Estimated Energy Requirements Research Articles

Nutritional status and function after high-calorie formula vs. Chinese food intervention in undernourished children with cerebral palsy.

AimTo investigate the efficacy and safety of high-calorie formula vs. Chinese daily food on the nutritional status and motor function of undernourished children with cerebral palsy (CP).MethodsIn this prospective, assessor-blind, and randomized controlled trial, we recruited children (1–10 years) with CP and undernutrition based on the WHO and the American Society for Parenteral and Enteral Nutrition criteria from the National Children's Medical Center. Participants were randomly allocated (1:1) to a high-calorie formula group or a Chinese daily food diet group (control group) for 6 months. Indirect calorimetry was used to estimate energy requirements. We compared the nutritional status and gross motor function of participants in both groups based on weight, height, z-scores (weight-for-age, height-for-age, weight-for-height, and BMI-for-age), and the Gross Motor Function Measure (GMFM), respectively, at baseline, 3-, and 6-months follow-up. In addition, the effective rate of nutritional intervention, and adverse events were simultaneously assessed.ResultsFrom July 2020 to December 2021, a total of 119 participants were enrolled and randomized, and 110 participants completed the study (with 54 children in the high-calorie formula group and 56 children in the control group). After 6 months of treatment, the weight, height, z-scores (weight-for-height, weight-for-age, and BMI-for-age), and GMFM of both groups were significantly improved (p < 0.05). There were significant differences in changes in weight, weight-for-age z-scores, and GMFM between the two groups (p < 0.05). During the study period, 16 children experienced at least one mild adverse event [9 (16.7%) in the formula group and 7 (12.5%) in the control group].ConclusionNutritional intervention with a high-calorie formula may be an effective and safe option in children with CP for improving undernutrition and gross motor dysfunction.Clinical trial registrationwww.chictr.org.cn, identifier: ChiCTR2000033878.

Weight loss and all-cause mortality: A propensity score matching cohort study

BackgroundWeight loss was supposed to help with decreasing risk of premature mortality. However, results on this topic remain debatable and limited by study design. ObjectiveThe present study aimed to investigate the association between weight loss and all-cause mortality among US adults with overweight or obesity in a national cohort study by using propensity score matching (PSM) analysis. MethodsA total of 5486 pairs of participants were matched in the National Health and Nutrition Examination Survey (NHANES, 2003–2015) after PSM. Hazard ratios (95% confidence intervals) (HRs (95% CIs)) were employed to evaluate the association between weight loss indicated by long-term weight loss (LTWL) and all-cause mortality by using Cox proportional hazards regression models. ResultsDuring a median follow-up of 6.8 years, 674 participants died from all-cause mortality. In each PSM match, compared with participants with LTWL < 5%, the HRs (95% CIs) for participants with LTWL of 5–9.9% (2877 pairs), 10–14.9% (1315 pairs), and ≥ 15% (1294 pairs) were 1.18 (0.83–1.68) (P = 0.366), 1.65 (1.17–2.34) (P = 0.005), and 1.91 (1.21–3.00) (P = 0.006), respectively. The significant increased risk of all-cause mortality for LTWL ≥ 15% remained among male, female, participants aged ≥ 65 years, without weight loss intention, with non-communicable diseases, and without exceeding estimated energy requirement. ConclusionWeight loss especially for being ≥ 15% should be cautious for US adults with overweight or obesity.

Gastrointestinal and sensory manifestations, nutrition management, and energy-protein intake in hospitalized patients with COVID-19.

