RxLR Effectors: Master Modulators, Modifiers and Manipulators.

Cytoplasmic effectors with an Arg-any amino acid-Arg-Leu (RxLR) motif are encoded by hundreds of genes within the genomes of oomycete Phytophthora spp. and downy mildew pathogens. There has been a dramatic increase in our understanding of the evolution, function, and recognition of these effectors. Host proteins with a wide range of subcellular localizations and functions are targeted by RxLR effectors. Many processes are manipulated, including transcription, post-translational modifications, such as phosphorylation and ubiquitination, secretion, and intracellular trafficking. This involves an array of RxLR effector modes-of-action, including stabilization or destabilization of protein targets, altering or disrupting protein complexes, inhibition or utility of target enzyme activities, and changing the location of protein targets. Interestingly, approximately 50% of identified host proteins targeted by RxLR effectors are negative regulators of immunity. Avirulence RxLR effectors may be directly or indirectly detected by nucleotide-binding leucine-rich repeat resistance (NLR) proteins. Direct recognition by a single NLR of RxLR effector orthologues conserved across multiple Phytophthora pathogens may provide wide protection of diverse crops. Failure of RxLR effectors to interact with or appropriately manipulate target proteins in nonhost plants has been shown to restrict host range. This knowledge can potentially be exploited to alter host targets to prevent effector interaction, providing a barrier to host infection. Finally, recent evidence suggests that RxLR effectors, like cytoplasmic effectors from fungal pathogen Magnaporthe oryzae, may enter host cells via clathrin-mediated endocytosis. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

Effects of land use types on the depth distribution of selected soil properties in two contrasting agro-climatic zones.

The depth distribution of soil properties are governed by several interacting factors including land use types (LUT) and agro-climate (AgC) factors. Yet, there is little information on the effects of LUT, AgC and their combination on soil properties along depth, which this study aimed to investigate. We collected a total of 36 composite soil samples using the manual percussion of a steel core tube layer by layer vertically up to 30 cm in sites representing both highland and lowlands, and analyzed for selected soil properties. A significant main effects of LUT on the depth distribution of bulk density (BD), Ca, Na, K and Cu, and AgC on soil texture, pH, EC, Ca, Na, K, P, Mn, Fe and Cu were noted. The two-way ANOVA analysis also revealed the significant effects of both LUT and AgC on the depth distribution of BD, Na, K, Cu and EC, reflecting their influences on the paths associated to bio-geo-recycling processes. Compared to crop and forestlands, the average SOC and Fe were lower while EC, CEC, Ca, Na, K, P, Mn and Zn were higher in homegarden located in highland than lowland, possibly the acid nature of the highland soil may make the extractable cations available. SOC was not significantly influenced by AgC, LUT and their interaction effect. Based on the Elemental Enrichment Ratio (EER), the SOC was concentrated in the upper surface soil in forest and cropland located both in highland (1.79, 1.33) and lowland (1.80, 1.57), respectively. The reverse propagation pattern SOC depth distribution in soils under homegarden with EER of 0.7 (highland) ad 0.8 (lowland) showed that implementing such system can accelerate carbon sinking and safely store it in subsoil. Also, diversified species composition associated with respective root architectures in the homegarden system, make it an efficient soil nutrient management, which should be widely promoted.

Relación entre el efecto relativo de la edad en el campeonato de España de golf en categorías Sub16 y el rendimiento deportivo / Relação entre o efeito relativo da idade no campeonato espanhol de golfeU16 e o desempenho desportivo / Relationship between the relative effect of age in the Spanish U16 golf championship and sporting performance

