Low plasma selenium concentrations are frequent in critically ill patients. However, whether this is due to systemic inflammation, a deficient nutritional state or both is still not clear. We aimed ...to determine the factors associated with low plasma selenium in critically ill children while considering the inflammatory response and nutritional status.
A prospective study was conducted in 173 children (median age 34 months) with systemic inflammatory response who had plasma selenium concentrations assessed 48 hours after admission and on the 5th day of ICU stay. The normal reference range was 0.58 μmol/L to 1.6 μmol/L. The outcome variable was 'low plasma selenium', which was defined as plasma selenium values below the distribution median during this period. The main explanatory variables were age, malnutrition, sepsis, C-reactive protein (CRP), and clinical severity scores. The data were analyzed using a Binomial Generalized Estimating Equations model, which includes the correlation between admission and 5th day responses.
Malnutrition and CRP were associated with low plasma selenium. The interaction effect between these two variables was significant. When CRP values were less than or equal to 40 mg/L, malnutrition was associated with low plasma selenium levels (odds ratio (OR) = 3.25, 95% confidence interval (CI) 1.39 to 7.63, P = 0.007; OR = 2.98, 95% CI 1.26 to 7.06, P = 0.013; OR = 2.49, 95% CI 1.01 to 6.17, P = 0.049, for CRP = 10, 20 and 40 mg/L, respectively). This effect decreased as CRP concentrations increased and there was loose significance when CRP values were >40 mg/L. Similarly, the effect of CRP on low plasma selenium was significant for well-nourished patients (OR = 1.13; 95% CI 1.06 to 1.22, P <0.001) but not for the malnourished (OR = 1.03; 95% CI 0.99 to 1.08, P = 0.16).
There is a significant interaction between the magnitude of the inflammatory response and malnutrition on low plasma selenium. This interaction should be considered when interpreting plasma concentrations as an index of selenium status in patients with systemic inflammation as well as in the decision on selenium supplementation.
Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large ...field experiment (
= 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were 1) framed as reminders to get flu shots that were already reserved for the patient and 2) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor's appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.
This study aimed to describe the dietary intake of ultra-processed foods (UPF) by children and adolescents with food allergy (FA) and to verify a possible association between the UPF intake with ...clinical characteristics and nutritional status in this group. This cross-sectional study included 110 children and adolescents with single or multiple FA IgE and non-IgE mediated. We evaluated food intake using the NOVA classification through the three 24-h recalls. The average contribution of UPF to total energy intake (calories) ranges from 21% in the first quartile to 43% in the last quartile (mean UPF intake 33.9 ± 14.9%). After binary logistic regression, an association was verified between dietary intake of UPF (>4th quartile) as a percentage of total energy intake and having multiple food allergies (OR 4.102; 95% CI - 1.331 to 12.643;
= .014). We concluded that children and adolescents with FA consumed a higher amount of UPF.
•The dietary intake of ultraprocessed foods (UPF) is associated directly with chronic subclinical inflammation in preterm infants.•There is a positive relationship between UPF intake and C-reactive ...protein levels among infants, irrespective of excess weight.•Infant feeding practices in preterm and full-term infants is characterized by low breast-feeding rates and high consumption of UPF.•The positive associations between UPF consumption and chronic subclinical inflammation may be associated with non-communicable chronic diseases in the future.
This study aimed to examine associations between consumption of ultraprocessed food (UPF) and C-reactive protein (CRP) levels in a sample of term and preterm infants.
In this cross-sectional study, 43 preterm infants (<34 wk), chronological age between 9 and 24 mo, were compared with a group of 47 healthy term infants of the same age. Data were collected on dietary intake, anthropometric measures, and serum CRP level (mg/L). The main exposure of interest was the consumption of UPF (excluding all types of milk), measured as the percentage of total energy intake.
The mean birth weight, gestational age, and corrected age were 1,245 ± 381.7 g, 29.9 ± 2.3 wk, and 14.3 ± 6.4 mo, respectively, in the preterm group. Infants in the preterm group consumed UPF less frequently (27–67.5% versus 40–87.0%; P = 0.038) but in a greater amount relative to total energy intake (39.8% 19.1–59.1%) versus 29.0% (14.5– 41.9%; P = 0.040) when compared with the term group. There was no statistically significant difference between the preterm and term groups regarding CRP levels. The consumption of UPF (percentage of energy intake) was independently associated with CRP levels (β = 0.007; 95% CI, 0.001–0.014; P = 0.034). A significant interaction between being born preterm and UPF consumption was found for CRP levels (P = 0.049). Breast-feeding was not associated with lower consumption of UPF in both groups (24–75.0% versus 43–79.6%; P = 0.404).
There is a positive relationship between UPF and CRP levels among infants, irrespective of excess weight. At the clinical practice level, a better comprehension of the associations between food processing and chronic inflammation may aid in individual dietary guidance.
This article sets out to describe how the EU Regulation No 650/2012 of 4 July 2012 on jurisdiction, applicable law, recognition and enforcement of decisions, and acceptance and enforcement of ...authentic instruments in matters of succession and on the creation of a European Certificate of Succession (hereinafter 'the EU Regulation') will change the conflicts of law rules to be applied by Italian courts to determine the applicable succession law and how such a change may impact Italian nationals residing outside Italy, particularly in Third Countries. Furthermore, the article will describe the opportunities provided by the transitional provisions laid down by the EU Regulation. Taking advantage of such opportunities might require to opt for a given succession law prior to 17 August 2015, as better explained in the main text.
