WorldWideScience

Sample records for supply supplemental outcomes

  1. Supply and consumption of cardiovascular food supplements in lithuania

    OpenAIRE

    Liubartaitė, Elvyra

    2017-01-01

    Supply and Consumption of Cardiovascular Food Supplements in Lithuania. The aim - to evaluate supply and consumption of cardiovascular food supplements in Lithuania. Work tasks: • To collect information on food supplements for heart health. • To rate the range of food supplements for heart health sold in Lithuania. • To analyze the consumption of food supplements for heart health. Research data were collected through questionnaire data collection method based on January-February, 2017 data. 4...

  2. The impact of nutritional supplement intake on diet behavior and obesity outcomes.

    Directory of Open Access Journals (Sweden)

    Sven Anders

    Full Text Available After decades-old efforts to nudge consumers towards healthier lifestyles through dietary guidelines, diet-related diseases are on the rise. In addition, a growing share of U.S. consumers proactively chooses nutritional supplements as an alternative preventative way of maintaining good health, a $25.5 billion industry in the United States. This paper investigates possible linkages between the economics of consumer supplement choices and the relationship to important dietary and health outcomes. We use National Health and Nutrition Examination Survey (NHANES data to estimate the impact of nutritional supplements intake on respondent's body weight outcomes, controlling for diet quality.: The focus of this article is to determine whether nutritional supplements takers differ from non-takers with regard to their health outcomes when controlling for differences in diet quality, based on individual Healthy Eating Index (HEI-2010 score. The analysis applies treatment effects estimators that account for the selection bias and endogeneity of self-reported behavior and diet-health outcomes. The analysis demonstrates a negative association between supplement intake and BMI but no significant effect on an individual's diet quality. Our findings suggest that individuals proactively invest into their health by taking nutritional supplements instead of improving diet quality through more nutritious food choices. Our results provide important contributions to the literature on a key food policy issue. Knowledge of the determinants of supplement demand in the context of strong diet-health trends should also be helpful to stakeholders in the U.S. produce sector in their competition over consumer market share.

  3. 14 CFR 121.643 - Fuel supply: Nonturbine and turbo-propeller-powered airplanes: Supplemental operations.

    Science.gov (United States)

    2010-01-01

    ... operating nontransport category airplanes type certificated after December 31, 1964, to fly for 30 minutes...-powered airplanes: Supplemental operations. 121.643 Section 121.643 Aeronautics and Space FEDERAL AVIATION... Flight Release Rules § 121.643 Fuel supply: Nonturbine and turbo-propeller-powered airplanes...

  4. The effect of omega-3 supplementation on pregnancy outcomes by smoking status.

    Science.gov (United States)

    Kuper, Spencer G; Abramovici, Adi R; Jauk, Victoria C; Harper, Lorie M; Biggio, Joseph R; Tita, Alan T

    2017-10-01

    Smoking during pregnancy is associated with adverse maternal and neonatal outcomes such as preterm delivery, intrauterine growth restriction, stillbirth, and low birth weight. Because smoking causes oxidative stress, some have suggested using antioxidants to counteract the effects of oxidative stress. Smokers have lower serum levels of omega-3 fatty acids, an important antioxidant, and thus, investigating whether omega-3 supplementation in smokers reduces adverse maternal and neonatal outcomes represents an important area of research. To investigate whether the antioxidant effect of omega-3 fatty acid supplementation on the incidence of adverse pregnancy outcomes differs between smokers and nonsmokers. Secondary analysis of a multicenter randomized controlled trial of omega-3 supplementation for preterm delivery prevention in women with a singleton pregnancy and a history of a previous singleton spontaneous preterm delivery. Subjects were randomized to begin omega-3 or placebo before 22 weeks, which was continued until delivery. All women received 17 alpha-hydroxyprogesterone caproate intramuscularly weekly beginning between 16 and 20 weeks of gestation and continued until 36 weeks of gestation or delivery, whichever occurred first. The primary outcome was spontaneous preterm delivery. Secondary outcomes were indicated preterm delivery, any preterm delivery (spontaneous and indicated), pregnancy-associated hypertension (gestational hypertension and preeclampsia), a neonatal composite (retinopathy of prematurity, intraventricular hemorrhage grade III or IV, patent ductus arteriosus, necrotizing enterocolitis, sepsis, respiratory morbidity, or perinatal death), low birth weight (omega-3 supplementation versus placebo in each subgroup. Zelen tests were performed to test for homogeneity of effect in smokers and nonsmokers. Of 851 subjects included in the analysis, 136 (16%) smoked. Baseline characteristics between omega-3 and placebo groups did not differ in smokers or

  5. Does supplementation of in-vitro culture medium with melatonin improve IVF outcome in PCOS?

    Science.gov (United States)

    Kim, Mi Kyoung; Park, Eun A; Kim, Hyung Joon; Choi, Won Yun; Cho, Jung Hyun; Lee, Woo Sik; Cha, Kwang Yul; Kim, You Shin; Lee, Dong Ryul; Yoon, Tae Ki

    2013-01-01

    Human pre-ovulatory follicular fluid (FF) contains a higher concentration of melatonin than serum. The aim of this study was to evaluate the effect of melatonin supplementation of culture medium on the clinical outcomes of an in-vitro maturation (IVM) IVF-embryo transfer programme for patients with polycystic ovarian syndrome (PCOS). Melatonin concentrations in the culture media of granulosa cells (GC) or cumulus-oocyte-complexes (COC) were measured and the clinical outcomes after using IVM media with or without melatonin were analysed. In the culture media of GC or COC, melatonin concentrations gradually increased. When human chorionic gonadotrophin priming protocols were used, implantation rates in the melatonin-supplemented group were higher than those of the non-supplemented control group (PPregnancy rates were also higher, although not significantly. The findings suggest that the addition of melatonin to IVM media may improve the cytoplasmic maturation of human immature oocytes and subsequent clinical outcomes. It is speculated that follicular melatonin may be released from luteinizing GC during late folliculogenesis and that melatonin supplementation may be used to improve the clinical outcomes of IVM IVF-embryo transfer. Melatonin is primarily produced by the pineal gland and regulates a variety of important central and peripheral actions related to circadian rhythms and reproduction. Interestingly, human pre-ovulatory follicular fluid contains a higher concentration of melatonin than serum. However, in contrast to animal studies, the direct role of melatonin on oocyte maturation in the human system has not yet been investigated. So, the aim of the study was to evaluate the effect of melatonin supplementation of culture medium on the clinical outcome of an in-vitro maturation (IVM) IVF-embryo transfer programme for PCOS patients. The melatonin concentrations in culture medium of granulosa cells (GC) or cumulus-oocyte-complexes (COC) were measured and the

  6. The impact of antioxidant supplementation on clinical outcomes in ...

    African Journals Online (AJOL)

    Methodology: A systematic review and meta-analysis of the English literature was performed to determine the effect of antioxidant micronutrient supplementation on clinically important outcomes in the critically ill. Pubmed, Google Scholar and Science Direct electronic databases were searched for papers published ...

  7. Effect of balanced protein energy supplementation during pregnancy on birth outcomes

    Directory of Open Access Journals (Sweden)

    Bhutta Zulfiqar A

    2011-04-01

    Full Text Available Abstract Background The nutritional status of the mother prior to and during pregnancy plays a vital role in fetal growth and development, and maternal undernourishment may lead to adverse perinatal outcomes including intrauterine growth restriction (IUGR. Several macronutrient interventions had been proposed for adequate protein and energy supplementation during pregnancy. The objective of this paper was to review the effect of balanced protein energy supplementation during pregnancy on birth outcomes. This paper is a part of a series of reviews undertaken for getting estimates of effectiveness of an intervention for input to Lives Saved Tool (LiST model. Methods A literature search was conducted on PubMed, Cochrane Library and WHO regional data bases to identify randomized trials (RCTs and quasi RCTs that evaluated the impact of balanced protein energy supplementation in pregnancy. Balanced protein energy supplementation was defined as nutritional supplementation during pregnancy in which proteins provided less than 25% of the total energy content. Those studies were excluded in which the main intervention was dietary advice to pregnant women for increase in protein energy intake, high protein supplementation (i.e. supplementation in which protein provides at least 25% of total energy content, isocaloric protein supplementation (where protein replaces an equal quantity of non-protein energy content, or low energy diet to pregnant women who are either overweight or who exhibit high weight gain earlier in gestation. The primary outcomes were incidence of small for gestational age (SGA birth, mean birth weight and neonatal mortality. Quality of evidence was evaluated according to the Child Health Epidemiology Reference group (CHERG adaptation of Grading of Recommendations Assessment, Development and Evaluation (GRADE criteria. Results The final number of studies included in our review was eleven comprising of both RCTs and quasi-RCTs. Our meta

  8. Managed groundwater development for water-supply security in Sub ...

    African Journals Online (AJOL)

    What is the scope for promoting much increased groundwater use for irrigated agriculture, and how might the investment risks be reduced and sustainable outcomes ensured? • How can the demand to expand urban groundwater use, for both further supplementing municipal water-supply systems and for direct in situ water ...

  9. Rumen microbial protein supply as estimated from purine derivative excretion on sheep receiving faba beans (vicia faba as supplement delivered at different feeding frequencies

    Directory of Open Access Journals (Sweden)

    Asmuddin Natsir

    2008-06-01

    Full Text Available Rapid and extensive degradation of faba beans (Vicia faba by ruminal microbes can result in substantial and undesirable N loss from the rumen. The purpose of this study was to test the hypothesis that offering faba beans as a supplement more than once a day to sheep receiving a combination of oaten chaff and lucerne chaff as a basal diet will increase microbial protein supply to the intestines. The experiment was conducted in a Latin square design (4 x 4 using four mature merino sheep. The treatments were: T0 = basal diet ad libitum + nil supplements, T1 = T0 + faba beans (FB fed once daily, T2 = T0 + FB fed twice daily, T3 = T0 + FB fed 8 times daily. The basal diet was given once per day at 09:00 in the morning while FB were given at the rate of approximately 0.5% of live body weight and delivered according to the treatment protocol. Urinary excretion of purine derivative (PD was used to estimate microbial protein supply. The results indicated that even though treatment statistically had no effects on total urine output, PD excretion in the urine, PD absorbed, estimated microbial N supply, and the efficiency of rumen microbial protein synthesis, provision of supplement to sheep numerically improved microbial N supply by 92% compared to that of control group. However, there were no differences within the supplemented group. Therefore, it is concluded that feeding faba beans more than once a day was unnecessary.

  10. Geographic inequities in liver allograft supply and demand: does it affect patient outcomes?

    Science.gov (United States)

    Rana, Abbas; Kaplan, Bruce; Riaz, Irbaz B; Porubsky, Marian; Habib, Shahid; Rilo, Horacio; Gruessner, Angelika C; Gruessner, Rainer W G

    2015-03-01

    Significant geographic inequities mar the distribution of liver allografts for transplantation. We analyzed the effect of geographic inequities on patient outcomes. During our study period (January 1 through December 31, 2010), 11,244 adult candidates were listed for liver transplantation: 5,285 adult liver allografts became available, and 5,471 adult recipients underwent transplantation. We obtained population data from the 2010 United States Census. To determine the effect of regional supply and demand disparities on patient outcomes, we performed linear regression and multivariate Cox regression analyses. Our proposed disparity metric, the ratio of listed candidates to liver allografts available varied from 1.3 (region 11) to 3.4 (region 1). When that ratio was used as the explanatory variable, the R(2) values for outcome measures were as follows: 1-year waitlist mortality, 0.23 and 1-year posttransplant survival, 0.27. According to our multivariate analysis, the ratio of listed candidates to liver allografts available had a significant effect on waitlist survival (hazards ratio, 1.21; 95% confidence interval, 1.04-1.40) but was not a significant risk factor for posttransplant survival. We found significant differences in liver allograft supply and demand--but these differences had only a modest effect on patient outcomes. Redistricting and allocation-sharing schemes should seek to equalize regional supply and demand rather than attempting to equalize patient outcomes.

  11. The impact of supply management on environmental performance outcomes

    Science.gov (United States)

    Tate, Wendy L.; Ellram, Lisa M.; Carter, Craig R.

    2004-12-01

    Environmentally responsible manufacturing is concerned with minimizing the environmental impact of products from development to end-of-life disposal or remanufacture. Environmental pressures from customers, regulation, legislation and competition have made organizations more aware of the impact that products have on the natural environment. This study focuses on environmental concerns during the early stages of product design. We examine these concerns with a specific focus on the involvement of supply management personnel, inter-organizational supplier relationships and a determination of how environmental issues affect supplier selection and supply base management. The literature on environmental supplier and purchasing involvement in product development and environmental supplier selection criteria and codes of conduct is reviewed. Following this, secondary data from the websites of environmentally proactive organizations will be gathered to examine what type of tracking is used for suppliers. Finally, discussions with proactive organizations will be presented during the conference that explore the role of supply management personnel in capturing, measuring, quantifying and reporting on the environmental costs and benefits associated with its suppliers. This research provides insights into how the involvement of supply management can improve the environmental performance outcomes of an organization.

  12. Trends in pregnancy outcomes in Malawian adolescents receiving antimalarial and hematinic supplements

    NARCIS (Netherlands)

    Msyamboza, Kelias; Savage, Emma; Kalanda, Gertrude; Kazembe, Peter; Gies, Sabine; d'Alessandro, Umberto; Brabin, Bernard J.

    2010-01-01

    Objective. To describe pregnancy outcomes of adolescent and adult primigravidae receiving antimalarials and hematinic supplementation and compare findings with a survey in this area a decade earlier. Design. Cross-sectional surveys in intervention and control sites. Setting. Community, antenatal and

  13. Effect of melatonin supplementation on pregnancy outcome in Wistar-Kyoto and Sprague-Dawley rats.

    Science.gov (United States)

    Singh, Harbindar Jeet; Saleh, Hisham Ibrahim; Gupalo, Sergey; Omar, Effat

    2013-04-25

    Although melatonin supplementation is known to influence numerous physiological functions, little is however known of its effects on pregnancy outcome. This study investigated the effects of melatonin supplementation on pregnancy outcome in Wistar-Kyoto (WKY) and Sprague-Dawley (SD) rats aged 12-13 weeks. Upon confirmation of proestrus, each female rat was housed overnight with a male of the same strain. On the next morning, following confirmation of mating (vaginal smear), WKY female rats were isolated into individual metabolic cages and given 0, 25, 50 or 100 mg/kg per day of melatonin in drinking water from day 1 of pregnancy to day 21 postpartum. SD females were given 0 or 100 mg/kg per day of melatonin. Maternal weight, duration of pregnancy, litter size, birth weight and body weight of pups up to day 42, and pup mortality were recorded. Data were analyzed using ANOVA for repeated measures. Compared to controls, maternal weight gain during pregnancy was significantly lower in melatonin-supplemented dams (P melatonin-supplemented dams (P melatonin (P melatonin was significantly lower than controls (P melatonin respectively, and all pup deaths occurred after day 21 of weaning. The results suggest that melatonin supplementation during antenatal and postpartum period appears to adversely affect litter size, pup growth and mortality in WKY and SD rats. The precise mechanism causing the death is not clear.

  14. Psychology of Supplementation in Sport and Exercise: Motivational Antecedents and Biobehavioral Outcomes

    Science.gov (United States)

    Lutz, Rafer; Arent, Shawn

    Research concerning the physiological and biobehavioral effects of supplements commonly used in sport or exercise settings has multiplied rapidly over the last decade. However, less attention has been directed to understanding the motivational pathways leading to sport and exercise supplement use. This chapter summarizes known usage rates for sport/fitness supplements and describes motivational theories and constructs that may be of use for understanding individuals' use of these substances. In this respect, we contend that researchers should consider behavioral approaches, the theory of planned behavior, balance theory, achievement goal theory, social physique anxiety, and muscle dysmorphia as useful for developing an understanding of the psychological influences on supplement use. For some of the latter theories/constructs, research has already shown support for their explanatory abilities, whereas research is scant and the utility for understanding sport/exercise supplement use is yet to be determined for many of the theories. In addition to describing the motivation behind supplement use, this chapter summarizes the biobehavioral effects of a select group of supplements commonly used to improve performance, fitness, or health. Specifically, we consider psychobiological effects of caffeine, creatine, Ginkgo biloba, and St. John's wort related to enhanced arousal, improved memory and cognition, enhanced brain function and protection, and reduced depression. There is promising initial evidence for the efficacy of these compounds in producing favorable psychological outcomes, although certain shortcomings of many studies on these compounds must be taken into account before reaching definitive conclusions.

  15. Folic acid supplementation during pregnancy for maternal health and pregnancy outcomes.

    Science.gov (United States)

    Lassi, Zohra S; Salam, Rehana A; Haider, Batool A; Bhutta, Zulfiqar A

    2013-03-28

    During pregnancy, fetal growth causes an increase in the total number of rapidly dividing cells, which leads to increased requirements for folate. Inadequate folate intake leads to a decrease in serum folate concentration, resulting in a decrease in erythrocyte folate concentration, a rise in homocysteine concentration, and megaloblastic changes in the bone marrow and other tissues with rapidly dividing cells To assess the effectiveness of oral folic acid supplementation alone or with other micronutrients versus no folic acid (placebo or same micronutrients but no folic acid) during pregnancy on haematological and biochemical parameters during pregnancy and on pregnancy outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2012) and we contacted major organisations working in micronutrient supplementation, including UNICEF Nutrition Section, World Health Organization (WHO) Maternal and Reproductive Health, WHO Nutrition Division, and National Center on Birth defects and Developmnetal Disabilities, US Centers for Disease Control and Prevention (CDC). All randomised, cluster-randomised and cross-over controlled trials evaluating supplementation of folic acid alone or with other micronutrients versus no folic acid (placebo or same micronutrients but no folic acid) in pregnancy. Two review authors independently assessed trials for inclusion, assessed risk of bias and extracted data. Data were checked for accuracy. Thirty-one trials involving 17,771 women are included in this review. This review found that folic acid supplementation has no impact on pregnancy outcomes such as preterm birth (risk ratio (RR) 1.01, 95% confidence interval (CI) 0.73 to 1.38; three studies, 2959 participants), and stillbirths/neonatal deaths (RR 1.33, 95% CI 0.96 to 1.85; three studies, 3110 participants). However, improvements were seen in the mean birthweight (mean difference (MD) 135.75, 95% CI 47.85 to 223.68). On the other hand, the review

  16. Does oral carbohydrate supplementation improve labour outcome? A systematic review and individual patient data meta-analysis.

    Science.gov (United States)

    Malin, G L; Bugg, G J; Thornton, J; Taylor, M A; Grauwen, N; Devlieger, R; Kardel, K R; Kubli, M; Tranmer, J E; Jones, N W

    2016-03-01

    Labour is a period of significant physical activity. The importance of carbohydrate intake to improve outcome has been recognised in sports medicine and general surgery. To assess the effect of oral carbohydrate supplementation on labour outcomes. MEDLINE (1966-2014), Embase, the Cochrane Library and clinical trial registries. Randomised controlled trials (RCT) of women randomised to receive oral carbohydrate in labour (inclusion criteria. Six authors responded, four supplied data (n = 691). Three studies used isotonic drinks (one placebo-controlled, two compared with standard care), and one an advice booklet regarding carbohydrate intake. The mean difference in energy intake between the intervention and control groups was small [three studies, 195 kilocalories (kcal), 95% CI 118-273]. There was no difference in the risk of caesarean section (RR 1.15, 95% CI 0.83- 1.61), instrumental birth (RR 1.26, 95% CI 0.96-1.66) or syntocinon augmentation (RR 0.99, 95% CI 0.86-1.13). Length of labour was similar (mean difference -3.15 minutes, 95% CI -35.14 to 41.95). Restricting the analysis to primigravid women did not affect the result. Oral carbohydrates did not increase the risk of vomiting (RR 1.09, 95% CI 0.78-1.52) or 1-minute Apgar score labour outcome. Oral carbohydrate does not affect labour. But the difference between intervention and control equals 10 teaspoons sugar. © 2016 Royal College of Obstetricians and Gynaecologists.

  17. Association between oral nutritional supplementation and clinical outcomes among patients with ESRD.

    Science.gov (United States)

    Cheu, Christine; Pearson, Jeffrey; Dahlerus, Claudia; Lantz, Brett; Chowdhury, Tania; Sauer, Peter F; Farrell, Robert E; Port, Friedrich K; Ramirez, Sylvia P B

    2013-01-01

    Oral nutritional supplementation (ONS) was provided to ESRD patients with hypoalbuminemia as part of Fresenius Medical Care Health Plan's (FMCHP) disease management. This study evaluated the association between FMCHP's ONS program and clinical outcomes. Analyses included FMCHP patients with ONS indication (n=470) defined as 2-month mean albumin management setting.

  18. High-dose docosahexaenoic acid supplementation of preterm infants: respiratory and allergy outcomes.

    Science.gov (United States)

    Manley, Brett J; Makrides, Maria; Collins, Carmel T; McPhee, Andrew J; Gibson, Robert A; Ryan, Philip; Sullivan, Thomas R; Davis, Peter G

    2011-07-01

    Docosahexaenoic acid (DHA) has been associated with downregulation of inflammatory responses. To report the effect of DHA supplementation on long-term atopic and respiratory outcomes in preterm infants. This study is a multicenter, randomized controlled trial comparing the outcomes for preterm infants DHA diet) or soy oil (standard-DHA) capsules. Data collected included incidence of bronchopulmonary dysplasia (BPD) and parental reporting of atopic conditions over the first 18 months of life. Six hundred fifty-seven infants were enrolled (322 to high-DHA diet, 335 to standard), and 93.5% completed the 18-month follow-up. There was a reduction in BPD in boys (relative risk [RR]: 0.67 [95% confidence interval (CI): 0.47-0.96]; P=.03) and in all infants with a birth weight of DHA group at either 12 or 18 months (RR: 0.41 [95% CI: 0.18-0.91]; P=.03) and at either 12 or 18 months in boys (RR: 0.15 [0.03-0.64]; P=.01). There was no effect on asthma, eczema, or food allergy. DHA supplementation for infants of Pediatrics.

  19. Randomised studies of income supplementation: a lost opportunity to assess health outcomes.

    Science.gov (United States)

    Connor, J; Rodgers, A; Priest, P

    1999-11-01

    Despite the wealth of evidence linking low income to ill health, there is little information from randomised studies on how much and how quickly these risks can be reversed by improvements in income. To conduct a systematic review of randomised studies of income supplementation, with particular reference to health outcomes. Extensive searches of electronic databases and contact with previous authors. As well as searching for trials that were specifically designed to assess the effects of increased income, studies of winners and losers of lotteries were also sought: if winning is purely chance, such studies are, in effect, randomised trials of increased income. Ten relevant studies were identified, all conducted in North America, mostly in the late 1960s and 1970s. Five trials were designed to assess the effects of income supplementation on workforce participation and randomised a total of 10,000 families to 3-5 years of various combinations of minimum income guarantees and reduced tax rates. Two trials were designed to assess re-offending rates in recently released prisoners and randomised a total of 2400 people to 3-6 months of benefits. One trial was designed to assess housing allowances and randomised 3500 families to three years of income supplements. One trial assessed the health effects of 12 months of income supplementation in 54 people with severe mental illness. Finally, one study compared three groups of people who won different amounts of money in a state lottery. In all these studies the interventions resulted in increases in income of at least one fifth. However, no reliable analyses of health outcome data are available. Extensive opportunities to reliably assess the effects of increases in income on health outcomes have been missed. Such evidence might have increased the consideration of potential health effects during deliberations about policies that have major implications for income, such as taxation rates, benefit policies, and minimum wage

  20. Effect of multiple micronutrient supplementation during pregnancy on maternal and birth outcomes

    Directory of Open Access Journals (Sweden)

    Yakoob Mohammad

    2011-04-01

    Full Text Available Abstract Objectives/background Given the widespread prevalence of micronutrient deficiencies in developing countries, supplementation with multiple micronutrients rather than iron-folate alone, could be of potential benefit to the mother and the fetus. These benefits could relate to prevention of maternal complications and reduction in other adverse pregnancy outcomes such as small-for-gestational age (SGA births, low birth weight, stillbirths, perinatal and neonatal mortality. This review evaluates the evidence of the impact of multiple micronutrient supplements during pregnancy, in comparison with standard iron-folate supplements, on specific maternal and pregnancy outcomes of relevance to the Lives Saved Tool (LiST. Data sources/review methods A systematic review of randomized controlled trials was conducted. Search engines used were PubMed, the Cochrane Library, the WHO regional databases and hand search of bibliographies. A standardized data abstraction and Child Health Epidemiology Reference (CHERG adaptation of the Grading of Recommendations Assessment, Development and Evaluation (GRADE technique were used for data abstraction and overall quality of evidence. Meta-analyses were performed to calculate summary estimates of utility to the LiST model for the specified outcome of incidence of SGA births. We also evaluated the potential impact of multiple micronutrients on neonatal mortality according to the proportion of deliveries occurring in facilities (using a threshold of 60% to indicate functionality of health systems for skilled births. Results We included 17 studies for detailed data abstraction. There was no significant benefit of multiple micronutrients as compared to iron folate on maternal anemia in third trimester [Relative risk (RR = 1.03; 95% confidence interval (CI: 0.87 – 1.22 (random model]. Our analysis, however, showed a significant reduction in SGA by 9% [RR = 0.91; 95% CI: 0.86 – 0.96 (fixed model]. In the fixed model

  1. Long-term outcome on renal replacement therapy in patients who previously received a keto acid-supplemented very-low-protein diet.

    Science.gov (United States)

    Chauveau, Philippe; Couzi, Lionel; Vendrely, Benoit; de Précigout, Valérie; Combe, Christian; Fouque, Denis; Aparicio, Michel

    2009-10-01

    The consequences of a supplemented very-low-protein diet remain a matter of debate with regard to patient outcome before or after the onset of renal replacement therapy. We evaluated the long-term clinical outcome during maintenance dialysis and/or transplantation in patients who previously received a supplemented very-low-protein diet. We assessed the outcome of 203 patients who received a supplemented very-low-protein diet for >3 mo (inclusion period: 1985-2000) and started dialysis after a mean diet duration of 33.1 mo (4-230 mo). The survival rate in the whole cohort was 79% and 63% at 5 and 10 y, respectively. One hundred two patients continued with chronic dialysis during the entire follow-up, and 101 patients were grafted at least once. Patient outcomes were similar to those of the French Dialysis Registry patients for the dialysis group and similar to the 865 patients who were transplanted in Bordeaux during the same period for the transplant group. There was no correlation between death rate and duration of diet. The lack of correlation between death rate and duration of diet and the moderate mortality rate observed during the first 10 y of renal replacement therapy confirm that a supplemented very-low-protein diet has no detrimental effect on the outcome of patients with chronic kidney disease who receive renal replacement therapy.

  2. Medication supply, healthcare outcomes and healthcare expenses: longitudinal analyses of patients with type 2 diabetes and hypertension.

    Science.gov (United States)

    Chen, Chi-Chen; Blank, Robert H; Cheng, Shou-Hsia

    2014-09-01

    Patients with chronic conditions largely depend on proper medications to maintain health. This study aims to examine, for patients with diabetes and hypertension, whether the appropriateness of the quantity of drug obtained is associated with favorable healthcare outcomes and lower expenses. This study utilized a longitudinal design with a seven-year follow-up period from 2002 to 2009 under a universal health insurance program in Taiwan. The patients under study were those aged 18 years or older and newly diagnosed with type 2 diabetes or hypertension in 2002. Generalized estimating equations were performed to examine the relationship between medication supply and health outcomes as well as expenses. The results indicate that while compared with patients with an appropriate medication supply, patients with either an undersupply or an oversupply of medications tended to have poorer healthcare outcomes. The study also found that an excess supply of medications for patients with diabetes or hypertension resulted in higher total healthcare expenses. Either an undersupply or an oversupply of medication was associated with unfavorable healthcare outcomes, and that medication oversupply was associated with the increased consumption of health resources. Our findings suggest that improving appropriate medication supply is beneficial for the healthcare system. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Effect of Zinc Supplementation on Growth Outcomes in Children under 5 Years of Age

    Directory of Open Access Journals (Sweden)

    Enju Liu

    2018-03-01

    Full Text Available (1 Background: The effects of zinc supplementation on child growth, and prior reviews of these studies, have shown mixed results. We aim to systematically review and meta-analyze randomized controlled trials evaluating effects of preventive zinc supplementation for 3 months or longer during pregnancy or in children up to age 5 years on pregnancy outcomes and child growth; (2 Methods: We searched PubMed, EMBASE, Cochrane Library, Web of Science, and trial registries for eligible trials up to October 10, 2017. Inclusion selection and data extractions were performed independently and in duplicate. Study quality was evaluated by the Cochrane Risk of Bias tool. Findings were pooled using random effects meta-analysis, with heterogeneity assessed by I2 and τ2 statistic, stratified analyses, and meta-regression, and publication bias by Egger’s and Begg’s tests; (3 Results: Seventy-eight trials with 34,352 unique participants were identified, including 24 during pregnancy and 54 in infancy/childhood. Maternal zinc supplementation did not significantly increase birth weight (weighted mean difference (WMD = 0.08 kg, 95%CI: −0.05, 0.22 or decrease the risk of low birth weight (RR = 0.76, 95%CI: 0.52–1.11. Zinc supplementation after birth increased height (WMD = 0.23 cm, 95%CI: 0.09–0.38, weight (WMD = 0.14 kg, 95%CI: 0.07–0.21, and weight-for-age Z-score (WMD = 0.04, 95%CI: 0.001–0.087, but not height-for-age Z-score (WMD = 0.02, 95%CI: −0.01–0.06 or weight-for-height Z score (WMD = 0.02, 95%CI: −0.03–0.06. Child age at zinc supplementation appeared to modify the effects on height (P-interaction = 0.002 and HAZ (P-interaction = 0.06, with larger effects of supplementation starting at age ≥2 years (WMD for height = 1.37 cm, 95%CI: 0.50–2.25; WMD for HAZ = 0.12, 95%CI: 0.05–0.19. No significant effects of supplementation were found on the risk of stunting, underweight or wasting; (4 Conclusion: Although the possibility of

  4. Intermittent oral iron supplementation during pregnancy (Review)

    Science.gov (United States)

    Peña-Rosas, Juan Pablo; De-Regil, Luz Maria; Dowswell, Therese; Viteri, Fernando E

    2014-01-01

    Background Anaemia is a frequent condition during pregnancy, particularly among women from developing countries who have insufficient iron intake to meet increased iron needs of both the mother and the fetus. Traditionally, gestational anaemia has been prevented with the provision of daily iron supplements throughout pregnancy, but adherence to this regimen due to side effects, interrupted supply of the supplements, and concerns about safety among women with an adequate iron intake, have limited the use of this intervention. Intermittent (i.e. one, two or three times a week on non-consecutive days) supplementation with iron alone or in combination with folic acid or other vitamins and minerals has recently been proposed as an alternative to daily supplementation. Objectives To assess the benefits and harms of intermittent supplementation with iron alone or in combination with folic acid or other vitamins and minerals to pregnant women on neonatal and pregnancy outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (23 March 2012). We also searched the WHO International Clinical Trials Registry Platform (ICTRP) for ongoing studies and contacted relevant organisations for the identification of ongoing and unpublished studies (23 March 2012). Selection criteria Randomised or quasi-randomised trials. Data collection and analysis We assessed the methodological quality of trials using standard Cochrane criteria. Two review authors independently assessed trial eligibility, extracted data and conducted checks for accuracy. Main results This review includes 21 trials from 13 different countries, but only 18 trials (with 4072 women) reported on our outcomes of interest and contributed data to the review. All of these studies compared daily versus intermittent iron supplementation. Three studies provided iron alone, 12 iron+folic acid and three more iron plus multiple vitamins and minerals. Their methodological quality was mixed

  5. Does specialist physician supply affect pediatric asthma health outcomes?

    Science.gov (United States)

    Filler, Guido; Kovesi, Tom; Bourdon, Erik; Jones, Sarah Ann; Givelichian, Laurentiu; Rockman-Greenberg, Cheryl; Gilliland, Jason; Williams, Marion; Orrbine, Elaine; Piedboeuf, Bruno

    2018-04-05

    Pediatrician and pediatric subspecialist density varies substantially among the various Canadian provinces, as well as among various states in the US. It is unknown whether this variability impacts health outcomes. To study this knowledge gap, we evaluated pediatric asthma admission rates within the 2 Canadian provinces of Manitoba and Saskatchewan, which have similarly sized pediatric populations and substantially different physician densities. This was a retrospective cross-sectional cohort study. Health regions defined by the provincial governments, have, in turn, been classified into "peer groups" by Statistics Canada, on the basis of common socio-economic characteristics and socio-demographic determinants of health. To study the relationship between the distribution of the pediatric workforce and health outcomes in Canadian children, asthma admission rates within comparable peer group regions in both provinces were examined by combining multiple national and provincial health databases. We generated physician density maps for general practitioners, and general pediatricians practicing in Manitoba and Saskatchewan in 2011. At the provincial level, Manitoba had 48.6 pediatricians/100,000 child population, compared to 23.5/100,000 in Saskatchewan. There were 3.1 pediatric asthma specialists/100,000 child population in Manitoba and 1.4/100,000 in Saskatchewan. Among peer-group A, the differences were even more striking. A significantly higher number of patients were admitted in Saskatchewan (590.3/100,000 children) compared to Manitoba (309.3/100,000, p < 0.0001). Saskatchewan, which has a lower pediatrician and pediatric asthma specialist supply, had a higher asthma admission rate than Manitoba. Our data suggest that there is an inverse relationship between asthma admissions and pediatrician and asthma specialist supply.

  6. A randomised trial of enteral glutamine supplementation for very preterm children showed no beneficial or adverse long-term neurodevelopmental outcomes.

    Science.gov (United States)

    Twilhaar, E Sabrina; de Kieviet, Jorrit F; Oosterlaan, Jaap; van Elburg, Ruurd M

    2018-04-01

    This study evaluated the long-term effects of enteral glutamine supplementation on neurodevelopmental outcomes of a Dutch cohort of very preterm children at 13 years of age. The cohort was enrolled in a randomised placebo-controlled trial between 2001 and 2003 in which infants received glutamine- or alanine-supplemented enteral nutrition during the first month of life. Participants were invited for follow-up at a mean age of 13.30 years. Motor, neurocognitive, academic and behavioural outcomes were assessed in 61 children. No differences were found between the groups regarding motor, intellectual, academic and behavioural functioning. Forward span visuospatial working memory performance was better in the controls (crude/adjusted model: d = 0.67/0.64, p = 0.02/0.02), but no difference was found for backward span. After the data were adjusted for confounders, the groups differed regarding parent-rated attention (crude/adjusted model: d = 0.47/0.73, p = 0.07/0.003), but both groups scored within the normal range. This was the first study on the long-term effects of enteral glutamine supplementation on the neurodevelopmental outcomes of very preterm children. Our study provided no evidence that enteral glutamine supplementation had any beneficial or adverse effects on the children's motor, neurocognitive, academic and behavioural outcomes at 13 years of age. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  7. Multiple supplements for beef heifers on pasture during the dry season: nutritional characteristics

    Directory of Open Access Journals (Sweden)

    Renata Pereira da Silva-Marques

    2015-02-01

    Full Text Available The objective was to evaluate levels of multiple supplements supplied to beef heifers in low supply of pasture on intake and nutrients digestibility, pH and concentration of ruminal ammonia nitrogen, nitrogen balance, synthesis and microbial efficiency. Five Nellore heifers with initial body weight of 344.00 ± 21.10 kg and average initial age of 22 months were used. The following supplements were evaluated as fed to the animals: control (mineral supplement and supplementation levels of 2, 4, 6 and 8 kg/animal/day, composing the following percentages of body weight (BW: 0.55, 1.11, 1.66 and 2.22%, respectively. The experimental design was a Latin square with five replications and five supplements. Intakes of total dry matter, crude protein (CP and total digestible nutrients, and total apparent digestibility of dry matter, crude protein, total carbohydrates and no fiber carbohydrates increased linearly (P <0.0001 and dry matter intake of forage decreased (P <0.0001 with supplementation levels. Supplementation strategies promoted reduction on ruminal pH (P = 0.0343 and increased concentration of ruminal ammonia nitrogen (NH3-N (P = 0.0004 before the supply of supplements, and after, this NH3-N presented quadratic behavior (P = 0.0023. Nitrogen intake, excretion of urea in urine and nitrogen excretion in feces increased linearly (P <0.0001 according to supplementation levels. The supply of high levels of multiple supplements reduces forage intake and presents itself as an alternative to cattle maintained in a systems with low supply of pasture in the dry season.

  8. Initiatives and outcomes of green supply chain management implementation by Chinese manufacturers.

    Science.gov (United States)

    Zhu, Qinghua; Sarkis, Joseph; Lai, Kee-hung

    2007-10-01

    This paper aims to explore the green supply chain management (GSCM) initiatives (implementation) of various manufacturing industrial sectors in China and examine the links between GSCM initiatives and performance outcomes. We conducted a survey to collect data from four typical manufacturing industrial sectors in China, namely, power generating, chemical/petroleum, electrical/electronic and automobile, and received 171 valid organizational responses for data analysis. Analysis of variance (ANOVA) was used to analyze the data. The results are consistent with our prediction that the different manufacturing industry types display different levels of GSCM implementation and outcomes. We specifically found that the electrical/electronic industry has relatively higher levels of GSCM implementation and achieves better performance outcomes than the other three manufacturer types. Implications of the results are discussed and suggestions for further research on the implementation of GSCM are offered.

  9. 14 CFR 25.1441 - Oxygen equipment and supply.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Oxygen equipment and supply. 25.1441... Oxygen equipment and supply. (a) If certification with supplemental oxygen equipment is requested, the... oxygen available in each source of supply. (d) The oxygen flow rate and the oxygen equipment for...

  10. Reactor auxiliary cooling facility and coolant supplying method therefor

    International Nuclear Information System (INIS)

    Ando, Koji; Kinoshita, Shoichiro.

    1996-01-01

    A reactor auxiliary cooling facility of the present invention comprises a coolant recycling line for recycling coolants by way of a reactor auxiliary coolant pump and a cooling load, a gravitational surge tank for supplying coolants to the coolant recycling line and a supplemental water supplying line for supplying a supply the supplemental water to the tank. Then, a pressurization-type supply water surge tank is disposed for operating the coolant recycling line upon performing an initial system performance test in parallel with the gravitational surge tank. With such a constitution, the period of time required from the start of the installation of reactor auxiliary cooling facilities to the completion of the system performance test can be shortened at a reduced cost without enlarging the scale of the facility. (T.M.)

  11. Reactor auxiliary cooling facility and coolant supplying method therefor

    Energy Technology Data Exchange (ETDEWEB)

    Ando, Koji; Kinoshita, Shoichiro

    1996-06-07

    A reactor auxiliary cooling facility of the present invention comprises a coolant recycling line for recycling coolants by way of a reactor auxiliary coolant pump and a cooling load, a gravitational surge tank for supplying coolants to the coolant recycling line and a supplemental water supplying line for supplying a supply the supplemental water to the tank. Then, a pressurization-type supply water surge tank is disposed for operating the coolant recycling line upon performing an initial system performance test in parallel with the gravitational surge tank. With such a constitution, the period of time required from the start of the installation of reactor auxiliary cooling facilities to the completion of the system performance test can be shortened at a reduced cost without enlarging the scale of the facility. (T.M.)

  12. 14 CFR 23.1441 - Oxygen equipment and supply.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Oxygen equipment and supply. 23.1441... Miscellaneous Equipment § 23.1441 Oxygen equipment and supply. (a) If certification with supplemental oxygen..., during the flight, the quantity of oxygen available in each source of supply. (d) Each required flight...

  13. The Effect of Intermittent Antenatal Iron Supplementation on Maternal and Infant Outcomes in Rural Viet Nam: A Cluster Randomised Trial

    Science.gov (United States)

    Hanieh, Sarah; Ha, Tran T.; Simpson, Julie A.; Casey, Gerard J.; Khuong, Nguyen C.; Thoang, Dang D.; Thuy, Tran T.; Pasricha, Sant-Rayn; Tran, Thach D.; Tuan, Tran; Dwyer, Terence; Fisher, Jane; Biggs, Beverley-Ann

    2013-01-01

    Background Anemia affects over 500 million women, and in pregnancy is associated with impaired maternal and infant outcomes. Intermittent antenatal iron supplementation is an attractive alternative to daily dosing; however, the impact of this strategy on infant outcomes remains unclear. We compared the effect of intermittent antenatal iron supplementation with daily iron supplementation on maternal and infant outcomes in rural Viet Nam. Methods and Findings This cluster randomised trial was conducted in Ha Nam province, Viet Nam. 1,258 pregnant women (<16 wk gestation) in 104 communes were assigned to daily iron–folic acid (IFA), twice weekly IFA, or twice weekly multiple micronutrient (MMN) supplementation. Primary outcome was birth weight. Mean birth weight was 3,148 g (standard deviation 416). There was no difference in the birth weights of infants of women receiving twice weekly IFA compared to daily IFA (mean difference [MD] 28 g; 95% CI −22 to 78), or twice weekly MMN compared to daily IFA (MD −36.8 g; 95% CI −82 to 8.2). At 32 wk gestation, maternal ferritin was lower in women receiving twice weekly IFA compared to daily IFA (geometric mean ratio 0.73; 95% CI 0.67 to 0.80), and in women receiving twice weekly MMN compared to daily IFA (geometric mean ratio 0.62; 95% CI 0.57 to 0.68), but there was no difference in hemoglobin levels. Infants of mothers who received twice weekly IFA had higher cognitive scores at 6 mo of age compared to those who received daily IFA (MD 1.89; 95% CI 0.23 to 3.56). Conclusions Twice weekly antenatal IFA or MMN did not produce a clinically important difference in birth weight, when compared to daily IFA supplementation. The significant improvement in infant cognitive outcomes at 6 mo of age following twice weekly antenatal IFA requires further exploration, and provides additional support for the use of intermittent, rather than daily, antenatal IFA in populations with low rates of iron deficiency. Trial registration

  14. 76 FR 67721 - PNE Energy Supply, LLC;

    Science.gov (United States)

    2011-11-02

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER12-186-000] PNE Energy Supply, LLC; Supplemental Notice that Initial Market-Based Rate Filing Includes Request for Blanket... Supply, LLC's application for market-based rate authority, with an accompanying rate tariff, noting that...

  15. Efficacy and safety outcomes in vitamin D supplement users in the fingolimod phase 3 trials.

    Science.gov (United States)

    Hongell, Kira; Silva, Diego G; Ritter, Shannon; Meier, Daniela Piani; Soilu-Hänninen, Merja

    2018-02-01

    Low serum levels of 25-hydroxyvitamin D have been associated with worse outcomes in multiple sclerosis (MS) patients treated with interferon-beta. Association of vitamin D nutrition on the outcomes of other MS therapies has been studied less. Whether patients in the phase 3 fingolimod trials using vitamin D supplements have better clinical, MRI and safety outcomes than non-users. Pooled data from phase 3 FREEDOMS trials was analyzed post hoc. Vitamin D use was defined as 'non-users' (n = 562), 'casual users' (n = 157) and 'daily users' (usage 100% time in the study, n = 110). Expanded Disability Status Scale change from baseline to month 24, and annual relapse rate and proportion of patients with relapses were similar across the vitamin D user groups. Proportion of patients free of new/enlarging T2 lesions significantly favored vitamin D 'daily users' versus 'non-users'. Mean number of lesions were lower and proportion of patients free of gadolinium-enhanced T1-lesions were higher in the 'daily users'. At month 12, percent brain volume change was significantly lower in the 'daily users' versus 'non-users' and remained low at month 24 (non-significant). Incidence of depression was lower for vitamin D 'daily users' (non-significant). We observed improved MRI outcomes on percent brain volume change and proportion of patients free of new/enlarging T2 lesions, and a trend of less depression in the 'daily users' of vitamin D supplement in patients in the FREEDOMS trials.

  16. Supplement to the Annual Energy Outlook 1993

    International Nuclear Information System (INIS)

    1993-01-01

    The Supplement to the Annual Energy Outlook 1993 is a companion document to the Energy Information Administration's (EIA) Annual Energy Outlook 1993 (AEO). Supplement tables provide the regional projections underlying the national data and projections in the AEO. The domestic coal, electric power, commercial nuclear power, end-use consumption, and end-use price tables present AEO forecasts at the 10 Federal Region level. World coal tables provide data and projections on international flows of steam coal and metallurgical coal, and the oil and gas tables provide the AEO oil and gas supply forecasts by Oil and Gas Supply Regions and by source of supply. All tables refer to cases presented in the AEO, which provides a range of projections for energy markets through 2010

  17. Energy and Protein Supplementation Does Not Affect Protein and Amino Acid Kinetics or Pregnancy Outcomes in Underweight Indian Women.

    Science.gov (United States)

    Dwarkanath, Pratibha; Hsu, Jean W; Tang, Grace J; Anand, Pauline; Thomas, Tinku; Thomas, Annamma; Sheela, C N; Kurpad, Anura V; Jahoor, Farook

    2016-02-01

    In India, the prevalence of low birth weight is high in women with a low body mass index (BMI), suggesting that underweight women are not capable of providing adequate energy and protein for fetal growth. Furthermore, as pregnancy progresses, there is increased need to provide methyl groups for methylation reactions associated with the synthesis of new proteins and, unlike normal-BMI American women, low-BMI Indian women are unable to increase methionine transmethylation and remethylation rates as pregnancy progresses from trimester 1 to 3. This also negatively influences birth weight. The aim was to determine the effect of dietary supplementation with energy and protein from 12 ± 1 wk of gestation to time of delivery compared with no supplement on pregnancy outcomes, protein kinetics, and the fluxes of the methyl group donors serine and glycine. Protein kinetics and serine and glycine fluxes were measured by using standard stable isotope tracer methods in the fasting and postprandial states in 24 pregnant women aged 22.9 ± 0.7 y with low BMIs [BMI (in kg/m(2)) ≤18.5] at 12 ± 1 wk (trimester 1) and 30 ± 1 wk (trimester 3) of gestation. After the first measurement, subjects were randomly assigned to either receive the supplement (300 kcal/d, 15 g protein/d) or no supplement. Supplementation had no significant effect on any variable of pregnancy outcome, and except for fasting state decreases in leucine flux (125 ± 7.14 compared with 113 ± 5.06 μmol ⋅ kg(-1) ⋅ h(-1); P = 0.04) and nonoxidative disposal (110 ± 6.97 compared with 101 ± 3.69 μmol ⋅ kg(-1) ⋅ h(-1); P = 0.02) from trimesters 1 to 3, it had no effect on any other leucine kinetic variable or urea, glycine, and serine fluxes. We conclude that in Indian women with a low BMI, supplementation with energy and protein from week 12 of pregnancy to time of delivery does not improve pregnancy outcome, whole-body protein kinetics, or serine and glycine fluxes. © 2016 American Society for Nutrition.

  18. Association between B vitamins supplementation and risk of cardiovascular outcomes: a cumulative meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Chi Zhang

    Full Text Available BACKGROUND: Observational studies suggest that B vitamin supplementation reduces cardiovascular risk in adults, but this association remains controversial. This study aimed to summarize the evidence from randomized controlled trials (RCTs investigating B vitamin supplementation for the primary or secondary prevention of major adverse cardiovascular outcomes and to perform a cumulative meta-analysis to determine the evidence base. METHODOLOGY AND PRINCIPAL FINDINGS: In April 2013, we searched PubMed, Embase, and the Cochrane Library to identify relevant RCTs. We included RCTs investigating the effect of B vitamin supplementation on cardiovascular outcome. Relative risk (RR was used to measure the effect using a random-effect model. Statistical heterogeneity scores were assessed using the Q statistic. We included data on 57,952 individuals from 24 RCTs: 12 primary prevention trials and 12 secondary prevention trials. In 23 of these trials, 10,917 major adverse cardiovascular events (MACE occurred; in 20 trials, 7,203 deaths occurred; in 15 trials, 3,422 cardiac deaths occurred; in 19 trials, 3,623 myocardial infarctions (MI occurred; and in 18 trials, 2,465 strokes occurred. B vitamin supplementation had little or no effect on the incidence of MACE (RR, 0.98; 95% confidence interval [CI]: 0.93-1.03; P = 0.37, total mortality (RR, 1.01; 95% CI: 0.97-1.05; P = 0.77, cardiac death (RR, 0.96; 95% CI: 0.90-1.02; P = 0.21, MI (RR, 0.99; 95% CI: 0.93-1.06; P = 0.82, or stroke (RR, 0.94; 95% CI: 0.85-1.03; P = 0.18. CONCLUSION/SIGNIFICANCE: B vitamin supplementation, when used for primary or secondary prevention, is not associated with a reduction in MACE, total mortality, cardiac death, MI, or stroke.

  19. Determinants of dietary supplement use--healthy individuals use dietary supplements.

    Science.gov (United States)

    Kofoed, Christina L F; Christensen, Jane; Dragsted, Lars O; Tjønneland, Anne; Roswall, Nina

    2015-06-28

    The prevalence of dietary supplement use varies largely among populations, and previous studies have indicated that it is high in the Danish population compared with other European countries. The diversity in supplement use across countries indicates that cultural and environmental factors could influence the use of dietary supplements. Only few studies investigating the use of dietary supplements have been conducted in the Danish population. The present cross-sectional study is based on 54,948 Danes, aged 50-64 years, who completed self-administrated questionnaires on diet, dietary supplements and lifestyle between 1993 and 1997. A health index including smoking, physical activity, alcohol and diet, and a metabolic risk index including waist circumference, urinary glucose and measured hypertension were constructed. Logistic regression was used to investigate these determinants in relation to the intake of dietary supplements. We found that 71 % of the participants were dietary supplement users; female sex, older age groups and higher educated participants were more likely to be users of any dietary supplements. One additional point in the health index was associated with 19, 16 and 9 % higher likelihood of being user of any, more common and less common supplements, respectively. In the metabolic risk index, one additional point was associated with 17 and 16 % lower likelihood of being user of any supplement and more common supplements, respectively. No significant association was found for less common supplement use. In conclusion, those with the healthiest lifestyle were more likely to use dietary supplements. Thus, lifestyle and dietary composition should be considered as confounders on supplement use and health outcomes.

  20. The effects of vitamin D supplementation on maternal and neonatal outcome: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Mahdieh Mojibian

    2015-11-01

    Full Text Available Background: Vitamin D supplementation during pregnancy has been supposed to defend against adverse gestational outcomes. Objective: This randomized clinical trial study was conducted to assess the effects of 50,000 IU of vitamin D every two weeks supplementation on the incidence of gestational diabetes (GDM, gestational hypertension, preeclampsia and preterm labor, vitamin D status at term and neonatal outcomes contrasted with pregnant women that received 400 IU vitamin D daily. Materials and Methods: 500 women with gestational age 12-16 weeks and serum 25 hydroxy vitamin D (25 (OH D less than 30 ng/ml randomly categorized in two groups. Group A received 400 IU vitamin D daily and group B 50,000 IU vitamin D every 2 weeks orally until delivery. Maternal and Neonatal outcomes were assessed in two groups. Results: The incidence of GDM in group B was significantly lower than group A (6.7% versus 13.4% and odds ratio (95% Confidence interval was 0.46 (0.24-0.87 (P=0.01. The mean ± SD level of 25 (OH D at the time of delivery in mothers in group B was significantly higher than A (37.9 ± 19.8 versus 27.2 ± 18.8 ng/ml, respectively (P=0.001. There were no differences in the incidence of preeclampsia, gestational hypertension, preterm labor, and low birth weight between two groups. The mean level of 25 (OH D in cord blood of group B was significantly higher than group A (37.9 ± 18 versus 29.7 ± 19ng/ml, respectively. Anthropometric measures between neonates were not significantly different. Conclusion: Our study showed 50,000 IU vitamin D every 2 weeks decreased the incidence of GDM.

  1. Inorganic and organic trace mineral supplementation in weanling pig diets

    Directory of Open Access Journals (Sweden)

    MARIA C. THOMAZ

    2015-06-01

    Full Text Available A study was conducted to evaluate the effects of dietary inorganic and organic trace minerals in two levels of supplementation regarding performance, diarrhea occurrence, hematological parameters, fecal mineral excretion and mineral retention in metacarpals and liver of weanling pigs. Seventy piglets weaned at 21 days of age with an average initial body weight of 6.70 ± 0.38 kg were allotted in five treatments: control diet (no added trace mineral premix; 50% ITMP (control diet with inorganic trace mineral premix supplying only 50% of trace mineral requirements; 50% OTMP (control diet with organic trace mineral premix supplying only 50% of trace mineral requirements; 100% ITMP (control diet with inorganic trace mineral premix supplying 100% of trace mineral requirements; and 100% OTMP (control diet with organic trace mineral premix supplying 100% of trace mineral requirements. Feed intake and daily weight gain were not affected by treatments, however, piglets supplemented by trace minerals presented better gain:feed ratio. No differences were observed at calcium, phosphorus, potassium, magnesium, sodium and sulfur excreted in feces per kilogram of feed intake. Treatments did not affect calcium, phosphorus, magnesium, sulfur and iron content in metacarpals. Trace mineral supplementation, regardless of level and source, improved the performance of piglets.

  2. Practical Issues in Evidence-Based Use of Performance Supplements: Supplement Interactions, Repeated Use and Individual Responses.

    Science.gov (United States)

    Burke, Louise M

    2017-03-01

    Current sports nutrition guidelines recommend that athletes only take supplements following an evidence-based analysis of their value in supporting training outcomes or competition performance in their specific event. While there is sound evidence to support the use of a few performance supplements under specific scenarios (creatine, beta-alanine, bicarbonate, caffeine, nitrate/beetroot juice and, perhaps, phosphate), there is a lack of information around several issues needed to guide the practical use of these products in competitive sport. First, there is limited knowledge around the strategy of combining the intake of several products in events in which performance benefits are seen with each product in isolation. The range in findings from studies involving combined use of different combinations of two supplements makes it difficult to derive a general conclusion, with both the limitations of individual studies and the type of sporting event to which the supplements are applied influencing the potential for additive, neutral or counteractive outcomes. The repeated use of the same supplement in sports involving two or more events within a 24-h period is of additional interest, but has received even less attention. Finally, the potential for individual athletes to respond differently, in direction and magnitude, to the use of a supplement seems real, but is hard to distinguish from normal day to day variability in performance. Strategies that can be used in research or practice to identify whether individual differences are robust include repeat trials, and the collection of data on physiological or genetic mechanisms underpinning outcomes.

  3. Monitoring and surveillance for multiple micronutrient supplements in pregnancy.

    Science.gov (United States)

    Mei, Zuguo; Jefferds, Maria Elena; Namaste, Sorrel; Suchdev, Parminder S; Flores-Ayala, Rafael C

    2017-12-22

    The World Health Organization (WHO) recommends iron-folic acid (IFA) supplementation during pregnancy to improve maternal and infant health outcomes. Multiple micronutrient (MMN) supplementation in pregnancy has been implemented in select countries and emerging evidence suggests that MMN supplementation in pregnancy may provide additional benefits compared to IFA alone. In 2015, WHO, the United Nations Children's Fund (UNICEF), and the Micronutrient Initiative held a "Technical Consultation on MMN supplements in pregnancy: implementation considerations for successful incorporation into existing programmemes," which included a call for indicators needed for monitoring, evaluation, and surveillance of MMN supplementation programmes. Currently, global surveillance and monitoring data show that overall IFA supplementation programmes suffer from low coverage and intake adherence, despite inclusion in national policies. Common barriers that limit the effectiveness of IFA-which also apply to MMN programmes-include weak supply chains, low access to antenatal care services, low-quality behaviour change interventions to support and motivate women, and weak or non-existent monitoring systems used for programme improvement. The causes of these barriers in a given country need careful review to resolve them. As countries heighten their focus on supplementation during pregnancy, or if they decide to initiate or transition into MMN supplementation, a priority is to identify key monitoring indicators to address these issues and support effective programmes. National and global monitoring and surveillance data on IFA supplementation during pregnancy are primarily derived from cross-sectional surveys and, on a more routine basis, through health and logistics management information systems. Indicators for IFA supplementation exist; however, the new indicators for MMN supplementation need to be incorporated. We reviewed practice-based evidence, guided by the WHO/Centers for Disease

  4. A randomised trial of enteral glutamine supplementation for very preterm children showed no beneficial or adverse long-term neurodevelopmental outcomes

    NARCIS (Netherlands)

    Twilhaar, E.S.; de Kieviet, J.F.; Oosterlaan, J.; van Elburg, R.M.

    2017-01-01

    Aim This study evaluated the long-term effects of enteral glutamine supplementation on neurodevelopmental outcomes of a Dutch cohort of very preterm children at 13 years of age. Methods The cohort was enrolled in a randomised placebo-controlled trial between 2001 and 2003 in which infants received

  5. A randomised trial of enteral glutamine supplementation for very preterm children showed no beneficial or adverse long-term neurodevelopmental outcomes

    NARCIS (Netherlands)

    Twilhaar, E. Sabrina; de Kieviet, Jorrit F.; Oosterlaan, Jaap; van Elburg, Ruurd M.

    2017-01-01

    This study evaluated the long-term effects of enteral glutamine supplementation on neurodevelopmental outcomes of a Dutch cohort of very preterm children at 13 years of age. The cohort was enrolled in a randomised placebo-controlled trial between 2001-2003 in which infants received glutamine- or

  6. Cost-effectiveness of age-related macular degeneration study supplements in the UK: combined trial and real-world outcomes data.

    Science.gov (United States)

    Lee, Aaron Y; Butt, Thomas; Chew, Emily; Agron, Elvira; Clemons, Traci E; Egan, Catherine A; Lee, Cecilia S; Tufail, Adnan

    2018-04-01

    To evaluate the cost-effectiveness of Age-Related Eye Disease Study (AREDS) 1 & 2 supplements in patients with either bilateral intermediate age-related macular degeneration, AREDS category 3, or unilateral neovascular age-related macular degeneration AMD (nAMD), AREDS category 4. A patient-level health state transition model based on levels of visual acuity in the better-seeing eye was constructed to simulate the costs and consequences of patients taking AREDS vitamin supplements. UK National Health Service (NHS). The model was populated with data from AREDS and real-world outcomes and resource use from a prospective multicentre national nAMD database study containing 92 976 ranibizumab treatment episodes. Two treatment approaches were compared: immediate intervention with AREDS supplements or no supplements. quality-adjusted life years (QALYs) and healthcare costs were accrued for each strategy, and incremental costs and QALYs were calculated for the lifetime of the patient. One-way and probabilistic sensitivity analyses were employed to test the uncertainty of the model. For AREDS category 3, the incremental cost-effectiveness ratio was £30 197. For AREDS category 4 compared with no intervention, AREDS supplements are more effective (10.59 vs 10.43 QALYs) and less costly (£52 074 vs 54 900) over the lifetime of the patient. The recommendation to publicly fund AREDS supplements to category 3 patients would depend on the healthcare system willingness to pay. In contrast, initiating AREDS supplements in AREDS category 4 patients is both cost saving and more effective than no supplement use and should therefore be considered in public health policy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Analysis of natural gas supply strategies at Fort Drum

    International Nuclear Information System (INIS)

    Stucky, D.J.; Shankle, S.A.; Anderson, D.M.

    1992-07-01

    This analysis investigates strategies for Fort Drum to acquire a reliable natural gas supply while reducing its gas supply costs. The purpose of this study is to recommend an optimal supply mix based on the life-cycle costs of each strategy analyzed. In particular, this study is intended to provide initial guidance as to whether or not the building and operating of a propane-air mixing station is a feasible alternative to the current gas acquisition strategy. The analysis proceeded by defining the components of supply (gas purchase, gas transport, supplemental fuel supply); identifying alternative options for each supply component; constructing gas supply strategies from different combinations of the options available for each supply component and calculating the life-cycle costs of each supply strategy under a set of different scenarios reflecting the uncertainty of future events

  8. SUPPLEMENTATION WITH VITAMINS C AND E DURING PREGNANCY FOR THE PREVENTION OF PREECLAMPSIA AND OTHER ADVERSE MATERNAL AND PERINATAL OUTCOMES: A SYSTEMATIC REVIEW AND METAANALYSIS

    Science.gov (United States)

    CONDE-AGUDELO, Agustín; ROMERO, Roberto; KUSANOVIC, Juan Pedro; HASSAN, Sonia

    2011-01-01

    OBJECTIVE To determine whether supplementation with vitamins C and E during pregnancy reduces the risk of preeclampsia and other adverse maternal and perinatal outcomes. STUDY DESIGN Systematic review and metaanalysis of randomized controlled trials. RESULTS Nine trials involving a total of 19,810 women were included. Overall, there were no significant differences between the vitamin and placebo groups in the risk of preeclampsia (9.6% versus 9.6%; relative risk 1.00, 95% confidence interval 0.92–1.09). Similar results were obtained when subgroup analyses were restricted to women at high risk or low/moderate risk for preeclampsia. Women supplemented with vitamins C and E were at increased risk of developing gestational hypertension and premature rupture of membranes, and a decreased risk of abruptio placentae. There were no significant differences between the vitamin and placebo groups in the risk of other adverse maternal or fetal/perinatal outcomes. CONCLUSION Supplementation with vitamins C and E during pregnancy does not prevent preeclampsia. PMID:21529757

  9. Fluid supplementation for neonatal unconjugated hyperbilirubinaemia.

    Science.gov (United States)

    Lai, Nai Ming; Ahmad Kamar, Azanna; Choo, Yao Mun; Kong, Juin Yee; Ngim, Chin Fang

    2017-08-01

    two major comparisons: IV fluid supplementation versus no fluid supplementation (six studies) and IV fluid supplementation versus oral fluid supplementation (one study). A total of 494 term, healthy newborn infants with unconjugated hyperbilirubinaemia were evaluated. All studies were at high risk of bias for blinding of care personnel, five studies had unclear risk of bias for blinding of outcome assessors, and most studies had unclear risk of bias in allocation concealment. There was low- to moderate-quality evidence for all major outcomes.In the comparison between IV fluid supplementation and no supplementation, no infant in either group developed bilirubin encephalopathy in the one study that reported this outcome. Serum bilirubin was lower at four hours postintervention for infants who received IV fluid supplementation (MD -34.00 μmol/L (-1.99 mg/dL), 95% CI -52.29 (3.06) to -15.71 (0.92); participants = 67, study = 1) (low quality of evidence, downgraded one level for indirectness and one level for suspected publication bias). Beyond eight hours postintervention, serum bilirubin was similar between the two groups. Duration of phototherapy was significantly shorter for fluid-supplemented infants, but the estimate was affected by heterogeneity which was not clearly explained (MD -10.70 hours, 95% CI -15.55 to -5.85; participants = 218; studies = 3; I² = 67%). Fluid-supplemented infants were less likely to require exchange transfusion (RR 0.39, 95% CI 0.21 to 0.71; RD -0.01, 95% CI -0.04 to 0.02; participants = 462; studies = 6; I² = 72%) (low quality of evidence, downgraded one level due to inconsistency, and another level due to suspected publication bias), and the estimate was similarly affected by unexplained heterogeneity. The frequencies of breastfeeding were similar between the fluid-supplemented and non-supplemented infants in days one to three based on one study (estimate on day three: MD 0.90 feeds, 95% CI -0.40 to 2.20; participants = 60) (moderate

  10. Children's emotional and behavioral problems and their mothers' labor supply.

    Science.gov (United States)

    Richard, Patrick; Gaskin, Darrell J; Alexandre, Pierre K; Burke, Laura S; Younis, Mustafa

    2014-01-01

    It has been documented that about 20% of children and adolescents suffer from a diagnosable mental or addictive disorder in the United States. The high prevalence of children's emotional and behavioral problems (EBP) might have a negative effect on their mothers' labor market outcomes because children with EBP require additional time for treatment. However, these children may require additional financial resources, which might promote mothers' labor supply. Previous studies have only considered chronic conditions in analyzing the impact of children's health on parental work activities. Moreover, most of these studies have not accounted for endogeneity in children's health. This article estimates the effects of children's EBP on their mothers' labor supply by family structure while accounting for endogeneity in children's health. We used the 1997 and 2002 Child Development Supplements (CDS) to the Panel Study of Income Dynamics (PSID). We used probit and bivariate probit models to estimate mothers' probability of employment, and tobit and instrumental variable tobit models to estimate the effects of children's EBP on their mothers' work hours. Findings show negative effects of children's EBP on their married mothers' employment and on their single mothers' work hours. © The Author(s) 2014.

  11. Short-term energy outlook annual supplement, 1993

    International Nuclear Information System (INIS)

    1993-01-01

    The Energy Information Administration (EIA) prepares quarterly, short-term energy supply, demand, and price projections for publication in February, May, August, and November in the Short-Term Energy Outlook (Outlook). An annual supplement analyzes the performance of previous forecasts, compares recent cases with those of other forecasting services, and discusses current topics related to the short-term energy markets. (See Short-Term Energy Outlook Annual Supplement, DOE/EIA-0202.) The forecast period for this issue of the Outlook extends from the third quarter of 1993 through the fourth quarter of 1994. Values for the second quarter of 1993, however, are preliminary EIA estimates (for example, some monthly values for petroleum supply and disposition are derived in part from weekly data reported in the Weekly Petroleum Status Report) or are calculated from model simulations using the latest exogenous information available (for example, electricity sales and generation are simulated using actual weather data). The historical energy data are EIA data published in the Monthly Energy Review, Petroleum Supply Monthly, and other EIA publications. Minor discrepancies between the data in these publications and the historical data in this Outlook are due to independent rounding

  12. Effects of biscuit-type feeding supplementation on the neurocognitive outcomes of HIV-affected school-age children: a randomized, double-blind, controlled intervention trial in Kenya

    Directory of Open Access Journals (Sweden)

    Kek Khee Loo

    2017-12-01

    Full Text Available Objective: To determine if meat or soy protein dietary supplementation will enhance the neurocognitive performance of HIV-affected children at-risk of malnutrition and food insecurity. Methods: A randomized, double-blind, controlled intervention trial evaluated the effect of nutritional supplementation on the neurocognitive outcomes of 49 HIV-affected school-age children in western Kenya. The intervention consisted in providing the mother, target child, and siblings with one of three isocaloric biscuit-type supplements – soy, wheat, or beef – on 5 days per week for 18 months. Neurocognitive outcomes of the target children were assessed by a battery of eight measures and followed up longitudinally for up to 24 months. Results: Mixed effects modeling demonstrated significant differences in the rates of increase over time among all three groups (F test degrees of freedom of 2, P<0.05 for Raven’s progressive matrices performance, but not for verbal meaning, arithmetic, digit span backward, forward, and total, embedded figure test, and Beery visual–motor integration scores. Conclusion: HIV-affected school-age children provided with soy protein supplementation showed greater improvement in nonverbal cognitive (fluid intelligence performance compared with peers who received isocaloric beef or wheat biscuits. Soy nutrients may have an enhancing effect on neurocognitive skills in HIV-affected school-age children.

  13. Use of micronutrient supplements among pregnant women in Alberta: results from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort.

    Science.gov (United States)

    Gómez, Mariel Fajer; Field, Catherine J; Olstad, Dana Lee; Loehr, Sarah; Ramage, Stephanie; McCargar, Linda J

    2015-10-01

    Maternal nutrient intake in the prenatal period is an important determinant of fetal growth and development and supports maternal health. Many women, however, fail to meet their prenatal nutrient requirements through diet alone and are therefore advised to consume nutrient supplements. The purpose of this study was to describe the use of natural health products (NHP) by pregnant women in each trimester of pregnancy. Women (n = 599) participating in the first cohort of the Alberta Pregnancy Outcomes and Nutrition (APrON) study completed an interviewer-administered supplement intake questionnaire during each trimester of pregnancy. NHP use was high, with >90% taking multivitamin/mineral supplements, and nearly half taking at least one additional single-nutrient supplement. Compliance with supplementation guidelines was high for folic acid (>90%), vitamin D (∼70%) and calcium (∼80%), but low for iron (<30%) and for all four nutrients together (≤11%). On average, women met or exceeded the recommended dietary allowance for folic acid, vitamin D and iron from NHPs alone, with median daily intakes of 1000 μg, 400 IU and 27 mg, respectively. The median calcium intake was 250 mg d(-1) . Up to 26% of women exceeded the tolerable upper intake level for folic acid and up to 19% did so for iron at some point of their pregnancy. Findings highlight the need to consider both dietary and supplemental sources of micronutrients when assessing the nutrient intakes of pregnant women. © 2013 John Wiley & Sons Ltd.

  14. Mineral supplementation for grazing ruminants

    International Nuclear Information System (INIS)

    McDowell, L.R.; Conrad, J.H.; Ellis, G.L.

    1986-01-01

    Grazing ruminants to which concentrate feeds cannot be economically fed must rely on self-feeding of mineral supplements. A number of factors affect mineral consumption of free-choice mixtures. Livestock exhibit little nutritional wisdom and will select palatable mixtures in preference to mixtures designed to meet their requirements. Palatability and appetite stimulators are often used to achieve a more uniform herd-wide consumption. It is best to formulate free-choice mixtures on the basis of analyses or other available data. However, when no information on mineral status is known, a free-choice complete mineral supplement is warranted. A 'complete' mineral mixture usually includes salt, a low fluoride P source, Ca, Co, Cu, I, Mn and Zn. Selenium, Mg, K, S, Fe or additional elements can be incorporated into a mineral supplement as new information suggests a need. The detriment to ruminant production caused by providing Ca, Se and Cu in excess can be greater than any benefit derived by providing a mineral supplement. In regions where high forage Mo predominates, three to five times the Cu content in mineral mixtures is needed to counteract Mo toxicity. Supplemental minerals are most critical during the wet season, when cattle are gaining weight rapidly and energy and protein supplies are adequate. Economic return on mineral supplementation is high. (author)

  15. Analysis of uranium supply to 2050

    International Nuclear Information System (INIS)

    Underhill, D.H.

    2002-01-01

    The 1999 uranium mine production was about 55% of the 61 500 tonnes uranium (t U) used by the nuclear industry, with the balance met by secondary supply. Based on a recent WEC-IIASA study which defines a wide range of possible future levels of nuclear electricity generation, it is estimated that by 2050 annual uranium requirements could increase to 177 000 and 283 000 t U respectively, in the mid and high cases, or fall to 52 000 t U in the low case. Cumulative requirements to 2050 for the low, mid and high cases are, respectively 3.39, 5.35 and 7.58 million t U. A new IAEA analysis describes how known uranium resources (RAR and EAR-1) plus undiscovered resources (EAR-II and SR), supplemented by secondary supplies, could be utilized to supply reactors to 2050. Secondary supplies include: existing inventories, blended down warhead material (LEU blended from HEU), MOX, Repu, and re-enrichment of tails. The methodology of this analysis estimates the amounts and annual deliveries of the secondary supply, plus non-market supply. The balance of demand is met from Market Based Production (MBP) or: 'Uranium produced at or below market price to satisfy requirements not met by other supply sources'. The analysis then evaluates the production role for 125 uranium deposits, which supply MBP considering individual deposit resources, production cost and capability, and timing. Production costs are classified from low ( $130/kgU). Annual supply and demand balancing is used to allocate the resources on an individual deposit basis, assuming use of the next lowest available cost production. Secondary supplies will continue to supplement mine production to about 2025, but their relative importance will decrease over the period. An analysis of the benefit of lowering the enrichment tails assay from 0.30% 235 U to 0.15% 235 U, when economically justified is also discussed. The report also discusses projected production cost trends to 2025 under the mid and high cases. The final

  16. Effect of maternal supplementation with vitamin E on the concentration of α-tocopherol in colostrum.

    Science.gov (United States)

    Melo, Larisse Rayanne Miranda de; Clemente, Heleni Aires; Bezerra, Dalila Fernandes; Dantas, Raquel Costa Silva; Ramalho, Héryka Myrna Maia; Dimenstein, Roberto

    To evaluate the effect of maternal supplementation with vitamin E on the concentration of α-tocopherol in colostrum and its supply to the newborn. This randomized clinical trial enrolled 99 healthy adult pregnant women; of these, 39 were assigned to the control group and 60 to the supplemented group. After an overnight fast, 5mL of blood and 2mL of colostrum were collected. After the first sampling (0h milk), the supplemented group received 400IU of supplementary vitamin E. Another 2mL milk aliquot was collected in both groups 24h after supplementation (24h milk). The samples were analyzed by high-performance liquid chromatography. The α-tocopherol content provided by colostrum was calculated by considering a daily intake of 396mL of milk and comparing the resulting value to the recommended daily intake for infants aged 0-6 months (4mg/day). The initial mean concentration of α-tocopherol in colostrum was 1509.3±793.7μg/dL in the control group and 1452.9±808.6μg/dL in the supplemented group. After 24h, the mean α-tocopherol concentration was 1650.6±968.7μg/dL in the control group (p>0.05) and 2346.9±1203.2μg/dL in the supplemented group (pvitamin E supply to the newborn to 9.3mg/day. Initially, 18 women in the supplemented group provided colostrum α-tocopherol contents below 4mg/day; after supplementation only six continued to provide less than the recommended amount. Maternal vitamin E supplementation increases the supply of the vitamin to the infant by providing more than twice the Recommended Daily Intake. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  17. OUTCOME OF ZINC SUPPLEMENTATION ON NUTRITIONAL INTAKE OF CKD PATIENTS

    Directory of Open Access Journals (Sweden)

    N. Sahni

    2012-06-01

    Conclusion: Zn supplementation alone failed to improve dietary intake as it seemed patients were scared to eat more/wrong/kidney unfriendly food in absence of clear dietary guidelines, but favorable results were observed when Zn supplementation was coupled with parametric, individualized dietary counseling which shows that role of diet counseling in removing food misconceptions & lack of knowledge is important to make any therapy effective. So there is a critical need for implementation of effective nutritional management strategies.

