Quality Of Adjustment Research Articles

Ultra-processed food intake and type 2 diabetes: A dose-response meta-analyses of prospective studies

Abstract Studies suggested a positive association between ultra-processed food (UPF) intake and risk of type 2 diabetes (T2DM). However, the magnitude of association varies across studies due to differences in population characteristics and methodological issues. It is also unclear about the exact shape of the association and whether the association is independent of diet quality and adiposity. We conducted a dose-response meta-analysis of prospective studies to summarize the association between UPF intake and T2DM risk. PubMed/MEDLINE, Web of Science, and Embase were searched through Jan. 2024 to identify relevant studies. Using random-effects models, summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated for each of the following unit increment in UPF intake: 10% (of total g/d), 100-g/d, and 1-serving/d. A non-linear dose-response meta-analysis was conducted using restricted cubic spline analysis. After screening 569 publications, 12 prospective cohort studies were included in this study. The summary RRs associated with every 10%, 100-g, and 1-serving increment in UPF intake were 1.13 (95% CI = 1.10-1.16), 1.05 (95% CI = 1.03-1.06), and 1.04 (95% CI = 1.03-1.05), respectively. The positive associations remained statistically significant after additional adjustment for diet quality, BMI, and total energy intake. The dose-response curve for g/d of UPF intake suggested evidence of nonlinearity (p-nonlinearity=0.0005), showing a steeper increase in risk at UPF intake >300 g/d. However, evidence for non-linearity was not observed with % and serving/d of UPF intake. The association did not significantly vary by method and timing of UPF assessment. Higher summary RRs were observed among studies from Europe and North America compared with those from other countries (p-heterogeneity=0.048). Our data suggest that higher UPF intake may increase T2DM risk, independent of diet quality and adiposity. Key messages • Higher intake of ultra-processed food is positively associated with the risk of type 2 diabetes. • Public health strategies should encourage healthier dietary choices by emphasizing reduction of UPF intake in dietary guidelines and implementing regulations on manufacturing and labeling of UPF.

Multi-omics profiling reveals the molecular mechanisms of H2O2-induced detrimental effects on Thamnaconus septentrionalis

BackgroundHydrogen peroxide (H2O2), a novel water treatment agent, can be used for disinfection, water quality adjustment, and disease prevention, while excessive H2O2 can injure farm animals, even leading to death. Hydrogen peroxide is a recommended disinfectant and bactericide for treating gill diseases and vibriosis in the greenfin horse-faced filefish Thamnaconus septentrionalis. However, its cumulative effect, toxic molecular mechanism and relevant signal transduction/metabolic networks in marine fishes are largely unknown.ResultsWe employed a multi-omics approach to investigate the detrimental effects of 50 mg/L H2O2 exposure (2 h/d) on filefish for 2 d, 4 d, and 6 d. Transcriptome sequencing showed that differentially expressed genes (DEGs) were mainly classified into functions such as signal transduction, nervous system, liver and bile acid metabolism, energy metabolism, cell adhesion and communication, inflammation and immune response. Metabolomic analysis found that the significantly changed metabolites (SCMs) were involved in phenylalanine metabolism, inflammatory mediator regulation, linoleic acid metabolism, and necroptosis. The main SCMs were cholic acid, carnitine C12:1, dimethylmalonic acid, glutamic acid, L-lactic acid, shikimic acid, 2-methylsuccinic acid, and others. Moreover, H2O2-induced oxidative stress also disturbs the balance of the gut microbiota, altering the microbial composition and affecting digestive processes.ConclusionsIntegrated multiomics analysis revealed that H2O2-induced detrimental impacts include mucosal damage, inflammatory and immune responses, altered energy metabolism, and gut microbiota disorders. These findings offer novel insights into the harmful effects and signal transduction/metabolic pathways triggered by H2O2 exposure in marine fishes.

