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Wild bees are important pollinators of crops and wildflowers but are exposed to a myriad of different anthropogenic stressors, such as pesticides and poor nutrition, as a consequence of intensive agriculture. These stressors do not act in isolation, but interact, and may exacerbate one another. Here, we assessed whether a field-realistic concentration of flupyradifurone, a novel pesticide that has been labelled as 'bee safe' by regulators, influenced bumblebee sucrose responsiveness and long-term memory. In a fully crossed experimental design, we exposed individual bumblebees (Bombus impatiens) to flupyradifurone at high (50% (w/w)) or low (15% (w/w)) sucrose concentrations, replicating diets that are either carbohydrate rich or poor, respectively. We found that flupyradifurone impaired sucrose responsiveness and long-term memory at both sucrose concentrations, indicating that better nutrition did not buffer the negative impact of flupyradifurone. We found no individual impact of sugar deficiency on bee behaviour and no significant interactions between pesticide exposure and poor nutrition. Our results add to a growing body of evidence demonstrating that flupyradifurone has significant negative impacts on pollinators, indicating that this pesticide is not 'bee safe'. This suggests that agrochemical risk assessments are not protecting pollinators from the unintended consequences of pesticide use.

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BACKGROUND: The COVID-19 pandemic and its associated public health mitigation strategies have dramatically changed patterns of daily life activities worldwide, resulting in unintentional consequences on behavioral risk factors, including smoking, alcohol consumption, poor nutrition, and physical inactivity. The infodemic of social media data may provide novel opportunities for evaluating changes related to behavioral risk factors during the pandemic. OBJECTIVE: We explored the feasibility of conducting a sentiment and emotion analysis using Twitter data to evaluate behavioral cancer risk factors (physical inactivity, poor nutrition, alcohol consumption, and smoking) over time during the first year of the COVID-19 pandemic. METHODS: Tweets during 2020 relating to the COVID-19 pandemic and the 4 cancer risk factors were extracted from the George Washington University Libraries Dataverse. Tweets were defined and filtered using keywords to create 4 data sets. We trained and tested a machine learning classifier using a prelabeled Twitter data set. This was applied to determine the sentiment (positive, negative, or neutral) of each tweet. A natural language processing package was used to identify the emotions (anger, anticipation, disgust, fear, joy, sadness, surprise, and trust) based on the words contained in the tweets. Sentiments and emotions for each of the risk factors were evaluated over time and analyzed to identify keywords that emerged. RESULTS: The sentiment analysis revealed that 56.69% (51,479/90,813) of the tweets about physical activity were positive, 16.4% (14,893/90,813) were negative, and 26.91% (24,441/90,813) were neutral. Similar patterns were observed for nutrition, where 55.44% (27,939/50,396), 15.78% (7950/50,396), and 28.79% (14,507/50,396) of the tweets were positive, negative, and neutral, respectively. For alcohol, the proportions of positive, negative, and neutral tweets were 46.85% (34,897/74,484), 22.9% (17,056/74,484), and 30.25% (22,531/74,484), respectively, and for smoking, they were 41.2% (11,628/28,220), 24.23% (6839/28,220), and 34.56% (9753/28,220), respectively. The sentiments were relatively stable over time. The emotion analysis suggests that the most common emotion expressed across physical activity and nutrition tweets was trust (69,495/320,741, 21.67% and 42,324/176,564, 23.97%, respectively); for alcohol, it was joy (49,147/273,128, 17.99%); and for smoking, it was fear (23,066/110,256, 20.92%). The emotions expressed remained relatively constant over the observed period. An analysis of the most frequent words tweeted revealed further insights into common themes expressed in relation to some of the risk factors and possible sources of bias. CONCLUSIONS: This analysis provided insight into behavioral cancer risk factors as expressed on Twitter during the first year of the COVID-19 pandemic. It was feasible to extract tweets relating to all 4 risk factors, and most tweets had a positive sentiment with varied emotions across the different data sets. Although these results can play a role in promoting public health, a deeper dive via qualitative analysis can be conducted to provide a contextual examination of each tweet.

