Middle and Long-Term Impact of a Very Low-Carbohydrate Ketogenic Diet on Cardiometabolic Factors: A Multi-Center, Cross-Sectional, Clinical Study

Background Interruption of domestic vector-borne transmission of Trypanosoma cruzi is still an unmet goal in several American countries. In 2007 we launched a long-term intervention program aimed to suppress house infestation with the main domestic vector in southern South America (Triatoma infestans) and domestic transmission in Pampa del Indio, a resource-constrained, hyperendemic municipality with 1446 rural houses inhabited by Creole and indigenous people, in the Argentine Chaco ecoregion. Here, we assessed whether the 10-year insecticide-based program combined with community mobilization blocked vector-borne domestic transmission of T. cruzi to humans and dogs. Methods We carried out two municipality-wide, cross-sectional serosurveys of humans and dogs (considered sentinel animals) during 2016–2017 to compare with baseline data. We used a risk-stratified random sampling design to select 273 study houses; 410 people from 180 households and 492 dogs from 151 houses were examined for antibodies to T. cruzi using at least two serological methods. Results The seroprevalence of T. cruzi in children aged <16 years was 2.5% in 2017 (i.e., 4- to 11-fold lower than before interventions). The mean annual force of child infection (λ) sharply decreased from 2.18 to 0.34 per 100 person-years in 2017. One of 102 children born after interventions was seropositive for T. cruzi; he had lifetime residence in an apparently uninfested house, no outside travel history, and his mother was T. cruzi-seropositive. No incident case was detected among 114 seronegative people of all ages re-examined serologically. Dog seroprevalence was 3.05%. Among native dogs, λ in 2016 (1.21 per 100 dog-years) was 5 times lower than at program onset. Six native adult dogs born after interventions and with stable lifetime residence were T. cruzi-seropositive: three had exposure to T. infestans at their houses and one was an incident case. Conclusions These results support the interruption of vector-borne transmission of T. cruzi to humans in rural Pampa del Indio. Congenital transmission was the most likely source of the only seropositive child born after interventions. Residual transmission to dogs was likely related to transient infestations and other transmission routes. Sustained vector control supplemented with human chemotherapy can lead to a substantial reduction of Chagas disease transmission in the Argentine Chaco.

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The short- and long-term impact of the Ramadan fast on body weight and cardiometabolic factors: a pilot study in an ethnic obese adolescent cohort.

Tijdschrift voor kindergeneeskunde ◽

10.1007/s12456-013-0093-z ◽

2013 ◽

Vol 81 (S1) ◽

pp. 96-96

Author(s):

Nalini N.E. Radhakishun ◽

Charlotte Blokhuis ◽

Mariska van Vliet ◽

Jos H. Beijnen ◽

Ines A. von Rosenstiel

Keyword(s):

Body Weight ◽

Pilot Study ◽

Obese Adolescent ◽

Short And Long Term ◽

Long Term Impact ◽

Cardiometabolic Factors

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Long-Term Ketogenic Diet Induces Metabolic Acidosis, Anemia, and Oxidative Stress in Healthy Wistar Rats

Journal of Nutrition and Metabolism ◽

10.1155/2020/3642035 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Aryadi Arsyad ◽

Irfan Idris ◽

Andi A. Rasyid ◽

Rezky A. Usman ◽

Kiki R. Faradillah ◽

...

