Fasting Research Articles

Effects of intermittent fasting on the histology and mRNA expression of major drug-metabolizing cyp450s in the liver of diabetic mice

ABSTRACT Introduction:There is a variation in drug response among patients who practice intermittent fasting. Alteration in the expression of drug-metabolizing enzymes (DMEs) can affect the pharmacokinetics and drug response. Aims: This research aimed to determine the effect of intermittent fasting on the mRNA expression of major drug-metabolizing cyp450s in the liver of diabetic mice. Methods: Thirty-two male Balb/c mice were divided into four groups; control, nonfasting diabetic, non-diabetic fasting, and diabetic fasting mice. Insulin-dependent diabetes was induced in mice by a single high-dose (250 mg/kg) streptozocin. Mice of non-diabetic and diabetic fasting groups were subjected to 10-day intermittent fasting for 17 hours daily. Then, the mRNA expression of mouse phase I DMEs cyp1a1, cyp2c29, cyp2d9, and cyp3a11 was analyzed using real-time polymerase chain reaction. In addition, the liver of mice in all groups was examined for pathohistological alterations. Results: Diabetes downregulated the mRNA expression of hepatic drug-metabolizing cyp450s in diabetic mice, while intermittent fasting significantly (P < 0.05) increased it. Also, cyp2d9 and cyp3a11 were upregulated in the liver of diabetic fasting mice. These alterations in the gene expression were correlated with the pathohistological alterations, where livers of diabetic mice showed dilatation in the blood sinusoids and inflammatory cells leukocyte infiltrations. Whereas livers of diabetic fasting mice showed almost comparable histological findings to control mice. Conclusions: Intermittent fasting can protect the liver against diabetes-induced hepatotoxicity and the down-regulation of DME genes in the diabetic liver. These results can explain, at least partly, the inter-individual variation in the drug response during practicing fasting.

Ramadan intermittent fasting is associated with ameliorated inflammatory markers and improved plasma sphingolipids/ceramides in subjects with obesity: lipidomics analysis

Intermittent fasting (IF) is associated with enormous metabolic alterations that underpin its diverse health effects. Changes in lipid metabolism, particularly ceramides, and other sphingolipids, are among the most notable of these alterations. This study investigated the lipidomic alterations associated with 29–30 days of Ramadan diurnal intermittent fasting (RIF) in metabolically healthy overweight and obese subjects. A prospective cohort of 57 overweight and obese adults (70% males, 38.4 ± 11.2 years), with an age range of 18–58 years was observed prior to and at the conclusion of Ramadan. At both time points, anthropometric, biochemical (lipid profile, glycemic, and inflammatory markers), and dietary intake measurements were taken. Using liquid chromatography-mass spectrometry, a lipidomic analysis of ceramides and other sphingolipids was conducted. Using paired sample t-tests, pre- and post-Ramadan anthropometric, biochemical, and dietary values were compared. RIF was associated with improved levels of lipid profile compartments and inflammatory markers. In addition, RIF was associated with a decrease in plasma sphingosine and sphinganine, which was accompanied by a decrease in sphingosine 1-phosphate and sphinganine 1-phosphate. In addition, RIF was associated with decreased C17, C22, and C24 sphingomyelin, but not C14, C16, C18, C20, and C24:1 sphingomyelin, as well as C20, C22, C24, and C24:1 dihydrosphingomyelin, but not C16 and C18 dihydrosphingomyelin. This study demonstrates that RIF is associated with improvements in plasma sphingosine, sphinganine sphingomyelin, and dihydrosphingomyelin lipid species, as well as improved lipid profile and inflammatory markers, which may confer short-term protection against cardiometabolic problems in patients with overweight/obesity.

