Specialized High�Protein Oral Nutrition Supplement Improves Home Nutrient Intake of Malnourished Older Adults Without Decreasing Usual Food Intake

Background: Reduced nutrient intake is common in patients after hospitalization, contributing to increased risk for readmissionand mortality. Oral nutrition supplements can improve nutrition status and clinical outcomes, but intake of food is prioritized byclinicians. This study examines the impact of a high-protein oral nutrition supplement (S-ONS) on nutrient intake post discharge. Methods: In a subset of patients (14 S-ONS and 16 placebo) from the NOURISH (Nutrition effect On Unplanned ReadmIssionsand Survival in Hospitalized patients) trial, 24-hour dietary recalls were conducted on 3 randomly selected days during the weeksof 30, 60, and 90 days post discharge. Nutrient intake was estimated using Nutrition Data System for Research software. Adequateenergy and protein intake were dened as 30 kcal/kg/d and 1.2 g/kg/d, respectively. Dietary Reference Intakes (DRIs) were usedfor other nutrients. Results: Less than half of patients met the requirements for energy, protein, and 12 micronutrients from foodintake alone during the study. Energy and protein intakes from food were not diminished relative to placebo. Considering nutrientintake from both food and S-ONS, 50% and 71% of patients receiving S-ONSs met energy and protein goals respectively at 90 days(compared with 29% and 36%, in the placebo group), and 100% met the DRI for total carbohydrate, iron, phosphorus, copper,selenium, thiamin, and riboavin at all time points, all of which were consumed at higher amounts vs placebo. Conclusion: Threemonths of S-ONS consumption increases intake of numerous nutrients without decreasing nutrient intake from food in oldermalnourished adults post discharge

Readmission and mortality in malnourished, older, hospitalized adults treated with a specialized oral nutritional supplement: A randomized clinical trial

SummaryBackgroundHospitalized, malnourished older adults have a high risk of readmission and mortality.ObjectiveEvaluation of a high-protein oral nutritional supplement (HP-HMB) containing beta-hydroxy-beta-methylbutyrate on postdischarge outcomes of nonelective readmission and mortality in malnourished, hospitalized older adults.DesignMulticenter, randomized, placebo-controlled, double-blind trial.SettingInpatient and posthospital discharge.PatientsOlder (≥65 years), malnourished (Subjective Global Assessment [SGA] class B or C) adults hospitalized for congestive heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease.InterventionsStandard-of-care plus HP-HMB (n = 328) or a placebo supplement (n = 324), 2 servings/day.MeasurementsPrimary composite endpoint was 90-day postdischarge incidence of death or nonelective readmission. Other endpoints included 30- and 60-day postdischarge incidence of death or readmission, length of stay (LOS), SGA class, body weight, and activities of daily living (ADL).ResultsThe primary composite endpoint was similar between HP-HMB (26.8%) and placebo (31.1%). No between-group differences were observed for 90-day readmission rate, but 90-day mortality was significantly lower with HP-HMB relative to placebo (4.8% vs. 9.7%; relative risk 0.49, 95% confidence interval [CI], 0.27 to 0.90; p = 0.018). The number-needed-to-treat to prevent 1 death was 20.3 (95% CI: 10.9, 121.4). Compared with placebo, HP-HMB resulted in improved odds of better nutritional status (SGA class, OR, 2.04, 95% CI: 1.28, 3.25, p = 0.009) at day 90, and an increase in body weight at day 30 (p = 0.035). LOS and ADL were similar between treatments.LimitationsLimited generalizability; patients represent a selected hospitalized population.ConclusionsAlthough no effects were observed for the primary composite endpoint, compared with placebo HP-HMB decreased mortality and improved indices of nutritional status during the 90-day observation period.Clinical trial registrationwww.ClinicalTrials.gov NCT01626742

In vitro assessment of the combined effect of eicosapentaenoic acid, green tea extract and curcumin C3 on protein loss in C2C12 myotubes

EPA has been clinically shown to reduce muscle wasting during cancer cachexia. This study investigates whether curcumin or green tea extract (GTE) enhances the ability of low doses of eicosapentaenoic acid (EPA) to reduce loss of muscle protein in an in vitro model. A low dose of EPA with minimal anti-cachectic activity was chosen to evaluate any potential synergistic effect with curcumin or GTE. Depression of protein synthesis and increase in degradation was determined in C2C12 myotubes in response to tumour necrosis factor-α (TNF-α) and proteolysis-inducing factor (PIF). EPA (50 μM) or curcumin (10 μg ml−1) alone had little effect on protein degradation caused by PIF but the combination produced complete inhibition, as did the combination with GTE (10 μg ml−1). In response to TNF-α (25 ng ml−1)-induced protein degradation, EPA had a small, but not significant effect on protein degradation; however, when curcumin and GTE were combined with EPA, the effect was enhanced. EPA completely attenuated the depression of protein synthesis caused by TNF-α, but not that caused by PIF. The combination of EPA with curcumin produced a significant increase in protein synthesis to both agents. GTE alone or in combination with EPA had no effect on the depression of protein synthesis by TNF-α, but did significantly increase protein synthesis in PIF-treated cells. Both TNF-α and PIF significantly reduced myotube diameter from 17 to 13 μm for TNF-α (23.5%) and 15 μm (11.8%) for PIF However the triple combination of EPA, curcumin and GTE returned diameters to values not significantly different from the control. These results suggest that either curcumin or GTE or the combination could enhance the anti-catabolic effect of EPA on lean body mass

