Oral Test Research Articles

Gestational diabetes and mental health: longitudinal analysis of data from the GEMS randomized trial.

There is limited high-quality evidence about perinatal mental health among women with gestational diabetes. We aimed to assess the risks and longitudinal changes in anxiety, depression, and health-related quality of life comparing women with gestational diabetes and those without among a contemporary cohort of pregnant women. Prospective cohort study of participants in the GEMS Trial. Women with a singleton pregnancy were eligible if they had a 75-g diagnostic oral glucose-tolerance test between 24 and 32 weeks' gestation, provided written informed consent, and completed questionnaires about anxiety, depression, and health-related quality of life at the study time points. There were no differences in risk for anxiety (RR 1.13, 95% CI 0.86, 1.49; p = 0.39) or depression (RR 1.08, 95% CI 0.78, 1.50; p = 0.64) between the two groups at 36 weeks' gestation or 6 months postpartum [anxiety: (RR 1.21, 95% CI 0.90, 1.63; p = 0.21); depression: (RR 0.84, 95% CI 0.55, 1.28; p = 0.43]. However, at 36 weeks' gestation participants with gestational diabetes reported better physical functioning, and at 6 months postpartum, better mental functioning (mean difference (MD) in scores 1.28, 95% CI 0.25, 2.30; p = 0.01) although worse physical functioning (MD -2.99, 95% CI -3.90, -2.07; p = < 0.001) compared to participants without. The risk for poor mental health during the perinatal period does not differ importantly among women diagnosed and treated for gestational diabetes compared to the general pregnant population.

Speaking exams with less anxiety in Intelligent Computer-Assisted Language Assessment (ICALA): mirroring EFL learners’ foreign language anxiety, shyness, autonomy, and enjoyment

A significant number of students experience anxiety when asked to speak in English. This unease, often rooted in factors such as shyness, lack of confidence, uncertainty, and a lack of motivation, can hinder their active participation during English oral exams. One of the most important goals that every English language teacher should strive to achieve is to assist pupils who are reticent in developing their self-confidence and improving their spoken English. Teachers can implement effective strategies in the classroom, particularly in online settings, to help hesitant students build confidence and speak English more comfortably. The research that is currently available on the subject of shyness and anxiety in students demonstrates that there is a significant gap in this area, and a critical examination is required. Consequently, the purpose of the current study was to investigate the impact of the implementation of Intelligent Computer-Assisted Language Assessment (ICALA) on EFL learners’ shyness, foreign language anxiety, autonomy, and enjoyment. Participants in this study were 65 students attending English language institutes in Tashkent, Uzbekistan. The results of the multivariate analysis of variance (MANOVA) indicate that applying ICALA in performing oral tests may moderate students’ shyness, foreign language anxiety, autonomy, and enjoyment in language assessment. This conclusion can be drawn from the findings of both aforementioned statistical methods. The ramifications of this investigation may be beneficial for individuals who are learning a language, those who are teaching language, and those who are making policy.

High interindividual variability of indoxyl sulfate production identified by an oral tryptophan challenge test

Indoxyl sulfate (IS) has been implicated in the pathogenesis of cardiovascular diseases. IS is converted from indole, a metabolite of dietary tryptophan through the action of gut microbial tryptophanase, by two hepatic enzymes: CYP2E1 and SULT1A1. We hypothesized that the effect of tryptophan intake on IS production might differ from person to person. We enrolled 72 healthy persons (33 ± 7 years; 54.2% women) to undergo an oral tryptophan challenge test (OTCT), in which 7 blood samples were collected at 0, 4, 8, 12, 24, 36, and 48 h following oral administration of L-tryptophan 2000 mg. We observed high interindividual variability of IS production in the response to an OTCT. Twenty-four subjects in the lowest tertile of the baseline-adjusted area under the curve of IS were defined as low-IS producers, whereas 24 subjects in the highest tertile were defined as high-IS producers. There was no significant difference in baseline characteristics or CYP2E1 and SULT1A1-SNP genotyping distributions between the two IS-producing phenotypes. However, distinct differences in gut microbial composition were identified. In addition, the abundance of tryptophanase was significantly higher in the high-IS producers than in the low-IS producers (P = 0.01). The OTCT may serve as personalized dietary guidance. High-IS producers are more likely to be at greater risk of cardiovascular diseases and may benefit from consuming foods low in tryptophan. Potential clinical applications of the OTCT in precision nutrition warrant further investigation.

