Introduction: Cyanide poisoning, whether it be accidental or intentional, remains a significant danger to adults and children, especially in societies where agriculture is a primary source of income. We examined the clinical follow-up, complications, and results of cyanide poisoning cases that occurred after eating the pits and seeds of plants containing cyanide glycosides, such as apricot kernels and almonds. Methods: Between 01/01/2017 and 01/08/2022, 14 children aged 1-18 years who were followed up with a prediagnosis of cyanide poisoning in our Paediatric Intensive Care Unit (PICU) were retrospectively analysed. Results: Eight of the patients followed with a preliminary diagnosis of cyanide poisoning were female and six were male. The most common admission month was July (42.8%) coinciding with the agricultural season. The most common symptoms at presentation were weakness and fatigue (n = 7). In the PICU, 4 patients presented lip cyanosis; 3, altered level of consciousness. Vomiting, seizure, headache, dizziness and palpitatons were less frequent. Four patients were treated with hydroxocobalamin (Cyanokit®) as an antidote due to acidosis in their blood gases. All patients treated for cyanide poisoning were discharged. Conclusions: Cyanide poisoning should be considered in paediatric patients with suspicious findings, sudden loss of consciousness, increased anion gap acidosis and lactic acidosis. The history of eating the seeds of plants such as apricot and almonds should be investigated.

Perivascular adipose tissue (PVAT) negatively regulates vascular muscle contraction. However, in the context of obesity, the PVAT releases vasoconstrictor substances that detrimentally affect vascular function. A pivotal player in this scenario is the peptide endothelin-1 (ET-1), which induces oxidative stress and disrupts vascular function. The present study postulates that obesity augments ET-1 production in the PVAT, decreases the function of the nuclear factor erythroid 2-related factor-2 (Nrf2) transcription factor, further increasing reactive oxygen species (ROS) generation, culminating in PVAT dysfunction. Male C57BL/6 mice were fed either a standard or a high-fat diet for 16 weeks. Mice were also treated with saline or a daily dose of 100 mg·kg-1 of the ETA and ETB receptor antagonist Bosentan, for 7 days. Vascular function was evaluated in thoracic aortic rings, with and without PVAT. Mechanistic studies utilized PVAT from all groups and cultured WT-1 mouse brown adipocytes. PVAT from obese mice exhibited increased ET-1 production, increased ECE1 and ETA gene expression, loss of the anticontractile effect, as well as increased ROS production, decreased Nrf2 activity, and downregulated expression of Nrf2-targeted antioxidant genes. PVAT of obese mice also exhibited increased expression of Tyr216-phosphorylated-GSK3β and KEAP1, but not BACH1 - negative Nrf2 regulators. Bosentan treatment reversed all these effects. Similarly, ET-1 increased ROS generation and decreased Nrf2 activity in brown adipocytes, events mitigated by BQ123 (ETA receptor antagonist). These findings place ET-1 as a major contributor to PVAT dysfunction in obesity and highlight that pharmacological control of ET-1 effects restores PVAT's cardiovascular protective role.

Background: Augmentative and alternative communication (AAC) is the approach that enhances communication competence in individuals with complex communication needs. With the advancement of technology, there are varieties of AAC applications with colored-graphic symbols and speech output, improving communication’s intelligibility compared to low-tech AAC systems. However, those AAC applications had some features that were not entirely suitable for Thai users, such as symbol appearance, speech intonation, etc. Objective: This study aimed to develop the first version of the Thai AAC application, A-Speak, based on Thai culture, lexicon, and intonation and remove other constraints that other AAC applications had, such as variation in voice-output age and gender. The proficiency of A-Speak regarding communication functions was also examined. Materials and methods: The participants comprised 15 individuals with cerebral palsy and complex communication needs. The participants were trained to use the A-Speak application, installed on a tablet, to communicate. The training procedures consisted of 3 phases: Phase 1: Train to select icons; Phase 2: Shift to different categories; and Phase 3: Use A-Speak to communicate. The researchers trained the participants to achieve adequate operational skills (i.e., Phases 1 and 2) before beginning Phase 3. In Phases 1 and 2, switches were employed to facilitate participants with limited mobility to operate A-Speak by finger. The researchers also taught the participants’ caregivers to continue training them at home. The researchers collected the participants’ communication abilities regarding communication functions in the recorded form. The data was reported into code numbers according to communication proficiency. Results: After receiving A-Speak training, all participants showed improvement in their communication abilities across a variety of communication functions. Participants showed significant progress in 10 out of 12 communication functions. The communication function in which participants exhibited the most improvement was explaining skills, whereas the communication function that showed the least development was storytelling skills. Conclusion: A-Speak AAC application reduced the constraints that possibly influenced communication intelligibility in the Thai language. Nevertheless, A-Speak still had a few drawbacks that required to be corrected to increase the productivity of this program. The findings indicated that participants gained communication skills through A-Speak as a means of communication. Keywords: A-Speak, augmentative and alternative communication, application, High-tech AAC