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BACKGROUND: Nutritional status of critically ill patients is an important factor affecting complications and mortality. This study aimed to investigate the impact of three nutritional indices, the Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT), on mortality in patients with sepsis in Japan. METHODS: This retrospective observational study used the Medical Data Vision database containing data from 42 acute-care hospitals in Japan. We extracted data on baseline characteristics on admission. GNRI, PNI, and CONUT scores on admission were also calculated. To evaluate the significance of these three nutritional indices on mortality, we used logistic regression to fit restricted cubic spline models and constructed Kaplan-Meier survival curves. RESULTS: We identified 32,159 patients with sepsis according to the inclusion criteria. Of them, 1804 patients were treated in intensive care units, and 3461 patients were non-survivors. When the GNRI dropped below 100, the risk of mortality rose sharply, as did that when the PNI dropped below about 40. An increased CONUT score was associated with increased mortality in an apparent linear manner. CONCLUSION: In sepsis management, GNRI and PNI values may potentially be helpful in identifying patients with a high risk of death.

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Salicylic acid (SA) plays an important role in the response of plants to abiotic stresses. Starvation stress affects plant cell metabolic activities, which further limits the normal growth and development of plants. It was reported that SA might play a regulatory role in the process of plant against starvation stress, but the mechanism involved in this process is still unclear. Thus, in this study, the transgenic plants overexpressing a SA binding protein 2 (SABP2) gene were exposed to starvation stress and the transgenic lines showed starvation-tolerant phenotype. Compared with wild-type (WT) plants, transgenic plants showed better growth status under poor-nutrition stress. Transgenic plants also showed more vigorous roots than WT plants. Physiological tests indicated that the transgenic plants showed higher relative water content (RWC), chlorophyll content, photosynthetic capacity, endogenous SA content, and lower ROS level compared to WT plants. Transcriptome analysis of tobacco plants identified 3, 748 differentially expressed genes (DEGs) between transgenic and WT plants under starvation stress. These DEGs are mainly involved in glycolysis/gluconeogenesis pathway group, MAPK signaling pathway group and plant hormone signal transduction pathway group. As determined by qPCR, up-regulated expression of fifteen genes such as abscisic acid receptor PYR1-like gene (NtPYR1-like), bidirectional sugar transporter N3-like gene (NtSWEETN3-like) and superoxide dismutase [Fe] chloroplastic-like gene (NtFeSOD-like), etc., was observed in transgenic plants under poor-nutrition stress which was in accordance with RNA-sequencing results. The modified pathways involved in plant hormone signaling are thought to be at least one of the main causes of the increased starvation tolerance of transgenic tobacco plants with altered SA homeostasis.

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INTRODUCTION: A bidirectional relationship exists between obesity and chronic pain. How the two variables influence one another is unclear, especially in the context of prescription opioid use. The current study aimed to explore the phenomenon of overeating in the context of chronic pain and obesity among adults prescribed opioids. METHODS: Adults with a self-reported pain condition taking a prescription opioid completed surveys for this exploratory study. Participants provided demographic data and reported appetite changes when in pain. Chi-square analyses and analyses of variances (ANVOAs) were conducted to establish baseline comparability among body mass index (BMI) groups. Relative risk ratios were calculated to determine risk for reporting an increased appetite among BMI groups. Participants' responses to an open-ended question on appetite when in pain were analyzed using qualitative descriptive analysis. RESULTS: In total, 219 participants' data were analyzed. Of these, 46.8% reported eating less, 38.2% reported an unchanged appetite, and 11.9% reported eating more to feel better when in pain. Adults with obesity were over three times more likely to report an increased appetite compared to adults with normal weight. Participants reported having either a nutritional or a non-food response to painful episodes. CONCLUSIONS: This preliminary study supports that some adults with chronic pain follow poor nutritional patterns when in pain which may make weight management difficult. Pain clinicians should assess and counsel clients for overeating or undereating risks to facilitate pain and weight management.

