Nutritional status and clinical outcome in elderly female surgical orthopaedic patients

The possible relationship between nutritional status and clinical outcome following orthopaedic hip surgery was investigated. The nutritional status of 60 elderly female patients admitted for elective total hip replacement (THR) and emergency fractured neck of femur surgery (FNF) was measured over time. Specific measures of clinical outcome, including well-being and functional status, were monitored during hospital stay and at 4, 8 and 26 weeks following discharge. Patients were allocated to a high nutritional risk group where any three of the following were less than the 5th percentile value: serum albumin, haemoglobin, triceps skinfold thickness, mid-upper arm muscle circumference and body weight. Using this definition, malnutrition was present in 4% of THR patients and 41% of FNF patients. It was found that the high risk patients had significantly longer convalescence periods, (median stay27.5 days compared with 0 days, P < 0.0009), and a greater proportion were dependent upon walking frames at 6 months (46% compared with 11%, P < 0.01). Fifty percent of the high risk patients had been living independently prior to admission, in contrast only 29% had returned to their homes at 6 months after discharge. The results indicate an apparent link between clinical outcome and nutritional status based upon the allocation procedure employed, which has the potential for ensuring cost-effective nutritional intervention.

Neural stem cells and cell replacement therapy: making the right cells

The past few years have seen major advances in the field of NSC (neural stem cell) research with increasing emphasis towards its application in cell-replacement therapy for neurological disorders. However, the clinical application of NSCs will remain largely unfeasible until a comprehensive understanding of the cellular and molecular mechanisms of NSC fate specification is achieved. With this understanding will come an increased possibility to exploit the potential of stem cells in order to manufacture transplantable NSCs able to provide a safe and effective therapy for previously untreatable neurological disorders. Since the pathology of each of these disorders is determined by the loss or damage of a specific neural cell population, it may be necessary to generate a range of NSCs able to replace specific neurons or glia rather than generating a generic NSC population. Currently, a diverse range of strategies is being investigated with this goal in mind. In this review, we focus on the relationship between NSC specification and differentiation and discuss how this information may be used to direct NSCs towards a particular fate.

Replacement of saturated with unsaturated fats had no impact on vascular function but beneficial effects on lipid biomarkers, E-selectin and blood pressure: results from the randomized, controlled Dietary Intervention and VAScular function (DIVAS) study

Background: Public health strategies to lower cardiovascular disease (CVD) risk involve reducing dietary saturated fatty acid (SFA) intake to ≤10% of total energy (%TE). However, the optimal type of replacement fat is unclear. Objective: We investigated the substitution of 9.5-9.6%TE dietary SFA with either monounsaturated (MUFA) or n-6 polyunsaturated fatty acids (PUFA) on vascular function and other CVD risk factors. Design: Using a randomized, controlled, single-blind, parallel group dietary intervention, 195 men and women aged 21-60 y with moderate CVD risk (≥50% above the population mean) from the United Kingdom followed one of three 16-wk isoenergetic diets (%TE target compositions, total fat:SFA:MUFA:n-6 PUFA): SFA-rich (36:17:11:4, n = 65), MUFA-rich (36:9:19:4, n = 64) or n-6 PUFA-rich (36:9:13:10, n = 66). The primary outcome measure was flow-mediated dilatation (%FMD); secondary outcome measures included fasting serum lipids, microvascular reactivity, arterial stiffness, ambulatory blood pressure, and markers of insulin resistance, inflammation and endothelial activation. Results: Replacing SFA with MUFA or n-6 PUFA did not significantly impact on %FMD (primary endpoint) or other measures of vascular reactivity. Of the secondary outcome measures, substitution of SFA with MUFA attenuated the increase in night systolic blood pressure (-4.9 mm Hg, P = 0.019) and reduced E-selectin (-7.8%, P = 0.012). Replacement with MUFA or n-6 PUFA lowered fasting serum total cholesterol (TC; -8.4% and -9.2%, respectively), low-density lipoprotein cholesterol (-11.3% and -13.6%) and TC to high-density lipoprotein cholesterol ratio (-5.6% and -8.5%) (P ≤ 0.001). These changes in low-density lipoprotein cholesterol equate to an estimated 17-20% reduction in CVD mortality. Conclusions: Substitution of 9.5-9.6%TE dietary SFA with either MUFA or n-6 PUFA did not impact significantly on %FMD or other measures of vascular function. However, the beneficial effects on serum lipid biomarkers, blood pressure and E-selectin offer a potential public health strategy for CVD risk reduction.

Effect of fat replacement by inulin on textural and structural properties of short dough biscuits

The aim of this study was to evaluate the effects of inulin as fat replacer on short dough biscuits and their corresponding doughs. A control formulation, with no replacement, and four formulations in which 10, 20, 30, and 40 % of shortening was replaced by inulin were studied. In the dough, shortening was observed surrounding flour components. At higher fat replacement levels, flour was more available for hydration leading to significant (P<0.05) harder doughs: from 2.76 (0.12)N in 10 % fat-replaced biscuits to 5.81 (1.56)N in 30 % fat-replaced ones. Biscuit structure was more continuous than dough structure. A continuous fat layer coated the matrix surface, where starch granules were embedded. In general, weight loss during baking and water activity decreased significantly (P<0.05) as fat replacement increased. Biscuit dimensions and aeration decreased when fat replacement increased, e.g., width gain was +1.20 mm in 10 fat-replaced biscuits and only +0.32 mm in 40 % fat-replaced ones. Panelist found biscuits with 20 % of fat replacement slightly harder than control biscuits. It can be concluded that shortening may be partially replaced, up to 20 %, with inulin. These low fat biscuits are similar than the control biscuits, and they can have additional health benefits derived from inulin presence.

Space, authenticity and utopia in the hip-hop teen dance film

The dance film flourished in the 2000s in the form of the hip-hop teen dance film. Such films as Save the Last Dance (Thomas Carter, 2001), Honey (Billy Woodruff, 2002) and Step Up (Anne Fletcher, 2006) drew on hip-hop’s dominance of the mainstream music industry and combined the teen film’s pre-existing social problem and musical narratives. Yet various tension were created by their interweaving of representations of post-industrial city youth with the utopian sensibilities of the classical Hollywood musical. Their narratives celebrated hip-hop performance, and depicted dance’s ability to bridge cultural boundaries and bring together couples and communities. These films used hip-hop to define space and identity yet often constructed divisions within their soundscapes, limiting hip-hop’s expressive potential. This article explores the cycle’s celebration of, yet struggle with, hip-hop through examining select films’ interactions between soundscape, narrative and form. It will engage with these films’ attempts to marry the representational, narrative and aesthetic meanings of hip-hop culture with the form and ideologies of the musical genre, particularly the tensions and continuities that arise from their engagement with the genre’s utopian qualities identified by Richard Dyer (1985). Yet whilst these films illustrate the tensions and challenges of combining hip-hop culture and the musical genre, they also demonstrate an effective integration of hip-hop soundscape and the dancing body in their depiction of dance, highlighting both form’s aesthetics of layering, rupture and flow (Rose, 1994: 22).