Background
Government and health organisations worldwide have recently reviewed the evidence on the role of dietary sugars in relation to health outcomes. Hence, it is timely to review current ...intakes of dietary sugars with respect to this guidance and as a benchmark for future surveillance.
Methods
This review collates data from nationally representative dietary surveys across the world and reports estimates of intakes of total and added sugars, and sucrose in different population subgroups. Total sugars includes all mono‐ and disaccharides; namely, glucose, fructose, lactose, sucrose and maltose. Added and free sugars differ in the quantity of natural sugars included in their definitions. Free sugars include sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates, whereas added sugars typically only refer to those added during processing.
Results
Most countries reported intakes of total sugars, with fewer reporting intakes of added sugars and sucrose. No country reported intakes of free sugars. The available data suggest that total sugars as a percentage of energy were highest in the infant (<4 years), with mean values ranging from 20.0% to 38.4%, and decreased over the lifespan to 13.5–24.6% in adults. Intakes of added sugars were higher in school‐aged children and adolescents (up to 19% of total energy) compared to younger children or adults.
Conclusions
Further research into the dietary patterns contributing to added sugars intake in children and adolescents is warranted. It would also be beneficial to policy guidance if future dietary surveys employed a uniform way of expressing sugars that is feasible to measure and has public health significance.
Studies of inflammatory bowel disease (IBD) have been inconclusive in relating microbiota with distribution of inflammation. We report microbiota, host transcriptomics, epigenomics and genetics from ...matched inflamed and non-inflamed colonic mucosa 50 Crohn's disease (CD); 80 ulcerative colitis (UC); 31 controls. Changes in community-wide and within-patient microbiota are linked with inflammation, but we find no evidence for a distinct microbial diagnostic signature, probably due to heterogeneous host-microbe interactions, and show only marginal microbiota associations with habitual diet. Epithelial DNA methylation improves disease classification and is associated with both inflammation and microbiota composition. Microbiota sub-groups are driven by dominant Enterbacteriaceae and Bacteroides species, representative strains of which are pro-inflammatory in vitro, are also associated with immune-related epigenetic markers. In conclusion, inflamed and non-inflamed colonic segments in both CD and UC differ in microbiota composition and epigenetic profiles.
The objective of this observational study was to investigate the risk factors for metritis, purulent vaginal discharge, and cytological endometritis. The hypothesis was that purulent vaginal ...discharge and cytological endometritis would have different risk factors because they represent distinct manifestations of uterine disease. Data generated from 1,363 Holstein cows (3 herds) enrolled in a randomized clinical trial were used. Calving history, periparturient disease incidence, and body condition score at calving and at 63 d in milk (DIM) were recorded. Serum nonesterified fatty acid concentration was measured once during the week before expected calving. Serum nonesterified fatty acid, β-hydroxybutyric acid, and haptoglobin (Hapto) concentrations were measured at 4±3, 11±3, and 18±3 DIM. Serum progesterone concentration was measured at 21±3, 35±3, 49±3, and 63±3 DIM. Metritis was diagnosed by farm managers within the first 20 DIM using a standardized definition. Cows were examined at 35±3 DIM by a veterinarian for purulent vaginal discharge (mucopurulent or worse vaginal discharge; Metricheck device) and cytological endometritis (≥6% polymorphonuclear cells on endometrial cytology; cytobrush device). Statistical analyses were performed using multivariable logistic regression models for each disease, accounting for the random effect of herd. Risk factors for metritis included increased nonesterified fatty acid prepartum (≥0.6mmol/L), dystocia, retained placenta, and increased Hapto in the first week postpartum (≥0.8g/L). Risk factors for purulent vaginal discharge included twinning, dystocia, metritis, and increased Hapto (≥0.8g/L) in the first week postpartum. Risk factors for cytological endometritis included low body condition score at parturition (≤2.75), hyperketonemia (≥1,100μmol/L), and increased Hapto (≥0.8g/L) in the first week postpartum. These results support the hypothesis that some of the risk factors for purulent vaginal discharge and cytological endometritis are different, which supports that they are distinct manifestations of uterine disease.
