The design and development of a dashboard for improving sustainable healthy food choices.

Over the last decade, several digital tools have been designed to provide consumers with nutritional and environmental impact information about their food choices post-consumption. Many of these tools lack behavioral change modules, have low user engagement, and ignore inherent environmental nutrition trade-offs to stimulate dietary change. This study presents the design and development of a decision support system to enhance consumer health while meeting sustainability goals from a pre-consumption perspective. The proposed decision support system, Dashboard for Improving Sustainable Healthy (DISH) food choices, employs behavioral features, traffic light labels, and nudges to inform end-users about the nutritional health performance and environmental impact of meals. DISH uses a simple metric that allows end-users to explore the potential minutes of healthy and productive life gained or lost from consuming 100 kcal of a meal. The metric combines the positive or negative nutritional health effects (µ-DALYs) of consuming a meal and environmental damage (endpoint impact expressed in DALYs) on human health. In the DISH application, end-users are rewarded or deducted EnCoins, which represent the number of silver or gold coins lost or gained based on the cost ($) of environmental damage (midpoint impacts) of a meal compared to reference sustainable healthy and unsustainable and unhealthy meal. DISH's gamification module enables end-users to track the potential minutes of healthy and productive life gained/lost and gold or silver rewards or deductions from consuming 100 kcal of a selected meal through cumulative minutes gained or lost and EnCoins. In promoting a sustainable diet culture, the gamification module enables users to create groups and communities where friends and families can track their sustainability performance through meal decisions. The DISH application is currently available online and can be accessed by an end-user through any device. Further pilot studies will focus on testing the technology in partner campus cafeterias.

A systematic review of dietary data collection methodologies for diet diversity indicators.

The purpose of the current study was to critically assess the gaps in the existing methodologies of dietary data collection for diet diversity indicators. The study proposed the importance of smartphone application to overcome the drawbacks. The review paper identified and assessed the conventional methodologies used in diet diversity indicators including Minimum Dietary Diversity for Women (MDD-W), Minimum Dietary Diversity of Infant and Young Child Feeding Practices (IYCF-MDD), and Household Dietary Diversity Score (HDDS). The 80 research studies from 38 countries were critically assessed on the basis of their research aim, study design, target audience, dietary data collection methodology, sample size, dietary data type, dietary data collection frequency, and location point of dietary data collection. Results indicated that most studies employed interviewer-administered 24-h recall assessing the dietary diversity. The review paper concluded that smartphone application had potential to overcome the identified limitations of conventional methodologies including recall bias, social-desirability bias, interviewer training, and cost-time constraints.

Designing sustainable circular bioeconomy solutions for the pulse industry: The case of crude pea starch as a substrate for single cell protein production.

Valorization of crude pea starch has become a key focus in the pea industry's sustainability pursuit. This study aimed to explore the circularity potential of crude pea starch as a nutrient-dense substrate for the solid-state cultivation of yeast (Saccharomyces cerevisiae) Single Cell Protein (SCP). Following the ISO 2006:14040/44 standard, a life cycle assessment (LCA) was performed to ascertain the environmental performance and operational dynamics of baseline and scenario pea starch-based yeast SCP process designs and identify optimal design considerations. Results demonstrated a higher relative contribution to the toxicity categories, with a relatively less contribution to global warming and land use. The distribution and media enrichment processes were identified as the hotspots, contributing about 32-55 % and 40-56 % to global warming and land use, respectively. Generally, train and air freight were more sustainable than lorry freight, respective of mileage and mass. Regarding system alteration, eliminating the media enrichment process could offset about 26 % of land footprint, with a similar trend for most impact categories. Process benchmarking showed up to a 3-fold reduction in global warming impacts relative to soybean meal, and about 71 % offset relative to fishmeal. Consequential LCA showed a general sustainability preference for substituting the aquacultural feeds with pea starch-based SCP, with a stronger emphasis on fishmeal substitution. Overall, these findings highlight the potential of the proposed SCP design as a sustainable upcycling solution with substitutionary potentials for conventional food and feeds, recommending further exploration in value and wealth creation.

Nutritional-environmental trade-offs in potato storage and processing for a sustainable healthy diet.