The impact of prolonged fasting on 24h energy metabolism and its 24h rhythmicity in healthy, lean males: A randomized cross-over trial

Human energy expenditure and substrate oxidation are under circadian control and food intake is a time cue for the human biological clock, leading to 24h feeding-fasting cycles in energy and substrate metabolism. In recent years, (intermittent) fasting protocols have also become popular to improve metabolic health. Here, we aimed to investigate the impact of food intake on the 24h patterns of energy metabolism as well as to provide data on the timeline of changes in energy metabolism that occur upon an extended period of fasting. In a randomized, cross-over design, twelve healthy males underwent a 60h fast which was compared to a 60h fed condition. In the fed condition meals were provided at energy balance throughout the study. Conditions were separated by a two week period of habitual diet. Volunteers resided in a respiration chamber for the entire 60h to measure energy expenditure and substrate oxidation hour by hour. Volunteers performed a standardized activity protocol while in the chamber. Blood samples were drawn after 12, 36 and 60h. Immediately following the breakfast meal (in the fed condition), fat oxidation became higher in the fasted condition compared to the fed condition and remained elevated throughout the study period. The initial rapid increase in fat oxidation corresponded with a decline in the hepatokine activin A (r=-0.86, p=0.001). The contribution of fat oxidation to total energy expenditure gradually increased with extended abstinence from food, peaking after 51h of fasting at 160mg/min. Carbohydrate oxidation stabilized at a low level during the second day of fasting and averaged around 60mg/min with only modest elevations in response to physical activity. Although 24h energy expenditure was significantly lower with prolonged fasting (11.0±0.4 vs 9.8±0.2 and 10.9±0.3 vs 10.3±0.3MJ in fed vs fasting, day 2 and 3 respectively, p<0.01), the 24h fluctuations in energy expenditure were comparable between the fasted and fed condition. The fluctuations in substrate oxidation were, however, significantly (p<0.001 for both carbohydrate and fat oxidation) altered in the fasted state, favouring fat oxidation. Energy expenditure displays a day-night rhythm, which is independent of food intake. In contrast, the day-night rhythm of both carbohydrate and fat oxidation is mainly driven by food intake. Upon extended fasting, the absolute rate of fat oxidation rapidly increases and keeps increasing during a 60h fast, whereas carbohydrate oxidation becomes progressively diminished. www.trialregister.nl NTR 2042.

Effect of Ramadan Fasting on Blood Glucose Level in Pregnant Women with Gestational and Type 2 Diabetes.

Pregnant women with diabetes are strongly advised against Ramadan fasting and have religious exemption, but a large proportion still choose to fast. Unfortunately, there is little information about glycemic control in these patients. This study aims to determine the fasting and postprandial blood glucose levels and to predict the risk factors for hypoglycemia in pregnant women with type 2 diabetes mellitus (DM) and gestational DM (GDM) who fast during Ramadan. A prospective cohort research was conducted at a single tertiary hospital between 2021 and 2023 on 70 pregnant women with GDM (n = 53) and type 2 DM (n = 17) in their second and third trimester. Their fasting and postprandial blood glucose levels during Ramadan were compared to those of the previous month, and hypoglycemia was defined as blood glucose levels less than 60 mg/dl. Binary regression was used to predict the risk variables for hypoglycemia. The GDM and type 2 DM groups were similar in terms of age, parity, number of fasting days, and number of daily fasting hours. Only 26.9% of the women who were permitted to fast were given special instructions for Ramadan fasting. Dietary intervention was more common in the GDM group, whereas insulin and metformin treatment were more common in the type 2 DM group. The fasting glucose level decreased significantly after Ramadan fasting in both groups, from 92.5 (17.4) mg/dl to 90 (17.13) mg/dl (p = 0.033). However, there were a significantly higher number of hypoglycemia events in the type 2 DM group. Further, type 2 DM was identified as a risk factor for hypoglycemia (OR = 6.23; 95% CI = 1.04-37.54; P = 0.046. The present findings indicate that Ramadan fasting may improve fasting glucose control. In addition, type 2 DM was identified as a risk factor for hypoglycemia.

