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To provide a scientific basis for establishing a portion size database for dietary assessment and nutritional education, we determined the portion sizes of commonly consumed food groups among Japanese children and adolescents aged 3–17 years. This study analysed 8-day weighed dietary record data from a nationwide survey conducted between November 2016 and August 2020. Participants were grouped into preschoolers (3–6 years, n=572), elementary school children (7–12 years, n=406) and middle/high school students (13–17 years, n=379). Age- and sex-specific portion sizes of 73 food groups were calculated as weighted averages of median portion sizes of the food items within each group, using the number of consumers for each item as weights. Overall, older participants had larger portion sizes than younger participants, but the magnitude of this difference varied between sexes and food groups. For most food groups, middle/high school students consumed 1.2–1.5 times (29 and 45 food groups for boys and girls, respectively) or 1.6–1.9 times (32 and 18 food groups for boys and girls, respectively) larger portion sizes than preschoolers. Portion sizes among middle/high school students were at least twice as large as those among preschoolers for ten food groups in boys, including staple foods, pork/beef, some vegetables, some beverages and salty snacks, but only for three food groups in girls. In conclusion, these differences in portion sizes according to age, sex and food group should be taken into account when assessing dietary intake and designing nutritional education for portion size control.
Nutrient-stimulated hormone therapies (NuSH) therapies, a key class within obesity management medications, have reshaped obesity and type 2 diabetes care, producing substantial weight loss, improved glycaemic control, and significant cardiometabolic benefits in adults and adolescents. Yet outcomes vary widely, and NuSH therapy-induced changes in appetite, eating behaviour, and gastrointestinal function can compromise nutrient intake, lean mass preservation, and long-term adherence. This review synthesises evidence across nutrition, behavioural science, microbiota research, and metabolic–bariatric surgery (MBS) to outline supportive strategies that optimise clinical outcomes with NuSHs.
Preclinical studies consistently show that NuSH therapies shift gut microbiota toward “lean-associated” profiles, while emerging human findings suggest that baseline microbial signatures may contribute to variability in response and tolerability. However, evidence in humans remains limited, heterogeneous, and underpowered. Across age groups, structured nutritional and behavioural support remains essential to ensure nutrient adequacy, manage side effects, strengthen adherence, and guide sustainable lifestyle change.
Key research priorities include defining behavioural and microbial contributors of treatment response and adherence, evaluating microbiota-targeted adjuncts, and developing scalable, multidisciplinary care models for both adult and paediatric populations. NuSH therapies are powerful tools, but their long-term success depends on integrated, personalised nutrition and behavioural care, with growing opportunity for microbiome-informed approaches.
The rules-based international order faces an existential paradox. Eight decades after its founding, international law has never been more vital to human flourishing, yet it has also never been more imperilled. Developments in recent years such as the invasion of Ukraine and the erosion of the multilateral trading system represent more than institutional failures – they expose critical fault lines that, if left unaddressed, threaten to fracture the foundational architecture of international law. This article explores what these trends reveal about the future of the international rule of law and contends that the way forward requires a spirit of sober optimism – one that neither abandons hope nor ignores hard realities about the existing legal order. It suggests that this approach represents our best hope for securing humanity’s shared future.
Mohenjo-daro was a major city of the Indus Civilisation (c. 2600–1900 BC), with excavations revealing evidence for public infrastructure, civic amenities and hundreds of residences. Archaeologists traditionally assume that urbanism is accompanied by economic stratification, but, at Mohenjo-daro, qualitative evidence of inequality is absent. Drawing on early excavation data, the authors here calculate Gini coefficients of residence area, providing a quantitative proxy of economic inequality. Their results indicate that Gini coefficients, and thus inequality, declined over time, coinciding with increased prosperity and the development of the city’s street plan, indicating that governance likely helped limit economic inequality.