Ultra-processed foods and the incidence of pre-diabetes and type 2 diabetes among Iranian adults: the Tehran lipid and glucose study

BackgroundNo study has investigated the association between ultra-processed food (UPF) and pre-diabetes development. Furthermore, prior investigations on the association between UPF and the risk of type 2 diabetes (T2D) were primarily conducted in Europe and America, and studies in other regions are lacking. We investigated the association between ultra-processed foods and the risk of pre-diabetes and T2D in a cohort of Iranians.MethodsThis prospective study, with a sample size of 1954 for pre-diabetes and 2457 for T2D, was conducted among adults’ participants (aged ≥ 18 years) from the Tehran Lipid and Glucose Study (TLGS). We defined UPF intake using NOVA calcification as a proportion of total energy, and calculated its average intake during the follow-ups. The hazard ratios (HR) and 95% confidence intervals (95% CI) for pre-diabetes/T2D across tertiles of total UPF and per 10% of its increment were examined using Cox proportional hazards models. We also investigated the possibility of non-linear association using a restricted cubic spline regression.ResultsWe identified 766 and 256 cases of pre-diabetes and T2D, respectively, during a median follow-up of 7 years for pre-diabetes and 8.6 years for T2D. In the multivariable adjusted model, a 10% increase in total UPF intake was associated with a 12% higher risk of pre-diabetes (HR = 1.12; 95% 1.02, 1.23). The incidence of pre-diabetes was also higher in those in tertile 3 than those in tertile 1 (HR = 1.28; 95% CI = 1.07, 1.52). Following additional adjustment for diet quality, the results remained unchanged. Spline regression demonstrated a J-shaped association between UPF and the risk of pre-diabetes; the risk of pre-diabetes did not increase until UPF consumption exceeded about 24% of total energy intake. Of the individual UPF, hydrogenated fat/mayonnaise/ margarine group was related to an increased risk of pre-diabetes. The total UPF and its individual items were not associated with T2D.ConclusionsThis study found a positive, non-linear relationship between total UPF and the risk of pre-diabetes in Iranian adults. Our data could not show any significant association between UPF and T2D risk.

Maternal diet in pregnancy and the risk of inflammatory bowel disease in the offspring: a prospective cohort study

BackgroundDiet has been hypothesized as a risk factor for development of inflammatory bowel disease (IBD). ObjectiveTo explore associations between maternal diet diversity and quality in pregnancy and the offspring’s risk of IBD. MethodsWe used data from a nationwide cohort study on 85,129 Norwegian children followed from birth (1999–2009) with information on maternal diet in pregnancy from validated food frequency questionnaires. Hazard ratios (aHRs) for IBD, Crohn’s disease (CD), and ulcerative colitis (UC) by maternal diet diversity, quality and intake amounts of individual food groups were adjusted for maternal body mass index, parental IBD, and socio-demographic factors. Sensitivity analyses adjusted for the child's early-life diet quality and antibiotic treatment. Dietary exposures were classified into tertiles, comparing low (reference) to medium, and high levels. ResultsDuring a mean follow-up time of 16.1 years (1,367,837 person-years of follow-up), 268 children developed IBD (CD, n=119; UC, n=76; IBD-unclassified, n=73). High compared with low diet diversity in pregnancy was associated with a lower risk of UC in the offspring (aHR 0.46, 95% confidence interval 0.25-0.87), with consistent findings after further adjustment for the child's early-life diet quality and antibiotic treatment. High compared with low diet diversity in pregnancy yielded aHRs of 0.81 for CD (0.51-1.28) and 0.75 for any IBD (0.55-1.02) in the offspring. A high compared with low diet quality in pregnancy or intakes of specific food groups were not associated with the offspring’s risk of IBD or its subtypes. ConclusionsOur findings suggest that a higher maternal diet diversity in pregnancy may be associated with a lower risk of UC in the offspring.

Quality of life in patients with myelin oligodendrocyte glycoprotein antibody associated disease compared to patients with AQP4-IgG positive neuromyelitis optica spectrum disorders: A Korean multicenter study