Efficacy and safety of Naga Bhasma and Nisha-Amalaki Churna in the management of Madhumeha (type 2 diabetes) - A double-blind, randomized, controlled clinical trial

Abstract Background: Increasing global incidence of diabetes is a serious issue and large number of researches are undergoing to find promising cure of this chronic disease. Many Ayurveda drugs have been evaluated for anti-diabetic properties; however, researches on metallic/mineral based drugs are very few. The present study aimed to assess the comparative efficacy and safety of Shashti Puta Naga Bhasma (SNB) - Trimshati Puta Naga Bhasma (TNB) with Nisha-Amalaki Churna (NAC), NAC and metformin in the management of type 2 diabetes. Materials and methods: In this prospective, randomized, double blind, active controlled study; 132 patients with type 2 diabetes were included and randomly divided into four groups. Patients were treated with NAC (125 mg) with placebo (roasted Sooji; course powder of wheat flour), SNB (62.5 mg) with NAC (125 mg), TNB (62.5 mg) with NAC (125 mg) twice daily before food with honey while patients in last group were continued with their ongoing Tablet Metformin 500 mg prescribed by physician as standard control without any other additional intervention for 90 days. The assessment of changes observed in blood glucose, glycosylated hemoglobin, lipid profile, hemogram, hepatic, renal profile, and clinical symptoms was carried out. Results: After 90 days of medication, fasting and postprandial blood glucose levels and clinical symptoms in three groups were significantly decreased when compared with baseline except NAC group. Hemogram and hepatic and renal profiles (safety parameters) in the four groups were not significantly different from the baseline. No adverse events were reported with the use of the studied medicine. Conclusion: SNB along with NAC possessed more symptomatic relief in comparison to TNB with NAC, NAC alone and Metformin thereby improving the quality of life of patients along with significant glycemic control and free from any significant side effects.

Liver Glycogen as a Sensitive Indicator of Food Limitation in Delta Smelt

AbstractAssessing habitat quality is a major goal of conservationists and restoration practitioners, but to associate habitat quality with biomarkers of vagile animals, the biomarkers must respond rapidly. Here, we identified a biomarker capable of rapidly detecting food limitation in the imperiled Delta Smelt (Hypomesus transpacificus), a pelagic fish endemic to the San Francisco Estuary (SFE). We conducted an experiment with fed and unfed treatments of hatchery-raised, sub-adult Delta Smelt that were sampled at 12 time points: 0, 1, 2, 3, 4, 5, 6, 7, 9, 11, 14, and 21 days. We then compared four biomarkers using Day 21 fish: RNA/DNA in liver, triglycerides in liver, glycogen in liver, and glycogen in muscle. Of the liver endpoints, glycogen had the largest difference between treatments at Day 21, so we compared it to muscle glycogen across all time points. Liver glycogen declined by 60% after 1 day of fasting and remained depressed in the fasting treatment across all subsequent time points. Muscle glycogen also responded rapidly, taking only 2 days to decline by 39% in the fasting treatment, but the difference was inconsistent across subsequent time points. When applied to hatchery-released Delta Smelt collected from the SFE, liver glycogen concentrations were less than half that of the fed hatchery fish, consistent with the hypothesis of food limitation in the wild, but also several other potential causes. This study highlights the utility of liver glycogen as an indicator of recent foraging success in Delta Smelt.

An efficient two-stage pipeline model with filtering algorithm for mislabeled malware detection

Most malware detectors rely on machine-learning approaches. However, new malware samples are growing very fast day by day, and their labeling is very expensive. Consequently, companies cannot label each sample submitted for analysis. Instead, they label certain samples and treat the remaining as benign. Unfortunately, malicious samples are mislabeled and become noisy inputs. Nevertheless, the accuracy of the detection model is diminished by the bias introduced by mislabeling. Even obfuscation and adversarial attacks make malware detection difficult sometimes. These challenges motivate us to propose a novel two-stage pipeline technique based on two distinct sample behavior specifiers. First, using dynamic analysis tools, system calls, and application programming interface (API) call traces of samples are collected. Dynamic analysis is selected since it resolves the obfuscation issue significantly compared to static analysis. Second, API and system call traces are translated into a bag of n-grams or a sequence of anomaly scores. Then, the struc2vec algorithm is used to select the best n-gram features. The sequence of anomaly scores is transformed into six meta-features. A two-stage pipeline is proposed to detect the mislabeled malware and protect the host from Black-Box attacks. Each pipeline stage has a filtering algorithm for identifying the real label of any mislabeled malware. Experimental results on the VirusTotal and Ember datasets indicate that our proposed model achieves a 0.79 Matthews Correlation Coefficient (MCC) and a 0.62 MCC for classifying over 18,000 mislabeled malware samples, respectively. Also, our proposed model performs better in comparison to the existing models.

