Psychosocial Risk and Health Behaviors as Predictors of Clinical Events in Patients Wait-Listed for a New Heart: Results from 7 Years of Follow-Up

We examined the long-term relationship of psychosocial risk and health behaviors on clinical events in patients awaiting heart transplantation (HTx). Psychosocial characteristics (e.g., depression), health behaviors (e.g., dietary habits, smoking), medical factors (e.g., creatinine), and demographics (e.g., age, sex) were collected at the time of listing in 318 patients (82% male, mean age = 53 years) enrolled in the Waiting for a New Heart Study. Clinical events were death/delisting due to deterioration, high-urgency status transplantation (HU-HTx), elective transplantation, and delisting due to clinical improvement. Within 7 years of follow-up, 92 patients died or were delisted due to deterioration, 121 received HU-HTx, 43 received elective transplantation, and 39 were delisted due to improvement. Adjusting for demographic and medical characteristics, the results indicated that frequent consumption of healthy foods (i.e., foods high in unsaturated fats) and being physically active increased the likelihood of delisting due improvement, while smoking and depressive symptoms were related to death/delisting due to clinical deterioration while awaiting HTx. In conclusion, psychosocial and behavioral characteristics are clearly associated with clinical outcomes in this population. Interventions that target psychosocial risk, smoking, dietary habits, and physical activity may be beneficial for patients with advanced heart failure waiting for a cardiac transplant.

Understanding dental caries as a non-communicable disease

The recent developments in the science underpinning our knowledge of both the initiation of dental caries and the subsequent behaviour of lesions over time gives us a solid base to understand caries differently. Advances in understanding the human and oral microbiome have come in parallel with the recognition of the importance of balancing protective and pathological risk factors. Caries prevention and management is now about controlling risk factors to maintain a balanced intraoral biofilm ecology that guards against a continuing low pH driven by the frequent consumption of sugars. Thus, caries control is no longer about attempts at eradicating any specific microorganism. Further, the present knowledge leads to the classification of dental caries as a non-communicable disease (NCD), which is vitally important from a policy perspective (both globally and at the country level). Caries shares similar risk factors with other chronic/systemic diseases, which provides opportunities for developing common prevention strategies and promoting health equity through action on the social determinants of health. So, preventing and controlling caries should be integrated across the so-called upstream, midstream and downstream levels and these activities can also help to control other NCDs.

Appraisal of Behaviour-change Models and Application of Transtheoretical Model-based Motivational Interviewing for Bottle Feeding Cessation- A Qualitative Study

Behaviour change is the key to prevention of diseases; oral diseases being no exception. Behaviours such as frequent consumption of sugar sweetened beverages (SSBs), feeding milk using a bottle and lack of oral hygiene maintenance are a few examples of behaviours that can cause early childhood caries. Dentists must adopt skills to counsel patients in a manner that will elicit behaviour change. Motivational Interviewing (MI) based on the transtheoretical model of behaviour-change has been effective in tobacco cessation and also has been shown effective in oral health behaviours. This qualitative study demonstrates effectiveness of MI practiced by a paediatric dentist for bottle-feeding cessation. Sixteen mothers were counselled by a single trained MI counsellor in one-to-one counselling sessions and followed up telephonically. Fifteen mothers could stop the practice of bottle feeding. Mothers reported positive feedback on the counselling sessions and satisfaction with the result.

Quantification of Some Metals in Commonly Consumed Canned Foods in South-west Nigeria: Probable Pointer to Metal Toxicity

Canned foods are one of the most commonly consumed products, due to benefits like the taste, handiness and convenience derived from them. On the other hand, these dietary products may be a means of heavy metal exposure and toxicant. This study aimed to quantify metals content in some frequently consumed canned foods in Nigeria as a possible source of toxicity. Twenty-two different commonly consumed brands of canned foods (Sweet corn, Green peas, Corned beef, Hotdog, Mushroom, Tin tomato, Mixed fruit, Baked beans, Mackerel (tomato sauce canned fish), Sardine (canned fish in vegetable oil) and Red kidney were analyzed for Ni, Cr, Cu, Pb and Al using Atomic Absorption Spectrophotometer after wet digestion. The results showed that the heavy metals concentration in the samples under study ranged from 0.55 to 0.86mg/kg (Ni), 0.00 to 0.41mg/kg (Cr), 1.40 to 1.76 mg/kg (Pb), 0.07 to 0.2mg/kg (Cu) and 4.71 to 16.4mg/kg (Al). The levels of Pb, Ni and Al were above FAO/WHO recommended limit of 0.01mg/kg, 0.05mg/kg and 7mg/kg respectively. The presence of heavy metals like lead (Pb) above the permissible limit calls for caution during production and in the frequent consumption of canned foods which may lead to accumulation of metals, toxicity and the sequelae.