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AIM: The preoperative poor nutrition of children with congenital heart disease (CHD) impacts the postoperative rehabilitation process of pediatric CHD cases. The factors of these children's preoperative poor nutrition, excluding the disease, have been underreported. The aim was to investigate the preoperative nutritional status of children with CHD who required a simple surgical repair and to analyze the maternal characteristics that are associated with poor nutrition in these sick children. METHODS: This was a cross-sectional survey. The weight and height of the children were measured, maternal data were collected via a questionnaire and a univariate analysis and multivariate logistic regression were used to analyze the association between maternal factors and the preoperative poor nutrition of the children with CHD. RESULTS: A total of 119 children with simple CHD were recruited to the study. The prevalence of poor nutrition was higher in the children with CHD ("cases") than in the healthy children ("controls"). An increased risk of poor nutrition was associated with lower mothers' perception, education level, understanding of the disease, and higher anxiety. CONCLUSIONS: Paying attention to maternal anxiety, depression, and knowledge and providing interventions for the mothers of children with CHD are important in order to promote the nutritional status of these children.

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To determine the impact of nutritional status and risk factors for undernutrition based on the changes in functional outcomes and rehabilitation success, defined as the ability of older adults to return as close as possible to their original functional state. Retrospective cohort study among 107 rehabilitation patients, aged ≥65 y. Data included demographics, Functional Independence Measure (FIM), Short Nutritional Assessment Questionnaire (SNAQ), reported weight, Mini-Mental Status Examination (MMSE), and Cumulative Illness Rating-Scale for Geriatrics (CIRS-G). Rehabilitation success was determined by delta-FIM. Higher vs. lower functioning patients were younger, had shorter hospitalization, and lower CIRS-G score with higher mean MMSE. Delta-FIM was significantly higher in patients with low malnutrition risk (SNAQ): 14.2 ± 10.5 vs. 6.9 ± 13.9 in undernourished patients, those who did not lose weight 14.5 ± 10.5 vs. 5.6 ± 12.8 in patients who lost weight with normal dietary intake, normal albumin, and lower CIES-G. Patients who achieved functional independence, FIMDC ≥90, ate normally and experienced less "appetite loss" [40.5% vs. 68.4%; P = 0.048]. Weight loss was the strongest negative predictor of delta-FIM (B = -9.094; P = 0.007). To conclude, nutritional status, mainly weight change, is an independent negative predictor for rehabilitation success.

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OBJECTIVES: To examine the association between nutritional status and frailty in older adults. DESIGN: Cross-sectional study. SETTING: Community-dwelling older adults were recruited from 10 study sites in South Korea. PARTICIPANTS: 1473 volunteers aged 70-84 years without severe cognitive impairment and who participated in the Korean Frailty and Aging Cohort Study (KFACS) conducted in 2016. MEASUREMENTS: Nutritional status was measured using the Mini Nutritional Assessment Short Form (MNA-SF). Frailty was assessed with the Fried's frailty index. The relationship between nutritional status and frailty was examined using the multinomial regression analysis, adjusting for covariates. RESULTS: Of the respondents 14.3% had poor nutrition (0.8% with malnutrition, 13.5% at risk of malnutrition). There were 10.7% who were frail, with 48.5% being prefrail, and 40.8% robust. Poor nutrition was related to a significantly increased risk of being prefrail (odds ratio [OR]: 1.59, 95% confidence interval [CI]: 1.09-2.32) and frail (OR: 3.30, 95% CI: 1.96-5.54). CONCLUSION: Poor nutritional status is strongly associated with frailty in older adults. More research to understand the interdependency between nutritional status and frailty may lead to better management of the two geriatric conditions.