Keyword(s):

Superoxide Dismutase ◽

Metabolic Acidosis ◽

Ketogenic Diet ◽

Wistar Rats ◽

Blood Gas ◽

High Fat ◽

Carbohydrate Diet ◽

Low Carbohydrate Diet ◽

Low Carbohydrate

Background. Ketogenic diet has been used as supportive therapy in a range of conditions including epilepsy, diabetes mellitus, and cancer. Objective. This study aimed to investigate the effects of long-term consumption of ketogenic diet on blood gas, hematological profiles, organ functions, and superoxide dismutase level in a rat model. Materials and Methods. Fifteen male Wistar rats were divided into control (n = 8) and ketogenic (n = 7) groups. Controls received standard diet contained 52.20% of carbohydrates, 7.00% fat, and 15.25% protein; meanwhile, the ketogenic group received a high-fat-low-carbohydrate diet which contained 5.66% of carbohydrate, 86.19% fat, and 8.15% protein. All rats were caged individually and received 30g of either standard or high-fat-low-carbohydrate pellets. The experiment was carried out for 60 days before the blood samples were taken and analyzed to obtain blood gas, cell counts, organ biomarkers, and plasma antioxidant superoxide dismutase (SOD) levels. Results. The rats subjected to ketogenic diet experienced a marked decrease in body weight, blood sugar, and increased blood ketones (p<0.05). The average blood pH was 7.36 ± 0.02 and base excess was −5.57 ± 2.39 mOsm/L, which were significantly lower than controls (p<0.05). Hematological analysis showed significantly lower erythrocyte, hemoglobin, and hematocrit levels. No significant changes were found in alanine aminotransferase, aspartate aminotransferase, urea, and creatinine levels, indicating normal liver and kidney functions. Nevertheless, plasma SOD level significantly reduced with ketogenic diet. Conclusion. Long-term ketogenic diet induces metabolic acidosis, anemia, and reduced antioxidant enzyme level in rats following 60 days of consuming high-fat-low-carbohydrate diet.

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Long-term impact of plain packaging of cigarettes with larger graphic health warnings: findings from cross-sectional surveys of Australian adolescents between 2011 and 2017

Tobacco Control ◽

10.1136/tobaccocontrol-2019-054988 ◽

2019 ◽

Vol 28 (e1) ◽

pp. e77-e84 ◽

Cited By ~ 5

Author(s):

Victoria M White ◽

Nicola Guerin ◽

Tahlia Williams ◽

Melanie A Wakefield

Keyword(s):

Smoking Prevalence ◽

Health Warnings ◽

Cross Sectional ◽

Plain Packaging ◽

School Based ◽

Negative Perceptions ◽

Long Term Impact ◽

Cigarette Packs ◽

Positive Character

ObjectiveTo assess the long-term impact of plain packaging (PP) of cigarettes with larger graphic health warnings (HW) introduced in December 2012 on adolescents’ relevant tobacco-related perceptions.MethodsCross-sectional school-based surveys of 12 to 17 year olds in 2011 (n=4413), 2013 (n=4423), 2014 (n=4576) and 2017 (n=4266). Students rated the character of four popular cigarette brands, indicated their agreement regarding brand differences in smoking ease, quitting, addictiveness, harmfulness and pack attractiveness and positive/negative perceptions of pack image. The frequency of students reading, attending to, thinking and talking about HW was assessed. Responses of students seeing cigarette packs in the previous 6 months (2011: 63%; 2013: 67%, 2014: 56%, 2017: 56%) were examined.ResultsSmoking prevalence declined from 2011 to 2017. Among students who had recently seen packs, cigarette packs were rated less positively and more negatively in 2017 than in 2011 (p<0.001) with ratings similar between 2013 and 2017. Positive character ratings for each brand reduced between 2011 and 2013 (ps<0.05) with further reductions between 2013 and 2017 (ps<0.05). Fewer students agreed, and more were uncertain, that brands differed in their smoking ease, addictiveness, harmfulness and pack attractiveness in 2017 than 2011. The frequency of students reading, attending, talking or thinking about HW did not change between 2011 and 2017.ConclusionsPP’s initial impact in reducing adolescent’s positive perceptions of cigarette packs and brand differences continued in the following years with tobacco packaging less appealing to young people in 2017 than 2011 and students more uncertain about brand differences.

