Agents In Management Research Articles

Far-infrared therapy promotes exercise capacity and glucose metabolism in mice by modulating microbiota homeostasis and activating AMPK

The benefits of physical exercise on human health make it desirable to identify new approaches that would mimic or potentiate the effects of exercise to treat metabolic diseases. However, whether far-infrared (FIR) hyperthermia therapy could be used as exercise mimetic to realize wide-ranging metabolic regulation, and its underling mechanisms remain unclear. Here, a specific far-infrared (FIR) rays generated from graphene-based hyperthermia devices might promote exercise capacity and metabolisms. The material characterization showed that the graphene synthesized by chemical vapour deposition (CVD) was different from carbon fiber, with single-layer structure and high electrothermal transform efficiency. The emission spectra generated by graphene-FIR device would maximize matching those adsorbed by tissues. Graphene-FIR enhanced both core and epidermal temperatures, leading to increased blood flow in the femoral muscle and the abdominal region. The combination of microbiomic and metabolomic analysis revealed that graphene-FIR modulates the metabolism of the gut-muscle axis. This modulation was characterized by an increased abundance of short-chain fatty acids (SCFA)-producing bacteria and AMP, while lactic acid levels decreased. Furthermore, the principal routes involved in glucose metabolism, such as glycolysis and gluconeogenesis, were found to be altered. Graphene-FIR managed to stimulate AMPK activity by activating GPR43, thus enhancing muscle glucose uptake. Furthermore, a microbiota disorder model also demonstrated that the graphene-FIR effectively restore the exercise endurance with enhanced p-AMPK and GLUT4. Our results provided convincing evidence that graphene-based FIR therapy promoted exercise capacity and glucose metabolism via AMPK in gut-muscle axis. These novel findings regarding the therapeutic effects of graphene-FIR suggested its potential utility as a mimetic agent in clinical management of metabolic disorders.

Unveiling the complex U‐shaped relationship between entrepreneurial orientation and exploratory/exploitative innovations: strategic planning as a moderator

Grounded in agency and stewardship theories, this study investigates the U‐shaped relationship between entrepreneurial orientation and exploratory/exploitative innovations and the moderating effects of strategic planning. Empirical data is collected from 396 A‐share listed public companies in China. Entrepreneurial orientation is assessed via internal R&D and external investment data, while content analysis captures exploitative, exploratory innovation, and strategic planning. The empirical findings yield two core conclusions: (1) This study finds the presence of U‐shaped relationships between entrepreneurial orientation and exploratory/exploitative innovations. As entrepreneurial orientation increases to an inflection point, it exhibits negative effects due to managerial agency behavior; however, beyond this point, it yields positive outcomes due to stewardship. (2) Strategic planning positively moderates the U‐shaped relationships, countering agency impact at low orientation levels while enhancing stewardship at higher levels. These insights advance entrepreneurial orientation research, agency vs. stewardship literature, and provide a roadmap for fostering exploratory and exploitative innovations through strategic integration of entrepreneurial orientation and leveraging of strategic planning.

Early Point-of-Care Thromboelastometry Reduces Mortality in Patients with Severe Trauma and Risk of Transfusion: An Analysis Based on the TraumaRegister DGU®.

