Effectiveness of Social Cognitive Theory-Based Interventions for Glycemic Control in Adults With Type 2 Diabetes Mellitus: Protocol for a Systematic Review and Meta-Analysis.

BACKGROUND: For those living with type 2 diabetes mellitus (T2DM), failing to engage in self-management behaviors leads to poor glycemic control. Social cognitive theory (SCT) has been shown to improve health behaviors by altering cognitive processes and increasing an individual's belief in their ability to accomplish a task. OBJECTIVE: We aim to present a protocol for a systematic review and meta-analysis to systematically identify, evaluate, and analyze the effect of SCT-based interventions to improve glycemic control in adults with T2DM. METHODS: This protocol follows the 2009 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Data sources will include PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, Cochrane Library, and Web of Science, and data will be reviewed with the use of customized text mining software. Studies examining SCT-based behavioral interventions for adults diagnosed with T2DM in randomized controlled trials located in the outpatient setting will be included. Intervention effectiveness will be compared with routine care. Screening and data collection will be performed in multiple stages with three reviewers as follows: (1) an independent review of titles/abstracts, (2) a full review, and (3) data collection with alternating teams of two reviewers for disputes to be resolved by a third reviewer. Study quality and risk of bias will be assessed by three reviewers using the Cochrane risk of bias tool. Standardized mean differences will be used to describe the intervention effect sizes with regard to self-efficacy and diabetes knowledge. The raw mean difference of HbA1c will be provided in a random effects model and presented in a forest plot. The expected limitations of this study are incomplete data, the need to contact authors, and analysis of various types of glycemic control measures accurately within the same data set. RESULTS: This protocol was granted institutional review board exemption on October 7, 2019. PROSPERO registration (ID: CRD42020147105) was received on April 28, 2020. The review began on April 29, 2020. The results of the review will be disseminated through conference presentations, peer-reviewed journals, and meetings. CONCLUSIONS: This systematic review will appraise the effectiveness of SCT-based interventions for adults diagnosed with T2DM and provide the most effective interventions for improving health behaviors in these patients. TRIAL REGISTRATION: PROSPERO CRD42020147105; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=147105. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/17148.

Dietary Protein Source and Phosphate Levels in Patients on Hemodialysis.

OBJECTIVE: To determine the sources of protein and phosphorus levels from the food consumed by patients on dialysis. DESIGN AND METHODS: This is a retrospective, secondary data analysis of the Comprehensive Dialysis Survey study participants who had a baseline food frequency questionnaire and baseline lab data (N = 358). We examined intake of protein, phosphorus, and 7 other key nutrients from a subcohort of the Comprehensive Dialysis Survey based on the published National Kidney Foundation Kidney Dialysis Outcome Quality Initiative's nutrition recommendations. We studied the relationship of dietary protein source (plant or animal) with phosphorus intake using self-reported data from food frequency questionnaires. Variables included in final analysis are demographic, lab variables (albumin and prealbumin, alpha-1 acid glycoprotein, and C-reactive protein), and nutrition variables (calorie density, protein density, total fat, saturated fat, cholesterol, carbohydrates, phosphorus, calcium, sodium, potassium, plant-based protein, animal-based protein, and daily protein intake). RESULTS: Most of the patients had a lower than recommended consumption of calories, protein, phosphorus, and potassium while sodium, total, and saturated fats were overconsumed. Patients intake of dietary protein and calories was proportional to the amount of food consumed for both plant- and animal-based food. The levels of dietary protein and phosphorus were significantly (P < .05) lower in patients who primarily consumed a plant-based diet than in those who mainly consumed an animal-based diet. CONCLUSIONS: Consuming more plant-based protein as part of a varied diet could be nutritionally adequate while limiting intake of absorbable dietary phosphorus. More research in plant-based protein diets and their impact on patients with end-stage renal disease is needed.

GC-MS study of changes in polar/mid-polar and volatile compounds in Persian lime (Citrus latifolia) during fruit growth.

BACKGROUND: Citrus fruits possess a high content of bioactive compounds whose changes during fruit maturation have not been studied in depth. Fruits were sampled from week 1, after fruit onset (7 days after flowering), to week 14. Volatile compounds isolated by headspace-solid-phase microextraction and polar extracts from all samples were analyzed by gas chromatography-mass spectrometry. RESULTS: The relative abundance of 107 identified metabolites allowed differences among samples at different stages of fruit growth to be established. Principal component analysis showed a clear discrimination among samples, and analysis of variance revealed significant differences in 94 out of the 107 metabolites. Among total volatiles, monoterpenes increased their relative abundance from 86% to 94% during fruit growth, d-limonene, γ-terpinene and ß-pinene being the most abundant; conversely, sesquiterpenes decreased from 11.5% to 2.8%, ß-bisabolene and α-bergamotene being the most concentrated. Sugars, in general, exhibited a gradual increase in abundance, reaching a maximum between weeks 9 and 12. Citric and malic acids, representing approximately 90% of the total identified carboxylic acids, reached a maximum concentration at commercial maturity (week 14). CONCLUSION: Of the 107 tentatively identified metabolites during Persian lime growth, sugars, carboxylic acids, and volatiles were those that experienced more significant changes and more clearly created differences among fruit growth stages. © 2018 Society of Chemical Industry.

