Search Results (259)

Background/Objectives: Consumption of ultra-processed foods (UPF) has been linked to poorer diet quality and adverse health outcomes. Although Chile ranks among the highest consumers of UPFs in Latin America, studies using primary dietary data, especially among older adults, are scarce. This study aimed to describe the food intake of Chilean older adults according to the degree of food processing, and to explore the association between UPF intake and sociodemographic, economic and health factors. Methods: A cross-sectional study of 434 non-institutionalized older adults (≥60 years) living in the Metropolitan Region of Chile was conducted. Dietary intake was assessed using interviewer-administered 24h recall, with a second assessment 8–15 days later in a random subsample (n = 60). Foods were classified according to the NOVA system into minimally processed foods (MPFs), culinary ingredients, processed foods (PF), or UPF. Usual energy intake was estimated using the MSM. Sociodemographic (sex, age, area), economic (income, education, health system), and health-related variables (chronic conditions, sedentary lifestyle, tobacco use) were collected through home-visit questionnaires. Anthropometric and functional measurements were taken by trained nutritionists. The association between UPF intake and studied variables was evaluated using multivariate fractional probit regression, with mean marginal effects presented. Results: Most of the participants were women (86.2%), aged 70–79 years (47.9%), and residents of urban areas (76.3%). Most of their calories came from MPF (45.7%), followed by PF (25.5%) and UPF (16.6%). Higher UPF intake was associated with living in an urban area (+3.8%; 95% CI 1.2–6.3%), higher education (+3.5%; 95% CI 1.1–6.0%), and being affiliated with the private health system (+9.1%; 95% CI 4.1–14.0%). Conclusions: In this community-based sample of Chilean older adults, UPF intake was associated with socioeconomic factors but not health status. Full article

Background: Systematic neoadjuvant therapy (NAT) is recommended for triple-negative (TNBC) and HER2+ breast cancers when tumor size at diagnosis is ≥2 cm. This study aimed to determine the proportion of patients in Nova Scotia with non-metastatic, incident, ≥2 cm TNBC and HER2+ breast cancer who received guideline-concordant NAT, stratified by administrative zone. Methods: This retrospective analysis utilized data from the Nova Scotia Breast Screening Program. Adult patients (18–80 years) with an incident, non-metastatic, ≥T2 breast cancer diagnosis between 2021 and 2023 were considered theoretically eligible for NAT, defined by a wait time of ≥4 months between core biopsy and surgery. Guideline-concordant care was confirmed through chart review and compared across health system administrative zones and over time. Results: Of the 291 women theoretically eligible for NAT, 67.0% received it. Significant differences in NAT receipt were observed across administrative zones (Central 73.1%, Eastern 72.9%, Northern 57.4%, Western 54.2%, p = 0.030). Conclusions: This study identifies meaningful regional disparities in NAT receipt for TNBC and HER2+ breast cancer in Nova Scotia. Targeted strategies to improve guideline concordance are warranted and may lead to better patient outcomes. Full article

Background: Prenatal diagnosis of life-limiting fetal conditions often leads to counseling focused primarily on therapeutic abortion. Perinatal hospice has emerged as an alternative model of care for families who choose to continue the pregnancy. This paper has two primary aims. First, it discusses structured perinatal hospice programs and their role in supporting parental decision-making after such diagnoses, with attention to ethical and emotional complexities. Second, the paper introduces NOVA-L (Navigating Options & Vital Assistance for Life-limiting conditions), a conceptual Decision Support System (DSS) designed to complement perinatal hospice care. Methods: The paper provides a conceptual and descriptive analysis of the Comfort Care clinical model. It also outlines the proposed architecture of NOVA-L. DSSs combine clinical guidelines, research data, and outcome registries on digital platforms, providing evidence-based information and AI-supported analytical tools. Their potential adaptation to perinatal hospice care is explored. Results: The Comfort Care model involves interdisciplinary counseling, structured communication, and psychosocial support to facilitate clarification of parental values and care pathways. NOVA-L is presented as a complementary tool that may enhance transparency in risk evaluation and option comparison through accessible interfaces under professional supervision. Conclusions: Structured perinatal hospice programs may enhance clarity and compassion in decision-making. The conceptual integration of AI-supported DSS tools, such as NOVA-L, could strengthen ethically grounded, emotionally sensitive parental support. Full article

