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Cervical cancer is preventable and treatable through regular screening and follow-up. However, the utilization of cervical cancer screening may vary widely based on individual lifestyles. The purpose of this study was to examine the differences in the adherence to cervical cancer screening guidelines in various dietary groups. Our study included 21,376 women from the United States and Canada, aged 30-69 from the Adventist Health Study-2, a large population-based prospective cohort study. Modified Poisson regression with robust variance estimation was used to determine the prevalence ratios of cervical cancer screening behavior in participants following five different dietary patterns (non-vegetarians, semi-vegetarians, pesco-vegetarians, lacto-ovo-vegetarians, and vegans). All analyses were adjusted for age, race/ethnicity, marital status, education, personal income, body mass index, smoking, alcohol use, exercise, and family history of all female cancer. Vegetarians, in general, had similar screening prevalence as non-vegetarians. However, vegans were 16% less likely to have had a Pap test compared to non-vegetarians (prevalence ratio (PR) = 0.84, 95% confidence interval 0.81-0.86). Women who were younger, Black, married, more educated, had a family history of all female cancer, had a higher income, and exercise reported higher compliance to a Pap test. It remains to be seen whether vegan women in Adventist Health-2 experience a higher incidence of cervical cancer or are diagnosed at a later stage compared to non-vegetarians.

Among all tree nuts, walnuts contain the highest total polyphenols by weight. This secondary data analysis examined the effect of daily walnut supplementation on the total dietary polyphenols and subclasses and the urinary excretion of total polyphenols in a free-living elderly population. In this 2-year prospective, randomized intervention trial (ID NCT01634841), the dietary polyphenol intake of participants who added walnuts daily to their diets at 15% of daily energy were compared to those in the control group that consumed a walnut-free diet. Dietary polyphenols and subclasses were estimated from 24 h dietary recalls. Phenolic estimates were derived from Phenol-Explorer database version 3.6. Participants in the walnut group compared to the control group had a higher intake of total polyphenols, flavonoids, flavanols, and phenolic acids in mg/d (IQR): 2480 (1955, 3145) vs. 1897 (1369, 2496); 56 (42,84) vs. 29 (15, 54); 174 (90, 298) vs. 140 (61, 277); and 368 (246, 569) vs. 242 (89, 398), respectively. There was a significant inverse association between dietary flavonoid intake and urine polyphenol excretion; less urinary excretion may imply that some of the polyphenols were eliminated via the gut. Nuts had a significant contribution to the total polyphenols in the diet, suggesting that a single food like walnuts added to habitual diet can increase the polyphenol intake in a Western population.

This study aims to examine lifestyle predictors of the utilization of colorectal cancer screening. Using modified Poisson regression, we studied self-reported colorectal cancer screening utilization (colonoscopy or fecal occult blood test) with various dietary and lifestyle characteristics among 33,922 subjects aged 51 + years in the Adventist Health Study-2, a large population-based prospective cohort study. According to the multivariable-adjusted models, vegetarians were less likely to report screening: vegans, prevalence ratio (PR) = 0.80 (95% confidence interval 0.77–0.83); lacto-ovo-vegetarians (0.95 [0.93–0.97]); and semi-vegetarians (0.97 [0.94–0.99]) compared to non-vegetarians. Blacks were more likely than non-Blacks to be screened (1.04 [1.02–1.06]) and males were less likely (0.93 [0.92–0.95]) to utilize the screening tests. Older subjects were more likely to be screened, and unmarried and divorced/widowed subjects were less likely to screen. Education, personal income, and BMI were positively associated with screening, with p-value for trend

Objective The aim of our study was to assess the association between a diagnosis of Systemic Lupus Erythematosus (SLE) and dietary pattern as well as demographic factors among subjects in the Adventist Health Study-2 (AHS-2) cohort. Methods Multivariable logistic regression modeling was used to assess the association between prevalence of self-reported SLE and dietary patterns (vegetarian, pesco-vegetarian and non-vegetarian). Potential confounding variables included were age, gender, race, education, and smoking history among 77,795 AHS-2 participants. Results There was a dose-response association between the prevalence of SLE with vegetarian diets, ordered by content of animal meats. The stricter vegetarians had 25% lower odds of reporting that they were currently being treated for SLE (OR = 0.75, 95% CI 0.56, 1.02) with intermediate levels for the pesco-vegetarians who eat fish (OR 0.88, 95% CI 0.57, 1.36), compared to non-vegetarians. As expected, there were also significant associations between the prevalence of SLE with sex, race, age, and smoking. Significantly fewer men were diagnosed with SLE compared to women (OR = 0.14, 95% CI: 0.08, 0.22). Compared to non-Hispanic Whites, non-Hispanic Blacks were significantly more likely to report a diagnosis of SLE (OR 1.69, 95% CI 1.29, 2.21). A significantly lower proportion of 30–39 year olds (OR 0.51, 95% CI 0.29, 0.90) reported a diagnosis of SLE when compared to those 60 or older. Also, ever smokers were more likely to report prevalent SLE than those who had never smoked (OR 1.71, 95% CI 1.27, 2.31). Conclusion We found that vegetarians had lower odds of doctor-diagnosed SLE with an increasing trend in prevalence from stricter vegetarians to pesco-vegetarians to non-vegetarians. We also note that the association with other demographic factors in AHS-2 was similar to that found in other studies. Future studies may focus on assessing the incidence and severity of the disease among vegetarians and non-vegetarians.

