Magnesium supplementation for the treatment of restless legs syndrome and periodic limb movement disorder : A systematic review

Magnesium supplementation is often suggested for restless legs syndrome (RLS) or period limb movement disorder (PLMD) based on anecdotal evidence that it relieves symptoms and because it is also commonly recommended for leg cramps. We aimed to review all articles reporting the effects of magnesium supplementation on changes in RLS and/or PLMD. We conducted a systematic search looking for all relevant articles and then two reviewers read all article titles and abstracts to identify relevant studies. Eligible studies were scored for their quality as interventional trials. We found 855 abstracts and 16 of these could not be definitively excluded for not addressing all aspects of our research question. Seven full-text articles were unlocatable and one was ineligible which left eight studies with relevant data. One was a randomised placebo-controlled trial, three were case series and four were case studies. The RCT did not find a significant treatment effect of magnesium but may have been underpowered. After quality appraisal and synthesis of the evidence we were unable to make a conclusion as to the effectiveness of magnesium for RLS/PLMD. It is not clear whether magnesium helps relieve RLS or PLMD or in which patient groups any benefit might be seen. (c) 2019 Elsevier Ltd. All rights reserved.Peer reviewe

The P323L substitution in the SARS-CoV-2 polymerase (NSP12) confers a selective advantage during infection

Background The mutational landscape of SARS-CoV-2 varies at the dominant viral genome sequence and minor genomic variant population. During the COVID-19 pandemic, an early substitution in the genome was the D614G change in the spike protein, associated with an increase in transmissibility. Genomes with D614G are accompanied by a P323L substitution in the viral polymerase (NSP12). However, P323L is not thought to be under strong selective pressure. Results Investigation of P323L/D614G substitutions in the population shows rapid emergence during the containment phase and early surge phase during the first wave. These substitutions emerge from minor genomic variants which become dominant viral genome sequence. This is investigated in vivo and in vitro using SARS-CoV-2 with P323 and D614 in the dominant genome sequence and L323 and G614 in the minor variant population. During infection, there is rapid selection of L323 into the dominant viral genome sequence but not G614. Reverse genetics is used to create two viruses (either P323 or L323) with the same genetic background. L323 shows greater abundance of viral RNA and proteins and a smaller plaque morphology than P323. Conclusions These data suggest that P323L is an important contribution in the emergence of variants with transmission advantages. Sequence analysis of viral populations suggests it may be possible to predict the emergence of a new variant based on tracking the frequency of minor variant genomes. The ability to predict an emerging variant of SARS-CoV-2 in the global landscape may aid in the evaluation of medical countermeasures and non-pharmaceutical interventions

Neighbourhood-level deprivation indices and postpartum women’s health: results from the Community Child Health Network (CCHN) multi-site study

Abstract Background Area-level socioeconomic characteristics have been shown to be related to health status and mortality however, little is known about the association between residential community characteristics in relation to postpartum women’s health. Methods Data from the longitudinal, multi-site Community Child Health Network (CCHN) study were used. Postpartum women (n = 2510), aged 18–40 were recruited from 2008 to 2012 within a month of delivery. Socioeconomic data was used to create deprivation indices. Census data were analysed using principal components analysis (PCA) and logistic regression to assess the association between deprivation indices (DIs) and various health indicators. Results PCA resulted in two unique DIs that accounted for 67.5% of the total variance of the combined all-site area deprivation. The first DI was comprised of variables representing a high percentage of Hispanic or Latina, foreign-born individuals, dense households (more than one person per room of residence), with less than a high-school education, and who spent more than 30% of their income on housing costs. The second DI was comprised of a high percentage of African-Americans, single mothers, and high levels of unemployment. In a multivariate logistic regression model, using the quartiles of each DI, women who reside in the geographic area of Q4-Q2 of the second DI, were almost twice as likely to have more than three adverse health conditions compared to those who resided in the least deprived areas. (Q2vs.Q1:OR = 2.09,P = 0.001,Q3vs.Q1:OR = 1.89,P = 0.006,Q4vs.Q1:OR = 1.95,P = 0.004 respectively). Conclusions Our results support the utility of examining deprivation indices as predictors of maternal postpartum health

Neighbourhood-level deprivation indices and postpartum women's health: results from the Community Child Health Network (CCHN) multi-site study.