Background: Thromboelastometry like ROTEM® is a point-of-care method used to assess the coagulation status of patients in a rapid manner being particularly useful in critical care settings, such as trauma, where quick and accurate assessment of coagulation can guide timely and appropriate treatment. Currently, this method is not yet comprehensively available with sparse data on its effectiveness in resuscitation rooms. The aim of this study was to assess the effect of early thromboelastometry on the probability of mass transfusions and mortality of severely injured patients. Methods: The TraumaRegister DGU® was retrospectively analyzed for severely injured patients (2011 until 2020) with information available regarding blood transfusions and Trauma-Associated Severe Hemorrhage (TASH) score components. Patients with an estimated risk of mass transfusion >2% were included in a matched-pair analysis. Cases with and without use of ROTEM® diagnostic were matched based on risk categories for mass transfusion. A total of 1722 patients with ROTEM® diagnostics could be matched with a non-ROTEM® patient with an identical risk category. Adult patients (≥16) admitted to a trauma center in Germany, Austria, or Switzerland with Maximum Abbreviated Injury Scale severity ≥3 were included. Results: A total of 83,798 trauma victims were identified after applying the inclusion and exclusion criteria. For 7740 of these patients, the use of ROTEM® was documented. The mean Injury Severity Score (ISS) in patients with ROTEM® was 24.3 compared to 19.7 in the non-ROTEM® group. The number of mass transfusions showed no significant difference (14.9% ROTEM® group vs. 13.4% non-ROTEM® group, p = 0.45). Coagulation management agents were given significantly more often in the ROTEM® subgroup. Mortality in the ROTEM® group was 4.1% less than expected (estimated mortality based on RISC II 34.6% vs. observed mortality 30.5% (n = 525)). In the non-ROTEM® group, observed mortality was 1.6% less than expected. Therefore, by using ROTEM® analysis, the expected mortality could be reduced by 2.5% (number needed to treat (NNT) 40; SMR of ROTEM® group: 1:0.88; SMR of non-ROTEM® group: 1:0.96; p = 0.081). Conclusions: Hemorrhage is still one of the leading causes of death of severely injured patients in the first hours after trauma. Early thromboelastometry can lead to a more targeted coagulation management, but is not yet widely available. This study demonstrated that ROTEM® was used for the more severely injured patients and that its use was associated with a less than expected mortality as well as a higher utilization of hemostatic products.

Plant growth‐promoting rhizobacteria and Trichoderma shift common vetch (Vicia sativa) physiology and phyllosphere bacteria toward antagonism against anthracnose caused by Colletotrichum spinaciae

AbstractBackgroundPlant phyllosphere microbes are important for the host plant's protection. Plant growth‐promoting rhizobacteria (PGPR) and Trichoderma are common biocontrol agents (BCAs) for disease management. Pathogens and BCAs can change the rhizosphere microbial composition; however, the effect of PGPR or Trichoderma on plant phyllosphere microbes, particularly for mesocosms involving the interaction between pathogens and BCAs, is not well known.MethodsHigh‐throughput sequencing was used to identify the phyllosphere bacterial community of common vetch interacting with Colletotrichum spinaciae, two PGPRs (Bacillus subtilis and Bacillus licheniformis), and Trichoderma longibrachiatum. We evaluated anthracnose severity, phyllosphere bacteria diversity and composition, and the relationship between the activities of plant defense enzymes and hormonal molecules in plants treated with individual and combined inoculations of PGPRs, Trichoderma, and C. spinaciae.ResultsPGPR or Trichoderma alone reduced disease severity. Trichoderma reduced the salicylic acid content, PGPR increased the catalase activity in plants, and co‐inoculation of PGPR and Trichoderma decreased the salicylic acid content. Inoculation of PGPR and Trichoderma individually or in combination changed the disease‐associated phyllosphere bacteria, and this effect was related to plant defense enzymes and hormonal molecules.ConclusionsWe suggest that the plant defense response induced by PGPR and Trichoderma results in the enrichment of a fraction of favorable chloroplastic bacteria, which facilitates plant defense against diseases.

Improving Functional Status of Older Adults Through Health Literacy Media: A Systematic Review

Older age can be followed by an aging process that shows a decrease in physical function due to various degenerative problems that reduce immunity caused the older adults vulnerable to infectious diseases. Health literacy can improve the physical function of the older adults in using self management agents, social support, access to health services and increasing the quality of life of older adults. The aim of this paper is to obtain the existence evidence of health literacy impact in improving older adults health status and functional or physical well-being living in community-setting and clinical setting. This paper used some databases Proquest database, PubMed, Sage Journal, Scopus, Ebscohost, Science Direct, anf Taylor & Francis. There are 11 articles published between 2014 - 2024 were reviewed using the PRISMA method. This review found that there are different types of health literacy media (print and digital) and there are combination of health literacy with physical activity interventions to deliver health information to older people. Standardized health literacy media in readability, and easy to use such as video/web/electronic, game-based, digital, and mobile-based and health literacy interventions combined with planned physical activities can increase knowledge, self-efficacy, cognitive function, quality of life, and reducing frailty score, fall risk, depression score.

