Review of policies to increase fruit and vegetable consumption and physical activity in 49 low- and middle-income countries.

BACKGROUND: Inadequate physical activity (PA) and consumption of fruits and vegetables (FV) are known risk factors for non-communicable diseases (NCDs). Consequently, the World Health Organization (WHO) encourages the development of policies to increase PA and FV consumption. We reviewed available policies between 2004 and 2013 to increase FV consumption and PA from a convenience sample of 49 LMICs. METHOD: Information on national policies were obtained from government ministries involved with the formulation of nutrition and PA policies, WHO databases and from PubMed and Scopus. RESULTS: Of the 49 countries, 57% had policies to increase FV consumption, and 76% had policies to promote PA. Policy reviews indicated strategies that focus on schools, communities, the general public, the environment, the economy, mass media and WHO recommendations. Of the 28 countries with FV policies, 18% had formulated policies that met the WHO recommendations for daily intake of FV. Likewise, of the 37 countries with PA policies, 24% had policies that promoted the WHO recommendations for daily PA. CONCLUSION: Greater progress has been made in developing policies to increase PA compared to policies to increase FV consumption in low- and middle-income countries. However, most countries are still lagging behind in developing policies to meet the WHO recommendations.

Strong-Isospin-Breaking Correction to the Muon Anomalous Magnetic Moment from Lattice QCD at the Physical Point.

All lattice-QCD calculations of the hadronic-vacuum-polarization contribution to the muon's anomalous magnetic moment to date have been performed with degenerate up- and down-quark masses. Here we calculate directly the strong-isospin-breaking correction to a_{µ}^{HVP} for the first time with physical values of m_{u} and m_{d} and dynamical u, d, s, and c quarks, thereby removing this important source of systematic uncertainty. We obtain a relative shift to be applied to lattice-QCD results obtained with degenerate light-quark masses of δa_{µ}^{HVP,m_{u}≠m_{d}}=+1.5(7)%, in agreement with estimates from phenomenology.

Sandwich consumption in relation to daily dietary intake and diet quality among US adults, 2003-2012.

OBJECTIVES: About one half of the US adult population consumed one or more sandwiches on any given day. Sandwich consumption may profoundly influence people's calorie intake and diet quality. However, few studies have investigated the nutritional impact of sandwich consumption at the national level. We examined sandwich consumption in relation to daily dietary intake and diet quality among US adults. STUDY DESIGN: Retrospective data analysis. METHODS: Nationally representative sample consisting of 27,075 adults 18 years of age and above came from the National Health and Nutrition Examination Survey (NHANES) 2003-2012 waves. Sandwich consumption was identified based on the What We Eat in America Food Category and the NHANES diet combination code. First-difference estimator addressed confounding bias from time-invariant unobservables (e.g. eating habits, taste preferences) by using within-individual variations in sandwich consumption between two non-consecutive 24-h dietary recalls. RESULTS: During 2003-2012, approximately 53.2% of US adults consumed sandwiches on any given day. Among sandwich consumers, nearly a quarter of daily total calorie intake and about a third of total fat, saturated fat, cholesterol, and sodium intake came from sandwich consumption. Men, non-Hispanic whites, young and middle-aged adults, people with higher income, and overweight/obese adults were more likely to consume sandwiches. Among those who consumed sandwiches on either but not both of the two dietary recall days, in comparison to no sandwich consumption, sandwich consumption on a dietary recall day was associated with an increase in daily intake of total energy by 98.7 kcal, total fat 6.8 g, and sodium 267.9 mg (P-value < 0.001). Statistically significant but relatively small differences were also found for other nutrients and food groups-sandwich consumption was associated with an increase in daily intake of sugar by 3.0 g (P-value < 0.01) and saturated fat 2.5 g (P-value < 0.001), a decrease in daily intake of vegetables by 8.4 g (P-value < 0.01), fruit 4.5 g (P-value < 0.05), and fibre 0.8 g (P-value < 0.001), and a decrease in the Healthy Eating Index-2010 score by 1.6 points (P-value < 0.001). CONCLUSIONS: Consumers should prudently evaluate the calorie/nutrient content of sandwich in order to make healthier dietary choices.

B→πll Form Factors for New Physics Searches from Lattice QCD.

The rare decay B→πℓ^{+}ℓ^{-} arises from b→d flavor-changing neutral currents and could be sensitive to physics beyond the standard model. Here, we present the first ab initio QCD calculation of the B→π tensor form factor f_{T}. Together with the vector and scalar form factors f_{+} and f_{0} from our companion work [J. A. Bailey et al., Phys. Rev. D 92, 014024 (2015)], these parametrize the hadronic contribution to B→π semileptonic decays in any extension of the standard model. We obtain the total branching ratio BR(B^{+}→π^{+}µ^{+}µ^{-})=20.4(2.1)×10^{-9} in the standard model, which is the most precise theoretical determination to date, and agrees with the recent measurement from the LHCb experiment [R. Aaij et al., J. High Energy Phys. 12 (2012) 125].

