Prevention of legionella infections from toilet flushing cisterns.

INTRODUCTION: Immunocompromised patients are at an increased risk of severe legionella infections. We present the results of an outbreak investigation initiated following a fatal case of hospital-acquired legionellosis linked to contaminated water from a toilet-flushing cistern. Additionally, we provide experimental data on the growth of Legionella spp. in flushing cisterns and propose a straightforward protocol for prevention. METHODS: We monitored the growth of Legionella spp. in the building's hot- and cold-water systems using quantitative bacterial culture on selective agar. Molecular typing of Legionella pneumophila isolates from the infected patient and the water system was conducted through core-genome multi-locus sequence typing (cgMLST). RESULTS: Legionella contamination in the hospital building's cold-water system was significantly higher than in the hot-water system and significantly higher in toilet flushing cistern's water compared with cold water from bathroom sinks and showers. Isolates from the patient and from the flushing cistern of the patient's bathroom were identical by cgMLST. In an experimental setting, daily toilet flushing for a period of 21 days resulted in a 67% reduction in the growth of Legionella spp. in the water of toilet flushing cisterns. Moreover, a one-time disinfection of cisterns with peracetic acid, followed by daily flushing, decreased legionella growth to less than 1% over a period of at least seven weeks in these setting. CONCLUSIONS: One-time disinfection of highly contaminated cisterns with peracetic acid and daily toilet flushing as short-term measure can significantly reduce legionella contamination in flushing cisterns. These measures may aid in preventing legionella infection among immunocompromised patients.

[Robot-assisted extraperitoneal ventral hernia repair-Experience from the first 61 consecutive operations with eTEP and eTAR techniques]. / Robotisch assistierte extraperitoneale Ventralhernienversorgung ­ Erfahrung der ersten 61 konsekutiven Operationen in eTEP- und eTAR-Technik.

BACKGROUND: As in many other fields of surgery, robotically assisted surgical procedures have been established in the treatment of ventral hernias in recent years. The use of the robot can combine the demands of a minimally invasive approach and retromuscular mesh placement. In addition to a transabdominal approach, these procedures can also be performed using an extraperitoneal approach. OBJECTIVES: The purpose of this study is to demonstrate that robotic total extraperitoneal management of abdominal wall hernias is safe and efficient. MATERIALS AND METHODS: A retrospective analysis of all robotically operated patients on ventral hernia using extraperitoneal eTEP technique from September 2019 to May 2022 was performed. RESULTS: A total of 61 ventral hernias were operated on using the robotic eTEP technique during the study period. In 14 patients retro-rectal dissection was extended laterally by an extraperitoneal transversus abdominis release (eTAR) because of the hernia size or a lateral hernia localization. In all cases, an uncoated synthetic mesh was placed in the retromuscular position with complete closure of the hernia defects. The median hernia defect area was 30 cm² (4-308 cm²). The median mesh size was 540 cm² (300-1350 cm²). The median mesh defect ratio (MDR) was 17.78 (3.06-145). One intraoperative and three postoperative complications were encountered. Neither conversion nor reoperation were required. CONCLUSION: The robotic extraperitoneal eTEP technique enables the required retromuscular mesh placement in a minimally invasive approach. With the possibility of a combination with a transversus abdominis release, even complex findings can be treated using this technique.

[Current robotic ventral hernia surgery exemplified by 50 consecutive patients]. / Aktuelle robotische Ventralhernienchirurgie am Beispiel von 50 konsekutiven Patienten.