Probiotic effect in preterm neonates with sepsis - A systematic review protocol.

Background: The microbiota in the intestine is made up of trillions of living bacteria that coexist with the host. Administration of antibiotics during neonatal infection causes depletion of gut flora resulting in gut dysbiosis. Over the last few decades, probiotics have been created and promoted as microbiota management agents to enrich gut flora. Probiotics decrease the overgrowth of pathogenic bacteria in the gut of preterm neonates, reducing the frequency of nosocomial infections in the Neonatal Intensive Care Unit (NICUs). Methods: The systematic review will include randomized control trials (RCTs) of premier neonates with sepsis. Studies will be retrieved from global databases like Cochrane CENTRAL, CINAHL Plus via EBSCO host, MEDLINE via PubMed, EMBASE, SCOPUS, Ovid, Web of Science, ProQuest Medical Library, Microsoft academic, and DOAJ by utilizing database-specific keywords. Screening, data extraction, and critical appraisal of included research will be carried out separately by two review writers. Findings will be reported in accordance with the PRISMS-P 2020 guidelines. Conclusions: The findings of this systematic review will help to translate the evidence-based information needed to encourage the implementation of potential research output in the field of neonatal intensive care, guide best clinical practise, assist policy making and implementation to prevent gut dysbiosis in neonates with sepsis by summarising and communicating the evidence on the topic. PROSPERO registration number: This systematic review protocol has been registered in PROSPERO (Prospective Register of Systematic Reviews) on 10 th March 2022. The registration number is CRD42022315980.

Effect of norethisterone dose and duration in the management of abnormal uterine bleeding: a narrative review and case report.

Abnormal uterine bleeding (AUB) is an acute/chronic variation in the normal menstrual cycle that affects adolescents, women of reproductive age and perimenopausal women. AUB affects approximately 3-30% of reproductive-aged women worldwide, and reduces their quality of life and productivity whilst increasing the overall healthcare burden. Its management requires thorough medical evaluation and individualized treatment. Depending on the severity and cause of AUB, its treatment ranges from lifestyle modifications and hormonal therapies to more invasive procedures or surgery. Although hormonal therapy is the preferred first-line measure in AUB, the available pharmacological options have various adverse effects. There exists a need for safer and more efficient treatment regimens with high patient compliance to effectively treat AUB. Norethisterone, also known as norethindrone, is a widely used synthetic analogue of progestogen. Controlled release formulations of norethisterone/ norethisterone acetate help maintain constant drug levels in the blood and exert minimal side-effects; therefore, they are promising therapeutic agents for effective AUB management. The present review summarizes the epidemiology and diagnosis of AUB, with a focus on the safety, efficacy and tolerability of norethisterone/ norethisterone acetate in AUB management. We also report a case of AUB in a 40-year-old woman, who was treated with NETA tablets. The treatment resulted in favourable outcomes, and patient satisfaction.

Sustainable Synthesis of Guanidine Derivatives and Computational Assessment of their Antidiabetic Efficacy.

Type 2 Diabetes Mellitus (T2DM) represents a significant and pressing worldwide health concern, necessitating the quest for enhanced antidiabetic pharmaceuticals. Guanidine derivatives, notably metformin and buformin, have emerged as pivotal therapeutic agents for T2DM management. The present study introduces an efficient one-pot synthesis method for the production of symmetrical guanidine compounds. This synthesis involves the reaction of isothiocyanates with secondary amines, employing an environmentally friendly and recyclable reagent, tetrabutylphosphonium tribromide (TBPTB). A comprehensive assessment of the biological activity of the synthesized guanidine compounds, specifically in the context of T2DM, has been rigorously conducted. Additionally, computational analyses have unveiled their substantial potential as promising antidiabetic agents. Results highlight the relevance of these compounds in the ongoing pursuit of novel therapeutic solutions for T2DM.</p>.