En la presente investigación se plantearon dos objetivos: 1) identificar la proporción de jugadores de golf en edad de formación que se clasificaban para los campeonatos de España en función del año y del trimestre del año de nacimiento tanto para el total de la muestra, como para la muestra dividida por sexos. 2) Analizar el efecto de la edad relativa sobre el rendimiento de los jugadores y las jugadoras de golf en el campeonato de España en las diferentes categorías para el total de la muestra, como para la muestra dividida por sexos. Se incluyeron un total de 794 jugadores de golf, (511 varones, media de edad: 13,91±2,08 años; y 283 mujeres, media de edad: 14,29±1,89 años). De cada participante se obtuvo la siguiente información: año de nacimiento, mes de nacimiento, inscripción y participación en el Campeonato de España de golf, posición obtenida en el campeonato. Se observaron diferencias significativas en cuanto a la asistencia al Campeonato de España en función del año de nacimiento (χ2=22,92; p=0,001) y en función del cuartil de nacimiento (χ2=57,59; p=0,001) al analizar el conjunto de los participantes. El análisis de regresión mostró que el puesto en el Campeonato de España puede ser un factor predicho por el año de nacimiento en un porcentaje entre el 7 % y el 15% de los casos (p<0,001-0,009). En base a estos resultados, sería necesario replantear el sistema de competición de los campeonatos nacionales de golf en edades en formación para garantizar una competición en igualdad de condiciones. (AU)

The present study had two objectives: 1) to identify the proportion of junior golfers qualifying for the Spanish Championships as a function of year and quarter ofthe year of birth for the total sample, as well as for the sample divided by sexes. 2) To analyse the effect of relative age on the performance of golf players at the Spanish Championships in the different categories for the total sample, as well as for the sample divided by sexes. A total of 794 golf players were included (511 males, mean age: 13.91±2.08 years; and 283 females, mean age: 14.29±1.89 years). The following information was obtained for each participant: year of birth, month of birth, participation in the Spanish Golf Championship, position obtained in the championship. Significant differences in attendance at the Spanish Championship were observed according to year of birth (χ2=22.92; p=0.001) and according to quartile of birth (χ2=57.59; p=0.001) when analysing the participants as a whole. The regression analysis showed that the place in the Spanish Championships can be a predictorof year of birth in a percentage between 7 % and 15 % of the cases (p<0.001-0.009). Based on these results, it would be necessary to rethink the competition system of the national golf championships to ensure a level playing field. (AU)

A presente investigação tinha dois objectivos: 1) identificar a proporção de jovens golfistas qualificados para o Campeonato de Espanha em função do ano e do trimestre do ano de nascimento para a amostra total, bem como para a amostra dividida por sexo. 2) Analisar o efeito da idade relativa no desempenho dos jogadores de golfe nos campeonatos espanhóis nas diferentes categorias para a amostra total, bem como para a amostra dividida por sexo. Foi incluído um total de 794 jogadores de golfe (511 homens, idade média: 13,91±2,08 anos; e 283 mulheres, idade média: 14,29±1,89 anos). Foram obtidas as seguintes informações para cada participante: ano de nascimento, mês de nascimento,inscrição e participação no Campeonato Espanhol de Golfe, posição obtida no campeonato. Foram observadas diferenças significativas naparticipação no Campeonato de Espanha de acordo com o ano de nascimento (χ2=22,92; p=0,001) e de acordo com o quartil de nascimento (χ2=57,59; p=0,001) ao analisar os participantes como um todo. A análise de regressão mostrou que o lugar no Campeonato de Espanha pode ser um preditor do ano de nascimento numa percentagem entre 7% e 15% dos casos (p<0,001-0,009). Com base nestes resultados, seria necessário repensar o sistema de competição dos campeonatos nacionais de golfe em júnior para assegurar um campo de jogo nivelado. (AU)

Relative risk reduction: Misinformative measure in clinical trials and COVID-19 vaccine efficacy.