BackgroundGastrointestinal and sensory manifestations (GSMs) of coronavirus disease 2019 (COVID‐19) may affect food intake, resulting in malnutrition and poor outcomes. We characterized the impact of GSMs and oral nutrition supplementation on energy‐protein intake (EPI) and hospital discharge in adult patients with COVID‐19.MethodsPatients from two hospitals were enrolled (n = 357). We recorded the presence and type of GSM at admission, estimated energy requirements (EER) and the EPI based on regular food intake (plate diagram sheets) during hospital stays. Patients not achieving 60% of their EER from food over 2 consecutive days received oral nutrition supplementation (ONS) with a high‐energy‐protein oral drink.ResultsMost patients (63.6%) presented with GSMs at admission. Anorexia was the most common manifestation (44%). Patients with anorexia or more than one GSMs were more likely to not achieve 60% EER on the first day of follow‐up and to require the ONS intervention (P ≤ 0.050). Prevalence of at least one GSM was higher in patients who did not achieve hospital discharge than in patients who achieved it (74.2% vs 54.6%, P = 0.038). The patients requiring ONS (26.9%) demonstrated good adherence to the intervention (79.3%), achieved their EER during 95.7% of the supplementation time, and presented with hospital discharge rates similar to patients not requiring ONS (92.2% vs 91.9%, respectively; P = 1.000).ConclusionsGSM were prevalent in COVID‐19 and it impaired EER attendance and patient recovery. ONS was well‐tolerated, aided EER attendance, and potentially facilitated hospital discharge.

Association between caloric adequacy and short-term clinical outcomes in critically ill patients using a weight-based equation: Secondary analysis of a cluster-randomized controlled trial.

BackgroundThere is controversy over the optimal energy delivery in intensive care units (ICUs). In this study, we aimed to evaluate the association between different caloric adequacy assessed by a weight-based equation and short-term clinical outcomes in a cohort of critically ill patients.MethodsThis is a secondary analysis of a cluster-randomized controlled trial (N = 2,772). The energy requirement was estimated as 25 kcal/kg of body weight. The study subjects were divided into three groups according to their caloric adequacy as calculated by the mean energy delivered from days 3 to 7 of enrollment divided by the estimated energy requirements: (1) received < 70% of energy requirement (hypocaloric), (2) received 70–100% of energy requirement (normocaloric), and (3) received > 100% of energy requirement (hypercaloric). Cox proportional hazards models were used to analyze the association between caloric adequacy and 28-day mortality and time to discharge alive from the ICU.ResultsA total of 1,694 patients were included. Compared with normocaloric feeding, hypocaloric feeding significantly increased the risk of 28-day mortality (hazard ratio [HR] = 1.590, 95% confidence interval [CI]: 1.162–2.176, p = 0.004), while hypercaloric feeding did not. After controlling for potential confounders, the association remained valid (adjusted HR = 1.596, 95% CI: 1.150–2.215, p = 0.005). The caloric adequacy was not associated with time to discharge alive from the ICU in the unadjusted and the adjusted models.ConclusionEnergy delivery below 70% of the estimated energy requirement during days 3–7 of critical illness is associated with 28-day mortality.Clinical trial registration[https://www.isrctn.com/ISRCTN12233792], identifier [ISRCTN12233792].

Determinants of Resting Energy Expenditure in Very Old Nursing Home Residents.

This study aimed to measure resting energy expenditure (REE) in institutionalized old persons and to determine factors possibly related to change in REE as a basis for estimating energy requirements. A monocentric cross-sectional study was conducted. Statistical approaches were conducted to determine independent factors associated with REE. Various published predictive equations of REE were compared to our population. 72 residents of a nursing home, mostly women (80.5%) aged 87.4±6.6 years were included. REE (indirect calorimetry), body composition (bio-impedance analysis), biological and anthropometric data were collected. Mean REE was 1006±181 kcal/d and was higher in men than in (1227±195 vs. 953±131 kcal/d, p<0.05). According to criteria adapted from the Global Leadership Initiative on Malnutrition consensus, 65.3 % of the institutionalized population were malnourished. In multivariate analysis adjusted on gender and age, REE was positively associated with calorie intake, fat-free mass (FFM), functional abilities (French Autonomie Gérontologie Groupe Iso Ressources scale), and elevated CRP level (> 25 mg/l). Significant differences (p<0.05) appeared between measured REE and predicted REE by using various published equations. REE of very old nursing home residents is influenced by FFM, calorie intake, functional abilities, and CRP levels and is poorly predicted by classical equations based on age, gender, height, and weight. This suggests a metabolic adaptation to caloric restriction and inflammation and prompts to consider the level of physical activity and muscle loss when assessing caloric requirements in this population.

Association of Polygenic Variants with Type 2 Diabetes Risk and Their Interaction with Lifestyles in Asians.