Background/Objectives: Soil microbiomes in agroecosystems are natural reservoirs of antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs), creating conditions for horizontal gene transfer (HGT) to clinically relevant bacteria. Southern West Siberia—a globally significant grain-producing region—lacks metagenomic characterization of its soil resistome. This study aimed to establish the first baseline profile of resistome and mobilome composition for West Siberian agricultural soils. Methods: Twelve composite soil samples were collected from agroecosystems under seven crop types across diverse soil types in southern West Siberia (September 2022). Shotgun metagenomics was performed on an Illumina NovaSeq 6000 platform. Taxonomic profiling used Kraken2/Bracken; ARG annotation used Prokka/DeepARG (identity ≥ 70%, probability score ≥ 0.8); while MGE characterization used Platon, HMMER v3.3.2, and Prokka-based integrase annotation. Resistome load was normalized to the single-copy housekeeping gene rpoB; ARG–MGE associations were defined as co-localization within 10 kb on the same contig. Results: Microbial communities were dominated by Pseudomonadota and Bacillota, with a stable core of Streptomycetaceae, Nitrobacteraceae, and Sphingomonadaceae. Normalized resistome load (N/rpoB 2.30–5.37) indicated moderate anthropogenic pressure. Dominant ARGs included efflux pumps (emrA, drrA, tetA, bcr, fsr), target modification (lnrL), and lipid A modification (arnA) genes. Class 1 integron integrase (intI1/rpoB 0.64–1.59) was detected in all 12 samples, exceeding unity in 9 of 12. ARG–MGE co-localizations were found in 11 of 12 samples. In sample Mg_155, genes emrA–emrB and bcr (NODE_16) and arnA and lnrL (NODE_6) were each independently associated with distinct prophage IntA integrase copies within Pseudomonas contigs, documenting multiple parallel horizontal transfer events encompassing resistance to five antibiotic classes. Conclusions: This work establishes the first metagenomic baseline of resistome and mobilome for West Siberian agroecosystems. The obtained data indicate moderate anthropogenic pressure on soil microbiomes, consistent with temperate agricultural systems with limited organic fertilizer input. The detected ARG–MGE co-localizations and evidence of prophage-mediated transfer of resistance determinants beyond their natural hosts suggest that mobilization potential in the region warrants consideration in future AMR monitoring programs. Full article

Background/Objective: Ultra-processed foods (UPFs) have become deeply embedded in global dietary patterns. However, their widespread consumption conceals the dual hidden risks of delayed physiological health effects and long-overlooked environmental externalities. Prior research has largely centered on health-driven dietary behaviors, with insufficient understanding of how perceptions of the environmental burden shape consumer choices, particularly in highly convenient, eating-out-dominated food environments. To address this gap, this study extends the theory of planned behavior (TPB) to examine how dual-risk perceptions influence intentions to reduce UPF consumption. Methods: Drawing on survey data from 362 Taiwanese consumers, this study analyzed the proposed theoretical model using structural equation modeling. Results: The findings show that (1) both health and environmental risk perceptions significantly and positively shape attitudes toward reducing UPF intake; (2) attitude, subjective norms, and perceived behavioral control (PBC) significantly increase reduction intentions, with subjective norms and attitude emerging as the strongest predictors; and (3) environmental awareness produces a counterintuitive diminishing marginal effect, negatively moderating the relationship between environmental burden perception and behavioral intention. Conclusions: These results extend the empirical foundation of the “green TPB” by demonstrating that the internalization of environmental costs complements traditional health motivations. The findings offer actionable implications for public health policy, including the implementation of front-of-pack warning labels and the use of the NOVA food classification system to advance sustainable diets. Full article