Background Walnut consumption counteracts oxidative stress and inflammation, 2 drivers of cognitive decline. Clinical data concerning effects on cognition are lacking. Objectives The Walnuts And Healthy Aging study is a 2-center (Barcelona, Spain; Loma Linda, CA) randomized controlled trial examining the cognitive effects of a 2-y walnut intervention in cognitively healthy elders. Methods We randomly allocated 708 free-living elders (63-79 y, 68% women) to a diet enriched with walnuts at ∼15% energy (30-60 g/d) or a control diet (abstention from walnuts). We administered a comprehensive neurocognitive test battery at baseline and 2 y. Change in the global cognition composite was the primary outcome. We performed repeated structural and functional brain MRI in 108 Barcelona participants. Results A total of 636 participants completed the intervention. Besides differences in nutrient intake, participants from Barcelona smoked more, were less educated, and had lower baseline neuropsychological test scores than those from Loma Linda. Walnuts were well tolerated and compliance was good. Modified intention-to-treat analyses (n = 657) uncovered no between-group differences in the global cognitive composite, with mean changes of -0.072 (95% CI: -0.100, -0.043) in the walnut diet group and -0.086 (95% CI: -0.115, -0.057) in the control diet group (P = 0.491). Post hoc analyses revealed significant differences in the Barcelona cohort, with unadjusted changes of -0.037 (95% CI: -0.077, 0.002) in the walnut group and -0.097 (95% CI: -0.137, -0.057) in controls (P = 0.040). Results of brain fMRI in a subset of Barcelona participants indicated greater functional network recruitment in a working memory task in controls. Conclusions Walnut supplementation for 2 y had no effect on cognition in healthy elders. However, brain fMRI and post hoc analyses by site suggest that walnuts might delay cognitive decline in subgroups at higher risk. These encouraging but inconclusive results warrant further investigation, particularly targeting disadvantaged populations, in whom greatest benefit could be expected.This trial was registered at clinicaltrials.gov as NCT01634841.

n-3 index, the erythrocyte proportion of the EPA + DHA fatty acids is a clinical marker of age-related disease risk. It is unclear whether regular intake of α-linolenic acid (ALA), a plant-derived n-3 polyunsaturated fatty acid, raises n-3 index in older adults. Of the 356 participants at the Loma Linda, CA centre from the original study, a randomly selected subset (n 192) was included for this secondary analysis (mostly Caucasian women, mean age 69 years). Participants were assigned to either the walnut (15 % of daily energy from walnuts) or the control group (usual diet, no walnuts) for 2 years. Erythrocyte fatty acids were determined at baseline and 1-year following intervention. No differences were observed for erythrocyte EPA, but erythrocyte DHA decreased albeit modestly in the walnut group (–0·125 %) and slightly improved in the control group (0·17 %). The change in n-3 index between the walnut and control groups was significantly different only among fish consumers (those who ate fish ≥ once/month). Longitudinal analyses combining both groups showed significant inverse association between the 1-year changes of the n-3 index and fasting plasma TAG (ß = −10), total cholesterol (ß = −5·59) and plasma glucose (ß = −0·27). Consuming ALA-rich walnuts failed to improve n-3 index in elders. A direct source of EPA/DHA may be needed to achieve desirable n-3 index, as it is inversely associated with cardiometabolic risk. Nevertheless, incorporating walnuts as part of heart healthy diets is still encouraged.

Avocado is a nutrient-rich food that has been shown to benefit the health and diet quality of adults. In this paper, we examined if habitual intake of avocado among adolescents is associated with their diet quality, food and nutrient intake, and measures of obesity and body composition. Participants aged 12–18 years old (n = 534) from selected public and Adventist middle-high schools reported their dietary intake in a web-based food frequency questionnaire (FFQ); anthropometrics were measured during school visits. Diet quality (DQI-I) and avocado intake were calculated from the FFQ; BMI z-scores (BMIz), waist-to-height ratio (WHtR), and fat mass (FM), fat-free mass (FFM), and %body fat (%BF) were determined from the anthropometric data. Compared to non-consumers, avocado consumers had significantly higher covariate-adjusted mean scores on total DQI-I (68.3 vs. 64.6) and energy-adjusted mean scores on variety (18.8 vs. 18.0) and adequacy (36.4 vs. 33.4). Avocado consumption was significantly associated with DQI-I components adequacy (β [SE] = 0.11 [0.03]) and moderation (β [SE] = 0.06 [0.03]) but not with BMIz, WHtR, FM, FFM, and %BF. Mean intakes of fruits, vegetables, and plant protein foods, total and vegetable proteins, dietary fiber, retinol, vitamin C, calcium, magnesium, iron, and potassium were significantly higher for avocado consumers; saturated and trans fats intakes were significantly higher for non-consumers. In our adolescent population, avocado consumption was associated with higher diet quality and intake of plant-based foods and shortfall nutrients, but not with measures of obesity and body composition. Studies are needed to determine the optimal amount of avocado that would confer health benefits during adolescence.

Laser plasma proton acceleration, where it was recently reported that near-100-MeV proton acceleration was demonstrated, offers the potential to realize a compact and cost-effective accelerator in the future. Because it can generate an extreme electric field that is over six orders of magnitude higher than that of a conventional radio-frequency accelerator apparatus. To understand the underlying physics of the acceleration process and increase maximum proton energy, precise measurement of both the energy spectrum and the two-dimensional distribution is required. Against this background, we have developed a new measurement method for laser-accelerated sub-GeV-class protons using the nuclear emulsion. Based on the Multiple Coulomb Scattering (MCS) method in an Emulsion Cloud Chamber (ECC), which is a stack of nuclear emulsion films and scatterer plates, the incident energies were inversely evaluated by the scattering angle. The proof-of-principle experiment has been conducted with the Heavy-Ion Medical Accelerator in Chiba (HIMAC) to verify that the ECC is able to identify sub-GeV protons with the MCS method. Combined with a technique of machine learning, a new measurement method has been developed to obtain an energy spectrum of laser-accelerated sub-GeV protons by the ECC with the MCS method., ICMaSS2021

We aim to determine the detection threshold of Kapton as an Etched Track Detector irradiated with 345 MeV/u U ion, as well as other several heavy ions of Al, Si, Ar, Kr and Xe. The heavier ions are found to have higher detection threshold in the stopping power. At the same stopping power, the track registration sensitivity decreases with increasing the nuclear charge of ions. U ion has the lowest sensitivity as S = 0.04 at the detection threshold of 3400 keV/μm. We have updated the conventional radial dose distribution theory using a relatively new experimentally supported formula for the effective charge up to U ion. The local doses at a track radius of 0.8 nm, which is half of the length of a repeat unit of Kapton, is useful to understand the relation between the sensitivity of heavy ions and the stopping power at each detection threshold.

