Altered extracellular matrix and mechanotransduction gene expression in rat bone tissue following long-term estrogen deficiency.

Osteoporosis is primarily associated with bone loss, but changes in bone tissue matrix composition and osteocyte mechanotransduction have also been identified. However, the molecular mechanisms underlying these changes and their relation to bone loss are not fully understood. The objectives of this study were to (1) conduct comprehensive temporal gene expression analyses on cortical bone tissue from ovariectomized rats, with a specific focus on genes known to govern matrix degradation, matrix production, and mechanotransduction, and (2) correlate these findings with bone mass, trabecular and cortical microarchitecture, and mineral and matrix composition. Microarray data revealed 35 differentially expressed genes in the cortical bone tissue of the ovariectomized cohort. We report that catabolic gene expression abates after the initial accelerated bone loss period, which occurs within the first 4 wk of estrogen deficiency. However, in long-term estrogen deficiency, we report increased expression of genes associated with extracellular matrix deposition (Spp1, COL1A1, COL1A2, OCN) and mechanotransduction (Cx43) compared with age-matched controls and short-term estrogen deficiency. These changes coincided with increased heterogeneity of mineral-to-matrix ratio and collagen maturity, to which extracellular matrix markers COL1A1 and COL1A2 were positively correlated. Interestingly, mineral heterogeneity and collagen maturity, exhibited a negative correlation with PHEX and IFT88, associated with mechanosensory cilia formation and Hedgehog (Hh) signaling. This study provides the first insight into the underlying mechanisms governing secondary mineralization and heterogeneity of matrix composition of bone tissue in long-term estrogen deficiency. We propose that altered mechanobiological responses in long-term estrogen deficiency may play a role in these changes.

Effectiveness of anthocyanin-containing foods and nutraceuticals in mitigating oxidative stress, inflammation, and cardiovascular health-related biomarkers: a systematic review of animal and human interventions.

Cardiovascular diseases (CVDs) are a group of chronic health disorders prevalent worldwide that claim millions of lives yearly. Inflammation and oxidative stress are intricately associated with myocardial tissue damage, endothelial dysfunction, and increased odds of heart failure. Thus, dietary strategies aimed at decreasing the odds of CVDs are paramount. In this regard, the consumption of anthocyanins, natural pigments found in edible flowers, fruits, and vegetables, has attracted attention due to their potential to promote cardiovascular health. The main mechanisms of action linked with their protective effects on antioxidant and anti-inflammatory activities, serum lipid profile modulation, and other cardiovascular health parameters are explained and exemplified. However, little is known about the dose-dependency nature of the effects, which anthocyanin has better efficiency, and whether anthocyanin-containing foods display better in vivo efficacy than nutraceuticals (i.e., concentrated extracts containing higher levels of anthocyanins than foods). Thus, this systematic review focused on determining the effects of anthocyanin-containing foods and nutraceuticals on biomarkers associated with CVDs using animal studies and human interventions supported by in vitro mechanistic insights. Overall, the results showed that the regular consumption of anthocyanin-containing foods and nutraceuticals improved vascular function, lipid profile, and antioxidant and anti-inflammatory effects. The daily dosage, the participants' health status, and the duration of the intervention also significantly influenced the results.

Association Between Hypoglycemia and the Occurrence of Early Onset Sepsis in Premature Infants.

BACKGROUND: We examined the association between hypoglycemia and the occurrence of early onset sepsis (EOS) in premature infants admitted to the neonatal intensive care unit (NICU). METHODS: We included infants discharged from 358 NICUs between 1997 and 2020 with gestational age <34 weeks, ≥1 culture collected in the first 3 days of life, and ≥1 serum glucose value recorded on the day of or day prior to culture collection. We used multivariable logistic regression and inverse probability weighting (IPW) and constructed models for three definitions of hypoglycemia: American Academy of Pediatrics (AAP), Pediatric Endocrine Society, and a definition based on neurodevelopmental studies. We performed subgroup analysis in EOS episodes caused by Gram-negative and Gram-positive organisms. RESULTS: Of the 62,178 infants and 64,559 cultures that met study inclusion criteria, 739 (1%) cultures were positive. The median (25th, 75th percentile) glucose value was 75 mg/dL (50, 106) on the day of or day prior to a positive culture versus 70 mg/dL (50, 95) on the day of or day prior to a negative culture. We found that hypoglycemia was not associated with the occurrence of EOS for all organisms and Gram-positive organisms, whereas there was a small but significant association between the lower AAP glucose cutoff value and EOS due to Gram-negative organisms (logistic regression: risk difference [RD] 0.24% [95% CI, 0.01-0.47]; IPW: RD 0.22% [95% CI, 0.00-0.43]). CONCLUSIONS: Hypoglycemia may be an early marker of EOS, particularly in episodes caused by Gram-negative organisms and when using a stricter definition of hypoglycemia.

Near-Death Experiences and Sleep Disturbance: An Exploratory Study Using Wrist Actigraphy.