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Hepatic steatosis, inflammation, and ER stress in mice maintained long term on a very low-carbohydrate ketogenic diet

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00539.2010 ◽

2011 ◽

Vol 300 (6) ◽

pp. G956-G967 ◽

Cited By ~ 84

Author(s):

Joel R. Garbow ◽

Jason M. Doherty ◽

Rebecca C. Schugar ◽

Sarah Travers ◽

Mary L. Weber ◽

...

Keyword(s):

Ketogenic Diet ◽

Western Diet ◽

Whole Body ◽

Resonance Spectroscopy ◽

Chow Diet ◽

High Fat ◽

Low Protein ◽

Low Carbohydrate ◽

Term Administration

Low-carbohydrate diets are used to manage obesity, seizure disorders, and malignancies of the central nervous system. These diets create a distinctive, but incompletely defined, cellular, molecular, and integrated metabolic state. Here, we determine the systemic and hepatic effects of long-term administration of a very low-carbohydrate, low-protein, and high-fat ketogenic diet, serially comparing these effects to a high-simple-carbohydrate, high-fat Western diet and a low-fat, polysaccharide-rich control chow diet in C57BL/6J mice. Longitudinal measurement of body composition, serum metabolites, and intrahepatic fat content, using in vivo magnetic resonance spectroscopy, reveals that mice fed the ketogenic diet over 12 wk remain lean, euglycemic, and hypoinsulinemic but accumulate hepatic lipid in a temporal pattern very distinct from animals fed the Western diet. Ketogenic diet-fed mice ultimately develop systemic glucose intolerance, hepatic endoplasmic reticulum stress, steatosis, cellular injury, and macrophage accumulation, but surprisingly insulin-induced hepatic Akt phosphorylation and whole-body insulin responsiveness are not impaired. Moreover, whereas hepatic Pparg mRNA abundance is augmented by both high-fat diets, each diet confers splice variant specificity. The distinctive nutrient milieu created by long-term administration of this low-carbohydrate, low-protein ketogenic diet in mice evokes unique signatures of nonalcoholic fatty liver disease and whole-body glucose homeostasis.

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The impact of knowledge and motivation management on creativity

Employee Relations ◽

10.1108/er-05-2016-0096 ◽

2017 ◽

Vol 39 (5) ◽

pp. 732-752 ◽

Cited By ~ 16

Author(s):

Lucía Muñoz-Pascual ◽

Jesús Galende

Keyword(s):

Employee Behavior ◽

Employee Creativity ◽

Cross Sectional ◽

Content Type ◽

Joint Influence ◽

Long Term Impact ◽

High Level ◽

The Impact ◽

Practical Implications

Purpose The purpose of this paper is to analyze the influence that two variables related to human resources (HR) have on employee creativity – namely, knowledge management (KM) and motivation management (MM). Design/methodology/approach The linear regression analyses are based on a sample of 306 employees from 11 Spanish companies belonging to three innovative clusters. In addition, “creativity” is considered an antecedent of technological innovation. Findings KM and intrinsic MM are shown to inform creativity, whereas extrinsic MM has no such effect. Practical implications Although this study is based on cross-sectional data, the findings might induce researchers to investigate the effects of other HR variables, such as the types of relations between employees and their long-term impact on creativity. Management should encourage KM and intrinsic MM across employees, as the results indicate that tacit KM, explicit KM and intrinsic MM encourage a positive attitude toward creativity among employees. Originality/value The main contribution is new empirical evidence on the joint influence of aptitudes (KM) and attitudes (MM) on employee creativity. In addition, the study includes a key measure of employee creativity. The evidence reveals the types of KM and MM that encourage or inhibit creative employee behavior. The results show that once employees have reached a medium-high level of extrinsic MM, creativity will be affected solely by intrinsic MM.