Nuclear emulsions are applied to identify multi-MeV protons accelerated by an intense PW-class laser. Although nuclear emulsions, which record the three-dimensional trajectories of charged particles, feature high sensitivity and a sub-micron spatial resolution, they have never been used for the detection of laser-accelerated ions. This is because intense laser-matter interactions generate not only ions but also copious electrons, including secondary electrons induced by X-rays, which are recorded as background noise in a nuclear emulsion. Therefore, it is not a trivial task to identify ion tracks in a nuclear emulsion exposed to such extreme mixed radiation fields. Here, for the first time, we have succeeded in identifying the signals from laser-accelerated protons in nuclear emulsions by suppressing the background noise signals through the use of desensitized development conditions, i.e., a developer solution with a pH of 7.3 and a development time of 25 min. The energy spectrum obtained from a stack of nuclear emulsion films shows good agreement with that obtained from a stack of films of the conventional solid-state nuclear track detector material CR-39, which is sensitive only to ions. An additional benchmark experiment with 100-MeV protons from a conventional accelerator apparatus confirms that nuclear emulsions have the potential to measure 100-MeV-class laser-accelerated protons.

We aim to elucidate the chemical damage structure in poly(allyl diglycol carbonate), PADC, exposed to UV photons with a wavelength of 222 nm using FT-IR spectrometric method. The number density of carbonyl (C˭O) in PADC, which composes carbonate ester, is hardly affected by the UV photons below the critical fluence of 3.0 × 1019 photons/cm2. The number density of carbonyl decreases only above the critical fluence, while those of ether and C-O-C in carbonate ester are monotonically cleaved. These findings corroborate the previous result using 28 MeV electron beams, in which the carbonate ester is lost only above the critical fluence of 1.6 × 1015 electrons/cm2, where the overlapping of electron tracks becomes significant. We extend the conventional track overlapping model to clarify the spatial distribution of point-like defects after the UV exposure. The discrete damage is seen at the critical condition, based on the extended track overlapping model.

Meat analogs have been proposed as a viable ‘lower carbon’ alternative to meats. However, data on the greenhouse gas (GHG) emissions from those products are limited. We performed partial (farm to f...

This study aims to examine lifestyle predictors of the utilization of colorectal cancer screening. Using modified Poisson regression, we studied self-reported colorectal cancer screening utilization (colonoscopy or fecal occult blood test) with various dietary and lifestyle characteristics among 33,922 subjects aged 51 + years in the Adventist Health Study-2, a large population-based prospective cohort study. According to the multivariable-adjusted models, vegetarians were less likely to report screening: vegans, prevalence ratio (PR) = 0.80 (95% confidence interval 0.77-0.83); lacto-ovo-vegetarians (0.95 [0.93-0.97]); and semi-vegetarians (0.97 [0.94-0.99]) compared to non-vegetarians. Blacks were more likely than non-Blacks to be screened (1.04 [1.02-1.06]) and males were less likely (0.93 [0.92-0.95]) to utilize the screening tests. Older subjects were more likely to be screened, and unmarried and divorced/widowed subjects were less likely to screen. Education, personal income, and BMI were positively associated with screening, with p-value for trend 0.001 for all three variables. A family history of colorectal cancer was associated with higher screening prevalence (1.15 [1.12-1.17]). Our stratified analyses on race and gender with dietary patterns showed non-Hispanic White vegans (PR = 0.77 [0.74-0.81]) and male vegans (PR = 0.76 [0.72-0.81]) were least likely compliant with colorectal cancer screening (p = 0.009 and p = 0.04, respectively). Vegans may believe that their personal risk for colorectal cancer is low due to their healthy lifestyle, resulting in lack of compliance to colorectal cancer screening. It remains to be seen whether vegans in AHS-2 also experience higher incidence of colorectal cancer or are diagnosed at a later stage.

Atomically thin graphene is a transparent, highly electrically and thermally conductive, light-weight, and the strongest material. To date, graphene has found applications in many aspects including transport, medicine, electronics, energy, defense, and desalination. We demonstrate another disruptive application of graphene in the field of laser-ion acceleration, in which the unique features of graphene play indispensable role. Laser driven ion sources have been widely investigated for pure science, plasma diagnostics, medical and engineering applications. Recent developments of laser technologies allow us to access radiation regime of laser ion acceleration with relatively thin targets. However, the thinner target is the less durable and can be easily broken by the pedestal or prepulse through impact and heating prior to the main laser arrival. One of the solutions to avoid this is plasma mirror, which is a surface plasma created by the foot of the laser pulse on an optically transparent material working as an effective mirror only for the main laser peak. So far diamond like carbon (DLC) is used to explore the ion acceleration in extremely thin target regime (< 10 nm) with plasma mirrors, and it is necessary to use plasma mirrors even in moderately thin target regime (10-100 nm) to realize energetic ion generation. However, firstly DLC is not 2D material, and therefore, it is very expensive to make it thin and flat. Moreover, graphene is stronger than diamond at extremely thin regime, and much more reasonable for mass-production. Furthermore, installing and operating plasma mirrors at high repetition rate is also costly. Here we show another direct solution using graphene as the thinnest and strongest target ever made. We develop a facile transfer method to fabricate large-area suspended graphene (LSG) as target for laser ion acceleration with precision down to a single atomic layer. Direct irradiation of the LSG targets with an ultra intense laser generates energetic carbons and protons evidently showing the durability of graphene without plasma mirror. This extends the new frontier of science on graphene under extreme electromagnetic field, such as energy frontier and nuclear fusion.

Ambient air pollutants are known risk factors for cardiovascular disease (CVD) morbidity and mortality with significant racial disparities. However, few studies have explored racial differences among highly susceptible subpopulations, such as renal transplant recipients (RTRs). Despite improvements in quality of life after transplantation, CVD remains the major cause of mortality, especially among Black recipients. This study aimed to evaluate potential racial differences in the association between long-term levels of PM2.5 and the risk of all-cause, total CVD, and coronary heart disease (CHD) mortality among RTRs. This retrospective study consists of 93,857 non-smoking adults who received a renal transplant between 2001 and 2015. Time-dependent Cox regression was used to assess the association between annual concentrations of PM2.5 and mortality risk. In the multivariable-adjusted models, a 10 μg/m3 increase in ambient PM2.5 levels found increased risk of all-cause (HR = 3.45, 95% CI: 3.08–3.78), CVD (HR = 2.38, 95% CI: 1.94–2.92), and CHD mortality (HR = 3.10, 95% CI: 1.96–4.90). Black recipients had higher risks of all-cause (HR = 4.09, 95% CI: 3.43–4.88) and CHD mortality (HR = 6.73, 95% CI: 2.96–15.32). High levels of ambient PM2.5 were associated with all-cause, CVD, and CHD mortality. The association tended to be higher among Black recipients than non-Blacks.

