The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more ...likely, so their applicability to other populations is unclear.
The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35–70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years (IQR 5·3–9·3). Dietary intake of 135 335 individuals was recorded using validated food frequency questionnaires. The primary outcomes were total mortality and major cardiovascular events (fatal cardiovascular disease, non-fatal myocardial infarction, stroke, and heart failure). Secondary outcomes were all myocardial infarctions, stroke, cardiovascular disease mortality, and non-cardiovascular disease mortality. Participants were categorised into quintiles of nutrient intake (carbohydrate, fats, and protein) based on percentage of energy provided by nutrients. We assessed the associations between consumption of carbohydrate, total fat, and each type of fat with cardiovascular disease and total mortality. We calculated hazard ratios (HRs) using a multivariable Cox frailty model with random intercepts to account for centre clustering.
During follow-up, we documented 5796 deaths and 4784 major cardiovascular disease events. Higher carbohydrate intake was associated with an increased risk of total mortality (highest quintile 5 vs lowest quintile quintile 1 category, HR 1·28 95% CI 1·12–1·46, ptrend=0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 95% CI 0·67–0·87, ptrend<0·0001; saturated fat, HR 0·86 0·76–0·99, ptrend=0·0088; monounsaturated fat: HR 0·81 0·71–0·92, ptrend<0·0001; and polyunsaturated fat: HR 0·80 0·71–0·89, ptrend<0·0001). Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 95% CI 0·64–0·98, ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality.
High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.
Full funding sources listed at the end of the paper (see Acknowledgments).
The association between intake of fruits, vegetables, and legumes with cardiovascular disease and deaths has been investigated extensively in Europe, the USA, Japan, and China, but little or no data ...are available from the Middle East, South America, Africa, or south Asia.
We did a prospective cohort study (Prospective Urban Rural Epidemiology PURE in 135 335 individuals aged 35 to 70 years without cardiovascular disease from 613 communities in 18 low-income, middle-income, and high-income countries in seven geographical regions: North America and Europe, South America, the Middle East, south Asia, China, southeast Asia, and Africa. We documented their diet using country-specific food frequency questionnaires at baseline. Standardised questionnaires were used to collect information about demographic factors, socioeconomic status (education, income, and employment), lifestyle (smoking, physical activity, and alcohol intake), health history and medication use, and family history of cardiovascular disease. The follow-up period varied based on the date when recruitment began at each site or country. The main clinical outcomes were major cardiovascular disease (defined as death from cardiovascular causes and non-fatal myocardial infarction, stroke, and heart failure), fatal and non-fatal myocardial infarction, fatal and non-fatal strokes, cardiovascular mortality, non-cardiovascular mortality, and total mortality. Cox frailty models with random effects were used to assess associations between fruit, vegetable, and legume consumption with risk of cardiovascular disease events and mortality.
Participants were enrolled into the study between Jan 1, 2003, and March 31, 2013. For the current analysis, we included all unrefuted outcome events in the PURE study database through March 31, 2017. Overall, combined mean fruit, vegetable and legume intake was 3·91 (SD 2·77) servings per day. During a median 7·4 years (5·5–9·3) of follow-up, 4784 major cardiovascular disease events, 1649 cardiovascular deaths, and 5796 total deaths were documented. Higher total fruit, vegetable, and legume intake was inversely associated with major cardiovascular disease, myocardial infarction, cardiovascular mortality, non-cardiovascular mortality, and total mortality in the models adjusted for age, sex, and centre (random effect). The estimates were substantially attenuated in the multivariable adjusted models for major cardiovascular disease (hazard ratio HR 0·90, 95% CI 0·74–1·10, ptrend=0·1301), myocardial infarction (0·99, 0·74–1·31; ptrend=0·2033), stroke (0·92, 0·67–1·25; ptrend=0·7092), cardiovascular mortality (0·73, 0·53–1·02; ptrend=0·0568), non-cardiovascular mortality (0·84, 0·68–1·04; ptrend =0·0038), and total mortality (0·81, 0·68–0·96; ptrend<0·0001). The HR for total mortality was lowest for three to four servings per day (0·78, 95% CI 0·69–0·88) compared with the reference group, with no further apparent decrease in HR with higher consumption. When examined separately, fruit intake was associated with lower risk of cardiovascular, non-cardiovascular, and total mortality, while legume intake was inversely associated with non-cardiovascular death and total mortality (in fully adjusted models). For vegetables, raw vegetable intake was strongly associated with a lower risk of total mortality, whereas cooked vegetable intake showed a modest benefit against mortality.
