Background: The NOVA food classification scheme divides foods into ultra-processed, processed, unprocessed, and culinary ingredients. Ultra-processed foods contribute >60% of energy to diets in the US. Objective: To characterize ultra-processed foods by energy density, nutrient density, and monetary cost. Methods: The 384 component foods of Fred Hutch (FHCRC) food frequency questionnaire (FFQ), were assigned to 4 NOVA categories and to 7 USDA MyPyramid food groups. Energy density was kcal/g. Nutrient density was measured using the Nutrient Rich Food index NRF 9.3 . Food prices were collected in local supermarkets from 2004 to 2016. Analyses examined time trends in food prices by NOVA category and by USDA food group. Results: The ultra-processed classification captured mostly grains (91%), fats and sweets (73%), dairy (71%), and beans, nuts and seeds (70%), but only 36% of meat, poultry and fish, 26% of vegetables, and 20% of fruit. Compared to unprocessed foods, ultra-processed foods had lower nutrient density (NRF 9.3 per 100 kcal: 21.2 vs. 108.5),higher energy density (mean (SD): 2.2 vs. 1.10 in kcal/g), and lower per calorie cost (0.55 vs. 1.45 in $/100 kcal). Ultra-processed foods did not increase in price as much as unprocessed foods over the 12 year period. Conclusion: Ultra-processed foods tend to be energy-dense, low-cost, and nutrient-poor. Low energy cost could be one mechanism linking ultra-processed foods with negative health outcomes. Food-based Dietary Guidelines may need to address food processing in relation to economic aspects of food choice.
The built environment (BE) has been viewed as an important determinant of health. Numerous studies have linked BE exposure, captured using a variety of methods, to diet quality and to area prevalence of obesity, diabetes, and cardiovascular disease. First‐generation studies defined the neighborhood BE as the area around the home. Second‐generation studies turned from home‐centric to person‐centric BE measures, capturing an individual’s movements in space and time. Those studies made effective uses of global positioning system tracking devices and mobile phones, sometimes coupled with accelerometers and remote sensors. Activity space metrics explored travel paths, modes, and destinations to assess BE exposure that was both person and context specific. However, as measures of the contextual exposome have become ever more fine‐grained and increasingly complex, connections to long‐term chronic diseases with complex etiologies, such as obesity, are in danger of being lost. Furthermore, few studies on obesity and the BE have included intermediate energy balance behaviors, such as diet and physical activity, or explored the potential roles of social interactions or psychosocial pathways. Emerging survey‐based applications that identify habitual destinations and associated travel patterns may become the third generation of tools to capture health‐relevant BE exposures in the long term.
IntroductionChoriocarcinoma is a highly malignant tumor of trophoblastic origin. Most cases present within one year of the antecedent pregnancy (molar or non-molar). However, very rarely, choriocarcinoma can develop from germ cells or from dedifferentiation of endometrial carcinoma into choriocarcinoma. This article concerns a case of choriocarcinoma developing 38 years after the patient's last pregnancy and 23 years after menopause.Case presentationA 73-year-old African-American woman presented with a three-week history of vaginal bleeding. A vaginal mass was seen on pelvic examination. Ultrasonography showed a thickened complex endometrial echo. Her β-human chorionic gonadotrophin level was found to be elevated (2,704,040 mIU/mL). Vaginal and uterine biopsies were suggestive of choriocarcinoma. Immunohistochemistry tests were positive for β-human chorionic gonadotrophin as well as cytokeratin and negative for octamer binding transcription factor 3/4 and α-fetoprotein, supporting the diagnosis of choriocarcinoma. A combination of etoposide, methotrexate, and dactinomycin, followed by cyclophosphamide and vincristine (the so-called EMA/CO regimen) was initiated. After seven cycles of chemotherapy, her β-human chorionic gonadotrophin level dropped below 5 mIU/mL. Our patient is being followed up at our oncology institute.ConclusionsWe report an extremely rare case of choriocarcinoma arising 23 years after menopause. A postmenopausal woman presenting with vaginal bleed from a mass and β-human chorionic gonadotrophin elevation should be evaluated by immunohistochemical analysis to rule out the possibilities of a germ cell origin of the tumor or dedifferentiation of an epithelial tumor. Absence of octamer binding transcription factor 3/4, α-fetoprotein and CD-30 staining helps in exclusion of most germ cell tumors. DNA polymorphism studies can be used to differentiate between gestational and non-gestational tumor origin. These require fresh tissue samples and are time consuming. Finally, the effective first-line therapy for β-human chorionic gonadotrophin-producing high-risk gestational as well as non-gestational trophoblastic tumors is combination chemotherapy (the EMA/CO regimen). Therefore, treatment should be commenced when a potential diagnosis of metastatic trophoblastic tumor is being considered.
). Tigers fed on seven prey species as shown by kill data. Tigers' scat analysis revealed the presence of five prey species. Prey selection by tigers based on scat analysis was in the following order: sambar> chital> nilgai> livestock> common langur. It is proposed to restock the tiger population initially with five tigers in Sariska and subsequent supplementation of two tigers every three years for a period of six years, which will allow the population to achieve demographic viability. Removal of anthropogenic pressure from the national park will be crucial for the long term survival of tigers in Sariska.
Countries in South East Asia are undergoing a nutrition transition, which typically involves a dietary shift from plant to animal proteins. To explore the main drivers of protein consumption, the SCRiPT (Socio Cultural Research in Protein Transition) study recruited a population sample in Malaysia (N = 1604). Participants completed in-person 24 h dietary recalls and socio-demographic surveys. Energy and nutrient intakes were estimated using Nutritionist Pro. A novel recipe-based frequency count coded protein sources as meat (chicken, beef, pork, and mutton), fish, eggs, dairy, and plants (cereals, pulses, tubers). Dietary intakes and frequencies were examined by gender, age, income, education, ethnicity, religion, and family status, using ANOVAs and general linear models. Energy intakes were 1869 kcal/d for men and 1699 kcal/d for women. Protein intakes were 78.5 g/d for men and 72.5 g/d for women. Higher energy and protein intakes were associated with Chinese ethnicity, higher education and incomes. Frequency counts identified plant proteins in 50% of foods, followed by meat (19%), fish (12%), eggs (12%), and dairy (7%). Most frequent source of meat was chicken (16%) rather than pork or beef (1.5% each). In bivariate analyses, animal protein counts were associated with younger age, higher education and incomes. In mutually adjusted multivariate regression models, animal proteins were associated with education and ethnicity; plant proteins were associated with ethnicity and religion. Protein choices in Malaysia involve socio-cultural as well as economic variables.
Precision agriculture requires new technologies for rapid diagnosis of plant stresses, such as nutrient deficiency and drought, before the onset of visible symptoms and subsequent yield loss. Here, we demonstrate a portable Raman probe that clips around a leaf for rapid, in vivo spectral analysis of plant metabolites including carotenoids and nitrates. We use the leaf-clip Raman sensor for early diagnosis of nitrogen deficiency of the model plant Arabidopsis thaliana as well as two important vegetable crops, Pak Choi (Brassica rapa chinensis) and Choy Sum (Brassica rapa var. parachinensis). In vivo measurements using the portable leaf-clip Raman sensor under full-light growth conditions were consistent with those obtained with a benchtop Raman spectrometer measurements on leaf-sections under laboratory conditions. The portable leaf-clip Raman sensor offers farmers and plant scientists a new precision agriculture tool for early diagnosis and real-time monitoring of plant stresses in field conditions.
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