BACKGROUND: In recent years there has been a rise in robotic techniques and approaches regarding hernia repair with extraperitoneal mesh placement. METHODS: A retrospective analysis of the first 50 patients who underwent robotic ventral hernia repair between May 2019 and November 2020 at the department of general surgery of the Kempten Clinic was performed. RESULTS: This case series consisted of 36 incisional hernias, 12 primary hernias (8 umbilical and 3 epigastric hernias in combination with a diastasis recti abdominis as well as 1 Spigelian hernia) and 2 parastomal hernias. A complete closure of the hernia was achieved in all cases. Extraperitoneal mesh placement in the retromuscular or preperitoneal space was achieved in 98 % of the ventral procedures. We used an extraperitoneal approach with retromuscular mesh implantation (r-eTEP= robotic enhanced view total extraperitoneal plasty) in 22 cases, 3 of those along with a transversus abdominis release (r-eTAR= robotic extraperitoneal transversus abdominis release) and 26 operations were carried out transperitoneally. These included 11 preperitoneal (r-vTAPP= robotic ventral TAPP), 7 retrorectus (TARUP= robotic transabdominal retromuscular umbilical prosthetic hernia repair) and 1 intraperitoneal onlay mesh placements (r-IPOM= robotic intraperitoneal onlay mesh) as well as 7 transperitoneal transversus abdominis releases with retromuscular mesh placement. The 2 parastomal hernias were treated with an intraperitoneal 3D funnel mesh. After the initial treatment of smaller hernias the indications could be rapidly extended to complex hernias in 38 % of this case series. One conversion to an open operation was necessary due to technical problems in closing the posterior rectus sheath. The complication rate was 12 % and the reintervention rate 4 %. CONCLUSION: Robotic surgery of ventral hernia is safe and effective. Even complex hernias can be treated minimally invasively with closure of the hernia defect and extraperitoneal mesh placement.

Gene expression analysis of MAOA and the clock gene ARNTL in individuals with bipolar disorder compared to healthy controls.

INTRODUCTION: Circadian rhythms are associated with bipolar disorder (BD). This cross-sectional study aimed at investigating ARNTL and MAOA gene expression differences (1) between individuals with BD and controls, (2) between affective episodes, and (3) the relationship between ARNTL and MAOA expression. METHODS: ARNTL and MAOA gene expression in peripheral mononuclear blood cells were analysed from fasting blood samples (BD n = 81, controls n = 54) with quantitative real-time PCR operating on TaqMan® assays (normalised to 18S RNA expression). ANCOVAs corrected for age, sex, body mass index, and medication was used to evaluate expression differences and correlation analyses for the relation between ARNTL and MAOA expression. RESULTS: ARNTL gene expression differed between affective episodes (F(2,78) = 3.198, p = 0.047, Partial Eta2= 0.083), but not between BD and controls (n.s.). ARNTL and MAOA expression correlated positively in BD (r = 0.704, p < 0.001) and in controls (r = 0.932, p < 0.001). MAOA expression differed neither between BD and controls nor between affective episodes (n.s.). DISCUSSION: Clock gene expression changes were observed in different affective states of BD. More precisely, ARNTL gene expression was significantly higher in euthymia than in depression. ARNTL and MAOA gene expression correlated significantly in BD and in controls, which emphasises the strong concatenation between circadian rhythms and neurotransmitter breakdown.

Analysis of flow field and turbulence predictions in a lung model applying RANS and implications for particle deposition.

Airflow and aerosol deposition in the human airways are important aspects for applications such as pulmonary drug delivery and human exposure to aerosol pollutants. Numerical simulations are widely used nowadays to shed light in airflow features and particle deposition patterns inside the airways. For that purpose, the Euler/Lagrange approach is adopted for predicting flow field and particle deposition through point-particle tracking. Steady-state RANS (Reynolds-averaged Navier-Stokes) computations of flow evolution in an extended lung model applying different turbulence models were conducted and compared to measurements as well as high resolution LES (large-eddy simulations) for several flow rates. In addition, various inlet boundary conditions were considered and their influence on the predicted flow field was analysed. The results showed that the mean velocity field was simulated reasonably well, however, turbulence intensity was completely under-predicted by two-equation turbulence models. Only a Reynolds-stress model (RSM) was able predicting a turbulence level comparable to the measurements and the high resolution LES. Remarkable reductions in wall deposition were observed when wall effects were accounted for in the drag and lift force expressions. Naturally, turbulence is an essential contribution to particle deposition and it is well known that two-equation turbulence models considerably over-predict deposition due to the spurious drift effect. A full correction of this error is only possible in connection with a Reynolds-stress turbulence model whereby the predicted deposition in dependence of particle diameter yielded better agreement to the LES predictions. Specifically, with the RSM larger deposition is predicted for smaller particles and lower deposition fraction for larger particles compared to LES. The local deposition fraction along the lung model was numerically predicted with the same trend as found from the measurements, however the values in the middle region of the lung model were found to be somewhat larger.

Plectin dysfunction in neurons leads to tau accumulation on microtubules affecting neuritogenesis, organelle trafficking, pain sensitivity and memory.

