bluuebunny/crossref_metadata_2025 huggingface dataset:
Aktivitas Antihiperglikemik Ekstrak Daun Gedi Merah (Abelmoschus manihot L.Medik) pada Tikus Model Diabetes Melitus Tipe II
Authors: Nuralifah  , Parawansah  , La Ode Muhammad Fitrawan  , Irvan Anwar  , Alya Zuhriyah
Published: March 2024

Type II diabetes mellitus is a metabolic disorder characterized by increased blood glucose levels due to damage to pancreatic β cells which causes reduced insulin production or abnormal insulin action. The leaves of Abelmoschus manihot L.Medik as an antidiabetic have been used empirically by the community. This study aims to determine the activity of the ethanol extract of Abelmoschus manihot L.Medik leaves as an antihyperglycemic agent in male rats fed a high-fat diet and experiencing type 2 DM induced by streptozotocin. The test animals were divided into six groups: the normal control group (KN) without treatment; the negative control group (K-), which was treated with 0.5% NaCMC, the positive control group (K+), which was treated with metformin 9 mg and the test group of extracts. With doses varying from 75 mg/kg, 150 mg/kg, and 300 mg/kg, rats were first given a high-fat diet, then induced by streptozotocin at a 30 mg/kg dose extract was given for seven days. The results of the phytochemical screening showed that the ethanol extract of red gedi leaves contained alkaloids, flavonoids, tannins, saponins, and steroids. The measurement results showed that administering ethanol extract of red gedi leaves (Abelmoschus manihot L.Medik) doses of 75 mg/kg, 150 mg/kg, and 300 mg/kg affected reducing blood glucose levels in male rats of the Wistar strain type II diabetes mellitus model. Significant based on the One-way ANOVA test and the Least Significance Difference (LSD) post hoc test.
Potensi Bandotan (Ageratum conyzoides Linn.) sebagai Pencegah Diabetes Melitus dan Komplikasi Terkait Platelet: Pendekatan in vivo
Authors: Nurramadhani A.Sida  , Henny Kasmawati  , Loly Subhiaty Idrus  , Ruslin
Published: March 2024

Daun Ageratum conyzoides Linn. memiliki efek sebagai antidiabetes melitus, namun data terkait efeknya terhadap kondisi kelainan agregasi platelet karena komplikasi DM belum pernah dilaporkan. Oleh sebab itu, pada penelitian ini dilakukan pengujian antidiabetes dan antiagregasi platelet ekstrak etanol daun Ageratum conyzoides Linn. Pemodelan hewan menggunakan induksi oral glukosa 20 g/kgBB 3 kali sehari, dan diberi pakan khusus lemak dan karbohidrat. Hewan dengan KGD > 135 mg/dL dibagi menjadi 6 kelompok, kontrol normal (KN), kontrol diabetes (K(-)), diabetes+glibenklamid (K(+)), hewan yang diberi ekstrak etanol daun Ageratum conyzoides Linn dosis 100 mg/kgBB (BD1), 200 mg/kgBB (BD2) dan 400 mg/kgBB) (BD3). Treatment dilakukan selama 14 hari. Agregasi platelet diukur berdasarkan waktu perdarahan dan waktu koagulasi. Ekstrak daun Ageratum conyzoides Linn. memiliki potensi sebagai antidiabetes (p<0,05) dengan dosis efektif yaitu 200 mg/kgBB dan menujukkan efektivitas yang sama dengan glibenklamid dalam menurunkan kadar glukosa darah (p>0,05). Namun, ekstrak etanol daun Ageratum conyzoides Linn. tidak menunjukkan adanya efek antiagregasi platelet pada tikus diabetes yang ditandai dengan penurunan waktu perdarahan dan waktu koagulasi (p>0,05). Berdasarkan hal tersebut, ekstrak daun Ageratum conyzoides Linn. dapat dikembangkan menjadi obat diabetes melitus, namun diduga tidak dapat digunakan untuk pencegahan komplikasi terkait agregasi platelet berdasarkan waktu perdarahan dan waktu koagulasi.
Clinical study: the impact of goal-directed fluid therapy on volume management during enhanced recovery after surgery in gastrointestinal procedures
Authors: Gao Ming , Chen Minggan , Dai Gang , Zhu Dengfeng , Cai Yiting
Published: March 2024

Background: Goal-directed fluid therapy, as a crucial component of accelerated rehabilitation after surgery, plays a significant role in expediting postoperative recovery and enhancing the prognosis of major surgical procedures.

Methods: In line with this, the present study aimed to investigate the impact of target-oriented fluid therapy on volume management during ERAS protocols specifically for gastrointestinal surgery. Patients undergoing gastrointestinal surgery at our hospital between October 2019 and May 2021 were selected as the sample population for this research.

