673 research outputs found

    Short chain fatty acid production from mycoprotein and mycoprotein fibre in an in vitro fermentation model

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    Dietary mycoprotein (marketed as QuornTM) has many health benefits, including reductions in energy intake. The majority of studies evaluating mycoprotein focus on the protein content and very few consider the fibre content. Fibre consumption is also associated with decreased energy intake, which is partly attributed to short chain fatty acids (SCFAs) from fibre fermentation by colonic bacteria. To study the SCFA-producing capability of mycoprotein, in vitro batch fermentations were conducted, and SCFA production compared with that from extracted mycoprotein fibre, oligofructose (OF), rhamnose, and laminarin. Mycoprotein and mycoprotein fibre were both fermentable, resulting in a total SCFA production of 24.9 (1.7) and 61.2 (15.7) mmol/L, respectively. OF led to a significantly higher proportion of acetate compared to all other substrates tested (92.6 (2.8)%, p < 0.01). Rhamnose generated the highest proportion of propionate (45.3 (2.0)%, p < 0.01), although mycoprotein and mycoprotein fibre yielded a higher proportion of propionate compared with OF and laminarin. Butyrate proportion was the highest with laminarin (28.0 (10.0)although mycoprotein fibre led to a significantly higher proportion than OF (p < 0.01). Mycoprotein is a valuable source of dietary protein, but its fibre content is also of interest. Further evaluation of the potential roles of the fibre content of mycoprotein is required

    The relationship between body mass index and short term postoperative outcomes in patients undergoing potentially curative surgery for colorectal cancer: a systematic review and meta-analysis

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    Background: The prevalence of obesity has increased worldwide over the last few decades, and is a well-recognized risk factor for colorectal cancer. Surgical site infection is the most frequent complication following surgery for colorectal cancer, and the main cause of postoperative morbidity. The aim of the present systematic review and meta-analysis was to examine the relationship between increasing BMI and postoperative surgical site infection following surgery for colorectal cancer. Methods: A systemic literature search was conducted using Medline, PubMed, Embase (Ovid) and Web of Science databases from inception to the end of August 2016. Studies examining the relationship between obesity and surgical site infection following surgery for colorectal cancer were included. Analysis of the data was performed using Review Manager version 5.3(The Nordic Cochrane Centre, The Cochrane Collaboration, Copen-hagen, Denmark,) Results: In this meta-analysis, a total of 9535 patients from 16 studies were included. BMI <30 vs ≥30 kg/m2 was used to examine the association of obesity and surgical site infection in patients from Western countries. The estimated pooled OR demonstrated that obesity increased the risk of surgical site infection by approximately 100% (OR = 2.13; 95% CI 1.66-2.72, p < 0.001).BMI <25 vs ≥25 kg/m2 was used to examine the association of obesity and surgical site infection from Asian countries. The estimated pooled OR demonstrated that obesity increased the risk of surgical site infection by approximately 60% (OR = 1.63; 95% CI 1.29-2.06, p < 0.001). There was little evidence of publication bias in the meta-analysis. Conclusion: From this systematic review and meta-analysis there was good evidence that obesity was associated with a significantly higher risk of developing surgical site infection following surgery for colorectal cancer in both ethnic groups. The magnitude of the effect warrants further investigation

    Hypoalbuminemia reflects nutritional risk, body composition and systemic inflammation and is independently associated with survival in patients with colorectal cancer

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    It has long been recognized that albumin has prognostic value in patients with cancer. However, although the Global Leadership Initiative on Malnutrition GLIM criteria (based on five diagnostic criteria, three phenotypic criteria and two etiologic criteria) recognize inflammation as an important etiologic factor in malnutrition, there are limited data regarding the association between albumin, nutritional risk, body composition and systemic inflammation, and whether albumin is associated with mortality independent of these parameters. The aim of this study was to examine the relationship between albumin, nutritional risk, body composition, systemic inflammation, and outcomes in patients with colorectal cancer (CRC). A retrospective cohort study (n = 795) was carried out in which patients were divided into normal and hypoalbuminaemic groups (albumin  <35 g/L) in the presence and absence of a systemic inflammatory response C-reactive protein (CRP >10 and <10 mg/L, respectively). Post-operative complications, severity of complications and mortality were considered as outcome measures. Categorical variables were analyzed using Chi-square test χ 2or linear-by-linear association. Survival data were analyzed using univariate and multivariate Cox regression. In the presence of a systemic inflammatory response, hypoalbuminemia was directly associated with Malnutrition Universal Screening Tool MUST (p < 0.001) and inversely associated with Body Mass Index BMI (p < 0.001), subcutaneous adiposity (p < 0.01), visceral obesity (p < 0.01), skeletal muscle index (p < 0.001) and skeletal muscle density (p < 0.001). There was no significant association between hypoalbuminemia and either the presence of complications or their severity. In the absence of a systemic inflammatory response (n = 589), hypoalbuminemia was directly associated with MUST (p < 0.05) and inversely associated with BMI (p < 0.01), subcutaneous adiposity (p < 0.05), visceral adiposity (p < 0.05), skeletal muscle index (p < 0.01) and skeletal muscle density (p < 0.001). Hypoalbuminemia was, independently of inflammatory markers, associated with poorer cancer-specific and overall survival (both p < 0.001). The results suggest that hypoalbuminemia in patients with CRC reflects both increased nutritional risk and greater systemic inflammatory response and was independently associated with poorer survival in patients with CRC

