PubMed, Web of Science, and the Cochrane Database of Systematic Reviews were searched for meta-analyses that provided risk estimates (±95% confidence intervals) for associations between intakes of ...whole and refined grains and risk of total and site-specific cancer. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Only meta-analyses that included whole grains and refined grains as separate food groups, and not as part of dietary patterns, were included. A total of 17 publications were identified that met inclusion criteria. Within these, results from a total of 54 distinct meta-analyses were reported for whole grains and 5 meta-analyses for refined grains. For total cancer mortality, 7 meta-analyses of cohort studies indicated that whole grain intake was associated with 6% to 12% lower risk in comparison of highest vs. lowest intake groups, and 3% to 20% lower risk for doses ranging from 15 to 90 g/day. For site-specific cancers, meta-analyses indicated that whole grain intake was consistently associated with lower risks of colorectal, colon, gastric, pancreatic, and esophageal cancers. Limited data were available for refined grains, with only 4 publications providing risk estimates, and only 1 of the meta-analyses included more than 3 studies. High intake of refined grains was associated with increased risk of colon and gastric cancer. By contrast, in the only dose-response meta-analysis, each 90 g/day consumption of refined grains was associated with a 6% lower risk of total cancer. In addition to the limited number of published meta-analyses on refined grains, results were also weakened due to the fact that refined grains were frequently defined to include both staple grain foods and indulgent grain foods, and the majority of studies included in the meta-analyses provided no specific definition of refined grains. Overall, meta-analyses of cohort and case-control studies consistently demonstrate that whole grain intake is associated with lower risk of total and site-specific cancer, and support current dietary recommendations to increase whole grain consumption. By contrast, the relationship between refined grain intake and cancer risk is inconclusive.
Dairy is one of the main sources for high quality protein in the human diet. Processing may, however, cause denaturation, aggregation, and chemical modifications of its amino acids, which may impact ...protein quality. This systematic review covers the effect of milk protein modifications as a result of heating, on protein digestion and its physiological impact. A total of 5363 records were retrieved through the Scopus database of which a total of 102 were included. Although the degree of modification highly depends on the exact processing conditions, heating of milk proteins can modify several amino acids. In vitro and animal studies demonstrate that glycation decreases protein digestibility, and hinders amino acid availability, especially for lysine. Other chemical modifications, including oxidation, racemization, dephosphorylation and cross-linking, are less well studied, but may also impact protein digestion, which may result in decreased amino acid bioavailability and functionality. On the other hand, protein denaturation does not affect overall digestibility, but can facilitate gastric hydrolysis, especially of β-lactoglobulin. Protein denaturation can also alter gastric emptying of the protein, consequently affecting digestive kinetics that can eventually result in different post-prandial plasma amino acid appearance. Apart from processing, the kinetics of protein digestion depend on the matrix in which the protein is heated. Altogether, protein modifications may be considered indicative for processing severity. Controlling dairy processing conditions can thus be a powerful way to preserve protein quality or to steer gastrointestinal digestion kinetics and subsequent release of amino acids. Related physiological consequences mainly point towards amino acid bioavailability and immunological consequences.
This article examines the function of documents as a data source in qualitative research and discusses document analysis procedure in the context of actual research experiences. Targeted to research ...novices, the article takes a nuts-and-bolts approach to document analysis. It describes the nature and forms of documents, outlines the advantages and limitations of document analysis, and offers specific examples of the use of documents in the research process. The application of document analysis to a grounded theory study is illustrated.
Saturation is mentioned in many qualitative research reports without any explanation of what it means and how it occurred. Recognizing the saturation point presents a challenge to qualitative ...researchers, especially in the absence of explicit guidelines for determining data or theoretical saturation. This research note examines the saturation concept in naturalistic inquiry and the challenges it presents. In particular, it summarizes the saturation process in a grounded theory study of community-based antipoverty projects. The main argument advanced in this research note is that claims of saturation should be supported by an explanation of how saturation was achieved and substantiated by clear evidence of its occurrence.