Evaluation of Blood Biomarkers Associated with Risk of Malnutrition in Older Adults: A Systematic Review and Meta-Analysis

Malnutrition is a common yet under-recognized problem in hospitalized patients. The aim of this paper was to systematically review and evaluate malnutrition biomarkers among order adults. Eligible studies were identified through Cochrane, PubMed and the ProQuest Dialog. A meta-regression was performed on concentrations of biomarkers according to malnutrition risks classified by validated nutrition assessment tools. A total of 111 studies were included, representing 52,911 participants (55% female, 72 ± 17 years old) from various clinical settings (hospital, community, care homes). The estimated BMI (p < 0.001) and concentrations of albumin (p < 0.001), hemoglobin (p < 0.001), total cholesterol (p < 0.001), prealbumin (p < 0.001) and total protein (p < 0.05) among subjects at high malnutrition risk by MNA were significantly lower than those without a risk. Similar results were observed for malnutrition identified by SGA and NRS-2002. A sensitivity analysis by including patients with acute illness showed that albumin and prealbumin concentrations were dramatically reduced, indicating that they must be carefully interpreted in acute care settings. This review showed that BMI, hemoglobin, and total cholesterol are useful biomarkers of malnutrition in older adults. The reference ranges and cut-offs may need to be updated to avoid underdiagnosis of malnutrition

Leaf litter traits predominantly control litter decomposition in streams worldwide

Aim Leaf litter decomposition in freshwater ecosystems is a vital process linking ecosystem nutrient cycling, energy transfer and trophic interactions. In comparison to terrestrial ecosystems, in which researchers find that litter traits predominantly regulate litter decomposition worldwide, the dominant factors controlling its decomposition in aquatic ecosystems are still debated, with global patterns not well documented. Here, we aimed to explore general patterns and key drivers (e.g., litter traits, climate and water characteristics) of leaf litter decomposition in streams worldwide. Location Global. Time period 1977-2018. Major taxa studied Leaf litter. Methods We synthesized 1,707 records of litter decomposition in streams from 275 studies. We explored variations in decomposition rates among climate zones and tree functional types and between mesh size groups. Regressions were performed to identify the factors that played dominant roles in litter decomposition globally. Results Litter decomposition rates did not differ among tropical, temperate and cold climate zones. Decomposition rates of litter from evergreen conifer trees were much lower than those of deciduous and evergreen broadleaf trees, attributed to the low quality of litter from evergreen conifers. No significant differences were found between decomposition rates of litter from deciduous and evergreen broadleaf trees. Additionally, litter decomposition rates were much higher in coarse- than in fine-mesh bags, which controled the entrance of decomposers of different body sizes. Multiple regressions showed that litter traits (including lignin, C:N ratio) and elevation were the most important factors in regulating leaf litter decomposition. Main conclusions Litter traits predominantly control leaf litter decomposition in streams worldwide. Although further analyses are necessary to explore whether commonalities of the predominant role of litter traits in decomposition exist in both aquatic and terrestrial ecosystems, our findings could contribute to the use of trait-based approaches in modelling the decomposition of litter in streams globally and exploring mechanisms of land-water-atmosphere carbon fluxes

Calculation model and influence factors of thermal conductivity of composite cement-based materials for geothermal well

Abstract The use of cement-based composites (CBC) with high thermal conductivity for geothermal well cementing is extremely important for the efficient development and use of geothermal energy. Accurate prediction of thermal conductivity can save a lot of experimental costs and time. At present, there is no specific calculation model for the thermal conductivity of CBC. In this study, the microstructure, thermal conductivity model and influencing factors of CBC were investigated by experimental tests, theoretical analysis and numerical simulation. The results showed that the cement-based material could be simplified into a two-layer structure of hydrated and unhydrated layers. Mathematical and numerical models based on the coupled Series model and the Maxwell–Eucken model were established to calculate the thermal conductivity for CBC. The mathematical and numerical models were found to be more accurate by comparison with the conventional models and experimental test results. The cubic packing was more favorable than the spherical packing to improve the thermal conductivity of CBC. The plate material had significant anisotropy. The thermal conductivity of CBC showed a rapid decrease followed by a slow decrease, a decrease followed by a slow increase and finally a rapid decrease, a rapid increase followed by an up and down fluctuation and finally a plateau, respectively, with the increase of filler particle diameter, spacing and curing temperature. Based on these results, the effective methods and future research directions were proposed to maximize the thermal conductivity of geothermal well cementing materials in actual engineering applications. The research findings can provide some technical references for the efficient development of geothermal energy and research on CBC with high thermal conductivity