Background/Objectives: Nutritional research emphasizes evaluating food processing levels alongside nutrient content. The Nova system categorizes foods as minimally processed foods (MPFs), processed culinary ingredients (PCIs), processed foods (PFs), and ultra-processed foods (UPFs). High UPF consumption is linked to adverse health outcomes in older adults. Traditional Food Frequency Questionnaires (FFQs) often fail to capture processing differences. This study evaluated the reproducibility and relative validity of a Nova-based FFQ (NFFQ-Elderly) in Italian healthy older adults aged ≥65 years. Methods: A total of 111 older adults (73.7 ± 5.9 years; 56.8% women) completed the NFFQ-Elderly twice (4–6 weeks interval). Relative validity was compared with a three-day weighed food record. Foods were categorized by Nova groups and analyzed for absolute intake, energy and weight percentages. Pearson correlation (r), intraclass correlation coefficients (ICCs), and Bland–Altman plots were used. Results: Reproducibility was satisfactory for MPFs (r = 0.75; ICC = 0.74), UPFs (r = 0.87; ICC = 0.85), and PFs (r ≈ 0.73; ICC ≈ 0.66–0.67). Relative validity was moderate for MPFs (r = 0.57; ICC = 0.53) and UPFs (r = 0.48; ICC ≈ 0.37), but lower for PCIs. Accuracy generally improved when intakes were expressed as percentages of total energy or weight. Bland–Altman analyses showed limited mean bias for MPFs and PFs, but higher variability for PCIs and absolute energy intake. Conclusions: The NFFQ-Elderly appears to be a suitable tool for ranking older adults according to their relative intake of MPFs and UPFs. Estimates for PCIs are less reliable, indicating caution when interpreting absolute intake values. Full article

Background/Objective: Continuous blood pressure (BP) monitoring is essential in clinical settings, where rapid hemodynamic changes influence patient management. While intra-arterial measurement remains the reference standard, non-invasive volume-clamp systems offer a potential alternative. We assessed the accuracy of finger-cuff-based continuous BP monitoring compared to invasive measurement in patients with pulmonary hypertension (PH). Methods: This post hoc analysis from a crossover RCT included PH patients who underwent repetitive hemodynamic assessments at rest and during exercise. The participants had simultaneous invasive BP monitoring via the radial artery and a non-invasive finger-cuff device (Finapres^® NOVA Basic). The mean blood pressure (mBP) was compared at rest, 50% of the maximal workload, and at the end of exercise using Bland–Altman and Taffé analysis. Results: In the study, 24 patients (seven female; 59 ± 14 years) contributed 385 paired mBP measurements. The invasive and non-invasive methods showed similar values at rest (96.1 ± 16.7 vs. 96.4 ± 17.2 mmHg) and during maximal exercise (106.8 ± 18.6 vs. 111.8 ± 21.6 mmHg). The overall Bland–Altman bias was 2.8 mmHg with wide limits of agreement (−39.6 to 45.3 mmHg), which remained broad across all exercise intensities. The Taffé analysis revealed a non-uniform, directionally dependent bias: the non-invasive system overestimated the mBP at low pressures and underestimated it at higher pressures. The measurement variability was substantially greater for the non-invasive method than for the invasive reference. Conclusions: In PH patients, finger-cuff-based continuous BP monitoring demonstrated acceptable group-level agreement but insufficient individual-level accuracy for clinical decision-making. Full article

