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enefits during ARRA did not significantly impact food security or diet quality in low-income children and adolescents. Additional research to better understand how SNAP benefits impact dietary choice is warranted.

The increase in SNAP benefits during ARRA did not significantly impact food security or diet quality in low-income children and adolescents. Additional research to better understand how SNAP benefits impact dietary choice is warranted.

The Final Rule of the Healthy Hunger Free Kids Act, published in 2016, required school districts participating in the federal Child Nutrition Programs to update their local wellness policies to reflect the more stringent requirements effective June 30,2017.

Our aim was to investigate whether Wisconsin school wellness policies (SWPs) were updated after the Final Rule, measure policy quality change, and describe mechanisms of successful policy change.

From 2016 through 2018, an explanatory sequential mixed-methods study examined change in SWP quality before and after the Final Rule was published. SWPs were collected in 2 waves reflecting policies written before and updated after the July 21, 2016 publication of the Final Rule. Semi-structured key-informant interviews were conducted with districts that demonstrated significant policy improvement.

Quantitative analysis examined 442 Wisconsin school districts’ SWPs. Semi-structured interviews were conducted with 14 school districts that demonstrated signife districts showed policy quality improvement in most areas. Interviews with successful districts indicate the common need for empowered leaders and supportive environments to facilitate culture change around student wellness.

Fewer than half of Wisconsin school districts updated their policies in the 10 months after the Final Rule was published. SWP from these districts showed policy quality improvement in most areas. Interviews with successful districts indicate the common need for empowered leaders and supportive environments to facilitate culture change around student wellness.

The nutritional status of women in the preconception period is of paramount importance due to its role in reproduction.

Our aim was to assess overall diet quality during the preconception period and its association with infant birth weight adjusted for gestational age (GA).

This is an observational longitudinal cohort of Hispanic people living in the United States.

Data are from the Hispanic Community Health Study/Study of Latinos baseline (2008-2011) and second clinic examinations (2014-2017). Included are the first 497 singleton live-born infants among the 2,556 women (younger than 45 years) who attended the second visit. Field sites were located in Miami, FL; Bronx, NY; Chicago, IL; and San Diego, CA, and represent individuals with heritage from Cuba, Dominican Republic, Mexico, Puerto Rico, and Central and South America.

Diet assessment included two 24-hour recalls from baseline. The 2010 Healthy Eating Index (HEI-2010) was used to measure diet quality, with higher scores indicating better qualit tertile of the HEI-2010 score was associated with a higher birth-weight z score and birth weight for GA percentile, and the continuous HEI-2010 score was only associated with birth weight for GA percentile. Preconception body mass index (calculated as kg/m

) did not modify these associations.

Overall diet quality, as measured by the HEI-2010, in the preconception period is associated with infant birth weight adjusted for GA among US Hispanic and Latina women.

Overall diet quality, as measured by the HEI-2010, in the preconception period is associated with infant birth weight adjusted for GA among US Hispanic and Latina women.

Emerging research indicates that eating timing may influence dietary intake and metabolic health. However, studies to date have not examined the association of multiple measures of eating timing with both dietary intake and metabolic health in adults with overweight and obesity.

To examine the association of multiple measures of eating timing with dietary intake (ie, dietary composition, diet quality, and eating frequency) and metabolic health (ie, body composition and cardiometabolic risk).

This is a cross-sectional analysis of baseline data from a weight loss and maintenance intervention collected from May 2015 to January2018.

Participants were women with overweight or obesity who were dependents of active duty and retired military personnel (N= 229; mean ± standard error, BMI= 34.7 ± 0.4 kg/m

, age= 40.9 ± 0.7 years). The study was conducted at military installations in Massachusetts, Connecticut, New York, Colorado, and Kentucky.

Eating timing variables examined included daily eating interval (d support for the mechanistic targeting of eating timing in behavioral interventions aimed at improving dietary intake and body composition.

These findings lend support for the mechanistic targeting of eating timing in behavioral interventions aimed at improving dietary intake and body composition.

To co-register conventional computed tomography angiography (CTA), with exvivo micro-computed tomography (microCT) and histology of popliteal atherosclerotic plaques. Improving the non-invasive imaging capabilities may be valuable to advance patient care with peripheral arterial obstructive disease towards lesion and individual based treatment.

In this prospective observational study, 12 popliteal arteries from 11 symptomatic patients who had undergone transfemoral amputations for chronic limb threatening ischaemia and who had pre-operative CTA, were analysed exvivo by microCT and histology. A total of 353 histological cross sections were co-registered with microCT and CTA, and classified as lipid rich (LP, n=26), fibrous (FP, n=80), or calcific (CP, n=247) plaques. find more CTA and microCT plaque density was calculated in 791 regions of interest as Hounsfield units (HU).