Comparative Evaluation of Feracrylum and Chlorhexidine in Nonsurgical Periodontal Therapy in Chronic Periodontitis: A Clinicomicrobiological Study

ABSTRACT Background: One common inflammatory illness that affects periodontal tissues is chronic periodontitis. By lowering inflammation and getting rid of periodontal bacteria, nonsurgical periodontal management is essential for treating chronic periodontitis. The objective of this study was to evaluate the effectiveness of chlorhexidine and feracrylum in nonsurgical periodontal management for persistent periodontitis. Techniques: As part of their periodontal therapy, 50 patients with a diagnosis of chronic periodontitis were randomized into two groups: first got chlorhexidine, while other Feracrylum received feracrylum. Microbiological analysis and clinical parameters were measured at baseline and 3 months later. Results: Clinical metrics showed a considerable improvement in both groups. Comparing feracrylum to chlorhexidine, the former showed stronger antibacterial action against periodontal infections. Conclusion: For nonsurgical periodontal management of chronic periodontitis, feracrylum shows similar effectiveness to chlorhexidine. Furthermore, feracrylum has better antibacterial activity against pathogens of the periodontal tissues, indicating that it might be used as a substitute antimicrobial agent in periodontal management.

The anti-aromatase and anti-estrogenic activity of plant products in the treatment of estrogen receptor-positive breast cancer

Despite being the focal point of decades of research, female breast cancer (BC) continues to be one of the most lethal cancers in the world. Given that 80 % of all diagnosed BC cases are estrogen receptor-positive (ER+) with carcinogenesis driven by estrogen-ERα signalling, current standard of care (SOC) hormone therapies are geared towards modulating the function and expression levels of estrogen and its receptors, ERα and ERβ. Currently, aromatase inhibitors (AIs), selective ER modulators (SERMs) and selective ER degraders (SERDs) are clinically prescribed for the management and treatment of ER+ BC, with the anti-aromatase activity of AIs abrogating estrogen biosynthesis, while the anti-estrogenic SERMs and SERDs antagonise and degrade the ER, respectively. The use of SOC hormone therapies is, however, significantly hampered by the onset of severe side-effects and the development of resistance. Given that numerous studies have reported on the beneficial effects of plant compounds and/or extracts and the multiple pathways through which they target ER+ breast carcinogenesis, recent research has focused on the use of dietary chemopreventive agents for BC management. When combined with SOC treatments, several of these plant components and/or extracts have demonstrated improved efficacy and/or synergistic impact. Moreover, despite a lack of in vivo investigations, plant products are generally reported to have a lower side-effect profile than SOC therapies and are therefore thought to be a safer therapeutic choice. Thus, the current review summarizes the findings from the last five years regarding the anti-aromatase and anti-estrogenic activity of plant products, as well as their synergistic anti-ER+ BC effects in combination with SOC therapies.

Comparative Analysis of Real-World Efficacy and Safety of Hypoxia-Inducible Factor Prolyl-Hydroxylase Inhibitors in Kidney Transplant Recipients Versus Nontransplant Individuals: A Single-Center Study

ObjectivesTo compare the efficacy and safety of hypoxia-inducible factor prolyl-hydroxylase inhibitors (HIF-PHis), a novel agent for management of anemia in chronic kidney disease (CKD), between transplant recipients and nontransplant individuals. MethodsA retrospective analysis was conducted on nondialysis-dependent CKD stage 3 to 5 patients treated with the HIF-PHi roxadustat or daprodustat at a single institution. Patients were categorized as kidney transplant recipients (KTRs) and non-KTRs. Efficacy outcomes (hemoglobin and creatinine levels) and safety profiles (rate of adverse events [AEs], descriptions, and discontinuations due to AEs) were assessed 3 months before and 6 months after HIF-PHi initiation within and then between the groups. ResultsThe study comprised 82 patients (KTR: 43, non-KTR: 39). Median ages significantly differed between the KTR (52.7 years) and non-KTR (82.9 years) groups (P < .001). Roxadustat was predominantly used in the KTR group (88.4%), while daprodustat was used in the non-KTR group (94.9%, P < .001). Both groups exhibited significant increases in Hb levels at 1, 3, and 6 months post-HIF-PHi initiation (P for trend, <.001), with a relative increase in Hb level at 6 months of 16% for KTRs and 13% for non-KTRs. Creatinine levels showed no significant changes over 6 months. Although no difference was observed in drug discontinuation due to AEs, the KTR group experienced a significantly higher rate of thrombotic events (18.6 vs 2.6%, P = .049). ConclusionsHIF-PHis demonstrate comparable efficacy for managing anemia in CKD, regardless of transplant status. However, heightened vigilance for thrombosis events is necessary during follow-up for KTRs.

