Evidence-Based role of nutrients and antioxidants for chronic pain management in musculoskeletal frailty and sarcopenia in aging

Musculoskeletal disorders in aging and pain are closely connected because of multiple mechanisms leading to loss of mobility and autonomy. Pain is predictive of diability and worsening frailty and the strength of this relationship increases with the severity of pain. This study presents a systematic review of randomized controlled trials, cross sectional studies, and observational studies based on treatment of pain in adults with musculoskeletal disorders using nutritional non-pharmacological (nutrients and antioxidants) interventions. The review found the efficiency of the following topics: (a) accession of the patient to a dietary counselling (e.g., daily recommended amount of protein-equivalent to at least of 1 g of protein per kilogram of body weight); (b) intake of glutamic acid-rich such as soy, egg, and cod and tryptophan-rich foods such as milk and peanuts-or taking quick-acting, free-form supplements; (c) supplementation of vitamin D and magnesium, if lacking; (d) weekly consumption of fish or supplements of omega-3 fatty acids; and (e) availability of botanicals, in particular curcumin and gingerol. These non-pharmacological interventions can help the pain therapist to create a personalized medicine (precision medicine), acting with the maximum efficacy and safety, and also reducing the dosage of analgesic drugs needed

Euclid: Modelling massive neutrinos in cosmology -- a code comparison

The measurement of the absolute neutrino mass scale from cosmological large-scale clustering data is one of the key science goals of the Euclid mission. Such a measurement relies on precise modelling of the impact of neutrinos on structure formation, which can be studied with $N$-body simulations. Here we present the results from a major code comparison effort to establish the maturity and reliability of numerical methods for treating massive neutrinos. The comparison includes eleven full $N$-body implementations (not all of them independent), two $N$-body schemes with approximate time integration, and four additional codes that directly predict or emulate the matter power spectrum. Using a common set of initial data we quantify the relative agreement on the nonlinear power spectrum of cold dark matter and baryons and, for the $N$-body codes, also the relative agreement on the bispectrum, halo mass function, and halo bias. We find that the different numerical implementations produce fully consistent results. We can therefore be confident that we can model the impact of massive neutrinos at the sub-percent level in the most common summary statistics. We also provide a code validation pipeline for future reference.Comment: 43 pages, 17 figures, 2 tables; published on behalf of the Euclid Consortium; data available at https://doi.org/10.5281/zenodo.729797

UceWeb: a Web-based Collaborative Tool for Collecting and Sharing Quality of Life Data.

Objectives: This work aims at building a platform where quality-of-life data, namely utility coefficients, can be elicited not only for immediate use, but also systematically stored together with patient profiles to build a public repository to be further exploited in studies on specific target populations (e.g. cost/utility analyses). Methods: We capitalized on utility theory and previous experience to define a set of desirable features such a tool should show to facilitate sound elicitation of quality of life. A set of visualization tools and algorithms has been developed to this purpose. To make it easily accessible for potential users, the software has been designed as a web application. A pilot validation study has been performed on 20 atrial fibrillation patients. Results: A collaborative platform, UceWeb, has been developed and tested. It implements the standard gamble, time trade-off and rating-scale utility elicitation methods. It allows doctors and patients to choose the mode of interaction to maximize patients' comfort in answering difficult questions. Every utility elicitation may contribute to the growth of the repository. Conclusion: UceWeb can become a unique source of data allowing researchers both to perform more reliable comparisons among healthcare interventions and build statistical models to gain deeper insight into quality of life data

Exercise, Nutrition, and Supplements in the Muscle Carnitine Palmitoyl-Transferase II Deficiency: New Theoretical Bases for Potential Applications.

Carnitine palmitoyltransferase II (CPTII) deficiency is the most frequent inherited disorder regarding muscle fatty acid metabolism, resulting in a reduced mitochondrial long-chain fatty acid oxidation during endurance exercise. This condition leads to a clinical syndrome characterized by muscle fatigue and/or muscle pain with a variable annual frequency of severe rhabdomyolytic episodes. While since the CPTII deficiency discovery remarkable scientific advancements have been reached in genetic analysis, pathophysiology and diagnoses, the same cannot be said for the methods of treatments. The current recommendations remain those of following a carbohydrates- rich diet with a limited fats intake and reducing, even excluding, physical activity, without, however, taking into account the long-term consequences of this approach. Suggestions to use carnitine and medium chain triglycerides remain controversial; conversely, other potential dietary supplements able to sustain muscle metabolism and recovery from exercise have never been taken into consideration. The aim of this review is to clarify biochemical mechanisms related to nutrition and physiological aspects of muscle metabolism related to exercise in order to propose new theoretical bases of treatment which, if properly tested and validated by future trials, could be applied to improve the quality of life of these patients