AIMS: Plectin, a universally expressed multi-functional cytolinker protein, is crucial for intermediate filament networking, including crosstalk with actomyosin and microtubules. In addition to its involvement in a number of diseases affecting skin, skeletal muscle, heart, and other stress-exposed tissues, indications for a neuropathological role of plectin have emerged. Having identified P1c as the major isoform expressed in neural tissues in previous studies, our aim for the present work was to investigate whether, and by which mechanism(s), the targeted deletion of this isoform affects neuritogenesis and proper nerve cell functioning. METHODS: For ex vivo phenotyping, we used dorsal root ganglion and hippocampal neurons derived from isoform P1c-deficient and plectin-null mice, complemented by in vitro experiments using purified proteins and cell fractions. To assess the physiological significance of the phenotypic alterations observed in P1c-deficient neurons, P1c-deficient and wild-type littermate mice were subjected to standard behavioural tests. RESULTS: We demonstrate that P1c affects axonal microtubule dynamics by isoform-specific interaction with tubulin. P1c deficiency in neurons leads to altered dynamics of microtubules and excessive association with tau protein, affecting neuritogenesis, neurite branching, growth cone morphology, and translocation and directionality of movement of vesicles and mitochondria. On the organismal level, we found P1c deficiency manifesting as impaired pain sensitivity, diminished learning capabilities and reduced long-term memory of mice. CONCLUSIONS: Revealing a regulatory role of plectin scaffolds in microtubule-dependent nerve cell functions, our results have potential implications for cytoskeleton-related neuropathies.

Dietary Intervention Reverses Fatty Liver and Altered Gut Microbiota during Early-Life Undernutrition.

Nonalcoholic fatty liver disease (NAFLD), largely studied as a condition of overnutrition, also presents in undernourished populations. Like NAFLD, undernutrition disrupts systemic metabolism and has been linked to gut microbiota dysbiosis. Indeed, chronic exposures to fecal microbes contribute to undernutrition pathology in regions with poor sanitation. Despite a growing prevalence of fatty liver disease, the influence of undernutrition and the gut microbiota remain largely unexplored. Here, we utilize an established murine model (C57BL/6J mice placed on a malnourished diet that received iterative Escherichia coli/Bacteroidales gavage [MBG mice]) that combines a protein/fat-deficient diet and iterative exposure to specific, fecal microbes. Fecal-oral contamination exacerbates triglyceride accumulation in undernourished mice. MBG livers exhibit diffuse lipidosis accompanied by striking shifts in fatty acid, glycerophospholipid, and retinol metabolism. Multiomic analyses revealed metabolomic pathways linked to the undernourished gut microbiome and hepatic steatosis, including phenylacetate metabolism. Intriguingly, fatty liver features were observed only in the early-life, but not adult, MBG model despite similar liver metabolomic profiles. Importantly, we demonstrate that dietary intervention largely mitigates aberrant metabolomic and microbiome features in MBG mice. These findings indicate a crucial window in early-life development that, when disrupted by nutritional deficiency, may significantly influence liver function. Our work provides a multifaceted study of how diet and gut microbes inform fatty liver progression and reversal during undernutrition.IMPORTANCE Nonalcoholic fatty liver disease (NAFLD) remains a global epidemic, but it is often studied in the context of obesity and aging. Nutritional deficits, however, also trigger hepatic steatosis, influencing health trajectories in undernourished pediatric populations. Here, we report that exposure to specific gut microbes impacts fatty liver pathology in mice fed a protein/fat-deficient diet. We utilize a multiomics approach to (i) characterize NAFLD in the context of early undernutrition and (ii) examine the impact of diet and gut microbes in the pathology and reversal of hepatic steatosis. We provide compelling evidence that an early-life, critical development window facilitates undernutrition-induced fatty liver pathology. Moreover, we demonstrate that sustained dietary intervention largely reverses fatty liver features and microbiome shifts observed during early-life malnutrition.

Optical characterization of the on-target OMEGA focal spot at high energy using the full-beam in-tank diagnostic.

The full-beam in-tank (FBIT) diagnostic has been deployed to directly measure the target-plane beam fluence profile, when operated at high energy, of the OMEGA Laser System at the University of Rochester's Laboratory for Laser Energetics. This paper presents the results of early measurements taken with this diagnostic and discusses an improvement that has overcome performance limitations discovered during the initial testing. The diagnostic gives new insight into the ability of the OMEGA Laser System to provide uniform fluence profiles that are consistent across all 60 beams in the laser. The ultimate goal of the FBIT diagnostic is to allow accurate assessment of the fluence uniformity on a spherical target in 60-beam implosion experiments.

