Bottom Category Research Articles

Does conservative or arthroscopic management of canine medial coronoid disease lead to improved outcomes?

Question In dogs diagnosed with medial coronoid disease, does arthroscopic surgical intervention, compared with conservative management, result in improved mobility and reduced pain? Clinical bottom line Category of research: Treatment. Number and type of study designs reviewed: Three studies were identified directly addressing the PICO question. One paper was a retrospective cohort study, another study was a prospective randomised control trial, and the third was a non-randomised non-blinded observational study. Strength of evidence: Weak. Outcomes reported: The first study was a prospective non-randomised study that did not identify a difference in gait evaluation at the 52 week recheck in dogs treated conservatively compared to those treated arthroscopically, with lameness exacerbated in the arthroscopic treatment group until the 26 week recheck. The second study, a retrospective non-randomised cohort study, showed greater, but not statistically different, owner-reported clinical metrology scores in dogs treated arthroscopically compared to those treated conservatively. Liverpool Osteoarthritis in Dogs (LOAD) and Pain Severity Scores (PSS) were higher but not statistically significant, yet Pain Interference Scores (PIS) were statistically significantly higher at 52 weeks in arthroscopically treated dogs compared to conservatively treated dogs. Age at diagnosis and at time of questionnaire completion were statistically significant for LOAD, PSS, and PIS, with older dogs having higher scores. The third study performed a non-blinded observational study assessing canine patients with bilateral medial coronoid disease, with unilateral arthroscopic subtotal coronoidectomy performed on the most clinically affected limb. Radiographs and computed tomography (CT) imaging were performed at diagnosis, with radiographs taken at follow-up. At the time of follow-up, arthroscopically treated limbs had a higher radiographic score than those treated conservatively, although a significant improvement in lameness was seen at the walk in arthroscopically treated limbs. Conservatively managed dogs showed an unchanged (non-significant) gait. Radiographic changes did not appear to correlate to severity of clinical signs. Conclusion: The quality of the published evidence available to answer the PICO question is weak, due to the design of the three reviewed studies. Low patient populations in these three studies also hinder the statistical power of any recommendations made. None of the three studies assesses the complex nature of medial coronoid disease to clearly answer the question posed. The decision to recommend arthroscopy over conservative management therefore depends on the judgement and experience of the veterinary surgeon attending the case. Additionally, assessment of the imaging findings is important when discussing prospective treatment options.

Consumption of Ultra-Processed Foods and Semen Quality in Healthy Young Men Living in Italy.

The study aim was to evaluate the association between UPF consumption and semen quality in a sample of healthy young men in Italy. A cross-sectional analysis was carried out using data from 126 participants (mean age ± SD 20.0 ± 1.2 years) enrolled in the FASt randomized controlled trial. Food intake was assessed through the European Prospective Investigation into Cancer and Nutrition (EPIC) FFQ. Food items were categorized according to the Nova classification based on their purpose and extent of processing as follows: (1) unprocessed/minimally processed foods; (2) processed culinary ingredients; (3) processed foods; and (4) UPFs. The weight ratio (%) between each Nova group (g/d) and total food (g/d) was then calculated. For semen analyses, sperm volume, concentration, motility and morphology were measured. The associations between UPF consumption (quarters of) and semen quality parameters were estimated using multivariable-adjusted linear regression models. Participants consuming high UPFs (Q4), compared to those in the bottom category of intake (Q1), had a lower sperm concentration (β = -54.16 × 106 cell/mL; 95%CI: -92.91 to -15.40; p for trend = 0.0020 across fourths) and progressive motility (β = -14.17%; 95%CI: -28.25 to -0.09; p for trend = 0.036). The percentage of normal morphology cells had a tendency to decrease amongst subjects consuming more UPFs compared to those with the lowest intake. A large dietary intake of UPFs was inversely associated with sperm concentration and progressive motility in reproductive-age men. These findings suggest that dietary recommendations for improving male fertility and sperm health should also recommend limiting UPFs.