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BACKGROUND: Vitamin D deficiency (VDD) continues to be associated with schizophrenia, but there is the dearth of information on the relationship between the severity of schizophrenia and plasma levels of vitamin D. This study, therefore, determined the plasma levels of vitamin D in different severity groups of schizophrenia. MATERIALS AND METHODS: Plasma level of vitamin D was determined in 60 patients with schizophrenia and 30 apparently healthy individuals who served as controls. Patients with schizophrenia were classified into mildly ill, moderately ill, markedly ill, and severely ill groups using the Positive and Negative Syndrome Scale (PANSS). RESULTS: The mean level of vitamin D was significantly lower in patients with schizophrenia compared with the controls. Similarly, there was a significant association between VDD and schizophrenia. The mean plasma levels of vitamin D were not significantly different when the mildly, moderately, markedly, and severely ill groups were compared with one another and there was no significant correlation between vitamin D level and PANSS scores. Furthermore, patients on atypical antipsychotics had an insignificantly lower level of vitamin D compared with the patients on typical antipsychotics. CONCLUSION: It could be concluded from this study that patients with schizophrenia have low plasma vitamin D level which does not appear to be associated with the severity of schizophrenia and type of antipsychotics. Therefore, regular screening for vitamin D status of patients with schizophrenia is suggested in order to allow for the institution of appropriate clinical intervention when necessary.

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Unhealthy lifestyle characteristics (i.e., physical inactivity, excess body mass, poor diet, and smoking) as well as associated poor health metrics (i.e., dyslipidemia, hyperglycemia, and hypertension) are the primary reasons for the current non-communicable disease crisis. Compared to those with the poorest of lifestyles and associated health metrics, any movement toward improving lifestyle and associated health metrics improves health outcomes. To address the non-communicable disease crisis we must: 1) acknowledge that healthy lifestyle (HL) interventions are a potent medicine; and 2) move toward a healthcare system that embraces primordial as much as, if not more than, secondary prevention with a heavy focus on HL medicine. This article introduces the Healthy Lifestyle Practitioner, focused on training health professionals to deliver HL medicine.

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BACKGROUND: Restaurant eating while optimizing nutrition and maintaining a healthy weight is challenging. Even when nutritional information is available, consumers often consider only calories. A quick and easy method to rate both caloric density and nutrition is an unmet need. A food rating system created to address that need is assessed in this study. METHODS: The food rating system categorizes food items into 3 color-coded categories: most healthy (green), medium healthy (yellow), or least healthy (red) based on calorie density and general nutritional quality from national guidelines. Nutritional information was downloaded from 20 popular fast-food chains. Nutritional assessments and the 3 color coded categories were compared using the Wilcoxon and Median tests to demonstrate the significance of nutrition differences. RESULTS: Green foods were significantly lower than yellow foods, which in turn were significantly lower than red foods, for calories and calories from fat, in addition to content of total fat, saturated fat and carbohydrates per 100 g serving weight (all P < .02). The green foods had significantly lower cholesterol than the yellow (P = .0006) and red (P < .0001) foods. Yellow foods had less sugar than red foods (P < .0001). Yellow foods were significantly higher in dietary fiber than red foods (P = .001). CONCLUSION: The food rating color-coded system identifies food items with superior nutrition, and lower caloric density. The smartphone app, incorporating the system, has the potential to improve nutrition; reduce the risk of developing diabetes, hypertension, heart disease, and stroke; and improve public health.

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Due to the nutritional transition in the last decades, the risk factors linked to food nutrition are in the spotlight of public policy and reduction of their prevalence is a key goal in the public health promotion strategies involving food security and nutrition (FSN). Understanding the factors underlying poor nutrition status is a must in order to execute successful policy interventions in the general population. This paper analyses the impact that social and individual behavior variables have on the risk factors linked to poor nutrition (obesity, high levels of cholesterol, glycaemia and sodium) using data from the National Health Survey 2009-2010 using a Seemingly Unrelated Equations (SUR) approach in order to have a consistent estimation outcome. Findings suggest that variables linked to social environment and individual behavior have a significant impact on the food-related health risk factors, taking account for social, demographic, genetic and economic controls. Unsurprisingly, when people underestimate their nutritional status, it conduces to a greater health risk, explaining up to 6 cms of abdominal girth and 3 points of the BMI index. Also, an insecure neighborhood and weak social networks explain part of the health risk. These results are a starting point to discuss the design of public policy regarding health and nutrition in order to promote the food security especially regarding information and education programs, where there is the possibility to strengthen the social support networks.