BackgroundArea-level socioeconomic characteristics have been shown to be related to health status and mortality however, little is known about the association between residential community characteristics in relation to postpartum women's health.MethodsData from the longitudinal, multi-site Community Child Health Network (CCHN) study were used. Postpartum women (n = 2510), aged 18-40 were recruited from 2008 to 2012 within a month of delivery. Socioeconomic data was used to create deprivation indices. Census data were analysed using principal components analysis (PCA) and logistic regression to assess the association between deprivation indices (DIs) and various health indicators.ResultsPCA resulted in two unique DIs that accounted for 67.5% of the total variance of the combined all-site area deprivation. The first DI was comprised of variables representing a high percentage of Hispanic or Latina, foreign-born individuals, dense households (more than one person per room of residence), with less than a high-school education, and who spent more than 30% of their income on housing costs. The second DI was comprised of a high percentage of African-Americans, single mothers, and high levels of unemployment. In a multivariate logistic regression model, using the quartiles of each DI, women who reside in the geographic area of Q4-Q2 of the second DI, were almost twice as likely to have more than three adverse health conditions compared to those who resided in the least deprived areas. (Q2vs.Q1:OR = 2.09,P = 0.001,Q3vs.Q1:OR = 1.89,P = 0.006,Q4vs.Q1:OR = 1.95,P = 0.004 respectively).ConclusionsOur results support the utility of examining deprivation indices as predictors of maternal postpartum health

Flour mixture of rice flour, corn and cassava starch in the production of gluten-free white bread

The use of rice flour corn and cassava starch was evaluated in several formulations aiming to find a flour mixture to replace wheat flour in the production of free-gluten white bread. Production parameters were evaluated through sensory analysis. The resulting breads were evaluated taking into account physical parameters (crumb appearance, specific volume and moisture) and sensorial parameters (flavor, appearance, crumb texture, crust color and satisfaction). Regarding flavor and moisture, breads prepared with the three different ingredients were not statistically different at 5% probability by the Tuckey test. However, they differed significantly regarding the specific volume, crumb texture, crust color, degree of satisfaction and external appearance. Rice flour bread presented the best parameters, being preferred by the sensory evaluation panel, followed by corn starch bread and cassava starch bread. Breads prepared with rice flour resulted in a softer product, presenting a better consistency with small alveoli homogeneously distributed. As far as crumb texture was concerned, corn starch bread presented larger alveoli, while cassava starch resulted in bread with expandable and gummy crumb, with granulation without alveoli, and undesirable sensorial characteristics. Production parameters were established based on these results and a mixture of flours, composed by 45% rice flour, 35% corn starch and 20% cassava starch presented good results originating bread with crumb formed by uniform and well distributed cells, and pleasant flavor and appearance.<br>Para desenvolver um sucedâneo para o pão de forma, isento de glúten, foram testadas as influências dos amidos de milho, de mandioca e da farinha de arroz, bem como das etapas de mistura, fermentação e assamento na qualidade do mesmo. Os parâmetros de fabricação foram determinados por meio de análises sensoriais durante a produção. As características sensoriais dos pães foram comparadas por meio de parâmetros físicos (aparência do miolo, volume específico e umidade) e com uma equipe de julgadores (sabor, aparência, textura do miolo, cor da casca e satisfação). Para os parâmetros sabor e umidade não houve diferença significativa a 5% de probabilidade pelo teste de Tuckey. Os pães produzidos com os 3 ingredientes diferiram significativamente quanto ao volume específico, à textura do miolo, à cor da casca, ao grau de satisfação e à aparência externa. Os pães de farinha de arroz apresentaram os melhores parâmetros, sendo preferidos pela equipe de provadores, seguidos pelos de amido de milho e por último de fécula de mandioca. Os pães elaborados com farinha de arroz resultaram em produto de maior maciez, melhor consistência com pequenos alvéolos homogeneamente distribuídos. Quanto ao aspecto da textura do miolo, os pães fabricados com amido de milho apresentaram alvéolos maiores. A fécula de mandioca resultou em pães com miolo extensível, gomoso e de granulação fechada sem alvéolos, com características sensoriais indesejáveis. Os parâmetros de produção foram estabelecidos a partir destes resultados e uma mistura de farinhas, composta por 45% de farinha de arroz, 35% de amido de milho e 20% de amido de mandioca apresentou um bom resultado, originando pães com miolo compostos por células de tamanho uniforme bem distribuídas e sabor e aparência agradáveis