The influence of muzzle gas on the temporary cavity.

Shot range, the muzzle-target distance, is a crucial parameter for forensic reconstruction of deaths by firearms. In a large number of cases, especially suicides, the forensic pathologist is confronted with contact or near-contact shots, where muzzle gases play an additional role. This study was conducted to systematically investigate the influence of muzzle gases on the temporary cavity (TC). A total of 72 shots were fired using full metal-jacketed bullets in four forensically relevant calibres from 10-, 5-, 3-, 2- and 1-cm distance and in close contact. Target model was the so-called reference cube (10% gelatine at 4 °C) with 12-cm edge length. The TC was recorded using high-speed video (HSV). Cross-sectional analysis was performed by cutting the blocks to 1-cm slices, which were evaluated by applying the polygon method. The TC of shots from 10 and 5 cm distance had a tubular form. This aspect changed depending on the cartridge with decreasing distance (≤ 3 cm) into a pear-like form, which was typical for contact shots. The cumulated heights of the TC increased with decreasing distance below 3 cm. Contact shots approximately doubled the extension of the TC compared with exclusive energy transfer. Whereas HSV documented an increasingly asymmetric profile with ballooning at the entry side, cross-sectional analysis of cracks in gelatine resulted in convex graphs with only slight asymmetry for contact shots. Additional damage in gelatine was detected for 3-cm distance or less in calibre .357 Magnum and ≤ 2 cm for .32 auto, .38 special and 9mm Luger. The increasing influence of muzzle gas pressure is detectable with decreasing shot range below 3 cm.

Experience and expectations of patients on weight loss: The Learning Health System Network Experience.

OBJECTIVE: Weight perception and degree of confidence in achieving healthy lifestyle can be determinants of engagement in obesity interventions. This study explored patients' perceived need for weight loss and the degree of self-confidence in ability to lose weight and sought to identify factors associated with patients' self-confidence in ability to lose weight. METHODS: The authors analysed data from a survey mailed to primary care patients within five sites of the Learning Health Systems Network that explored participants' prior experience with weight management. RESULTS: Among the 2,263 participants who completed the survey section on 'Patients' Experience with Weight Management', perceived need to lose 51 lb or more was statistically significant among those with class III obesity compared with other body mass index (BMI) groups (p value < 0.001). Reported desire to lose weight was also significantly higher among those with the highest BMI than those who were overweight (p value < 0.001). However, this same group had the lowest belief in ability to lose weight (p value < 0.001). In a multiple regression analysis, female gender, higher BMI and need to lose >10 lb were each independently associated with less belief in being able to lose weight. CONCLUSIONS: Patients had varying perceptions on weight loss; those with category III obesity had the highest desire to lose weight but had the least confidence in ability to lose weight. Higher BMI, female gender and need to lose >10 lb were associated with decreased self-confidence in ability to lose weight.

PIV measurements of the SimInhale benchmark case.

Particle Image Velocimetry (PIV) measurements with the aim of providing experimental data for the SimInhale benchmark case are presented within this work. We, therefore, present a refractive index matched, transparent model of the benchmark geometry, in which the velocity and turbulent kinetic energy fields are examined at flow rates comparable to 15, 30 and 60 L/min (Re ≈ 1000-4500) in air. Furthermore, these results are compared with Large Eddy Simulations (LES). The results reveal a Reynolds number independence of the qualitative velocity field in the range covered within this work. Good agreement is found between the PIV and LES data, with a slight over-prediction of turbulent kinetic energies by the simulations. The obtained experimental data will be part of a common, publicly accessible ERCOFTAC database along with additional results published recently.

Tripled yield in direct-drive laser fusion through statistical modelling.

Focusing laser light onto a very small target can produce the conditions for laboratory-scale nuclear fusion of hydrogen isotopes. The lack of accurate predictive models, which are essential for the design of high-performance laser-fusion experiments, is a major obstacle to achieving thermonuclear ignition. Here we report a statistical approach that was used to design and quantitatively predict the results of implosions of solid deuterium-tritium targets carried out with the 30-kilojoule OMEGA laser system, leading to tripling of the fusion yield to its highest value so far for direct-drive laser fusion. When scaled to the laser energies of the National Ignition Facility (1.9 megajoules), these targets are predicted to produce a fusion energy output of about 500 kilojoules-several times larger than the fusion yields currently achieved at that facility. This approach could guide the exploration of the vast parameter space of thermonuclear ignition conditions and enhance our understanding of laser-fusion physics.

