Laktoseintoleranz Pathophysiologische Folgen einer möglichen Calciumunterversorgung

Laktoseintoleranz kann bei Personen mit Laktasemangel nach dem Genuss laktosehaltiger Lebensmittel auftreten und äußert sich in Form von gastrointestinalen Symptomen. In Mitteleuropa sind 15-20 % der Bevölkerung von Laktosemalabsorption betroffen, weltweit bis zu 75 %. Ein Verdacht auf Laktoseintoleranz muss durch Diagnosemethoden überprüft werden. Die Möglichkeiten dabei bestehen in einem Laktosebelastungstest, dem Wasserstoff- Atemtest, Biopsieverfahren oder dem Gentest. So kann das Vorliegen von Laktosemalabsorption mit großer Sicherheit ermittelt werden. Da bis dato kein Medikament gegen Laktoseintoleranz bekannt ist, erfolgt die Therapie mit diätetischen Maßnahmen. Zur Symptomvermeidung können laktosehaltige Produkte aus der Nahrung ausgeschlossen werden oder das Enzym Laktase kann exogen zugeführt werden. Milchprodukte, die mit Laktase vorbehandelt wurden, können konventionelle Milchprodukte ersetzen. Da auch bei Personen mit ausgeprägter Laktoseintoleranz eine gewisse Restenzymaktivität besteht, ist es nicht nötig, Milch und Milchprodukte aus der Ernährung auszuschließen und die daraus resultierenden großen ernährungsphysiologischen Nachteile in Kauf zu nehmen. Die Versorgung mit Calcium kann durch einen solchen Ausschluss beeinträchtigt sein, da Milch und Milchprodukte zwei der wichtigsten Quellen für den Mineralstoff darstellen. Im Idealfall sollen 1000 bis 1200 mg Calcium täglich aufgenommen werden. Wird über die Nahrung zu wenig des Mineralstoffs zugeführt, greift der Organismus für die Aufrechterhaltung wichtiger biochemischer Funktionen auf das Skelett als Calciumspeicher zurück. So kann es in Wechselwirkung mit Vitamin D-Mangel zu Stoffwechselstörungen der Knochen kommen, die durch mangelhaften Calciumeinbau oder vermehrten Mineralstoffabbau charakterisiert sind. Beispiele dafür sind Osteomalazie, Rachitis, Osteopenie und Osteoporose. Das Risiko, an Krebs zu erkranken, wird von einer Vielzahl von Faktoren beeinflusst. Insbesondere die Prävalenz für Kolon- und Kolorektalkrebs, zusätzlich wahrscheinlich auch die Häufigkeit von Brustkrebs, kann durch Supplementation mit Calcium verringert werden. Weiters wird das Auftreten des prämenstruellen Syndroms durch 79 niedrige Calciumaufnahme begünstigt. Bei laktoseintoleranten Personen soll, um das Vorkommen pathophysiologischer Veränderungen zu mindern, die ausreichende Calciumversorgung sichergestellt werden. Dies ist durch Aufklärung über die Verträglichkeit von Milchprodukten oder über alternative Nahrungsmittelquellen und Supplemente möglich. 80Lactose intolerance can affect people with lactase deficiencies after the consumption of food containing lactose and manifests itself in gastrointestinal symptoms. In Central Europe about 15-20 % of the population suffer from lactose intolerance, worldwide the percentage is about 75 %. A possible lactose intolerance needs to be verified by diagnostic methods such as breath tests, lactose exposure test, biopsy and gene tests. Until now there is no medical therapy available to cure lactose intolerance. Thus, it can only be treated with the help of nutritional therapy. The treatments range from excluding lactose containing foods completely from the diet to consuming lactase in the form of tablets or in yogurt. Further, diary products which have been pretreated with lactase are available to replace conventional products. Since even people with a pronounced lactose intolerance can normally tolerate certain amounts of lactose it is not necessary to completely exclude milk and dairy products from the diet and consequently risk severe nutritional deficiencies. Milk and Dairy products are important sources of calcium, and the recommended intake of 1000 to 1200 g per day is difficult to achieve without ingesting them. If calcium intake through nutrition is deficient, the organism has to use calcium from skeletal storages to assure the function of important calcium dependent biochemical mechanisms. In combination with a vitamin D deficiency this can lead to disorders of bone metabolism, which are characterized in deficient mineral integration or increased calcium depletion, such as osteoporosis, osteomalacia, rickets and osteopenia. The risk of suffering from cancer is enhanced by multiple factors, such as a deficient calcium intake. An increased intake of calcium can reduce the risk of (for) colon- and colorectal cancer. There is also some evidence that breast cancer and premenstrual syndromes can be significantly improved by calcium supplementation. Summing up, people suffering from lactose intolerance are advised to assure appropriate calcium consumption to reduce the risk of the above mentioned pathophysiological changes. Additionally, those people should be educated about the safe use of diary products, food supplements and the consumption of alternative calcium sources