Over the last several decades, there has been a considerable growth in type 2 diabetes (T2DM) in Asians. A pathophysiological mechanism in Asian T2DM is closely linked to low insulin secretion, β-cell mass, and inability to compensate for insulin resistance. We hypothesized that genetic variants associated with lower β-cell mass and function and their combination with unhealthy lifestyle factors significantly raise T2DM risk among Asians. This hypothesis was explored with participants aged over 40. Participants were categorized into T2DM (case; n = 5383) and control (n = 53,318) groups. The genetic variants associated with a higher risk of T2DM were selected from a genome-wide association study in a city hospital-based cohort, and they were confirmed with a replicate study in Ansan/Ansung plus rural cohorts. The interacted genetic variants were identified with generalized multifactor dimensionality reduction analysis, and the polygenic risk score (PRS)-nutrient interactions were examined. The 8-SNP model was positively associated with T2DM risk by about 10 times, exhibiting a higher association than the 20-SNP model, including all T2DM-linked SNPs with p < 5 × 10−6. The SNPs in the models were primarily involved in pancreatic β-cell growth and survival. The PRS of the 8-SNP model interacted with three lifestyle factors: energy intake based on the estimated energy requirement (EER), Western-style diet (WSD), and smoking status. Fasting serum glucose concentrations were much higher in the participants with High-PRS in rather low EER intake and high-WSD compared to the High-EER and Low-WSD, respectively. They were shown to be higher in the participants with High-PRS in smokers than in non-smokers. In conclusion, the genetic impact of T2DM risk was mainly involved with regulating pancreatic β-cell mass and function, and the PRS interacted with lifestyles. These results highlight the interaction between genetic impacts and lifestyles in precision nutrition.

Effect of resistive and radiative heats on enhanced heat transfer of parabolic trough solar collector

The total amount of existing solar energy on earth is more than the World's current and estimated energy requirements. The radiative heat from the sun is capable of producing electricity. This study deals with hydrogen energy storage by growing the heat transmission enactment of PTSC (Parabolic Trough Solar Collector) in the presence of thermic heat, resistive heat, buoyancy, magnetic field, and uneven heat sink/source. The Oldroyd-B and Maxwell fluids are the shear-thinning fluids with rheological differences. This study investigates the best heat transfer performer among these two, which helps to enhance the heat transfer in PTSC. A mathematical model was established and resolved numerically to examine this. The study outcomes are deliberated with the assistance of pictorial and numerical evaluations. Thermal radiation with Oldroyd-B fluid combination helps to enhance the heat transmission rate of PTSC to another level.

Piezoresistive Memories Based on Two-Dimensional Nano-Scale Electromechanical Systems

In this work we present piezoresistive memory-bits based on two-dimensional nano-scale electro-mechanical systems. We demonstrate it is possible to achieve different electrical responses by fine control of micro-structural asymmetries and that information can be encoded in the geometrical configuration of the device and read as in classical ReRAM memories by measuring the current flowing across it. Based on the potential energy landscape of the device, we estimate the energy cost to operate the proposed memories. The estimated energy requirements for a single bit compete with existing technologies.

An assessment of strategies for sustainability priority challenges in Jordan using a water–energy–food Nexus approach

This study aimed at supporting robust decision-making for planning and management of water–energy–food Nexus systems in the country of Jordan. Nexus priority challenges in Jordan were identified as (1) water scarcity, (2) agricultural productivity and water quality, and (3) shift to energy independence. We created a water–energy–food Nexus model that integrates three modelling frameworks: (1) the Water Evaluation and Planning system WEAP model to estimate water demands, supplies and allocation; (2) the MABIA model to estimate crop production, and, (3) a GIS-based energy modelling tool to estimate energy requirements of the water system. Through a set of scenario runs, results show how desalination is needed to address water scarcity, but it has to be coupled with low-carbon electricity generation in order to not exacerbate climate change. Improving water productivity in agriculture improves most of the studied dimensions across the water–energy–food security nexus; however, it does little for water scarcity at the municipal level. Reducing non-revenue water can have positive effects on municipal unmet demand and reduction of energy for pumping, but it does not improve agricultural water productivity and may have negative feedback effects on the Jordan Valleys aquifer levels. Energy efficiency can support energy-intensive projects, like desalination, by substantially reducing the load on the energy system, preventing increased emissions and achieving a more resilient water system. Finally, when all interventions are considered together all of the major drawbacks are reduced and the benefits augmented, producing a more holistic solution to the WEF Nexus challenges in Jordan.