Effect of light and feeding regimes on the daily rhythm of thermal preference in Nile tilapia (Oreochromis niloticus)

Fish thermal preference varies throughout the day by allowing them to develop their biological processes under the most suitable thermal conditions. This study aimed to determine the effect of light and feeding regimes on the daily rhythm of thermal preference in Nile tilapia (Oreochromis niloticus). For this purpose, fish were allowed to freely choose their preferred temperature with different lighting conditions (experiment 1) and feeding schedules (experiment 2) using a multichamber tank with a thermal gradient from 26 °C to 34 °C or at a constant temperature of 30 °C (control). Fish were exposed to three different photoperiod combination [Light:Dark (LD) cycle, inverted LD cycle (DL) and constant darkness conditions (DD)] and four different feeding schedules [random (RD), feeding in the mid-light phase (mid-light, ML) or the mid-dark phase (mid-dark, MD), and fasting (FT)] . Regardless of the feeding/fasting protocol, a daily rhythm of temperature preference was observed, which suggests the role of LD cycles as the main synchronizer. In all the experimental phases, tilapia chose higher temperatures at dusk and cooler temperatures at dawn. Persistence of the rhythm for DD and FT indicated that an endogenous pacemaker may drive this rhythm. In both experiments, when fish were placed in the experimental tank on a thermal gradient for the first time, fish exhibited a stress-induced hyperthermia (SIH) response, characterized by the selection of higher temperatures. Conversely, the fish fed at MD selected cooler temperatures at night than the fish fed at ML or RD. Finally, FT resulted in selecting temperatures below the thermal optimum. These findings provide new insights into ecological and evolutionary aspects of fish thermoregulation, and might be useful for designing feeding protocols, which could impact fish welfare and, therefore, optimize fish production.

Short-term intensive fasting enhances the immune function of red blood cells in humans

BackgroundFasting is known to influence the immune functions of leukocytes primarily by regulating their mobilization and redistribution between the bone marrow and the peripheral tissues or circulation, in particular via relocalization of leukocytes back in the bone marrow. However, how the immune system responds to the increased risk of invasion by infectious pathogens with fewer leukocytes in the peripheral blood during fasting intervention remains an open question.ResultsWe used proteomic, biochemical and flow cytometric tools to evaluate the impact of short-term intensive fasting (STIF), known as beego, on red blood cells by profiling the cells from the STIF subjects before and after 6 days of fasting and 6 days of gradual refeeding. We found that STIF, by triggering the activation of the complement system via the complement receptor on the membrane of red blood cells, boosts fairly sustainable function of red blood cells in immune responses in close relation to various pathogens, including viruses, bacteria and parasites, particularly with the pronounced capacity to defend against SARS-CoV-2, without compromising their oxygen delivery capacity and viability.ConclusionSTIF fosters the immune function of red blood cells and therefore, it may be considered as a nonmedical intervention option for the stronger capacity of red blood cells to combat infectious diseases.

Effect of Fasting Ramadan on Different Laboratory Parameters on Type 2 Diabetic Mellitus Patients

