematic analysis was used to identify priorities and perceived barriers to HIV research with pregnant women. RESULTS: Experts discussed a breadth of needed research, including safety, efficacy, and appropriate dosing of: newer antiretrovirals for pregnant women, emerging preventive strategies, and treatment for coinfections. Challenges to conducting research on pregnancy and HIV included ethical concerns, such as how to weigh risks and benefits in pregnancy; legal concerns, such as restrictive interpretations of current regulations and liability issues; financial and professional disincentives, including misaligned funder priorities and fear of reputational damage; and analytical and logistical complexities, such as challenges recruiting and retaining pregnant women to sufficiently power analyses. CONCLUSION: Investigators face numerous challenges to conducting needed HIV research with pregnant women. Advancing such research will require clearer guidance regarding ethical and legal uncertainties; incentives that encourage rather than discourage investigators to undertake such research; and a commitment to earlier development of safety and efficacy data through creative trial designs.

Thyroid hormone levels associated with active and passive cigarette smoking.

BACKGROUND: Active and passive cigarette smoking are a risk factor among women of reproductive age-leading to reproductive health morbidity, including fetal and infant death and developmental problems with the newborn. However, the underlying physiological mechanisms for these ill-effects are not fully understood. Smoke exposure may affect various metabolic and biological processes, including hormone biosynthesis and secretion, interfere with thyroid hormone release, binding, transport, storage, and clearance, associated with adverse effects on the thyroid resulting in changes in circulating hormone concentrations. We measured and compared serum thyroid hormone and thyroid stimulating hormone (TSH) concentrations in active, passive, and nonsmokers and determined their association with cigarette tobacco smoke exposure. We use a comprehensive approach to assess the interrelationships between active and passive tobacco smoke exposure and thyroid hormone levels by employing innovative hormone analysis techniques. METHODS: Serum was obtained from women (18-44 years of age). Thyroxine (T4), triiodothyronine (T3), and cotinine concentrations were quantified using isotope dilution high performance liquid chromatography tandem mass spectrometry, and TSH concentrations by chemiluminescence. RESULTS: Serum concentrations of the various hormones of active smokers, passive smokers, and nonsmokers (nonexposed), respectively, were as follows. Median TSH concentrations were 1.02, 1.06, and 1.12 mIU/L (p < 0.001 for the comparison of each group with the other two groups), and mean TSH levels were 1.40 mIU/L, confidence interval (CI) 0.07-6.83 mIU/L; 1.30 mIU/L, CI 0.25-3.01 mIU/L; and 1.50 mIU/mL, CI 0.71-4.00 mIU/L. Median serum T4 concentrations were 7.6, 7.9, and 8.7 microg/dL, and median serum T3 concentrations were 92.0, 84.0, and 102.0 ng/dL (p < 0.0001). Mean T3 levels were 99.1 ng/dL, CI 52.1-204.3 ng/dL; 87.6 ng/dL, CI 40.1-160.2 ng/dL; and 106.6 ng/dL, CI 46.4-175.0 ng/dL. Pair-wise comparisons of the three study groups indicate statistically significant differences in serum T4 (p < 0.01) and T3 (p < 0.001) means for the comparison of each group with the other two groups. CONCLUSIONS: This study is unique in examining the association of serum cotinine and thyroid hormone concentrations using liquid chromatography tandem mass spectrometry in women smokers, passive smokers, and nonsmokers. Active and passive exposure to cigarette tobacco smoke is associated with a mild inhibitory effect on the thyroid reflected in higher serum T4 and T3 in nonsmokers compared to smokers in this cohort of women.