  18. Descriptive characteristics and health outcomes of the food by prescription nutrition supplementation program for adults living with HIV in Nyanza Province, Kenya.

    Science.gov (United States)

    Nagata, Jason M; Cohen, Craig R; Young, Sera L; Wamuyu, Catherine; Armes, Mary N; Otieno, Benard O; Leslie, Hannah H; Dandu, Madhavi; Stewart, Christopher C; Bukusi, Elizabeth A; Weiser, Sheri D

    2014-01-01

    The clinical effects and potential benefits of nutrition supplementation interventions for persons living with HIV remain largely unreported, despite awareness of the multifaceted relationship between HIV infection and nutrition. We therefore examined descriptive characteristics and nutritional outcomes of the Food by Prescription (FBP) nutrition supplementation program in Nyanza Province, Kenya. Demographic, health, and anthropometric data were gathered from a retrospective cohort of 1,017 non-pregnant adult patients who enrolled into the FBP program at a Family AIDS Care and Education Services (FACES) site in Nyanza Province between July 2009 and July 2011. Our primary outcome was FBP treatment success defined as attainment of BMI>20, and we used Cox proportional hazards to assess socio-demographic and clinical correlates of FBP treatment success. Mean body mass index was 16.4 upon enrollment into the FBP program. On average, FBP clients gained 2.01 kg in weight and 0.73 kg/m2 in BMI over follow-up (mean 100 days), with the greatest gains among the most severely undernourished (BMI 20, though 44.5% achieved a BMI increase ≥0.5. Greater BMI at baseline, younger age, male gender, and not requiring highly active antiretroviral therapy (HAART) were associated with a higher rate of attainment of BMI>20. This study reports significant gains in weight and BMI among patients enrolled in the FBP program, though only a minority of patients achieved stated programmatic goals of BMI>20. Future research should include well-designed prospective studies that examine retention, exit reasons, mortality outcomes, and long-term sustainability of nutrition supplementation programs for persons living with HIV.

  19. Calcium supplementation to prevent pre-eclampsia - a systematic ...

    African Journals Online (AJOL)

    Background. Calcium supplementation during pregnancy may prevent high blood pressure and preterm labour. Objective. To assess the effects of calcium supplementation during pregnancy on hypertensive disorders of pregnancy and related maternal and child adverse outcomes. Design. A systematic review of ...

  20. Using Soft Systems Methodology to Address Supply Chain Management Problems

    Directory of Open Access Journals (Sweden)

    Gulender Gencoglu

    2002-05-01

    Full Text Available This paper reports an investigation of if, and how, Soft Systems Methodology (SSM might.be used to facilitate better management of industry supply chains. In two workshops involving supply chain managers from the Textile Clothing and Footwear (TCF industry and industry facilitators, ways in which SSM techniques might supplement existing Supply Chain Management (SCM workshop approaches have been explored. Specifically, the placement of SSM techniques within a workshop setting, reactions to the techniques, perceived reasons for using SSM, together with strengths and difficulties encountered, have been examined.

  1. Muscle Mass and Weight Gain Nutritional Supplements

    Science.gov (United States)

    Campbell, Bill

    There are numerous sports supplements available that claim to increase lean body mass. However, for these sports supplements to exert any favorable changes in lean body mass, they must influence those factors regulating skeletal muscle hypertrophy (i.e., satellite cell activity, gene transcription, protein translation). If a given sports supplement does favorably influence one of these regulatory factors, the result is a positive net protein balance (in which protein synthesis exceeds protein breakdown). Sports supplement categories aimed at eliciting a positive net protein balance include anabolic hormone enhancers, nutrient timing pre- and postexercise workout supplements, anticatabolic supplements, and nitric oxide boosters. Of all the sports supplements available, only a few have been subject to multiple clinical trials with repeated favorable outcomes relative to increasing lean body mass. This chapter focuses on these supplements and others that have a sound theoretical rationale in relation to increasing lean body mass.

  2. Clinical Outcome And Arginine Serum of Acute Ischemic Stroke Patients Supplemented by Snakehead Fish Extract

    Science.gov (United States)

    Pudjonarko, Dwi; Retnaningsih; Abidin, Zainal

    2018-02-01

    Background: Levels of arginine associated with clinical outcome in acute ischemic stroke (AIS). Arginine is a protein needed to synthesis nitric oxide (NO), a potential vasodilator and antioxidant. Snakehead fish is a source of protein which has antioxidant activity. Snakehead fish contains mineral, vitamin, and amino acids. One of the amino acids that were found quite high in snakehead fish extract is arginine. The aim of this study was done to determine the effect of snakehead fish extracts (SFE) on serum arginin levels and clinical outcome of AIS patients. Methods: It was double-blind randomized pretest-posttest control group design, with. AIS patients were divided into two groups i.e. snakehead fish extracts (SFE) and control. SFE group were administered 15 grams SFE for 7 days . Arginine serum levels and clinical outcome (measured by National Institute of Health Stroke Scale = NIHSS) were measured before and after treatment, other related factors were also analyzed in Logistic regression. Results: A total of 42 subjects who were performed random allocation as SFE or control group. There was no differences in subject characteristics between the two groups. There was a differences Δ arginine serum levels between SFE and control (33.6±19.95 μmol/L 0.3±2.51 μmol/L pgender factor that affected on improvement of NIHSS (OR=7; p=0,01). Conclusion: There is Clinical outcome improvement and enhancement of arginine serum levels in AIS patient with snakehead fish extract supplementation.

  3. Effect of micronutrient supplementation on treatment outcomes in children with intrathoracic tuberculosis

    DEFF Research Database (Denmark)

    Lodha, Rakesh; Mukherjee, Aparna; Singh, Varinder

    2014-01-01

    BACKGROUND: Micronutrients play an important role in immune function. To our knowledge, there have been no comprehensive studies on the role of micronutrient supplementation in children with tuberculosis. OBJECTIVE: We assessed the effect of micronutrient supplementation in children treated...... with antituberculosis therapy (ATT). DESIGN: A randomized, double-blind, placebo-controlled trial that used a 2 × 2 factorial design was undertaken at 2 teaching hospitals in Delhi. Children with newly diagnosed intrathoracic tuberculosis were enrolled, and they received ATT together with daily supplementation for 6 mo...

  4. Maternal amino acid supplementation for intrauterine growth restriction

    Science.gov (United States)

    Brown, Laura D; Green, Alice S; Limesand, Sean W; Rozance, Paul J

    2011-01-01

    Maternal dietary protein supplementation to improve fetal growth has been considered as an option to prevent or treat intrauterine growth restriction. However, in contrast to balanced dietary supplementation, adverse perinatal outcomes in pregnant women who received high amounts of dietary protein supplementation have been observed. The responsible mechanisms for these adverse outcomes are unknown. This review will discuss relevant human and animal data to provide the background necessary for the development of explanatory hypotheses and ultimately for the development therapeutic interventions during pregnancy to improve fetal growth. Relevant aspects of fetal amino acid metabolism during normal pregnancy and those pregnancies affected by IUGR will be discussed. In addition, data from animal experiments which have attempted to determine mechanisms to explain the adverse responses identified in the human trials will be presented. Finally, we will suggest new avenues for investigation into how amino acid supplementation might be used safely to treat and/or prevent IUGR. PMID:21196387

  5. Natural gas annual 1993 supplement: Company profiles

    Energy Technology Data Exchange (ETDEWEB)

    1995-02-01

    The Natural Gas Annual provides information on the supply and disposition of natural gas to a wide audience including industry, consumers, Federal and State agencies, and educational institutions. This report, the Natural Gas Annual 1993 Supplement: Company Profiles, presents a detailed profile of 45 selected companies in the natural gas industry. The purpose of this report is to show the movement of natural gas through the various States served by the companies profiled. The companies in this report are interstate pipeline companies or local distribution companies (LDC`s). Interstate pipeline companies acquire gas supplies from company owned production, purchases from producers, and receipts for transportation for account of others. Pipeline systems, service area maps, company supply and disposition data are presented.

  6. Association between Oral Nutritional Supplementation and Clinical Outcomes among Patients with ESRD

    Science.gov (United States)

    Cheu, Christine; Pearson, Jeffrey; Dahlerus, Claudia; Lantz, Brett; Chowdhury, Tania; Sauer, Peter F.; Farrell, Robert E.; Port, Friedrich K.

    2013-01-01

    Summary Background and objectives Oral nutritional supplementation (ONS) was provided to ESRD patients with hypoalbuminemia as part of Fresenius Medical Care Health Plan’s (FMCHP) disease management. This study evaluated the association between FMCHP’s ONS program and clinical outcomes. Design, setting, participants, & measurements Analyses included FMCHP patients with ONS indication (n=470) defined as 2-month mean albumin <3.8 g/dl until reaching a 3-month mean ≥3.8 g/dl from February 1, 2006 to December 31, 2008. Patients did not receive ONS if deemed inappropriate or refused. Patients on ONS were compared with patients who were not, despite meeting ONS indication. Patients with ONS indication regardless of use were compared with Medicare patients with similar serum albumin levels from the 2007 Centers for Medicare and Medicaid Services Clinical Performance Measures Project (CPM). Cox models calculated adjusted hospitalization and mortality risks at 1 year. Results Among patients with indication for ONS, 276 received supplements and 194 did not. ONS use was associated with 0.058 g/dl higher serum albumin overall (P=0.02); this difference decreased by 0.001 g/dl each month (P=0.05) such that the difference was 0.052 g/dl (P=0.04) in month 6 and the difference was no longer significant in month 12 . In analyses based on ONS use, ONS patients had lower hospitalization at 1 year (68.4%; P<0.01) versus patients without ONS (88.7%), but there was no significant reduction in mortality risk (P=0.29). In analyses based on ONS indication, patients with indication had lower mortality at 1 year (16.2%) compared with CPM patients (23.4%; P<0.01). Conclusions These findings suggest that ONS use was associated with significantly lower hospitalization rates but had no significant effect on mortality in a disease management setting. PMID:23085729

  7. Effects of alpha-lipoic acid supplementation in different stages on growth performance, antioxidant capacity and meat quality in broiler chickens.

    Science.gov (United States)

    Guo, Z Y; Li, J L; Zhang, L; Jiang, Y; Gao, F; Zhou, G H

    2014-01-01

    This experiment was conducted to investigate the effect of basal dietary supplementation with 500 mg/kg alpha-lipoic acid (LA) on growth performance, antioxidant capacity and meat quality in different stages in broiler chickens. A total of 240 Arbor Acre chickens were randomly assigned into 4 treatment groups, each treatment containing 6 replicates of 10 chickens each. Group 1 was the control group without LA supplementation; Group 2 was supplied with LA in the starter period; Group 3 was supplied with LA in the grower period; and Group 4 was supplied with LA in the whole period. The results showed that LA supplementation improved average feed intake and body weight gain in all three experimental groups, especially in Group 2. LA supplementation significantly decreased abdominal fat yield in Groups 3 and 4. LA supplementation all improved hepatic total antioxidant capacity, the level of glutathione, the activities of total superoxide dismutase, catalase (CAT) and glutathione peroxidase, in particular in Group 4. LA supplementation decreased the activity of liver xanthine oxidase (XO) in all experimental groups, and that of liver monoamine oxidase in Group 3. The activities of liver CAT and XO in Group 2 were higher than that in Group 3. LA supplementation elevated the pH24 h and decreased drip loss in breast meat in Groups 3 and 4. In conclusion, LA supplementation can improve growth performance, antioxidant properties and meat quality in broiler chicken. LA supplementation in the starter period can improve growth performance and supplementation in the grower - and in the whole period can improve carcass characteristics. There was no significant difference in meat quality of broiler chickens fed on LA-supplemented diet in different stages.

  8. The impact of antioxidant supplementation on clinical outcomes in ...

    African Journals Online (AJOL)

    cells from the damaging effects of excess free radical build-up. The ... supplementation of vitamins and trace elements, particularly vitamin A, C, E, ... articles were found using manual searching, such as reviewing the reference lists of other ...

  9. Supplementation of prebiotics in infant formula

    Directory of Open Access Journals (Sweden)

    Močić Pavić A

    2014-06-01

    Full Text Available Ana Močić Pavić, Iva Hojsak Referral Center for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, Zagreb, Croatia Background: In recent years prebiotics have been added to infant formula to make it resemble breast milk more closely and to promote growth and development of beneficial intestinal microbiota. This review aims to present new data on the possible positive effects of prebiotics in infant formula on intestinal microbiota (bifidogenic and lactogenic effect and on clinical outcomes including growth, infections, and allergies. With that aim, a literature search of the Cochrane Central Register of Controlled Trials (CENTRAL, EMBASE, Scopus, PubMed/Medline, Web of Science, and Science Direct in the last 10 years (December 2003 to December 2013 was performed. Results: Altogether 24 relevant studies were identified. It was found that during intervention, prebiotics can elicit a bifidogenic and lactogenic effect. As far as clinical outcomes were concerned, 14 studies investigated the effect of infant formula supplemented with prebiotics on growth and found that there was no difference when compared with non-supplemented infant formula. All available data are insufficient to support prebiotic supplementation in order to reduce risk of allergies and infections. Conclusion: There is currently no strong evidence to recommend routine supplementation of infant formulas with prebiotics. Further well-designed clinical studies with long-term follow-up are needed. Keywords: prebiotics, infant formula, growth, allergy, infections, supplementation

  10. Ovarian arteries supply to the pelvic lesions: angiographic identification and endovascular interventional management

    International Nuclear Information System (INIS)

    Wang Maoqiang; Liu Fengyong; Duan Feng; Wang Zhongpu; Wang Zhijun; Song Lei

    2006-01-01

    Objective: To investigate the frequency of the ovarian arteries (OVA) supply to the pelvic lesions and to evaluate the safety of transcatheter arterial embolization (TAE) of the OVA. Methods: Ninety-six patients referred for hypogastric-uterine arterial chemoembolization or embolization underwent selective ovarian arteriography,including pelvic malignancies in 63 cases, uterine fibroid in 17, and obstetric hemorrhage in 16 cases. Mean patient age was 46 years (range, 16-62 years). TAE supplementally was performed in patients with OVA supply to the pelvic lesions, using polyvinyl alcohol particles, gelatin sponge particles, and microcoils. The frequency of OVA supply to the pelvic lesions, the predictive factors, the technique and clinical significances of OVA embolization, were evaluated. Results: Bilateral OVA were catheterized selectively in 58 patients, and unilateral OVA in 38 patients. Thirty-three women (34.4%) had at least one ovarian artery supplying the pelvic lesions, including pelvic malignancies in 18, the fibroid in 5, and obstetric hemorrhage in 10 cases. The higher incidence of OVA supply to the pelvic lesions was observed in patients with obstetric disorders (χ 2 =6.73, P=0.009), with history of the pelvic surgery (χ 2 =3.55, P=0.04), with post embolization of the uterine arteries (χ 2 =6.80, P=0.009), and in patients with dysplasia of uterine artery bilaterally or unilaterally (χ 2 =3.40, P=0.04). Technical success of OVA embolization was achieved in the 33 cases, without severe complications related to the procedure. Persistent bleeding from the vagina was seen in 4 patients with obstetric hemorrhage after hypogastric-uterine arterial embolization, their bleeding ceased immediately after supplemental OVA embolization. Four patients developed transient symptoms of ovarian dysfunction after the hypogastric-uterine and OVA embolization. Conclusion: About 34% of the pelvic lesions can be supplied by OVA. Supplemental TAE of OVA is a safe and

  11. Effect of maternal multiple micronutrient vs iron-folic acid supplementation on infant mortality and adverse birth outcomes in rural Bangladesh: the JiVitA-3 randomized trial.

    Science.gov (United States)

    West, Keith P; Shamim, Abu Ahmed; Mehra, Sucheta; Labrique, Alain B; Ali, Hasmot; Shaikh, Saijuddin; Klemm, Rolf D W; Wu, Lee S-F; Mitra, Maithilee; Haque, Rezwanul; Hanif, Abu A M; Massie, Allan B; Merrill, Rebecca Day; Schulze, Kerry J; Christian, Parul

    Maternal micronutrient deficiencies may adversely affect fetal and infant health, yet there is insufficient evidence of effects on these outcomes to guide antenatal micronutrient supplementation in South Asia. To assess effects of antenatal multiple micronutrient vs iron-folic acid supplementation on 6-month infant mortality and adverse birth outcomes. Cluster randomized, double-masked trial in Bangladesh, with pregnancy surveillance starting December 4, 2007, and recruitment on January 11, 2008. Six-month infant follow-up ended August 30, 2012. Surveillance included 127,282 women; 44,567 became pregnant and were included in the analysis and delivered 28,516 live-born infants. Median gestation at enrollment was 9 weeks (interquartile range, 7-12). Women were provided supplements containing 15 micronutrients or iron-folic acid alone, taken daily from early pregnancy to 12 weeks postpartum. The primary outcome was all-cause infant mortality through 6 months (180 days). Prespecified secondary outcomes in this analysis included stillbirth, preterm birth (<37 weeks), and low birth weight (<2500 g). To maintain overall significance of α = .05, a Bonferroni-corrected α = .01 was calculated to evaluate statistical significance of primary and 4 secondary risk outcomes (.05/5). Among the 22,405 pregnancies in the multiple micronutrient group and the 22,162 pregnancies in the iron-folic acid group, there were 14,374 and 14,142 live-born infants, respectively, included in the analysis. At 6 months, multiple micronutrients did not significantly reduce infant mortality; there were 764 deaths (54.0 per 1000 live births) in the iron-folic acid group and 741 deaths (51.6 per 1000 live births) in the multiple micronutrient group (relative risk [RR], 0.95; 95% CI, 0.86-1.06). Multiple micronutrient supplementation resulted in a non-statistically significant reduction in stillbirths (43.1 vs 48.2 per 1000 births; RR, 0.89; 95% CI, 0.81-0.99; P = .02) and significant

  12. Children’s Emotional and Behavioral Problems and Their Mothers’ Labor Supply

    Directory of Open Access Journals (Sweden)

    Patrick Richard PhD

    2014-11-01

    Full Text Available It has been documented that about 20% of children and adolescents suffer from a diagnosable mental or addictive disorder in the United States. The high prevalence of children’s emotional and behavioral problems (EBP might have a negative effect on their mothers’ labor market outcomes because children with EBP require additional time for treatment. However, these children may require additional financial resources, which might promote mothers’ labor supply. Previous studies have only considered chronic conditions in analyzing the impact of children’s health on parental work activities. Moreover, most of these studies have not accounted for endogeneity in children’s health. This article estimates the effects of children’s EBP on their mothers’ labor supply by family structure while accounting for endogeneity in children’s health. We used the 1997 and 2002 Child Development Supplements (CDS to the Panel Study of Income Dynamics (PSID. We used probit and bivariate probit models to estimate mothers’ probability of employment, and tobit and instrumental variable tobit models to estimate the effects of children’s EBP on their mothers’ work hours. Findings show negative effects of children’s EBP on their married mothers’ employment and on their single mothers’ work hours.

  13. Empiric potassium supplementation and increased survival in users of loop diuretics.

    Directory of Open Access Journals (Sweden)

    Charles E Leonard

    Full Text Available The effectiveness of the clinical strategy of empiric potassium supplementation in reducing the frequency of adverse clinical outcomes in patients receiving loop diuretics is unknown. We sought to examine the association between empiric potassium supplementation and 1 all-cause death and 2 outpatient-originating sudden cardiac death (SD and ventricular arrhythmia (VA among new starters of loop diuretics, stratified on initial loop diuretic dose.We conducted a one-to-one propensity score-matched cohort study using 1999-2007 US Medicaid claims from five states. Empiric potassium supplementation was defined as a potassium prescription on the day of or the day after the initial loop diuretic prescription. Death, the primary outcome, was ascertained from the Social Security Administration Death Master File; SD/VA, the secondary outcome, from incident, first-listed emergency department or principal inpatient SD/VA discharge diagnoses (positive predictive value = 85%.We identified 654,060 persons who met eligibility criteria and initiated therapy with a loop diuretic, 27% of whom received empiric potassium supplementation (N = 179,436 and 73% of whom did not (N = 474,624. The matched hazard ratio for empiric potassium supplementation was 0.93 (95% confidence interval, 0.89-0.98, p = 0.003 for all-cause death. Stratifying on initial furosemide dose, hazard ratios for empiric potassium supplementation with furosemide < 40 and ≥ 40 milligrams/day were 0.93 (0.86-1.00, p = 0.050 and 0.84 (0.79-0.89, p < 0.0001. The matched hazard ratio for empiric potassium supplementation was 1.02 (0.83-1.24, p = 0.879 for SD/VA.Empiric potassium supplementation upon initiation of a loop diuretic appears to be associated with improved survival, with a greater apparent benefit seen with higher diuretic dose. If confirmed, these findings support the use of empiric potassium supplementation upon initiation of a loop diuretic.

  14. Consumption of nutritional supplements among adolescents: usage and perceived benefits.

    Science.gov (United States)

    O'Dea, Jennifer A

    2003-02-01

    The aim of the study was to obtain rich qualitative data about the type of nutritional supplements and drinks consumed by adolescents, and the reasons for their consumption, with particular emphasis on the perceived benefits of nutritional supplementation. Semi-structured focus group interviews (n = 16) were conducted among 78 adolescents aged 11-18 years from a co-educational government high school. Participants reported consuming sports drinks, vitamin and mineral supplements, energy drinks, herbal supplements, guarana, creatine, high protein milk supplements, and coenzyme Q10. Reasons for supplement use included perceived short-term health benefits, prevention of illness, improved immunity, parental supply of supplements, taste, energy boost, better sports performance and to rectify a poor diet. Results suggest that some adolescents consume nutritional supplements, sports drinks and energy drinks for their perceived physiological benefits, and that they may not be aware of any potential risks. Health educators should be aware that adolescents seek specific health benefits from nutritional supplements and drinks, which may be better achieved through appropriate consumption of a nutritious diet. Health education programmes should incorporate the perceptions, aspirations and motivations of young people into the planning of interventions and activities in order to make them most relevant and effective.

  15. Identifying bottlenecks in the iron and folic acid supply chain in Bihar, India: a mixed-methods study.

    Science.gov (United States)

    Wendt, Amanda S; Stephenson, Rob; Young, Melissa F; Verma, Pankaj; Srikantiah, Sridhar; Webb-Girard, Amy; Hogue, Carol J; Ramakrishnan, Usha; Martorell, Reynaldo

    2018-04-12

    Maternal anaemia prevalence in Bihar, India remains high despite government mandated iron supplementation targeting pregnant women. Inadequate supply has been identified as a potential barrier to iron and folic acid (IFA) receipt. Our study objective was to examine the government health system's IFA supply and distribution system and identify bottlenecks contributing to insufficient IFA supply. Primary data collection was conducted in November 2011 and July 2012 across 8 districts in Bihar, India. A cross-sectional, observational, mixed methods approach was utilized. Auxiliary Nurse Midwives were surveyed on current IFA supply and practices. In-depth interviews (n = 59) were conducted with health workers at state, district, block, health sub-centre, and village levels. Overall, 44% of Auxiliary Nurse Midwives were out of IFA stock. Stock levels and supply chain practices varied greatly across districts. Qualitative data revealed specific bottlenecks impacting IFA forecasting, procurement, storage, disposal, lack of personnel, and few training opportunities for key players in the supply chain. Inadequate IFA supply is a major constraint to the IFA supplementation program, the extent of which varies widely across districts. Improvements at all levels of infrastructure, practices, and effective monitoring will be critical to strengthen the IFA supply chain in Bihar.

  16. Natural gas annual 1992: Supplement: Company profiles

    Energy Technology Data Exchange (ETDEWEB)

    1994-01-01

    The data for the Natural Gas Annual 1991 Supplement : Company Profiles are taken from Form EIA-176, (open quotes) Annual Report of Natural and Supplemental Gas Supply and Disposition (close quotes). Other sources include industry literature and corporate annual reports to shareholders. The companies appearing in this report are major interstate natural gas pipeline companies, large distribution companies, or combination companies with both pipeline and distribution operations. The report contains profiles of 45 corporate families. The profiles describe briefly each company, where it operates, and any important issues that the company faces. The purpose of this report is to show the movement of natural gas through the various States served by the 45 large companies profiled.

  17. Pharmaceutical supply chain risks: a systematic review

    Science.gov (United States)

    2013-01-01

    Introduction Supply of medicine as a strategic product in any health system is a top priority. Pharmaceutical companies, a major player of the drug supply chain, are subject to many risks. These risks disrupt the supply of medicine in many ways such as their quantity and quality and their delivery to the right place and customers and at the right time. Therefore risk identification in the supply process of pharmaceutical companies and mitigate them is highly recommended. Objective In this study it is attempted to investigate pharmaceutical supply chain risks with perspective of manufacturing companies. Methods Scopus, PubMed, Web of Science bibliographic databases and Google scholar scientific search engines were searched for pharmaceutical supply chain risk management studies with 6 different groups of keywords. All results found by keywords were reviewed and none-relevant articles were excluded by outcome of interests and researcher boundaries of study within 4 steps and through a systematic method. Results Nine articles were included in the systematic review and totally 50 main risks based on study outcome of interest extracted which classified in 7 categories. Most of reported risks were related to supply and supplier issues. Organization and strategy issues, financial, logistic, political, market and regulatory issues were in next level of importance. Conclusion It was shown that the majority of risks in pharmaceutical supply chain were internal risks due to processes, people and functions mismanagement which could be managed by suitable mitigation strategies. PMID:24355166

  18. Pharmaceutical supply chain risks: a systematic review.

    Science.gov (United States)

    Jaberidoost, Mona; Nikfar, Shekoufeh; Abdollahiasl, Akbar; Dinarvand, Rassoul

    2013-12-19

    Supply of medicine as a strategic product in any health system is a top priority. Pharmaceutical companies, a major player of the drug supply chain, are subject to many risks. These risks disrupt the supply of medicine in many ways such as their quantity and quality and their delivery to the right place and customers and at the right time. Therefore risk identification in the supply process of pharmaceutical companies and mitigate them is highly recommended. In this study it is attempted to investigate pharmaceutical supply chain risks with perspective of manufacturing companies. Scopus, PubMed, Web of Science bibliographic databases and Google scholar scientific search engines were searched for pharmaceutical supply chain risk management studies with 6 different groups of keywords. All results found by keywords were reviewed and none-relevant articles were excluded by outcome of interests and researcher boundaries of study within 4 steps and through a systematic method. Nine articles were included in the systematic review and totally 50 main risks based on study outcome of interest extracted which classified in 7 categories. Most of reported risks were related to supply and supplier issues. Organization and strategy issues, financial, logistic, political, market and regulatory issues were in next level of importance. It was shown that the majority of risks in pharmaceutical supply chain were internal risks due to processes, people and functions mismanagement which could be managed by suitable mitigation strategies.

  19. Using formative research to promote antenatal care attendance and iron folic acid supplementation in Zinder, Niger.

    Science.gov (United States)

    Hess, Sonja Y; Ouédraogo, Césaire T; Bamba, Ibrahim F; Wessells, K Ryan; Keith, Nancy; Faye, Thierno; Ndiaye, Banda; Doudou, Maimouna; Nielsen, Jennifer

    2018-04-01

    In Niger, use of antenatal care (ANC) and iron folic acid (IFA) supplements is suboptimal. The objectives of this paper are as follows: (a) to conduct formative research to understand barriers and beliefs among pregnant women related to ANC, IFA supplementation, and pregnancy outcomes; (b) assess the quality of currently provided ANC services; (c) use the findings to guide the development of programmatic interventions to improve coverage of ANC services and IFA supplementation of pregnant women. Structured in-home interviews (n = 72) and focus groups (n = 4) were conducted with pregnant women in 4 randomly selected villages in rural Zinder. ANC consultations (n = 33) were observed in 5 randomly selected health centres, and exit interviews were conducted with all pregnant women and seven health agents following these observations. During workshops with stakeholders, results of the formative research were interpreted, and programmatic interventions were developed. In home interviews, 72% of women reported having attended at least one ANC visit. They also reported husbands (71%), mothers (40%), and friends (33%) supporting ANC attendance. Among those having attended ANC, only 65% reported taking IFA the day prior to the interview. Three of five health centres visited had IFA in stock. Health staff did not provide IFA supplements during 18 of 33 observed ANC consultations of which only 7 cases could be explained by the lack of IFA supplements in stock. Findings were used to design a 3-pronged intervention: (a) behaviour change communication activities in communities; (b) quality improvement activities in health centres to strengthen ANC; and (c) provision of key supplies required for ANC. © 2017 John Wiley & Sons Ltd.

  20. results of an interview with pregnant women in Berlin concerning supplements

    OpenAIRE

    Alex, Stefania

    2010-01-01

    The maternal nutritional status before and during pregnancy is a determinant for the health of the mother and her child. Besides the higher need of macronutrients to get enough energy, the supply with micronutrients plays an important role. Especially a sufficient intake of iodine, folate and iron is essential for the health of the mother and the development of the child. This is difficult to reach without supplementation. Therefore a supplementation with 100-200 μg iodine and 400 μg folate s...

  1. HIV/AIDS, food supplementation and livelihood programs in Uganda: a way forward?

    Directory of Open Access Journals (Sweden)

    Jessica E Yager

    Full Text Available BACKGROUND: Over the last decade, health, nutrition and policy experts have become increasingly aware of the many ways in which food insecurity and HIV infection negatively impact and reinforce one another. In response, many organizations providing HIV care began supplying food aid to clients in need. Food supplementation, however, was quickly recognized as an unsustainable and incomplete intervention. Many HIV care organizations therefore developed integrated HIV and livelihood programs (IHLPs to target the root causes of food insecurity. METHODS AND FINDINGS: We conducted a qualitative study using in-depth interviews with 21 key informants who worked at seven organizations providing HIV care, food aid, or IHLPs in Kampala, Uganda in 2007-2008 to better understand the impact of IHLPs on the well-being of people living with HIV and AIDS (PLWHAs and the challenges in transitioning clients from food aid to IHLPs. There was strong consensus among those interviewed that IHLPs are an important intervention in addressing food insecurity and its adverse health consequences among PLWHAs. Key informants identified three main challenges in transitioning PLWHAs from food supplementation programs to IHLPs: (1 lack of resources (2 timing of the transition and (3 logistical considerations including geography and weather. Factors seen as contributing to the success of programs included: (1 close involvement of community leaders (2 close ties with local and national government (3 diversification of IHLP activities and (4 close integration with food supplementation programs, all linked through a central program of HIV care. CONCLUSION: Health, policy and development experts should continue to strengthen IHLPs for participants in need. Further research is needed to determine when and how participants should be transitioned from food supplementation to IHLPs, and to determine how to better correlate measures of food insecurity with objective clinical outcomes so

  2. Athletes and Supplements: Prevalence and Perspectives.

    Science.gov (United States)

    Garthe, Ina; Maughan, Ronald J

    2018-03-01

    In elite sport, where opponents are evenly matched, small factors can determine the outcome of sporting contests. Not all athletes know the value of making wise nutrition choices, but anything that might give a competitive edge, including dietary supplements, can seem attractive. Between 40% and 100% of athletes typically use supplements, depending on the type of sport, level of competition, and the definition of supplements. However, unless the athlete has a nutrient deficiency, supplementation may not improve performance and may have a detrimental effect on both performance and health. Dietary supplements are classified as a subcategory of food, so manufacturers are not required to provide evidence of product safety and efficacy, nor obtain approval from regulatory bodies before marketing supplements. This creates the potential for health risks, and serious adverse effects have been reported from the use of some dietary supplements. Athletes who compete in sports under an anti-doping code must also realize that supplement use exposes them to a risk of ingesting banned substances or precursors of prohibited substances. Government systems of regulations do not include specific laboratory testing for banned substances according to the WADA list, so a separate regulatory framework to evaluate supplements for their risk of provoking a failed doping test is needed. In the high-performance culture typical of elite sport, athletes may use supplements regardless of possible risks. A discussion around medical, physiological, cultural, and ethical questions may be warranted to ensure that the athlete has the information needed to make an informed choice.

  3. Daily oral iron supplementation during pregnancy

    Science.gov (United States)

    Peña-Rosas, Juan Pablo; De-Regil, Luz Maria; Dowswell, Therese; Viteri, Fernando E

    2014-01-01

    Background Iron and folic acid supplementation has been the preferred intervention to improve iron stores and prevent anaemia among pregnant women, and it may also improve other maternal and birth outcomes. Objectives To assess the effects of daily oral iron supplements for pregnant women, either alone or in conjunction with folic acid, or with other vitamins and minerals as a public health intervention. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (2 July 2012). We also searched the WHO International Clinical Trials Registry Platform (ICTRP) (2 July 2012) and contacted relevant organisations for the identification of ongoing and unpublished studies. Selection criteria Randomised or quasi-randomised trials evaluating the effects of oral preventive supplementation with daily iron, iron + folic acid or iron + other vitamins and minerals during pregnancy. Data collection and analysis We assessed the methodological quality of trials using standard Cochrane criteria. Two review authors independently assessed trial eligibility, extracted data and conducted checks for accuracy. Main results We included 60 trials. Forty-three trials, involving more than 27,402 women, contributed data and compared the effects of daily oral supplements containing iron versus no iron or placebo. Overall, women taking iron supplements were less likely to have low birthweight newborns (below 2500 g) compared with controls (8.4% versus 10.2%, average risk ratio (RR) 0.81; 95% confidence interval (CI) 0.68 to 0.97, 11 trials, 8480 women) and mean birthweight was 30.81 g greater for those infants whose mothers received iron during pregnancy (average mean difference (MD) 30.81; 95% CI 5.94 to 55.68, 14 trials, 9385 women). Preventive iron supplementation reduced the risk of maternal anaemia at term by 70% (RR 0.30; 95% CI 0.19 to 0.46, 14 trials, 2199 women) and iron deficiency at term by 57% (RR 0.43; 95% CI 0.27 to 0.66, seven trials, 1256 women

  4. Dietary supplements for football.

    Science.gov (United States)

    Hespel, P; Maughan, R J; Greenhaff, P L

    2006-07-01

    Physical training and competition in football markedly increase the need for macro- and micronutrient intake. This requirement can generally be met by dietary management without the need for dietary supplements. In fact, the efficacy of most supplements available on the market is unproven. In addition, players must be cautious of inadequate product labelling and supplement impurities that may cause a positive drug test. Nonetheless, a number of dietary supplements may beneficially affect football performance. A high endurance capacity is a prerequisite for optimal match performance, particularly if extra time is played. In this context, the potential of low-dose caffeine ingestion (2 - 5 mg . kg body mass(-1)) to enhance endurance performance is well established. However, in the case of football, care must be taken not to overdose because visual information processing might be impaired. Scoring and preventing goals as a rule requires production of high power output. Dietary creatine supplementation (loading dose: 15 - 20 g . day(-1), 4 - 5 days; maintenance dose: 2 - 5 g g . day(-1)) has been found to increase muscle power output, especially during intermittent sprint exercises. Furthermore, creatine intake can augment muscle adaptations to resistance training. Team success and performance also depend on player availability, and thus injury prevention and health maintenance. Glucosamine or chondroitin may be useful in the treatment of joint pain and osteoarthritis, but there is no evidence to support the view that the administration of these supplements will be preventative. Ephedra-containing weight-loss cocktails should certainly be avoided due to reported adverse health effects and positive doping outcomes. Finally, the efficacy of antioxidant or vitamin C intake in excess of the normal recommended dietary dose is equivocal. Responses to dietary supplements can vary substantially between individuals, and therefore the ingestion of any supplement must be assessed

  5. Oral calorie supplements for cystic fibrosis.

    Science.gov (United States)

    Smyth, Rosalind L; Rayner, Oli

    2017-05-04

    Poor nutrition occurs frequently in people with cystic fibrosis and is associated with other adverse outcomes. Oral calorie supplements are used to increase total daily calorie intake and improve weight gain. However, they are expensive and there are concerns they may reduce the amount of food eaten and not improve overall energy intake. This is an update of a previously published review. To establish whether in people with cystic fibrosis, oral calorie supplements: increase daily calorie intake; and improve overall nutritional intake, nutritional indices, lung function, survival and quality of life. To assess adverse effects associated with using these supplements. We searched the Cochrane Cystic Fibrosis Trials Register comprising references from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings. We contacted companies marketing oral calorie supplements.Last search: 18 October 2016. Randomised or quasi-randomised controlled trials comparing use of oral calorie supplements for at least one month to increase calorie intake with no specific intervention or additional nutritional advice in people with cystic fibrosis. We independently selected the included trials, assessed risk of bias and extracted data. We contacted the authors of included trials and obtained additional information for two trials. We identified 21 trials and included three, reporting results from 131 participants lasting between three months and one year. Two trials compared supplements to additional nutritional advice and one to no intervention. Two of the included trials recruited only children. In one trial the risk of bias was low across all domains, in a second trial the risk of bias was largely unclear and in the third mainly low. Blinding of participants was unclear in two of the trials. Also, in one trial the clinical condition of groups appeared to be unevenly balanced at baseline and in another trial there were

  6. Reliability of dc power supplies in nuclear power plant application

    International Nuclear Information System (INIS)

    Eisenhut, D.G.

    1978-01-01

    In June 1977 the reliability of dc power supplies at nuclear power facilities was questioned. It was postulated that a sudden gross failure of the redundant dc power supplies might occur during normal plant operation, and that this could lead to insufficient shutdown cooling of the reactor core. It was further suggested that this potential for insufficient cooling is great enough to warrant consideration of prompt remedies. The work described herein was part of the NRC staff's efforts aimed towards putting the performance of dc power supplies in proper perspective and was mainly directed towards the particular concern raised at that time. While the staff did not attempt to perform a systematic study of overall dc power supply reliability including all possible failure modes for such supplies, the work summarized herein describes how a probabilistic approach was used to supplement our more usual deterministic approach to reactor safety. Our evaluation concluded that the likelihood of dc power supply failures leading to insufficient shutdown cooling of the reactor core is sufficiently small as to not require any immediate action

  7. Inferior phrenic arteries supply to the pulmonary hemorrhagic lesions: angiographic identification and interventional management

    International Nuclear Information System (INIS)

    Wang Maoqiang; Liu Fengyong; Duan Feng; Song Peng; Wang Zhijun; Wang Zhongpu

    2007-01-01

    Objective: To describe the manifestations of the inferior phrenic arteries (IPA) supply to the pulmonary hemorrhagic lesions and to evaluate the safety and efficacy of transcatheter arterial embolization (TAE) of the IPA. Methods: The clinical data and imaging findings of eighteen patients with the additional blood supply to the pulmonary hemorrhagic lesions from the IPA were evaluated retrospectively. The causes of the bleeding were lung malignancies in 9, bronchiectasis in 7, and chronic inflammation in 2 patients. TAE supplementally was performed in patients with IPA supply to the pulmonary lesions, using polyvinyl alcohol particles, gelatin sponge particles, and microcoils. Results: Selective arteriogram demonstrates an enlarged IPA, with numerous branches and hypervascularity in all 18 cases, with tumor staining in 9, the contrast material extravasation in 6, and non-specific staining in 2 cases. In addition, IPA-to-pulmonary shunting was found in 9 cases. All the lesions supplying by IPA were adjacent to the pleurae, including adjacent to the diaphragmatic pleura in 11, the mediastinal pleura in 5, and the lateral pleura of the lower lobe in 2 cases. Technical success of IPA embolization was achieved in the 18 cases. Embolization of other nonbronchial systemic arteries (the internal thoracic artery in 7 and intercostal artery in 3) was performed at the same session. All bleeding ceased immediately after' supplemental IPA embolization. Follow-up time ranged from 8 months to 4 years. Mild recurrent hemoptysis occurred in 3 patients at 1,2, 6 months respectively, after the embolization. These patients were responsive to conservative management. Recurrent bleeding did not occur in 15 patients during the follow-up. Conclusion: The pulmonary hemorrhagic lesions, especially adjacent to the diaphragmatic and mediastinal pleurae, can be supplied by IPA, and may result in clinical failure following BAE. Supplemental TAE of IPA is a safe and effective adjunct to BAE in

  8. Effects of supplemental vibrational force on space closure, treatment duration, and occlusal outcome: A multicenter randomized clinical trial.

    Science.gov (United States)

    DiBiase, Andrew T; Woodhouse, Neil R; Papageorgiou, Spyridon N; Johnson, Nicola; Slipper, Carmel; Grant, James; Alsaleh, Maryam; Khaja, Yousef; Cobourne, Martyn T

    2018-04-01

    A multicenter parallel 3-arm randomized clinical trial was carried out in 3 university hospitals in the United Kingdom to investigate the effect of supplemental vibratory force on space closure and treatment outcome with fixed appliances. Eighty-one subjects less than 20 years of age with mandibular incisor irregularity undergoing extraction-based fixed appliance treatment were randomly allocated to supplementary (20 minutes/day) use of an intraoral vibrational device (AcceleDent; OrthoAccel Technologies, Houston, Tex) (n = 29), an identical nonfunctional (sham) device (n = 25), or fixed-appliance only (n = 27). Space closure in the mandibular arch was measured from dental study casts taken at the start of space closure, at the next appointment, and at completion of space closure. Final records were taken at completion of treatment. Data were analyzed blindly on a per-protocol basis with descriptive statistics, 1-way analysis of variance, and linear regression modeling with 95% confidence intervals. Sixty-one subjects remained in the trial at start of space closure, with all 3 groups comparable for baseline characteristics. The overall median rate of initial mandibular arch space closure (primary outcome) was 0.89 mm per month with no difference for either the AcceleDent group (difference, -0.09 mm/month; 95% CI, -0.39 to 0.22 mm/month; P = 0.57) or the sham group (difference, -0.02 mm/month; 95% CI, -0.32 to 0.29 mm/month; P = 0.91) compared with the fixed only group. Similarly, no significant differences were identified between groups for secondary outcomes, including overall treatment duration (median, 18.6 months; P >0.05), number of visits (median, 12; P >0.05), and percentage of improvement in the Peer Assessment Rating (median, 90.0%; P >0.05). Supplemental vibratory force during orthodontic treatment with fixed appliances does not affect space closure, treatment duration, total number of visits, or final occlusal outcome. NCT02314975

  9. High dietary zinc supply reduces the digestibility of phosphorus in pig diets1

    DEFF Research Database (Denmark)

    Poulsen, Hanne Damgaard; Blaabjerg, Karoline; Sørensen, Kristina Ulrich

    2016-01-01

    . However, divalent metal ions may bind phytate, leaving phytate less accessible to phytase-induced hydrolysis. The objective was to examine the effects of increased Zn supply on the apparent total tract digestibility (ATTD) of P in pig diets supplemented with microbial phytase. A wheat, barley, and soy–based...... diet (4.3 g P/kg DM, 3.1 g phytate P/kg DM, and no feed phosphate) were heat treated at 81°C (plant phytase diet was divided into 3 batches that were supplemented with 0, 100 or 2,500 mg...... a significant (P diet decreased the ATTD of plant P by about 16% in microbial phytase–supplemented diets....

  10. Effects of nutritional supplementation for HIV patients starting antiretroviral treatment

    DEFF Research Database (Denmark)

    Olsen, Mette Frahm; Abdissa, Alemseged; Kæstel, Pernille

    2014-01-01

    Objectives: To determine the effects of lipid based nutritional supplements with either whey or soy protein in patients with HIV during the first three months of antiretroviral treatment (ART) and to explore effects of timing by comparing supplementation at the start of ART and after three months....../µL (−2 to 53 cells/µL) were CD4. Effects of the soy containing supplement on immune recovery were not significant. The effects of the two supplements, however, were not significantly different in direct comparison. Exploratory analysis showed that relatively more lean body mass was gained by patients...... with undetectable viral load at three months. Patients receiving delayed supplementation had higher weight gain but lower gains in functional outcomes. Conclusions: Lipid based nutritional supplements improved gain of weight, lean body mass, and grip strength in patients with HIV starting ART. Supplements...

  11. Systematic review: primary and secondary prevention of gastrointestinal cancers with antioxidant supplements

    DEFF Research Database (Denmark)

    Bjelakovic, G.; Nikolova, D.; Simonetti, R.G.

    2008-01-01

    BACKGROUND: The evidence on whether antioxidant supplements prevent gastrointestinal cancers is contradictory. AIM: To assess the beneficial and harmful effects of antioxidant supplements in preventing gastrointestinal cancers. METHODS: Using the Cochrane Collaboration methodology, we reviewed...... the randomized trials comparing antioxidant supplements with placebo or no intervention on the occurrence of gastrointestinal cancers. We searched electronic databases and reference lists until October, 2007. Our outcome measures were gastrointestinal cancers, overall mortality and adverse events. Outcomes were....... The antioxidant supplements were without a significant effect on the occurrence of gastrointestinal cancers (RR 0.94, 95% CI 0.83-1.06, I(2) = 54.0%). The heterogeneity seemed to be explained by bias risk (low-bias risk trials RR 1.04, 95% CI 0.96-1.13 compared to high-bias risk trials RR 0.59, 95% CI 0...

  12. Effect of maternal vitamin D3 supplementation on maternal health, birth outcomes, and infant growth among HIV-infected Tanzanian pregnant women: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Sudfeld, Christopher R; Manji, Karim P; Duggan, Christopher P; Aboud, Said; Muhihi, Alfa; Sando, David M; Al-Beity, Fadhlun M Alwy; Wang, Molin; Fawzi, Wafaie W

    2017-09-04

    Vitamin D has significant immunomodulatory effects on both adaptive and innate immune responses. Observational studies indicate that adults infected with HIV with low vitamin D status may be at increased risk of mortality, pulmonary tuberculosis, and HIV disease progression. Growing observational evidence also suggests that low vitamin D status in pregnancy may increase the risk of adverse birth and infant health outcomes. As a result, antiretroviral therapy (ART) adjunct vitamin D 3 supplementation may improve the health of HIV-infected pregnant women and their children. The Trial of Vitamins-5 (ToV5) is an individually randomized, double-blind, placebo-controlled trial of maternal vitamin D 3 (cholecalciferol) supplementation conducted among 2300 HIV-infected pregnant women receiving triple-drug ART under Option B+ in Dar es Salaam, Tanzania. HIV-infected pregnant women of 12-27 weeks gestation are randomized to either: 1) 3000 IU vitamin D 3 taken daily from randomization in pregnancy until trial discharge at 12 months postpartum; or 2) a matching placebo regimen. Maternal participants are followed-up at monthly clinic visits during pregnancy, at delivery, and then with their children at monthly postpartum clinic visits. The primary efficacy outcomes of the trial are: 1) maternal HIV disease progression or death; 2) risk of small-for-gestational age (SGA) births; and 3) risk of infant stunting at 1 year of age. The primary safety outcome of the trial is incident maternal hypercalcemia. Secondary outcomes include a range of clinical and biological maternal and child health outcomes. The ToV5 will provide causal evidence on the effect of vitamin D 3 supplementation on HIV progression and death, SGA births, and infant stunting at 1 year of age. The results of the trial are likely generalizable to HIV-infected pregnant women and their children in similar resource-limited settings utilizing the Option B+ approach. ClinicalTrials.gov identifier: NCT02305927

  13. Randomized Controlled Trial of DHA Supplementation during Pregnancy: Child Adiposity Outcomes

    Science.gov (United States)

    Foster, Byron A.; Escaname, Elia; Powell, Theresa L.; Larsen, Benjamin; Siddiqui, Sartaj K.; Menchaca, John; Aquino, Christian; Ramamurthy, Rajam; Hale, Daniel E.

    2017-01-01

    Investigating safe and effective interventions in pregnancy that lower offspring adiposity is important given the burden of obesity and subsequent metabolic derangements. Our objective was to determine if docosahexaenoic acid (DHA) given during pregnancy to obese mothers results in lower offspring adiposity. This study was a long-term follow-up of a randomized trial of mothers with gestational diabetes or obesity who were randomized to receive DHA supplementation at 800 mg/day or placebo (corn/soy oil) starting at 25–29 weeks gestation. Anthropometric measures were collected at birth and maternal erythrocyte DHA and arachidonic (AA) levels were measured at 26 and 36 weeks gestation. At two- and four-year follow-up time points, offspring adiposity measures along with a diet recall were assessed. A significant increase in erythrocyte DHA levels was observed at 36 weeks gestation in the supplemented group (p < 0.001). While no significant differences by measures of adiposity were noted at birth, two or four years by randomization group, duration of breastfeeding (p < 0.001), and DHA level at 36 weeks (p = 0.002) were associated with body mass index z-score. Our data suggest that DHA supplementation during pregnancy in obese mothers may have long-lasting effects on offspring measures of adiposity. PMID:28574453

  14. Influence of oral glutamine supplementation on survival outcomes of patients treated with concurrent chemoradiotherapy for locally advanced non-small cell lung cancer

    International Nuclear Information System (INIS)

    Topkan, Erkan; Parlak, Cem; Topuk, Savas; Pehlivan, Berrin

    2012-01-01

    Glutamine (Gln) supplementation during concurrent chemoradiotherapy (C-CRT) effectively reduces the incidence and severity of acute radiation-induced esophagitis (RIE). However, there are concerns that Gln might stimulate tumor growth, and therefore negatively impact the outcomes of anticancer treatment. We retrospectively investigated the effect of co-administration of oral Gln during C-CRT on survival outcomes of patients with stage IIIB non-small cell lung carcinoma (NSCLC). We additionally evaluated role of oral Gln in preventing C-CRT-induced weight change, acute and late toxicities. The study included 104 patients: 56 (53.8%) received prophylactic powdered Gln (Gln+) orally at a dose of 10 g/8 h and 48 (46.2%) did not receive Gln (Gln-) and served as controls. The prescribed radiation dose to the planning target volume was 66 Gy in 2-Gy fractions. Primary endpoints of progression-free survival (PFS), local/regional progression-free survival (LRPFS), and overall survival (OS) were correlated with status of Gln supplementation. Oral Gln was well tolerated except for mild nausea/vomiting in 14 (25.0%) patients. There was no C-CRT-related acute or late grade 4–5 toxicity. Administration of Gln was associated with a decrease in the incidence of grade 3 acute radiation-induced esophagitis (RIE) (7.2% vs. 16.7% for Gln+ vs. Gln-; p=0.02) and late-RIE (0% vs. 6.3%; p=0.06), a reduced need for unplanned treatment breaks (7.1% vs. 20.8%; p=0.04), and reduced incidence of weight loss (44.6% vs. 72.9%; p=0.002). At a median follow-up of 24.2 months (range 9.2-34.4) the median OS, LRPFS, and PFS for Gln+ vs. Gln- cohorts were 21.4 vs. 20.4 (p=0.35), 14.2 vs.11.3 (p=0.16), and 10.2 vs. 9.0 months (p=0.11), respectively. In our study, supplementation with Gln during C-CRT had no detectable negative impact on tumor control and survival outcomes in patients with Stage IIIB NSCLC. Furthermore, Gln appeared to have a beneficial effect with respect to prevention of weight loss

  15. Effect of enzyme supplementation on the nutritive value of malted ...

    African Journals Online (AJOL)

    The composition of malted sorghum sprout (MSP) and its nutritive value when supplemented with an exogenous enzyme was investigated using weanling albino rats. A nitrogen free basal diet was formulated along with a soya bean meal (SBM) reference diet (10% CP) and two test diets each containing 10% CP supplied ...

  16. Effects of varying ruminally undegradable protein supplementation on forage digestion, nitrogen metabolism, and urea kinetics in Nellore cattle fed low-quality tropical forage.

    Science.gov (United States)

    Batista, E D; Detmann, E; Titgemeyer, E C; Valadares Filho, S C; Valadares, R F D; Prates, L L; Rennó, L N; Paulino, M F

    2016-01-01

    Effects of supplemental RDP and RUP on nutrient digestion, N metabolism, urea kinetics, and muscle protein degradation were evaluated in Nellore heifers () consuming low-quality signal grass hay (5% CP and 80% NDF, DM basis). Five ruminally and abomasally cannulated Nellore heifers (248 ± 9 kg) were used in a 5 × 5 Latin square. Treatments were the control (no supplement) and RDP supplementation to meet 100% of the RDP requirement plus RUP provision to supply 0, 50, 100, or 150% of the RUP requirement. Supplemental RDP (casein plus NPN) was ruminally dosed twice daily, and RUP supply (casein) was continuously infused abomasally. Jugular infusion of [NN]-urea with measurement of enrichment in urine was used to evaluate urea kinetics. The ratio of urinary 3-methylhistidine to creatinine was used to estimate skeletal muscle protein degradation. Forage NDF intake (2.48 kg/d) was not affected ( ≥ 0.37) by supplementation, but supplementation did increase ruminal NDF digestion ( Urea entry rate and gastrointestinal entry rate of urea were increased by supplementation ( urea entry rate and tended ( = 0.07) to linearly increase gastrointestinal entry rate of urea. Urea use for anabolic purposes tended ( = 0.07) to be increased by supplementation, and RUP provision also tended ( = 0.08) to linearly increase the amount of urea used for anabolism. The fraction of recycled urea N incorporated into microbial N was greater ( urea from the renal tubule than did supplemented heifers. Overall, unsupplemented heifers had greater mobilization of AA from myofibrillar protein, which provided N for urea synthesis and subsequent recycling. Supplemental RUP, when RDP was supplied, not only increased N retention but also supported increased urea N recycling and increased ruminal microbial protein synthesis.

  17. Interactions of commonly used dietary supplements with cardiovascular drugs: a systematic review

    Directory of Open Access Journals (Sweden)

    Kanji Salmaan

    2012-05-01

    Full Text Available Abstract Background The objective of this systematic review was to examine the benefits, harms and pharmacokinetic interactions arising from the co-administration of commonly used dietary supplements with cardiovascular drugs. Many patients on cardiovascular drugs take dietary supplements for presumed benefits and may be at risk for adverse supplement-drug interactions. Methods The Allied and Complementary Medicine Database, the Cochrane Library, EMBASE, International Bibliographic Information on Dietary Supplements and MEDLINE were searched from the inception of the review to October 2011. Grey literature was also reviewed. Two reviewers independently screened records to identify studies comparing a supplement plus cardiovascular drug(s with the drug(s alone. Reviewers extracted data using standardized forms, assessed the study risk of bias, graded the strength of evidence and reported applicability. Results Evidence was obtained from 65 randomized clinical trials, 2 controlled clinical trials and 1 observational study. With only a few small studies available per supplement, evidence was insufficient for all predefined gradable clinical efficacy and harms outcomes, such as mortality and serious adverse events. One long-term pragmatic trial showed no benefit from co-administering vitamin E with aspirin on a composite cardiovascular outcome. Evidence for most intermediate outcomes was insufficient or of low strength, suggesting no effect. Incremental benefits were noted for triglyceridemia with omega-3 fatty acid added to statins; and there was an improvement in levels of high-density lipoprotein cholesterol with garlic supplementation when people also consumed nitrates Conclusions Evidence of low-strength indicates benefits of omega-3 fatty acids (plus statin, or calcium channel blockers and antiplatelets and garlic (plus nitrates or warfarin on triglycerides and HDL-C, respectively. Safety concerns, however, persist.

  18. Evaluation of supplemental nutrition in elderly orthopaedic patients.

    OpenAIRE

    Driver, Lynn.

    1994-01-01

    A degree of malnutrition is evident in many elderly patients on admission to hospital. The increased metabolic demands of surgery, and low food intake during the post operative period, can cause a further deterioration in nutritional status, with adverse effects on clinical outcome. Sip feed supplements offer a simple and inexpensive method of providing nutrition support. 'The present study has evaluated the efficacy of, and compliance to, sip feed supplements in elderly patients undergoing e...

  19. Integration of decentralised renewable power supply plants in the grid - security of supply in the residential sector; Integration dezentraler regenerativer Energieversorgungsanlagen in den Netzbetrieb - Versorgungssicherheit im Wohnbereich

    Energy Technology Data Exchange (ETDEWEB)

    Bendel, C.; Nestle, D. [Kassel Univ. (DE). Inst. fuer Solare Energietechnik e.V. (ISET)

    2007-06-15

    By supplementing the existing technical and legal interface between the public network and the customer with intelligent components and applying the principle of local decision-making on the basis of central and local information BEMI (bidirectional energy management interface) creates a platform through which both suppliers and consumers can contribute substantially to the integration of naturally supply-dependent energy resources in the low-voltage supply network. This article describes a laboratory-scale system which demonstrates the performance capability of BEMI, which is being further improved through test runs.

  20. Sustainability of Drinking Water Supply Projects in Rural of North ...

    African Journals Online (AJOL)

    Background: Safe water supply coverage in the rural areas of Ethiopia is very marginal. The coverage still remains very low because of limited progress in water supply activities in these areas. Factors affecting the continued use of the outcome of water supply projects in the background of limited resources are not well ...

  1. Adherence to iron supplements among women receiving antenatal care at Mulago National Referral Hospital, Uganda-cross-sectional study.

    Science.gov (United States)

    Kiwanuka, Tusuubira S; Ononge, Sam; Kiondo, Paul; Namusoke, Fatuma

    2017-10-25

    Antenatal iron supplementation is a cost effective way of reducing iron deficiency anaemia among pregnant women in resource limited countries like Uganda. Poor adherence to iron supplements has limited its effectiveness in reducing maternal anaemia as evidenced by the high burden of iron deficiency anemia in Sub-saharan Africa. The aim of this study was to determine the level of and factors associated with adherence to iron supplementation among women attending antenatal clinic at Mulago National Referral Hospital, Kampala, Uganda. Three hundred and seventy pregnant women were recruited in a cross sectional survey in Mulago National Referral Hospital antenatal clinic after informed consent between February and April 2014. Levels of adherence to iron supplements were assessed using visual analogue scale and factors associated collected using an interviewer administered questionnaire. About 12% (11.6%) of the mothers attending the antenatal clinic adhered to iron supplements over 30 day period. Mothers who had had four or more antenatal visits prior to the survey [odds ratio (OR) = 1.49, 95% confidence interval (CI) 1.12-1.97], had more than 2 week supply of iron supplements in the previous visit (OR 2.81, 95% CI 1.02-1.09), prior health education (OR 1.56, 95% CI 1.07-2.29) were more likely to adhere to iron supplements. Inadequate drug supplies and fear for side effects were the main reasons why participants missed the iron supplements. There was low adherence to iron supplements among mothers attending antenatal clinic at Mulago National Referral  Hospital. We recommend a national evaluation of adherence to iron supplements and look at ways of increasing adherence.

  2. The effect of protein and carbohydrate supplementation on strength training outcome of rehabilitation in ACL patients

    DEFF Research Database (Denmark)

    Holm, Lars; Esmarck, Birgitte; Mizuno, Masao

    2006-01-01

    supplementation groups: Protein+Carbohydrate (PC), Isocaloric-Carbohydrate (IC), or Placebo (PL), ingesting the supplementation immediately after each of 36 training sessions. Determined from images of thigh cross-sections (magnetic resonance imaging) the hypertrophy of the quadriceps muscle differed....... The results from this study demonstrate that restoration of the distal vasti muscle mass and knee extension muscle strength with resistance training is promoted further by protein-containing nutrient supplementation immediately after single exercise sessions. Thus, exercise-related protein supplementation may...... was therefore to investigate if nutrient supplementation during 12 weeks of conservative rehabilitation strength training could enhance hypertrophy and strength of the quadriceps muscle in ACL-injured patients. Twenty-six ACL-injured men and women were included and randomly distributed into three...

  3. Indirect Potable Reuse: A Sustainable Water Supply Alternative

    Directory of Open Access Journals (Sweden)

    Clemencia Rodriguez

    2009-03-01

    Full Text Available The growing scarcity of potable water supplies is among the most important issues facing many cities, in particular those using single sources of water that are climate dependent. Consequently, urban centers are looking to alternative sources of water supply that can supplement variable rainfall and meet the demands of population growth. A diversified portfolio of water sources is required to ensure public health, as well as social, economical and environmental sustainability. One of the options considered is the augmentation of drinking water supplies with advanced treated recycled water. This paper aims to provide a state of the art review of water recycling for drinking purposes with emphasis on membrane treatment processes. An overview of significant indirect potable reuse projects is presented followed by a description of the epidemiological and toxicological studies evaluating any potential human health impacts. Finally, a summary of key operational measures to protect human health and the areas that require further research are discussed.

  4. Indirect Potable Reuse: A Sustainable Water Supply Alternative

    Science.gov (United States)

    Rodriguez, Clemencia; Van Buynder, Paul; Lugg, Richard; Blair, Palenque; Devine, Brian; Cook, Angus; Weinstein, Philip

    2009-01-01

    The growing scarcity of potable water supplies is among the most important issues facing many cities, in particular those using single sources of water that are climate dependent. Consequently, urban centers are looking to alternative sources of water supply that can supplement variable rainfall and meet the demands of population growth. A diversified portfolio of water sources is required to ensure public health, as well as social, economical and environmental sustainability. One of the options considered is the augmentation of drinking water supplies with advanced treated recycled water. This paper aims to provide a state of the art review of water recycling for drinking purposes with emphasis on membrane treatment processes. An overview of significant indirect potable reuse projects is presented followed by a description of the epidemiological and toxicological studies evaluating any potential human health impacts. Finally, a summary of key operational measures to protect human health and the areas that require further research are discussed. PMID:19440440

  5. Vitamin D supplementation for women during pregnancy

    Science.gov (United States)

    De-Regil, Luz Maria; Palacios, Cristina; Ansary, Ali; Kulier, Regina; Peña-Rosas, Juan Pablo

    2013-01-01

    Background Vitamin D deficiency or insufficiency is thought to be common among pregnant women. Vitamin D supplementation during pregnancy has been suggested as an intervention to protect against adverse gestational outcomes. Objectives To examine whether supplements with vitamin D alone or in combination with calcium or other vitamins and minerals given to women during pregnancy can safely improve maternal and neonatal outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2011), the International Clinical Trials Registry Platform (ICTRP) (31 October 2011), the Networked Digital Library of Theses and Dissertations (28 October 2011) and also contacted relevant organisations (8 April 2011). Selection criteria Randomised and quasi-randomised trials with randomisation at either individual or cluster level, evaluating the effect of supplementation with vitamin D alone or in combination with other micronutrients for women during pregnancy. Data collection and analysis Two review authors independently i) assessed the eligibility of studies against the inclusion criteria ii) extracted data from included studies, and iii) assessed the risk of bias of the included studies. Data were checked for accuracy. Main results The search strategy identified 34 potentially eligible references. We included six trials assessing a total of 1023 women, excluded eight studies, and 10 studies are still ongoing. Five trials involving 623 women compared the effects of vitamin D alone versus no supplementation/placebo and one trial with 400 women compared the effects of vitamin D and calcium versus no supplementation. Only one trial with 400 women reported on pre-eclampsia: women who received 1200 IU vitamin D along with 375 mg of elemental calcium per day were as likely to develop pre-eclampsia as women who received no supplementation (average risk ratio (RR) 0.67; 95% confidence interval (CI) 0.33 to 1.35). Data from four trials

  6. Post-discharge supplementation of vitamins and minerals for preterm neonates.

    Science.gov (United States)

    Dall'Agnola, Alberto; Beghini, Lorenzo

    2009-10-01

    Ninety percent of premature babies has nutritional deficiency at discharge. It is very important that not only carbohydrates, proteins, fats, but also mineral salts, and vitamins are in quantities and adequate quality according to the needs of the various scientific neonatal and nutrition programs so as to avoid any shortcomings or excess. The growth, neurodevelopmental outcome and quality of life depend on, among other factors, an adequate nutritional supply with essential nutrients including minerals. It is now recommended that all infants and children, including adolescents, have a minimum daily intake of 400 IU of vitamin D beginning soon after birth. The standard initial dose of vitamin K1 for full term infants (1.0 mg) may be too high for premature infants. The addition of folate and especially vitamin B-12 with formula feedings, provided an effective and nontoxic means of reducing anemia of prematurity. Several investigators have reported higher plasma concentrations of selenium and glutathione peroxidase in preterm infants fed with selenium-supplemented formula than in infants fed with unsupplemented formula.

  7. IOC consensus statement: dietary supplements and the high-performance athlete

    Science.gov (United States)

    Maughan, Ronald J; Burke, Louise M; Dvorak, Jiri; Larson-Meyer, D Enette; Peeling, Peter; Rawson, Eric S; Walsh, Neil P; Garthe, Ina; Geyer, Hans; Meeusen, Romain; van Loon, Lucas J C; Shirreffs, Susan M; Spriet, Lawrence L; Stuart, Mark; Vernec, Alan; Currell, Kevin; Ali, Vidya M; Budgett, Richard GM; Ljungqvist, Arne; Mountjoy, Margo; Pitsiladis, Yannis P; Erdener, Uğur; Engebretsen, Lars

    2018-01-01

    Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition programme. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including (1) the management of micronutrient deficiencies, (2) supply of convenient forms of energy and macronutrients, and (3) provision of direct benefits to performance or (4) indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can benefit the athlete, but others may harm the athlete’s health, performance, and/or livelihood and reputation (if an antidoping rule violation results). A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome and habitual diet. Supplements intended to enhance performance should be thoroughly trialled in training or simulated competition before being used in competition. Inadvertent ingestion of substances prohibited under the antidoping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete’s health and awareness of the potential for harm must be paramount; expert professional opinion and assistance is strongly advised before an athlete embarks on supplement use. PMID:29540367

  8. IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete.

    Science.gov (United States)

    Maughan, Ronald J; Burke, Louise M; Dvorak, Jiri; Larson-Meyer, D Enette; Peeling, Peter; Phillips, Stuart M; Rawson, Eric S; Walsh, Neil P; Garthe, Ina; Geyer, Hans; Meeusen, Romain; van Loon, Luc; Shirreffs, Susan M; Spriet, Lawrence L; Stuart, Mark; Vernec, Alan; Currell, Kevin; Ali, Vidya M; Budgett, Richard G M; Ljungqvist, Arne; Mountjoy, Margo; Pitsiladis, Yannis; Soligard, Torbjørn; Erdener, Uğur; Engebretsen, Lars

    2018-03-01

    Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition program. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including the management of micronutrient deficiencies, supply of convenient forms of energy and macronutrients, and provision of direct benefits to performance or indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can offer benefits to the athlete, but others may be harmful to the athlete's health, performance, and/or livelihood and reputation if an anti-doping rule violation results. A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome, and habitual diet. Supplements intended to enhance performance should be thoroughly trialed in training or simulated competition before implementation in competition. Inadvertent ingestion of substances prohibited under the anti-doping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete's health and awareness of the potential for harm must be paramount, and expert professional opinion and assistance is strongly advised before embarking on supplement use.

  9. Community-based distribution of iron-folic acid supplementation in low- and middle-income countries: a review of evidence and programme implications.

    Science.gov (United States)

    Kavle, Justine A; Landry, Megan

    2018-02-01

    The present literature review aimed to review the evidence for community-based distribution (CBD) of iron-folic acid (IFA) supplementation as a feasible approach to improve anaemia rates in low- and middle-income countries. The literature review included peer-reviewed studies and grey literature from PubMed, Cochrane Library, LILAC and Scopus databases. Low- and middle-income countries. Non-pregnant women, pregnant women, and girls. CBD programmes had moderate success with midwives and community health workers (CHW) who counselled on health benefits and compliance with IFA supplementation. CHW were more likely to identify and reach a greater number of women earlier in pregnancy, as women tended to present late to antenatal care. CBD channels had greater consistency in terms of adequate supplies of IFA in comparison to clinics and vendors, who faced stock outages. Targeting women of reproductive age through school and community settings showed high compliance and demonstrated reductions in anaemia. CBD of IFA supplementation can be a valuable platform for improving knowledge about anaemia, addressing compliance and temporary side-effects of IFA supplements, and increasing access and coverage of IFA supplementation. Programmatic efforts focusing on community-based platforms should complement services and information provided at the health facility level. Provision of training and supportive supervision for CHW on how to counsel women on benefits, side-effects, and when, why, and how to take IFA supplements, as part of behaviour change communication, can be strengthened, alongside logistics and supply systems to ensure consistent supplies of IFA tablets at both the facility and community levels.

  10. n-3 polyunsaturated fatty acid supplementation during cancer chemotherapy

    OpenAIRE

    Morland, Sarah Louise; Martins, Karen J.B.; Mazurak, Vera C.

    2016-01-01

    Evidence from several clinical trials suggests that n-3 polyunsaturated fatty acid (n-3 PUFA) supplementation during cancer chemotherapy improves patient outcomes related to chemotherapy tolerability, regardless of the type of chemotherapy used. While the effects of n-3 PUFA supplementation during chemotherapy have been the subject of several reviews, the mechanisms by which n-3 PUFA improve patient responses through improved chemotherapy tolerability are unclear. There are several barriers c...

