BackgroundICU patients lose muscle mass rapidly and maintenance of muscle mass may contribute to improved survival rates and quality of life. Protein provision may be beneficial for preservation of muscle mass and other clinical outcomes, including survival. Current protein recommendations are expert-based and range from 1.2 to 2.0 g/kg. Thus, we performed a systematic review and meta-analysis on protein provision and all clinically relevant outcomes recorded in the available literature.MethodsWe conducted a systematic review and meta-analyses, including studies of all designs except case control and case studies, with patients aged ≥18 years with an ICU stay of ≥2 days and a mean protein provision group of ≥1.2 g/kg as compared to <1.2 g/kg with a difference of ≥0.2 g/kg between protein provision groups. All clinically relevant outcomes were studied. Meta-analyses were performed for all clinically relevant outcomes that were recorded in ≥3 included studies.ResultsA total of 29 studies published between 2012 and 2022 were included. Outcomes reported in the included studies were ICU, hospital, 28-day, 30-day, 42-day, 60-day, 90-day and 6-month mortality, ICU and hospital length of stay, duration of mechanical ventilation, vomiting, diarrhea, gastric residual volume, pneumonia, overall infections, nitrogen balance, changes in muscle mass, destination at hospital discharge, physical performance and psychological status. Meta-analyses showed differences between groups in favour of high protein provision for 60-day mortality, nitrogen balance and changes in muscle mass.ConclusionHigh protein provision of more than 1.2 g/kg in critically ill patients seemed to improve nitrogen balance and changes in muscle mass on the short-term and likely 60-day mortality. Data on long-term effects on quality of life are urgently needed.
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This report focuses on the feasibility of the power-to-ammonia concept. Power-to-ammonia uses produced excess renewable electricity to electrolyze water, and then to react the obtained hydrogen with nitrogen, which is obtained through air separation, to produce ammonia. This process may be used as a “balancing load” to consume excess electricity on the grid and maintain grid stability. The product, ammonia, plays the role of a chemical storage option for excess renewable energy. This excess energy in the form of ammonia can be stored for long periods of time using mature technologies and an existing global infrastructure, and can further be used either as a fuel or a chemical commodity. Ammonia has a higher energy density than hydrogen; it is easier to store and transport than hydrogen, and it is much easier to liquefy than methane, and offers an energy chain with low carbon emissions.The objective of this study is to analyze technical, institutional and economic aspects of power-to-ammonia and the usage of ammonia as a flexible energy carrier.
Renewing agricultural grasslands for improved yields and forage quality generally involves eliminating standing vegetation with herbicides, ploughing and reseeding. However, grassland renewal may negatively affect soil quality and related ecosystem services. On clay soil in the north of the Netherlands, we measured grass productivity and soil chemical parameters of ‘young’ (5–15 years since last grassland renewal) and ‘old’ (>20 years since last grassland renewal) permanent grasslands, located as pairs at 10 different dairy farms. We found no significant difference with old permanent grassland in herbage dry matter yield and fertilizer nitrogen (N) response, whereas herbage N yield was lower in young permanent grassland. Moreover, the young grassland soil contained less soil organic matter (SOM), soil organic carbon (C) and soil organic N compared to the old grassland soil. Grass productivity was positively correlated with SOM and related parameters such as soil organic C, soil organic N and potentially mineralizable N. We conclude that on clay soils with 70% desirable grasses (i.e., Lolium perenne and Phleum pratense) or more, the presumed yield benefit of grassland renewal is offset by a loss of soil quality (SOM and N-total). The current practice of renewing grassland after 10 years without considering the botanical composition, is counter-productive and not sustainable.
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The reclaiming of street spaces for pedestrians during the COVID-19 pandemic, such as on Witte de Withstraat in Rotterdam, appears to have multiple benefits: It allows people to escape the potentially infected indoor air, limits accessibility for cars and reduces emissions. Before ordering their coffee or food, people may want to check one of the many wind and weather apps, such as windy.com: These apps display the air quality at any given time, including, for example, the amount of nitrogen dioxide (NO2), a gas responsible for an increasing number of health issues, particularly respiratory and cardiovascular diseases. Ships and heavy industry in the nearby Port of Rotterdam, Europe’s largest seaport, exacerbate air pollution in the region. Not surprisingly, in 2020 Rotterdam was ranked as one of the unhealthiest cities in the Netherlands, according to research on the health of cities conducted by Arcadis. Reducing air pollution is a key target for the Port Authority and the City of Rotterdam. Missing, however, is widespread awareness among citizens about how air pollution links to socio-spatial development, and thus to the future of the port city cluster of Rotterdam. To encourage awareness and counter the problem of "out of sight - out of mind," filmmaker Entrop&DeZwartFIlms together with ONSTV/NostalgieNet, and Rotterdam Veldakademie, are collaborating with historians of the built environment and computer science and public health from TU Delft and Erasmus University working on a spatial data platform to visualize air pollution dynamics and socio-economic datasets in the Rotterdam region. Following discussion of findings with key stakeholders, we will make a pilot TV-documentary. The documentary, discussed first with Rotterdam citizens, will set the stage for more documentaries on European and international cities, focusing on the health effects—positive and negative—of living and working near ports in the past, present, and future.