Relationship between Anemia and Falls among Postmenopausal Women in Korea.

This study was conducted to explore the relationship between anemia and falls in postmenopausal women. The relationships between energy, protein, iron, and vitamin C intake were also checked. The data of this study are a combination of data from the Korea National Health and Nutrition Examination Survey (KNHANES) collected from the KNHANES VI-2,3 (2014–2015) and VII-1,2,3 (2016–2018). Falls and anemia were compared according to the subjects’ characteristics. Phi and Cramer’s V coefficient were applied to find the strength of association. Energy, protein, iron, and vitamin C intake and anemia were investigated. The relationship between the status as anemic and the occurrence of falls was analyzed using binary logistic regression. Of the 6665 subjects, 274 had a fall, and 596 had anemia. If the energy intake did not meet the estimated energy requirements, the state of anemia was significantly higher with a weak association. When protein, iron, and vitamin C did not meet the recommended nutrient intake, the anemia state was considerably higher with a weak to moderate association. Postmenopausal women with anemia were more likely to fall than subjects without anemia (OR = 1.88, p = 0.003). Additionally, anemia was confirmed to be related to insufficient energy, protein, iron, and vitamin C intake.

Earthworm burrowing modes and rates depend on earthworm species and soil mechanical resistance

Earthworms drive multiple soil processes, but their specific impact on soil functions differs between earthworm species and ecological categories. A key challenge in modern agriculture is soil compaction due to heavy machinery, but we have limited quantitative knowledge about how the burrowing activity of different earthworm species is affected by compaction. Here, we address this question in a laboratory experiment with 2-D terraria, where we used Aporrectodea caliginosa (Savigny, 1826) and Aporrectodea longa (Ude, 1885) as representatives of two different ecological categories. We exposed both species to four different soil mechanical resistance levels and monitored their burrowing activity for three days. We quantified burrowing rates and cast production, assessed the burrowing mode, and estimated energy requirements as a function of soil mechanical resistance. The results showed that the burrowing rates of both earthworm species significantly decreased with increasing soil mechanical resistance, but that the impact was species-dependent and lower for A. longa. Earthworms changed their burrowing mode towards ingestion when soil mechanical resistance increased, and this shift was more prominent for A. caliginosa that primarily burrowed via cavity expansion (i.e. by pushing soil aside) at low soil mechanical resistance. We further show that energy requirement and cast produced per unit burrow length increased with soil mechanical resistance. Our study revealed significant and species-dependent adverse effects of soil mechanical resistance on earthworm burrowing, which in turn has consequences for many soil processes mediated by earthworms, such as water infiltration, soil aeration, nutrient cycling and soil organic matter turnover.

Evaluation of Artificial Neural Network to Model Performance Attributes of a Mechanization Unit (Tractor-Chisel Plow) under Different Working Variables

The focal objective of the current research is to apply artificial neural network (ANN) and multiple linear regression (MLR) methods for modeling the performance attributes of a mechanization unit (tractor-chisel plow) during the plowing process under both different soil types and working variables. Two different parameters to represent working conditions and soil type were considered as potential input parameters. The first parameter represented soil type by calculating soil texture index as a combination of clay, silt, and sand. The second one was constructed into one dimensionless parameter, namely the field working index. This index linked most working variables such as plowing speed, plow width, soil moisture content, soil bulk density, tractor power, and plowing depth. The performance of the created ANN and MLR models was appraised by computing mean-absolute-error criterion for the testing dataset. The mean absolute error values for draft force, effective field capacity, fuel consumption, drawbar power, overall energy efficiency, rate of plowed soil volume, and loading factor, were 1.44 kN, 0.03 ha/h, 1.17 L/h, 2.28 kW, 0.68%, 73.97 m3/h, and 0.08 (decimal), respectively, when the ANN model was applied. In addition, coefficient of determination (R2) acted as a criterion for judging the performance of the developed models, and their values when ANN was applied were 0.569, 0.384, 0.516, 0.454, 0.486, 0.777, and 0.730 for the same performance attributes, respectively. When the MLR model was applied, the corresponding values of R2 were 0.239, 0.358, 0.352, 0.429, 0.511, 0.482, and 0.422, respectively, for the same attributes. The current study adds to the standing literature by contributing data and information regarding the performance attributes of a tractor-chisel plow unit under specific working variables and soil types. In addition, the models developed for plowing operations in different soil texture and under the field working index are recommended for use in budgeting for diesel consumption, in calculating operation cost, in matching mechanization units of tractor-chisel plows, in estimating energy requirements of tractor-chisel plow combinations, etc.