The use of adjuvant chemotherapy in cats with mammary carcinomas undergoing surgical removal.

PICO Question In cats with mammary carcinomas undergoing surgical removal, does the addition of adjuvant chemotherapy compared with surgical removal alone result in increased survival time? Clinical bottom line Category of research Treatment. Number and type of study designs reviewed Five retrospective cohort studies were critically reviewed. Strength of evidence Weak. Outcomes reported In cats with mammary carcinomas undergoing surgical removal, the addition of adjuvant chemotherapy compared with surgical removal alone was significantly associated with an increase in disease-specific survival time in one of the studies. This statistical significance was not found in the other four papers. Conclusion All five studies reviewed presented weak evidence for the clinical question due to their retrospective nature and weak study design. It is, therefore, concluded that there is not enough evidence to suggest that cats with mammary carcinomas that have undergone surgical treatment will have a longer survival time if treated with adjuvant chemotherapy. More prospective, placebo-controlled, double-blinded studies are needed to understand the clinical significance of adjuvant chemotherapy in cats with mammary carcinomas.

Dairy intake in association with asthma symptoms among a large sample of children and adolescents: a cross-sectional study.

Dairy products may be associated with an increased risk of asthma, although there is little scientific evidence to support this association. The goal of this study was to explore the association between dairy consumption and asthma symptoms. This cross-sectional study was conducted on children and adolescents aged 6-8 and 13-14 years living in central Iran. Dietary food consumption was assessed using a multiple-choice questionnaire. Logistic regression was used to obtain odds ratios for the association between milk, other dairy products, and total dairy consumption with the risk of asthma symptoms. In total, 7,667 participants (3,414 boys and 4,253 girls) were included in the current study. Milk intake and total dairy consumption were not associated with the likelihood of wheezing, asthma confirmed by a doctor, current asthma, and asthma medication use. In addition, there was no association between other dairy product intake and the odds of wheezing in the past 12 months in the crude model. However, after adjusting for several confounders, those in the top category had lower odds of wheezing in the past 12 months than those in the bottom category (OR: 0.58; 95% CI: 0.40-0.85). The consumption of dairy products other than milk, including cheese and yogurt, might reduce the likelihood of wheezing in children and adolescents.

Praktik Akuntansi Hijau pada Perusahan Tambang Nikel PT. Vale Indonesia Tbk.

This study aims to analyze green accounting practices at the Nickel Mining Company PT Vale Indonesia Tbk. This research is qualitative research with a case study approach. The data used is the company's annual and/or sustainability report for 2020-2022. The results showed that the company has implemented green accounting quite well, but detailed details about environmental costs are not visible, either in the Annual report or in the Sustainability Report. The treatment of environmental costs that have been incurred is recorded as other expenses in the company's income statement. Sustainability performance at PT Vale Indonesia Tbk. is inseparable from the three triple bottom line categories, namely economic performance, environmental performance and social performance as a manifestation of green accounting. Green Accounting Practices provide effects or benefits in improving economic performance, environmental performance and social performance, but it is also undeniable that there are still several challenges regarding green accounting practices in the future.

Triglyceride-glucose index is associated with hypertension incidence up to 13 years of follow-up in mexican adults

The triglyceride-glucose index (TyG index) is an indicator of insulin resistance that has been studied recently. The relationship between insulin resistance and the risk of hypertension has been documented previously. However, there is limited knowledge regarding the association of the TyG index with hypertension incidence. This study aimed to evaluate the association of the TyG index with changes in blood pressure (BP) and hypertension incidence in Mexican adults. This analysis was performed using the Health Workers Cohort Study data. The TyG index was estimated as Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2] and divided into categories defined by tertiles. The analysis was conducted using fixed-effects linear regression models (n = 1,545) and Cox proportional hazards regression models (n = 1,113), adjusting for potential confounding variables. The incidence rates (95% CI) for the low, medium, and high categories of the TyG index were 22.1 (17.8, 27.5), 35.8 (30.1, 42.7), and 49.4 (42.1, 57.9), respectively. An increase in the levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) was observed when changing from a low to a medium (DBP: β 2.55 mmHg, 95% CI 0.81, 4.29) and from a low to a high category of the TyG index (SBP: β 3.10 mmHg, 95% CI 1.16, 5.04; DBP: β 4.91 mmHg, 95% CI 2.88, 6.94). Furthermore, participants within the top category of the TyG index had a 56% higher risk of hypertension than those in the bottom category (HR = 1.56; 95% CI 1.18, 2.08). These results support the hypothesis that the TyG index is associated with high blood pressure in Mexican adults.

