Health food blogger: friend or foe?

The Scientific Advisory Committee on Nutrition (SACN) and the World Health Organisation (WHO) have recently updated nutritional guidelines for a reduced sugar intake. With the increased popularity of online health-food bloggers and 'refined-sugar free' recipes, this review looked to analyse recipes from popular online bloggers to validate the veracity of their 'sugar-free' and 'healthy' claims and assess their adherence to recently implemented nutritional guidelines

Managing membership : Ireland and the European Economic Community 1973-1979

Defence date: 9 February 2015Examining Board: Professor Kiran Patel, University of Maastricht (Supervisor); Professor Federico Romero, European University Institute; Professor Joe Lee, New York University; Professor Gary Murphy, Dublin City University.Managing Ireland's relations with the EEC after accession suffered from several shortcomings which bore direct consequences for its overall handling of membership. Those difficulties were linked firstly to resistence towards administrative reform nationally and secondly to its relations with the EEC prior to accession. Initially, the Department of Finance led negotiations but Lynch decided to nominate Foreign Affairs as official gate-keeper of Ireland's relations with the EEC in 1970. Finance concentrated on readying and gathering information and data for negotiations from departments at home while the DFA concentrated its efforts on actual negotiations in Brussels. While maximising resources in the short-term, this effectively straddled EEC policy between departments and delayed the evolution of a domestic mechanism for filtering Ireland's relations through one body/department. That split did not help enhance co-ordination after membership. This situation was complicated by the fact that officials in the two departments had very different perceptions of what membership was and could become. It is argued that the model which emerged for 'managing membership' had significant repercussions on decision-making and its relations with the EEC. Difficulties and inconsistencies are highlighted relating to specific policies such as ERDF and EMS in the final chapters of this dissertation. The DFA managed to assert its position and central co-ordinating role particularly during Ireland's first Presidency of the European Council in 1975 but it was side-lined once more as negotiations for EMS approached. Finance and the Taoiseach's Office took the lead in these negotiations. But ineffective filtering of Irish policy toward the EEC through the DFA meant that considerable institutional memory in diplomatic relations was under-utilised and this is noted in this research. Despite the DFA's relentless efforts to make its mark and defend its gatekeeping function throughout the 1970s, its role was diminished even further with the arrival of a new government in 1979

Primary Graft Failure after Heart Transplantation

Primary graft failure (PGF) is a devastating complication that occurs in the immediate postoperative period following heart transplantation. It manifests as severe ventricular dysfunction of the donor graft and carries significant mortality and morbidity. In the last decade, advances in pharmacological treatment and mechanical circulatory support have improved the outlook for heart transplant recipients who develop this complication. Despite these advances in treatment, PGF is still the leading cause of death in the first 30 days after transplantation. In today's climate of significant organ shortages and growing waiting lists, transplant units worldwide have increasingly utilised “marginal donors” to try and bridge the gap between “supply and demand.” One of the costs of this strategy has been an increased incidence of PGF. As the threat of PGF increases, the challenges of predicting and preventing its occurrence, as well as the identification of more effective treatment modalities, are vital areas of active research and development

Ireland's adaptation to membership of the EEC : early dealings with the European regional and development fund

Is based on a part of the author's EUI PhD thesis, 201

Investigation of the Mechanism of Interaction between Mesenchymal Stromal Cells and Macrophages and the Potential for Mesenchymal Stromal Cells and their Secreted Mediators to Enhance Bacterial Phagocytosis and Killing in Sepsis