Evaluation of the Sex-Specific Nature of Nutrition Assessment Within the Nutrition Care Process: Case Study Vignettes of Transgender and Gender Diverse Patients

ObjectivesCertain aspects of nutrition assessment within the Nutrition Care Process (NCP) are sex-specific, meaning they require nutrition professionals to select a male or female sex (i.e., growth charts, body fat percentage, and the normal ranges for certain biochemical markers). This presents a unique question for nutrition professionals working with transgender and gender diverse (TGGD) patients who may be medically transitioning or identify as non-binary.MethodsLB is a 17 year-old, white individual who was assigned male at birth, identifies as non-binary, and uses they/their pronouns. They wear both masculine and feminine clothing and are not interested in pursuing medical interventions. LB is 5’5” and weighs 120 lbs. Which growth chart would be appropriate to assess LB's weight status? JY is a 50 year-old African American individual who assigned female at birth, identifies as transgender male, and uses he/his or they/their pronouns. JY's past medical history indicates he medically transitioned in his mid-20s, has been on masculinizing HT for the past 25 years, and is amenorrheic. Given JY's past medical history, which reference values would be most appropriate to assess hemoglobin and hematocrit? Hemoglobin - 12 g/dl Hematocrit - 37% RBCs - 5.0 ml Platelet count - 250,000 WBC - 6,000 cells/ml MR is a 30 year-old, Hispanic individual who was assigned male at birth, identifies as transgender female, and uses she/her pronouns. She started feminizing HT one month ago, is 5’8” tall and weighs 180 lbs; she would prefer a smaller physique and expressed that she would like to lose about 30 lbs. MR walks her dog for 30 minutes daily. Using the Estimated Energy Requirement (EER) equation, what are MR's energy needs to maintain her current weight? What energy requirement would support MR's weight loss goal?ResultsThe cases of LB, JY and MR illustrate the potential strategies that nutrition professionals can utilize. 1. Use reference values consistent with sex assigned at birth for patients who have not medically transitioned (LB). 2. Individualize nutrition assessment to align with the client's medical transition (JY). 3. Express data as a range between the female-male reference values (MR).ConclusionsNutrition professionals can apply specific strategies and clinical reasoning to address sex-specific aspects of nutrition assessment when caring for TGGD patients.Funding SourcesNone.

The Roles of Fatty Acids and Apolipoproteins in the Kidneys.

The kidneys are organs that require energy from the metabolism of fatty acids and glucose; several studies have shown that the kidneys are metabolically active tissues with an estimated energy requirement similar to that of the heart. The kidneys may regulate the normal and pathological function of circulating lipids in the body, and their glomerular filtration barrier prevents large molecules or large lipoprotein particles from being filtered into pre-urine. Given the permeable nature of the kidneys, renal lipid metabolism plays an important role in affecting the rest of the body and the kidneys. Lipid metabolism in the kidneys is important because of the exchange of free fatty acids and apolipoproteins from the peripheral circulation. Apolipoproteins have important roles in the transport and metabolism of lipids within the glomeruli and renal tubules. Indeed, evidence indicates that apolipoproteins have multiple functions in regulating lipid import, transport, synthesis, storage, oxidation and export, and they are important for normal physiological function. Apolipoproteins are also risk factors for several renal diseases; for example, apolipoprotein L polymorphisms induce kidney diseases. Furthermore, renal apolipoprotein gene expression is substantially regulated under various physiological and disease conditions. This review is aimed at describing recent clinical and basic studies on the major roles and functions of apolipoproteins in the kidneys.