The UK food-based dietary guidelines (FBDG) are a key public health tool that provides evidence-based recommendations for a healthy diet. However, adherence is low, with less than 0.1% of the UK population meeting all nine recommendations set out in the Eatwell Guide. A population-level shift towards a diet aligned with the FBDG would lower rates of obesity and non-communicable diseases (1). Health professionals, who play a central role in translating dietary guidance into practice, have highlighted limitations in both the FBDG and its communication. This review highlights the views of health professionals in calling for a substantial “shake up” of the Eatwell Guide. It sets out considerations of updating the UK dietary recommendations to include the integration of sustainability alongside nutrition modelling, and a review of supporting tools, resources and communication strategies. Investment from the UK government together with engagement from health professionals and other unbiased stakeholders is needed to develop a government-created and funded central hub of practical and adaptable resources which pulls together efforts from individual health professionals and other organisations to provide practical advice that can be tailored and personalised for individuals and diverse communities. This review summarises the current views of health professionals on the Eatwell Guide, advocating for a comprehensive “shake-up” of the UK FBDG and its communication to improve population’s adherence to dietary patterns that support both human and environmental health.
In 1971, Davies proved that finitely many parallel line segments can be simultaneously fully rotated in an arbitrarily small area. In this paper, we show that an even stronger statement holds: The unit square can be fully rotated in such a way that each initially vertical line segment sweeps a set of small area.
A set in ${\mathbb{R}}^n$ is said to have the strong Kakeya property if for any two of its positions, the set can be continuously moved between these two positions in an arbitrarily small volume. We use the above result to show that a wide family of sets in ${\mathbb{R}}^3$, for instance, the lateral surface of a cylinder, have the strong Kakeya property.
Mobility limitations due to chronic musculoskeletal pain are a major contributor to disability in older adults, yet current pharmacological treatments often have limited efficacy and increase the risk of polypharmacy. Omega (ω)-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have demonstrated anti-inflammatory and analgesic properties, but are under-consumed among older U.S. adults. Krill oil, a marine-derived source of EPA and DHA with enhanced bioavailability compared to typical fish oils and additional bioactive compounds such as astaxanthin and choline, may offer a promising nutritional intervention. This pilot study will assess the feasibility and acceptability of a 3-month randomized, double-blind, placebo-controlled trial of krill oil supplementation (4 g/day: 1,288 mg EPA+DHA, 0.45 mg astaxanthin, 320 mg choline) versus placebo (mixed vegetable oils) in 40 community-dwelling adults aged ≥60 years with chronic musculoskeletal pain. Primary outcomes include feasibility (recruitment, retention, adherence) and acceptability (participant satisfaction). Secondary outcomes include changes in the omega-3 index, ω-6/ω-3 ratio, and inflammation (hs-CRP), as well as exploratory changes in pain intensity and functional interference, and physical function (Short Physical Performance Battery, 6-Minute Walk Test). Findings will inform the design of future fully powered trials that may ultimately contribute to the evidence for omega-3 supplementation as a non-pharmacological strategy to support healthy aging and functional independence in older adults.
This study aimed to identify the factors associated with mortality and the duration of hospital and paediatric intensive care unit (PICU) stay in children diagnosed with acute myocarditis (AM).
Methods:
This multicentre retrospective study was conducted across 11 PICUs over an 18-month period. Cases were classified as survivors or non-survivors, and comparisons were made between the two groups. The factors influencing hospital and PICU length of stay (LOS) were analysed only among survivors.
Results:
A total of 90 patients were included, of whom 54 (60%) were female. The PICU mortality rate was 21.1%. Significant differences between survivors and non-survivors were observed in sex distribution, presence of chronic disease, presenting symptoms (exercise intolerance and vomiting), hypoxia, hypotension, and tachycardia at admission, hospital LOS, intensive care scores, initial and peak pro-brain natriuretic peptide levels, initial and final left ventricular ejection fraction (LVEF), presence of cardiogenic shock, need for respiratory support, and use of inotropic agents (p < 0.05). Among survivors, younger age and lower initial LVEF were associated with longer PICU LOS, whereas higher intensive care scores and elevated cardiac biomarker levels showed positive correlations with both hospital and PICU LOS.
