A double-blind, randomized, controlled crossover trial of glutamine supplementation in home parenteral nutrition

Objective: Studies suggest clinical benefit of glutamine-supplemented parenteral nutrition. The aim was to determine if the inclusion of 10 g of glutamine as part of the nitrogen source of home parenteral nutrition (HPN) reduces infectious complications. Subjects/Methods: Thirty-five patients on HPN were recruited and 22 completed the study. Patients were randomized to receive either standard HPN or glutamine-supplemented HPN. Patients were assessed at randomization, 3 and 6 months later then they were crossed over to the alternative HPN and reassessed at 3 and 6 months. Assessments included plasma amino acid concentrations, intestinal permeability and absorption, nutritional status, oral and parenteral intake, quality of life, routine biochemistry and haematology. Results: No difference was seen between the groups at randomization. No difference was detected between the treatment phases for infective complications (55% in the standard treatment phase and 36% in the glutamine-supplemented phase P 0.67). There were no differences in nutritional status, intestinal permeability, plasma glutamine concentrations or quality of life. Conclusion: Although limited by the sample size, the study has shown that glutamine as part of the nitrogen source of parenteral nutrition can be given to patients on HPN for 6 months without any adverse effects.

Whole-grain wheat breakfast cereal has a prebiotic effect on the human gut microbiota: a double-blind, placebo-controlled, crossover study

Epidemiological studies have shown an inverse association between dietary intake of whole grains and the risk of chronic disease. This may be related to the ability to mediate a prebiotic modulation of gut microbiota. However, no studies have been conducted on the microbiota modulatory capability of whole-grain (WG) cereals. In the present study, the impact of WG wheat on the human intestinal microbiota compared to wheat bran (WB) was determined. A double-blind, randomised, crossover study was carried out in thirty-one volunteers who were randomised into two groups and consumed daily 48g breakfast cereals, either WG or WB, in two 3-week study periods, separated by a 2-week washout period. Numbers of faecal bifidobacteria and lactobacilli (the target genera for prebiotic intake), were significantly higher upon WG ingestion compared with WB. Ingestion of both breakfast cereals resulted in a significant increase in ferulic acid concentrations in blood but no discernible difference in faeces or urine. No significant differences in faecal SCFA, fasting blood glucose, insulin, total cholesterol (TC), TAG or HDL-cholesterol were observed upon ingestion of WG compared with WB. However, a significant reduction in TC was observed in volunteers in the top quartile of TC concentrations upon ingestion of either cereal. No adverse intestinal symptoms were reported and WB ingestion increased stool frequency. Daily consumption of WG wheat exerted a pronounced prebiotic effect on the human gut microbiota composition. This prebiotic activity may contribute towards the beneficial physiological effects of WG wheat.

Flavonoid supplement improves leg health and reduces fluid retention in pre-menopausal women in a double-blind, placebo-controlled study

Flavonoid extracts derived from plant foods have been shown to benefit certain types of fluid retention. However, no studies have investigated these compounds for use in premenstrual fluid retention, a complaint common among women with otherwise normal menstrual cycles. Therefore, we conducted a double-blind, placebo-controlled, pilot study into the effect of a daily flavonoid extract (Colladeen(R), 320 mg oligomeric procyanidins) on premenstrual fluid retention. Fluid retention was assessed at baseline and throughout 4 menstrual cycles of the intervention using validated questionnaires. Leg girth was also measured at baseline and at the end of the study. Thirty subjects completed the study (n = 18 active treatment; n = 12 placebo). Although no significant changes in leg girth measurements were noted, there was a significant improvement in subjective "leg health" scores after flavonoid treatment compared to placebo (p = 0.013). Furthermore, this was accompanied by an improvement in reported premenstrual fluid retention nearing significance (p = 0.066). We conclude that flavonoids supplements may provide a new therapeutic direction to counter premenstrual fluid retention and improve leg health. A larger study is now warranted.