Biocontrol of Southern Blight Caused by Sclerotium rolfsii in Pepper Plants Using Bacillus subtilis GJ6-14

Southern blight, caused by the soil-borne fungus Sclerotium rolfsii, is a serious disease that affects many economically important crops. In this study, we selected Bacillus subtilis GJ6-14, from a total of 260 strains, to control Southern blight in pepper plants. In both seedling and plant tests, GJ6-14 significantly suppressed disease incidence and severity compared to control, furthermore, GJ6-14 demonstrated efficient colonization in the rhizosphere by maintaining the population from log 5.41 to log 3.92 in the pathogen-inoculated plants, indicating its potential as a biocontrol agent. Molecular analysis revealed up-regulation of defense-related genes, such as a 7.6-fold increase in LOX1 and 15.5-fold increase in PR1, at 72 hr after inoculation of S. rolfsii in GJ6-14-treated plants, suggesting activation of plant defense mechanisms. Overall, our findings highlight the promising role of B. subtilis GJ6-14 as a potential biocontrol agent in sustainable management of Southern blight in pepper plants.

Endophytic Trichoderma: Potential and Prospects for Plant Health Management.

The fungus Trichoderma is widely regarded as the most common fungal biocontrol agent for plant health management. More than 25 Trichoderma species have been extensively studied and have demonstrated significant potential in inhibiting not only phytopathogen growth but also insect pest infestations. In addition to their use as biopesticides, there is increasing evidence that several Trichoderma species can function as fungal endophytes by colonizing the tissues of specific plants. This colonization enhances a plant's growth and improves its tolerance to abiotic and biotic stresses. In recent decades, there has been a proliferation of literature on the role of Trichoderma endophytes in crop protection. Although the mechanisms underlying plant-fungal endophyte interactions are not yet fully understood, several studies have suggested their potential application in agriculture, particularly in the mitigation of plant pests and diseases. This review focuses on the diversity of Trichoderma endophytic strains and their potential use in controlling specific diseases and pests of crop plants. Trichoderma endophytes are considered a potential solution to reduce production costs and environmental impact by decreasing reliance on agrochemicals.

Omarigliptin/rosinidin combination ameliorates cyclophosphamide-induced lung toxicity in rats: The interaction between glucagon-like peptide-1, TXNIP/NLRP3 inflammasome signaling, and PI3K/Akt/FoxO1 axis

Cyclophosphamide is an anti-neoplastic drug that has shown competence in the management of a broad range of malignant tumors. In addition, it represents a keystone agent for management of immunological conditions. Despite these unique properties, induction of lung toxicity may limit its clinical use. Omarigliptin is one of the dipeptidyl peptidase-4 inhibitors that has proven efficacy in management of diabetes mellitus. Rosinidin is an anthocyanidin flavonoid that exhibited promising results in management of diseases characterized by oxidative stress, inflammation, and apoptosis. The present work investigated the possible effects of omarigliptin with or without rosinidin on cyclophosphamide-induced lung toxicity with an exploration of the molecular mechanisms that contribute to these effects. In a rodent model of cyclophosphamide elicited lung toxicity, the potential efficacy of omarigliptin with or without rosinidin was investigated at both the biochemical and the histopathological levels. Both omarigliptin and rosinidin exhibited a synergistic ability to augment the tissue antioxidant defenses, mitigate the inflammatory pathways, restore glucagon-like peptide-1 levels, modulate high mobility group box 1 (HMGB1)/receptors of advanced glycation end products (RAGE)/nuclear factor kappa B (NF-κB) axis, downregulate the fibrogenic mediators, and create a balance between the pathways involved in apoptosis and the autophagy signals in the pulmonary tissues. In conclusion, omarigliptin/rosinidin combination may be introduced as a novel therapeutic modality that attenuates the different forms of lung toxicities induced by cyclophosphamide.