Background Diabetes mellitus (DM) is one of the most common chronic diseases in nearly all countries, and continues to increase in numbers and significance, as changing lifestyles lead to reduced physical activity, and increased obesity. It has been estimated that by the year 2030, there will be 8.6 million adult with diabetes in Egypt, making it the country with the tenth largest population of diabetic in the world. Diabetes is associated with reduced life expectancy, significant morbidity due to micro and macro vascular complications and diminished quality of life. Objective To study the impact of Ramadan fasting on metabolic parameters and anthropometry in type 2 DM in Egypt. Patients and Methods This study was conducted on 80 type 2 diabetic patients who were intending to fast Ramadan. During Ramadan (2014) the average fasting hours were 15 h. Patients were recruited from the internal medicine outpatient clinic at Ain Shams University hospitals and from the nutrition institute. 6 Patients were under insulin treatment (Biphasic human insulin) &amp; 74 patients were under oral hypoglycemic treatment {52 on combination treatment sulfonylurea + metformin &amp; 9 on metformin only &amp;13 of them were on sulfonylurea only}. Results We found that there was a statistically significant increase as regard lipid profile (serum triglycerides, serum total cholesterol, LDL-cholesterol and HDL-cholesterol) in after Ramadan measurement. Also CVD risk parameters have untimely increased after Ramadan this parameters including (10 years risk (Framingham score) systolic and diastolic blood pressure). In addition (Creatinine, HOMA IR and fasting insulin) showed increased level in after Ramadan measurement which indicate deterioration of blood glucose parameters. There was no statistical significant changes seen as regard anthropometric measures (BMI, WHR) in pre Ramadan and after Ramadan measurement. Also there was no statistical significant changes regarding fasting, 2 hours plasma glucose, A1c levels between pre-Ramadan fasting &amp; after-Ramadan. In addition CRP and ACR showed no significant changes as regard measurement between before and after Ramadan. Conclusion Ramadan fasting appears to have significant effect on lipid profiles that could adversely impact cardiovascular outcome. These effects are mostly due to quality and quantity of food intake during Ramadan and the negative impact of sedentary life style. In addition the number of fasting days and period of daily fasting could affect glycemic control and renal function tests. Bad dietary habits, lack of exercise and irregular drug intake during Ramadan has a negative impact on glycemic control.

September 11 — All-Russian Day of Sobriety

In 1913 in Russia, at the insistence of the ministers of the Russian Orthodox Church, it was decided to celebrate the All-Russian Day of Sobriety for the first time, and this was done in St. Petersburg with the participation of a group of public people. This date coincided with the day of strict fasting, when the Orthodox world celebrates a great church holiday — the Beheading of St. John the Baptist: according to the new calendar, this day falls on September 11th. Legend has it that being in a drunken stupor, Herod Antipas cut off the head of the holy Prophet during a feast. In all the Orthodox churches of the country, a procession is held on this date, and prayers are read to John the Baptist with a request to free all those who suffer from the disease of insobriety and send them healing. On this day, it is customary to pray to the Icon of the Inexhaustible Chalice, which, as legend has it, is able to save from alcoholism, and priests call on relatives to come and light a candle for the healing of all the unfortunate heavy drinkers. On September 11, not a single tavern traditionally worked, wine shops were closed, and the most severe punishment was envisioned for the sale of alcoholic beverages.

ОЦЕНКА СТОМАТОЛОГИЧЕСКОГО СТАТУСА И ПОКАЗАТЕЛЕЙ ГОМЕОСТАЗА ПОЛОСТИ РТА У ЛИЦ, СОБЛЮДАЮЩИХ ПОСТ

Subject of study. Dental status, indicators of oral homeostasis in persons, diet and oral hygiene in persons observing the fast of Ramadan.&#x0D; Purpose of the study. To study the dental status, indicators of homeostasis of the oral cavity and the nature of nutrition in persons observing the fast of Ramadan.&#x0D; Methodology. The study involved 37 male volunteers, aged 25 to 35 years, belonging to the second health group, who did not undergo SARS-CoV-2, with an orthognathic bite, a satisfactory level of hygiene, a PMA equal to zero, and a KPU index below 1.5. In previous years, the studied persons strictly observed the fast of Ramadan and this year, too, were firmly determined to observe it. Before the start, on the 15th day and after the end of the fast, the study studied the hygienic state of the oral cavity, the state of the teeth, the state of periodontal tissues, the functional activity of the salivary glands, the viscosity and pH of saliva, the level of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) and the activity of antioxidant enzymes – superoxide dismutase (SOD), oral fluid catalase. After completing the fast, they filled out questionnaires that included questions about oral care and diet during fasting.&#x0D; Results. In persons observing the fast of Ramadan, the reaction of saliva is shifted to the acid side, the functional activity of saliva decreases, and the viscosity of saliva increases. This leads to a deterioration in the hygienic state of the oral cavity, the formation of soft and hard deposits on the teeth and the development of gum disease. There is also an imbalance in the lipid peroxidation-antioxidants system, an increase in the concentration of pro-inflammatory cytokines IL-1β, IL-6, TNF-α, both on the 15th day of fasting and after its completion.&#x0D; Conclusions. The results of the study allow dentists and nutritionists to purposefully develop recommendations on diet and prevention of dental diseases for people who observe the fast of Ramadan.