Over the last decade, poor diets and limited access to nutritious foods have been critical drivers of micronutrient deficiency in human health. However, food fortification at an industrialized scale in developed countries has helped eliminate deficiency-related diseases. In developing countries, fortified foods and biofortified materials have been delivered to nutrient-deficient communities. While these strategies have produced significant and acclaimed results, reports from the Food and Agricultural Organization suggest that over a quarter of the world's population suffers from micronutrient deficiency. This implies that there are still declines in micronutrients in food products at different nodes along the food value chain (FVC). Hence, this study sets out to track micronutrient leakages at specific nodes of the FVC using potato household storage, processing, and consumption in the United States as a case study. The experiment was laid out in a full factorial design with three storage conditions (cupboard at (17.5-22.4 °C, 32.7-48% RH), refrigerator at (-1.8 - 0.89 °C, 37.5-66.1% RH) and ideal condition at (7.2-11.1 °C, 85.0-92.4% RH)), two storage times (2 weeks (±3 days) and 5 weeks (±3 days)) and three household processing pathways (boiling in water, baking at 204 °C, and frying in vegetable oil at 149-204 °C). Additionally, we explored the dynamics of optimal household storage and processing pathways by placing a high, low, or equal priority on environmental sustainability or nutrient retention. The results show that storing potatoes for 5 weeks (±3 days) and processing through boiling (in water at 100 °C), baking (at 204 °C), and frying (in vegetable oil at 149-204 °C) are associated with 33.5%, 40.3% and 15.0% greater nutrient loss than a similar processing scenario after 2 weeks (±3 days) of storage. Additionally, storing and processing potatoes after 5 weeks (±3 days) results in approximately 2.2 ± 0.7 times more damage to human health, ecosystem safety, and resource availability than storing and processing potatoes after 2 weeks (±3 days), averaged between the different storage conditions. Storing and processing after 5 weeks (±3 days) results in approximately 53.6 ± 10.3 times more damage to human health, species disappearing per year, and USD loss than freshly purchased and processed potatoes. Perhaps the most significant finding from the study is that storing potatoes in cupboards and boiling (BL-CP pathway) is optimal for achieving a sustainable healthy diet, as it yields the optimal combination of nutrient retention and low environmental damage. Insights from the study could be translated to support consumer decision-making as they weigh the value of environmental sustainability against nutrition in the context of household potato storage and processing.

Sustainable healthy diet modeling for a plant-based dietary transitioning in the United States.

The potential environmental and nutritional benefits of plant-based dietary shifts require thorough investigation to outline suitable routes to achieve these benefits. Whereas dietary consumption is usually in composite forms, sustainable healthy diet assessments have not adequately addressed composite diets. In this study, we build on available data in the Food4HealthyLife calculator to develop 3 dietary concepts (M) containing 24 model composite diet scenarios (S) assessed for their environmental and nutritional performances. The Health Nutritional Index (HENI) and Food Compass scoring systems were used for nutritional quality profiling and estimates of environmental impact were derived from previously reported midpoint impact values for foods listed in the What We Eat in America database. The diets were ranked using the Kruskal‒Wallis nonparametric test, and a dual-scale data chart was employed for a trade-off analysis to identify the optimal composite diet scenario. The results showcased a distinct variation in ranks for each scenario on the environment and nutrition scales, describing an inherent nonlinear relationship between environmental and nutritional performances. However, trade-off analysis revealed a diet with 10% legumes, 0.11% red meat, 0.28% processed meat and 2.81% white meat could reduce global warming by 54.72% while yielding a diet quality of 74.13 on the Food Compass Scoring system. These observations provide an interesting forecast of the benefits of transitioning to an optimal plant- and animal-based dieting pattern, which advances global nutritional needs and environmental stewardship among consumers.

Design and Development of 'Diet DQ Tracker': A Smartphone Application for Augmenting Dietary Assessment.

