PROMISE:effect of protein supplementation on fat-free mass preservation after bariatric surgery, a randomized double-blind placebo-controlled trial

Introduction: Protein malnutrition after bariatric surgery is a severe complication and leads to significant morbidity. Previous studies have shown that protein intake and physical activity are the most important factors in the preservation of fat-free mass during weight loss. Low protein intake is very common in patients undergoing bariatric surgery despite dietary counseling. Protein powder supplements might help patients to achieve the protein intake recommendations after bariatric surgery and could therefore contribute to preserve fat-free mass. This double-blind randomized placebo-controlled intervention study aims to assess the effect of a daily consumed clear protein powder shake during the first 6 months after bariatric surgery on fat-free mass loss in the first 12 months after laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods and analysis:Inclusion will take place at the outpatient clinic of the bariatric expertise center for obesity of the Maasstad Hospital. Patients will be randomly assigned to either the intervention or control group before surgery. The intervention group will receive a clear protein powder shake of 200 ml containing 20 g of whey protein dissolved in water which should be taken daily during the first 6 months after LRYGB on top of their normal postoperative diet. The control group will receive an isocaloric, clear, placebo shake containing maltodextrine. Postoperative rehabilitation and physiotherapeutical guidance will be standardized and similar in both groups. Also, both groups will receive the same dietary advice from specialized dieticians. The main study parameter is the percentage of fat-free mass loss 6 months after surgery, assessed by multi-frequency bioelectrical impedance analysis (MF-BIA). Ethics and dissemination: The protocol, version 2 (February 20, 2022) has been approved by the Medical Research Ethics Committees United (MEC-U) (NL 80414.100.22). The results of this study will be submitted to peer-reviewed journals. Trial registration: ClinicalTrials.gov NCT05570474. Registered on October 5, 2022.</p

Dual-Earner Family Policies at Work for Single-Parent Families

Family dynamics are changing and single-parent families are becoming more common across countries. In their flagship report “Progress of the World’s Women, 2019–2020,” UN Women (2019) demonstrated that, contrary to popular belief, couples with children do not constitute a majority of all families, but rather there are many different types of families. Single parenthood is considered a “new social risk” in poverty and inequality (Bonoli, 2013). Therefore, policy makers and legislators have designed targeted policy specifically for single parents, such as targeted child benefits to single parents. In addition, legislation and social policy have been designed and implemented specifically for single parents, such as child support and family law such as child custody and shared residence. This study takes a different approach, based on the universalist argument that without adequate social protection that benefits all families, those families that are more vulnerable are often hit the hardest. We focus on family policies, and specifically we examine whether and to what extent single parents benefit from the same family policies that are available to all families with children

Study of ageing and gain limits of microstrip gas chambers at high rates

The CMS experiment comprises MSGCs as one of the key detection elements for high luminosity tracking at LHC. In addition to the high dose rate of 10 mC/year per cm of strip, these detectors have to survive the hostile presence of highly ionizing particles, neutrons low energy gammas and hadrons. In this report we present the results of systematic tests on maximum safe operational gain limits in MSGCs before the discharge. Long term ageing tests performed on prototype open Ibanana¹ modules envisaged to be arranged around the interaction region in the forward part of the CMS tracker show no evidence of gain drop up to equivalent ~ 10 years of LHC operation. A comparison is made between argon and neon gas mixtures with DME in equal proportions by investigating long term irradiation effects on chamber operation by introducing controlled and reproducible pollution in the gas lines

Brain Glucose Metabolism in Aphasia: A Model of the Interrelationship of Frontal Lobe Regions on Fluency

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Broca's Aphasia: Comparison to Metabolically Matched Aphasic Subjects

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Syntactic Facility in Fluent Aphasia

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