Association between empirical dietary inflammatory index, odds, and severity of anxiety disorders: A case-control study.

Diet may be a modifiable factor in the prevention of psychiatric disorders by modulating inflammation. In this study, we evaluated the association between empirical dietary inflammatory index (EDII) that is designed to evaluate the inflammatory potential of diets and anxiety disorders (AD) in adults. This case-control study was carried out on 85 patients who were group matched by gender with 170 healthy subjects. Data for dietary intake were assessed by using a 147-item validated food frequency questionnaire (FFQ). Anthropometric measures were collected using standard methods. EDII score was developed according to participants' dietary intakes of 28 predefined food groups. Multivariate odds ratios (OR) with 95% confidence intervals (CI) were used to investigate the association of empirically derived inflammatory potential of the diet and anxiety disorder. We observed that after adjusting for confounders, individuals in the top category of EDII score were 2.09 fold more likely to have anxiety disorder compared with those in the bottom category (OR: 2.09, 95% CI: 1.01, 4.33). Also, higher EDII contributed to a higher GAD-7 score (p < .001). There was a significant positive linear association between EDII and AD (β = 3.64, p < .001). After controlling for potential confounders AD had a strong positive correlation with the EDII score (r = .61, p-value <.001). In conclusion, in this case-control study, we realized that there is a positive association between the EDII score, odds, and severity of anxiety disorder. Ultimately, the potential role necessitates clarifying this association by conducting large-population prospective cohort studies.

Comparing clinical outcomes of dogs suffering from degenerative lumbosacral stenosis upon surgical or nonsurgical treatment

