Moderate carbohydrate, moderate protein weight loss diet reduces cardiovascular disease risk compared to high carbohydrate, low protein diet in obese adults: A randomized clinical trial

<p>Abstract</p> <p>Background</p> <p>To evaluate the metabolic effects of two weight loss diets differing in macronutrient composition on features of dyslipidemia and post-prandial insulin (INS) response to a meal challenge in overweight/obese individuals.</p> <p>Methods</p> <p>This study was a parallel-arm randomized 4 mo weight loss trial. Adults (n = 50, 47 ± 7 y) matched on BMI (33.6 ± 0.6 kg/m², <it>P </it>= 0.79) consumed energy restricted diets (deficit ~500 kcal/d): PRO (1.6 g.kg^-1.d^-1protein and < 170 g/d carbohydrate) or CHO (0.8 g.kg^-1.d^-1protein and > 220 g/d carbohydrate) for 4 mos. Meal challenges of respective diets were utilized for determination of blood lipids and post-prandial INS and glucose response at the beginning and end of the study.</p> <p>Results</p> <p>There was a trend for PRO to lose more weight (-9.1% vs. -7.3%, <it>P </it>= 0.07) with a significant reduction in percent fat mass compared to CHO (-8.7% vs. -5.7%; <it>P </it>= 0.03). PRO also favored reductions in triacylglycerol (-34% vs. -14%; <it>P </it>< 0.05) and increases in HDL-C (+5% vs. -3%; <it>P </it>= 0.05); however, CHO favored reduction in LDL-C (-7% vs. +2.5%; <it>P </it>< 0.05). INS responses to the meal challenge were improved in PRO compared to CHO (<it>P </it>< 0.05) at both 1 hr (-34.3% vs. -1.0%) and 2 hr (-9.2% vs. +46.2%), an effect that remained significant after controlling for weight or fat loss (both <it>P </it>< 0.05).</p> <p>Conclusion</p> <p>A weight loss diet with moderate carbohydrate, moderate protein results in more favorable changes in body composition, dyslipidemia, and post-prandial INS response compared to a high carbohydrate, low protein diet suggesting an additional benefit beyond weight management to include augmented risk reduction for metabolic disease.</p

Intérêt d’un score de la qualité de l'évaluation pour l'apprentissage pour évaluer la rétroaction écrite dans la formation postdoctorale en anesthésiologie : étude de généralisabilité et de décision

Background: Competency based residency programs depend on high quality feedback from the assessment of entrustable professional activities (EPA). The Quality of Assessment for Learning (QuAL) score is a tool developed to rate the quality of narrative comments in workplace-based assessments; it has validity evidence for scoring the quality of narrative feedback provided to emergency medicine residents, but it is unknown whether the QuAL score is reliable in the assessment of narrative feedback in other postgraduate programs. Methods: Fifty sets of EPA narratives from a single academic year at our competency based medical education post-graduate anesthesia program were selected by stratified sampling within defined parameters [e.g. resident gender and stage of training, assessor gender, Competency By Design training level, and word count (≥17 or &lt;17 words)]. Two competency committee members and two medical students rated the quality of narrative feedback using a utility score and QuAL score. We used Kendall’s tau-b co-efficient to compare the perceived utility of the written feedback to the quality assessed with the QuAL score. The authors used generalizability and decision studies to estimate the reliability and generalizability coefficients. Results: Both the faculty’s utility scores and QuAL scores (r = 0.646, p &lt; 0.001) and the trainees’ utility scores and QuAL scores (r = 0.667, p &lt; 0.001) were moderately correlated. Results from the generalizability studies showed that utility scores were reliable with two raters for both faculty (Epsilon=0.87, Phi=0.86) and trainees (Epsilon=0.88, Phi=0.88). Conclusions: The QuAL score is correlated with faculty- and trainee-rated utility of anesthesia EPA feedback. Both faculty and trainees can reliability apply the QuAL score to anesthesia EPA narrative feedback. This tool has the potential to be used for faculty development and program evaluation in Competency Based Medical Education. Other programs could consider replicating our study in their specialty.Contexte : La qualité de la rétroaction à la suite de l’évaluation d’activités professionnelles confiables (APC) est d’une importance capitale dans les programmes de résidence fondés sur les compétences. Le score QuAL (Quality of Assessment for Learning) est un outil développé pour évaluer la qualité de la rétroaction narrative dans les évaluations en milieu de travail. Sa validité a été démontrée dans le cas des commentaires narratifs fournis aux résidents en médecine d'urgence, mais sa fiabilité n’a pas été évaluée dans d'autres programmes de formation postdoctorale. Méthodes : Cinquante ensembles de commentaires portant sur des APC d'une seule année universitaire dans notre programme postdoctoral en anesthésiologie – un programme fondé sur les compétences – ont été sélectionnés par échantillonnage stratifié selon des paramètres préétablis [par exemple, le sexe du résident et son niveau de formation, le sexe de l'évaluateur, le niveau de formation en Compétence par conception, et le nombre de mots (≥17 ou &lt;17 mots)]. Deux membres du comité de compétence et deux étudiants en médecine ont évalué la qualité de la rétroaction narrative à l'aide d'un score d'utilité et d'un score QuAL. Nous avons utilisé le coefficient tau-b de Kendall pour comparer l'utilité perçue de la rétroaction écrite et sa qualité évaluée à l’aide du score QuAL. Les auteurs ont utilisé des études de généralisabilité et de décision pour estimer les coefficients de fiabilité et de généralisabilité. Résultats : Les scores d'utilité et les scores QuAL des enseignants (r = 0,646, p &lt; 0,001) et ceux des étudiants (r = 0,667, p &lt; 0,001) étaient modérément corrélés. Les résultats des études de généralisabilité ont montré qu’avec deux évaluateurs les scores d'utilité étaient fiables tant pour les enseignants (Epsilon=0,87, Phi=0,86) que pour les étudiants (Epsilon=0,88, Phi=0,88). Conclusions : Le score QuAL est en corrélation avec l'utilité de la rétroaction sur les APC en anesthésiologie évaluée par les enseignants et les étudiants. Les uns et les autres peuvent appliquer de manière fiable le score QuAL aux commentaires narratifs sur les APC en anesthésiologie. Cet outil pourrait être utilisé pour le perfectionnement professoral et l'évaluation des programmes dans le cadre d’une formation médicale fondée sur les compétences. D'autres programmes pourraient envisager de reproduire notre étude dans leur spécialité