Conclusion:
In paediatric patients with AM, younger age, lower initial LVEF, and higher intensive care scores and cardiac biomarker values are associated with prolonged PICU stay. Early identification of these factors may help predict clinical course and optimise intensive care management.
Colchester Museums has collected Roman-period medical instruments from the town since the late nineteenth century. Brought together here, along with items from the town housed in other institutions, their typological links or differences are explored, along with their wide range of uses. They are set in a variety of contexts, including a conquest-period British Doctor’s kit from Stanway, near Colchester, the alloys used in their manufacture, their distribution across the town and its suburbs, the diseases evident from late Romano-British human remains in the town’s cemeteries, and herbal remedies and other treatments. Interpretation of a previously enigmatic collyrium stamp attests to an eye infection not previously recorded in Roman Britain.
Self-concept in adolescence plays a key role in psychological adjustment, yet its development in twins remains underexplored — especially in Central Europe. While previous studies suggest minor differences between monozygotic (MZ) and dizygotic (DZ) twins, cultural and contextual influences may affect how twins perceive themselves. This mixed-method study examined 336 Czech adolescent twins (168 twin pairs; 32 MZ, 136 DZ) aged 11–15 years. Participants completed three standardized instruments: the Behavioral and Psychological Adjustment Questionnaire (BPQA), the School Performance and Adjustment Scale (SPAS), and the Rosenberg Self-Esteem Scale (RSES). Quantitative analyses included t tests, Analyses of Variance (ANOVAs), and Pearson correlations. To triangulate findings, focus group interviews were conducted with three twin pairs and analyzed thematically. No statistically significant differences were found between MZ and DZ twins across BPQA, SPAS, and RSES measures. However, small, nonsignificant trends suggested slightly higher emotional self-concept scores in MZ twins. A modest gender difference emerged: girls reported more internalizing symptoms. Correlational analysis showed that lower behavioral difficulties were associated with higher school adjustment and self-esteem. Thematic analysis from focus groups confirmed key patterns such as the emotional safety of twinship and the struggle for individuality. Zygosity does not appear to be a major predictor of self-concept in early adolescence. Instead, self-perception in twins is shaped by a complex interplay of mental health, family dynamics, and peer context. Future research should compare twin self-concept development across cultures to further examine sociocultural influences.
In preparation for a planned change of Emergency Medical Services triaging of suspected stroke dispatch in Alberta, we conducted a modeling exercise to predict the return on investment (ROI) of switching from the current endovascular thrombectomy (EVT) within a 6 h window to a 24 h window.
Methods:
Using the Alberta Health Services administrative databases, we estimated the health service utilization (HSU) (including inpatient, outpatient, physician services and prescription drugs) cost of patients with stroke treated with EVT24h following the case-mix group plus methodology. The impact of EVT on HSU cost avoidance (B) and the cost (C) of EVT24h implementation were estimated, including costs for EVT procedure, diagnostic imaging and ambulance for all suspected strokes. Finally, ROI was calculated as the benefit divided by the cost (ROI = B/C). Threshold, deterministic and probabilistic sensitivity analyses were performed.
Results:
There were 288 patients treated with EVT24h between 2021/22 and 2023/24. The HSU cost per patient in the year following EVT treatment was estimated at $92,201. Given the impact of EVT was 30%, the benefit of EVT was estimated at $39,515. The cost of EVT24h implementation was $24,358 per EVT patient. Accordingly, ROI was estimated at 1.6 (ranged 0.7−2.0), and cost avoidance per patient was $15,157 (ranged − $8013 to $25,362). Given that there were 96 EVT24h per year, the cost avoidance for the health system would be $1.5 million annually. The probabilistic sensitivity analysis showed that the probability for EVT24h to be cost-avoidable (or ROI > 1) was 88.5%.