Background/Objectives: People with HIV (PWH) remain at high risk for cardiovascular and metabolic complications despite effective antiretroviral therapy (ART). Diet quality is an important modifiable factor that may influence these complications. Diets high in ultra-processed foods (UPF) have been linked to adverse metabolic and inflammatory profiles in the general population, but their impact on PWH remains poorly understood. The NOVA 4 classification categorizes foods by degree of processing, from unprocessed/minimally processed (NOVA 1) to UPF (NOVA 4). Methods: We conducted a cross-sectional study of adults with virologically suppressed HIV on stable ART. Assessments included dietary intake consisting of 24 h recalls analyzed with Nutrition Data System for Research software (NDSR) and classified into NOVA categories by a registered dietitian and the following characteristics: body composition (total and regional fat by DEXA and CT scan abdomen), cardiometabolic variables (glucose, HbA1C, HOMA-IR, lipids, blood pressure), and biomarkers of inflammation, immune activation, and gut integrity quantified by ELISA. Patients were stratified into NOVA 4 groups based on the median and quartile proportions of total energy intake from NOVA 4 foods. Associations between dietary NOVA and outcomes were analyzed using generalized additive models (GAMs) adjusted for age, sex, race, and CD4 count. Results: Among 222 PWH (mean age 45.4 ± 14.2 years; 31% female; 66% non-white; BMI 30.61 ± 7.91 kg/m²), median NOVA 4 intake was 45.6% of total energy intake. Participants with higher vs. lower NOVA 4 intake showed differences in diet quality, but in GAMs, higher NOVA 4 intake was not associated with higher levels of inflammatory, cardiometabolic, gut integrity, and body composition variables. Conclusions: In PWH, UPF consumption was high but not associated with markers of cardiometabolic health, systemic inflammation, or gut integrity. This may reflect the multifactorial nature of the heightened inflammation in PWH, potentially obscuring the effect of diet. Full article

We reported the first isolation and characterization of Neopestalotiopsis spp. from symptomatic strawberry plants in Nova Scotia, Canada. Morphological and multilocus sequence analyses confirmed that these isolates were closely related to previously identified aggressive Neopestalotiopsis spp. strains from strawberry and blueberry in the southeastern United States and other countries. Five representative isolates were evaluated for pathogenicity on detached leaves, whole plants, and fruits of multiple strawberry cultivars. The results revealed significant variation in virulence, with isolate NS-1 causing the most severe necrosis across all tissue types. Statistical analysis revealed significant effects of isolate, cultivar, and their interaction on disease severity, indicating differential cultivar responses to the tested isolates. Notably, tissue-specific differences were observed, with some isolates being aggressive on leaves but less virulent on fruit or whole plants, reinforcing the importance of multi-organ phenotyping in resistance screening. Phylogenetic analysis clustered the Nova Scotia isolates within the same clade as Neopestalotiopsis isolate 17–43 L from strawberry and isolates from blueberry, suggesting a potential epidemiological link. The shared nursery propagation system of strawberries and blueberries raises the risk of cross-infection, posing a substantial challenge to disease management strategies in both crops. Collectively, these findings underscore the urgent need for continued surveillance, population-level pathogen analysis, and the development of resistant cultivars to mitigate the spread of this emerging and rapidly evolving pathogen. Full article

Background/Objectives: Emerging evidence suggests that ultra-processed food (UPF) consumption may be associated with depressive symptoms, yet data in the early postpartum period remain limited. This pilot study aimed to examine the association between UPF intake and postpartum depressive symptoms among women in the early postpartum. Methods: In this cross-sectional pilot study, 137 women within 6–8 weeks postpartum were recruited from hospitals, maternity clinics, and online support networks in Greece. Dietary intake was assessed using a validated food frequency questionnaire and classified according to the NOVA system. UPF consumption was categorized into quartiles. Postpartum depressive symptoms were evaluated using the Edinburgh Postnatal Depression Scale (EPDS), with clinically significant symptoms defined as EPDS ≥ 13. Multivariable logistic regression analyses were conducted, adjusting for sociodemographic and lifestyle factors. Results: The prevalence of clinically significant postpartum depressive symptoms was 29.9%. No statistically significant associations were observed in adjusted models. However, a higher prevalence of depressive symptoms was observed among women in the highest UPF intake quartile (40.0%) compared with lower quartiles (25.7–28.1%). Poor sleep quality was independently associated with higher odds of depressive symptoms, whereas breastfeeding was associated with lower odds. Confidence intervals were wide, indicating limited statistical precision due to the small sample size. Conclusions: While no statistically significant association was observed in multivariable analyses, a higher prevalence of depressive symptoms was noted among women in the highest UPF intake quartile. The wide confidence intervals indicate substantial uncertainty, and the findings should be interpreted with caution. Larger, adequately powered studies are required to confirm these findings. Full article