BackgroundLittle is known about the quality of life (QOL) of patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). We compared QOL and associated factors in patients with MOGAD and aquaporin4 IgG (AQP4-IgG) positive neuromyelitis optica spectrum disorder (NMOSD). MethodsThis multicenter questionnaire study compared the QOL of 41 patients with MOGAD and 78 with AQP4-IgG positive NMOSD. Patients who were positive for AQP4-IgG or MOG antibodies were included. WHO Quality of Life Scale Brief Version was used to assess QOL in physical, psychological, social, and environmental domains. QOL, sleep quality, pain, fatigue, and depression were compared between the two groups. The factors associated with QOL in each group and the entire cohort were analyzed. ResultsThe proportion of patients with poor QOL was not significantly different between MOGAD (51.22 %) and AQP4-IgG positive NMOSD (58.97 %, p = 0.054). In the MOGAD group, the pain score (β=-1.032, p = 0.001) and depression score (β=-0.694, p = 0.007) were negatively associated with physical and psychological QOL, respectively. Sleep quality was negatively associated with physical (β=-1.506, p = 0.034) and psychological (β =-2.064, p = 0.033) QOL. When the entire cohort was analyzed, a positive MOG antibody was independently associated with worse psychological QOL (β=-8.998, p = 0.013) compared to positive AQP4-Ab after adjustment for sleep quality, depression, fatigue, and pain. ConclusionsThe overall QOL of the patients of MOGAD was comparable to that of AQP4-IgG positive NMOSD. Patients with MOGAD were experiencing sleep disorder, fatigue, and depression at similar degrees to those of patients with AQP4-IgG positive NMOSD. Further consideration of sleep quality and psychological QOL is required to improve QOL in patients with MOGAD.

Dynamic Progression of Hypertension and Diabetes in the Democratic Republic of Congo from 2019 to 2023.

Introduction: The Democratic Republic of Congo (DRC) does not have national prevalence data for arterial hypertension (HTN) or diabetes (type I and II combined) to aid evidence-based decision-making, despite the assumption of epidemiological transition in low- and middle-income countries. The aim of this study was to estimate a proxy of prevalence for HTN and diabetes. Methodology: This study used routine monthly reported data pertaining to HTN and diabetes from the District Health Information Software 2 (DHIS2), spanning 2019-2023. Data underwent quality assessment and adjustments using standardization before analysis. Equity analyses were carried out at the national and sub-national levels. Epidemiological curves and maps were produced to analyze trends in the prevalence of HTN and diabetes among adults aged 18 and over. Permission to use the data was obtained from the regulatory authority. Results: Over five years, incidence of HTN increased from 13.23% (CI 95%: 13.22-13.24) to 15.23% (CI 95%: 15.22-15.24) (+15.1% relative increase), and diabetes rose from 2.73% (CI 95%: 2.72-2.74) to 3.345% (CI 95%: 3.34-3.35) (+16.3% relative increase), with provincial variations observed. Conclusions: In the DRC, hypertension and diabetes are advancing rapidly. Primary and preventative healthcare services and public health interventions must prioritize these diseases.

Influence of carrier gas flow rate and particle size of AISI M2 in the laser-directed energy deposition process

ABSTRACT Additive manufacturing (AM) is a rapid prototyping technology that offers many advantages over conventional manufacturing processes. However, to make the most of the AM advantages, some requirements need to be met, such as the adjustment of process parameters and quality of the feedstock. This work assessed the influence of carrier gas flow rate and particle size of AISI M2 in the laser-directed energy deposition process (L-DED). Different carrier gas flow rates were tested for two powders with particle size of 53–150 µm (larger range) and 20–53 µm (lower range). The variation of carrier gas flow rate and particle size was assessed in single lines and layers. The results show that increasing the carrier gas flow rate provides better powder convergence in the region where there is interaction with the laser beam and faster particle velocity. The lower range tends to have greater efficiency in the deposition of single lines and layers. Regarding geometric characteristics, the aspect ratio did not show a well-defined trend as a function of the carrier gas flow rate and particle size, however, the layer height tends to be greater for the lower range, while the dilution tends to be greater for the larger range.

HPV vaccination strategy for 14-year-old females and economic returns for cervical cancer prevention in Wuxi City, China: a cost effectiveness analysis