The purpose of the current study was to describe the design, development, and validation of the 'Diet DQ Tracker'. The 'Diet DQ Tracker' is the first self-administered smartphone app designed to collect dietary data for diet diversity indicators. The main objective of the app was to replace the traditional methods of dietary data collection, such as in-person or telephone 24 h recall via pen and paper questionnaire or tablets. The real-time meal recording, extensive food database, and automatic score calculations and visualizations for MDD-W, IYCF-MDD, and HDDS have the potential to overcome the drawbacks of 24 h recalls. Recall depends on respondent memory, food expertise, and time consumption and demands skilled interviewers. Further, SAIN, LIM recommendations in the app prompt users to diversify diets with healthy foods. The pilot study determined the acceptability, feasibility, and relative validity of the 'Diet DQ Tracker' with a 24 h dietary recall. The results demonstrated minimal differences in dietary scores by both methodologies. The app, being convenient, easy to use, less time-consuming, and enjoyable, was preferred by the entire study sample over 24 h recall. The app will be continually updated with foods from different cultures for validating in large-scale studies. The future studies will help to improve the subsequent versions of the app.

Transitioning to sustainable healthy diets: A model-based and conceptual system thinking approach to optimized sustainable diet concepts in the United States.

Food production and consumption are essential in human existence, yet they are implicated in the high occurrences of preventable chronic diseases and environmental degradation. Although healthy food may not necessarily be sustainable and vice versa, there is an opportunity to make our food both healthy and sustainable. Attempts have been made to conceptualize how sustainable healthy food may be produced and consumed; however, available data suggest a rise in the prevalence of health-related and negative environmental consequences of our food supply. Thus, the transition from conceptual frameworks to implementing these concepts has not always been effective. This paper explores the relative environmental and health risks associated with highly consumed food groups and develops a methodological workflow for evaluating the sustainability of diet concepts in the context of different health, socio-economic and environmental indicators. In addition, we apply the multi-criteria decision-making techniques (an integrated Analytic Hierarchy Process- Technique for order preference by similarity to ideal solution (AHP-TOPSIS) model) to examine the health and environmental impact of selected sustainable healthy diet concepts implemented in the United States. The principal findings indicate that adopting plant-based diet patterns would benefit the environment and the population's health. However, the up-scale, broad adoption and implementation of these concepts are hindered by critical bottlenecks. Hence we propose potential modification strategies through a conceptual system thinking approach to deliver optimized sustainable diet concepts to aid in the realization of the anticipated benefits of adoption/implementation.

Impact of thermo-sonication on quality indices of starch-based sauces.

In this study, ultrasonication, a physical, relatively cheap, and environmentally benign technology, was investigated to characterize its effect on functional properties of rice starch and rice starch-based sauces. Temperature-assisted ultrasound treatment improved the granular swelling power, fat and water absorption capacities, and thermal properties of rice starch, signifying its suitability in the formulation of starch-based sauces. Rheological characterization of the formulated sauces revealed a shear-thinning flow behavior, well described by the Ostwald de Waele model, while viscoelastic properties showed the existence of a weak gel. Results indicated that ultrasonication significantly enhanced the pseudoplastic behavior of starch-based sauces. Additionally, textural analysis showed that textural attributes (stickiness, stringiness, and work of adhesion) were also improved with ultrasonication. Moreover, enhanced freeze/thaw stability was also achieved with ultrasound-treated starch-based sauces. Overall, the results from this study show that ultrasound-treated starches can be used in the formulation of sauces and potentially other food products, which meets the requirements for clean label and minimally processed foods.

Evaluation of New Antibacterial Drugs and their Combinations in a Murine Model to Identify Short Duration Alternative Chemotherapy for Leprosy.

The objective of the research is to test the efficacy of new drugs and drug combinations in mice infected with Mycobacterium leprae (M. leprae) as alternative to current WHO MDT. Individual drugs tested were Rifampicin (RMP), Rifapentine (RPT) and Moxifloxacin (MOXI). Drug combinations were RMP, Clarithromycin (CLARI), Minocycline (MINO) and RMP, MINO and Ofloxacin (OFLO). RPT drug combinations were RPT, CLARI, MINO and RPT, OFLO, MINO. Both the drugs and drug combinations were used as daily regimen and intermittent regimen. WHO MB MDT served as a positive control. Mice pre-inoculated with M. leprae were allotted to daily and intermittent groups and administered selected drugs and drug combinations. At the end of 12 months post sub-inoculation, mice were sacrificed and the proportion % of viable bacilli were counted using Spearman and Karber method. It was noted that RMP, RPT and Moxifloxacin indicated a range of 89.99% to 99.99% bactericidal effect when used in daily or intermittent doses in both normal and TR mice. Drug combinations showed bactericidal effect comparable to that of WHO MDT. From the study it was concluded that if the present duration of MDT has to be shortened then daily dose regimen with RMP/MINO/OFLO or RPT/CLARI/MINO are recommended for a clinical trial.

