Does Creatine Supplementation Increase Muscle Strength in Women?

The purpose of this study was to see if creatine supplementation increased muscular strength in women. Ten females were assigned to either a creatine (CG) or a placebo (PG) group with five subjects in each. The study lasted five weeks with one week of pre-testing, three weeks of creatine use which included one week of loading (12-13 g/day for seven days) and two weeks of maintenance (3-4 g/day for 14 days), and one week of post testing. Pre- and post-test strength were measured with a one repetition maximal lift (1RM) on the bench press and the leg press. All subjects were required to perform a 20-minute warm-up before 1RM measurements to help avoid injury. Each subject then completed two warm-up sets with the bench press or leg press to prepare the working muscle for the 1RM test. After warm-up sets, each subject then completed one repetition lifts until their max lift was attained. Subjects were required to rest a minimum of two minutes in between lifts. No subject performed more than four, one repetition lifts. Over the course of the three-week study, all subjects performed similar workout routines. The results of the post-test 1RM values were not significant between the two groups. The CG increased their mean leg press 1RM (70 ± 47.2 lbs.) and mean bench press 1RM (12 ± 2.2 lbs.). The PG increased their mean leg press 1RM (56 ± 12.7 lbs) and mean bench press 1RM (8 ± 2.8 lbs). Although the PG started and ended with a greater 1RM, the CG displayed a larger mean relative average than did the PG. The CG increased their relative average for the bench press and leg press by 11.3% and 18.6%, respectively compared to the PI increases of 6.5%, 13.2%, respectively. It is concluded that three weeks of creatine supplementation in women failed to significantly increase leg press and bench press strength greater than a placebo

Does Creatine Supplementation Increase Muscle Strength in Women?

The purpose of this study was to see if creatine supplementation increased muscular strength in women. Ten females were assigned to either a creatine (CG) or a placebo (PG) group with five subjects in each. The study lasted five weeks with one week of pre-testing, three weeks of creatine use which included one week of loading (12-13 g/day for seven days) and two weeks of maintenance (3-4 g/day for 14 days), and one week of post testing. Pre- and post-test strength were measured with a one repetition maximal lift (1RM) on the bench press and the leg press. All subjects were required to perform a 20-minute warm-up before 1RM measurements to help avoid injury. Each subject then completed two warm-up sets with the bench press or leg press to prepare the working muscle for the 1RM test. After warm-up sets, each subject then completed one repetition lifts until their max lift was attained. Subjects were required to rest a minimum of two minutes in between lifts. No subject performed more than four, one repetition lifts. Over the course of the three-week study, all subjects performed similar workout routines. The results of the post-test 1RM values were not significant between the two groups. The CG increased their mean leg press 1RM (70 ± 47.2 lbs.) and mean bench press 1RM (12 ± 2.2 lbs.). The PG increased their mean leg press 1RM (56 ± 12.7 lbs) and mean bench press 1RM (8 ± 2.8 lbs). Although the PG started and ended with a greater 1RM, the CG displayed a larger mean relative average than did the PG. The CG increased their relative average for the bench press and leg press by 11.3% and 18.6%, respectively compared to the PI increases of 6.5%, 13.2%, respectively. It is concluded that three weeks of creatine supplementation in women failed to significantly increase leg press and bench press strength greater than a placebo

Hematocrit Evaluation for Identifying Risk of Cyanotic Nephropathy in Patients with Congenital Cyanotic Heart Disease

Background: With modern advances in cardiac care, patients with congenital cyanotic heart disease (CCHD) are living longer. As a result of this, the medical community is recognizing an increasing prevalence of non-cardiac complications in these patients. One of the most common complications is development of cyanotic nephropathy, which in turn leads to polycythemia. Elevated hematocrit levels can be an indicator of this process. Due to increased prevalence and a relative lack of qualified specialists, primary care clinicians are in need of an alternative, inexpensive test to establish these patients’ risk of developing cyanotic nephropathy. Measurement of hematocrit fulfills this need. Methods: An exhaustive search of available medical literature was performed using Medline-Ovid, CINAHL, and Web of Science, using the search terms heart defects, kidney diseases, and hematocrit. Google Scholar was also searched, using the terms congenital cyanotic heart disease, kidney disease, and hematocrit. Included studies were evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group guidelines. Results: A total of 78 studies were screened. The cumulative result of the search gave a total of two studies meeting inclusion criteria: two cross-sectional observational studies demonstrating that elevated hematocrit levels can be a reliable indicator of risk of progression to cyanotic nephropathy in patients with CCHD. Conclusion: Elevated hematocrit levels can be a reliable prognostic indicator of the development of cyanotic nephropathy in patients with CCHD. Hematocrit evaluation is the best resource available to primary care clinicians when evaluating patients with CCHD for the risk of developing cyanotic nephropathy. Current evidence suggests that frequent hematocrit screening could lead to early identification of renal damage. By using hematocrit as an evaluation tool, primary care clinicians can positively impact the quality of life of patients with CCHD. Close monitoring of these patients with appropriate diagnostic studies, such as hematocrit, can also lead to a more manageable distribution of patients with CCHD among the healthcare system between specialists and primary care providers. Keywords: congenital cyanotic heart disease, heart defects, chronic kidney disease, cyanotic nephropathy, hematocri