Diagnostic Accuracy of a Point-Of-Care aMMP-8 Test for Discriminating Periodontal Health Status in Adults: Validation Trials and Updated Meta-Analysis.

To evaluate the diagnostic accuracy of an active matrix metalloproteinase-8 (aMMP-8) point-of-care oral rinse test (POC-ORT) for predicting periodontitis in treatment-naïve subjects in two independent studies and update a recent meta-analysis. The aMMP-8 POC-ORT index test was performed in a representative population in Hong Kong, China, and a consecutive convenience sample in Shanghai, China. The reference standard was the 2017 World Workshop classification of periodontal diseases. Sensitivity, specificity, and the area under the receiver operating characteristic (AUROC) curve were assessed. The original data were used to update a recent Bayesian meta-analysis following the current Cochrane guideline for diagnostic trials. The GRADE framework was used to interpret the strength and certainty of the evidence. Three-hundred and eighty-four and 390 subjects were enrolled in the Hong Kong and Shanghai studies, respectively; 74.5% and 67.2% had periodontitis. An aMMP-8-positive test predicted periodontitis with an AUROC of 0.661 and 0.669 in the two studies. The updated systematic review and meta-analysis included eight studies and 2048 subjects. After considering the risk of bias, indirectness, inconsistency, imprecision and publication bias, it showed moderate certainty of a sensitivity of 0.59 (95% CrI: 0.42-0.75), a specificity of 0.82 (95% CrI: 0.68-0.93) and a hierarchical summary AUROC of 0.77 (95% CrI: 0.74-0.81). There is moderate certainty that the aMMP-8 POC-ORT test predicts periodontitis with low to moderate sensitivity, moderate to high specificity, and moderate accuracy. Its high false-negative rate does not allow the replacement of clinical examinationswhen available. The moderate to high positive predictive value shows the potential utility of a positive test for self-detection or co-management of periodontitis in a medical setting and its incorporation in multi-test diagnostics. Further investigations are highly warranted.

Preparation and Hypoglycemic Effect of Magnolia Officinalis Polysaccharide Oral Liquid.

In this paper, an oral liquid containing Magnolia officinalis polysaccharide was formulated and its hypoglycemic effects were investigated. An orthogonal test was conducted based on single-factor experiments to optimize the formulation guided by sensory evaluations. Its stability and safety were also assessed. The oral liquid was administered via gavage to STZ-induced diabetic mice at low (2.5mL/kg), medium (5mL/kg) and high (10mL/kg) doses. Blood glucose levels were monitored weekly. After 8weeks of treatment, the oral glucose tolerance test (OGTT) was performed and fasting insulin levels, lipid profiles, oxidative stress levels in serum and liver, and the activities of hexokinase (HK) and pyruvate kinase (PK) in the liver were measured. Results indicated that the optimal formulation contained 0.2% steviol glycosides, 0.2% ascorbic acid, a pH of 5.0, and 0.5% ginger juice, yielding a sensory evaluation score of 94 ± 0.58. The oral liquid remained stable at room temperature for 12months and passed acute oral toxicity testing. After 8weeks, diabetic mice exhibited a significant reduction in blood glucose levels (P < 0.01), enhanced glucose metabolism, increased fasting insulin levels, and decreased lipid levels. Additionally, antioxidant capacity improved, and HK and PK activities increased significantly in the diabetic mice. In conclusion, the Magnolia officinalis polysaccharide oral liquid demonstrated potential antidiabetic effects by promoting glucose utilization in peripheral tissues, increasing fasting insulin levels, and enhancing antioxidant capacity alongside HK and PK activities. This formulation could represent a promising hypoglycemic health product.

