Increasing Protein at the Expense of Carbohydrate in the Diet Down-Regulates Glucose Utilization as Glucose Sparing Effect in Rats

High protein (HP) diet could serve as a good strategy against obesity, provoking the changes in energy metabolic pathways. However, those modifications differ during a dietary adaptation. To better understand the mechanisms involved in effect of high protein diet (HP) on limiting adiposity in rats we studied in parallel the gene expression of enzymes involved in protein and energy metabolism and the profiles of nutrients oxidation. Eighty male Wistar rats were fed a normal protein diet (NP, 14% of protein) for one week, then either maintained on NP diet or assigned to a HP diet (50% of protein) for 1, 3, 6 and 14 days. mRNA levels of genes involved in carbohydrate and lipid metabolism were measured in liver, adipose tissues, kidney and muscles by real time PCR. Energy expenditure (EE) and substrate oxidation were measured by indirect calorimetry. Liver glycogen and plasma glucose and hormones were assayed. In liver, HP feeding 1) decreased mRNA encoding glycolysis enzymes (GK, L-PK) and lipogenesis enzymes(ACC, FAS), 2) increased mRNA encoding gluconeogenesis enzymes (PEPCK), 3) first lowered, then restored mRNA encoding glycogen synthesis enzyme (GS), 4) did not change mRNA encoding β-oxidation enzymes (CPT1, ACOX1, βHAD). Few changes were seen in other organs. In parallel, indirect calorimetry confirmed that following HP feeding, glucose oxidation was reduced and fat oxidation was stable, except during the 1st day of adaptation where lipid oxidation was increased. Finally, this study showed that plasma insulin was lowered and hepatic glucose uptake was decreased. Taken together, these results demonstrate that following HP feeding, CHO utilization was increased above the increase in carbohydrate intake while lipogenesis was decreased thus giving a potential explanation for the fat lowering effect of HP diets

Evaluation of formant frequencies in Persian speaking children with different degrees of hearing loss

Background: This study compared formant frequencies in vowel productionamongchildren with different degrees of hearing loss (HL) and normal hearing. Methods: This study was carried out on 40 children with different degrees of HL (moderate, moderate to severe, severe, and profound). Forty age (7 to 9 years old) and gender (22 males and 18 females) matched children with normal hearing were included. After collecting acoustic data during vowel production (/a/i/,/u/) for 3 seconds, the mean of the F1 and F2 were selected using the Praat software. The data were analyzed using analysis of variance (ANOVA) and Dunnett’s Post Hoc test. Results: Several differences in formant frequencies were confirmed with ANOVA tests. The results from Dunnett’s post hoc test showed that the F2 value of /a/ and /i/ in the control group were significantly different from all groups with HL (P < 0.05). However, the F1’s of the control group in all 3 vowels were significantly different only from the profound group. Conclusions: There was little distinction between vowels of HL children, and their vowel space had become centralized presumably due to limited auditory feedback, relative invisibility of the articulatory gestures needed for vowel production, and similar tongue position for all vowels. The second formant tended to be affected more than the first formant because less audibility and the difficulty of its learning through vision

The Voices of Survivors Documentary: Using Patient Narrative to Educate Physicians About Domestic Violence

This article describes a method of developing physician education materials using analysis of domestic violence patient experiences and patients' descriptions of their experiences. The process began with interviews of 21 domestic violence survivors, focusing on what they wanted to teach physicians. Qualitative analysis of these interviews identified 4 main themes regarding what survivors wanted physicians to understand about life in an abusive relationship: that domestic violence is universal, that it is more than just physical assaults, that it is all about power and control, and that it affects the entire family. Because what survivors wanted from physicians differed depending on where they were in their abusive relationships, recommendations were developed for each of 5 common situations: when a patient may not yet recognize the abuse, when s/he may not be ready or able to disclose the abuse, when s/he chooses to remain in an abusive relationship, when s/he is seeking care for an acute assault, and when s/he has left the relationship but not yet healed. Interview excerpts representing each of the identified themes are used to create a 30-minute educational documentary. A written companion guide covers the traditional aspects of domestic violence education. In teaching about domestic violence or other health problems where it is difficult for physicians to understand their patients intuitively, an educator's most important role may be to direct learners to listen to the experience and wisdom of patients