Purpose of reviewSkeletal muscle mass with aging, during critical care, and following critical care is a determinant of quality of life and survival. In this review, we discuss the mechanisms that underpin skeletal muscle atrophy and recommendations to offset skeletal muscle atrophy with aging and during, as well as following, critical care.Recent findingsAnabolic resistance is responsible, in part, for skeletal muscle atrophy with aging, muscle disuse, and during disease states. Anabolic resistance describes the reduced stimulation of muscle protein synthesis to a given dose of protein/amino acids and contributes to declines in skeletal muscle mass. Physical inactivity induces: anabolic resistance (that is likely exacerbated with aging), insulin resistance, systemic inflammation, decreased satellite cell content, and decreased capillary density. Critical illness results in rapid skeletal muscle atrophy that is a result of both anabolic resistance and enhanced skeletal muscle breakdown.SummaryInsofar as atrophic loss of skeletal muscle mass is concerned, anabolic resistance is a principal determinant of age-induced losses and appears to be a contributor to critical illness-induced skeletal muscle atrophy. Older individuals should perform exercise using both heavy and light loads three times per week, ingest at least 1.2 g of protein/kg/day, evenly distribute their meals into protein boluses of 0.40 g/kg, and consume protein within 2 h of retiring for sleep. During critical care, early, frequent, and multimodal physical therapies in combination with early, enteral, hypocaloric energy (ﰅ10–15kcal/kg/day), and high-protein (>1.2 g/kg/day) provision is recommended.
The purpose of this paper is to investigate how resistance to change might be a consequence of differences in professional discourse of professional groups working together in a change program.
(1) Background: Recent research showed that subtypes of patients with type 2 diabetes may differ in response to lifestyle interventions based on their organ-specific insulin resistance (IR). (2) Methods: 123 Subjects with type 2 diabetes were randomized into 13-week lifestyle intervention, receiving either an enriched protein drink (protein+) or an isocaloric control drink (control). Before and after the intervention, anthropometrical and physiological data was collected. An oral glucose tolerance test was used to calculate indices representing organ insulin resistance (muscle, liver, and adipose tissue) and β-cell functioning. In 82 study-compliant subjects (per-protocol), we retrospectively examined the intervention effect in patients with muscle IR (MIR, n = 42) and without MIR (no-MIR, n = 40). (3) Results: Only in patients from the MIR subgroup that received protein+ drink, fasting plasma glucose and insulin, whole body, liver and adipose IR, and appendicular skeletal muscle mass improved versus control. Lifestyle intervention improved body weight and fat mass in both subgroups. Furthermore, for the MIR subgroup decreased systolic blood pressure and increased VO2peak and for the no-MIR subgroup, a decreased 2-h glucose concentration was found. (4) Conclusions: Enriched protein drink during combined lifestyle intervention seems to be especially effective on increasing muscle mass and improving insulin resistance in obese older, type 2 diabetes patients with muscle IR.
The transition towards an economy of wellbeing is complex, systemic, dynamic and uncertain. Individuals and organizations struggle to connect with and embrace their changing context. They need to create a mindset for the emergence of a culture of economic well-being. This requires a paradigm shift in the way reality is constructed. This emergence begins with the mindset of each individual, starting bottom-up. A mindset of economic well-being is built using agency, freedom, and responsibility to understand personal values, the multi-identity self, the mental models, and the individual context. A culture is created by waving individual mindsets together and allowing shared values, and new stories for their joint context to emerge. It is from this place of connection with the self and the other, that individuals' intrinsic motivation to act is found to engage in the transitions towards an economy of well-being. This project explores this theoretical framework further. Businesses play a key role in the transition toward an economy of well-being; they are instrumental in generating multiple types of value and redefining growth. They are key in the creation of the resilient world needed to respond to the complex and uncertain of our era. Varta-Valorisatielab, De-Kleine-Aarde, and Het Groene Brein are frontrunner organizations that understand their impact and influence. They are making bold strategic choices to lead their organizations towards an economy of well-being. Unfortunately, they often experience resistance from stakeholders. To address this resistance, the consortium in the proposal seeks to answer the research question: How can individuals who connect with their multi-identity-self, (via personal values, mental models, and personal context) develop a mindset of well-being that enables them to better connect with their stakeholders (the other) and together address the transitional needs of their collective context for the emergence of a culture of the economy of wellbeing?
To treat microbial infections, antibiotics are life-saving but the increasing antimicrobial resistance is a World-wide problem. Therefore, there is a great need for novel antimicrobial substances. Fruit and flower anthocyanins have been recognized as promising alternatives to traditional antibiotics. How-ever, for future application as innovative alternative antibiotics, the full potential of anthocyanins should be further investigated. The antimicrobial potential of anthocyanin mixtures against different bacterial species has been demonstrated in literature. Preliminary experiments performed by our laboratories, using grape, rose and red cabbage anthocyanins against S. aureus and E. coli confirmed the antimicrobial potential of these substances. Hundreds of different anthocyanin entities have been described. However, which of these entities hold antimicrobial effects is currently unknown. Our preliminary data show that an-thocyanins extracted from grape, rose and red cabbage contain different collections of anthocyanin entities with differential antimicrobial efficacies. Our focus is on the extraction and characterization of anthocyanins from various crop residues. Grape peels are residues in the production of wine, while red rose and tulip leaves are residues in the production of tulip bulbs and regular horticulture. The presence of high-grade substances for pharmacological purposes in these crops may provide an innovative strategy to add value to other-wise invaluable crop residues. This project will be performed by the collaborative effort of our institute together with the Medi-cal Microbiology department of the University Medical Center Groningen (UMCG), 'Wijnstaete', a small-scale wine-producer (Lemelerveld) and Imenz Bioengineering (Groningen), a company that develops processes to improve the production of biobased chemicals from waste products. Within this project, we will focus on the antimicrobial efficacy of anthocyanin-mixtures from sources that are abundantly and locally available as a residual waste product. The project is part of a larger re-search effect to further characterize, modify and study the antimicrobial effects of specific anthocy-anin entities.
Recent research by the renowned Royal Institution of Chartered Surveyors (RICS) shows that more than 2/3 of all CO2 is emitted during the building process and less than 1/3 during use to heat the building and the tap water. Lightweight, local and biobased materials such as biocomposites to replace concrete and fossil based cladding are in the framework of climate change, a necessity for future building. Using plant fiber in polymer composites is especially interesting for construction since natural fibers exhibit comparative good mechanical properties with small specific weight, which defines the potential for lightweight constructions. The use of renewable resources, will affect the ecosystem favorably and the production costs of construction materials could also decrease. However, one disadvantage of natural fibers in plastics is their hydrophilic properties. In construction the materials need to meet special requirements like the resistance against fluctuating weather conditions (Ticoalu et al., 2010). In contrast to synthetic fibers, the natural ones are more moisture- and UV-radiation-sensitive. That may lead to degradation of these materials and a decreasing in quality of products. (Lopez et al., 2006; Mokhothu und John, 2017) Tanatex and NPSP have approached CoE BBE/Avans to assist in a study where fibres impregnated with the (modified) Tanatex products will be used for reinforcement of thermoset biopolymers. The influence of the different Tanatex products on the moisture absorption of natural/cellulosic fibers and the adhesion on the fibers on main composite matrix will be measured. The effect of Tantex products can optimize the bonding reaction between the resin and the fibers in the (bio) composite and result to improved strength and physico-chemical properties of the biocomposite materials. (word count: 270)