CTA and microCT could identify plaque components that were confirmed by histology such as fibrous tissue (FP), lipid pool/core (LP), and calcius becoming a useful tool for exvivo assessment of atherosclerosis and towards lesion based treatment.

CTA and microCT can be used to identify histological atherosclerotic plaque components, with better diagnostic performance for microCT. This study demonstrates the feasibility of using microCT to assess plaque morphology lesions in a manner that approaches histology thus becoming a useful tool for ex vivo assessment of atherosclerosis and towards lesion based treatment.

Colonoscopy demands a considerable amount of resources, and little is known about its diagnostic yield among inpatients.

To assess indications, diagnostic yield and findings of colonoscopy for inpatients, and to identify risk factors for relevant findings and cancer.

Multicentre, prospective, observational study including 12 hospitals. Consecutive adult inpatients undergoing colonoscopy were evaluated from February through November 2019.

1,302 inpatients underwent colonoscopy. Diagnostic yield for relevant findings and cancer was 586 (45%) and 112 (8.6%), respectively. Adequate colon cleansing was achieved in 896 (68.8%) patients. Split-dose/same-day regimen was adopted in 847 (65%) patients. Factors associated to relevant findings were age ≥70 years (RR 1.32), male gender (RR 1.11), blood loss (RR 1.22) and adequate cleansing (RR 1.63). Age ≥70 years (RR 2.08), no previous colonoscopy (RR 2.69) and split-dose/same-day regimen (RR 1.59) significantly increased cancer detection. Implementing adequate cleansing and split-dose/same-day regimen in all patients would increase the diagnostic yield for any relevant findings and cancer from 43% to 70% and from 6% to 10%, respectively.

Relevant colorectal diseases and cancer were frequent among inpatients. Factors associated with detection of relevant findings were identified. Adequate colon cleansing and split-dose/same-day regimen significantly increased colonoscopy diagnostic yield.

Relevant colorectal diseases and cancer were frequent among inpatients. Factors associated with detection of relevant findings were identified. Adequate colon cleansing and split-dose/same-day regimen significantly increased colonoscopy diagnostic yield.

Patients’ experience with healthcare professionals could influence their clinical outcomes.

To assess inflammatory bowel disease (IBD) patients’ experience with their disease, their treatment and their relationship with their physician.

A one-week cross-sectional study was conducted in 42 IBD centres. 2011 consecutive outpatients with IBD completed an anonymous self-report questionnaire assessing their experience with and knowledge of IBD.

A quantitative assessment of the doctor-patient relationship revealed that patients’ knowledge of IBD and IBD treatment ranged from 7.4 to 8.3 out of 10. In addition to IBD physicians, other sources of information about IBD and current treatment mainly included the internet (80% and 63%, respectively) and general practitioners (61% and 54%). Knowledge about education programmes (28%) was poor, resulting in a lack of willingness to further use these resources (25%). Concerns about IBD treatment were raised in 76% of patients, mostly related to the fear of adverse events (47%) and a lack of efficacy (33%). The need of alternative healthcare professionals was reported by 89% of the sample.

In a large cohort of patients, we highlighted gaps in the management of patients with IBD regarding the need for higher-quality information and the implementation of alternative healthcare professionals.

In a large cohort of patients, we highlighted gaps in the management of patients with IBD regarding the need for higher-quality information and the implementation of alternative healthcare professionals.Brain radiotherapy (BR) is a well-recognized approach for multiple brain metastases (BMs) from non-small-cell lung cancer (NSCLC). However, the prognosis for these patients remains poor. Apatinib, an antiangiogenic agent targeting vascular endothelial growth factor receptor-2, has shown excellent efficacy in multiple solid tumors. This phase II (WWW. ClinicalTrials.gov Identifier VEGFR-2 NCT03801200) randomized trial aims to evaluate the efficacy and safety of this combined modality paradigm in patients with BMs from driver mutation-negative NSCLC. This is a multicenter, open-label, randomized controlled clinical trial. A total of 90 eligible patients will be allocated in a 11 ratio, to either the experimental group (concurrent apatinib and BR) or the control group (BR alone). The primary endpoint is intracranial progression-free survival. The secondary endpoints include intracranial objective response rate, intracranial disease control rate, intracranial time to progression, overall survival, and occurrence of peritumoral brain edema using standardized measurement. Quality of life and adverse events will also be evaluated. Assessments will be carried out before enrollment (baseline) along with 4 and 12 weeks after radiotherapy, followed by every 12 weeks thereafter and up to 24 months. In summary, the aim of this trial is to demonstrate the clinical efficacy and safety of concurrent BR and apatinib in patients with driver mutation-negative NSCLC with multiple BMs, in efforts to expand management options for this population with poor prognosis.