PICO question In dogs suffering from degenerative lumbosacral stenosis (DLSS), is surgical treatment more effective than nonsurgical therapy in reducing lumbosacral pain and neurological dysfunction in the long-term? Clinical bottom line Category of research Treatment. Number and type of study designs reviewed Two papers were critically reviewed. They were prospective and retrospective studies. Strength of evidence Weak. Outcomes reported Besides the two studies, there are no other studies currently available that directly compare long-term clinical outcome of patients that have undergone nonsurgical and surgical treatment respectively. In the study comparing clinical outcome of nonsurgical treatment by epidural steroid injection (ESI) and surgical treatment of degenerative lumbosacral stenosis, dogs were classified into clinical severity groups ranging from mild to moderate to severe. Mild cases demonstrated degenerative lumbosacral stenosis (DLSS) compatible clinical signs such as lumbosacral pain, reluctance to climb stairs / jump / raise up, lameness and muscle atrophy but no neurological deficits. Moderate cases presented DLSS compatible clinical signs in combination with neurological deficits such as reduced flexor withdrawal, proprioceptive deficits and nerve root signature. Severe cases demonstrated DLSS compatible clinical signs with more severe neurological deficits such as tail paresis and absent perineal reflex. Clinical outcomes were considered complete if clinical signs had resolved at follow-up consultations, partial if there was substantial but incomplete improvement in clinical signs and failed if the dog did not improve or deteriorated further. Improvements in patient condition were measured in terms of clinical outcome grading which is in relation to the initial clinical severity group assigned to each dog. Improvement after single dose of ESI was seen in 27/32 dogs, with 17/22 (after accounting for four dogs whose owners have refused further treatment, five dogs lost to follow-up after re-check as well as one dog whose owners have opted for repeated ESI instillations) relapsing within 6 months. All 17 of these dogs that suffered a relapse after single ESI subsequently underwent surgical treatment and demonstrated improvement in clinical signs, with a complete response seen in eight dogs and a partial response seen in nine dogs. In the study comparing clinical outcome of conservative treatment of exercise restriction with phenylbutazone administration and surgical treatment of degenerative lumbosacral stenosis, outcomes were classified as good in dogs that regained preoperative activity levels; acceptable in dogs with persistent abnormality or requiring continued medication though otherwise active, and poor in all other cases. Out of 16 dogs treated surgically, 11 were treated by dorsal lumbosacral laminectomy and excision of the dorsal portion of the lumbosacral disc, while the other five had additional unilateral facetectomy to decompress the seventh lumbar nerve. Out of the 11 dogs treated with dorsal lumbosacral laminectomy and excision of the dorsal portion of the lumbosacral disc, 6/11 (54.5%) of dogs were deemed to have a good outcome, while 3/11 (27.3%) of dogs were deemed to have an acceptable outcome. Out of the five dogs treated with dorsal lumbosacral laminectomy and excision of the dorsal portion of the lumbosacral disc with additional unilateral facetectomy, 3/5 (60%) of dogs were deemed to have an acceptable outcome. The outcome of conservative treatment was deemed good in 8/16 (50%) of dogs in the conservative treatment group. Conclusion There is evidence suggesting that both nonsurgical and surgical treatments can improve clinical outcomes and reduce lower back pain and neurological deficits. However, based on the current limited literature, it cannot be ascertained whether surgical treatments are more effective than nonsurgical treatments in improving long-term clinical outcomes and vice versa. In the study that tested the efficacy of epidural steroid injection, only a single dose of steroids was given in this study, making it a potential reason for the high rate of relapse following nonsurgical treatment. For surgical treatment of DLSS, the type of surgical procedure chosen would also depend on the part of the lumbosacral region which fails and leads to compression. In conclusion, randomised controlled trials that compare different forms of nonsurgical treatment with surgical treatment for dogs with DLSS caused by different underlying factors need to be conducted to properly address the PICO question. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

Adherence to the MIND diet is inversely associated with odds and severity of anxiety disorders: a case–control study

BackgroundThe association between the Mediterranean-DASH diet Intervention for Neurodegenerative Delay (MIND) diet, odds, and severity of anxiety disorders (AD) is still unclear. We aimed to investigate whether adherence to MIND diet is associated with odds and severity of AD.MethodsThe present case–control study carried out on 85 patients who were group matched by gender with 170 healthy subjects. Data for dietary intake was assessed by using a 147-item validated food frequency questionnaire (FFQ). Anthropometric measures were collected using standard methods. The MIND diet score was calculated using FFQ. We assessed anxiety disorder severity using the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Multivariate odds ratios (OR) with 95% confidence intervals (CI) were used to investigate the association of MIND diet and anxiety disorder.ResultsWe observed that higher adherence to MIND diet was associated with the lower GAD-7 score (p < 0.001). Individuals in the top category of MIND diet score were 97% less likely to have AD compared with those in the bottom category (OR: 0.03, 95% CI: 0.01, 0.09). There was significant reverse linear association between MIND diet score and AD (β = -3.63, p < 0.001).ConclusionsIn conclusion, we provided some evidence indicating negative association between adherence to MIND diet, odds, and severity of AD. Finally, due to the probable preventive role of diet, it is vital to clarify the association between diet and AD through large-scale prospective cohort studies in the future.

In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine associated with a reduction in postoperative pain score?