Results: 41 cases of gastrointestinal surgery patients were collected from our hospital over 3 recent years. Compared with T1, MAP levels were significantly increased from T2 to T5; cardiac output (CO) was significantly decreased from T2 to T3, and significantly increased from T4 to T5; and SV level was significantly increased from T3 to T5. Compared with T2, HR and cardiac index (CI) were significantly elevated at T1 and at T3–T5. Compared with T3, SVV was significantly decreased at T1, T2, T4, and T5; CO and stroke volume (SV) levels were increased significantly at T4 and T5. In this study, pressor drugs were taken for 23 days, PACU residence time was 40.22 ± 12.79 min, time to get out of bed was 12.41 ± 3.97 h, exhaust and defecation time was 18.11 ± 7.52 h, and length of postoperative hospital stay was 4.47 ± 1.98 days. The average HAMA score was 9.11 ± 2.37, CRP levels were 10.54 ± 3.38 mg/L, adrenaline levels were 132.87 ± 8.97 ng/L, and cortisol levels were 119.72 ± 4.08 ng/L. Prealbumin levels were 141.98 ± 10.99 mg/L at 3 d after surgery, and 164.17 ± 15.84 mg/L on the day of discharge. Lymphocyte count was 1.22 ± 0.18 (109/L) at 3 d after surgery, and 1.47 ± 0.17 (109/L) on the day of discharge. Serum albumin levels were 30.51 ± 2.28 (g/L) at 3 d after surgery, and 33.52 ± 2.07 (g/L) on the day of discharge.

Conclusion: Goal-directed fluid therapy (GDFT) under the concept of Enhanced Recovery After Surgery (ERAS) is helpful in volume management during radical resection of colorectal tumors, with good postoperative recovery. Attention should be paid to the influence of pneumoperitoneum and intraoperative posture on GDFT parameters.
Assessment of carbon sink capacity and its value accounting for a farmed shellfish in the coastal wetland of the Yalu River Estuary
Authors: Hao Yanju , Tan Zhenjiang , Cai Yueyin , Liang Shengkang , Zhang Guangshuai , Wang Quangming , Li Qing
Published: March 2024

The carbon sink of cultivation shellfish in coastal wetlands is characterized as both highly ecological and economic value, thus making great contributions to achieving carbon neutrality. In this study, the main species of cultured shellfish (Ruditapes philippinarum, Meretrix meretrix, Sinonovacula constricta, Scapharca suberenata, and Grassostrea gigas) were selected as the research objects in the coastal wetland of the Yalu River Estuary to measure shellfish yields and carbon contents. Combined with the data from the cultured shellfish of fishery statistics of Donggang city, Dandong, Liaoning Province, China, the carbon sequestration capacity was calculated, and the carbon sink values of cultured shellfish also evaluated on the base of the diverse shellfish carbon sequestration ratios. The carbon sink conversion ratio of cultivation shellfish decreased in the following order: S. suberenata, R. philippinarum, G. gigas, S. constricta, and M. meretrix. The total carbon sequestration of cultured shellfish in the Yalu River Estuary Coastal Wetland from 2015 to 2019 was approximately 110,500 tC. The yield and the carbon sequestration quantity of R. philippinarum accounted for 76.60~83.30% of the total yield and 79.07~85.41% of the total carbon sequestration quantity. The value of the carbon sink was approximately 63,710,600 yuan. Among the species of cultured shellfish, R. philippinarum was the largest contributor to the carbon sink value. Based on Tapio’s decoupling model, R. philippinarum has the most ideal state of decoupling between carbon sink and economic growth of cultured shellfish, followed by M. meretrix and S. suberenata. Our results illustrate that the development of coastal wetland shellfish aquaculture has a positive contribution to reducing carbon emissions and increasing carbon sinks.
Differences in kinetic factors affecting gait speed between lesion sides in patients with stroke
Authors: Sekiguchi Yusuke , Owaki Dai , Honda Keita , Izumi Shin-Ichi , Ebihara Satoru
Published: March 2024

The differences in kinetic mechanisms of decreased gait speed across brain lesion sides have not been elucidated, including the arrangement of motor modules reflected by kinetic interjoint coordination. The purpose of this study was to elucidate the differences in the kinetic factors of slow gait speed in patients with stroke on the lesion sides. A three-dimensional motion analysis system was employed to assess joint moment in the lower limb and representative gait parameters in 32 patients with right hemisphere brain damage (RHD) and 38 patients with left hemisphere brain damage (LHD) following stroke as well as 20 healthy controls. Motor module composition and timing were determined using principal component analysis based on the three joint moments in the lower limb in the stance phase, which were the variances accounted for principal components (PCs) and the peak timing in the time series of PCs. A stepwise multiple linear regression analysis was performed to identify the most significant joint moment and PC-associated parameter in explaining gait speed. A negligible difference was observed in age, weight, height, and gait speed among patients with RHD and LHD and controls. The following factors contributed to gait speed: in patients with RHD, larger ankle plantarflexion moment on the paretic (p = 0.001) and nonparetic (p = 0.002) sides and ankle dorsiflexion moment on the nonparetic side (p = 0.004); in patients with LHD, larger ankle plantarflexion moment (p < 0.001) and delayed peak timing of the first PC (p = 0.012) on the paretic side as well as ankle dorsiflexion moment on the nonparetic side (p < 0.001); in the controls, delayed peak timing of the first PC (p = 0.002) on the right side and larger ankle dorsiflexion moment (p = 0.001) as well as larger hip flexion moment on the left side (p = 0.023). The findings suggest that the kinetic mechanisms of gait speed may differ among patients with RHD following patients with stroke with LHD, and controls.
Vaccine development: obligate intracellular bacteria new tools, old pathogens: the current state of vaccines against obligate intracellular bacteria
Authors: van Schaik E. J. , Fratzke A. P. , Gregory A. E. , Dumaine Jennifer E. , Samuel J. E.
Published: March 2024

