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Postprandial glycaemic response to white and wholemeal bread consumption between normal weight and overweight/obese healthy adults
Get PDFObesity and the increased postprandial glycaemic response (PPGR) are risk factors for type 2 diabetes. Few studies have explored the association of body weight with PPGRs. The study aimed to investigate the PPGR between healthy adults with normal weight and overweight/obesity to two commercially available breads (white and wholemeal) with different dietary fibre contents. In this acute randomised crossover trial, 20 healthy adults (10 normal weight, 10 overweight/obese) consumed two slices of white (100 g, fibre 3.6 g) or wholemeal bread (88 g, fibre 5.6 g) alongside 150 ml of orange juice and 10 g butter on separate visits in random order after fasting for 8-12 hours. The blood glucose concentration was measured fasted, 30 min, 60 min, 90 min and 120 min postprandially by finger pricks. Information on age, gender, ethnicity, body mass index (BMI), and body fat percentage were collected. Two-way repeated measures ANCOVA was used for controlling for age, gender, ethnicity and body fat percentage, and results showed no significant difference was observed in fasting blood glucose concentrations (F(1, 14)=2.968, P=0.107), incremental areas under the curve (iAUCs) (F (1, 14) = 0.702, P=0.416) and peak values (PVs) (F (1, 14) = 0.507, P=0.488) between participants with normal weight and overweight/obesity, or in fasting blood glucose concentrations (F(1, 14)=0.007, P=0.964), iAUCs (F (1, 14) = 0.008, P=0.929) and PVs (F (1, 14) = 0.036, P=0.851) between white and wholemeal bread consumption. The BMI or body fat percentage was not associated with iAUCs or PVs regardless of bread type adjusted by age, gender and ethnicity. Our results did not find that body weight is associated with PPGR in healthy adults, and the wholemeal bread used in the current study did not deliver the health benefit of attenuating PPGR compared with white bread consumption despite the higher dietary fibre content
Smooth Backfitting for Additive Hazard Rates
Get PDFSmooth backfitting was first introduced in an additive regression setting via a direct projection alternative to the classic backfitting method by Buja, Hastie and Tibshirani. This paper translates the original smooth backfitting concept to a survival model considering an additively structured hazard. The model allows for censoring and truncation patterns occurring in many applications such as medical studies or actuarial reserving. Our estimators are shown to be a projection of the data into the space of multivariate hazard functions with smooth additive components. Hence, our hazard estimator is the closest nonparametric additive fit even if the actual hazard rate is not additive. This is different to other additive structure estimators where it is not clear what is being estimated if the model is not true. We provide full asymptotic theory for our estimators. We propose an implementation of estimators that show good performance in practice
Healthcare responding to violence and abuse in Brazil: a quasi-experimental difference-in-differences analysis
Get PDFBackground: Domestic violence against women (DVAW) is a public health issue and a breach of human rights, yet evidence on effective interventions remains limited, particularly in low-income and middle-income countries. This study aimed to evaluate changes in identification and referral to specialist support associated with system-level strategies implemented within Brazilian primary healthcare (PHC) to strengthen the response to DVAW. The strategies comprised an intervention called Healthcare Responding to Violence and Abuse (HERA).
Methods: Using a quasi-experimental design, HERA was implemented in eight PHC clinics, while 33 served as controls. Data on DVAW identification and referral were obtained from the national Epidemiological Surveillance System. Difference-in-differences analysis, using negative binomial regression, assessed HERA's impact, controlling for patient inflow, clinical supervision, COVID-19 lockdown, region, and clinic. Results are reported as marginal effects with 95% confidence intervals (CI).
Findings: There was an increase in the probability of DVAW identification (0.47; 95% CI 0.18–0.77) and referral to support services (0.38; 95% CI 0.03–0.73), when adjusting for panel effects and time. The results were even larger when further controlling for additional variables (0.82 for identification [95% CI 0.44–1.21] and 0.87 for referrals [95% CI 0.47–1.29]).
Interpretation: HERA strategies increased DVAW identification and referral in PHC settings. Clinics implementing HERA were already more likely to identify and refer cases before the implementation, suggesting that HERA's strategies may be more effective in clinics that find DVAW interventions more acceptable, at least in Brazil. Funding: NIHR Global Health Research Group Award
Quantitative analysis of idiopathic epiretinal membrane traction: an updated version of the relaxation index
Get PDFPurpose
The aim of this work was to track tangential traction of idiopathic epiretinal membrane from an initial assessment to the immediate post-operative phase using an enhanced version of the relaxation index (RI).
Methods
A retrospective analysis was conducted on 9 patients who underwent peeling surgery for idiopathic, symptomatic, and progressive epiretinal membrane. The RI assesses the displacement of vascular crossings in time from a fixed point, which is the retinal pigmented epithelium. This updated iteration integrates infrared images paired with OCT scans instead of OCTA.
Results
The study encompassed three timepoints: T1 (initial appointment), T2 (1 week pre-surgery), and Post (1 month post-surgery). T1 was 12± 9 months prior to surgery. A statistically significant difference (p<0.001) in RI was observed across all three timepoints; however, there was no significant correlation between RI and visual acuity (p>0.05).