Conclusion:
The expansion of EVT from 6 to 24 h is expected to result in a positive ROI.
Over the last 20 years, many countries have experienced the rise of radical right-wing populist (RRP) actors that threaten democratic governance, including in Latin America. These actors have deployed a variety of discursive frames based on economic grievances and (perceived) changing social values. The 2018 elections in Costa Rica were part of this phenomenon: a right-wing populist outsider presidential candidate deployed several frames and earned the most votes in the first round of voting. We analyze support for this candidate to understand which sectors of society were galvanized by the deployment of economic, anti-establishment, and cultural frames. We find that economic frames had much weaker traction than anti-establishment and cultural frames and that opposition to same-sex marriage was the frame with the strongest galvanizing effect across a wide range of demographic groups, beyond the expected ones. These findings support extant scholarship demonstrating the effective politicization of cultural issues by RRP actors for electoral purposes.
Currently, market demand indicates a trend towards the use of milk proteins in food products. Technological innovations in milk protein production have facilitated the development of new products that can be adapted to various food systems. Despite the growing use of milk protein concentrates (MPCs), much remains to be understood regarding how the interactions between these proteins can lead to a more cost-effective ratio and better utilization of their properties. Although a variety of MPCs are available in the market, the industry may face difficulties replacing one brand's product with another. This is because although the products have the same protein content, their production history can interfere with their technological properties. Therefore, the objective of this study was (a) to create a protocol for analyses that allows the segregation of MPCs based on their key characteristics and, using these results and statistical treatments, (b) to develop a diagram to guide the industry, research and development sectors, and/or procurement departments on the potential application of these products and even the possible substitution of one MPC for another. To this end, nine MPC brands were classified based on their rehydration capacity, browning potential, foaming ability and thermal stability. The results of each analysis were scored to generate a rating that classified the samples and enabled the creation of a technological application diagram.
Freyberg Place in Auckland’s central business district has emerged as a focal site for youth cultural gatherings. Within this space, university students have localised transnational popular culture, generating new cultural meanings, identities, and affiliations. Over the past decade, Hallyu, and K-pop in particular, has expanded significantly in Aotearoa, New Zealand. This study draws on personal accounts from university student K-pop fans of diverse backgrounds, with attention to their involvement in Auckland’s K-festival, random play dances, and the University of Auckland K-pop Planet club and its Konstellation dance crew. These narratives demonstrate how participation in K-pop activities facilitated adaptation to the residential, social, and academic challenges of university life, while simultaneously fostering peer networks and community belonging. Engagement in these events also enabled students to acquire leadership experience and transferable skills relevant to future employment. Face-to-face fan practices and embodied participation through dance provided an avenue for affective immersion, reinforcing identification with global fan networks. For these students, K-pop constituted both an alternative to Western popular music and a medium through which they articulated transnational identities, positioning themselves as globally connected cultural consumers.
Recent work in variationist sociolinguistics has argued for greater interactional accountability in analyses of linguistic variation. The present article contributes to this line of inquiry by exploring the interactional conditioning of a relatively new pronoun – man – in two datasets: (i) a corpus of speech and social media data from young people in East London recorded in 2016/17 and (ii) a more recent social media corpus of fifty English-language TikTok videos and their comments. Analyses reveal that man is principally used as a third-person singular pronoun (man said ‘one two five’) and less often as a first-person singular pronoun (man’s doing that voice recording thing) contra to previous findings. I argue that third-person singular man is most commonly used in so-called moments of ‘byplay’ in which the interlocutor is temporarily excluded from the discourse. In this context, man draws attention to the actions or comments of an interlocutor, typically for ridicule or emphasis. I then briefly consider the relationship of man to the pronominal use of bro (bro said ‘he’s going to heaven’) before speculating that the interactional potentials of man/bro could, potentially, promote their diffusion beyond the communities in which they first emerged.