Obligate intracellular bacteria have remained those for which effective vaccines are unavailable, mostly because protection does not solely rely on an antibody response. Effective antibody-based vaccines, however, have been developed against extracellular bacteria pathogens or toxins. Additionally, obligate intracellular bacteria have evolved many mechanisms to subvert the immune response, making vaccine development complex. Much of what we know about protective immunity for these pathogens has been determined using infection-resolved cases and animal models that mimic disease. These studies have laid the groundwork for antigen discovery, which, combined with recent advances in vaccinology, should allow for the development of safe and efficacious vaccines. Successful vaccines against obligate intracellular bacteria should elicit potent T cell memory responses, in addition to humoral responses. Furthermore, they ought to be designed to specifically induce strong cytotoxic CD8+ T cell responses for protective immunity. This review will describe what we know about the potentially protective immune responses to this group of bacteria. Additionally, we will argue that the novel delivery platforms used during the Sars-CoV-2 pandemic should be excellent candidates to produce protective immunity once antigens are discovered. We will then look more specifically into the vaccine development for Rickettsiaceae, Coxiella burnetti, and Anaplasmataceae from infancy until today. We have not included Chlamydia trachomatis in this review because of the many vaccine related reviews that have been written in recent years.
Anticipatory action for drought in the Sahel: an innovation for drought risk management or a buzzword?
Authors: Parodi Luca Sergio Italo , Enenkel Markus , Lombardi Niccolò , Ngaina Joshua
Published: March 2024

Anticipatory action is an approach that combines early warning information with flexible, pre-positioned funds to trigger actions that mitigate the impact of predictable shocks on the most vulnerable people. Historically, drought is the climatic hazard that led to the highest and most severe humanitarian impacts in the Sahel. This region, according to climate projections, will be one of the most deeply affected by climate change in future years, leading to considerable changes to societies, economies, as well as impacting rural communities. While this negative projection may lead to further increases in humanitarian consequences, recent experiences from integrating anticipatory action for drought into humanitarian practice hold positive prospects. This article will review current experiences on anticipatory action for drought in the Sahel and shed light on whether this approach has brought innovation in local disaster risk management. Through the review of recent initiatives in Burkina Faso, Chad and Niger, this paper highlights key advancements as well as gaps and challenges pertaining to key components of anticipatory action and disaster risk management, namely: (1) data, risk analysis and early warning; (2) funding; (3) preparedness and community engagement; (4) learning, coordination and partnership; (5) policies and institutional frameworks. Even in challenging environments like in the Sahel, anticipatory action for drought can become an integral component of standard disaster risk management and financing strategies. However, this process will require more robust evidence about which ingredients of anticipatory action approaches lead to the desired result.
Predicting the level of social media use among journalists: machine learning analysis
Authors: Elareshi Mokhtar , Al Shami Ahmad , Ziani Abdulkrim , Chaudhary Shubhda , Youssef Noora
Published: March 2024

Within the long-drawn of COVID-19, the impact of social media is important for the public and journalists to re-engage with each other due to the relentless churning out of information. This paper investigates Arab journalists' use of social media during COVID-19 through Machine Learning (ML) models to predict future use and the main factor(s) deriving the respondents to such use. It aims to analyze the relationship between Arab journalists' online activity and their use of social media platforms during the COVID-19 pandemic. To assess the frequency of social media usage among Arab journalists and its correlation with their primary tasks and accomplishments. To test the accuracy of these models, we collected 1,443 Arab journalists via an online survey in 2020 using a random sampling approach. Key variables like online active journalists, Facebook group usage, and frequency of usage were studied. The received responses were subjected to ML analysis such as K-Nearest Neighbors (KNN), Decision Tree, and Ensemble Bagged Tree (EBT). The EBT predicted that Arab journalists would continue to rely on social media to various degrees as a viable source to fulfill their main tasks and accomplishments.
Complex global dynamics of conditionally stable slopes: effect of initial conditions
Authors: Prekrat D. , Todorović-Vasović N. K. , Vasović N. , Kostić S.
Published: March 2024

In the present paper, we investigate the effect of the initial conditions on the dynamics of the spring-block landslide model. The time evolution of the studied model, which is governed by a system of stochastic delay differential equations, is analyzed in the mean-field approximation, which qualitatively exhibits the same dynamics as the initial model. The results of the numerical analysis show that changing the initial conditions has different effects in different parts of the parameter space of the model. Namely, moving away from the fixed-point initial conditions has a stabilizing effect on the dynamics when the noise, the friction parameters a (higher values) and c as well as the spring stiffness k are taken into account. The stabilization manifests itself in a complete suppression of the unstable dynamics or a partial limitation of the effect of some friction parameters. On the other hand, the destabilizing effect of changing the initial conditions occurs for the lower values of the friction parameters a and for b. The main feature of destabilization is the complete suppression of the sliding regime or a larger parameter range with a transient oscillatory regime. Our approach underlines the importance of analyzing the influence of initial conditions on landslide dynamics.
A qualitative study of mentors’ perceptions and experiences of a near-peer mentoring program for medical students
Authors: Pölczman Lea , Jámbor Márk , Győrffy Zsuzsa , Purebl György , Végh András , Girasek Edmond
Published: March 2024

Introduction

During their academic studies, medical students may encounter a variety of challenging situations. It is no wonder that they have a higher prevalence of poor mental health than the general population. Mentoring programs have proven useful in promoting mental health in medical education. The study aimed to explore the perceptions and experiences of medical students as mentors in a near-peer mentoring program.