Conclusion
The RI emerges as a comprehensive and direct parameter for objectively assessing and monitoring tangential traction in three dimensions across an extensive area of the posterior pole. Further streamlining of the process is necessary to integrate this feature into clinical practice effectively
Mismatches between UK food supply and dietary guidelines: A dietary gap assessment
Get PDFObjective:
To examine how aligned the UK food supply is with the Eatwell Guide and identify discrepancies which should be addressed to support the availability of healthy diets for the population.
Design:
A dietary gap assessment was carried out on the 2022 UK food supply with FAOSTAT Food Balance Sheets (FAO-FBS) data, including domestic production, imports and exports, and excluding animal feed, seeds and non-food uses. Foods were grouped into potatoes and cereals, oils and spreads, dairy, protein, fruit and vegetables, and sugar. The percentage contribution of each food group to the food supply was compared to the Eatwell Guide. An overview of the food supply from 2010-2022 was also created. To triangulate the data, FAO-FBS data were compared with the 2022 data from the Department for Environment, Food and Rural Affairs (DEFRA).
Setting:
UK, 2010-2022
Participants:
N/A
Results:
The proportion of fruit and vegetables, potatoes and cereals in the UK food supply were lower than the Eatwell Guide, while dairy and oil were higher. Only 7% of the food produced in the UK in 2022 was fruit and vegetables. This was the second smallest proportion, after oils and spreads (6%), and about half the amount of sugar beet produced (13%).
Conclusion:
Although the relationship between food supply and consumption is complex, taking a more coherent approach by integrating dietary recommendations with the food supply could help increase the availability of the recommended healthy diet. Going forwards, DEFRA should include dietary gap assessments in future Food Security Reports
A debate: does Lean Startup represent a giant leap?
No full textThe Lean Startup approach, introduced by Eric Ries in 2011, has become a widely recognised method in entrepreneurship, emphasising rapid experimentation, customer feedback, and iterative development over traditional business planning. Building on a debate from the DRUID 2023 conference, this article presents scholarly reflections on whether the Lean Startup represents a ‘giant leap’ in our understanding of entrepreneurship, offering arguments both for and against this claim. The discussion highlights both the strengths and limitations of the Lean Startup approach, ultimately emphasising the need for a nuanced perspective on the conditions under which tools such as the Lean Startup are most effective to foster entrepreneurship and business model innovation
Dynamic stiffness method for free vibration of beams and frameworks using higher order shear deformation theory
Get PDFThe dynamic stiffness method for free vibration of beams and frameworks is developed using a higher order shear deformation theory. Starting with the displacement field, the potential and kinetic energies of the beam in flexural vibration, are first formulated. Then, Hamilton’s principle is applied to derive the governing differential equations and associated natural boundary conditions. Next, the differential equations are solved to obtain the expressions for flexural displacement, bending rotation and the first derivative of the flexural displacement. The expressions for the shear force, bending moment and the higher-order moment are obtained from the natural boundary conditions resulting from the Hamiltonian formulation. Finally, the force vector comprising the amplitudes of the shear force, bending moment and the higher-order moment is related to the amplitudes of the displacement vector comprising the flexural displacement, bending rotation and the first derivative of the flexural displacement through the frequency-dependent dynamic stiffness matrix. The dynamic stiffness matrix for axial motion which is uncoupled from the flexural motion is now implemented to the dynamic stiffness matrix in flexural motion to analyse individual beams and frameworks for their free vibration characteristics by applying the Wittrick-Willaims algorithm. Illustrative examples are given, and significant conclusions are drawn
The anti-spherical Hecke categories for Hermitian symmetric pairs
No full textWe calculate the p-Kazhdan–Lusztig polynomials for Hermitian symmetric pairs and prove that the corresponding anti-spherical Hecke categories categories are standard Koszul. We prove that the combinatorial invariance conjecture can be lifted to the level of graded Morita equivalences between subquotients of these Hecke categories
Co-Planar Sensor for Impedimetric Characterization of Aqueous Solutions
Get PDFA minimal complexity co-planar screen-printed sensor has been developed to streamline impedimetric analysis and characterization of aqueous solutions, offering a less complex alternative to conventional liquid sample handling methods. The sensor design allows for repeatable measurement sensitivity and accuracy independent of analyte volume variations, within a range of 10μ L to 18μ L. Comprehensive mathematical modeling, experimental evaluation, and statistical analysis were conducted to assess the sensor's performance. The results indicate significant potential for the sensor in practical applications, highlighting its efficacy and reliability ina queous solution characterization
Pleasure and the Pain Cave: Sport, Kink, and Jouissance
No full textThis paper explores the complex relationship between pleasure and pain in both sport and BDSM, challenging the common perception that seeking pain is irrational or pathological. Drawing on psychoanalytic theories, the authors argue that the pursuit of ‘pleasurable pain’ in these contexts reflects a deeper psychic drive, specifically Lacan's concept of the ‘death drive’. The paper critiques dominant narratives that rationalize pain in sports as a means to an end while stigmatizing the desire for pain in BDSM as deviant. By analyzing athletes' and BDSM practitioners' experiences, the authors suggest that both groups engage with pain as a form of jouissance- the pursuit of an intense, potentially overwhelming experience that goes beyond what is pleasurable. This interdisciplinary discussion aims to demystify the enjoyment of pain, proposing that the pain experienced in sport can be understood through the same lens as the pain in BDSM, thus revealing potential for mutual understanding
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