Tracking energy expenditure using VCO2 in ventilated out of hospital arrest patients.

Following publication of guidelines (2) dietetic assessment in critical care at Liverpool Heart and Chest Hospital (LHCH) was revised to include taking VCO2 measurements, in order to help estimate energy requirements as the inaccuracy of predictive weight-based equations is well known (1+2).

Nutrition Support among Critically Ill Pediatric Patients: The Current Practice

Background: Pediatric Intensive Care Unit (PICU) admitted patients are considered as a nutritionally high-risk population, for whom optimum energy and nutrient delivery is an important treatment strategy preventing organ dysfunction and subsequently poor clinical outcomes. Objectives: The present study aimed to investigate the nutritional adequacy indices and their probable relations to clinical outcomes in critically ill children. Methods: This project was a retrospective cross-sectional study carried out at the Akbar Children’s Hospital, Mashhad, Iran. All critically ill children with PICU stay &gt;48 hours during May-June 2019 were enrolled. Age, gender, medical diagnosis, nutritional status, energy and protein requirements and deliveries, and clinical outcomes of patients were extracted. Results: Seventy-one patients were included, among whom 39 subjects (54.9%) were male. The prevalence of malnutrition was 45.3% and 52.4% in PICU patients with surgical and non-surgical underlying diseases, respectively. There were significant associations between the nutritional status of the patients (upon the PICU admission time), infection, and mortality rate. Mean±SEM values of the estimated energy requirement and delivered energy were 85.7±1.6 and 68.3±2.1 kcal/kg/d, respectively. In addition, the estimated protein requirement and protein delivery were 2.5±0.08 and 1.8±0.03 gr/kg/d, respectively. Energy intake had a negative association with infection rate and lower protein delivery was negatively associated with prolonged duration of mechanical ventilation. Conclusions: Significant associations were found between energy/protein delivery and some clinical outcomes. The findings indicated the necessity of immediate further studies on the efficacy of different nutritional interventions as well as monitoring of optimal nutrition support barriers in critically ill children.

Usual Nutrient Intake Distribution and Prevalence of Inadequacy among Australian Children 0-24 Months: Findings from the Australian Feeding Infants and Toddlers Study (OzFITS) 2021.

(1) Background: Breastmilk provides all the nutrition an infant requires between 0–6 months. After that, complementary foods are needed to meet the child’s increasing energy and nutrient requirements. Inadequate energy and nutrient intake may lead to growth faltering, impaired neurodevelopment, and increased disease risk. While the importance of early life nutrition is well recognized, there are few investigations assessing the nutritional adequacy of Australian children <24 months. Here, we describe usual energy and nutrient intake distributions, including the prevalence of inadequate intakes and exceeding the upper limit (UL), in a national sample of Australian children 6– 24 months and infants < six months who had commenced solids and/or formula. (2) Methods: Dietary intakes were assessed using a one-day food record for 976 children with a repeat one-day record in a random subset. (3) Results: Based on the Nutrient Reference Values for Australia and New Zealand, children’s intakes were above the Adequate Intake or Estimated Average Requirement for most nutrients. Exceptions were iron and zinc where the prevalence of inadequacy was estimated to be 90% and 20%, respectively, for infants aged 6–11.9 months. Low iron intake was also observed in one quarter of toddlers 12–24 months. On average, children consumed 10% more energy than predicted based on Estimated Energy Requirements, and ~10% were classified as overweight based on their weight for length. One third of toddlers exceeded the tolerable upper limit for sodium and consumed > 1000 mg/day. Of the children under six months, 18% and 43% exceeded the UL for vitamin A (retinol) and zinc. (4) Conclusions: Compared to nutrient reference values, diets were sufficient for most nutrients; however, iron was a limiting nutrient for infants aged 6–11.9 months and toddlers 12–24 months potentially putting them at risk for iron deficiency. Excessive sodium intake among toddlers is a concern as this may increase the risk for hypertension.

