Effects of Omega-3 Fatty Acids on Flow-mediated Dilatation and Carotid Intima Media Thickness: A Meta-analysis.

PURPOSE OF REVIEW: To investigate the effects of omega-3 fatty acids on flow-mediated dilatation (FMD) and carotid intima-media thickness (CIMT) and explore the factors influencing these effects. RECENT FINDINGS: FMD was significantly higher in the omega-3 fatty acid group compared to the control group (mean difference = 0.90%; p = 0.0003). In particular, the subgroup with CHD (both EPA + DHA < 1 g/day and ≥ 1 g/day) and the subgroup without CHD but with CHD risk factors (only EPA + DHA ≥ 1 g/day) showed significantly increased FMD after supplementation of omega-3 fatty acids. CIMT was not significantly different between the omega-3 fatty acid and control groups (standardized mean difference = -0.08; p = 0.26). Subgroup analysis of CHD patients was not conducted because of the limited number of studies. Intake of omega-3 fatty acids improved FMD in patients with CHD and patients with risk factors for CHD. Further research is needed on the effects of omega-3 fatty acids on CIMT.

Effects of very low-carbohydrate ketogenic diets on lipid profiles in normal-weight (body mass index < 25 kg/m2) adults: a meta-analysis.

CONTEXT: Very low-carbohydrate diets or ketogenic diets (KDs) have garnered attention for weight loss in patients with overweight or obesity as well as for normal-weight adults, yet the adverse effects of KDs, such as dyslipidemia in normal-weight adults, have not been studied extensively. OBJECTIVE: This meta-analysis aimed to identify the effects of KDs on the lipid profile in normal-weight (body mass index [BMI] < 25 kg/m2) adults from randomized controlled trials. DATA SOURCES: PubMed and Embase databases were searched on November 21, 2021, using search terms representing KDs and lipid profiles. Two researchers independently screened articles according to PICOS inclusion criteria. DATA EXTRACTION: General study information, dietary data, and lipid profiles were extracted from eligible studies. Risk of bias was assessed using the Cochrane risk of bias 2 tool. DATA ANALYSIS: Fixed- or random-effects meta-analysis was performed to estimate the effects of KDs on total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglycerides, apolipoprotein A (apoA), and apolipoprotein B (apoB), considering heterogeneity across studies. The certainty of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. RESULTS: Three studies were selected for meta-analysis. A KD significantly increased TC by 1.47 mmol/L (95%CI, 0.72-2.22 mmol/L), LDL-C by 1.08 mmol/L (95%CI, 0.37-1.79 mmol/L), and apoB by 0.35 g/L (95%CI, 0.06-0.65 g/L). In addition, a KD significantly increased HDL-C by 0.35 mmol/L (95%CI, 0.27-0.42 mmol/L) and apoA by 0.34 g/L (95%CI, 0.28-0.41 g/L) compared with control diets. Triglyceride levels were not significantly different between KDs and control diets (P = 0.63). CONCLUSION: This study suggests unfavorable effects of KDs on TC and LDL-C in normal-weight adults. Although an increase in HDL-C can compensate for unfavorable changes in lipids, normal-weight individuals should consider the risk of hypercholesterolemia when consuming a KD. Results for triglycerides were inconsistent.

Incidence and characteristics of physical disabilities in patients with postconcussion syndromefollowing mTBI.

This study aimed to examine the incidence and characteristics of physical disabilities in patients with postconcussion syndrome (PCS) after a mild traumatic brain injury (mTBI). Of 203 patients diagnosed with PCS after mTBI, 10 patients with definite physical disabilities (worse than moderate disability on the Glasgow outcome scale [GOS], <4 points and inability to walk independently on the Functional Ambulation Category [FAC], <3 points) were enrolled. Ten of the 203 patients included in the analysis based on prespecified inclusion criteria were further evaluated. Seven patients had moderate disability on the GOS, whereas the remaining 3 showed severe disability. On the Modified Barthel Index, 5 patients were moderately dependent, and 2 patients were severely dependent. By the Motricity Index, 9 patients showed mild quadriparesis, and 1 had mild hemiparesis. All 10 patients could grasp-release their fingers as per the Modified Brunnstrom Classification. By contrast, 7 patients required verbal supervision for independent gait by the FAC, and the remaining 3 patients needed intermittent support from 1 person for independent gait. Approximately 5% of patients with PCS after mTBI had a definite physical disability, and most of these patients showed mild quadriparesis. These results suggest that a definite physical disability can occur in patients with PCS after mTBI.