BackgroundSince December 2021, Wuxi, China has offered a two-dose human papillomavirus (HPV) vaccination to 14-year-old females for free. This study evaluated the costs and benefits of this vaccination scheduled in the Expanded Program on Immunization in Wuxi from the perspective of the cities’ demographic characteristics, economic development, and policy support.MethodsThe model-based economic evaluation used TreeAge Pro software to construct a decision tree-Markov model for the vaccination strategy in which 100,000 14-year-old females received two doses of bivalent HPV vaccine or no vaccination. Costs and effects of the strategy were assessed from a societal perspective through literature research and data obtained from the Wuxi Centre for Disease Control and Prevention. Univariate, multivariate, and probabilistic sensitivity analyses assessed the stability of the findings.ResultsThe cost of the bivalent HPV vaccine in Wuxi is 711.3 CNY. The two-dose of bivalent HPV vaccine for 100,000 14-year-old females would cost an additional 658,016 CNY compared to no vaccination, but would result in 1,960 Quality Adjustment Years of Life (QALYs). Using the per capita gross domestic product of 187,415 CNY in 2021 in Wuxi as the willingness-to-pay threshold, the vaccination strategy costs 3,357.37 CNY per QALY gained, which is much lower than the threshold, suggesting that it is a very cost-effective strategy. In addition, the vaccine strategy reduced the incidence of cervical cancer by 300 cases and cervical cancer deaths by 181 cases, representing a benefit-cost ratio of 2.86 (> 1) when health output outcomes were measured in monetary terms. These results suggested that the vaccination strategy was advantageous. Sensitivity analyses showed that changes in the parameters did not affect the conclusions and that the findings were robust.ConclusionsCompared to no vaccination, the delivery of two doses of bivalent HPV vaccine for 14-year-old females was a more highly cost-effective and optimal strategy.

An Efficient Progressive Grid Generation Method Considering Internal Quality and Boundary Grid Adjustment

Due to its elegant appearance and high structural efficiency, free-form grid structures are increasingly adopted in architectural design. However, it is a challenging task for engineers to generate a uniform and well-shaped grid on a free-form surface while considering the processing of both interior and boundary of grid, especially for composite surfaces. To generate well-shaped grids with uniform rods, regular cells and smooth visual effects over free-form surfaces, this paper develops an innovative triangular grid generation method capable of automatically managing grid boundary with extending initial surface. In the method, nodes of grid structure are considered to be zero mass particles and are progressively added to the extended surface from geometric center to the boundary of surface. A boundary-processing algorithm is then established to evenly distribute nodes on initial boundary curve, while ensuring that grid cells at the boundary do not exhibit elongation. A mechanical simulation system based on spring-mass model is improved to optimize spatial grid structure, rods of grid are regarded as linear springs, a surface attraction force and an anchoring force are performed on grid nodes. Moreover, the proposed method allows architects change grid direction and rods length easily, which can greatly improve the efficiency of design. Several case studies show that the method can effectively avoid distortion of grids and generate well-shaped grids that can meet aesthetic requirements.

Citrus limon peel-based biosynthesis: Lead oxide, zinc oxide, cadmium oxide, and copper oxide nano quantum dots for subtraction of anionic Actas Pink dye (AAPD)

ABSTRACT Adsorption is a highly effective method for wastewater quality adjustment, offering advantages such as low cost and availability of adsorbents. This study investigates the efficient removal of Anionic Actas Pink dye (AAPD), a major contributor to environmental pollution. Green adsorbents including lead oxide (PbO), zinc oxide (ZnO), cadmium oxide (CdO), and copper oxide (CuO) were synthesized via eco-friendly routes for AAPD removal. Maximum adsorption capacities (qe) were observed at pH 7 (PbO, ZnO, CdO) and pH 2 (CuO and native) with values of 83.83 mg/g at 100 ppm, 75.65 mg/g at 100 ppm, 70.50 mg/g 75 ppm, 61.21 mg/g at 150 ppm, and 52.69 mg/g at 150 ppm, respectively, using an adsorbent dose of 0.05 g/50 mL at temperature of 37°C, and 90 min contact time. Adsorption followed Langmuir isotherm for all adsorbents except native, with PbO also fitting Freundlich and Dubinin–Radushkevich isotherms. Kinetics adsorption data supported pseudo-second-order, while thermodynamic analysis indicated spontaneous and exothermic nature. Effects of electrolytes, surfactants, and desorption were also evaluated. Characterization through FTIR, SEM, and XRD confirmed the morphology and functional groups of these nano-quantum dots. Citrus limon peel-based biosynthesis offers sustainable, eco-friendly, and cost-effective alternatives, highlighting their potential for dye adsorption.