Determination of |V(us)|| from a lattice QCD calculation of the K → πℓν semileptonic form factor with physical quark masses.

We calculate the kaon semileptonic form factor f+(0) from lattice QCD, working, for the first time, at the physical light-quark masses. We use gauge configurations generated by the MILC Collaboration with Nf = 2 + 1 + 1 flavors of sea quarks, which incorporate the effects of dynamical charm quarks as well as those of up, down, and strange. We employ data at three lattice spacings to extrapolate to the continuum limit. Our result, f+(0) = 0.9704(32), where the error is the total statistical plus systematic uncertainty added in quadrature, is the most precise determination to date. Combining our result with the latest experimental measurements of K semileptonic decays, one obtains the Cabibbo-Kobayashi-Maskawa matrix element |V(us)| = 0.22290(74)(52), where the first error is from f+(0) and the second one is from experiment. In the first-row test of Cabibbo-Kobayashi-Maskawa unitarity, the error stemming from |V(us)| is now comparable to that from |V(ud)|.

Leptonic-decay-constant ratio f(K+)/f(π+) from lattice QCD with physical light quarks.

A calculation of the ratio of leptonic decay constants f(K+)/f(π+) makes possible a precise determination of the ratio of Cabibbo-Kobayashi-Maskawa (CKM) matrix elements |V(us)|/|V(ud)| in the standard model, and places a stringent constraint on the scale of new physics that would lead to deviations from unitarity in the first row of the CKM matrix. We compute f(K+)/f(π+) numerically in unquenched lattice QCD using gauge-field ensembles recently generated that include four flavors of dynamical quarks: up, down, strange, and charm. We analyze data at four lattice spacings a ≈ 0.06, 0.09, 0.12, and 0.15 fm with simulated pion masses down to the physical value 135 MeV. We obtain f(K+)/f(π+) = 1.1947(26)(37), where the errors are statistical and total systematic, respectively. This is our first physics result from our N(f) = 2+1+1 ensembles, and the first calculation of f(K+)/f(π+) from lattice-QCD simulations at the physical point. Our result is the most precise lattice-QCD determination of f(K+)/f(π+), with an error comparable to the current world average. When combined with experimental measurements of the leptonic branching fractions, it leads to a precise determination of |V(us)|/|V(ud)| = 0.2309(9)(4) where the errors are theoretical and experimental, respectively.

Refining new-physics searches in B→Dτν with lattice QCD.

The semileptonic decay channel B→Dτν is sensitive to the presence of a scalar current, such as that mediated by a charged-Higgs boson. Recently, the BABAR experiment reported the first observation of the exclusive semileptonic decay B→Dτ(-)ν, finding an approximately 2σ disagreement with the standard-model prediction for the ratio R(D)=BR(B→Dτν)/BR(B→Dℓν), where ℓ = e,µ. We compute this ratio of branching fractions using hadronic form factors computed in unquenched lattice QCD and obtain R(D)=0.316(12)(7), where the errors are statistical and total systematic, respectively. This result is the first standard-model calculation of R(D) from ab initio full QCD. Its error is smaller than that of previous estimates, primarily due to the reduced uncertainty in the scalar form factor f(0)(q(2)). Our determination of R(D) is approximately 1σ higher than previous estimates and, thus, reduces the tension with experiment. We also compute R(D) in models with electrically charged scalar exchange, such as the type-II two-Higgs-doublet model. Once again, our result is consistent with, but approximately 1σ higher than, previous estimates for phenomenologically relevant values of the scalar coupling in the type-II model. As a by-product of our calculation, we also present the standard-model prediction for the longitudinal-polarization ratio P(L)(D)=0.325(4)(3).

[Artists, their performances, their muscles and their fears]. / L'artiste, sa performance, ses muscles et son angoisse.

A thorough physical examination of the artist is a prerequisite of good physiotherapy. A musician should bring his/her instrument(s) and should undress in order to be examined. Being able to examine a dancer at the exercise barre is a significant advantage. In addition, this examination should always include quality medical iconography. Physiotherapy is a genuine treatment. This, however, also means that it has its own restrictions and involves dangers and contraindications.

[From the analogic to the digital era: technical EEG progress for presurgical investigations of refractory partial epilepsies]. / De l'ère analogique à l'ère numérique: évolution des techniques électro-encéphalographiques dans le bilan préchirurgical des épilepsies partielles pharmacorésistantes.

Over the past two decades, exploration of epileptic patients has benefited from technological advances in electroencephalography. Computerized equipment can simultaneously retrieve cerebral electric activity and signs of the patient's ictal activity. The computer era has improved reliability, storage and analysis of the recorded data and provides easier communication tools for multidisciplinary staff and patient case studies. Therefore, an increasing number of patients could benefit from presurgical investigations and surgical treatment.