    The relationship between computed tomography‐derived body composition and survival in colorectal cancer: the effect of image software

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    Background: In the literature, there is considerable variation of the proportion of patients reported as having a low skeletal muscle index (SMI) (sarcopenia) or skeletal muscle radiodensity (SMD) (myosteatosis). The aim of the present study was to compare two commonly used software packages, one manual and one semi‐automated to quantify body composition of patients with colorectal cancer. Methods: The study included 341 patients with colorectal cancer. ImageJ and Slice‐O‐Matic were used to quantify the computed tomography images for total fat index, visceral obesity (visceral fat index, VFI), high subcutaneous fat index (SFI), sarcopenia (SMI), and myosteatosis (SMD). Bland–Altman analysis was conducted to test agreement of the two software programs for these indices. Survival analysis was carried out using previously defined thresholds and Cox regression. Results: In Bland–Altman analysis, ImageJ gave consistently higher values for all body composition parameters (P < 0.001), resulting in more patients classified as high SFI (P < 0.001) and high VFI (P < 0.001) and fewer patients being classified as low SMI (P < 0.0001) and SMD (P < 0.001). The difference between SFI calculated using ImageJ and Slice‐O‐Matic was +7.9%. The difference between VFI, calculated using ImageJ and Slice‐O‐Matic, was +20.3%. The difference between low SMI and SMDs, estimated using ImageJ and Slice‐O‐Matic, was +2.9% and +1.2%, respectively. SFI, VFI, SMI (Dolan), SMD (Dolan), SMI (Martin), and SMD (Martin) were significantly associated with shorter overall survival using ImageJ (all P < 0.05). Conclusions: ImageJ when compared with Slice‐O‐Matic gave higher values of different body composition parameters, and this impacted on the number of patients classified according to defined thresholds and their relationship with survival

    The relationship between body mass index, sex, and postoperative outcomes in patients undergoing potentially curative surgery for colorectal cancer

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    Background: There is increasing evidence that an increased BMI is associated with increased complications after surgery for colorectal cancer (CRC). However, the basis of this relationship is not clear. Since men and women have different fat distribution, with men more likely to have excess visceral fat in BMI defined obesity, there may be a sex difference in the surgical site infection (SSIs) rate in the obese. Therefore, the aim of this study was to examine the relationship between sex, BMI, clinic-pathological characteristics and the development of postoperative infective complications after surgery for CRC and to establish whether there were gender differences in complication following surgery for CRC. Design: Data were recorded prospectively for patients undergoing potentially curative surgery for CRC in a single centre between 1997 and 2016. Patient characteristics were recorded and complications were classified as either infective or non-infective. The relationship between sex, BMI, associated clinicopathological characteristics and presences of complications were examined by Chi-square test for linear association and multivariate binary logistic regression model. Results: A total of 1039 patients were included. There were significant differences in the presence of complications between male and female (p ≤ 0.001), the rate of complication was higher in obese male (44%); in particular SSIs, wound infection and anastomotic leak (p ≤ 0.05). The rate of surgical site infection was 12% in male patients with normal BMI compared with 26% in those with a BMI ≥30 (p ≤ 0.001), while the rate of SSIs in female patients was 10% in those with normal BMI and those with a BMI ≥30. In males, BMI remained significantly associated with SSI on multivariate analysis [(OR = 1.42, 95% CI 1.13–1.78) P = 0,002]. Conclusions: Obesity prior to surgery for CRC increases the risk of infective complications in both male and female. Increased BMI in male patients was associated greater risk of SSIs and wound infection compared to female patients. Male obese patients should be considered at high risk of developing post-operative infective complications

    Nurturing the young shoots of talent: Using action research for exploration and theory building

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    This is an Author's Accepted Manuscript of an article published in European Early Childhood Education Research Journal, 19(4), 433-450, 2011, copyright Taylor & Francis, available online at: http://www.tandfonline.com/10.1080/1350293X.2011.623515.This paper reports the outcomes of a set of action research projects carried out by teacher researchers in 14 local education authorities in England, working collaboratively with university tutors, over a period of three years. The common aim of all the projects was to explore practical ways of nurturing the gifts and talents of children aged four–seven years. The project was funded by the Department of Education and Skills in England as part of the government's gifted and talented programme. The project teachers felt that their understanding of issues relating to nurturing the gifts and talents of younger children was enhanced through their engagement in the project. It was possible to map the findings of the projects to the English government's National Quality Standards for gifted and talented education which include: (1) identification; (2) effective provision in the classroom; (3) enabling curriculum entitlement and choice; (4) assessment for learning; (5) engaging with community, families and beyond. The findings are also analysed within the framework of good practice in educating children in the first years of schooling. Participating practitioners felt that action research offered them a suitable methodology to explore the complexity of the topic of giftedness through cycles of planning, action and reflection and personal theory building