The increasing prevalence of childhood obesity has been accompanied by an increase in consumption of ultra-processed foods (UPF), characterized by high energy density and low nutritional quality. Emerging evidence suggests that dietary patterns rich in UPF may contribute to low-grade systemic inflammation and early metabolic dysfunction in children and adolescents. Objective: This systematic review aimed to evaluate the association between UPF consumption and markers of inflammation and metabolic health in pediatric populations. Methods: A systematic literature search was conducted on PubMed in accordance with PRISMA guidelines. Observational and interventional studies evaluating UPF intake or diet-related inflammatory potential in children and adolescents (≤18 years) were included. Outcomes of interest included inflammatory biomarkers (e.g., C-reactive protein, interleukins, tumor necrosis factor-α) and metabolic parameters (e.g., insulin resistance, lipid profile, glucose metabolism). Results: A limited number of studies have directly assessed UPF consumption using the NOVA classification. Overall, these studies suggest a potential association between increased UPF intake and adverse metabolic outcomes, although findings on inflammatory markers remain inconsistent. A larger body of indirect evidence, including studies assessing dietary inflammatory indices and related dietary patterns, consistently supports a link between pro-inflammatory diets and increased inflammation and metabolic dysregulation in pediatric populations. Conclusions: Although direct evidence on UPF consumption remains limited, the available findings, supported by complementary indirect evidence, suggest a plausible relationship between UPF-rich diets, inflammation, and metabolic health in children and adolescents. Further well-designed studies are needed to clarify causality and improve the standardization of dietary assessment methods. Full article

Background: Given the limited evidence in the field, the present study aimed to explore the association of UPF intake with food literacy levels in an adult Mediterranean-based population. Methods: Self-reported demographic and anthropometric data were collected from 317 apparently healthy adults (52.5% males) Food literacy and dietary intake of this population were also assessed. Foods were classified as ultra-processed according to the NOVA system, and their contribution to total daily energy intake (%) was calculated. Then, participants were grouped into the (1) higher UPF intake (HUPFI), and (2) lower UPF intake (LUPFI) groups, based on the median value of this population as a cut-off. Results: Between-group analysis revealed that LUPFI scored statistically significantly higher than the HUPFI group in total food literacy (93.5 [84.0–104.0] vs. 86.0 [78.0–99.0], p < 0.001) and in three out of five food literacy sub-dimensions. Sub-analysis revealed no differences between LUPFI and HUPFI groups of individuals with normal weight. In participants with overweight or obesity, the LUPFI group scored lower than the HUPFI in the total food literacy score (95.0 [87.0–104.0] vs. 81.0 [70.0–94.0], p < 0.001) and in each sub-dimension. Conclusions: Higher UPF intake was associated, in adults with overweight or obesity, with lower levels of food literacy. Full article

Background: Diet quality and food processing patterns are increasingly recognized as important determinants of Crohn’s disease (CD) risk and disease outcomes; however, direct comparisons with healthy populations using integrated nutrient- and processing-based frameworks remain limited. Therefore, we aim to quantify ultra-processed food (UPF) consumption using the NOVA classification, compare UPF intake between CD patients and healthy controls, and assess its association with diet quality indices. Methods: Baseline dietary intake data were analyzed from two randomized controlled trial cohorts: adults with mild to moderately active CD enrolled in the Crohn’s Disease Therapeutic Dietary Intervention (CD-TDI) trial (n = 64; NCT04596566), and healthy adults participating in the MAPMed study (n = 33, NCT06765369). Dietary intake was assessed using two non-consecutive 24 h recalls collected with the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24^®). Energy-normalized macronutrient and micronutrient intakes were compared with Dietary Reference Intakes (DRIs). Overall diet quality was evaluated using the Healthy Eating Index-2020 (HEI-2015), Alternate Mediterranean Diet score (aMED), and Dietary Inflammatory Index (DII). Foods were classified according to the NOVA food processing system to estimate total and proportional energy intake from UPFs (NOVA group 4). Results: Both the CD cohort and healthy cohort exhibited suboptimal dietary patterns, with HEI scores indicating a need for improvement, low adherence to the Mediterranean diet (aMED), and neutral-to-pro-inflammatory DII scores, with no significant between-group differences (all p > 0.05). Although total energy intake differed between groups (p = 0.04), the proportion of energy derived from UPFs (NOVA group 4) accounted for half of the total intake in both cohorts (51.3–51.8%; p = 0.55). Higher UPF intake was associated with lower HEI and aMED scores and higher DII scores. Conclusions: In this study, there were no significant differences in the dietary patterns in those with CD compared to healthy controls. The high contribution of UPFs observed in both cohorts underscores widespread suboptimal dietary quality and highlights the utility of NOVA-based food processing measures as complementary to nutrient-based assessments for understanding diet-related inflammatory burden in CD. Full article

