Comparison of a Standardized High-Fat Meal versus a High-Fat Meal Scaled to Body Mass for Measuring Postprandial Triglycerides: A Randomized Crossover Study

Post-meal triglycerides are an independent cardiovascular disease (CVD) risk factor, but the ideal high-fat meal formulation has yet to be standardized and is one challenge prohibiting widespread clinical adoption of postprandial triglyceride assessment. Two general approaches often used are giving individuals a high-fat meal scaled to body weight or a standardized high-fat meal containing a set fat bolus. A recent expert panel statement has endorsed the latter, specifying 75 g of fat as an appropriate fat dosage. Despite this recommendation, no study to date has tested whether there is a difference in postprandial triglycerides or if risk classification is affected based on these different approaches. We recruited 16 generally healthy individuals with roughly equal distribution among body mass index (BMI)class (n = 5–6/per BMI category) and sex (n = 2–3 M/F) within each BMI class. Each participant underwent two abbreviated fat tolerance tests separated by ~1 week: one with a scaled to body weight high-fat meal (9 kcal/kg; 70% fat) and a standardized meal containing 75 g of fat (70% fat). Fasting, 4 h, and absolute change in triglycerides across the entire sample and within each BMI category were similar regardless of high-fat meal. Only one participant with obesity had discordant postprandial responses between the fat tolerance tests (i.e., different CVD risk classification). These findings suggest that, within a certain range of fat intake, generally healthy individuals will have a similar postprandial triglyceride response. Considering the greater convenience of utilizing standardized high-fat meals, our data suggest that a standardized high-fat meal may be acceptable for large-scale studies and clinical implementation.

Options for reforming agricultural subsidies from health, climate, and economic perspectives

Agricultural subsidies are an important factor for influencing food production and therefore part of a food system that is seen as neither healthy nor sustainable. Here we analyse options for reforming agricultural subsidies in line with health and climate-change objectives on one side, and economic objectives on the other. Using an integrated modelling framework including economic, environmental, and health assessments, we find that on a global scale several reform options could lead to reductions in greenhouse gas emissions and improvements in population health without reductions in economic welfare. Those include a repurposing of up to half of agricultural subsidies to support the production of foods with beneficial health and environmental characteristics, including fruits, vegetables, and other horticultural products, and combining such repurposing with a more equal distribution of subsidy payments globally. The findings suggest that reforming agricultural subsidy schemes based on health and climate-change objectives can be economically feasible and contribute to transitions towards healthy and sustainable food systems.

Novel 2-D histogram based Soft thresholding for Brain Tumor Detection and Image Compression

The objective of image compression is to extract meaningful clusters in a given image. Significant groups are possible with absolute threshold values. 1-D histogram-based multilevel thresholding is computationally complex and reconstructed image visual quality comparatively low because of equal distribution of energy over the entire histogram plan. So, 2-D histogram-based multilevel thresholding is proposed in this paper by maximizing the Renyi entropy with a novel hybrid Genetic Algorithm, Particle Swarm Optimization and Symbiotic Organisms Search (hGAPSO-SOS), and the obtained results are compared with state of the art optimization techniques. Recent study reveals that PSNR fails in measuring the visual quality because of mismatch with the objective mean opinion scores (MOS). So, we incorporate a weighted PSNR (WPSNR) and visual PSNR (VPSNR). Experimental results examined on Magnetic Resonance images of brain, and results with 2-D histogram reveal that hGAPSO-SOS method can be efficiently and accurately used in multilevel thresholding problem.