Treatment and vaccine efficacy in clinical trials are often reported in the media and medical journals as the relative risk reduction. The present article explains why the relative risk reduction is a misinformative measure that promotes disinformation when reporting efficacy in clinical research studies such as randomized controlled trials for COVID-19 vaccines. The relative risk reduction is based on the relative risk, a proportional measure or ratio used in epidemiologic studies to estimate the probability of a disease associated with an exposure. The present article demonstrates how the relative risk reduction and relative risk obscure the magnitude of disease risk reduction in clinical research. The absolute risk reduction is shown to be a more precise and reliable measure of treatment and vaccine efficacy in clinical research studies. The absolute risk reduction reciprocal also measures the number needed to treat or vaccinate, and is a more accurate measure than the relative risk reduction for comparing risk reductions of clinical studies. Additionally, the present article reviews consequences of COVID-19 vaccine efficacy misinformation disseminated through media reports. The article concludes that relative risk reduction should not be used to measure treatment and vaccine efficacy in clinical trials. What is new?: •Unreliability of relative measures in clinical trials is graphically illustrated, demonstrating constant relative measures as absolute measures change.•Misuse of relative measures in clinical research is historically linked to misinterpretation of Jerome Cornfield's advice on measuring causative and associative effects.•Consequences of disinformation and misinformation related to COVID-19 vaccine efficacy and modern clinical medicine are described.•The proper use of absolute measures in meta-analyses is explained.

Ensino emergencial remoto: uma perspectiva da neurofisiologia / Remote emergency teaching: a neurophysiology perspective

No ano de 2020, iniciou-se uma emergência de saúde pública mundial. A fim de frear a transmissão do SARSCoV-2, foram aplicadas medidas de distanciamento social, que reduziram o contato interpessoal e deflagraram mudanças profundas em comportamentos relacionados à interação social. Os sistemas educacionais ao redor do mundo têm se adaptado a esta nova realidade, adotando protocolos emergenciais caracterizados, em grande parte, pela substituição das atividades presenciais pelas virtuais. O objetivo deste artigo é dialogar sobre os impactos do distanciamento social no ensino superior através de uma abordagem neurofisiológica, conectando estresse, empatia e o contexto histórico do ensino emergencial quando comparado ao Ensino à Distância, além das ferramentas à nossa disposição e as complexidades do ambiente virtual. Os professores devem estar conscientes do impacto do estresse e do uso de ferramentas digitais e de ensino à distância na formação dos estudantes, buscando formas responsáveis de passar por este momento histórico e estratégias para lidar eficientemente com os desafios no ensino evocados pela pandemia.

In 2020, a worldwide public health emergency began. In order to curb the transmission of the SARS CoV-2, measures of social distancing were applied, which reduced interpersonal contact and triggered profound changes in behaviors related to social interaction. Educational systems around the world have adapted to this new reality, adopting emergency protocols characterized, in large part, by replacing classroom activities with virtual ones. The objective of this article is to discuss the impacts of social distancing in higher education through a neurophysiological approach, connecting stress, empathy and the historical context of emergency education when compared to Distance Learning, in addition to the tools at our disposal and the complexities of the virtual environment. Teachers must be aware of the impact of stress and the use of digital and distance learning tools on student training, looking for responsible ways to go through this historical moment and strategies to deal effectively with the teaching challenges evoked by the pandemic.

Investigation on thermodynamic performance analysis and environmental effects of various new refrigerants used in air conditioners.