  11. Closeout of NRC Bulletin 88-05: Nonconforming materials supplied by Piping Supplies, Inc., at Folsom, New Jersey, and West Jersey Manufacturing Company at Williamstown, New Jersey

    International Nuclear Information System (INIS)

    1990-05-01

    This report documents the activities that led to the closeout of U.S. Nuclear Regulatory Commission (NRC) Bulletin 88-05, which was issued on May 6, 1988. The bulletin required that licensees submit information on materials supplied by Piping Supplies, Inc. (PSI) and West Jersey Manufacturing Company (WJM), and requested that they (1) ensure that these materials complied with the American Society of Mechanical Engineers, Boiler and Pressure Vessel Code (ASME Code) and design specifications or were suitable for their intended service or (2) replace such materials. Supplements 1 and 2 were issued on June 15 and August 3, 1988, respectively. In Supplement 2, another affiliated supplier, Chews Landing Metal Manufacturers, Incorporated (CLM), was identified. The staff concluded that (1) the analytical procedures used to qualify the nonconforming parts and the analysis results provide and adequate basis for resolving the staff's concerns regarding fitting and flanges; (2) even though the materials supplied by PSI, WJM, and CLM with falsified certified material test reports do not meet the ASME Code, their use is an acceptable alternative in accordance with Section 50.55a(a)(3)(ii) of Title 10 of the Code of Federal Regulations; (3) activities in response to Bulletin 88-05 regarding fittings and flanges can be closed for all operating plants; and (4) licensees should evaluate the use of product forms other fittings and flanges

  12. Vitamin C supplementation in pregnancy.

    Science.gov (United States)

    Rumbold, Alice; Ota, Erika; Nagata, Chie; Shahrook, Sadequa; Crowther, Caroline A

    2015-09-29

    Vitamin C supplementation may help reduce the risk of pregnancy complications such as pre-eclampsia, intrauterine growth restriction and maternal anaemia. There is a need to evaluate the efficacy and safety of vitamin C supplementation in pregnancy. To evaluate the effects of vitamin C supplementation, alone or in combination with other separate supplements on pregnancy outcomes, adverse events, side effects and use of health resources. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2015) and reference lists of retrieved studies. All randomised or quasi-randomised controlled trials evaluating vitamin C supplementation in pregnant women. Interventions using a multivitamin supplement containing vitamin C or where the primary supplement was iron were excluded. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Twenty-nine trials involving 24,300 women are included in this review. Overall, 11 trials were judged to be of low risk of bias, eight were high risk of bias and for 10 trials it was unclear. No clear differences were seen between women supplemented with vitamin C alone or in combination with other supplements compared with placebo or no control for the risk of stillbirth (risk ratio (RR) 1.15, 95% confidence intervals (CI) 0.89 to 1.49; 20,038 participants; 11 studies; I² = 0%; moderate quality evidence), neonatal death (RR 0.79, 95% CI 0.58 to 1.08; 19,575 participants; 11 studies; I² = 0%), perinatal death (average RR 1.07, 95% CI 0.77 to 1.49; 17,105 participants; seven studies; I² = 35%), birthweight (mean difference (MD) 26.88 g, 95% CI -18.81 to 72.58; 17,326 participants; 13 studies; I² = 69%), intrauterine growth restriction (RR 0.98, 95% CI 0.91 to 1.06; 20,361 participants; 12 studies; I² = 15%; high quality evidence), preterm birth (average RR 0.99, 95% CI 0.90 to 1.10; 22,250 participants; 16 studies; I² = 49%; high quality evidence

  13. Vitamin E supplementation in people with cystic fibrosis.

    Science.gov (United States)

    Okebukola, Peter O; Kansra, Sonal; Barrett, Joanne

    2017-03-06

    People with cystic fibrosis are at an increased risk of fat-soluble vitamin deficiency including vitamin E. Vitamin E deficiency can cause a host of conditions such as haemolytic anaemia, cerebellar ataxia and cognitive difficulties. Vitamin E supplementation is widely recommended in cystic fibrosis and aims to ameliorate this deficiency. This is an updated version of the review. To determine the effects of any level of vitamin E supplementation on the frequency of vitamin E deficiency disorders in people with cystic fibrosis. We searched the Cochrane Group's Cystic Fibrosis Trials Register and also searched international trial registers for any ongoing clinical trials that were not identified during our register search.Date of last search of the Register: 10 October 2016. Date of last search of international trial registers: 15 February 2017. Randomised controlled trials and quasi-randomised controlled trials comparing any preparation of vitamin E supplementation to placebo or no supplement, regardless of dosage or duration. Two authors extracted outcome data from each study (published information) and assessed the risk of bias of each included study. Four studies with a total of 141 participants were included in the review, two of these were in children (aged six months to 14.5 years), and the other two did not specify participants' age. All studies used different formulations and doses of vitamin E for various durations of treatment (10 days to six months). Two studies compared the supplementation of fat-soluble as well as water-soluble formulations to no supplementation in different arms of the same study. A third study compared a water-soluble formulation to a placebo; and in the fourth study a fat-soluble formulation of vitamin E was assessed against placebo.At one month, three months and six months, water-soluble vitamin E significantly improved serum vitamin E levels compared with control: at one month, two studies, mean difference 17.66 (95% confidence

  14. Performance and nutritional evaluation of beef cattle raised on pasture, castrated at different ages, with and without supplementation

    Directory of Open Access Journals (Sweden)

    Anilza Andréia da Rocha

    2012-04-01

    Full Text Available The objective of this study was to evaluate performance and nutritional traits of beef cattle raised on pastures, castrated at different ages, with and without supplementation. Forty-four crossbred young bulls with predominance of Zebu breed at initial average age of 120±30 days were used in the experiment. Animals were distributed in a completely randomized design in a factorial arrangement with four ages of castration and two supplementation systems. The animals were distributed into four groups and placed on Brachiaria decumbens Stapf pastures, where they were fed concentrate supplementation or mineral salt ad libtum (control. Animals were castrated at 120, 240 and 360 days of age with average body weight of 115, 175 and 276 kg, castrated or not, in each supplementation group. Concentrate supplement composition and the amount supplied to the animals varied according to the time of the year and development phase of the animals. Trials were carried out to evaluate nutritional variables in each of the following phases: suckling, growth in the dry season and growth in the dry/rainy transition season. Concentrate supplementation improved the use of pasture, although it may have caused substitutive effect in all seasons evaluated. Castration of the animals before the dry season impaired animal development until the following dry/rainy transition season, especially when carried out during weaning. Concentrate supply may reduce some effects of this stress.

  15. Methylsulfonylmethane: Applications and Safety of a Novel Dietary Supplement

    OpenAIRE

    Matthew Butawan; Rodney L. Benjamin; Richard J. Bloomer

    2017-01-01

    Methylsulfonylmethane (MSM) has become a popular dietary supplement used for a variety of purposes, including its most common use as an anti-inflammatory agent. It has been well-investigated in animal models, as well as in human clinical trials and experiments. A variety of health-specific outcome measures are improved with MSM supplementation, including inflammation, joint/muscle pain, oxidative stress, and antioxidant capacity. Initial evidence is available regarding the dose of MSM needed ...

  16. Cointegration and prediction analysis of market supply in the Dutch pig-farming industry

    NARCIS (Netherlands)

    Kuiper, W.E.; Meulenberg, M.T.G.

    1997-01-01

    In this paper we derive a restricted vector err or-correction model (RVECM) to predict the Dutch gross indigenous pig production (GIP). For this purpose, we model the long-run supply behaviour of the producers of piglets and fattened pigs. We supplemented Johansen's maximum likelihood procedure with

  17. Efficacy and safety of creatine supplementation in juvenile dermatomyositis: A randomized, double-blind, placebo-controlled crossover trial.

    Science.gov (United States)

    Solis, Marina Yazigi; Hayashi, Ana Paula; Artioli, Guilherme Giannini; Roschel, Hamilton; Sapienza, Marcelo Tatit; Otaduy, Maria Concepción; De Sã Pinto, Ana Lucia; Silva, Clovis Artur; Sallum, Adriana Maluf Elias; Pereira, Rosa Maria R; Gualano, Bruno

    2016-01-01

    It has been suggested that creatine supplementation is safe and effective for treating idiopathic inflammatory myopathies, but no pediatric study has been conducted to date. The objective of this study was to examine the efficacy and safety of creatine supplementation in juvenile dermatomyositis (JDM) patients. In this study, JDM patients received placebo or creatine supplementation (0.1 g/kg/day) in a randomized, crossover, double-blind design. Subjects were assessed at baseline and after 12 weeks. The primary outcome was muscle function. Secondary outcomes included body composition, aerobic conditioning, health-related quality of life, and muscle phosphocreatine (PCr) content. Safety was assessed by laboratory parameters and kidney function measurements. Creatine supplementation did not affect muscle function, intramuscular PCr content, or any other secondary outcome. Kidney function was not affected, and no side effects were reported. Twelve weeks of creatine supplementation in JDM patients were well-tolerated and free of adverse effects, but treatment did not affect muscle function, intramuscular PCr, or any other parameter. © 2015 Wiley Periodicals, Inc.

  18. [Insufficient evidence supporting iron supplementation in anaemia during pregnancy].

    Science.gov (United States)

    Wiegerinck, Melanie M; Mol, Ben Willem J

    2012-01-01

    The Royal Dutch Organization of Midwives (KNOV) recently presented their practice guideline 'Anaemia in midwifery practice'. The guideline identified available evidence on diagnosis, prognosis and treatment of anaemia in pregnancy. Anaemia based on iron deficiency and subsequent treatment with iron supplementation are probably the most frequent aspects of care for pregnant women. However, there is surprisingly enough no evidence of the efficacy of iron supplementation treatment on relevant clinical outcomes in pregnant women with anaemia. We plead to make the next guideline a multidisciplinary one. Such a guideline may lead to a large pragmatic trial evaluating the efficacy of iron supplementation treatment for patients with anaemia.

  19. Bio-economic efficiency of supplementation for steers in Marandu Grass pasture

    Directory of Open Access Journals (Sweden)

    Daniel Marino Guedes de Carvalho

    2014-09-01

    Full Text Available The objective was to evaluate the effect of mineral salt (MS, multiple (MS, energy (ES and protein supplements (PS on performance, behavior and production cost of the cattle in Marandu grass pasture. The experiment lasted 84 days, conducted in the experimental area consists of four paddocks of 1.45 ha. Twenty steers were used with age and initial body weight of 172 kg and 10 months, respectively. It used a completely randomized design with four treatments and five replicate. The energy, multiple and protein supplements was supplied on 1.0 kg day-1. The animals were weighed at the beginning and end of the experiment, to determine the average daily gain (ADG. The weight gain of animals was 0.380, 0.600, 0.750 and 0.730 kg/day, respectively, for treatments MS, ES, MS and PS, have been verified statistical difference between supplemented animals and animals than received only mineral salt. The multiple supplement produced ADG 49.33% and 20.00% higher than the mineral salt. The multiple and protein supplements permitted average performance 18.92% higher than the energy supplement. There was no difference in behavior of grazing (P> 0.05. Animals receiving the mineral mixture had time to 8.40 hours of grazing animal day-1. The multiple supplement provided better economic performance considering the sale of animals to 350 kg body weight.

  20. An Increase in Dietary Supplement Exposures Reported to US Poison Control Centers.

    Science.gov (United States)

    Rao, Nisha; Spiller, Henry A; Hodges, Nichole L; Chounthirath, Thiphalak; Casavant, Marcel J; Kamboj, Amrit K; Smith, Gary A

    2017-09-01

    The objective of this study was to investigate the epidemiology of dietary supplement exposures in the USA. A retrospective analysis was conducted of out-of-hospital dietary supplement exposures reported to the National Poison Data System from 2000 through 2012. There were 274,998 dietary supplement exposures from 2000 through 2012. The annual rate of dietary supplement exposures per 100,000 population increased by 46.1% during 2000-2002, decreased 8.8% during 2002-2005, and then increased again by 49.3% from 2005 to 2012. These trends were influenced by the decrease in ma huang exposures starting in 2002. Miscellaneous dietary supplements accounted for 43.9% of all exposures, followed by botanicals (31.9%), hormonal products (15.1%), and other supplements (5.1%). The majority of dietary supplement exposures (70.0%) occurred among children younger than 6 years old and were acute (94.0%) and unintentional (82.9%). Serious medical outcomes accounted for 4.5% of exposures and most (95.0%) occurred among individuals 6 years and older. Ma huang products, yohimbe, and energy products were the categories associated with the greatest toxicity. There was an overall increase in the rate of dietary supplement exposures from 2000 through 2012. Although the majority of these exposures did not require treatment at a health care facility or result in serious medical outcomes, exposures to yohimbe and energy products were associated with considerable toxicity. Our results demonstrate the success of the FDA ban on ma huang products and the need for FDA regulation of yohimbe and energy products in the USA.

  1. Characteristics of efficacy evidence supporting approval of supplemental indications for prescription drugs in United States, 2005-14: systematic review.

    Science.gov (United States)

    Wang, Bo; Kesselheim, Aaron S

    2015-09-23

    To characterize the types of comparators and endpoints used in efficacy trials for approvals of supplemental indications, compared with the data supporting these drugs' originally approved indications. Systematic review. Publicly accessible data on supplemental indications approved by the US Food and Drug Administration from 2005 to 2014. Types of comparators (active, placebo, historical, none) and endpoints (clinical outcomes, clinical scales, surrogate) in the efficacy trials for these drugs' supplemental and original indication approvals. The cohort included 295 supplemental indications. Thirty per cent (41/136) of supplemental approvals for new indications were supported by efficacy trials with active comparators, compared with 51% (47/93) of modified use approvals and 11% (7/65) of approvals expanding the patient population (Pindications, 30% (28/93) of modified indication approvals, and 22% (14/65) of expanded population approvals (P=0.29). Orphan drugs had supplemental approvals for 40 non-orphan indications, which were supported by similar proportions of trials using active comparators (28% (11/40) for non-orphan supplemental indications versus 24% (10/42) for original orphan indications; P=0.70) and clinical outcome endpoints (25% (10/40) versus 31% (13/42); P=0.55). Wide variations were seen in the evidence supporting approval of supplemental indications, with the fewest active comparators and clinical outcome endpoints used in trials leading to supplemental approvals that expanded the patient population. © Wang et al 2015.

  2. B vitamin and/or ω-3 fatty acid supplementation and cancer: ancillary findings from the supplementation with folate, vitamins B6 and B12, and/or omega-3 fatty acids (SU.FOL.OM3) randomized trial.

    Science.gov (United States)

    Andreeva, Valentina A; Touvier, Mathilde; Kesse-Guyot, Emmanuelle; Julia, Chantal; Galan, Pilar; Hercberg, Serge

    2012-04-09

    To advance knowledge about the cancer-chemopreventive potential of individual nutrients, we investigated the effects of B vitamin and/or ω-3 fatty acid supplements on cancer outcomes among survivors of cardiovascular disease. This was an ancillary study of the Supplementation With Folate, Vitamins B(6) and B(12) and/or Omega-3 Fatty Acids (SU.FOL.OM3) secondary prevention trial (2003-2009). In all, 2501 individuals aged 45 to 80 years were randomized in a 2 × 2 factorial design to one of the following 4 daily supplementation groups: (1) 5-methyltetrahydrofolate (0.56 mg), pyridoxine hydrochloride (vitamin B(6); 3 mg) and cyanocobalamin (vitamin B(12); 0.02 mg); (2) eicosapentaenoic and docosahexaenoic acid (600 mg) in a 2:1 ratio; (3) B vitamins and ω-3 fatty acids; or (4) placebo. Overall and sex-specific hazard ratios (HRs) and 95% CIs regarding the cancer outcomes were estimated with Cox proportional hazards models. After 5 years of supplementation, incident cancer was validated in 7.0% of the sample (145 events in men and 29 in women), and death from cancer occurred in 2.3% of the sample. There was no association between cancer outcomes and supplementation with B vitamins (HR, 1.15 [95% CI, 0.85-1.55]) and/or ω-3 fatty acids (HR, 1.17 [95% CI, 0.87-1.58]). There was a statistically significant interaction of treatment by sex, with no effect of treatment on cancer risk among men and increased cancer risk among women for ω-3 fatty acid supplementation (HR, 3.02 [95% CI, 1.33-6.89]). We found no beneficial effects of supplementation with relatively low doses of B vitamins and/or ω-3 fatty acids on cancer outcomes in individuals with prior cardiovascular disease. Trial Registration  isrctn.org Identifier: ISRCTN41926726.

  3. Supplements in pregnancy: the latest recommendations

    Science.gov (United States)

    Martínez García, Rosa María

    2016-07-12

    Pregnancy is a challenge from the nutritional point of view, because nutrient requirements are increased and alter its intake can affect maternal and fetal health. Micronutrient defi ciency states are related to preeclampsia, intrauterine growth restriction, abortion and congenital anomalies. Currently, the diet of many expectant mothers is insufficient in micronutrients, in this cases supplementation is necessary. It is recommended supplementation with folic acid in doses of 400 mcg / day and 5 mg/day in risk pregnant, and should begin at least one month before conception and during the first 12 weeks gestation, and extend it throughout pregnancy in mothers with nutritional risk. It is important to keep watch the proper dose of folic acid to prevent possible adverse effects of unmetabolized accumulation in plasma. A high percentage of pregnant women presented iron deficiency anemia, being recommended intermittent use of iron supplements (with lower gastrointestinal alteration and oxidative stress); not recommended for mothers without anemia (hemoglobin> 13.5 g / L). Since calcium absorption is increased up to 40% in gestation, its supplementation is not recommended for mothers with adequate intakes (3 dairy / day), and its use must be reserved to women with inadequate intakes and / or high risk of preeclampsia. Regarding the iodine, there are confl icting positions by different working groups established potassium iodide supplementation in women who do not reach their recommended intake (3 servings of milk and dairy products + 2 g of iodized salt), with their diets. Given that vitamin A and D can be toxic to mother and fetus, it is not recommended its supplementation except in cases of deficiency. Although the use of multiple micronutrients supplements may favorably impact the outcome of pregnancy, more scientific evidence is needed to establish the replacement of iron and folic acid with a multiple micronutrient supplement.

  4. The Storytelling Organization: A Study of Story Performance in an Office-Supply Firm.

    Science.gov (United States)

    Boje, David M.

    1991-01-01

    Analyzes how employees in a large office supply firm performed stories to make sense of events, introduce change, and gain political advantage. These stories were dynamic, varied by context, and were often challenged and reinterpreted by listeners. The collective story telling system allowed members to supplement individual memories with…

  5. 14 CFR 121.646 - En-route fuel supply: flag and supplemental operations.

    Science.gov (United States)

    2010-01-01

    ... supply requirements are met: (1) The airplane has enough fuel to meet the requirements of § 121.645(b); (2) The airplane has enough fuel to fly to the Adequate Airport— (i) Assuming a rapid decompression... for flight a turbine-engine powered airplane with more than two engines for a flight more than 90...

  6. The role of secondary uranium supplies through 2013 and beyond

    International Nuclear Information System (INIS)

    Lohrey, Klaus; Aul, Friedel; Kwasny, Rolf

    2010-01-01

    This article examines 4 dimensions of secondary supply: - The Western World's past reliance on secondary supply as a supplement to primary production,- The availability of secondary supplies from now until 2013 and - above all - continued availability of secondary supplies after the HEU deal's expiration in 2013,- Russia's requirements for secondary supply beyond 2013; and - The global requirement for secondary supplies post-2013. Historically, uranium production has seen 3 major phases. Industrial-scale uranium mining started long before the material was needed to fuel commercial nuclear power plants. The first phase, called ''Procurement of Weapons Uranium,'' extended from the 1950s into the early-1960s. Between 1975 and 1980 there was a second huge wave of primary uranium production. The mines' annual output doubled, driven by very ambitious plans for the construction of additional NPPs, further fuelled by the oil crisis of 1973. Throughout the third phase, which started in the mid 1980s, the Western World's natural uranium production remained significantly below the actual reactor demand. This was - and still is - a unique situation within the world's commodities markets. Secondary supplies have recently covered between 30 and 40% of the worldwide nuclear fuel demand. Since the bulk of the secondary supplies can be made available and fabricated into reactor fuel at costs which are below the current prices of fresh uranium, secondary supplies are widely given preference over fresh uranium. But what about the worldwide secondary supplies' role in the years to come, particularly after the expiration of the US-Russian HEU-LEU Agreement in 2013? (orig.)

  7. Ketoanalogues supplementation decreases dialysis and mortality risk in patients with anemic advanced chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Che-Hsiung Wu

    Full Text Available The benefit of alpha-Ketoanalogues (KA supplementation for chronic kidney disease (CKD patients that followed low-protein diet (LPD remains undetermined.We extracted longitudinal data for all CKD patients in the Taiwan National Health Insurance from January 1, 2000 through December 31, 2010. A total of 1483 patients with anemic advanced CKD treated with LPD, who started KA supplementation, were enrolled in this study. We analyzed the risks of end stage renal disease and all-cause mortality using Cox proportional hazard models with influential drugs as time-dependent variables.A total of 1113 events of initiating long-term dialysis and 1228 events of the composite outcome of long-term dialysis or death occurred in patients with advanced CKD after a mean follow-up of 1.57 years. Data analysis suggests KA supplementation is associated with a lower risk for long-term dialysis and the composite outcome when daily dosage is more than 5.5 tablets. The beneficial effect was consistent in subgroup analysis, independent of age, sex, and comorbidities.Among advanced CKD patients that followed LPD, KA supplementation at an appropriate dosage may substantially reduce the risk of initiating long-term dialysis or of developing the composite outcome. KA supplementation represents an additional therapeutic strategy to slow the progression of CKD.

  8. Nutrient supply of plants in aquaponic systems

    Directory of Open Access Journals (Sweden)

    Andras Bittsanszky

    2016-10-01

    Full Text Available In this preliminary article we present data on plant nutrient concentrations in aquaponics systems, and we compare them to nutrient concentrations in “standard” hydroponic solutions. Our data shows that the nutrient concentrations supplied by the fish in the aquaponics system are significantly lower for most nutrients compared to hydroponic systems. Nevertheless, plants do thrive in solutions that have lower nutrient levels compared to “standard” hydroponic solutions. This is especially true for green leafy vegetables that rarely need additional nutritional supplementation. It is concluded that in the highly complex system of aquaponics, special care has to be taken, via continuous monitoring of the chemical composition of the circulating water, to provide adequate concentrations and ratios of nutrients, and especially for the potentially toxic component, ammonium. If certain plants require nutrient supplementation, we consider that one based on organic substances would be most beneficial. However, protocols for the application of such nutrient amendments still need to be developed.

  9. Effects of health insurance on labour supply: A systematic review

    NARCIS (Netherlands)

    Quynh, Nga Le Thi; Groot, Wim; Tomini, Sonila M.; Tomini, Florian

    2017-01-01

    This study provides a systematic review of empirical evidence on the labour supply effects of health insurance. The outcomes in the 63 studies reviewed include labour supply in terms of hours worked and the probability of employment, self-employment and the level of economic formalisation. One of

  10. Preoperative oral nutritional interventions in surgery, including arginine- and glutamine-enhanced supplements

    NARCIS (Netherlands)

    Brinkmann, S.J.H.; Buijs, N.; Luttikhold, J.; Mahdavian Delavary, B.; Niessen, F.B.; van Leeuwen, P.A.M.

    2013-01-01

    The patients' condition prior to surgery is of major importance for clinical outcome. It is believed nowadays that artificial nutrition in the form of a preoperative drink may improve postoperative outcome. Until now, a clear overview concerning the effects of preoperative supplementation on

  11. The efficacy of protein supplementation during recovery from muscle-damaging concurrent exercise.

    Science.gov (United States)

    Eddens, Lee; Browne, Sarah; Stevenson, Emma J; Sanderson, Brad; van Someren, Ken; Howatson, Glyn

    2017-07-01

    This study investigated the effect of protein supplementation on recovery following muscle-damaging exercise, which was induced with a concurrent exercise design. Twenty-four well-trained male cyclists were randomised to 3 independent groups receiving 20 g protein hydrolysate, iso-caloric carbohydrate, or low-calorific placebo supplementation, per serve. Supplement serves were provided twice daily, from the onset of the muscle-damaging exercise, for a total of 4 days and in addition to a controlled diet (6 g·kg -1 ·day -1 carbohydrate, 1.2 g·kg -1 ·day -1 protein, remainder from fat). Following the concurrent exercise session at time-point 0 h, comprising a simulated high-intensity road cycling trial and 100 drop-jumps, recovery of outcome measures was assessed at 24, 48, and 72 h. The concurrent exercise protocol was deemed to have caused exercise-induced muscle damage (EIMD), owing to time effects (p 0.05) were observed for any of the outcome measures. The present results indicate that protein supplementation does not attenuate any of the indirect indices of EIMD imposed by concurrent exercise, when employing great rigour around the provision of a quality habitual diet and the provision of appropriate supplemental controls.

  12. Haulier Value Creation in Supply Chains

    DEFF Research Database (Denmark)

    Borgström, Benedikte; Gammelgaard, Britta

    2017-01-01

    Purpose: Road transport is a dynamic sector with market changes because of liberalization and increasing demand of transport and logistics services. Shippers’ supply chain objectives of low costs and agility and a demanding operating environment due to, for example, congestion is challenging...... understanding of capability deployment. Original/value: This research shows that innovation of transport companies’ (hauliers’ and other types of logistics providers’) value propositions drives competitiveness. The strategy-as-practice approach is applied as the theoretical lens for understanding and developing...... strategic outcomes of transport and logistics provision and supply chain value creation....

  13. Dairy cow responses to graded levels of rapeseed and soya bean expeller supplementation on a red clover/grass silage-based diet.

    Science.gov (United States)

    Rinne, M; Kuoppala, K; Ahvenjärvi, S; Vanhatalo, A

    2015-12-01

    The effects of rapeseed and soya bean expeller (SBE) supplementation on digestion and milk production responses in dairy cows were investigated in an incomplete Latin square design using five cows and four 3-week periods. The experimental diets consisted of five concentrate treatments fed at a rate of 9 kg/day: a mixture of barley and oats, which was replaced with rapeseed or SBE at two levels (CP concentration (g/kg dry matter (DM)) of 130 for the control concentrate and 180 and 230 for the two protein supplemented levels). A mixture of grass and red clover silage (1:1) was fed ad libitum and it had a CP concentration of 157 g/kg DM. Supply of nutrients to the lower tract was measured using the omasal canal sampling technique, and total digestion from total faecal collection. Protein supplementation increased omasal canal amino acid (AA) flows and plasma concentrations of AA, and was also reflected as increased milk production. However, N use efficiency (NUE) decreased with increased protein supplementation. Rapeseed expeller (RSE) tended to increase silage DM intake and elicited higher milk production responses compared with SBE and also resulted in a higher NUE. The differences between the protein supplements in nitrogen metabolism were relatively small, for example, there were no differences in the efficiency of microbial protein synthesis or omasal canal flows of nitrogenous components between them, but plasma methionine concentration was lower for soya bean-fed cows at the high CP level in particular. The lower milk protein production responses to SBE than to RSE supplementation were at least partly caused by increased silage DM and by the lower methionine supply, which may further have been amplified by the use of red clover in the basal diet. Although feed intake, diet digestion, AA supply and milk production were all consistently improved by protein supplementation, there was a simultaneous decrease in NUE. In the current study, the milk protein production

  14. Oral protein calorie supplementation for children with chronic disease

    Science.gov (United States)

    Francis, Damian K; Smith, Joanne; Saljuqi, Tawab; Watling, Ruth M

    2015-01-01

    Background Poor growth and nutritional status are common in children with chronic diseases. Oral protein calorie supplements are used to improve nutritional status in these children. These expensive products may be associated with some adverse effects, e.g. the development of inappropriate eating behaviour patterns. This is a new update of a Cochrane review last updated in 2009. Objectives To examine evidence that in children with chronic disease, oral protein calorie supplements alter daily nutrient intake, nutritional indices, survival and quality of life and are associated with adverse effects, e.g. diarrhoea, vomiting, reduced appetite, glucose intolerance, bloating and eating behaviour problems. Search methods Trials of oral protein calorie supplements in children with chronic diseases were identified through comprehensive electronic database searches, handsearching relevant journals and abstract books of conference proceedings. Companies marketing these products were also contacted. Most recent search of the Group's Trials Register: 24 February 2015. Selection criteria Randomised or quasi-randomised controlled trials comparing oral protein calorie supplements for at least one month to increase calorie intake with existing conventional therapy (including advice on improving nutritional intake from food or no specific intervention) in children with chronic disease. Data collection and analysis We independently assessed the outcomes: indices of nutrition and growth; anthropometric measures of body composition; calorie and nutrient intake (total from oral protein calorie supplements and food); eating behaviour; compliance; quality of life; specific adverse effects; disease severity scores; and mortality; we also assessed the risk of bias in the included trials. Main results Four studies (187 children) met the inclusion criteria. Three studies were carried out in children with cystic fibrosis and one study included children with paediatric malignant disease

  15. Supply kits for antenatal and childbirth care: a systematic review.

    Science.gov (United States)

    Aleman, Alicia; Tomasso, Giselle; Cafferata, María Luisa; Colomar, Mercedes; Betran, Ana Pilar

    2017-12-13

    It is critical to increase the uptake of interventions proven to be effective to improve maternal and perinatal outcomes. Supply kits have been suggested to be a feasible strategy designed to ensure timely availability and effective follow-up of care. We conducted a systematic review to summarize the evidence on the uptake, effectiveness and safety of supply kits for maternal care. MEDLINE, the Cochrane Pregnancy and Childbirth Group's Trials Register, Campbell Collaboration, Lilacs, Embase and unpublished studies were searched. Studies that reported the efficacy, safety and use of supply kits for maternal healthcare were eligible. Participants were pregnant women or in childbirth. Supply kits were defined as a collection of medicines, supplies or instruments packaged together with the aim of conducting a healthcare task. Two reviewers independently performed the screening, data extraction, and methodological and quality assessment. 24 studies were included: 4 of them were systematic reviews and 20 primary studies. Eighteen studies evaluated a so-called "clean delivery kit". In all but two studies, the kits were used by more than half of the participants. A meta-analysis was deemed inappropriate due to the heterogeneity in study design, in the components of the interventions implemented, in the content of the kits, and in outcomes. Nine studies assessed neonatal outcomes and found statistically significant reductions in cord infection, sepsis and tetanus-related mortality in the intervention group. Three studies showed evidence of reduced neonatal mortality (OR 0.52, 0.60 and 0.71) with statistically significant confidence intervals in all cases. Four studies reported odd ratios for maternal mortality, but only one showed evidence of a statistically significant decrease in this outcome but it was ascribed to hand washing prior to childbirth and not with the use of kits. This review suggests potential benefits in the use of supply kits to improve maternal and

  16. Safety evaluation report related to the operation of WPPSS Nuclear Project No. 2, (Docket No. 50-397). Supplement No. 4

    International Nuclear Information System (INIS)

    1983-12-01

    Supplement No. 4 to the Safety Evaluation Report on the application filed by Washington Public Power Supply System for a license to operate the WPPSS Nuclear Project No. 2, located in Richland, Washington, has been prepared by the Division of Licensing, Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement reports the status of certain items that had not been resolved at the time of publication of the Safety Evaluation Report and Supplement Nos. 1, 2 and 3

  17. Effects of vitamins, fatty acids, minerals, and other dietary supplements on schizophrenic symptoms in people with schizophrenia

    OpenAIRE

    Smedslund, Geir; Berg, Rigmor C.

    2011-01-01

    ENGLISH: There is considerable scientific disagreement about the possible effects of dietary supplements on mental health and illness. Do dietary supplements (possibly in megadoses) have an effect on symptoms and consequences of schizophrenia? We critically appraised randomized controlled trials about supplemental vitamins, fatty acids and other dietary supplements given to people diagnosed with schizophrenia. The primary outcome was symptoms of schizophrenia. We evaluated the evidence to be ...

  18. Safety evaluation report related to the operation of WPPSS Nuclear Project No. 2, Docket No. 50-397, Washington Public Power Supply System

    International Nuclear Information System (INIS)

    1982-12-01

    Supplement 2 to the Safety Evaluation Report for Washington Public Power Supply System's application for a license to operate WNP-2 (Docket No. 50-397), located in Benton County, Washington, approximately 12 miles north of Richland, Washington, has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. This supplement reports the status of certain items that had not been resolved at the time of publication of the Safety Evaluation Report and Supplement 1

  19. Effects of supplementary folic acid and vitamin B(12) on hepatic metabolism of dairy cows according to methionine supply.

    Science.gov (United States)

    Preynat, A; Lapierre, H; Thivierge, M C; Palin, M F; Cardinault, N; Matte, J J; Desrochers, A; Girard, C L

    2010-05-01

    The present experiment was undertaken to study the interactions between dietary supplements of rumen-protected methionine (RPM) and intramuscular injections of folic acid and vitamin B(12), given from 3 wk before calving to 16 wk of lactation, on hepatic metabolism of lactating dairy cows. Sixty multiparous Holstein cows were assigned to 10 blocks of 6 cows each according to their previous milk production. Within each block, 3 cows were fed a diet calculated to supply Met as 1.83% of metabolizable protein, whereas the 3 other cows were fed the same diet supplemented with 18g of RPM calculated to provide Met as 2.23% of metabolizable protein. Within each level of Met, the cows received no vitamin supplement or weekly intramuscular injections of 160mg of folic acid alone or combined with 10mg of vitamin B(12). Liver biopsies were taken at 2, 4, 8, and 16 wk of lactation. Liver concentrations of folates and vitamin B(12) were increased by their respective supplements but this response to vitamin supplements was altered by methionine supply. Concentrations of total lipids and triglycerides increased in livers of cows fed RPM, whereas concentrations of cholesterol ester, cholesterol, diglycerides, phosphatidylethanolamine, and phosphatidylcholine were not affected. Folic acid, alone or combined with vitamin B(12), tended to increase the ratio of phosphatidylcholine to phosphatidylethanolamine. Gene expression of 5,10-methylene-tetrahydrofolate reductase, microsomal transfer protein, and phosphatidylethanolamine methyltransferase were higher in liver of cows fed RPM supplements. The relative mRNA abundance of 5,10-methylene-tetrahydrofolate reductase and methylmalonyl-CoA mutase were increased by the combined injections of folic acid and vitamin B(12), whereas those of methionine synthase and methionine synthase reductase were not affected by treatments. These results suggest that increasing supply of methyl groups, as preformed labile methyl groups or through

  20. Effects of creatine supplementation on cardiac autonomic functions in bodybuilders.

    Science.gov (United States)

    Mert, Kadir Uğur; Ilgüy, Serdar; Dural, Muhammet; Mert, Gurbet Özge; Özakin, Engin

    2017-06-01

    Bodybuilder-type workouts may affect heart rate variability (HRV), which has considerable potential to assess the role of autonomic nervous system (ANS). A scientifically designed approach is necessary for bodybuilders to achieve better results while protecting their health. In this study, we aimed to investigate HRV parameters in bodybuilders compared to healthy control subjects and effects of creatine supplementation. A total of 48 male participants (16 controls, 16 supplement (-), 16 supplement (+)) were evaluated in our study. Bodybuilders who were taking creatine supplementation were enrolled in supplement (+) group. HRV parameters were measured from 24-hour Holter recordings of all participants. When mean heart rates were compared with control group (71.5 ± 12.6 beats/min), statistically significant difference was revealed in supplement (-) group (61.8 ± 6.8 beats/min; P = 0.022) unlike supplement (+) group (69.63 ± 14.1 beats/min; P = 0.650). HRV analyses revealed significant parasympathetic shift in supplement (-) group. No significant difference was demonstrated on HRV parameters, except high frequency (P = 0.029) in supplement (+) group. Conclusively, elevated parasympathetic modulation, which is favorable cardiovascular outcome of exercise, was demonstrated in bodybuilders. However, our study also revealed that creatine supplementation attenuates this favorable effect in ANS by limiting elevation of parasympathetic modulation. Although the sympathetic slight shift is attributed to creatine supplementation, it cannot be discriminated from the effects of over training. © 2017 Wiley Periodicals, Inc.

  1. Human Donor Milk or Formula: A Qualitative Study of Maternal Perspectives on Supplementation.

    Science.gov (United States)

    Rabinowitz, Molly R; Kair, Laura R; Sipsma, Heather L; Phillipi, Carrie A; Larson, Ilse A

    2018-04-01

    Breastfeeding is fundamental to maternal and child health and is the most cost-effective intervention to reduce child mortality. Pasteurized human donor milk (HDM) is increasingly provided for term newborns requiring temporary supplementation. Few studies examine maternal perspectives on supplementation of term newborns. We conducted semistructured in-person interviews with mothers of term newborns (n = 24) during postpartum hospitalization. Mothers were asked whether they had chosen or would choose to supplement with HDM versus infant formula, if medically indicated, and why. Data were gathered to saturation and analyzed inductively by consensus. Emerging semantic themes were compared between mothers who chose or would choose HDM and those who chose or would choose infant formula. Most mothers had concerns about HDM, including uncertainty regarding screening and substances passed through HDM. Experiences with prior children influenced decision-making. Mothers who chose or would choose HDM (56%, n = 14) praised it as "natural," and some felt suspicious of infant formula as "synthetic." Mothers who chose or would choose infant formula (44%, n = 10) did not know enough about HDM to choose it, and many viewed infant formula as a short-term solution to supply concerns. Mothers unanimously mistrusted online milk purchasing sources, although the majority felt positively about using a friend or family member's milk. Counseling regarding term newborn supplementation should focus on HDM education, specifically on areas of greatest concern and uncertainty such as donor selection, screening, transmission of substances, and mother's milk supply. Research is needed to assess the long-term impact of attitudes and choices on breastfeeding.

  2. Tying supply chain costs to patient care.

    Science.gov (United States)

    Parkinson, Rosalind C

    2014-05-01

    In September 2014, the FDA will establish a unique device identification (UDI) system to aid hospitals in better tracking and managing medical devices and analyzing their effectiveness. When these identifiers become part of patient medical records, the UDI system will provide a much-needed link between supply cost and patient outcomes. Hospitals should invest in technology and processes that can enable them to trace supply usage patterns directly to patients and analyze how these usage patterns affect cost and quality.

  3. NAD+ Supplementation Attenuates Methylmercury Dopaminergic and Mitochondrial Toxicity in Caenorhabditis Elegans

    Science.gov (United States)

    Caito, Samuel W.; Aschner, Michael

    2016-01-01

    Methylmercury (MeHg) is a neurotoxic contaminant of our fish supply that has been linked to dopaminergic (DAergic) dysfunction that characterizes Parkinson’s disease. We have previously shown that MeHg causes both morphological and behavioral changes in the Caenorhabditis elegans DAergic neurons that are associated with oxidative stress. We were therefore interested in whether the redox sensitive cofactor nicotinamide adenine dinucleotide (NAD+) may be affected by MeHg and whether supplementation of NAD + may prevent MeHg-induced toxicities. Worms treated with MeHg showed depletion in cellular NAD + levels, which was prevented by NAD + supplementation prior to MeHg treatment. NAD + supplementation also prevented DAergic neurodegeneration and deficits in DAergic-dependent behavior upon MeHg exposure. In a mutant worm line that cannot synthesize NAD + from nicotinamide, MeHg lethality and DAergic behavioral deficits were more sensitive to MeHg than wildtype worms, demonstrating the importance of NAD + in MeHg toxicity. In wildtype worms, NAD + supplementation provided protection from MeHg-induced oxidative stress and mitochondrial dysfunction. These data show the importance of NAD + levels in the response to MeHg exposure. NAD + supplementation may be beneficial for MeHg-induced toxicities and preventing cellular damage involved in Parkinson’s disease. PMID:26865665

  4. Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality

    DEFF Research Database (Denmark)

    Smith, Emily R; Shankar, Anuraj H; Wu, Lee S-F

    2017-01-01

    -analysis of individual patient included data from 17 randomised controlled trials done in 14 low-income and middle-income countries, which compared multiple micronutrient supplements containing iron-folic acid versus iron-folic acid alone in 112 953 pregnant women. We generated study-specific estimates and pooled...... subgroup estimates using fixed-effects models and assessed heterogeneity between subgroups with the χ(2) test for heterogeneity. We did sensitivity analyses using random-effects models, stratifying by iron-folic acid dose, and exploring individual study effect. FINDINGS: Multiple micronutrient supplements...... containing iron-folic acid provided significantly greater reductions in neonatal mortality for female neonates compared with male neonates than did iron-folic acid supplementation alone (RR 0·85, 95% CI 0·75-0·96 vs 1·06, 0·95-1·17; p value for interaction 0·007). Multiple micronutrient supplements resulted...

  5. The Music Industry Conference Guide for Music Educators. A Supplement to the Music Educators Journal.

    Science.gov (United States)

    Music Educators Journal, 1988

    1988-01-01

    This supplement is a comprehensive guide to the music industry designed for music teachers. Included are tips for contacting music businesses and suggestions on ordering music, robes, instruments, computer software, and other supplies. Includes an annotated directory of Music Industry Conference members. (JDH)

  6. 15 CFR Supplement No. 2 to Part 740 - Items That May Be Donated To Meet Basic Human Needs Under the Humanitarian License Exception

    Science.gov (United States)

    2010-01-01

    ... Basic Human Needs Under the Humanitarian License Exception No. Supplement No. 2 to Part 740 Commerce and... Supplement No. 2 to Part 740—Items That May Be Donated To Meet Basic Human Needs Under the Humanitarian... Medicines and Supplies (c) Clothes and Household Goods Bedding Clothes Cooking Utensils Fabric Personal...

  7. Maternal Folic Acid Supplementation during Pregnancy and Childhood Allergic Disease Outcomes: A Question of Timing?

    Science.gov (United States)

    McStay, Catrina L.; Prescott, Susan L.; Bower, Carol; Palmer, Debra J.

    2017-01-01

    Since the early 1990s, maternal folic acid supplementation has been recommended prior to and during the first trimester of pregnancy, to reduce the risk of infant neural tube defects. In addition, many countries have also implemented the folic acid fortification of staple foods, in order to promote sufficient intakes amongst women of a childbearing age, based on concerns surrounding variable dietary and supplementation practices. As many women continue to take folic acid supplements beyond the recommended first trimester, there has been an overall increase in folate intakes, particularly in countries with mandatory fortification. This has raised questions on the consequences for the developing fetus, given that folic acid, a methyl donor, has the potential to epigenetically modify gene expression. In animal studies, folic acid has been shown to promote an allergic phenotype in the offspring, through changes in DNA methylation. Human population studies have also described associations between folate status in pregnancy and the risk of subsequent childhood allergic disease. In this review, we address the question of whether ongoing maternal folic acid supplementation after neural tube closure, could be contributing to the rise in early life allergic diseases. PMID:28208798

  8. The predicted lifetime costs and health consequences of calcium and vitamin D supplementation for fracture preventio

    DEFF Research Database (Denmark)

    Hagen, G.; Wisløff, T.; Sønbø Kristiansen, Ivar

    2016-01-01

    Summary: Some studies indicate that calcium supplementation increases cardiovascular risk. We assessed whether such effects could counterbalance the fracture benefits from supplementation. Accounting for cardiovascular outcomes, calcium may cause net harm and would not be cost-effective. Clinicians...... and to evaluate the cost-effectiveness of such supplementation. Methods: We created a probabilistic Markov simulation model that was analysed at the individual patient level. We analysed 65-year-old Norwegian women with a 2.3 % 10-year risk of hip fracture and a 9.3 % risk of any major fracture according......-, and high-risk scenario. Results: Assuming no cardiovascular effects, CaD supplementation produces improved health outcomes resulting in an incremental gain of 0.0223 quality-adjusted life years (QALYs) and increases costs by €322 compared with no treatment (cost-effectiveness ratio €14,453 per QALY gained...

  9. Long-term trends in U.S. gas supply and prices: 1992 edition of the GRI baseline projection of U.S. energy supply and demand to 2010

    International Nuclear Information System (INIS)

    Woods, T.J.

    1991-12-01

    The paper summarizes the gas supply outlook in the 1992 Edition of the GRI Baseline Projection of U.S. Energy Supply and Demand, which has been adopted as a major input to the planning cycle leading to the development of the Gas Research Institute (GRI) 1993 research and development program. The 1992 projection presents the GRI planning outlook for the economic and the energy supply and demand situation to the year 2010. It was prepared independently by GRI using publicly available data and a framework of commercially available models that GRI has developed over several years. It is not derived from the views of GRI member companies. The 1992 Edition of the GRI Baseline Projection presents an optimistic outlook for the U.S. gas industry in which increased gas supply can be obtained at competitive prices. The gas prices in the 1992 projection support growth in all major U.S. gas supply sources: lower-48, Alaska, Canada, Mexico, and LNG. By about 2005, U.S. gas supply is at its highest level ever. By 2010, U.S. gas supply has grown to almost 25 quads. U.S. gas production increases 2.6 quads between 1990 and 2010; imports increase 2.2 quads. Although imports do not increase as much as U.S. gas production, they account for an increased share of U.S. gas supply. The import share grows from 7 percent to 12 percent over the projection period. Supplemental gas sources provide about 1 percent of U.S. gas supply

  10. EDM forum supplement overview.

    Science.gov (United States)

    Calonge, Ned

    2012-07-01

    The Agency for Health Research and Quality funded the Electronic Data Methods Forum (EDM Forum) to share the experiences and learnings from 11 research teams funded through three different grant programs, each of which involve the use of electronic clinical data in Comparative Effectiveness Research and Patient-Centered Outcomes Research. This overview is meant to describe the context in which the EDM forum was created and to introduce the set of papers in this supplement to Medical Care that describe the challenges and approaches to the use of electronic clinical data in the three key areas of analytic methods, clinical informatics and data governance. The participants in the EDM Forum are providing innovative approaches to generate information that can support the building of a "learning health care system." The compilation of papers presented in this supplement should serve as a resource to others working to develop the infrastructure for collecting, validating and using electronic data for research.

  11. Keto-analogues and essential aminoacids and other supplements in the conservative management of chronic kidney disease.

    Science.gov (United States)

    Cupisti, Adamasco; Bolasco, Piergiorgio

    2017-06-01

    The manipulation of dietary protein intake is the mainstay of nutritional treatment of patients affected by chronic renal insufficiency, with the aim to reduce the burden of uremic toxins in order to decrease uremic toxicity and delay the need for dialysis. Consensus exists regarding the benefit of progressive protein restriction towards delaying the progression of renal failure and the need for dialysis, provided adequate energy supply. Although pivotal, protein restriction is only one aspect of the dietary management of chronic kidney disease (CKD) patients. Additional features, though strictly related to proteins, include modifications in sodium, phosphorus and energy intake, as well as in the source (animal or plant derived) of protein and lipids. In addition, supplements play an important role as a means to obtain both beneficial effects and nutritional safety in the renal patient. Essential amino acid and ketoacid mixtures are the most utilized types of supplementation in CKD patients on restricted protein regimens. The essential amino acids plus ketoacid supplementation is mandatory in conjunction with a very low-protein diet in order to assure an adequate essential amino acid supply. It is needed to safely implement a very low protein (and phosphorus) intake, so as to obtain the beneficial effect of a severe protein restriction while preventing malnutrition. Protein-free products and energy supplements are also crucial for the prevention of protein-energy wasting in CKD patients. Calcium, iron, native vitamin D and omega-3 PUFAs are other types of supplementation of potential benefits in the CKD patients on conservative management.

  12. A Randomized Trial of Vitamin D Supplementation on Vascular Function in CKD.

    Science.gov (United States)

    Kumar, Vivek; Yadav, Ashok Kumar; Lal, Anupam; Kumar, Vinod; Singhal, Manphool; Billot, Laurent; Gupta, Krishan Lal; Banerjee, Debasish; Jha, Vivekanand

    2017-10-01

    Vitamin D deficiency associates with mortality in patients with CKD, and vitamin D supplementation might mitigate cardiovascular disease risk in CKD. In this randomized, double-blind, placebo-controlled trial, we investigated the effect of cholecalciferol supplementation on vascular function in 120 patients of either sex, aged 18-70 years, with nondiabetic CKD stage 3-4 and vitamin D deficiency (serum 25-hydroxyvitamin D ≤20 ng/ml). We randomized patients using a 1:1 ratio to receive either two directly observed oral doses of cholecalciferol (300,000 IU) or matching placebo at baseline and 8 weeks. The primary outcome was change in endothelium-dependent brachial artery flow-mediated dilation at 16 weeks. Secondary outcome measures included changes in pulse wave velocity and circulating biomarkers. Cholecalciferol supplementation significantly increased endothelium-dependent brachial artery flow-mediated dilation at 16 weeks, whereas placebo did not (between-group difference in mean change: 5.49%; 95% confidence interval, 4.34% to 6.64%; P vitamin D deficiency, vitamin D supplementation may improve vascular function. This study is registered with the Clinical Trials Registry of India (no.: CTRI/2013/05/003648). Copyright © 2017 by the American Society of Nephrology.

  13. Associations between adherence and outcomes among older, type 2 diabetes patients: evidence from a Medicare Supplemental database

    Directory of Open Access Journals (Sweden)

    Boye KS

    2016-08-01

    Full Text Available Kristina Secnik Boye,1 Sarah E Curtis,1 Maureen J Lage,2 Luis-Emilio Garcia-Perez3 1Global Patient Outcomes and Real World Evidence, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 2HealthMetrics Outcomes Research, LLC, Bonita Springs, FL, 3Global Medical Affairs, Lilly Diabetes, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA Objective: To examine the association between adherence to glucose-lowering agents and patient outcomes, including costs, acute-care resource utilization, and complications, in an older, type 2 diabetic population.Data and methods: The study used Truven’s Medicare Supplemental database from July 1, 2009 to June 30, 2014. Patients aged 65 years or older were included if they had at least two type 2 diabetes diagnoses and received a glucose-lowering agent from July 1, 2010 through June 30, 2011. Multivariable analyses examined the relationships among 3-year patient outcomes and levels of adherence, proxied by the proportion of days covered. Outcomes included all-cause medical costs, diabetes-related medical costs, acute-care resource utilization, and acute complications.Results: In this study (N=123,235, higher adherence was linked to reduced costs and improved health outcomes. For example, comparing an individual with adherence of proportion of days covered <20% to one with proportion of days covered ≥80% illustrates an average saving of $28,824 in total 3-year costs. Furthermore, a 1% increase in adherence among 1,000 patients was associated with all-cause savings of $65,464 over 3 years. The probability of a hospitalization, an emergency room (ER visit, or an acute complication decreased monotonically as adherence levels got higher, as did the number of hospitalizations, ER visits, and days hospitalized (P<0.005.Conclusion: Higher adherence was associated with substantially less need for acute care, as indicated by a lowered probability of hospitalization or ER use, a reduced

  14. Failure of controlling massive hemoptysis in bronchiectasis through BAE due to aberration blood supply from inferior phrenic arteries

    International Nuclear Information System (INIS)

    Liu Fengyong; Duan Feng; Wang Maoqiang; Song Peng; Wang Zhijun; Wang Zhongpu

    2008-01-01

    Objective: To describe the manifestations of the inferior phrenic arterial (IPA) blood supply in hemoptysis of bronchiectasis and to evaluate the safety and efficacy of transcatheter arterial embolization (TAE)of the IPA. Methods: During the past 5 years, 62 patients with hemoptysis due to bronchiectasis underwent BAE including 10 with additional blood supply from IPA. Mean patient age was 42.5 years (range, 26-58 years). Supplemental TAE using gelatin sponge particles and microcoils was undertaken in IPA supplying cases. The imaging findings of the IPA angiography, the predictive factors, the technique and clinical significance including safety of IPA embolization, were evaluated. Results: Selective arteriogram demonstrated enlargement of IPA, with numerous branches and neovasculature in all 10 cases, including contrast material extravasation in 4, and non-specific staining in 6 cases. In addition, there were IPA-to- pulmonary shunting in 8 cases, adjacent to the pleurae involving diaphragmatic and mediastinal pleura in 6 and only mediastinal pleura in 4. Technical success of IPA embolization was achieved in all 10 cases. Embolization of other nonbronchial systemic arteries (the internal thoracic artery in 4 and intercostal artery in 2)were performed at the same session. All bleedings ceased immediately after supplemental IPA embolization. Follow- up ranged from 8 months to 3 years, including mild recurrent hemoptysis in 2 patients at 2, 3 months respectively, but responsible to conservative management and no recurrent bleeding in 8 patients. Conclusion: Bronchiectatic hemoptysis may be further supplied by IPA, resulting in clinical failure of BAE and supplemental TAE of IPA is a safe and effective adjunct to BAE in the management. (authors)

  15. Increasing levels of crude protein in multiple supplements for grazing beef heifers in rainy season

    Directory of Open Access Journals (Sweden)

    Lívia Vieira de Barros

    2015-06-01

    Full Text Available The objective was to evaluate the effect of multiple supplements with differents levels of crude protein (CP or mineral supplements on the nutritional parameters and performance of beef heifers grazing Uruchloa decumbens in the rainy season. A complete random design was employed. The treatments were made up of increasing levels of CP in the multiple supplements and a control treatment (MM in which animals were offered only mineral mixture. Multiple supplements contained 17; 30; 43 and 56% of CP, for treatments CP17; CP30; CP43 and CP56, respectively. Average daily gain (ADG (g was 447.7; 554.6; 638.4; 587.9; 590.4, for treatments MM, CP17; CP30; CP43 and CP56, respectively. A quadratic effect of the levels of crude protein was found (p< 0.10 on ADG. A greater intake of dry matter (DM, organic matter (OM, CP, ether extract (EE, non-fibrous carbohydrates (NFC, total digestible nutrients (TDN, and digested dry matter (p< 0.10 was found in animals supplemented with multiple supplements. Multiple supplements increased the apparent digestibility coefficient of DM, CP, EE and NFC. Supply of multiple multiple supplements for heifers grazing in medium to high quality pastures in the rainy season improves the performance of the animals.

  16. Nutritional supplements for people being treated for active tuberculosis

    Science.gov (United States)

    Grobler, Liesl; Nagpal, Sukrti; Sudarsanam, Thambu D; Sinclair, David

    2016-01-01

    Background Tuberculosis and malnutrition are linked in a complex relationship. Tuberculosis may cause undernutrition through increased metabolic demands and decreased intake, and nutritional deficiencies may worsen the disease, or delay recovery by depressing important immune functions. At present, there is no evidence-based nutritional guidance for adults and children being treated for tuberculosis. Objectives To assess the effects of oral nutritional supplements in people being treated with antituberculous drug therapy for active tuberculosis. Search methods We searched the Cochrane Infectious Disease Group Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1, 2016), MEDLINE (from 1946 to 4 February 2016), EMBASE (from 1980 to 4 February 2016), LILACS (from 1982 to 4 February 2016), the metaRegister of Controlled Trials (mRCT), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), and the Indian Journal of Tuberculosis up to 4 February 2016, and checked the reference lists of all included studies. Selection criteria Randomized controlled trials that compared any oral nutritional supplement given for at least four weeks with no nutritional intervention, placebo, or dietary advice only for people being treated for active tuberculosis. The primary outcomes of interest were all-cause death, and cure at six and 12 months. Data collection and analysis Two review authors independently selected trials for inclusion, and extracted data and assessed the risk of bias in the included trials. We presented the results as risk ratios (RR) for dichotomous variables, and mean differences (MD) for continuous variables, with 95% confidence intervals (CIs). Where appropriate, we pooled data from trials with similar interventions and outcomes. We assessed the quality of the evidence using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Main results Thirty-five trials

  17. Does Supplementation with Omega-3 PUFAs Add to the Prevention of Cardiovascular Disease?

    Science.gov (United States)

    Rizos, Evangelos C; Elisaf, Moses S

    2017-06-01

    Omega-3 fatty acids are increasingly used for the protection of cardiovascular disease. The main but not the sole mechanism of action is the reduction of triglyceride levels. In this review, we summarize the effect of omega-3 supplements on all-cause and cardiovascular mortality, myocardial infarction, and stroke from the relevant randomized controlled trials. Twenty-one randomized controlled trials assessed omega-3 supplementation on mortality and cardiovascular-related outcomes. From these studies, as well as from the relevant meta-analyses, we found that omega-3 supplements do not exert a consistent benefit for cardiovascular protection. There is uncertainty of a clear profit from omega-3 supplementation in cardiovascular disease.

  18. Reduction of Sodium Arsenite-Mediated Adverse Effects in Mice using Dietary Supplementation of Water Hyacinth (Eichornia crassipes) Root Powder.

    Science.gov (United States)

    Sarker, Rim Sabrina Jahan; Ahsan, Nazmul; Hossain, Khaled; Ghosh, Paritosh Kumar; Ahsan, Chowdhury Rafiqul; Akhand, Anwarul Azim

    2012-07-01

    In this study, we evaluated the protective effects of water Hyacinth Root Powder (HRP) on arsenic-mediated toxic effects in mice. Swiss albino mice, used in this study, were divided into four different groups (for each group n=5). The control group was supplied with normal feed and water, Arsenic group (As-group) was supplied with normal feed plus arsenic (sodium arsenite)-containing water, and arsenic+hyacinth group (As+Hy group) was supplied with feed supplemented with HRP plus arsenic water. The remaining Hy-group was supplied with feed supplemented with HRP plus normal water. Oral administration of arsenic reduced the normal growth of the mice as evidenced by weight loss. Interestingly, tip of the tails of these mice developed wound that caused gradual reduction of the tail length. Supplementation of HRP in feed significantly prevented mice growth retardation and tail wounding in As+Hy group mice. However, the growth pattern in Hy-group mice was observed to be almost similar to that of the control group indicating that HRP itself has no toxic or negative effect in mice. Ingested arsenic also distorted the shape of the blood cells and elevated the serum enzymes such as lactate dehydrogenase (LDH), alkaline phosphatase (ALP) and serum glutamic pyruvic transaminase (SGPT). Importantly, elevation of these enzymes and distortion of blood cell shape were partially reduced in mice belong to As+Hy group, indicating HRP-mediated reduction of arsenic toxicity. Therefore, the preventive effect of hyacinth root on arsenic-poisoned mice suggested the future application of hyacinth to reduce arsenic toxicity in animal and human.

  19. The Search for Value and Meaning in the Cocoa Supply Chain in Costa Rica

    Science.gov (United States)

    Jessica Haynes; Frederick Cubbage; D. Evan Mercer; Erin Sills

    2012-01-01

    Qualitative interviews with participants in the cocoa (Theobroma cacao) supply chain in Costa Rica and the United States were conducted and supplemented with an analysis of the marketing literature to examine the prospects of organic and Fairtrade certification for enhancing environmentally and socially responsible trade of cocoa from Costa Rica. Respondents were...

  20. Maintaining adequate nutrient supply - Principles, decision-support tools, and best management practices [Chapter 6

    Science.gov (United States)

    Robert B. Harrison; Douglas A. Maguire; Deborah Page-Dumroese

    2011-01-01

    Maintaining adequate nutrient supply to maintain or enhance tree vigor and forest growth requires conservation of topsoil and soil organic matter. Sometimes nutrient amendments are also required to supplement inherent nutrient-pool limitations or replenish nutrients removed in harvested material. The goal is to maintain the productive potential of the soil and, when...

  1. Effect of oral supplementation of the linoleic and gammalinolenic acids on the diabetic pregnant rats

    Directory of Open Access Journals (Sweden)

    Marcos Consonni

    2012-10-01

    Full Text Available The aim of this work was to evaluate the direct protective action of oral fatty acid supplementation against the deleterious effect of hyperglycemia on maternal reproductive outcomes; fetal growth and development on female Wistar rats. The animals were distributed into four experimental groups: G1= non-diabetic without supplementation (Control group; G2= non-diabetic treated with linoleic (LA and gammalinolenic acid (GLA (1 mL of Gamaline-V/day; G3= diabetic without supplementation and G4= diabetic treated with LA and GLA. Diabetes was induced by streptozotocin (40 mg/kg. At day 21 of pregnancy, the gravid uterus was weighed and dissected to count the dead and live fetuses, resorption, implantation, and corpora lutea numbers. The fetuses were analyzed for external and internal anomalies. The treatment with Gamaline-V supplementation to diabetic rats interfered in the maternal reproductive outcome (reduced number of live fetuses and embryonic implantation; however, it protected the deleterious on the incidence of congenital anomalies caused by hyperglycemia.

  2. Vitamin supplementation for preventing miscarriage.

    Science.gov (United States)

    Balogun, Olukunmi O; da Silva Lopes, Katharina; Ota, Erika; Takemoto, Yo; Rumbold, Alice; Takegata, Mizuki; Mori, Rintaro

    2016-05-06

    Miscarriage is a common complication of pregnancy that can be caused by a wide range of factors. Poor dietary intake of vitamins has been associated with an increased risk of miscarriage, therefore supplementing women with vitamins either prior to or in early pregnancy may help prevent miscarriage. The objectives of this review were to determine the effectiveness and safety of any vitamin supplementation, on the risk of spontaneous miscarriage. We searched the Cochrane Pregnancy and Childbirth Group Trials Register (6 November 2015) and reference lists of retrieved studies. All randomised and quasi-randomised trials comparing supplementation during pregnancy with one or more vitamins with either placebo, other vitamins, no vitamins or other interventions. We have included supplementation that started prior to conception, periconceptionally or in early pregnancy (less than 20 weeks' gestation). Three review authors independently assessed trials for inclusion, extracted data and assessed trial quality. We assessed the quality of the evidence using the GRADE approach. The quality of evidence is included for numerical results of outcomes included in the 'Summary of findings' tables. We included a total of 40 trials (involving 276,820 women and 278,413 pregnancies) assessing supplementation with any vitamin(s) starting prior to 20 weeks' gestation and reporting at least one primary outcome that was eligible for the review. Eight trials were cluster-randomised and contributed data for 217,726 women and 219,267 pregnancies in total.Approximately half of the included trials were assessed to have a low risk of bias for both random sequence generation and adequate concealment of participants to treatment and control groups. Vitamin C supplementation There was no difference in the risk of total fetal loss (risk ratio (RR) 1.14, 95% confidence interval (CI) 0.92 to 1.40, seven trials, 18,949 women; high-quality evidence); early or late miscarriage (RR 0.90, 95% CI 0.65 to 1

  3. Vitamin D and cardiometabolic outcomes: a systematic review

    Science.gov (United States)

    Background: Vitamin D may modify risk of cardiometabolic outcomes (type 2 diabetes, hypertension, or cardiovascular disease). Purpose: Examine the association of vitamin D status and the effect of vitamin D supplementation on cardiometabolic outcomes. Data Sources: English-language studies in MEDLIN...

  4. Enhanced acetone-butanol-ethanol production from lignocellulosic hydrolysates by using starchy slurry as supplement.

    Science.gov (United States)

    Yang, Ming; Kuittinen, Suvi; Vepsäläinen, Jouko; Zhang, Junhua; Pappinen, Ari

    2017-11-01

    This study aims to improve acetone-butanol-ethanol production from the hydrolysates of lignocellulosic material by supplementing starchy slurry as nutrients. In the fermentations of glucose, xylose and the hydrolysates of Salix schwerinii, the normal supplements such as buffer, minerals, and vitamins solutions were replaced with the barley starchy slurry. The ABE production was increased from 0.86 to 14.7g/L by supplementation of starchy slurry in the fermentation of xylose and the utilization of xylose increased from 29% to 81%. In the fermentations of hemicellulosic and enzymatic hydrolysates from S. schwerinii, the ABE yields were increased from 0 and 0.26 to 0.35 and 0.33g/g sugars, respectively. The results suggested that the starchy slurry supplied the essential nutrients for ABE fermentation. The starchy slurry as supplement could improve the ABE production from both hemicellulosic and cellulosic hydrolysate of lignocelluloses, and it is particularly helpful for enhancing the utilization of xylose from hemicelluloses. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Surgical Outcomes of Plaque Excision and Grafting and Supplemental Tunica Albuginea Plication for Treatment of Peyronie's Disease With Severe Compound Curvature.

    Science.gov (United States)

    Chow, Alexander K; Sidelsky, Steven A; Levine, Laurence A

    2018-05-22

    There are limited data in the literature that describe the management of Peyronie's disease (PD) with severe compound curvature, which often requires additional straightening procedures after plaque excision and grafting (PEG) to achieve functional penile straightening (compound curvature treated with PEG and supplemental tunica albuginea plication (TAP). We performed a retrospective chart review of patients with PD and acute angulation who underwent PEG (group 1) and patients with compound curvature who underwent PEG with TAP (group 2) between 2007 and 2016. Primary post-operative outcomes of interest include change in penile curvature, change in measured stretched penile length, and subjective report on penile sensation and sexually induced penile rigidity. 240 Men with PD were included in the study, of which 79 (33%) patients in group 1 underwent PEG and 161 (67%) in group 2 underwent PEG and TAP. There was no difference in associated PD co-morbidities including age, hypertension, hyperlipidemia, hypogonadism, diabetes, or tobacco use. After artificial induction of erection with intracorporal trimix injection, the average primary curvature was 73 (range, 20-120) degrees for group 1 compared to 79 (range, 35-140) degrees for group 2 (P = .01). Group 2 had an average secondary curvature of 36 (20-80 degrees). After completion of PEG, men in group 2 had an average residual curvature of 30 (range, 20-50) degrees which required 1-6 TAPs to achieve functional straightness (compound curvature to date. Limitations of this study include the retrospective nature of the analysis as well as the lack of a validated objective measurement of erectile function after penile straightening. Our study found no baseline difference in underlying co-morbidities in men with severe compound curvature compared with men with acute severe angulated curvature. Men with severe compound curvature represent a severe and under-recognized population of men with PD who can be surgically

  6. Measures for a reliable and environmental power supply. Massnahmen fuer eine sichere und umweltvertraegliche Energieversorgung

    Energy Technology Data Exchange (ETDEWEB)

    Dolinski, U; Ziesing, H J

    1978-01-01

    This brochure, supplement and final part of a 1976 DIW study (Reliability, Pricing, and Environmental Aspects of Power Supply), presents the necessary technical and energy policy measures required for achieving certain goals in energy policy. Present and future measures taken in West Germany are presented. Effects and consequences of these steps are investigated, although a quantitative analysis was only possible in a few cases. Measures for ensuring the energy supply are listed according to energy sources; measures to reduce environmental pollution deal with pollutant emissions, thermal pollution, optical and acoustic load factors, and energy conservation.

  7. Therapeutic brain modulation with targeted large neutral amino acid supplements in the Pah-enu2 phenylketonuria mouse model.

    Science.gov (United States)

    van Vliet, Danique; Bruinenberg, Vibeke M; Mazzola, Priscila N; van Faassen, Martijn Hjr; de Blaauw, Pim; Pascucci, Tiziana; Puglisi-Allegra, Stefano; Kema, Ido P; Heiner-Fokkema, M Rebecca; van der Zee, Eddy A; van Spronsen, Francjan J

    2016-11-01

    Phenylketonuria treatment consists mainly of a Phe-restricted diet, which leads to suboptimal neurocognitive and psychosocial outcomes. Supplementation of large neutral amino acids (LNAAs) has been suggested as an alternative dietary treatment strategy to optimize neurocognitive outcome in phenylketonuria and has been shown to influence 3 brain pathobiochemical mechanisms in phenylketonuria, but its optimal composition has not been established. In order to provide additional pathobiochemical insight and develop optimal LNAA treatment, several targeted LNAA supplements were investigated with respect to all 3 biochemical disturbances underlying brain dysfunction in phenylketonuria. Pah-enu2 (PKU) mice received 1 of 5 different LNAA-supplemented diets beginning at postnatal day 45. Control groups included phenylketonuria mice receiving an isonitrogenic and isocaloric high-protein diet or the AIN-93M diet, and wild-type mice receiving the AIN-93M diet. After 6 wk, brain and plasma amino acid profiles and brain monoaminergic neurotransmitter concentrations were measured. Brain Phe concentrations were most effectively reduced by supplementation of LNAAs, such as Leu and Ile, with a strong affinity for the LNAA transporter type 1. Brain non-Phe LNAAs could be restored on supplementation, but unbalanced LNAA supplementation further reduced brain concentrations of those LNAAs that were not (sufficiently) included in the LNAA supplement. To optimally ameliorate brain monoaminergic neurotransmitter concentrations, LNAA supplementation should include Tyr and Trp together with LNAAs that effectively reduce brain Phe concentrations. The requirement for Tyr supplementation is higher than it is for Trp, and the relative effect of brain Phe reduction is higher for serotonin than it is for dopamine and norepinephrine. The study shows that all 3 biochemical disturbances underlying brain dysfunction in phenylketonuria can be targeted by specific LNAA supplements. The study thus

  8. Prenatal vitamin d supplementation and child respiratory health: a randomised controlled trial.

    Science.gov (United States)

    Goldring, Stephen T; Griffiths, Chris J; Martineau, Adrian R; Robinson, Stephen; Yu, Christina; Poulton, Sheree; Kirkby, Jane C; Stocks, Janet; Hooper, Richard; Shaheen, Seif O; Warner, John O; Boyle, Robert J

    2013-01-01

    Observational studies suggest high prenatal vitamin D intake may be associated with reduced childhood wheezing. We examined the effect of prenatal vitamin D on childhood wheezing in an interventional study. We randomised 180 pregnant women at 27 weeks gestation to either no vitamin D, 800 IU ergocalciferol daily until delivery or single oral bolus of 200,000 IU cholecalciferol, in an ethnically stratified, randomised controlled trial. Supplementation improved but did not optimise vitamin D status. Researchers blind to allocation assessed offspring at 3 years. Primary outcome was any history of wheeze assessed by validated questionnaire. Secondary outcomes included atopy, respiratory infection, impulse oscillometry and exhaled nitric oxide. Primary analyses used logistic and linear regression. We evaluated 158 of 180 (88%) offspring at age 3 years for the primary outcome. Atopy was assessed by skin test for 95 children (53%), serum IgE for 86 (48%), exhaled nitric oxide for 62 (34%) and impulse oscillometry of acceptable quality for 51 (28%). We found no difference between supplemented and control groups in risk of wheeze [no vitamin D: 14/50 (28%); any vitamin D: 26/108 (24%) (risk ratio 0.86; 95% confidence interval 0.49, 1.50; P = 0.69)]. There was no significant difference in atopy, eczema risk, lung function or exhaled nitric oxide between supplemented groups and controls. Prenatal vitamin D supplementation in late pregnancy that had a modest effect on cord blood vitamin D level, was not associated with decreased wheezing in offspring at age three years. Controlled-Trials.com ISRCTN68645785.

  9. Sports Supplements

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Sports Supplements KidsHealth / For Teens / Sports Supplements What's in ... really work? And are they safe? What Are Sports Supplements? Sports supplements (also called ergogenic aids ) are ...

  10. A social network model of supply chain management in formal and informal inter-firm engagement

    Directory of Open Access Journals (Sweden)

    Lokhman Hakim Osman

    2015-12-01

    Full Text Available Background: This research looks into the different effects of firms' network structural positions in an upstream supply network upon the firms' level of relational capital outcomes.  Previous research has largely focus on the context of decentralized network structure.  However, the supply network is a centralized network because of the existence of the focal firm.  The existence of the focal firm may influence the impact of relational capital outcomes.  Methods: The objective of this research is to determine the type of network structural positions required to obtain reasonable relational capital outcome in upstream supply network.  Results and conclusions: This study found that, network structural positions i.e. betweeness centrality contributed to firms' level of relational capital influence. In conclusion, firms, embedded in upstream supply network benefits differently in terms of relational capital through different degree of embeddedness.  Firms' resources should be re-aligned to match the benefits with the different network structural positions.

  11. Efficacy of using a combination of rendered protein products as an undegradable intake protein supplement for lactating, winter-calving, beef cows fed bromegrass hay.

    Science.gov (United States)

    Encinias, A M; Lardy, G P; Leupp, J L; Encinias, H B; Reynolds, L P; Caton, J S

    2005-01-01

    Seventy-two (36 in each of two consecutive years) lactating, British-crossbred cows (609 +/- 19 kg) were used to evaluate effects of feeding a feather meal-blood meal combination on performance by beef cows fed grass hay. Bromegrass hay (9.6% CP, DM basis) was offered ad libitum and intake was measured daily in individual Calan electronic headgates. Acclimation to Calan gates began approximately 20 d after parturition, and treatments were initiated 21 d later. Cows were assigned randomly to one of four treatments (DM basis) for 60 d: 1) nonsupplemented control (CON), 2) energy control (ENG; 790 g/d; 100% beet pulp), 3) degradable intake protein (DIP; 870 g/d; 22% beet pulp and 78% sunflower meal), or 4) undegradable intake protein (UIP; 800 g/d; 62.5% sunflower meal, 30% hydrolyzed feather meal, and 7.5% blood meal). Net energy concentrations of supplements were formulated to provide similar NE(m) intakes (1.36 Mcal/d). The DIP and UIP supplements were calculated to supply similar amounts of DIP (168 g/d) and to supply 64 and 224 g/d of UIP, respectively. Forage DMI (kg/d) decreased in supplemented vs. nonsupplemented (P = 0.03) and DIP vs. UIP (P = 0.001); however, when expressed as a percentage of BW, forage DMI was not different (P = 0.23). Supplemented cows tended (P = 0.17) to lose less BW than CON. Body condition change was not affected (P = 0.60) by postpartum supplementation. No differences were noted in milk production (P = 0.29) or in calf gain during the supplementation period (P = 0.74). Circulating insulin concentrations were not affected by treatment (P = 0.42). In addition, supplementation did not affect circulating concentrations of NEFA (P = 0.18) or plasma urea nitrogen (P = 0.38). Results of the current study indicate that supplementation had little effect on BW, BCS, milk production, or calf BW when a moderate-quality forage (9.6% CP) was fed to postpartum, winter-calving cows in optimal body condition (BCS > 5). Supplemental UIP did not enhance

  12. The Growth of Private Regulation of Labor Standards in Global Supply Chains

    DEFF Research Database (Denmark)

    Knudsen, Jette Steen

    2013-01-01

    Multinational corporations (MNCs) have come under pressure to adopt private regulatory initiatives such as supplier codes of conduct in order to address poor working conditions in global supply chain factories. While a well-known literature explores drivers and outcomes of such monitoring schemes...... requirements in global supply chains even though compliance is a “mission impossible” for many smaller firms. As a result of this development, the private regulatory system is facing growing strain.......Multinational corporations (MNCs) have come under pressure to adopt private regulatory initiatives such as supplier codes of conduct in order to address poor working conditions in global supply chain factories. While a well-known literature explores drivers and outcomes of such monitoring schemes......, this literature focuses mainly on large firms and has ignored the growing integration of small- and medium-sized enterprises (SMEs) into global supply chains. Furthermore, the literature on corporate social responsibility (CSR) in SMEs primarily emphasizes domestic initiatives and not global challenges. Focusing...