The effect of back massage applied by spouses on sleep quality, menopausal complaints and marital adjustment in climacteric women

IntroductionMenopause brings many physical and psychosocial problems. These problems negatively affect women, their spouses, and marital relations. Therefore, complementary and integrative methods could be an alternative approach to manage menopause-related problems. ObjectiveThis study aimed to examine the effect of back massages applied by spouses on sleep quality, menopausal complaints and the marital adjustment of women in the climacteric period. MethodsThe study was designed as a randomized controlled trial with a pretest and a posttest. A total of 63 couples was randomized to the intervention group (n= 33) or control group (n= 30). Back massages were taught to the spouses of the women in the intervention group. The massage was applied 15 minutes before bedtime, twice a week for four weeks. Data were collected by using the Pittsburgh Sleep Quality Index (PSQI), the Menopause Symptoms Rating Scale (MSRS) and the Marital Adjustment Scale (MAS). Data were analyzed before (the first follow-up) and after the intervention (the final follow-up). ResultsThis study revealed that menopausal complaints were significantly reduced in women and sleep quality was improved in the intervention group (p<0.001). In addition, the marital adjustment of the couples significantly increased in the intervention group (p<0.001). ConclusionsThe findings showed that back massages applied by the spouse helped to reduce menopausal complaints in women, and improved sleep quality and increased the marital adjustment of the couples. These results are promising for using back massage as an easy, safe and cost-effective method to manage menopause-related problems.

Smart grid power quality monitoring and regulation based on photoelectric sensors and optical system signal processing

With the rapid development of smart grids, power quality monitoring and regulation have become an important task to ensure the stable operation of the power grid. Traditional power quality monitoring methods have problems such as low monitoring accuracy and poor real-time performance. Therefore, this article proposes a smart grid power quality monitoring and adjustment method based on photoelectric sensors and optical system signal processing to improve monitoring accuracy and real-time performance. This article uses photoelectric sensors to monitor the power quality in the power grid in real-time, and transmits the monitoring data to the optical system. Signal processing of monitoring data through optical systems to extract key parameters related to power quality. Finally, by adjusting the relevant equipment of the smart grid, the regulation and optimization of power quality can be achieved. The experimental results show that the smart grid power quality monitoring and adjustment method based on photoelectric sensors and optical system signal processing can effectively improve monitoring accuracy and real-time performance. Through real-time monitoring and regulation of power quality, the stability and reliability of the power grid have been significantly improved.

Study on Factors of Urban Transportation Service Quality Based on Analytic Hierarchy Process: A Case Study of Gangtok City

Promoting the use of public transportation requires an in - depth knowledge of the variables that affect the choice of public transportation mode, including the process of implementing policy, as it has become a crucial component of government strategies to reduce carbon emissions from the transportation sector globally. A variety of factors impacting the usage of public transportation have been identified in previous studies, but few have been included in a single study. In order to boost the use of public transportation, it is essential to make it more attractive to travellers by conducting frequent Service Quality (SQ) assessments and adjustments. Understanding the passengers’ expectations towards public transportation are important, and assessing the SQ is an important tool for evaluating the total performance of the Gangtok’s public transportation system. The purpose of the existing study was to study the expectations and perceptions of city’s passengers regarding SQ in public transportation. In order to comprehend how the present commuters’ prefer a particular service quality attribute a series of interviews with passengers were undertaken. MCDM technique was adopted for this. The paper focuses on service quality factors for urban transportation system by adopting AHP technique. In this study perception of passengers using public transport in Gangtok is taken from the field. The case study is taken for Gangtok city in the state of Sikkim. The study involves study of passengers from various bus stop locations of the city. The results of the research showed substantial discrepancies among expectations and perceptions of city’s commuters, along with widespread dissatisfaction with the delivery of public transit services in hilly areas as a whole. The reliability and adaptiveness of these service have been critical in describing the overall quality of transportation services in hilly areas, and best practices were used to develop a set of recommendations for transportation operators and local officials.

