Dietary patterns in pregnancy and associations with nutrient intakes

Despite the recent popularity in the use of dietary patterns to investigate diet-disease associations, the associations between dietary patterns and nutrient intakes have not been fully explored. This paper determines the linear and non-linear associations between estimated nutrient intake (considered as both absolute and relative intake) and distinct dietary patterns, obtained during the third trimester of pregnancy using principal components analysis (PCA). It also examines the proportion of variability explained by the patterns in food and nutrient intakes. Pregnant women were asked to record the frequency of consumption of a variety of food items as part of regular self-completion questionnaires, the primary source of data collection in the Avon Longitudinal Study of Parents and Children, 12 035 cases were available. Individual dietary components were identified using PCA and scores on these components were related to estimated nutrient intakes. Five individual dietary patterns were established to best describe the types of diet being consumed in pregnancy. Scores on the ‘processed’ and ‘confectionery’ patterns were negatively related to the estimated intake of most nutrients with the exception of energy, fats and sugars, which increased with higher scores. Scores on the ‘health-conscious’ and ‘traditional’ components showed positive linear relationships with all nutrients. The results presented here suggest that dietary patterns adequately characterize dietary intake. There is, therefore, potential for dietary patterns to be used as a valid tool in assessing the relationship between diet and health outcomes, and dietary pattern scores could be used as covariates in specific nutrient-disease studies

Who is leading Europe's cities?

The majority of Europeans live in urban areas, giving cities a critical role in addressing the continent’s most pressing policy challenges, from inequality to climate change. LSE Cities’ European Cities Programme has created a knowledge hub of key data from nearly 160 of Europe’s capital and largest cities, allowing them to track the changing nature of these challenges, and how cities approach them. Among other things, they are monitoring the changing profile of Europe’s elected city leaders, the extent to which they reflect Europe’s growing diversity, and changes in the urban political landscape

Public innovation: building capacity in Europe’s city governments

This new report, led by LSE Cities and developed in partnership with Bloomberg Philanthropies and Eurocities, is based on a Eurocities Pulse survey of 65 European cities and seven deep-dive case studies. It maps the landscape of government innovation capacity in Europe’s cities, and asks what’s working, what can cities learn from each other, and where they need more support to meet the challenges of the 21st century through city government innovation. Cities across Europe, like those around the world, are grappling with unprecedented challenges – whether it’s addressing the climate crisis, managing disruptive technologies, fostering more inclusive economies, or supporting rapidly ageing populations. The scale and urgency of these challenges mean cities are confronted, as perhaps never before, with the need to innovate. Public sector innovation – from mission-driven policies to citizens’ assemblies or new cross-sector leadership roles – is increasingly being recognised as a necessity rather than a ‘nice-to-have’. But innovation in city governments does not happen by magic. City governments must build up their innovation muscles – their capacity to generate new ideas, test them and learn the lessons. Building on work by the OECD and others, this report identifies four key components that make up a city’s capacity to innovate: leadership capabilities, organisational capabilities, analytical capabilities, partnership capabilities. This report describes how European cities are working to build their innovation capacity across these four components

The effect of comorbidities on diagnostic interval for lung cancer and mesothelioma: A cohort study using linked data from the Clinical Practice Research Datalink and the Cancer Registry

Objective Resilience in healthcare has been defined as “the capacity to adapt to challenges and changes at different system levels, to maintain high quality care”. This work aimed to investigate how the challenges posed by the presence of comorbidities impacted on the delivery of timely lung cancer/mesothelioma diagnosis in older patients. Methods Patients with incident lung cancer/mesothelioma aged at least 65y in 2019 were identified in the Clinical Practice Research Datalink and linked Cancer Registry data. Diagnostic interval (DI) was defined as time from first presentation with a symptom suggestive of lung cancer/mesothelioma to diagnosis date, including symptoms up to 12 months pre-diagnosis. Co-morbidities were grouped as four “alternative explanation” conditions, which might mimic lung cancer symptoms, and ten “competing demand” conditions, which might delay cancer referral by competing for the clinician’s time. Other factors considered were usual consultation frequency, smoking and BMI. Associations with DI were investigated using multivariate linear regression. Results Data were available for 10424 lung cancer/mesothelioma patients. In adjusted analyses DI was longer in patients with “alternative explanation” conditions, increasing by 27.6 (95%CI 22.9 – 32.4 days) and 72.0 (65.6, 78.4) days in patients with one and two or more conditions respectively. Number of competing demand conditions was not associated with DI in adjusted analyses. However, both usual consultation frequency and increasing consultation frequency in the year before diagnosis were independently positively associated with diagnostic interval, which was 23.0 (17.8, 28.3) days higher in patients with an increased consultation rate. DI was also increased in ever-smokers and in underweight patients compared to those in the normal weight range. Conclusion The presence of conditions offering alternative explanations for lung cancer/mesothelioma symptom is associated with delayed diagnosis. Patients with higher consultation frequencies also had longer DIs, implying competing demand is also an issue. Strategies to increase the resilience of healthcare systems to these challenges to timely diagnosis should be considered

