Association between Unhealthful Plant-Based Diets and Possible Risk of Dyslipidemia

The relationship between the various types of diets derived from plants and vulnerability of dyslipidemia has rarely been investigated, and limited data exist in Asians whose dietary pattern is fairly different from that of the Western population. We aim to analyze the relationship between three plant-based diet indices (PDI) and the risk of dyslipidemia. Participants included 173,209 Korean adults who were aged ≥40 years from the Korean Genome and Epidemiology Study_Health Examination (2004–2013). A food frequency questionnaire (FFQ) was used to assess dietary intake. Three PDI were quantified for the study: overall PDI, healthful PDI (hPDI), and unhealthful PDI (uPDI). Among the 147,945 included, 48,166 (32.6%) of participants had dyslipidemia. Great adherence to uPDI was related with 15% greater odds of having dyslipidemia (OR: 1.15; 95% CI: 1.11–1.20, p-trend < 0.0001). No significant association was observed between PDI, hPDI, and dyslipidemia. The association between uPDI and dyslipidemia was significantly stronger among participants aged ≥55 years when compared to participants aged <55 years (p-value for interaction = 0.001). The quality of plant foods is vital in preventing dyslipidemia among people consuming high plant-based food diets.

Older Age Instead of Body Mass Index Predicts Cancer-Associated Thrombosis: Validation of Khorana Score in Cancer Patients Undergoing Chemotherapy with East Asian Ethnicity

Khorana score has been the most widely used for the prediction of cancer-associated thrombosis (CAT) and recent pivotal phase III trials including AVERT and CASSINI adopted Khorana score in the inclusion criteria. However, most studies in development and use of Khorana score were conducted in Western cancer patients. The prevalence of VTE is known to be substantially lower in Asians than in the Western population. In case of body mass index (BMI), experts suggest an adjusted cut-off points of the classification of weight status in Asian population since they are usually thinner than Westerners. In addition, risk of CAT according to the sites of cancer may need reassessment since the characteristics of each site of cancer varies among geographic regions or ethnicity. For those reasons, we thought that Khorana score needs to be separately validated in Asian population and conducted a retrospective real-world analysis. By using the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM), we collected de-identified data of the newly diagnosed cancer patients who underwent chemotherapy from January 2016 to June 2019 at Seoul National University Hospital (SNUH), Seoul, South Korea. Patients were eligible if they 1) had a new diagnosis code of cancer and 2) had initiated chemotherapy within 3 months after the first recoding of the cancer diagnosis. The patients undergoing chemotherapy were identified based on their prescription of chemotherapeutic agents and the procedural code for the first-time patient education for chemotherapy. Among the selected cancer patients, values of complete blood cell counts (CBC), body weight, and height on the very day of or the day closest to the chemotherapy initiation were obtained. A patient was counted as having a VTE if he or she had both newly-recorded diagnosis code of VTE and new record of anticoagulant medication code within 1 week after the emergence of VTE diagnosis code. Cumulative incidence of CAT was estimated at the time of 3, 6, and 12 months after the date of chemotherapy initiation. A total of 10,588 patients with cancer and chemotherapy were eligible and only 1.33% (141 patients) had a CAT at 6 months after the chemotherapy initiation, suggesting lower overall incidence of CAT in Asian population. Pancreas (4.9%) was the most common primary cancer site but CAT incidence rate in patients with stomach cancer was limited to 1.6%, reflecting different characteristics of the disease between the East and the West. The CAT incidences in patients with lung cancer (1.4%) and lymphoma (1.1%) were lower than expected, in line with a recent meta-analysis (Mulder at al.; Haematologica 2019), but CAT incidences in patients with liver (3.4%) and biliary (3.0%) cancer were higher than expected considering the Khorana scoring system. Among 7,431 patients who had all data for the calculation of Khorana score, 5,549 patients (74.7%) had a BMI of &lt; 25 kg/m 2, followed by 1,633 patients (15.4%) with a BMI of 25.0-29.9 kg/m 2. Only 39 patients (0.4%) had a BMI of 35 &gt; kg/m 2, showing the difference of BMI distribution according to the ethnicity. Moreover, BMI was not associated with CAT development at all, whereas the 3 CBC parameters and the site of cancers were associated with CAT occurrence. In addition, patients who aged ≥ 65 years had significantly higher CAT risk compared to younger group. In a multivariate regression analysis (Table 1), age ≥ 65 years, leukocyte ≥ 11 x 10 3/μL, and sites of cancers were independently associated with the development of CAT. Hemoglobin &lt; 10 g/dL and platelet ≥ 350 x 10 3/μL showed a tendency of association but failed to reach statistical significance. When we classified the 7,431 patients according to the Khorana scoring system, 8.0% of the patients were considered as high risk group and their incidence of CAT at 6 months was 3.36% (Table 2), showing a smaller proportion of patients assigned to high risk group and their lower absolute risk of CAT compared to Western population. In conclusion, Khorana scoring system was only partially validated in Korean cancer patients who underwent first-line chemotherapy: BMI was not but older age was a good predictor for the prediction of CAT occurrence. Weighing the risk of CAT according to the sites of cancers also needs some improvement. Further studies for better CAT risk stratification reflecting ethnic or regional differences are warranted. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

ANTHROPOMETRIC ANALYSIS OF THE HIP JOINT IN CENTRAL INDIA POPULATION USING COMPUTED TOMOGRAPHY

Background: The presently available hip prosthesis used in hip arthroplasty are designed based on the anthropometry of Western patients. These prosthesis do not replicate the exact anatomy of Indian patients, leading to postoperative complications and requiring revision surgery for correction. If the manufacturers keep in considering the anthropometric parameters of Indians while designing the prosthesis, this may lead to better clinical and functional outcome and higher patient satisfaction. So the present study was undertaken to understand the anthropometric variables of hip joint of Central Indian population and to compare these variables with the other Indian Ethnic groups and western population using computed tomographic images. Materials And Methods: We had included 200 patients and both the left and right side hip joints were analysed. The anthropometric variables included were Neck-Shaft Angle (NSA), Head Diameter (HD), Neck Width (NW), Acetabular Angle of sharp(AA), Horizontal Offset (HO), Vertical Offset (VO), Medullary Canal Diameter at the level of Lesser Trochanter (MDLT), and Acetabular Version (AV) were measured in all these individuals. Comparison of these parameters was done between the left and right side and among the males and females and compared with various populations and statistically analyzed Result: The mean values were NSA 132.53°, NW 25.11 mm, HD 43.94 mm, AA of sharp 43.11°, HO 43.76 mm, VO 56.37 mm, MDLT 23.00 mm, and AV 19.47°. We found a large variations in these parameters among the Indian ethnic groups and western population. Significant differences were seen between the males and females. Conclusion: This study indicates that there are significant differences in anthropometric parameters of proximal femur among the Central India population compared with Western population. Even within the Indian population, the anthropometric parameters vary from region to region.

The “Great Replacement”

This chapter explores contemporary ideas of racial conflict and its manifestation in forms of racial domestic terrorism. First, the chapter explores importance of Enoch Powell’s late 1960s polemics against immigration in the United Kingdom. For Powell, the fear that unregulated immigration would be symptomatic of a larger concern of the decline of the West. Nonetheless, Powell’s position regained salience with the contemporary articulation of fears that immigration from the global South will “replace” Western population. Here the work of Renaud Camus is salient. The chapter argues that the idea of a world in which white Western racial hierarchy is dismantled is a world at odds with the imagined social cohesion of the West itself.