Traditional Asian fermented soy food products are associated with reduced cardiovascular disease risk in prospective studies, but few randomized controlled trials have been conducted in at-risk populations. The aim of this study was to investigate the effect of a commercial non-probiotic fermented soy product on blood lipids in adults with cardiovascular risk biomarkers. In a randomized, crossover, intervention study, 27 men and women (aged 29–75 y) exhibiting at least two risk factors, consumed two packets (12.5 g each) daily of a fermented powdered soy product, or an isoenergic control powder made from germinated brown rice for 12 weeks each. The consumption of the fermented soy product resulted in a significantly greater mean change from baseline (compared to the germinated rice, all p &lt, 0.05) in total cholesterol of −0.23 mmol/L (CI: −0.40, −0.06) compared with 0.14 mmol/L (CI: −0.03, 0.31), respectively, and low density lipoprotein (LDL) cholesterol −0.18 mmol/L (CI: −0.32, −0.04) compared with 0.04 mmol/L (CI: −0.01, 0.018) respectively. This was accompanied by an increase in high density lipoprotein (HDL) cholesterol in the germinated rice group, a decrease in apolipoprotein B (ApoB) in the fermented soy group, and a between-treatment effect in apolipoprotein A1 (ApoA1), however, the ratio of the LDL:HDL and of Apo B:ApoA1 did not differ between the groups. The ratio of total cholesterol:LDL decreased in men in the fermented soy group (p &lt, 0.001). Twenty-four-hour urine collection at the end of each treatment period resulted in an increased excretion expressed as a ratio in μmol/d between treatments of 10.93 (CI: 5.07, 23.54) for daidzein, 1.24 (CI: 1.14, 4.43) for genistein, and, 8.48 (CI: 4.28, 16.80) for glycitein, all p &lt, 0.05. The fermented soy powder consumed by participants in this study without implementing other changes in their typical diets, decreased the total and LDL cholesterol, and may serve as a dietary strategy to manage blood lipids. The trial was registered at ClinicalTrials.gov as NCT03429920.

Eggs contain important compounds related to enhanced cognition, but it is not clear if egg consumption, as a whole, has a direct impact on memory decline in older adults. This study aimed to determine whether egg intake levels predict the rate of memory decline in healthy older adults after sociodemographic and dietary controls. We conducted a secondary analysis of data from 470 participants, age 50 and over, from the Biospsychosocial Religion and Health Study. Participants completed a food frequency questionnaire, which was used to calculate egg intake and divide participants into Low (

OBJECTIVES: The purpose of this study was to examine the effects of dietary nitrate and anthocyanins on exercise performance in healthy untrained individuals. METHODS: In a randomized double-blind crossover study, six men (mean age 24.3 y) and 23 women (mean age 24.1 y) were randomly assigned to Treatment A (5.05 g beetroot powder + placebo/d) or Treatment B (5.05 g beetroot powder + 480 mg tart cherry/d) for seven days. Each treatment was followed by a seven-day washout after which subjects switched treatments. At the end of each treatment period, subjects performed a modified Wingate Anaerobic Test on a Monark 928E bike. Data on speed (RPM), power (watts), and heart rate were collected and analyzed using linear mixed models adjusted for baseline subject characteristics, treatment sequence (A-B, B-A), energy (kcal), and sleep (hours). RESULTS: Average heart rate during the first five seconds of the cycling sprint was significantly lower after treatment A than after treatment B (−1.6 to 2.7 BPM, P

OBJECTIVES: To determine the effect of daily intake of macadamia nuts on macronutrient intake and nutrient displacement in overweight and obese adults in a randomized crossover study. METHODS: This randomized cross-over study was comprised of two phases, each lasting eight weeks. Participants (n = 35) were randomly assigned first to either the intervention (15% of calorie needs from macadamia nuts) or control (habitual diet) phase, with a two-week washout followed by the other phase. A total of six 24-hour recalls, two at baseline and two during each phase were conducted. Period adjustment t-test was used to determine the differences in macronutrient intake between the two phases. The displacement of nutrients was done by subtracting the observed intake of a particular nutrient from its’ expected intake. RESULTS: Compared to the control phase, there were marginal increases in the consumption of total energy (mean diff = 145 kcal), total fiber (mean diff = 2 g) and a significant increase in the consumption of total fat (mean diff = 35 g, P

OBJECTIVES: While touted for their health benefits, research on the effects of avocado consumption on health is limited. Given their dense content of monounsaturated fatty acids (MUFA), carotenoids, fiber, and micronutrients, avocados have the potential to boost cognitive function. It has been shown that diets rich in MUFA may improve global cognitive performance and prevent cognitive decline. The carotenoids lutein and zeaxanthin may also enhance brain function. Only one randomized trial assessing the effects of avocado intake on cognition has been published to date, and the results were positive. The objective of this current study is to determine if consuming a meal of avocado on toast yields measurable changes in cognitive performance. METHODS: Using a randomized 2 × 2 cross-over design, acute cognitive changes were assessed via a 25-minute long test battery in 27 participants after an isocaloric test meal of either avocado on wheat toast or cream cheese and jelly on wheat toast. After an approximately 2-week wash out period, participants returned to complete the study protocol with the alternate meal. Verbal learning and memory, working memory, processing speed, semantic fluency, and global cognition were measured in the fasting state and again in the postprandial state (3 hours after consumption of the breakfast test meal). Linear mixed models analysis was used to determine if meal type provided any significant boost in acute cognitive scores. RESULTS: The following fixed effects were included in the model: visit number, sequence of intervention, test meal, age, pre/post measures, and interaction between test meal and pre/post measures. Subjects were included as a random effect. No significant differences between intervention groups in pre/post measures were detected. CONCLUSIONS: These preliminary results need to be confirmed with a larger sample (currently underway). Also, given the nutrient composition of avocados, it is possible that longer term studies may yield different results. FUNDING SOURCES: Hass Avocado Board, Mission Viejo, CA.

