In Pictures: Japanese Chef Carves Food into Incredible Pieces of Art

Spice Cake with Maple Buttercream Frosting

Ingredients

2-1/3 cups all-purpose flour
1 cup white sugar
1 tsp baking soda
1 tbsp ground cinnamon
1 tsp ground nutmeg
1 tsp ground ginger
1 tsp cloves
1 tsp salt
1 cup packed brown sugar
2/3 cup shortening
1 cup buttermilk
3 eggs

Buttercream Frosting

1/2 cup shortening
1/2 cup butter, softened
1 tsp maple flavoured extract
4 cups icing sugar
2 tbsp milk

Method

  1. To make frosting: Cream butter and shortening together. Add maple flavouring. Gradually add icing sugar. Add milk slowly and continue beating until light and airy. Add more milk if necessary.
  2. Preheat oven to 350°F (175°C). Grease and flour two 9-inch cake pans or one oblong pan.
  3. In a large bowl, sift flour, white sugar, baking soda, cinnamon, nutmeg, ginger, cloves, and salt together. Add brown sugar, 2/3 cup shortening, and buttermilk. Beat 2 minutes.
  4. Add eggs, one at a time, beating well after each addition.
  5. Bake at 350°F (175°C) for 30 to 35 minutes in cake pans, or oblong pan for 45 minutes, until toothpick inserted in center comes out clean. Cool.
  6. Decorate with buttercream frosting.

Makes 1 cake.

Source: Manitoba Egg Farmers

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Better Lifestyle Habits are Useful Additions to Optimize Management of Atrial Fibrillation

Weight loss, regular physical activity and other lifestyle changes are effective yet underused strategies that should be added to optimize management of atrial fibrillation (an abnormal heart rhythm), according to “Lifestyle and Risk Factor Modification for Reduction of Atrial Fibrillation,” a new Scientific Statement from the American Heart Association published today in the Association’s flagship journal Circulation.

Atrial fibrillation (AF) is an abnormal heart rhythm that affects at least 2.7 million people in the United States and is increasing as the population grows older. In AF, the upper chambers of the heart, called the atria, beat rapidly and erratically, interfering with proper movement of blood through the chambers, which can allow blood clots to form. Parts of these clots can break off and flow to the brain, causing an ischemic stroke. People who have AF have a five-fold greater risk of having a stroke compared to people without the condition.

To reduce stroke risk in their patients, health professionals use medications or procedures to regulate the heart rate, prevent abnormal heart rhythms (AF) and reduce blood clotting.

“While established medical treatment protocols remain essential, helping AF patients adopt healthier lifestyle habits whenever possible may further help to reduce episodes of AF,” said Mina K. Chung, M.D., chair of the writing group for the scientific statement, and a cardiologist and professor of medicine at the Cleveland Clinic.

Weight management with weight loss, nutrition interventions among individuals who are overweight and appropriate, individualized physical activity plans to increase fitness are three lifestyle modifications that have the potential to benefit AF patients.

Obesity can contribute to enlargement and stretching of the heart’s upper chambers, changing the way the chambers work and making AF more likely to occur and to be persistent rather than occasional. In an Australian study, people who were overweight or had obesity and lost at least 10% of their body weight were less likely to develop AF or to have it become persistent; and, in some cases, persistent AF became intermittent or disappeared entirely.

In addition, obesity is often associated with sleep apnea, a type of disordered breathing that also raises the risk of AF. Patients with obesity/overweight should be screened for sleep apnea and receive treatment if they have it.

Regular, moderate physical activity does not increase AF risk and may help in preventing and treating the condition. However, the statement notes that extreme levels of physical activity, such as that undertaken by endurance athletes and professional football players, may raise the risk of AF.

“To help patients make healthy lifestyle changes, we suggest setting specific, progressive achievable weight and exercise targets, and prescribing lifestyle intervention programs that can provide appropriate supports. Using a pedometer, smartphone/watch apps or other wearable devices that provide activity feedback, as well as apps that help people track food intake, can be helpful to keep people motivated. Encouragement and reinforcement from the patients’ physicians and health care team can also increase patients’ dedication,” said Chung.

Other lifestyle habits that raise the risk of AF include smoking and moderate or high alcohol use. Smoking not only raises the risk of getting AF, it also reduces the effectiveness of a treatment for AF called ablation (a procedure to destroy cells that generate abnormal rhythms). Patients should be counseled to stop smoking and may be referred to a smoking cessation program.

Studies have also found that moderate or high alcohol use – drinking more than 7 drinks/week in women and 14 drinks/week in men – raises the risk of AF. In a recent study, reducing or abstaining from alcohol was shown to improve heart rhythm control.