Morphological effects of acetylcarvacrol on thyroid of Wistar rats subjected to repeated dose dermal and oral toxicity tests

ABSTRACT Acetylcarvacrol is a semi-synthetic product derived from carvacrol and has known activity against ticks. In vertebrates, the thyroid has been used as a bioindicator in toxicity studies due to its sensitivity to external factors. Thus, the objective of this study was to evaluate the toxic effects of acetylcarvacrol in Wistar rats subjected to repeated dose dermal and oral toxicity tests by means of histopathological analysis of the thyroid. For each test, the rats were divided into 4 groups containing 5 animals. In the topical treatment test, acetylcarvacrol was applied to the trichotomized back of each animal at concentrations of 26, 52 and 104 μL/mL for 21 days. In the oral test, the animals were fed acetylcarvacrol by gavage at concentrations of 26, 52 and 104 μL/mL for 30 days. The control groups were treated only with the vehicles. A significant increase in interstitial tissue vascularization was observed in the group treated topically with the highest concentration of acetylcarvacrol compared to the control. No significant changes were observed between the treatment and control groups in the oral experiment. The comparison between the treated groups and their respective controls also showed no differences in the colloid, the follicle and the follicular cells. The reduced occurrence of changes in this tissue suggests relative safety for use in the control of ticks, although caution is needed when using it at high concentrations or for long periods of time.

The Role of Basophil Activation Test in the Diagnosis of Pediatric Egg Allergy in Turkey: A Comparison of Clinical and Laboratory Findings with Real-Life Data.

Egg allergy is among the most common food allergies in children, significantly affecting the dietary habits and quality of life of both the affected children and their families. This study aims to assess the clinical role of the Basophil Activation Test (BAT) in children with egg allergy and to evaluate its diagnostic accuracy in comparison to other tests. The study included 46 children with egg allergy. Patients were classified into three groups: IgE-mediated, non-IgE-mediated, and mixed-type allergies. Each patient underwent a Skin Prick Test, serum-specific IgE test, BAT, and Oral Food Challenge. The sensitivity and specificity of each diagnostic test were evaluated. Egg SpIgE positivity was observed in all patients with IgE-mediated allergy (100%) and in 77.78% of those with mixed-type allergy, while only 47.1% of patients with non-IgE-mediated allergy were positive (p = 0.008). BAT positivity was significantly higher in IgE-mediated (72.7%) and mixed-type allergies (50.0%) compared to non-IgE-mediated allergies (17.6%) (p = 0.013). Compared to the oral provocation test, Egg SpIgE had a sensitivity of 0.73 and specificity of 0.33, BAT had a sensitivity of 0.46 and specificity of 0.67, and SPT had a sensitivity of 0.44 and specificity of 0.60. Although Egg SpIgE demonstrated the highest sensitivity, its low specificity makes it less reliable for accurately identifying non-allergic individuals. In contrast, BAT, with its highest specificity and moderate sensitivity, aligns more closely with the oral provocation test in accurately diagnosing egg allergy. When comparing the positivity rates of Egg SpIgE, BAT, and SPT according to allergy types, IgE-mediated allergies showed significantly higher positivity rates. BAT demonstrated high specificity and moderate sensitivity in both IgE-mediated and mixed-type allergies, making it the most compatible test with the oral provocation test for the accurate diagnosis of egg allergy. Given that this test is currently used only for research purposes in our country, it is recommended that BAT be more widely adopted in clinical practice in accordance with guideline recommendations.

Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Prevalence and Associated Risk Factors in a Large Cohort of US Children.