Diyanet Çocuk Dergisinde İlhami Ayrancı’nın Hikâyeleri

The Diyanet Çocuk (Diyanet Children) is a journal for children that started its publication life in 1979 and continues to be published once a month today. As stated in its name, the journal belongs to the Presidency of Religious Affairs. Studying how children's literature gets a place in a religious magazine is important for the development of religious children's literature. The fact that the periodical in question of the journal has a long history clearly demonstrates this development. In Turkish literature, the first forms used in writing for children are fairy tales and stories. The story type is widely preferred to give children the values they want to be given. For this reason, in this study, fifteen stories of Assoc. Prof. Dr. İlhami Ayrancı, published in the journal between February of 1993 and November 2002, were examined. After the information about the journal was mentioned first, information about the author Ayrancı was given. Fifteen works then were examined, and the outstanding topics were identified, and their pedagogical relation to the child was discussed. The volumes between 1979 and 2013 have not been digitized. Therefore, the study was carried out in the periodicals archive located in the Library of the Presidency of Religious Affairs. Although the writings have a memoir feature, they have been conveyed by narrating. For this reason, it has been evaluated as a story. Some parts are in the mood of conversation as if talking to the reader, sometimes at the beginning of the stories and sometimes at the end. Each part is irrespective of each other. The author acts a teacher and often includes dialogues with his students in the school environment. According to our findings, the stories are not suitable for classification. However, if we refer to the content, five of the fifteen stories focuses on motherhood. Some have been written on the importance of caring for the mother and obedience. In the two stories, children were given information about religious terms such as “fasting and religous day”. In addition, in the stories, there are topics such as not being greedy, appreciating, not being prejudiced, and not breaking hearts. On the other hand, some sentences like “...the bodies could only be recovered from the hillside piece by piece." which are pedagogically inappropriate descriptions includes, but the author's sensitivity to children is clearly visible. The stories written by Ayrancı, published in the Journal of Diyanet Children, inform children about both ethical, moral, and religious issues.

Effects of Fasting on the Physiological and Psychological Responses in Middle-Aged Men.

Tracking changes in the body during fasting takes into account indicators of mental well-being and physiological parameters. The aim of the study was to measure psychological and physiological reactions, along with their mutual relations, caused by 8 days of water-only fasting. Fourteen men aged 35 to 60 participated in the study, divided into two groups, younger and elder. In addition to physiological parameters, psychological data were collected using four different tests. The obtained results confirmed reduction in body weight, systolic blood pressure, resting diastolic blood pressure and glucose level, and increase in resting heart rate, cortisol and β-hydroxybutyrate concentration. However, no significant psychological changes were observed under the influence of fasting intervention. A significant interaction effect occurred for the state anxiety variable determined before and after the fasting intervention for both groups. Moreover, negative correlations between physiological (cortisol) and psychological factors of subjectively assessed stress were revealed. The only effect on cognitive ability was seen when responding to simple tasks. The study confirmed the beneficial effect of 8 days of water-only fasting on physiological variables without affecting mental well-being. The relatively high level of well-being after fasting intervention was independent of the physiological indicators of stress.

Short-duration cold exposure decreases fasting-induced glucose intolerance but has no effect on resting energy expenditure

The aim of the present study was to investigate whether brief cold exposure can reverse fasting-induced glucose intolerance and insulin resistance, and improve resting energy expenditure (REE). Twelve young non-obese women were randomly assigned to undergo the following conditions: 2 days of fasting with two 10-min whole-body cold-water immersions on separate days (FAST-COLD), 2 days of fasting without cold-water immersions (FAST), 2 days of usual diet with two 10-min whole-body cold-water immersions on separate days (COLD), or 2 days of usual diet without cold-water immersions (CON) in a randomised crossover fashion. Changes in REE and substrate utilisation, and glucose tolerance and insulin sensitivity from the oral glucose tolerance test were examined. The results showed that FAST-COLD and FAST trials increased (P < 0.05) REE and decreased (P < 0.05) respiratory quotient, but these variables did not differ significantly between the FAST-COLD and FAST trials. The glucose and insulin area under the curves (AUCs) were higher (P < 0.05) in the FAST-COLD and FAST trials than in the CON and COLD trials, and these AUCs were lower (P < 0.05) in the FAST-COLD than in the FAST trial. Matsuda index was lower in the FAST trial than in the CON trial (P < 0.05), and tended to be greater after the FAST-COLD trial than after the FAST trial (P = 0.060). In conclusion, cold exposure had no effect on REE but decreased fasting-induced glucose intolerance which was accompanied by a maintained insulin sensitivity.