Artichoke leaf extract (Cynara scolymus) reduces plasma cholesterol in otherwise healthy hypercholesterolemic adults: A randomized, double blind placebo controlled trial

Cardiovascular diseases are the chief causes of death in the UK, and are associated with high circulating levels of total cholesterol in the plasma. Artichoke leaf extracts (ALEs) have been reported to reduce plasma lipids levels, including total cholesterol, although high quality data is lacking. The objective of this trial was to assess the effect of ALE on plasma lipid levels and general well-being in otherwise healthy adults with mild to moderate hypercholesterolemia. 131 adults were screened for total plasma cholesterol in the range 6.0-8.0 mmol/l, with 75 suitable volunteers randomised onto the trial. Volunteers consumed 1280 mg of a standardised ALE, or matched placebo, daily for 12 weeks. Plasma total cholesterol decreased in the treatment group by an average of 4.2% (from 7.16 (SD 0.62) mmol/l to 6.86 (SD 0.68) mmol/l) and increased in the control group by an average of 1.9% (6.90 (SD 0.49) mmol/l to 7.03 (0.61) mmol/l), the difference between groups being statistically significant (p = 0.025). No significant differences between groups were observed for LDL cholesterol, HDL cholesterol or triglyceride levels. General well-being improved significantly in both the treatment (11%) and control groups (9%) with no significant differences between groups. In conclusion, ALE consumption resulted in a modest but favourable statistically significant difference in total cholesterol after 12 weeks. In comparison with a previous trial, it is suggested that the apparent positive health status of the study population may have contributed to the modesty of the observed response. (C) 2008 Elsevier GmbH. All rights reserved.

Targeting the plasmepsin 4 orthologs of Plasmodium sp with "Double Drug" inhibitors

Plasmepsin 4 (PM4) is a digestive vacuole enzyme found in all Plasmodium species examined to date. While P. falciparum has three additional aspartic proteinases in its digestive vacuole in addition to plasmepsin 4, other Plasmodium species have only PM4 in their digestive vacuole. Therefore, PM4 may be a good target for the development of an antimalarial drug. This study presents data obtained with PM4s from several Plasmodium species. Low nanomolar K-i values have been observed for all PM4s studied.

Upper limb tremor suppression in ADL via an orthosis incorporating a controllable double viscous beam actuator

Neuromuscular disorders affect millions of people world-wide. Upper limb tremor is a common symptom, and due to its complex aetiology it is difficult to compensate for except, in particular cases by surgical intervention or drug therapy. Wearable devices that mechanically compensate for limb tremor could benefit a considerable number of patients, but the technology to assist suffers in this way is under-developed. In this paper we propose an innovative orthosis that can dynamically suppress pathological tremor, by applying viscous damping to the affected limb in a controlled manner. The orthosis design utilises a new actuator design based on Magneto-Rheological Fluids that efficiently deliver damping action in response to the instantaneous tremor frequency and amplitude.

Impedance control of redundant drive joints with double actuation

This paper proposes impedance control of redundant drive joints with double actuation (RDJ-DA) to produce compliant motions with the future goal of higher bandwidth. First, to reduce joint inertia, a double-input-single-output mechanism with one internal degree of freedom (DOF) is presented as part of the basic structure of the RDJ-DA. Next, the basic structure of RDJ-DA is further explained and its dynamics and statics are derived. Then, the impedance control scheme of RDJ-DA to produce compliant motions is proposed and the validity of the proposed controller is investigated using numerical examples.

Insights into redox cycling of sulfur and iron in peatlands using high-resolution diffusive equilibrium thin film (DET) gel probe sampling

