Comparison of resting and total energy expenditure in peritoneal dialysis patients and body composition measured by dual-energy X-ray absorptiometry

Under basal resting conditions muscle metabolism is reduced, whereas metabolism increases with physical activity. We wished to determine whether there was an association between resting energy expenditure (REE) and total energy expenditure (TEE) in peritoneal dialysis (PD) patients and lean body mass (LBM). We determined REE and TEE by recently validated equations, using doubly labelled isotopic water, and LBM by dual-energy X-ray absorptiometry (DXA) scanning. We studied 87 patients, 50 male (57.4%), 25 diabetic (28.7%), mean age 60.3±17.6 years, with a median PD treatment of 11.4 (4.7-29.5) months. The mean weight was 70.1±17.7 kg with a REE of 1509±245 kcal/day and TEE 1947±378 kcal/day. REE was associated with body size (weight r=0.78 and body mass index (BMI) r=0.72) and body composition (LBM r=0.77, lean body mass index (LBMI) r=0.76, r=0.62), all P<0.001). For TEE, there was an association with weight r=0.58, BMI r=0.49 and body composition (LBM r=0.64, LBMI (r=0.54), all P<0.001). We compared LBMI measured by DXA and that estimated by the Boer equation using anthropomorphic measurements, which overestimated and underestimated LBM for smaller patients and heavier patients, respectively. Muscle metabolism is reduced at rest and increases with physical activity. Whereas previous reports based on REE did not show any association with LBM, we found an association between both REE and TEE, using a recently validated equation derived from dialysis patients, and LBM measured by DXA scanning. Estimation of muscle mass from anthropomorphic measurements systematically overestimated LBM for small patients and conversely underestimated for heavier patients

Palaeoenvironmental analysis of the Miocene barnacle facies: case studies from Europe and South America

Acorn barnacles are sessile crustaceans common in shallow-water settings, both in modern oceans and in the Miocene geological record. Barnacle-rich facies occur from polar to equatorial latitudes, generally associated with shallow-water, high-energy, hard substrates. The aim of this work is to investigate this type of facies by analysing, from the palaeontological, sedimentological and petrographical points of view, early Miocene examples from Northern Italy, Southern France and South-western Peru. Our results are then compared with the existing information on both modern and fossil barnacle-rich deposits. The studied facies can be divided into two groups. The first one consists of very shallow, nearshore assemblages where barnacles are associated with an abundant hard-substrate biota (e.g., barnamol). The second one includes a barnacle-coralline algae association, here named “barnalgal” (= barnacle / red algal dominated), related to a deeper setting. The same pattern occurs in the distribution of both fossil and recent barnacle facies. The majority of them are related to very shallow, high-energy, hard-substrate, a setting that represents the environmental optimum for the development of barnacle facies, but exceptions do occur. These atypical facies can be identified through a complete analysis of both the skeletal assemblage and the barnacle association, showing that barnacle palaeontology can be a powerful tool for palaeoenvironmental reconstruction

A single weekly Kt/Vurea target for peritoneal dialysis patients does not provide an equal dialysis dose for all

Dialysis adequacy is traditionally based on urea clearance, adjusted for total body volume (Kt/Vurea), and clinical guidelines recommend a Kt/Vurea target for peritoneal dialysis. We wished to determine whether adjusting dialysis dose by resting and total energy expenditure would alter the delivered dialysis dose. The resting and total energy expenditures were determined by equations based on doubly labeled isotopic water studies and adjusted Kturea for resting energy expenditure and total energy expenditure in 148 peritoneal dialysis patients (mean age, 60.6 years; 97 male [65.5%]; 54 diabetic [36.5%]). The mean resting energy expenditure was 1534 kcal/d, and the total energy expenditure was 1974 kcal/day. Using a weekly target Kt/V of 1.7, Kt was calculated using V measured by bioimpedance and the significantly associated (r = 0.67) Watson equation for total body water. Adjusting Kt for resting energy expenditure showed a reduced delivered dialysis dose (ml/kcal per day) for women versus men (5.5 vs. 6.2), age under versus over 65 years (5.6 vs. 6.4), weight 80 kg (5.8 vs. 6.1), low versus high comorbidity (5.9 vs. 6.2), all of which were significant. Adjusting for the total energy expenditure showed significantly reduced dosing for those employed versus not employed (4.3 vs. 4.8), a low versus high frailty score (4.5 vs. 5.0) and nondiabetic versus diabetic (4.6 vs. 4.9). Thus, the current paradigm for a single target Kt/Vurea for all peritoneal dialysis patients does not take into account energy expenditure and metabolic rate and may lead to lowered dialysis delivery for the younger, more active female patient

