Acute effects of extruded pea fractions on glycemic response, insulin, appetite, and food intake in healthy young adults, results of a double-blind, randomized crossover trial.

Benefits of pulse consumption on glycemic control are well established; however, research examining the effects of pulse fractions incorporated into extruded products is limited. In a randomized, repeated-measures crossover study, adults (n = 26) consumed cereals made with oat flour (control), oat flour and pea starch (starch), oat flour and pea protein (protein), oat flour, pea starch and pea protein (starch+protein), oat flour, pea fibre and pea protein (fibre+protein), and pea fibre, pea starch and pea protein (fibre+starch+protein). Blood glucose (BG) and insulin concentrations, and appetite incremental area under the curve (iAUC) were calculated before (0-120 min) and after (120-200 min) the ad libitum meal for measurement of food intake. Pre-meal, overall mean BG and iAUC were lower following the protein, starch+protein, protein+fibre, and the fibre+starch+protein cereals compared with the starch and control. For pre-meal overall mean insulin concentrations, fibre+protein led to a lower response compared with control, starch+protein, and protein cereals. Fibre+starch+protein also led to lower insulin compared with protein cereal. Pre-meal insulin iAUC was lower following fibre+protein compared with control and protein cereals. The inclusion of yellow pea protein and fibre in oat-based breakfast cereal reduces postprandial glycemia; however this effect is dependent on fraction type. ClinicalTrials.gov: NCT02366572. Novelty: Inclusion of pulse protein and fibre in oat flour-based breakfast cereal reduces postprandial glucose response. The glycemic benefits of whole pulses are at least somewhat retained in some pulse fractions.

Acute effects of extruded pulse snacks on glycemic response, insulin, appetite, and food intake in healthy young adults in a double blind, randomized, crossover trial.

Research indicates that the postprandial glycemic benefits of consuming whole pulses are retained when consumed in a mixed meal, pureed, and ground into flours. The glycemic benefits of pulse flours when incorporated into extruded products are unknown. In a randomized, repeated-measures crossover study, adults (n = 26) consumed extruded corn snacks made with the addition of 40% pulse flour from either whole yellow pea, split yellow pea, green lentil, chickpea, or pinto bean. The control snack was 100% corn. Food intake was measured with an ad libitum meal consumed at 120 min. Blood glucose (BG), insulin and appetite were measured regularly before (pre-meal, 0-120 min) and after (post-meal, 140-200 min) the meal. Pinto bean and chickpea snacks led to lower (p < 0.05) pre-meal BG incremental area under the curve (iAUC), compared with control, whole yellow pea and green lentil snacks. Pinto bean snack also led to lower (pre-meal BG (p < 0.05) and insulin (p < 0.05) iAUC compared with control, whole yellow pea, and split yellow pea snacks. There were no differences in food intake or appetite. These findings indicate that effects of replacing corn with pulse flours in extruded snacks on BG, and insulin are dependent on pulse type. ClinicalTrials.gov Identifier: NCT02402504. Registered on 30 March 2015. Novelty: The incorporation of pinto bean and chickpea flour into extruded corn snacks improves postprandial glycemic response. Pulse containing snacks were equally as palatable as the corn snacks. The incorporation of pulses into corn snacks increased the protein and fibre content.

Mitigation of excessive fatigue associated with functional electrical stimulation.

OBJECTIVE: Restoration of motor function in paralyzed limbs using functional electrical stimulation (FES) is undermined by rapid fatigue associated with artificial stimulation. Typically, single electrodes are used to activate muscles with FES. However, due to the highly distributed branching of muscle nerves, a single electrode may not be able to activate the entire array of motor axons supplying a muscle. Therefore, stimulating muscle with multiple electrodes might enable access to a larger volume of muscle and thereby reduce fatigue. APPROACH: Accordingly, we compared the endurance times that ankle dorsiflexion could be sustained at 20% maximum voluntary force using feedback controlled stimulation (25 Hz) of human tibialis anterior (TA) using one or four percutaneous intramuscular electrodes. In addition, we measured endurance times in response to direct stimulation of the nerve supplying TA and during voluntary contraction. In all sessions involving electrical stimulation, an anesthetic nerve block proximal to the site of stimulation was used to isolate the effects of stimulation and alleviate discomfort. MAIN RESULTS: Endurance time associated with stimuli delivered by a single intramuscular electrode (84 ± 19 s) was significantly smaller than that elicited by four intramuscular electrodes (232 ± 123 s). Moreover, endurance time in response to nerve stimulation (787 ± 201 s) was not significantly different that that produced during voluntary contraction (896 ± 272 s). SIGNIFICANCE: Therefore, excessive fatigue associated with FES is probably due to the inability of conventional FES systems to enlist the full complement of motor axons innervating muscle and can be mitigated using multiple electrodes or nerve-based electrodes.