PICO question In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine via intraperitoneal or subcutaneous injections, in comparison with the use of a control substance or other analgesic measure, associated with a reduction in postoperative pain score? Clinical bottom line The category of research question: Treatment. The number and type of study designs that were critically appraised: Three studies were critically appraised in this Knowledge Summary. They included two prospective, blinded, randomised, controlled clinical trials and one prospective randomised, blinded clinical trial. Strength of evidence: Weak. The outcomes reported: Bupivacaine does not eliminate postoperative pain in cats undergoing ovariohysterectomies; minimal evidence was found to suggest that it was better at reducing postoperative pain scores in comparison to other analgesics. However, bupivacaine may provide analgesic benefits to cats when administered via intraperitoneal or subcutaneous injections as local anaesthesia and in combination with other analgesic agents. The need for postoperative rescue analgesia was minimised when bupivacaine was administered prior to or during the ovariohysterectomy. Conclusion: When compared to a control, pain scores for the participating cats were lower after administration of bupivacaine, however, statistical significance was only reached in one of the studies. Additionally, other medications were found to lower the post operative pain score to a greater effect. However, bupivacaine administration is cheap and simple to perform, so it’s use as part of a multimodal analgesic protocol is supported. Confounding factors within the studies may have altered the perceived effectiveness of the analgesic properties of bupivacaine though, so further investigation involving larger cohorts with standardised controls would be prudent. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

In horses undergoing volatile anaesthesia, is recovery quality superior with sevoflurane compared to isoflurane?

PICO question In horses undergoing volatile anaesthesia, is recovery quality superior with the use of sevoflurane compared to isoflurane during the maintenance phase? Clinical bottom line The category of research question Treatment Number and type of study designs reviewed Seven papers were available for critical appraisal. Of the seven papers, six were prospective, randomised trials and four of these were of crossover design. Of the same seven papers, three were experimental and four were clinical. Strength of evidence Moderate Outcomes reported Five out of seven critically appraised articles found that there was no clinically significant improvement in recovery quality following volatile anaesthesia with sevoflurane compared to isoflurane. Two of the seven articles did find improvement in recovery quality following the use of sevoflurane over isoflurane, but both studies were of crossover design, one of these studies used non-blinded evaluators and the second study used both unblinded and blinded evaluators and a recovery quality scoring scale that did not show interobserver reliability. Conclusion In healthy horses presented for elective surgical and diagnostic imaging procedures in a clinical setting, there is no significant difference in recovery quality following the use of sevoflurane or isoflurane for the maintenance phase. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

Pathophysiologic Processes and Novel Biomarkers Associated With Congestion in Heart Failure

BackgroundCongestion is the main driver behind symptoms of heart failure (HF), but pathophysiology related to congestion remains poorly understood. ObjectivesUsing pathway and differential expression analyses, the authors aim to identify biological processes and biomarkers associated with congestion in HF. MethodsA congestion score (sum of jugular venous pressure, orthopnea, and peripheral edema) was calculated in 1,245 BIOSTAT-CHF patients with acute or worsening HF. Patients with a score ranking in the bottom or top categories of congestion were deemed noncongested (n = 408) and severely congested (n = 142), respectively. Plasma concentrations of 363 unique proteins (Olink Proteomics Multiplex CVD-II, CVD-III, Immune Response and Oncology II panels) were compared between noncongested and severely congested patients. Results were validated in an independent validation cohort of 1,342 HF patients (436 noncongested and 232 severely congested). ResultsDifferential protein expression analysis showed 107/363 up-regulated and 6/363 down-regulated proteins in patients with congestion compared with those without. FGF-23, FGF-21, CA-125, soluble ST2, GDF-15, FABP4, IL-6, and BNP were the strongest up-regulated proteins (fold change [FC] >1.30, false discovery rate [FDR], P < 0.05). KITLG, EGF, and PON3 were the strongest down-regulated proteins (FC <−1.30, FDR P < 0.05). Pathways most prominently involved in congestion were related to inflammation, endothelial activation, and response to mechanical stimulus. The validation cohort yielded similar findings. ConclusionsSevere congestion in HF is mainly associated with inflammation, endothelial activation, and mechanical stress. Whether these pathways play a causal role in the onset or progression of congestion remains to be established. The identified biomarkers may become useful for diagnosing and monitoring congestion status.