Contributions of the microbiome to intestinal inflammation in a gut-on-a-chip.

The intestinal microbiome affects a number of biological functions of the organism. Although the animal model is a powerful tool to study the relationship between the host and microbe, a physiologically relevant in vitro human intestinal system has still unmet needs. Thus, the establishment of an in vitro living cell-based system of the intestine that can mimic the mechanical, structural, absorptive, transport and pathophysiological properties of the human intestinal environment along with its commensal bacterial strains can promote pharmaceutical development and potentially replace animal testing. In this paper, we present a microfluidic-based gut model which allows co-culture of human and microbial cells to mimic the gastrointestinal structure. The gut microenvironment is recreated by flowing fluid at a low rate (21 µL/h) over the microchannels. Under these conditions, we demonstrated the capability of gut-on-a-chip to recapitulate in vivo relevance epithelial cell differentiation including highly polarized epithelium, mucus secretion, and tight membrane integrity. Additionally, we observed that the co-culture of damaged epithelial layer with the probiotics resulted in a substantial responded recovery of barrier function without bacterial overgrowth in a gut-on-a-chip. Therefore, this gut-on-a-chip could promote explorations interaction with host between microbe and provide the insights into questions of fundamental research linking the intestinal microbiome to human health and disease.

Effects of Coffee Consumption on Insulin Resistance and Sensitivity: A Meta-Analysis.

Coffee is widely consumed worldwide and impacts glucose metabolism. After a previous meta-analysis that evaluated the effects of coffee consumption on insulin resistance and sensitivity, additional randomized controlled trials (RCTs) were conducted. This meta-analysis aimed to evaluate the effects of coffee consumption on insulin resistance or sensitivity. We selected RCTs that evaluated the effects of coffee consumption for seven days or more on insulin sensitivity or resistance using surrogate indices (homeostasis model assessment for insulin resistance (HOMA-IR) and Matsuda index). The fixed-effects or random-effects model was used according to heterogeneity. Four studies with 268 participants were analyzed in this meta-analysis. Coffee consumption significantly decreased HOMA-IR compared to control (mean difference (MD) = -0.13; 95% CI = -0.24--0.03; p-value = 0.01). However, the significance was not maintained in the sensitivity analysis (MD = -0.04; 95% CI = -0.18-0.10; p-value = 0.55) after excluding data from the healthy, young, normal-weight group. Matsuda index was not significantly different between coffee and control groups (standardized mean difference (SMD) = -0.33; 95% CI = -0.70-0.03; p-value = 0.08). In conclusion, long-term coffee consumption has a nonsignificant effect on insulin resistance and sensitivity. More studies evaluating the effects of coffee consumption in the healthy, young, and normal-weight individuals are needed.

Effect of biochemical and biomechanical factors on vascularization of kidney organoid-on-a-chip.

Kidney organoids derived from the human pluripotent stem cells (hPSCs) recapitulating human kidney are the attractive tool for kidney regeneration, disease modeling, and drug screening. However, the kidney organoids cultured by static conditions have the limited vascular networks and immature nephron-like structures unlike human kidney. Here, we developed a kidney organoid-on-a-chip system providing fluidic flow mimicking shear stress with optimized extracellular matrix (ECM) conditions. We demonstrated that the kidney organoids cultured in our microfluidic system showed more matured podocytes and vascular structures as compared to the static culture condition. Additionally, the kidney organoids cultured in microfluidic systems showed higher sensitivity to nephrotoxic drugs as compared with those cultured in static conditions. We also demonstrated that the physiological flow played an important role in maintaining a number of physiological functions of kidney organoids. Therefore, our kidney organoid-on-a-chip system could provide an organoid culture platform for in vitro vascularization in formation of functional three-dimensional (3D) tissues.

Challenge for Diagnostic Assessment of Deep Learning Algorithm for Metastases Classification in Sentinel Lymph Nodes on Frozen Tissue Section Digital Slides in Women with Breast Cancer.