ABSTRACT: Near-death experiences (NDEs) are nonordinary states of consciousness typically occurring on the brink of death. Sleep changes after NDEs have been described, including shorter sleep duration, longer sleep latency, and more sleep disturbances; however, objective verification is lacking. In this exploratory research, 57 participants took part in a 14-day actigraphy study and were assigned to three groups: those who have had an NDE ( n = 26); those who experienced a near-death event but without NDE ( n = 12); and those who had never come close to death ( n = 19). No significant differences were found between groups for actigraphy data. Paired samples t tests indicated significant differences between subjective and objective measures of sleep onset latency, sleep duration, and sleep efficiency, notably among the NDE group. Findings are indicative of the phenomenon known as sleep state misperception (SSM), which may have clinical implications for the study of NDEs and SSM.

Using a teach-back intervention significantly improves knowledge, perceptions, and satisfaction of patients with Nurses' discharge medication education.

BACKGROUND: Evidence indicates that patients desire medication information, but clinicians often fail to teach this information in an understandable way. Teach-Back promotes effective clinician-patient communication and enhances medication adherence, satisfaction with education, and hospital experiences. AIMS: This study examined effects of a nurse-led Teach-Back intervention, Teaching Important Medication Effects (TIME), compared with usual care on patients' knowledge, experiences, and satisfaction with medication education before and after discharge. The aims were to examine patients' priority learning needs, group differences in new medication knowledge before and after discharge, and post-discharge experience and satisfaction with medication instruction. METHODS: A longitudinal pretest/post-test, 2-group design was used with 107 randomly selected medical-surgical patients from an academic hospital. After receiving medication instructions, patients were interviewed before and within 72 h after discharge. Bivariate analyses were used to assess group differences in demographic and outcome variables. RESULTS: Usual care (n = 52) and TIME (n = 55) groups' characteristics were equivalent. Knowing new medication names and side effects were top learning priorities. Medication side effect knowledge was better in TIME versus usual care groups at discharge (94.3% vs. 72.5%, p = .003) and follow-up (93.9% vs.75.8%, p = .04). TIME positively influenced patients' medication education experiences; specifically, nurses always explained why a new medication was needed and its side effects. TIME was associated with patients being very satisfied with nurses' education versus usual care (97% vs. 46.9%, p < .001). LINKING EVIDENCE TO ACTION: TIME was significantly and positively associated with knowledge of new medication side effects over time and experiences and satisfaction with nurses' medication education. Teach-Back was effective in educating patients about new medications. It is an essential approach for patient education, requiring clinicians to confirm patients' retention and understanding of new information with each encounter.

Patient-reported outcome measures in third molar surgery: a scoping review.

Despite a surge of interest in patient-centred outcomes (PROMs) in healthcare settings, they remain an underutilised resource in third molar surgery. Clinicians and researchers in the field of oral surgery who are interested in incorporating PROMs into their clinical practice may face challenges in instrument selection with as yet no consensus registry available. PROMs have undoubtedly transcended their original brief as research instruments, with the collection of PROMs data now a routine undertaking in many healthcare systems. Quality improvement, appropriate resource allocation, and measurement of effectiveness of interventions are but a few of their advantages. This review article presents a scoping overview of the instruments most relevant to the third molar surgery population.

Variations in reporting of clinician-reported outcome measures in third molar surgery: A focused review.

Clinician-reported outcome measures (ClinRO measures) play a fundamental role in quality assurance throughout healthcare systems. With commissioners turning ever more frequently to ClinRO data to evaluate and compare individual hospital performance and casemix, and funding decisions increasingly relying on these data, agreed core outcome sets (COS) are essential for the collection of standardised specialty-specific outcomes. Beyond their role in service commissioning, COS enable standardisation of outcomes in clinical studies, allowing comparisons to be drawn between similar trials as well as pooling of data for systematic reviews and metaanalyses. This review explores those ClinRO measures most commonly reported in the third molar literature, highlighting inconsistencies in ClinRO selection, measurement and reporting among researchers. We recognise here a prime opportunity for the specialty to address this lag in COS relative to other surgical specialties. With the Quality Outcomes in Maxillofacial Surgery (QOMS) overseeing the institution of many subspecialty-specific national databases in recent years, OMFS is well placed to develop a series of COS for each subspecialty domain for the benefit of researchers, clinicians and ultimately, patients.

Autologous platelet concentrates in oral surgery: protocols, properties, and clinical applications.

Autologous platelet concentrates (APCs) are a relatively new phenomenon, with initial reports of their regenerative potential published as recently as 1998. Despite their relative infancy, a huge body of evidence exists in support of their capacity to promote osseous and soft tissue regeneration through the physiologic processes of platelet activation and subsequent growth factor release. APCs have transformed many areas of healthcare and are now considered an essential component of the surgical milieu. In this narrative review, we explore the evolution of autologous platelet therapies with a particular emphasis on their contemporary applications in oral surgery, which rather fittingly was the first specialty to report the regenerative potential of APCs.

Policy implications for awareness gaps in antimicrobial resistance (AMR) and antimicrobial use among commercial Nepalese poultry producers.