  13. Effect of Supplemental Vitamin E for the Prevention and Treatment of Cardiovascular Disease

    Science.gov (United States)

    Shekelle, Paul G; Morton, Sally C; Jungvig, Lara K; Udani, Jay; Spar, Myles; Tu, Wenli; Suttorp, Marika J; Coulter, Ian; Newberry, Sydne J; Hardy, Mary

    2004-01-01

    OBJECTIVE To evaluate and synthesize the evidence on the effect of supplements of vitamin E on the prevention and treatment of cardiovascular disease. DESIGN Systematic review of placebo-controlled randomized controlled trials; meta-analysis where justified. MEASUREMENTS AND MAIN RESULTS Eighty-four eligible trials were identified. For the outcomes of all-cause mortality, cardiovascular mortality, fatal or nonfatal myocardial infarction, and blood lipids, neither supplements of vitamin E alone nor vitamin E given with other agents yielded a statistically significant beneficial or adverse pooled relative risk (for example, pooled relative risk of vitamin E alone = 0.96 [95% confidence interval (CI), 0.84 to 1.10]; 0.97 [95% CI, 0.80 to 1.90]; and 0.72 [95% CI, 0.51 to 1.02] for all-cause mortality, cardiovascular mortality, and nonfatal myocardial infarction, respectively. CONCLUSIONS There is good evidence that vitamin E supplementation does not beneficially or adversely affect cardiovascular outcomes. PMID:15061748

  14. The effects of an L-methionine combination supplement on ...

    African Journals Online (AJOL)

    Interventions. L-methionine combination supplement (L-methionine, vitamin B6, vitamin B12, folic acid and magnesium) or placebo containing potato starch. Main outcome measures. Incidence of URTS was recorded during the runner's preparation for an ultramarathon race (75 days) and recovery from the same (75 days).

  15. A combined supplementation of vitamin B12 and omega-3 fatty acids across two generations improves cardiometabolic variables in rats.

    Science.gov (United States)

    Khaire, Amrita; Rathod, Richa; Randhir, Karuna; Kale, Anvita; Joshi, Sadhana

    2016-09-14

    Our earlier studies indicate that micronutrients (vitamin B12, folic acid) and omega-3 fatty acids especially docosahexaenoic acid (DHA) are interlinked in one carbon cycle. The present study examines the effects of a sustained vitamin B12 deficiency/supplementation in the presence of omega-3 fatty acids across two generations on the pregnancy outcome and cardiometabolic profile [blood pressure, plasma lipid profile (cholesterol and triglycerides), plasma/liver fatty acid profile and hepatic lipid metabolism] in the second generation adult Wistar rat offspring. Two generations of animals were fed the following diets: control; vitamin B12 deficient; vitamin B12 supplemented; vitamin B12 deficient diet supplemented with omega-3 fatty acids; vitamin B12 and omega-3 fatty acid supplemented diets. Male offspring were sacrificed at 3 months of age. Vitamin B12 deficiency lowered the weight gain (p blood pressure, and lowered the levels of plasma/liver DHA (p lipid profile. Vitamin B12 supplementation showed weight gain, blood pressure and the fatty acid profile similar to the control. However, it increased (p acid supplementation to the vitamin B12 deficient group lowered the weight gain although the levels of cardiometabolic variables were comparable to the control. Omega-3 fatty acid supplementation in the presence of vitamin B12 improved the pregnancy outcome and all cardio-metabolic variables. Our study highlights the adverse effects of sustained vitamin B12 deficiency across two generations on the pregnancy outcome, fatty acid profile and blood pressure while a combined supplementation of vitamin B12 and omega-3 fatty acids is beneficial.

  16. Supply of nutrients and productive responses in dairy cows given diets based on restrictively fermented silage

    Directory of Open Access Journals (Sweden)

    P. HUHTANEN

    2008-12-01

    Full Text Available The objective of this paper is to review research which has evaluated the feeding of dairy cows with diets containing large proportions of grass silage. In Finland, milk production systems evolved are based on the use of restrictively fermented silages. Higher potential yields, smaller production risks than with cereal grains, short grazing period and high digestibility of grasses grown in northern latitudes have facilitated this development. Factors affecting nutrient supply from these diets are discussed. Digestibility is determined mainly by the stage of maturity at harvesting and it is not markedly affected by the level of energy and protein supplementation. Intake of grass silage is influenced both by digestibility and fermentation characteristics. Efficiency of microbial synthesis is high in animals given diets based on restrictively fermented silage but rumen fermentation pattern is characterised by low molar proportions of propionate. Production responses to additional concentrate are relatively small, especially when the amount of concentrate exceeds 10 kg day-1. High substitution of silage dry matter (DM, negative associative effects on digestion and partitioning of energy towards body tissues account for small production responses. Protein supplementation has consistently increased milk protein yield but responses do not appear to be related to the level of milk production, silage crude protein content, amount of concentrate or stage of lactation. The new protein evaluation system provides an accurate prediction of protein yield with the typical Finnish dairy cow diets. The high slopes (ca. 0.5 between protein supply and milk protein yield within experiments suggest that protein supply is suboptimal and protein supplements are used with a high efficiency.;

  17. l-Carnitine Supplementation in Recovery after Exercise.

    Science.gov (United States)

    Fielding, Roger; Riede, Linda; Lugo, James P; Bellamine, Aouatef

    2018-03-13

    Given its pivotal role in fatty acid oxidation and energy metabolism, l-carnitine has been investigated as ergogenic aid for enhancing exercise capacity in the healthy athletic population. Early research indicates its beneficial effects on acute physical performance, such as increased maximum oxygen consumption and higher power output. Later studies point to the positive impact of dietary supplementation with l-carnitine on the recovery process after exercise. It is demonstrated that l-carnitine alleviates muscle injury and reduces markers of cellular damage and free radical formation accompanied by attenuation of muscle soreness. The supplementation-based increase in serum and muscle l-carnitine contents is suggested to enhance blood flow and oxygen supply to the muscle tissue via improved endothelial function thereby reducing hypoxia-induced cellular and biochemical disruptions. Studies in older adults further showed that l-carnitine intake can lead to increased muscle mass accompanied by a decrease in body weight and reduced physical and mental fatigue. Based on current animal studies, a role of l-carnitine in the prevention of age-associated muscle protein degradation and regulation of mitochondrial homeostasis is suggested.

  18. Folic acid supplements in pregnancy and early childhood respiratory health.

    Science.gov (United States)

    Håberg, S E; London, S J; Stigum, H; Nafstad, P; Nystad, W

    2009-03-01

    Folate supplementation is recommended for pregnant women to reduce the risk of congenital malformations. Maternal intake of folate supplements during pregnancy might also influence childhood immune phenotypes via epigenetic mechanisms. To investigate the relationship between folate supplements in pregnancy and risk of lower respiratory tract infections and wheeze in children up to 18 months of age. In the Norwegian Mother and Child Cohort Study, questionnaire data collected at several time points during pregnancy and after birth on 32,077 children born between 2000 and 2005 were used to assess the effects of folate supplements during pregnancy on respiratory outcomes up to 18 months of age, while accounting for other supplements in pregnancy and supplementation in infancy. Folate supplements in the first trimester were associated with increased risk of wheeze and respiratory tract infections up to 18 months of age. Adjusting for exposure later in pregnancy and in infancy, the relative risk for wheeze for children exposed to folic acid supplements in the first trimester was 1.06 (95% CI 1.03 to 1.10), the relative risk for lower respiratory tract infections was 1.09 (95% CI 1.02 to 1.15) and the relative risk for hospitalisations for lower respiratory tract infections was 1.24 (95% CI 1.09 to 1.41). Folic acid supplements in pregnancy were associated with a slightly increased risk of wheeze and lower respiratory tract infections up to 18 months of age. The results suggest that methyl donors in the maternal diet during pregnancy may influence respiratory health in children consistent with epigenetic mechanisms.

  19. Coordinating Contracts for Two-Stage Fashion Supply Chain with Risk-Averse Retailer and Price-Dependent Demand

    Directory of Open Access Journals (Sweden)

    Minli Xu

    2013-01-01

    Full Text Available When the demand is sensitive to retail price, revenue sharing contract and two-part tariff contract have been shown to be able to coordinate supply chains with risk neutral agents. We extend the previous studies to consider a risk-averse retailer in a two-echelon fashion supply chain. Based on the classic mean-variance approach in finance, the issue of channel coordination in a fashion supply chain with risk-averse retailer and price-dependent demand is investigated. We propose both single contracts and joint contracts to achieve supply chain coordination. We find that the coordinating revenue sharing contract and two-part tariff contract in the supply chain with risk neutral agents are still useful to coordinate the supply chain taking into account the degree of risk aversion of fashion retailer, whereas a more complex sales rebate and penalty (SRP contract fails to do so. When using combined contracts to coordinate the supply chain, we demonstrate that only revenue sharing with two-part tariff contract can coordinate the fashion supply chain. The optimal conditions for contract parameters to achieve channel coordination are determined. Numerical analysis is presented to supplement the results and more insights are gained.

  20. Probiotic supplementation in children with cystic fibrosis-a systematic review.

    Science.gov (United States)

    Ananthan, Anitha; Balasubramanian, Haribalakrishna; Rao, Shripada; Patole, Sanjay

    2016-10-01

    Probiotics may benefit in cystic fibrosis (CF) as gut dysbiosis is associated with gastrointestinal symptoms and exacerbation of respiratory symptoms in CF. We conducted a systematic review of randomized controlled trials (RCTs) and non-RCTs of probiotic supplementation in children with CF, using the Cochrane methodology, preferred reporting items for systematic reviews (PRISMA) statement, and meta-analysis of observational studies in epidemiology (MOOSE) guidelines. Primary outcomes were pulmonary exacerbations, duration of hospitalization and antibiotics, and all-cause mortality. Secondary outcomes included gastrointestinal symptoms, markers of gut inflammation, and intestinal microbial balance. A total of nine studies (RCTs, 6, non-RCTs, 3; N = 275) with some methodological weaknesses were included in the review. The pooled estimate showed significant reduction in the rate of pulmonary exacerbation (fixed effects model, two parallel group RCTs and one cross-over trial: relative risk (RR) 0.25, (95 % confidence interval (95 % CI) 0.15,0.41); p probiotic supplementation. Probiotic supplementation significantly improved gastrointestinal symptoms (one RCT, one non-RCT) and gut microbial balance (decreased Proteobacteria, increased Firmicutes, and Bacteroides in one RCT, one non-RCT). Limited low-quality evidence exists on the effects of probiotics in children with CF. Well-designed adequately powered RCTs assessing clinically meaningful outcomes are required to study this important issue. • Gut dysbiosis is frequent in children with cystic fibrosis due to frequent exposure to pathogens and antibiotics. • Probiotics decrease gut dysbiosis and improve gut maturity and function. What is New: • This comprehensive systematic review shows that current evidence on the safety and efficacy of probiotics in children with cystic fibrosis is limited and of low quality. • Well-designed and adequately powered trials assessing clinically important outcomes are

  1. Behavior pattern of beef heifers supplemented with different energy sources on oat and ryegrass pasture

    Directory of Open Access Journals (Sweden)

    Luiz Angelo Damian Pizzuti

    2012-08-01

    Full Text Available The objective of this study was to evaluate behavior patterns of heifers grazing on black oat (Avena strigosa Schreb. and ryegrass (Lolium multiflorum Lam., fed supplementation with brown rice meal and/or protected fat. A total of 28 Charolais × Nellore crossbred heifers at average initial age of 18 months and with initial live weight of 274.9±4.97 kg were used in the experiment. Animals were kept in oat + ryegrass pastures and distributed in the following treatments: no supplementation; Megalac (MEG: protected fat supplementation; supplementation with brown rice meal (BRM; and supplementation with BRM + MEG. The neutral detergent fiber (NDF intake of pasture either in kg or in percentage of live weight was not changed by supply of supplement, but increased linearly (0.045 kg per day over grazing periods. Supplementation with BRM and BRM + MEG reduced grazing time, 49.63%, in relation to non-supplemented animals and animals supplemented with MEG, 63.13%. Feeding seasons per minute increased over the experimental period with reduction in time spent in each feeding station. The number of bites per feeding station decreased linearly, with a variation of 34.48% in the late grazing period. Heifers supplemented with BRM and BRM + MEG require less time for grazing and increase their idle time, with no modification in displacement patterns within the paddocks and pasture ingestion. Grazing and idle time does not change in the distinct periods of pasture use, but rumination time increases with days of pasture use and with increase in NDF intake.

  2. Empirical Analysis of Green Supply Chain Management Practices in Indian Automobile Industry

    Science.gov (United States)

    Luthra, S.; Garg, D.; Haleem, A.

    2014-04-01

    Environmental sustainability and green environmental issues have an increasing popularity among researchers and supply chain practitioners. An attempt has been made to identify and empirically analyze green supply chain management (GSCM) practices in Indian automobile industry. Six main GSCM practices (having 37 sub practices) and four expected performance outcomes (having 16 performances) have been identified by implementing GSCM practices from literature review. Questionnaire based survey has been made to validate these practices and performance outcomes. 123 complete questionnaires were collected from Indian automobile organizations and used for empirical analysis of GSCM practices in Indian automobile industry. Descriptive statistics have been used to know current implementation status of GSCM practices in Indian automobile industry and multiple regression analysis has been carried out to know the impact on expected organizational performance outcomes by current GSCM practices adopted by Indian automobile industry. The results of study suggested that environmental, economic, social and operational performances improve with the implementation of GSCM practices. This paper may play an important role to understand various GSCM implementation issues and help practicing managers to improve their performances in the supply chain.

  3. Energy Supply and Demand Planning Aspects in Slovenia

    International Nuclear Information System (INIS)

    Tomsic, M.; Urbancic, A.; Al Mansour, F.; Merse, S.

    1997-01-01

    Slovenia can be considered a sufficiently homogenous region, even though specific climatic conditions exist in some parts of the country. Urban regions with high energy consumptions density differ in logistic aspects and in the potential of renewable energy sources. The difference in household energy demand is not significant. The planning study is based on the ''Integrated Resource Planning'' approach. A novel energy planning tool, the MESAP-PlaNet energy system model, supplemented by auxiliary models of technology penetration, electricity demand analysis and optimal expansion planning (the WASP package) has been used. The following segments has been treated in detail: industry, households and both central and local supply systems. Three intensities of energy efficiency strategies are compared: Reference, Moderate and Intensive. The intensity of demand side management programs influence the level and dynamics of activation of conservation potentials. Energy tax is considered in the Moderate and Intensive strategies. On the supply side the issue of domestic coal use is discussed. Reduction in the use of coal is linked to energy efficiency strategies. It has been found that energy efficiency strategies consistently improve economic efficiency, security of supply and protection of health and environment. The only conflicting area is social acceptability, due to both the energy tax reform and the loss of mining jobs. (author)

  4. Biomass supply chain optimisation for Organosolv-based biorefineries.

    Science.gov (United States)

    Giarola, Sara; Patel, Mayank; Shah, Nilay

    2014-05-01

    This work aims at providing a Mixed Integer Linear Programming modelling framework to help define planning strategies for the development of sustainable biorefineries. The up-scaling of an Organosolv biorefinery was addressed via optimisation of the whole system economics. Three real world case studies were addressed to show the high-level flexibility and wide applicability of the tool to model different biomass typologies (i.e. forest fellings, cereal residues and energy crops) and supply strategies. Model outcomes have revealed how supply chain optimisation techniques could help shed light on the development of sustainable biorefineries. Feedstock quality, quantity, temporal and geographical availability are crucial to determine biorefinery location and the cost-efficient way to supply the feedstock to the plant. Storage costs are relevant for biorefineries based on cereal stubble, while wood supply chains present dominant pretreatment operations costs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Long-term effects of LCPUFA supplementation on childhood cognitive outcomes.

    Science.gov (United States)

    Colombo, John; Carlson, Susan E; Cheatham, Carol L; Shaddy, D Jill; Kerling, Elizabeth H; Thodosoff, Jocelynn M; Gustafson, Kathleen M; Brez, Caitlin

    2013-08-01

    The effect of long-chain polyunsaturated fatty acid (LCPUFA) intake on cognitive development is controversial. Most randomized trials have assessed cognition at 18 mo, although significant development of cognitive abilities (early executive function) emerge later. The objective was to evaluate cognition beyond 18 mo and longitudinal cognitive change from 18 mo to 6 y in children who were fed variable amounts of docosahexaenoic acid (0.32%, 0.64%, and 0.96% of total fatty acids) and arachidonic acid (ARA; 0.64%) compared with children who were not fed LCPUFA as infants. Eighty-one children (19 placebo, 62 LCPUFA) who participated in a double-blind, randomized trial of LCPUFA supplementation as infants were re-enrolled at 18 mo and tested every 6 mo until 6 y on age-appropriate standardized and specific cognitive tests. LCPUFA supplementation did not influence performance on standardized tests of language and performance at 18 mo; however, significant positive effects were observed from 3 to 5 y on rule-learning and inhibition tasks, the Peabody Picture Vocabulary Test at 5 y, and the Weschler Primary Preschool Scales of Intelligence at 6 y. Effects of LCPUFAs were not found on tasks of spatial memory, simple inhibition, or advanced problem solving. The data from this relatively small trial suggest that, although the effects of LCPUFAs may not always be evident on standardized developmental tasks at 18 mo, significant effects may emerge later on more specific or fine-grained tasks. The results imply that studies of nutrition and cognitive development should be powered to continue through early childhood. This parent trial was registered at clinicaltrials.gov as NCT00266825.

  6. Chromium supplementation improved post-stroke brain infarction and hyperglycemia.

    Science.gov (United States)

    Chen, Wen-Ying; Mao, Frank Chiahung; Liu, Chia-Hsin; Kuan, Yu-Hsiang; Lai, Nai-Wei; Wu, Chih-Cheng; Chen, Chun-Jung

    2016-04-01

    Hyperglycemia is common after acute stroke and is associated with a worse outcome of stroke. Thus, a better understanding of stress hyperglycemia is helpful to the prevention and therapeutic treatment of stroke. Chromium is an essential nutrient required for optimal insulin activity and normal carbohydrate and lipid metabolism. Beyond its nutritional effects, dietary supplement of chromium causes beneficial outcomes against several diseases, in particular diabetes-associated complications. In this study, we investigated whether post-stroke hyperglycemia involved chromium dynamic mobilization in a rat model of permanent focal cerebral ischemia and whether dietary supplement of chromium improved post-stroke injury and alterations. Stroke rats developed brain infarction, hyperglycemia, hyperinsulinemia, glucose intolerance, and insulin resistance. Post-stroke hyperglycemia was accompanied by elevated secretion of counter-regulatory hormones including glucagon, corticosterone, and norepinephrine, decreased insulin signaling in skeletal muscles, and increased hepatic gluconeogenesis. Correlation studies revealed that counter-regulatory hormone secretion showed a positive correlation with chromium loss and blood glucose increased together with chromium loss. Daily chromium supplementation increased tissue chromium levels, attenuated brain infarction, improved hyperglycemia, and decreased plasma levels of glucagon and corticosterone in stroke rats. Our findings suggest that stroke rats show disturbance of tissue chromium homeostasis with a net loss through urinary excretion and chromium mobilization and loss might be an alternative mechanism responsible for post-stroke hyperglycemia.

  7. Tyrosine supplementation for phenylketonuria.

    Science.gov (United States)

    Webster, Diana; Wildgoose, Joanne

    2013-06-05

    and extracted the data. Six trials were found, of which three trials reporting the results of a total of 56 participants, were suitable for inclusion in the review. The blood tyrosine concentrations were significantly higher in the participants receiving tyrosine supplements than those in the placebo group, mean difference 23.46 (95% confidence interval 12.87 to 34.05). No significant differences were found between any of the other outcomes measured. From the available evidence no recommendations can be made about whether tyrosine supplementation should be introduced into routine clinical practice. Further randomised controlled studies are required to provide more evidence.

  8. Use of Dietary Supplements in Patients Seeking Treatment at a Periodontal Clinic

    Directory of Open Access Journals (Sweden)

    Wendy E. Ward

    2013-04-01

    Full Text Available Dietary supplement use may modify the risk of periodontal disease but effects on wound healing after periodontal procedures are less clear. This study characterized dietary supplement use by male and female patients (n = 376 attending a periodontal clinic—information that is essential for evidence-based intervention studies that may improve patient outcomes after periodontal procedures. Calcium, vitamin D, multivitamin and vitamin C were most commonly used. A greater (p ≤ 0.05 number of males took no supplements compared to females, and more (p ≤ 0.05 females than males took ≥ four supplements. Females took more (p ≤ 0.05 calcium, vitamin D, fish oil, green tea, magnesium, omega 3,6,9 and B vitamin complex. Younger patients (31–50 years had the highest (p ≤ 0.05 frequency of no supplement use compared to older age groups. Patients over age 50 had a higher (p ≤ 0.05 frequency of using ≥ four supplements including calcium and vitamin D. Supplement use was lower (p ≤ 0.05 in smokers, particularly for calcium, fish oil, green tea and vitamin D. In conclusion, females, older individuals and non-smokers have higher supplement use. Future dietary intervention studies can focus on supplements with known biological activities—anti-inflammatory, antioxidant or osteogenic activity—that may enhance wound healing after reconstructive periodontal procedures.

  9. Multi-micronutrient supplementation during pregnancy for prevention of maternal anaemia and adverse birth outcomes in a high-altitude area: a prospective cohort study in rural Tibet of China.

    Science.gov (United States)

    Kang, Yijun; Dang, Shaonong; Zeng, Lingxia; Wang, Duolao; Li, Qiang; Wang, Jianpeng; Ouzhu, Luobu; Yan, Hong

    2017-09-01

    Anaemia during pregnancy, characterised by Hb anaemia among pregnant women and their infants' health in a high-altitude area. A prospective cohort study was carried out in two rural counties in Tibet from 2007 to 2012. A total of 1149 eligible pregnant women were allocated daily supplementation with FA in one county and MMN containing a recommended allowance of twenty-three vitamins and minerals in another county starting ≤24 weeks of gestation and continuing until delivery. Compared with the FA group, prenatal supplementation with MMN was significantly associated with reduced odds of anaemia in the third trimester. This was demonstrated in the primary outcome, with an adjusted OR (AOR) of 0·63; 95 % CI 0·45, 0·88 and P=0·007 and also reduced odds of preterm delivery (AOR: 0·31; 95 % CI 0·15, 0·61; P=0·001). There was no difference between MMN and FA groups in mean birth weight (adjusted mean difference: 36·78; 95 % CI -19·42, 92·98 g; P=0·200), whereas MMN supplementation significantly reduced the odds of low-birth weight (LBW) babies (AOR: 0·58; 95 % CI 0·36, 0·91; P=0·019). In conclusion, the antenatal MMN supplementation in rural Tibet is associated with a reduction of maternal anaemia in the third trimester, and may potentially decrease the risk of preterm delivery and LBW babies.

  10. Folic acid supplementation and preterm birth: results from observational studies.

    Science.gov (United States)

    Mantovani, Elena; Filippini, Francesca; Bortolus, Renata; Franchi, Massimo

    2014-01-01

    Folic acid (FA) supplementation is recommended worldwide in the periconceptional period for the prevention of neural tube defects. Due to its involvement in a number of cellular processes, its role in other pregnancy outcomes such as miscarriage, recurrent miscarriage, low birth weight, preterm birth (PTB), preeclampsia, abruptio placentae, and stillbirth has been investigated. PTB is a leading cause of perinatal mortality and morbidity; therefore its association with FA supplementation is of major interest. The analysis of a small number of randomized clinical trials (RCTs) has not found a beneficial role of FA in reducing the rate of PTBs. The aim of this review was to examine the results from recent observational studies about the effect of FA supplementation on PTB. We carried out a search on Medline and by manual search of the observational studies from 2009 onwards that analyzed the rate of PTB in patients who received supplementation with FA before and/or throughout pregnancy. The results from recent observational studies suggest a slight reduction of PTBs that is not consistent with the results from RCTs. Further research is needed to better understand the role of FA supplementation before and during pregnancy in PTB.

  11. BONE CHARACTERISTICS OF BROILERS SUPPLEMENTED WITH VITAMIN D

    Directory of Open Access Journals (Sweden)

    S Colet

    2015-09-01

    Full Text Available ABSTRACTVitamin D is added to broiler diets to supply its physiological requirement for bone formation. The fast growth rate of modern broilers is often associated with poor bone formation. Increasing vitamin D supplementation levels and the use of more available sources have applied to try to prevent leg problems, to increase carcass yield, and to improve the performance of broilers. The present study evaluated three vitamin D supplementation levels (1 3,500 IU (control; (2 control + 1,954 IU of 25-hydroxycholecalciferol; and (3 control + 3,500 IU of vitamin D in broiler diets supplied up to 21 days of age. The objective was to investigate if the vitamin D levels above the recommendations could reduce leg problems in broilers. In this experiment, a total of 1,296 one-day-old male and female Cobb(r 500 broilers were used. A 2 x 3 factorial arrangement was applied, consisting of two sexes and three vitamin D levels. No difference was found between the levels of vitamin D (p > 0.05, the performance of males or females, the gait score, the valgus and varus incidence, the tibial dyschondroplasia incidence, the occurance of femoral degeneration, the bone colorimetric, and the carcass yield. Parts yield differences were found (p > 0.05, except for liver and intestine yields. We concluded that the lowest tested vitamin D level (3,500 IU per kilogram of feed added to the diet was the best choice in terms of cost/benefit to help minimizing leg problems in broilers.

  12. Haematological effects of multimicronutrient supplementation in non-pregnant Gambian women

    NARCIS (Netherlands)

    Gulati, R.; Bailey, R.; Prentice, A. M.; Brabin, B. J.; Owens, S.

    2009-01-01

    Background/Objectives:The use of multimicronutrient (MMN) supplementation to reduce the burden of anaemia in non-pregnant women of reproductive age has been little studied, particularly in Africa. The objective of the study was to evaluate haematological outcomes in non-pregnant, rural Gambian women

  13. Student Outcomes Assessment of a Logistics and Supply Chair Management Major

    Science.gov (United States)

    Walter, Clyde Kenneth

    2012-01-01

    Assessment of specialized programs, such as logistics and supply chain management program described here, may pose challenges because previous experience are less widely shared than in the more mainline subjects. This case study provides one model that may guide other faculties facing a similar assignment. The report detailed the steps followed to…

  14. Oral protein calorie supplementation for children with chronic disease.

    Science.gov (United States)

    Francis, Damian K; Smith, Joanne; Saljuqi, Tawab; Watling, Ruth M

    2015-05-27

    Poor growth and nutritional status are common in children with chronic diseases. Oral protein calorie supplements are used to improve nutritional status in these children. These expensive products may be associated with some adverse effects, e.g. the development of inappropriate eating behaviour patterns. This is a new update of a Cochrane review last updated in 2009. To examine evidence that in children with chronic disease, oral protein calorie supplements alter daily nutrient intake, nutritional indices, survival and quality of life and are associated with adverse effects, e.g. diarrhoea, vomiting, reduced appetite, glucose intolerance, bloating and eating behaviour problems. Trials of oral protein calorie supplements in children with chronic diseases were identified through comprehensive electronic database searches, handsearching relevant journals and abstract books of conference proceedings. Companies marketing these products were also contacted.Most recent search of the Group's Trials Register: 24 February 2015. Randomised or quasi-randomised controlled trials comparing oral protein calorie supplements for at least one month to increase calorie intake with existing conventional therapy (including advice on improving nutritional intake from food or no specific intervention) in children with chronic disease. We independently assessed the outcomes: indices of nutrition and growth; anthropometric measures of body composition; calorie and nutrient intake (total from oral protein calorie supplements and food); eating behaviour; compliance; quality of life; specific adverse effects; disease severity scores; and mortality; we also assessed the risk of bias in the included trials. Four studies (187 children) met the inclusion criteria. Three studies were carried out in children with cystic fibrosis and one study included children with paediatric malignant disease. Overall there was a low risk of bias for blinding and incomplete outcome data.Two studies had a high

  15. Rationale, design, methodology and sample characteristics for the Vietnam pre-conceptual micronutrient supplementation trial (PRECONCEPT: a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Nguyen Phuong H

    2012-10-01

    Full Text Available Abstract Background Low birth weight and maternal anemia remain intractable problems in many developing countries. The adequacy of the current strategy of providing iron-folic acid (IFA supplements only during pregnancy has been questioned given many women enter pregnancy with poor iron stores, the substantial micronutrient demand by maternal and fetal tissues, and programmatic issues related to timing and coverage of prenatal care. Weekly IFA supplementation for women of reproductive age (WRA improves iron status and reduces the burden of anemia in the short term, but few studies have evaluated subsequent pregnancy and birth outcomes. The Preconcept trial aims to determine whether pre-pregnancy weekly IFA or multiple micronutrient (MM supplementation will improve birth outcomes and maternal and infant iron status compared to the current practice of prenatal IFA supplementation only. This paper provides an overview of study design, methodology and sample characteristics from baseline survey data and key lessons learned. Methods/design We have recruited 5011 WRA in a double-blind stratified randomized controlled trial in rural Vietnam and randomly assigned them to receive weekly supplements containing either: 1 2800 μg folic acid 2 60 mg iron and 2800 μg folic acid or 3 MM. Women who become pregnant receive daily IFA, and are being followed through pregnancy, delivery, and up to three months post-partum. Study outcomes include birth outcomes and maternal and infant iron status. Data are being collected on household characteristics, maternal diet and mental health, anthropometry, infant feeding practices, morbidity and compliance. Discussion The study is timely and responds to the WHO Global Expert Consultation which identified the need to evaluate the long term benefits of weekly IFA and MM supplementation in WRA. Findings will generate new information to help guide policy and programs designed to reduce the burden of anemia in women and

  16. Supply Chain Coordination and Consumer Awareness for Pollution Reduction

    Directory of Open Access Journals (Sweden)

    Bowon Kim

    2016-04-01

    Full Text Available To understand the dynamics of the manufacturer’s effort to reduce pollution in a supply chain consisting of manufacturer, retailer, and consumers, we analyze four cases according to consumer awareness of the pollution’s harmful effect, i.e., environmentally aware versus ignorant, and supply chain coordination, i.e., competitive versus cooperative. Applying differential games, we derive managerial implications: the most significant is that the supply chain coordination strategy becomes irrelevant to reducing the pollution, if the consumers are not environmentally aware or sensitive enough. It highlights the critical role played by the consumer awareness in curbing the pollution in the supply chain. In addition, we find the transfer price and the potential market size are important factors to determine each case’s relative effectiveness. Under a regular condition, where the transfer price from the retailer to the manufacturer is sufficiently high, the consumer-aware and competitive case can generate a better outcome in reducing the pollution than those with ignorant consumers. However, the opposite might occur if the transfer price is excessively low, giving the manufacturer little motivation to make an effort to reduce the pollution. For the cooperative supply chain, it is the potential market size that determines whether the consumer-aware case is better than the consumer-ignorant. In fact, it turns out that there is a stronger result, i.e., the feasibility condition enforces that the market is always big enough to make the consumer-aware cooperative case better than the consumer-ignorant cases. We further discuss managerial as well as policy implications of these analysis outcomes.

  17. Increasing vaginal progesterone gel supplementation after frozen-thawed embryo transfer significantly increases the delivery rate

    DEFF Research Database (Denmark)

    Alsbjerg, Birgit; Polyzos, Nikolaos P; Elbaek, Helle Olesen

    2013-01-01

    The aim of this study was to evaluate the reproductive outcome in patients receiving frozen-thawed embryo transfer before and after doubling of the vaginal progesterone gel supplementation. The study was a retrospective study performed in The Fertility Clinic, Skive Regional Hospital, Denmark....... A total of 346 infertility patients with oligoamenorrhoea undergoing frozen-thawed embryo transfer after priming with oestradiol and vaginal progesterone gel were included. The vaginal progesterone dose was changed from 90mg (Crinone) once a day to twice a day and the reproductive outcome during the two...... rate (8.7% versus 20.5%, respectively; P=0.002). Doubling of the vaginal progesterone gel supplementation during frozen-thawed embryo transfer cycles decreased the early pregnancy loss rate, resulting in a significantly higher delivery rate. This study evaluated the reproductive outcome of 346 women...

  18. SPORT SUPPLEMENTATION

    OpenAIRE

    Alexandаr Marinkov

    2016-01-01

    Sport supplementation is essential for athletes performance and achievements. The well balanced and structured supplementation is a challenge for sport medicine because must be done a balance between potential benefits and potential risks (anti-doping rule violations and others). In this review are structured the most used categories sport supplementations. Nutritional supplements used in sport could be divided in some main categories like: amino acids, vitamins, proteins and antioxidants. Fo...

  19. Vitamin K supplementation for cystic fibrosis.

    Science.gov (United States)

    Jagannath, Vanitha A; Thaker, Vidhu; Chang, Anne B; Price, Amy I

    2017-08-22

    Cystic fibrosis is a genetic disorder which can lead to multiorgan dysfunction. Malabsorption of fat and fat-soluble vitamins (A, D, E, K) may occur and can cause subclinical deficiencies of some of these vitamins. Vitamin K is known to play an important role in both blood coagulation and bone formation. Supplementation with vitamin K appears to be one way of addressing the deficiency, but there is very limited agreement on the appropriate dose and frequency of use of these supplements. This is an updated version of the review. To assess the effects of vitamin K supplementation in people with cystic fibrosis and to determine the optimal dose and route of administration of vitamin K for both routine and therapeutic use. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Most recent search: 30 January 2017. Randomised and quasi-randomised controlled trials of all preparations of vitamin K used as a supplement compared to either no supplementation (or placebo) at any dose or route and for any duration, in children or adults diagnosed with cystic fibrosis (by sweat test or genetic testing). Two authors independently screened papers, extracted trial details and assessed their risk of bias. Two trials (total of 32 participants) each lasting one month were included in the review and were assessed as having a moderate risk of bias. One was a dose-ranging parallel group trial in children (aged 8 to 18 years); and the other (with an older cohort) had a cross-over design comparing supplements to no treatment, but no separate data were reported for the first intervention period. Neither of the trials addressed any of the primary outcomes (coagulation, bone formation and quality of life). Both trials reported the restoration of serum vitamin K and undercarboxylated osteocalcin

  20. Prenatal vitamin C and E supplementation in smokers is associated with reduced placental abruption and preterm birth: a secondary analysis.

    Science.gov (United States)

    Abramovici, A; Gandley, R E; Clifton, R G; Leveno, K J; Myatt, L; Wapner, R J; Thorp, J M; Mercer, B M; Peaceman, A M; Samuels, P; Sciscione, A; Harper, M; Saade, G; Sorokin, Y

    2015-12-01

    Smoking and pre-eclampsia (PE) are associated with increases in preterm birth, placental abruption and low birthweight. We evaluated the relationship between prenatal vitamin C and E (C/E) supplementation and perinatal outcomes by maternal self-reported smoking status focusing on outcomes known to be impacted by maternal smoking. A secondary analysis of a multi-centre trial of vitamin C/E supplementation starting at 9-16 weeks in low-risk nulliparous women with singleton gestations. We examined the effect of vitamin C/E by smoking status at randomisation using the Breslow-Day test for interaction. The trial's primary outcomes were PE and a composite outcome of pregnancy-associated hypertension (PAH) with serious adverse outcomes. Perinatal outcomes included preterm birth and abruption. There were no differences in baseline characteristics within subgroups (smokers versus nonsmokers) by vitamin supplementation status. The effect of prenatal vitamin C/E on the risk of PE (P = 0.66) or PAH composite outcome (P = 0.86) did not differ by smoking status. Vitamin C/E was protective for placental abruption in smokers (relative risk [RR] 0.09; 95% CI 0.00-0.87], but not in nonsmokers (RR 0.92; 95% CI 0.52-1.62) (P = 0.01), and for preterm birth in smokers (RR 0.76; 95% CI 0.58-0.99) but not in nonsmokers (RR 1.03; 95% CI 0.90-1.17) (P = 0.046). In this cohort of women, smoking was not associated with a reduction in PE or the composite outcome of PAH. Vitamin C/E supplementation appears to be associated with a reduction in placental abruption and preterm birth among smokers. © 2014 Royal College of Obstetricians and Gynaecologists.

  1. Creatine supplementation with specific view to exercise/sports performance: an update

    Directory of Open Access Journals (Sweden)

    Cooper Robert

    2012-07-01

    Full Text Available Abstract Creatine is one of the most popular and widely researched natural supplements. The majority of studies have focused on the effects of creatine monohydrate on performance and health; however, many other forms of creatine exist and are commercially available in the sports nutrition/supplement market. Regardless of the form, supplementation with creatine has regularly shown to increase strength, fat free mass, and muscle morphology with concurrent heavy resistance training more than resistance training alone. Creatine may be of benefit in other modes of exercise such as high-intensity sprints or endurance training. However, it appears that the effects of creatine diminish as the length of time spent exercising increases. Even though not all individuals respond similarly to creatine supplementation, it is generally accepted that its supplementation increases creatine storage and promotes a faster regeneration of adenosine triphosphate between high intensity exercises. These improved outcomes will increase performance and promote greater training adaptations. More recent research suggests that creatine supplementation in amounts of 0.1 g/kg of body weight combined with resistance training improves training adaptations at a cellular and sub-cellular level. Finally, although presently ingesting creatine as an oral supplement is considered safe and ethical, the perception of safety cannot be guaranteed, especially when administered for long period of time to different populations (athletes, sedentary, patient, active, young or elderly.

  2. The Efficacy of a Pre-Workout Vegan Supplement on High-Intensity Cycling Performance in Healthy College-Aged Males.

    Science.gov (United States)

    Gallien, Gabrielle; Bellar, David; Davis, Greggory R

    2017-11-02

    There is a limited supply of sport nutrition supplements currently available for vegan or vegetarian athletes. In addition, the efficacy of a vegan or vegetarian pre-workout supplement that does not contain any processed ingredients or stimulants is currently unknown. The purpose of the current study was to examine the effects of an unprocessed vegan pre-workout supplement on high-intensity cycling performance. Participants completed three separate cycling trials following the consumption of a vegan pre-workout supplement, an isocaloric processed supplement, or a zero-calorie placebo supplement. Each supplement was consumed 30 minutes prior to each trial, and each cycling trial was separated by a minimum of 72 hours. Supplements were administered using a randomized, double-blind cross-over design. Each cycling trial was performed at a workload equal to 80% VO 2peak until exhaustion. The average time in seconds (s) until exhaustion values for the vegan, isocaloric, and zero-calorie supplements were 482 ± 163, 480 ± 157, and 496 ± 238, respectively. Consumption of the vegan supplement did not significantly improve performance compared to an isocaloric and zero-calorie supplement (F = 0.12, p =.89). The results of this study indicate that individuals who choose a vegan pre-workout supplement (over an isocaloric or zero-calorie product) will not experience any acute decrements or ergogenic benefits in cycling performance. Although the present study does not support performance benefits of the tested vegan pre-workout supplement before cycling, additional research examining various exercise intensities and modalities is warranted.

  3. Santa Inês sheep supplementation on urochloa grass pasture during the dry season: intake, nutrient digestibility and performance

    Directory of Open Access Journals (Sweden)

    Paulo José Presídio Almeida

    2012-03-01

    Full Text Available This study was conducted with the objective of evaluating the effect of concentrate supplementation, formulated with different ingredients (Mesquite pod meal, sorghum meal or wheat meal and mineral supplementation on performance, intake and digestibility of nutrients in Santa Inês lambs grazing on urochloa grass during the dry season. Twenty-four uncastrated weaned Santa Inês sheep, with average body weight (BW 20±2 kg with an average of 120 days of age were used in the assay. The experiment lasted 75 days. The animals grazing deferred Urochloa grass (Urochloa mosambicensis (Hack Daudy were distributed into four treatments consisting of mineral supplementation provided ad libitum and concentrated supplements containing mesquite pod meal, sorghum meal or wheat meal, supplied 10 g /kg BW on dry matter basis. The intakes of dry matter (DM and crude protein (CP were affected by the intake of concentrate supplement, regardless of the ingredients used in the supplements, compared with the mineral supplementation treatment, since the consumption of forage was reduced in 30% with mesquite pod meal supplement, and neutral detergent fiber (NDF intake was not affected in relation to treatments. The digestibility of DM and CP were higher for treatments with supplements, and NDF digestibility did not differ between treatments. A significant difference was observed in the values of average daily gain for the treatments with concentrate supplementation compared with the one of mineral supplementation. The supplementation with concentrate in grazing enables improvement of performance, intake and digestibility of nutrients regardless of the ingredient used in the supplement.

  4. Could We Really Use Aloe vera Food Supplements to Treat Diabetes? Quality Control Issues

    Directory of Open Access Journals (Sweden)

    Solomon Habtemariam

    2017-01-01

    Full Text Available Diabetes UK has recently listed a number of herbs and spices that have been clinically shown to improve blood glucose control in type-2 diabetes patients and the diabetes high-risk group. With Aloe vera being top in this list, its health benefit along with health and beauty/food retailers supplying it was illustrated in detail. Previous article from this laboratory scrutinised the merit of using A. vera as an alternative therapy to prescription antidiabetic drugs and the risk of using food supplements in the market which do not qualify as drug preparations. In continuation of this discussion, the present study assesses three Aloe Pura brands and one Holland and Barret brand of A. vera juice supplements in the UK market through chromatographic and spectroscopic analysis. While the polysaccharide active ingredient, acemannan, appears to be within the recommended limit, it was found that Aloe Pura (one of the best-selling brands for A. vera supplement products have benzoate additive that does not appear in the supplement levels. Moreover, two of the Aloe Pura brand juices contain methanol, suggesting that the International Aloe Science Council (IASC certification does not guarantee the medicinal quality of these products. The therapeutic fitness of such supplements is discussed.

  5. Could We Really Use Aloe vera Food Supplements to Treat Diabetes? Quality Control Issues

    Science.gov (United States)

    2017-01-01

    Diabetes UK has recently listed a number of herbs and spices that have been clinically shown to improve blood glucose control in type-2 diabetes patients and the diabetes high-risk group. With Aloe vera being top in this list, its health benefit along with health and beauty/food retailers supplying it was illustrated in detail. Previous article from this laboratory scrutinised the merit of using A. vera as an alternative therapy to prescription antidiabetic drugs and the risk of using food supplements in the market which do not qualify as drug preparations. In continuation of this discussion, the present study assesses three Aloe Pura brands and one Holland and Barret brand of A. vera juice supplements in the UK market through chromatographic and spectroscopic analysis. While the polysaccharide active ingredient, acemannan, appears to be within the recommended limit, it was found that Aloe Pura (one of the best-selling brands for A. vera supplement) products have benzoate additive that does not appear in the supplement levels. Moreover, two of the Aloe Pura brand juices contain methanol, suggesting that the International Aloe Science Council (IASC) certification does not guarantee the medicinal quality of these products. The therapeutic fitness of such supplements is discussed. PMID:29511381

  6. Effects of Dietary Supplementation of Astaxanthin and Sesamin on Daily Fatigue: A Randomized, Double-Blind, Placebo-Controlled, Two-Way Crossover Study

    Directory of Open Access Journals (Sweden)

    Ayano Imai

    2018-02-01

    Full Text Available Severe fatigue can negatively affect quality of life, and oxidative stress may play a role in its mechanism. The aim of this study was to evaluate the effect of dietary supplementation of astaxanthin and sesamin (AS, strong food-derived antioxidants, on fatigue. Twenty-four healthy volunteers were supplemented with AS and placebo, each for four weeks. After each supplementation period, participants underwent tasks inducing mental and physical fatigue (visual display terminal task and ergometer task, respectively. Subjective fatigue was evaluated using a visual analogue scale during and after the mental and physical tasks, and daily subjective fatigue was evaluated by the Chalder fatigue questionnaire. Secondary outcomes included other subjective feelings, work efficiency, autonomic nerve activity, levels of an oxidative stress marker (plasma phosphatidylcholine hydroperoxide (PCOOH and safety. AS supplementation was associated with significantly improved recovery from mental fatigue compared with placebo. Increased PCOOH levels during mental and physical tasks were attenuated by AS supplementation. No differences between AS and placebo were detected in secondary outcomes, and no adverse effects of AS supplementation were observed. In conclusion, AS supplementation may be a candidate to promote recovery from mental fatigue which is experienced by many healthy people.

  7. Compost supplementation with nutrients and microorganisms in composting process.

    Science.gov (United States)

    Sánchez, Óscar J; Ospina, Diego A; Montoya, Sandra

    2017-11-01

    The composting is an aerobic, microorganism-mediated, solid-state fermentation process by which different organic materials are transformed into more stable compounds. The product obtained is the compost, which contributes to the improvement of physical, chemical and microbiological properties of the soil. However, the compost usage in agriculture is constrained because of its long-time action and reduced supply of nutrients to the crops. To enhance the content of nutrients assimilable by the plants in the compost, its supplementation with nutrients and inoculation with microorganisms have been proposed. The objective of this work was to review the state of the art on compost supplementation with nutrients and the role played by the microorganisms involved (or added) in their transformation during the composting process. The phases of composting are briefly compiled and different strategies for supplementation are analyzed. The utilization of nitrogenous materials and addition of microorganisms fixing nitrogen from the atmosphere or oxidizing ammonia into more assimilable for plants nitrogenous forms are analyzed. Several strategies for nitrogen conservation during composting are presented as well. The supplementation with phosphorus and utilization of microorganisms solubilizing phosphorus and potassium are also discussed. Main groups of microorganisms relevant during the composting process are described as well as most important strategies to identify them. In general, the development of this type of nutrient-enriched bio-inputs requires research and development not only in the supplementation of compost itself, but also in the isolation and identification of microorganisms and genes allowing the degradation and conversion of nitrogenous substances and materials containing potassium and phosphorus present in the feedstocks undergoing the composting process. In this sense, most important research trends and strategies to increase nutrient content in the compost

  8. Methylsulfonylmethane: Applications and Safety of a Novel Dietary Supplement

    Directory of Open Access Journals (Sweden)

    Matthew Butawan

    2017-03-01

    Full Text Available Methylsulfonylmethane (MSM has become a popular dietary supplement used for a variety of purposes, including its most common use as an anti-inflammatory agent. It has been well-investigated in animal models, as well as in human clinical trials and experiments. A variety of health-specific outcome measures are improved with MSM supplementation, including inflammation, joint/muscle pain, oxidative stress, and antioxidant capacity. Initial evidence is available regarding the dose of MSM needed to provide benefit, although additional work is underway to determine the precise dose and time course of treatment needed to provide optimal benefits. As a Generally Recognized As Safe (GRAS approved substance, MSM is well-tolerated by most individuals at dosages of up to four grams daily, with few known and mild side effects. This review provides an overview of MSM, with details regarding its common uses and applications as a dietary supplement, as well as its safety for consumption.

  9. Compliance of zinc supplementation by care givers of children suffering from diarrhea

    Directory of Open Access Journals (Sweden)

    Smita S Valekar

    2014-12-01

    Full Text Available Background: Over 2 million children die as a result of diarrhea and dehydration every year. A new ORS formula and introduction of Zinc supplementation offers much improved outcomes for the treatment of childhood diarrhea. Aims: To assess the compliance of Zinc supplementation by caregivers Objectives: 1. To assess the compliance of Zinc supplementation by caregivers, 2. To find out the reason for non-compliance 3. To study the association of socio-demographic variables and non-compliance of children suffering from diarrhea Materials & Method:  Study Design: Cross-sectional survey Study Period: from 1st Sept. 2014 to 31st Oct. 2014 Study Area: Pediatric Outpatient department of Tertiary Care Hospital Inclusion Criteria: Under five children suffering from diarrhea attending Pediatric OPD Study Tool: Questionnaire was administered to care givers and follow up was done on 3rd, 7th & 14th day of Zinc supplementation. Result: 84% of non-compliance was seen in this study. Conclusion: The compliance of Zinc supplementation is poor among caretakers of children suffering from diarrhea.

  10. l-Carnitine Supplementation in Recovery after Exercise

    Directory of Open Access Journals (Sweden)

    Roger Fielding

    2018-03-01

    Full Text Available Given its pivotal role in fatty acid oxidation and energy metabolism, l-carnitine has been investigated as ergogenic aid for enhancing exercise capacity in the healthy athletic population. Early research indicates its beneficial effects on acute physical performance, such as increased maximum oxygen consumption and higher power output. Later studies point to the positive impact of dietary supplementation with l-carnitine on the recovery process after exercise. It is demonstrated that l-carnitine alleviates muscle injury and reduces markers of cellular damage and free radical formation accompanied by attenuation of muscle soreness. The supplementation-based increase in serum and muscle l-carnitine contents is suggested to enhance blood flow and oxygen supply to the muscle tissue via improved endothelial function thereby reducing hypoxia-induced cellular and biochemical disruptions. Studies in older adults further showed that l-carnitine intake can lead to increased muscle mass accompanied by a decrease in body weight and reduced physical and mental fatigue. Based on current animal studies, a role of l-carnitine in the prevention of age-associated muscle protein degradation and regulation of mitochondrial homeostasis is suggested.

  11. Intake, digestibility, and rumen and metabolic characteristics of cattle fed low-quality tropical forage and supplemented with nitrogen and different levels of starch.

    Science.gov (United States)

    de Oliveira Franco, Marcia; Detmann, Edenio; de Campos Valadares Filho, Sebastião; Batista, Erick Darlisson; de Almeida Rufino, Luana Marta; Barbosa, Marcília Medrado; Lopes, Alexandre Ribeiro

    2017-06-01

    Effects of nitrogen supplementation associated with different levels of starch on voluntary intake, digestibility, and rumen and metabolic characteristics of cattle fed low-quality tropical forage ( Brachiaria decumbens hay, 7.4% crude protein, CP) were evaluated using ruminal and abomasal cannulated steers. Five European×Zebu young bulls (186 kg body weight, BW) were distributed according to a 5×5 Latin square. The following treatments were evaluated: control, supplementation with 300 g CP/d (0:1), supplementation with 300 g starch/d and 300 g CP/d (1:1), supplementation with 600 g starch/d and 300 g CP/d (2:1), and supplementation with 900 g starch/d and 300 g CP/d (3:1). A mixture of nitrogenous compounds provided 1/3 from true protein (casein) and 2/3 from non-protein nitrogen (mixture of urea and ammonium sulphate, 9:1) was used as the nitrogen supplement. In order to supply energy a unique source of corn starch was used. Supplements increased (p0.05) forage intake. There was a cubic effect (pdigestibility, but did not affect (p>0.05) neutral detergent fibre corrected for ash and protein (NDFap) digestibility. There was a positive linear effect (pdigestibility. Total NDFap digestibility was not affected (p>0.05) by the amount of supplemental starch. Ruminal ammonia nitrogen concentrations were higher (p<0.05) in supplemented animals, however, a negative linear effect (p<0.05) of amount of starch was observed. Supplements increased (p<0.05) the nitrogen balance (NB) and efficiency of nitrogen utilization. These effects were attributed to increased body anabolism, supported by higher (p<0.05) serum concentration of insulin-like growth factor 1. Increasing the amount of starch tended (p<0.06) to linearly increase the NB. In spite of this, there was a highest NB value for the 2:1 starch:CP ratio amongst the treatments with supplementation. Nitrogen supplementation in cattle fed low-quality tropical forage increases nitrogen retention in the animal's body. An

  12. Protein and energy supplementation in elderly people at risk from malnutrition.

    Science.gov (United States)

    Milne, Anne C; Potter, Jan; Vivanti, Angela; Avenell, Alison

    2009-04-15

    Evidence for the effectiveness of nutritional supplements containing protein and energy, often prescribed for older people, is limited. Malnutrition is more common in this age group and deterioration of nutritional status can occur during illness. It is important to establish whether supplementing the diet is an effective way of improving outcomes for older people at risk from malnutrition. This review examined trials for improvement in nutritional status and clinical outcomes when extra protein and energy were provided, usually as commercial 'sip-feeds'. We searched The Cochrane Library, MEDLINE, EMBASE, Healthstar, CINAHL, BIOSIS, CAB abstracts. We also hand searched nutrition journals and reference lists and contacted 'sip-feed' manufacturers. Randomised and quasi-randomised controlled trials of oral protein and energy supplementation in older people, with the exception of groups recovering from cancer treatment or in critical care. Two reviewers independently assessed trials prior to inclusion and independently extracted data and assessed trial quality. Authors of trials were contacted for further information as necessary. Sixty-two trials with 10,187 randomised participants have been included in the review. Maximum duration of intervention was 18 months. Most included trials had poor study quality. The pooled weighted mean difference (WMD) for percentage weight change showed a benefit of supplementation of 2.2% (95% confidence interval (CI) 1.8 to 2.5) from 42 trials. There was no significant reduction in mortality in the supplemented compared with control groups (relative risk (RR) 0.92, CI 0.81 to 1.04) from 42 trials. Mortality results were statistically significant when limited to trials in which participants (N = 2461) were defined as undernourished (RR 0.79, 95% CI 0.64 to 0.97).The risk of complications was reduced in 24 trials (RR 0.86, 95% CI 0.75 to 0.99). Few trials were able to suggest any functional benefit from supplementation. The WMD for length

  13. Folic Acid Supplementation and Preterm Birth: Results from Observational Studies

    Directory of Open Access Journals (Sweden)

    Elena Mantovani

    2014-01-01

    Full Text Available Introduction. Folic acid (FA supplementation is recommended worldwide in the periconceptional period for the prevention of neural tube defects. Due to its involvement in a number of cellular processes, its role in other pregnancy outcomes such as miscarriage, recurrent miscarriage, low birth weight, preterm birth (PTB, preeclampsia, abruptio placentae, and stillbirth has been investigated. PTB is a leading cause of perinatal mortality and morbidity; therefore its association with FA supplementation is of major interest. The analysis of a small number of randomized clinical trials (RCTs has not found a beneficial role of FA in reducing the rate of PTBs. Aim of the Study. The aim of this review was to examine the results from recent observational studies about the effect of FA supplementation on PTB. Materials and Methods. We carried out a search on Medline and by manual search of the observational studies from 2009 onwards that analyzed the rate of PTB in patients who received supplementation with FA before and/or throughout pregnancy. Results. The results from recent observational studies suggest a slight reduction of PTBs that is not consistent with the results from RCTs. Further research is needed to better understand the role of FA supplementation before and during pregnancy in PTB.

  14. Woodfuel supply business in Canada: An overview

    Energy Technology Data Exchange (ETDEWEB)

    1980-01-01

    An overview of wood fuel supply in Canada is presented in order to increase awareness about the need for and the operation of woodfuel supply businesses. Background is provided on the residential heating and woodfuel situation from a national perspective. In 1979, under 2% of Canadian households got their primary heat from wood and 7% supplemented their heat from wood, coke, or coal. The implications of increasing this percentage are discussed. Typical characteristics of woodfuel suppliers are outlined; it is seen that 98% of the slightly more than 1,000 woodfuel dealers in Canada are part-time operators. Demand for wood, types of wood fuels (including wood chips and pellets), the role of wood fuel in local economic development, and forest management considerations are also reviewed. Case studies of representative wood-fuel businesses are presented to show the variation in practices across Canada. Finally, a manual on setting up, running, and planning woodfuel operations is included. Recommendations are made on business structure, personnel and management, marketing and pricing, scheduling, cost estimation, wood procurement, harvesting, processing, delivery, and safety. 90 refs., 12 figs., 7 tabs.

  15. Is Branched-Chain Amino Acids Supplementation an Efficient Nutritional Strategy to Alleviate Skeletal Muscle Damage? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Alexandre Fouré

    2017-09-01

    Full Text Available Amino acids and more precisely, branched-chain amino acids (BCAAs, are usually consumed as nutritional supplements by many athletes and people involved in regular and moderate physical activities regardless of their practice level. BCAAs have been initially shown to increase muscle mass and have also been implicated in the limitation of structural and metabolic alterations associated with exercise damage. This systematic review provides a comprehensive analysis of the literature regarding the beneficial effects of BCAAs supplementation within the context of exercise-induced muscle damage or muscle injury. The potential benefit of a BCAAs supplementation was also analyzed according to the supplementation strategy—amount of BCAAs, frequency and duration of the supplementation—and the extent of muscle damage. The review protocol was registered prospectively with Prospective Register for Systematic Reviews (registration number CRD42017073006 and followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Literature search was performed from the date of commencement until August 2017 using four online databases (Medline, Cochrane library, Web of science and ScienceDirect. Original research articles: (i written in English; (ii describing experiments performed in Humans who received at least one oral BCAAs supplementation composed of leucine, isoleucine and valine mixture only as a nutritional strategy and (iii reporting a follow-up of at least one day after exercise-induced muscle damage, were included in the systematic review analysis. Quality assessment was undertaken independently using the Quality Criteria Checklist for Primary Research. Changes in indirect markers of muscle damage were considered as primary outcome measures. Secondary outcome measures were the extent of change in indirect markers of muscle damage. In total, 11 studies were included in the analysis. A high heterogeneity was found regarding the

  16. Rising U.S. Earnings Inequality and Family Labor Supply: The Covariance Structure of Intrafamily Earnings

    OpenAIRE

    Dean R. Hyslop

    2001-01-01

    This paper studies the labor supply contributions to individual and family earnings inequality during the period of rising wage inequality in the early 1980's. Working couples have positively correlated labor market outcomes, which are almost entirely attributable to permanent factors. An intertemporal family labor supply model with this feature is used to estimate labor supply elasticities for husbands of 0.05, and wives of 0.40. This implies that labor supply explains little of the rising a...

  17. Dehydroepiandrosterone (DHEA) supplementation and IVF outcome in poor responders.

    Science.gov (United States)

    Triantafyllidou, Olga; Sigalos, George; Vlahos, Nikos

    2017-06-01

    Ovarian stimulation of poor ovarian responders still remains a challenging issue. The incidence of poor responders among infertile women is reported in 9-24% IVF cycles and is associated with very low clinical pregnancy rates. Different treatments have been reported in the literature in an attempt to identify the best stimulation protocol for those patients. Administration of dehydroepiandrosterone acetate (DHEA) was suggested as a promising treatment. It is well known that androgens can influence ovarian follicular growth, augment steroidogenesis, promote follicular recruitment and increase the number of primary and pre-antral follicles. The purpose of this review is to evaluate the effect of DHEA supplementation on women with diminished ovarian reserve. Because of the uncertainty of published data, we suggest that well-designed multicentre RCTs are required to provide more insight on the effectiveness of DHEA. The absence of significant side effects should not be considered as an argument to support DHEA treatment.

  18. Do Syrian refugees have increased risk for worser pregnancy outcomes? Results of a tertiary center in İstanbul.

    Science.gov (United States)

    Güngör, Emre Sinan; Seval, Olcay; İlhan, Gülşah; Verit, Fatma Ferda

    2018-03-01

    To compare obstetric and perinatal outcomes of Syrian refugee pregnants and Turkish counterparts who gave birth at a tertiary center in İstanbul. A retrospective study including the birth records of 704 Syrian refugees and 744 Turkish pregnant women between January 2016 and May 2017 were analyzed. Demographic data, obstetric and neonatal outcomes were compared. The primary aims of this study were to evaluate the pregnancy outcomes and cesarean rates between the groups. The secondary outcomes were the use of antenatal vitamin supplementation, hemoglobin-hematocrit values, and maternal complications. Our results showed that the use of folic acid and iron supplementation rates during pregnancy were similar between the groups (folic acid supplementation 8.1% vs 6.5%, p=0.264; iron supplementation 20.7% vs 19.6%, p=0.125; respectively for Turkish women and Syrian refugees). Cesarean rates were significantly higher for Turkish patients than in Syrian refugees (42.7% vs 32.7%; pyrian refugees (37.7±2.3 vs 36.4±2.3 weeks, pyrian refugees, respectively, p=0.105). Although obstetric complications were seen more often in Syrian refugees, it did not reach statistical difference (9.7% vs 8.1%, respectively, p=0.285). Syrian refugees use antenatal vitamin supplementations at similar rates to Turkish citizens and obstetric and perinatal outcomes are similar between the groups.

  19. Biochemical and clinical effects of Whey protein supplementation in Parkinson's disease: A pilot study.

    Science.gov (United States)

    Tosukhowong, Piyaratana; Boonla, Chanchai; Dissayabutra, Thasinas; Kaewwilai, Lalita; Muensri, Sasipa; Chotipanich, Chanisa; Joutsa, Juho; Rinne, Juha; Bhidayasiri, Roongroj

    2016-08-15

    Parkinson's disease (PD) is an oxidative stress-mediated degenerative disorder. Elevated plasma homocysteine (Hcy) is frequently found in the levodopa-treated PD patients, is associated with disease progression and is a marker of oxidative stress. Whey protein is a rich source of cysteine, and branched-chain amino acids (BCAA). It has been shown that supplementation with Whey protein increases glutathione synthesis and muscle strength. In this study, we conducted a placebo-controlled, double-blind study (NCT01662414) to investigate the effects of undenatured Whey protein isolate supplementation for 6months on plasma glutathione, plasma amino acids, and plasma Hcy in PD patients. Clinical outcome assessments included the unified Parkinson's disease rating scale (UPDRS) and striatal L-3,4-dihydroxy-6-(18)F-fluorophenylalanine (FDOPA) uptake were determined before and after supplementation. 15 patients received Whey protein, and 17 received Soy protein, served as a control group. Significant increases in plasma concentration of reduced glutathione and the ratio of reduced to oxidized glutathione were found in the Whey-supplemented patients but not in a control group. This was associated with a significant decrease of plasma levels of Hcy. The plasma levels of total glutathione were not significantly changed in either group. Plasma BCAA and essential amino acids (EAA) were significantly increased in the Whey-supplemented group only. The UPDRS and striatal FDOPA uptake in PD patients were not significantly ameliorated in either group. However, significant negative correlation was observed between the UPDRS and plasma BCAA and EAA in the pre-supplemented PD patients. This study is the first to report that Whey protein supplementation significantly increases plasma reduced glutathione, the reduced to oxidized glutathione ratio, BCAAs and EAAs in patients with PD, together with a concomitant significant reduction of plasma Hcy. However, there were no significant changes in

  20. Sustainable Supply Chain Design by the P-Graph Framework

    Science.gov (United States)

    The present work proposes a computer-aided methodology for designing sustainable supply chains in terms of sustainability metrics by resorting to the P-graph framework. The methodology is an outcome of the collaboration between the Office of Research and Development (ORD) of the ...

  1. The clinical content of preconception care: nutrition and dietary supplements.

    Science.gov (United States)

    Gardiner, Paula M; Nelson, Lauren; Shellhaas, Cynthia S; Dunlop, Anne L; Long, Richard; Andrist, Sara; Jack, Brian W

    2008-12-01

    Women of child-bearing age should achieve and maintain good nutritional status prior to conception to help minimize health risks to both mothers and infants. Many women may not be aware of the importance of preconception nutrition and supplementation or have access to nutrition information. Health care providers should be knowledgeable about preconception/pregnancy-related nutrition and take the initiative to discuss this information during preconception counseling. Women of reproductive age should be counseled to consume a well-balanced diet including fruits and vegetables, iron and calcium-rich foods, and protein-containing foods as well as 400 microg of folic acid daily. More research is critically needed on the efficacy and safety of dietary supplements and the role of obesity in birth outcomes. Preconception counseling is the perfect opportunity for the health care provider to discuss a healthy eating guideline, dietary supplement intake, and maintaining a healthy weight status.

  2. Complementarity in dietary supplements and foods: are supplement users vegetable eaters?

    Science.gov (United States)

    Kang, Hyoung-Goo; Joo, Hailey Hayeon; Choi, Kyong Duk; Lee, Dongmin; Moon, Junghoon

    2017-01-01

    Background : The consumption of fruits, vegetables, and dietary supplements correlate. Most previous studies have aimed to identify the determinants of supplement uses or the distinct features of supplement users; this literature lacks a discussion on dietary supplement consumption as a predictor of fruit and vegetable consumption. Objective : This study examines how dietary supplement consumption correlates with fruit and vegetable consumption by combining scanner data and surveys of Korean household grocery shopping. Methods : Propensity score matching (PSM) is used to identify the relationship between dietary supplement consumption and fruit and vegetable consumption in a household. A logit regression using supplement consumption as the dependent variable is used. Then, the supplement takers (the treatment group) are matched with non-takers (the control group) based on the propensity scores estimated in the logit regression. The fruit and vegetable consumption levels of the groups are then compared. Results : We found that dietary supplement use is associated with higher fruit and vegetable consumption. This supports the health consciousness hypothesis based on attention bias, availability heuristics, the focusing effect, and the consumption episode effect. It rejects the health substitute hypothesis based on economic substitutes and mental accounting. Conclusions : Future research on the health benefits of dietary supplements should address the complementary consumption of fruits/vegetables and their health benefits to avoid misstating the health effects of supplements.

  3. Vitamin D supplementation, bone turnover, and inflammation in HIV-infected patients.

    Science.gov (United States)

    Benguella, L; Arbault, A; Fillion, A; Blot, M; Piroth, C; Denimal, D; Duvillard, L; Ornetti, P; Chavanet, P; Maillefert, J-F; Piroth, L

    2018-04-13

    To assess whether vitamin D supplementation could be associated with a modification of inflammatory markers and bone turnover in HIV-1-infected patients. Patients who participated in an initial survey in 2010 and who were followed in the same department were included in a new study in 2012. Between 2010 and 2012, vitamin D supplementation was offered to patients presenting with hypovitaminosis D as per appropriate guidelines. Clinical examinations were performed, and fasting blood samples were taken for inflammation and bone marker evaluations. Of the 263 patients who participated in the 2010 study, 198 were included in the 2012 study. Hypovitaminosis D was observed in 47% (36/77) of participants supplemented as per appropriate guidelines, in 78% (75/97) of transiently or incompletely supplemented participants, and in 71% (17/24) of non-supplemented participants (mainly because vitamin D levels in 2010 were normal). No significant correlation between vitamin D supplementation and the 2-year inflammation outcome (IL-6 and hsCRP) or C-terminal telopeptide levels was observed. However, a decrease in IL6 levels over the 2 years significantly correlated with reaching a normal vitamin D level (OR=0.89 per+1pg/mL IL6 increase, 95% CI=0.81-0.97, P=0.015). Vitamin D supplementation decreases the risk of hypovitaminosis D but does not decrease the risk of inflammation nor bone turnover, unless normal 25-OH vitamin D levels are reached. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  4. Glutamine supplementation maintains intramuscular glutamine concentrations and normalizes lymphocyte function in infected early weaned pigs.

    Science.gov (United States)

    Yoo, S S; Field, C J; McBurney, M I

    1997-11-01

    Numerous studies in humans and rats have shown that glutamine supplementation during stressful conditions has favorable outcomes. However, the requirements for glutamine during weaning are unknown. Thus, the effects of glutamine supplementation in healthy and infected weaned pigs were investigated. At 21 d of age, pigs were weaned to an elemental diet supplemented with glutamine (+Gln) or an isonitrogenous diet containing nonessential amino acids (-Gln). At 26 d of age, pigs were intraperitoneally injected with Escherichia coli (+Ecoli) or buffered saline (-Ecoli) and killed at 28 d of age. Infection decreased (P Ecoli+Gln pigs were greater (P Ecoli-Gln pigs and not different than those of noninfected pigs. Hence, glutamine supplementation maintained muscular glutamine concentrations and normalized lymphocyte function in infected pigs.

  5. Nutritional supplements for people being treated for active tuberculosis: A technical summary.

    Science.gov (United States)

    Grobler, L; Durao, S; Van der Merwe, S M; Wessels, J; Naude, C E

    2017-12-13

    Tuberculosis and nutrition are intrinsically linked in a complex relationship. Altered metabolism and loss of appetite associated with tuberculosis may result in undernutrition, which in turn may worsen the disease or delay recovery. We highlight an updated Cochrane review assessing the effects of oral nutritional supplements in people with active tuberculosis who are receiving antituberculosis drug therapy. The review authors conducted a comprehensive search (February 2016) for all randomised controlled trials comparing any oral nutritional supplement, given for at least 4 weeks, with no nutritional intervention, placebo or dietary advice only in people receiving antituberculosis treatment. Of the 35 trials (N=8 283 participants) included, seven assessed the provision of free food or high-energy supplements, six assessed multi-micronutrient supplementation, and 21 assessed single- or dual-micronutrient supplementation. There is currently insufficient evidence to indicate whether routinely providing free food or high-energy supplements improves antituberculosis treatment outcomes (i.e. reduced death and increased cure rates at 6 and 12 months), but it probably improves weight gain in some settings. Plasma levels of zinc, vitamin D, vitamin E and selenium probably improve with supplementation, but currently no reliable evidence demonstrates that routine supplementation with multi-, single or dual micronutrients above the recommended daily intake has clinical benefits (i.e. reduced death, increased cure rate at 6 and 12 months, improved nutritional status) in patients receiving antituberculosis treatment. In South Africa, most provinces implement a supplementation protocol based on nutritional assessment and classification of individuals rather than on disease diagnosis or treatment status.

  6. Zinc supplements for preventing otitis media.

    Science.gov (United States)

    Gulani, Anjana; Sachdev, Harshpal S

    2014-06-29

    Otitis media is inflammation of the middle ear and is usually caused by infection. It affects people of all ages but is particularly common in young children. Around 164 million people worldwide have long-term hearing loss caused by this condition, 90% of them in low-income countries. As zinc supplements prevent pneumonia in disadvantaged children, we wanted to investigate whether zinc supplements could also prevent otitis media. To evaluate whether zinc supplements prevent otitis media in adults and children of different ages. We searched CENTRAL (2014, Issue 1), MEDLINE (1950 to February week 4, 2014) and EMBASE (1974 to March 2014). Randomised, placebo-controlled trials of zinc supplements given at least once a week for at least a month for preventing otitis media. Two review authors independently assessed the eligibility and methodological quality of the included trials and extracted and analysed data. We summarised results using risk ratios (RRs) or rate ratios for dichotomous data and mean differences (MDs) for continuous data. We combined trial results where appropriate. No new trials were identified for inclusion in this update. We identified 12 trials for inclusion, 10 of which contributed outcomes data. There were a total of 6820 participants. In trials of healthy children living in low-income communities, two trials did not demonstrate a significant difference between the zinc-supplemented and placebo groups in the numbers of participants experiencing an episode of definite otitis media during follow-up (3191 participants); another trial showed a significantly lower incidence rate of otitis media in the zinc group (rate ratio 0.69, 95% confidence interval (CI) 0.61 to 0.79, n = 1621). A small trial of 39 infants undergoing treatment for severe malnutrition suggested a benefit of zinc for the mean number of episodes of otitis media (mean difference (MD) -1.12 episodes, 95% CI -2.21 to -0.03). Zinc supplements did not seem to cause any serious adverse

  7. Financialization across the Pacific: Manufacturing cost ratios, supply chains and power

    OpenAIRE

    Froud, Julie; Johal, Sukhdev; Leaver, Adam; Williams, Karel

    2014-01-01

    This article argues that thirty years ago favourable cost conditions helped build productive power in Asia, whereas now US financial power drives and benefits from low labour costs in China, using the very different supply chain positions of Apple Inc. and Foxconn International Holdings (FIH) as examples. In the first section, the authors bring together the literatures on financialization and global supply chains to contextualise the pressures and outcomes discussed. A temporal dimension is a...

  8. Environmental responsibilities of livestock feeding using trace mineral supplements

    Directory of Open Access Journals (Sweden)

    Daniel Brugger

    2015-09-01

    Full Text Available Trace elements are essential dietary components for livestock species. However, they also exhibit a strong toxic potential. Therefore, their fluxes through the animal organism are tightly regulated by a complex molecular machinery that controls the rate of absorption from the gut lumen as well as the amount of excretion via faeces, urine and products (e.g., milk in order to maintain an internal equilibrium. When supplemented in doses above the gross requirement trace elements accumulate in urine and faeces and, hence, manure. Thereby, trace element emissions represent a potential threat to the environment. This fact is of particular importance in regard to the widely distributed feeding practice of pharmacological zinc and copper doses for the purpose of performance enhancement. Adverse environmental effects have been described, like impairment of plant production, accumulation in edible animal products and the water supply chain as well as the correlation between increased trace element loads and antimicrobial resistance. In the light of discussions about reducing the allowed upper limits for trace element loads in feed and manure from livestock production in the European Union excessive dosing needs to be critically reconsidered. Moreover, the precision in trace element feeding has to be increased in order to avoid unnecessary supplementation and, thereby, heavy metal emissions from livestock production. Keywords: Trace element, Livestock, Homeostasis, Pharmacological supplementation, Accumulation, Environment

  9. Tryptophan provision by dietary supplementation of a Bacillus subtilis mutant strain in piglets

    DEFF Research Database (Denmark)

    Torres-Pitarch, A; Nielsen, B.; Canibe, Nuria

    2015-01-01

    Supplementing Bacillus (B.) subtilis mutants selected to overproduce a specific amino acid (AA) may be an alternative method to provide essential AA in pig diets. Two experiments on a B. subtilis strain selected to overproduce Trp were conducted using 8-kg pigs fed Trp-deficient diets for 20 d. B....... subtilis were supplied in a low or high dose in Experiments 1 and 2, respectively. The Trp-deficient diet (0.15 SID Trp:Lys) reduced (p subtilis strain was not able...... to counterbalance the Trp deficiency in any of the two experiments. No effect of B. subtilis supplementation to piglet diets was observed on the plasma AA profile. In conclusion, this mutant strain of B. subtilis was not able to compensate a Trp deficiency in the tested doses....