Is Dietary Protein Intake Predictive of 1-Year Mortality in Dialysis Patients?

BACKGROUND: High mortality in dialysis patients may be associated with protein-energy wasting (PEW) syndrome characterized by progressively depleted protein and energy stores. While early diagnosis and treatment of PEW can reduce mortality, clinically practical measures for its detection are lacking. Poor dietary protein intake (DPI) is associated with risk of malnutrition and PEW. However, the impact of DPI on mortality is unclear. The purpose of this study is to examine the ability of DPI to predict 1-year mortality in dialysis patients. METHODS: This prospective, secondary study using data from the Comprehensive Dialysis Study and United States Renal Data System examined risk factors associated with 1-year mortality in dialysis patients. RESULTS: Seventeen (7.5%) of the 227 subjects died within 1 year following baseline data collection. One year survivors were significantly younger (60 ± 13.6 versus 71 ± 12.8; P = 0.0043), had a lower Charlson Comorbidity Index score (1.6 ± 2.3 versus 4.0 ± 3.6; P = 0.0157), higher serum albumin level (3.5 ± 0.5 versus 3.3 ± 0.4; P = 0.0173) and had higher DPI (63 ± 33.7 versus 49.5 ± 21.5 g/day; P = 0.0386) than those who died. In multivariable Cox proportional hazards model analyses, only the Charlson Comorbidity Index adjusted hazard ratio for death (1.24) was significantly associated with increased mortality. The Comprehensive Dialysis Study data showed no association between DPI and 1-year mortality in dialysis patients. CONCLUSIONS: Future studies using more precise measures should further examine the impact of DPI on mortality given the known association of DPI with PEW syndrome and the definitive link between PEW syndrome and survival in dialysis patients.

Stability and Stabilization of Enzyme Biosensors: The Key to Successful Application and Commercialization.

Fifty-five years have passed and more than 100,000 articles have been published since the first report of an electrochemical enzyme biosensor. However, very few biosensors have reached practical application and commercialization. The bulk of the research effort has been on increasing sensitivity and selectivity. In contrast, the number of publications dealing with stability or stabilization of enzyme biosensors is very small. Here, we critically review enzyme stabilization strategies as well as the progress that has been done in the past 20 years with respect to enzyme biosensor stabilization. Glucose oxidase, lactate oxidase, alcohol oxidase, and xanthine oxidase are the focus of this review because of their potential applications in food. The inconsistency in reporting biosensor stability was identified as a critical hurdle to research progress in this area. Fundamental questions that remain unanswered are outlined.

GC-MS analysis of headspace and liquid extracts for metabolomic differentiation of citrus Huanglongbing and zinc deficiency in leaves of 'Valencia' sweet orange from commercial groves.

INTRODUCTION: Citrus Huanglongbing (HLB) is considered the most destructive citrus disease worldwide. Symptoms-based detection of HLB is difficult due to similarities with zinc deficiency. OBJECTIVE: To find metabolic differences between leaves from HLB-infected, zinc-deficient, and healthy 'Valencia' orange trees by using GC-MS based metabolomics. METHODOLOGY: Analysis based on GC-MS methods for untargeted metabolite analysis of citrus leaves was developed and optimized. Sample extracts from healthy, zinc deficient, or HLB-infected sweet orange leaves were submitted to headspace solid phase micro-extraction (SPME) and derivatization treatments prior to GC-MS analysis. RESULTS: Principal components analysis achieved correct classification of all the derivatized liquid extracts. Analysis of variance revealed 6 possible biomarkers for HLB, of which 5 were identified as proline, ß-elemene, (-)trans- caryophyllene, and α-humulene. Significant (P < 0.05) differences in oxo-butanedioic acid, arabitol, and neo-inositol were exclusively detected in samples from plants with zinc deficiency. Levels of isocaryophyllen, α-selinene, ß-selinene, and fructose were significantly (P < 0.05) different in healthy leaves only. CONCLUSION: Results suggest the potential of using identified HLB biomarkers for rapid differentiation of HLB from zinc deficiency.