Household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may play a key role in times of increased infection, particularly among children. We aimed to determine the prevalence of SARS-CoV-2 antibodies and identify risk factors associated with SARS-CoV-2 antibody positivity in children. Unvaccinated children aged 18 months to 11 years between August 2022 and June 2023 underwent oral fluid testing for SARS-CoV-2 antibodies. Caregivers completed electronic surveys at 4 major healthcare practices in Northern and Central New Jersey. Information was collected on demographics, household size, vaccination status, and prior SARS-CoV-2-related illness. Multivariable logistic regression determined individual and household-level factors associated with SARS-CoV-2 antibody positivity. A total of 870 children provided tests and corresponding surveys. Children were predominantly Hispanic (37%) or non-Hispanic Black (30%), and on average 5.7 years old. Overall SARS-CoV-2 antibody positivity was 68%. Risk factors for SARS-CoV-2 positivity include Hispanic or non-Hispanic Black race/ethnicity (adjusted odds ratios [aOR], 2.29 and 1.95 vs. White race/ethnicity; P < .01) and later enrollment in the study period. Children from households with ≥1 vaccinated adult were 52% less likely to be antibody positive than those from households with no vaccinated adults (aOR: 0.38, [95% confidence interval 0.2 to 0.69]). There is high burden of SARS-CoV-2 infection among children over time. Adult vaccination appears to be a protective factor in helping to mitigate coronavirus disease 2019 (COVID-19) infection among children. Increased vaccination of adults in the community can help inform COVID-19 prevention strategies for minors in the household.

Effect of vestibular training on cognitive functions in people with multiple sclerosis: A randomized controlled trial.

Cognitive dysfunction is prevalent but inadequately treated in people with multiple sclerosis (PwMS). Central vestibular functions are associated with multiple cognitive domains in PwMS, even when controlling for disability status. To our knowledge, the effectiveness of vestibular training on cognition in PwMS has never been explored. The study's purpose was to determine the effect of vestibular training on PwMS's cognitive functions. Forty PwMS with relapsing-remitting MS, primarily fatigued, were randomly divided into two equal groups. The control group (GI) was treated with aerobic endurance exercises using stationary bicycle training. The study group (GII) was treated with aerobic endurance exercises as GI in addition to a designed vestibular training program. Outcome measures of cognition were assessed pre- and post-treatment using the Arabic version of Brief International Cognitive Assessment for MS (BICAMS-A) and serum Brain-derived neurotrophic factor (BDNF). Post-treatment, there was a significant increase of oral Symbol Digit Modalities Test (SDMT), California Verbal Learning Test II (CVLT-II), revised Brief Visuospatial retention Test (BVRT-R) of BICAMS-A and serum BDNF in both study and control groups. There was a significant increase in CVLT-II, BVRT-R of BICAMS-A and serum BDNF in the study group compared to the control group (P < 0.05). Vestibular training is an effective and innovative approach for improving cognitive functions in PwMS. PACTR202311670782148.

Single oral toxicity assessment and phytochemical analysis of the Ficus erecta Thunb. Leaves extract.

Ficus erecta Thunb. is a traditional medicinal plant used to treat various diseases in Asian countries. We recently reported the potential of the ethanol extract of F. erecta Thunb. leaves (EEFE) as a source of functional foods for cognitive improvement. However, there is insufficient scientific evidence supporting the safety of EEFE. In this study, we performed an acute oral toxicity test using Sprague-Dawley rats following Good Laboratory Practice regulations to assess the possible toxicity of EEFE. After single oral administration of EEFE at a maximum dose of 5000mg/kg, the mortality, clinical signs, body weight changes, and gross findings were monitored for 2 weeks. No mortality was observed, and EEFE had no adverse effects on body weight or gross findings in all EEFE-administered rats. On the first day after administration, EEFE-colored stool was observed in both male and female groups. However, these symptoms were considered to be transient, caused by the color of the test substance. Overall, the approximate lethal dose of EEFE was determined to be over 5000mg/kg in the acute toxicity test. Additionally, we established and validated a high-performance liquid chromatography-diode array detector-based analytical method for the quality control of EEFE using rutin as a marker compound. The method showed excellent linearity, accuracy, repeatability, and precision. The findings of this study could serve as fundamental data for ensuring the safety and standardization of EEFE.