Dissolved organic radiocarbon in the central Pacific Ocean

© The Author(s), 2019. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Druffel, E. R. M., Griffin, S., Wang, N., Garcia, N. G., McNichol, A. P., Key, R. M., & Walker, B. D. Dissolved organic radiocarbon in the central Pacific Ocean. Geophysical Research Letters, 46(10), (2019):5396-5403, doi:10.1029/2019GL083149.We report marine dissolved organic carbon (DOC) concentrations, and DOC ∆14C and δ13C values in seawater collected from the central Pacific. Surface ∆14C values are low in equatorial and polar regions where upwelling occurs and high in subtropical regions dominated by downwelling. A core feature of these data is that 14C aging of DOC (682 ± 86 14C years) and dissolved inorganic carbon (643 ± 40 14C years) in Antarctic Bottom Water between 54.0°S and 53.5°N are similar. These estimates of aging are minimum values due to mixing with deep waters. We also observe minimum ∆14C values (−550‰ to −570‰) between the depths of 2,000 and 3,500 m in the North Pacific, though the source of the low values cannot be determined at this time.We thank Jennifer Walker, Xiaomei Xu, and Dachun Zhang for their help with the stable carbon isotope measurements; John Southon and staff of the Keck Carbon Cycle AMS Laboratory for their assistance and advice; the support of chief scientists Samantha Siedlecki, Molly Baringer, Alison Macdonald, and Sabine Mecking; the guidance of Jim Swift and Dennis Hansell for shared ship time; and Sarah Bercovici for collecting water on the GoA cruise. We appreciate the comments of Christian Lewis and Niels Hauksson on this manuscript. This work was supported by NSF (OCE‐141458941 to E. R. M. D. and OCE‐0824864, OCE‐1558654, and Cooperative Agreement OCE1239667 to R. M. K. and A. P. M.), the Fred Kavli Foundation, the Keck Carbon Cycle AMS Laboratory, and the NSF/NOAA‐funded GO‐SHIP Program. This research was undertaken, in part, thanks to funding from the Canada Research Chairs program (to B. D. W.) and an American Chemical Society Petroleum Research Fund New Directions grant (55430‐ND2 to E. R. M. D. and B. D. W.). Data from the P16N cruises are available in Table S2 in the Supporting Information and at the Repeat Hydrography Data Center at the CCHDO website (http://cdiac.esd.ornl.gov/oceans/index.html) using the expo codes 3RO20150329, 3RO20150410, and 3RO20150525. There are no real or perceived financial conflicts of interests for any author.2019-11-0