Assessment of a Real-world Learning Curve for the Endoscopic Resection of Gastric Gastrointestinal Stromal Tumors.

Endoscopic resection (ER) is a proven treatment for gastric gastrointestinal stromal tumors (gGISTs). We aimed to assess the learning curve (LC) associated with ER for gGISTs and identify determinants. We conducted an analysis of 289 patients who underwent the ER of gGISTs by an experienced endoscopist. To characterize the LC, we employed cumulative sum analysis of the duration of surgery. The participants were divided into an early phase (cases 1-50) and a later phase (case 51-289), which were compared. Furthermore, we identified risk factors for the conversion from endoscopic to laparoscopic resection (LR). The durations of surgery and hospitalization were shorter, and there were fewer complications and fasting days in the later phase. The conversion rates to LR were 6.0% and 2.5% in the early and later phases, respectively. The tumor diameter (≥3.0 cm) and invasion beyond the muscularis propria were significant risk factors for conversion to LR (odds ratio 17.92, 95% confidence interval 2.66-120.87; and 58.03, 6.40-525.84; respectively). The LC for ER of gGISTs lasts for approximately 50 cases. In addition, tumors ≥3.0 cm in diameter and those that invade beyond the muscularis propria are more likely to require conversion to LR.

The effect of prolonged irregular search and rescue operations on the hematological blood parameters of service dogs of medium breeds

The aim of the study was to assess the impact of prolonged irregular search and rescue operations on the hematological blood parameters of service dogs of medium breeds. The study was conducted on dogs of medium breeds: Border Collie, Australian Shepherd, Nova Scotia Retriever. The age of the animals ranged from four to ten years, and the body weight from 16.2 to 22.0 kg. Assessment of the condition of the animals before and after their participation in search and rescue operations was carried out based on the results of a clinical examination and a clinical blood test. A general blood test was performed on a Mindray BC-2800 Vet hematological analyzer. The following indicators were determined: the number of leukocytes; erythrocytes; hemoglobin level; erythrocyte sedimentation rate (ESR). The leukogram was derived from stained blood smears using an OLYMPUS CX23 Evidence immersion microscope. Based on the data obtained during the physical examination, there were no signs of any diseases, all the animals were clinically healthy. At the same time, the occurrence of obvious stress was noted in all. Blood sampling from animals was carried out after at least eight hours of a starvation diet, from the lateral subcutaneous vein of the thoracic limb, taking into account compliance with the rules of asepsis and antiseptics. It was found that the loads during prolonged irregular search and rescue operations have an impact on the clinical picture of the blood, expressed in a decrease in the average number of erythrocytes, hemoglobin, rod-shaped neutrophils, lymphocytes, and monocytes, as well as an increase in the number of leukocytes, eosinophils and neutrophils, as well as an increase in the rate of erythrocyte sedimentation.

Does Religious Fasting Have a Protective Role against Metabolic Syndrome in Individuals Aged >50 Years?