Cardiovascular-kidney-metabolic (CKM) syndrome integrates excess adiposity, metabolic dysfunction, kidney impairment, subclinical cardiovascular diseases, and clinical events along a staged continuum that invites unified prevention and treatment. Ultra-processed foods (UPFs) are a complex, high-prevalence exposure that may influence risk across CKM stages through nutrient profiles, additives, processing-induced compounds, and packaging-related contaminants. This review synthesizes epidemiologic, mechanistic, and translational evidence with attention to exposure definition and analytic rigor. We summarize NOVA-based UPF operationalization across dietary assessment tools, highlighting misclassification of mixed dishes, brand heterogeneity, and energy under-reporting, and we propose further examination of energy-adjusted models, calibration, and harmonized metrics. Observational studies consistently associate higher UPF intake with adiposity, diabetes, chronic kidney disease, cardiovascular events, and mortality, with modest to moderate effect sizes that are heterogeneous across populations. Mechanistic data from metabolomics, lipidomics, proteomics, and the gut microbiome converge on pathways of inflammation, lipid metabolism, oxidative and metabolic stress, and intestinal barrier dysfunction; in selected cohorts, multi-omics modules account for a substantial minority of UPF-outcome associations. We outline quality-control pipelines, batch-effect prevention/correction, and multiple-testing control necessary for reproducible diet-omics. Translationally, targeted lipidomic and proteomic panels show promise for CKM risk stratification and monitoring but require validation, clinical thresholds, and guideline endorsement. Equity and global context, including differences in product mix, food systems, and care capacity, modify population impact. We conclude with a research agenda prioritizing harmonized exposure metrics, error-aware modeling, standardized multi-omics workflows, and adequately powered, stage-specific interventions capable of testing mediation and prognostic utility. Full article

Clonal propagation of rust-resistant sugar pine (Pinus lambertiana Dougl.) is currently limited by extreme rooting recalcitrance and highly variable donor responses to nursery management. This study identified seed zone-specific nutritional sensitivities and evaluated rooting success; we hypothesized that northern seed sources would exhibit greater sensitivity to high nutrient loads and that stable microclimates would outperform high-intensity rooting systems. In Study 1, seedlings from five United States Department of Agriculture seed zones were grown for 27 weeks in five nutrient solutions (tap-water control, modified Hoagland, Foliage-Pro^®, Andrejow, and FloraNova^®) spanning 0.72–3.00 dS m⁻¹. The nutrient-rich Foliage-Pro^® and FloraNova^® solutions defined the upper end of the nutrient-intensity range and revealed strong seed zone contrasts: northern zones (526, 550) showed marked sensitivity, with survival declining from 70 to 100% in the control to 15–40% under the highest-EC formulations, whereas southern zones (992, 993) maintained high survival (≥75%) across all treatments and exhibited increased branching (up to 3.7 branches plant⁻¹) under higher-nutrient solutions. In Study 2, stem cuttings were rooted in three environments (non-mist, hydroponic, and aeroponic) and four hormone treatments (control, Clonex^®, Dip’n Grow^®, and IBA + Ethrel). Rooting occurred exclusively in the non-mist propagator; untreated controls achieved 65% success and outperformed all hormone treatments (0–10%). These results demonstrate that P. lambertiana propagation depends on seed zone-specific donor nutrition and stable, hormone-independent rooting environments. Full article