‘Sense of place’ has become a central concept in the analysis of the cultural, personal and mental health risks posed by a changing climate. However, such place-related understandings of mental ...health and wellbeing remain largely limited to Indigenous health contexts. In this article we argue the relevance of sense of place in understanding the mental health impacts of climate change on family farmers who retain close living and working relationships to the land. We conducted a community-based qualitative case study located in the Western Australian Wheatbelt - a region that has experienced some of the most significant climate change in Australia. A three-part interview series was conducted with 22 family farmers between February 2013 and April 2014, and 15 interviews with various agricultural and mental health key informants. The research findings reveal that recently observed patterns of climate change have exacerbated farmers' worries about the weather, undermined notions of self-identity, and contributed to cumulative and chronic forms of place-based distress, culminating in heightened perceived risk of depression and suicide. The research findings highlight the tightly coupled ecosystem health-human health relationships that exist for family farmers living in regions affected by climate change, as well as the significance of farmers' place-based attachments and identities for their mental health and wellbeing.
•Sense of place is a significant driver of farmers' mental health and wellbeing.•Weather influences farmers' emotional and psychological states.•Climate change-related mental health risks cumulate over time.•A place-based approach may limit climate change mental health risks to farmers.
The host response to SARS-CoV-2 infection provide insights into both viral pathogenesis and patient management. The host-encoded microRNA (miRNA) response to SARS-CoV-2 infection, however, remains ...poorly defined. Here we profiled circulating miRNAs from ten COVID-19 patients sampled longitudinally and ten age and gender matched healthy donors. We observed 55 miRNAs that were altered in COVID-19 patients during early-stage disease, with the inflammatory miR-31-5p the most strongly upregulated. Supervised machine learning analysis revealed that a three-miRNA signature (miR-423-5p, miR-23a-3p and miR-195-5p) independently classified COVID-19 cases with an accuracy of 99.9%. In a ferret COVID-19 model, the three-miRNA signature again detected SARS-CoV-2 infection with 99.7% accuracy, and distinguished SARS-CoV-2 infection from influenza A (H1N1) infection and healthy controls with 95% accuracy. Distinct miRNA profiles were also observed in COVID-19 patients requiring oxygenation. This study demonstrates that SARS-CoV-2 infection induces a robust host miRNA response that could improve COVID-19 detection and patient management.
Abstract Background In accordance with the 2007 American College of Cardiology and American Heart Association infective endocarditis (IE) guideline update, antibiotic prophylaxis is now being ...restricted to a smaller number of cardiac conditions with very high risk for adverse outcomes from IE. However, there is scant data on IE trends since this major practice change in the United States. Objectives The aim of this study was to compare temporal trends in IE incidence, microbiology, and outcomes before and after the change in the 2007 IE prophylaxis guideline in the United States. Methods The NIS (Nationwide Inpatient Sample) database was used to investigate IE hospitalization rates in the United States from 2000 through 2011. The mean annual rates of IE before and after the 2007 guideline change were compared using segmented regression analysis. Results There were 457,052 IE-related hospitalizations in the United States from 2000 to 2011, with a steady increase in incidence (p < 0.001). The trend in IE hospitalization rates from 2000 to 2007 and from 2008 to 2011 was not significantly different (p = 0.74). The increases in the number of Staphylococcus IE cases per million population during the study periods 2000 to 2007 and 2008 to 2011 were similar (p = 0.13), but Streptococcus IE hospitalization rates were significantly higher after the release of new guidelines (p = 0.002). Finally, valve replacement rates for IE steadily increased from 2000 to 2007 (p = 0.03) but showed a plateau from 2007 to 2011. Overall, there was no significant difference in the rates of valve replacement for IE before and after the release of new guideline (p = 0.23). Conclusions These results show that IE incidence has increased in the United States over the past decade. With regard to the microbiology of IE, there has been a significant rise in the incidence of Streptococcus IE since the 2007 guideline revisions. However, the rates of hospitalization and valve surgery for IE have not increased since the change in IE prophylaxis guideline in 2007.
The highly prevalent parasite Toxoplasma gondii manipulates its host's behavior. In infected rodents, the behavioral changes increase the likelihood that the parasite will be transmitted back to its ...definitive cat host, an essential step in completion of the parasite's life cycle. The mechanism(s) responsible for behavioral changes in the host is unknown but two lines of published evidence suggest that the parasite alters neurotransmitter signal transduction: the disruption of the parasite-induced behavioral changes with medications used to treat psychiatric disease (specifically dopamine antagonists) and identification of a tyrosine hydroxylase encoded in the parasite genome. In this study, infection of mammalian dopaminergic cells with T. gondii enhanced the levels of K+-induced release of dopamine several-fold, with a direct correlation between the number of infected cells and the quantity of dopamine released. Immunostaining brain sections of infected mice with dopamine antibody showed intense staining of encysted parasites. Based on these analyses, T. gondii orchestrates a significant increase in dopamine metabolism in neural cells. Tyrosine hydroxylase, the rate-limiting enzyme for dopamine synthesis, was also found in intracellular tissue cysts in brain tissue with antibodies specific for the parasite-encoded tyrosine hydroxylase. These observations provide a mechanism for parasite-induced behavioral changes. The observed effects on dopamine metabolism could also be relevant in interpreting reports of psychobehavioral changes in toxoplasmosis-infected humans.