The main aim of this present investigation is to evaluate performance and environmental impact analysis of various novel mixture refrigerants as R22 replacements theoretically. Refrigerants with lower global warming potential (GWP) can be adequate for bringing down emissions which are concerned for air conditioners. In this investigation, twenty-seven refrigerants were developed at several compositions. Important studies such as computation of CO2 emissions using total equivalent warming impact (TEWI), toxicity and flammability analysis of various considered refrigerants were also carried out in this investigation. Performance analysis of refrigerants was conducted under different operating conditions. Results showed that the energy efficiency ratios (EERs) of refrigerants such as R1270, RM30 (R152a/R1270/RE170 of 25/71/4 by mass percentage) and RM50 (R152a/R1270/RE170 of 10/85/5 by mass percentage) were closer to that of R22 and they are relatively lower than R22 by 0.95%, 1.34% and 1.80%, respectively. Toxicity investigation exhibited that all the refrigerants studied were classified into nontoxic category (A) whereas flammability investigation revealed that all the novel refrigerant mixtures (RM10 to RM50) were classified into flammable category (A3). CO2 emissions (TEWI) released from air conditioner working with R1270, RM30 and RM50 were 7.41%, 6.85% and 6.51%, respectively, lower than that of R22. In terms of several thermodynamic aspects, the performance of refrigerants such as R1270, RM30 and RM50 were superior to those of R22 and its various considered alternatives working under different operating conditions, although their EERs are fairly lower than R22 and hence, these refrigerants could be considered suitable environment-friendly alternatives to R22 used in air conditioners. The present study gives essential information and a road map towards the development of low GWP R22 alternative refrigerant blends from the viewpoint of toxicity, flammability, performance aspects, environmental and safety aspects, respectively.

Proximal reflux: biochemical mediators, markers, therapeutic targets, and clinical correlations.

Airway reflux is implicated in the pathophysiology of a wide range of adult and pediatric upper and lower airway diseases. However, the diagnosis of proximal reflux-associated disease remains challenging due to evolving clinical criteria and institutional and regional variances in diagnostic practices. Evidence suggests that nonacidic contents of reflux may serve as both pathologic mediators of and biomarkers for reflux in the upper airway. Furthermore, they offer potential pharmaceutical and surgical intervention targets and are the focus of novel clinical diagnostic tools currently under investigation.

Comparative analysis of chemical constituents of deer hide and deer hide gelatin by "peptidomics-modifications" methods / 药学学报

Collagen is the main constituent of gelatinous Chinese medicine, with deer hide gelatin (Cervi Corii Colla, DHG) made from deer hide (DH) through a complex thermal and high-pressure processing procedure. During this procedure some amino acids in collagen undergo hydroxylation and deamidation. In the present study, comparative analysis of proteins and peptides in DH and DHG was carried out using "peptidomics-modifications" methods. Nano-LC-MS/MS was used to analyze proteins and peptides in DH and DHG, and the number and sites of modification were determined as well. The amount of hydroxylation and deamidation that occurred in DHG was significantly greater than that in DH, suggesting that under thermal and high-pressure processing these modifications occurred more frequently on certain amino acids in collagen, and might be correlated with hydrophobicity. The occurrence and mechanism of hydroxylation and deamidation in DH processing procedures should be explored in further research. The present study provides important evidence of the chemical constituents and the correlation of processing procedures with these modifications, and also suggests some investigative ideas for DHG processing optimization and improvement of quality standards.

Expansive carotid artery remodeling: possible marker of vulnerable plaque.

OBJECTIVE: Accumulated findings in the pathophysiology of atherosclerosis have demonstrated that not only luminal narrowing but also plaque characteristics influence the risk of future ischemic events. The morphology of the carotid artery (CA) changes in response to atherosclerotic development by expansive remodeling (ER), the clinical significance of which remains unclear. This study aimed to define associations between ER and local risk factors, including CA geometry and traditional systemic risk factors for ischemic events, to determine whether ER could serve as a clinical marker of carotid vulnerable plaque. METHODS: The authors retrospectively analyzed 66 patients with CA stenosis who were scheduled to undergo carotid endarterectomy or CA stenting. They calculated ER ratios in the internal CA (ICA) from long-axis MR images and as the maximal distance between the lumen and the outer borders of the plaque perpendicular to the axis of the ICA/the maximal luminal diameter of the distal ICA at a region unaffected by atherosclerosis. Relative overall signal intensity (roSI) was calculated to assess intraplaque hemorrhage and defined as the signal intensity of plaque on an axial T1-weighted image with maximal stenosis relative to that of the adjacent sternocleidomastoid muscle. The authors evaluated CA geometry by calculating the angles between the common CA (CCA) and ICA, and between the CCA and external CA (ECA) using digital subtraction angiography. The ER ratios, age, sex, percentage of stenosis, roSI, hypertension, hyperlipidemia, low-density lipoprotein, statin medication, diabetes, smoking habit, and ischemic heart disease were compared between 33 symptomatic and 33 asymptomatic patients. The authors also compared symptomatic status, age, sex, percentage of stenosis, ICA angle, ECA angle, roSI, and other traditional atherosclerotic risk factors between groups with extensive and slight ER. RESULTS: The ER ratio was significantly greater in symptomatic than in asymptomatic patients (1.91 ± 0.46 vs 1.68 ± 0.40, p < 0.05). The ICA angle was significantly larger in the group with extensive ER than in those with slight ER (33.9° ± 20.2° vs 21.7° ± 13.8°, p < 0.01). The roSI, ECA angle, percentage stenosis, or any other traditional vascular risk factors were not associated with ER. CONCLUSIONS: Carotid ER might be an independent indicator of carotid vulnerable plaque, which should be validated in a longitudinal study of patients with carotid atherosclerosis, including those with nonstenotic to moderate stenosis.