Evaluation of anti-bacterial activity of Rifapentine, Clarithromycin, Minocycline, Moxifloxacin, Ofloxacin and their combinations in Murine Model of Rifampicin Resistant Leprosy.

Leprosy, a debilitating disease of the skin and peripheral nerves is caused by Mycobacterium leprae (M. leprae) and is treated by multidrug therapy (MDT) comprising of Dapsone, Rifampicin and Clofazimine. Resistance to any of these drugs poses a threat to the current disease control strategies. With the emergence of Rifampicin resistance in leprosy, it is important that alternative drugs need to be tested to develop a treatment strategy to combat drug resistant leprosy. In the current study, we have investigated WHO MDT, Rifapentine, Clarithromycin, Minocycline, Moxifloxacin, Ofloxacin and their combinations in intermittent and daily dose regimens in rifampicin resistant strains of M. leprae through mouse foot pad experiments in order to determine the loss in viability of M. leprae in response to these drugs and their combinations. Our findings suggest that WHO MDT is still the best combination in Rifampicin resistance cases. Combination of Moxifloxacin with Minocycline and Clarithromycin may also be taken up for clinical trials in cases with Rifampicin resistant leprosy. Rifapentine and Moxifloxacin can be effective alternative drugs to replace Rifampicin where required either in daily dose shorter duration regimens or intermittent dose longer regimen to treat resistant strains.

Measurement of Change in the Knowledge and Attitude about Leprosy in Physiotherapy Students Undergoing Intensive One Week Training in Leprosy.

Leprosy is a disease that causes not only physical problems, but also mental and social problems. In the post integration era, every health care professional needs to understand about leprosy, to be able to diagnose and treat them. Physiotherapy students, in their usual syllabus, have minimal exposure to leprosy, in spite of the fact that they have a major role in preventing impairments and disabilities caused by leprosy, as well as treating such impairments. In order to educate physiotherapy students on leprosy, a one-week intensive training course was organised. This study was done to assess if the intensive training to physiotherapy students resulted in increase in their knowledge on leprosy and change their attitude positively. A batch consisting of 42 physiotherapy students went through the one-week training programme. The improvement in knowledge and attitude were assessed through a pre-test and a post-test design. Results showed that there was significant improvement in knowledge (53.05%) and brought positive change in attitude (75.0%). Such training programmes are recommended for all physiotherapy students.

Factors affecting functional outcome of opponens replacement in median nerve paralysis in leprosy.

In this study, the factors affecting functional outcomes of opponens replacement in median nerve paralysis in leprosy, were investigated. Fifty six patients who underwent opponens transfer between 1995 and 2001 were included in the study. The average duration of follow up is 7.3 years with a range of 4-10 years. Functional assessments were done through assessment of grip strength, pinch strengths and fine manipulation and the results were interpreted using Sundararaj (1984) criteria. 76.6% had excellent or good results, 13.3% fair and 10.1% poor results. Pinch strength, grip strength and fine manipulation showed improvement after surgery. Logistic regression analysis showed that duration of paralysis had a significant independent effect on the outcome.

Long term results of tibilalis posterior tendon transfer for foot drop in leprosy.

Seventy four patients, who underwent tibialis posterior transfer between 1960 and 1970 at the Schieffelin Leprosy Research & Training Centre, were reviewed more than 10 years follow up. Sixty four patients (86.5%) improved from a high stepping gait to a heel toe gait. The foot at rest position and the range of movement which were seen after surgery were retained. Postoperative complications were minimal. Interosseous method was better than the circumtibial. Tibilais posterior tendon transfer has served the gait and foot function in the long term.

Factors affecting functional outcome of surgical correction of claw hand in leprosy.