A high consumption of added sugar has been associated with several cardiovascular risk factors, including obesity, type 2 diabetes mellitus and dyslipidemia. The main goal was to assess the association of sugary food and drink intake on the risk of stroke mortality. The Adventist Health Study-2 (AHS-2) is a prospective study with approximately 96,000 participants from the United States and Canada. Subjects were recruited from 2002 to 2007 at which time they completed a comprehensive food frequency questionnaire including intake of sugar added sweet foods and drinks. Subjects were followed with respect to National Death Index (NDI) mortality information through 2015. This is a low sugar consuming cohort where about 50% also adhere to a vegetarian dietary pattern. After applying exclusion criteria, the final analytical sample consisted of 53,482 study subjects. Cox Proportional hazard regression was used in the analyses adjusting for important demographic, lifestyle and medical variables. Four hundred and seventy two fatal strokes occurred during an average of 9.5 years or 509, 119 person-years of follow-up. Compared to the lowest quartile of sugary food intake (0 to 1.6 times/week), the hazard ratio of fatal stroke for the highest quartile (> 7 times/week) of sugary food intake was 0.86 (95% CI: 0.65 to 1.13), after adjusting for covariates. The hazard ratios did not change significantly when stratifying on gender and race. Consumption of added sugar was not associated with fatal stroke in this low sugar consuming population. Further research is needed in populations with higher intakes of sugar-sweetened foods and with diverse backgrounds and dietary patterns. Key words: Diet, sugar, stroke, cardiovascular diseases.

International audience; The detection threshold of poly(allyl dyglycol carbonate), PADC, for C ions is determined as 55 eV/nm in stopping power, which is significantly higher than that for proton and He ions. The stopping power is not a universal parameter for expressing the detection threshold of PADC. A new physical parameter of Radial Electron Fluence around Ion Tracks, REFIT, is proposed to describe the detection threshold of PADC. It is defined as the number density of electrons passing through the surface of a cylinder of a certain radius that is co-axial with the trajectory. Furthermore, preliminary calculations are presently being performed using the Monte Carlo simulation code of Geant4-DNA. The values of the REFIT at the detection thresholds for each ion are of the same order. Several issues affecting implementation of the REFIT paramter are discussed. These include the effects of impact parameter relating to the initial locations of secondary electrons, the effects of electron attachment below the cut off energy of 7.4 eV and the necessity of a more physically realistic medium than water for Monte Carlo simultaions.

G values of the losses of typical functional groups in PET films along boron ion tracks have been determined using FT-IR spectrometry. G value for the loss of aromatic-ring clearly increases above 270 eV/nm. Those of ester and ethylene increase around the slightly lower stopping power of 250 eV/nm. The detection thresholds are defined by determining the original points from which the evolution of etch pit starts along the latent track, when the chemical etching was progressing starting from the front surface of each incident ion trajectory. The thresholds for B, C, N, O, Ar and Kr ions have been determined for other kind of PET sheets. Values of the sensitivity at the thresholds are fairly higher at heavy ions with smaller atomic number.

Patients with chronic pain (CP) and substance use disorder (SUD) are complex, not yet adequately described, and in need of comprehensive treatments that address both diseases concurrently. Our objectives were to (a) describe a cohort of CP patients who failed traditional treatment (mainly opioids) – then developed opioid use disorder (OUD) and other SUDs and (b) evaluate a comprehensive inpatient treatment program for these patients. Patients were enrolled in an inpatient CP program. Treatment consisted of medical detoxification, group process/education, external and internal qigong, osteopathic manual medicine, and qigong-based mindfulness. Patients also received 20 h per week of 12-step recovery-based SUD treatment. Patients were evaluated at the beginning of treatment (first assessment, day 1–5 range) and at days 30 and 45. Assessments were: Beck Depression Inventory-II, Brief Pain Inventory, West Haven-Yale Multidimensional Pain Inventory (patient section), and McGill Pain Questionnaire. The Global Impression of Change Scale was administered at day 45. A mixed model analysis was used to evaluate treatment progress. Demographic data revealed an older cohort with OUD, other SUDs, and multiple pain diagnoses who failed traditional treatment. Questionnaire evaluations were consistent and similar across all of the above measures: patients’ scores showed marked, statistically significant improvements in depression, pain, and quality of life ratings. The most substantial improvements occurred between the first and second assessments. The findings are sufficiently encouraging to warrant further evaluation of the protocol and to plan comparative studies.

A new diagnosis method for the discriminative detection of laser-accelerated multi-MeV carbon ions from background oxygen ions utilizing solid-state nuclear track detectors (SSNTDs) is proposed. The idea is to combine two kinds of SSNTDs having different track registration sensitivities: Bisphenol A polycarbonate detects carbon and the heavier ions, and polyethylene terephthalate detects oxygen and the heavier ions. The method is calibrated with mono-energetic carbon and oxygen ion beams from the heavy ion accelerator. Based on the calibration data, the method is applied to identify carbon ions accelerated from multilayered graphene targets irradiated by a high-power laser, where the generation of high-energy high-purity carbon ions is expected. It is found that 93 ± 1% of the accelerated heavy ions with energies larger than 14 MeV are carbons. The results thus obtained support that carbon-rich heavy ion acceleration is achieved.

It is well established that diabetic patients with poor glycemic control have increased susceptibility to infections, but glucose levels have not been directly associated with this increase. The assessment of the effects of glycosylated hemoglobin (A1 c) on the body’s ability to fight infections may be useful directly in establishing a link between elevated blood sugar and the risk of infections. A total of 127 subjects in Heart Pilot Study (HPS), sub-study of the Adventist Health Study 2 (AHS-2) completed a lifestyle, medical and food frequency questionnaire (FFQ) at baseline between 2013 and 2014. The A1 c and phagocytic index (PI) were measured in the same blood sample and their associations were assessed using linear regression. Mean blood glucose (MBG) was estimated based on A1 c levels using a standard formula. Three levels of MBG were used to compare prediabetic and diabetic ranges to the normal range. The PI is the average number of bacteria in the cytoplasm of 50 neutrophils, manually counted under a light microscope after the whole blood was briefly exposed to a standard dose of bacteria and stained. In multivariable analysis, we found that MBG in the prediabetic (117 to137 mg/dL) and diabetic (>137 mg/dL) ranges were associated with 12.9% (b= -0.129, 95% CI: -0.30, 0.05) and 20.4% decrease in PI (b= -0.204, 95% CI: -0.592, 0.184) compared to that, observed among those with normal MBG (p for trend=0.119). Elevated MBG levels contribute a decrease in the PI among those in the prediabetic and diabetic range compared to the normal range. Although our findings were not quite statistically significant due to low power which are clinically relevant in line with observations of an increased infections among diabetics. Further research on larger populations is needed. Key words: A1 c, hemoglobin A1 c, phagocytosis, neutrophils, phagocytic index, diabetes, infection.