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Cancer care disruption and reorganisation during the COVID-19 pandemic in Australia: A patient, carer and healthcare worker perspective

PLoS ONE ◽

10.1371/journal.pone.0257420 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257420

Author(s):

Rhiannon Edge ◽

Josh Meyers ◽

Gabriella Tiernan ◽

Zhicheng Li ◽

Alexandra Schiavuzzi ◽

...

Keyword(s):

Cancer Patients ◽

Cancer Care ◽

Healthcare Workers ◽

Psychosocial Support ◽

Cross Sectional ◽

Pandemic Response ◽

Long Term Impact ◽

Uncertain Time ◽

Survey Responses

The COVID-19 pandemic has dramatically impacted cancer care worldwide. Disruptions have been seen across all facets of care. While the long-term impact of COVID-19 remains unclear, the immediate impacts on patients, their carers and the healthcare workforce are increasingly evident. This study describes disruptions and reorganisation of cancer services in Australia since the onset of COVID-19, from the perspectives of people affected by cancer and healthcare workers. Two separate online cross-sectional surveys were completed by: a) cancer patients, survivors, carers, family members or friends (n = 852) and b) healthcare workers (n = 150). Descriptive analyses of quantitative survey data were conducted, followed by inductive thematic content analyses of qualitative survey responses relating to cancer care disruption and perceptions of telehealth. Overall, 42% of cancer patients and survivors reported experiencing some level of care disruption. A further 43% of healthcare workers reported atypical delays in delivering cancer care, and 50% agreed that patient access to research and clinical trials had been reduced. Almost three quarters (73%) of patients and carers reported using telehealth following the onset of COVID-19, with high overall satisfaction. However, gaps were identified in provision of psychological support and 20% of participants reported that they were unlikely to use telehealth again. The reorganisation of cancer care increased the psychological and practical burden on carers, with hospital visitation restrictions and appointment changes reducing their ability to provide essential support. COVID-19 has exacerbated a stressful and uncertain time for people affected by cancer and healthcare workers. Service reconfiguration and the adoption of telehealth have been essential adaptations for the pandemic response, offering long-term value. However, our findings highlight the need to better integrate psychosocial support and the important role of carers into evolving pandemic response measures. Learnings from this study could inform service improvements that would benefit patients and carers longer-term.

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Therapeutic Use of the Ketogenic Diet in Refractory Epilepsy: What We Know and What Still Needs to Be Learned

Nutrients ◽

10.3390/nu12092616 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2616

Author(s):

Iwona Maria Zarnowska

Keyword(s):

Ketogenic Diet ◽

Refractory Epilepsy ◽

Epileptic Activity ◽

Clinical Settings ◽

Modified Atkins Diet ◽

Current State ◽

Wide Range ◽

Low Carbohydrate ◽

The Brain

Ketogenic diet (KD) has been used to treat epilepsy for 100 years. It is a high-fat, low-carbohydrate, and sufficient-protein-for-growth diet that mimics the metabolic changes occurring during starvation. Except for classic KD, its modified counterparts, including modified Atkins diet and low-glycemic-index treatment, have gained grounds to increase palatability and adherence. Strong evidence exists that the KD offers protection against seizures in difficult-to-treat epilepsy and possesses long-lasting anti-epileptic activity, improving long-term disease outcome. The KD can also provide symptomatic and disease-modifying activity in a wide range of neurodegenerative diseases. In an era of highly available new anti-seizure medications (ASMs), the challenge of refractory epilepsy has still not been solved. This metabolic therapy is increasingly considered due to unique mechanisms and turns out to be a powerful tool in the hands of a skillful team. Despite decades of extensive research to explain the mechanism of its efficacy, the precise mechanism of action is to date still largely unknown. The key feature of this successful diet is the fact that energy is derived largely from fat but not from carbohydrates. Consequently, fundamental change occurs regarding the method of energy production that causes alterations in numerous biochemical pathways, thus restoring energetic and metabolic homeostasis of the brain. There are barriers during the use of this special and individualized therapy in many clinical settings worldwide. The aim of this review is to revisit the current state of the art of therapeutic application of KD in refractory epilepsy.