The objective of this paper is to study the results and the factors that impact the results of claw hand surgery in leprosy. 110 patients who underwent claw hand correction between 2002 and 2006 were followed up and studied. Brand's criteria for objective assessment and a visual analog scale for subjective assessment were used. The factors studied were age, sex, clinical, duration of paralysis, long flexor tightness, degree of contracture and type of surgery. Objective assessment showed Excellent or Good results in 76.6%, Fair in 20% and Poor in 3.4%. Subjective assessment showed that 80.8% were fully satisfied or satisfied. Regression analysis showed that age, degree of contracture,duration of paralysis and long flexor contracture were seen as significant factors impacting results of claw hand correction.

Impact of migration on new case detection rates in leprosy in Gudiyatham Taluk, Tamil Nadu, India.

Migration of persons affected by leprosy was hinted at as early as 1929 (Bhaskara Rao 1930). All new cases of leprosy in Isfahan Province (Iran) were found to be migrants (Asilian et al 2005). Chudasama (2007) suspected increase in leprosy cases in Surat district to migration. These suggest migration contributes to new cases. This study was done to find out 1. Extent of migration among new cases, 2. Characteristics of migrants, 3. Occupational pattern 4.Reasons for migration. 5. Place of origin of migrants 6. Assimilation of migrants into the society. Trained staff collected information regarding migration using special questionnaire from all 222 new untreated cases from the field area of Community Health department during 2004 to 2008. Migrants were 10.4%. Distribution of place of residence, age, gender, marital status, education, mode of detection, Ridley-Jopling and MB/PB classifications of migrants were not significantly different from that of nonmigrants. Grade 2 deformities were more among migrants. All migrants found occupation. Mostly men migrated for job and women for joining their husbands. The role of migration in increasing the number of new cases cannot be minimized. Enhanced efforts should be made to provide adequate medical, health and rehabilitation services for them also.

A preliminary study of locognosia in people affected by leprosy.

Locognosia is the ability to localize a sensory stimulus on the body's surface and can be tested by graded filaments (Semmes-Weinstein monofilaments). This point localization of sensation (locognosia) wastested by SW filaments over four quadrants of the pulp of the fingers in ulnar/median and ulnar paralysis in 38 new patients affected by leprosy. The results were compared with standard testing of sensation at selected sites by Semmes Weinstein monofilament. Both pulp quadrant testing and standard site testing were done in leprosy patients and also in a group of controls. Sensation was tested in 73 hands in leprosy patients and 34 hands in controls. Results indicate a positive correlation between locognosia and standard SW filament testing. When locognosia and standard SW filament tests were compared, there was significant difference between the two tests to pick up abnormal sensation in leprosy patients both over the entire hand and over individual fingers. This preliminary study suggests that locognosia may be a useful tool to diagnose sensory impairment in leprosy. Further studies are required to corroborate this.

Recent trends in new case detection rates in leprosy by age and sex in Gudiyatham Taluk, Tamil Nadu, India.

In the race towards eradication of leprosy, the emphasis has shifted from prevalence to new case detection rates which are proxyfor true incidence rates. There is great need for reliable data on new case detection rates over time, classified by age and sex. In this paper, the trend of age specific and sex specific new cases detection rates, from 2001 to 2009, for the field area of Schieffelin Institute of Health-Research and Leprosy Centre are presented and implications discussed. The appropriate age distribution of Census of India 2001 was used to estimate the age distribution of the area. Three year moving averages were computed for age specific rates. The age group 55+ had the highest rate among all age groups from 2002 to 2006 and afterwards declined a little. The rates of ages 15-34 and 35-54 were high and their patterns over 2002 to 2008 were the same. The specific rates of children (0-14) were declining generally through 2002 to 2008. The specific rates of males were slightly higher than the females all through 2001 to 2009 but the difference between male and female rates was not significant at anyyear (P > 0.05).

Opponens plasty rehabilitation protocol--a case report.

In this case report of opponens plasty, we will attempt to accomplish two objectives: 1) to characterize some innovative modifications to the standard rehabilitation protocol for an opponens plasty and 2) to explain the role and advantages of a new muscle re-education splint in this modified protocol.