    Genomics reveals historic and contemporary transmission dynamics of a bacterial disease among wildlife and livestock

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    Whole-genome sequencing has provided fundamental insights into infectious disease epidemiology, but has rarely been used for examining transmission dynamics of a bacterial pathogen in wildlife. In the Greater Yellowstone Ecosystem (GYE), outbreaks of brucellosis have increased in cattle along with rising seroprevalence in elk. Here we use a genomic approach to examine Brucella abortus evolution, cross-species transmission and spatial spread in the GYE. We find that brucellosis was introduced into wildlife in this region at least five times. The diffusion rate varies among Brucella lineages (∼3 to 8 km per year) and over time. We also estimate 12 host transitions from bison to elk, and 5 from elk to bison. Our results support the notion that free-ranging elk are currently a self-sustaining brucellosis reservoir and the source of livestock infections, and that control measures in bison are unlikely to affect the dynamics of unrelated strains circulating in nearby elk populations

    Defining Well Clear Separation for Unmanned Aircraft Systems Operating with Non-Cooperative Aircraft

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    Detect-and-Avoid (DAA) systems are essential to the safe operations of Unmanned Aircraft Systems, and have the objectives of mitigating collisions with and remaining Well Clear of manned aircraft. This paper analyzes four candidate DAA Well Clear definitions for non-cooperative aircraft using mitigated performance metrics of DAA systems. These DAA Well Clear definitions were proposed in previous work based on their unmitigated collision risk and maneuver initiation range. In this work they are evaluated using safety and operational suitability metrics computed from a large number of representative encounters. Results suggest that although the four candidate DAA Well Clear definitions provide comparable safety, the alerting characteristics give preference for the DAA Well Clear definition without a temporal parameter

    Aerobic exercise in obese diabetic patients with chronic kidney disease: a randomized and controlled pilot study

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    <p>Abstract</p> <p>Background</p> <p>Patients with obesity, diabetes, and chronic kidney disease (CKD) are generally physically inactive, have a high mortality rate, and may benefit from an exercise program.</p> <p>Methods</p> <p>We performed a 24-week randomized controlled feasibility study comparing aerobic exercise plus optimal medical management to medical management alone in patients with type 2 diabetes, obesity (body mass index [BMI] > 30 kg/m<sup>2</sup>), and stage 2-4 CKD (estimated glomerular filtration rate [eGFR] 15-90 mL/min/1.73 m<sup>2 </sup>with persistent proteinuria). Subjects randomized to exercise underwent thrice weekly aerobic training for 6 followed by 18 weeks of supervised home exercise. The primary outcome variable was change in proteinuria.</p> <p>Results</p> <p>Seven subjects randomized to exercise and 4 control subjects completed the study. Exercise training resulted in an increase in exercise duration during treadmill testing, which was accompanied by slight but insignificant decreases in resting systolic blood pressure and 24-hour proteinuria. Exercise did not alter GFR, hemoglobin, glycated hemoglobin, serum lipids, or C-reactive protein (CRP). Caloric intake and body weight and composition also did not change with exercise training.</p> <p>Conclusion</p> <p>Exercise training in obese diabetic patients with CKD is feasible and may have clinical benefits. A large-scale randomized controlled trial to determine the effects of exercise on renal functions, cardiovascular fitness, inflammation, and oxidative stress in diabetic patients with CKD is planned.</p

    Profiling humoral immune responses to Clostridium difficile-specific antigens by protein microarray analysis

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    Clostridium difficile is an anaerobic, Gram-positive, and spore-forming bacterium that is the leading worldwide infective cause of hospital-acquired and antibiotic-associated diarrhea. Several studies have reported associations between humoral immunity and the clinical course of C. difficile infection (CDI). Host humoral immune responses are determined using conventional enzyme-linked immunosorbent assay (ELISA) techniques. Herein, we report the first use of a novel protein microarray assay to determine systemic IgG antibody responses against a panel of highly purified C. difficile-specific antigens, including native toxins A and B (TcdA and TcdB, respectively), recombinant fragments of toxins A and B (TxA4 and TxB4, respectively), ribotypespecific surface layer proteins (SLPs; 001, 002, 027), and control proteins (tetanus toxoid and Candida albicans). Microarrays were probed with sera from a total of 327 individuals with CDI, cystic fibrosis without diarrhea, and healthy controls. For all antigens, precision profiles demonstrated<10% coefficient of variation (CV). Significant correlation was observed between microarray and ELISA in the quantification of antitoxin A and antitoxin B IgG. These results indicate that microarray is a suitable assay for defining humoral immune responses to C. difficile protein antigens and may have potential advantages in throughput, convenience, and cost
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