The effect of protein and essential amino acid supplementation on muscle strength and performance in patients with chronic heart failure – A systematic review

Purpose Critically low skeletal muscle mass and strength, observed in 20% of people with chronic heart failure (CHF), reduces functional capacity, quality of life (QoL) and survival. Protein and essential amino acid (EAA) supplementation could be a viable treatment strategy to prevent declines in muscle strength and performance, and subsequently improve QoL and survival. This systematic review (PROSPERO: CRD42018103649) aimed to assess the effect of dietary protein and/or EAA supplementation on muscle strength and performance in people with CHF. Methods Searches of PubMed, MEDLINE and Embase identified studies that reported changes in strength or muscle performance following protein and/or EAA supplementation in patients with CHF. Following PRISMA guidelines and using predefined inclusion/exclusion criteria relating to participants, intervention, control, outcome and study design, two reviewers independently screened titles, abstracts and full manuscripts for eligibility. Risk of bias was assessed using Cochrane Risk of Bias Tool (RCTs) or Mixed Methods Appraisal Tool (cohort studies). Data were extracted for analysis using predefined criteria. Results Five randomised controlled trials (RCT) and one cohort study met our inclusion criteria. All RCTs had a high risk of bias. The methodological quality of the cohort study was moderate. Heterogeneity of extracted data prevented meta-analyses, qualitative synthesis was therefore performed. Data from 167 patients with CHF suggest that protein and/or EAA supplementation does not improve strength, but may increase six-minute walk test distance, muscle mass and QoL. Conclusions The limited quality of the studies makes firm conclusions difficult, however protein and/or EAA supplementation may improve important outcome measures related to sarcopenia. High-quality randomised controlled studies are needed

Acute inhibition of MEK suppresses congenital melanocytic nevus syndrome in a murine model driven by activated NRAS and Wnt signaling

Congenital melanocytic nevus (CMN) syndrome is the association of pigmented melanocytic nevi with extra-cutaneous features, classically melanotic cells within the central nervous system, most frequently caused by a mutation of NRAS codon 61. This condition is currently untreatable and carries a significant risk of melanoma within the skin, brain, or leptomeninges. We have previously proposed a key role for Wnt signaling in the formation of melanocytic nevi, suggesting that activated Wnt signaling may be synergistic with activated NRAS in the pathogenesis of CMN syndrome. Some familial pre-disposition suggests a germ-line contribution to CMN syndrome, as does variability of neurological phenotypes in individuals with similar cutaneous phenotypes. Accordingly, we performed exome sequencing of germ-line DNA from patients with CMN to reveal rare or undescribed Wnt-signaling alterations. A murine model harboring activated NRASQ61K and Wnt signaling in melanocytes exhibited striking features of CMN syndrome, in particular neurological involvement. In the first model of treatment for this condition, these congenital, and previously assumed permanent, features were profoundly suppressed by acute post-natal treatment with a MEK inhibitor. These data suggest that activated NRAS and aberrant Wnt signaling conspire to drive CMN syndrome. Post-natal MEK inhibition is a potential candidate therapy for patients with this debilitating condition

Pneumonia caused by Moraxella catarrhalis in haematopoietic stem cell transplant patients. Report of two cases and review of the literature

Moraxella catarrhalis is a gram negative diplococcus that causes a variety of upper and lower respiratory tract infections. Patients with malignant, hematological disorders treated with intensive cytotoxic chemotherapy, and recipients of various forms of haematopoietic stem cell transplant receiving immunosuppressive agents are at high risk of developing severe infections and septic complications. Early detection of the organism and prompt treatment with appropriate antibiotics provide both resolution of the infection and prevention of further consequences. Two patients with haematopoietic stem cell transplant who developed pneumonia caused by M. catarrhalis at King Faisal Specialist Hospital and Research Centre in Riyadh are reported and the literature is reviewed. To our knowledge, these are the first case reports of M. catarrhalis pneumonia in haematopoietic stem cell transplant patients

Structural changes in FeOx/γ-Al2O3 catalysts during ethylbenzene dehydrogenation

The structural changes that occur in a FeOx/γ-Al2O3 catalyst during the dehydrogenation of ethylbenzene in a fluidized CREC Riser Simulator have been investigated. Chemical and morphological changes are observed to take place as a result of reaction. Electron microscopy reveals the formation of needle-like alumina structures apparently enclosing iron oxide particles. The formation of such structures at relatively low temperatures is unexpected and has not previously been reported. Additionally, X-ray diffraction and Mössbauer spectroscopy confirmed the reduction of the oxidation state of iron, from Fe2O3 (haematite) to Fe3O4 (magnetite). Iron carbides, Fe3C and ɛ-Fe2C, were detected by electron microscopy through electron diffraction and lattice fringes analysis. Carbon deposition (coking) on the catalyst surface also occurs. The observed structural changes are likely to be closely correlated with the catalytic properties of the materials, in particular with catalyst deactivation, and thereby provide important avenues for future study of this industrially important reaction. Fe2O3/Al2O3 catalyst undergoes chemical and morphological changes during ethylbenzene dehydrogenation forming Al2O3 needles which appear to contain reduced Fe3O4 particles. Fe3C also forms during reaction

Effect of pulsed delivery and bouillon base on saltiness and bitterness perceptions of salt delivery profiles partially substituted with KCl

Reducing salt levels in processed food is an important target for a growing numbers of food manufacturers. The effects of pulsed delivery (Dynataste) and bouillon base on saltiness and bitterness perception of partially substituted solutions (KCl) were investigated. Pulsed delivery did not enhance salt perception and resulted in greater Overall Bitterness Scores for the same level of substitution with KCl. The presence of the bouillon base masked to a certain extent the loss of saltiness induced by the substitution and resulted in lower Overall Bitterness Scores of the substituted profiles