LEA (late embryogenesis abundant) proteins in both plants and animals are associated with tolerance to water stress resulting from desiccation and cold shock. However, although various functions of ...LEA proteins have been proposed, their precise role has not been defined. Recent bioinformatics studies suggest that LEA proteins might behave as molecular chaperones, and the current study was undertaken to test this hypothesis. Recombinant forms of AavLEA1, a group 3 LEA protein from the anhydrobiotic nematode Aphelenchus avenae, and Em, a group 1 LEA protein from wheat, have been subjected to functional analysis. Heat-stress experiments with citrate synthase, which is susceptible to aggregation at high temperatures, suggest that LEA proteins do not behave as classical molecular chaperones, but they do exhibit a protective, synergistic effect in the presence of the so-called chemical chaperone, trehalose. In contrast, both LEA proteins can independently protect citrate synthase from aggregation due to desiccation and freezing, in keeping with a role in water-stress tolerance; similar results were obtained with lactate dehydrogenase. This is the first evidence of anti-aggregation activity of LEA proteins due to water stress. Again, a synergistic effect of LEA and trehalose was observed, which is significant given that non-reducing disaccharides are known to accumulate during dehydration in plants and nematodes. A model is proposed whereby LEA proteins might act as a novel form of molecular chaperone, or 'molecular shield', to help prevent the formation of damaging protein aggregates during water stress.
We present broadband X-ray analyses of a sample of bright ultraluminous X-ray sources (ULX) with the goal of investigating the spectral similarity of this population to the known ULX pulsars, M82 ...X-2, NGC 7793 P13, and NGC 5907 ULX. We perform a phase-resolved analysis of the broadband XMM-Newton+NuSTAR data set of NGC 5907 ULX, finding that the pulsed emission from the accretion column in this source exhibits a similar spectral shape to that seen in both M82 X-2 and NGC 7793 P13, and that this is responsible for the excess emission observed at the highest energies when the spectra are fit with accretion disk models. We then demonstrate that similar "hard" excesses are seen in all ULXs in the broadband sample. Finally, for ULXs where the nature of the accretor is currently unknown, we test whether the hard excesses are all consistent with being produced by an accretion column similar to those present in M82 X-2, NGC 7793 P13, and NGC 5907 ULX. Based on the average shape of the pulsed emission, we find that in all cases a similar accretion column can successfully reproduce the observed data, consistent with the hypothesis that this ULX sample may be dominated by neutron star accretors. Compared to the known pulsar ULXs, our spectral fits for the remaining ULXs suggest that the non-pulsed emission from the accretion flow beyond the magnetosphere makes a stronger relative contribution than the component associated with the accretion column. If these sources do also contain neutron star accretors, this may help to explain the lack of detected pulsations.
ABSTRACT We report the detection of coherent pulsations from the ultraluminous X-ray source (ULX) NGC 7793 P13. The 0.42 s nearly sinusoidal pulsations were initially discovered in broadband X-ray ...observations using XMM-Newton and NuSTAR taken in 2016. We subsequently also found pulsations in archival XMM-Newton data taken in 2013 and 2014. The significant (>5 ) detection of coherent pulsations demonstrates that the compact object in P13 is a neutron star, and given the observed peak luminosity of 1040 erg s − 1 (assuming isotropy), it is well above the Eddington limit for a 1.4 M accretor. This makes P13 the second ULX known to be powered by an accreting neutron star. The pulse period varies between epochs, with a slow but persistent spin-up over the 2013-2016 period. This spin-up indicates a magnetic field of B 1.5 × 1012 G, typical of many Galactic accreting pulsars. The most likely explanation for the extreme luminosity is a high degree of beaming; however, this is difficult to reconcile with the sinusoidal pulse profile.