Urinary excretion of total proteins, albumin, and beta 2-microglobulin during rest and exercise in diabetic adolescents with and without retinopathy.

To determine whether protein excretion during exercise is an earlier sign of renal dysfunction in diabetic adolescents than the basal measurements, urinary creatinine, total proteins, albumin, and beta 2-microglobulin were studied before, immediately after, and 30 min after exercise until exhaustion on a bicycle ergometer in a group of 21 adolescent diabetic boys (Albustix negative) and in a comparable control group. Among the 21 diabetic subjects, 11 had an incipient retinopathy diagnosed by fluorescein angiography. Urinary output of creatinine was similar in diabetic and in nondiabetic groups, and did not vary during exercise. At rest, the urinary output of total proteins, albumin, and beta 2-microglobulin was significantly higher in diabetic subjects than in controls. These data suggest that the subclinical proteinuria of diabetes is of mixed origin, being both glomerular and tubular. An exercise test leading to exhaustion did not give any additional information other than the basal excretion. There was no difference between diabetic subjects with early retinal vascular changes and those free from all retinopathy.

Expression of nitric oxide synthase isoforms in the thyroid gland: evidence for a role of nitric oxide in vascular control during goiter formation.

The thyroid gland is a highly vascular tissue, and its blood flow changes dramatically in various pathological conditions. Although the mechanisms regulating these changes in vascularity and blood flow are not well understood, candidate mediators include endothelin-1 (ET-1) and nitric oxide (NO). In the present study, we used a reverse transcriptase-polymerase chain reaction assay to determine which components of these vasoregulatory pathways are present in the thyroid and to analyze changes in gene expression in an experimental model of goiter formation and involution. Expression of messenger RNAs (mRNAs) encoding ET-1, ET receptors (ETA and ETB), ET-converting enzyme, and the three nitric oxide synthase (NOS) isoforms (NOS I, NOS II, and NOS III) was readily detected in the rat thyroid. After goiter formation was induced by thiouracil and a low iodine diet, there was increased expression of the genes encoding ET-related proteins (ET-1, 3.2-fold; ETA, 2.9-fold; ETB, 3.5-fold) as well as two of the three NOS isoforms (NOS I, 2.7-fold; NOS III, 4.9-fold). During iodide-induced involution, the ET-related mRNA levels remained elevated, whereas those of the two NOS isoforms returned to basal values. ET-converting enzyme, NOS II, and thyroglobulin mRNAs were minimally affected in this model, providing evidence for selective regulation of these genes. To assess whether NO plays a role in vascular changes during goiter formation, animals were treated with a NOS inhibitor, N-nitro-L-arginine methyl ester (NAME). NOS activity in the thyroid was inhibited by more than 75% after treatment with NAME. Thyroid hormone and TSH levels were unchanged. Although NAME had little effect on overall thyroid size, vascular expansion during goiter formation was decreased by 36%. We conclude that the thyroid gland expresses a complex network of vasoactive genes whose expression is regulated dynamically during thyroid goiter formation and involution. NO production and probably other locally produced vasoactive substances are involved in changes in thyroid vascularization.

Ocular findings in metachromatic leukodystrophy. An electron microscopic and enzyme study in different clinical and genetic variants.

Histopathological studies of the eyes from three patients affected with the infantile form of metachromatic leukodystrophy (MLD) showed the storage of metachromatic complex lipids in the retinal ganglion cells, in the optic nerve and the ciliary nerves, as well as the storage of a mucopolysaccharide-like material in the nonpigmented epithelium of the ciliary body. The lesions were limited to the optic, ciliary, and sensory nerves in a fourth patient with the juvenile form of the disorder. These morphological aspects, which are probably related to differences in sulfatase A activities, may explain the variability of the ocular manifestations in metachromatic leukodystrophy. Seven children affected with infantile MLD or with mucosulfatidosis were examined by conjunctival biopsy. Typical lesions of the sensory nerves were obvious and allowed the diagnosis of the disease. However, it seemed impossible to separate the different forms by histopathological studies only. The tear enzymes were assayed in most of the cases and demonstrated a profound deficiency of arylsulfatase A, or of arylsulfatase A and B, in the classical MLD and in mucosulfatidosis, respectively.

Club endings containing substance P-like immunoreactivity in human retinal vessels: Whole mount preparation.

Substance P-like immunoreactivity was studied by fluorescence immunohistochemistry in human retinal vessels of the whole mount preparation. Substance P immunoreactive nerve fibers were seen to run along the arteries and some veins. Club terminals are in contact with the vessel wall. Substance P may act as a vasoregulator in the human retina.

Adult form of basal cell naevus syndrome: a family study.