AKSESIBILITAS LAYANAN FISIK BAGI PENYANDANG DISABILITAS DI PERPUSTAKAAN UMUM DAERAH KABUPATEN JEMBER

The Government of Jember Regency is actively implementing the Regional Regulation (PERDA) of Jember Regency No. 7 of 2016 concerning the Protection and Fulfillment of the Rights of Persons with Disabilities, especially on equal distribution of access to information in public spaces, one of which is the library. This study discusses the accessibility of disabled users at the Regional Public Library of Jember Regency. The method used in this study is a qualitative description through data collection, interviews, observations and literature. The analysis of physical accessibility which includes parking areas, pedestrian paths, guide paths for library door services, circulation desks, signs, ramps, layouts and toilets so far has carried the spirit of a disability-friendly library, although it is not fully compliant with IFLA standards, but this is a capital for its development. management of the main causes of the program and the diversity of types of services with consideration of the degree of disability in the Jember Regency Public Library.

The Nutritional Preponderance and Propensity to COVID-19 in Children

Aims & Objectives: Nutrition plays a very important role in the Immunity and Immunoregulation in children. The risk of acquiring an infection is very high in malnourished and underweight children, which is what we venture out to find out in our study by researching the susceptibility for COVID-19 in children and comparing it with their nutritional status. Materials & Methods: Our Tertiary Childrens hospital had 46 COVID positive children admitted in 2020, the nutritional status analysis, showed that there were four children 8.6% (n=4) in Obese category, 19.5%, nine (n=9) children were Overweight, 17.39 %, 8 children Underweight (n=8) and 25 children were 54.3% well nourished. Results: This case series describes the various features in COVID-19 in children with and without co-morbidities primarily focusing on the nutritional profile. This is the first single centre case series globally on COVID-19. Our cohort showed no significant relation between COVID-19 and the nutritional status. We saw an equal distribution of COVID-19 in children irrespective of their nutritional status at admission. Conclusions: We did not notice any statistical significance in the age group or the nutritional status in children infected with COVID-19

CIPP evaluation model - The agreement of the five ministers: Arranging and organizing junior high school teachers

The purpose of this study is to use a descriptive qualitative method to describe the program of the agreement of the five ministers that was implemented in Salatiga. According to the findings, the implementation of the program to organize and arrange Civil Servant teachers in the city of Salatiga is still not going well. This issue prompted additional research into the process of leveling and rearranging teachers. Problems in the implementation of the ongoing program at the Salatiga Education Office were discovered with the assistance of CIPP. In terms of context, the implementation procedures are consistent with the Regional Government’s procedures in terms of vision and mission, objectives, and identification of needs and opportunities. The input is seen to be by the Mayor of Salatiga’s decision, such as aspects of strategy, procedures, and teacher placement. However, the Education, Youth, and Sports Office does not manage funds because there is no allocation. The stages of the process have been running, including readiness identification and monitoring, mutation implementation, and discipline. The result stage demonstrates that while not all of them have achieved their goals, such as equal distribution of teachers in schools, they have done well in terms of benefits, impacts, and sustainability. As a result of the results obtained from the input and output aspects, the Salatiga government must allocate funds for the teacher transfer program for organizing and rearranging middle school teachers in Salatiga to run as expected.

Rural Revitalisation Process of Nation-Building in Nepal

Government of Nepal has been trying to revitalize rural areas after 1950s as a strategy of nation-building. The demands of ethnic groups are basically inclined with quest for ethnic identity, equality, and greater representation in the political structure. Among the ethnic groups, the largest groups are Janajati, Madhesi and Dalits. In this stance, this library based study tried to look at problems and prospects of balance development as an outcomes of revitalization process of nation-building. At the same time the study also tried to identify essential driver of rural revitalization in Nepali context. The study found that equal distribution of development is difficult in terms of its social, regional and cultural diversity. Poverty, unemployment, landlessness, rapid population is major push factor in Nepal to overcome from this problem. Besides these problems there are some prospects through which rural setting can be revitalized economically, socially, politically such as agriculture. One essential driver of rural revitalization is rurbanomics, an approach that emphasizes the linkages between rural and urban economies. Growing urbanization in most countries enhances the importance of rural areas—by boosting demand for food, diverse diets, and goods and services that the rural economy can meet. Rurbanomics, therefore, frames rural and urban economies as equal partners.Ending hunger and malnutrition to achieve both the Sustainable Development Goals and climate goals requires us to initiate a range of evidence-based actions to advance rural revitalization in all regions of the world. Rural revitalization represents the most realistic way to achieve such a dramatic transformation to ensure that rural people and rural areas can thrive for generations to come.

