The development of an EU-wide nutrition and physical activity expert knowledge base to support a personalised mobile application across various EU population groups.

A healthy lifestyle comprising regular physical activity and an adequate diet is imperative for the prevention of non-communicable diseases such as hypertension and some cancers. Advances in information computer technology offer the opportunity to provide personalised lifestyle advice directly to the individual through devices such as smartphones or tablets. The overall aim of the PROTEIN project (Wilson-Barnes et al., 2021) was to develop a smartphone application that could provide tailored and dynamic nutrition and physical activity advice directly to the individual in real time. However, to create this mobile health (m-health) smartphone application, a knowledge base of reference ranges for macro-/micronutrient intake, anthropometry, biochemical, physiological and sleep parameters was required to underpin the parameters of the recommender systems. Therefore, the principal aim of this emerging research paper is to describe the process by which experts in nutrition and physiology from the PROTEIN consortium collaborated to develop the nutritional and physical activity requirements, based upon existing recommendations, for 10 separate population groups living within the EU including, but not limited to healthy adults, adults with type 2 diabetes mellitus, cardiovascular disease, excess weight, obesity and iron deficiency anaemia. A secondary aim is to describe the development of a library of 24-h meal plans appropriate for the same groups and also encompassing various dietary preferences and allergies. Overall, the consortium devised an extensive nutrition and physical activity knowledge base that is pertinent to 10 separate EU user groups, is available in 7 different languages and is practically implemented via a library of culturally appropriate, 24-h meal plans.

Neural correlates of the volitional regulation of the desire for food.

OBJECTIVE: In this study, we investigate the brain mechanisms of the conscious regulation of the desire for food using functional magnetic resonance imaging. Further, we examine associations between hemodynamic responses and participants' cognitive restraint of eating (CRE), as well as their susceptibility to uncontrolled eating. SUBJECTS: Seventeen non-vegetarian, right-handed, female Caucasian participants (age: 20-30 years, mean 25.3 years±3.1 s.d.; BMI: 20.2-31.2 kg m(-2), mean 25.1±3.5 s.d.). MEASUREMENTS: During scanning, our participants viewed pictures of food items they had pre-rated according to tastiness and healthiness. Participants were either allowed to admit to the desire for the food (ADMIT) or they were instructed to downregulate their desire using a cognitive reappraisal strategy, that is, thinking of negative long-term health-related and social consequences (REGULATE). RESULTS: Comparing the hemodynamic responses of the REGULATE with the ADMIT condition, we observed robust activation in the dorsolateral prefrontal cortex (DLPFC), the pre-supplementary motor area, the inferior frontal gyrus (IFG), the dorsal striatum (DS), the bilateral orbitofrontal cortex (OFC), the anterior insula and the temporo-parietal junction (TPJ). Activation in the DLPFC and the DS strongly correlated with the degree of dietary restraint under both conditions. CONCLUSION: Cortical activation in the DLPFC, the pre-supplementary motor area and the inferior frontal gyrus (IFG) are known to underpin top-down control, inhibition of learned associations and pre-potent responses. The observed hemodynamic responses in the lateral OFC, the DS, the anterior insula and the TPJ support the notion of reward valuation and integration, interoceptive awareness, and self-reflection as key processes during active regulation of desire for food. In conclusion, an active reappraisal of unhealthy food recruits the brain's valuation system in combination with prefrontal cognitive control areas associated with response inhibition. The correlations between brain responses and CRE suggest that individuals with increased cognitive restraint show an automatic predisposition to regulate the hedonic aspects of food stimuli. This cognitive control might be necessary to counterbalance a lack of homeostatic mechanisms.

[Urban shrinkage and challenges for the public health-care service]. / Städtische Schrumpfungsprozesse und Herausforderungen für den öffentlichen Gesundheitsdienst.

In the 21st century, urban development is facing new challenges caused by the simultaneous growing and shrinking of cities and urban regions. Whilst the development patterns and instruments of urban growth are well-known and widely accepted, the processes of shrinkage with its broad consequences, sphere of impact and speed need intensive investigation. In particular, urban restructuring including housing demolition brings about psychological stress situations for the affected inhabitants. Until the present time public services, including health-care, are poorly prepared to cope with the new situation. To take account of these new challenges, the adaptation of tasks, instruments and targets is urgently needed. To be successful, a continuous cooperation and communication between municipal institutions and housing enterprises responsible for urban and housing development is indispensable. Furthermore, appropriately focussed scientific research results can support the creation of adequate strategies and instruments.

[Lymphocyte subpopulations in patients at risk of sepsis in a surgical intensive care unit]. / Lymphozytensubpopulationen bei sepsisgefährdeten Patienten einer operativen Intensivstation.