Dental x-rays and the risk of thyroid cancer and meningioma: a systematic review and meta-analysis of current epidemiological evidence

Background: Exposure to moderate-to-high doses of ionising radiation is the only established environmental risk factor for thyroid cancer and brain and CNS tumours. Considering the high life-time prevalence and frequency of exposure to dental x-rays, the most common source of diagnostic radiation exposure in the general population, even a small associated increase in cancer risk would be of considerable public health importance. With the objective to inform clinical practice and guidelines, we synthesised the current epidemiological evidence on the association between dental x-rays and the risk of thyroid cancer, meningioma and other cancers of the head and neck region. Methods: The Medline, Embase and Web of Science databases were searched to identify eligible studies. Summary odds ratio/relative risk estimates and confidence intervals were extracted, and pooled risk ratios (RR) for each cancer were calculated using random effects meta-analysis. Results: The literature search identified 5537 publications; of these, 26 studies including 10,868 cancer patients were included in the synthesis. The random effects meta-analyses, based on seven studies of thyroid cancer (six case-control, one cohort) and eight studies of meningioma (all case-control), showed that multiple (or repeated) exposures to dental x-rays were significantly associated with an increased risk of thyroid cancer (pooled RR = 1.87, 95% CI 1.11–3.15) and meningioma (pooled RR = 1.53, 95% CI 1.26–1.85). There was no association with glioma, and there were too few studies of other cancers of the head and neck region to conduct a meaningful meta-analysis. Conclusions: Based on a meta-analysis of retrospective case-control studies, these findings provide some support to the hypothesis that multiple (or repeated) exposures to dental x-rays may be associated with an increased risk of thyroid cancer and meningioma. These studies did not include individual organ doses and ages at exposure, and are subject to recall bias and other limitations. Furthermore, the thyroid exposure has decreased dramatically over time from the use of thyroid shields and improved technology/equipment. Prospective studies, based on dental x-rays records and patient follow-up, are needed to test the hypothesis further and clarify the possible cancer risk associated with dental radiography, as although the risk at the individual level, particularly with improved technology/equipment, is likely to be very low, the proportion of the population exposed is high. Considering that about one-third of the general population in developed countries is routinely exposed to one or more dental x-rays per year, these findings manifest the need to reduce diagnostic radiation exposure as much as possible

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Old cities, new ambitions: the future of urban Europe

Europe’s cities have long been at the cutting edge of civic innovation. But the challenges they are facing – climate crisis, pandemics, growing inequalities, migration, populism, new technologies – can feel increasingly daunting. Over the last two years, LSE Cities has been working on a new initiative to support Europe’s urban governments as they navigate the complex challenges ahead. The European Cities Programme, a research, engagement and capacity building programme supported by Bloomberg Philanthropies, brings together city leaders, policy makers and civil society movements from across the continent to plan pathways towards more just, sustainable and democratic futures

Hexanuclear Ln6L6 Complex Formation by using an Unsymmetric Ligand

Multinuclear, self‐assembled lanthanide complexes present clear opportunities as sensors and imaging agents. Despite the widely acknowledged potential of this class of supramolecule, synthetic and characterization challenges continue to limit systematic studies into their self‐assembly restricting the number and variety of lanthanide architectures reported relative to their transition metal counterparts. Here we present the first study evaluating the effect of ligand backbone symmetry on multinuclear lanthanide complex self‐assembly. Replacement of a symmetric ethylene linker with an unsymmetric amide at the centre of a homoditopic ligand governs formation of an unusual Ln6L6 complex with coordinatively unsaturated metal centres. The choice of triflate as a counterion, and the effect of ionic radii are shown to be critical for formation of the Ln6L6 complex. The atypical Ln6L6 architecture is characterized using a combination of mass spectrometry, luminescence, DOSY NMR and EPR spectroscopy measurements. Luminescence experiments support clear differences between comparable Eu6L6 and Eu2L3 complexes, with relatively short luminescent lifetimes and low quantum yields observed for the Eu6L6 structure indicative of non‐radiative decay processes. Synthesis of the Gd6L6analogue allows three distinct Gd···Gd distance measurements to be extracted using homo‐RIDME EPR experiments