Occurrence, Profile, and Potential Risks of Novel and Legacy Polyfluoroalkyl Substances in Bullfrogs: Pilot Study in an Intensive Aquaculture Region, China

Per- and polyfluoroalkyl substances (PFASs) have captured worldwide attention due to their persistent and bioaccumulative characteristics. The bullfrog is a highly nutritious and edible aquatic product, but the PFAS accumulation characteristics of bullfrogs had not been paid attention. The present study analyzed the PFAS concentrations in different tissues of cultured bullfrogs and relevant water and sediments collected from the aquaculture region in the coastal area of South China. Results showed that total PFAS concentrations were 50.26–364.25 ng/L in water, with a mean of 135.58 ng/L; concentrations in effluent water were significantly higher than those in influent water, which means bullfrog farming could increase contaminants into the surroundings. The total PFAS concentrations varied from 2.89 to 162.26 ng/g·dw in sediment. The distribution profile of PFASs in sediment was similar to that of water, with short chain playing a significant role. Total PFASs in bullfrog tissues were 3.36–84.07 ng/g·dw, with the highest values in the digestive system (intestines and stomach). As for one novel PFAS alternative, chlorinated polyfluorinated ether sulfonate (F-53B) was found at high detectable levels in all habitat samples and had a higher value of logarithmic bioaccumulation factors. The estimated dietary intake (EDI) for residents in the study area was generally higher than that in other regions; however, the hazard ratios (HRs) for most detected PFASs were far below the safety threshold value “1.” These results suggest that frequent consumption of these bullfrogs would basically not cause severe health effects on local residents in terms of PFASs.

Assessing Dietary Intake Patterns Through Cluster Analysis Among Adolescents in Selected Districts of Bihar and Assam From India: A Cross-Sectional Survey

Background: In the recent decade, dietary pattern assessment has evolved as a promising tool to describe the whole diet and represent inter-correlations between different dietary components. We aimed to derive the dietary patterns of adolescents (10–19 years) using cluster analysis on food groups and evaluate these patterns according to their socio-demographic profile.Methods: This community-based cross-sectional study was conducted in two districts, each from Bihar and Assam in India. Adolescents (10–19 years) were enrolled from both rural and urban areas. The dietary intake was assessed through a pre-validated single food frequency questionnaire. Cluster analysis was performed by a 2-step procedure to explore dietary patterns, pre-fixed at 2 clusters. Clusters were analyzed with respect to socio-demographic characteristics using binomial logistic regression.Results: A total of 826 girls and 811 boys were enrolled in the study. We found two major dietary patterns, namely a low- and high-mixed diet. The low-mixed diet (76.5% prevalence) had daily consumption of green vegetables, including leafy vegetables, with less frequent consumption of other foods. The high-mixed diet (23.5% prevalence) had more frequent consumption of chicken, meat, egg, and milk/curd apart from green vegetables. Adolescent boys had 3.6 times higher odds of consuming a low-mixed diet compared to girls. Similarly, adolescents with lower education grades and from marginalized social classes had two times higher odds of taking a low-mixed diet than their respective counterparts.Conclusions: The high consumption of a low-mixed diet and relatively less milk consumption limit the comprehensive growth of adolescents. Improvement in dietary intake of adolescents from marginalized sections of society can prove to be an important deterrent in mitigating India's nutritional challenges.

Differences in Dietary Patterns among the Polish Elderly: A Challenge for Public Health

The aim of the study was to assess the diversity of dietary patterns within the elderly, in relation to the region of residence, household structure, and socioeconomic status. The questionnaire was conducted in a group of 427 Polish adults aged 60 and older from June to September 2019. The sample was selected by means of the snowball method in two regions. Principal component analysis (PCA) was used to extract and identify three dietary patterns (factors) from the frequency of eating 32 groups of foods. Logistic regression analysis was used to determine the relationship between the identified dietary patterns (DPs), region, household status, and socioeconomic index (SES). Adherence to the identified DPs, i.e., traditional, prudent, and adverse, was associated with socioeconomic status (SES) and living environment, i.e., living alone, with partner, or with family, while the region did not differentiate them. Less people living with their family were characterized by the frequent consumption of traditional food (the upper tertile of this DP), while more of them often consumed food that was typical for both prudent and adverse DPs (the upper tertiles of these DPs). The presence of a partner when living with family did not differentiate the adherence to DPs. A high SES decreased the chances of adhering to the upper tertiles of the “prudent” and “traditional” DPs, while living with family increased the chances of adhering to both the upper and middle tertiles of the “prudent” DP. Identifying the dietary patterns of the elderly contributes to a better understanding of the food intake of the senior citizens living in different social situations, in order to support public policies and nutritional counseling among this age group.