Prevalence and Factors Associated with Non-Adherence to Warfarin Treatment: A Single Center Study in Sri Lanka

Introduction: Warfarin is a prescription oral anticoagulant that has a narrow therapeutic index. This study was conducted to assess the prevalence and the associated factors of non-adherence to Warfarin treatment.Methodology: A cross-sectional study was conducted among a sample of 282 patients who are on warfarin and attending haematology and general medical clinics at a Tertiary care hospital in Sri Lanka. Adult patients who had started warfarin treatment 3 months ago with a clear diagnosis of warfarin indication were included in the study. Adherence was measured using the modified Morisky Medication Adherence Scale (MMAS-8). The Oral Anticoagulation Knowledge test (OAK) was used to assess knowledge.Results: Nearly 40% had insufficient knowledge of warfarin. The prevalence of non-adherence was detected as 57.8%. Patients who had unsatisfactory knowledge of warfarin were more likely to have non-adherence to warfarin treatment (OR 15.58, 95% CI 8.05-30.16, p&lt;0.001). None of the sociodemographic or treatment-related factors were associated with non-adherence.Conclusion and recommendations: Patients who had unsatisfactory knowledge of warfarin were more likely to have non-adherence to warfarin treatment, interventions will be required to increase knowledge of warfarin among patients who are on warfarin.

Berberine nanostructured lipid carriers by ultrasonication technique: initial study for skin and oral administration

Abstract Berberine (BBR), a natural bioactive ingredient from Eastern nations, has low solubility and permeability that limits its applications. Hence, berberine nanostructured lipid carriers (BBR-NLCs) were fabricated to improve the drug therapeutic effectiveness. Glycerol monostearate, stearic acid and oleic acid were chosen for lipid base whereas Pluronic F127, Span 80, and Transcutol-P were used as the surfactant and co-surfactant. BBR-NLCs had an average particle size of 82 nm, zeta potential of −32 mV, and narrow size distribution (PDI approximately 0.2), prepared with probe ultrasonication at 490 W in 15 min. In addition, BBR-NLCs prepared at optimized conditions showed around 92% of encapsulation efficiency with drug loading over 5.5%. NLCs presented sustained released through mouse skin, dialysis membrane in Franz cell model, and oral dissolution test, compared with free drug over 24 h. Moreover, blank NLCs even increased the cell viability of HaCaT and HEK293T cells at lower concentrations. NLCs significantly enabled higher interactive BBR quantity with investigated cells. Therefore, BBR-NLCs could be considered as a potential nanocarrier for improved bioavailability of this therapeutic agent.

Effectiveness of Marungko Approach in Enhancing the Reading Performance among Grade 1 Pupils of San Antonio Elementary School

This study aimed to determine the effectiveness of Marungko Approach in enhancing the reading performance of Grade 1 pupils of San Antonio Elementary School, Sta Marcela, Apayao in School Year 2023-2024. This study utilized the Quasi- Experimental type of research in gathering the responses employing the quantitative approach. To gather the necessary data needed in the study, the researcher utilized the Block-out Oral Reading Test and FLAT (Fluency and Literacy Assessment Tool) as a tool to assess the reading performance of the Grade 1 learners. The researcher prepared the research design and tools that were used in the study. Approval and recommendation from the principal were sought. The research instruments used was the BORT (Block-out Oral Reading Test). The Pre-BORT (Block-out Oral Reading Test) was administered by the researcher to identify the reading level of the Grade 1 pupils which was based on the word recognition and comprehension. The Post BORT (Block-out Oral Reading Test) using Marungko Approach was administered to test whether the reading performance of the non-reader pupils increased. The findings reveal a significant improvement in reading performance, particularly among non-reader pupils, indicating that the Marungko Approach effectively fosters reading fluency and comprehension. The results suggest that this instructional strategy can be broadly applied in early literacy education, providing a strong foundation for developing reading skills. Based on the findings of the study, were drawn three conclusions. The Grade I pupils have improved their reading performance after the Marungko Approach was used in teaching reading. The use of the Marungko Approach to teach reading resulted to a significant mean gain in the reading performance of the Grade 1 pupils from pretest to posttest. The Marungko Approach could significantly improve the reading performance of Grade 1 pupils. From the findings and conclusions, it is recommended that teachers should use the Marungko Approach in teaching reading and should conduct LAC Session to parents to capacitate them use the Marungko Approach in teaching their children reading. This initiative seeks to increase parental involvement in literacy education. Additionally, future research should look into how effective the Marungko Approach is in different schools to confirm its benefits and flexibility.