The deceleration of bullets in gelatine - A study based on high-speed video analysis.

The velocity of a projectile is of crucial importance to calculate its kinetic energy. The study was performed to investigate if a measurement of the velocity profile of a bullet in gelatine was feasible using high-speed video. More than 50 records captured with a SA-X2 Photron camera at 40,000 fps (40k) and 10 µs exposure time were analysed frame by frame. A measurement accuracy of one pixel could be realised. Records of free flying bullets with known velocity served as a control. In further experimental shots from distance the "12 cm reference cube" was used as target model. 18 full metal jacketed bullets and 20 deforming bullets in forensically relevant calibres were fired. In addition 11 expanding bullets were studied with a close-up setting of the camera and 81,000 fps (81k) at 2.5 µs exposure time. A quasi-constant deceleration of the FMJ bullets in gelatine with a relative loss of velocity of 8.4% (.32 auto) and 13.2% (9 mm Luger) was observed. Expanding bullets showed a much higher deceleration and a relative loss of about 56% for the copper hollow point bullet and 73% for the .32 auto Gold Dot. The targeted analysis of the .32 auto Gold Dot based on 81k videos revealed an abrupt drop of the bullet velocity within the first 75 µs, the time needed for full expansion. The deformation of the Action-4 (9 mm Luger) was completely achieved within the first 2 cm of gelatine. After the deformation of the bullet the final deceleration was approximately constant. This could be demonstrated successfully by separating the deformation process experimentally from the final deceleration of the deformed bullet.

Remission of obesity among a nationally representative sample of US children.

BACKGROUND: Little is known about the incidence and natural history of obesity remission among children outside of weight loss programmes. OBJECTIVES: The objectives are to characterize and identify sociodemographic and early life predictors of obesity remission between kindergarten and eighth grade among a nationally representative sample of US children. METHODS: The sample included children with obesity [age-specific and gender-specific body mass index percentile (BMI) ≥95] at the spring kindergarten assessment of the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99. Weight categories across 8 years of follow-up were used to identify three transition patterns: persistent obesity remission, non-persistent obesity remission and non-remission. Weight, height and BMI changes between remission categories were examined and predictors of persistent remission were identified. RESULTS: One-third of children with obesity in kindergarten experienced remission during follow-up and 21.6% of children experienced persistent remission through eighth grade. Female gender and high socio-economic status predicted persistent remission; these associations were attenuated after accounting for baseline BMI. Children experiencing persistent remission gained less weight across waves than those experiencing non-remission. CONCLUSIONS: A meaningful proportion of young children with obesity experience remission by eighth grade. Further study is needed to identify factors that support obesity remission among children outside of treatment contexts.

Power balancing the multibeam OMEGA laser.

Multibeam lasers often require an output beam balance that specifies the degree of simultaneity of the laser output energy, instantaneous power, or instantaneous irradiance (power per unit area). This work describes the general problem of balancing a multibeam laser. Specific techniques used to balance the output power of the 60-beam pulsed OMEGA Laser System are discussed along with a measured reduction of beam-to-beam imbalance. In particular, the square-pulse distortion induced by a simple saturating amplifier operating with its output at some fraction of its saturation fluence is derived, and a method to exchange gain between saturated amplifiers in a single beam that have different saturation fluences to adjust balance is described.

Sperm mitochondrial dysfunction and oxidative stress as possible reasons for isolated asthenozoospermia.

Reduced sperm motility, defined as asthenozoospermia, is a frequent cause of male infertility, and is mainly connected with the dysfunction of sperm mitochondria. The aim of this study was to identify the proteins, and thereby the metabolic pathways, responsible for asthenozoospermia, using 2-DE and MALDI-TOF MS, and correlate the results obtained with those of two mitochondrial tests: JC-1 and MitoSox Red. The JC-1 test was performed to test sperm mitochondrial activity, and the MitoSox Red test was performed to check whether the observed sperm poor motility is associated with mitochondrial reactive oxygen species (ROS) production. To identify proteins strictly connected with reduced sperm motility, men with isolated asthenozoospermia (n = 4 versus 10 normozoospermic controls) alone were included in the study. The proteomic analyses resulted in the identification of 25 sperm proteins that are differentially expressed in asthenozoospermic individuals. Most of the identified proteins were downregulated and were involved in energy production; however, we have also identified structural sperm proteins and proteins secreted by the epididymis. The latter, together with the results from MitoSox Red assay, may provide insights into the pathophysiological basis of asthenozoospermia.