Methods

A qualitative study was carried out between March and April 2022 at Semmelweis University in Budapest, Hungary. Five focus group discussions (FGDs) included 26 medical students who were enrolled as mentors in the mentoring program. The recordings were transcribed verbatim and anonymized. An deductive and semantic approach was adopted, and the data were analyzed with thematic analysis.

Results

Three major themes were identified: professional and personal growth and reflections on the mentoring experience. Mentors reported growth in social and practical problem-solving skills, self-confidence, psychosocial benefits, and both personal and professional development. The program had a great impact on students’ sense of self-efficacy, self-awareness, perception of their competencies, and adherence to their boundaries.

Discussion

In conclusion, the mentors strongly emphasized the professional and psychosocial benefits they perceived while participating in the mentoring program. Therefore, the experiences obtained during the mentoring are important milestones. Mentoring programs could greatly improve students both personally and professionally so that later, they will be the best possible professionals in the field of health care.
Shattering the glass ceiling for women in gardening and landscaping: a mini-review
Authors: Sdao Anna Elisa , Zeller Sharon , De Lucia Barbara
Published: March 2024

The history of gardening and landscaping has historically been a male monopoly, and until the 20th century, women could not get anywhere near a career in these fields. This brief review focuses on some of the women who paved the way in Europe and the USA. It also attempts to tell some lesser-known stories, focusing on those who turned to gardening and landscaping, subjects that have been much less explored in floriculture. This review does not claim to be exhaustive, although it does attempt to draw attention to a historical period between the Victorian age and the present day. Women’s significant contributions range from dissemination to teaching, research, education, association and popularization of gardening and landscaping. In this paper, we briefly discuss, in the 21st century, men and women who may have similarities in education and work experience, but these similarities do not lead to comparable careers or positions in academic departments. Some scientific studies that have an impact on the design and sustainable management of green spaces linked to ecosystem services are considered. Finally, the contribution of women in landscape architecture is briefly examined.
Silicone implant surface microtopography modulates inflammation and tissue repair in capsular fibrosis
Authors: Schoberleitner Ines , Faserl Klaus , Tripp Christoph H. , Pechriggl Elisabeth Judith , Sigl Stephan , Brunner Andrea , Zelger Bettina , Hermann-Kleiter Natascha , Baier Leoni , Steinkellner Theresia , Sarg Bettina , Egle Daniel , Brunner Christine , Wolfram Dolores
Published: March 2024

Excessive fibrous capsule formation around silicone mammary implants (SMI) involves immune reactions to silicone. Capsular fibrosis, a common SMI complication linked to host responses, worsens with specific implant topographies. Our study with 10 patients investigated intra- and inter-individually, reduced surface roughness effects on disease progression, wound responses, chronic inflammation, and capsular composition. The results illuminate the significant impact of surface roughness on acute inflammatory responses, fibrinogen accumulation, and the subsequent fibrotic cascade. The reduction of surface roughness to an average roughness of 4 μm emerges as a promising approach for mitigating detrimental immune reactions, promoting healthy wound healing, and curbing excessive fibrosis. The identified proteins adhering to rougher surfaces shed light on potential mediators of pro-inflammatory and pro-fibrotic processes, further emphasizing the need for meticulous consideration of surface design. The composition of the implant capsule and the discovery of intracapsular HSP60 expression highlight the intricate web of stress responses and immune activation that can impact long-term tissue outcomes.
An updated advancement of bifunctional IL-27 in inflammatory autoimmune diseases
Authors: Xu Wang-Dong , Wang Da-Cheng , Zhao Ming , Huang An-Fang
Published: March 2024

Interleukin-27 (IL-27) is a member of the IL-12 family. The gene encoding IL-27 is located at chromosome 16p11. IL-27 is considered as a heterodimeric cytokine, which consists of Epstein–Barr virus (EBV)-induced gene 3 (Ebi3) and IL-27p28. Based on the function of IL-27, it binds to receptor IL-27rα or gp130 and then regulates downstream cascade. To date, findings show that the expression of IL-27 is abnormal in different inflammatory autoimmune diseases (including systemic lupus erythematosus, rheumatoid arthritis, Sjogren syndrome, Behcet’s disease, inflammatory bowel disease, multiple sclerosis, systemic sclerosis, type 1 diabetes, Vogt–Koyanagi–Harada, and ankylosing spondylitis). Moreover, in vivo and in vitro studies demonstrated that IL-27 is significantly in3volved in the development of these diseases by regulating innate and adaptive immune responses, playing either an anti-inflammatory or a pro-inflammatory role. In this review, we comprehensively summarized information about IL-27 and autoimmunity based on available evidence. It is hoped that targeting IL-27 will hold great promise in the treatment of inflammatory autoimmune disorders in the future.
Overview of microbial studies in sandflies and their progress toward development of paratransgenic approach for the control of Leishmania sp.
Authors: Vaselek Slavica
Published: March 2024