Effects of Intermittent Kangaroo Mother Care on Low-Birth-Weight Neonates: A Retrospective Before-and-After Study

Objective. To compare outcomes of low-birth-weight neonates delivered before and after implementation of intermittent kangaroo mother care (KMC) in terms of duration of hospital stay, mortality rate, and clinical outcome. Methods. This is a retrospective analytical study that included all neonates delivered in a tertiary government hospital with birth weight of less than 2000 grams before and after intermittent KMC implementation from January 2015 to December 2016. Chart review was done for demographics, mortality profile, and length of hospital stay. Chi-square test and Student’s t-test were used to compare mortality rate and length of hospital stay, and odds ratio was used for mortality outcome. Results. A total of 677 low birth weight newborns were reviewed and of these, 276 (79.8%) neonates in group 1 (Pre-intermittent KMC implementation), and 263 (79.4%) neonates in group 2 (Post-intermittent KMC implementation) fulfilled the inclusion criteria. The duration of hospital stay of neonates enrolled in KMC was significantly shorter (p ≤ 0.05). In Groups 1 and 2, 93–94% of neonates were discharged improved with a 5–6% mortality of almost equal distribution. There was no significant difference in mortality between groups 1 and 2 (OR 1.19, 95% CI 0.59, 2.42). Conclusion. There was no significant difference in mortality rate and cause of death pre- and post-intermittent KMC implementation. However, the length of hospital stay among the LBW neonates discharged improved was significantly shortened.

The adolescent pattern of sleep spindle development revealed by HD-EEG polisomnography

Sleep spindles are developmentally relevant cortical oscillatory patterns; however, they have mostly been studied by considering the entire spindle frequency range (11 to 15 Hz) without a distinction between the functionally and topographically different slow and fast spindles, using relatively few electrodes and analysing wide age-ranges. Here, we employ HD-EEG polysomnography in three age-groups between 12 to 20 years of age, with an equal distribution between the two genders, and analyse the adolescent developmental pattern of the four major parameters of slow and fast sleep spindles. Most of our findings corroborate those very few previous studies that also make a distinction between slow and fast spindles in their developmental analysis. We find spindle frequency increasing with age, although spindle density change is not obvious in our study. We confirm the declining tendencies for amplitude and duration, although within narrower, more specific age-windows than previously. Spindle frequency seems to be higher in females in the oldest age-group. Based on the pattern of our findings, we suggest that HD-EEG, specifically targeting slow and fast spindle ranges and relatively narrow age-ranges would advance the understanding of both adolescent development and the functional relevance of sleep spindles in general.

Review of Clinical Equipoise: Examples from Oncology Trials

Background: The current standards that govern clinical research have been shaped over the years through many historical, social, and political events. The third principle of the Belmont report, Justice, guides the scientific community toward equal distribution of benefits and risks in research involving human subjects. Clinical equipoise is the status of genuine uncertainty by the investigator about the superiority of one treatment arm over the other. The term clinical equipoise was proposed to provide an ethical ground to conduct randomized controlled clinical trials. Objective: The objective of this review is to provide the reader with an overview about the emergence of the term equipoise and its utilization in randomized controlled trials. Methods: In the current review article, the major oncology clinical trials and relevant patents were reviewed for the application/utilization of clinical equipoise. Results: The concept of clinical equipoise has been challenged and different alternatives were proposed. Yet, these alternatives received numerous critiques and failed to fully replace equipoise. In addition, several patents related to anticancer agents tested in the described studies were examined. No specific reference was made as part of the patent to the status of clinical equipoise. Alternatively, a description of the study arms was provided. Conclusion: There is a need for revisiting the concept of equipoise and its suggested alternatives, for its ethical essence while addressing related challenges.