Evaluating the effectiveness of oral HIV self testing according to distribution models in Cameroon

Innovative strategies such as HIV self-testing (HIVST) are useful for identifying hard-to-reach people living with HIV/AIDS (PLHIV), especially in developing settings where considerable gaps still exist in reaching the first 95% UNAIDS target. We evaluated the effectiveness of HIVST in Cameroon using several distribution models and investigated the predictors of HIV seropositivity among self-testers. The study was conducted from 2021 to 2022 in three regions in Cameroon. HIVST kits were distributed according to 5 distribution models: antenatal, postnatal, maternal and child clinics (ANC/PNC/MCH); partners of PLHIV; workplace; community and HIV-testing services (HTS). Overall, 42,687 people received oral HIVST kits, among whom 15.6% were HIV first-testers. Approximately 85% reported on the test outcome; 2.3% (n = 825) were reactive, and 75.8% came for test confirmation. After the confirmation test, a concordance of 85% was found with the national algorithm. Overall, the HIV seroprevalence was 1.5% [95% CI: 1.4–1.6]; ANC/PNC/MCHC: 1.9%, partners of PLHIV: 6.9%, workplace: 0.5%, community: 0.1% and HTS: 7.0%, p < 0.001. The positivity rate among first-testers was 1.2%. Youths < 25 years had a lower seroprevalence (0.4%) than older people (2.6% and 2.7% for those aged 25–39 and those aged ≥ 40 years, respectively), p < 0.001. Seropositivity was negatively associated with secondary distribution, workplace model, community model and age < 25 years. On the other hand, partners of PLHIV model, HTS model, female sex and first-time-testers were positively associated with seropositivity. In Cameroon, oral HIVST is an effective approach for identifying undiagnosed PLHIV, especially when using ANC/PNC/MCHC, partners of PLHIV and HTS distribution models. However, to ensure the successful scale-up of HIVST in Cameroon, guidelines should be revised to fine-tune the target populations for HIVST and optimize the use of resources.

Gut microbes with the gbu genes determine TMAO production from L-carnitine intake and serve as a biomarker for precision nutrition

ABSTRACT Gut microbial metabolism of L-carnitine, which leads to the production of detrimental trimethylamine N-oxide (TMAO), offers a plausible link between red meat consumption and cardiovascular risks. Several microbial genes, including cntA/B, the cai operon, and the recently identified gbu gene cluster, have been implicated in the conversion of dietary L-carnitine into TMA(O). However, the key microbial genes and associated gut microbes involved in this pathway have not been fully explored. Utilizing the oral carnitine challenge test (OCCT), which specifically measures TMAO production from L-carnitine intake and identifies TMAO producer phenotypes, we compared the abundance of microbial genes between low- and high-TMAO producers across three independent cohorts. Our findings consistently revealed that the gbu gene cluster, rather than cntA/B or the cai operon, was significantly enriched in high-TMAO producers. We further analyzed 292 paired multi-omic datasets from OCCT and shotgun metagenomic sequencing, which demonstrated a significant positive correlation between the abundance of fecal gbu genes and L-carnitine-induced TMAO production, with gbuB showing the strongest correlation. Interestingly, these fecal gbu genes were found to increase with L-carnitine supplementation and decrease with a plant-based diet. Notably, we verified a previously uncultured gbu-containing bacterium, JAGTTR01 sp018223385, as the major contributor to TMA formation in the human gut. We isolated these gbu-containing gut microbes and confirmed their role in TMA/TMAO production using anaerobic incubation and a gnotobiotic mouse model. Using an in-house collection of gbu-containing isolates, we developed a qPCR-based method to quantify fecal gbuB and validated its correlation with L-carnitine-mediated TMAO production as measured by OCCT. Overall, these findings suggest that gbu-containing gut microbes are crucial for TMAO increases following L-carnitine intake and may serve as biomarkers or targets for personalized nutrition.