BACKGROUND: Nepal's poultry industry has increased with a growing middle class, which has translated to an increase in antimicrobial consumption and thus a rise in antimicrobial resistance (AMR). Describing and understanding antimicrobial use practices among commercial poultry producers in Nepal may help minimize the risks of AMR development in both humans and animals and determine the effectiveness of relevant policies. METHODS: From July to August 2018, poultry farmers were randomly recruited from Nepal's Chitwan District to participate in a cross-sectional study. The lead producer in each poultry operation was administered a quantitative structured-survey via a 30-min interview. Participants were asked to provide demographics, production practices, and knowledge about their antimicrobial use practices. Descriptive data analysis was performed to obtain frequencies and compare practices. RESULTS: In total, 150 commercial poultry producers of whom raised between 300 and 40,000 birds completed the interviews. Only 33% (n = 49) of producers reported knowing what AMR was, and among them only 50% (n = 25) consulted a veterinarian for treatment options. Antimicrobial administration for growth promotion was still employed by 13% of poultry producers. Similarly, critically important antimicrobial drugs, specifically colistin, were identified at 35% of participating operations. Producers reported low overall understanding and compliance of withdrawal periods (n = 41; 27%), which may result in both AMR development and adverse health reactions among consumers who ingest antimicrobial residues. Although Nepal has publicized antimicrobial use policies and awareness campaigns to instill healthy production practices, most producers (82%) were unaware of them. CONCLUSION: Many Nepalese poultry producers lack overall antimicrobial use and AMR awareness, which is evidenced by low antimicrobial withdrawal period compliance, use of antimicrobials for growth promotion, and the sustained use of critically important antimicrobials. Improved outreach and educational capacities, paired with increased veterinary resources and extensive monitoring in operations and retail meat products, may increase AMR awareness and policy enforcement.

Conservation of the Low-shear Modeled Microgravity Response in Enterobacteriaceae and Analysis of the trp Genes in this Response.

Low fluid shear force, including that encountered in microgravity models, induces bacterial responses, but the range of bacteria capable of responding to this signal remains poorly characterized. We systematically analyzed a range of Gram negative Enterobacteriaceae for conservation of the low-shear modeled microgravity (LSMMG) response using phenotypic assays, qPCR, and targeted mutations. Our results indicate LSMMG response conservation across Enterobacteriacae with potential variance in up- or down-regulation of a given response depending on genus. Based on the data, we analyzed the role of the trp operon genes and the TrpR regulator in the LSMMG response using targeted mutations in these genes in S. Typhimurium and E. coli. We found no alteration of the LSMMG response compared to WT in these mutant strains under the conditions tested here. To our knowledge, this study is first-of-kind for Citrobacter, Enterobacter, and Serratia, presents novel data for Escherichia, and provides the first analysis of trp genes in LSMMG responses. This impacts our understanding of how LSMMG affects bacteria and our ability to modify bacteria with this condition in the future.

Preference for infant-directed speech in preterm infants.

The current study explores the effects of exposure to maternal voice on infant sucking in preterm infants. Twenty-four preterm infants averaging 35 weeks gestational age were divided randomly into two groups. A contingency between high-amplitude sucking and presentation of maternal voice was instituted for one group while the other group served as a yoked control. No significant differences were observed in sucking of the two groups, but the degree of pitch modulation of the maternal voice predicted an increase in the rate of infant sucking.

A series of IncQ-based reporter plasmids for use in a range of Gram negative genera.

Many studies require expression analysis of the same gene/promoter across a range of bacterial genera. However, there is currently a lack of availability of reporters based on the broad host range IncQ replicon, which is compatible with a popular improved IncP transfer system that is self-transfer defective. We report IncQ lacZ reporter plasmids with features including: (1) compatibility with IncP, IncW, and pBHR/pBBR replicons, (2) a variety of antibiotic markers (Sp-r, Sm-r, Km-r, Cm-r), (3) convenient mobilization via a novel self-transfer-defective IncP conjugation system, and (4) complete DNA sequences. Utility is demonstrated using three different promoters in different Gram negative genera.

The undershoot bias: learning to act optimally under uncertainty.

Learning in stochastic environments is increasingly viewed as an important psychological ability. To extend these results from a perceptual to a motor domain, we tested whether participants could learn to solve a stochastic minimal-time task using exploratory learning. The task involved moving a cursor on a computer screen to a target. We systematically varied the degree of random error in movement in three different conditions; each condition had a distinct time-optimal solution. We found that participants approximated the optimal solutions with practice. The results show that adults are sensitive to the stochastic structure of a task and naturally adjust the magnitude of an undershoot bias to the particular movement error of a task.

Attention during looking and reaching as assessed by heart rate in 7(1/2)-month-old infants.

Attention mediates the acquisition and encoding of information about the world and is central to motor action. Heart rate deceleration and behavioral inhibition are sensitive indices of the attentional process, but it is unknown whether these indices are valid in the context of overt action. The current study investigated the relationship between visual attention, action, and heart rate during reaching in 7(1/2)-month-old infants. We found that infants showed prolonged looking and large heart rate decelerations on reaching and looking trials. We conclude that overt action itself does not prevent the autonomic and behavioral changes that are also seen in attention to simple visual displays and that attention is maintained throughout the act of reaching.