During their whole life insects are exposed to the impact of different microbes from various sources. The role of microbes in the life of insects is of immense importance, and there is an ample of evidence showing that microbes can affect different aspects of insect physiology, behaviors as well as their potential and capacity to transmit pathogens. Sandflies are main vectors of Leishmania parasites – causative agent of leishmaniasis. Leishmaniasis is a difficult, disfiguring and if not treated deadly disease ranked among the top 10 neglected tropical diseases. In comparison to other medically and veterinary important insect vectors where microbial investigations already progressed toward field studies and practical application of paratransgenic approach, in the field of sandflies and leishmaniasis control microbial investigations are at their beginning. This mini review provides a summary of the key moments in the overall microbial studies in sandflies and highlights the urgency of detailed microbial investigations to progress toward the development of paratransgenic approach.
A critical role for IFN-β signaling for IFN-κ induction in keratinocytes
Authors: Xu Bin , Musai Jon , Tan Yee Sun , Hile Grace A. , Swindell William R. , Klein Benjamin , Qin J. Tingting , Sarkar Mrinal K. , Gudjonsson Johann E. , Kahlenberg J. Michelle
Published: March 2024

Background/Purpose

Cutaneous lupus erythematosus (CLE) affects up to 70% of patients with systemic lupus erythematosus (SLE), and type I interferons (IFNs) are important promoters of SLE and CLE. Our previous work identified IFN-kappa (IFN-κ), a keratinocyte-produced type I IFN, as upregulated in non-lesional and lesional lupus skin and as a critical regulator for enhanced UVB-mediated cell death in SLE keratinocytes. Importantly, the molecular mechanisms governing regulation of IFN-κ expression have been relatively unexplored. Thus, this study sought to identify critical regulators of IFN-κ and identified a novel role for IFN-beta (IFN-β).

Methods

Human N/TERT keratinocytes were treated with the RNA mimic poly (I:C) or 50 mJ/cm2 ultraviolet B (UVB), followed by mRNA expression quantification by RT-qPCR in the presence or absence neutralizing antibody to the type I IFN receptor (IFNAR). IFNB and STAT1 knockout (KO) keratinocytes were generated using CRISPR/Cas9.

Results

Time courses of poly(I:C) and UVB treatment revealed a differential expression of IFNB, which was upregulated between 3 and 6 h and IFNK, which was upregulated 24 h after stimulation. Intriguingly, only IFNK expression was substantially abrogated by neutralizing antibodies to IFNAR, suggesting that IFNK upregulation required type I IFN signaling for induction. Indeed, deletion of IFNB abrogated IFNK expression. Further exploration confirmed a role for type I IFN-triggered STAT1 activation.

Conclusion

Collectively, our work describes a novel mechanistic paradigm in keratinocytes in which initial IFN-κ induction in response to poly(I:C) and UVB is IFNβ1-dependent, thus describing IFNK as both an IFN gene and an interferon-stimulated gene.
Application of coastal acoustic tomography: calibration of open boundary conditions on a numerical ocean model for tidal currents
Authors: Taniguchi Naokazu , Mutsuda Hidemi , Arai Masazumi , Sakuno Yuji , Hamada Kunihiro , Huang Chen-Fen , Guo JenHwa , Takahashi Toshiyuki , Yoshiki Kengo , Yamamoto Hironori
Published: March 2024

Coastal acoustic tomography (CAT), which measures path-averaged currents from reciprocal acoustic transmission experiments and reconstructs velocity fields from the multiple path-averaged current data, is useful for monitoring tidal currents in coastal shallow water, especially if data assimilation is employed. Previous CAT data assimilation studies have focused on state estimation problems, i.e., the reconstruction of tidal currents and following dynamical discussion. In this study, we investigate the use of path-averaged currents in a boundary control problem. Specifically, we aim to use the observed path-averaged currents to determine the parameters of a numerical ocean model, which were tidal amplitudes and phases as the open boundary conditions in this study. We investigate two methods: using the ensemble Kalman filter (EnKF) results and a linearization approach called model Green’s function method. Both calibration methods decreased the amplitudes of tidal constituents at the open boundaries. We compare the model performance between the model predictions with and without the calibration of the open boundary conditions. The model predictions with the calibrated open boundary conditions improved the agreement with the observed path-averaged current. We also implemented the sequential updates of EnKF with the two calibrated open boundary conditions. The EnKF results with the independently calibrated two open boundary conditions improved the agreement with the comparison data obtained by acoustic Doppler current profiler measurement compared with the original EnKF result with the initial open boundary conditions.
Diet-induced ketosis in adult patients with subacute acquired brain injury: a feasibility study
Authors: Edwards Maria G. P. , Andersen Jens R. , Curtis Derek J. , Riberholt Christian G. , Poulsen Ingrid
Published: March 2024

Background

Research in animal models on cerebral metabolism after brain injury highlights the potential benefits of ketosis in reducing secondary brain injury, but studies in humans are lacking.

Aim

This study aimed to examine if a 6-week ketogenic diet intervention with added medium-chain triglycerides (MCT) was feasible in adult patients with acquired brain injury in the subacute phase, whether ketosis could be achieved and maintained, and to what extent serious adverse reactions, adverse reactions, serious adverse events, and adverse events occured.