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Quantifying long-term evolution of intra-urban spatial interactions

Journal of The Royal Society Interface ◽

10.1098/rsif.2014.1089 ◽

2015 ◽

Vol 12 (102) ◽

pp. 20141089 ◽

Cited By ~ 13

Author(s):

Lijun Sun ◽

Jian Gang Jin ◽

Kay W. Axhausen ◽

Der-Horng Lee ◽

Manuel Cebrian

Keyword(s):

Community Structure ◽

Transport Cost ◽

Spatial Interactions ◽

Cross Sectional ◽

Line Extension ◽

Before And After ◽

Spatial Reorganization ◽

Long Term Impact ◽

The Impact

Understanding the long-term impact that changes in a city's transportation infrastructure have on its spatial interactions remains a challenge. The difficulty arises from the fact that the real impact may not be revealed in static or aggregated mobility measures, as these are remarkably robust to perturbations. More generally, the lack of longitudinal, cross-sectional data demonstrating the evolution of spatial interactions at a meaningful urban scale also hinders us from evaluating the sensitivity of movement indicators, limiting our capacity to understand the evolution of urban mobility in depth. Using very large mobility records distributed over 3 years, we quantify the impact of the completion of a metro line extension: the Circle Line (CCL) in Singapore. We find that the commonly used movement indicators are almost identical before and after the project was completed. However, in comparing the temporal community structure across years, we do observe significant differences in the spatial reorganization of the affected geographical areas. The completion of CCL enables travellers to re-identify their desired destinations collectively with lower transport cost, making the community structure more consistent. These changes in locality are dynamic and characterized over short timescales, offering us a different approach to identify and analyse the long-term impact of new infrastructures on cities and their evolution dynamics.

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Who Should the Military Recruit? The Effects of Institutional, Occupational, and Self-Enhancement Enlistment Motives on Soldier Identification and Behavior

Armed Forces & Society ◽

10.1177/0095327x17695360 ◽

2017 ◽

Vol 43 (4) ◽

pp. 579-607 ◽

Cited By ~ 6

Author(s):

Todd D. Woodruff

Keyword(s):

Organizational Behavior ◽

Organizational Identification ◽

Military Recruit ◽

Cross Sectional ◽

Educational Funding ◽

Long Term Impact ◽

And Behavior ◽

The Military ◽

Positive Effect

The U.S. military spends millions of dollars and substantial institutional effort to understand enlistment motives and appropriately target incentives, recruiting effort, and marketing to prospective members. Similarly, researchers have worked for decades to identify, understand, and conceptualize enlistment motives. Much less effort has been made to understand the effect enlistment motives/goals have on individuals after they join. This research uses well-established enlistment motives/goals to identify and understand their effects on soldiers’ value to the military in terms of organizational identification and critical discretionary behaviors. Using multicohort cross-sectional data from future, initial training, and currently serving soldiers, this research finds that intrinsic enlistment motives/goals, such as altruistic service and self-enhancement, create greater relational and behavioral value than most extrinsic/economic enlistment motives/goals such as pay, gaining skills for future employment, and educational funding. Intrinsic enlistment motives/goals have a strong positive effect on perceptions of the organization, social satisfaction, organizational identification, and discretionary pro-organizational behaviors. Conversely, economic enlistment goals tend to be associated with higher levels of economic satisfaction but decreased organizational identification and pro-organizational behavior. Importantly, these effects tend to persist among soldiers who have been in the military for years. Contrary to the institutional–occupational framework, self-focused enlistment goals, both intrinsic and extrinsic, can creative substantial value for the military when they are aligned with organizational interests. Based on these findings, the practice of using enlistment motives/goals to maximizing enlistment without considering their long-term impact on relationship quality and behavior appears myopic and may fail to maximize long-term value for the military.

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