Reflux and the Voice: Getting Smarter About Laryngopharyngeal Reflux.

Dysphonia is often blamed on laryngopharyngeal reflux (LPR) in the face of a normal flexible laryngoscopic examination. LPR remains primarily (and unfortunately) a diagnosis of exclusion rather than inclusion in the face of vague throat complaints and laryngeal signs attributed to reflux. LPR remains misdiagnosed and overdiagnosed as the cause of many identical, vague throat symptoms and laryngeal complaints. Despite LPR being commonly implicated as the cause of a myriad of nonspecific pharyngeal symptoms, LPR as a physiologic process is common. Whether or not it is a contributor to a patient's symptoms, especially dysphonia, is the focus of this article.

O-GlcNAc homeostasis contributes to cell fate decisions during hematopoiesis.

The addition of a single ß-d-GlcNAc sugar (O-GlcNAc) by O-GlcNAc-transferase (OGT) and O-GlcNAc removal by O-GlcNAcase (OGA) maintain homeostatic O-GlcNAc levels on cellular proteins. Changes in protein O-GlcNAcylation regulate cellular differentiation and cell fate decisions, but how these changes affect erythropoiesis, an essential process in blood cell formation, remains unclear. Here, we investigated the role of O-GlcNAcylation in erythropoiesis by using G1E-ER4 cells, which carry the erythroid-specific transcription factor GATA-binding protein 1 (GATA-1) fused to the estrogen receptor (GATA-1-ER) and therefore undergo erythropoiesis after ß-estradiol (E2) addition. We observed that during G1E-ER4 differentiation, overall O-GlcNAc levels decrease, and physical interactions of GATA-1 with both OGT and OGA increase. RNA-Seq-based transcriptome analysis of G1E-ER4 cells differentiated in the presence of the OGA inhibitor Thiamet-G (TMG) revealed changes in expression of 433 GATA-1 target genes. ChIP results indicated that the TMG treatment decreases the occupancy of GATA-1, OGT, and OGA at the GATA-binding site of the lysosomal protein transmembrane 5 (Laptm5) gene promoter. TMG also reduced the expression of genes involved in differentiation of NB4 and HL60 human myeloid leukemia cells, suggesting that O-GlcNAcylation is involved in the regulation of hematopoietic differentiation. Sustained treatment of G1E-ER4 cells with TMG before differentiation reduced hemoglobin-positive cells and increased stem/progenitor cell surface markers. Our results show that alterations in O-GlcNAcylation disrupt transcriptional programs controlling erythropoietic lineage commitment, suggesting a role for O-GlcNAcylation in regulating hematopoietic cell fate.

24-h severe energy restriction impairs postprandial glycaemic control in young, lean males.