Los factores de riesgo a la salud asociados con la alimentación son un foco clave en las estrategias de promoción de la salud y de seguridad alimentaria y nutricional en Chile (SAN). Este artículo entrega un análisis de los efectos que variables conductuales y sociales tienen sobre los factores de riesgo asociados a una mala nutrición (obesidad, altos niveles de colesterol, glicemia elevada y altos niveles de sodio), en base a la Encuesta Nacional de Salud 2009-2010 utilizando una estimación por regresiones aparentemente no relacionadas (SUR). Los resultados revelan que las variables asociadas a aspectos conductuales y sociales tienen un impacto significativo en los factores de riesgo de salud alimentaria, controlando por variables demográficas, genéticas y socioeconómicas. Destaca el efecto de la subestimación de las personas respecto a su estado nutricional, que puede explicar hasta 6 cm de circunferencia abdominal y 3 puntos en el IMC. Asimismo, las redes de apoyo social y económico a nivel individual juegan un rol fundamental. Los resultados entregados son un insumo relevante para la discusión sobre los mecanismos que la política pública debiese tener a fin de promover la seguridad alimentaria y nutricional, en particular al diseñar programas de educación e información a la población, donde existe la posibilidad de fortalecer las redes de apoyo existentes.

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OBJECTIVES: The effects of nutritional management among other intervention components have not been examined for hip-fractured elderly persons with poor nutritional status. Accordingly, this study explored the intervention effects of an in-home program using a comprehensive care model that included a nutrition-management component on recovery of hip-fractured older persons with poor nutritional status at hospital discharge. DESIGN: A secondary analysis of data from a randomized controlled trial with 24-month follow-up. SETTING: A 3000-bed medical center in northern Taiwan. PARTICIPANTS: Subjects were included only if they had "poor nutritional status" at hospital discharge, including those at risk for malnutrition or malnourished. The subsample included 80 subjects with poor nutritional status in the comprehensive care group, 87 in the interdisciplinary care group, and 85 in the usual care group. INTERVENTIONS: The 3 care models were usual care, interdisciplinary care, and comprehensive care. Usual care provided no in-home care, interdisciplinary care provided 4 months of in-home rehabilitation, and comprehensive care included management of depressive symptoms, falls, and nutrition as well as 1 year of in-home rehabilitation. MEASUREMENTS: Data were collected on nutritional status and physical functions, including range of motion, muscle power, proprioception, balance and functional independence, and analyzed using a generalized estimating equation approach. We also compared patients' baseline characteristics: demographic characteristics, type of surgery, comorbidities, length of hospital stay, cognitive function, and depression. RESULTS: Patients with poor nutritional status who received comprehensive care were 1.67 times (95% confidence interval 1.06-2.61) more likely to recover their nutritional status than those who received interdisciplinary and usual care. Furthermore, the comprehensive care model improved the functional independence and balance of patients who recovered their nutritional status over the first year following discharge, but not of those who had not yet recovered. CONCLUSIONS: An in-home program using the comprehensive care model with a nutritional component effectively improved the nutritional status of hip-fractured patients with poor nutrition. This comprehensive care intervention more effectively improved recovery of functional independence and balance for patients with recovered nutritional status.

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OBJECTIVES: To study the association between maternal vitamin B12 levels and fetal growth restriction. METHODS: In this nested case-control study, a cohort of low-risk women attending the antenatal clinic had their blood samples taken and stored at 28-31 weeks gestation. They were followed until delivery. Fifty-eight women delivering babies less than 2500 g were taken as cases and an equal number of controls delivering babies more than 2500 g were taken from the same cohort. Their B12 levels were assayed and studied for statistical significance. RESULTS: The baseline characteristics of both groups were similar. The number of women with serum B12 levels less than 200 pg/mL were similar in both groups: 33% versus 29% (P = 0.84). Type of kitchen fuel used was taken as a surrogate marker for socioeconomic status. More women in the cases used non-LPG (liquid petroleum gas) kitchen fuels such as kerosene and wood than in controls, 35% versus 19% (P = 0.06). CONCLUSIONS: No association between maternal vitamin B12 levels and fetal growth restriction was found in this study. Low birth weight babies were more common in women of low socioeconomic status.

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