A behavioural syndrome, but less evidence for a relationship with cognitive traits in a spatial orientation context

Final LMMs with significant confounding factors on personality and cognitive traits in harvest mice. Table S2. Between-individual correlations among personality and cognitive traits (spatial recognition and spatial learning performance) in harvest mice, calculated from a multivariate mixed model. Table S3. Within-individual correlations between personality and cognitive traits (spatial recognition and spatial learning performance) in harvest mice, calculated from a multivariate mixed model. Table S4. Test for a cognitive syndrome caused by a speed-accuracy trade-off in harvest mice: Between-individual correlations among personality traits and decision styles (decision speed and accuracy) calculated from a multivariate mixed model. Table S5. Test for a cognitive syndrome caused by a speed-accuracy trade-off in harvest mice: Within-individual correlations between personality traits and decision styles (decision speed and accuracy) calculated from a multivariate mixed model. (PDF 324 kb

Quantitative study about the estimated impact of the AI Act

With the Proposal for a Regulation laying down harmonised rules on Artificial Intelligence (AI Act) the European Union provides the first regulatory document that applies to the entire complex of AI systems. While some fear that the regulation leaves too much room for interpretation and thus bring little benefit to society, others expect that the regulation is too restrictive and, thus, blocks progress and innovation, as well as hinders the economic success of companies within the EU. Without a systematic approach, it is difficult to assess how it will actually impact the AI landscape. In this paper, we suggest a systematic approach that we applied on the initial draft of the AI Act that has been released in April 2021. We went through several iterations of compiling the list of AI products and projects in and from Germany, which the Lernende Systeme platform lists, and then classified them according to the AI Act together with experts from the fields of computer science and law. Our study shows a need for more concrete formulation, since for some provisions it is often unclear whether they are applicable in a specific case or not. Apart from that, it turns out that only about 30\% of the AI systems considered would be regulated by the AI Act, the rest would be classified as low-risk. However, as the database is not representative, the results only provide a first assessment. The process presented can be applied to any collections, and also repeated when regulations are about to change. This allows fears of over- or under-regulation to be investigated before the regulations comes into effect.Comment: The raw data and the various categorizations (including the preprocessing steps) are submitted as wel

Food lokal/global in Bewegung

Nahrungsmittel und Ernährung sind eng verwoben mit Lebensstilen, kulturellen Praktiken, Konsumgewohnheiten sowie mit Vorstellungen von gesundem und ungesundem Leben. Gleichzeitig bergen der Umgang mit Nahrungsmitteln, ihre Produktion, Verarbeitung, Vermarktung, aber auch ihr Konsum in einer globalisierten Welt politisches Konfliktpotenzial. Die hier präsentierte sozial- und kulturwissenschaftliche Auseinandersetzung mit Nahrungsmitteln sowie Ernährung und Essen basiert auf einem transdisziplinären Zugang und richtet den Blick auf Food-Politiken und -Praktiken. Das Feld der Food-Politiken nimmt Bezug auf die (lokalen) Antworten auf die skizzierten globalen agrar- und finanzwirtschaftlichen Problematiken in Verbindung mit Ernährungsweisen und Essen sowie Nahrungsmittelproduktion und -handel. Der Themenblock Food-Praktiken analysiert und diskutiert lokale Ernährungs- und Nahrungsmittelpraktiken, in denen sich globale Praktiken, Politiken und Herausforderungen, ausgelöst nicht zuletzt durch die Covid-19 Pandemie, abbilden. Insgesamt zeigen die Beiträge die Bandbreite des Themas Food und die Produktivität einer transdisziplinären Forschung, durch die Spannungsverhältnisse von In-Wert-Setzung von Nahrungsmitteln und Ernährung im Geflecht globaler und lokaler Praktiken und Politiken sichtbar gemacht und bearbeitet werden können.Peer Reviewe

