Consumer enthusiasm in plant-based eating has resulted in the rapid expansion of plant-based meat (PBM) products. The extensive processing required to simulate meat warrants further investigation regarding PBMs nutritional quality and healthiness, particularly considering the health halo that has surrounded these products. An online audit of dominant UK supermarkets evaluated PBM (n = 209) against ‘standard’ (n = 2143) and ‘reduced’ (e.g. low fat) meat equivalents (n = 100), across eight product categories. This evaluation included NOVA categorisation, Nutritional Profiling Model (NPM) classification, on-pack claims, micronutrient content and product affordability. PBM products were typically more favourable than ‘standard’ meat equivalents for energy density, dietary fibre, total and saturated fat content. However, they contained significantly higher salt in most product categories. Differences between PBM and ‘reduced’ meat comparators were more nuanced. PBM products were significantly more expensive than ‘standard’ meat equivalents in four of the eight product categories (p < .05). Few PBM and zero meat-based products reported micronutrient information. While all PBM and most meat-based products were characterised as ultra-processed, PBM products demonstrated a lower (‘healthier’) NPM score compared to ‘standard’ meat equivalents across all product categories (p ≤ .001). Although no significant differences were detected between PBM and ‘reduced’ meat-based products, a greater proportion of PBM products were classified as ‘healthier’ according to NPM compared to ‘standard’ and ‘reduced’ meat equivalents. Thus PBM products may offer healthier alternatives with the potential to synergistically support public and planetary health. Future manufacturing practices should consider cost-effective fortification and reformulation strategies to improve nutritional quality and affordability of PBMs.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading chronic liver disease worldwide. While total SFA intake has been linked to MASLD, the contribution of specific SFA and the mechanism underlying the SFA-MASLD association remain unclear. This study evaluated the associations of individual SFA with MASLD and the mediating roles of insulin resistance (IR) and serum albumin. We used data from seven National Health and Nutrition Examination Survey (NHANES) cycles (2005–2018) in a cross-sectional analysis. Associations between individual SFA and MASLD were estimated via logistic regression with restricted cubic splines (RCS). Weighted quantile sum (WQS) and quantile g-computation (QGC) models assessed the mixture associations. Mediation analysis evaluated the proportions of these associations accounted for by serum albumin and IR. Compared with the reference group, the highest tertile of intake was associated with increased odds of MASLD for C4:0 (OR = 1·12, 95 % CI 1·01, 1·25), C6:0 (OR = 1·15, 95 % CI 1·04, 1·28), C14:0 (OR = 1·20, 95 % CI 1·08, 1·33), C16:0 (OR = 1·24, 95 % CI 1·12, 1·38) and C18:0 (OR = 1·25, 95 % CI 1·12, 1·39). RCS models revealed largely linear dose–response relationships. Both WQS and QGC indicated a positive joint association of SFA with MASLD, with C16:0 identified as a major contributor. Among SFA significantly associated with MASLD, IR accounted for 30·0–47·4 % of the associations, while serum albumin accounted for 5·9–8·0 %. Higher intakes of short- and long-chain SFA, both individually and collectively, are associated with higher odds of MASLD. IR and serum albumin may partially explain these associations. These findings support the development of precision dietary strategies targeting specific SFA for MASLD prevention.

Public policies contribute to structural racism and health inequities. To dismantle structural racism and advance health equity, methods aligning scientific evidence, community priorities, and political will are needed to implement equity-focused interventions. This study combined community-based participatory research and legal epidemiology methods to inform local policy in East Point, Georgia. The community informed a comprehensive policy approach to address social determinants of health (SDOH) and advance health equity and identified East Point’s Comprehensive Plan Update as an opportunity to advance health equity through policy. Key findings informed a legal epidemiology study to assess variation in including equity and health equity in comprehensive plans across 32 jurisdictions. Limited adoption of equity and health equity provisions were found, revealing opportunities to inform the East Point policymaking process. Research findings were summarized and disseminated to the community and policymakers. In 2023, East Point adopted equity, health, and health equity into its comprehensive plan for the first time. This case study demonstrates that collaborative, multi-sector, community-centered approaches can support policy interventions that address historical race-based, health-harming policies, and thereby dismantle structural racism. Inclusion of health equity in East Point’s comprehensive plan provides a foundation for future implementation of policies that address SDOH and health inequities.

Microsurgical treatment of complex cerebral aneurysms – whether giant aneurysms or those in the technically challenging posterior circulation – carries substantial perioperative morbidity and mortality. Despite significant advances in endovascular therapy, surgical intervention remains the only definitive option for a subset of these lesions. To facilitate dissection and reduce tension within the aneurysm sac, various aneurysm flow arrest strategies have been developed. Early methods included local arrest (e.g., temporary clipping) and systemic arrest (e.g., adenosine-induced asystole, rapid ventricular pacing or total circulatory arrest). These have evolved into more targeted cerebral flow arrest techniques, such as retrograde suction decompression, providing greater precision and control. Because aneurysm flow arrest inherently risks distal cerebral ischemia, hypothermic neuroprotection was introduced to prolong the safe ischemic interval – transitioning from early high-morbidity systemic deep hypothermia to recent selective brain cooling with more favorable outcomes. The integration of multimodal intraoperative neuromonitoring, including evoked potential monitoring and respiratory rate monitoring, for real-time cerebral ischemia detection, has further improved safety. Together, controlled aneurysm flow arrest and selective brain protection with intraoperative neuromonitoring create brief, precisely timed windows that permit safe aneurysm manipulation and definitive treatment of high-risk lesions. As such complex cases are less commonly treated surgically, much of the specialized knowledge is passed informally. This article reviews the anesthetic considerations for the surgical management of giant and posterior circulation aneurysms, drawing on decades of our institutional experience.