Data from: Leaf litter traits predominantly control litter decomposition in streams worldwide

Aim Leaf litter decomposition in freshwater ecosystems is a vital process linking ecosystem nutrient cycling, energy transfer, and trophic interactions. In comparison to terrestrial ecosystems, in which researchers find that litter traits predominantly regulate its decomposition worldwide, the dominant factors controlling litter decomposition in aquatic ecosystems are still debated with global patterns not well documented. Here, we aimed to explore general patterns and key drivers (e.g. litter traits, climate, and water characteristics) of leaf litter decomposition in streams worldwide. Location Global Time period 1977-2018 Leaf litter Methods We synthesized 1707 records of litter decomposition in streams from 275 studies. We explored variations in decomposition rates among climate zones, tree functional types, and between mesh size groups. Regressions were performed to identify the factors that play dominant roles in litter decomposition globally. Results Litter decomposition rates did not differ among tropical, temperate, and cold climate zones. Decomposition rates of litter from evergreen conifer trees (EC) were much lower than those of deciduous and evergreen broad-leaf trees (DB and EB), attributed to the low quality of litter from EC. No significant differences were found between decomposition rates of DB and EB. Additionally, litter decomposition rates were much higher in coarse- than in fine-mesh bags, which control the entrance of decomposers of different body sizes. Multiple regressions showed that litter traits (including lignin, C:N ratio) and altitude were the most important factors in regulating leaf litter decomposition. Main conclusions Litter traits predominantly control leaf litter decomposition in streams worldwide. While further analyses are necessary to explore whether commonalities of litter traits’ predominant role in decomposition exist in both aquatic and terrestrial ecosystems, our findings could contribute to using trait-based approaches in modeling the decomposition of litter in streams globally and exploring mechanisms of land-water-atmosphere carbon fluxes

Exploring the Mechanism of Inhibition of Au Nanoparticles on the Aggregation of Amyloid-β(16-22) Peptides at the Atom Level by All-Atom Molecular Dynamics

The abnormal self-assembly of the amyloid-β peptide into toxic β-rich aggregates can cause Alzheimer’s disease. Recently, it has been shown that small gold nanoparticles (AuNPs) inhibit Aβ aggregation and fibrillation by slowing down the nucleation process in experimental studies. However, the effects of AuNPs on Aβ oligomeric structures are still unclear. In this study, we investigate the conformation of Aβ(16-22) tetramers/octamers in the absence and presence of AuNPs using extensive all-atom molecular-dynamics simulations in explicit solvent. Our studies demonstrate that the addition of AuNPs into Aβ(16-22) solution prevents β-sheet formation, and the inhibition depends on the concentration of Aβ(16-22) peptides. A detailed analysis of the Aβ(16-22)/Aβ(16-22)/water/AuNPs interactions reveals that AuNPs inhibit the β-sheet formation resulting from the same physical forces: hydrophobic interactions. Overall, our computational study provides evidence that AuNPs are likely to inhibit Aβ(16-22) and full-length Aβ fibrillation. Thus, this work provides theoretical insights into the development of inorganic nanoparticles as drug candidates for treatment of AD

Serum Total Adiponectin Is Associated with Impaired Glucose Tolerance in Asian Indian Females but Not in Males

Objective: Adiponectin may play a role in the development of type 2 diabetes and cardiovascular disease (CVD). However, little is known about the relationship between adiponectin and impaired glucose tolerance (IGT). We investigated the association between adiponectin and IGT and between adiponectin and cardiovascular risk factors among subjects with IGT. Research Design and Methods: Subjects with normal glucose tolerance (NGT)(n = 571) and impaired glucose tolerance (n = 167) were recruited from the Chennai Urban Rural Epidemiology Study in south India. Serum total adiponectin levels were measured using a radioimmunoassay (Linco Research, St. Charles, MO). High sensitivity C-reactive protein (hsCRP) was estimated by nephelometry. Results: In sex-stratified analyses, adiponectin was significantly associated with IGT in females [odds ratio (OR): 0.93, 95% confidence interval (CI): 0.872-0.991, p = 0.026] after controlling for age, waist circumference, blood pressure, alcohol consumption, smoking, lipid profile, and glycemic indices; in males there was no significant association (OR = 0.90, 95% CI: 0.798-1.012, p = 0.078). In prediabetic females, adiponectin was not associated with any CVD risk factors (age, waist circumference, blood pressure, cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, fasting glucose, fasting insulin, and insulin resistance level), but was associated negatively with 2-hour postplasma glucose levels (r = -0.243, p < 0.05) and hsCRP (r = -0.219, p < 0.05) after adjusting for demographic and biomedical indices. No associations with CVD risk factors were observed in males with IGT. Conclusion: Serum total adiponectin levels are associated with IGT, 2-hour postplasma glucose, and hsCRP in Asian Indian females but not in males