Methods

Patients ≥18 years of age diagnosed with subacute acquired brain injury and an expectation of hospitalisation ≥6 weeks were included in the intervention group. Patients not included in the intervention group were included in a standard care reference group. The intervention consisted of a ketogenic diet supplemented with MCT to obtain a plasma concentration of β-hydroxybutyrate (BHB) ≥0.5 mmol/L. Patients who were enterally fed were given KetoCal® 2.5:1 LQ MCT Multi Fiber (Nutricia A/S, Allerød, Denmark), supplemented with Liquigen® (Nutricia A/S, Allerød, Denmark). Patients consuming oral nutrition were given KetoCal® 2.5:1 LQ MCT Multi Fiber supplemented with Liquigen®, in addition to ketogenic meals.

Results

During a 13-week inclusion period, 12 of 13 eligible patients (92% [95% CI: 67% to 99%]) were included in the intervention group, and 17 of 18 excluded patients (94% [95% CI: 74% to 99%]) were included in the reference group. Eight patients (67%) completed the 6-week intervention. It took a median of 1 day to achieve ketosis from starting a 100% MCT ketogenic diet, and it was maintained for 97% of the intervention period after ketosis was obtained. There were no serious adverse reactions to the MCT ketogenic diet, and patients experienced adverse reactions not considered serious in 9.5% of days with the intervention. The MCT ketogenic diet was accepted by patients on all intervention days, and in the two patients transitioning from enteral feeding to oral intake, there were no complications related to transitioning.

Conclusion

Intervention with MCT ketogenic diet is feasible and tolerated for 6 weeks in hospitalised adult patients with subacute acquired brain injury. Randomised controlled trials are needed to assess the benefits and harms of the MCT ketogenic diet and the effect on patients’ recovery.

Clinical trial registration:ClinicalTrials.gov, identifier [NCT04308577].
The virtual reality classroom: a randomized control trial of medical student knowledge of postpartum hemorrhage emergency management
Authors: Dunlop Kristyn , Dillon Grace , McEvoy Aoife , Kane Daniel , Higgins Shane , Mangina Eleni , McAuliffe Fionnuala M.
Published: March 2024

Objective

To investigate the use of a virtual reality learning environment (VRLE) to enhance medical student knowledge of postpartum hemorrhage (PPH) emergency management and insertion of a postpartum balloon.

Methods

A randomized control trial involving medical students from University College Dublin, Ireland. Participants were randomly allocated to the intervention group (VRLE tutorial) or control group (PowerPoint tutorial on the same topic). All participants completed pre-learning experience and post-learning experience surveys. Both groups were timed and assessed on postpartum balloon insertion technique on a model pelvis. The primary outcome was assessment of student knowledge. Secondary outcomes included confidence levels, time taken to complete the task, technique assessment, satisfaction with the learning environment, and side effects of VR.

Results

Both learning experiences significantly (p < 0.001) enhanced student performance on the post-learning experience multiple choice questionnaire, with no difference between the intervention and control groups. In the intervention group, time for task completion was significantly less compared to the control group (1–2 min vs. 2–3 min, p = 0.039). Both learning experiences significantly (p < 0.001) enhanced student confidence, with no significant difference between intervention and control groups. 100% of the students using the VRLE enjoyed the experience, and 82.4% were very likely to recommend use of VRLE in medical education. 94.1% of the students felt the VRLE was beneficial over didactic teaching.

Conclusion

Receiving formal instruction, regardless of format, enhances students’ knowledge and confidence of the topic covered. Students who received instruction via the VRLE assembled the postpartum balloon faster than students who received didactic teaching. VR may be beneficial in teaching hands-on procedural skills in obstetrics and gynecology education.
Comprehensive literature review of oral and intravenous contrast-enhanced PET/CT: a step forward?
Authors: Metrard Gilles , Cohen Clara , Bailly Matthieu
Published: March 2024

The integration of diagnostic CT scans into PET/CT facilitates a comprehensive single examination, presenting potential advantages for patients seeking a thorough one-shot check-up. The introduction of iodinated contrast media during PET scanning raises theoretical concerns about potential interference with uptake quantification, due to the modification of tissue density on CT. Nevertheless, this impact appears generally insignificant for clinical use, compared to the intrinsic variability of standardized uptake values. On the other hand, with the growing indications of PET, especially 18F-FDG PET, contrast enhancement increases the diagnostic performances of the exam, and provides additional information. This improvement in performance achieved through contrast-enhanced PET/CT must be carefully evaluated considering the associated risks and side-effects stemming from the administration of iodinated contrast media. Within this article, we present a comprehensive literature review of contrast enhanced PET/CT, examining the potential impact of iodinated contrast media on quantification, additional side-effects and the pivotal clinically demonstrated benefits of an all-encompassing examination for patients. In conclusion, the clinical benefits of iodinated contrast media are mainly validated by the large diffusion in PET protocols. Contrary to positive oral contrast, which does not appear to offer any major advantage in patient management, intravenous iodine contrast media provides clinical benefits without significant artifact on images or quantification. However, studies on the benefit–risk balance for patients are still lacking.
Development of a co-culture system for green production of caffeic acid from sugarcane bagasse hydrolysate
Authors: Wang Xihui , Zhao Cui , Lu Xinyao , Zong Hong , Zhuge Bin
Published: March 2024