Although drinking caffeinated beverages has not been shown to increase the risk of AF, about 1 in 4 people with the condition report that it can trigger an episode according to several studies noted in the statement.

The scientific evidence on lifestyle and AF is limited because the studies on the subject are mostly observational, which can identify links but cannot prove cause and effect.

“We need more research in this area, including randomized trials (which can prove cause and effect) to help determine the effects of and the best ways to achieve long-term, lifestyle and risk factor modification for our patients with AF. In particular, we need further work on the effects of high intensity and other physical activities, and studies on the need for and effects of screening and treating sleep apnea for AF. However, the data emerging support the beneficial effects of lifestyle modification to reduce AF and are a call to action to develop and utilize integrated, multidisciplinary teams and/or structured programs that can facilitate intensive and comprehensive lifestyle counseling for our patients with AF. We encourage health care teams to consider lifestyle interventions in addition to medical management for all patients with AF,” said Chung.

Source: American Heart Association

Dual Method May Boost Accuracy of Prostate Cancer Diagnosis

Adding MRI to a standard tissue biopsy appears to enhance the accuracy of a prostate cancer diagnosis, new research finds.

The study, led by researchers at the U.S. National Cancer Institute (NCI), found that combining the two methods cut the rate of “underdiagnosis” by more than half, compared to use of either MRI or biopsy alone.

“With the addition of MRI-targeted biopsy to systematic biopsy, we can now identify the most lethal cancers within the prostate earlier, providing patients the potential for better treatment before the cancers spread,” study senior author Dr. Peter Pinto said in an NCI news release. Pinto is with the Urologic Oncology Branch of the NCI’s Center for Cancer Research.

In conventional prostate cancer care, the current main method of diagnosis is systematic biopsy. It’s a non-targeted method of taking tissue samples from across the prostate gland. But as the NCI team pointed out, this method can still potentially miss areas of cancer.

MRI-targeted biopsies could lead to better accuracy, Pinto’s group said. In this approach, doctors merge previously taken MRI images of suspected cancer with real-time ultrasound technology, and are better able to detect more high-grade cancers than systematic biopsies.

In this study, the researchers investigated whether it would be better to replace systematic biopsy with MRI-targeted biopsies or to use both tests together.

The study included more than 2,100 men with prostate lesions that were visible on an MRI scan. All of the men underwent both MRI-targeted biopsies as well as traditional systematic biopsies.

Of these men, 1,312 were diagnosed with cancer and 404 underwent prostatectomy — the removal of the entire prostate.

Reporting in the March 5 issue of the New England Journal of Medicine, Pinto’s team said that adding MRI-targeted biopsy to systematic biopsy led to 208 more cancer diagnoses, compared to using systematic biopsy alone.

The addition of MRI-targeted biopsy also led to 458 changes in diagnosis, alerting patients of a more aggressive cancer that might need more aggressive treatment, based on analysis of the biopsied tissue.

The two-method approach also provided more accurate diagnosis than MRI-targeted biopsies alone.

For example, among the men who underwent prostatectomy, systematic biopsy alone underdiagnosed about 40% of cancers, while MRI-targeted biopsy alone underdiagnosed about 30%. In contrast, combined biopsy underdiagnosed just 14.4% of the cancers, the researchers found.

And on the other hand, systematic biopsy alone underdiagnosed 16.8% of the most aggressive cancers, while MRI-targeted biopsy alone underdiagnosed 8.7% of the most aggressive cancers. But combining the two biopsy methods missed only 3.5% of the most aggressive cancers, Pinto’s group said.

“Prostate cancer has been one of the only solid tumors diagnosed by performing systematic biopsies ‘blind’ to the cancer’s location,” Pinto noted. “For decades, this has led to the overdiagnosis and subsequent unnecessary treatment of non-lethal cancers, as well as to missing aggressive high-grade cancers and their opportunity for cure.”

Two prostate cancer specialists said the study could be a game-changer in prostate cancer care.

“The study represents the culmination of much research and has now changed the trajectory of the evaluation of elevated [prostate-specific antigen] and prostate cancer diagnosis,” said Dr. Manish Vira. He’s vice chair of urologic research at the Arthur Smith Institute for Urology, in New Hyde Park, N.Y.

However, Vira cautioned that no method is perfect when it comes to accurate diagnosis, and that is “an important point to discuss with patients.”

Dr. Art Rastinehad is vice chair of urology at Lenox Hill Hospital in New York City. He called the NCI team “pioneers” in advancing the science of prostate cancer diagnosis.

According to Rastinehad, the new study also “reinforces the recent update by the American Urological Association,” in which the group recommended that an MRI precede every prostate biopsy.

Source: HealthDay


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