By applying a coverage-based read selection and filtration through a healthy plant dataset, and a post-assembly contig selection based on homology and linkage, genome sequence drafts were obtained ...for four phytoplasma strains belonging to the 16SrIII group (X disease clade), namely Vaccinium Witches' Broom phytoplasma (647 754 nt in 272 contigs), Italian Clover Phyllody phytoplasma strain MA (597 245 nt in 197 contigs), Poinsettia branch-inducing phytoplasma strain JR1 (631 440 nt in 185 contigs) and Milkweed Yellows phytoplasma (583 806 nt in 158 contigs). Despite assignment to different 16SrIII subgroups, the genomes of the four strains were similar, comprising a highly conserved core (92-98 % similar in their nucleotide sequence among each other over alignments about 500 kb in length) and a minor strain-specific component. As far as their protein complement was concerned, they did not differ significantly in their basic metabolism potential from the genomes of other wide-host-range phytoplasmas sequenced previously, but were distinct from strains of other species, as well as among each other, in genes encoding functions conceivably related to interactions with the host, such as membrane trafficking components, proteases, DNA methylases, effectors and several hypothetical proteins of unknown function, some of which are likely secreted through the Sec-dependent secretion system. The four genomes displayed a group of genes encoding hypothetical proteins with high similarity to a central domain of IcmE/DotG, a core component of the type IVB secretion system of Gram-negative Legionella spp. Conversely, genes encoding functional GroES/GroEL chaperones were not detected in any of the four drafts. The results also indicated the significant role of horizontal gene transfer among different 'Candidatus Phytoplasma' species in shaping phytoplasma genomes and promoting their diversity.
Ataxia-telangiectasia (A-T) is a DNA repair disorder characterized by changes in several organs and systems. Advances in clinical protocols have resulted in increased survival of A-T patients, ...however disease progression is evident, mainly through metabolic and liver changes.
To identify the frequency of significant hepatic fibrosis in A-T patients and to verify the association with metabolic alterations and degree of ataxia.
This is a cross-sectional study that included 25 A-T patients aged 5 to 31 years. Anthropometric data, liver, inflammatory, lipid metabolism and glucose biomarkers (oral glucose tolerance test with insulin curve-OGTT) were collected. The Cooperative Ataxia Rating Scale was applied to assess the degree of ataxia. The following were calculated: Homeostasis Model Assessment-Insulin Resistance, Homeostasis Model Assessment-Adiponectin (HOMA-AD), Matsuda index, aspartate aminotransferase (AST): platelet ratio index, nonalcoholic fatty liver disease fibrosis score and BARD score. Liver ultrasonography and transient liver elastography by FibroScan
were performed.
Significant hepatic fibrosis was observed in 5/25 (20%). Patients in the group with significant hepatic fibrosis were older (p < 0.001), had lower platelet count values (p = 0.027), serum albumin (p = 0.019), HDL-c (p = 0.013) and Matsuda index (p = 0.044); and high values of LDL-c (p = 0.049), AST (p = 0.001), alanine aminotransferase (p = 0.002), gamma-glutamyl transferase (p = 0.001), ferritin (p = 0.001), 120-min glycemia by OGTT (p = 0.049), HOMA-AD (p = 0.016) and degree of ataxia (p = 0.009).
A non-invasive diagnosis of significant hepatic fibrosis was observed in 20% of A-T patients associated with changes in liver enzymes, ferritin, increased HOMA-AD, and the severity of ataxia in comparison with patients without hepatic fibrosis.
•We examine under what conditions people provide accurate feedback to others.•People are overconfident about their attractiveness even at high stakes.•People do not provide honest face-to-face ...feedback to less attractive participants.•People are more honest when feedback is anonymous.
We examine under what conditions people provide accurate feedback to others. We use feedback regarding attractiveness, a trait people care about, and for which objective information is hard to obtain. Our results show that people avoid giving accurate face-to-face feedback to less attractive individuals, even if lying in this context comes at a monetary cost to both the person who gives the feedback and the receiver. A substantial increase of these costs does not increase the accuracy of feedback. However, when feedback is provided anonymously, the aversion to giving negative feedback is reduced.
Zinc is an important nutrient involved in cell division, physical growth, and immune system function. Most studies evaluating the nutritional status related to zinc and prematurity were conducted ...with hospitalized preterm infants. These studies show controversial results regarding the prevalence of deficiency, clinical implications, and the effect of zinc supplementation on mortality, infectious diseases, and growth in these groups. This study aimed to compare serum and erythrocyte zinc levels in a group of preterm and full-term infants after 9 months of age, and related the zinc levels to dietary intake and anthropometric indicators in both groups. This cross-sectional study compared 43 preterm infants (24 to 33 weeks) aged 9-24 months to 47 full-term healthy infants. Outcome measures: anthropometric indicators and dietary intake. Blood sample for serum and erythrocyte zinc levels (ICP-MS, Inductively Coupled Plasma Mass Spectrometry). There was no difference between the groups regarding the mean of serum and erythrocyte zinc. Variables associated with higher serum zinc levels were breastfeeding at evaluation (
= 20.11 µg/dL, 95% CI 9.62-30.60,
< 0.001) and the later introduction of solid foods (
= 6.6 µg/dL, 95% CI 5.3-11.4,
< 0.001). Breastfeeding was also associated with higher erythrocyte zinc levels. The zinc levels were adequate in both groups, there was no association with anthropometric indicators or dietary intake and were slightly influenced by breastfeeding and time of solid food introduction.
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