Comparison of equations of resting and total energy expenditure in peritoneal dialysis patients using body composition measurements determined by multi-frequency bioimpedance

Background & aims: Waste products of metabolism accumulate in patients with kidney failure and it has been proposed that the amount of dialysis treatment patients require be adjusted for energy expenditure. This requires validation of methods to estimate energy expenditure in dialysis patients. Methods: We compared values of resting energy expenditure (REE) estimated in peritoneal dialysis (PD) patients using a selection of available equations with estimates derived using a novel equation recently validated in chronic kidney disease patients (CKD equation). We also determined the relationship of these estimates of REE and of total energy expenditure (TEE – which is REE plus physical activity associated energy expenditure (PAEE) estimated using the Recent Physical Activity Questionnaire) – to bioimpedance-derived parameters of body composition. Results: We studied 118 adult PD patients; 75 male (63.6%), 33 diabetic (28.5%), Caucasoid (42.4%), mean age 59.3 ± 18.2 years and weight 73.1 ± 16.6 kg. REE with the CKD equation was 1532 ± 237 kcal/day, which was more than that for Mifflin–St. Joer 1425 ± 254, Harris–Benedict 1489 ± 267, Katch–McArdle 1492 ± 243, but less than Cunningham 1648 ± 248 kcal/day. Bland Altman mean bias ranged from −107 to 111 kcal/day. TEE was 1924 (1700–2262) kcal/day, and on multi-variate analysis was associated with appendicular muscle mass and nitrogen appearance rate (β 34.3, p < 0.001 and β 5.6, p = 0.002, respectively). Conclusion: With reference to the CKD equation, the majority of standard equations underestimate REE in PD patients. Whereas the Cunningham equation overestimates REE. TEE was associated with appendicular muscle mass and estimated dietary protein intake

Palaeoenvironmental analysis of the Miocene barnacle facies: Case studies from Europe and South America

Acorn barnacles are sessile crustaceans common in shallow-water settings, both in modern oceans and in the Miocene geological record. Barnacle-rich facies occur from polar to equatorial latitudes, generally associated with shallow-water, high-energy, hard substrates. The aim of this work is to investigate this type of facies by analysing, from the palaeontological, sedimentological and petrographical points of view, early Miocene examples from Northern Italy, Southern France and South-western Peru. Our results are then compared with the existing information on both modern and fossil barnacle-rich deposits. The studied facies can be divided into two groups. The first one consists of very shallow, nearshore assemblages where barnacles are associated with an abundant hard-substrate biota (e.g., barnamol). The second one includes a barnacle-coralline algae association, here named &quot;barnalgal&quot; (=barnacle/red algal dominated), related to a deeper setting. The same pattern occurs in the distribution of both fossil and recent barnacle facies. The majority of them are related to very shallow, high-energy, hard-substrate, a setting that represents the environmental optimum for the development of barnacle facies, but exceptions do occur. These atypical facies can be identified through a complete analysis of both the skeletal assemblage and the barnacle association, showing that barnacle palaeontology can be a powerful tool for palaeoenvironmental reconstruction