A comparative nutritional life cycle assessment of processed and unprocessed soy-based meat and milk alternatives including protein quality adjustment

Efforts towards sustainable food systems have stimulated the development of plant-based alternatives to meat and milk. However, the debate on the nutritional quality of (processed) plant products compared to animal products remains unresolved, and combined assessments are needed to assess the benefits and trade-offs of these products in future diets. Using life cycle assessment (LCA) combined with nutrient density measurements and the Digestible Indispensable Amino Acid Score (DIAAS), this case study evaluates different processing stages of soy-based products, including cooked soybeans, tofu, soy drink, and a processed soy-based meat analogue (SBMA) produced in Switzerland. The nutritional LCA (n-LCA) showed that the environmental impact of all soy-based meat alternatives was 4–20 times lower than that of beef, especially when locally sourced soy was used. The differences were smaller when compared to chicken meat. All soy-based products showed lower DIAAS compared to animal products, but the results from the combined n-LCA were always less favourable for animal products in this case study. Contribution analyses showed that despite the high level of processing, the raw materials contributed significantly to the environmental footprint of SBMA, exceeding 50% in some environmental impact categories. Moreover, comparisons within the soy-based alternatives revealed a lower environmental impact of the minimally processed products. The higher protein quality and quantity of the processed SBMA were not sufficient to offset its higher environmental impact in this case study. SBMA also contained highest level of sodium and saturated fatty acids, highlighting the need for careful food formulation. Overall, this study showed the potential of soy-based alternatives to meat and milk to reduce the environmental impact of food production whilst highlighting the importance of considering their nutritional quality and the role of processing. Overall, this research provides insight into the potential of plant-based alternatives to meat and milk for sustainable diets amid the global challenge of climate change and changing dietary patterns.

Variability of scan quality and perfusion density in longitudinal optical coherence tomography angiography imaging

Background/aimsOptical coherence tomography angiography (OCT-A) images are subject to variability, but the extent to which learning impacts OCT-A measurements is unknown. We determined whether there is a learning effect in...

Recycling of iron and steel slag for carbon reduction and low‐environment load application

AbstractThe high‐value utilization of blast furnace slag (BFS) and steel slag (SS) as a valuable resource in the field of carbon reduction represents a green revolution, and also is an indispensable path toward breaking through resource and environmental constraints and achieving high‐quality, sustainable development through solid waste utilization in the steel industry. Achieving resource recycling while harnessing the untapped latent energy of resources and exploring their carbon sequestration capabilities has become a crucial avenue for further valorization through waste utilization. BFS and SS discharged from iron‐making or steel‐making furnaces carry a significant amount of latent heat, especially the calcium oxide component in SS, which gives it a unique advantage in the field of comprehensive BFS and SS utilization and carbonation‐based SS utilization. This article discusses the current research status of low‐carbon‐waste‐heat utilization in the production of microcrystalline glass, cementitious materials, functional adsorbents, and other products through front‐end modification of molten BFS and SS. This report also provides an overview of carbon capture by utilizing BFS and SS, offering insights into the research directions for subsequent heat recovery, online quality adjustment, high‐value utilization, and carbon sequestration using BFS and SS in the steel industry.

Lower intake of plant-derived nitrate is associated with higher odds of frailty: a cross- sectional study in community-dwelling older women

Frailty is a distinctive health state related to the ageing process in which multiple body systems gradually lose their in-built reserves, and is associated with declines across sensory, neurological, cardiovascular, and musculoskeletal systems(1). Previously, relationships have been identified between high dietary nitrate intake and several components of frailty including muscle strength and cognitive function, as well as vascular disease(2). However, little is known about the relationship between dietary nitrate intake and frailty in older adults. We investigated if higher habitual nitrate intake, derived from plant (e.g., vegetables, grains, beans, and fruits) and animal foods (e.g., meats, cheese, yoghurt) was associated with frailty in older women.1390 community-dwelling older women (mean age 75.1 ± 2.7 years) from the Perth Longitudinal Study of Ageing Women completed a validated semi-quantitative food frequency questionnaire (FFQ) at baseline (1998). Nitrate concentrations in food were obtained from our recently published international plant and animal nitrate databases and applied to each of the plant and animal foods within the FFQ (described in3). Frailty was operationalised using a standardised frailty index (FI) of cumulative deficits from 33 variables across multiple health domains (physical, mental, comorbidities), with a score ≥0.25 indicating frailty. Cross-sectional associations between dietary nitrate derived from plant and animal foods (separately) with frailty were analysed using multivariable-adjusted logistic regression models as part of restricted cubic splines. Models were adjusted for lifestyle and dietary factors (not used in the FI) that included age, smoking history, protein, alcohol, and energy intake.Frailty was observed in 276 (19.9 %) women. Median (IQR) daily plant and animal nitrate were 72.1 (55.6-90.0) mg/day and 3.5 (2.2-5.1) mg/day, respectively. A significant non-linear relationship was observed between higher plant nitrate intake and frailty, with a nadir recorded once intakes of ~64 mg/day were achieved (median of quartile [Q]2). Specifically, compared to women with the lowest intake of plant-derived nitrate (Q1, median 45 mg/day), women in Q2 (OR 0.69 95%CI 0.56-0.84), Q3 (OR 0.67 95%CI 0.50-0.90) and Q4 (OR 0.66 95%CI 0.45-0.98) had lower odds for frailty (all p&lt;0.05). Additional adjustment for diet quality (Nutrient Rich Food Index per 1000 kJ) or total plasma 25-hydroxyvitamin D did not alter the findings. Nitrate derived specifically from vegetables and grains were found to drive these results. No relationship was observed between animal-derived nitrate and frailty.Community-dwelling older women consuming higher amounts of nitrate derived primarily from plants were less likely to present with frailty. Consuming 1-2 servings (75-150 g) per day of nitrate- rich green leafy vegetables, as part of total vegetable intake, will provide adequate nitrate levels (&gt;70 mg/day) that could serve as a novel intervention to limit frailty.

