Rethinking fat as a fuel for endurance exercise

Abstract

A key element contributing to deteriorating exercise capacity during physically demanding sport appears to be reduced carbohydrate availability coupled with an inability to effectively utilize alternative lipid fuel sources. Paradoxically, cognitive and physical decline associated with glycogen depletion occurs in the presence of an over-abundance of fuel stored as body fat that the athlete is apparently unable to access effectively. Current fuelling tactics that emphasize high-carbohydrate intakes before and during exercise inhibit fat utilization. The most efficient approach to accelerate the body’s ability to oxidize fat is to lower dietary carbohydrate intake to a level that results in nutritional ketosis (i.e., circulating ketone levels >0.5 mmol/L) while increasing fat intake for a period of several weeks. The coordinated set of metabolic adaptations that ensures proper interorgan fuel supply in the face of low-carbohydrate availability is referred to as keto-adaptation. Beyond simply providing a stable source of fuel for the brain, the major circulating ketone body, beta-hydroxybutyrate, has recently been shown to act as a signalling molecule capable of altering gene expression, eliciting complementary effects of keto-adaptation that could extend human physical and mental performance beyond current expectation. In this paper, we review these new findings and propose that the shift to fatty acids and ketones as primary fuels when dietary carbohydrate is restricted could be of benefit for some athletes.     

Strategic fit among knowledge attributes,knowledge management systems,and service positioning

Knowledge management systems (KMSs) support high-quality services while shaping and improving positioning of services. Given such strategic importance of KMS, this study explores the effects of different types of KMS, which respond to the attributes (i.e., diversity and tacitness) of collective knowledge, on service (re-)positioning. Through a case study of a financial consulting company at the core of KMSs, combinations of the two knowledge attributes are used to determine which type of KMS (i.e., information library, deepened stock, thought islands, and shared brain) offers the greatest efficiency and effectiveness in service (re-)positioning. The joint concerns of service innovation scope and specificity are also considered. Finally, the study discusses the theoretical and practical implications on KMS design and functionality in the new business age of service innovation.     

Application of association and decision rules on intellectual capital

Intellectual capital (IC), leading to sustainable competitiveness shapes the patterns of business reality nowadays. IC disclosure has become a critical necessity in this new framework. Being a novel interdisciplinary study, the aim of this paper was to examine IC disclosure by Greek publicly traded firms implementing association and decision rules. Firms were divided into three classes (low, medium and high) according to their IC disclosure, measured by the content analysis methodology. The association rules of each class were specified, highlighting IC reporting profile and focus of the firms belonging to each class. Firms in the high class were shown to have strongly realised the crucial need for a reporting change. Teamwork, corporate culture and extra-firm potential appeared to be underlined. Applying the decision tree methodology, the paper succeeded in proving the remuneration–incentive system, R&D and business collaborations items as the IC reporting-related factors differentiating classes.     

Spontaneous Tumor Lysis Syndrome in an Infant: A Case Report

Tumor lysis syndrome has been observed in patients with malignancies with high cellular burden and high cell turnover, tumor sensitive to therapy, especially after initiating medical treatment. It very rarely occurs spontaneously. The case described here is of 6 months male infant who presented with fever since 1 month and loose stools associated with blood since 15 days. The laboratory investigations showed lactate dehydrogenase (LDH) of 6,192 IU/L and serum uric acid 18.2 mg/dl along with pancytopenia. The infant presented with electrolyte abnormalities and renal failure.     

Advances in urinary protein biomarkers for urogenital and non-urogenital pathologies

The discovery of protein biomarkers that reflect the biological state of the body is of vital importance to disease management. Urine is an ideal source of biomarkers that provides a non-invasive approach to diagnosis, prognosis and prediction of diseases. Consequently, the study of the human urinary proteome has increased dramatically over the last 10 years, with many studies being published. This review focuses on urinary protein biomarkers that have shown potential, in initial studies, for diseases affecting the urogenital tract, specifically chronic kidney disease and prostate cancer, as well as other non-urogenital pathologies such as breast cancer, diabetes, atherosclerosis and osteoarthritis. PubMed was searched for peer-reviewed literature on the subject, published in the last 10 years. The keywords used were “urine, biomarker, protein, and/or prostate cancer/breast cancer/chronic kidney disease/diabetes/atherosclerosis/osteoarthritis”. Original studies on the subject, as well as a small number of reviews, were analysed including the strengths and weaknesses, and we summarized the performance of biomarkers that demonstrated potential. One of the biggest challenges found is that biomarkers are often shared by several pathologies so are not specific to one disease. Therefore, the trend is shifting towards implementing a panel of biomarkers, which may increase specificity. Although there have been many advances in urinary proteomics, these have not resulted in similar advancements in clinical practice due to high costs and the lack of large data sets. In order to translate these potential biomarkers to clinical practice, vigorous validation is needed, with input from industry or large collaborative studies.Key words: urine, protein, biomarker     

Hemolysis from a nurses’ standpoint – survey from four Croatian hospitals

Introduction

Hemolysis can occur during sample collection, handling and transport. It is more frequent when the non-laboratory staff performs sampling. The aim of this study was to assess nurses’ knowledge on the causes of hemolysis and consequential impact on the laboratory tests results. Additionally, the differences in knowledge, related to work experience, professional degree and previous education about hemolysis were explored.

Materials and methods

An anonymus survey, containing 11 questions on demographics, causes of hemolysis, its impact on biochemical parameters and nurses’ attitude towards additional education in preanalytics, was conducted in four Croatian hospitals. The answers were compared by Chi-squared and Fischer exact test.

Results

In total, 562 survey results were collected. Majority of nurses declared familiarity with the term “hemolysis” (99.6%). There were 77% of correct answers regarding questions about the causes of hemolysis, but only 50% when it comes to questions about interference in biochemical tests. The percentage of correct answers about causes was significantly lower (P = 0.029) among more experienced nurses, and higher (P = 0.027) in those with higher professional degree, while influence of previous education was not significant. Also, higher percentage of correct answers about interferences was encountered in nurses with longer work experience (P = 0.039). More than 70% of nurses declared that additional education about preanalytical factors would be beneficial.

Conclusion

Croatian nurses are familiar with the definition of hemolysis, but a lack of knowledge about causes and influence on laboratory test results is evident. Nurses are eager to improve their knowledge in this field of preanalytical phase.Key words: hemolysis, nurses, survey, preanalytical phase