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Background: Given the urgency of transitioning towards sustainable nutrition, dietary shifts that provide co-benefits to human health and the environment are imperative. There is currently no database of the environmental impacts of foods that reflects Canada's unique geographical and agri-climatic context and regional inputs and emissions. To determine sustainable diets, harmonising nutritional considerations with environmental impacts is also essential for an equitable comparison of foods. We aimed to develop a Canadian Food Life Cycle Inventory database and a multidimensional index to enable a joint assessment of the health and environmental impacts of foods in Canada. Methods: The Canadian Food Life Cycle Inventory database uses life cycle assessment methodology to evaluate environmental impacts. The datasets mirror Canada's food consumption patterns, averaging the spectrum of agricultural practices weighted by domestic production and import shares. The database is structured according to the nomenclature and categorisation of the Canadian Nutrient File. Environmental sustainability is assessed using a cradle-to-grave approach, including indicators such as greenhouse gas emissions, eutrophication, particulate matter, freshwater usage, land use, non-renewable energy consumption, and food loss and waste. Environmental impacts are quantified through an environmental impact score (EIS) assigned to each impact category for a given food. The EIS-nutrition (EIS-N) integrates the evaluation of nutritional quality with environmental impacts using Nutri-Score, a validated food nutrient-profiling tool. The EIS-N is modelled as a ratio of the EIS to the Nutri-Score values. Findings: Preliminary results show the greatest environmental impacts for animal-based foods, particularly beef, in agreement with current literature. Foods with greater nutritional quality also generally show greater environmental sustainability, with some exceptions for particular impact categories. Interpretation: The database and index have potential to serve as powerful tools to support researchers, policy makers, and consumers, harnessing big data to drive efficient food and climate solutions for systems transformation. Funding: Province of Ontario and University of Toronto, CIHR SMART Healthy Cities Training Platform, and University of Toronto's Temerty Faculty of Medicine.

Summary: Background: Empiric treatment of sexually transmitted infections can cause unnecessary antibiotic use. We determined if near-to-patient-testing (NPT) for Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium (MG) improved antibiotic-use for a range of clinical presentations. Methods: Clients attending with non-gonococcal urethritis (NGU), proctitis, as STI-contacts, or for an MG-test-of-cure (MG-TOC) between March and December 2021 were recruited. Participants received near-to-patient-testing (NPT-group) for the three STIs using the GeneXpert® System (Cepheid), and concurrent routine-testing by transcription-mediated-amplification (TMA; Aptima, Hologic). Antibiotic-use among NGU or proctitis cases in the NPT-group was compared to clinic-controls undergoing routine-testing only. The proportion in the NPT-group who notified partners

Abstract Background Standardised therapeutic monitoring of field skin cancerisation is challenging. 5‐fluorouracil (5‐FU) is a common topical therapy for ultraviolet radiation (UV) and actinic keratosis (AK) but is often accompanied with adverse side effects. Monitoring of patients following treatment can be improved with novel imaging technologies. Objectives This case series used new, improved facial imaging technology in assessing topical 5‐FU treatment for actinic damage. Methods A case series followed 18 participants treated with topical 5‐FU over 2 weeks, with facial imaging at baseline, at the end of treatment and at Week 12 posttreatment. Skin characteristics were automatically measured across selected treatment areas using the VISIA three‐dimensional (3D) multispectral facial imaging system. Results VISIA analysis recorded sharp increases in erythema, UV‐spots and skin roughness at Week 2 followed by reduction of erythema, UV‐spots and skin roughness at 12 weeks posttreatment compared to baseline. Skin hyper‐ and hypopigmentation was observed across treatment areas at Week 2 returning to baseline levels by Week 12. Participants demonstrated improved skin texture indicating smoother skin and significantly diminished UV‐spots. Conclusions 3D, multispectral facial imaging can facilitate topical treatment monitoring of field cancerisation. 5‐FU treatment of field cancerisation as observed in VISIA images and data are consistent with clinical experience. 3D, multispectral imaging was efficient, noninvasive and objective in monitoring treatment of actinic damage, for example, by measurement of erythema as a surrogate marker for inflammation. For clinical trials of new treatment modalities for facial photodamage and field cancerisation, 3D multispectral imaging features new tools for analysis of skin characteristics, including objective quantification of erythema, skin texture, UV‐spots and other inflammation‐related changes triggered by 5‐FU treatment.