PURPOSE: Assessing the status of metastasis in sentinel lymph nodes (SLNs) by pathologists is an essential task for the accurate staging of breast cancer. However, histopathological evaluation of SLNs by a pathologist is not easy and is a tedious and time-consuming task. The purpose of this study is to review a challenge competition (HeLP 2018) to develop automated solutions for the classification of metastases in hematoxylin and eosin-stained frozen tissue sections of SLNs in breast cancer patients. MATERIALS AND METHODS: A total of 297 digital slides were obtained from frozen SLN sections, which include post-neoadjuvant cases (n = 144, 48.5%) in Asan Medical Center, South Korea. The slides were divided into training, development, and validation sets. All of the imaging datasets have been manually segmented by expert pathologists. A total of 10 participants were allowed to use the Kakao challenge platform for six weeks with two P40 GPUs. The algorithms were assessed in terms of the AUC (area under receiver operating characteristic curve). RESULTS: The top three teams showed 0.986, 0.985, and 0.945 AUCs for the development set and 0.805, 0.776, and 0.765 AUCs for the validation set. Micrometastatic tumors, neoadjuvant systemic therapy, invasive lobular carcinoma, and histologic grade 3 were associated with lower diagnostic accuracy. CONCLUSION: In a challenge competition, accurate deep learning algorithms have been developed, which can be helpful in making frozen diagnosis of intraoperative SLN biopsy. Whether this approach has clinical utility will require evaluation in a clinical setting.

Detection of infectious hypodermal and hematopoietic necrosis virus and white spot syndrome virus in whiteleg shrimp (Penaeus vannamei) imported from Vietnam to South Korea.

In this study, whiteleg shrimp (Penaeus vannamei) imported from Vietnam were collected from South Korean markets, and examined for 2 viruses: infectious hypodermal and hematopoietic necrosis virus (IHHNV, recently classified as decapod penstyldensovirus-1), and white spot syndrome virus (WSSV). Among 58 samples, we detected IHHNV in 23 samples and WSSV in 2 samples, using polymerase chain reaction and sequencing analyses. This is the first report of IHHNV and WSSV detection in imported shrimp, suggesting that greater awareness and stricter quarantine policies regarding viruses infecting shrimp imported to South Korea are required.

Recurrent Carotid Cavernous Fistula Originating from a Giant Cerebral Aneurysm after Placement of a Covered Stent.

We report the case of a recurrent carotid cavernous fistula (CCF) originating from a giant cerebral aneurysm (GCA) after placement of a covered stent. A 47-year-old woman presented with sudden onset of severe headache, and left-sided exophthalmos and ptosis. Cerebral angiography revealed a CCF caused by rupture of a GCA in the cavernous segment of the left internal carotid artery. Two covered stents were placed at the neck of the aneurysm. The neurological symptoms improved at first, but were aggravated in the 6 months following the treatment. Contrast agent endoleak was seen in the distal area of the stent. Even though additional treatments were attempted via an endovascular approach, the CCF could not be cured. However, after trapping the aneurysm using coils and performing superficial temporal artery-middle cerebral artery bypass, the neurological symptoms improved. In cases of recurrent CCF originating from a GCA after placement of a covered stent, it is possible to treat the CCF by endovascular trapping and surgical bypass.

The effectiveness of infrared thermography in patients with whiplash injury.

OBJECTIVE: This study aims to visualize the subjective symptoms before and after the treatment of whiplash injury using infrared (IR) thermography. METHODS: IR thermography was performed for 42 patients who were diagnosed with whiplash injury. There were 19 male and 23 female patients. The mean age was 43.12 years. Thermal differences (ΔT) in the neck and shoulder and changes in the thermal differences (ΔdT) before and after treatment were analyzed. Pain after injury was evaluated using visual analogue scale (VAS) before and after treatment (ΔVAS). The correlations between ΔdT and ΔVAS results before and after the treatment were examined. We used Digital Infrared Thermal Imaging equipment of Dorex company for IR thermography. RESULTS: The skin temperature of the neck and shoulder immediately after injury showed 1-2℃ hyperthermia than normal. After two weeks, the skin temperature was normal range. ΔT after immediately injuy was higher than normal value, but it was gradually near the normal value after two weeks. ΔdT before and after treatment were statistically significant (p<0.05). VAS of the neck and shoulder significantly reduced after 2 week (p=0.001). Also, there was significant correlation between ΔdT and reduced ΔVAS (the neck; r=0.412, p<0.007) (the shoulder; r=0.648, p<0.000). CONCLUSION: The skin temperature of sites with whiplash injury is immediately hyperthermia and gradually decreased after two weeks, finally it got close to normal temperature. These were highly correlated with reduced VAS. IR thermography can be a reliable tool to visualize the symptoms of whiplash injury and the effectiveness of treatment in clinical settings.