Caffeic acid (CA) is a phenolic acid compound widely used in pharmaceutical and food applications. However, the efficient synthesis of CA is usually limited by the resources of individual microbial platforms. Here, a cross-kingdom microbial consortium was developed to synthesize CA from sugarcane bagasse hydrolysate using Escherichia coli and Candida glycerinogenes as chassis. In the upstream E. coli module, shikimate accumulation was improved by intensifying the shikimate synthesis pathway and blocking shikimate metabolism to provide precursors for the downstream CA synthesis module. In the downstream C. glycerinogenes module, conversion of p-coumaric acid to CA was improved by increasing the supply of the cytoplasmic cofactor FAD(H2). Further, overexpression of ABC transporter-related genes promoted efflux of CA and enhanced strain resistance to CA, significantly increasing CA titer from 103.8 mg/L to 346.5 mg/L. Subsequently, optimization of the inoculation ratio of strains SA-Ec4 and CA-Cg27 in this cross-kingdom microbial consortium resulted in an increase in CA titer to 871.9 mg/L, which was 151.6% higher compared to the monoculture strain CA-Cg27. Ultimately, 2311.6 and 1943.2 mg/L of CA were obtained by optimization of the co-culture system in a 5 L bioreactor using mixed sugar and sugarcane bagasse hydrolysate, respectively, with 17.2-fold and 14.6-fold enhancement compared to the starting strain. The cross-kingdom microbial consortium developed in this study provides a reference for the production of other aromatic compounds from inexpensive raw materials.
Eukaryotic yeast V1-ATPase rotary mechanism insights revealed by high-resolution single-molecule studies
Authors: Yanagisawa Seiga , Bukhari Zain A. , Parra Karlett J. , Frasch Wayne D.
Published: March 2024

Vacuolar ATP-dependent proton pumps (V-ATPases) belong to a super-family of rotary ATPases and ATP synthases. The V1 complex consumes ATP to drive rotation of a central rotor that pumps protons across membranes via the Vo complex. Eukaryotic V-ATPases are regulated by reversible disassembly of subunit C, V1 without C, and VO. ATP hydrolysis is thought to generate an unknown rotary state that initiates regulated disassembly. Dissociated V1 is inhibited by subunit H that traps it in a specific rotational position. Here, we report the first single-molecule studies with high resolution of time and rotational position of Saccharomyces cerevisiae V1-ATPase lacking subunits H and C (V1ΔHC), which resolves previously elusive dwells and angular velocity changes. Rotation occurred in 120° power strokes separated by dwells comparable to catalytic dwells observed in other rotary ATPases. However, unique V1ΔHC rotational features included: 1) faltering power stroke rotation during the first 60°; 2) a dwell often occurring ∼45° after the catalytic dwell, which did not increase in duration at limiting MgATP; 3) a second dwell, ∼2-fold longer occurring 112° that increased in duration and occurrence at limiting MgATP; 4) limiting MgATP-dependent decreases in power stroke angular velocity where dwells were not observed. The results presented here are consistent with MgATP binding to the empty catalytic site at 112° and MgADP released at ∼45°, and provide important new insight concerning the molecular basis for the differences in rotary positions of substrate binding and product release between V-type and F-type ATPases.
Roles of pyroptosis and immune infiltration in aortic dissection
Authors: Ge Xiaogang , Cai Qiqi , Cai Yangyang , Mou Caiguo , Fu Junhui , Lin Feng
Published: March 2024

Introduction: Aortic dissection (AD) is often fatal, and its pathogenesis involves immune infiltration and pyroptosis, though the molecular pathways connecting these processes remain unclear. This study aimed to investigate the role of immune infiltration and pyroptosis in AD pathogenesis using bioinformatics analysis.

Methods: Two Gene Expression Omnibus datasets and a Gene Cards dataset of pyroptosis-related genes (PRGs) were utilized. Immunological infiltration was assessed using CIBERSORT, and AD diagnostic markers were identified through univariate logistic regression and least absolute shrinkage and selection operator regression. Interaction networks were constructed using STRING, and weighted gene correlation network analysis (WGCNA) was employed to identify important modules and essential genes. Single-sample gene set enrichment analysis determined immune infiltration, and Pearson correlation analysis assessed the association of key genes with infiltrating immune cells.

Results: Thirty-one PRGs associated with inflammatory response, vascular epidermal growth factor receptor, and Rap1 signaling pathways were identified. WGCNA revealed seven important genes within a critical module. CIBERSORT detected immune cell infiltration, indicating significant changes in immune cell infiltration and pyroptosis genes in AD and their connections.

Discussion: Our findings suggest that key PRGs may serve as indicators for AD or high-risk individuals. Understanding the role of pyroptosis and immune cell infiltration in AD pathogenesis may lead to the development of novel molecular-targeted therapies for AD.