Eating Patterns, Chronotypes, and Their Relationship with Metabolic Health in the Early Postpartum Period in Women after Gestational Diabetes Mellitus.

Observational studies have shown a relationship between eating patterns and chronotypes with metabolic health in the general population and in healthy pregnancies. Data are lacking in the postpartum period, which is characterized by an externally driven misalignment of sleep and food intake. We investigated the associations between eating patterns, chronotypes, and metabolic health in the early postpartum period in women who had gestational diabetes mellitus (GDM). We prospectively included 313 women who completed their 6-8 weeks postpartum visit between January 2021 and March 2023 at the Lausanne University Hospital. Women filled questionnaires on the timing of food intake, sleep (a shortened Pittsburgh Sleep Quality Questionnaire), and the chronotype (the Morningness-Eveningness Questionnaire) and underwent HbA1c and fasting plasma glucose measurements. After adjustments for weight, sleep quality, or breastfeeding, the later timing of the first and last food intake were associated with higher fasting plasma glucose and HbA1c levels 6-8 weeks postpartum (all p ≤ 0.046). A higher number of breakfasts per week and longer eating durations were associated with lower fasting plasma glucose levels (all p ≤ 0.028). The chronotype was not associated with metabolic health outcomes. Eating patterns, but not the chronotype, were associated with worsened metabolic health in the early postpartum period in women with previous GDM.

Pengaruh Teamwork Terhadap Kinerja Karyawan Pada Perusahaan

This research discusses the importance of teamwork in improving employee performance in a company. Teamwork is an effective way to unite all employees in achieving company goals with better results. Several important aspects of teamwork include clear goals, open and honest communication, cooperative decision making, and an atmosphere of trust. Research shows that teamwork has a positive influence on employee performance, especially in teams involved in complex knowledge work. Other factors that influence employee performance include competence, work motivation, leadership, and work environment. Employee performance assessments are carried out to improve work quality, career development and compensation adjustments. This research uses qualitative methods with literature studies to explore information from various relevant sources.

The efficiency of public expenditures on basic services: The case of South African municipalities

AbstractThis paper examines the efficiency of service delivery across 213 local and metropolitan municipalities in South Africa, focusing on four critical areas: electricity, water, sewerage and waste removal. Utilising a order‐ partial frontier efficiency analysis (PFEA), the study calculates output‐oriented efficiency scores for each municipality, incorporating adjustments for service quality based on an ‘infrastructure quality‐index’. Our empirical findings indicate marked variations in efficiency, with electricity services exhibiting the highest efficiency rate at 35%, while waste removal lags behind at 22%. Additionally, municipalities centred around small urban towns are found to be more efficient, challenging the widely held view that larger municipalities are better equipped for efficient service delivery. The analysis offers empirical insights into local government performance in South Africa, underscoring the need for targeted policy interventions to address efficiency gaps. These results not only inform fiscal and administrative decentralisation strategies but also set the groundwork for future research exploring the underlying factors affecting municipal efficiency.