Glaucarubinone from Simarouba glauca DC. as a potential biocontrol agent for mosquito vector management

The study explored Simarouba glauca DC. for mosquito larvicidal potential by performing bioactivity-guided chemical investigation of its root extract resulting in isolation of the known bioactive metabolite glaucarubinone (1). Mosquito larvicidal activity of glaucarubinone (1) against the three vector species viz. Anopheles stephensi, Aedes aegypti, and Culex quinquefasciatus was determined using a modified WHO 2005 protocol. It was observed that Culex quinquefasciatus larvae were the most susceptible species with LC50 13.88 ppm and LC90 70.01 ppm followed by Aedes aegypti and Anopheles stephensi at 24 h of exposure. The mode of action as observed microscopically is the lysis of midgut and thorax cells of the third instar larvae. The crystal structure of the glaucarubinone (1) is reported for the first time using X-ray crystallography. This phytochemical product has the potential to act as a green alternative to existing chemical-based insecticides for integrated vector management.

GINS1 as a Novel Biomarker of Survival in Colon Adenocarcinoma Patients — A Secondary Publication

The study focused on elaborating the role of GINS1 expression and its regulatory mechanisms in colon adenocarcinoma (COAD). Using the UALCAN informational index, GINS1 expression assessment unveiled a critical up-regulation in malignant cells that stood out from normal controls, suggesting its contribution to COAD expansion. Further dismantling GINS1 expression across various boundaries revealed unsurprising up-regulation in different malignant development stages, racial groups, genders, and age classes in COAD patients, characteristics for its imperative role in cancer progression. Moreover, this study investigated the promoter methylation status of GINS1, uncovering a critical uniqueness between COAD samples and normal controls. Analyzing promoter methylation across various clinical boundaries uncovered powerful variations, with particular methylation patterns seen across cancer stages, race groups, genders, and age groups. Survival analysis using the Kaplan-Meier (KM) plotter tool showed a colossal connection between GINS1 expression levels and overall survival (OS) in COAD patients, with low GINS1 expression interfacing with higher OS. Additionally, mutational examination using the cBioPortal stage revealed that no critical change was found in COAD. Overall, these findings revealed the complex contribution of GINS1 in COAD pathogenesis, underlining its actual limit as a prognostic biomarker and supportive therapeutic agent in COAD management.

GEN-RWD Sandbox: bridging the gap between hospital data privacy and external research insights with distributed analytics

BackgroundArtificial intelligence (AI) has become a pivotal tool in advancing contemporary personalised medicine, with the goal of tailoring treatments to individual patient conditions. This has heightened the demand for access to diverse data from clinical practice and daily life for research, posing challenges due to the sensitive nature of medical information, including genetics and health conditions. Regulations like the Health Insurance Portability and Accountability Act (HIPAA) in the U.S. and the General Data Protection Regulation (GDPR) in Europe aim to strike a balance between data security, privacy, and the imperative for access.ResultsWe present the Gemelli Generator - Real World Data (GEN-RWD) Sandbox, a modular multi-agent platform designed for distributed analytics in healthcare. Its primary objective is to empower external researchers to leverage hospital data while upholding privacy and ownership, obviating the need for direct data sharing. Docker compatibility adds an extra layer of flexibility, and scalability is assured through modular design, facilitating combinations of Proxy and Processor modules with various graphical interfaces. Security and reliability are reinforced through components like Identity and Access Management (IAM) agent, and a Blockchain-based notarisation module. Certification processes verify the identities of information senders and receivers.ConclusionsThe GEN-RWD Sandbox architecture achieves a good level of usability while ensuring a blend of flexibility, scalability, and security. Featuring a user-friendly graphical interface catering to diverse technical expertise, its external accessibility enables personnel outside the hospital to use the platform. Overall, the GEN-RWD Sandbox emerges as a comprehensive solution for healthcare distributed analytics, maintaining a delicate equilibrium between accessibility, scalability, and security.