Intermittent energy restriction (IER) involves short periods of severe energy restriction interspersed with periods of adequate energy intake, and can induce weight loss. Insulin sensitivity is impaired by short-term, complete energy restriction, but the effects of IER are not well known. In randomised order, fourteen lean men (age: 25 (sd 4) years; BMI: 24 (sd 2) kg/m2; body fat: 17 (4) %) consumed 24-h diets providing 100 % (10 441 (sd 812) kJ; energy balance (EB)) or 25 % (2622 (sd 204) kJ; energy restriction (ER)) of estimated energy requirements, followed by an oral glucose tolerance test (OGTT; 75 g of glucose drink) after fasting overnight. Plasma/serum glucose, insulin, NEFA, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP) and fibroblast growth factor 21 (FGF21) were assessed before and after (0 h) each 24-h dietary intervention, and throughout the 2-h OGTT. Homoeostatic model assessment of insulin resistance (HOMA2-IR) assessed the fasted response and incremental AUC (iAUC) or total AUC (tAUC) were calculated during the OGTT. At 0 h, HOMA2-IR was 23 % lower after ER compared with EB (P<0·05). During the OGTT, serum glucose iAUC (P<0·001), serum insulin iAUC (P<0·05) and plasma NEFA tAUC (P<0·01) were greater during ER, but GLP-1 (P=0·161), GIP (P=0·473) and FGF21 (P=0·497) tAUC were similar between trials. These results demonstrate that severe energy restriction acutely impairs postprandial glycaemic control in lean men, despite reducing HOMA2-IR. Chronic intervention studies are required to elucidate the long-term effects of IER on indices of insulin sensitivity, particularly in the absence of weight loss.

[Comparison of the accuracy of rectal endoscopic sonography and magnetic resonance imaging in the diagnosis of colorectal endometriosis]. / Comparaison de l'échoendoscopie rectale et de l'IRM pour le diagnostic de l'atteinte colorectale par l'endométriose.

OBJECTIVE: To compare the accuracy of magnetic resonance imaging (MRI) and rectal endoscopic sonography (RES) for the diagnosis of colorectal endometriosis. METHODS: In retrospective study, 407 patients operated on service of gynecology of Tenon hospital for deep endometriosis with suspected colorectal involvement. All patients underwent MRI and then RES. RESULTS: In the study, 239 patients (59%) had colorectal endometriosis which were diagnosed with the histology. The sensitivity, specificity, positive and negative predictive value (PPV and NPV) of RES and MRI for the diagnosis of colorectal endometriosis were respectively 92%, 87%, 91%, 88% and 85%, 88%, 91%, 80%. The accuracy of RES was not significantly different than MRI (90% versus 86%, P=0.09). CONCLUSION: RES is a good exam to diagnose colorectal endometriosis. It is able to improve diagnosis performances.

An investigation into the relationship between plain water intake and glycated Hb (HbA1c): a sex-stratified, cross-sectional analysis of the UK National Diet and Nutrition Survey (2008-2012).

The aim of this study was to analyse the association between plain water intake and glycated Hb (HbA1c) in the National Diet and Nutrition Survey (2008-2012) rolling survey. These data included diet (4-d diaries) and HbA1c (fasted blood sample) measures of 456 men and 579 women aged 44 (sd 18) years with full information on covariates of interest (age, ethnicity, BMI, smoking status, education, other beverage intake, energy intake and fibre). Data were analysed using sex-stratified linear and logistic regressions modelling the associations of cups per d (240 ml) of plain water with HbA1c, and odds of HbA1c≥5·5 %, respectively. Substitution analyses modelled the replacement of sugar-sweetened beverages, fruit juice and artificially sweetened beverages with plain water. After adjustment, 1 cup/d of plain water was associated with a -0·04 % lower HbA1c (95 % CI -0·07, -0·02) in men. In logistic regression, men had a 22 % (95 % CI 10, 32 %) reduced odds of HbA1c≥5·5 %/cup per d of plain water. There was no evidence of an association with either HbA1c or odds of HbA1c≥5·5 % in women. None of the substitution models was associated with a change in odds of HbA1c≥5·5 %. Plain water intake was associated with lower HbA1c in men but not in women. Substituting water for specific beverages was not associated with a reduced odds of HbA1c≥5·5 %, suggesting that the addition of water is the more pertinent factor. Future trials should test whether the relationships between water intake and HbA1c is causal as this could be a cost-effective and simple health intervention.