  10. Determinants of dietary supplement use - healthy individuals use dietary supplements

    DEFF Research Database (Denmark)

    Kofoed, Christina L F; Christensen, Jane; Dragsted, Lars Ove

    2015-01-01

    influence the use of dietary supplements. Only few studies investigating the use of dietary supplements have been conducted in the Danish population. The present cross-sectional study is based on 54 948 Danes, aged 50-64 years, who completed self-administrated questionnaires on diet, dietary supplements...... and lifestyle between 1993 and 1997. A health index including smoking, physical activity, alcohol and diet, and a metabolic risk index including waist circumference, urinary glucose and measured hypertension were constructed. Logistic regression was used to investigate these determinants in relation...... to the intake of dietary supplements. We found that 71 % of the participants were dietary supplement users; female sex, older age groups and higher educated participants were more likely to be users of any dietary supplements. One additional point in the health index was associated with 19, 16 and 9 % higher...

  11. The role of supply-chain initiatives in reducing deforestation

    Science.gov (United States)

    Lambin, Eric F.; Gibbs, Holly K.; Heilmayr, Robert; Carlson, Kimberly M.; Fleck, Leonardo C.; Garrett, Rachael D.; le Polain de Waroux, Yann; McDermott, Constance L.; McLaughlin, David; Newton, Peter; Nolte, Christoph; Pacheco, Pablo; Rausch, Lisa L.; Streck, Charlotte; Thorlakson, Tannis; Walker, Nathalie F.

    2018-01-01

    A major reduction in global deforestation is needed to mitigate climate change and biodiversity loss. Recent private sector commitments aim to eliminate deforestation from a company's operations or supply chain, but they fall short on several fronts. Company pledges vary in the degree to which they include time-bound interventions with clear definitions and criteria to achieve verifiable outcomes. Zero-deforestation policies by companies may be insufficient to achieve broader impact on their own due to leakage, lack of transparency and traceability, selective adoption and smallholder marginalization. Public-private policy mixes are needed to increase the effectiveness of supply-chain initiatives that aim to reduce deforestation. We review current supply-chain initiatives, their effectiveness, and the challenges they face, and go on to identify knowledge gaps for complementary public-private policies.

  12. Protein supplementation with sports protein bars in renal patients.

    Science.gov (United States)

    Meade, Anthony

    2007-05-01

    Malnutrition prevalence in patients on dialysis is well established. The protein requirements for both hemodialysis and peritoneal dialysis have been documented elsewhere, including the Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines for Nutrition in Chronic Renal Failure. The clinical challenge is to assist patients in meeting these targets, especially in those with anorexia. Traditional supplements have included fluid, which is an issue for patients who are fluid restricted. The study objectives were to (1) investigate the range of sports protein supplements that may be suitable for patients on hemodialysis to use and (2) trial nonfluid protein supplements in patients on hemodialysis. Known manufacturers of sports protein bars and other sports supplements available in Australia were contacted for the nutrient breakdown of high-protein products, specifically potassium, protein, and phosphorus contents. As a result, selected high-protein sports bars (Protein FX, Aussie Bodies, Port Melbourne, Victoria, Australia) were used as an alternative to the more commonly used renal-specific fluid supplements (Nepro, Abbott Laboratories, Abbott Park, IL; Novasource Renal, Novartis Nutrition Corporation, Fremont, MI; and Renilon, Nutricia, Wiltshire, UK) in patients with poor nutritional status requiring supplementation. Patient satisfaction and clinical nutrition markers were investigated. The study took place at inpatient, in-center, and satellite hemodialysis settings in Adelaide, South Australia. A total of 32 patients (16 females and 16 males) with an average age of 62.9 years (range 32-86 years) undergoing hemodialysis (acute and maintenance) were included. Subjects were selected by the author as part of routine clinical nutrition care. Patients trialed sports protein bars as a protein supplement alone or in conjunction with other supplementary products. All patients were in favor of the trial, with 22 of 32 patients continuing with the protein

  13. Supply chain management: New organisational practices for changing procurement realities

    DEFF Research Database (Denmark)

    Rask, Morten; Andersen, Poul Houman

    2003-01-01

    we use an analytical technique known as the degree-of-freedom analysis. It is suggested that new organisational practices such as key supply management, team based management and changing skill requirements of purchasing personnel may be an outcome of implementing SCM practices towards suppliers....... Theoretical and practical implications are derived. The main implications are that procurement officers must develop their communicative and boundary-spanning abilities in order to take on their new position as key supply purchaser linking actors both internal and external, to the lead firm....

  14. [Dual action of vitamin C versus degradation and supplementation].

    Science.gov (United States)

    Kaliś, Katarzyna

    2015-11-17

    The article discusses vitamin C from the point of view of its supplementation with food and in the form of oral supplements. The dual action of vitamin C is connected with the presence of oxygen, which may reduce the amount of the vitamin in food products, influence thermal resistance, cause degradation and show an antioxidation effect. Vitamin C stimulates the immune cells and collagen synthesis. It may protect the LDL fraction against oxidation, and therefore it is interesting for cosmetology, rheumatology, immunology and dietetics. The latest research with respect to vitamin C proved that it has the ability to dissolve neurotoxic senile plaques. Equally effective in the treatment of Alzheimer's disease is the oxidised form of vitamin C, i.e. dehydroascorbic acid. Vitamin C may be used in a combined vitamin E supplementation to avoid the pro-oxidative effect and reduce the risk of diabetes mellitus type 2 complications. In the review there is a description of the types of vitamin C degradation depending on a specific factor such as pH, temperature, oxygen, enzyme and the impact of diet on the quantity of the supplied vitamin. The literature data confirmed the positive influence of vitamin C as an addition to food. The last part of the article presents the methods of vitamin C protection used in food processing technology and of determining its content in food products. Additionally, the article describes the problems related to vitamin C oxidation processes during food processing and storage. The presented research results indicate that an adequate diet contains a sufficient amount of vitamin C for healthy people. In the case of chronic patients it is better to use supplementation.

  15. Large Neutral Amino Acid Supplementation Exerts Its Effect through Three Synergistic Mechanisms: Proof of Principle in Phenylketonuria Mice.

    Directory of Open Access Journals (Sweden)

    Danique van Vliet

    Full Text Available Phenylketonuria (PKU was the first disorder in which severe neurocognitive dysfunction could be prevented by dietary treatment. However, despite this effect, neuropsychological outcome in PKU still remains suboptimal and the phenylalanine-restricted diet is very demanding. To improve neuropsychological outcome and relieve the dietary restrictions for PKU patients, supplementation of large neutral amino acids (LNAA is suggested as alternative treatment strategy that might correct all brain biochemical disturbances caused by high blood phenylalanine, and thereby improve neurocognitive functioning.As a proof-of-principle, this study aimed to investigate all hypothesized biochemical treatment objectives of LNAA supplementation (normalizing brain phenylalanine, non-phenylalanine LNAA, and monoaminergic neurotransmitter concentrations in PKU mice.C57Bl/6 Pah-enu2 (PKU mice and wild-type mice received a LNAA supplemented diet, an isonitrogenic/isocaloric high-protein control diet, or normal chow. After six weeks of dietary treatment, blood and brain amino acid and monoaminergic neurotransmitter concentrations were assessed.In PKU mice, the investigated LNAA supplementation regimen significantly reduced blood and brain phenylalanine concentrations by 33% and 26%, respectively, compared to normal chow (p<0.01, while alleviating brain deficiencies of some but not all supplemented LNAA. Moreover, LNAA supplementation in PKU mice significantly increased brain serotonin and norepinephrine concentrations from 35% to 71% and from 57% to 86% of wild-type concentrations (p<0.01, respectively, but not brain dopamine concentrations (p = 0.307.This study shows that LNAA supplementation without dietary phenylalanine restriction in PKU mice improves brain biochemistry through all three hypothesized biochemical mechanisms. Thereby, these data provide proof-of-concept for LNAA supplementation as a valuable alternative dietary treatment strategy in PKU. Based on these

  16. Biochemical and Anthropometric Effects of a Weight Loss Dietary Supplement in Healthy Men and Women

    Directory of Open Access Journals (Sweden)

    Cameron G. McCarthy

    2012-01-01

    Full Text Available Background We have recently noted an acute increase in circulating free fatty acids and glycerol, as well as resting metabolic rate, when men and women ingested the dietary supplement OxyELITE Pro™ in a single dose. We have also noted a reduction in appetite when subjects were treated with this supplement for 14 consecutive days. It is possible that such findings may favor body weight and fat loss over time. Therefore, the purpose of the present study was to determine the effects of this dietary supplement on weight loss and associated markers using an eight week intervention. Methods Exercise-trained subjects were randomly assigned in double blind manner to ingest either the dietary supplement (n = 16; aged 22.8 ± 0.7 or a placebo (n = 16; 22.5 ± 0.5 every day for eight weeks. Body weight, body composition, skinfold thickness, serum lipids, and appetite were measured as the primary outcome variables. As measures of supplement safety, a complete blood count and comprehensive metabolic panel were performed, and resting heart rate and blood pressure were measured (pre and post intervention. Results No interactions or main effects were noted for our primary outcome measures ( P > 0.05. However, when comparing pre and post intervention values for the supplement, significant decreases were noted in appetite, body weight, body fat percentage, and skinfold thickness ( P 0.05, with the exception of an increase in HDL-C ( P 0.05, with the exception of monocytes, for which an interaction effect was noted ( P = 0.04. Conclusion These data indicate that the dietary supplement OxyELITE Pro™ may assist in weight and body fat loss in a sample of exercise-trained men and women. The supplement does not result in any adverse effects pertaining to resting blood pressure or bloodborne markers of safety; however a small increase in resting heart rate is observed.

  17. Supply chain collaboration aligns order-winning strategy with business outcomes

    Directory of Open Access Journals (Sweden)

    Pongpak Banchuen

    2017-06-01

    Full Text Available The paper aims to find out whether appropriate choice of collaboration will enable the required order-winners, leading to improved business outcomes. Structural equation modelling (SEM was employed with cross-sectional data to test the hypothesised relationships among order-winners, modes of collaboration, and business outcomes. Results indicate that firms that focus on flexibility, quality, and delivery should develop strategic collaboration with suppliers to achieve market and innovation improvement. Cost- and quality-focussed firms should develop operational collaboration to achieve resource efficiency. The model allows managers to understand the right alignment of external suppliers while working on their own order-winners being pursued to win business performance.

  18. Does folic acid supplementation prevent or promote colorectal cancer? Results from model-based predictions.

    Science.gov (United States)

    Luebeck, E Georg; Moolgavkar, Suresh H; Liu, Amy Y; Boynton, Alanna; Ulrich, Cornelia M

    2008-06-01

    Folate is essential for nucleotide synthesis, DNA replication, and methyl group supply. Low-folate status has been associated with increased risks of several cancer types, suggesting a chemopreventive role of folate. However, recent findings on giving folic acid to patients with a history of colorectal polyps raise concerns about the efficacy and safety of folate supplementation and the long-term health effects of folate fortification. Results suggest that undetected precursor lesions may progress under folic acid supplementation, consistent with the role of folate role in nucleotide synthesis and cell proliferation. To better understand the possible trade-offs between the protective effects due to decreased mutation rates and possibly concomitant detrimental effects due to increased cell proliferation of folic acid, we used a biologically based mathematical model of colorectal carcinogenesis. We predict changes in cancer risk based on timing of treatment start and the potential effect of folic acid on cell proliferation and mutation rates. Changes in colorectal cancer risk in response to folic acid supplementation are likely a complex function of treatment start, duration, and effect on cell proliferation and mutations rates. Predicted colorectal cancer incidence rates under supplementation are mostly higher than rates without folic acid supplementation unless supplementation is initiated early in life (before age 20 years). To the extent to which this model predicts reality, it indicates that the effect on cancer risk when starting folic acid supplementation late in life is small, yet mostly detrimental. Experimental studies are needed to provide direct evidence for this dual role of folate in colorectal cancer and to validate and improve the model predictions.

  19. Barriers and enablers for iron folic acid (IFA) supplementation in pregnant women.

    Science.gov (United States)

    Siekmans, Kendra; Roche, Marion; Kung'u, Jacqueline K; Desrochers, Rachelle E; De-Regil, Luz Maria

    2017-12-22

    In order to inform large scale supplementation programme design, we review and summarize the barriers and enablers for improved coverage and utilization of iron and folic acid (IFA) supplements by pregnant women in 7 countries in Africa and Asia. Mixed methods were used to analyse IFA supplementation programmes in Afghanistan, Bangladesh, Indonesia, Ethiopia, Kenya, Nigeria, and Senegal based on formative research conducted in 2012-2013. Qualitative data from focus-group discussions and interviews with women and service providers were used for content analysis to elicit common themes on barriers and enablers at internal, external, and relational levels. Anaemia symptoms in pregnancy are well known among women and health care providers in all countries, yet many women do not feel personally at risk. Broad awareness and increased coverage of facility-based antenatal care (ANC) make it an efficient delivery channel for IFA; however, first trimester access to IFA is hindered by beliefs about when to first attend ANC and preferences for disclosing pregnancy status. Variable access and poor quality ANC services, including insufficient IFA supplies and inadequate counselling to encourage consumption, are barriers to both coverage and adherence. Community-based delivery of IFA and referral to ANC provides earlier and more frequent access and opportunities for follow-up. Improving ANC access and quality is needed to facilitate IFA supplementation during pregnancy. Community-based delivery and counselling can address problems of timely and continuous access to supplements. Renewed investment in training for service providers and effective behaviour change designs are urgently needed to achieve the desired impact. © 2018 John Wiley & Sons Ltd.

  20. [Recommendations on vitamin D and calcium supplements for adults in Spain].

    Science.gov (United States)

    Rigueira García, Ana Isabel

    2012-10-01

    Calcium supplements and vitamin D are involved in current debates of health, as cardiovascular safety of calcium, and correction of vitamin levels. The aim is to review the possibilities of making better use of supplements marketed in Spain, depending on their availability, information and related epidemiology. Analysis of comercial offer and available information about pharmacological aspects of Spanish medicinal supplements in data-sheets (39), guides and reports current institutional and professional, with additional search of this information and epidemiological data related Spanish in Cochrane Database of Systematic Reviews ®, PubMed ® (tool "Clinical Queries"), Dialnet database and hand search of Spanish journals directly related. There is no uniformity in terms of indication, expression of content, dosages, precautions and safety in data sheets or technical reports. The literature search found more recent publications volume for vitamin D than calcium, No evidence was found to establish appropriate dosing regimens indisputable or universal, or cholecalciferol bioavailability tests with aqueous vehiculización. In Spain nutritional situation is found generally suitable for the calcium but a status mostly unsuitable for vitamin D with several references for insufficiency and vitamin deficiency in adults. Corrective treatments primarily affect calcium supplements. There is an ample supply of calcium and vitamin D in Spain, whose drug design should rethink because don't respond to the needs identified or correction possibilities currently recommended. It should also improve and update their information, with particular interest in health status related to hypovitaminosis D.

  1. Effect of raceme-localized supplemental light on soybean reproductive abscission

    International Nuclear Information System (INIS)

    Myers, R.L.; Brun, W.A.; Brenner, M.L.

    1987-01-01

    The percentage of soybean [Glycine max (L.) Merr.] reproductive structures that abscise is a potentially important yield factor. To better understand the involvement of light in the abscission of reproductive structures, a series of in vitro raceme-culture and growth-chamber experiments were conducted. In the in vitro raceme-culture experiments, racemes with four to six flowers at or past anthesis were excised from the soybean plant (genotype IX93-100), embedded in a complete nutrient, solid agar medium, and subjected to various light treatments. A series of three experiments indicated that the racemes contain a photoreceptor, possibly phytochrome, capable of regulating sucrose accumulation. In each of the growth chamber studies, supplemental light was supplied directly to individual soybean flowers via fiber optic light guides. The light source increased the photon flux to the flowers by 10-fold. The first growth chamber experiment showed that flowers receiving supplemental light were more intense sinks for 14 C-sucrose than were controls (intensity value of 1.0 vs 0.4 x 10 -7 , intensity = [dps of flower/dps of raceme]/[kg dry wt of flower]). In a second study, 42% of flowers treated with supplemental light set pods, while only 26% of control flowers set pods. A third experiment showed that red supplemental light produced 55% fruit set, compared to 41% set for far-red light, and 35% for controls. These experiments indicate that both photoassimilate accumulation and abscission in young soybean reproductive structures may be regulated by light quality

  2. Do mobile clinics provide high-quality antenatal care? A comparison of care delivery, knowledge outcomes and perception of quality of care between fixed and mobile clinics in central Haiti.

    Science.gov (United States)

    Phillips, Erica; Stoltzfus, Rebecca J; Michaud, Lesly; Pierre, Gracia Lionel Fils; Vermeylen, Francoise; Pelletier, David

    2017-10-16

    Antenatal care (ANC) is an important health service for women in developing countries, with numerous proven benefits. Global coverage of ANC has steadily increased over the past 30 years, in part due to increased community-based outreach. However, commensurate improvements in health outcomes such as reductions in the prevalence of maternal anemia and infants born small-for-gestational age have not been achieved, even with increased coverage, indicating that quality of care may be inadequate. Mobile clinics are one community-based strategy used to further improve coverage of ANC, but their quality of care delivery has rarely been evaluated. To determine the quality of care of ANC in central Haiti, we compared adherence to national guidelines between fixed and mobile clinics by performing direct observations of antenatal care consultations and exit interviews with recipients of care using a multi-stage random sampling procedure. Outcome variables were eight components of care, and women's knowledge and perception of care quality. There were significant differences in the predicted proportion or probability of recommended services for four of eight care components, including intake, laboratory examinations, infection control, and supplies, iron folic acid supplements and Tetanus Toxoid vaccine provided to women. These care components were more likely performed in fixed clinics, except for distribution of supplies, iron-folic acid supplements, and Tetanus Toxoid vaccine, more likely provided in mobile clinics. There were no differences between clinic type for the proportion of total physical exam procedures performed, health and communication messages delivered, provider communication or documentation. Women's knowledge about educational topics was poor, but women perceived extremely high quality of care in both clinic models. Although adherence to guidelines differed by clinic type for half of the care components, both clinics had a low percentage of overall services

  3. Omega 3 fatty acids, gestation and pregnancy outcomes.

    Science.gov (United States)

    Larqué, Elvira; Gil-Sánchez, Alfonso; Prieto-Sánchez, María Teresa; Koletzko, Berthold

    2012-06-01

    Pregnancy is associated with a reduction in maternal serum docosahexaenoic acid (DHA, 22:6 n-3) percentage and its possible depletion in the maternal store. Since the synthesis of long chain polyunsaturated fatty acids (LCPUFA) in the fetus and placenta is low, both the maternal LCPUFA status and placental function are critical for their supply to the fetus. Maternal supplementation with DHA up to 1 g/d or 2·7 g n-3 LCPUFA did not have any harmful effect. DHA supplementation in large studies slightly the enhanced length of gestation (by about 2 days), which may increase the birth weight by about 50 g at delivery. However no advice can be given on their general using to avoid preterm deliveries in low or high risk pregnancies. Several studies, but not all, reported improvements of the offspring in some neurodevelopmental tests as a result of DHA supplementation during gestation, or, at least, positive relationships between maternal or cord serum DHA percentages and cognitive skills in young children. The effect seems more evident in children with low DHA proportions, which raises the question of how to identify those mothers who might have a poor DHA status and who could benefit from such supplementation. Most studies on the effects of n-3 LCPUFA supplementation during pregnancy on maternal depression were judged to be of low-to-moderate quality, mainly due to small sample sizes and failure to adhere to Consolidated Standards of Reporting Trials guidelines. In contrast, the effects of n-3 LCPUFA supplementation on reducing allergic diseases in offspring are promising.

  4. The impact of exercise and vitamin D supplementation on physical function in community-dwelling elderly individuals: A randomized trial.

    Science.gov (United States)

    Aoki, Kana; Sakuma, Mayumi; Endo, Naoto

    2018-04-25

    We investigated the impact of exercise and vitamin D supplementation on physical function and locomotor dysfunction in community-dwelling elderly individuals. In total, 148 community-dwelling elderly individuals (aged ≥60 years) who were not taking osteoporosis medications participated in a 24-week intervention. The participants were randomly divided into an exercise group, vitamin D group, and exercise and vitamin D group. The participants and outcome-assessing staff were not blinded to group assignment. Exercise comprised three daily sets each of single-leg standing (1 min/leg/set) and squatting (5-6 repetitions/set); vitamin D supplementation was 1000 IU/day. Participants were contacted every 2 weeks to check on their condition and encourage continued participation. The primary outcome was lower limb muscle strength and mass; secondary outcomes were several physical function measurements, serum 25-hydroxyvitamin D levels, and results of a self-assessment questionnaire completed pre- and post-intervention. We analyzed data from 45, 42, and 43 participants in the exercise, vitamin D, and exercise and vitamin D groups, respectively, who completed the intervention. Locomotive syndrome, which involves reduced mobility due to locomotive organ impairment, was diagnosed in 99 participants (76.2%). Many physical function measurements improved in all groups. Lower limb muscle mass increased significantly in all three groups, with no significant differences between the groups in the degree of change. The average serum 25-hydroxyvitamin D of all vitamin D-supplemented participants increased from 28.1 ng/ml to 47.3 ng/ml after vitamin D supplementation. Both exercise and vitamin D supplementation independently improved physical function and increased muscle mass in community-dwelling elderly individuals. Moreover, the combination of exercise and vitamin D supplementation might further enhance these positive effects. UMIN Clinical Trial, UMIN000028229. Copyright © 2018

  5. Willingness to pay for small-quantity lipid-based nutrient supplements for women and children: Evidence from Ghana and Malawi.

    Science.gov (United States)

    Adams, Katherine P; Vosti, Stephen A; Ayifah, Emmanuel; Phiri, Thokozani E; Adu-Afarwuah, Seth; Maleta, Kenneth; Ashorn, Ulla; Arimond, Mary; Dewey, Kathryn G

    2018-04-01

    Small-quantity lipid-based nutrient supplements (SQ-LNS) are designed to enrich maternal and child diets with the objective of preventing undernutrition during the first 1,000 days. Scaling up the delivery of supplements such as SQ-LNS hinges on understanding private demand and creatively leveraging policy-relevant factors that might influence demand. We used longitudinal stated willingness-to-pay (WTP) data from contingent valuation studies that were integrated into randomized controlled nutrition trials in Ghana and Malawi to estimate private valuation of SQ-LNS during pregnancy, postpartum, and early childhood. We found that average stated WTP for a day's supply of SQ-LNS was more than twice as high in Ghana than Malawi, indicating that demand for SQ-LNS (and by extension, the options for effective delivery of SQ-LNS) may be very context specific. We also examined factors associated with WTP, including intervention group, household socioeconomic status, birth outcomes, child growth, and maternal and child morbidity. In both sites, WTP was consistently negatively associated with household food insecurity, indicating that subsidization might be needed to permit food insecure households to acquire SQ-LNS if it is made available for purchase. In Ghana, WTP was higher among heads of household than among mothers, which may be related to control over household resources. Personal experience using SQ-LNS was not associated with WTP in either site. © 2017 The Authors. Maternal and Child Nutrition published by John Wiley & Sons, Ltd.

  6. Maternal fish oil supplementation in lactation: effect on developmental outcome in breast-fed infants

    DEFF Research Database (Denmark)

    Lauritzen, L.; Jørgensen, M.H.; Olsen, S.F.

    2005-01-01

    Docosahexaenoic acid (DHA) accumulates in the brain during the 1st and 2nd years of life. The objective of this study was to see if an increased content of DHA in breast-milk via maternal fish oil (FO)-supplementation affects mental development in term infants. one hundred twenty-two Danish mothe...

  7. Does folic-acid supplementation prevent or promote colorectal cancer? Results from model-based predictions

    OpenAIRE

    Luebeck, EG; Moolgavkar, SH; Liu, AY; Boynton, A; Ulrich, CM

    2008-01-01

    Folate is essential for nucleotide synthesis, DNA-replication and methyl-group supply. Low-folate status has been associated with increased risks of several cancer types, suggesting a chemopreventive role of folate. However, recent findings on giving folic acid (FA) to patients with a history of colorectal polyps raise concerns about the efficacy and safety of folate supplementation and the long-term health effects of folate fortification. Results suggest that undetected precursor lesions may...

  8. The Effect of Omega-3 Docosahexaenoic Acid Supplementation on Gestational Length: Randomized Trial of Supplementation Compared to Nutrition Education for Increasing n-3 Intake from Foods

    Directory of Open Access Journals (Sweden)

    Mary A. Harris

    2015-01-01

    Full Text Available Objective. DHA supplementation was compared to nutrition education to increase DHA consumption from fish and DHA fortified foods. Design. This two-part intervention included a randomized double-blind placebo controlled DHA supplementation arm and a nutrition education arm designed to increase intake of DHA from dietary sources by 300 mg per day. Setting. Denver Health Hospitals and Clinics, Denver, Colorado, USA. Population. 871 pregnant women aged 18–40 were recruited between16 and 20 weeks of gestation of whom 564 completed the study and complete delivery data was available in 505 women and infants. Methods. Subjects received either 300 or 600 mg DHA or olive oil placebo or nutrition education. Main Outcome Variable. Gestational length. Results. Gestational length was significantly increased by 4.0–4.5 days in women supplemented with 600 mg DHA per day or provided with nutrition education. Each 1% increase in RBC DHA at delivery was associated with a 1.6-day increase in gestational length. No significant effects on birth weight, birth length, or head circumference were demonstrated. The rate of early preterm birth (1.7% in those supplemented with DHA (combined 300 and 600 mg/day was significantly lower than in controls. Conclusion. Nutrition education or supplementation with DHA can be effective in increasing gestational length.

  9. Clinical benefits of oral nutritional supplementation for elderly hip fracture patients: a single blind randomised controlled trial.

    Science.gov (United States)

    Myint, Ma Wai Wai; Wu, Jenny; Wong, Euann; Chan, Suk Ping; To, Tze Shing Jess; Chau, Mei Wa Rosanna; Ting, Kwai Hing; Fung, Pui Man; Au, Kit Sing Derrick

    2013-01-01

    malnutrition is an important risk factor for poor outcome in patients recovering after hip fracture surgery. This study aimed to investigate the clinical, nutritional and rehabilitation effects of an oral nutritional supplementation (ONS) in an inpatient rehabilitation setting. this was an observer-blinded randomised controlled trial of elderly post-surgical proximal femoral fracture patients. A ready-to-use oral liquid nutritional supplementation (18-24 g protein and 500 kcal per day) in addition to hospital diet was compared with hospital diet only. Both groups received usual rehabilitation therapy and oral calcium and vitamin D supplements. Outcomes were compared at discharge from rehabilitation and after 4 weeks of discharge. The primary outcome parameters were the serum albumin level, the body mass index (BMI), the functional independence measure (FIM) and the elderly mobility scale (EMS). Secondary outcome parameters were frequency of complications, inpatient length of stay, mortality and acute hospital use within 6 months after discharge. a total of 126 patients were recruited, 65 in the supplementation arm and 61 in the control arm. There was a significant difference in change in BMI with a decrease of 0.25 and 0.03 kg/m(2) in the ONS group and 0.72 and 0.49 kg/m(2) in the control group at hospital discharge and follow-up, respectively (P = 0.012). The length of stay in rehabilitation ward was shortened by 3.80 (SE = 1.81, P = 0.04) days favouring the ONS group. The total number of infection episodes was also reduced significantly. No difference was observed in the rate of change of the serum albumin level, the FIM and the EMS. clinical and nutritional benefits were seen in this trial but rehabilitation benefits could not be demonstrated.

  10. Influence of Zinc Supplementation in Acute Diarrhea Differs by the Isolated Organism

    Directory of Open Access Journals (Sweden)

    Archana B. Patel

    2010-01-01

    Full Text Available Zinc supplementation is recommended in all acute diarrheas in children from developing countries. We aimed to assess whether zinc supplementation would be equally effective against all the common organisms associated with acute diarrheas. We used data on 801 children with acute diarrhea recruited in a randomized, double blind controlled trial (ISRCTN85071383 of zinc and copper supplementation. Using prespecified subgroup analyses, multidimensionality reduction analyses, tests of heterogeneity, and stepwise logistic regression for tests of interactions, we found that the influence of zinc on the risk of diarrhea for more than 3 days depended on the isolated organism—beneficial in Klebsiella, neutral in Esherichia coli and parasitic infections, and detrimental in rotavirus coinfections. Although we found similar results for the outcome of high stool volume, the results did not reach statistical significance. Our findings suggest that the current strategy of zinc supplementation in all cases of acute diarrheas in children may need appropriate fine tuning to optimize the therapeutic benefit based on the causative organism, but further studies need to confirm and extend our findings.

  11. Dietary supplementation with probiotics during late pregnancy: outcome on vaginal microbiota and cytokine secretion.

    Science.gov (United States)

    Vitali, Beatrice; Cruciani, Federica; Baldassarre, Maria Elisabetta; Capursi, Teresa; Spisni, Enzo; Valerii, Maria Chiara; Candela, Marco; Turroni, Silvia; Brigidi, Patrizia

    2012-10-18

    The vaginal microbiota of healthy women consists of a wide variety of anaerobic and aerobic bacterial genera and species dominated by the genus Lactobacillus. The activity of lactobacilli helps to maintain the natural healthy balance of the vaginal microbiota. This role is particularly important during pregnancy because vaginal dismicrobism is one of the most important mechanisms for preterm birth and perinatal complications. In the present study, we characterized the impact of a dietary supplementation with the probiotic VSL#3, a mixture of Lactobacillus, Bifidobacterium and Streptococcus strains, on the vaginal microbiota and immunological profiles of healthy women during late pregnancy. An association between the oral intake of the probiotic VSL#3 and changes in the composition of the vaginal microbiota of pregnant women was revealed by PCR-DGGE population profiling. Despite no significant changes were found in the amounts of the principal vaginal bacterial populations in women administered with VSL#3, qPCR results suggested a potential role of the probiotic product in counteracting the decrease of Bifidobacterium and the increase of Atopobium, that occurred in control women during late pregnancy. The modulation of the vaginal microbiota was associated with significant changes in some vaginal cytokines. In particular, the decrease of the anti-inflammatory cytokines IL-4 and IL-10 was observed only in control women but not in women supplemented with VSL#3. In addition, the probiotic consumption induced the decrease of the pro-inflammatory chemokine Eotaxin, suggesting a potential anti-inflammatory effect on the vaginal immunity. Dietary supplementation with the probiotic VSL#3 during the last trimester of pregnancy was associated to a modulation of the vaginal microbiota and cytokine secretion, with potential implications in preventing preterm birth. ClinicalTrials.gov NCT01367470.

  12. Dietary supplementation with probiotics during late pregnancy: outcome on vaginal microbiota and cytokine secretion

    Directory of Open Access Journals (Sweden)

    Vitali Beatrice

    2012-10-01

    Full Text Available Abstract Background The vaginal microbiota of healthy women consists of a wide variety of anaerobic and aerobic bacterial genera and species dominated by the genus Lactobacillus. The activity of lactobacilli helps to maintain the natural healthy balance of the vaginal microbiota. This role is particularly important during pregnancy because vaginal dismicrobism is one of the most important mechanisms for preterm birth and perinatal complications. In the present study, we characterized the impact of a dietary supplementation with the probiotic VSL#3, a mixture of Lactobacillus, Bifidobacterium and Streptococcus strains, on the vaginal microbiota and immunological profiles of healthy women during late pregnancy. Results An association between the oral intake of the probiotic VSL#3 and changes in the composition of the vaginal microbiota of pregnant women was revealed by PCR-DGGE population profiling. Despite no significant changes were found in the amounts of the principal vaginal bacterial populations in women administered with VSL#3, qPCR results suggested a potential role of the probiotic product in counteracting the decrease of Bifidobacterium and the increase of Atopobium, that occurred in control women during late pregnancy. The modulation of the vaginal microbiota was associated with significant changes in some vaginal cytokines. In particular, the decrease of the anti-inflammatory cytokines IL-4 and IL-10 was observed only in control women but not in women supplemented with VSL#3. In addition, the probiotic consumption induced the decrease of the pro-inflammatory chemokine Eotaxin, suggesting a potential anti-inflammatory effect on the vaginal immunity. Conclusion Dietary supplementation with the probiotic VSL#3 during the last trimester of pregnancy was associated to a modulation of the vaginal microbiota and cytokine secretion, with potential implications in preventing preterm birth. Trial registration ClinicalTrials.gov NCT01367470

  13. Effect of Bifidobacterium breve M-16V supplementation on fecal bifidobacteria in preterm neonates--a randomised double blind placebo controlled trial.

    Science.gov (United States)

    Patole, Sanjay; Keil, Anthony D; Chang, Annie; Nathan, Elizabeth; Doherty, Dorota; Simmer, Karen; Esvaran, Meera; Conway, Patricia

    2014-01-01

    Probiotic supplementation significantly reduces the risk of necrotising enterocolitis (NEC) and all cause mortality in preterm neonates. Independent quality assessment is important before introducing routine probiotic supplementation in this cohort. To assess product quality, and confirm that Bifidobacterium breve (B. breve) M-16V supplementation will increase fecal B. breve counts without adverse effects. Strain identity (16S rRNA gene sequencing), viability over 2 year shelf-life were confirmed, and microbial contamination of the product was ruled out. In a controlled trial preterm neonates (Gestation breve M-16V (3×109 cfu/day) or placebo (dextrin) supplementation until the corrected age 37 weeks. Stool samples were collected before (S1) and after 3 weeks of supplementation (S2) for studying fecal B. breve levels using quantitative PCR (Primary outcome). Secondary outcomes included total fecal bifidobacteria and NEC≥Stage II. Categorical and continuous outcomes were analysed using Chi-square and Mann-Whitney tests, and McNemar and Wilcoxon signed-rank tests for paired comparisons. A total of 159 neonates (Probiotic: 79, Placebo: 80) were enrolled. Maternal and neonatal demographic characteristics were comparable between the groups. The proportion of neonates with detectable B. breve increased significantly post intervention: Placebo: [S1:2/66 (3%), S2: 25/66 (38%), pbreve counts in both groups were below detection (breve M-16V is a suitable probiotic strain for routine use in preterm neonates. Australia New Zealand Clinical Trial Registry ACTRN 12609000374268.

  14. Effect of low-dose versus higher-dose antenatal iron supplementation on child health outcomes at 36 months of age in Viet Nam: longitudinal follow-up of a cluster randomised controlled trial.

    Science.gov (United States)

    Hanieh, Sarah; Ha, Tran T; Simpson, Julie A; Braat, Sabine; Thuy, Tran T; Tran, Thach D; King, Janet; Tuan, Tran; Fisher, Jane; Biggs, Beverley-Ann

    2017-01-01

    Intermittent iron-folic acid supplementation (IFA) is currently recommended for pregnant women in populations where anaemia prevalence among pregnant women is Viet Nam among children of 36 months of age, born to women previously enrolled in a cluster randomised controlled trial of antenatal micronutrient supplementation (daily IFA (60 mg elemental iron) vs twice-weekly IFA (60 mg elemental iron) vs twice-weekly multiple micronutrient (MMN) supplementation (60 mg elemental iron)). Primary outcomes were height-for-age z-scores (HAZ), according to WHO growth standards and cognitive composite scores (Bayley Scales of Infant and Toddler Development, third edition) at 36 months of age. A total of 1017 children born to mothers enrolled in the cluster randomised trial were assessed at 36 months of age. Adjusted mean differences (MDs) in HAZ were -0.14 (95% CI -0.28 to -0.01) and -0.15 (95% CI -0.29 to -0.01) in children born to mothers who received twice-weekly IFA or MMN compared with those who received daily IFA. Children born to mothers who received twice-weekly MMN had lower composite motor scores compared with those who received daily IFA (MD -2.07, 95% CI -4.11 to -0.03). There were no differences in composite cognitive scores in the twice-weekly compared with daily regimens. Low-dose antenatal IFA supplementation (120 mg elemental iron per week) resulted in lower HAZ and motor composite scores in children compared with higher-dose antenatal IFA supplementation (420 mg elemental iron per week). This highlights the importance of adequate iron stores during pregnancy and the need for careful monitoring when lower-dose antenatal iron regimens are used. Australia New Zealand Clinical Trials Registry: 12610000944033.

  15. The Influence of Prolonged Acetylsalicylic Acid Supplementation-Induced Gastritis on the Neurochemistry of the Sympathetic Neurons Supplying Prepyloric Region of the Porcine Stomach.

    Directory of Open Access Journals (Sweden)

    Katarzyna Palus

    Full Text Available This experiment was designed to establish the localization and neurochemical phenotyping of sympathetic neurons supplying prepyloric area of the porcine stomach in a physiological state and during acetylsalicylic acid (ASA induced gastritis. In order to localize the sympathetic perikarya the stomachs of both control and acetylsalicylic acid treated (ASA group animals were injected with neuronal retrograde tracer Fast Blue (FB. Seven days post FB injection, animals were divided into a control and ASA supplementation group. The ASA group was given 100 mg/kg of b.w. ASA orally for 21 days. On the 28th day all pigs were euthanized with gradual overdose of anesthetic. Then fourteen-micrometer-thick cryostat sections were processed for routine double-labeling immunofluorescence, using primary antisera directed towards tyrosine hydroxylase (TH, dopamine β-hydroxylase (DβH, neuropeptide Y (NPY, galanin (GAL, neuronal nitric oxide synthase (nNOS, leu 5-enkephalin (LENK, cocaine- and amphetamine- regulated transcript peptide (CART, calcitonin gene-related peptide (CGRP, substance P (SP and vasoactive intestinal peptide (VIP. The data obtained in this study indicate that postganglionic sympathetic nerve fibers supplying prepyloric area of the porcine stomach originate from the coeliac-cranial mesenteric ganglion complex (CCMG. In control animals, the FB-labelled neurons expressed TH (94.85 ± 1.01%, DβH (97.10 ± 0.97%, NPY (46.88 ± 2.53% and GAL (8.40 ± 0.53%. In ASA group, TH- and DβH- positive nerve cells were reduced (85.78 ± 2.65% and 88.82 ± 1.63% respectively. Moreover, ASA- induced gastritis resulted in increased expression of NPY (76.59 ± 3.02% and GAL (26.45 ± 2.75% as well as the novo-synthesis of nNOS (6.13 ± 1.11% and LENK (4.77 ± 0.42% in traced CCMG neurons. Additionally, a network of CART-, CGRP-, SP-, VIP-, LENK-, nNOS- immunoreactive (IR nerve fibers encircling the FB-positive perikarya were observed in both intact and ASA

  16. Decision-making under surprise and uncertainty: Arsenic contamination of water supplies

    Science.gov (United States)

    Randhir, Timothy O.; Mozumder, Pallab; Halim, Nafisa

    2018-05-01

    With ignorance and potential surprise dominating decision making in water resources, a framework for dealing with such uncertainty is a critical need in hydrology. We operationalize the 'potential surprise' criterion proposed by Shackle, Vickers, and Katzner (SVK) to derive decision rules to manage water resources under uncertainty and ignorance. We apply this framework to managing water supply systems in Bangladesh that face severe, naturally occurring arsenic contamination. The uncertainty involved with arsenic in water supplies makes the application of conventional analysis of decision-making ineffective. Given the uncertainty and surprise involved in such cases, we find that optimal decisions tend to favor actions that avoid irreversible outcomes instead of conventional cost-effective actions. We observe that a diversification of the water supply system also emerges as a robust strategy to avert unintended outcomes of water contamination. Shallow wells had a slight higher optimal level (36%) compare to deep wells and surface treatment which had allocation levels of roughly 32% under each. The approach can be applied in a variety of other cases that involve decision making under uncertainty and surprise, a frequent situation in natural resources management.

  17. Supply chain reaction

    International Nuclear Information System (INIS)

    Snieckus, Darius

    2000-01-01

    'Logic' (Leading Oil and Gas Industry Competitiveness) is a government-industry supply chain management initiative which aims to improve the competitiveness of the UK's North Sea business by 1 billion UK pounds by 2002 and its export performance by 50% inside 5 years. Much of the article is devoted to the background and views of Logic's chief executive Chris. Freeman. Freeman makes clear that 'unlike Crine, we are not a cost-reduction initiative: that may be one of the outcomes, but we are really focusing on the co-operation side of things'. Logic aims to change the culture of the UK offshore industry through example. Freeman believes that the creation of collaborative success will flag up industry and give credence to Logics objectives

  18. The effect of folic acid, protein energy and multiple micronutrient supplements in pregnancy on stillbirths

    Directory of Open Access Journals (Sweden)

    Bhutta Zulfiqar A

    2011-04-01

    Full Text Available Abstract Background Pregnancy is a state of increased requirement of macro- and micronutrients, and malnourishment or inadequate dietary intake before and during pregnancy, can lead to adverse perinatal outcomes including stillbirths. Many nutritional interventions have been proposed during pregnancy according to the nutritional status of the mother and baseline risk factors for different gestational disorders. In this paper, we have reviewed three nutritional interventions including peri-conceptional folic acid supplementation, balanced protein energy supplementation and multiple micronutrients supplementation during pregnancy. This paper is a part of a series to estimate the effect of interventions on stillbirths for input to Live Saved Tool (LiST model. Methods We systematically reviewed all published literature to identify studies evaluating effectiveness of peri-conceptional folic acid supplementation in reducing neural tube defects (NTD, related stillbirths and balanced protein energy and multiple micronutrients supplementation during pregnancy in reducing all-cause stillbirths. The primary outcome was stillbirths. Meta-analyses were generated where data were available from more than one study. Recommendations were made for the Lives Saved Tool (LiST model based on rules developed by the Child Health Epidemiology Reference Group (CHERG. Results There were 18 studies that addressed peri-conceptional folic acid supplementation for prevention of neural tube defects (NTDs. Out of these, 7 studies addressed folic acid supplementation while 11 studies evaluated effect of folic acid fortification. Pooled results from 11 fortification studies showed that it reduces primary incidence of NTDs by 41 % [Relative risk (RR 0.59; 95 % confidence interval (CI 0.52-0.68]. This estimate has been recommended for inclusion in the LiST as proxy for reduction in stillbirths. Pooled results from three studies considered to be of low quality and suggest that

  19. Content validity and nursing sensitivity of community-level outcomes from the Nursing Outcomes Classification (NOC).

    Science.gov (United States)

    Head, Barbara J; Aquilino, Mary Lober; Johnson, Marion; Reed, David; Maas, Meridean; Moorhead, Sue

    2004-01-01

    To evaluate the content validity and nursing sensitivity of six community-level outcomes from the Nursing Outcomes Classification (NOC; Johnson, Maas, & Moorhead, 2000). A survey research design was used. Questionnaires were mailed to 300 public health nursing experts; 102 nurses responded. Experts evaluated between 11 and 30 indicators for each of the six outcomes for: (a) importance of the indicators for measuring the outcome, and (b) influence of nursing on the indicators. Content validity and nursing sensitivity of the outcomes were estimated with a modified Fehring technique. All outcomes were deemed important; only Community Competence had an outcome content validity score < .80. The outcome sensitivity score for Community Health: Immunity was .80; other outcome scores ranged from .62-.70. Indicator ratios for all 102 indicators met the study criterion for importance, with 87% designated as critical and 13% as supplemental. Sensitivity ratios reflected judgments that 45% of the indicators were sensitive to nursing intervention. The study provided evidence of outcome content validity and nursing sensitivity of the study outcomes; further validation research is recommended, followed by testing of the study outcomes in clinical practice. Community-level nursing-sensitive outcomes will potentially enable study of the efficacy and effectiveness of public health interventions focused on improving health of populations and communities.

  20. Intergenerational impact of paternal lifetime exposures to both folic acid deficiency and supplementation on reproductive outcomes and imprinted gene methylation.

    Science.gov (United States)

    Ly, Lundi; Chan, Donovan; Aarabi, Mahmoud; Landry, Mylène; Behan, Nathalie A; MacFarlane, Amanda J; Trasler, Jacquetta

    2017-07-01

    Do paternal exposures to folic acid deficient (FD), and/or folic acid supplemented (FS) diets, throughout germ cell development adversely affect male germ cells and consequently offspring health outcomes? Male mice exposed over their lifetimes to both FD and FS diets showed decreased sperm counts and altered imprinted gene methylation with evidence of transmission of adverse effects to the offspring, including increased postnatal-preweaning mortality and variability in imprinted gene methylation. There is increasing evidence that disruptions in male germ cell epigenetic reprogramming are associated with offspring abnormalities and intergenerational disease. The fetal period is the critical time of DNA methylation pattern acquisition for developing male germ cells and an adequate supply of methyl donors is required. In addition, DNA methylation patterns continue to be remodeled during postnatal spermatogenesis. Previous studies have shown that lifetime (prenatal and postnatal) folic acid deficiency can alter the sperm epigenome and increase the incidence of fetal morphological abnormalities. Female BALB/c mice (F0) were placed on one of four amino-acid defined diets for 4 weeks before pregnancy and throughout pregnancy and lactation: folic acid control (Ctrl; 2 mg/kg), 7-fold folic acid deficient (7FD; 0.3 mg/kg), 10-fold high FS (10FS, 20 mg/kg) or 20-fold high FS (20FS, 40 mg/kg) diets. F1 males were weaned to their respective prenatal diets to allow for diet exposure during all windows of germline epigenetic reprogramming: the erasure, re-establishment and maintenance phases. F0 females were mated with chow-fed males to produce F1 litters whose germ cells were exposed to the diets throughout embryonic development. F1 males were subsequently mated with chow-fed female mice. Two F2 litters, unexposed to the experimental diets, were generated from each F1 male; one litter was collected at embryonic day (E)18.5 and one delivered and followed postnatally. DNA

  1. Dual action of vitamin C versus degradation and supplementation

    Directory of Open Access Journals (Sweden)

    Katarzyna Kaliś

    2015-11-01

    Full Text Available The article discusses vitamin C from the point of view of its supplementation with food and in the form of oral supplements. The dual action of vitamin C is connected with the presence of oxygen, which may reduce the amount of the vitamin in food products, influence thermal resistance, cause degradation and show an antioxidation effect. Vitamin C stimulates the immune cells and collagen synthesis. It may protect the LDL fraction against oxidation, and therefore it is interesting for cosmetology, rheumatology, immunology and dietetics. The latest research with respect to vitamin C proved that it has the ability to dissolve neurotoxic senile plaques. Equally effective in the treatment of Alzheimer’s disease is the oxidised form of vitamin C, i.e. dehydroascorbic acid. Vitamin C may be used in a combined vitamin E supplementation to avoid the pro-oxidative effect and reduce the risk of diabetes mellitus type 2 complications. In the review there is a description of the types of vitamin C degradation depending on a specific factor such as pH, temperature, oxygen, enzyme and the impact of diet on the quantity of the supplied vitamin. The literature data confirmed the positive influence of vitamin C as an addition to food. The last part of the article presents the methods of vitamin C protection used in food processing technology and of determining its content in food products. Additionally, the article describes the problems related to vitamin C oxidation processes during food processing and storage. The presented research results indicate that an adequate diet contains a sufficient amount of vitamin C for healthy people. In the case of chronic patients it is better to use supplementation.

  2. Calcium supplements

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007477.htm Calcium supplements To use the sharing features on this page, please enable JavaScript. WHO SHOULD TAKE CALCIUM SUPPLEMENTS? Calcium is an important mineral for the ...

  3. Docosahexaenoic acid (DHA) and arachidonic acid (ARA) balance in developmental outcomes.

    Science.gov (United States)

    Colombo, John; Jill Shaddy, D; Kerling, Elizabeth H; Gustafson, Kathleen M; Carlson, Susan E

    2017-06-01

    The DHA Intake and Measurement of Neural Development (DIAMOND) trial represents one of only a few studies of the long-term dose-response effects of LCPUFA-supplemented formula feeding during infancy. The trial contrasted the effects of four formulations: 0.00% docosahexaenoic acid (DHA)/0.00% arachidonic acid (ARA), 0.32% DHA/0.64% ARA, 0.64% DHA/0.64% ARA, and 0.96% DHA/0.64% ARA against a control condition (0.00% DHA/0.00% ARA). The results of this trial have been published elsewhere, and show improved cognitive outcomes for infants fed supplemented formulas, but a common finding among many of the outcomes show a reduction of benefit for the highest DHA dose (i.e., 0.96%DHA/0.64% ARA, that is, a DHA: ARA ratio 1.5:1.0). The current paper gathers and summarizes the evidence for the reduction of benefit at this dose, and in an attempt to account for this reduced benefit, presents for the first time data from infants' red blood cell (RBC) assays taken at 4 and 12 months of age. Those assays indicate that blood DHA levels generally rose with increased DHA supplementation, although those levels tended to plateau as the DHA-supplemented level exceeded 0.64%. Perhaps more importantly, ARA levels showed a strong inverted-U function in response to increased DHA supplementation; indeed, infants assigned to the formula with the highest dose of DHA (and highest DHA/ARA ratio) showed a reduction in blood ARA relative to more intermediate DHA doses. This finding raises the possibility that reduced ARA may be responsible for the reduction in benefit on cognitive outcomes seen at this dose. The findings implicate the DHA/ARA balance as an important variable in the contribution of LCPUFAs to cognitive and behavioral development in infancy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Labor Supply Flexibility and Portfolio Choice

    OpenAIRE

    Zvi Bodie; William Samuelson

    1989-01-01

    This paper develops a model showing that people who have flexibility in choosing how much to work will prefer to invest substantially more of their money in risky assets than if they had no such flexibility. Viewed in this way, labor supply flexibility offers insurance against adverse investment outcomes. The model provides support for the conventional wisdom that the young can tolerate more risk in their investment portfolios than the old. The model has other implications for the study of ho...

  5. Protein-containing nutrient supplementation following strength training enhances the effect on muscle mass, strength, and bone formation in postmenopausal women

    DEFF Research Database (Denmark)

    Holm, Lars; Olesen, Jens L; Matsumoto, Keitaro

    2008-01-01

    .0 +/- 1.4%); nutrient group: 0.953 +/- 0.051 to 0.978 +/- 0.043 g/mm(3) (3.8 +/- 3.4%)] when adjusted for age, body mass index, and BMD at inclusion. Bone formation displayed an interaction (P increased osteocalcin at 24 wk in the nutrient group. In conclusion, we report...... that nutrient supplementation results in superior improvements in muscle mass, muscle strength, femoral neck BMD, and bone formation during 24 wk of strength training. The observed differences following such a short intervention emphasize the significance of postexercise nutrient supply on musculoskeletal......We evaluated the response of various muscle and bone adaptation parameters with 24 wk of strength training in healthy, early postmenopausal women when a nutrient supplement (protein, carbohydrate, calcium, and vitamin D) or a placebo supplement (a minimum of energy) was ingested immediately...

  6. Food supplements: survey of the ASL TO3.

    Science.gov (United States)

    Valfrè, R; Bioletti, L; Spagna, S; Rolle, M; Zucaro, D; Vietti, F; Laurenti, P

    2014-01-01

    supplements at gyms located on the territory of ASLTO3: 59 gyms are available on territory, but only in one of them supplements are sold. Some customers of these gyms have filled a questionnaire concerning the consumption of supplements. The processing of the questionnaires showed that 27% of respondents in the past 2 years used only occasionally food supplements. For 42% of the subjects the use of these products was to achieve weight loss, for 33% for athletes and 17% have used specific products in the case of particular physiological situations such as pregnancy and lactation. The reasons that lead to the use of dietary supplements, in all cases, are attributed to the improvement of health status. In addition, in 50% of cases the pharmacist has led to the use of these products or, alternatively, friends and relatives. The general practitioner is often not informed even in case of disturbances introduced after their use (seen in 8% of our sample). The majority of the sample (58%) said that they had benefited from the use of supplements and they are aware (68%) that there could be contraindications. A greater knowledge of the topic, with attention focused on the entire supply chain of the product, is essential to ensure the safety of consumers in the use of food supplements. For these reasons a more detailed check on the procedure is essential: selection and verification of suppliers (especially for raw materials coming from Eastern countries, because they are not subjected to a thorough inspection); traceability of products marketed; correspondence between manufactured and authorized products. Finally, promote an awareness campaign at all levels is necessary, including general practitioners for a conscious purchase.

  7. Resveratrol food supplements

    DEFF Research Database (Denmark)

    Aschemann-Witzel, Jessica; Grunert, Klaus G

    2015-01-01

    Background: Consumers increasingly choose food supplements in addition to their diet. Research on supplement users finds they are likely to be female, older and well-educated; Furthermore, supplement users are often characterised as being especially health-oriented, an observation which is termed...... the ‘inverse supplement hypothesis’. However, results are dependent on the substance in question. Little is known so far about botanicals in general, and more specifically, little is known about resveratrol. The psychographic variables of food supplement users are yet relatively underexplored. By comparing US...... and Danish respondents, we aimed to identify whether sociodemographic variables, health status, health beliefs and behaviour and interest in food aspects specifically relevant to resveratrol (e.g., naturalness, indulgence, and Mediterranean food) explain favourable attitudes and adoption intentions toward...

  8. Influence of protein nutrition and virginiamycin supplementation on feedlot growth performance and digestive function of calf-fed Holstein steers.

    Science.gov (United States)

    Salinas-Chavira, J; Barreras, A; Plascencia, A; Montano, M F; Navarrete, J D; Torrentera, N; Zinn, R A

    2016-10-01

    Two experiments were conducted to examine the influence of protein and virginiamycin (VM) supplementation on feedlot growth performance, digestion, and metabolizable AA (MAA) supply of calf-fed Holstein steers. Growth performance and dietary energetics were evaluated in 120 Holstein steers (127 ± 9 kg). During the initial 112-d feeding period, a steam-flaked corn-based diet was balanced to meet either 100% (MAB) or 87% (UREA) of MAA requirements. Diets were supplemented with or without 22.5 mg/kg VM in a 2 × 2 factorial arrangement. Subsequently (d 112 to 308), all steers received the UREA diet with or without VM. During the initial 112-d, MAB increased ADG, G:F, and dietary NE ( 0.10) across initial supplementation treatments. Overall (d 1 to 308), MAB did not affect ADG ( > 0.10) but enhanced G:F efficiency ( = 0.03) and dietary NE ( = 0.05). During the initial 112-d period and through the remainder of the experiment, VM increased G:F ( 0.10) on ruminal digestion of OM, NDF, starch, microbial efficiency, or total tract digestion of OM and NDF. The MAB increased indispensable AA flow to the small intestine ( 0.10) total tract N digestion. Extrapolating from AA supplies in the metabolism study, MAB satisfied indispensable AA requirements during the initial 112-d period, whereas the UREA diet met 73.5% and 79.2% of methionine and lysine requirements, respectively. During the subsequent periods (d 112 to 308) indispensable AA supplies exceeded theoretical requirements. We conclude that enhancements in energy utilization when diets are balanced to meet MAA requirements of calf-fed Holstein steers during the initial 112-d feedlot period remain appreciable throughout time on feed. Virginiamycin enhanced efficiency of energy utilization throughout the feedlot growing-finishing period.

  9. Decision-Making for Supply Chain Integration Supply Chain Integration

    CERN Document Server

    Lettice, Fiona; Durowoju, Olatunde

    2012-01-01

    Effective supply chain integration, and the tight co-ordination it creates, is an essential pre-requisite for successful supply chain management.  Decision-Making for Supply Chain Integration is a practical reference on recent research in the area of supply chain integration focusing on distributed decision-making problems. Recent applications of various decision-making tools for integrating supply chains are covered including chapters focusing on: •Supplier selection, pricing strategy and inventory decisions in multi-level supply chains, •RFID-enabled distributed decision-making, •Operational risk issues and time-critical decision-making for sensitive logistics nodes, Modelling end to end processes to improve supply chain integration, and •Integrated systems to improve service delivery and optimize resource use. Decision-Making for Supply Chain Integration provides an insight into the tools and methodologies of this field with support from real-life case studies demonstrating successful application ...

  10. Effects of antioxidant supplementation on the aging process

    Directory of Open Access Journals (Sweden)

    Domenico Fusco

    2007-10-01

    clinical conditions typical of older age (ie, cardiovascular disease, Alzheimer’s disease, cancer. We will also discuss studies that have evaluated whether antioxidant supplementation might improve major outcomes of interest in older persons (ie, physical performance, muscle strength, longevity. Given the large amount of data available on the antioxidant supplementation topic, this overview is not intended to be exhaustive. The aim of this paper is to provide the main basis from which future studies should start and indicate which the main limitations that need to be addressed are.Keywords: aging, anti-aging medicine, antioxidant supplementation, oxidative damage

  11. Effect of potassium chloride supplementation in drinking water on broiler performance under heat stress conditions.

    Science.gov (United States)

    Ahmad, T; Khalid, T; Mushtaq, T; Mirza, M A; Nadeem, A; Babar, M E; Ahmad, G

    2008-07-01

    The effect of water supplementation of KCl on performance of heat-stressed Hubbard broilers was evaluated in the present experiment. The 3 experimental treatments (i.e., control, 0.3 and 0.6% KCl) were allocated to 3 replicates of 15 birds each. The control group was kept on dugout tap water, whereas the other 2 groups were supplied water supplemented with 0.3 and 0.6% KCl (wt/vol) by supplementing 3 and 6 g of KCl, respectively, per liter of drinking water. Broilers were provided ad libitum access to feed and water for the experimental period of 7 to 42 d of age and kept in open-sided house. The birds were reared under continuous thermostress (minimum 28.2 +/- 1.02 and maximum 37.5 +/- 0.78 degrees C) environment. Supplementing drinking water with 0.6% KCl reduced panting-phase blood pH to 7.31 and significantly increased live BW gain by 14.5 (P = 0.036) and 7.9% (P = 0.029) at 28 and 42 d of age, respectively, relative to control. An improved (P = 0.04) feed:gain and lowered body temperature were noted in groups supplemented with 0.6% KCl as compared with control and 0.3% KCl. Enhanced physiological adaptation with 0.6% KCl was evidenced by a more favorable pH during the panting phase in the present study. These findings demonstrated a possibility of better broiler live performance through KCl supplementation under conditions of severe heat stress (35 to 38 degrees C).

  12. Basic Assumptions of the New Price System and Supplements to the Tariff System for Electricity Sale

    International Nuclear Information System (INIS)

    Klepo, M.

    1995-01-01

    The article outlines some basic assumptions of the new price system and major elements of the latest proposition for the changes and supplements to the Tariff system for Electricity Sale in the Republic of Croatia, including the analysis of those elements which brought about the present unfavourable and non-productive relations within the electric power system. The paper proposes measures and actions which should by means of a price system and tariff policy improve the present unfavourable relations and their consequences and achieve a desirable consumption structure and characteristics, resulting in rational management and effective power supply-economy relationships within the electric power system as a subsystem of the power supply sector. (author). 2 refs., 3 figs., 4 tabs

  13. n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease.

    Science.gov (United States)

    Asbell, Penny A; Maguire, Maureen G; Pistilli, Maxwell; Ying, Gui-shuang; Szczotka-Flynn, Loretta B; Hardten, David R; Lin, Meng C; Shtein, Roni M

    2018-05-03

    Dry eye disease is a common chronic condition that is characterized by ocular discomfort and visual disturbances that decrease quality of life. Many clinicians recommend the use of supplements of n-3 fatty acids (often called omega-3 fatty acids) to relieve symptoms. In a multicenter, double-blind clinical trial, we randomly assigned patients with moderate-to-severe dry eye disease to receive a daily oral dose of 3000 mg of fish-derived n-3 eicosapentaenoic and docosahexaenoic acids (active supplement group) or an olive oil placebo (placebo group). The primary outcome was the mean change from baseline in the score on the Ocular Surface Disease Index (OSDI; scores range from 0 to 100, with higher scores indicating greater symptom severity), which was based on the mean of scores obtained at 6 and 12 months. Secondary outcomes included mean changes per eye in the conjunctival staining score (ranging from 0 to 6) and the corneal staining score (ranging from 0 to 15), with higher scores indicating more severe damage to the ocular surface, as well as mean changes in the tear break-up time (seconds between a blink and gaps in the tear film) and the result on Schirmer's test (length of wetting of paper strips placed on the lower eyelid), with lower values indicating more severe signs. A total of 349 patients were assigned to the active supplement group and 186 to the placebo group; the primary analysis included 329 and 170 patients, respectively. The mean change in the OSDI score was not significantly different between the active supplement group and the placebo group (-13.9 points and -12.5 points, respectively; mean difference in change after imputation of missing data, -1.9 points; 95% confidence interval [CI], -5.0 to 1.1; P=0.21). This result was consistent across prespecified subgroups. There were no significant differences between the active supplement group and the placebo group in mean changes from baseline in the conjunctival staining score (mean difference in

  14. Awareness and Attitude towards Use of Dietary Supplements and the Perceived Outcomes Among Saudi Adult Male Members of Fitness Centers in Saudi Arabia.

    Science.gov (United States)

    Alfawaz, Hanan A; Krishnaswamy, Soundararajan; Al-Faifi, Latifah; Atta, Halima Ali Bin; Al-Shayaa, Mohammad; Alghanim, Saad A; Al-Daghri, Nasser M

    2017-11-15

    Dietary supplements are believed to enhance athletic performance and/or prevent/reverse pathological states. Despite the increasing use of dietary supplements in Saudi Arabia, systematic studies in this field are lacking. This study aims to assess the relation between demographic and social characteristics and dietary supplement use among adult males in Saudi Arabia. Demographic and dietary supplements data from fitness club participants were collected through a questionnaire and Pearson Chi-square test was used to determine associations. A total of 448 apparently healthy adult males above 20 years of age, who were registered at fitness centers located in Saudi Arabia participated in the study. Majority [275 (62%)] of the study participants were younger (20-30 years), of normal weight [189 (43%)], without health problems [332 (79%)] and obtained an undergraduate degree or higher [336 (77%)]. Majority (58%) took supplements under the supervision of a professional and the rest depended on internet (22%), friends (12%) or books (4%) for choosing supplement types. The main motives of the participants for visiting the fitness center were: weight loss [N=149(35%)], keeping fit [N=101(24%)] and muscle building [N=151(35%)]. One hundred fifty-five participants (44%) were taking supplements on a daily basis with 34 (10%) having taken it for a prolonged duration (>1 year). The most commonly used supplements were proteins (29%) and multivitamins (21%). Supplement use was not associated with the participants' family income or level of education, but, was positively associated with younger age (<31 years) [χ 2 (2, N= 443) = 4.96, p=0.03.

  15. Investigation of Prevalence of Energizer Drugs and Supplements Consumption and Effective Factors Among Bodybuilder Men in Karaj (2011

    Directory of Open Access Journals (Sweden)

    F. Shoshtarizadeh

    2013-08-01

    Full Text Available Background: Body builder athletes’ high attention to form of body can result in high prevalence of nutritional disorders and habit to energizer drugs consumption. With notice to abuse problems of these drugs, this research was carried out to estimate prevalence of energizer drugs and supplements consumption in Karaj body builder men in 2011. Method: In cross-sectional (description- analytical research 780 Karaj body builder men were selected randomly. Data were collected through interview with questionnaires containing demographic questions and using information of drugs. Data were analyzed with SPSS software (Ver. 19 and κ² test with meaningful level of P<0.05. Result: Prevalence of consumption in studied sample from different types of supplements and energizer drugs was estimated 88.2%. The most consumption prevalence belonged to food supplements and vitamins group and combination of those (69.9%. About anabolic and energizer compounds and also hormonal drugs and corticosteroids, prevalence was 5.6% and 2.1% respectively and 7.7% totally. There was meaningful relation between experience times of abuse problems, place of drug and supplement supply and attention to being permissible or impermissible of those items with type of drugs or supplement (P = 0.001. Also relation between consumption of supplements and drugs with main goal in using them was meaningful (P = 0.045. Conclusion: Consumption of supplement and energizer drugs in Karaj body builder men has high prevalence.

  16. The effect of nutritional supplementation on quality of life in people living with HIV

    DEFF Research Database (Denmark)

    Tesfaye Woldeyohannes, Markos; Kæstel, Pernille; Olsen, Mette Frahm

    2016-01-01

    the subsequent 3 months. METHODS: Randomized controlled trial in three ART clinics within public health facilities in Jimma, Ethiopia. Participants were PLHIV eligible to start ART with body mass index >17kg/m(2) and given daily supplements of 200 grams of LNS containing whey or soy either during the first 3......OBJECTIVE: To determine the effects of lipid-based nutrient supplements (LNS) on the quality of life of people living with HIV (PLHIV) during the first 3 months of antiretroviral treatment (ART), and to investigate the effects of timing of supplementation by comparing with supplementation during...... months or the subsequent months of ART. The outcome was measured in terms of total quality of life scores on the adapted version of the WHOQOL-HIV-BREF assessed at baseline, 3 and 6 months. RESULTS: Of the 282 participants, 186 (66.0%) were women. The mean age (standard deviation SD) was 32.8 (±9...

  17. Evaluation of congruence among dietary supplement use and motivation for supplementation in young, Canadian athletes.

    Science.gov (United States)

    Parnell, Jill A; Wiens, Kristin; Erdman, Kelly Anne

    2015-01-01

    Dietary supplement use is endemic in young athletes; however, it is unclear if their choices are congruent with their motivation for supplementation and the established benefits of the dietary supplements. The aim of this study was to evaluate the relationships between dietary supplement use and self-reported rationale in young athletes. Canadian athletes (n = 567; 11-25 years; 76% club or provincial level, 24% national or higher) completed a questionnaire designed to assess supplementation patterns and motivation for supplementation. Chi square tests examined associations between dietary supplements and self-reported rationale for use. Vitamin and mineral supplements, including vitamin-enriched water, were associated with several health- and performance- related reasons (p performance reasons, as were performance foods (protein powder, sport bars, sport gels, etc.). Plant extracts and fatty acids were primarily associated with health reasons, particularly immune support (p performance rationales and supplementation for common ergogenic aids, however, less so for vitamin and mineral supplements, vitamin-enriched water, and plant extracts. Incongruences were found between fatty acids, protein supplements, vitamin and mineral supplements, vitamin-enriched water, and plant extracts and health motivators for supplementation. Educational interventions are essential to ensure young athletes are using dietary supplements safely and effectively.

  18. The effects of selenate and sulphate supply on the accumulation and volatilization of Se by cabbage, kohlrabi and alfalfa plants grown hydroponically

    Directory of Open Access Journals (Sweden)

    R. HAJIBOLAND

    2008-12-01

    Full Text Available The effect of Selenium (Se supplementation at five levels of 0 (control, 5, 10, 15, 20 ìM in plants supplied with one of four concentrations of sulphur (S including 0.05, 0.25, 0.5 and 1.0 mM was investigated in two varieties of Brassica oleracea (cabbage and kohlrabi and alfalfa (Medicago sativa L. in a hydroponic experiment. In severely S deficient plants (0.05 mM, Se acted as a toxic element, alfalfa was the most susceptible plant that died at this treatment. However, in plants supplied with near adequate (0.5 mM or adequate (1.0 mM S, Se acted as a growth promoting element. The most pronounced stimulation of growth was observed in cabbage and the lowest in alfalfa. Increasing S concentration in the medium, reduced Se uptake and transport. In contrast, S uptake and transport increased in response to Se addition. Se volatilization was higher in alfalfa than cabbage and kohlrabi when expressed on unit shoot dry weight or leaf area basis, but not when expressed per plant. Results suggested that Se supplementation of plants supplied with adequate S, not only had beneficial effects on plants growth but also can have application in enrichment of livestock fodder and human food.;

  19. Supply-chain environmental effects of wastewater utilities

    International Nuclear Information System (INIS)

    Stokes, Jennifer R; Horvath, Arpad

    2010-01-01

    This letter describes a comprehensive modeling framework and the Wastewater-Energy Sustainability Tool (WWEST) designed for conducting hybrid life-cycle assessments of the wastewater collection, treatment, and discharge infrastructure in the United States. Results from a case study treatment plant which produces electricity using methane offgas are discussed. The case study system supplements influent with 'high-strength organic waste' to augment electricity production. The system balance is 55 kg of greenhouse gases per million liters of wastewater. Sensitivity analysis confirms that reusing biogas from anaerobic digestion for electricity reduces life-cycle greenhouse gas emissions by nine times. When biogas is captured and reused for electricity, material production (e.g., chemicals and pipes) and the corresponding supply chains, rather than energy production, are responsible for most of the environmental effects. When biogas is flared, the material and energy production contributions are similar.

  20. Better postpartal performance in dairy cows supplemented with rumen-protected methionine compared with choline during the peripartal period.

    Science.gov (United States)

    Zhou, Z; Vailati-Riboni, M; Trevisi, E; Drackley, J K; Luchini, D N; Loor, J J

    2016-11-01

    The onset of lactation in dairy cows is characterized by high output of methylated compounds in milk when sources of methyl group are in short supply. Methionine and choline (CHOL) are key methyl donors and their availability during this time may be limiting for milk production, hepatic lipid metabolism, and immune function. Supplementing rumen-protected Met and CHOL may improve overall performance and health of transition cows. The objective of this study was to evaluate the effect of supplemental rumen-protected Met and CHOL on performance and health of transition cows. Eighty-one multiparous Holstein cows were used in a randomized, complete, unbalanced block design with 2×2 factorial arrangement of Met (Smartamine M, Adisseo NA, Alpharetta, GA) and CHOL (ReaShure, Balchem Inc., New Hampton, NY) inclusion (with or without). Treatments (20 to 21 cows each) were control (CON), CON+Met (SMA), CON+CHOL (REA), and CON+Met+CHOL (MIX). From -50 to -21d before expected calving, all cows received the same diet (1.40Mcal of NE L /kg of DM) with no Met or CHOL. From -21d to calving, cows received the same close-up diet (1.52Mcal of NE L /kg of DM) and were assigned randomly to treatments (CON, SMA, REA, or MIX) supplied as top dresses. From calving to 30 DIM, cows were fed the same postpartal diet (1.71Mcal of NE L /kg of DM) and continued to receive the same treatments through 30 DIM. The Met supplementation was adjusted daily at 0.08% DM of diet and REA was supplemented at 60g/d. Incidence of clinical ketosis and retained placenta tended to be lower in Met-supplemented cows. Supplementation of Met (SMA, MIX) led to greater DMI compared with other treatments (CON, REA) in both close-up (14.3 vs. 13.2kg/d, SEM 0.3) and first 30d postpartum (19.2 vs. 17.2kg/d, SEM 0.6). Cows supplemented with Met (SMA, MIX) had greater yields of milk (44.2 vs. 40.4kg/d, SEM 1.2), ECM (44.6 vs. 40.5kg/d, SEM 1.0), and FCM (44.6 vs. 40.8kg/d, SEM 1.0) compared with other (CON, REA) treatments

  1. Assessment of nutrition, supplementation and body composition parameters on the example of professional volleyball players.