Structure, spin correlations and magnetism of the S=1/2S = 1/2 square-lattice antiferromagnet Sr2_2CuTe1−x_{1-x}Wx_xO6_6 (0≤x≤10 \leq x \leq 1)

Quantum spin liquids are highly entangled magnetic states with exotic properties. The $S = 1/2$ square-lattice Heisenberg model is one of the foundational models in frustrated magnetism with a predicted, but never observed, quantum spin liquid state. Isostructural double perovskites Sr$_2$CuTeO$_6$ and Sr$_2$CuWO$_6$ are physical realizations of this model, but have distinctly different types magnetic order and interactions due to a $d^{10}/d^0$ effect. Long-range magnetic order is suppressed in the solid solution Sr$_2$CuTe$_{1-x}$W$_x$O$_6$ in a wide region of $x = 0.05-0.6$, where the ground state has been proposed to be a disorder-induced spin liquid. Here we show that the spin-liquid-like $x = 0.2$ and $x = 0.5$ samples have distinctly different local spin correlations, which suggests they have different ground states. Furthermore, the previously ignored interlayer coupling between the square-planes is likely to play a role in the suppression of magnetic order on the W-rich side at $x \approx 0.6$. These results highlight the complex magnetism of Sr$_2$CuTe$_{1-x}$W$_x$O$_6$ and hint at a new quantum critical point at $x \approx 0.3$.Comment: 19+8 pages, 6+8 figure

Kinetic Characterisation of a Single Chain Antibody against the Hormone Abscisic Acid: Comparison with Its Parental Monoclonal

A single-chain Fv fragment antibody (scFv) specific for the plant hormone abscisic acid (ABA) has been expressed in the bacterium Escherichia coli as a fusion protein. The kinetics of ABA binding have been measured using surface plasmon resonance spectrometry (BIAcore 2000) using surface and solution assays. Care was taken to calculate the concentration of active protein in each sample using initial rate measurements under conditions of partial mass transport limitation. The fusion product, parental monoclonal antibody and the free scFv all have low nanomolar affinity constants, but there is a lower dissociation rate constant for the parental monoclonal resulting in a three-fold greater affinity. Analogue specificity was tested and structure-activity binding preferences measured. The biologically-active (+)-ABA enantiomer is recognised with an affinity three orders of magnitude higher than the inactive (-)-ABA. Metabolites of ABA including phaseic acid, dihydrophaseic acid and deoxy-ABA have affinities over 100-fold lower than that for (+)-ABA. These properties of the scFv make it suitable as a sensor domain in bioreporters specific for the naturally occurring form of ABA

Neuroimaging studies of pediatric social anxiety: paradigms, pitfalls and a new direction for investigating the neural mechanisms

Social Anxiety Disorder (SAD) is a common and debilitating condition that typically manifests in adolescence. Here we describe cognitive factors engaged by brain-imaging tasks, which model the peer-based social interactions that evoke symptoms of SAD. We then present preliminary results from the Virtual School paradigm, a novel peer-based social interaction task. This paradigm is designed to investigate the neural mechanisms mediating individual differences in social response flexibility and in participants’ responses to uncertainty in social contexts. We discuss the utility of this new paradigm for research on brain function and developmental psychopathology.https://doi.org/10.1186/2045-5380-3-1

Stratification of PD-1 blockade response in melanoma using pre- and post-treatment immunophenotyping of peripheral blood

Efficacy of checkpoint inhibitor therapies in cancer varies greatly, with some patients showing complete responses while others do not respond and experience progressive disease. We aimed to identify correlates of response and progression following PD-1-directed therapy by immunophenotyping peripheral blood samples from 20 patients with advanced malignant melanoma before and after treatment with the PD-1 blocking antibody pembrolizumab. Our data reveal that individuals responding to PD-1 blockade were characterised by increased CD8 T cell proliferation following treatment, while progression was associated with an increase in CTLA-4-expressing Treg. Remarkably, unsupervised clustering analysis of pre-treatment T cell subsets revealed differences in individuals that went on to respond to PD-1 blockade compared to individuals that did not. These differences mapped to expression of the proliferation marker Ki67 and the costimulatory receptor CD28 as well as the inhibitory molecules 2B4 and KLRG1. While these results require validation in larger patient cohorts, they suggest that flow cytometric analysis of a relatively small number of T cell markers in peripheral blood could potentially allow stratification of PD-1 blockade treatment response prior to therapy initiation