A Population-Based Case-Control Study on Dietary Total Antioxidant Capacity in Relation to Breast Cancer in a Middle-Eastern Country

ObjectivesData on the association between dietary total antioxidant capacity (dTAC) and odds of breast cancer are scare. This is particularly relevant to developing countries where dietary intakes of antioxidants seem insufficient. This population-based case-control study was conducted to investigate the association between dietary TAC intake and odds of breast cancer among Iranian women. MethodsIn this population-based case-control study, 350 newly diagnosed cases of breast cancer were recruited and 700 age-matched control subjects were enrolled. Dietary intakes were examined by the use of a 106-item dish-based validated FFQ. Dietary total antioxidant capacity of each participant was computed by summing up dTAC from all foods and dishes using ferric reducing antioxidant potential (FRAP) method. The quintile cut-off point of energy-adjusted dTAC was obtained in the control group. These cut-off points were used to classify all study participants into quintiles in terms of dTAC intake. ResultsAfter controlling for potential confounders, individuals in the highest category of dietary TAC were 22% less likely to have breast cancer compared to those in the bottom category (OR: 0.78; 95% CI: 0.47, 1.30); however, this finding was not statistically significant. Participants in the third quintile had significantly lower odds for breast cancer compared with those in the first quintile (OR: 0.57; 95% CI: 0.34–0.93). Stratified-analysis by menopausal status revealed significant association between dietary total anti-oxidant capacity and odds of breast cancer in pre-menopause women, even after adjustment for BMI (OR: 0.03; 95% CI: 0.004, 0.22). Such a significant inverse association was seen in postmenopausal women for those in the third quintile of dietary TAC compared with those in the first quintile (OR: 0.45; 95% CI: 0.26–0.78). ConclusionsIt seems that dietary total antioxidant capacity might be inversely associated with odds of breast cancer, particularly in premenopausal. Further prospective investigations are needed to confirm these findings. Funding SourcesNo funding sources.

Mid-Life Physical Activity and Late-Life Cognitive Performance among American Indians

Introduction: Research on factors associated with late-life cognitive performance in diverse racial/ethnic groups is increasingly important due to the growing size and racial diversity of the elder population. Methods: Using data on American Indians (AIs) from the Strong Heart Study, we measured associations between mid-life physical activity (PA), assessed by a questionnaire or pedometer, and performance on tests of general cognitive function, phonemic fluency, verbal learning and memory, and processing speed. Cognitive tests were administered 7–21 years after PA measurements. To estimate associations, we used regression models with and without inverse-probability weights to account for potential attrition bias in the cohort. Results: Questionnaire and pedometer measures of PA were positively associated with cognitive function. Participants in the top quartile of questionnaire-based PA had Modified Mini-Mental State examination scores 3.2 (95% CI: 1.5–4.9) points higher than participants in the lowest quartile. Phonemic fluency scores also trended higher for participants in the top compared to the bottom categories for both PA measures: top questionnaire quartile = 2.7 (95% CI: 0.6–4.8) points higher and top pedometry tertile = 6.7 (95% CI: 2.7–10.7) points higher. We observed no associations between PA and tests assessing verbal learning and memory, or processing speed. Weighted model results were similar, but less precise. Conclusions: In this cohort of AIs with relatively low levels of PA, positive associations between mid-life PA and late-life cognitive performance were dose-dependent and of modest clinical significance.