Reconceptualizing Due Process in Juvenile Justice: Contributions from Law and Social Science

This article challenges the accepted wisdom, at least since the Supreme Court\u27s decision in Gault, that procedures in juvenile delinquency court should mimic the adult criminal process. The legal basis for this challenge is Gault itself, as well as the other Supreme Court cases that triggered the juvenile justice revolution of the past decades, for all of these cases relied on the due process clause, not the provisions of the Constitution that form the foundation for adult criminal procedure. That means that the central goal in juvenile justice is fundamental fairness, which does not have to be congruent with the adversarial tradition of adult criminal court. Instead, as the Court\u27s administrative procedure cases illustrate, fundamental fairness theory aims at constructing the procedural framework that best promotes fairness, accuracy and efficiency in the setting in question. Social science, and in particular procedural justice research, can play an important role in fashioning this framework, because it can empirically examine various procedural mechanisms, in various settings, with these objectives in mind. To date, procedural justice research suggests that the procedures associated with the adult criminal process are not optimal even in that setting, much less in a regime focused on rehabilitating or punishing children. We propose a performance-based management system for implementing these legal and scientific insights in the juvenile justice context

K.Vita: a feasibility study of a blend of medium chain triglycerides to manage drug-resistant epilepsy

This prospective open-label feasibility study aimed to evaluate acceptability, tolerability and compliance with dietary intervention with K.Vita, a medical food containing a unique ratio of decanoic acid to octanoic acid, in individuals with drug-resistant epilepsy. Adults and children aged 3-18 years with drug-resistant epilepsy took K.Vita daily whilst limiting high-refined sugar food and beverages. K.Vita was introduced incrementally with the aim of achieving ≤35% energy requirements for children or 240 ml for adults. Primary outcome measures were assessed by study completion, participant diary, acceptability questionnaire and K.Vita intake. Reduction in seizures or paroxysmal events was a secondary outcome. 23/35 (66%) children and 18/26 (69%) adults completed the study; completion rates were higher when K.Vita was introduced more gradually. Gastrointestinal disturbances were the primary reason for discontinuation, but symptoms were similar to those reported from ketogenic diets and incidence decreased over time. At least three-quarters of participants/caregivers reported favourably on sensory attributes of K.Vita, such as taste, texture and appearance, and ease of use. Adults achieved a median intake of 240 ml K.Vita, and children 120 ml (19% daily energy). Three children and one adult had ß-hydroxybutyrate >1 mmol/l. There was 50% (95% CI 39-61%) reduction in mean frequency of seizures/events. Reduction in seizures or paroxysmal events correlated significantly with blood concentrations of medium chain fatty acids (C10 and C8) but not ß-hydroxybutyrate. K.Vita was well accepted and tolerated. Side effects were mild and resolved with dietetic support. Individuals who completed the study complied with K.Vita and additional dietary modifications. Dietary intervention had a beneficial effect on frequency of seizures or paroxysmal events, despite absent or very low levels of ketosis. We suggest that K.Vita may be valuable to those with drug-resistant epilepsy, particularly those who cannot tolerate or do not have access to ketogenic diets, and may allow for more liberal dietary intake compared to ketogenic diets, with mechanisms of action perhaps unrelated to ketosis. Further studies of effectiveness of K.Vita are warranted

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Reconceptualizing Due Process in Juvenile Justice: Contributions from Law and Social Science

This Article challenges the accepted wisdom, at least since the Supreme Court\u27s decision in Gault, that procedures in juvenile delinquency court should mimic the adult criminal process. The legal basis for this challenge is Gault itself, as well as the other Supreme Court cases that triggered the juvenile justice revolution of the past decades, for all of these cases relied on the due process clause, not the provisions of the Constitution that form the foundation for adult criminal procedure. The Court\u27s reliance on due process means that the central goal in juvenile justice is fundamental fairness, which does not have to be congruent with the adversarial tradition of adult criminal court. Instead, as the Court\u27s administrative procedure cases illustrate, fundamental fairness theory aims at constructing the procedural framework that best promotes fairness, accuracy and efficiency in the setting at issue. Social science, and in particular procedural justice research, can play an important role in fashioning this framework, because it can empirically examine various procedural mechanisms, in various settings, with these objectives in mind. To date, procedural justice research suggests that the procedures associated with the adult criminal process are not optimal even in that setting, much less in a regime focused on rehabilitating or punishing children. We propose a performance-based management system for implementing these legal and scientific insights in the juvenile justice context