Background: Sepsis is the leading cause of death among the critically ill. The development of immune suppression in these patients leads to the inability to clear infection and ultimately results in a poor outcome. It is thought that immunomodulatory therapies directed at enhancing the host response to infection may represent a novel means for treating sepsis. Mesenchymal stromal cells (MSCs) represent one such option as they have been shown to improve organ function and clear infection in preclinical models of sepsis. The interaction between MSCs and macrophages has been demonstrated as essential to their therapeutic effects, however their specific mechanism of action to improve bacterial clearance remains unclear.Methods: The impact of MSC therapy on macrophage functions of phagocytosis, reactive oxygen species production and bacterial killing was assessed using co-culture assays. The specific molecular mechanism of phagocytosis activated was investigated by interrogating phagocytic receptor expression and activity. Lipid mediator profiling of MSC and macrophage co-cultures was performed to identify important mediators of MSCmacrophage crosstalk. Finally, the therapeutic effects of MSCs and Lipoxin A4 (LXA4) were examined in an in vivo model of rodent pneumonia.Results: MSCs improved macrophage functions of phagocytosis and bacterial killing in a paracrine manner. Specifically, MSCs improved phagocytosis by modulating Fcgreceptors. MSCs shifted the lipid mediator profile of macrophages towards resolution, with a significant increase in LXA4 production. Furthermore, LXA4 itself enhanced phagocytosis to a similar level as MSCs, also in an Fcg-receptor dependent manner. Both MSCs and LXA4 demonstrated safety and efficacy as therapeutics in rodent pneumonia by enhancing measures of pulmonary mechanics, reducing indices of inflammation, and improving bacterial clearance.Conclusion: MSCs, and their secreted mediator LXA4, improve macrophage phagocytosis in an Fcg-receptor dependent manner. Both MSCs and LXA4 represent novel immunomodulatory therapeutics that enhance host defence and thus may improve outcome in sepsis.</p

Biomarkers for the early detection of pressure ulcers in the intensive care setting: A comparison between sub-epidermal moisture measurements and interleukin-1α

Pressure ulcer (PU) prevention in the intensive care unit (ICU) is an important clinical issue as critically unwell patients are at high risk of developing PUs. However, current methods of PU detection are limited, especially for early detection. This study aimed to establish the correlation between Interleukin-1α (IL-1α)/total protein (TP) and sub-epidermal moisture (SEM) measurements in the early identification of PUs in ICU patients. This study employed an observational research design using the STROBE guidelines. Following ethical approval, 53 participants were recruited and sebum was obtained using Sebutape from weight-bearing areas (sacrum, heels and a control site). SEM measurements were taken from the same anatomical sites. Both measures were taken at the same time and participants were followed up for 5 days, or until discharge or death. Correlations between SEM delta measurements, IL-1α, TP and PU incidence and other demographic information were explored using Spearman\u27s correlation for data not normally distributed, and Pearson\u27s R correlation coefficient for normally distributed data. Mean baseline SEM delta measurements indicate abnormal readings for all anatomical sites except the control site, consistent with previous studies. Mean baseline IL-1α/TP readings were higher for the sacrum versus both heels and, on average, readings were higher for the control site versus all other anatomical locations. This is conflicting, given that the control site was non-weight bearing. There were very weak or weak correlations between SEM delta measurements and IL-1α/TP readings. SEM measurements are quick and easy to obtain and results are instant, however Sebutape sampling takes significantly longer and is challenging to conduct among haemodynamically unstable patients. Obtaining SEM measurements is more practical and feasible than Sebutape sampling to assess for the presence of inflammation

Biomarkers for the early detection of pressure ulcers in the intensive care setting: A comparison between sub‐epidermal moisture measurements and interleukin‐1α