Distributed stimulation increases force elicited with functional electrical stimulation.

OBJECTIVE: The maximum muscle forces that can be evoked using functional electrical stimulation (FES) are relatively modest. The reason for this weakness is not fully understood but could be partly related to the widespread distribution of motor nerve branches within muscle. As such, a single stimulating electrode (as is conventionally used) may be incapable of activating the entire array of motor axons supplying a muscle. Therefore, the objective of this study was to determine whether stimulating a muscle with more than one source of current could boost force above that achievable with a single source. APPROACH: We compared the maximum isometric forces that could be evoked in the anterior deltoid of anesthetized monkeys using one or two intramuscular electrodes. We also evaluated whether temporally interleaved stimulation between two electrodes might reduce fatigue during prolonged activity compared to synchronized stimulation through two electrodes. MAIN RESULTS: We found that dual electrode stimulation consistently produced greater force (~50% greater on average) than maximal stimulation with single electrodes. No differences, however, were found in the fatigue responses using interleaved versus synchronized stimulation. SIGNIFICANCE: It seems reasonable to consider using multi-electrode stimulation to augment the force-generating capacity of muscles and thereby increase the utility of FES systems.

An examination of the health profile, service use and care needs of older adults in residential care facilities.

Private, unregulated residential care facilities have become an increasingly important component of the continuum of housing and care for frail older adults in Canada. To date, this growing segment of the older population has received very little research attention. This study involved an in-depth examination of the functional/health profile, patterns of service use, and medical/care needs of a representative sample of 178 older adults in residential care facilities in the City of Ottawa. The results indicate great diversity in resident and facility profiles in this setting and confirm earlier impressions that special care units in the residential care sector have become increasingly close to being unlicensed pseudo-nursing homes. Despite the heavy burden of care, the evidence suggests that the care needs of the majority of residents are adequately met in the residential care environment. The results can inform future research, case finding, educational, and policy planning initiatives in this setting.

Dielectric study of the molecular mobility and the isothermal crystallization kinetics of an amorphous pharmaceutical drug substance.

During the development of new pharmaceutical products based on drug substances in their amorphous form, the molecular mobility of an amorphous active ingredient was characterized in detail within a very broad time-temperature range. The relation between the isothermal crystallization kinetics and the dynamics of this amorphous substance was investigated. First, dynamic dielectric spectroscopy (DDS) and the thermostimulated current (TSC) techniques were used to analyze the molecular mobility of the amorphous drug substance over a wide frequency and temperature range (the drug substance is referred to as SSR in this text and was chosen as a model glass-forming system). Two relaxation processes, corresponding to different molecular motions, were identified. The beta(a)-relaxation process, associated with intramolecular oscillation of small dipolar groups, followed Arrhenius temperature behavior over the entire time-temperature domain that was studied. However, the main alpha(a)-relaxation process, assigned to the dielectric manifestation of the dynamic glass transition of the amorphous phase, was described by Vogel-Fulcher-Tammann (VFT) and Arrhenius behavior above and below the glass transition temperature (T(g)) respectively. The physical meaning of these complex dynamics is explained in the context of the Adam and Gibbs (AG) model, by the temperature dependence of the size of cooperatively rearranging regions (CRR) that govern the time scale of delocalized molecular motions. The distinction between the molecular mobility and the structural relaxation of amorphous systems below T(g) is discussed. This work shows that the complementary nature of both DDS and TSC techniques is essential to directly analyze the intramolecular and molecular motions of disordered phases over a wide time-temperature range above and below the T(g). Second, real-time dielectric measurements were carried out to determine the isothermal crystallization kinetics of the SSR amorphous drug. Whatever the crystalline form obtained over time in the crystallization process, the decrease of the dielectric response of amorphous phase, which is characteristic of the isothermal crystallization, was studied to monitor the time dependence of the degree of crystallinity. The characteristic crystallization time, derived from Kohlrausch-Williams-Watt (KWW)-Avrami analyses performed at different temperatures, followed an Arrhenius temperature dependence. Behaviors specific to the molecular mobility of the amorphous drug substance were compared with the characteristic crystallization time. It was concluded that the crystal growth process of the SSR drug seems to be controlled by the intramolecular motions involving the beta(a)-relaxation mode and not by the molecular motions responsible for the alpha(a)-relaxation mode in the range of temperatures >T(g). Subsequent studies will focus on the crystallization process of the SSR drug in the glassy state (T < T(g)).