Refined grains are included as part of an unhealthy, or Western, dietary pattern, which has been shown to be associated with increased risk of cardiovascular disease (CVD). To clarify the association ...between refined grain intake and CVD risk, Pubmed and Scopus databases were searched for relevant cohort studies from database inception to June 30, 2022. Only studies that examined refined grains as a distinct consumption category and not as part of a dietary pattern, were included. Meta-analyses were performed using Cochrane's RevMan 5.4.1 software, applying inverse variance risk ratios in random effects models for each outcome of interest. Heterogeneity was assessed with Cochrane's Q (chi
) and I
statistics. Meta-analyses of hazard ratios (HR) and 95% confidence intervals (CI) obtained from 17 prospective cohort studies (>875,000 participants) indicated that refined grain intake was not associated with risk of CVD (HR = 1.08, 95% CI, 0.99-1.18, I
= 70%; 9 cohorts), stroke (HR = 1.06, 95% CI 0.92-1.23, I
= 70%; 9 cohorts), or heart failure (HR = 0.95, 95% CI 0.77-1.16, I
= 10%; 5 cohorts). White rice intake was also not associated with risk of CVD (HR = 0.93, 95% CI 0.86-1.00, I
= 25%; 7 cohorts) or stroke (HR = 1.03, 95% CI 0.93-1.14, I
= 22%; 7 cohorts). No significant publication bias was evident (Egger's test P values all > 0.05). The lack of association between refined grain intake and CVD risk was observed in meta-analyses of studies that restricted analyses to only staple grain foods (e.g., bread, cereal, pasta, white rice), as well as for meta-analyses of studies that included both staple and indulgent grain foods (e.g., cakes, cookies, doughnuts, brownies, muffins, pastries). Probable confounding from unmeasured variables in studies included in the meta-analyses diminishes the overall quality of evidence. Although refined grains are included as a component of the Western dietary pattern, the results of the meta-analyses suggest that refined grains do not contribute to the higher CVD risk associated with this unhealthy dietary pattern. This information should be considered in formulation of future dietary recommendations.
Refined grain intake is widely assumed to be associated with adverse health outcomes, including increased risk for cardiovascular disease (CVD), type 2 diabetes (T2D), and obesity. The 2015 Dietary ...Guidelines Advisory Committee recommended that to improve dietary quality, the US population should replace most refined grains with whole grains. This recommendation was based largely on results from studies that examined dietary patterns, not separate food groups. A Western dietary pattern typically includes red and processed meat, sugar-sweetened foods and beverages, French fries, and high-fat dairy products, as well as refined grains, and has been linked to increased risk of many chronic diseases. However, when evaluated as a distinct food category, 11 meta-analyses of prospective cohort studies, which included a total of 32 publications with data from 24 distinct cohorts, demonstrated that refined grain intake was not associated with all-cause mortality, T2D, CVD, coronary heart disease (CHD), stroke, hypertension, or cancer. By contrast, consumption of red and processed meat was consistently associated with increased risk of these same health outcomes. Refined grain consumption up to 6–7 servings/d (1 serving = 30 g) was not associated with higher risk of CHD, T2D, hypertension, or all-cause mortality. Moreover, total grain intake was not associated with risk of CVD, CHD, stroke, or cancer, but was associated with lower risk of all-cause mortality. Consequently, the recommendation to reduce refined grain intake based on results from studies linking a Western dietary pattern to numerous adverse health outcomes is contrary to a substantial body of published scientific evidence. Future research needs to better define refined grain intake to distinguish between staple grain foods and indulgent grain foods, and to better design randomized controlled trials to resolve discrepancies between results from observational studies and such trials with regard to determining the benefits of whole grains compared with refined grains.