    Science.gov (United States)

    Zapolska, Joanna; Witczak, Katarzyna; Mańczuk, Angelika; Ostrowska, Lucyna

    2014-01-01

    Volleyball is a team game belonging to a group of sports disciplines that involve indirect fighting. Adequate energy coverage in athletes is a crucial issue. It depends primarily on the type, intensity and duration of physical activity related to the sports discipline practiced and to the training cycle duration. The average energy requirement in sportsmen is 50% higher than that of adults. The aim of the study was to characterize the mode of nutrition, including dietary supplements and to assess somatic indices in female volleyball players of the AZS Bialystok team. The study involved 17 women. Research tools included a questionnaire consisting of 24-hour recall, a questionnaire survey concerning supplement intake and body composition analysis performed using a bioimpedance analyzer InBody 220. Data analysis indicates that the anthropometric characteristics and body composition of the AZS Bialystok players meet the recommendations associated with the somatic features in volleyball. Daily diet of the volleyball players were of low-energy with regard to the recommendations for physically active people, with very low supply of carbohydrates and dietary fiber, excessive proportion of saturated fatty acids and dietary cholesterol, and too low content of monounsaturated and polyunsaturated fatty acids. Supply of vitamins and minerals was found to be alarmingly low, especially of iron and calcium; diet supplementation was insufficient. No significant abnormalities were noted in body composition of the study athletes. However, they are recommended to increase muscle mass and slightly reduce body fat. Results of diet evaluation show the need for education in the field of nutrition and the necessity of further research into dietary habits among sportsmen.

  2. Prenatal DHA Status and Neurological Outcome in Children at Age 5.5 Years Are Positively Associated

    NARCIS (Netherlands)

    Victoria Escolano-Margarit, M.; Ramos, Rosa; Beyer, Jeannette; Csabi, Gyoergyi; Parrilla-Roure, Montserrat; Cruz, Francisco; Perez-Garcia, Miguel; Hadders-Algra, Mijna; Gil, Angel; Decsi, Tamas; Koletzko, Berthold V.; Campoy, Cristina

    Beneficial effects of perinatal DHA supply on later neurological development have been reported. We assessed the effects of maternal DHA supplementation on the neurological development of their children. Healthy pregnant women from Spain, Germany, and Hungary were randomly assigned to a dietary

  3. Port supply chain integration : analyzing biofuel supply chains

    NARCIS (Netherlands)

    Stevens, Leonie C. E.; Vis, Iris F. A.

    2016-01-01

    This paper focuses on port supply chain integration to strengthen operational and business performance. We provide a structured and comprehensive method to enable port supply chain integration and demonstrate its applicability to the biofuel supply chain. We define the value proposition, role,

  4. Effect of omega-3 supplementation on neuropathy in type 1 diabetes: A 12-month pilot trial.

    Science.gov (United States)

    Lewis, Evan J H; Perkins, Bruce A; Lovblom, Leif E; Bazinet, Richard P; Wolever, Thomas M S; Bril, Vera

    2017-06-13

    To test the hypothesis that 12 months of seal oil omega-3 polyunsaturated fatty acids (ω-3 PUFA) supplementation will stop the known progression of diabetic sensorimotor polyneuropathy (DSP) in type 1 diabetes mellitus (T1DM). Individuals with T1DM and evidence of DSP as determined by a Toronto Clinical Neuropathy Score ≥1 were recruited to participate in a single-arm, open-label trial of seal oil ω-3 PUFA supplementation (10 mL·d -1 ; 750 mg eicosapentaenoic acid, 560 mg docosapentaenoic acid, and 1,020 mg docosahexaenoic acid) for 1 year. The primary outcome was the 1-year change in corneal nerve fiber length (CNFL) measured by in vivo corneal confocal microscopy, with sensory and nerve conduction measures as secondary outcomes. Forty participants (53% female), aged 48 ± 14 years, body mass index 28.1 ± 5.8 with diabetes duration of 27 ± 18 years, were enrolled. At baseline, 23 participants had clinical DSP and 17 did not. Baseline CNFL was 8.3 ± 2.9 mm/mm 2 and increased 29% to 10.1 ± 3.7 mm/mm 2 ( p = 0.002) after 12 months of supplementation. There was no change in nerve conduction or sensory function. Twelve months of ω-3 supplementation was associated with increase in CNFL in T1DM. NCT02034266. This study provides Class IV evidence that for patients with T1DM and evidence of DSP, 12 months of seal oil omega-3 supplementation increases CNFL. © 2017 American Academy of Neurology.

  5. Revolutionary business trends in supply chain management

    Directory of Open Access Journals (Sweden)

    Mijušković Veljko

    2010-01-01

    Full Text Available Contemporary turbulent business conditions in the era of high technology bring inherent rapid changes. In order to survive, the imperative set upon all market players is not the position of a follower but more of an anticipator and trend setter. These unexpected changes erase existing business models, traditional enterprise paradigms and customary philosophies. A business isolated in its way of seeing operations and unconnected with other strategic constituents within the supply chain is destined to fail. On the other hand, even those businesses that do get involved with contemporary trends are not automatically guaranteed with the market survival. The spirit of change must therefore be deeply integrated within the organization, so that the new 'mantra' could become strategic but also operative driver on all fronts of doing business, at all times. The goal of this paper is to try to illustrate and categorize comprehensive fundamental changes which are more and more present in the modern supply chains. The analysis shows that the spirit of business model changes is not a fiction but reality, thus their deepness truly revolutionizes the functioning of traditional supply chains. The first part of the paper shows actual market situation within the supply chains. 'Kaleidoscope of changes' in the chain shows that its operations have been altered compared to traditional way of doing business, having assimilated the fact that final customers identify multiple dimensions of value while choosing products or services. The market survival demands the perception and possession of all these dimensions. The second part explains the supply chain changes focusing on ten most important trends. Their implementation creates revolutionary effects compared to traditional business matrix. Finally, the third part, identifies key challenges and inhibitors that might emerge during the 'restructuring' of the traditional supply chains, as a real-life situation limitation

  6. Whole or ground millet grain provided in two supplementation frequencies for grazing beef cattle: nutritional parameters

    Directory of Open Access Journals (Sweden)

    João Marcos Beltrame Benatti

    2014-05-01

    Full Text Available The objective of this study was to evaluate the processing of millet grain provided at two supplementation frequencies for grazing beef cattle during the dry season on nutritional parameters. Five rumen-cannulated crossbred steers, with 24 to 26 months of age and average body weight of 428.6±26.06 kg, were assigned to a Latin square design (5 × 5 in a 2 × 2 + 1 factorial arrangement, as follows: two forms of millet grain (whole grains - or ground; WG - GG, two strategies of concentrate supplementation (daily distribution - 7X; or three times a week - 3X and a control treatment (mineral mixture - MM. Animals were kept in five paddocks of 0.24 ha each with Marandu grass pastures. Concentrate supplements were supplied at 2.00 and 4.66 kg/animal/day for treatments 7X and 3X, respectively. The concentrate supplementation enhanced the intake of total dry matter (DM and organic matter (OM and nutrients compared with mineral supplementation. No differences were found between dry matter intake and forage organic matter intake. The values of digestibility coefficients of DM, OM, ether extract, total carbohydrates and non-fiber carbohydrates were increased by concentrate supplementation. Regarding concentrations of rumen ammonia nitrogen, the interactions among time × treatment × day and day × treatment had effects on the measurements of ruminal pH. Plasma urea nitrogen, urinary urea excretion and urinary urea N excretion differed only between MM treatment and the others, with no interference of grain physical form and supplementation frequency on those variables. The millet grain processing does not alter forage intake, but improves digestibility. Daily supplementation increases digestibility of dry matter and neutral detergent fiber.

  7. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems.

    Science.gov (United States)

    Hofmeyr, G Justus; Lawrie, Theresa A; Atallah, Alvaro N; Duley, Lelia; Torloni, Maria R

    2014-06-24

    Pre-eclampsia and eclampsia are common causes of serious morbidity and death. Calcium supplementation may reduce the risk of pre-eclampsia, and may help to prevent preterm birth. To assess the effects of calcium supplementation during pregnancy on hypertensive disorders of pregnancy and related maternal and child outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 March 2013) and contacted study authors for more data where possible. We updated the search in May 2014 and added the results to the 'Awaiting Classification' section of the review. Randomised controlled trials (RCTs) comparing high-dose (at least 1 g daily of calcium) or low-dose calcium supplementation during pregnancy with placebo or no calcium. We assessed eligibility and trial quality, extracted and double-entered data. High-dose calcium supplementation (≥1 g/day)We included 14 studies in the review, however one study contributed no data. We included 13 high-quality studies in our meta-analyses (15,730 women). The average risk of high blood pressure (BP) was reduced with calcium supplementation compared with placebo (12 trials, 15,470 women: risk ratio (RR) 0.65, 95% confidence interval (CI) 0.53 to 0.81; I² = 74%). There was also a significant reduction in the risk of pre-eclampsia associated with calcium supplementation (13 trials, 15,730 women: RR 0.45, 95% CI 0.31 to 0.65; I² = 70%). The effect was greatest for women with low calcium diets (eight trials, 10,678 women: average RR 0.36, 95% CI 0.20 to 0.65; I² = 76%) and women at high risk of pre-eclampsia (five trials, 587 women: average RR 0.22, 95% CI 0.12 to 0.42; I² = 0%). These data should be interpreted with caution because of the possibility of small-study effect or publication bias.The composite outcome maternal death or serious morbidity was reduced (four trials, 9732 women; RR 0.80, 95% CI 0.65 to 0.97; I² = 0%). Maternal deaths were not significantly different (one trial of 8312 women: calcium

  8. Tomato and lycopene supplementation and cardiovascular risk factors: A systematic review and meta-analysis.

    Science.gov (United States)

    Cheng, Ho Ming; Koutsidis, Georgios; Lodge, John K; Ashor, Ammar; Siervo, Mario; Lara, José

    2017-02-01

    Epidemiological evidence suggests an association between consumption of tomato products or lycopene and lower risk for cardiovascular diseases (CVD). Our aim was to evaluate the state of the evidence from intervention trials on the effect of consuming tomato products and lycopene on markers of cardiovascular (CV) function. We undertook a systematic review and meta-analysis on the effect of supplementing tomato and lycopene on CV risk factors. Three databases including Medline, Web of science, and Scopus were searched from inception to August 2016. Inclusion criteria were: intervention trials reporting effects of tomato products and lycopene supplementation on CV risk factors among adult subjects >18 years of age. The outcomes of interest included blood lipids (total-, HDL-, LDL-cholesterol, triglycerides, oxidised-LDL), endothelial function (flow-mediated dilation (FMD), pulse wave velocity (PWV)) and blood pressure (BP) inflammatory factors (CRP, IL-6) and adhesion molecules (ICAM-1). Random-effects models were used to determine the pooled effect sizes. Out of 1189 publications identified, 21 fulfilled inclusion criteria and were meta-analysed. Overall, interventions supplementing tomato were associated with significant reductions in LDL-cholesterol (-0.22 mmol/L; p = 0.006), IL-6 (standardised mean difference -0.25; p = 0.03), and improvements in FMD (2.53%; p = 0.01); while lycopene supplementation reduced systolic-BP (-5.66 mmHg; p = 0.002). No other outcome was significantly affected by these interventions. The available evidence on the effects of tomato products and lycopene supplementation on CV risk factors supports the view that increasing the intake of these has positive effects on blood lipids, blood pressure and endothelial function. These results support the development of promising individualised nutritional strategies involving tomatoes to tackle CVD. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Proline Precursors and Collagen Synthesis: Biochemical Challenges of Nutrient Supplementation and Wound Healing.

    Science.gov (United States)

    Albaugh, Vance L; Mukherjee, Kaushik; Barbul, Adrian

    2017-11-01

    Wound healing is a complex process marked by highly coordinated immune fluxes into an area of tissue injury; these are required for re-establishment of normal tissue integrity. Along with this cascade of cellular players, wound healing also requires coordinated flux through a number of biochemical pathways, leading to synthesis of collagen and recycling or removal of damaged tissues. The availability of nutrients, especially amino acids, is critical for wound healing, and enteral supplementation has been intensely studied as a potential mechanism to augment wound healing-either by increasing tensile strength, decreasing healing time, or both. From a practical standpoint, although enteral nutrient supplementation may seem like a reasonable strategy to augment healing, a number of biochemical and physiologic barriers exist that limit this strategy. In this critical review, the physiology of enteral amino acid metabolism and supplementation and challenges therein are discussed in the context of splanchnic physiology and biochemistry. Additionally, a review of studies examining various methods of amino acid supplementation and the associated effects on wound outcomes are discussed. © 2017 American Society for Nutrition.

  10. Food supplementation does not increase demographic rates in a passerine species of conservation concern

    Directory of Open Access Journals (Sweden)

    Innes M.W. Sim

    2015-05-01

    Full Text Available Numerous studies have examined the effects of the provision of supplementary food on aspects of avian reproductive success, but far fewer have gone on to examine the potential positive effects of food supplementation on the demographic rates which are key for population growth rate. Testing for potential effects of food shortage on vital rates is likely to be particularly important in species of high conservation concern, where populations are particularly small, isolated or decreasing rapidly. Here we test the effects of the provision of supplementary food on reproductive success, body condition at fledging and post-fledging survival of ring ouzels (Turdus torquatus, a species of high conservation concern in the UK. However, food supplementation had no detectable effect on any of these parameters. There was no significant difference in return rates of fed and unfed fledglings in the year following hatching, and most post-fledging mortality was apparently caused by predation by raptors and mustelids. We conclude that the supply of invertebrate food sources for nestlings was not a major limiting factor in our study area, at least during this two-year study. Further studies are required to quantify the precise mix of habitats used by ring ouzels, at the appropriate scale, which provide concealment from predators and access to food supplies throughout the spring and summer months.

  11. Variation in Formula Supplementation of Breastfed Newborn Infants in New York Hospitals.

    Science.gov (United States)

    Nguyen, Trang; Dennison, Barbara A; Fan, Wei; Xu, Changning; Birkhead, Guthrie S

    2017-07-01

    We examined the variation between 126 New York hospitals in formula supplementation among breastfed infants after adjusting for socioeconomic, maternal, and infant factors and stratifying by level of perinatal care. We used 2014 birth certificate data for 160 911 breastfed infants to calculate hospital-specific formula supplementation percentages by using multivariable hierarchical logistic regression models. Formula supplementation percentages varied widely among hospitals, from 2.3% to 98.3%, and was lower among level 1 hospitals (18.2%) than higher-level hospitals (50.6%-57.0%). Significant disparities in supplementation were noted for race and ethnicity (adjusted odds ratios [aORs] were 1.54-2.05 for African Americans, 1.85-2.74 for Asian Americans, and 1.25-2.16 for Hispanics, compared with whites), maternal education (aORs were 2.01-2.95 for ≤12th grade, 1.74-1.85 for high school or general education development, and 1.18-1.28 for some college or a college degree, compared with a Master's degree), and insurance coverage (aOR was 1.27-1.60 for Medicaid insurance versus other). Formula supplementation was higher among mothers who smoked, had a cesarean delivery, or diabetes. At all 4 levels of perinatal care, there were exemplar hospitals that met the HealthyPeople 2020 supplementation goal of ≤14.2%. After adjusting for individual risk factors, the hospital-specific, risk-adjusted supplemental formula percentages still revealed a wide variation. A better understanding of the exemplar hospitals could inform future efforts to improve maternity care practices and breastfeeding support to reduce unnecessary formula supplementation, reduce disparities, increase exclusive breastfeeding and breastfeeding duration, and improve maternal and child health outcomes. Copyright © 2017 by the American Academy of Pediatrics.

  12. Efficacy of iron fortification compared to iron supplementation among Vietnamese schoolchildren.

    Science.gov (United States)

    Thi Le, Huong; Brouwer, Inge D; Burema, Jan; Nguyen, Khan Cong; Kok, Frans J

    2006-12-05

    The effect of iron fortification is generally assumed to be less than iron supplementation; however, the magnitude of difference in effects is not known. The present study aims to compare the efficacy of these two strategies on anaemia and iron status. After screening on low Hb, 425 anaemic children in six primary schools in Tam Nong district of Phu Tho province were included in a randomized, placebo-controlled trial comparing two groups receiving iron fortified instant noodles or iron supplementation for 6 months and a control group, with children in all groups having been dewormed. Blood samples were collected before and after intervention for haemoglobin, serum ferritin (SF), serum transferrin receptor (TfR), C-reactive protein (CRP), and haemoglobinopathies analysis. Regression analysis was used to assess the effect of iron fortification and iron supplementation on haemoglobin concentration, SF, TfR, body iron, and anaemic status as outcome variables. The improvement of haemoglobin, SF, and body iron level in the group receiving iron fortification was 42% (2.6 g/L versus 6.2 g/L), 20% (23.5 microg/L versus 117.3 microg/L), and 31.3% (1.4 mg/kg versus 4.4 mg/kg) of that in the iron supplementation group. The prevalence of anaemia dropped to 15.1% in the control group, with an additional reduction of anaemia of 8.5% in the iron supplementation group. The additional reduction due to iron fortification was 5.4%, which amounts to well over 50% of the impact of supplementation. In conclusion, the efficacy of iron fortification based on reduction of prevalence of anaemia, and on the change in haemoglobin level, is about half of the maximum impact of supplementation in case of optimal compliance. Thus, in a population of anaemic children with mild iron deficiency, iron fortification should be the preferred strategy to combat anaemia.

  13. Linking consumer energy efficiency with security of supply

    International Nuclear Information System (INIS)

    Rutherford, J.P.; Scharpf, E.W.; Carrington, C.G.

    2007-01-01

    Most modern energy policies seek to achieve systematic ongoing incremental increases in consumer energy efficiency, since this contributes to improved security of supply, favourable environmental outcomes and increased economic efficiency. Yet realised levels of efficiency are typically well below the most cost-effective equilibrium due to variety of behavioural and organisational barriers, which are often linked to information constraints. In addition efficient users are normally unrewarded for collective benefits to system security and to the environment, thus reducing the incentives for energy consumers to invest in efficiency improvements. This paper examines the dichotomies and symmetries between supply- and demand-side solutions to energy security concerns and reviews opportunities to overcome barriers to improved consumer efficiency. A security market is identified as a mechanism to promote both demand- and supply-side investments that support electricity system security. Such a market would assist in setting the optimal quantity of reserves while achieving an efficient balance between supply- and demand-side initiatives. It would also help to smooth overall investment throughout the energy system by encouraging incremental approaches, such as distributed generation and demand-side alternatives where they provide competitive value. Although the discussion is applicable to energy systems in general, it focuses primarily on electricity in New Zealand

  14. Vitamin D supplementation for treatment of seasonal affective symptoms in healthcare professionals

    DEFF Research Database (Denmark)

    Frandsen, Tenna Bloch; Pareek, Manan; Hansen, Jens Peter

    2014-01-01

    BACKGROUND: Low serum 25-hydroxyvitamin D levels (25(OH)D) have been associated with a higher likelihood of seasonal affective disorder (SAD) and poor mental well-being, yet firm evidence for either remains lacking. Thus, vitamin D supplementation may alleviate symptoms associated with SAD. METHODS...... for the Hamilton Depression Rating Scale, Seasonal Affective Disorders (SIGH-SAD). The secondary outcome was World Health Organization-Five Well-Being Index (WHO-5) of the healthcare professionals during the winter period and the exploratory outcome measures were weight, waist circumference, blood pressure...

  15. Effect of sulfur supplements on cellulolytic rumen micro-organisms and microbial protein synthesis in cattle fed a high fibre diet.

    Science.gov (United States)

    McSweeney, C S; Denman, S E

    2007-11-01

    To examine the effect of sulfur-containing compounds on the growth of anaerobic rumen fungi and the fibrolytic rumen bacteria Ruminococcus albus, Ruminococcus flavefaciens and Fibrobacter succinogenes in pure culture and within the cattle rumen. The effect of two reduced sulfur compounds, 3-mercaptopropionic acid (MPA) or 3-mercapto-1-propanesulfonic acid as the sole S source on growth of pure fibroyltic fungal and bacterial cultures showed that these compounds were capable of sustaining growth. An in vivo trial was then conducted to determine the effect of sulfur supplements (MPA and sodium sulfate) on microbial population dynamics in cattle fed the roughage Dichanthium aristatum. Real-time PCR showed significant increases in fibrolytic bacterial and fungal populations when cattle were supplemented with these compounds. Sulfate supplementation leads to an increase in dry matter intake without a change in whole tract dry matter digestibility. Supplementation of low S-containing diets with either sodium sulfate or MPA stimulates microbial growth with an increase in rumen microbial protein supply to the animal. Through the use of real-time PCR monitoring, a better understanding of the effect of S supplementation on discrete microbial populations within the rumen is provided.

  16. Randomized controlled trial of supplemental augmentative and alternative communication versus voice rest alone after phonomicrosurgery.

    Science.gov (United States)

    Rousseau, Bernard; Gutmann, Michelle L; Mau, Theodore; Francis, David O; Johnson, Jeffrey P; Novaleski, Carolyn K; Vinson, Kimberly N; Garrett, C Gaelyn

    2015-03-01

    This randomized trial investigated voice rest and supplemental text-to-speech communication versus voice rest alone on visual analog scale measures of communication effectiveness and magnitude of voice use. Randomized clinical trial. Multicenter outpatient voice clinics. Thirty-seven patients undergoing phonomicrosurgery. Patients undergoing phonomicrosurgery were randomized to voice rest and supplemental text-to-speech communication or voice rest alone. The primary outcome measure was the impact of voice rest on ability to communicate effectively over a 7-day period. Pre- and postoperative magnitude of voice use was also measured as an observational outcome. Patients randomized to voice rest and supplemental text-to-speech communication reported higher median communication effectiveness on each postoperative day compared to those randomized to voice rest alone, with significantly higher median communication effectiveness on postoperative days 3 (P=.03) and 5 (P=.01). Magnitude of voice use did not differ on any preoperative (P>.05) or postoperative day (P>.05), nor did patients significantly decrease voice use as the surgery date approached (P>.05). However, there was a significant reduction in median voice use pre- to postoperatively across patients (Pcommunication increased patient-perceived communication effectiveness on postoperative days 3 and 5 over voice rest alone. With the prevalence of smartphones and the widespread use of text messaging, supplemental text-to-speech communication may provide an accessible and cost-effective communication option for patients on vocal restrictions. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  17. Vitamin A, iron and zinc deficiency in Indonesia : micronutrient interactions and effects of supplementation

    NARCIS (Netherlands)

    Dijkhuizen, M.A.; Wieringa, F.T.

    2001-01-01

    The research described in this thesis was concerned with vitamin A, iron and zinc deficiency in pregnant and lactating women and in infants. The effects of supplementation withβ-carotene, iron and zinc on micronutrient status, growth, pregnancy outcome and immune function, and interactions

  18. Protein-containing nutrient supplementation following strength training enhances the effect on muscle mass, strength, and bone formation in postmenopausal women

    DEFF Research Database (Denmark)

    Holm, Lars; Olesen, J.L.; Matsumoto, K.

    2008-01-01

    .4%); nutrient group: 0.953 ± 0.051 to 0.978 ± 0.043 g/mm3 (3.8 ± 3.4%)] when adjusted for age, body mass index, and BMD at inclusion. Bone formation displayed an interaction (P increased osteocalcin at 24 wk in the nutrient group. In conclusion, we report that nutrient supplementation...... results in superior improvements in muscle mass, muscle strength, femoral neck BMD, and bone formation during 24 wk of strength training. The observed differences following such a short intervention emphasize the significance of postexercise nutrient supply on musculoskeletal maintenance.......We evaluated the response of various muscle and bone adaptation parameters with 24 wk of strength training in healthy, early postmenopausal women when a nutrient supplement (protein, carbohydrate, calcium, and vitamin D) or a placebo supplement (a minimum of energy) was ingested immediately...

  19. A Holistic ICT Solution to Improve Matching between Supply and Demand over the Water Supply Distribution Chain

    Directory of Open Access Journals (Sweden)

    Gabriel Anzaldi

    2014-12-01

    Full Text Available While many water management tools exist, these systems are not usually interconnected and therefore cannot communicate between one another, preventing Integrated Water Resources Management to be fully achieved. This paper presents the solution proposed by WatERP project* where a novel solution enables better matching between water supply and demand from holistic perspective. Subsystems that control the production, management and consumption of water will be interconnected through both information architecture and intelligent infrastructure. The main outcome will consist of, a web-based Open Management Platform integrating near real-time knowledge on water supplies and demand, from sources to users, across geographic and organizational scales and supported by a knowledge base where information will be structured in water management ontology to ensure interoperability and maximize usability. WatERP will thus provide a major contribution to: 1 Improve coordination among actors, 2 Foster behavioural change, 3 Reduce water and energy consumption, 4 Optimize water accountability.

  20. Botanical supplements: detecting the transition from ingredients to supplements

    Science.gov (United States)

    Methods were developed using flow injection mass spectrometry (FIMS) and chemometrics for the comparison of spectral similarities and differences of 3 botanical ingredients and their supplements: Echinacea purpurea aerial samples and solid and liquid supplements, E. purpurea root samples and solid s...

  1. Causes of shortage and delay in material supply: a preliminary study

    Science.gov (United States)

    Rahman, M. M.; Yap, Y. H.; Ramli, N. R.; Dullah, M. A.; Shamsuddin, M. S. W.

    2017-11-01

    Shortage and delay in materials supply is argued to be one of the most important factors that lead to delay in construction project delivery globally. However, the relevant underlying reasons vary from country to country. As such, this paper summarises the outcomes of a study that targeted identifying causes of shortage and delay in materials supply in Brunei Darussalam. The study was conducted through fifteen semi-structured interviews of contractors and materials suppliers in Brunei. The study identified six causes of shortageof materials and nine causes of delay in materials supply in Brunei. The most importantcausefor shortage of materials relates to the origin or availability of construction materials. On the other hand, the most influential cause of delay in material supply was found to be poor materials procurement and inventory management system, which has other underlying reasons such as late identification of the type of materials needed. The observations are expected to help in formulating or reviewing relevant policies, in order to ensure on-time project delivery.

  2. Antioxidant supplementation for lung disease in cystic fibrosis

    DEFF Research Database (Denmark)

    Ciofu, Oana; Lykkesfeldt, Jens

    2014-01-01

    BACKGROUND: Airway infection leads to progressive damage of the lungs in cystic fibrosis and oxidative stress has been implicated in the etiology. Supplementation of antioxidant micronutrients (vitamin E, vitamin C, ß-carotene and selenium) or glutathione may therefore potentially help maintain...... COLLECTION AND ANALYSIS: Two authors independently selected studies, extracted data and assessed the risk of bias in the included studies. We contacted trial investigators to obtain missing information. Primary outcomes are lung function and quality of life; secondary outcomes are oxidative stress...... or by inhalation) appears to improve lung function in some cases and decrease oxidative stress; however, due to the very intensive antibiotic treatment and other treatments that cystic fibrosis patients receive, the beneficial effect of antioxidants is very difficult to assess in patients with chronic infection...

  3. Postnatal fish oil supplementation in high-risk infants to prevent allergy: randomized controlled trial.

    Science.gov (United States)

    D'Vaz, N; Meldrum, S J; Dunstan, J A; Martino, D; McCarthy, S; Metcalfe, J; Tulic, M K; Mori, T A; Prescott, S L

    2012-10-01

    Relative deficiency of dietary omega 3 polyunsaturated fatty acids (n-3 PUFA) has been implicated in the rising allergy prevalence in Westernized countries. Fish oil supplementation may provide an intervention strategy for primary allergy prevention. The objective of this study was to assess the effect of fish oil n-3 PUFA supplementation from birth to 6 months of age on infant allergic disease. In a double-blind randomized controlled trial, 420 infants at high atopic risk received a daily supplement of fish oil containing 280 mg docosahexaenoic acid and 110 mg eicosapentaenoic acid or a control (olive oil), from birth to age 6 months. PUFA levels were measured in 6-month-old infants' erythrocytes and plasma and their mothers' breast milk. Eczema, food allergy, asthma and sensitization were assessed in 323 infants for whom clinical follow-up was completed at 12 months of age. At 6 months of age, infant docosahexaenoic acid and eicosapentaenoic acid levels were significantly higher (both P acid levels were lower (P = .003) in the fish oil group. Although n-3 PUFA levels at 6 months were associated with lower risk of eczema (P = .033) and recurrent wheeze (P = .027), the association with eczema was not significant after multiple comparisons and there was no effect of the intervention per se on the primary study outcomes. Specifically, between-group comparisons revealed no differences in the occurrence of allergic outcomes including sensitization, eczema, asthma, or food allergy. Postnatal fish oil supplementation improved infant n-3 status but did not prevent childhood allergic disease.

  4. Improving the uptake of preconception care and periconceptional folate supplementation: what do women think?

    Directory of Open Access Journals (Sweden)

    Chapman Anna

    2010-12-01

    Full Text Available Abstract Background Despite strong evidence of the benefits of preconception interventions to improve pregnancy outcomes, the delivery and uptake of preconception care in general and periconceptional folate supplementation in particular remains low. The aim of this study was to determine women's views of the barriers and enablers to the uptake of preconception care and periconceptional folate supplementation. Methods Focus groups were undertaken in 2007 with 17 women of reproductive age (18-45 years. To identify key issues and themes within the data, focus groups were analysed using an inductive process of thematic analysis. Results Most women were unaware of the need to attend for preconception care and were surprised at the breadth of issues involved. Women also felt general practitioners (GPs should be more proactive in promoting preconception care availability but acknowledged that they themselves had to be thinking about pregnancy or becoming pregnant to be receptive to it. Barriers to periconceptional folate supplementation included confusion about reasons for use, dose, duration, timing and efficacy of folate use. Enablers included the desire to do anything they could to ensure optimum pregnancy outcomes, and promotional material and letters of invitation from their GP to advise them of the availability and the need for preconception care. Conclusion A number of important barriers and enablers exist for women regarding the delivery and uptake of preconception care and periconceptional folate supplementation. It is essential that these patient perspectives are addressed in both the implementation of evidence based clinical practice guidelines and in the systematic design of an intervention to improve preconception care delivery.

  5. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress—A Systematic Review

    Science.gov (United States)

    Boyle, Neil Bernard; Lawton, Clare; Dye, Louise

    2017-01-01

    Background: Anxiety related conditions are the most common affective disorders present in the general population with a lifetime prevalence of over 15%. Magnesium (Mg) status is associated with subjective anxiety, leading to the proposition that Mg supplementation may attenuate anxiety symptoms. This systematic review examines the available evidence for the efficacy of Mg supplementation in the alleviation of subjective measures of anxiety and stress. Methods: A systematic search of interventions with Mg alone or in combination (up to 5 additional ingredients) was performed in May 2016. Ovid Medline, PsychInfo, Embase, CINAHL and Cochrane databases were searched using equivalent search terms. A grey literature review of relevant sources was also undertaken. Results: 18 studies were included in the review. All reviewed studies recruited samples based upon an existing vulnerability to anxiety: mildly anxious, premenstrual syndrome (PMS), postpartum status, and hypertension. Four/eight studies in anxious samples, four/seven studies in PMS samples, and one/two studies in hypertensive samples reported positive effects of Mg on subjective anxiety outcomes. Mg had no effect on postpartum anxiety. No study administered a validated measure of subjective stress as an outcome. Conclusions: Existing evidence is suggestive of a beneficial effect of Mg on subjective anxiety in anxiety vulnerable samples. However, the quality of the existing evidence is poor. Well-designed randomised controlled trials are required to further confirm the efficacy of Mg supplementation. PMID:28445426

  6. Effect of Lycopene Supplementation on Oxidative Stress: An Exploratory Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Science.gov (United States)

    Chen, Jinyao; Song, Yang

    2013-01-01

    Abstract Lycopene is a potentially useful compound for preventing and treating cardiovascular diseases and cancers. Studies on the effects of lycopene on oxidative stress offer insights into its mechanism of action and provide evidence-based rationale for its supplementation. In this analysis, randomized controlled trials of the effects of oral lycopene supplementation on any valid outcomes of oxidative stress were identified and pooled through a search of international journal databases and reference lists of relevant publications. Two reviewers extracted data from each of the identified studies. Only studies of sufficient quality were included. Twelve parallel trials and one crossover trial were included in the systematic review, and six trials provided data for quantitative meta-analysis. Our results indicate that lycopene supplementation significantly decreases the DNA tail length, as determined using comet assays, with a mean difference (MD) of −6.27 [95% confidence interval (CI) −10.74, −1.90] (P=.006) between the lycopene intervention groups and the control groups. Lycopene supplementation does not significantly prolong the lag time of low-density lipoprotein (MD 3.76 [95% CI −2.48, 10.01]; P=.24). Lycopene possibly alleviates oxidative stress; however, biomarker research for oxidative stress needs be more consistent with the outcomes in lycopene intervention trials for disease prevention. PMID:23631493

  7. Getting Help From Others: The Effects of Demand and Supply

    Science.gov (United States)

    2014-01-01

    Objectives. This article investigates whether the help with care needs that is received from others depends on the potential supply of family helpers. Methods. Data from the first round of survey data collected in the National Health and Aging Trends Study are used to create measures of whether help is received, the number of helpers, and the hours of help received. Regression analysis is used to relate these outcomes to indicators of the demand for and supply of helpers. Results. Analyses suggest limited evidence that the receipt of help is a supply-driven phenomenon. Although the measures of child–caregiver supply are not associated with a binary indicator of help received, caregiver-supply factors are associated with the number of helpers and the total hours of help received. Discussion. Findings on the total number of helpers and total hours of care have implications for the division of care labor within families and between families and nonfamily members. Foreseeable trends in the demand for and the supply of help suggest further evolution in patterns of elders’ receipt of help with care needs. Even if those with needs for care continue to have their needs addressed by one or more helpers, the number of helpers, and the aggregate amount of help they provide, is likely to undergo adjustment in response to changing family patterns. PMID:25342824

  8. Digestive Enzyme Supplementation for Autism Spectrum Disorders: A Double-Blind Randomized Controlled Trial

    Science.gov (United States)

    Munasinghe, Sujeeva A.; Oliff, Carolyn; Finn, Judith; Wray, John A.

    2010-01-01

    To examine the effects of a digestive enzyme supplement in improving expressive language, behaviour and other symptoms in children with Autism Spectrum Disorder. Randomized, double-blind placebo-controlled trial using crossover design over 6 months for 43 children, aged 3-8 years. Outcome measurement tools included monthly Global Behaviour Rating…

  9. Creatine supplementation prevents hyperhomocysteinemia, oxidative stress and cancer-induced cachexia progression in Walker-256 tumor-bearing rats.

    Science.gov (United States)

    Deminice, Rafael; Cella, Paola Sanches; Padilha, Camila S; Borges, Fernando H; da Silva, Lilian Eslaine Costa Mendes; Campos-Ferraz, Patrícia L; Jordao, Alceu Afonso; Robinson, Jason Lorne; Bertolo, Robert F; Cecchini, Rubens; Guarnier, Flávia Alessandra

    2016-08-01

    The purpose of this study was to investigate (1) the impact of tumor growth on homocysteine (Hcy) metabolism, liver oxidative stress and cancer cachexia and, (2) the potential benefits of creatine supplementation in Walker-256 tumor-bearing rats. Three experiments were conducted. First, rats were killed on days 5 (D5), 10 (D10) and 14 (D14) after tumor implantation. In experiment 2, rats were randomly assigned to three groups designated as control (C), tumor-bearing (T) and tumor-bearing supplemented with creatine (TCr). A life span experiment was conducted as the third experiment. Creatine was supplied in drinking water for 21 days (8 g/L) in all cases. Tumor implantation consisted of a suspension of Walker-256 cells (8.0 × 10(7) cells in 0.5 mL of PBS). The progressive increase (P creatine supplementation promoted a 28 % reduction of tumor weight (P Creatine supplementation was unable to decrease Hcy concentration and to increase SAM/SAH ratio in tumor tissue. These data suggest that creatine effects on hepatic impaired Hcy metabolism promoted by tumor cell inoculation are responsible to decrease plasma Hcy in tumor-bearing rats. In conclusion, Walker-256 tumor growth is associated with progressive hyperhomocysteinemia, body weight loss and liver oxidative stress in rats. Creatine supplementation, however, prevented these tumor-associated perturbations.

  10. Photosynthetically supplemental lighting for vegetable crop production with super-bright laser diode

    Science.gov (United States)

    Hu, Yongguang; Li, Pingping; Shi, Jintong

    2007-02-01

    Although many artificial light sources like high-pressure sodium lamp, metal halide lamp, fluorescent lamp and so on are commonly used in horticulture, they are not widely applied because of the disadvantages of unreasonable spectra, high cost and complex control. Recently new light sources of light-emitting diode (LED) and laser diode (LD) are becoming more and more popular in the field of display and illumination with the improvement of material and manufacturing, long life-span and increasingly low cost. A new type of super-bright red LD (BL650, central wavelength is 650 nm) was selected to make up of the supplemental lighting panel, on which LDs were distributed with regular hexagon array. Drive circuit was designed to power it and adjust light intensity. System performance including temperature rise and light intensity distribution under different vertical/horizontal distances were tested. Photosynthesis of sweet pepper and eggplant leaf under LD was measured with LI-6400 to show the supplemental lighting effects. The results show that LD system can supply the maximum light intensity of 180 μmol/m2 •s at the distance of 50 mm below the panel and the temperature rise is little within 1 °C. Net photosynthetic rate became faster when LD system increased light intensity. Compared with sunlight and LED supplemental lighting system, LD's promotion on photosynthesis is in the middle. Thus it is feasible for LD light source to supplement light for vegetable crops. Further study would focus on the integration of LD and other artificial light sources.

  11. Effect of supplementation on the performance of grazing Belgian Blue double-muscled heifers.

    Science.gov (United States)

    Fiems, L O; De Boever, J L; Vanacker, J M

    2013-11-01

    Six experiments were conducted to investigate the effect of a feed supplement on the performance of grazing Belgian Blue double-muscled (BBDM) heifers with an initial weight and age of 195 ± 43 kg and 190 ± 52 days. Treatments included were: Exp. 1: supplementation with beet pulp (BP): 2 kg/day per head v. ad libitum intake; Exp. 2: supplementation ad libitum with BP v. a mixture of BP and soybean meal (SBM; BP/SBM ratio of 80/20; FW (fresh weight) basis); Exp. 3: supplementation with 4 kg/day per head of a mixture of BP/SBM (80/20; FW basis) v. BP/formaldehyde-treated SBM (BP/FSBM); Exp. 4: supplementation with 4 kg/day per head of a mixture with a similar protein content (125 g DVE per kg dry matter (DM)), consisting of 80/20 BP/SBM v. 92/8 BP/FSBM; Exp. 5: supplementation with 3 kg/day per head of a mixture of BP/SBM (80/20; FW basis) v. BP/DDGS (dried distillers grains and solubles; 70/30, FW basis); and Exp. 6: supplementation with 3 kg/day per head of 80/20 BP/SBM v. maize silage (MS) and SBM, on the basis of a similar protein concentration in the DM as the 80/20 BP/SBM supplement, and fed at a similar amount of DM as in the BP/SBM group. Supplementing BP ad libitum did not affect daily gain (0.54 v. 0.48 kg) and partial feed conversion (3.62 kg on average) compared with 2 kg/day. Supplying SBM besides BP increased growth rate compared with BP (0.87 v. 0.62 kg/day; P 0.10), but blood urea levels were reduced by FSBM (P < 0.05). DDGS tended to increase growth rate (0.77 v. 0.59 kg/day; P < 0.10) compared with BP/SBM, without effect on partial feed conversion. Replacing BP by MS did not affect daily gain, but partial feed conversion tended to be higher (3.21 v. 3.60 kg/kg body weight (BW) gain; P = 0.062). Increasing the supplement (80/20 BP/SBM) level from 3 to 4 kg daily, corresponding to 1.02% and 1.18% of the mean BW, respectively, resulted in a tendency (P = 0.121) for an increased growth rate. Grazing BBDM heifers of <1 year of age necessitate extra

  12. Rescue of corpus luteum function with peri-ovulatory HCG supplementation in IVF/ICSI GnRH antagonist cycles in which ovulation was triggered with a GnRH agonist

    DEFF Research Database (Denmark)

    Al Humaidan, Peter Samir Heskjær; Bungum, L; Bungum, M

    2006-01-01

    Previous studies found a poor clinical outcome when a GnRH agonist (GnRHa) was used to trigger ovulation in GnRH antagonist IVF/ICSI cycles. This study aimed to determine the clinical and endocrine effects as well the optimal timing of HCG supplementation. Forty-five normogonadotrophic IVF/ICSI p......RHa supplemented with 1500 IU HCG 35 h later (group 3) seems to secure a normal luteal phase and a normal clinical pregnancy outcome....

  13. Zinc Supplementation Does Not Alter Indicators of Insulin Secretion and Sensitivity in Black and White Female Adolescents.

    Science.gov (United States)

    Lobene, Andrea J; Kindler, Joseph M; Jenkins, Nathan T; Pollock, Norman K; Laing, Emma M; Grider, Arthur; Lewis, Richard D

    2017-07-01

    Background: Zinc is a micronutrient involved in the production of, and peripheral sensitivity to, pancreatic β cell-derived insulin. To our knowledge, the effect of zinc supplementation on insulin outcomes, and potential risk of diabetes, in otherwise healthy children in the United States has not been investigated. Objective: The objective of this study was to determine the influence of zinc supplementation on insulin outcomes in black and white girls in the early stages of adolescence. A secondary objective was to determine relations between baseline zinc concentrations and insulin outcomes. Methods: Healthy black and white girls aged 9-11 y were randomly assigned to daily supplementation of zinc (9 mg elemental Zn/d; n = 75; blacks: n = 35) or placebo ( n = 72; blacks: n = 32) for 4 wk. Fasting serum insulin, glucose, and C-peptide were assessed at baseline and at 4 wk. C-peptide and glucose values were used to calculate the computer model-derived homeostatic model assessment of insulin resistance (HOMA2-IR). Changes in outcome measures were compared by using repeated-measures, mixed-model ANOVA. Results: Baseline plasma zinc was not correlated with C-peptide ( r = -0.07), insulin ( r = -0.06), or HOMA2-IR ( r = -0.09) (all P > 0.05) after controlling for race and age. Treatment × time interactions for C-peptide and HOMA2-IR were not significant (both P > 0.05). Although the treatment × race × time interactions for C-peptide and HOMA2-IR were not significant (both P = 0.08), black girls who received the placebo experienced slight increases in C-peptide (15.7%) and HOMA2-IR (17.7%) ( P = 0.06). Conclusions: Four weeks of zinc supplementation had no effect on insulin outcomes in healthy black and white early-adolescent girls, although C-peptide and HOMA2-IR tended to increase in black girls who received placebo. Additional trials that are appropriately powered should further explore the effect of zinc on markers of diabetes risk, and whether race affects this

  14. Supply chain planning and management method:the fruit purchasing company case

    Directory of Open Access Journals (Sweden)

    Julio Kyosen Nakatani

    2018-06-01

    Full Text Available Abstract On the world stage, Brazil is the third largest world fruit producer. However, purchasing fruit companies are suffering from the effects of fluctuations in production and demand, inefficiency in production and information trade, lack of understanding of the dynamics of supply and reduction in profitability for all members of the fruit production chain. The supply chain management has been touted as one of the ways to reduce this volatility and improve outcomes for all involved with the supply chain. However, results of recent researches do not relate it directly to the fruit industry. To solve this problem, the present research aimed to analyze the planning and management of the supply chain of a fruit purchasing company and identify contributions and improvements to the theories and methods related to supply chain management to propose a method for planning and management the supply chain of fruit purchasing companies. It was conducted a case study from a mango fruit purchasing company using interviews with industry experts to assess the applicability, functionality and usefulness from the managerial point of view of the proposed method. Data analysis was done through the cross analysis of the methods of the supply chain management and the description of the case. The results of the study allowed the development of a method for planning and management the supply chain of fruit purchasing company. With the proposition of this method is expected to contribute with a sequence of steps to assist in planning and management of supply chain managers and specialists from a fruit purchasing company.

  15. Food retailer practices, attitudes and beliefs about the supply of healthy foods.

    Science.gov (United States)

    Andreyeva, Tatiana; Middleton, Ann E; Long, Michael W; Luedicke, Joerg; Schwartz, Marlene B

    2011-06-01

    Non-supermarket food retailers can be a promising channel for increasing the availability of healthy foods in underserved communities. The present paper reports on retailer practices, attitudes and beliefs about the supply of healthy foods before and after the introduction of new subsidies for healthy foods by the US Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in October 2009. We designed and conducted in-person standardized interviews with store owners and managers to assess perceptions of demand and profits for different foods, supply networks, barriers to stocking healthy foods and their changes following implementation of the new WIC packages. Non-supermarket retailers in five towns of Connecticut, USA (n 68 in 2009 and n 58 in 2010). Owners and managers of WIC-authorized and non-WIC convenience stores and non-chain grocery stores. Retailers identified customer demand as the primary factor in stocking decisions. They reported observing a significantly weaker demand for healthy foods compared with unhealthy foods, although it improved for certain foods with the new WIC subsidies. Less healthy foods were also perceived as more profitable. Supplier networks varied by product from convenient manufacturer delivery for salty snacks to self-supply for produce. WIC retailers were able to quickly adapt and supply healthy foods required under the new WIC programme guidelines. Retailers other than supermarkets currently perceive little demand for healthy foods, but new WIC subsidies have the power to change these perceptions. Supply barriers seem secondary in the limited offerings of healthy foods by stores and could be overcome when policy changes generate new demand for healthy foods.

  16. Design of an Integrated Methodology for Analytical Design of Complex Supply Chains

    Directory of Open Access Journals (Sweden)

    Shahid Rashid

    2012-01-01

    Full Text Available A literature review and gap analysis indentifies key limitations of industry best practice when modelling of supply chains. To address these limitations the paper reports on the conception and development of an integrated modelling methodology designed to underpin the analytical design of complex supply chains. The methodology is based upon a systematic deployment of EM, CLD, and SM techniques; the integration of which is achieved via common modelling concepts and decomposition principles. Thereby the methodology facilitates: (i graphical representation and description of key “processing”, “resourcing” and “work flow” properties of supply chain configurations; (ii behavioural exploration of currently configured supply chains, to facilitate reasoning about uncertain demand impacts on supply, make, delivery, and return processes; (iii predictive quantification about relative performances of alternative complex supply chain configurations, including risk assessments. Guidelines for the application of each step of the methodology are described. Also described are recommended data collection methods and expected modelling outcomes for each step. The methodology is being extensively case tested to quantify potential benefits & costs relative to current best industry practice. The paper reflects on preliminary benefits gained during industry based case study modelling and identifies areas of potential improvement.

  17. Calcium Bioavailability from Mineral Waters with Different Mineralization in Comparison to Milk and a Supplement.

    Science.gov (United States)

    Greupner, Theresa; Schneider, Inga; Hahn, Andreas

    2017-07-01

    The aim of the present study was to compare the bioavailability of calcium from 3 mineral waters with different concentrations of minerals with that of milk and a calcium supplement. A single-center, randomized controlled trial with a crossover design with 21 healthy men and women was conducted at the Institute of Food Science and Human Nutrition, Leibniz University Hannover. The participants consumed the 5 test products providing 300 mg of calcium each on 5 examination days with 1-week wash-out phases in between. Primary outcome variables were the area under the curve of serum calcium levels for 10-hour (AUC 0-10h ) and 24-hour urinary calcium excretion. In all groups, no significant differences in the AUC 0-10h of serum calcium levels as well as in the 24-hour urinary calcium excretion were observed. Likewise, mean changes in serum phosphate and urinary phosphate, as well as serum parathormone, showed no differences between the groups. Given an equivalent bioavailability of calcium in all test products, neither a high concentration of SO 4 2- or of HCO 3 influenced the bioavailability of calcium. Accordingly, the use of mineral water with high concentrations of calcium constitutes a calorie-free calcium source that can improve calcium supply.

  18. Assessment of Aeromedical Evacuation Transport Patient Outcomes With and Without Cabin Altitude Restriction

    Science.gov (United States)

    2017-08-24

    adverse events occurred in cardiac patients; most of the events required supplemental oxygen due to the development of chest pain . The adverse clinical...5.48, p = 0.02), but only 3 were clinically relevant—1 chest pain (CAR) and 3 desaturations (non-CAR). Appendix C contains additional PMQR...Supplemental Patient Diagnosis Information Diagnoses at Discharge (outcomes) CAR Non-CAR Head & Neck (including cervical spine) • Fatal head

  19. Optimization and coordination of South-to-North Water Diversion supply chain with strategic customer behavior

    Directory of Open Access Journals (Sweden)

    Zhi-song Chen

    2012-12-01

    Full Text Available The South-to-North Water Diversion (SNWD Project is a significant engineering project meant to solve water shortage problems in North China. Faced with market operations management of the water diversion system, this study defined the supply chain system for the SNWD Project, considering the actual project conditions, built a decentralized decision model and a centralized decision model with strategic customer behavior (SCB using a floating pricing mechanism (FPM, and constructed a coordination mechanism via a revenue-sharing contract. The results suggest the following: (1 owing to water shortage supplements and the excess water sale policy provided by the FPM, the optimal ordering quantity of water resources is less than that without the FPM, and the optimal profits of the whole supply chain, supplier, and external distributor are higher than they would be without the FPM; (2 wholesale pricing and supplementary wholesale pricing with SCB are higher than those without SCB, and the optimal profits of the whole supply chain, supplier, and external distributor are higher than they would be without SCB; and (3 considering SCB and introducing the FPM help increase the optimal profits of the whole supply chain, supplier, and external distributor, and improve the efficiency of water resources usage.

  20. Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis.

    Science.gov (United States)

    Liu, Xiaoqian; Machado, Gustavo C; Eyles, Jillian P; Ravi, Varshini; Hunter, David J

    2018-02-01

    To investigate the efficacy and safety of dietary supplements for patients with osteoarthritis. An intervention systematic review with random effects meta-analysis and meta-regression. MEDLINE, EMBASE, Cochrane Register of Controlled Trials, Allied and Complementary Medicine and Cumulative Index to Nursing and Allied Health Literature were searched from inception to April 2017. Randomised controlled trials comparing oral supplements with placebo for hand, hip or knee osteoarthritis. Of 20 supplements investigated in 69 eligible studies, 7 (collagen hydrolysate, passion fruit peel extract, Curcuma longa extract, Boswellia serrata extract, curcumin, pycnogenol and L-carnitine) demonstrated large (effect size >0.80) and clinically important effects for pain reduction at short term. Another six (undenatured type II collagen, avocado soybean unsaponifiables, methylsulfonylmethane, diacerein, glucosamine and chondroitin) revealed statistically significant improvements on pain, but were of unclear clinical importance. Only green-lipped mussel extract and undenatured type II collagen had clinically important effects on pain at medium term. No supplements were identified with clinically important effects on pain reduction at long term. Similar results were found for physical function. Chondroitin demonstrated statistically significant, but not clinically important structural improvement (effect size -0.30, -0.42 to -0.17). There were no differences between supplements and placebo for safety outcomes, except for diacerein. The Grading of Recommendations Assessment, Development and Evaluation suggested a wide range of quality evidence from very low to high. The overall analysis including all trials showed that supplements provided moderate and clinically meaningful treatment effects on pain and function in patients with hand, hip or knee osteoarthritis at short term, although the quality of evidence was very low. Some supplements with a limited number of studies and

  1. Compensatory gain of crossbred heifers supplemented in pastures under evaluation hormonal profile and blood parameters

    Directory of Open Access Journals (Sweden)

    Geraldo Trindade Júnior

    2015-06-01

    Full Text Available The objective of this experiment was to verify the effect of nutritional management that alternates periods of energy/protein restriction and refeeding of grazing crossbred heifers during their prepuberty on the hormonal profile and blood parameters. The study was conducted at Princesa do Mateiro farm in Ribeirão do Largo, in the southwest region of the state of Bahia. Twenty crossbred heifers 5/8 Dairy Guzerat x 3/8 Dutch with an average age of 12 months and average body weight of 187 ± 13.74 kg were used at the beginning of the experiment. It lasted 238 days, 14 out of them were for the animals’ adaptation. The animals were kept in rotational grazing of Brachiariabrizantha cv. Marandú pastures and randomly assigned to two treatments: Control (T100 = animals receiving concentrate supplement to supply 100% of the nutrients requirement to gain 750 g day-1 of live weight and Compensatory Nutrition (CN. The animals of the CN treatment alternated periods of Restriction (T80 = receiving concentrate supplement to meet 80% of the demand for nutrients of the (T100 and periods of Refeeding (T120 = getting concentrate supplement to supply 120% of the nutrient requirements of the (T100 The final plasma concentrations of IGF-I, glucose and urea were higher (P0.05. There were positive correlations (P<0.05 between IGF-I, insulin, glucose and cholesterol, and a negative correlation (P<0.05 between IGF-I and urea. There were also positive correlation (P<0.05 between insulin and glucose and positive correlation (P<0.05 between glucose and cholesterol. There was a negative correlation (P<0.05 of the urea with cholesterol, progesterone and protein. Progesterone also showed a positive correlation (P<0.05 with the protein.

  2. EFFECT OF SHORT-TERM CAFFEINE SUPPLEMENTATION ON STRESS RESPONSE AND IMMUNE SYSTEM OF MALE ATHLETES

    Directory of Open Access Journals (Sweden)

    Asghar Tofighi

    2014-03-01

    Full Text Available Vigorous exercise stress might be leading cause of immune system disorders and appearance of acute and chronic inflammation in human body. Caffeine supplementation prior to exercise can be effective on body immune response. This study aimed to evaluate the effect of short-term caffeine supplementation on immune response and stress index in male athletes after an exhaustive aerobic exercise. Materials and methods : In a double-blind study 24 male athletes (endurance runner and triathlon randomly divided in Caffeine supplementation (CAF and Placebo (CON groups. One hour prior to main exhaustive treadmill test (Bruce test CAF group consumed caffeine (6 Mg/BW and CON group received placebo. Blood samples were collected before and immediately after exercise test from anticubital vein. After supplying serum; Cortisol, leukocyte and serum Heat shock protein 72 (Hsp72 concentrations were determined using ELISA method. Paired and independent t student test was used for analysis of inter and intra group differences respectively. Results: serum cortisol and Hsp72 concentrations in CON group was significantly higher than CAF group (P0.05. In addition Mean of variation in CON group was significantly higher than CAF group (P<0.05. Conclusions: Based on study results caffeine supplementation prior to short-term exhaustive aerobic exercise has positive effect on innate immunity and body defensive system.

  3. EFFECT OF SHORT-TERM CAFFEINE SUPPLEMENTATION ON STRESS RESPONSE AND IMMUNE SYSTEM OF MALE ATHLETES

    Directory of Open Access Journals (Sweden)

    Asghar Tofighi

    2014-04-01

    Full Text Available Vigorous exercise stress might be leading cause of immune system disorders and appearance of acute and chronic inflammation in human body. Caffeine supplementation prior to exercise can be effective on body immune response. This study aimed to evaluate the effect of short-term caffeine supplementation on immune response and stress index in male athletes after an exhaustive aerobic exercise. Materials and methods : In a double-blind study 24 male athletes (endurance runner and triathlon randomly divided in Caffeine supplementation (CAF and Placebo (CON groups. One hour prior to main exhaustive treadmill test (Bruce test CAF group consumed caffeine (6 Mg/BW and CON group received placebo. Blood samples were collected before and immediately after exercise test from anticubital vein. After supplying serum; Cortisol, leukocyte and serum Heat shock protein 72 (Hsp72 concentrations were determined using ELISA method. Paired and independent t student test was used for analysis of inter and intra group differences respectively. Results: serum cortisol and Hsp72 concentrations in CON group was significantly higher than CAF group (P0.05. In addition Mean of variation in CON group was significantly higher than CAF group (P<0.05. Conclusions: Based on study results caffeine supplementation prior to short-term exhaustive aerobic exercise has positive effect on innate immunity and body defensive system.

  4. Methyl donor supplementation blocks the adverse effects of maternal high fat diet on offspring physiology.

    Directory of Open Access Journals (Sweden)

    Jesselea Carlin

    Full Text Available Maternal consumption of a high fat diet during pregnancy increases the offspring risk for obesity. Using a mouse model, we have previously shown that maternal consumption of a high fat (60% diet leads to global and gene specific decreases in DNA methylation in the brain of the offspring. The present experiments were designed to attempt to reverse this DNA hypomethylation through supplementation of the maternal diet with methyl donors, and to determine whether methyl donor supplementation could block or attenuate phenotypes associated with maternal consumption of a HF diet. Metabolic and behavioral (fat preference outcomes were assessed in male and female adult offspring. Expression of the mu-opioid receptor and dopamine transporter mRNA, as well as global DNA methylation were measured in the brain. Supplementation of the maternal diet with methyl donors attenuated the development of some of the adverse effects seen in offspring from dams fed a high fat diet; including weight gain, increased fat preference (males, changes in CNS gene expression and global hypomethylation in the prefrontal cortex. Notable sex differences were observed. These findings identify the importance of balanced methylation status during pregnancy, particularly in the context of a maternal high fat diet, for optimal offspring outcome.

  5. Energy-saving implications from supply chain improvement: An exploratory study on China's consumer goods retail system

    International Nuclear Information System (INIS)

    Wang, Xi; Cai, Hua; Florig, H. Keith

    2016-01-01

    Despite significant public attentions to green supply chain management, few studies have explicitly addressed the energy implications of consumer-goods supply surplus, especially in developing countries like China. This study explored the energy-saving potential from improving supply chain efficiencies and reducing excess inventory in China's retail system from a life-cycle perspective. Through embodied energy analysis, we found that energy invested pre-manufacture contributed 80–95% of the total energy embodied in consumer products. Although embodied energy intensities had declined by 60–90% since the mid-1990s, the lessened marginal improvements implied that 'low hanging fruits' have largely been captured, and the search for new opportunities for energy-saving is in demand. Positive correlations between total economic inputs and embodied energy in consumer goods indicated possible synergy effect between cost-reduction and energy-saving in supply system management. And structural path analysis identified sector-specific energy management priorities for each retail-related sector. This study suggested that improving supply chain efficiencies provides a promising supplement to China's current industrial energy-efficient projects which target reducing direct energy use per se as an intra-firm cost-saving measure. From the life-cycle perspective, the definition of 'green sector' might have to be reconsidered in China towards a more energy-efficient economy and society.

  6. Dietary arachidonic acid in perinatal nutrition

    DEFF Research Database (Denmark)

    Lauritzen, Lotte; Fewtrell, Mary; Agostoni, Carlo

    2015-01-01

    Arachidonic acid (AA) is supplied together with docosahexaenoic acid (DHA) in infant formulas, but we have limited knowledge about the effects of supplementation with either of these long-chain polyunsaturated fatty acids (LCPUFA) on growth and developmental outcomes. AA is present in similar lev...

  7. Vitamin and Mineral Supplement Fact Sheets

    Science.gov (United States)

    ... website Submit Search NIH Office of Dietary Supplements Vitamin and Mineral Supplement Fact Sheets Search the list ... Supplements: Background Information Botanical Dietary Supplements: Background Information Vitamin and Mineral Fact Sheets Botanical Supplement Fact Sheets ...

  8. Supply Chain Connectivity: Enhancing Participation in the Global Supply Chain

    OpenAIRE

    Patalinghug, Epictetus E.

    2015-01-01

    Supply chain connectivity is vital for the efficient flow of trade among APEC economies. This paper reviews the literature and supply chain management, describes the barriers to enhancing participation in global supply chain, analyzes the various measures of supply chain performance, and suggests steps for the Philippines to fully reap the benefits of the global value chain.

  9. Active components in food supplements

    NARCIS (Netherlands)

    Siemelink M; Jansen EHJM; Piersma AH; Opperhuizen A; LEO

    2000-01-01

    The growing food supplement market, where supplements are both more diverse and more easily available (e.g. through Internet) formed the backdrop to the inventory of the active components in food supplements. The safety of an increased intake of food components via supplements was also at issue

  10. The effect of different physical forms of rapeseed as a fat supplement on the activity of some enzymes in the duodenal chyme of dairy cows

    DEFF Research Database (Denmark)

    Moharerry, A.; Brask, Maike; Weisbjerg, Martin Riis

    2014-01-01

    Studies on nutritional regulation of digestive enzymes in ruminants are scarce. Fat supplementation of diets for dairy cows changes the supply of nutrients for absorption and transport. The aim of this experiment was to study the effect of the physical form of rapeseed (Brassica napus) fat......) and three fat-supplemented rations with either rapeseed cake (RSC), whole cracked rape seed (WCR), or rapeseed oil (RSO). The correlation coefficients among duodenal enzyme activities and the relationship between α-amylase and protease activities were examined. Diurnal samples were taken from the duodenum...

  11. Oral supplementation with L‐homoarginine in young volunteers

    Science.gov (United States)

    Atzler, Dorothee; Schönhoff, Mirjam; Cordts, Kathrin; Ortland, Imke; Hoppe, Julia; Hummel, Friedhelm C.; Gerloff, Christian; Jaehde, Ulrich; Jagodzinski, Annika; Böger, Rainer H.; Choe, Chi‐un

    2016-01-01

    Aims Low blood concentrations of the naturally occurring amino acid L‐homoarginine (L‐hArg) are related to impaired cardiovascular outcome and mortality in humans and animals. L‐hArg is a weak substrate of nitric oxide synthase and an inhibitor of arginases in vitro. The aim of our study was to obtain kinetic and dynamic data after oral L‐hArg supplementation. Methods In a double‐blind, randomized, placebo‐controlled crossover study, 20 young volunteers received 125 mg L‐hArg once daily for 4 weeks. Kinetic parameters (C max, T max and AUC0‐24h) were calculated after ingestion of single and multiple doses of oral supplementation as primary endpoint. Secondary endpoints that were evaluated were routine laboratory, L‐arginine, asymmetric dimethylarginine (ADMA), pulse wave velocity (PWV), augmentation index (AIx), flow‐mediated vasodilatation (FMD), corticospinal excitability, i.e. motor threshold (MT), and cortical excitability, i.e. intracortical inhibition (ICI) and facilitation (ICF). Results One hour after ingestion (T max), L‐hArg increased the baseline L‐hArg plasma concentration (2.87 ± 0.91 μmol l−1, mean ± SD) by 8.74 ± 4.46 [95% confidence intervals 6.65; 10.9] and 17.3 ± 4.97 [14.9; 19.6] μmol l−1 (C max), after single and multiple doses, respectively. Once‐only and 4 weeks of supplementation resulted in AUCs0‐24h of 63.5 ± 28.8 [50.0; 76.9] and 225 ± 78.5 [188; 2624] μmol l−1*h, for single and multiple doses, respectively. Routine laboratory parameters, L‐arginine, ADMA, PWV, AIx, FMD, MT, ICI and ICF did not change by L‐hArg supplementation compared to baseline. Conclusion Once daily orally applied 125 mg L‐hArg raises plasma L‐hArg four‐ and sevenfold after single dose and 4 weeks of supplementation, respectively, and is safe and well tolerated in young volunteers. PMID:27434056

  12. Supplemental shielding of BMIT SOE-1 at the Canadian Light Source

    International Nuclear Information System (INIS)

    Bassey, Bassey; Abueidda, Abdallah; Cubbon, Grant; Street, Darin; Sabbir Ahmed, Asm; Wysokinski, Tomasz W.; Belev, George; Chapman, Dean

    2014-01-01

    High field superconducting wiggler beamlines present shielding challenges due to the high critical energy of the synchrotron spectrum. An unexpected, but predictable, weakness in the secondary optical enclosure (SOE-1) was discovered on the BioMedical Imaging and Therapy (BMIT) insertion device (ID) beamline 05ID-2 at the Canadian Light Source (CLS). SOE-1 is a monochromatic beam hutch; the beam in it is supplied by three monochromators housed in an upstream primary optical enclosure (POE-3). The initial shielding of SOE-1 was based on a shielding calculation against target scattered and direct monochromatic (fundamental and harmonics) beams from the monochromators in POE-3. During a radiation survey of the hutch, radiation above the expected level was measured at the downstream end of SOE-1. This increment in radiation level is attributed to scattered white beam into SOE-1 by a K-Edge subtraction (KES) monochromator's crystal (a single crystal monochromator) in POE-3. Though this is peculiar to the BMIT beamline 05ID-2, it may not be uncommon for other beamlines that use single crystal monochromators. Calculations of the level of expected leakage radiation due to the scattered white beam arriving on the downstream wall of the SOE-1 are presented, as well as the supplemental shielding that will reduce the leakage to less than 1 μSv/h as required at the CLS. Also presented are the installed supplemental shielding, and a comparison of the calculations and measurements of the dose rates on the back wall of SOE-1 End Wall, before and after installation of the supplemental shielding. - Highlights: • We discovered an unexpected weakness in the shielding of BMIT SOE-1 End Wall. • We predicted the source of the weakness-scattering of white beam into SOE-1. • White beam scattered into SOE-1 by the crystal of a single crystal monochromator. • We calculated and installed the required supplemental shielding. • With the installed supplemental shielding, we have

  13. Randomized Controlled Trial of Supplemental Augmentative and Alternative Communication versus Voice Rest Alone after Phonomicrosurgery

    Science.gov (United States)

    Rousseau, Bernard; Gutmann, Michelle L.; Mau, I-fan Theodore; Francis, David O.; Johnson, Jeffrey P.; Novaleski, Carolyn K.; Vinson, Kimberly N.; Garrett, C. Gaelyn

    2015-01-01

    Objective This randomized trial investigated voice rest and supplemental text-to-speech communication versus voice rest alone on visual analog scale measures of communication effectiveness and magnitude of voice use. Study Design Randomized clinical trial. Setting Multicenter outpatient voice clinics. Subjects Thirty-seven patients undergoing phonomicrosurgery. Methods Patients undergoing phonomicrosurgery were randomized to voice rest and supplemental text-to-speech communication or voice rest alone. The primary outcome measure was the impact of voice rest on ability to communicate effectively over a seven-day period. Pre- and post-operative magnitude of voice use was also measured as an observational outcome. Results Patients randomized to voice rest and supplemental text-to-speech communication reported higher median communication effectiveness on each post-operative day compared to those randomized to voice rest alone, with significantly higher median communication effectiveness on post-operative day 3 (p = 0.03) and 5 (p = 0.01). Magnitude of voice use did not differ on any pre-operative (p > 0.05) or post-operative day (p > 0.05), nor did patients significantly decrease voice use as the surgery date approached (p > 0.05). However, there was a significant reduction in median voice use pre- to post-operatively across patients (p communication increased patient perceived communication effectiveness on post-operative days 3 and 5 over voice rest alone. With the prevalence of smartphones and the widespread use of text messaging, supplemental text-to-speech communication may provide an accessible and cost-effective communication option for patients on vocal restrictions. PMID:25605690

  14. Further analysis of multicentre cystathionine beta synthase deficiency thrombosis data and metabolic pathways suggests potentially better treatment via improved cysteine supplementation, diet, antioxidant supplementation, follow-up and testing for thrombophilic mutations

    Directory of Open Access Journals (Sweden)

    David Vance

    2017-01-01

    Full Text Available Background Homozygous or compound heterozygous Cystathionine-beta-synthase deficiency (CBS-- may result in thrombosis. Treatment has included various combinations of: low-methionine diets, cystine (cystine dimer-enriched amino acid supplementation, vitamin B6, folic acid, vitamin B12 and betaine. Treatment compliance and outcomes even in the most-developed countries are mostly sub-optimal and variable, and the differing theoretical metabolic ramifications due to differing treatments have not been well addressed. The aim of this work was to further analyse the thrombosis events data of Yap et al (2001/2003, and to compare these with the rate of thrombosis in the general population, and to examine the theoretical significance of the metabolic pathways affected by CBS-- and its treatments, and so find any potential improvements in treatments, considering also less-developed areas. Methods Yap et al’s (2001/2003 data of the thrombosis outcomes of five major (CBS---treating centers: in Dublin, Sydney, Nijmegen, Manchester and London; were statistically compared with outcomes predicted by Mudd et al’s (1985 untreated natural history outcomes, and then Dublin versus the others; these rates were then compared with those of general populations; and treatments were examined regarding their theoretical metabolic ramifications. Results There were less thrombosis outcomes (P<.05 in the treated and followed CBS-- patient groups of each of the five centers, even when considered singly, than that expected in the absence of treatment by reference to the natural history data of Mudd et al (1985, but the reduction was less than half that claimed by Yap et al, and the remaining level of thrombosis is roughly 10 times that of the general population. The thromboses outcome (nil of the Dublin group is better than that of the other four groups, but only at P ~ 0.16 with the other four groups combined, or P = 0.14 to 0.23 singly. Treatment regimens differ, including

  15. MICROBIOLOGICAL QUALITY OF FOOD SUPPLEMENTS.

    Science.gov (United States)

    Ratajczak, Magdalena; Kubicka, Marcelina M; Kamińska, Dorota; Długaszewska, Jolanta

    2015-01-01

    Many specialists note that the food offered today - as a result of very complex technological processing - is devoid of many components that are important for the organism and the shortages have to be supplemented. The simplest for it is to consume diet supplements that provide the missing element in a concentrated form. In accordance with the applicable law, medicinal products include all substances or mixtures of substances that are attributed with properties of preventing or treating diseases with humans or animals. Permits to admit supplements to the market are issued by the Chief Sanitary Inspector and the related authorities; permits for medicines are issued by the Chief Pharmaceutical Inspector and the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products. Therefore, admittance of a supplement to the market is less costly and time consuming_than admittance of a medicine. Supplements and medicines may contain the same component but medicines will have a larger concentration than supplements. Sale of supplements at drug stores and in the form of tablets, capsules, liquids or powders makes consumer often confusing supplements with medicines. Now there are no normative documents specifying limits of microbiological impurities in diet supplements. In Polish legislation, diet supplements are subject to legal acts concerning food. Medicines have to comply with microbiological purity requirements specified in the Polish Pharmacopeia. As evidenced with the completed tests, the proportion of diet supplement samples with microbiological impurities is 6.5%. Sales of diet supplements have been growing each year, they are consumed by healthy people but also people with immunology deficiencies and by children and therefore consumers must be certain that they buy safe products.

  16. Alignment of global supply networks based on strategic groups of supply chains

    Directory of Open Access Journals (Sweden)

    Nikos G. Moraitakis

    2017-09-01

    Full Text Available Background: From a supply chain perspective, often big differences exist between global raw material suppliers’ approaches to supply their respective local markets. The progressing complexity of large centrally managed global supply networks and their often-unknown upstream ramifications increase the likelihood of undetected bottlenecks and inefficiencies. It is therefore necessary to develop an approach to strategically master the upstream complexity of such networks from a holistic supply chain perspective in order to align regional competitive priorities and supply chain structures. The objective of this research is hence to develop an approach for the supply-chain-based alignment of complex global supply networks. Method: We review existing literature from the fields of supply chain and network management, strategic sourcing, and strategic management. Based on the literature review and theoretical and practical considerations we deduce a conceptual approach to consider upstream supply chain structures in supply network alignment initiatives. Results: On the basis of these considerations and current empirical literature we transfer strategic group theory to the supply network management context. The proposed approach introduces strategic groups of supply chains as a segmentation criterion for complex global supply networks which enables the network-wide alignment of competitive priorities. Conclusion: Supply-chain-based segmentation of global supply network structures can effectively reduce the complexity, firms face when aiming to strategically align their supply chains on a holistic level. The results of this research are applicable for certain types of global supply networks and can be used for network alignment and strategy development. The approach can furthermore generate insights useable for negotiation support with suppliers.

  17. Regulatory focus, self-efficacy and outcome expectations as drivers of motivation to consume healthy food products.

    Science.gov (United States)

    Tudoran, Ana Alina; Scholderer, Joachim; Brunsø, Karen

    2012-10-01

    In this paper we apply the principle of Regulatory Focus Theory to investigate the interaction between self-efficacy and outcome expectations on individuals' intentions to adopt health behaviors. The participants, 959 individuals (Survey 1) and 2400 individuals (Survey 2), reported self-efficacy beliefs and outcome expectations with regard to the consumption of omega-3 supplements and omega-3-enriched food products. We found that the relationship prevention outcome expectations-intention was significantly attenuated at low levels of self-efficacy and strengthened at high levels of self-efficacy, respectively; whereas, the relationship promotion outcome expectations-intention was unaffected by the perceived levels of self-efficacy. The implications suggest that consumers' motivation to adopt healthy food products, such as omega-3 supplements and omega-3 enriched products, should be encouraged by stimulating promotion outcome expectations. However, when a prevention frame is used, the individuals' motivation should be significantly enhanced by self-efficacy beliefs. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Is there a place for nutritional supplements in the treatment of idiopathic male infertility?