EXPRESS: Frequency versus Intensity: How Thinking of a Frequent Consumption Indulgence as Social versus Solitary affects Preferences for How to Cut Back

Many consumers engage in frequent consumption indulgences. Because such indulgences accumulate resource costs (e.g., money, calories), consumers are often prompted or need to cut back, posing questions for how to design cut-back programs with consumer appeal. This research distinguishes between frequent indulgences that consumers think of as social (vs. solitary), demonstrating that thinking of an indulgence as social (vs. solitary) decreases preferences to cut “frequency” (how often the indulgence occasion occurs) and increases preferences to cut “intensity” (choosing a within-category substitute that involves lower resource expenditure). These effects are explained by differentiating between enjoyment from the product itself versus enjoyment from aspects outside the product. Thinking of an indulgence as social (vs. solitary) heightens anticipated enjoyment particularly for aspects outside of the product, decreasing interest in cutting the number of occasions (cutting frequency) and increasing interest in cutting back on the product itself via a within-category substitute (cutting intensity). This divergence in cut-back preferences for social (vs. solitary) experiences is thus eliminated: 1) when consumers think of social experiences with distant (vs. close) others, which involve lower enjoyment outside of the product, or 2) when solitary experiences primarily involve heightened enjoyment for aspects outside of the product.

Mucormycoses in Covid-19 Patients

Objective: The goal of the study was to report clinical characteristics, contributing variables and outcome of patients with coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM). Study Design: Observational/descriptive study Place and Duration: Multan Medical and Dental College and Bakhtawar Amin Medical and Dental College. Duration Jan 2021 to July 2021. Methods: Total 90 patients of both genders had symptoms of mucormycosis during pandemic corona virus disease were presented in this study. Patients were aged between 22-80 years. Patients detailed demographics age, sex, body mass index and duration of disease were calculated after taking informed written consent. Patients were admitted in COVID-19 emergency ward and underwent for RT-PCR and MRI. Comorbidities, symptoms and cause of mucormycosis were assessed. At the end of study mortality rate, hospital stay and ICU admission were calculated. The SPSS 20.0 version was used to examine the entire set of data. Results: Majority of the patients 65 (72.2%) were males and the rest were females 25 (27.8%). Mean age of the patients were 51.42±12.64 years with mean BMI 28.44±8.72 kg/m2. 55 (61.1%) cases had COVID-19 and 35 (38.9%) were recovered from corona virus in this study. Mean duration of mucormycosis was 18.08±7.11 days. Most common symptoms of disease were eye pain/swollen of eyes, nasal stiffness, headache and blurring of vision. Rhino-orbital mucormycosis found in 63 (70%) cases. Majority of the cases were from urban areas 60 (66.7%) and 38 (42.2%) were literate. Diabetes mellitus was the most common comorbidity found in 70 (77.8%). Frequent consumption of the steroids during pandemic disease was the most common cause found in 59 (65.6%) cases. Mortality rate was 32 (35.6%) at the end of study. Conclusion: In this study we found that the complication of COVID-19 in high-risk patients can be mucormycosis. Poor diabetes mellitus is a significant CAM predisposing factor and frequent usage of excess steroids were the most common cause. Systematic surveillance for diabetes mellitus control and to educate the doctors are indicated for early detection of CAM. Keywords: COVID-19, Mucormycosis, Diabetes Mellitus, Steroids, Mortality

Monitoring of risk factors of cardiovascular diseases in adult men

The study aims to evaluate the monitoring of risk factors of cardiovascular diseases in the young population, which significantly contribute to the origin and development of cardiovascular diseases, such as peripheral artery diseases, atherosclerosis, stroke, and others. We focused on a group of young adult men (n = 110) in the age range of 30 to 50 years, which we selected from the database of 800 patients hospitalized in the Cardio Center in Nitra during 2010 – 2020. When evaluating the influence of meat products consumption frequency on biochemical parameters and BMI, we recorded a statistically significant effect at the level of p <0.05 in the evaluation of meat products such as salami, brawn, and sausages. When consuming sausages, BMI values also increased with increasing frequency of consumption. The effect on BMI was also observed when eating salami, between consuming 1 – 2 times a week and not at all. We recorded a statistically significant effect (p <0.05) in frequent consumption of brawn (1 – 2 weeks) on the level of HDL cholesterol. The most frequent fish consumption was 1 – 2 times a month for freshwater (51.8%) and marine fish (56.3%). Daily consumption of fruit was reported in 64.6% of men, while daily consumption of vegetables was recorded in only 44.6% of men. In the lifestyle assessment, we focused on probands' time spent on physical activity. Only 35.5% of men stated that they spend more than an hour a day on physical activity. 40% of men from the surveyed respondents were active smokers. Another risk factor for cardiovascular diseases is stress, which significantly affected up to 42.7% of respondents. Nutrition and lifestyle play an important role in the prevention of cardiovascular diseases, which significantly affect blood lipid parameters, vascular endothelial elasticity, and factors determining the etiopathogenesis of cardiovascular diseases.