Infection remains a major cause of morbidity and mortality in intensive care medicine. The increased susceptibility of the severely injured patient to sepsis and consecutive multiorgan failure has been attributed to abnormalities in cell-mediated immunity. The purpose of our study was to determine changes in the pattern of lymphocyte subpopulations in severely injured patients and to relate these changes to any development of sepsis and to outcome (indirect immunofluorescence with monoclonal antibodies). During 14 months we investigated 28 patients (ages 15-65 years) suffering from severe multisystem trauma (22 cases) or diffuse peritonitis (6 cases), 6 of whom (21.4%) developed sepsis and multiorgan failure; 4 of these 6 septic patients died. According to the clinical data, patients developed sepsis between the 3rd and 6th days after trauma. We therefore defined days 1-3 as the preseptic phase, days 3-6 as the phase of sepsis development, and days 4-10 as the phase of septic disease. In the preseptic phase there was no statistically significant difference in the pattern of the eight lymphocyte subpopulations measured between patients who later developed sepsis and those who did not. During the phase of sepsis development, however, the patients who did develop sepsis showed significantly reduced numbers of CD2-, CD8-, and CD20-positive cells (P = 0.0003; P = 0.009; P = 0.012). The number of helper cells (CD4) was also decreased, but the difference between the two groups failed to reach statistical significance (P = 0.08).(ABSTRACT TRUNCATED AT 250 WORDS)

[Effect of opioids on granulocyte adherence]. / Der Einfluss von Opioiden auf die Granulozytenadhärenz.

The influence of clinically relevant concentrations of fentanyl, alfentanil, morphine, pethidine, and buprenorphine on polymorphonuclear neutrophilic granulocyte (PMN) adherence was investigated in vitro by using nylon fibre columns. Since none of the drugs produced any significant (p less than 0.05) change of adherence, no evidence of opioid mediated increased risk of postoperative bacterial infection could be found.

[Anesthesia induction agents and granulocyte adherence]. / Narkoseeinleitungsmittel und Granulozytenadhärenz.

The influence of clinically relevant concentrations of thiopentone sodium, methohexitone, and etomidate on polymorphonuclear neutrophilic granulocyte (PMN) adherence was investigated in vitro by using nylon fibre columns. The three induction agents produced dose-dependently a significant (p less than 0.01) reduction in adherence. This effect is possibly related to increased risk of postoperative bacterial infection. Further studies on this problem are recommended.

[Effect of pancuronium bromide on the adherence of polymorphonuclear neutrophilic granulocytes in vitro]. / Uber den Einfluss von Pancuroniumbromid auf die Adhärenz polymorphkerniger neutrophiler Granulozyten in vitro.

Infection is still an important problem following surgery. Polymorphonuclear neutrophil granulocytes (PMN) play a vital role in host defenses against invading bacteria; thus, adverse effects on PMN caused by anesthetic agents are of general interest. In this study, we examined the influence of pancuronium bromide on PMN adherence in vitro. Heparinized venous blood samples were obtained from 18 healthy male adult donors. Each specimen was divided. One part was used to determine the adherence of untreated PMN, while pancuronium bromide was added to the other. Two concentrations (1.3 or 0.5 micrograms relaxant/ml blood) were tested. PMN adherence was studied using nylon fiber columns as described by MacGregor et al. Both concentrations of pancuronium bromide caused an inhibition of adherence, which was significant in the case of the higher dosage (p less than 0.05). There is a direct correlation between the intensity of PMN adherence and the extent of granulocyte delivery to sites of inflammation. Therefore, it seems possible that clinical concentrations of pancuronium bromide may be able to increase the risk of developing bacterial infections. Further studies concerning this problem should be conducted.

[Change in the adhesiveness of polymorphonuclear neutrophilic granulocytes by the intravenous anesthetics midazolam and ketamine]. / Uber Veränderung der Adhärenz polymorphkerniger neutrophiler Granulozyten durch die intravenösen Anästhetika Midazolam und Ketamin.

The influence of midazolam and ketamine on polymorphonuclear neutrophil granulocyte (PMN) adherence was investigated in vitro by using nylon fiber columns. Both a concentration of 1.0 microgram midazolam/ml blood and 0.2 microgram/ml caused a reduction of adherence. This decrease was significant (p less than 0.05) in the case of the higher dosage. The two concentrations of ketamine used (1.3 micrograms/ml resp. 0.5 microgram/ml) produced a significant reduction of adherence too. Thus both anesthetic agents are able to impair PMN function in vitro dose-dependently. This feature is possibly related to increased risk of postoperative bacterial infection. Further studies concerning this problem should be conducted.

[Changes in lymphocyte subpopulations in relation to anesthesia procedure]. / Veränderungen von Lymphozytensubpopulationen in Abhängigkeit vom Narkoseverfahren.

44 patients undergoing comparable gynaecological operations received either halothane- modified neuroleptanaesthesia or a combination of epidural and NLA. Monoclonal antibodies were used to determine 8 different lymphocyte subpopulations in blood samples drawn before and after anaesthesia and on the first postoperative day. Cell populations were counted by fluorescent microscopy. Halothane anaesthesia produced both a depression of T-cells (72.67% preoperatively to 52.79% postoperatively) and of the helper/suppressor ratio (1.46 to 1.10); meanwhile activated T-cells increased from 2.33% to 6.83%. After neuroleptanaesthesia as well as after halothane the HLA-DR positive cells decreased (21.05% to 19.29%; 25.22% to 20.29%). The B-cell fraction was elevated from 2.33% to 6.83% following combined anaesthesia. The potential of the anaesthetics to produce subsequent alterations in host defense is discussed.