    Directory of Open Access Journals (Sweden)

    Davide Arcaniolo

    2014-09-01

    Full Text Available Objective: Infertility affects 15% of couples in fertile age. Male factor is a cause of infertility in almost half of cases, mainly due to oligoasthenoteratozoospermia (OAT. The purpose of this study is to review the effects of nutritional supplements as medical treatment for idiopathic male infertility. Material and methods: A Pub Med and Medline review of the published studies utilizing nutritional supplements for the treatment of male infertility has been performed. Results: Clinical trials on Vitamin E, Vitamin A, Vitamin C. Arginine, Carnitine, N-Acetyl-Carnitine, Glutathione, Coenzyme Q10, Selenium and Zinc were reviewed. Although there is a wide variability in selected population, dose regimen and final outcomes, nutritional supplements both alone and in combination seems to be able to improve semen parameters (sperm count, sperm motility and morphology and pregnancy rate in infertile men. Conclusions: There are rising evidences from published randomized trials and systematic review suggesting that nutritional supplementation may improve semen parameters and the likelihood of pregnancy in men affected by OAT. This improvement, however, is not consistent and there is a wide variation in the treatment regimens used. Well designed and adequately powered RCTs are needed to better clarify the role of nutritional supplements as treatment for male infertility.

  19. Implementing a "quality by design" approach to assure the safety and integrity of botanical dietary supplements.

    Science.gov (United States)

    Khan, Ikhlas A; Smillie, Troy

    2012-09-28

    Natural products have provided a basis for health care and medicine to humankind since the beginning of civilization. According to the World Health Organization (WHO), approximately 80% of the world population still relies on herbal medicines for health-related benefits. In the United States, over 42% of the population claimed to have used botanical dietary supplements to either augment their current diet or to "treat" or "prevent" a particular health-related issue. This has led to the development of a burgeoning industry in the U.S. ($4.8 billion per year in 2008) to supply dietary supplements to the consumer. However, many commercial botanical products are poorly defined scientifically, and the consumer must take it on faith that the supplement they are ingesting is an accurate representation of what is listed on the label, and that it contains the purportedly "active" constituents they seek. Many dietary supplement manufacturers, academic research groups, and governmental organizations are progressively attempting to construct a better scientific understanding of natural products, herbals, and botanical dietary supplements that have co-evolved with Western-style pharmaceutical medicines. However, a deficiency of knowledge is still evident, and this issue needs to be addressed in order to achieve a significant level of safety, efficacy, and quality for commercial natural products. The authors contend that a "quality by design" approach for botanical dietary supplements should be implemented in order to ensure the safety and integrity of these products. Initiating this approach with the authentication of the starting plant material is an essential first step, and in this review several techniques that can aid in this endeavor are outlined.

  20. Getting help from others: the effects of demand and supply.

    Science.gov (United States)

    Wolf, Douglas A

    2014-11-01

    This article investigates whether the help with care needs that is received from others depends on the potential supply of family helpers. Data from the first round of survey data collected in the National Health and Aging Trends Study are used to create measures of whether help is received, the number of helpers, and the hours of help received. Regression analysis is used to relate these outcomes to indicators of the demand for and supply of helpers. Analyses suggest limited evidence that the receipt of help is a supply-driven phenomenon. Although the measures of child-caregiver supply are not associated with a binary indicator of help received, caregiver-supply factors are associated with the number of helpers and the total hours of help received. Findings on the total number of helpers and total hours of care have implications for the division of care labor within families and between families and nonfamily members. Foreseeable trends in the demand for and the supply of help suggest further evolution in patterns of elders' receipt of help with care needs. Even if those with needs for care continue to have their needs addressed by one or more helpers, the number of helpers, and the aggregate amount of help they provide, is likely to undergo adjustment in response to changing family patterns. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Taking iron supplements

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007478.htm Taking iron supplements To use the sharing features on this page, ... levels. You may also need to take iron supplements as well to rebuild iron stores in your ...

  2. Identification of metformin poor responders, requiring supplemental insulin, during randomization of metformin versus insulin for the control of gestational diabetes mellitus.

    Science.gov (United States)

    Ashoush, Sherif; El-Said, Mourrad; Fathi, Hisham; Abdelnaby, Mohamed

    2016-06-01

    To evaluate glycemic control among women with gestational diabetes mellitus (GDM) under insulin versus metformin (with or without insulin supplementation), and to identify metformin poor responders requiring supplemental insulin. In Ain Shams University Hospital, mothers with 26-32-week GDM pregnancies, failing diet control, were randomized to receive metformin (n = 47) or insulin (n = 48). The primary outcome was glycemic control. Secondary outcomes included maternal weight, parameters predicting successful metformin monotherapy, neonatal hypoglycemia, and birthweight. Women using metformin (23.4% needing supplemental insulin) gained less weight (P metformin group was related to initial body mass index, HbA1c, oral glucose tolerance test (GTT), and first week mean glucose level. The 1-h glucose level during initial GTT (Hr1-GTT) and the mean fasting glucose level during the first week of therapy (Wk1-mFG) were the two independent parameters associated with requiring supplemental insulin. Women with Hr1-GTT >212 mg/dL and Wk1-mFG >95 mg/dL had a risk ratio of 58.6 (95%CI: 3.68-933.35, P = 0.004) and 11.5 (95%CI: 2.77-47.34,= 0.0008), respectively for needing supplemental insulin during the course of the study compared with women without. Metformin is an effective and safe alternative to insulin in GDM. Women using metformin (± supplemental insulin) had similar glycemic control, less weight gain, and similar rates of side-effects as those on insulin monotherapy. Insulin supplementation to metformin therapy was more likely with elevated Hr1-GTT and Wk1-mFG. © 2016 Japan Society of Obstetrics and Gynecology.

  3. The effectiveness of zinc supplementation in men with isolated hypogonadotropic hypogonadism

    Directory of Open Access Journals (Sweden)

    Yan-Ling Liu

    2017-01-01

    Full Text Available A multicenter, open-label, randomized, controlled superiority trial with 18 months of follow-up was conducted to investigate whether oral zinc supplementation could further promote spermatogenesis in males with isolated hypogonadotropic hypogonadism (IHH receiving sequential purified urinary follicular-stimulating hormone/human chorionic gonadotropin (uFSH/hCG replacement. Sixty-seven Chinese male IHH patients were recruited from the Departments of Endocrinology in eight tertiary hospitals and randomly allocated into the sequential uFSH/hCG group (Group A, n = 34 or the sequential uFSH plus zinc supplementation group (Group B, n = 33. In Group A, patients received sequential uFSH (75 U, three times a week every other 3 months and hCG (2000 U, twice a week treatments. In Group B, patients received oral zinc supplementation (40 mg day−1 in addition to the sequential uFSH/hCG treatment given to patients in Group A. The primary outcome was the proportion of patients with a sperm concentration ≥1.0 × 106 ml−1 during the 18 months. The comparison of efficacy between Groups A and B was analyzed. Nineteen of 34 (55.9% patients receiving sequential uFSH/hCG and 20 of 33 (60.6% patients receiving sequential uFSH/hCG plus zinc supplementation achieved sperm concentrations ≥1.0 × 106 ml−1 by intention to treat analyses. No differences between Group A and Group B were observed as far as the efficacy of inducing spermatogenesis (P = 0.69. We concluded that the sequential uFSH/hCG plus zinc supplementation regimen had a similar efficacy to the sequential uFSH/hCG treatment alone. The additional improvement of 40 mg day−1 oral zinc supplementation on spermatogenesis and masculinization in male IHH patients is very subtle.

  4. Interaction of Carbamazepine with Herbs, Dietary Supplements, and Food: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Sophia Yui Kau Fong

    2013-01-01

    Full Text Available Background. Carbamazepine (CBZ is a first-line antiepileptic drug which may be prone to drug interactions. Systematic review of herb- and food-drug interactions on CBZ is warranted to provide guidance for medical professionals when prescribing CBZ. Method. A systematic review was conducted on six English databases and four Chinese databases. Results. 196 out of 3179 articles fulfilled inclusion criteria, of which 74 articles were reviewed and 33 herbal products/dietary supplement/food interacting with CBZ were identified. No fatal or severe interactions were documented. The majority of the interactions were pharmacokinetic-based (80%. Traditional Chinese medicine accounted for most of the interactions (n=17, followed by food (n=10, dietary supplements (n=3, and other herbs/botanicals (n=3. Coadministration of 11 and 12 of the studied herbal products/dietary supplement/food significantly decreased or increased the plasma concentrations of CBZ. Regarding pharmacodynamic interaction, Xiao-yao-san, melatonin, and alcohol increased the side effects of CBZ while caffeine lowered the antiepileptic efficacy of CBZ. Conclusion. This review provides a comprehensive summary of the documented interactions between CBZ and herbal products/food/dietary supplements which assists healthcare professionals to identify potential herb-drug and food-drug interactions, thereby preventing potential adverse events and improving patients’ therapeutic outcomes when prescribing CBZ.

  5. Routine Iron Supplementation and Anaemia by Third Trimester in a Nigerian Hospital.

    Science.gov (United States)

    Adanikin, Abiodun I; Awoleke, Jacob O; Olofinbiyi, Babatunde A; Adanikin, Pipeloluwa O; Ogundare, Omobolanle R

    2015-10-01

    Anaemia in pregnancy is associated with adverse maternal and fetal outcome. Unfortunately, in developing countries its prevalence has continued to rise. To improve the situation, iron supplement is routinely prescribed during pregnancy. We therefore examine the impact of the intervention as being currently practised in our clinical setting. In total, 255 prenatal clinic attendees who had more than 8 weeks of prescribed iron supplements were sampled. Data was obtained on their socio-demographic features, haemoglobin concentration at booking, compliance with iron supplements and third trimester haemoglobin value. Observed iron supplementation compliance rate was 184(72.2%). There was a significant drop in mean haemoglobin (Hb) concentration between the two time points (booking Hb: 32.56±2.99; third trimester Hb: 31.67±3.01; mean diff: 0.89±3.04; t = 4.673; 95% CI= 0.52-1.27; p= Anaemia increased from 132(51.8%) to 150(58.8%) by the third trimester. Increase in anaemia occurred in both iron-compliant and non-compliant groups. Non-compliance however had higher odds of predicting anaemia by the third trimester (OR: 1.83; 95% CI: 1.03-3.26; p: 0.04). Although iron supplementation is still a good intervention in developing countries, it is not sufficient to reduce overall prevalence of anaemia by the third trimester. There is a need to look beyond the approach and reinforce the importance of better feeding practices, food fortification and reduced frequency of pregnancies.

  6. Supplementation of monensin and Optimase to beef cows consuming low-quality forage during late gestation and early lactation.

    Science.gov (United States)

    Linneen, S K; McGee, A L; Cole, J R; Jennings, J S; Stein, D R; Horn, G W; Lalman, D L

    2015-06-01

    Two experiments were designed to investigate the effects of feeding monensin and/or slow release urea with a fibrolytic feed enzyme (Optimase; Alltech, Inc., Nicholasville, KY) on performance, milk production, calf growth performance, and blood metabolites in beef cows. Spring-calving cows and heifers were used in a completely randomized design in Exp. 1 (N = 84; 534 ± 68 kg initial BW) and Exp. 2 (N = 107; 508 ± 72 kg initial BW). Exp. 1 supplements were formulated to meet cow protein requirements and fed daily and included 1) cottonseed meal with no monensin (control); or 2) monensin added to control to supply 200 mg per head per d (MON). In Exp. 2, experimental supplements included 1) cottonseed meal/wheat middlings (CS) fed at a rate to provide adequate DIP and CP according to , 2) the CS plus soybean hulls and 61 g per cow per d Optimase (OPT), 3) the CS plus monensin to supply 200 mg per cow per d (MON2), and 4) OPT plus MON2 (Combo). Cows were fed in last trimester through early lactation in Exp. 1 and during 2nd trimester in Exp. 2. Data were analyzed using the Mixed procedure in SAS with animal as the experimental unit. In Exp. 1, treatment did not affect cow BW or BCS change (P > 0.19). Calf birth BW was not affected by dam treatment (P = 0.24); however, calves from dams consuming MON weighed more (P Milk production did not significantly differ among treatments (P > 0.41). In Exp. 2, mean cow BW and BCS were similar (P > 0.35) among treatments on d 90. However, from d 0 to 54, cows assigned to the OPT supplement gained less BCS (P = 0.02) compared with cows assigned to the CS supplement. Cumulative BCS gain was greater (P calf performance during early lactation seems to be clearer. Replacing a portion of oilseed N in the supplement with Optimase may marginally reduce cow performance. Further research is needed to determine both the effects of monensin and the implications of combining monensin with Optimase on forage intake and cow performance at

  7. Water supply

    International Nuclear Information System (INIS)

    Peterson, F.L.

    1986-01-01

    Options and methodologies for the development of fresh water supplies on Bikini Atoll are much the same as those practiced in the rest of the Marshall Islands and for that matter, most atolls in the central Pacific Ocean Basin. That is, rainfall distribution on Bikini produces a distinct wet season, lasting from about May through November, with the remaining months being generally dry. As a result, fresh water from surface catchments tends to be plentiful during the wet season? but is usually scarce during the dry months, and alternative sources such as groundwater must be utilized during this time. On Bikini the problems of fresh water supply are somewhat more difficult than for most Marshall Island atolls because rainfall is only about half the Marshall Island's average. Tus water supply is a critical factor limiting the carrying capacity of Bikini Atoll. To address this problem BARC has undertaken a study of the Bikini Atoll water supply. Te primary objectives of this work are to determine: (1) alternatives available for fresh water supply, 2 the amounts, location and quality of available supplies and 3 optimal development methods. The study planned for one's year duration, has been underway only since the summer of 1985 and is thus not yet fully completed. However, work done to date, which is presented in this report of preliminary findings, provides a reasonably accurate picture of Bikini's fresh water supplies and the various options available for their development. The work remaining to be completed will mainly add refinements to the water supply picture presented in the sections to follow

  8. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress—A Systematic Review

    Directory of Open Access Journals (Sweden)

    Neil Bernard Boyle

    2017-04-01

    Full Text Available Background: Anxiety related conditions are the most common affective disorders present in the general population with a lifetime prevalence of over 15%. Magnesium (Mg status is associated with subjective anxiety, leading to the proposition that Mg supplementation may attenuate anxiety symptoms. This systematic review examines the available evidence for the efficacy of Mg supplementation in the alleviation of subjective measures of anxiety and stress. Methods: A systematic search of interventions with Mg alone or in combination (up to 5 additional ingredients was performed in May 2016. Ovid Medline, PsychInfo, Embase, CINAHL and Cochrane databases were searched using equivalent search terms. A grey literature review of relevant sources was also undertaken. Results: 18 studies were included in the review. All reviewed studies recruited samples based upon an existing vulnerability to anxiety: mildly anxious, premenstrual syndrome (PMS, postpartum status, and hypertension. Four/eight studies in anxious samples, four/seven studies in PMS samples, and one/two studies in hypertensive samples reported positive effects of Mg on subjective anxiety outcomes. Mg had no effect on postpartum anxiety. No study administered a validated measure of subjective stress as an outcome. Conclusions: Existing evidence is suggestive of a beneficial effect of Mg on subjective anxiety in anxiety vulnerable samples. However, the quality of the existing evidence is poor. Well-designed randomised controlled trials are required to further confirm the efficacy of Mg supplementation.

  9. Efficacy of iron fortification compared to iron supplementation among Vietnamese schoolchildren

    Directory of Open Access Journals (Sweden)

    Nguyen Khan

    2006-12-01

    Full Text Available Abstract The effect of iron fortification is generally assumed to be less than iron supplementation; however, the magnitude of difference in effects is not known. The present study aims to compare the efficacy of these two strategies on anaemia and iron status. After screening on low Hb, 425 anaemic children in six primary schools in Tam Nong district of Phu Tho province were included in a randomized, placebo-controlled trial comparing two groups receiving iron fortified instant noodles or iron supplementation for 6 months and a control group, with children in all groups having been dewormed. Blood samples were collected before and after intervention for haemoglobin, serum ferritin (SF, serum transferrin receptor (TfR, C-reactive protein (CRP, and haemoglobinopathies analysis. Regression analysis was used to assess the effect of iron fortification and iron supplementation on haemoglobin concentration, SF, TfR, body iron, and anaemic status as outcome variables. The improvement of haemoglobin, SF, and body iron level in the group receiving iron fortification was 42% (2.6 g/L versus 6.2 g/L, 20% (23.5 μg/L versus 117.3 μg/L, and 31.3% (1.4 mg/kg versus 4.4 mg/kg of that in the iron supplementation group. The prevalence of anaemia dropped to 15.1% in the control group, with an additional reduction of anaemia of 8.5% in the iron supplementation group. The additional reduction due to iron fortification was 5.4%, which amounts to well over 50% of the impact of supplementation. In conclusion, the efficacy of iron fortification based on reduction of prevalence of anaemia, and on the change in haemoglobin level, is about half of the maximum impact of supplementation in case of optimal compliance. Thus, in a population of anaemic children with mild iron deficiency, iron fortification should be the preferred strategy to combat anaemia.

  10. Dietary supplementation with cysteine prevents adverse metabolic outcomes of repeated cures with paracetamol in old rats.

    Science.gov (United States)

    Mast, Carole; Pourpe, Charlène; Voyard, Guillaume; Rémond, Didier; Migné, Carole; Centeno, Delphine; Dardevet, Dominique; Savary-Auzeloux, Isabelle; Papet, Isabelle

    2017-12-01

    Cysteine (Cys), a conditionally indispensable amino acid, is required for the detoxification of paracetamol (acetaminophen, N-acetyl-para-aminophenol, 4-hydroxy-acetanilide, APAP), a drug of widespread use in older persons. We recently reported that repeated APAP cures could worsen sarcopenia in old rats, likely to be due to the impairment of Cys/GSH homoeostasis. The aim of the study was to evaluate whether a dietary Cys supplementation during APAP cures could improve Cys/GSH homoeostasis and thus preserve skeletal muscle. Male 21·5-month-old Wistar rats received three 2-week-long cures of APAP (1 % of diet) alone or with extra Cys (0·5 % of diet), intercalated with washout periods of 2 weeks (APAP and APAP-Cys groups, respectively). They were compared with untreated control rats (CT group). CT and APAP-Cys groups were pair-fed to the APAP group. Dietary Cys supplementation was efficient to prevent increase in liver mass (P<0·0001), decrease in liver GSH (P<0·0001), increase in blood GSH concentration (P<0·0001), and to some extent, decrease in plasma free Cys concentration (P<0·05), all induced by repeated APAP cures. The addition of Cys to APAP cures decreased plasma alanine transaminase (P<0·05), the fractional synthesis rate of liver proteins (P<0·01), and increased masses of extensor digitorum longus (P<0·01), and soleus (P<0·05), compared with the APAP group. Cys supplementation prevented alteration in Cys/GSH homoeostasis and increased some muscle masses in old rats under repeated cures with a non-toxic dose of APAP.

  11. What Can Healthcare Supply Chains Learn from Consumer-Product Supply Chains?

    OpenAIRE

    Schwarz, Leroy B.

    2008-01-01

    A Framework for Thinking About Supply-Chain Management: “The IDIB Portfolio” (Information, Decision-making, Implementation, Buffer system) Describe Supply-Chains for Consumer Products Before “Wal-Mart” Describe Supply-Chains for Consumer Products After “Wal-Mart” Describe Stylized Supply Chain for Healthcare Products

  12. Birth Order and Child Cognitive Outcomes: An Exploration of the Parental Time Mechanism

    Science.gov (United States)

    Monfardini, Chiara; See, Sarah Grace

    2016-01-01

    Higher birth order positions are associated with poorer outcomes due to smaller shares of resources received within the household. Using a sample of Panel Study of Income Dynamics-Child Development Supplement children, we investigate if the negative birth order effect we find in cognitive outcomes is due to unequal allocation of mother and father…

  13. Placebo in sports nutrition: a proof-of-principle study involving caffeine supplementation.

    Science.gov (United States)

    Saunders, B; de Oliveira, L F; da Silva, R P; de Salles Painelli, V; Gonçalves, L S; Yamaguchi, G; Mutti, T; Maciel, E; Roschel, H; Artioli, G G; Gualano, B

    2017-11-01

    We investigated the effects of supplement identification on exercise performance with caffeine supplementation. Forty-two trained cyclists (age 37 ± 8 years, body mass [BM] 74.3 ± 8.4 kg, height 1.76 ± 0.06 m, maximum oxygen uptake 50.0 ± 6.8 mL/kg/min) performed a ~30 min cycling time-trial 1 h following either 6 mg/kgBM caffeine (CAF) or placebo (PLA) supplementation and one control (CON) session without supplementation. Participants identified which supplement they believed they had ingested ("caffeine", "placebo", "don't know") pre- and post-exercise. Subsequently, participants were allocated to subgroups for analysis according to their identifications. Overall and subgroup analyses were performed using mixed-model and magnitude-based inference analyses. Caffeine improved performance vs PLA and CON (P ≤ 0.001). Correct pre- and post-exercise identification of caffeine in CAF improved exercise performance (+4.8 and +6.5%) vs CON, with slightly greater relative increases than the overall effect of caffeine (+4.1%). Performance was not different between PLA and CON within subgroups (all P > 0.05), although there was a tendency toward improved performance when participants believed they had ingested caffeine post-exercise (P = 0.06; 87% likely beneficial). Participants who correctly identified placebo in PLA showed possible harmful effects on performance compared to CON. Supplement identification appeared to influence exercise outcome and may be a source of bias in sports nutrition. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Prescription Omega-3 Fatty Acid Products and Dietary Supplements Are Not Interchangeable.

    Science.gov (United States)

    Hilleman, Daniel; Smer, Aiman

    2016-01-01

    To provide an overview of prescription and dietary supplement omega-3 fatty acid (OM3-FA) products and considerations for clinical use. Narrative review. The PubMed database was searched for cardiovascular-related investigations focused on eicosapentaenoic acid (EPA) and/or docosahexaenoic acid (DHA) (limit: English-only articles). Additional regulatory information on prescription and dietary supplements was obtained from United States Food and Drug Administration online sources. Prescription QM3-FA products are supported by robust clinical development and safety monitoring programs, whereas dietary supplements are not required to demonstrate safety or efficacy prior to marketing. There are no over-the-counter OM3-FA products available in the United States. Investigations of OM3-FA dietary supplements show that quantities of EPA and DHA are highly variable within and between brands. Dietary supplements also may contain potentially harmful components, including oxidized OM3-FA, other lipids, cholesterol, and toxins. Prescription OM3-FA products may contain DHA and EPA or EPA alone. All prescription OM3-FA products have demonstrated statistically significant triglyceride reduction as monotherapy or in combination with statins in patients with hypertriglyceridemia. Differential effects between products containing EPA and DHA compared with a high-purity EPA product (icosapent ethyl) have clinical implications: Increases in low-density lipoprotein cholesterol associated with DHA have the potential to confound strategies for managing patients with dyslipidemia. Cardiovascular outcomes studies of prescription CM3-FA products are ongoing. OM3-FA dietary supplements should not be substituted for prescription products, and prescription OM3-FA products that contain DHA are not equivalent to or interchangeable with high-purity EPA (icosapent ethyl) and should not be substituted for it.

  15. In-class Active Video Game Supplementation and Adherence to Cardiac Rehabilitation.

    Science.gov (United States)

    Ruivo, Jorge Manuel Arsénio Dos Santos; Karim, Kay; OʼShea, Roisin; Oliveira, Rosa Celeste Santos; Keary, Louis; OʼBrien, Claire; Gormley, John Patrick

    2017-07-01

    The application of active video games (AVGs) during cardiac rehabilitation (CR) sessions could potentially facilitate patient adherence. The feasibility, safety, and efficacy of in-class AVG supplementation as an alternative to conventional phase 2 programs were investigated. A pilot, evaluator-blinded, intention-to-treat, randomized controlled trial recruited 32 low-moderate risk CR participants and allocated them to conventional or AVG-supplemented exercise. Both groups experienced equal exercise loads for 6 weeks. Patients were assessed at baseline, end of the program, and after an 8-week followup. Adherence and safety-related outcomes were the primary endpoints. Secondary outcomes included change in exercise capacity, daily physical activity (PA), energy expenditure (EE), and psychometric profiling. Patients (males 81%; 60 ± 10 years) presented with typical cardiovascular risk factors and similar baseline characteristics. Participants did not perceive an increased risk of injury and were more interactive. At the end of the program, there was a lower tendency for dropping out (6% vs 19%, P > .05), a significant improvement in PA (322 vs 247 arbitrary acceleration units/min, P = .047) and related EE per body weight (13 vs 11 kcal/kg/d, P = .04) among AVG participants compared with controls. No significant differences between groups for adverse medical events, exercise capacity, affect toward exercise, anxiety, depression, or quality-of-life changes were reported. The additional use of AVGs during CR sessions is feasible, safe, and significantly improved daily PA and EE. A dropout reduction trend among its users, which needs to be confirmed in a larger trial, raises awareness to AVG supplementation as a promising strategy to increase CR adherence.

  16. Optimal Design of Magnetic ComponentsinPlasma Cutting Power Supply

    Science.gov (United States)

    Jiang, J. F.; Zhu, B. R.; Zhao, W. N.; Yang, X. J.; Tang, H. J.

    2017-10-01

    Phase-shifted transformer and DC reactor are usually needed in chopper plasma cutting power supply. Because of high power rate, the loss of magnetic components may reach to several kilowatts, which seriously affects the conversion efficiency. Therefore, it is necessary to research and design low loss magnetic components by means of efficient magnetic materials and optimal design methods. The main task in this paper is to compare the core loss of different magnetic material, to analyze the influence of transformer structure, winding arrangement and wire structure on the characteristics of magnetic component. Then another task is to select suitable magnetic material, structure and wire in order to reduce the loss and volume of magnetic components. Based on the above outcome, the optimization design process of transformer and dc reactor are proposed in chopper plasma cutting power supply with a lot of solutions. These solutions are analyzed and compared before the determination of the optimal solution in order to reduce the volume and power loss of the two magnetic components and improve the conversion efficiency of plasma cutting power supply.

  17. Issues in Nutrition: Dietary Supplements.

    Science.gov (United States)

    Thompson, Margaret E; Noel, Mary Barth

    2017-01-01

    The majority of American adults report use of one or more dietary supplements every day or occasionally. The Dietary Supplement Health and Education Act of 1994 defines dietary supplements and regulates their manufacture and distribution. One of the most commonly used supplements is vitamin D. Measurement of serum levels of vitamin D must be undertaken with the caveats that different laboratories define normal levels differently, and that there is rarely a clinical correlation with the actual level. Patients should understand that supplements should not be used to excess, as there are toxicities and other adverse effects associated with most of them. There currently is considerable research being performed on probiotics and how the gut microbiome affects health and disease states. Protein supplements may be useful in reducing mortality rates in elderly patients but they do not appear to increase quality of life. If used, protein supplements should contain essential amino acids. Casein and whey supplements, derived from dairy sources, help transport essential amino acids to tissues. Although there have been many studies investigating the role of vitamin supplements in disease prevention, there have been few conclusive positive results. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  18. Lead in calcium supplements (abstract)

    International Nuclear Information System (INIS)

    Rehman, S.; Khalid, N.

    2011-01-01

    Lead present in calcium supplements is of grave concern as some lead levels have been measured up to the extent of regulatory limit set by the United States. Calcium supplements inevitably get contaminated with lead as both are naturally occurring elements. Therefore, it is imperative to indicate its level in these supplements in order to create awareness among consumers. In this study, a sophisticated analytical technique, atomic absorption spectrometry was used to analyze Pb contents in 27 commonly consumed Ca supplements manufactured by different national and multinational companies. The daily intake of lead through these supplements was calculated. Only 10% of the calcium supplements analyzed met the criteria of acceptable Pb levels (1.5 mu g/daily dose) in supplements/consumer products set by the United States. It was also found that Pb intake was highest in chelated calcium supplements 28.5 mu g/daily dose, whereas lowest 0.47 mu g/daily dose through calcium supplements with vitamin D formulation. In order to validate our results from the study conducted, IAEA-certified reference material (animal bone, H-5) was analyzed for its Pb levels. The levels of Pb determined were quite in good agreement with the certified values. (author)

  19. Physician-Patient Communication about Dietary Supplements

    Science.gov (United States)

    Tarn, Derjung M.; Paterniti, Debora A.; Good, Jeffrey S.; Coulter, Ian D.; Galliher, James M.; Kravitz, Richard L.; Karlamangla, Arun; Wenger, Neil S.

    2013-01-01

    Objective Describe the content and frequency of provider-patient dietary supplement discussions during primary care office visits. Methods Inductive content analysis of 1477 transcribed audio-recorded office visits to 102 primary care providers was combined with patient and provider surveys. Encounters were collected in Los Angeles, California (2009–2010), geographically-diverse practice settings across the United States (2004–2005), and Sacramento, CA (1998–1999). Results Providers discussed 738 dietary supplements during encounters with 357 patients (24.2% of all encounters in the data). They mentioned: 1) reason for taking the supplement for 46.5% of dietary supplements; 2) how to take the supplement for 28.2%; 3) potential risks for 17.3%; 4) supplement effectiveness for 16.7%; and 5) supplement cost or affordability for 4.2%. Of these five topics, a mean of 1.13 (SD=1.2) topics were discussed for each supplement. More topics were reviewed for non-vitamin non-mineral supplements (mean 1.47 (SD=1.2)) than for vitamin/mineral supplements (mean 0.99 (SD=1.1); psupplements are occurring, it is clear that more discussion might be needed to inform patient decisions about supplement use. Practice Implication Physicians could more frequently address topics that may influence patient dietary supplement use, such as the risks, effectiveness, and costs of supplements. PMID:23466249

  20. The role of supply chain collaboration in supply chain risk mitigation

    OpenAIRE

    Chen, Jie

    2017-01-01

    In the last two decades, supply chain operations have changed drastically. Globalization of the market, shortened product life cycle, global outsourcing and offshoring, and increasing complexity of the supply base has resulted in modern supply chains becoming more vulnerable than ever. There are also more frequent natural or man-made disasters which disrupt the supply chain operations. All these have led to higher exposure of risks of supply chains and the failure to manage the...

  1. Promise and problems with supply chain management approaches to health care purchasing.

    Science.gov (United States)

    Ford, Eric W; Scanlon, Dennis P

    2007-01-01

    Double-digit health care inflation, coupled with widespread reports of poor care quality and deadly medical errors, has caused private sector employers to reevaluate their health benefits purchasing strategies, with a focus on supply chain management approaches. In other industries, this strategy has proven to be an effective method for simultaneously reducing costs and increasing quality. This article describes four current applications of supply chain management network methodologies to health care systems and identifies potential ways to improve purchasers' return on investment. In particular, information exchanges, purchase decision, and payment agreement components of integrated supply chains are described. First, visual depictions of the health care supply chain are developed from a purchaser's perspective. Next, five nationwide programs designed to realign incentives and rewards across the health care supply chain are described. Although several nationwide efforts are gaining traction in the marketplace, at this time, no cost reduction and quality improvement program initiative appears to systematically align the entire health care supply chain from providers to purchasers, raising doubt about the ability of supply chain management network techniques to significantly impact the health care marketplace in the short run. Current individual efforts to coordinate the health care supply chain do not act on all of the actors necessary to improve outcomes, promote safety, and control costs. Nevertheless, there are indications that several of the individual efforts are coming together. If national efforts touching on all critical elements can coordinate with purchasers, then the health care supply chain's performance may improve significantly.

  2. The Important Role of Carbohydrates in the Flavor, Function, and Formulation of Oral Nutritional Supplements

    Directory of Open Access Journals (Sweden)

    Smaro Kokkinidou

    2018-06-01

    Full Text Available Patients who are malnourished or at-risk for malnutrition often benefit from the consumption of oral nutritional supplements (ONS. ONS supply a range of micro- and macro-nutrients, and they can be used to supplement a diet or provide total nutrition. Since ONS are specially formulated products, all ONS ingredients—including carbohydrates—are added ingredients. This may seem to be at odds with the growing public health discourse on the need to reduce “added sugars” in the diet. However, carbohydrate is an essential nutrient for human health and is a critical ingredient in ONS. Helping to educate patients on the value of “added sugars” in ONS may be useful to improve compliance with nutritional recommendations when ONS are indicated. This perspective paper reviews the important roles of “added sugars” in ONS, in terms of flavor, function, and product formulation.

  3. Decision Analysis of Advertising and Price for Bilateral Competing Supply Chain

    Directory of Open Access Journals (Sweden)

    Cheng-Tang Zhang

    2013-01-01

    Full Text Available The outcome of centralized equilibrium, prisoner's dilemma equilibrium, and decentralized equilibrium under different decision models has been provided with regards to bilateral competing supply chain system, either side of which is composed of one manufacturer and one retailer. Theoretical analysis indicates a positive correlation between price and one's own advertising investment level and a negative correlation between price and the opponent's advertising investment level. Through analysis of numerical examples, the results reveal a first mover advantage that leads to prisoner's dilemma in the system as well as the impact that price and advertising competition intensity has on the supply chain's choice of decision model.

  4. Scoping Study of Airlift Circulation Technologies for Supplemental Mixing in Pulse Jet Mixed Vessels

    Energy Technology Data Exchange (ETDEWEB)

    Schonewill, Philip P. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Berglin, Eric J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Boeringa, Gregory K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Buchmiller, William C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Burns, Carolyn A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Minette, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-04-07

    At the request of the U.S. Department of Energy Office of River Protection, Pacific Northwest National Laboratory (PNNL) conducted a scoping study to investigate supplemental technologies for supplying vertical fluid motion and enhanced mixing in Waste Treatment and Immobilization Plant (WTP) vessels designed for high solids processing. The study assumed that the pulse jet mixers adequately mix and shear the bottom portion of a vessel. Given that, the primary function of a supplemental technology should be to provide mixing and shearing in the upper region of a vessel. The objective of the study was to recommend a mixing technology and configuration that could be implemented in the 8-ft test vessel located at Mid-Columbia Engineering (MCE). Several mixing technologies, primarily airlift circulator (ALC) systems, were evaluated in the study. This technical report contains a review of ALC technologies, a description of the PNNL testing and accompanying results, and recommended features of an ALC system for further study.

  5. Nutritional Supplements for Strength Power Athletes

    Science.gov (United States)

    Wilborn, Colin

    Over the last decade research involving nutritional supplementation and sport performance has increased substantially. Strength and power athletes have specific needs to optimize their performance. Nutritional supplementation cannot be viewed as a replacement for a balanced diet but as an important addition to it. However, diet and supplementation are not mutually exclusive, nor does one depend on the other. Strength and power athletes have four general areas of supplementation needs. First, strength athletes need supplements that have a direct effect on performance. The second group of supplements includes those that promote recovery. The third group comprises the supplements that enhance immune function. The last group of supplements includes those that provide energy or have a direct effect on the workout. This chapter reviews the key supplements needed to optimize the performance and training of the strength athlete.

  6. Design of Supply Chain Networks with Supply Disruptions using Genetic Algorithm

    OpenAIRE

    Taha, Raghda; Abdallah, Khaled; Sadek, Yomma; El-Kharbotly, Amin; Afia, Nahid

    2014-01-01

    The design of supply chain networks subject to disruptions is tackled. A genetic algorithm with the objective of minimizing the design cost and regret cost is developed to achieve a reliable supply chain network. The improvement of supply chain network reliability is measured against the supply chain cost.

  7. Black grape extract supplementation attenuates blood oxidative stress in response to acute exercise

    Directory of Open Access Journals (Sweden)

    A Skarpańska-Stejnborn

    2010-03-01

    Full Text Available The flavonoid-rich active compound in grapes is claimed to be one of the most important natural products. Hence, the objective of our research was to study parameters of the prooxidative-antioxidative balance in athletes supplied with Panace-Vid 2000® preparation consisting of black wine grape extract (Vitis vinifera. The study was carried out on 22 male rowers. The subjects from the supplemented group (n=10 were given one gelatin capsule containing Panace-Vid 2000® three times a day, for six weeks, while the control group (n=12 was given placebo. Before and after the supplementation period, the athletes performed a physical exercise test on the rowing ergometer; varying between 40 and 90% of maximal aerobic power. Each 3-min exercise session was followed by thirty seconds of rest. Blood was sampled from the rowers before the exercise test, one minute after its completion, and after a 24-h recovery period. The activity of antioxidative enzymes (superoxide dismutase, glutathione peroxidase was determined and the concentration of thiobarbituric acid-reactive substances was measured in the hemolysate of red blood cells. The Total Antioxidant Capacity was determined in the blood plasma. The concentration of lactic acid was measured in the whole blood. An analysis of the results revealed that the supply of grape extract, in the form of Panace-Vid 2000® preparation, contributed to a significant increase in plasma antioxidative capacity and to an insignificant increase in superoxide dismutase, as well as a lower activity of glutathione peroxidase and reduced concentration of lipid peroxidation product levels.

  8. Impact of supplemental instruction leader on the success of supplemental instruction model

    Science.gov (United States)

    Mahabaduge, Hasitha; Haslam, Jeanne

    Supplemental instruction utilizes peer-assisted study sessions to provide review sessions on course material and an opportunity to discuss and work out problems. The impact of supplemental instruction on student performance is well researched and used in a large number of universities around the world due to its proven success. However, the impact of the student leader who plays a significant role in this model is rarely discussed in the literature. We present a case study on the impact of student leader on the success of supplemental instruction model. This case study was done for an Introductory Physics course correlating student performance and the supplemental instruction sessions they attended. Further analysis revealed that the academic performance and work ethics of the student leader has a significant impact on the success of the supplemental instruction model. Important factors to consider when selecting a student leader, the challenges and possible remedies will also be discussed.

  9. Selenium supplementation in thyroid associated ophthalmopathy:an update

    Directory of Open Access Journals (Sweden)

    Aruna Dharmasena

    2014-04-01

    Full Text Available The therapeutic effect of selenium (Se has already been proven in thyroid disease and thyroid associated ophthalmopathy (TAO. In spite of clear scientific proof of its benefits in TAO, there appears to be no clear agreement among the clinicians regarding its optimum dose, duration of the treatment, efficacy and safety to date. In this review, the author summarises the findings of 135 English language articles published on this subject over the past four decades from 1973 to 2013. The regulation and metabolism of thyroid hormones require a steady supply of Se and recent studies have revealedseveral possible mechanisms by which Se improves the severity of thyroid disease and TAO. These mechanisms include 1 inhibitory effect of HLA-DR molecule expression on thyrocytes; 2 profound reductions of thyroid stimulating hormone (TSH receptor antibodies (TSHR-Ab and TPO antibodies (TPO-Ab; 3 prevention of dysregulation of cell-mediated immunity and B cell function; 4 neutralising reactive oxygen species (ROS and inhibition of redox control processes required for the activation, differentiation and action of lymphocytes, macrophages, neutrophils, natural killer cells involved in both acute and chronic orbital inflammation in TAO; 5 inhibition of expression of pro-inflammatory cytokines and 6 inhibition of prostaglandin and leukotriene synthesis. An increased oxidative stress has been observed in both acute and chronic phases of thyroid disease with raised tissue concentrations of ROS. The benefits of Se supplementation in individuals with TAO appear to be proportionate to the degree of systemic activity of the thyroid disease. The maximal benefit of Se supplementation is therefore seen in the subjects who are hyperthyroid. Restoration of euthyroidism is one of the main goals in the management of TAO and when anti-thyroid drugs are combined with Se, the patients with Graves’ disease (GD and autoimmune thyroiditis (AIT achieved euthyroidism faster than

  10. Perioperative Testosterone Supplementation Increases Lean Mass in Healthy Men Undergoing Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial.

    Science.gov (United States)

    Wu, Brian; Lorezanza, Dan; Badash, Ido; Berger, Max; Lane, Christianne; Sum, Jonathan C; Hatch, George F; Schroeder, E Todd

    2017-08-01

    Rehabilitation after repair of the anterior cruciate ligament (ACL) is complicated by the loss of leg muscle mass and strength. Prior studies have shown that preoperative rehabilitation may improve muscle strength and postoperative outcomes. Testosterone supplementation may likewise counteract this muscle loss and potentially improve clinical outcomes. The purpose was to investigate the effect of perioperative testosterone administration on lean mass after ACL reconstruction in men and to examine the effects of testosterone on leg strength and clinical outcome scores. It was hypothesized that testosterone would increase lean mass and leg strength and improve clinical outcome scores relative to placebo. Randomized controlled trial; Level of evidence, 1. Male patients (N = 13) scheduled for ACL reconstruction were randomized into 2 groups: testosterone and placebo. Participants in the testosterone group received 200 mg of intramuscular testosterone weekly for 8 weeks beginning 2 weeks before surgery. Participants in the placebo group received saline following the same schedule. Both groups participated in a standard rehabilitation protocol. The primary outcome was the change in total lean body mass at 6 and 12 weeks. Secondary outcomes were extensor muscle strength, Tegner activity score, and Knee injury and Osteoarthritis Outcome Score. There was an increase in lean mass of a mean 2.7 ± 1.7 kg at 6 weeks postoperatively in the testosterone group compared with a decrease of a mean 0.1 ± 1.5 kg in the placebo group ( P = .01). Extensor muscle strength of the uninjured leg also increased more from baseline in the testosterone group (+20.8 ± 25.6 Nm) compared with the placebo group (-21.4 ± 36.7 Nm) at 12 weeks ( P = .04). There were no significant between-group differences in injured leg strength or clinical outcome scores. There were no negative side effects of testosterone noted. Perioperative testosterone supplementation increased lean mass 6 weeks after ACL

  11. Gender-Associated Impact of Early Leucine Supplementation on Adult Predisposition to Obesity in Rats

    Directory of Open Access Journals (Sweden)

    Nora López

    2018-01-01

    Full Text Available Early nutrition plays an important role in development and may constitute a relevant contributor to the onset of obesity in adulthood. The aim of this study was to evaluate the long-term impact of maternal leucine (Leu supplementation during lactation on progeny in rats. A chow diet, supplemented with 2% Leu, was supplied during lactation (21 days and, from weaning onwards, was replaced by a standard chow diet. Then, at adulthood (6 months of age, this was replaced with hypercaloric diets (either with high-fat (HF or high-carbohydrate (HC content, for two months, to induce obesity. Female offspring from Leu-supplemented dams showed higher increases in body weight and in body fat (62% than their respective controls; whereas males were somehow protected (15% less fat than the corresponding controls. This profile in Leu-females was associated with altered neuronal architecture at the paraventricular nucleus (PVN, involving neuropeptide Y (NPY fibers and impaired expression of neuropeptides and factors of the mTOR signaling pathway in the hypothalamus. Interestingly, leptin and adiponectin expression in adipose tissue at weaning and at the time before the onset of obesity could be defined as early biomarkers of metabolic disturbance, predisposing towards adult obesity under the appropriate environment.

  12. Gender-Associated Impact of Early Leucine Supplementation on Adult Predisposition to Obesity in Rats

    Science.gov (United States)

    López, Nora; Sánchez, Juana; Palou, Andreu; Serra, Francisca

    2018-01-01

    Early nutrition plays an important role in development and may constitute a relevant contributor to the onset of obesity in adulthood. The aim of this study was to evaluate the long-term impact of maternal leucine (Leu) supplementation during lactation on progeny in rats. A chow diet, supplemented with 2% Leu, was supplied during lactation (21 days) and, from weaning onwards, was replaced by a standard chow diet. Then, at adulthood (6 months of age), this was replaced with hypercaloric diets (either with high-fat (HF) or high-carbohydrate (HC) content), for two months, to induce obesity. Female offspring from Leu-supplemented dams showed higher increases in body weight and in body fat (62%) than their respective controls; whereas males were somehow protected (15% less fat than the corresponding controls). This profile in Leu-females was associated with altered neuronal architecture at the paraventricular nucleus (PVN), involving neuropeptide Y (NPY) fibers and impaired expression of neuropeptides and factors of the mTOR signaling pathway in the hypothalamus. Interestingly, leptin and adiponectin expression in adipose tissue at weaning and at the time before the onset of obesity could be defined as early biomarkers of metabolic disturbance, predisposing towards adult obesity under the appropriate environment. PMID:29329236

  13. Effect of intermittent glutamine supplementation on skeletal muscle is not long-lasting in very old rats.

    Science.gov (United States)

    Meynial-Denis, D; Beaufrère, A-M; Mignon, M; Patureau Mirand, P

    2013-01-01

    Muscle is the major site for glutamine synthesis via glutamine synthetase (GS). This enzyme is increased 1.5-2 fold in 25-27-mo rats and may be a consequence of aging-induced stress. This stimulation is similar to the induction observed following a catabolic state such as glucocorticoid treatment (6 to 24 months). Although oral glutamine supply regulates the plasma glutamine level, nothing is known if this supplementation is interrupted before the experiment. Adult (8-mo) and very old (27-mo) female rats were exposed to intermittent glutamine supplementation for 50 % of their age lifetime. Treated rats received glutamine added to their drinking water and control rats water alone but the effect of glutamine supplementation was only studied 15 days after the last supplementation. Glutamine pretreatment discontinued 15 days before the experiment increased plasma glutamine to ~ 0.6 mM, a normal value in very old rats. However, it failed to decrease the up-regulated GS activity in skeletal muscle from very old rats. Our results suggest that long-term treatment with glutamine started before advanced age but discontinued 15 days before rat sacrifice is effective in increasing plasma glutamine to recover basal adult value and in maintaining plasma glutamine in very old rats, but has no long-lasting effect on the GS activity of skeletal muscle with advanced age.

  14. Recent developments in uranium resources and supply. Proceedings of a technical committee meeting held in Vienna, 24-28 May 1993

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    In recent years substantial uncertainties regarding uranium supply have made it very difficult for both uranium producers and users to plan for the future. In 1992 uranium production met only about 63 percent of reactor requirements. This resulted in a very unstable supply/demand balance where inventory drawdown (supplemented by minor amounts of reprocessing) filled the 20,960 tonne shortfall. The IAEA convened this Technical Committee meeting to take advantage of the new opportunities to collect and analyse information related to the future supply and demand balance and to help reduce uncertainties regarding the relationship. The meeting was effective in bringing together experts from all regions to share, exchange and disseminate information regarding uranium related activities. This meeting on Recent Developments in Uranium Resources and Supply was held in Vienna from 24 to 26 May 1993. It was attended by 47 participants from 23 countries. Twenty-one papers were presented. Contributions from China, the Czech Republic, India, Kazakhstan, Mongolia, Romania and the Russian Federation represent new information in this field. Refs, figs and tabs.

  15. Oral iron supplements for children in malaria-endemic areas

    Science.gov (United States)

    Neuberger, Ami; Okebe, Joseph; Yahav, Dafna; Paul, Mical

    2016-01-01

    Background Iron-deficiency anaemia is common during childhood. Iron administration has been claimed to increase the risk of malaria. Objectives To evaluate the effects and safety of iron supplementation, with or without folic acid, in children living in areas with hyperendemic or holoendemic malaria transmission. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library, MEDLINE (up to August 2015) and LILACS (up to February 2015). We also checked the metaRegister of Controlled Trials (mRCT) and World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) up to February 2015. We contacted the primary investigators of all included trials, ongoing trials, and those awaiting assessment to ask for unpublished data and further trials. We scanned references of included trials, pertinent reviews, and previous meta-analyses for additional references. Selection criteria We included individually randomized controlled trials (RCTs) and cluster RCTs conducted in hyperendemic and holoendemic malaria regions or that reported on any malaria-related outcomes that included children younger than 18 years of age. We included trials that compared orally administered iron, iron with folic acid, and iron with antimalarial treatment versus placebo or no treatment. We included trials of iron supplementation or fortification interventions if they provided at least 80% of the Recommended Dietary Allowance (RDA) for prevention of anaemia by age. Antihelminthics could be administered to either group, and micronutrients had to be administered equally to both groups. Data collection and analysis The primary outcomes were clinical malaria, severe malaria, and death from any cause. We assessed the risk of bias in included trials with domain-based evaluation and assessed the quality of the evidence using the Grading of Recommendations Assessment

  16. Role of Diet and Nutritional Supplements in Parkinson’s Disease Progression

    Directory of Open Access Journals (Sweden)

    Laurie K. Mischley

    2017-01-01

    Full Text Available Objectives. The goal of this study is to describe modifiable lifestyle variables associated with reduced rate of Parkinson’s disease (PD progression. Methods. The patient-reported outcomes in PD (PRO-PD were used as the primary outcome measure, and a food frequency questionnaire (FFQ was used to assess dietary intake. In this cross-sectional analysis, regression analysis was performed on baseline data to identify the nutritional and pharmacological interventions associated with the rate of PD progression. All analyses were adjusted for age, gender, and years since diagnosis. Results. 1053 individuals with self-reported idiopathic PD were available for analysis. Foods associated with the reduced rate of PD progression included fresh vegetables, fresh fruit, nuts and seeds, nonfried fish, olive oil, wine, coconut oil, fresh herbs, and spices (P<0.05. Foods associated with more rapid PD progression include canned fruits and vegetables, diet and nondiet soda, fried foods, beef, ice cream, yogurt, and cheese (P<0.05. Nutritional supplements coenzyme Q10 and fish oil were associated with reduced PD progression (P=0.026 and P=0.019, resp., and iron supplementation was associated with faster progression (P=0.022. Discussion. These are the first data to provide evidence that targeted nutrition is associated with the rate of PD progression.

  17. Developmental Outcomes at 24 Months of Age in Toddlers Supplemented with Arachidonic Acid and Docosahexaenoic Acid: Results of a Double Blind Randomized, Controlled Trial

    Science.gov (United States)

    Devlin, Angela M.; Chau, Cecil M. Y.; Matheson, Julie; McCarthy, Deanna; Yurko-Mauro, Karin; Innis, Sheila M.; Grunau, Ruth E.

    2017-01-01

    Little is known about arachidonic acid (ARA) and docosahexaenoic acid (DHA) requirements in toddlers. A longitudinal, double blind, controlled trial in toddlers (n = 133) age 13.4 ± 0.9 months (mean ± standard deviation), randomized to receive a DHA (200 mg/day) and ARA (200 mg/day) supplement (supplement) or a corn oil supplement (control) until age 24 months determined effects on neurodevelopment. We found no effect of the supplement on the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III) cognitive and language composites and Beery–Buktenica Developmental Test of Visual–Motor Integration (Beery VMI) at age 24 months. Supplemented toddlers had higher RBC phosphatidylcholine (PC), phosphatidylethanolamine (PE), and plasma DHA and ARA compared to placebo toddlers at age 24 months. A positive relationship between RBC PE ARA and Bayley III Cognitive composite (4.55 (0.21–9.00), B (95% CI), p = 0.045) in supplemented boys, but not in control boys, was observed in models adjusted for baseline fatty acid, maternal non-verbal intelligence, and BMI z-score at age 24 months. A similar positive relationship between RBC PE ARA and Bayley III Language composite was observed for supplemented boys (11.52 (5.10–17.94), p < 0.001) and girls (11.19 (4.69–17.68), p = 0.001). These findings suggest that increasing the ARA status in toddlers is associated with better neurodevelopment at age 24 months. PMID:28878181

  18. Developmental Outcomes at 24 Months of Age in Toddlers Supplemented with Arachidonic Acid and Docosahexaenoic Acid: Results of a Double Blind Randomized, Controlled Trial

    Directory of Open Access Journals (Sweden)

    Angela M. Devlin

    2017-09-01

    Full Text Available Little is known about arachidonic acid (ARA and docosahexaenoic acid (DHA requirements in toddlers. A longitudinal, double blind, controlled trial in toddlers (n = 133 age 13.4 ± 0.9 months (mean ± standard deviation, randomized to receive a DHA (200 mg/day and ARA (200 mg/day supplement (supplement or a corn oil supplement (control until age 24 months determined effects on neurodevelopment. We found no effect of the supplement on the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III cognitive and language composites and Beery–Buktenica Developmental Test of Visual–Motor Integration (Beery VMI at age 24 months. Supplemented toddlers had higher RBC phosphatidylcholine (PC, phosphatidylethanolamine (PE, and plasma DHA and ARA compared to placebo toddlers at age 24 months. A positive relationship between RBC PE ARA and Bayley III Cognitive composite (4.55 (0.21–9.00, B (95% CI, p = 0.045 in supplemented boys, but not in control boys, was observed in models adjusted for baseline fatty acid, maternal non-verbal intelligence, and BMI z-score at age 24 months. A similar positive relationship between RBC PE ARA and Bayley III Language composite was observed for supplemented boys (11.52 (5.10–17.94, p < 0.001 and girls (11.19 (4.69–17.68, p = 0.001. These findings suggest that increasing the ARA status in toddlers is associated with better neurodevelopment at age 24 months.

  19. Contract Coordination in Dual Sourcing Supply Chain under Supply Disruption Risk

    Directory of Open Access Journals (Sweden)

    Tong Shu

    2015-01-01

    Full Text Available This paper explores a coordination model for a three-echelon supply chain including two different manufacturers, one distributer and one retailer via the combined option and back contracts. And one manufacturer provides the high wholesale price with low supply disruption risk and the other is completely the opposite. This differs from the previous supply chain coordination model. Firstly, supply disruption is added to the three-echelon supply chain. Secondly, considering the coordination of the supply chain, we deploy the combined option and back contracts which are seldom used in the previous study. Furthermore, it is interesting that supply disruption risk and buyback factor do not affect the distributor’s order quantity from the manufacturer who has low product price and unreliable operating ability, while the order quantity increases with the rise of option premium and option strike price. The distributor’s order quantity from the manufacturer, which has high product price and reliable operating ability, increases with the rise of supply disruption risk but decreases when the buyback factor, option premium, and option strike price decrease.

  20. Fast screening and quantitation of microcystins in microalgae dietary supplement products and water by liquid chromatography coupled to time of flight mass spectrometry

    International Nuclear Information System (INIS)

    Ortelli, Didier; Edder, Patrick; Cognard, Emmanuelle; Jan, Philippe

    2008-01-01

    Cyanobacteria, commonly called 'blue-green algae', may accumulate in surface water supplies as 'blooms' and may concentrate on the surface as blue-green 'scums'. Some species of cyanobacteria produce toxins and are of relevance to water supplies and to microalgae dietary supplements. To ensure the safety of drinking water and blue-green algae products, analyses are the only way to determine the presence or absence of toxins. This paper shows the use of ultra performance liquid chromatography (UPLC) coupled to orthogonal acceleration time of flight (TOF) mass spectrometry for the detection and quantitation of microcystins. The method presented is very sensitive, simple, fast, robust and did not require fastidious clean-up step. Limits of detection of 0.1 μg L -1 in water and 0.1-0.2 μg g -1 in microalgae samples were achieved. Method performances were satisfactory and appropriate for monitoring of water and dietary supplements. The method was applied in routine to samples taken from Swiss market or buy on internet website. Among 19 samples, six showed the presence of microcystins LR and LA at harmful levels

  1. U-shaped curve for risk associated with maternal hemoglobin, iron status, or iron supplementation.

    Science.gov (United States)

    Dewey, Kathryn G; Oaks, Brietta M

    2017-12-01

    Both iron deficiency (ID) and excess can lead to impaired health status. There is substantial evidence of a U-shaped curve between the risk of adverse birth outcomes and maternal hemoglobin concentrations during pregnancy; however, it is unclear whether those relations are attributable to conditions of low and high iron status or to other mechanisms. We summarized current evidence from human studies regarding the association between birth outcomes and maternal hemoglobin concentrations or iron status. We also reviewed effects of iron supplementation on birth outcomes among women at low risk of ID and the potential mechanisms for adverse effects of high iron status during pregnancy. Overall, we confirmed a U-shaped curve for the risk of adverse birth outcomes with maternal hemoglobin concentrations, but the relations differ by trimester. For low hemoglobin concentrations, the link with adverse outcomes is more evident when hemoglobin concentrations are measured in early pregnancy. These relations generally became weaker or nonexistent when hemoglobin concentrations are measured in the second or third trimesters. Associations between high hemoglobin concentration and adverse birth outcomes are evident in all 3 trimesters but evidence is mixed. There is less evidence for the associations between maternal iron status and adverse birth outcomes. Most studies used serum ferritin (SF) concentrations as the indicator of iron status, which makes the interpretation of results challenging because SF concentrations increase in response to inflammation or infection. The effect of iron supplementation during pregnancy may depend on initial iron status. There are several mechanisms through which high iron status during pregnancy may have adverse effects on birth outcomes, including oxidative stress, increased blood viscosity, and impaired systemic response to inflammation and infection. Research is needed to understand the biological processes that underlie the U-shaped curves

  2. Intestinal microbiota and immune related genes in sea cucumber (Apostichopus japonicus) response to dietary β-glucan supplementation

    International Nuclear Information System (INIS)

    Yang, Gang; Xu, Zhenjiang; Tian, Xiangli; Dong, Shuanglin; Peng, Mo

    2015-01-01

    β-glucan is a prebiotic well known for its beneficial outcomes on sea cucumber health through modifying the host intestinal microbiota. High-throughput sequencing techniques provide an opportunity for the identification and characterization of microbes. In this study, we investigated the intestinal microbial community composition, interaction among species, and intestinal immune genes in sea cucumber fed with diet supplemented with or without β-glucan supplementation. The results show that the intestinal dominant classes in the control group are Flavobacteriia, Gammaproteobacteria, and Alphaproteobacteria, whereas Alphaproteobacteria, Flavobacteriia, and Verrucomicrobiae are enriched in the β-glucan group. Dietary β-glucan supplementation promoted the proliferation of the family Rhodobacteraceae of the Alphaproteobacteria class and the family Verrucomicrobiaceae of the Verrucomicrobiae class and reduced the relative abundance of the family Flavobacteriaceae of Flavobacteria class. The ecological network analysis suggests that dietary β-glucan supplementation can alter the network interactions among different microbial functional groups by changing the microbial community composition and topological roles of the OTUs in the ecological network. Dietary β-glucan supplementation has a positive impact on immune responses of the intestine of sea cucumber by activating NF-κB signaling pathway, probably through modulating the balance of intestinal microbiota. - Highlights: • Dietary β-glucan supplementation increases the abundance of Rhodobacteraceae and Verrucomicrobiaceae in the intestine. • Dietary β-glucan supplementation changes the topological roles of OTUs in the ecological network. • Dietary β-glucan supplementation has a positive impact on the immune response of intestine of sea cucumber

  3. Intestinal microbiota and immune related genes in sea cucumber (Apostichopus japonicus) response to dietary β-glucan supplementation

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Gang [The Key Laboratory of Mariculture, Ministry of Education, Fisheries College, Ocean University of China (China); Xu, Zhenjiang [Biofrontiers Institute, University of Colorado, Boulder, CO (United States); Tian, Xiangli, E-mail: xianglitian@ouc.edu.cn [The Key Laboratory of Mariculture, Ministry of Education, Fisheries College, Ocean University of China (China); Dong, Shuanglin [The Key Laboratory of Mariculture, Ministry of Education, Fisheries College, Ocean University of China (China); Peng, Mo [School of Animal Science and Technology, Jiangxi Agricultural University (China)

    2015-02-27

    β-glucan is a prebiotic well known for its beneficial outcomes on sea cucumber health through modifying the host intestinal microbiota. High-throughput sequencing techniques provide an opportunity for the identification and characterization of microbes. In this study, we investigated the intestinal microbial community composition, interaction among species, and intestinal immune genes in sea cucumber fed with diet supplemented with or without β-glucan supplementation. The results show that the intestinal dominant classes in the control group are Flavobacteriia, Gammaproteobacteria, and Alphaproteobacteria, whereas Alphaproteobacteria, Flavobacteriia, and Verrucomicrobiae are enriched in the β-glucan group. Dietary β-glucan supplementation promoted the proliferation of the family Rhodobacteraceae of the Alphaproteobacteria class and the family Verrucomicrobiaceae of the Verrucomicrobiae class and reduced the relative abundance of the family Flavobacteriaceae of Flavobacteria class. The ecological network analysis suggests that dietary β-glucan supplementation can alter the network interactions among different microbial functional groups by changing the microbial community composition and topological roles of the OTUs in the ecological network. Dietary β-glucan supplementation has a positive impact on immune responses of the intestine of sea cucumber by activating NF-κB signaling pathway, probably through modulating the balance of intestinal microbiota. - Highlights: • Dietary β-glucan supplementation increases the abundance of Rhodobacteraceae and Verrucomicrobiaceae in the intestine. • Dietary β-glucan supplementation changes the topological roles of OTUs in the ecological network. • Dietary β-glucan supplementation has a positive impact on the immune response of intestine of sea cucumber.

  4. The Effect of Carnitine Supplementation on Hyperammonemia and Carnitine Deficiency Treated with Valproic Acid in a Psychiatric Setting

    OpenAIRE

    Nakamura, Masaru; Nagamine, Takahiko

    2015-01-01

    Objective: The aim of this study was to investigate the effect of levocarnitine (active isoform of carnitine, L-Carnitine) supplementation on serum ammonia and carnitine levels simultaneously, and their clinical outcomes in valproic acid-treated psychiatric subjects.

  5. Using alfalfa leaf meal as a supplement in late-gestation beef heifer and nursing beef calf diets.

    Science.gov (United States)

    Zehnder, C M; Maddock, T D; DiCostanzo, A; Miller, L R; Hall, J M; Lamb, G C

    2010-06-01

    Two experiments were conducted to investigate using alfalfa leaf meal (ALM; 22% CP, DM basis) in beef cattle diets. In Exp. 1, a total of 24 late-gestation Angus heifers (initial BW 470 +/- 9 kg) were blocked by BW, calving date, and BCS to 1 of 4 dietary treatments in a randomized complete block design. All heifers were offered a basal hay diet (7.4% CP and 67.6% NDF, DM basis). Treatments were arranged as a 2 x 2 factorial consisting of CP supplied at 100 or 112.5% of the recommended daily intake using either soybean meal (SBM) or ALM as the supplemental protein source. Treatments were fed for an average of 100 d before calving. Total DMI was unaffected by supplemental protein source, although heifers consumed more (P Feeding 112.5% of recommended CP to heifers increased precalving rate of BW gain (P = 0.004) and DM digestibility (P = 0.003). Protein source did not affect DM digestibility (P = 0.17). Neither supplemental protein source nor protein amount affected changes in BCS or calving traits. In Exp. 2, replicates of treatments were conducted over 2 consecutive years at 2 locations in northern Minnesota to determine the effects of including ALM in creep-fed supplements on nursing calf performance, supplement BW gain efficiency (GF; BW gain over control/supplement intake), and cow performance. Treatments were control (no supplement), ALM supplement (58% ALM, as-fed basis), or a wheat middling- and soybean hull-based supplement (MIDD). Milk intake (estimated by the weigh-suckle-weigh technique) was similar among treatments. Creep-fed calves had greater (P creep feed DMI than those offered ALM (2.6 vs. 1.3 kg/d, respectively). A year x treatment interaction was noted for GF (P = 0.02). In yr 1, GF for calves offered ALM was greater (P = 0.006) than GF for calves offered MIDD, but in yr 2, there were no differences. Alfalfa leaf meal may substitute for SBM in beef heifer wintering diets and conventional creep feed ingredients. When included in creep feed diets

  6. Supplemental parenteral nutrition in critically ill patients: a study protocol for a phase II randomised controlled trial.

    Science.gov (United States)

    Ridley, Emma J; Davies, Andrew R; Parke, Rachael; Bailey, Michael; McArthur, Colin; Gillanders, Lyn; Cooper, David J; McGuinness, Shay

    2015-12-24

    Nutrition is one of the fundamentals of care provided to critically ill adults. The volume of enteral nutrition received, however, is often much less than prescribed due to multiple functional and process issues. To deliver the prescribed volume and correct the energy deficit associated with enteral nutrition alone, parenteral nutrition can be used in combination (termed "supplemental parenteral nutrition"), but benefits of this method have not been firmly established. A multi-centre, randomised, clinical trial is currently underway to determine if prescribed energy requirements can be provided to critically ill patients by using a supplemental parenteral nutrition strategy in the critically ill. This prospective, multi-centre, randomised, stratified, parallel-group, controlled, phase II trial aims to determine whether a supplemental parenteral nutrition strategy will reliably and safely increase energy intake when compared to usual care. The study will be conducted for 100 critically ill adults with at least one organ system failure and evidence of insufficient enteral intake from six intensive care units in Australia and New Zealand. Enrolled patients will be allocated to either a supplemental parenteral nutrition strategy for 7 days post randomisation or to usual care with enteral nutrition. The primary outcome will be the average energy amount delivered from nutrition therapy over the first 7 days of the study period. Secondary outcomes include protein delivery for 7 days post randomisation; total energy and protein delivery, antibiotic use and organ failure rates (up to 28 days); duration of ventilation, length of intensive care unit and hospital stay. At both intensive care unit and hospital discharge strength and health-related quality of life assessments will be undertaken. Study participants will be followed up for health-related quality of life, resource utilisation and survival at 90 and 180 days post randomisation (unless death occurs first). This trial

  7. Supplementation with a recombinant human chorionic gonadotropin microdose leads to similar outcomes in ovarian stimulation with recombinant follicle-stimulating hormone using either a gonadotropin-releasing hormone agonist or antagonist for pituitary suppression.

    Science.gov (United States)

    Cavagna, Mario; Maldonado, Luiz Guilherme Louzada; de Souza Bonetti, Tatiana Carvalho; de Almeida Ferreira Braga, Daniela Paes; Iaconelli, Assumpto; Borges, Edson

    2010-06-01

    To compare the outcomes of protocols for ovarian stimulation with recombinant hCG microdose, with GnRH agonists and antagonists for pituitary suppression. Prospective nonrandomized clinical trial. A private assisted reproduction center. We studied 182 patients undergoing intracytoplasmic sperm injection (ICSI) cycles, allocated into two groups: GnRH agonist group, in which patients received a GnRH agonist (n = 73), and a GnRH antagonist group, in which patients were administered a GnRH antagonist for pituitary suppression (n = 109). Pituitary suppression with GnRH agonist or GnRH antagonist. Ovarian stimulation carried out with recombinant FSH and supplemented with recombinant hCG microdose. Total dose of recombinant FSH and recombinant hCG administered; E(2) concentrations and endometrial width on the day of hCG trigger; number of follicles aspirated, oocytes and mature oocytes retrieved; fertilization, pregnancy (PR), implantation, and miscarriage rates. The total dose of recombinant FSH and recombinant hCG administered were similar between groups, as were the E(2) concentrations and endometrial width. The number of follicles aspirated, oocytes, and metaphase II oocytes collected were also comparable. There were no statistically significant differences in fertilization, PR, implantation, and miscarriage rates in the GnRH agonist and GnRH antagonist groups. When using recombinant hCG microdose supplementation for controlled ovarian stimulation (COS), there are no differences in laboratory or clinical outcomes with the use of either GnRH antagonist or agonist for pituitary suppression. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Dual Competing Photovoltaic Supply Chains: A Social Welfare Maximization Perspective

    Science.gov (United States)

    Su, Shong-Iee Ivan

    2017-01-01

    In the past decades, the inappropriate subsidy policies in many nations have caused problems such as serious oversupply, fierce competition and subpar social welfare in the photovoltaic (PV) industry in many nations. There is a clear shortage in the PV industry literature regarding how dual supply chains compete and the key decision issues regarding the competition between dual PV supply chains. It is critical to develop effective subsidy policies for the competing PV supply chains to achieve social welfare maximization. This study has explored the dual PV supply chain competition under the Bertrand competition assumption by three game-theoretical modeling scenarios (or supply chain strategies) considering either the public subsidy or no subsidy from a social welfare maximization perspective. A numerical analysis complemented by two sensitivity analyses provides a better understanding of the pricing and quantity decision dynamics in the dual supply chains under three different supply chain strategies and the corresponding outcomes regarding the total supply chain profits, the social welfare and the required total subsidies. The key findings disclose that if there are public subsidies, the dual PV supply chains have the strongest intention to pursue the decentralized strategy to achieve their maximal returns rather than the centralized strategy that would achieve the maximal social welfare; however, the government would need to pay for the maximal subsidy budget. Thus, the best option for the government would be to encourage the dual PV supply chains to adopt a centralized strategy since this will not only maximize the social welfare but also, at the same time, minimize the public subsidy. With a smart subsidy policy, the PV industry can make the best use of the subsidy budget and grow in a sustainable way to support the highly demanded solar power generation in many countries trying very hard to increase the proportion of their clean energy to combat the global

  9. Dual Competing Photovoltaic Supply Chains: A Social Welfare Maximization Perspective

    Directory of Open Access Journals (Sweden)

    Zhisong Chen

    2017-11-01

    Full Text Available In the past decades, the inappropriate subsidy policies in many nations have caused problems such as serious oversupply, fierce competition and subpar social welfare in the photovoltaic (PV industry in many nations. There is a clear shortage in the PV industry literature regarding how dual supply chains compete and the key decision issues regarding the competition between dual PV supply chains. It is critical to develop effective subsidy policies for the competing PV supply chains to achieve social welfare maximization. This study has explored the dual PV supply chain competition under the Bertrand competition assumption by three game-theoretical modeling scenarios (or supply chain strategies considering either the public subsidy or no subsidy from a social welfare maximization perspective. A numerical analysis complemented by two sensitivity analyses provides a better understanding of the pricing and quantity decision dynamics in the dual supply chains under three different supply chain strategies and the corresponding outcomes regarding the total supply chain profits, the social welfare and the required total subsidies. The key findings disclose that if there are public subsidies, the dual PV supply chains have the strongest intention to pursue the decentralized strategy to achieve their maximal returns rather than the centralized strategy that would achieve the maximal social welfare; however, the government would need to pay for the maximal subsidy budget. Thus, the best option for the government would be to encourage the dual PV supply chains to adopt a centralized strategy since this will not only maximize the social welfare but also, at the same time, minimize the public subsidy. With a smart subsidy policy, the PV industry can make the best use of the subsidy budget and grow in a sustainable way to support the highly demanded solar power generation in many countries trying very hard to increase the proportion of their clean energy to

  10. Dual Competing Photovoltaic Supply Chains: A Social Welfare Maximization Perspective.

    Science.gov (United States)

    Chen, Zhisong; Su, Shong-Iee Ivan

    2017-11-20

    In the past decades, the inappropriate subsidy policies in many nations have caused problems such as serious oversupply, fierce competition and subpar social welfare in the photovoltaic (PV) industry in many nations. There is a clear shortage in the PV industry literature regarding how dual supply chains compete and the key decision issues regarding the competition between dual PV supply chains. It is critical to develop effective subsidy policies for the competing PV supply chains to achieve social welfare maximization. This study has explored the dual PV supply chain competition under the Bertrand competition assumption by three game-theoretical modeling scenarios (or supply chain strategies) considering either the public subsidy or no subsidy from a social welfare maximization perspective. A numerical analysis complemented by two sensitivity analyses provides a better understanding of the pricing and quantity decision dynamics in the dual supply chains under three different supply chain strategies and the corresponding outcomes regarding the total supply chain profits, the social welfare and the required total subsidies. The key findings disclose that if there are public subsidies, the dual PV supply chains have the strongest intention to pursue the decentralized strategy to achieve their maximal returns rather than the centralized strategy that would achieve the maximal social welfare; however, the government would need to pay for the maximal subsidy budget. Thus, the best option for the government would be to encourage the dual PV supply chains to adopt a centralized strategy since this will not only maximize the social welfare but also, at the same time, minimize the public subsidy. With a smart subsidy policy, the PV industry can make the best use of the subsidy budget and grow in a sustainable way to support the highly demanded solar power generation in many countries trying very hard to increase the proportion of their clean energy to combat the global

  11. Improving the nutritional quality and shelf life of broiler meat by feeding diets supplemented with fermented pomegranate (Punica granatum L.) by-products.

    Science.gov (United States)

    Ahmed, S T; Ko, S-Y; Yang, C-J

    2017-12-01

    1. Four experimental diets containing 0, 0.5, 1.0 and 2.0% fermented pomegranate by-products (FPB) were supplied to 320d-old broilers to evaluate the effects of FPB on growth performance, nutritional composition, fatty acid profile and oxidative stability of meat. 2. Dietary supplementation of FPB linearly increased the weight gain and feed intake of broilers with linear reduction in feed conversion ratio. 3. The crude protein, iron, magnesium, and sodium content were linearly higher, whereas cholesterol was linearly lower in the breast meat of FPB-supplemented broilers. In thigh meat, linearly lower ether extract and cholesterol with higher moisture was noted in response to increasing levels of FPB. 4. The proportion of saturated fatty acids was both linearly and quadratically lower in breast and thigh meat, whereas those of monounsaturated fatty acids of breast (linear and quadratic) and n-3 fatty acids of breast and thigh (linear) meat was higher in the FPB-supplemented broilers. The n-6/n-3 ratio of breast meat was linearly lower in response to FPB supplementation. The hypocholesterolaemic to hypercholesterolaemic ratio of thigh meat was higher in the FPB-supplemented groups. 5. The thiobarbituric acid reactive substances and pH value were lower in the breast and thigh meat of FPB-supplemented broilers. 6. Thus, additive supplementation of the diet with up to 2% FPB improved the nutritional quality, fatty acid profile and shelf life of broiler meat.