Background: The assessment of polyphenol intake in free-living subjects is challenging, mostly because of the difficulty in accurately measuring phenolic content and the wide presence of phenolics in foods.Objective: The aims of this study were to evaluate the validity of polyphenol intake estimated from food-frequency questionnaires (FFQs) by using the mean of 6 measurements of a 24-h dietary recall (24-HR) as a reference and to apply a unique method-of-triads approach to assess validity coefficients (VCs) between latent "true" dietary estimates, total urinary polyphenol (TUP) excretion, and a surrogate biomarker (plasma carotenoids).Design: Dietary intake data from 899 adults of the Adventist Health Study 2 (AHS-2; 43% blacks and 67% women) were obtained. Pearson correlation coefficients (r), corrected for attenuation from within-person variation in the recalls, were calculated between 24-HRs and FFQs and between 24-HRs and TUPs. VCs and 95% CIs between true intake and polyphenol intakes from FFQs, 24-HRs, and the biomarkers TUPs and plasma carotenoids were calculated.Results: Mean ± SD polyphenol intakes were 717 ± 646 mg/d from FFQs and 402 ± 345 mg/d from 24-HRs. The total polyphenol intake from 24-HRs was correlated with FFQs in crude (r = 0.51, P < 0.001) and deattenuated (r = 0.63; 95% CI: 0.61, 0.69) models. In the triad model, the VC between the FFQs and theoretical true intake was 0.46 (95% CI: 0.20, 0.93) and between 24-HRs and true intake was 0.61 (95% CI: 0.38, 1.00).Conclusions: The AHS-2 FFQ is a reasonable indicator of total polyphenol intake in the AHS-2 cohort. Urinary polyphenol excretion is limited by genetic variance, metabolism, and bioavailability and should be used in addition to rather than as a replacement for dietary intake assessment.

The solid state nuclear track detector CR-39 is the most reliable ion detector used in laser-driven ion acceleration experiments. This is because CR-39 detectors can measure from one ion without X-ray and electron noise generated by the interaction between the intense laser pulse and the target matter. In addition, the incident energy and the spatial distributions of the laser-accelerated ions are also revealed by the careful analysis of the etch pits in CR-39 detectors. The present paper comments on CR-39 detectors based on previous studies with a focus on an analysis technique of the etch pits to obtain the incident energy of the laser-accelerated ions.

Accumulating evidence links nut consumption with an improved risk of metabolic syndrome (MetS), however, long-term trials are lacking. We examined the effects of a daily dose of walnuts for two years on MetS in a large elderly cohort. A total of 698 healthy elderly participants were randomly assigned to either a walnut supplemented or a control diet. The participants in the walnut group were provided with packaged walnuts (1, 1.5, or 2 oz. or ~15% of energy) and asked to incorporate them into their daily habitual diet. The participants in the control group were asked to continue with their habitual diet and abstain from eating walnuts and other tree nuts. Intake of n-3 fatty acid supplements was not permitted in either group. Fasting blood chemistries, blood pressure, and anthropometric measurements were obtained at baseline and at the end of intervention. A total of 625 participants (67% women, mean age 69.1 y) completed this two-year study (90% retention rate). Triglycerides decreased in both walnut (&minus, 0.94 mg/dl) and control (&minus, 0.96 mg/dl) groups, with no significant between-group differences. There was a non-significant decrease in systolic and diastolic blood pressure in the walnut group (&minus, 1.30 and &minus, 0.71 mm Hg, respectively) and no change in the control group. Fasting blood glucose decreased by ~1 point in both the walnut and control groups. There were no significant between-group differences in the development or reversion of MetS. In conclusion, supplementing the diet of older adults with a daily dose of walnuts had no effect on MetS status or any of its components, although the walnut group tended to have lower blood pressure.

OBJECTIVES: To assess the relationship between habitual avocado intake, and cardiometabolic risk factors and metabolic syndrome (MetS). We hypothesized that regular avocado intake is associated with a lower occurrence of elevated blood glucose (BG), TG, blood pressure (BP), and waist circumference (WC), and/or decreased HDL-cholesterol (HDL-C). METHODS: This cross-sectional analysis was done on a random sample (n = ∼850) of subjects from the Adventist Health Study-2 cohort. Diet was assessed using a quantitative FFQ, which included an item for avocado/guacamole intake. Avocado intake (g/day) was calculated: f * s * n where f = the weighted frequency of avocado; s = the weighted portion size of avocado; and n = standard serving size (32 g) of avocado. FFQ data was also used to calculate total energy intake. Medication use, fasting BG, TG, HDL-C, BP, and WC were assessed during clinics. MetS was defined as follows: ≥3 of the diagnostic criteria defined by the Adult Treatment Panel III. Descriptive statistics including differences of means were analyzed. Logistic regression was used to determine the odds of metabolic syndrome for non-consumers (0 g/day; reference) versus consumers (>0 g/day; 51% of subjects) of avocado. Covariates were measured via a questionnaire: age, gender, race, education, energy intake, and dietary patterns. RESULTS: The odds for MetS for avocado consumers was non-significantly lower compared to nonconsumers: OR (95% CI) 0.87 (0.58, 1.30). Mean diastolic BP and WC were significantly lower among avocado consumers compared to nonconsumers. Mean HDL-C, TG, BG, and systolic BP did not differ between groups. CONCLUSIONS: No relationship between habitual avocado intake and MetS has been found. However, there may be an inverse relationship between avocado intake and specific cardiometabolic risk factors: diastolic BP and WC. FUNDING SOURCES: Hass Avocado Board, NIH, National Cancer Institute.

