Bioavailable Vitamin D in Obese Children: The Role of Insulin Resistance.

Context: Studies examining vitamin D levels in association with childhood obesity usually do not consider the effect of insulin on vitamin D–binding protein and do not calculate the unbound, bioavailable vitamin D. Objective: This study aimed to evaluate in a group of children 1) the concentrations of both total 25-hydroxyvitamin D and bioavailable fraction, and 2) the potential role of insulin resistance in modulating the concentrations of bioavailable vitamin D. Design, Setting, and Patients or Other Participants: This was a cross-sectional study at a University Pediatric Department in which 63 obese children and 21 lean controls were enrolled. Main Outcome Measures: Total 25-hydroxyvitamin D and vitamin D–binding protein were measured, twosingle-nucleotide polymorphisms in the coding region of the vitaminD–binding protein (rs4588 and rs7041) were studied, and the vitamin D bioavailable fraction was calculated. Results: Obese children showed total 25-hydroxyvitamin D levels lower compared with nonobese children (21.36.7 ng/mL vs 29.611.7 ng/mL; P.0004). Bioavailable 25-hydroxyvitaminDlevels were not different among the two groups (3.1 1.6 ng/mL vs 2.6 1.2 ng/mL; P .05). Insulinresistant children showed higher bioavailable levels of 25-hydroxyvitamin D compared with noninsulin- resistant children (3.4 1.4 ng/mL vs 2.0 0.9 ng/mL; P .013) and an inverse correlation between insulin resistance and vitamin D–binding protein was found (r: 0.40; P .024). Conclusions: Obese children present levels of bioavailable 25-hydroxyvitamin D similar to those of normal-weight children due to reduced concentration of vitamin D–binding protein. The insulin resistance could play a role in this reduced concentrat

Anticipatory nausea in cyclical vomiting

BACKGROUND: Cyclical Vomiting Syndrome (CVS) is characterised by discrete, unexplained episodes of intense nausea and vomiting, and mainly affects children and adolescents. Comprehending Cyclical Vomiting Syndrome requires awareness of the severity of nausea experienced by patients. As a subjective symptom, nausea is easily overlooked, yet is the most distressing symptom for patients and causes many behavioural changes during attacks. CASE PRESENTATION: This first-hand account of one patient's experience of Cyclical Vomiting Syndrome shows how severe nausea contributed to the development of anticipatory nausea and vomiting (ANV), a conditioned response frequently observed in chemotherapy patients. This conditioning apparently worsened the course of the patient's disease. Anticipatory nausea and vomiting has not previously been recognised in Cyclical Vomiting Syndrome, however predictors of its occurrence in oncology patients indicate that it could complicate many cases. CONCLUSION: We suggest a model whereby untreated severe and prolonged nausea provokes anxiety about further cyclical vomiting attacks. This anxiety facilitates conditioning, thus increasing the range of triggers in a self-perpetuating manner. Effective management of the nausea-anxiety feedback loop can reduce the likelihood of anticipatory nausea and vomiting developing in other patients

Overlap in signaling between Smoothened and the α subunit of the heterotrimeric G protein G₁₃

The Hedgehog family of morphogens has long been known to utilize, through the 7-transmembrane protein Smoothened (Smo), the heterotrimeric G protein Gi in both canonical and noncanonical forms of signaling. Other G proteins, while not specifically utilized by Smo, may nonetheless provide access to some of the events controlled by it. We reported several years ago that the G protein G₁₃ activates one or more forms of the Gli family of transcription factors. While the Gli transcription factors are well known targets for Smo, the uncertain mechanism of activation by G₁₃ and the identity of the targeted Gli(s) limited predictions as to the extent to which G₁₃ might mimic Smo’s actions. We evaluate here the potential for overlap in G₁₃ and Smo signaling using C3H10T1/2 and 3T3-L1 cells as models of osteogenesis and adipogenesis, respectively. We find in C3H10T1/2 cells that a constitutively active form of Gα₁₃ (Gα₁₃QL) increases Gli1 mRNA, as does a constitutively active form of Smo (SmoA1). We find as well that Gα₁₃QL induces alkaline phosphatase activity, a marker of osteogenesis, albeit the induction is far less substantial than that achieved by SmoA1. In 3T3-L1 cells both Gα₁₃QL and SmoA1 markedly suppress adipogenic differentiation as determined by triglyceride accumulation. RNA sequencing reveals that Gα₁₃QL and SmoA1 regulate many of the same genes but that quantitative and qualitative differences exist. Differences also exist, we find, between SmoA1 and purmorphamine, an agonist for Smo. Therefore, while comparisons of constitutively active proteins are informative, extrapolations to the setting of agonists require care