Role of Amyloidogenic and Non-Amyloidogenic Protein Spaces in Neurodegenerative Diseases and their Mitigation Using Theranostic Agents.

Neurodegenerative diseases (NDDs) refer to a complex heterogeneous group of diseases which are associated with the accumulation of amyloid fibrils or plaques in the brain leading to progressive loss of neuronal functions. Alzheimer's disease is one of the major NDD responsible for 60-80 % of all dementia cases. Currently, there are no curative or disease-reversing/modifying molecules for many of the NDDs except a few such as donepezil, rivastigmine, galantamine, carbidopa and levodopa which treat the disease-associated symptoms. Similarly, there are very few FDA-approved tracers such as flortaucipir (Tauvid) for tau fibril imaging and florbetaben (Neuraceq), flutemetamol (Vizamyl), and florbetapir (Amyvid) for amyloid imaging available for diagnosis. Recent advances in the cryogenic electron microscopy reported distinctly different microstructures for tau fibrils associated with different tauopathies highlighting the possibility to develop tauopathy-specific imaging agents and therapeutics. In addition, it is important to identify the proteins that are associated with disease development and progression to know about their 3D structure to develop various diagnostics, therapeutics and theranostic agents. The current article discusses in detail the disease-associated amyloid and non-amyloid proteins along with their structural insights. We comprehensively discussed various novel proteins associated with NDDs and their implications in disease pathology. In addition, we document various emerging chemical compounds developed for diagnosis and therapy of different NDDs with special emphasis on theranostic agents for better management of NDDs.

Insulin Management for Gestational and Type 2 Diabetes in Pregnancy.

Insulin is preferred as the first-line agent for glucose management of gestational diabetes mellitus and type 2 diabetes in pregnancy when nutritional and lifestyle modifications are unable to achieve pregnancy-specific glucose targets. Individual heterogeneity in defects of insulin secretion or sensitivity in liver and muscle, unique genetic influences on pregnancy glycemic regulation, and variable cultural and lifestyle behaviors that affect meal, activity, sleep, and occupational schedules necessitate a personalized approach to insulin regimens. Newer insulin preparations have been developed to mimic the physiologic release of endogenous insulin, maintaining appropriate basal levels to cover hepatic gluconeogenesis and simulate the rapid, meal-related, bolus rise of insulin. Such physiologic basal-bolus dosing of insulin can be administered safely, achieving tighter glycemic control while reducing episodes of hypoglycemia. Insulin initiation and titration require understanding the pharmacodynamics of different insulin preparations in addition to a patient's glycemic profiles, effect of variable nutritional intake and mealtimes, physical activity, stress, timing of sleep cycles, and cultural habits. Educating and empowering patients to learn how their glucose responds to insulin, portion and content of meals, and physical activity can increase personal engagement in therapy, flexibility in eating patterns, and improved glycemic control. This Clinical Expert Series article is focused on optimizing insulin management (initiation, dosing, and titration) of gestational and type 2 diabetes in pregnancy.

Steer Clear: Inadvertent Use Of Antimicrobials Can Cause Unintentional Harm To Wound Healing

This article aims to raise awareness regarding the inadvertent misuse and/or overuse of antimicrobial agents in wound management and provide the correct indications, concentrations, and application techniques for commonly used antimicrobials to enhance wound care outcomes. A literature review revealed that misuse of topical antimicrobials can compromise wound healing and lead to adverse effects. Each antimicrobial presents unique benefits and challenges, necessitating careful consideration of indications, concentrations, and duration of use to optimize therapeutic outcomes. To mitigate the misuse of antimicrobials, wound care professionals must continually assess the wound and make changes to treatment based on the assessment finding. Moreover, by advocating for policy changes and access to specialized wound care services, health-care providers can further enhance patient care and reduce the risk of complications associated with improper