Safety of adaptive ventilation modes ISV and PSV when weaning the patient from a respirator

Introduction.Currently there are no reports or recommendations concerning the ventilator weaning process. Appliance of the intellectual adaptive ventilation mode (iSV) represented in indigenous Russian unit ALV ZISLINE МV200 К 1.19 («Triton» Yekaterinburg) is highly potential. It provides minute ventilation target volume regardless of spontaneous patient’s respiratory activity and controls the pressure-support ventilation level (PSV) after each ventilatory cycle. Object was to increase safety of a patient’s spontaneous breathing adaptation period after longtime artificial lung ventilation.Materials and methods.Using the continuous sampling method we’ve surveyed 46 patients at the ages from 34 to 81 y.o. (median is 65.5 y.o.) being under prolonged artificial lung ventilation treatment at ICU from 5 to 28 full days. The groups are divided into 2 depending on the assisted respiration method for spontaneous breathing adaptation. In the 1st group (n = 25) the PSV mode was used for the purpose of spontaneous breathing adaptation. In the 2nd group (n = 21) the iSV mode was employed. The safety of conducting artificial lung ventilation was estimated by the dynamic of the arterial CO2 level, arterial oxygen saturation, pressure-support value, oxygen and energy intake value and a 24-hour fluid balance.Results.The comparison study of the metabolic indicants showed a higher rate of estimated energy requirement in the PSV mode authentically different by 3-5 full days, positive fluid balance conditioned by positive airway pressure and certain fluid retention which confirms more active respiratory load in the PSV mode. In the iSV mode from the 3rd till the 5th full day there’s negative fluid balance. By the 7th-10th full day it becomes slightly positive which proves electrolyte and fluid balance stabilization.Discussion.Most of the studies related to the study of the advantages of one or another method of auxiliary ventilation used the success of weaning as the primary indicator. In our study, we focused on the main respiratory indicators and the adequacy of ventilation when using auxiliary modes, as well as metabolic costs. In our study, we noted a decrease in the number of days spent by patients in IUC when using the iSV mode compared with the use of the PSV mode. We have determined a significant reduction in the estimated energy demand when using the adaptive ventilation mode compared to the pressure support mode, regardless of the PS level, as well as an increase in VO2 and VCO2.Conclusion.Thus, the iSV mode is believed to be more physiological than the PSV as it not only makes less demands on the respiratory system but it also allows to stabilize a patient's fluid balance during recovery after his/her critical condition.

An Examination of the Sex-Specific Nature of Nutrition Assessment within the Nutrition Care Process: Considerations for Nutrition and Dietetics Practitioners Working with Transgender and Gender Diverse Clients

An Examination of the Sex-Specific Nature of Nutrition Assessment within the Nutrition Care Process: Considerations for Nutrition and Dietetics Practitioners Working with Transgender and Gender Diverse Clients

Thermal, High Pressure, and Ultrasound Inactivation of Various Fruit Cultivars’ Polyphenol Oxidase: Kinetic Inactivation Models and Estimation of Treatment Energy Requirement

Polyphenol oxidase (PPO) catalyses the browning reaction during fruit processing and storage. It is considered a threat to clean labels and minimally processed fruit products. Unwanted changes in fruits’ appearance and quality represent a cost to the industry. High pressure and ultrasound, in addition to thermal treatment, are effective in reducing PPO activity and producing high-quality products. PPO from different fruit cultivars behaves differently when submitted to different treatments. A systematic review was conducted, where treatment parameters, PPO inactivation data (≥80% inactivation), and kinetic inactivation parameters (rate constant (k), activation energy (Ea), D-value, and z-value) by different treatments were collected. Additionally, the estimated energy requirements for the inactivation of PPO (≥80%) by different treatments were calculated and compared. Resistance to various treatments varies between fruit cultivars. For the same temperature, the inactivation of PPO by ultrasound combined with heat is more effective than thermal treatment alone, and the high pressure combined thermal process. The majority of the thermal, HPP, and ultrasound inactivation of PPO in fruits followed first-order behaviour. Some fruit cultivars, however, showed biphasic inactivation behaviour. The estimated specific energy requirements calculated based on the mass of processed fruit sample to inactivate ≥80% polyphenol oxidase for the thermal process was 87 to 255 kJ/kg, while for high pressure processing it was 139 to 269 kJ/kg and for ultrasound it was 780 to 10,814 kJ/kg.