High spatial resolution vertical profiles of pore-water chemistry have been obtained for a peatland using diffusive equilibrium in thin films (DET) gel probes. Comparison of DET pore-water data with more traditional depth-specific sampling shows good agreement and the DET profiling method is less invasive and less likely to induce mixing of pore-waters. Chloride mass balances as water tables fell in the early summer indicate that evaporative concentration dominates and there is negligible lateral flow in the peat. Lack of lateral flow allows element budgets for the same site at different times to be compared. The high spatial resolution of sampling also enables gradients to be observed that permit calculations of vertical fluxes. Sulfate concentrations fall at two sites with net rates of 1.5 and 5.0nmol cm− 3 day− 1, likely due to a dominance of bacterial sulfate reduction, while a third site showed a net gain in sulfate due to oxidation of sulfur over the study period at an average rate of 3.4nmol cm− 3 day− 1. Behaviour of iron is closely coupled to that of sulfur; there is net removal of iron at the two sites where sulfate reduction dominates and addition of iron where oxidation dominates. The profiles demonstrate that, in addition to strong vertical redox related chemical changes, there is significant spatial heterogeneity. Whilst overall there is evidence for net reduction of sulfate within the peatland pore-waters, this can be reversed, at least temporarily, during periods of drought when sulfide oxidation with resulting acid production predominates.

Comparison between pre-enrichment in single- or double-strength buffered peptone water for recovery of Salmonella enterica serovar Typhimurium DT104 from acidic marinade sauces containing spices.

The ability of the standard pre-enrichment procedure in buffered peptone water (BPW) to recover Salmonella Typhimurium from acidic marinade sauces containing spices was tested by inoculating marinade sauces with known numbers of an antibiotic-resistant marker strain of Salmonella Typhimurium DT104 prior to pre-enrichment. Viable numbers of salmonellae present in BPW after 24h incubation depended on the inoculum level. If initial cell numbers were low (below 103 cfu per 250 ml BPW) final cell concentrations were also low and, in some cases, no growth occurred. The problem was overcome by use of double-strength BPW that neutralised the acidity and allowed good recovery from otherwise inhibitory marinade sauces.

Contribution of the double layer to transient faradaic processes: implications for hydrodynamic modulated voltammetry of nanostructures

The electrochemistry of Pt nanostructured electrodes is investigated using hydrodynamic modulated voltammetry (HMV). Here a liquid crystal templating process is used to produce platinum-modified electrodes with a range of surface areas (roughness factor 42.4-280.8). The electroreduction of molecular oxygen at these nanostructured platinum surfaces is used to demonstrate the ability of HMV to discriminate between faradaic and nonfaradaic electrode reactions. The HMV approach shows that the reduction of molecular oxygen experiences considerable signal loss within the high pseudocapacitive region of the voltammetry. Evidence for the contribution of the double layer to transient mass transfer events is presented. In addition, a model circuit and appropriate theoretical analysis are used to illustrate the transient responses of a time variant faradaic component. This in conjunction with the experimental evidence shows that, far from being a passive component in this system, the double layer can contribute to HMV faradaic reactions under certain conditions.

The relationship between convection and sea surface temperature on intraseasonal timescales

The relationship between tropical convection, surface fluxes, and sea surface temperature (SST) on intraseasonal timescales has been examined as part of an investigation of the possibility that the intraseasonal oscillation is a coupled atmosphere–ocean phenomenon. The unique feature of this study is that 15 yr of data and the whole region from the Indian Ocean to the Pacific Ocean have been analyzed using lag-correlation analysis and compositing techniques. A coherent relationship between convection, surface fluxes, and SST has been found on intraseasonal timescales in the Indian Ocean, Maritime Continent, and west Pacific regions of the Tropics. Prior to the maximum in convection, there are positive shortwave and latent heat flux anomalies into the surface, followed by warm SST anomalies about 10 days before the convective maximum. Coincident with the convective maximum, there is a minimum in the shortwave flux, followed by a cooling due to increased evaporation associated with enhanced westerly wind stress, leading to negative SST anomalies about 10 days after the convection. The relationships are robust from year to year, including both phases of the El Niño–Southern Oscillation (ENSO) although the eastward extent of the region over which the relationship holds varies with the phase of ENSO, consistent with the variations in the eastward extent of the warm pool and westerly winds. The spatial scale of the anomalies is about 60° longitude, consistent with the scale of the intraseasonal oscillation. The spatial and temporal characteristics of the surface flux and SST perturbations are consistent with the surface flux variations forcing the ocean, and the magnitudes of the anomalies are consistent with mixed-layer depths appropriate to the Indian Ocean and west Pacific