On the basis of the abundance of specific bacterial genera, the human gut microbiota can be divided into two relatively stable groups that might have a role in personalized nutrition. We studied ...these simplified enterotypes as prognostic markers for successful body fat loss on two different diets. A total of 62 participants with increased waist circumference were randomly assigned to receive an ad libitum New Nordic Diet (NND) high in fiber/whole grain or an Average Danish Diet for 26 weeks. Participants were grouped into two discrete enterotypes by their relative abundance of Prevotella spp. divided by Bacteroides spp. (P/B ratio) obtained by quantitative PCR analysis. Modifications of dietary effects of pre-treatment P/B group were examined by linear mixed models. Among individuals with high P/B the NND resulted in a 3.15 kg (95% confidence interval (CI): 1.55; 4.76, P<0.001) larger body fat loss compared with ADD, whereas no differences was observed among individuals with low P/B (0.88 kg (95% CI: -0.61; 2.37, P=0.25)). Consequently, a 2.27 kg (95% CI: 0.09; 4.45, P=0.041) difference in responsiveness to the diets were found between the two groups. In summary, subjects with high P/B ratio appeared more susceptible to lose body fat on diets high in fiber and whole grain than subjects with a low P/B ratio.
Purpose
Quality of life (QOL) is an important concept in the field of health and medicine. QOL is a complex concept that is interpreted and defined differently within and between disciplines, ...including the fields of health and medicine. The aims of this study were to systematically review the literature on QOL in medicine and health research and to describe the country of origin, target groups, instruments, design, and conceptual issues.
Methods
A systematic review was conducted to identify research studies on QOL and health-related quality of life (HRQOL). The databases Scopus, which includes Embase and MEDLINE, CINAHL, and PsycINFO were searched for articles published during one random week in November 2016. The ten predefined criteria of Gill and Feinstein were used to evaluate the conceptual and methodological rigor.
Results
QOL research is international and involves a variety of target groups, research designs, and QOL measures. According to the criteria of Gill and Feinstein, the results show that only 13% provided a definition of QOL, 6% distinguished QOL from HRQOL. The most frequently fulfilled criteria were: (i) stating the domains of QOL to be measured; (ii) giving a reason for choosing the instruments used; and (iii) aggregating the results from multiple items.
Conclusion
QOL is an important endpoint in medical and health research, and QOL research involves a variety of patient groups and different research designs. Based on the current evaluation of the methodological and conceptual clarity of QOL research, we conclude that the majority QOL studies in health and medicine have conceptual and methodological challenges.
Abdominal aortic aneurysm (AAA) is a complex disease which is incompletely accounted for. Basement membrane (BM) Collagen IV (COL4A1/A2) is abundant in the artery wall, and several lines of evidence ...indicate a protective role of baseline COL4A1/A2 in AAA development. Using Col4a1/a2 hemizygous knockout mice (Col4a1/a2
, 129Svj background) we show that partial Col4a1/a2 deficiency augmented AAA formation. Although unchallenged aortas were morphometrically and biomechanically unaffected by genotype, explorative proteomic analyses of aortas revealed a clear reduction in BM components and contractile vascular smooth muscle cell (VSMC) proteins, suggesting a central effect of the BM in maintaining VSMCs in the contractile phenotype. These findings were translated to human arteries by showing that COL4A1/A2 correlated to BM proteins and VSMC markers in non-lesioned internal mammary arteries obtained from coronary artery bypass procedures. Moreover, in human AAA tissue, MYH11 (VSMC marker) was depleted in areas of reduced COL4 as assessed by immunohistochemistry. Finally, circulating COL4A1 degradation fragments correlated with AAA progression in the largest Danish AAA cohort, suggesting COL4A1/A2 proteolysis to be an important feature of AAA formation. In sum, we identify COL4A1/A2 as a critical regulator of VSMC phenotype and a protective factor in AAA formation.
Background
Total knee arthroplasty (TKA) is associated with intense post‐operative pain. Besides providing optimal analgesia, reduction in side effects and enhanced mobilization are important in this ...elderly population. The adductor‐canal‐blockade is theoretically an almost pure sensory blockade. We hypothesized that the adductor‐canal‐blockade may reduce morphine consumption (primary endpoint), improve pain relief, enhance early ambulation ability, and reduce side effects (secondary endpoints) after TKA compared with placebo.
Methods
Patients aged 50–85 years scheduled for TKA were included in this parallel double‐blind, placebo‐controlled randomized trial. The patients were allocated to receive a continuous adductor‐canal‐blockade with intermittent boluses via a catheter with either ropivacaine 0.75% (n = 34) or placebo (n = 37) (http://www.clinicaltrials.gov Identifier: NCT01104883).