The Christian Orthodox Church (COC) fasting is a periodic vegetarian-type diet lasting 180-200 days annually in which seafood and snails are allowed on all fasting days. Our aim was to investigate the effects of COC fasting on metabolic syndrome (MetS) in adults >50 years. One hundred seventy-six individuals participated in the study (mean age 59.7 ± 6.0 years). Eighty-nine had been following the COC fasting regime since their childhood and eighty-seven were non-fasters. Anthropometric measurements, blood samples, and nutrient intake data were collected at a scheduled appointment, during a non-fasting period. Fasters had significantly higher hip circumference (102 ± 8.5 vs. 98.8 ± 7.5 cm, p = 0.009), low-density lipoprotein (LDL) cholesterol (136 ± 73 vs. 115 ± 51 mg/dL, p = 0.033), and folic acid levels (6.0 ± 4.0 vs. 3.0 ± 1.2 ng/mL, p = 0.018), as well as lower systolic blood pressure (SBP) (131 ± 13 vs. 136 ± 14 mmHg, p = 0.045), diastolic blood pressure (DBP) (80 ± 8 vs. 83 ± 7 mmHg, p = 0.007), glucose (87 ± 16 vs. 93 ± 25 mg/dL, p = 0.039), and triglycerides (143 ± 94 vs. 175 ± 84 mg/dL, p = 0.040). Fasters had significantly less intake of calories (1493.65 ± 363.74 vs. 1614.65 ± 426.28 kcal, p = 0.044) and fat (81.17 ± 25.47 vs. 90.74 ± 24.75 g, p = 0.012), whereas they also consumed significantly less vitamin A-retinol, vitamin B2, vitamin B12, vitamin E, folic acid, pantothenic acid, calcium, phosphorus, zinc, and significantly more vitamin C (p < 0.005 for all comparisons). BP was significantly higher in non-fasters (44.8 vs. 22.5%, p = 0.002), whereas MetS was more frequently present in non-fasters vs. fasters, with a marginal level of significance (35.6 vs. 22.5%, p = 0.055). COC fasting may affect beneficially MetS prevalence in individuals >50 years, although future research is needed before reaching definite conclusions.

Smart Agriculture Automation using ESP8266 Node MCU

Today agriculture is growing fast and changing day by day but farmers face problems every day, these problems are always problems every day, but if you do not solve this problem in time, it can create serious problems. The problem that the water pump works with three-phase voltage, but sometimes the three-phase voltage is not the same in three-phases, resulting in the dark voltage of one phase voltage or the high and low voltage of one of voltage level. If the water pump voltage becomes incompatible after a while, it will be burned or damage water pumps. The second problem is that sometimes the water in the well will decrease in agriculture, but the pump works, that is, the pump runs dry, which will affect the pump because dry running will be damaged pump. The third problem is when water is used for plants to grow, but how can you be sure that how much plants need water, this is important but you don't know you are wasting water. Our system, reducing impacts, protecting pumps and conserving water while maintaining the humidity our services require.

Transpyloric Tube Placement Shortens Time to Full Feeding in Left Congenital Diaphragmatic Hernia

BackgroundNutritional complications have an impact in both short- and long-term morbidity of patients with congenital diaphragmatic hernia (CDH). We aimed to compare time to full enteral tube feeding depending on route -gastric (GT) or transpyloric (TPT)- in newborns with left CDH (L-CDH). MethodsRetrospective cohort study of L-CDH patients admitted to a referral tertiary care NICU between January 2007 and December 2014. Lethal chromosomal abnormalities and death before initiation of enteral nutrition were exclusion criteria. Results37 patients were fed through GT, 46 by TPT. TPT children took 11.0 (6.8) days to reach full enteral tube feeding and spent 16.6 (8.1) days on parenteral nutrition vs 16.8 (14.7) days (p = 0.041) and 22.7 (13.5) days (p = 0.020) of GT patients. TPT children had 3.9 (2.4) days of fasting due to GI issues and 20% had episodes of decreased rates of enteral nutrition for extra-GI complications vs 11.4 (11.1) days (p = 0.028) and 49% (p = 0.006). According to the best fitting model (R2 0.383, p < 0.001), the TPT-group achieved full enteral feeding 8.4 days earlier than the GT-group (95% CI -14.76 to - 2.02 days), after adjustment by severity of illness during the first days, o/e LHR_liver and class of diaphragmatic defect. There were no differences in growth outcomes and length of stay between survivors of GT and TPT groups. ConclusionTPT shortens time to full enteral nutrition, especially in the most severe L-CDH patients. We propose that placement of a TPT at the end of the surgical repair procedure should be considered, especially in higher-risk patients. Level of EvidenceTreatment study, Level III. Retrospective comparative, case–control study.