Seesaw Neutrino Signals at the Large Hadron Collider

We discuss the scenario with gauge singlet fermions (right-handed neutrinos) accessible at the energy of the Large Hadron Collider. The singlet fermions generate tiny neutrino masses via the seesaw mechanism and also have sizable couplings to the standard-model particles. We demonstrate that these two facts, which are naively not satisfied simultaneously, are reconciled in the five-dimensional framework in various fashions, which make the seesaw mechanism observable. The collider signal of tri-lepton final states with transverse missing energy is investigated for two explicit examples of the observable seesaw, taking account of three types of neutrino mass spectrum and the constraint from lepton flavor violation. We find by showing the significance of signal discovery that the collider experiment has a potential to find signals of extra dimensions and the origin of small neutrino masses.Comment: 27 pages, 4 figure

Two-loop Corrections to the B to pi Form Factor from QCD Sum Rules on the Light-Cone and |V(ub)|

We calculate the leading-twist O(alphas^2 beta0) corrections to the B to pi transition form factor f+(0) in light-cone sum rules. We find that, as expected, there is a cancellation between the O(alphas^2 beta0) corrections to fB f+(0) and the large corresponding corrections to fB, calculated in QCD sum rules. This suggests the insensitivity of the form factors calculated in the light-cone sum rules approach to this source of radiative corrections. We further obtain an improved determination of the CKM matrix element |V(ub)|, using latest results from BaBar and Belle for f+(0)|V(ub)|.Comment: 18 pages, 3 figure

Fermion Masses in Emergent Electroweak Symmetry Breaking

We consider the generation of fermion masses in an emergent model of electroweak symmetry breaking with composite $W,Z$ gauge bosons. A universal bulk fermion profile in a warped extra dimension is used for all fermion flavors. Electroweak symmetry is broken at the UV (or Planck) scale where boundary mass terms are added to generate the fermion flavor structure. This leads to flavor-dependent nonuniversality in the gauge couplings. The effects are suppressed for the light fermion generations but are enhanced for the top quark where the $Zt{\bar t}$ and $Wt{\bar b}$ couplings can deviate at the $10-20$ level in the minimal setup. By the AdS/CFT correspondence our model implies that electroweak symmetry is not a fundamental gauge symmetry. Instead the Standard Model with massive fermions and $W,Z$ gauge bosons is an effective chiral Lagrangian for some underlying confining strong dynamics at the TeV scale, where mass is generated without a Higgs mechanism.Comment: modified discussion in Sec 3.1, version published in JHE

The Light Stop Scenario from Gauge Mediation

In this paper we embed the light stop scenario, a MSSM framework which explains the baryon asymmetry of the universe through a strong first order electroweak phase transition, in a top-down approach. The required low energy spectrum consists in the light SM-like Higgs, the right-handed stop, the gauginos and the Higgsinos while the remaining scalars are heavy. This spectrum is naturally driven by renormalization group evolution starting from a heavy scalar spectrum at high energies. The latter is obtained through a supersymmetry-breaking mix of gauge mediation, which provides the scalars masses by new gauge interactions, and gravity mediation, which generates gaugino and Higgsino masses. This supersymmetry breaking also explains the \mu\ and B_\mu\ parameters necessary for electroweak breaking and predicts small tri-linear mixing terms A_t in agreement with electroweak baryogenesis requirements. The minimal embedding predicts a Higgs mass around its experimental lower bound and by a small extension higher masses m_H\lesssim 127 GeV can be accommodated.Comment: 20 pages, 3 figures; v2: changes in the conventions; v3: more details on the Higgs mass prediction, version published in JHE