Associations between energy density of meals and snacks and overall diet quality and adiposity measures in British children and adolescents: the National Diet and Nutrition Survey.

This cross-sectional study examined how energy density (ED) of meals and snacks are associated with overall diet quality and adiposity measures in 1617 British children aged 4-18 years from the 1997 National Diet and Nutrition Survey. On the basis of data from 7-d weighed dietary record, all eating occasions were divided into meals or snacks on the basis of time (meals: 06.00-09.00, 12.00-14.00 and 17.00-20.00 hours; snacks: all others) or contribution to energy intake (EI) (meals: ≥15 %; snacks: <15 %). ED of meals and snacks was calculated on the basis of food only. Overall diet quality was assessed using the Mediterranean diet score (range 0-8). Irrespective of the definition of meals and snacks, ≥67 % of EI was derived from meals, whereas ED of meals was lower than ED of snacks (mean: 8·50-8·75 v. 9·69-10·52 kJ/g). Both ED of meals and ED of snacks were inversely associated with total intakes of vegetables, fruits, dietary fibre and overall diet quality and positively associated with total intakes of fat. However, the associations were stronger for ED of meals. The change in the Mediterranean diet score with a 1-unit increase of ED (kJ/g) was -0·35 to -0·30 for ED of meals and -0·09 to -0·06 for ED of snacks (all P<0·0001). After adjustment for potential confounders, all measures of ED of meals and snacks did not show positive associations with adiposity measures. In conclusion, although both ED of meals and ED of snacks were associated with adverse profiles of overall diet quality (but not adiposity measures), stronger associations were observed for ED of meals.

Energy density of meals and snacks in the British diet in relation to overall diet quality, BMI and waist circumference: findings from the National Diet and Nutrition Survey.

This cross-sectional study examined how energy density (ED) in meals and snacks is associated with overall diet quality, BMI and waist circumference (WC). On the basis of the data from 7-d weighed dietary record, all eating occasions were divided into meals or snacks based on time (meals: 06.00-10.00, 12.00-15.00 and 18.00-21.00 hours; snacks: others) or contribution to energy intake (EI) (meals: ≥15; snacks: <15%) in 1451 British adults aged 19-64 years. Irrespective of the definition of meals and snacks, both meal ED and snack ED (kJ/g; calculated on the basis of solid food only) were inversely associated with overall diet quality assessed by the healthy diet indicator (regression coefficient (ß)=-0·29 to -0·21 and -0·07 to -0·04, respectively) and Mediterranean diet score (ß=-0·43 to -0·30 and -0·13 to -0·06, respectively) in both sexes (P≤0·002), although the associations were stronger for meal ED. After adjustment for potential confounders, in both men and women, meal ED based on EI contribution showed positive associations with BMI (ß=0·34; 95% CI 0·06, 0·62 and ß=0·31; 95% CI 0·01, 0·61, respectively) and WC (ß=0·96; 95% CI 0·27, 1·66 and ß=0·67; 95% CI 0·04, 1·30, respectively). In addition, meal ED based on time was positively associated with WC in men (ß=0·59; 95% CI 0·07, 1·10) and snack ED based on time was positively associated with BMI in women (ß=0·15; 95% CI 0·04, 0·27). In analyses in which only acceptable EI reporters were included, similar results were obtained. In conclusion, the findings suggest stronger associations of meal ED with overall diet quality, BMI and WC compared with snack ED.

Corrigendum: Voice Pathology Detection Using Modulation Spectrum-Optimized Metrics.