Higher fruit, vegetable, and legume consumption was associated with a lower risk of non-cardiovascular, and total mortality. Benefits appear to be maximum for both non-cardiovascular mortality and total mortality at three to four servings per day (equivalent to 375–500 g/day).
Full funding sources listed at the end of the paper (see Acknowledgments).
A series of solar energetic particle (SEP) events was observed by the Integrated Science Investigation of the Sun (IS IS) on the Parker Solar Probe (PSP) during the period from 2019 April 18 through ...24. The PSP spacecraft was located near 0.48 au from the Sun on Parker spiral field lines that projected out to 1 au within ∼25° of the near-Earth spacecraft. These SEP events, though small compared to historically large SEP events, were among the largest observed thus far in the PSP mission and provide critical information about the space environment inside 1 au during SEP events. During this period, the Sun released multiple coronal mass ejections (CMEs). One of these CMEs observed was initiated on 2019 April 20 at 01:25 UTC, and the interplanetary CME (ICME) propagated out and passed over the PSP spacecraft. Observations by the Electromagnetic Fields Investigation show that the magnetic field structure was mostly radial throughout the passage of the compression region and the plasma that followed, indicating that PSP did not directly observe a flux rope internal to the ICME, consistent with the location of PSP on the ICME flank. Analysis using relativistic electrons observed near Earth by the Electron, Proton and Alpha Monitor on the Advanced Composition Explorer demonstrates the presence of electron seed populations (40-300 keV) during the events observed. The energy spectrum of the IS IS-observed proton seed population below 1 MeV is close to the limit of possible stationary-state plasma distributions out of equilibrium. IS IS observations reveal the enhancement of seed populations during the passage of the ICME, which likely indicates a key part of the preacceleration process that occurs close to the Sun.
Blood purification practices, also referred to as blood cleansing or detoxification, is an ancient concept which is widespread within African traditional medicine. There is, however, limited ...consolidated information about the selection of plant species, the purpose of use and how the preparation is made. An in-depth examination of how regional communities use medicinal plants for blood purification is needed to better understand this ethnopharmacological practice.
To gather knowledge on the traditional use of medicinal plants used for the purpose of blood purification by laypersons in northern Maputaland, KwaZulu-Natal, South Africa.
An ethnobotanical survey was conducted on medicinal plants used in the rural areas of northern Maputaland for blood purification. Interviews were conducted in 55 homesteads, where the most knowledgeable participant per household was interviewed using structured questionnaires. Information collected included knowledge of the concept of blood purification, purpose for medicating, plant selection, and mode of preparation. The most important species and families were identified through indices.
Sixty-four plant species from 35 families were recorded as blood purifiers for the treatment of ailments linked to the need for blood purification. Terminalia sericea Burch. ex DC. was the most used plant species (mentioned by 39% of the people interviewed). The conditions that were mostly associated with blood purification were skin complaints, gastro-intestinal disorders, and overall improvement of general health. Blood purification is also commonly used for non-medical purposes such as granting good luck or as a love charm. Six new plant species and five new Zulu vernacular names had not previously been documented for blood purification.
The frequently mentioned use of medicinal plants for blood purification by the rural community of northern Maputaland clearly emphasises the importance of this cultural practice. There is no doubt that when examining African traditional medicine, holistic terms such as “blood cleansing” cannot be ignored. Future studies may provide a better understanding of this often misunderstood and undocumented practice.
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•Skin complaints was recorded as the greatest need for blood purification.•This was followed by general health concerns and gastrointestinal diseases.•Low dosages of potentially toxic plants were recommended.•Terminalia sericea was the most used plant species for blood purification.•Twenty-six plant combinations were recorded for use as blood purifiers.
Radiation transport codes have been an increasingly important tool for studying the space radiation environment, which includes high‐energy and high‐nuclear‐charge particles. The unique advantage of ...transport models lies in covering a wider range of particles, energies, and angles than would be attainable in a laboratory or measurable by an instrument. However, since there are several transport codes developed by different teams that have contributed heavily to the literature, differences are expected between such codes. In this work, we use five such radiation transport codes (FLUctuating KAscade, GEometry ANd Tracking, High‐Energy Transport Code‐Human Exploration and Development in Space, Monte Carlo N‐Particle, and Particle and Heavy Ion Transport code System) to study the radiation environment near the Moon, specifically the lunar “albedo” radiation, which is the radiation emitted by the lunar surface through interactions with incident galactic cosmic rays and solar energetic particles. The primary goal of this paper is to provide a general characterization of the lunar albedo radiation and to find the areas where the modeled transport codes agree and disagree by using almost identical input parameters. The results of this work show overall good agreement between the codes. However, some areas of discrepancies exist that are reported herein. Thus, this paper equips the space weather and radiation biology communities with a comparison between popular radiation transport models applied to lunar albedo radiation. The overall agreement and, in some cases, discrepancies between these transport codes provide fundamental insight necessary for assessing code reliability and identifying where further study and improvements are needed to advance our understanding of lunar albedo radiation.