Economic tradeoffs and risk between traditional bottom and container culture of oysters on Maryland farms

Availability of new oyster production methods offers a variety of choices for oyster farmers that include the overall business model, marketing strategy, scale of production, and the production method. Cost structures and relative profitability vary across production methods, scales, and business models. Maryland oyster farms were used as the basis for an assessment of the relative economic tradeoffs among traditional and newer, more intensive, production methods based on farm-level data. Oyster farmers in Maryland were interviewed in 2018 and 2019 to collect data from farm records on expenditures, prices, investment in equipment and facilities, and common problems. Production method/scale categories identified included annual production levels of ≤200 bushels and >200 bushels for traditional bottom culture and ≤6,000 and >6,000 boxes (100-count) for container culture. Cost structures were identified for each category, and accounting and economic net returns (profit) calculated for each (in $/bushel for traditional bottom culture and $/box for container culture). Stochastic dominance for profitability was assessed across the four farming categories. Cost structures differed substantially across the four categories, with fuel the greatest expense for traditional bottom culture farms and labor, followed by marketing costs, the greatest expenses for container culture farms. All categories were profitable based on accounting net returns, but only the large-scale farms for each production method were profitable in terms of economic net returns. The most profitable category was the large-scale container culture category followed by the large-scale bottom culture category, but the larger traditional bottom culture category was the least risky (by first-order stochastic dominance). Risk was substantially greater for the larger container culture category and for the smaller bottom culture category. Continued Extension support is needed to provide assistance with comprehensive business financial planning and risk mitigation (including efforts to reduce yield variability), especially for startup farms seeking to grow to provide full-time salaries for owners/operators.

Usefulness of cardiometabolic index for the estimation of diabetes risk among general population in rural China: a community-based study

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiometabolic index (CMI) defines adiposity based on triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio and waist-to-height ratio (WHtR). This newly proposed metric has been used to detect multiple cardiovascular risk factors, but data relative to diabetes in the general population are lacking. This study aims to validate CMI’s utility of discriminating diabetes and compares it with other indexes among general Chinese population. Methods Analyses were based on a cross-sectional study of 11,478 participants that underwent assessment of metabolic and anthropometric parameters in rural areas of northeastern China in 2013. CMI was calculated by TG/HDL-C × WHtR. Multivariate logistic regressions were performed to clarify CMI’s association with diabetes, ROC analyses were engaged to investigate CMI’s discriminating ability for diabetes. Results The prevalence of diabetes was 9.93% in males while 10.76% in females, and increased with CMI’s increment. After full adjustment, each SD increment of CMI had odds ratios (ORs) for diabetes of 1.471 (1.367–1.584) and 1.422 (1.315–1.539) in females and males, respectively. Compared with bottom categories of CMI, the top quartiles had ORs of 3.736 (2.783–5.015) in females and 3.697 (2.757–4.958) in males. The ROC results showed an excellent discriminating power of CMI (AUC: 0.702 for females, 0.664 for males). Conclusions An increasing CMI was correlated with higher odds of diabetes, supporting CMI as a useful and economic measure to screen and quantify diabetes in general Chinese population. Monitoring and promoting achievement of dyslipidemia and abdominal obesity based on CMI may improve subclinical and cardiovascular outcomes. Abstract Figure.

Predicting growth in US durables spending using consumer durables-buying attitudes

This study employs the Michigan Surveys of Consumers (MSC) data on durables-buying attitudes to predict monthly growth in durables spending in real time. We specify and estimate a univariate moving-average (MA) and five augmented-MA models that utilize past information in consumer durables-buying attitudes (calculated using all survey responses and the responses of participants in three income categories). We show that the augmented model that utilizes durables-buying attitudes of consumers in both bottom and top income categories produces the most informative forecasts for 2008-2019. These forecasts show over-prediction and yet are directionally accurate under asymmetric loss. We further show that the forecast errors are generally orthogonal to changes in both interest rates and income growth, and to changes in important relevant MSC variables. In concluding, we first note that consumer durables-buying attitudes disaggregated by income help detect useful information for predicting growth in durables spending, and then discuss the policy implications.

The implications of changing education distributions for life expectancy gradients.