Objectives: Some geographic regions in high-income countries (HIC), including Australia, have poor healthy food access and a high burden of diet-related chronic disease. Scalable and sustainable strategies to strengthen community food systems have the potential to address these inequities. To inform future interventions in regions with poor healthy food access in Sydney, Australia, and beyond, we systematically reviewed randomised controlled trials of community-based food access interventions in HIC, to identify effects on dietary behaviours and health outcomes. Methods: Four electronic databases were searched. Studies involving community-based healthy food access strategies (solely or combined with education/behaviour change) and measuring effects on dietary behaviours and/or health outcomes were identified. Data on dietary behaviours, health outcomes and intervention descriptions were extracted, and the risk of bias was assessed. Results: Seven studies met inclusion criteria, with most conducted in the US (n = 6). Intervention strategies included food pantry-based interventions (n = 2), mobile produce markets (n = 2) and community farms (n = 3). Most interventions (n = 6, 85%) incorporated educational and/or behavioural change aspects. All studies measured fruit and vegetable (F&V) intake, with nearly all (n =6, 85%) reporting significant beneficial effects. Conclusion: Preliminary evidence in our synthesis demonstrates that multicomponent community-based food system interventions promise to improve F&V intake in regions of HICs. Recommendations for improving future evaluations are identified to build evidence for policymakers and urban planners to enact upstream and downstream strategies to strengthen community healthy food, particularly in geographic regions with the greatest health inequities.

Detecting relevant odours from background odours is important for animal behaviour. Here the authors design a task to study this process in mice.

Inflammatory skin conditions are the 4th leading cause of non-fatal health burden in the general population worldwide. The diagnosis of skin lesions due to systemic drug reactions, viral or bacterial exanthems, or in patients with psoriasis, atopic dermatitis or contact dermatitis is often difficult and relies heavily upon conventional histopathologic examination. Conversely, it is widely accepted that the cutaneous profile of inflammatory markers, or ‘inflammatory signature’, is differentially expressed in various skin conditions. In this pilot study, we investigated the possibility of inflammatory skin disease diagnosis from an immunological perspective in small punch biopsies. We collected lesional and perilesional punch biopsies from 139 patients suffering from a variety of inflammatory skin conditions and attending the Dermatology Department at the Princess Alexandra Hospital in Brisbane, Australia. Using bead-based immunoassays we were able to measure 13 out of 17 inflammatory markers from a pre-selected multi-analyte panel and to detect significant differences between lesional and perilesional biopsies from each individual patient. Hierarchical and unbiased clustering methods based on inflammatory signatures grouped psoriasis and atopic dermatitis lesions into individual clusters in contrast to other skin conditions, highlighting the potential of inflammatory signatures to be used as diagnostic differentiators and to inform alternative targets in anti-inflammatory treatment strategies.

Abstract Background Institutions are a recommended setting for dietary interventions and nutrition policies as these provide an opportunity to improve health by creating healthy food environments. In Australia, state and territory governments encourage or mandate institutions in their jurisdiction to adopt nutrition policies. However, no work has analysed the policy design across settings and jurisdictions. This study aimed to compare the design and components of government-led institutional nutrition policies between Australian states and territories, determine gaps in existing policies, and assess the potential for developing stronger, more comprehensive policies. Methods Government-led institutional nutrition policies, in schools, workplaces, health facilities and other public settings, were identified by searching health and education department websites for each Australian state and territory government. This was supplemented by data from other relevant stakeholder websites and from the Food Policy Index Australia website. A framework for monitoring and evaluating nutrition policies in publicly-funded institutions was used to extract data and a qualitative analysis of the design and content of institutional nutrition policies was performed. Comparative analyses between the jurisdictions and institution types were conducted, and policies were assessed for comprehensiveness. Results Twenty-seven institutional nutrition policies were identified across eight states and territories in Australia. Most policies in health facilities and public schools were mandatory, though most workplace policies were voluntary. Twenty-four included nutrient criteria, and 22 included guidelines for catering/fundraising/advertising. While most included implementation guides or tools and additional supporting resources, less than half included tools/timelines for monitoring and evaluation. The policy design, components and nutrient criteria varied between jurisdictions and institution types, though all were based on the Australian Dietary Guidelines. Conclusions Nutrition policies in institutions present an opportunity to create healthy eating environments and improve population health in Australia. However, the design of these policies, including lack of key components such as accountability mechanisms, and jurisdictional differences, may be a barrier to implementation and prevent the policies having their intended impact.

Piezo proteins form mechanically activated ion channels that are responsible for our sense of light touch, proprioception, and vascular blood flow. Upon activation by mechanical stimuli, Piezo channels rapidly inactivate in a voltage-dependent manner through an unknown mechanism. Inactivation of Piezo channels is physiologically important, as it modulates overall mechanical sensitivity, gives rise to frequency filtering of repetitive mechanical stimuli, and is itself the target of numerous human disease-related channelopathies that are not well understood mechanistically. Here, we identify the globular C-terminal extracellular domain as a structure that is sufficient to confer the time course of inactivation and a single positively charged lysine residue at the adjacent inner pore helix as being required for its voltage dependence. Our results are consistent with a mechanism for inactivation that is mediated through voltage-dependent conformations of the inner pore helix and allosteric coupling with the C-terminal extracellular domain.