A 32-year-old patient had marked reduction of visual acuity due to falciform folds of the retina and retinal detachment, and severe neurological abnormality: bilateral pyramidal involvement, fasciculation in all limbs and gait ataxia. Skull radiographs showed internal frontal hyperostosis; CT scan showed calcification of the falx cerebri, and multiple arachnoid cysts were shown by myelography. A naevoid lesion had previously been removed from the left forearm. There was a history of ophthalmological symptoms in the mother and the daughter of the propositus. His son has "café au lait" spot on the abdomen and dentigerous cysts. The diagnosis of an adult form of basal cell naevus syndrome with an autosomal dominant mode of inheritance is discussed.

Charcot-Marie-Tooth disease associated with retinal pigment dystrophy and protanopia. Neurological, ophthalmological and genetic study of a family.

Neurological, ophthalmological and genetic investigations were performed on a family, a member of which presented with a rare association of tapeto-retinal degeneration, protanopia and Charcot-Marie-Tooth disease (CMT), and asked for genetic counseling. The neurological enquiry was completed by measurement of motor nerve conduction velocity in several completed by measurement of motor nerve conduction velocity in several members of the family. The propositus was submitted to a muscle biopsy. The ophthalmological examination included ophthalmoscopy, fluorescein angiography, electroretinogram and electrooculogram. The propositus, a woman aged 40, had typical CMT disease and her father also had a mild form of it. She had protanopia as had her father, her son and her nephew. In addition she had large macular pigmented changes, described as retinal dystrophy, "flavus flavimaculatus." Her mother had only senile pigmented modification of the fundus and her three daughters had mild macular pigmented changes, like "salt and pepper." Two genes are probably involved: one for protanopia with X linked recessive inheritance, the other responsible of CMT and tapeto-retinal degeneration, with an autosomal dominant inheritance, giving a 50% risk of recurrence.

Ocular findings in Niemann-Pick disease.

Light and electron microscopic studies of the eyes of a 3 1/2-year-old girl who died of Niemann-Pick disease disclosed accumulation of intralysosomal lipid material in all cells other than those that were pigmented. The nonpigmented layer of the ciliary process and the ganglion cells of the retina were especially involved. Electron microscopy revealed two main types of lipid cytosomes. The presumptive explanation for this finding is that the metabolism of the stored material in neurons differs from that in other cells. Topographic and structural studies of the pathologic pigment epithelium suggested that pigmented cells show storage material either when they are in intimate contact with affected cells or when the enzyme defect interferes with the catabolism of the outer segments.

Ocular findings in I-cell disease (mucolipidosis type II).

The ultrastructural study of the eyes in seven patients affected with I-cell disease (mucolipidosis type II) revealed important changes in the corneal, scleral, and uveal fibroblasts, while other cells were rarely involved. This explains the inconstant corneal clouding and the absence of ophthalmoscopic abnormalities clinically. At any moment of a patient's life, conjunctival biopsy specimens show characteristic alterations and allow the rapid and secure diagnosis of I-cell disease. This examination should be widely used in the screening of lysosomal diseases.

Kidney transplantation in primary oxalosis.

A 33 year old patient with primary oxalosis was submitted to cadaver kidney transplantation after 15 months treatment by hemodialysis. During the dialysis period, he developed complete heart block which immediately followed bilateral nephrectomy. The transplant functioned correctly and was found to excrete large amounts of oxalate. Death, which supervened 7 months after transplantation, was due to miliary tuberculosis. The patient's own kidneys and various organs examined post mortem showed extensive oxalate deposits, which were mainly observed in the graft, conducting system of the heart, ocular structures, spleen and pancreas. The problems of managing terminal uremia secondary to primary oxalosis are discussed.

One-stage reconstruction of an infected skin and Achilles tendon defect with a composite distally planned lateral arm flap.

In this paper, the treatment of a complicated Achilles tendon defect with a composite lateral arm flap with distal design of the skin paddle has been presented. The extended portion of the flap was sufficient to restore adequate contour to the posterior aspect of the ankle, and reinervation showed good protective sensation at 1 year. In terms of resurfacing, the use of the reinervated lateral arm flap with a distal design of the skin paddle seems advantageous. The weakening of the reconstructed Achilles tendon, although without clinical incidence and impairment of elbow extensors at this stage, may indicate that a better substitute than the triceps tendon has to be found. Nevertheless, we would best reconstruct such an Achilles tendon defect by the same technique because of the well vascularized autologous tissue it provides, limiting the risk of infection.

[Macular dystrophy in menkes disease. Histological ocular study (author's transl)]. / Dystrophie maculaire dans une maladie de Menkes. Etude histologique oculaire.

Pathological ocular study of a boy presenting Menkes disease and died at age 5 months showed rarefaction of outer nuclear layer and degenerative visual cells' outer segments in macular area.