Industrialized societies produce many convenience foods with aluminum additives that enhance various food properties and use alum (aluminum sulfate or aluminum potassium sulfate) in water treatment ...to enable delivery of large volumes of drinking water to millions of urban consumers. The present causality analysis evaluates the extent to which the routine, life-long intake, and metabolism of aluminum compounds can account for Alzheimer's disease (AD), using Austin Bradford Hill's nine epidemiological and experimental causality criteria, including strength of the relationship, consistency, specificity, temporality, dose-dependent response, biological rationale, coherence with existing knowledge, experimental evidence, and analogy. Mechanisms that underlie the risk of low concentrations of aluminum relate to (1) aluminum's absorption rates, allowing the impression that aluminum is safe to ingest and as an additive in food and drinking water treatment, (2) aluminum's slow progressive uptake into the brain over a long prodromal phase, and (3) aluminum's similarity to iron, in terms of ionic size, allows aluminum to use iron-evolved mechanisms to enter the highly-active, iron-dependent cells responsible for memory processing. Aluminum particularly accumulates in these iron-dependent cells to toxic levels, dysregulating iron homeostasis and causing microtubule depletion, eventually producing changes that result in disconnection of neuronal afferents and efferents, loss of function and regional atrophy consistent with MRI findings in AD brains. AD is a human form of chronic aluminum neurotoxicity. The causality analysis demonstrates that chronic aluminum intake causes AD.
The objectives of this observational study were to determine and compare diagnostic criteria for postpartum endometritis in dairy cows. Data generated from 1,044 Holstein cows (6 herds) enrolled in a ...randomized clinical trial were used. Cows were examined for endometritis at 35±3 d (exam 1) and 56±3 d (exam 2) after parturition, using endometrial cytology (cytobrush technique), vaginal discharge scoring (Metricheck device; Simcrotech, Hamilton, New Zealand), and cervical diameter measurement (transrectal palpation). Reproductive data were recorded until 200 d after parturition. Diagnostic criteria for cytological and clinical endometritis were determined based on detrimental effect on subsequent reproductive performance, using logistic regression and Cox proportional hazard models accounting for the effect of herd clustering. Comparison of diagnostic criteria was performed using endometrial cytology as reference test or by quantifying the agreement between diagnostic approaches. At exam 1, diagnostic criteria were ≥6% polymorphonuclear cells and mucopurulent or worse (purulent or foul) vaginal discharge for cytological and clinical endometritis, respectively. At exam 2, diagnostic criteria were ≥4% polymorphonuclear cells and mucopurulent or worse vaginal discharge for cytological and clinical endometritis, respectively. Cows were classified as having cytological endometritis only, clinical endometritis only, or both cytological and clinical endometritis. Prevalence at exam 1 was 13.5, 9.4, and 5.8% for cytological endometritis only, clinical endometritis only, and both cytological and clinical endometritis, respectively. The detrimental effects of cytological and clinical endometritis on reproductive performance were additive. Among cows with clinical endometritis, only 38 and 36% had cytological endometritis at exam 1 and exam 2, respectively. Combination of diagnostic criteria improved neither the accuracy for predicting cytological endometritis nor the agreement between cytological and clinical endometritis. Overall, these results suggested that cytological and clinical endometritis may represent different manifestations of reproductive tract disease. They also suggested that use of the terminology clinical endometritis may not be accurate and that purulent vaginal discharge may be more descriptive.
The COVID-19 pandemic has fundamentally changed society and the delivery of health care in Canada. Given that much health care is delivered by residents, postgraduate medical education has also had ...to transform. Residents have been redeployed and rotations modified, moved or suspended. Procedural specialties postponed many elective surgeries and many clinics have transitioned to a virtual model. In an unprecedented decision, certifying colleges cancelled oral examinations and postponed written ones to the fall of 2020. Amid efforts to prevent a surge in infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that could overwhelm the health care system, Canada has entered a new paradigm of medical education. Recruitment of residents for both postgraduate year 1 (PGY-1) and subspecialty positions has traditionally relied on cross-country travel for in-person interviews, followed by use of a matching algorithm. In 2021, however, residency interviews will be conducted online, saving both candidates and programs substantial costs. Although eliminating or reducing travel costs could potentially make selection more equitable, well-connected candidates may still be at an advantage, and program selection committees may find it difficult to make decisions without face-to-face meetings.
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