Conclusion: This study provides insights into the molecular mechanisms underlying AD pathogenesis, highlighting the importance of immune infiltration and pyroptosis. Identification of diagnostic markers and potential therapeutic targets may improve the management of AD and reduce associated morbidity and mortality.
Regulatory role of RNA-binding proteins in microRNA biogenesis
Authors: Hynes Claire , Kakumani Pavan Kumar
Published: March 2024

MicroRNAs (miRNAs) are small non-coding RNAs that silence gene expression through their interaction with complementary sequences in the 3′ untranslated regions (UTR) of target mRNAs. miRNAs undergo a series of steps during their processing and maturation, which are tightly regulated to fine-tune their abundance and ability to function in post-transcriptional gene silencing. miRNA biogenesis typically involves core catalytic proteins, namely, Drosha and Dicer, and several other RNA-binding proteins (RBPs) that recognize and interact with miRNA precursors and/or their intermediates, and mature miRNAs along with their interacting proteins. The series of RNA-protein and protein-protein interactions are critical to maintaining miRNA expression levels and their function, underlying a variety of cellular processes. Throughout this article, we review RBPs that play a role in miRNA biogenesis and focus on their association with components of the miRNA pathway with functional consequences in the processing and generation of mature miRNAs.
Efficacy of repetitive transcranial magnetic stimulation with different application parameters for post-stroke cognitive impairment: a systematic review
Authors: Wang Yuhan , Wang Linjia , Ni Xixiu , Jiang Minjiao , Zhao Ling
Published: March 2024

Background

Cognitive impairment is a prevalent consequence of stroke, seriously affecting recovery and quality of life while imposing substantial burdens on both patients’ families and society. Repetitive transcranial magnetic stimulation (rTMS) has emerged as an effective intervention for post-stroke cognitive impairment (PSCI). However, the a lack of standardized and explicit guidelines regarding rTMS application parameters. Therefore, this study systematically evaluated the efficacy of various parameters of rTMS in treating PSCI and explored its potential mechanism.

Methods

We conducted a comprehensive search across seven scientific databases, namely China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (Wanfang), China Science and Technology Journal Database (VIP), Web of Science, PubMed, Embase, and Cochrane Library, to identify randomized controlled trials (RCTs) investigating the efficacy of rTMS for PSCI. The search encompassed the period from database creation until July 28, 2023. To evaluate the risk of bias in included studies, we employed the Cochrane recommended risk of bias assessment tool. Furthermore, we extracted relevant clinical application parameters associated with rTMS and performed comparative analyses to assess their therapeutic effects under different parameter settings.

Results

The present study included 45 RCTs involving a total of 3,066 patients with PSCI. Both high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) and low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) demonstrated safety and efficacy, yet failed to exhibit significant differentiation in terms of cognitive improvement. Furthermore, intermittent theta burst stimulation (iTBS), although yielding positive results, did not surpass traditional rTMS in effectiveness. Combining HF-rTMS with LF-rTMS resulted in superior efficacy compared to single rTMS intervention. Moreover, the combination of rTMS with other cognitive therapies exhibited potential for enhanced benefits among patients.

Conclusion

rTMS can effectively and safely enhance cognitive function, improve quality of life, and enhance activities of daily living in patients with PSCI. Furthermore, the combination of rTMS with other conventional rehabilitation methods can yield additional positive effects. However, due to insufficient evidence, an optimal parameter protocol for rTMS can not be currently recommended. Future research should prioritize orthogonal experimental design methods that incorporate multiple parameters and levels to determine the optimal parameter protocol for rTMS in PSCI.
Evaluation of the reach and utilization of the American College of Lifestyle Medicine’s Culinary Medicine Curriculum
Authors: Staffier Kara Livingston , Holmes Shannon , Karlsen Micaela Cook , Kees Alexandra , Shetty Paulina , Hauser Michelle E.
Published: March 2024

Introduction

Despite the growing interest in “food as medicine,” healthcare professionals have very limited exposure to nutrition as part of their training. Culinary medicine (CM), an evidence-based field integrating nutrition education with culinary knowledge and skills, offers one approach to fill this training gap. The American College of Lifestyle Medicine published a complimentary Culinary Medicine Curriculum (CMC) in 2019, and the objective of this study is to evaluate its reach and utilization, as well as to collect feedback from users.

Methods

Individuals who downloaded the CMC prior to March 1, 2022 (N = 6,162) were emailed an invitation to participate in an online, cross-sectional survey. The survey included both multiple choice and free-text questions about whether CM sessions were conducted, if and how the CMC was used, if and how it was modified for use, and additional requested resources. Free-text responses were inductively coded, and quantitative data was summarized using descriptive statistics.

Results

A total of 522 respondents provided consent, indicated that they had downloaded the curriculum, and completed the survey. Of the 522, 366 (70%) reported that they had not led or created any CM sessions. The top-reported reason for not leading a session was lack of time (29%). The remaining respondents who did create a CM session did so across various settings, including academic, clinical, coaching, and other settings, and a variety of professionals delivered the CMC sessions, including physicians (50%), registered dietitian nutritionists (30%), and chefs (25%). The majority of respondents (81%) modified the CMC in some way, with many using the curriculum for guidance or ideas only. Patient education materials (66%) and cooking technique instruction videos (59%) were among top requested resources.

Discussion

The CMC is a versatile resource that can be successfully adapted for use across various settings and by various types of health professionals and practitioners. Future research should investigate whether training in CM results in improved health outcomes for patients/clients. The curriculum will continue to grow to address the needs of users by expanding to include more digital content such as curriculum videos and cooking technique videos.