Background Elevated plasma methylmalonic acid (MMA) is a functional biomarker of vitamin B-12 status but limited information is available on its prevalence in US vegetarians. Objectives The study examines the prevalence of plasma MMA ≥0.27 µmol/L in those consuming vegetarian diets, its associations with vitamin B-12 intake and biomarkers, and the modifying effect of vegetarian patterns on these associations. Methods In this cross-sectional study (n = 785), concentrations of MMA, vitamin B-12, holotranscobalamin (holoTC), and homocysteine (Hcy) were determined in participants of the calibration substudy of the Adventist Health Study 2 (AHS-2). Vitamin B-12 intake from food, fortified food, and supplements was assessed by six 24-h recalls. Regression models were used to estimate ORs of having high MMA as related to vitamin B-12 status biomarkers, vitamin B-12 intake, and dietary pattern. Results The prevalence of low vitamin B-12 status defined by serum vitamin B-12

Lunasin, a peptide isolated from soybeans, has been shown to exert antioxidant, anticarcinogenic, and hypocholesterolemic effects in animal and in vitro models. In a triple-blind, placebo-controlled crossover study, 31 participants (female: 19, male: 12, mean age 61 ± 9.9 years) were randomized to an 8-week treatment of lunasin-enriched soy extract (335mg/d) or placebo. A 3-week washout period was utilized between treatments. Serum lipids, glucose, and insulin, as well as blood pressure and anthropometrics, were measured at baseline, week 7, and week 8 of each treatment period. There were nonsignificant reductions in cardiometabolic risk factors with treatment: total cholesterol -0.1mmol/L, 95% CI [-0.28, 0.03]; LDL cholesterol -0.07mmol/L, 95% CI [-0.2, 0.06]; triglyceride 0% mmol/L, 95% CI (-10%, 11%]; fasting serum glucose -2% mmol/L, 95% CI [-4%, 1%]; BMI -0.05 kg/m2, 95% CI [-0.17, 0.07] and waist circumference -0.63cm, 95% CI [-1.8, 0.53]. Supplementation with lunasin-enriched soy extract for 8 weeks did not result in significant changes in serum lipids, glucose, insulin resistance, blood pressure, BMI, or waist circumference. Future studies should focus on a higher dosage, larger sample size, and/or longer treatment to determine the independent role of lunasin, if any, in the effect of soy on cardiometabolic risk factors.

Avocados contain nutrients and bioactive compounds that may help reduce the risk of becoming overweight/obese. We prospectively examined the effect of habitual avocado intake on changes in weight and body mass index (BMI). In the Adventist Health Study (AHS-2), a longitudinal cohort (~55,407, mean age ~56 years, U.S. and Canada), avocado intake (standard serving size 32 g/day) was assessed by a food frequency questionnaire (FFQ). Self-reported height and weight were collected at baseline. Self-reported follow-up weight was collected with follow-up questionnaires between four and 11 years after baseline. Using the generalized least squares (GLS) approach, we analyzed repeated measures of weight in relation to avocado intake. Marginal logistic regression analyses were used to calculate the odds of becoming overweight/obese, comparing low (&gt, 0 to &lt, 32 g/day) and high (&ge, 32 g/day) avocado intake to non-consumers (reference). Avocado consumers who were normal weight at baseline, gained significantly less weight than non-consumers. The odds (OR (95% CI)) of becoming overweight/obese between baseline and follow-up was 0.93 (0.85, 1.01), and 0.85 (0.60, 1.19) for low and high avocado consumers, respectively. Habitual consumption of avocados may reduce adult weight gain, but odds of overweight/obesity are attenuated by differences in initial BMI values.

A series of FT-IR spectrometric studies has been performed to understand the latent track structure in poly(allyl diglycol carbonate), PADC, which were exposed to proton beams with energies of 20, 30 and 70 MeV. These energies are too high to register etchable tracks in PADC. Chemical damage parameters, such as damage density, effective track core radius and radiation chemical yields, for losses of ether bond, carbonate ester bond and CH groups in PADC are evaluated as a function of the stopping power, which were compared to the previous results for 5.7 MeV proton and heavy ions, between He and Xe. Graphs of the chemical damage parameters are given at the wide stopping powers ranging from 1 to 12,000 keV/μm. The decreasing behaviors of the ether and carbonate ester bonds are on the almost identical trends with those of the heavy ions. On the contrary to this, the reducing behavior of CH groups is similar to that of the gamma rays. Different dependence of the chemical damage parameters for the loss of CH groups is found on the stopping powers between the both sides of the detection threshold as an etched track detector.

A combination of CR-39 track detectors and a stepwise energy filter is a simple method to measure the energy spectrum of laser-accelerated protons. The number of etch pits in each area of the CR-39 detector is expected to represent the energy spectrum because the different thicknesses of the filters result in different areas into which the energy reaches in CR-39. However, the higher energy regions may overlap depending on the sensitivity of CR-39. To avoid overlapping, i.e., overestimation of the number of etch pits for each energy region, a correction method for the energy spectrum from the number of etch pits was developed. Based on the calculation results of the reaching energy values and incident energy ranges for CR-39, etch pits are selected that should be counted in each area. CR-39 with stepwise energy filters provides a corrected energy spectrum of laser-accelerated protons by applying the developed method.

OBJECTIVES: We sought to assess the effect of daily consumption of macadamia nuts as 15% of calories on body weight, BMI, waist circumference, percent body fat and skeletal muscle mass in overweight/obese men and women with elevated cardiometabolic risk. METHODS: Utilizing a randomized crossover design, we randomized 38 subjects to consume macadamia nuts daily as 15% of calories for 8 weeks (intervention) and their usual diet for 8 weeks (control), with a 2-week washout. Three subjects dropped out early; n = 35 for analysis. Subjects were healthy men and postmenopausal women with a BMI of 25–39, a waist circumference of >101.6 cm for men and >88.9 cm for women, and one additional cardiovascular risk factor (fasting plasma glucose >100 mg/dL, triglycerides ≥150 mg/dl, total cholesterol >200 mg/dL, LDL-C > 100 mg/dL, blood pressure ≥130/85 mmHg or taking anti-hypertensive medication). Macadamia nuts were provided in pre-weighed daily portions as 15% of calories calculated using the Mifflin-St. Jeor equation. Percent body fat and skeletal muscle mass (kg) were determined by bioelectrical impedance analysis. A mixed model analysis was performed with treatment, sequence, phase, and baseline values as fixed-effect terms and subjects as a random-effects term. RESULTS: Compared to control, consumption of macadamia nuts led to a mean weight change of –348 g (84.13 vs. 83.78 kg; P = 0.15) a mean BMI change of –0.15 kg/m(2) (30.61 vs. 30.47 kg/m(2); P = 0.12), and a mean waist circumference change of 0.17 cm (107.41 vs. 107.58 cm; P = 0.61). Percent body fat increased by an average of 0.26% after eating nuts (42.70 vs. 42.96%; P = 0.16). Skeletal muscle mass was slightly but significantly lower after eating nuts with a mean change of –0.237 kg (26.33 vs. 26.09 kg; P = 0.017). CONCLUSIONS: Daily consumption of high-fat macadamia nuts for eight weeks in overweight and obese individuals did not change anthropometrics including body weight, BMI, waist circumference, and % body fat. Skeletal muscle mass was slightly lowered but likely not clinically relevant. FUNDING SOURCES: Hort Innovation, Sydney, Australia.

