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Use of high-fat, ketogenic diets (KDs) to support physical performance has grown in popularity over recent years. While these diets enhance fat and reduce carbohydrate oxidation during exercise, the impact of a KD on physical performance remains controversial. The objective of this work was to assess the effect of KDs on physical performance compared with mixed macronutrient diets [control (CON)]. A systematic review of the literature was conducted using PubMed and Cochrane Library databases. Randomized and nonrandomized studies were included if participants were healthy (free of chronic disease), nonobese [BMI (kg/m2) 0.5 mmol/L) compared with CON (fat, 12-38% of total energy intake) diets for ≥14 d, followed by a physical performance test. Seventeen studies (10 parallel, 7 crossover) with 29 performance (13 endurance, 16 power or strength) outcomes were identified. Of the 13 endurance-type performance outcomes, 3 (1 time trial, 2 time-to-exhaustion) reported lower and 10 (4 time trials, 6 time-to-exhaustion) reported no difference in performance between the KD compared with CON. Of the 16 power or strength performance outcomes, 3 (1 power, 2 strength) reported lower, 11 (4 power, 7 strength) no difference, and 2 (power) enhanced performance in the KD compared with the CON. Risk of bias identified some concern of bias primarily due to studies allowing participants to self-select diet intervention groups and the inability to blind participants to the study intervention. Overall, the majority of null results across studies suggest that a KD does not have a positive or negative impact on physical performance compared with a CON diet. However, discordant results between studies may be due to multiple factors, such as the duration consuming study diets, training status, performance test, and sex differences, which will be discussed in this systematic review.Thyroid hormone (T3) plays pivotal roles in vertebrate development, acting via nuclear T3 receptors (TRs) that regulate gene transcription by promoting post-translational modifications to histones. Tariquidar manufacturer Methylation of cytosine residues in deoxyribonucleic acid (DNA) also modulates gene transcription, and our recent finding of predominant DNA demethylation in the brain of Xenopus tadpoles at metamorphosis, a T3-dependent developmental process, caused us to hypothesize that T3 induces these changes in vivo. Treatment of premetamorphic tadpoles with T3 for 24 or 48 hours increased immunoreactivity in several brain regions for the DNA demethylation intermediates 5-hydroxymethylcytosine (5-hmC) and 5-carboxylcytosine, and the methylcytosine dioxygenase ten-eleven translocation 3 (TET3). Thyroid hormone treatment induced locus-specific DNA demethylation in proximity to known T3 response elements within the DNA methyltransferase 3a and Krüppel-like factor 9 genes, analyzed by 5-hmC immunoprecipitation and methylation sensitive restriction enzyme digest. Chromatin-immunoprecipitation (ChIP) assay showed that T3 induced TET3 recruitment to these loci. Furthermore, the messenger ribonucleic acid for several genes encoding DNA demethylation enzymes were induced by T3 in a time-dependent manner in tadpole brain. A TR ChIP-sequencing experiment identified putative TR binding sites at several of these genes, and we provide multiple lines of evidence to support that tet2 contains a bona fide T3 response element. Our findings show that T3 can promote DNA demethylation in developing tadpole brain, in part by promoting TET3 recruitment to discrete genomic regions, and by inducing genes that encode DNA demethylation enzymes.

In the United States, educational disparities in disability are large and increasing, but the mechanisms underlying them are not well understood. We estimate the proportion of population-level educational disparities in disability incidence explained by excess body mass index (BMI), smoking, and manual labor.

We use waves 2003-2015 of the nationally representative Panel Study of Income Dynamics to calculate observed disability incidence and counterfactual incidence absent the key mediators (3,129 individuals; 13,168 observations). We take advantage of earlier-life measures, including childhood socioeconomic status, 1986 BMI, and occupational history between 1968 and 2001. To account for distinct processes in women and men at middle versus older ages, we stratify by gender and at age 65.

Educational disparities in disability incidence were evident in women and men at younger and older ages, and were largest among older women. Together, the mediators of interest were estimated to explain roughly 60% of disparities in younger women, 65%-70% in younger men, 40% in older women, and 20%-60% in older men. The main contributors to disparities appeared to be excess BMI and smoking in younger women; manual labor and smoking in younger men; excess BMI in older women; and smoking in older men.

These mediators explain much of disparities in earlier-age disability; successful interventions to address these factors may substantially reduce them. However, a considerable proportion of disparities remained unexplained, particularly at older ages, reflecting the myriad pathways by which educational attainment can influence disability status.

These mediators explain much of disparities in earlier-age disability; successful interventions to address these factors may substantially reduce them. However, a considerable proportion of disparities remained unexplained, particularly at older ages, reflecting the myriad pathways by which educational attainment can influence disability status.

Brand-name drugs, including biologics, have been the primary source of increasing prescription drug spending in the US. Each state has drug product selection laws that regulate whether and how pharmacists can substitute prescriptions for brand-name drugs with more affordable equivalents, either small-molecule generic drugs or interchangeable biologics, but the details of these laws can vary.

To examine the variation in state drug product selection laws with regard to factors that may affect which version of a drug is dispensed.

A cross-sectional analysis was performed, using a legal database, to obtain information on state laws of all states plus Washington, DC, as they existed on September 1, 2019.

Whether substitution was mandatory or permissive, patient consent was needed prior to substitution, patient notification of substitution was required independent of the drug's packaging, and/or pharmacists were protected from special risk of liability for substitution.

For small-molecule and biologic drugs, descriptive statistics were generated for the 4 exposure variables.

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