Results
Seventy‐five patients were randomized in a 1 : 1 ratio and 71 patients were analyzed. Morphine consumption from 0 to 24 h was significantly reduced in the ropivacaine group compared with the placebo group (40 ± 21 vs. 56 ± 26 mg, P = 0.006). Pain was significantly reduced in the ropivacaine group during 45 degrees flexion of the knee (P = 0.01), but not at rest (P = 0.06). Patients in the ropivacaine group performed the ambulation test, the Timed‐Up‐and‐Go (TUG) test, at 24 h significantly faster than patients in the placebo group (36 ± 17 vs. 50 ± 29 s, P = 0.03).
Conclusion
The adductor‐canal‐blockade significantly reduced morphine consumption and pain during 45 degrees flexion of the knee compared with placebo. In addition, the adductor‐canal‐blockade significantly enhanced ambulation ability assessed by the TUG test.
Background
Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown.
Methods
This prospective mixed‐method ...cross‐sectional survey took place at four university hospitals in Denmark. We enrolled 570 pediatric patients who we asked to report their pain experience and its management during the previous 24 hours. For patients identified as having moderate to severe pain, patient characteristics and analgesia regimes were reviewed.
Results
Two hundred and thirteen children (37%) responded that they had experienced pain in the previous 24 hours. One hundred and thirty four (24%) indicated moderate to severe pain and 43% would have preferred an intervention to alleviate the pain. In children hospitalized for more than 24 hours, the prevalence of moderate/severe pain was significantly higher compared to children admitted the same day. The single most common painful procedure named by the children was needle procedures, such as blood draw and intravenous cannulation.
Conclusion
This study reveals high pain prevalence in children across all age groups admitted to four Danish university hospitals. The majority of children in moderate to severe pain did not have a documented pain assessment, and evidence‐based pharmacological and/or integrative (‘non‐pharmacological’) measures were not systematically administered to prevent or treat pain. Thus, practice changes are needed.
A high dietary protein (P) content and low glycemic index (LGI) have been suggested to be beneficial for weight management, but long-term studies are scarce.
The DIOGENES randomized clinical trial ...investigated the effect of P and GI on weight loss maintenance in overweight or obese adults in eight centers across Europe. This study reports the 1-year results in two of the centers that extended the intervention to 1 year.
After an 8-week low-calorie diet (LCD), 256 adults (body mass index >27 kg m(-)(2)) were randomized to five ad libitum diets for 12 months: high P/LGI (HP/LGI), HP/high GI (HP/HGI), low P/LGI (LP/LGI), LP/HGI and a control diet. During the first 6 months, foods were provided for free through a shop system and during the whole 12-month period, subjects received guidance by a dietician. Primary outcome variable was the change in body weight over the 12-month intervention period.
During the LCD period, subjects lost 11.2 (10.8, 12.0) kg (mean (95% confidence interval (CI))). Average weight regain over the 12-month intervention period was 3.9 (95% CI 3.0-4.8) kg. Subjects on the HP diets regained less weight than subjects on the LP diets. The difference in weight regain after 1 year was 2.0 (0.4, 3.6) kg (P=0.017) (completers analysis, N=139) or 2.8 (1.4, 4.1) kg (P<0.001) (intention-to-treat analysis, N=256). No consistent effect of GI on weight regain was found. There were no clinically relevant differences in changes in cardiometabolic risk factors among diet groups.
A higher protein content of an ad libitum diet improves weight loss maintenance in overweight and obese adults over 12 months.
Aim
Metabolic health may deteriorate with age as a result of altered body composition and decreased physical activity. Endurance exercise is known to counter these changes delaying or even preventing ...onset of metabolic diseases. High‐intensity interval training (HIIT) is a time efficient alternative to regular endurance exercise, and the aim of this study was to investigate the metabolic benefit of HIIT in older subjects.
Methods
Twenty‐two sedentary male (n = 11) and female (n = 11) subjects aged 63 ± 1 years performed HIIT training three times/week for 6 weeks on a bicycle ergometer. Each HIIT session consisted of five 1‐minute intervals interspersed with 1½‐minute rest. Prior to the first and after the last HIIT session whole‐body insulin sensitivity, measured by a hyperinsulinaemic‐euglycaemic clamp, plasma lipid levels, HbA1c, glycaemic parameters, body composition and maximal oxygen uptake were assessed. Muscle biopsies were obtained wherefrom content of glycogen and proteins involved in muscle glucose handling were determined.