The planetary health diet (PHD) is a mostly plant-based diet that aims to optimise human health while minimising the environmental impact of food production. Limited data exist on whether the PHD fulfils key nutritional requirements during pregnancy. This research aimed to examine the PHD in early pregnancy and how it aligns with daily nutrient intake and European Food Safety Authority (EFSA) dietary guidelines. Pregnant women (n 678) from two Irish cohorts (ROLO and MicrobeMom) were analysed, and PHD index (PHDI) scores were assigned based on data from 3-d food diaries. Women were dichotomised by the median score to create a ‘High PHDI’ (> 88·99) and a ‘Low PHDI’ group (≤ 88·99). Differences in nutrient intakes and adherence to dietary guidelines between ‘High’ and ‘Low’ PHDI groups were explored. Compared with those with a ‘Low’ score, those with a ‘High’ PHDI score reported higher intakes of dietary fibre (g/d) (17·32 (13·39, 21·08) v. 21·74 (18·28, 25·88), P < 0·001), Fe (mg/d) (10·48 (8·48, 12·82) v. 12·06 (9·48, 14·60), P < 0·001), folate (µg dietary folate equivalent per d) (250·73 (193·88, 312·45) v. 279·57 (219·43, 356·81), P < 0·001) and Ca (mg/d) (837·75 (695·36, 1056·72) v. 956·57 (751·84, 1155·03), P < 0·001). A greater proportion of women in the ‘High PHDI’ group met EFSA recommendations for dietary fibre intake (10·3 % v. 28·9 %, P < 0·001). The PHD may support maternal nutritional adequacy in pregnancy while promoting environmental sustainability. Our findings provide valuable insights that can inform future dietary recommendations for pregnancy, contributing to both maternal health and planetary well-being.

The purpose of this systematic review and meta-analysis was to investigate the effects of hesperidin supplementation on inflammatory and oxidative stress biomarkers in human adults. A systematic literature search was conducted in PubMed, EMBASE and Cochrane Central Register of Controlled Trials from inception to 4 January 2025 to identify eligible randomised controlled trials. Ten randomised controlled trials with a total of 532 participants were included. The results indicated that hesperidin supplementation significantly reduced the serum levels of C-reactive protein or high-sensitivity C-reactive protein (SMD: –0·43; 95 % CI –0·71, –0·15; P = 0·002) and TNF-α (SMD: –0·51; 95 % CI –0·95, –0·07; P = 0·02) in adults, while no significant beneficial effect of hesperidin on IL-6 was observed (SMD: –0·25; 95 % CI –0·52, 0·01; P = 0·06). In addition, hesperidin intake showed a beneficial impact on the IL-6 level in patients with diseases (type 2 diabetes and myocardial infarction) (SMD: –0·38; 95 % CI –0·72, –0·04; P = 0·03) yet not in healthy adults without diagnosed diseases. Our findings demonstrated that hesperidin supplementation could lower the serum levels of C-reactive protein or high-sensitivity C-reactive protein and TNF-α in adults.

Vitamin D has been associated with depression, potentially via anti-inflammatory mechanisms, yet data are scarce, particularly in adolescence. We investigated (1) whether lower vitamin D status is associated with greater depression severity and (2) whether this association is statistically moderated by inflammation in patients of a child and adolescent psychiatry department. At admission, fasting morning venous blood was drawn. Serum vitamin D (25-hydroxy-cholecalciferol (25(OH)D)) and C-reactive protein (CRP) were analysed in all participants (n 465 (64·7 %♀; 11·3–18·9 years)). In a subsample (n 177), we additionally measured tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ) and interleukin (IL)-1β, IL-6, IL-8 and IL-10. Depression severity was assessed by the Beck Depression Inventory II (BDI-II) (n 450), the Diagnostic System for Mental Disorders in Childhood and Adolescence via self-assessment (DISYPS Self) (n 441) and parent-assessment (DISYPS Proxy) (n 422). Overall, 43·2 % (n 201) were at risk for vitamin D deficiency (< 30 nmol/l), and 73·5–83·2 % – depending on assessment tool – showed at least mild depression. Linear regression revealed an inverse association between 25(OH)D and BDI-II in both crude and CRP-adjusted full-sample models. Logistic regressions showed a robust inverse association between 25(OH)D and DISYPS Proxy, but not for DISYPS Self. Although 25(OH)D was inversely correlated with some pro-inflammatory markers, neither their inclusion in regression models nor formal mediation analyses supported inflammation as a mediator of the vitamin D–depression association. Overall, our results suggest that vitamin D relates modestly to both depression and inflammation in adolescence. However, based on the measured parameters, we cannot confirm that anti-inflammatory effects are the link between vitamin D and depression.

Schistosomiasis mansoni, caused by the trematode Schistosoma mansoni, is a major public health issue in Northeastern Brazil. This study compares the diagnostic performance of Kato-Katz (KK) and spontaneous sedimentation (Lutz) techniques in detecting S. mansoni infections in three areas of Sergipe, Northeastern Brazil, each with varying degrees of schistosomiasis endemicity. We compared the performance of Kato-Katz (KK) and spontaneous sedimentation (SSM) in three localities of Sergipe and Alagoas with different endemicity levels. Stool samples were examined by both methods, and individuals were considered positive if at least one test was positive. KK showed higher sensitivity across all sites (88.5%–100%), while SSM performed better in moderately endemic areas (up to 61.5%). These complementary performance profiles suggest that using both methods in combination could yield a measurable increase in case detection – potentially improving prevalence estimates, guiding more accurate treatment interventions, and strengthening surveillance strategies in areas with heterogeneous transmission intensities.