Piezo ion channels transduce mechanical forces into biological signals. Here, the authors use magnetic tweezers to pull specific regions of Piezo1, identifying mechanically sensitive domains that are essential for channel activation and inactivation.

Porphyria cutanea tarda (PCT) is the most common type of porphyria worldwide and is often initially diagnosed when cutaneous manifestations arise. We present two patients where misdiagnosis of PCT occurred due to the condition masquerading as epidermolysis bullosa acquisita histologically. In patients with undifferentiated bullous/erosive skin conditions occurring in photo-distributed regions, PCT should be considered in the differential diagnosis irrespective of histopathological findings on biopsies and further investigated and treated appropriately.

Syringomas are benign adnexal neoplasms of eccrine lineage, which occur most commonly in the periorbital region in middle-aged females. These cutaneous lesions rarely occur on the scalp, are typically asymptomatic and are predominantly of cosmetic significance. Involvement of the scalp may be indistinguishable from that of scarring alopecia. We present an unusual case of clinically inapparent syringomas occurring on the scalp of a 56-year-old female with alopecia who was subsequently diagnosed with lichen planopilaris after repeated scalp biopsy. In patients with unexplained hair loss, or in cases that are refractive to treatment, clinicians should perform scalp biopsy to exclude the diagnosis of rare neoplastic lesions like syringomas and to diagnose associated conditions.

Objective. To evaluate if new imiquimod formulations using a shorter treatment duration are safe and efficacious to treat anogenital warts. Methods. In two studies 534 women ≥12 years of age (mean 33.4) with 2–30 warts (mean 7.9) and total wart area ≥10 mm2 (mean 166.3) were randomized (1 : 2 : 2) to placebo (106), imiquimod 2.5% (212) or 3.75% (216) creams applied once daily until complete clearance or a maximum of 8 weeks. Results. For placebo, imiquimod 2.5% and 3.75%, respectively, complete clearance of all warts was achieved in 14.2%, 28.3%, and 36.6% of women (intent-to-treat, P=0.008 imiquimod 2.5%, and P

Vitamin D binding protein-macrophage activating factor (DBP-maf) is a potent inhibitor of tumor growth. Its activity, however, has been attributed to indirect mechanisms such as boosting the immune response by activating macrophages and inhibiting the blood vessel growth necessary for the growth of tumors.In this study we show for the first time that DBP-maf exhibits a direct and potent effect on prostate tumor cells in the absence of macrophages. DBP-maf demonstrated inhibitory activity in proliferation studies of both LNCaP and PC3 prostate cancer cell lines as well as metastatic clones of these cells. Flow cytometry studies with annexin V and propidium iodide showed that this inhibitory activity is not due to apoptosis or cell death. DBP-maf also had the ability to inhibit migration of prostate cancer cells in vitro. Finally, DBP-maf was shown to cause a reduction in urokinase plasminogen activator receptor (uPAR) expression in prostate tumor cells. There is evidence that activation of this receptor correlates with tumor metastasis.These studies show strong inhibitory activity of DBP-maf on prostate tumor cells independent of its macrophage activation.

Background On average, Australian adults consume 3500 mg sodium per day, almost twice the recommended maximum level of intake. The Australian government through the Healthy Food Partnership initiative has developed a voluntary reformulation programme with sodium targets for 27 food categories. We estimated the potential impact of this programme on household sodium purchases (mg/day per capita) and examined potential differences by income level. We also modelled and compared the effects of applying the existing UK reformulation programme targets in Australia.Methods This study used 1 year of grocery purchase data (2018) from a nationally representative consumer panel of Australian households (Nielsen Homescan) that was linked with a packaged food and beverage database (FoodSwitch) that contains product-specific sodium information. Potential reductions in per capita sodium purchases were calculated and differences across income level were assessed by analysis of variance. All analyses were modelled to the Australian population in 2018.Results A total of 7188 households were included in the analyses. The Healthy Food Partnership targets covered 4307/26 728 (16.1%) unique products, which represented 22.3% of all packaged foods purchased by Australian households in 2018. Under the scenario that food manufacturers complied completely with the targets, sodium purchases will be reduced by 50 mg/day per capita, equivalent to 3.5% of sodium currently purchased from packaged foods. Reductions will be greater in low-income households compared with high-income households (mean difference −7 mg/day, 95% CI −4 to −11 mg/day, p