Pressure ulcer (PU) prevention in the intensive care unit (ICU) is an important clinical issue as critically unwell patients are at high risk of developing PUs. However, current methods of PU detection are limited, especially for early detection. This study aimed to establish the correlation between Interleukin‐1α (IL‐1α)/total protein (TP) and sub‐epidermal moisture (SEM) measurements in the early identification of PUs in ICU patients. This study employed an observational research design using the STROBE guidelines. Following ethical approval, 53 participants were recruited and sebum was obtained using Sebutape from weight‐bearing areas (sacrum, heels and a control site). SEM measurements were taken from the same anatomical sites. Both measures were taken at the same time and participants were followed up for 5 days, or until discharge or death. Correlations between SEM delta measurements, IL‐1α, TP and PU incidence and other demographic information were explored using Spearman's correlation for data not normally distributed, and Pearson's R correlation coefficient for normally distributed data. Mean baseline SEM delta measurements indicate abnormal readings for all anatomical sites except the control site, consistent with previous studies. Mean baseline IL‐1α/TP readings were higher for the sacrum versus both heels and, on average, readings were higher for the control site versus all other anatomical locations. This is conflicting, given that the control site was non‐weight bearing. There were very weak or weak correlations between SEM delta measurements and IL‐1α/TP readings. SEM measurements are quick and easy to obtain and results are instant, however Sebutape sampling takes significantly longer and is challenging to conduct among haemodynamically unstable patients. Obtaining SEM measurements is more practical and feasible than Sebutape sampling to assess for the presence of inflammation

An Artificial-Intelligence-Discovered Functional Ingredient, NRT_N0G5IJ, Derived from Pisum sativum, Decreases HbA1c in a Prediabetic Population

The prevalence of prediabetes is rapidly increasing, and this can lead to an increased risk for individuals to develop type 2 diabetes and associated diseases. Therefore, it is necessary to develop nutritional strategies to maintain healthy glucose levels and prevent glucose metabolism dysregulation in the general population. Functional ingredients offer great potential for the prevention of various health conditions, including blood glucose regulation, in a cost-effective manner. Using an artificial intelligence (AI) approach, a functional ingredient, NRT_N0G5IJ, was predicted and produced from Pisum sativum (pea) protein by hydrolysis and then validated. Treatment of human skeletal muscle cells with NRT_N0G5IJ significantly increased glucose uptake, indicating efficacy of this ingredient in vitro. When db/db diabetic mice were treated with NRT_N0G5IJ, we observed a significant reduction in glycated haemoglobin (HbA1c) levels and a concomitant benefit on fasting glucose. A pilot double-blinded, placebo controlled human trial in a population of healthy individuals with elevated HbA1c (5.6% to 6.4%) showed that HbA1c percentage was significantly reduced when NRT_N0G5IJ was supplemented in the diet over a 12-week period. Here, we provide evidence of an AI approach to discovery and demonstrate that a functional ingredient identified using this technology could be used as a supplement to maintain healthy glucose regulation

Radiomic Detection of Malignancy within Thyroid Nodules Using Ultrasonography&mdash;A Systematic Review and Meta-Analysis

Background: Despite investigation, 95% of thyroid nodules are ultimately benign. Radiomics is a field that uses radiological features to inform individualized patient care. We aimed to evaluate the diagnostic utility of radiomics in classifying undetermined thyroid nodules into benign and malignant using ultrasonography (US). Methods: A diagnostic test accuracy systematic review and meta-analysis was performed in accordance with PRISMA guidelines. Sensitivity, specificity, and area under curve (AUC) delineating benign and malignant lesions were recorded. Results: Seventy-five studies including 26,373 patients and 46,175 thyroid nodules met inclusion criteria. Males accounted for 24.6% of patients, while 75.4% of patients were female. Radiomics provided a pooled sensitivity of 0.87 (95% CI: 0.86&ndash;0.87) and a pooled specificity of 0.84 (95% CI: 0.84&ndash;0.85) for characterizing benign and malignant lesions. Using convolutional neural network (CNN) methods, pooled sensitivity was 0.85 (95% CI: 0.84&ndash;0.86) and pooled specificity was 0.82 (95% CI: 0.82&ndash;0.83); significantly lower than studies using non-CNN: sensitivity 0.90 (95% CI: 0.89&ndash;0.90) and specificity 0.88 (95% CI: 0.87&ndash;0.89) (p &lt; 0.05). The diagnostic ability of radiologists and radiomics were comparable for both sensitivity (OR 0.98) and specificity (OR 0.95). Conclusions: Radiomic analysis using US provides a reproducible, reliable evaluation of undetermined thyroid nodules when compared to current best practice