  12. Utilization of folic acid and iron supplementation services by pregnant women attending an antenatal clinic at a regional referral hospital in Kenya.

    Science.gov (United States)

    Maina-Gathigi, L; Omolo, J; Wanzala, P; Lindan, C; Makokha, A

    2013-09-01

    To determine utilization of iron and folic acid supplementation services among pregnant women in Kenya. A cross sectional study was conducted at Nyeri Hospital, a regional referral hospital in central Kenya. Women attending the antenatal clinic were selected through systematic sampling. A semi-structured questionnaire was administered to collect information on utilization of folic acid and iron supplementation services. Women who ingested folic acid or iron supplements for >4 days in a week were considered "highly compliant". The health worker in-charge of the antenatal clinic was interviewed about the frequency of supplement stock-outs during the past year. Haemoglobin concentration was measured directly from one drop of capillary blood and measured using portable HEMOCUE B-Hb photometer. Of the 381 women interviewed, only 23.6 % obtained antenatal care in the first trimester; 69.3 and 51.2 % received folic acid and iron supplements, respectively. However, only half (45-58 %) received any information about supplementation. Most women were initiated on folic acid (80.7 %) or iron (67.7 %) after 12 and 16 weeks of gestation, respectively, well after the recommended time period. However, more than 80 % of those who received folic acid and iron were highly compliant. Stock-outs were common at the facility. Of 361 women tested for Hb level, the prevalence of anaemia (Hb levels importance of supplements to pregnant women. Women who come late to antenatal clinic miss opportunities to start supplementation early in pregnancy. Problems with supply chain management exacerbate the problem.

  13. Granulocyte Macrophage Colony Stimulating Factor Supplementation in Culture Media for Subfertile Women Undergoing Assisted Reproduction Technologies: A Systematic Review

    Science.gov (United States)

    Siristatidis, Charalampos; Vogiatzi, Paraskevi; Salamalekis, George; Creatsa, Maria; Vrachnis, Nikos; Glujovsky, Demián; Iliodromiti, Zoe; Chrelias, Charalampos

    2013-01-01

    Granulocyte macrophage colony stimulating factor (GM-CSF) is a cytokine/growth factor produced by epithelial cells that exerts embryotrophic effects during the early stages of embryo development. We performed a systematic review, and six studies that were performed in humans undergoing assisted reproduction technologies (ART) were located. We wanted to evaluate if embryo culture media supplementation with GM-CSF could improve success rates. As the type of studies and the outcome parameters investigated were heterogeneous, we decided not to perform a meta-analysis. Most of them had a trend favoring the supplementation with GM-CSF, when outcomes were measured in terms of increased percentage of good-quality embryos reaching the blastocyst stage, improved hatching initiation and number of cells in the blastocyst, and reduction of cell death. However, no statistically significant differences were found in implantation and pregnancy rates in all apart from one large multicenter trial, which reported favorable outcomes, in terms of implantation and live birth rates. We propose properly conducted and adequately powered randomized controlled trials (RCTs) to further validate and extrapolate the current findings with the live birth rate to be the primary outcome measure. PMID:23509457

  14. Food safety standards in the fresh produce supply chain: advantages and disadvantages

    NARCIS (Netherlands)

    Uyttendaele, M.; Jacxsens, L.; Boxstael, Van S.; Kirezieva, K.; Luning, P.

    2015-01-01

    Abstract : Food safety standards in the fresh produce supply chain are discussed in view of the outcomes of a European Union Directorates General (EU DG) Research project FP7 Veg-i-Trade ‘Impact of climate change and international trade on the safety of fresh produce’. Various standards are outlined

  15. Supply Chain Management og Supply Chain costing

    DEFF Research Database (Denmark)

    Nielsen, Steen; Mortensen, Ole

    2002-01-01

    Formålet med denne artikel er at belyse de muligheder som ligger i at integrere virksomhedens økonomiske styring med begrebet Supply Chain Management (SCM). Dette søges belyst ved først at beskrive den teoretiske ramme, hvori SCM indgår. Herefter analyseres begrebet Supply Chain Costing (SCC) som...... Århus. Et resultat er, at via begrebet Supply Chain Costing skabes der mulighed for at måle logistikkædens aktiviteter i kr./øre. Anvendelsen af denne information har også strategisk betydning for at kunne vælge kunde og leverandør. Ved hjælp af integrationen skabes der også helt nye mulighed...

  16. Supply-chain trade and labor market outcomes : The case of the 2004 European Union enlargement

    NARCIS (Netherlands)

    Kaplan, Lennart C.; Kohl, Tristan; Martínez-Zarzoso, Inmaculada

    2018-01-01

    The structure of international trade is increasingly characterized by fragmentation of production processes and trade policy. Yet, how trade policy affects supply-chain trade is largely unexplored territory. This paper shows how the accession of 10 Central and Eastern European Countries (CEECs) to

  17. Effectiveness of food supplements in increasing fat-free tissue accretion in children with moderate acute malnutrition

    DEFF Research Database (Denmark)

    Fabiansen, Christian; Yaméogo, Charles W; Iuel-Brockdorf, Ann-Sophie

    2017-01-01

    ) accretion over 12 weeks. Other outcomes comprised recovery rate and additional anthropometric measures. Of 1,609 children, 4 died, 61 were lost to follow-up, and 119 were transferred out due to supplementation being switched to non-experimental products. No children developed allergic reaction. At inclusion...

  18. A Dietary Supplement Containing and Velvet Bean Improves Sleep Quality in Men and Women

    Directory of Open Access Journals (Sweden)

    Cameron G. McCarthy

    2012-01-01

    Full Text Available Background Impaired sleep quality is commonplace within industrialized societies, as evidenced by the increasing number of prescription sleep aids available. Certain herbal preparations have been suggested to provide a natural benefit to sleep; however, limited controlled data are available documenting this benefit. In the present study we tested the effect of an experimental dietary supplement, containing the active ingredients Chlorophytum borivilianum and Velvet bean, on sleep quality using the Pittsburgh Sleep Quality Index (PSQI. Methods Eighteen healthy and active men and women, with evidence of impaired sleep quality, consumed the supplement daily for 28 days. The PSQI was administered before and after the intervention period. As indicators of safety, resting heart rate and blood pressure were measured, and a complete blood count, comprehensive metabolic panel, and lipid panel were determined. Results Sleep quality was influenced by the supplement, as evidenced by an improvement in every category of the PSQI questionnaire ( P < 0.05, with most category scores improving approximately 50% from pre to post intervention. No adverse outcomes were noted with use of the supplement, as indicated by no change in resting heart rate, blood pressure, or any bloodborne parameter. Conclusions An investigational dietary supplement containing the active ingredients Chlorophytum borivilianum and Velvet bean improves sleep quality in men and women. Additional placebo controlled trials are needed to corroborate these findings in individuals with self-reported sleeping difficulty.

  19. Efficacy of probiotic supplement for gestational diabetes mellitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Pan, Jiajia; Pan, Qiangwei; Chen, Yumei; Zhang, Hongping; Zheng, Xiaodong

    2017-09-19

    Probiotic supplement might be beneficial for gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of probiotic supplement in gestational diabetes mellitus. PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of probiotic supplement in gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome were fasting serum insulin and fasting plasma glucose. Meta-analysis was performed using the fixed-effect or random-effect model. Six RCTs involving 830 patients were included in the meta-analysis. Overall, compared with control intervention in gestational diabetes mellitus, probiotic supplementation intervention was found to significantly reduce fasting serum insulin (Std. mean difference = -0.95; 95% CI = -1.73 to -0.17; p gestational age (Std. mean difference = 0.07; 95% CI = -0.20-0.34; p = .63), and gestational weight (Std. mean difference = -0.11; 95% CI = -0.38-0.16; p = .43). Compared with control intervention in gestational diabetes mellitus, probiotic supplementation was found to significantly reduce insulin resistance (HOMA-IR) and fasting serum insulin, but had no substantial influence on fasting plasma glucose, gestational age and gestational weight.

  20. Herbs, Supplements and Alternative Medicines

    Science.gov (United States)

    ... A A Listen En Español Herbs, Supplements and Alternative Medicines It is best to get vitamins and minerals ... this section Medication Other Treatments Herbs, Supplements, and Alternative Medicines Types of Dietary Supplements Side Effects and Drug ...

  1. A research view of supply chain management: Developments and topics for exploration

    Directory of Open Access Journals (Sweden)

    JR Stock

    2009-12-01

    Full Text Available There have been advances in the understanding of supply chain management (SCM since its inception in the early-1980s. However, there are still some basic issues of SCM that remain unresolved. Much of the research that has been conducted takes one or more of the following three perspectives: (1 development of methods and techniques to study SCM and its components/processes; (2 developing solutions or answers to specific supply chain-related problems or challenges; and/or (3 measuring the results or outcomes of supply chain strategies and tactics. Each of these three perspectives is briefly examined, with selected examples from the literature cited to illustrate the type of research that has been conducted. Some potential areas of research exploration are presented. The areas examined include: theory development, and SCM processes and functions.

  2. Future restrictions for sinks in the CDM. How about a cap on supply?

    International Nuclear Information System (INIS)

    Forner, C.; Jotzo, F.

    2002-01-01

    The first commitment period of the Kyoto Protocol is expected to result in only a small role for the Clean Development Mechanism (CDM), including afforestation and reforestation projects. Wide ranging concerns regarding sinks in the CDM have been reflected in the Marrakech Accords capping the total amount of emission offsets from sinks projects to be used by Annex I countries. Decisions about the second commitment period and beyond are likely to be of far greater importance for these projects. This paper contributes to the discussion on how caps on sinks under the CDM could be used to obtain overall improved outcomes for developing countries. We examine two distinctive ways in which quantitative caps on sinks in the CDM can be implemented: one, restricting the use of sinks CERs to meet targets, as under the Marrakech Accords (a cap on demand); and two, restricting supply of sink CERs using a quota system. We argue in favour of a supply side cap, if Parties are to preserve the idea of limiting sinks in the CDM. Limiting the supply of credits could lead to better financial outcomes for developing countries as a whole, make higher-cost projects viable which may have better sustainability impacts, and provide an alternative to deal with equity concerns between developing countries

  3. Survival and Neurodevelopmental Outcomes of Preterms Resuscitated With Different Oxygen Fractions

    NARCIS (Netherlands)

    Boronat, Nuria; Aguar, Marta; Rook, Denise; Iriondo, Martin; Brugada, María; Cernada, María; Nuñez, Antonio; Izquierdo, Montserrat; Cubells, Elena; Martinez, María; Parra, Anna; van Goudoever, Hans; Vento, Máximo

    2016-01-01

    Stabilization of preterm infants after birth frequently requires oxygen supplementation. At present the optimal initial oxygen inspiratory fraction (Fio2) for preterm stabilization after birth is still under debate. We aimed to compare neurodevelopmental outcomes of extremely preterm infants at 24

  4. Abuse and Misuse of Selected Dietary Supplements Among Adolescents: a Look at Poison Center Data.

    Science.gov (United States)

    Biggs, Jessica M; Morgan, Jill A; Lardieri, Allison B; Kishk, Omayma A; Klein-Schwartz, Wendy

    2017-01-01

    The use of dietary supplements has increased and is associated with adverse effects. Indications for use include recreation, body image concerns, mood enhancement, or control of medical conditions. The risk of adverse effects may be enhanced if agents are used improperly. The objective of this study was to determine the frequency of abuse and misuse of 4 dietary substances among adolescents reported nationally to poison centers. Secondary outcomes included an assessment of medical outcomes, clinical effects, location of treatments provided, and treatments administered. This descriptive retrospective review assessed data concerning the use of garcinia (Garcinia cambogia), guarana (Paullinia cupana), salvia (Salvia divinorum), and St John's wort (Hypericum perforatum) among adolescents reported nationally to poison centers from 2003 to 2014. Adolescents with a singlesubstance exposure to one of the substances of interest coded as intentional abuse or misuse were included. Poison center calls for drug information or those with unrelated clinical effects were excluded. Data were collected from the National Poison Data System. There were 84 cases: 7 cases of Garcinia cambogia, 28 Paullinia cupana, 23 Salvia divinorum, and 26 Hypericum perforatum. Garcinia cambogia was used more frequently by females (100% versus 0%), and Paullinia cupana and Salvia divinorum were used more frequently by males (61% versus 36% and 91% versus 9%, respectively). Abuse, driven by Salvia divinorum, was more common overall than misuse. Abuse was also more common among males than females (p <0.001). Use of these agents fluctuated over time. Overall, use trended down since 2010, except for Garcinia cambogia use. In 62 cases (73.8%), the medical outcome was minor or had no effect or was judged as nontoxic or minimally toxic. Clinical effects were most common with Paullinia cupana and Salvia divinorum. Treatment sites included emergency department (n = 33; 39.3%), non-healthcare facility (n = 24

  5. Why US children use dietary supplements

    Science.gov (United States)

    Bailey, Regan L.; Gahche, Jaime J.; Thomas, Paul R.; Dwyer, Johanna T.

    2013-01-01

    Background: Dietary supplements are used by one-third of children. We examined motivations for supplement use in children, the types of products used by motivations, and the role of physicians and health care practitioners in guiding choices about supplements. Methods: We examined motivations for dietary supplement use reported for children (from birth to 19 y of age; n = 8,245) using the National Health and Nutrition Examination Survey 2007–2010. Results: Dietary supplements were used by 31% of children; many different reasons were given as follows: to “improve overall health” (41%), to “maintain health” (37%), for “supplementing the diet” (23%), to “prevent health problems” (20%), and to “boost immunity” (14%). Most children (~90%) who use dietary supplements use a multivitamin–mineral or multivitamin product. Supplement users tend to be non-Hispanic white, have higher family incomes, report more physical activity, and have health insurance. Only a small group of supplements used by children (15%) were based on the recommendation of a physician or other health care provider. Conclusion: Most supplements used by children are not under the recommendation of a health care provider. The most common reasons for use of supplements in children are for health promotion, yet little scientific data support this notion in nutrient-replete children. PMID:24002333

  6. Supplement to the "Compendium of Occupational Profiles at the Skilled Blue- and White-collar Worker Level." Situations and Trends: Supply and Demand for Skilled Workers. CEDEFOP Panorama. Supplement.

    Science.gov (United States)

    Sellin, Burkart

    A study examined the supply and demand for skilled workers in the following sectors throughout the member countries of the European Community: agriculture (including horticulture and forestry); food industry and trades; hotels, restaurants, and catering industry; tourism; transport; textile industry; textile clothing; leather; wood; building…

  7. Biofuel supply chain, market, and policy analysis

    Science.gov (United States)

    Zhang, Leilei

    Renewable fuel is receiving an increasing attention as a substitute for fossil based energy. The US Department of Energy (DOE) has employed increasing effort on promoting the advanced biofuel productions. Although the advanced biofuel remains at its early stage, it is expected to play an important role in climate policy in the future in the transportation sector. This dissertation studies the emerging biofuel supply chain and markets by analyzing the production cost, and the outcomes of the biofuel market, including blended fuel market price and quantity, biofuel contract price and quantity, profitability of each stakeholder (farmers, biofuel producers, biofuel blenders) in the market. I also address government policy impacts on the emerging biofuel market. The dissertation is composed with three parts, each in a paper format. The first part studies the supply chain of emerging biofuel industry. Two optimization-based models are built to determine the number of facilities to deploy, facility locations, facility capacities, and operational planning within facilities. Cost analyses have been conducted under a variety of biofuel demand scenarios. It is my intention that this model will shed light on biofuel supply chain design considering operational planning under uncertain demand situations. The second part of the dissertation work focuses on analyzing the interaction between the key stakeholders along the supply chain. A bottom-up equilibrium model is built for the emerging biofuel market to study the competition in the advanced biofuel market, explicitly formulating the interactions between farmers, biofuel producers, blenders, and consumers. The model simulates the profit maximization of multiple market entities by incorporating their competitive decisions in farmers' land allocation, biomass transportation, biofuel production, and biofuel blending. As such, the equilibrium model is capable of and appropriate for policy analysis, especially for those policies

  8. Implementing an Oxygen Supplementation and Monitoring Protocol on Inpatient Pediatric Bronchiolitis: An Exercise in Deimplementation

    Directory of Open Access Journals (Sweden)

    Brian LeCleir

    2017-01-01

    Full Text Available Aim. Our goal in this study is to evaluate the effectiveness of our oxygen (O2 protocol to reduce length of stay (LOS for children hospitalized with bronchiolitis. Methods. In this retrospective cohort study, the outcomes of children ≤ 24 months old that were admitted with bronchiolitis and placed on the O2 protocol were compared to historical controls. The primary outcome was hospital length of stay. Secondary outcomes were duration of O2 supplementation, rates of pediatric intensive care unit transfer, and readmission. Results. Groups were not significantly different in age, gender, and rates of respiratory distress score assessment. Significantly more severely ill patients were in the O2 protocol group. There were no significant differences between control and O2 protocol groups with regard to mean LOS, rates of pediatric intensive care unit transfer, or seven-day readmission rates. By multiple regression analysis, the use of the O2 protocol was associated with a nearly 20% significant decrease in the length of hospitalization (p=0.030. Conclusion. Use of O2 supplementation protocol increased LOS in the more ill patients with bronchiolitis but decreased overall LOS by having a profound effect on patients with mild bronchiolitis.

  9. Annual Statistical Supplement, 2002

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2002 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  10. Annual Statistical Supplement, 2010

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2010 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  11. Annual Statistical Supplement, 2007

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2007 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  12. Annual Statistical Supplement, 2001

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2001 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  13. Annual Statistical Supplement, 2016

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2016 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  14. Annual Statistical Supplement, 2011

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2011 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  15. Annual Statistical Supplement, 2005

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2005 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  16. Annual Statistical Supplement, 2015

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2015 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  17. Annual Statistical Supplement, 2003

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2003 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  18. Annual Statistical Supplement, 2017

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2017 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  19. Annual Statistical Supplement, 2008

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2008 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  20. Annual Statistical Supplement, 2014

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2014 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  1. Annual Statistical Supplement, 2004

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2004 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  2. Annual Statistical Supplement, 2000

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2000 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  3. Annual Statistical Supplement, 2009

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2009 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  4. Annual Statistical Supplement, 2006

    Data.gov (United States)

    Social Security Administration — The Annual Statistical Supplement, 2006 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

  5. Deposition of carotenoids in egg yolk by short-term supplement of coloured carrot (Daucus carota) varieties as forage material for egg-laying hens.

    Science.gov (United States)

    Hammershøj, Marianne; Kidmose, Ulla; Steenfeldt, Sanna

    2010-05-01

    Supplying egg-laying hens with different forage materials may influence egg production and quality. The aim of this study was to examine the short-term effects of standard feed plus 70 g day(-1) per hen of three coloured carrot varieties (orange, yellow and purple) as forage material in comparison with a standard feed control on egg production, egg yolk colour and deposition of carotenoids in the yolk. Carrot supplementation reduced feed intakes significantly, but not on a dry matter basis. Orange carrot treatment significantly reduced egg mass production, whereas yellow and purple carrot treatments did not differ from the control. Egg and yolk weights of all carrot-supplemented treatments were significantly lower than those of the control, but yolk percentages were similar. Yolk redness increased significantly in the order control 1.5-fold) and beta-carotene (>100-fold) compared with the control. Supplementing the feed of egg-laying hens with coloured carrots efficiently increased yolk colour parameters and carotenoid contents, which gives opportunities for improved nutritional value of eggs from forage material-supplemented hens.

  6. The effect of universal maternal antenatal iron supplementation on neurodevelopment in offspring: a systematic review and meta-analysis.

    Science.gov (United States)

    Jayasinghe, C; Polson, R; van Woerden, H C; Wilson, P

    2018-05-04

    Although antenatal iron supplementation is beneficial to mothers, its impact on the neurodevelopment of offspring is controversial. A systematic review and meta-analysis was undertaken to assess whether routine maternal antenatal iron supplementation confers later neurodevelopmental benefit to offspring. Electronic databases were searched using MESH terms or key words and identified papers were reviewed by two independent reviewers. The study quality was assessed using the Cochrane risk of bias assessment tool. The review was registered in the PROSPERO CRD data base. Seven publications were identified, based on four randomised trials published between 2006 and 2016. Three of the trials were in the Asian sub-continent. A range of tools were used to evaluate neurodevelopment. Meta-analysis of outcomes from the three RCTs meeting our inclusion criteria showed minimal effect of antenatal iron supplementation on the neurodevelopment of offspring, which was not statistically significant: weighted mean difference of 0.54 (95% CI: -0.67 to 1.75); test for overall effect Z = 0.87; p = 0.38; and heterogeneity 48%. Meta-analysis of outcomes of these RCTs at later stages of development produced similar results. The benefit of routine antenatal iron supplementation on neurodevelopment in offspring was not statistically significant in this relatively limited set of trials, and some benefit cannot be excluded in areas with a high prevalence of maternal anaemia. A large randomized controlled trial showing significant benefit would be required to modify our conclusions.

  7. Comparative responses of intake and rumen function in sheep and goats to supplementation of barley straw forages with urea and sulphur

    International Nuclear Information System (INIS)

    Tan, C.M.; Poppi, D.P.; Sykes, A.R.

    1989-01-01

    Goats and sheep were offered a low quality barley straw (0.72% N) with or without a urea (0.3% N of DM) and sodium sulphate (0.03% S of DM) supplement. There was little difference in apparent digestibility intake and digestible organic matter intake of barley straw between the control animals and the supplemented animals, or between the two species. This lack of difference may be due to the fact that the in vivo digestion of the straw (37% apparent DM digestibility) was close to its potential digestibility. Though the rumen ammonia concentration of goats was higher (P < 0.01) than that of sheep, the digestion rate of straw in the rumen was higher (P < 0.01) for sheep. It was concluded that higher rumen ammonia levels in goats did not confer any advantage to this species in terms of digestion rate and duodenal protein supply and that both species failed to respond to urea and sulphur supplementation. (author). 33 refs, 4 tabs

  8. Influence of Farmer demographics and Supply Chain Issues on Organized Retailer Performance

    Directory of Open Access Journals (Sweden)

    Prabhu Aruna

    2018-01-01

    Full Text Available Advances in information technology and increased social networking have increased health awareness among people in this era. The increased health awareness has prompted people to eat healthy and stay fit. In this regard, the food sector has seen tremendous demand in terms of good quality vegetables/fruits, cereals, with hygiene, nutrition, proteins etc. With the consumer willing to pay an extra premium for the quality expected, it has been observed that the producers are still offered low prices for a good quality produce whereas the intermediaries grab a huge share of the price paid by the consumer. This research tried to understand the supply chain with the farmers in focus and explored the influence of farmer demographics and the supply chain issues on the performance of the organized retail. Linear regression analysis was used to test the linear relationship of supply chain issues with organized retailer performance. The outcome of the study implies that independent variables like demographic characteristics and supply chain issues had no control over the retailer’s performance.

  9. The Search for Value and Meaning in the Cocoa Supply Chain in Costa Rica

    Directory of Open Access Journals (Sweden)

    Erin Sills

    2012-07-01

    Full Text Available Qualitative interviews with participants in the cocoa (Theobroma cacao supply chain in Costa Rica and the United States were conducted and supplemented with an analysis of the marketing literature to examine the prospects of organic and Fairtrade certification for enhancing environmentally and socially responsible trade of cocoa from Costa Rica. Respondents were familiar with both systems, and most had traded at least organic cocoa for some period. However, most individuals said that they were seeking better product differentiation and marketing than has been achieved under the organic and Fairtrade systems. Many suggested that more direct recognition of individual growers and the unique value of their cocoa throughout the production chain would be more helpful than certification for small companies in the cocoa supply chain. These findings suggest new marketing techniques that convey an integration of meaning into the cocoa and chocolate supply chain as a differentiation strategy. This involves integration of the story of producers’ commitment and dedication; shared producer and consumer values of social and environmental responsibility; and personal relationships between producers and consumers. This marketing approach could enhance the ability of smaller companies to successfully vie with their larger competitors and to produce cocoa in a more environmentally and socially acceptable manner.

  10. The Use of Supply Chains and Supply Chain Management in the ...

    African Journals Online (AJOL)

    Dr Peter Schmitz

    supply chain management to guide the production of maps. Supply chain management can ... Distribution and logistics. Product flow. Information flow and Money. The Firm. Data from supplier(s) ..... In Global Supply Chains: Developing Skills ...

  11. Vitamin D supplementation and lipid profile: what does the best available evidence show?

    Science.gov (United States)

    Challoumas, Dimitrios

    2014-07-01

    Vitamin D supplements have increasingly been used for the treatment and prevention of osteoporosis. Historically, effects of the vitamin on the cardiovascular (CV) system have been proposed and demonstrated in the literature, including benefits on serum lipids. Although observational studies support an association between increased serum vitamin D levels and a favorable lipid profile, interventional studies have shown no effects. This review presents and analyzes all the related randomized controlled trials (RCTs) identified in the literature from 1987 to present. A systematic literature search was conducted via MEDLINE, Cochrane Library and EMBASE and, out of 19 relevant RCTs identified, only one reported benefits of vitamin D supplementation on lipid profile parameters, while the rest showed no effects or even adverse outcomes, which are highlighted by the only meta-analysis in the field. Attempts to explain the paradox of beneficial findings of observational studies versus discouraging results of interventional studies have been made and the most popular suggests that high serum vitamin D concentrations may not be the cause of good health but its outcome instead, as healthy people are more likely to stay outdoors longer and have better eating habits. For definitive answers to be given, large, well-designed RCTs need to be conducted that will take into account and adjust for dietary consumption as well as serum calcium and parathyroid hormone levels, both of which have been shown to be associated with the CV system. Until then, recommendations for vitamin D supplementation should not change. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Energy supply. Energieversorgung

    Energy Technology Data Exchange (ETDEWEB)

    Eickhof, N.

    1983-01-01

    This anthology presents nine papers dealing with the following subjects: 1) international and national aspects of energy supply, 2) regional and local energy supply concepts, and 3) issues of district-heat supply. Each of the nine papers was entered separately.

  13. The effect of supplementing sow and piglet diets with different forms of iron

    Directory of Open Access Journals (Sweden)

    Aliny Kétilim Novais

    Full Text Available ABSTRACT The objective of this study was to evaluate the effect of chelated iron supplementation on gestating and lactating sows and on their suckling and weaned piglets. Reproductive traits, piglet performance, hematological parameters, and the iron concentrations in colostrum, milk, and stillborn livers were measured. Ninety-six sows were subjected to one of three treatment groups. Group T1 comprised pregnant and lactating sows treated with diets supplemented with inorganic iron (551 mg Fe/kg and suckling piglets administered 200 mg of injectable iron dextran. Group T2 was the same as T1, except that sows after 84 days of gestation, lactating sows, and suckling piglets were fed a diet supplemented with 150 mg Fe/kg of chelated iron, and suckling piglets were administered injectable iron dextran. Group T3 was the same as T2 but without injectable iron dextran for suckling piglets. During the nursery phase, all of the weaned piglets were penned with their original groups or treatments and received isonutritive and isocaloric feeds. Piglets from the T2 and T3 groups also received an additional 150 mg Fe/kg of chelated iron via their feed. There were no differences among the treatments for reproductive traits or the iron concentrations in the colostrum, milk, or liver. The piglets that did not receive the injectable iron dextran showed the poorest performance during the pre-and post-weaning phases and showed the poorest hematological parameters of the suckling piglets. The chelated iron supplementation is insufficient to meet piglet demand. The iron dextran supply is necessary for suckling and weaned piglets.

  14. Effects of acute sleep deprivation and caffeine supplementation on anaerobic performance.

    Science.gov (United States)

    Moore, Joss; McDonald, Ciaran; McIntyre, Alan; Carmody, Kevin; Donne, Bernard

    2018-01-01

    Athletes involved in team sports may be subject to varying degrees of sleep deprivation either before or after training and competition. Despite the belief among athletes and coaches of the importance of adequate sleep for ensuing performance, the effect of sleep loss on team-sport anaerobic performance remains unclear. There is conflicting evidence in the scientific literature as to the impact of acute sleep deprivation and caffeine supplementation on anaerobic performance indices. The purpose of this study is to investigate the effect of 24 hours of acute sleep deprivation on anaerobic performance and the effect of caffeine supplementation on anaerobic performance in the sleep deprived state. 11 club level games players (n=11, 25±4 yr, 178±7.5 cm, 80.2±10.4 kg, 15.1±5.6% body fat) participated in a repeated measures double-blinded placebo control trial. Following familiarisation, each participant returned for testing on three separate occasions. One of the testing sessions took place following a night of normal sleep and the other two sessions took place following 24 hours of sleep deprivation with supplementation of either placebo or 6 mg.kg- 1 of caffeine. During each testing session participants performed the vertical jump height, 20-m straight sprint, Illinois speed agility test and 5-m shuttle run. No significant differences were detected comparing non sleep deprived and sleep deprived interventions in any of the assessed outcome measures. There were also no significant differences observed in any of the outcome measures when comparing caffeine and placebo data in the sleep deprived state. In this cohort of athletes, a 24-h period of acute sleep deprivation did not have any significant impact on anaerobic performance. Caffeine also did not have any effect of on anaerobic performance in the sleep-deprived state.

  15. Effects of acute sleep deprivation and caffeine supplementation on anaerobic performance

    Directory of Open Access Journals (Sweden)

    Joss Moore

    Full Text Available Purpose: Athletes involved in team sports may be subject to varying degrees of sleep deprivation either before or after training and competition. Despite the belief among athletes and coaches of the importance of adequate sleep for ensuing performance, the effect of sleep loss on team-sport anaerobic performance remains unclear. There is conflicting evidence in the scientific literature as to the impact of acute sleep deprivation and caffeine supplementation on anaerobic performance indices. The purpose of this study is to investigate the effect of 24 hours of acute sleep deprivation on anaerobic performance and the effect of caffeine supplementation on anaerobic performance in the sleep deprived state. Methods: 11 club level games players (n=11, 25±4 yr, 178±7.5 cm, 80.2±10.4 kg, 15.1±5.6% body fat participated in a repeated measures double-blinded placebo control trial. Following familiarisation, each participant returned for testing on three separate occasions. One of the testing sessions took place following a night of normal sleep and the other two sessions took place following 24 hours of sleep deprivation with supplementation of either placebo or 6 mg.kg- 1 of caffeine. During each testing session participants performed the vertical jump height, 20-m straight sprint, Illinois speed agility test and 5-m shuttle run. Results: No significant differences were detected comparing non sleep deprived and sleep deprived interventions in any of the assessed outcome measures. There were also no significant differences observed in any of the outcome measures when comparing caffeine and placebo data in the sleep deprived state. Conclusion: In this cohort of athletes, a 24-h period of acute sleep deprivation did not have any significant impact on anaerobic performance. Caffeine also did not have any effect of on anaerobic performance in the sleep-deprived state.

  16. A decade of developments in the area of fat supplementation research with beef cattle and sheep.

    Science.gov (United States)

    Hess, B W; Moss, G E; Rule, D C

    2008-04-01

    Supplementing ruminant animal diets with fat has been investigated as a means to influence a variety of physiological processes or to alter fatty acid composition of food products derived from ruminant animals. Several digestion experiments have been conducted with beef cattle and sheep to elucidate the effects of supplemental fat on utilization of other dietary components. Negative associative effects are not likely to be observed in ruminants consuming forage-based diets with supplemental fat at forage diets. For ruminants fed high-concentrate diets, supplementing fat at 6% of diet DM is expected to have minimal impacts on utilization of other dietary components. Although there is greater potential to supply the ruminant animal with unsaturated fatty acids from dietary origin if fat is added to high-concentrate diets, incomplete ruminal biohydrogenation of C18 unsaturated fatty acids results in an increase in duodenal flow of 18:1 trans fatty acids regardless of basal diet consumed by the animal. The biohydrogenation intermediate 18:1 trans-11 (trans-vaccenic acid) is the likely precursor to cis-9, trans-11 CLA because the magnitude of increase in CLA content in tissues or milk of ruminants fed fat is much greater than the increase in CLA presented to the small intestine of ruminants fed fat supplements. Duodenal flow of trans-vaccenic acid is also substantially greater than CLA. Increasing unsaturated fatty acids status of ruminants imparts physiological responses that are separate than the energy value of supplemental fat. Manipulating maternal diet to improve unsaturated fatty acid status of the neonate has practical benefits for animals experiencing stress due to exposure to cold environments or conditions which mount an immune response. Supplementing fat to provide an additional 16 to 18 g/d of 18:2n-6 to the small intestine of beef cows for the first 60 to 90 d of lactation will have negative impacts on reproduction and may impair immune function of the

  17. Supplement consumption in body builder athletes

    Science.gov (United States)

    Karimian, Jahangir; Esfahani, Parivash Shekarchizadeh

    2011-01-01

    BACKGROUND: Widespread use of supplements is observed among world athletes in different fields. The aim of this study was to estimate the prevalence and determinants of using supplements among body builder athletes. METHODS: This cross-sectional study was conducted on 250 men and 250 women from 30 different bodybuilding clubs. Participants were asked to complete a self-administered standardized anonymous check-list. RESULTS: Forty nine percent of the respondents declared supplement use. Men were more likely to take supplements than women (86.8% vs. 11.2%, p = 0.001). Reasons for using supplements were reported to be for health (45%), enhancing the immune system (40%) and improving athletic performance (25%). Most athletes (72%) had access to a nutritionist but underused this resource. Coaches (65%) had the greatest influence on supplementation practices followed by nutritionists (30%) and doctors (25%) after them. CONCLUSIONS: The prevalence of supplement use among bodybuilders was high. Sex, health-related issues and sport experts were determinant factors of supplement use. PMID:22973330

  18. Effect of preventive supplementation with zinc and other micronutrients on malaria and diarrhoeal morbidity in African children

    NARCIS (Netherlands)

    Veenemans, J.

    2011-01-01

    Background: Zinc is important for innate and adaptive immune responses
    to infection. Preventive zinc supplementation has been shown to reduce
    the incidence of acute diarrhoea by 20%. Few trials have evaluated its effect
    against malaria. Because trial results for both outcomes are

  19. Assessing patients' attitudes towards dietary supplements.

    Science.gov (United States)

    Wierzejska, Regina; Jarosz, Mirosław; Siuba, Magdalena; Rambuszek, Michał

    2014-01-01

    There is currently many over the counter products on the market that exert nutritional or physiological effects on the human body. The differences between dietary supplements and non-prescription drugs are however poorly understood by the average consumer and may thus affect their expectations as to the desired effect produced on the body. To evaluate patients' knowledge and attitudes towards dietary supplements as compared to non-prescription drugs. Subjects were 335 patients of the Mazowiecki Voivodeship Hospital in Warsaw, Poland. The data were collected from a face-to-face interview using a single and multiple choice questionnaire with 10 questions on dietary supplements. Statistical analysis used the Chi-square (χ2) test. The majority of respondents were found to be familiar with the term 'dietary supplements', but had difficulties in classifying these products into appropriate categories. Over 55% do not consider dietary supplements to be foodstuffs and more than 40% considered such products to be drugs. Most respondents thought that the main purpose of taking dietary supplements is to improve nutrition, but over one third expected them to also treat disease. Over 70% declared taking notice to which category the non-prescription products they bought belongs to ie. whether non-prescription drugs (medicinal products) or dietary supplements. Many patients mistakenly believe that dietary supplements are drugs and can be used to treat disease and health disorders. dietary supplements, opinion on dietary supplements, nutrition, dietary supplement vs. medicinal product.

  20. The effect of protein supplementation on quality of life, physical function, and muscle strength in patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Ahnfeldt-Mollerup, Peder; Hey, Henrik; Johansen, Camilla

    2015-01-01

    of protein supplementation for non--sarcopenic patients with COPD has yet not previously been examined. AIM: The aim of this trial was to evaluate the effect of protein supplementation on quality of life, physical function, muscle strength and biochemical blood markers in patients diagnosed with COPD......, mental state was measured by means of St George Respiratory Questionnaire, physical performance was evaluated by shuttle walking test and maximal muscle strength test, and fasting blood samples were analysed. RESULTS: Supplementing exercise with protein had no additional effect on any of the outcome...... measures. However, shuttle walk time, St George total score and subscore for impact improved as effect of time. CONCLUSION: This trial was unable to provide evidence for the effect of protein supplementation on quality of life, physical function, and muscle strength in non--sarcopenic patients...

  1. Antioxidant vitamin supplementation for preventing and slowing the progression of age-related cataract.

    Science.gov (United States)

    Mathew, Milan C; Ervin, Ann-Margret; Tao, Jeremiah; Davis, Richard M

    2012-06-13

    Age-related cataract is a major cause of visual impairment in the elderly. Oxidative stress has been implicated in its formation and progression. Antioxidant vitamin supplementation has been investigated in this context. To assess the effectiveness of antioxidant vitamin supplementation in preventing and slowing the progression of age-related cataract. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 2), MEDLINE (January 1950 to March 2012), EMBASE (January 1980 to March 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to March 2012), Open Grey (System for Information on Grey Literature in Europe) (www.opengrey.eu/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 2 March 2012. We also checked the reference lists of included studies and ongoing trials and contacted investigators to identify eligible randomized trials. We included only randomized controlled trials in which supplementation with one or more antioxidant vitamins (beta-carotene, vitamin C and vitamin E) in any form, dosage or combination for at least one year was compared to another antioxidant vitamin or to placebo. Two authors extracted data and assessed trial quality independently. We pooled results for the primary outcomes, i.e., incidence of cataract and incidence of cataract extraction. We did not pool results of the secondary outcomes - progression of cataract and loss of visual acuity, because of differences in definitions of outcomes and data presentation. We pooled results by type of cataract when data were available. We did not perform a sensitivity analysis. Nine trials involving 117

  2. Constructivism applied to psychiatric-mental health nursing: an alternative to supplement traditional clinical education.

    Science.gov (United States)

    DeCoux Hampton, Michelle

    2012-02-01

    With the popularity of accelerated pre-licensure nursing programmes and the growth in nursing student enrolments, traditional clinical education continues to be a challenge to deliver. Nursing faculty members are required to develop and implement educational innovations that achieve effective learning outcomes, while using fewer resources. The purpose of this qualitative study was to explore the effectiveness of a constructivism-based learning project to achieve specific learning outcomes and to supplement approximately 30 clinical hours in a psychiatric-mental health nursing course. Students participated in a 10-week, multistage project that examined life histories, treatment resources, and evidence-based practice, as applied to a single individual with a mental illness. Students reported increased understanding of mental health and illness, developed personal relevance associated with the knowledge gained, and learned to problem solve with regard to nursing care of individuals diagnosed with mental illness. For many students, there also appeared to be a reduction in stigmatized attitudes towards mental illness. Constructivism-based learning is a promising alternative to supplement clinical hours, while effectively achieving learning outcomes. Future research is needed to further validate the use of this method for the learning of course content, as well as the reduction of stigma. © 2011 The Author. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  3. Health, Social, and Economic Outcomes Experienced by Families as a Result of Receiving Assistance from a Community-Based Diaper Bank.

    Science.gov (United States)

    Massengale, Kelley E C; Erausquin, Jennifer Toller; Old, Michelle

    2017-10-01

    Objectives This paper aims to describe low-income recipients of a community-based diaper bank and the multiple daily challenges they face. Our paper seeks to document the health, social, and financial outcomes recipients experienced after receiving assistance. Methods We surveyed families (n = 150) about their experiences receiving diapers from a diaper bank in the southeastern United States. Additionally, we conducted short, focused interviews with families (n = 15) about outcomes after receiving diapers. Results Families experience regularly a range of challenges meeting basic needs. These difficulties include high unmet needs for transportation, food, and nonfood essentials such as personal hygiene items. Families experiencing the greatest difficulty in paying utility or medical bills were significantly more likely to have a high level of diaper need compared to families facing these challenges less often (AORs ranging from 3.40 to 9.39). As a result of receiving diapers, families reported positive health, social, and economic outcomes. Families reported positive changes in parental mood; improved child health and happiness; increased opportunities for childcare, work, and school attendance; and the ability to divert household finances toward other basic needs, including utilities and medical care. Conclusions for Practice The monetary value of the supplemental provision of diapers is a small investment in affected families' economic, social, and health outcomes. The positive effects continue far longer than the diapers provided. We demonstrate the social value of such an operation, and recommend the expansion of federal, state, and local safety net programs to help low-income families secure a steady supply of diapers.

  4. Architectures for Green-Field Supply Chain Integration: Supply Chain Integration Design

    OpenAIRE

    Radanliev, Petar

    2015-01-01

    This paper applied case study research to design architectures for green-field supply chain integration. The integration design is based on a case study of a supply chain integration of 5 companies, operating in different, but supply chain complimenting industry sectors. The case study research is applied to design and validate the architectures in a real world scenario. The supply\\ud chain integration architectures enable the conversion of individual into integrated strategies. The architect...

  5. Pengukuran Kinerja Supply Chain Dengan Pendekatan Supply Chain Operation References (SCOR)

    OpenAIRE

    Rizki Wahyuniardi; Moh. Syarwani; Ryan Anggani

    2017-01-01

    PT. Brodo Ganesha Indonesia is a national company engaged in manufacturing with the production of leather shoes. The company has many stakeholders and it is difficult to manage its supply chain, thereby affecting the effectiveness and efficiency of the company's supply chains. The research was conducted to measure the performance of supply chain by using Supply Chain Operation References (SCOR) approach. The initial hierarchy model of performance measurement is tailored to the company's condi...

  6. Supply chain integration and performance : the moderating effect of supply complexity

    NARCIS (Netherlands)

    Giménez, C.; van der Vaart, T.; van Donk, D.P.

    2012-01-01

    Purpose - The purpose of this paper is to investigate the effectiveness of supply chain integration in different contexts. More specifically, it aims to show that supply chain integration is only effective in buyer-supplier relationships characterised by high supply complexity.

  7. 30 CFR 256.12 - Supplemental sales.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Supplemental sales. 256.12 Section 256.12..., General § 256.12 Supplemental sales. (a) The Secretary may conduct a supplemental sale in accordance with the provisions of this section. (b) Supplemental sales shall be governed by the regulations in this...

  8. Nutritional Supplements for Endurance Athletes

    Science.gov (United States)

    Rasmussen, Christopher J.

    Athletes engaged in heavy endurance training often seek additional nutritional strategies to help maximize performance. Specific nutritional supplements exist to combat certain factors that limit performance beginning with a sound everyday diet. Research has further demonstrated that safe, effective, legal supplements are in fact available for today's endurance athletes. Several of these supplements are marketed not only to aid performance but also to combat the immunosuppressive effects of intense endurance training. It is imperative for each athlete to research the legality of certain supplements for their specific sport or event. Once the legality has been established, it is often up to each individual athlete to decipher the ethics involved with ingesting nutritional supplements with the sole intent of improving performance.

  9. 7 CFR 1955.22 - State supplements.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true State supplements. 1955.22 Section 1955.22 Agriculture... Real and Chattel Property § 1955.22 State supplements. State Supplements will be prepared with the... supplements will be submitted to the National Office for post approval in accordance with FmHA or its...

  10. Biomass supply from alternative cellulosic crops and crop residues: A spatially explicit bioeconomic modeling approach

    International Nuclear Information System (INIS)

    Egbendewe-Mondzozo, Aklesso; Swinton, Scott M.; Izaurralde, César R.; Manowitz, David H.; Zhang, Xuesong

    2011-01-01

    This paper introduces a spatially-explicit bioeconomic model for the study of potential cellulosic biomass supply. For biomass crops to begin to replace current crops, farmers must earn more from them than from current crops. Using weather, topographic and soil data, the terrestrial ecosystem model, EPIC, dynamically simulates multiple cropping systems that vary by crop rotation, tillage, fertilization and residue removal rate. EPIC generates predicted crop yield and environmental outcomes over multiple watersheds. These EPIC results are used to parameterize a regional profit-maximization mathematical programming model that identifies profitable cropping system choices. The bioeconomic model is calibrated to 2007–09 crop production in a 9-county region of southwest Michigan. A simulation of biomass supply in response to rising biomass prices shows that cellulosic residues from corn stover and wheat straw begin to be supplied at minimum delivered biomass:corn grain price ratios of 0.15 and 0.18, respectively. At the mean corn price of $162.6/Mg ($4.13 per bushel) at commercial moisture content during 2007–2009, these ratios correspond to stover and straw prices of $24 and $29 per dry Mg. Perennial bioenergy crops begin to be supplied at price levels 2–3 times higher. Average biomass transport costs to the biorefinery plant range from $6 to $20/Mg compared to conventional crop production practices in the area, biomass supply from annual crop residues increased greenhouse gas emissions and reduced water quality through increased nutrient loss. By contrast, perennial cellulosic biomass crop production reduced greenhouse gas emissions and improved water quality. -- Highlights: ► A new bioeconomic model predicts biomass supply and its environmental impacts. ► The model captures the opportunity cost of switching to new cellulosic crops. ► Biomass from crop residues is supplied at lower biomass price than cellulosic crops. ► Biomass from cellulosic crops has

  11. 47 CFR 61.86 - Supplements.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Supplements. 61.86 Section 61.86... Rules for Tariff Publications of Dominant and Nondominant Carriers § 61.86 Supplements. A carrier may not file a supplement except to suspend or cancel a tariff publication, or to defer the effective date...

  12. Meat supplementation improves growth, cognitive, and behavioral outcomes in Kenyan children

    NARCIS (Netherlands)

    Neumann, C.G.; Murphy, S.P.; Gewa, C.; Grillenberger, M.; Bwibo, N.O.

    2007-01-01

    A randomized, controlled school feeding study was conducted in rural Embu District, Kenya to test for a causal link between animal-source food intake and changes in micronutrient nutrition and growth, cognitive, and behavioral outcomes. Twelve primary schools were randomly assigned to 1 of 4 groups.

  13. Phytotherapy and Nutritional Supplements on Breast Cancer

    Directory of Open Access Journals (Sweden)

    C. M. Lopes

    2017-01-01

    Full Text Available Breast cancer is the most frequent type of nonskin malignancy among women worldwide. In general, conventional cancer treatment options (i.e., surgery, radiotherapy, chemotherapy, biological therapy, and hormone therapy are not completely effective. Recurrence and other pathologic situations are still an issue in breast cancer patients due to side effects, toxicity of drugs in normal cells, and aggressive behaviour of the tumours. From this point of view, breast cancer therapy and adjuvant methods represent a promising and challenging field for researchers. In the last few years, the use of some types of complementary medicines by women with a history of breast cancer has significantly increased such as phytotherapeutic products and nutritional supplements. Despite this, the use of such approaches in oncologic processes may be problematic and patient’s health risks can arise such as interference with the efficacy of standard cancer treatment. The present review gives an overview of the most usual phytotherapeutic products and nutritional supplements with application in breast cancer patients as adjuvant approach. Regardless of the contradictory results of scientific evidence, we demonstrated the need to perform additional investigation, mainly well-designed clinical trials in order to establish correlations and allow for further validated outcomes concerning the efficacy, safety, and clinical evidence-based recommendation of these products.

  14. Cell culture media supplementation of infrequently used sugars for the targeted shifting of protein glycosylation profiles.

    Science.gov (United States)

    Hossler, Patrick; Racicot, Christopher; Chumsae, Christopher; McDermott, Sean; Cochran, Keith

    2017-03-01

    Mammalian cells in culture rely on sources of carbohydrates to supply the energy requirements for proliferation. In addition, carbohydrates provide a large source of the carbon supply for supporting various other metabolic activities, including the intermediates involved in the protein glycosylation pathway. Glucose and galactose, in particular, are commonly used sugars in culture media for these purposes. However, there exists a very large repertoire of other sugars in nature, and many that have been chemically synthesized. These sugars are particularly interesting because they can be utilized by cells in culture in distinct ways. In the present work it has been found that many infrequently used sugars, and the corresponding cellular response towards them as substrates, led to differences in the protein N-glycosylation profile of a recombinant glycoprotein. The selective media supplementation of raffinose, trehalose, turanose, palatinose, melezitose, psicose, lactose, lactulose, and mannose were found to be capable of redirecting N-glycan oligosaccharide profiles. Despite this shifting of protein glycosylation, there were no other adverse changes in culture performance, including both cell growth and cellular productivity over a wide range of supplemented sugar concentrations. The approach presented highlights a potential means towards both the targeted shifting of protein glycosylation profiles and ensuring recombinant protein comparability, which up to this point in time has remained under-appreciated for these under-utilized compounds. © 2017 American Institute of Chemical Engineers Biotechnol. Prog., 33:511-522, 2017. © 2017 American Institute of Chemical Engineers.

  15. Supplementing female rats with DHA-lysophosphatidylcholine increases docosahexaenoic acid and acetylcholine contents in the brain and improves the memory and learning capabilities of the pups

    Energy Technology Data Exchange (ETDEWEB)

    Valenzuela, A.; Nieto, S.; Sanhueza, J.; Morgado, N.; Rojas, I.; Zanartu, P.

    2010-07-01

    Docosahexaenoic acid (Dha) is supplied to the foetus and newborn through the mother from their own reserves and their diet. No consensus about the best form to supplement DHA has been established. We propose that DHA containing lysophosphatidylcholine (DHA-LPC), obtained from DHA-rich eggs may be a suitable form of DHA and choline (the precursor of acetylcholine) supplementation. We evaluated the effectiveness of DHA-LPC to increase DHA and acetylcholine concentration in the brain of pups born from female rats supplemented with DHA-LPC before and during pregnancy. We also evaluated the effect of DHA supplementation on learning and memory capabilities of pups through the Skinner test for operant conditioning. Female Wistar rats received 40-day supplementation of DHA-LPC (8 mg DHA/kg b.w/daily.), before and during pregnancy. After delivery, plasma, erythrocyte, liver, and adipose tissue DHA and plasma choline were analyzed. Brains from 60 day-old pups separated into frontal cortex, cerebellum, striatum, hippocampus, and occipital cortex, were assessed for DHA, acetylcholine, and acetylcholine transferase (CAT) activity. Pups were subjected to the Skinner box test. DHA-LPC supplementation produces higher choline and liver DHA contents in the mothers plasma and increases the pups DHA and acetylcholine in the cerebellum and hippocampus. CAT was not modified by supplementation. The Skinner test shows that pups born from DHA-LPC supplemented mothers exhibit better scores of learning and memory than the controls. Conclusion: DHA-LPC may be an adequate form for DHA supplementation during the perinatal period. (Author) 66 refs.

  16. Republic of India : Service Level Benchmarking, Citizen Voice and Performance Improvement Strategies in Urban Water Supply and Sanitation

    OpenAIRE

    World Bank Group

    2016-01-01

    This synthesis report details the process, outputs and intermediate outcomes of the Water and Sanitation Program - World Bank (WSP) Technical Assistance (TA) to Service Level Benchmarking, Citizen Voice and Performance Improvement Strategies in Urban Water Supply and Sanitation (UWSS) in India. This technical assistance (TA) sought to strengthen accountability for service outcomes in urban...

  17. Role of magnesium supplementation in the treatment of depression: A randomized clinical trial.

    Directory of Open Access Journals (Sweden)

    Emily K Tarleton

    Full Text Available Current treatment options for depression are limited by efficacy, cost, availability, side effects, and acceptability to patients. Several studies have looked at the association between magnesium and depression, yet its role in symptom management is unclear. The objective of this trial was to test whether supplementation with over-the-counter magnesium chloride improves symptoms of depression. An open-label, blocked, randomized, cross-over trial was carried out in outpatient primary care clinics on 126 adults (mean age 52; 38% male diagnosed with and currently experiencing mild-to-moderate symptoms with Patient Health Questionnaire-9 (PHQ-9 scores of 5-19. The intervention was 6 weeks of active treatment (248 mg of elemental magnesium per day compared to 6 weeks of control (no treatment. Assessments of depression symptoms were completed at bi-weekly phone calls. The primary outcome was the net difference in the change in depression symptoms from baseline to the end of each treatment period. Secondary outcomes included changes in anxiety symptoms as well as adherence to the supplement regimen, appearance of adverse effects, and intention to use magnesium supplements in the future. Between June 2015 and May 2016, 112 participants provided analyzable data. Consumption of magnesium chloride for 6 weeks resulted in a clinically significant net improvement in PHQ-9 scores of -6.0 points (CI -7.9, -4.2; P<0.001 and net improvement in Generalized Anxiety Disorders-7 scores of -4.5 points (CI -6.6, -2.4; P<0.001. Average adherence was 83% by pill count. The supplements were well tolerated and 61% of participants reported they would use magnesium in the future. Similar effects were observed regardless of age, gender, baseline severity of depression, baseline magnesium level, or use of antidepressant treatments. Effects were observed within two weeks. Magnesium is effective for mild-to-moderate depression in adults. It works quickly and is well tolerated

  18. Patients with Nonalcoholic Fatty Liver Disease Have a Low Response Rate to Vitamin D Supplementation.

    Science.gov (United States)

    Dasarathy, Jaividhya; Varghese, Rony; Feldman, Abram; Khiyami, Amer; McCullough, Arthur J; Dasarathy, Srinivasan

    2017-10-01

    Background: Hypovitaminosis D is associated with an increased severity of nonalcoholic fatty liver disease (NAFLD), but reports on the response to cholecalciferol (vitamin D 3 ) supplementation are conflicting. Objective: The objective of this study was to determine if standard vitamin D 3 supplementation is effective in NAFLD with hypovitaminosis D. Methods: Sixty-five well-characterized adults [age (mean ± SD): 51.6 ± 12.3 y] with biopsy-proven NAFLD were screened. Forty-two patients (the ratio of men to women was 13:29) had hypovitaminosis D (plasma 25-hydroxyvitamin D [25(OH)D] D treated with 2000 IU cholecalciferol (vitamin D 3 ) daily for 6 mo per clinical practice. Plasma 25(OH)D, hepatic and metabolic panels, and metabolic syndrome components were assessed before and after cholecalciferol supplementation. Body composition was measured by using bioelectrical impedance analysis. The primary outcome measure was plasma 25(OH)D ≥30 ng/mL at the end of the study. Secondary outcomes included change in serum transaminases, fasting plasma glucose, and insulin and homeostasis model assessment of insulin resistance (HOMA-IR). Chi-square, Student's t tests, correlation coefficient, and multivariate analysis were performed. Results: Twenty-six (61.9%) patients had nonalcoholic steatohepatitis (NASH), and 16 (38.1%) had hepatic steatosis. After 6 mo of cholecalciferol supplementation, plasma 25(OH)D ≥30 ng/mL was observed in 16 subjects (38.1%; responders) whereas the remaining 26 patients (61.9%) were nonresponders with plasma 25(OH)D D in the majority of patients with NASH. Further studies are needed to determine if higher doses are effective. This trial was registered at clinicaltrials.gov as 13-00153. © 2017 American Society for Nutrition.

  19. Modification by antioxidant supplementation of changes in human lung function associated with air pollutant exposure: A systematic review

    Directory of Open Access Journals (Sweden)

    Chow Katherine S

    2011-07-01

    Full Text Available Abstract Background Outdoor air pollution, given its demonstrated negative effects on the respiratory system, is a growing public health concern worldwide, particularly in urban cities. Human exposure to pollutants such as ozone, nitrogen oxides, combustion-related particulate matter and oxides of sulfur is responsible for significant cardiopulmonary morbidity and mortality in both adults and children. Several antioxidants have shown an ability to partially attenuate the negative physiological and functional impacts of air pollutants. This study systematically presents current data on the potential benefits of antioxidant supplementation on lung function outcomes associated with air pollutant exposures in intact humans. Methods Electronic databases (MEDLINE, EMBASE, BIOSIS Previews, Web of Sciences, Environmental Sciences & Pollution Management and TOXNET were systematically searched for all studies published up to April 2009. Search terms relating to the concepts of respiratory tract diseases, respiratory function tests, air pollution, and antioxidants were used. Data was systematically abstracted from original articles that satisfied selection criteria for inclusion. For inclusion, the studies needed to have evaluated human subjects, given supplemental antioxidants, under conditions of known levels of air pollutants with measured lung function before and after antioxidant administration and/or air pollution exposure. Selected studies were summarized and conclusions presented. Results Eight studies investigated the role of antioxidant supplementation on measured lung function outcomes after subject exposure to air pollutants under controlled conditions; 5 of these studies concluded that pollutant-induced airway hyper-responsiveness and diminution in lung function measurements were attenuated by antioxidant supplementation. The remaining five studies took place under ambient (uncontrolled exposures and unanimously concluded that antioxidant

  20. Effects of Intraoperative Fluid Management on Postoperative Outcomes : A Hospital Registry Study

    NARCIS (Netherlands)

    Shin, Christina H; Long, Dustin R; McLean, Duncan; Grabitz, Stephanie D; Ladha, Karim; Timm, Fanny P; Thevathasan, Tharusan; Pieretti, Alberto; Ferrone, Cristina; Hoeft, Andreas; Scheeren, Thomas W L; Thompson, Boyd Taylor; Kurth, Tobias; Eikermann, Matthias

    2017-01-01

    OBJECTIVE: Evaluate the dose-response relationship between intraoperative fluid administration and postoperative outcomes in a large cohort of surgical patients. BACKGROUND: Healthy humans may live in a state of fluid responsiveness without the need for fluid supplementation. Goal-directed protocols

  1. Pengukuran Kinerja Supply Chain Dengan Pendekatan Supply Chain Operation References (SCOR

    Directory of Open Access Journals (Sweden)

    Rizki Wahyuniardi

    2017-12-01

    Full Text Available PT. Brodo Ganesha Indonesia is a national company engaged in manufacturing with the production of leather shoes. The company has many stakeholders and it is difficult to manage its supply chain, thereby affecting the effectiveness and efficiency of the company's supply chains. The research was conducted to measure the performance of supply chain by using Supply Chain Operation References (SCOR approach. The initial hierarchy model of performance measurement is tailored to the company's condition to measure its supply chain performance, while the normalization of Snorm De Boer serves to equalize the value of the matrix used as the measurement indicator. The level of importance of performance attributes is measured by weighting with subjective questionnaires. Value of performance attribute obtained reliability 19,74, responsiveness 16,91, agility 11,00; and asset management 12.26. The total performance score of 59.90. This value indicates that the performance of the supply chain is in an average position.

  2. Dietary probiotic supplementation improves growth and the intestinal morphology of Nile tilapia.

    Science.gov (United States)

    Ramos, M A; Batista, S; Pires, M A; Silva, A P; Pereira, L F; Saavedra, M J; Ozório, R O A; Rema, P

    2017-08-01

    Probiotic administration can be a nutritional strategy to improve the immune response and growth performance of fish. The current study aimed to evaluate the effects of a probiotic blend (Bacillus sp., Pediococcus sp., Enterococcus sp., Lactobacillus sp.) as a dietary supplement on growth performance, feed utilization, innate immune and oxidative stress responses and intestinal morphology in juvenile Nile tilapia (Oreochromis niloticus). The probiotic was incorporated into a basal diet at three concentrations: 0 g/kg (A0: control), 3 g/kg (A1: 1.0×106 colony forming unit (CFU)/g) and 6 g/kg (A2: 2.3×106 CFU/g diet). After 8 weeks of probiotic feeding, weight and specific growth rate where significantly higher in fish-fed A1 diet than in fish-fed A0. Alternative complement in plasma was significantly enhanced in fish-fed A2 when compared with A0. The hepatic antioxidant indicators were not affected by probiotic supplementation. Villi height and goblet cell counts increased significantly in the intestine of fish-fed A1 and A2 diets compared with A0. The dietary probiotic supplementation was maintained until 20 weeks of feeding. Then the selected immune parameters, digestive enzymes and apparent digestibility of diets were studied. No effect of probiotic feeding was observed after that longer period supplementation. The dietary supplementation of mixed species probiotic may constitute a valuable nutritional approach towards a sustainable tilapia aquaculture. The improvement of the immune responses and intestinal morphology play an important role in increasing growth performance, nutrient absorption and disease resistance in fish, important outcomes in such a competitive and developing aquaculture sector.

  3. Supply chain management/ Some lessons learned the hard way.

    Science.gov (United States)

    Nuttall, Stephen

    2013-01-01

    This paper will look at some of the experiences, lessons and frustrations experienced in managing supply chains for business continuity. No-one has time to make all the mistakes, nor to learn all the lessons on their own, so it is useful to share experiences. Over the last 25 years, the author has been involved in supply chain management as a contract manager; a programme and project manager; and as a business continuity manager. Although times change, there are some fundamental principles that are absolutely critical in making sure that supply chains do what they are needed to do/ to keep business going. Supply chains are here to stay. Indeed, with today's drive towards outsourcing, best-shoring and contracting out, they are becoming more important every year and this will only continue over time. Moreover, in the highly competitive markets in which all organisations operate, suppliers may well be carrying out operations that not all that long ago would have been considered to be part of core business. Getting the right relationship with the supply chain is more critical than ever before.1 What does this mean to business continuity professionals? They need to think not just about their own BC plans, but about the plans of their suppliers, and even those of their suppliers' suppliers. This may seem obvious, but unlike internal BC plans written by and for an organisation, it must be considered just what a supplier's plans are designed to achieve. What business outcomes will their plans deliver? If they recover their own business, how does that affect the business they serve? Are others' assumptions of how they will react in line with theirs?

  4. Children and Dietary Supplements

    Science.gov (United States)

    ... Clinical Digest for health professionals Children and Dietary Supplements Share: September 2012 © Matthew Lester Research has shown that many children use herbs and other dietary supplements. However, there are little data available on their ...

  5. Exploring future scenarios for the global supply chain of tuna

    Science.gov (United States)

    Mullon, C.; Guillotreau, P.; Galbraith, E. D.; Fortilus, J.; Chaboud, C.; Bopp, L.; Aumont, O.; Kaplan, D.

    2017-06-01

    The abundance of tuna, an important top predator that ranges throughout tropical and subtropical oceans, is now largely determined by fishing activity. Fishing activity, in turn, is determined by the interaction of fish availability, fishing capacity, fishing costs and global markets for tuna products. In the face of overfishing, the continued sustainable supply of tuna is likely to require improved global governance, that would benefit from modeling frameworks capable of integrating market forces with the availability of fish in order to consider alternative future projections. Here we describe such a modeling framework, in which we develop several simple, contrasting scenarios for the development of the tuna supply chain in order to illustrate the utility of the approach for global evaluation of management strategies for tuna and other complex, stock-structured fisheries. The model includes multiple national and multi-national fishing fleets, canneries and fresh/frozen markets, and connects these to global consumers using a network of flows. The model is calibrated using recent data on fish catch, cannery and fresh/frozen production, and consumption. Scenarios explore the control on future outcomes in the global tuna fishery by representing, in a simple way, the effects of (1) climate change, (2) changes in the global demand for tuna, and (3) changes in the access to fishing grounds (marine reserves). The results emphasize the potential importance of increasing demand in provoking a global collapse, and suggest that controlling tuna production by limiting technical efficiency is a potential countermeasure. Finally we discuss the outcomes in terms of potential extensions of the scenario approach allowed by this global network model of the tuna supply chain.

  6. A supply chain contract with flexibility as a risk-sharing mechanism for demand forecasting

    Science.gov (United States)

    Kim, Whan-Seon

    2013-06-01

    Demand forecasting is one of the main causes of the bullwhip effect in a supply chain. As a countermeasure for demand uncertainty as well as a risk-sharing mechanism for demand forecasting in a supply chain, this article studies a bilateral contract with order quantity flexibility. Under the contract, the buyer places orders in advance for the predetermined horizons and makes minimum purchase commitments. The supplier, in return, provides the buyer with the flexibility to adjust the order quantities later, according to the most updated demand information. To conduct comparative simulations, four-echelon supply chain models, that employ the contracts and different forecasting techniques under dynamic market demands, are developed. The simulation outcomes show that demand fluctuation can be effectively absorbed by the contract scheme, which enables better inventory management and customer service. Furthermore, it has been verified that the contract scheme under study plays a role as an effective coordination mechanism in a decentralised supply chain.

  7. Maternal supplementation for prevention and treatment of vitamin D deficiency in exclusively breastfed infants.

    Science.gov (United States)

    Haggerty, Linda L

    2011-06-01

    Current research links newborn and infant vitamin D deficiency with various clinical outcomes, including rickets, failure to thrive, type 1 diabetes, and other immune-related diseases. Breastfed infants are often at a greater risk of developing deficiency due to their mothers' low vitamin D status. Human milk reflects the vitamin D status of the mother and often contains inadequate levels of 25-hydroxyvitamin D for infant nutrition. In 2008 the American Academy of Pediatrics (AAP) recommended 400 IU of vitamin D supplementation of all infants. However, research has indicated low levels of compliance of vitamin D supplementation of breastfed infants and a high incidence of vitamin D deficiency in the United States. Many breastfeeding advocates believe that the AAP's recommendations undermine breastfeeding, implying that human milk is inadequate for infant nutrition. Lactating mothers are also reluctant to add any supplements to their breastmilk. The literature review will examine the effectiveness and safety of maternal vitamin D supplementation for prevention and/or treatment of vitamin D deficiency in breastfed infants and lactating mothers. This method of prevention and intervention provides pediatric providers and certified lactation consultants with an alternative approach for education, counseling, promotion of breastfeeding, and treatment to improve maternal and infant health.

  8. Effective food supply chains : generating, modelling and evaluating supply chain scenarios

    NARCIS (Netherlands)

    Vorst, van der J.G.A.J.

    2000-01-01

    Logistical co-ordination in FMCG supply chains

    The overall objectives of the research described in this thesis were to obtain insight into the applicability of the concept Supply Chain Management (SCM) in food supply chains (SCs) from a logistical point of view, and to

  9. Energy perspectives 2035 - Volume 5, analysis and appraisal of Swiss electricity supplies

    International Nuclear Information System (INIS)

    Rits, V.; Kirchner, A.

    2007-01-01

    This comprehensive report published by the Swiss Federal Office of Energy (SFOE) reviews various possibilities for meeting future electricity demands in Switzerland. The effects of these options on total economic costs, the environment and security of supply are described and discussed. The study was carried out quantitatively for the most part and then supplemented in a qualitative manner. The methodical approach to this comprehensive study is discussed. The present situation is noted and possible options for the period up to 2050 are discussed. Electricity supplies from hydropower, nuclear energy, fossil-powered generation and combined heat and power are looked at, as is energy from waste incineration plants and renewable sources of energy. Four energy scenarios are discussed, including the variants 'business as usual', 'increased co-operation', 'new priorities' and 'on the way to a 2000-Watt society'. For certain scenarios, sub-variants are presented and discussed. The scenarios and their variants are then compared with respect to their costs, options for covering possible shortages, technological potentials, emissions, wastes and the need for imports. The authors present their conclusions. The report is completed with an appendix

  10. Effect of Bifidobacterium breve M-16V supplementation on fecal bifidobacteria in preterm neonates--a randomised double blind placebo controlled trial.

    Directory of Open Access Journals (Sweden)

    Sanjay Patole

    Full Text Available BACKGROUND: Probiotic supplementation significantly reduces the risk of necrotising enterocolitis (NEC and all cause mortality in preterm neonates. Independent quality assessment is important before introducing routine probiotic supplementation in this cohort. AIM: To assess product quality, and confirm that Bifidobacterium breve (B. breve M-16V supplementation will increase fecal B. breve counts without adverse effects. METHODS AND PARTICIPANTS: Strain identity (16S rRNA gene sequencing, viability over 2 year shelf-life were confirmed, and microbial contamination of the product was ruled out. In a controlled trial preterm neonates (Gestation <33 weeks ready to commence or on feeds for <12 hours were randomly allocated to either B. breve M-16V (3×109 cfu/day or placebo (dextrin supplementation until the corrected age 37 weeks. Stool samples were collected before (S1 and after 3 weeks of supplementation (S2 for studying fecal B. breve levels using quantitative PCR (Primary outcome. Secondary outcomes included total fecal bifidobacteria and NEC≥Stage II. Categorical and continuous outcomes were analysed using Chi-square and Mann-Whitney tests, and McNemar and Wilcoxon signed-rank tests for paired comparisons. RESULTS: A total of 159 neonates (Probiotic: 79, Placebo: 80 were enrolled. Maternal and neonatal demographic characteristics were comparable between the groups. The proportion of neonates with detectable B. breve increased significantly post intervention: Placebo: [S1:2/66 (3%, S2: 25/66 (38%, p<0.001] Probiotic: [S1: 29/74 (40%, S2: 67/74 (91%, p<0.001]. Median S1 B. breve counts in both groups were below detection (<4.7 log cells x g(-1, increasing significantly in S2 for the probiotic group (log 8.6 while remaining <4.7 log in the control group (p<0.001. There were no adverse effects including probiotic sepsis and no deaths. NEC≥Stage II occurred in only 1 neonate (placebo group. CONCLUSION: B. breve M-16V is a suitable probiotic

  11. Optimizing the electronic health record to standardize administration and documentation of nutritional supplements.

    Science.gov (United States)

    Citty, Sandra W; Kamel, Amir; Garvan, Cynthia; Marlowe, Lee; Westhoff, Lynn

    2017-01-01

    Malnutrition in hospitalized patients is a major cause for hospital re-admission, pressure ulcers and increased hospital costs. Methods to improve the administration and documentation of nutritional supplements for hospitalized patients are needed to improve patient care, outcomes and resource utilization. Staff at a medium-sized academic health science center hospital in the southeastern United States noted that nutritional supplements ordered for patients at high risk for malnutrition were not offered or administered to patients in a standardized manner and/or not documented clearly in the electronic health record as per prescription. This paper reports on a process improvement project that redesigned the ordering, administration and documentation process of oral nutritional supplements in the electronic health record. By adding nutritional products to the medication order sets and adding an electronic nutrition administration record (ENAR) tab, the multidisciplinary team sought to standardize nutritional supplement ordering, documentation and administration at prescribed intervals. This process improvement project used a triangulated approach to evaluating pre- and post-process change including: medical record reviews, patient interviews, and nutrition formula room log reports. Staff education and training was carried out prior to initiation of the system changes. This process change resulted in an average decrease in the return of unused nutritional formula from 76% returned at baseline to 54% post-process change. The process change resulted in 100% of nutritional supplement orders having documentation about nutritional medication administration and/or reason for non-administration. Documentation in the ENAR showed that 41% of ONS orders were given and 59% were not given. Significantly more patients reported being offered the ONS product (p=0.0001) after process redesign and more patients (5% before ENAR and 86% after ENAR reported being offered the correct

  12. Haptoglobin phenotype, preeclampsia risk and the efficacy of vitamin C and E supplementation to prevent preeclampsia in a racially diverse population.

    Directory of Open Access Journals (Sweden)

    Tracey L Weissgerber

    Full Text Available Haptoglobin's (Hp antioxidant and pro-angiogenic properties differ between the 1-1, 2-1, and 2-2 phenotypes. Hp phenotype affects cardiovascular disease risk and treatment response to antioxidant vitamins in some non-pregnant populations. We previously demonstrated that preeclampsia risk was doubled in white Hp 2-1 women, compared to Hp 1-1 women. Our objectives were to determine whether we could reproduce this finding in a larger cohort, and to determine whether Hp phenotype influences lack of efficacy of antioxidant vitamins in preventing preeclampsia and serious complications of pregnancy-associated hypertension (PAH. This is a secondary analysis of a randomized controlled trial in which 10,154 low-risk women received daily vitamin C and E, or placebo, from 9-16 weeks gestation until delivery. Hp phenotype was determined in the study prediction cohort (n = 2,393 and a case-control cohort (703 cases, 1,406 controls. The primary outcome was severe PAH, or mild or severe PAH with elevated liver enzymes, elevated serum creatinine, thrombocytopenia, eclampsia, fetal growth restriction, medically indicated preterm birth or perinatal death. Preeclampsia was a secondary outcome. Odds ratios were estimated by logistic regression. Sampling weights were used to reduce bias from an overrepresentation of women with preeclampsia or the primary outcome. There was no relationship between Hp phenotype and the primary outcome or preeclampsia in Hispanic, white/other or black women. Vitamin supplementation did not reduce the risk of the primary outcome or preeclampsia in women of any phenotype. Supplementation increased preeclampsia risk (odds ratio 3.30; 95% confidence interval 1.61-6.82, p<0.01 in Hispanic Hp 2-2 women. Hp phenotype does n