Anthropometric assessment: ESPGHAN quality of care survey from paediatric hospitals in 28 European countries

Objectives Assessment of anthropometric data is essential for paediatric healthcare. We surveyed the implementation of European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) evidence-based guidelines and practical recommendations on nutritional care, particularly regarding anthropometric measurements. Methods Paediatric hospitals from 28 European countries provided pseudonymized data through online questionnaires on hospital characteristics and their standards of nutritional care. Practical tasks assessed an unbiased collection and reporting of anthropometric measurements in random patients' files and discharge letters. Results Of 114 hospitals (67% academic), 9% have no nutritionist/dietitian available, 18% do not provide standard policy to assess weight and height and 15% lack training for nursing staff for accurate performance. A wall-mounted stadiometer to measure standing height and equipment for sitting weight is unavailable in 9% and 32%, respectively. Infant length is measured by one instead of two healthcare professionals and with a tape instead of a rigid length measuring board in 58% and 15% of hospitals, respectively. The practical tasks reviewed 1414 random patients, thereof 446 younger than 2 years of age. Missing documentation occurred significantly more often for height versus weight and their percentiles in infants ≤2 years versus older children, and in general paediatric versus gastrointestinal patients, with no difference between academic and nonacademic hospitals. Review of documented anthropometric data in discharge letters disclosed that consultants significantly underestimated the deficits in their units compared to documented data. Conclusions The survey revealed significant gaps in performance and documentation of anthropometry in the participating hospitals. A resurvey will assess changes in quality of care over time

A Preoperative Clinical Risk Score Including C-Reactive Protein Predicts Histological Tumor Characteristics and Patient Survival after Surgery for Sporadic Non-Functional Pancreatic Neuroendocrine Neoplasms:An International Multicenter Cohort Study

Background: Oncological survival after resection of pancreatic neuroendocrine neoplasms (panNEN) is highly variable depending on various factors. Risk stratification with preoperatively available parameters could guide decision-making in multidisciplinary treatment concepts. C-reactive Protein (CRP) is linked to inferior survival in several malignancies. This study assesses CRP within a novel risk score predicting histology and outcome after surgery for sporadic non-functional panNENs. Methods: A retrospective multicenter study with national exploration and international validation. CRP and other factors associated with overall survival (OS) were evaluated by multivariable cox-regression to create a clinical risk score (CRS). Predictive values regarding OS, disease-specific survival (DSS), and recurrence-free survival (RFS) were assessed by time-dependent receiver-operating characteristics. Results: Overall, 364 patients were included. Median CRP was significantly higher in patients >60 years, G3, and large tumors. In multivariable analysis, CRP was the strongest preoperative factor for OS in both cohorts. In the combined cohort, CRP (cut-off >= 0.2 mg/dL; hazard-ratio (HR):3.87), metastases (HR:2.80), and primary tumor size >= 3.0 cm (HR:1.83) showed a significant association with OS. A CRS incorporating these variables was associated with postoperative histological grading, T category, nodal positivity, and 90-day morbidity/mortality. Time-dependent area-under-the-curve at 60 months for OS, DSS, and RFS was 69%, 77%, and 67%, respectively (all p <0.001), and the inclusion of grading further improved the predictive potential (75%, 84%, and 78%, respectively). Conclusions: CRP is a significant marker of unfavorable oncological characteristics in panNENs. The proposed internationally validated CRS predicts histological features and patient survival

Accuracy in Diagnosis of Celiac Disease Without Biopsies in Clinical Practice

L

Impact of infection on proteome-wide glycosylation revealed by distinct signatures for bacterial and viral pathogens

Mechanisms of infection and pathogenesis have predominantly been studied based on differential gene or protein expression. Less is known about posttranslational modifications, which are essential for protein functional diversity. We applied an innovative glycoproteomics method to study the systemic proteome-wide glycosylation in response to infection. The protein site-specific glycosylation was characterized in plasma derived from well-defined controls and patients. We found 3862 unique features, of which we identified 463 distinct intact glycopeptides, that could be mapped to more than 30 different proteins. Statistical analyses were used to derive a glycopeptide signature that enabled significant differentiation between patients with a bacterial or viral infection. Furthermore, supported by a machine learning algorithm, we demonstrated the ability to identify the causative pathogens based on the distinctive host blood plasma glycopeptide signatures. These results illustrate that glycoproteomics holds enormous potential as an innovative approach to improve the interpretation of relevant biological changes in response to infection