Management policy for postoperative acromegaly patients with normal IGF-1 and high GH levels on oral glucose tests.

Acromegaly patients occasionally achieve either of the remission criterion of IGF-1 or GH level postoperatively; however, treatment for patients with discordant IGF-1 and GH levels remains unclear. This study aimed to clarify the clinical courses and features of postoperative patients with normal IGF-1 and high GH levels and support their management. Overall, 110 acromegaly patients underwent initial surgery and a 75-g oral glucose tolerance test (OGTT) 3 months postoperatively. Of the 110, 23 patients with normal IGF-1 and nadir GH levels of ≥ 0.4µg/L on OGTT (high-GH group) were categorized into three subtypes based on their repeated examinations thereafter: late-remission type (nadir GH level on OGTT of < 0.4µg/L later), recurrence type (elevated IGF-1 and GH levels later), and persistent type (normal IGF-1 levels and constantly high nadir GH levels on OGTTs). Proportion of patients in the high-GH group was 23.6%, and they were distributed as follows: late-remission type (n = 10), recurrence type (n = 5), and persistent type (n = 8). There were significantly more women (P = 0.0178) than men in the late-remission type, and patients in the persistent type had significantly larger tumors (P = 0.0110) and higher preoperative GH levels (P = 0.0018) than those that achieved complete remission 3 months postoperatively. Careful monitoring without additional medications is recommended at first in acromegaly patients with normal IGF-1 and high GH levels considering the possibility of recurrence in the future.

Prediction of metabolic subphenotypes of type 2 diabetes via continuous glucose monitoring and machine learning

AbstractThe classification of type 2 diabetes and prediabetes does not consider heterogeneity in the pathophysiology of glucose dysregulation. Here we show that prediabetes is characterized by metabolic heterogeneity, and that metabolic subphenotypes can be predicted by the shape of the glucose curve measured via a continuous glucose monitor (CGM) during standardized oral glucose-tolerance tests (OGTTs) performed in at-home settings. Gold-standard metabolic tests in 32 individuals with early glucose dysregulation revealed dominant or co-dominant subphenotypes (muscle or hepatic insulin-resistance phenotypes in 34% of the individuals, and β-cell-dysfunction or impaired-incretin-action phenotypes in 40% of them). Machine-learning models trained with glucose time series from OGTTs from the 32 individuals predicted the subphenotypes with areas under the curve (AUCs) of 95% for muscle insulin resistance, 89% for β-cell deficiency and 88% for impaired incretin action. With CGM-generated glucose curves obtained during at-home OGTTs, the models predicted the muscle-insulin-resistance and β-cell-deficiency subphenotypes of 29 individuals with AUCs of 88% and 84%, respectively. At-home identification of metabolic subphenotypes via a CGM may aid the risk stratification of individuals with early glucose dysregulation.

Reduced Intra- and Extracellular Circulating Postprandial Lysosomal Acid Lipase Activity in Patients with MASLD.