[This corrects the article on p. 1 in vol. 4, PMID: 26835449.].

Femoral cam deformity due to anterior capsular force: A theoretical model with MRI and cadaveric correlation.

BACKGROUND: Cam deformity is associated with epiphyseal extension onto the anterosuperior femoral head-neck before physeal closure. A century ago, anatomists speculated that this femoral prominence acts as a pulley bar to withstand capsular compression in hip extension with pressure concentrated where the zona orbicularis (ZO) joins the iliofemoral ligament (IFL). An animal model has shown that growth plates deflect laterally and distally when exposed to forces perpendicular to growth. These observations raise the question of whether capsular pressure against the epiphysis can stimulate cam formation. PURPOSE: The purposes are to measure: (1) the distance from the ZO/IFL confluence to the maximal epiphyseal extension (MEE) and cam apex; and (2) acetabular depth at this location, since less coverage increases capsular contact on the physis. METHODS: MRI scans of 39 subjects (47 hips) were measured. Acetabular depth was compared between those with and without a cam deformity. Secondarily, anatomic findings were correlated on a cadaveric specimen. RESULTS: The cam apex and MEE were adjacent to the ZO/IFL confluence in all subjects (mean, 6.3 mm). Controlling for sex, acetabular depth was less (12.5%, p = 0.012) in the group with cam deformity. Contact points were confirmed in the specimen. CONCLUSIONS: The cam apex and MEE occur at the ZO/IFL confluence in the thickest region of the anterosuperior capsule and vary with acetabular depth. This supports a theoretical model postulating that capsular forces against an immature epiphysis may induce cam formation, particularly in individuals who repetitively tension the anterior capsule.

Airway reflux.

An ever-increasing number of adult and pediatric disorders have been shown to be influenced or caused by airway reflux. This has become a controversial and complicated aspect of medicine that requires a multidisciplinary approach. Evidence indicates that it is not only the acidic components of gastric refluxate that injure extraesophageal tissues but also the nonacidic components, such as pepsin and bile. There is a realization that proton pump inhibitors will not be effective when nonacidic components of refluxate are causing the problem. New in vitro and in vivo models for the study of airway reflux and new therapeutic and surgical approaches are discussed in this review article.

A high-fat, high-glycaemic index, low-fibre dietary pattern is prospectively associated with type 2 diabetes in a British birth cohort.

The combined association of dietary fat, glycaemic index (GI) and fibre with type 2 diabetes has rarely been investigated. The objective was to examine the relationship between a high-fat, high-GI, low-fibre dietary pattern across adult life and type 2 diabetes risk using reduced rank regression. Data were from the MRC National Survey of Health and Development. Repeated measures of dietary intake estimated using 5-d diet diaries were available at the age of 36, 43 and 53 years for 1180 study members. Associations between dietary pattern scores at each age, as well as longitudinal changes in dietary pattern z-scores, and type 2 diabetes incidence (n 106) from 53 to 60-64 years were analysed. The high-fat, high-GI, low-fibre dietary pattern was characterised by low intakes of fruit, vegetables, low-fat dairy products and whole-grain cereals, and high intakes of white bread, fried potatoes, processed meat and animal fats. There was an increasing trend in OR for type 2 diabetes with increasing quintile of dietary pattern z-scores at the age of 43 years among women but not among men. Women in the highest z-score quintile at the age of 43 years had an OR for type 2 diabetes of 5·45 (95 % CI 2·01, 14·79). Long-term increases in this dietary pattern, independently of BMI and waist circumference, were also detrimental among women: for each 1 sd unit increase in dietary pattern z-score between 36 and 53 years, the OR for type 2 diabetes was 1·67 (95 % CI 1·20, 2·43) independently of changes in BMI and waist circumference in the same periods. A high-fat, high-GI, low-fibre dietary pattern was associated with increased type 2 diabetes risk in middle-aged British women but not in men.