Recent research has proposed that shifting education distributions across cohorts are influencing estimates of educational gradients in mortality. We use data from the United States and Finland covering four decades to explore this assertion. We base our analysis around our new finding: a negative logarithmic relationship between relative education and relative mortality. This relationship holds across multiple age groups, both sexes, two very different countries, and time periods spanning four decades. The inequality parameters from this model indicate increasing relative mortality differentials over time. We use these findings to develop a method that allows us to compute life expectancy for any given segment of the education distribution (e.g., education quintiles). We apply this method to Finnish and American data to compute life expectancy gradients that are adjusted for changes in the education distribution. In Finland, these distribution-adjusted education differentials in life expectancy between the top and bottom education quintiles have increased by two years for men, and remained stable for women between 1971 and 2010. Similar distribution-adjusted estimates for the U.S. suggest that educational disparities in life expectancy increased by 3.3 years for non-Hispanic white men and 3.0 years for non-Hispanic white women between the 1980s and 2000s. For men and women, respectively, these differentials between the top and bottom education quintiles are smaller than the differentials between the top and bottom education categories by 18% and 39% in the U.S. and by 39% and 100% in Finland. Had the relative inequality parameters of mortality governing the Finnish and U.S. populations remained constant at their earliest period values, the difference in life expectancy between the top and bottom education quintiles would – because of overall mortality reductions – have declined moderately. The findings suggest that educational expansion may bias estimates of trends in educational differences in life expectancy upwards.

Association between dietary fat intake and odds of Gastro-esophageal Reflux Disorder. (GERD) in Iranian adults

Background:Most information on the association of dietary fat intake and gastro-esophageal reflux disorder (GERD) came from developed countries, where lifestyle and other dietary components might be different from those in developing countries. This cross-sectional study was, therefore, conducted to investigate the association between dietary fat intake and odds of having GERD in a large group of Iranian population.Study Design:This cross-sectional study was done among 3362 adult population in Isfahan, Iran. Dietary intakes were collected by the use of a validated semi-quantitative food frequency questionnaire.Methods:Assessment of GERD was done using a validated self-administered questionnaire examining the frequency of heartburn in the last 3 months. Individuals with the presence of heartburn symptoms sometimes, often or always during the last 3 months were defined as having GERD.Results:Participants in the top category of dietary fat intake had higher daily intakes of energy, macronutrients and micronutrients. Dietary intakes of all food groups were also significantly higher among those in the top quintile as compared with those in the bottom category of dietary fat intake (P < 0.001 for all). There were no significant associations between dietary fat intake and incidence of GERD in general population. Crude and multivariable-adjusted models revealed no significant associations between dietary fat intake and having GERD in either gender.Conclusions:We found no significant association between dietary fat intake and odds of having GERD in this population. Further studies, in particular of prospective designs, are warranted to clarify this association.

Fruit and vegetable consumption in relation to primary headaches: the MEPHASOUS study.

Fruit and vegetable consumption may beneficially affect the odds of primary headaches due to their antioxidant contents. However, no study has examined the association between fruit and vegetable consumption and primary headaches among university students. To assess the relation between fruit and vegetable intakes and primary headaches among Iranian university students. Overall, 83,214 university students with an age range of ≥ 18years participated in the present study. Dietary intakes and also data on confounding variables were collected using validated questionnaires. Data on dietary intakes were collected using a validated dietary habits questionnaire. We used the International Classification of Headache Disorders-3 (ICHD-3) criteria to define primary headaches. Fruit consumption was negatively associated with primary headaches; such that after controlling for potential confounders, greater intake of fruits was associated with 30% lower odds of primary headaches (OR: 0.70, 95% CI 0.58-0.84). Such an inverse association was also found for vegetable consumption. In the fully adjusted model, students in the top category of vegetable consumption were 16% less likely to have primary headaches compared with those in the bottom category (OR: 0.84, 95% CI 0.74-0.95). Subgroup analysis revealed that fruit consumption was inversely associated with primary headaches in females, unlike males, and vegetable consumption was inversely associated with these headaches in males, as opposed to females. Moreover, fruit and vegetable consumption was related to lower odds of primary headaches in normal-weight students. Fruit and vegetable intakes were associated with reduced odds of primary headaches. Level III, cross-sectional analytic studies.