Aerosol and splatter generation with rotary handpieces used in restorative and orthodontic dentistry:a systematic review

Abstract: Introduction: The COVID-19 pandemic has caused major disruptions in dental care globally, in part due to the potential for contaminated aerosol to be generated by dental activities. This systematic review assesses the literature for changes in aerosol-contamination levels when rotary instruments are used, (1) as distance increases from patient’s mouth; (2) as time passes after the procedure; and (3) when using different types of handpieces. Methods: The review methods and reporting are in line with PRISMA statements. A structured search was conducted over five platforms (September 2021). Studies were assessed independently by two reviewers. To be eligible studies had to assess changes in levels of aerosol contamination over different distances, and time points, with rotary hand instruments. Studies’ methodologies and the sensitivity of the contamination-measurement approaches were evaluated. Results are presented descriptively. Results: From 422 papers identified, 23 studies were eligible. All investigated restorative procedures using rotary instruments and one study additionally looked at orthodontic bracket adhesive material removal. The results suggest contamination is significantly reduced over time and distance. However, for almost all studies that investigated these two factors, the sizes of the contaminated particles were not considered, and there were inconclusive findings regarding whether electric-driven handpieces generate lower levels of contaminated particles. Conclusion: Aerosol contamination levels reduce as distances, and post-procedure times increase. However, there was sparce and inconsistent evidence on the clearing time and no conclusions could be drawn. High-speed handpieces produce significantly higher levels of contamination than slow-speed ones, and to a lesser extent, micro-motor handpieces. However, when micro-motor handpieces were used with water, the contamination levels rose and were similar to high-speed handpiece contamination levels

Hydroisomerisation and hydrocracking of n-heptane: modelling and optimisation using a hybrid Artificial Neural Network–Genetic Algorithm (ANN–GA)

In this paper, the focus is on upgrading the value of naphtha compounds represented by n-heptane (n-C7H16) with zero octane number using a commercial zeolite catalyst consisting of a mixture of 75% HY and 25% HZSM-5 loaded with different amounts, 0.25 to 1 wt.%, of platinum metal. Hydrocracking and hydroisomerisation processes are experimentally and theoretically studied in the temperature range of 300–400 °C and under various contact times. A feedforward artificial neural network (FFANN) based on two hidden layers was used for the purpose of process modelling. A total of 80% of the experimental results was used to train the artificial neural network, with the remaining results being used for evaluation and testing of the network. Tan-sigmoid and log-sigmoid transfer functions were used in the first and second hidden layers, respectively. The optimum number of neurons in hidden layers was determined depending on minimising the mean absolute error (MAE). The best ANN model, represented by the multilayer FFANN, had a 4–24–24–12 topology. The ANN model accurately simulates the process in which the correlation coefficient (R2) was found to be 0.9918, 0.9492, and 0.9426 for training, validation, and testing, respectively, and an average of 0.9767 for all data. In addition, the operating conditions of the process were optimised using the genetic algorithm (GA) towards increasing the octane number of the products. MATLAB® Version 2020a was utilised to complete all required computations and predictions. Optimal operating conditions were found through the theoretical study: 0.85 wt.% Pt-metal loaded, 359.36 °C, 6.562 H2/n-heptane feed ratio, and 3.409 h−1 weight-hourly space velocity (WHSV), through which the maximum octane number (RON) of 106.84 was obtained. Finally, those operating conditions largely matched what was calculated from the results of the experimental study, where the highest percentage of the resulting isomers was found with about 78.7 mol% on the surface of the catalyst loaded with 0.75 wt.% Pt-metal at 350 °C using a feed ratio of 6.5 H2/n-C7 and WHSV of 2.98 h−1

Differences between Belgian and Brazilian Group A Streptococcus Epidemiologic Landscape

BACKGROUND: Group A Streptococcus (GAS) clinical and molecular epidemiology varies with location and time. These differences are not or are poorly understood. METHODS AND FINDINGS: We prospectively studied the epidemiology of GAS infections among children in outpatient hospital clinics in Brussels (Belgium) and Brasília (Brazil). Clinical questionnaires were filled out and microbiological sampling was performed. GAS isolates were emm-typed according to the Center for Disease Control protocol. emm pattern was predicted for each isolate. 334 GAS isolates were recovered from 706 children. Skin infections were frequent in Brasília (48% of the GAS infections), whereas pharyngitis were predominant (88%) in Brussels. The mean age of children with GAS pharyngitis in Brussels was lower than in Brasília (65/92 months, p<0.001). emm-typing revealed striking differences between Brazilian and Belgian GAS isolates. While 20 distinct emm-types were identified among 200 Belgian isolates, 48 were found among 128 Brazilian isolates. Belgian isolates belong mainly to emm pattern A–C (55%) and E (42.5%) while emm pattern E (51.5%) and D (36%) were predominant in Brasília. In Brasília, emm pattern D isolates were recovered from 18.5% of the pharyngitis, although this emm pattern is supposed to have a skin tropism. By contrast, A–C pattern isolates were unfrequently recovered in a region where rheumatic fever is still highly prevalent. CONCLUSIONS: Epidemiologic features of GAS from a pediatric population were very different in an industrialised country and a low incomes region, not only in term of clinical presentation, but also in terms of genetic diversity and distribution of emm patterns. These differences should be taken into account for designing treatment guidelines and vaccine strategies