Results
Insulin sensitivity (P = .011) and maximal oxygen uptake increased (P < .05) in both genders, while plasma cholesterol (P < .05), low‐density lipoprotein (P < .05), visceral fat mass (P < .05) and per cent body fat (P < .05) decreased after 6 weeks of HIIT. HbA1c decreased only in males (P = .001). Muscle glycogen content increased in both genders (P = .001) and in line GLUT4 (P < .05), glycogen synthase (P = .001) and hexokinase II (P < .05) content all increased.
Conclusion
Six weeks of HIIT significantly improves metabolic health in older males and females by reducing age‐related risk factors for cardiometabolic disease.
We describe an automated computer algorithm designed to remove background contamination from the Van Allen Probes Magnetic Electron Ion Spectrometer (MagEIS) electron flux measurements. We provide a ...detailed description of the algorithm with illustrative examples from on‐orbit data. We find two primary sources of background contamination in the MagEIS electron data: inner zone protons and bremsstrahlung X‐rays generated by energetic electrons interacting with the spacecraft material. Bremsstrahlung X‐rays primarily produce contamination in the lower energy MagEIS electron channels (∼30–500 keV) and in regions of geospace where multi‐MeV electrons are present. Inner zone protons produce contamination in all MagEIS energy channels at roughly L < 2.5. The background‐corrected MagEIS electron data produce a more accurate measurement of the electron radiation belts, as most earlier measurements suffer from unquantifiable and uncorrectable contamination in this harsh region of the near‐Earth space environment. These background‐corrected data will also be useful for spacecraft engineering purposes, providing ground truth for the near‐Earth electron environment and informing the next generation of spacecraft design models (e.g., AE9).
Key Points
MagEIS instrument can quantify and remove background contamination from electron measurements
Most earlier measurements suffer from unquantifiable and uncorrectable contamination
Two primary sources of contamination are found: inner zone protons and bremsstrahlung X‐rays generated by energetic electrons
The nuclear hormone receptor peroxisome proliferator-activated receptor gamma (PPARgamma) is a member of the PPARgamma family. The endogenous activators of all members of the PPARgamma family are a ...variety of fatty acids, which suggests that the PPARs are highly involved in lipid metabolism. In the present paper, the current understanding of the involvement of PPARgamma in adipocyte proliferation and adipose tissue formation is extensively reviewed, and it is stressed that PPARgamma seems to be a major regulator in the differentiation of adipocytes. Thiazoledinediones (TZDs) are a group of PPARgamma-agonists used in the treatment of type 2 diabetes (T2D) since 1997. They are characterized by their ability to decrease insulin resistance, and have been suggested to slow down the progression of insulin resistance. Treatment with TZD requires several weeks of treatment to decrease plasma glucose levels, but in addition they markedly decrease plasma triglycerides and free fatty acids. A major drawback of treatment with TZD is body fat gain, but some evidence suggests that the fat is redistributed in a favourable direction, that is, from visceral to subcutaneous depots. However, the effect of long-term treatment on weight gain following TZD treatment is unknown, and it may be questioned whether the use of these 'adipogenic compounds' is appropriate, considering that excess body fat is almost a prerequisite for the development of type 2 diabetes.
Since the beginning of the 21st century, electronic monitoring (EM) has emerged as a cost‐efficient supplement to existing catch monitoring programmes in fisheries. An EM system consists of various ...activity sensors and cameras positioned on vessels to remotely record fishing activity and catches. The first objective of this review was to describe the state of play of EM in fisheries worldwide and to present the insights gained on this technology based on 100 EM trials and 12 fully implemented programmes. Despite its advantages, and its global use for monitoring, progresses in implementation in some important fishing regions are slow. Within this context, the second objective was to discuss more specifically the European experiences gained through 16 trials. Findings show that the three major benefits of EM were as follows: (a) cost‐efficiency, (b) the potential to provide more representative coverage of the fleet than any observer programme and (c) the enhanced registration of fishing activity and location. Electronic monitoring can incentivize better compliance and discard reduction, but the fishing managers and industry are often reluctant to its uptake. Improved understanding of the fisher's concerns, for example intrusion of privacy, liability and costs, and better exploration of EM benefits, for example increased traceability, sustainability claims and market access, may enhance implementation on a larger scale. In conclusion, EM as a monitoring tool embodies various solid strengths that are not diminished by its weaknesses. Electronic monitoring has the opportunity to be a powerful tool in the future monitoring of fisheries, particularly when integrated within existing monitoring programmes.
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