Plain Language Summary
Replicating the lunar radiation environment in a laboratory is extremely difficult for multiple reasons. One of the most effective alternatives is to use computer simulations equipped with the physical and mathematical tools to help us understand radiation in space. However, there are multiple radiation codes developed by different teams. Comparing the results from such codes and finding the areas of agreement and disagreement in their results help in improving the codes and in providing a better understanding of the space radiation environment. In this work, we studied the lunar radiation environment by comparing five different well‐known radiation codes. In general, the results show a good agreement between the codes. However, we found some areas of disagreements that are reported herein.
Key Points
The lunar albedo radiation was modeled using five different radiation transport codes: FLUctuating KAscade, GEometry ANd Tracking, High‐Energy Transport Code‐Human Exploration and Development in Space, Monte Carlo N‐Particle, and Particle and Heavy Ion Transport code System
The results of this work show overall good agreement between the codes. However, some areas of discrepancies exist that are reported herein
Since the beginning of the space age, the Sun has been in a multi-cycle period of elevated activity (secular maximum). This secular maximum is the longest in the last 9300 years. Since the end of ...solar cycle 21 (SC21), however, the Sun has shown a decline in over-all activity, which has remarkably increased the fluxes of galactic cosmic rays (GCRs). Here, we investigate the correlation between the modulation of GCRs, the heliospheric magnetic field, and solar wind speed for the last 24 solar cycles to find trends that can potentially be used to predict future solar activity. Specifically, we develop a tool for predicting future magnetic field intensity, based on the hysteresis in the GCR variation, during the last phases of the current cycle. This method estimates that SC25 will be as weak as or weaker than SC24. This would mean that the Sun has likely entered a secular minimum, which, according to historical records, should last for another two cycles (SC2527and SC26).
Objective
To describe the developmental risks, and its influence, in young children from a low-income South African community.
Method
An exploratory, cross-sectional research study design was ...employed. Developmental screening was conducted during home visits with 126 caregivers and children between 0 and 42 months of age from a low-income South African community. Children who failed the rescreen were referred for diagnostic assessment. A binomial logistic regression was used to determine the effect of developmental risks on developmental outcomes.
Results
Seventy-three percent of children screened were identified with a possible developmental delay (n = 59) according to caregiver-report using the PEDS tools. The regression model was statistically significant (χ
2
(3) = 34.902, p < 0.001) with exposure to multiple languages (p < 0.05; odds ratio 3.810, CI 1.2–12.4) most indicative of potential developmental delay. Older children (19–42 months) were also more at risk of developmental delay (p < 0.001) than younger children (0–18 months).
Conclusions for Practice
Healthcare professionals serving these vulnerable populations should create awareness amongst caregivers about the effect of developmental risks, in particularly multiple language exposure, on development.
Context.
GRB 220627A is a rare burst with two distinct
γ
-ray emission episodes separated by almost 1000 s that triggered the
Fermi
Gamma-ray Burst Monitor twice. High-energy GeV emission was ...detected by the
Fermi
Large Area Telescope coincident with the first emission episode but not the second. The discovery of the optical afterglow with MeerLICHT led to MUSE observations which secured the burst redshift to
z
= 3.08, making this the most distant ultra-long gamma-ray burst (GRB) detected to date.
Aims.
The progenitors of some ultra-long GRBs have been suggested in the literature to be different to those of normal long GRBs. Our aim is to determine whether the afterglow and host properties of GRB 220627A agree with this interpretation.
Methods.
We performed empirical and theoretical modelling of the afterglow data within the external forward shock framework, and determined the metallicity of the GRB environment through modelling the absorption lines in the MUSE spectrum.
Results.
Our optical data show evidence for a jet break in the light curve at ∼1.2 days, while our theoretical modelling shows a preference for a homogeneous circumburst medium. Our forward shock parameters are typical for the wider GRB population, and we find that the environment of the burst is characterised by a sub-solar metallicity.
Conclusions.
Our observations and modelling of GRB 220627A do not suggest that a different progenitor compared to the progenitor of normal long GRBs is required. We find that more observations of ultra-long GRBs are needed to determine if they form a separate population with distinct prompt and afterglow features, and possibly distinct progenitors.
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