Low fasting blood lysosomal acid lipase (LAL) activity is associated with the pathogenesis of metabolic hepatic steatosis. We measured LAL activity in blood and plasma before and after an oral fat tolerance test (OFTT) in patients with metabolic-dysfunction-associated steatotic liver disease (MASLD). Twenty-six controls and seventeen patients with MASLD but without diabetes were genotyped for the patatin-like phospholipase 3 (PNPLA3) rs738409 variant by RT-PCR and subjected to an OFTT, measuring LAL activity in blood and plasma with a fluorimetric method. LAL activity in blood both under fasting and 4 h after OFTT (0.846 ± 0.309 nmol/spot/h vs. 1.180 ± 0.503 nmol/spot/h p < 0.01) was lower in patients with MASLD compared to controls. These differences were present only in carriers of the PNPLA3 variant. In controls not carrying the PNPLA3 variant, the postprandial increase in blood LAL activity was negatively correlated with that of serum triglycerides (p < 0.05). Extracellular LAL activity in plasma was lower in patients with MASLD (n = 9) compared to controls (n = 8) in the fasting state (p < 0.01) and 4 h post-meal (p < 0.05). The area under the curve up to 6 h of plasma LAL activity was lower in patients with MASLD than in controls (p < 0.05) and correlated negatively with that of triglycerides only in controls (r = -0.841; p < 0.01). Patients with MASLD have reduced LAL activity in blood and plasma both before and 4 h after a meal. In patients with MASLD, the physiological negative correlation between circulating LAL levels and postprandial hypertriglyceridemia is lost.

The Effect of Using English Animation Videos on Students' Speaking Ability

This research aims to collect empirical data regarding the effectiveness of using English animated videos in improving the speaking skills of eighth grade students at SMPN 9 South Tangerang. The research method used is quantitative with a quasi-experimental approach. The population of this research was class VIII students at SMPN 9 South Tangerang. A total of 60 students were selected as samples using purposive sampling techniques and divided into two groups, namely the experimental group and the control group. The instrument used was an oral test given before and after treatment. Pre-test and post-test data were analyzed using the t-test. The pre-test results showed that the average score of the experimental group was slightly higher than the control group, while the post-test results showed a significant difference, with the experimental group's score being much higher than the control group. The research results show a significance value (p) of 0.000 with a confidence level of α = 0.05, which shows that the use of English animated videos is effective in improving students' speaking skills in eighth grade at SMPN 9 South Tangerang.

Three limited interaction approaches to understanding the epidemiology of HIV among YMSM in the US

BackgroundUsing a theoretically-grounded approach to the epidemiological study of HIV incidence among a national, diverse sample of sexual and gender minority (SGM) men (age 17 -29 years), as well as examining HIV incidence through an innovative geospatial lens, is of considerable public health significance. Our overarching objectives are to assemble a U.S.-based national cohort of diverse SGM men: (1) to estimate HIV incidence in SGM men followed every 6 months for up to 24 months, (2) to assess the association of individual and geospatial factors associated with HIV incidence and (3) to determine the relative efficiency and acceptability of three different, discrete study enrollment approaches (including completion of remote HIV testing). The purpose of this manuscript is to describe the study protocol.MethodsThe cohort is composed of English- and/or Spanish-speaking SGM men at risk for HIV, age 17–29 years and living in the United States and its territories. We used multiple methods to recruit our sample including social networking apps like GrindrTM. If a participant was eligible for the study, they completed an address intake form so an HIV test could be mailed to their home or chosen address. We assembled three cohorts using different enrollment approaches. Cohort 1 used Zoom video calls with study staff observing participants use of OraQuick test with oral swabs at the baseline visit. Cohort 2 used No Zoom and OraSure oral fluid tests that participants mailed to an external lab. Cohort 3 used No Zoom/self-administration of OraQuick tests and participants uploading test results to an online portal (REDCap).DiscussionThis study will provide important data on multilevel determinants of HIV incidence among SGM men at the national level, allowing us to examine important differences by local jurisdiction, region and state and to better understand the impact of individual, social and geospatial factors on HIV incidence to help inform future prevention strategies.