Composite GUTs: models and expectations at the LHC

We investigate grand unified theories (GUTs) in scenarios where electroweak (EW) symmetry breaking is triggered by a light composite Higgs, arising as a Nambu-Goldstone boson from a strongly interacting sector. The evolution of the standard model (SM) gauge couplings can be predicted at leading order, if the global symmetry of the composite sector is a simple group G that contains the SM gauge group. It was noticed that, if the right-handed top quark is also composite, precision gauge unification can be achieved. We build minimal consistent models for a composite sector with these properties, thus demonstrating how composite GUTs may represent an alternative to supersymmetric GUTs. Taking into account the new contributions to the EW precision parameters, we compute the Higgs effective potential and prove that it realizes consistently EW symmetry breaking with little fine-tuning. The G group structure and the requirement of proton stability determine the nature of the light composite states accompanying the Higgs and the top quark: a coloured triplet scalar and several vector-like fermions with exotic quantum numbers. We analyse the signatures of these composite partners at hadron colliders: distinctive final states contain multiple top and bottom quarks, either alone or accompanied by a heavy stable charged particle, or by missing transverse energy.Comment: 55 pages, 13 figures, final version to be published in JHE

Do you think it's a disease? a survey of medical students

Background: The management of medical conditions is influenced by whether clinicians regard them as "disease" or "not a disease". The aim of the survey was to determine how medical students classify a range of conditions they might encounter in their professional lives and whether a different name for a condition would influence their decision in the categorisation of the condition as a 'disease' or 'not a disease'. Methods. We surveyed 3 concurrent years of medical students to classify 36 candidate conditions into "disease" and "non-disease". The conditions were given a 'medical' label and a (lay) label and positioned where possible in alternate columns of the survey. Results: The response rate was 96% (183 of 190 students attending a lecture): 80% of students concurred on 16 conditions as "disease" (eg diabetes, tuberculosis), and 4 as "non- disease" (eg baldness, menopause, fractured skull and heat stroke). The remaining 16 conditions (with 21-79% agreement) were more contentious (especially obesity, infertility, hay fever, alcoholism, and restless leg syndrome). Three pairs of conditions had both a more, and a less, medical label: the more medical labels (myalgic encephalomyelitis, hypertension, and erectile dysfunction) were more frequently classified as 'disease' than the less medical (chronic fatigue syndrome, high blood pressure, and impotence), respectively, significantly different for the first two pairs. Conclusions: Some conditions excluded from the classification of "disease" were unexpected (eg fractured skull and heat stroke). Students were mostly concordant on what conditions should be classified as "disease". They were more likely to classify synonyms as 'disease' if the label was medical. The findings indicate there is still a problem 30 years on in the concept of 'what is a disease'. Our findings suggest that we should be addressing such concepts to medical students

Getting DNA and RNA out of the dark with 2CNqA: a bright adenine analogue and interbase FRET donor

With the central role of nucleic acids there is a need for development of fluorophores that facilitate the visualization of processes involving nucleic acids without perturbing their natural properties and behaviour. Here, we incorporate a new analogue of adenine, 2CNqA, into both DNA and RNA, and evaluate its nucleobase-mimicking and internal fluorophore capacities. We find that 2CNqA displays excellent photophysical properties in both nucleic acids, is highly specific for thymine/uracil, and maintains and slightly stabilises the canonical conformations of DNA and RNA duplexes. Moreover, the 2CNqA fluorophore has a quantum yield in single-stranded and duplex DNA ranging from 10% to 44% and 22% to 32%, respectively, and a slightly lower one (average 12%) inside duplex RNA. In combination with a comparatively strong molar absorptivity for this class of compounds, the resulting brightness of 2CNqA inside double-stranded DNA is the highest reported for a fluorescent base analogue. The high, relatively sequence-independent quantum yield in duplexes makes 2CNqA promising as a nucleic acid label and as an interbase F\uf6rster resonance energy transfer (FRET) donor. Finally, we report its excellent spectral overlap with the interbase FRET acceptors qAnitro and tCnitro, and demonstrate that these FRET pairs enable conformation studies of DNA and RNA