The Role of Electron Captures in Chandrasekhar Mass Models for Type Ia Supernovae

The Chandrasekhar mass model for Type Ia Supernovae (SNe Ia) has received increasing support from recent comparisons of observations with light curve predictions and modeling of synthetic spectra. It explains SN Ia events via thermonuclear explosions of accreting white dwarfs in binary stellar systems, being caused by central carbon ignition when the white dwarf approaches the Chandrasekhar mass. As the electron gas in white dwarfs is degenerate, characterized by high Fermi energies for the high density regions in the center, electron capture on intermediate mass and Fe-group nuclei plays an important role in explosive burning. Electron capture affects the central electron fraction Y_e, which determines the composition of the ejecta from such explosions. Up to the present, astrophysical tabulations based on shell model matrix elements were only available for light nuclei in the sd-shell. Recently new Shell Model Monte Carlo (SMMC) and large-scale shell model diagonalization calculations have also been performed for pf-shell nuclei. These lead in general to a reduction of electron capture rates in comparison with previous, more phenomenological, approaches. Making use of these new shell model based rates, we present the first results for the composition of Fe-group nuclei produced in the central regions of SNe Ia and possible changes in the constraints on model parameters like ignition densities and burning front speeds.Comment: 26 pages, 8 figures, submitted to Ap

Gamow-Teller strength in 54Fe and 56Fe

Through a sequence of large scale shell model calculations, total Gamow-Teller strengths ($S_+$ and $S_-$) in $^{54}$Fe and $^{56}$Fe are obtained. They reproduce the experimental values once the $\sigma\tau$ operator is quenched by the standard factor of $0.77$. Comparisons are made with recent Shell Model Monte Carlo calculations. Results are shown to depend critically on the interaction. From an analysis of the GT+ and GT$-$ strength functions it is concluded that experimental evidence is consistent with the $3(N-Z)$ sum rule.Comment: 6 pages, RevTeX 3.0 using psfig, 7 Postscript figures included using uufile

Gamow-Teller strength distributions for nuclei in pre-supernova stellar cores

Electron-capture and $\beta$-decay of nuclei in the core of massive stars play an important role in the stages leading to a type II supernova explosion. Nuclei in the f-p shell are particularly important for these reactions in the post Silicon-burning stage of a presupernova star. In this paper, we characterise the energy distribution of the Gamow-Teller Giant Resonance (GTGR) for mid-fp-shell nuclei in terms of a few shape parameters, using data obtained from high energy, forward scattering (p,n) and (n,p) reactions. The energy of the GTGR centroid $E_{GT}$ is further generalised as function of nuclear properties like mass number, isospin and other shell model properties of the nucleus. Since a large fraction of the GT strength lies in the GTGR region, and the GTGR is accessible for weak transitions taking place at energies relevant to the cores of presupernova and collapsing stars, our results are relevant to the study of important $e^-$-capture and $\beta$-decay rates of arbitrary, neutron-rich, f-p shell nuclei in stellar cores. Using the observed GTGR and Isobaric Analog States (IAS) energy systematics we compare the coupling coefficients in the Bohr-Mottelson two particle interaction Hamiltonian for different regions of the Isotope Table.Comment: Revtex, 28 pages +7 figures (PostScript Figures, uuencoded, filename: Sutfigs.uu). If you have difficulty printing the figures, please contact [email protected]. Accepted for publication in Phys. Rev. C, Nov 01, 199

Electron capture on iron group nuclei

We present Gamow-Teller strength distributions from shell model Monte Carlo studies of fp-shell nuclei that may play an important role in the pre-collapse evolution of supernovae. We then use these strength distributions to calculate the electron-capture cross sections and rates in the zero-momentum transfer limit. We also discuss the thermal behavior of the cross sections. We find large differences in these cross sections and rates when compared to the naive single-particle estimates. These differences need to be taken into account for improved modeling of the early stages of type II supernova evolution