The nucleoside analog GS-441524 strongly inhibits feline infectious peritonitis (FIP) virus in tissue culture and experimental cat infection studies.

Feline infectious peritonitis (FIP) is a common and highly lethal coronavirus disease of domestic cats. Recent studies of diseases caused by several RNA viruses in people and other species indicate that antiviral therapy may be effective against FIP in cats. The small molecule nucleoside analog GS-441524 is a molecular precursor to a pharmacologically active nucleoside triphosphate molecule. These analogs act as an alternative substrate and RNA-chain terminator of viral RNA dependent RNA polymerase. We determined that GS-441524 was non-toxic in feline cells at concentrations as high as 100 uM and effectively inhibited FIPV replication in cultured CRFK cells and in naturally infected feline peritoneal macrophages at concentrations as low as 1 uM. We determined the pharmacokinetics of GS-441524 in cats in vivo and established a dosage that would sustain effective blood levels for 24 h. In an experimental FIPV infection of cats, GS-441524 treatment caused a rapid reversal of disease signs and return to normality with as little as two weeks of treatment in 10/10 cats and with no apparent toxicity.

Anesthetic Considerations for an Adult Patient with Freeman-Sheldon Syndrome Undergoing Open Heart Surgery.

Freeman-Sheldon syndrome (FSS) or "whistling face" syndrome is a rare congenital disorder complicated by characteristic facial deformities and muscular contractures. We report on a 64-year-old male patient presenting for surgical replacement of his aortic valve and review the available literature on anesthetic considerations and perioperative management principles. FSS frequently poses a significant challenge to airway management and gaining vascular access. Moreover, these patients are reportedly at risk for developing malignant hyperthermia (MH) or neuroleptic malignant syndrome.

Intermediate care units : Recommendations on facilities and structure.

A growing number of patients with increasingly complex or specialized diseases are being treated in hospitals worldwide. The treatment requirements of some of these patients are exceeding the capacity of standard nursing units. However, the severity of these diseases or the treatment requirements for these specific clinical pictures do not always justify admission to an intensive care unit. For this reason, an increasing number of special units (intermediate care units) are being set up to offer highly specialized treatment and close monitoring, in order to fulfil an intermediate role between the standard care unit and the intensive care unit. The recommendations of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) on the personnel, capacity, equipment and structure of these units are intended to provide the framework for the setting up and operation of intermediate care units in collaboration with experts on both an evidence-based and an expert-based basis (where scientific evidence is not available). Where only minimal or indirect evidence is available, patient safety is paramount in the formulation of the recommendation.

Interrelationships of child appetite, weight and snacking among Hispanic preschoolers.

BACKGROUND: Snacking among US preschoolers has increased in recent decades, raising questions about whether snacking contributes to dietary excess. OBJECTIVES: This research aimed to characterize snacking contributions to dietary excess and to evaluate associations with appetite and weight among preschool-aged children. METHODS: This study is a cross-sectional, observational study of 187 Hispanic low-income preschoolers. Three 24-h dietary recalls were used to assess snacking frequency and parameters of dietary excess including energy, saturated fat, trans fats and added sugars. Parental reports of child satiety responsiveness, food responsiveness, and enjoyment of food were obtained. Child height and weight were measured. RESULTS: Children consumed 28% (395 kcal) of daily energy from snacks eaten at 2.3 ± 1.0 occasions per day. Greater snacking frequency was associated with greater daily intakes of energy (p < 0.05) and added sugars (p < 0.001). Among overweight/obese children, higher enjoyment of food was associated with more frequent snacking and greater energy intake from snacks (p = 0.01). Inverse associations of enjoyment of food with snacking frequency and energy intake were seen among normal weight children (p < 0.05). CONCLUSIONS: More frequent snacking among low-income Hispanic preschoolers may contribute to excessive intakes of energy and added sugars, particularly among overweight/obese children with greater motivation to eat.