OBJECTIVES: Previous reports indicate that intake of some soy products may be associated with improvements in blood lipids but few studies examined fermented soy foods. Q CAN PLUS® is a functional food product derived from fermented soybeans. To evaluate the effects of fermented soy on cardiovascular risk factors, we implemented a clinical trial to compare the effects of the fermented soy powder (Q CAN PLUS®) against a placebo (sprouted brown rice powder) in individuals at risk for cardiovascular diseases. METHODS: Twenty-seven adults at risk for cardiovascular diseases (29–75 years old; 78% female; mean BMI [32.3 kg/m2 ± 7.3]) were randomized to consume either 2 pouches (12–15 g powder/pouch) per day of fermented soy powder (Q CAN PLUS®), or a sprouted brown rice powder for 12 weeks each, in a crossover design trial. The intervention phases were separated by a two week wash out period. Measurements and biospecimens were taken at baseline and at weeks 11 and 12 of each phase. Assessment included blood lipids, blood pressure, blood glucose, blood insulin, and anthropometric measures. For each of the outcomes, a mixed model was fitted to compare changes from pre- to post-treatment and between treatments. The models included treatment, time, interaction between treatment and time, phase, visit within phase and enrollment period as fixed effects terms and subjects as random effects terms. RESULTS: Between treatment results from the mixed model analysis show that fermented soy powder intake significantly reduced serum cholesterol (mean change −8.95 mg/dL; P = 0.0024), LDL (mean change −6.96 mg/dL; P = 0.0317), and HDL (−1.29 mg/dL; P = 0.0036) compared with the sprouted brown rice powder. Within treatment results indicated that fermented soy powder significantly reduced total cholesterol (P = 0.0073) and LDL (P = 0.0132), while reductions in HDL were not statistically significant. Within treatment results were not statistically different for the placebo phase except for an increase in HDL (mean change 3.61; P = 0.0026). CONCLUSIONS: These data indicate that regular intake of fermented soy powder results in a reduction in serum total and LDL cholesterol which may have beneficial implications for the reduction of cardiovascular risk factors in adults. FUNDING SOURCES: BESO Biological Research Inc. Diamond Bar, CA, USA.

It has been confirmed that the density of carbonate ester in poly(allyl diglycol carbonate) (PADC), which is a well-known polymeric nuclear track detector CR-39, begins decreasing above a critical dose of about 60 kGy during exposures to Co-60 gamma rays and Ultra Soft X-rays (USX: Kα (Al) with energy 1.49 keV). After exposure to Co-60 gamma rays at 77 K and room temperature (RT), a significant difference in Electron Spin Resonance (ESR) spectra has been observed at both sides of a critical dose of 60 kGy, where is a threshold for the degradation of carbonate ester in PADC. Namely, the types of free radicals in PADC are different from each other below and above this critical dose. Changes in FT-IR spectra of carbonate ester in PADC above critical doses for gamma ray and USX exposures have also been observed, while that of ether decreases linearly with increasing absorbed dose. These results are well concordant with previous results obtained with 28 MeV electron beams. They also indicate that at least two hits of electrons are needed to destroy the carbonate ester in PADC. The layered structure of ion tracks in PADC can be explained thanks to these experimental results. Also, some clues for the identification of created radicals have been obtained from the results using both ESR and IR.

To investigate the association between plasma concentration of vitamin B12 and B12 intake from supplements, fortified foods, and animal source foods among vegetarians and non-vegetarians, we conducted a cross-sectional analysis among 728 participants of the Adventist Health Study 2 (AHS-2) calibration study. The median age of participants was 58 years, 65.4% were female, and 50.3% were White. We used six 24 h dietary recalls to measure B12 intake, serum vitamin B12, and holotranscobalamin (holoTC) concentration. B12 supplements had a significantly positive association with plasma B12 among all subjects (p trend &lt, 0.001), especially among vegans and lacto-ovo vegetarians (p trend &lt, 0.001). Among non-users of B12 supplements, B12 intake from milk substitutes was significantly positively associated with holoTC (p trend &lt, 0.004) and serum B12 (p trend &lt, 0.030). In non-vegetarians, holoTC was significantly positively associated with B12 intake from eggs, while serum B12 was significantly positively associated with B12 intake from milk in the upper tertile compared to the lower, and B12 intake from meat in the middle compared to the lower tertile intake (p &lt, 0.011). Supplements containing B12 followed by B12 intake from milk substitutes were significant contributors of plasma vitamin B12 concentration.

Modified structure along ion tracks in poly(allyl diglycol carbonate), PADC, films exposed to protons and heavy ions, He, C, Ne, Ar, Fe, and Xe, in air has been examined by means of FT-IR spectroscopy, covering the stopping power ranging from 10 to 12,000 keV/μm. The damage density for the loss of CH groups and the amount of formed OH groups along each tracks are estimated and compared to the previous results on the ether and the carbonate ester bonds. The CH groups are lost in the center region of the track core with other functional groups and the OH groups are created as new end-points of the polymer network. We obtained the molar absorption coefficient for OH of water absorbed in PADC films as 9.7 × 103 M−1 cm−1. It has been assumed that the coefficient is applicable to the OH groups on the polymer. The amount of OH groups are almost equivalent to the damage density of the ether bonds.

Background Meat intake is associated with increased risk of type 2 diabetes (T2D). It is not clear if egg intake is associated with T2D risk because purported associations may be due to concurrent consumption of eggs with meat. Objective Our aim was to differentiate any associations between meat and egg consumption and the risk of T2D. Design In this longitudinal study, 55,851 participants of the Adventist Health Study 2 who were free of diabetes provided demographic, anthropometric, and dietary data at baseline. Meat and egg intakes were assessed with a validated quantitative food-frequency questionnaire. Responses to 2 follow-up questionnaires determined incident T2D cases. Multivariate-adjusted logistic regression was used to determine relations between meat and egg intake and incident T2D. Results T2D cases identified during a mean 5.3 y of follow-up totaled 2772. Meat intake of >0 to