Safe Alternatives Research Articles

Polymer electrolytes based on PEO and lithium tetraalkoxyborate salts with ionic liquid properties for lithium-based batteries

The development of lithium-ion batteries (LIBs) with improved safety features is crucial due to the inherent risks associated with liquid electrolytes, such as fires, explosions, and leakage. This study explores the potential of solid polymer electrolytes (SPEs) based on poly(ethylene oxide) (PEO) and lithium tetraalkoxyborate salts (LiTAB) with ionic liquid properties as a safer alternative. Ionic liquids (ILs) are examined for their high ionic conductivity, wide electrochemical window, and excellent thermal stability, despite their high synthesis costs and viscosity challenges. The study proposes the use of a novel LiTAB salt with an oligomeric star-shaped anion structure that reduces mobility, enhancing lithium ion transference numbers. This IL serves as both a lithium salt and an active plasticizer in PEO-based SPEs, offering potential for 3D printing applications. Experimental results demonstrate that these electrolytes exhibit favorable rheological properties, high ionic conductivities, and significant lithium ion transference numbers, addressing the key limitations of conventional PEO-based electrolytes. The findings suggest that incorporating these LiTAB salts in SPEs could significantly enhance the safety and performance of LIBs, particularly for applications in miniaturized consumer electronics and electronic implants.

Red and Green LED Light Therapy: A Comparative Study in Androgenetic Alopecia.

Androgenetic alopecia (AGA) affects both men and women, characterized by progressive hair thinning. While current treatments like minoxidil and finasteride have efficacy limitations and side effects, low-level light therapy (LLLT) using red or near-infrared light has emerged as a promising alternative. Recent animal studies suggest potential benefits from green LED light, though human data are sparse. This study utilized an innovative LED helmet emitting red and green LED light on respective halves of the frontal scalp, delivering an energy density of 40 J/cm2 over 20 min. Clinical photography, physician evaluations on a 7-point scale, patient satisfaction, and measurements of hair density and hair diameter were employed. Data were analyzed using linear mixed-effects models, with significance set at p < 0.05. Seventeen participants (47.1% male, 52.9% female, average age 46.47 years) demonstrated notable improvements after 6 months of treatment. Red and green LEDs both significantly increased hair diameter, non-vellus hair density, and satisfaction scores. Notably, the red LED therapy resulted in a statistically significant decrease in vellus hair density and achieved a greater increase in hair diameter compared to the green LED therapy. Minimal adverse effects were reported, primarily consisting of tolerable scalp heat and mild redness. Both red and green LED therapies effectively enhanced hair growth, increasing density and thickness over 6 months. Red LED demonstrated superior improvements in specific measures. Consequently, both therapies present safe and viable alternatives for the management of AGA, expanding the repertoire of available treatment options.

Vascular Stress Markers Following Inhalation of Heated Tobacco Products: A Study on Extracellular Vesicles.

The advent of heated tobacco products (HTPs) has introduced new variables in the study of nicotine delivery systems and their health implications. Amidst concerns over cardiovascular effects, this study aims to elucidate the acute impact of HTP inhalation on extracellular vesicles (EV) levels in young, healthy individuals. In this controlled, acute exposure study, 23 young, healthy volunteers were subjected to HTP inhalation. EV levels of endothelial and platelet origin were quantified through flow cytometry before and after exposure. Data analysis was performed using multiple measures ANOVA to assess changes in EV concentrations. Our findings reveal a significant increase in EVs of endothelial and platelet origin following short-term HTP inhalation with nicotine. Notably, no significant change was observed in leukocyte- and neutrophil-derived EVs. This increase in EVs suggests acute vascular stress, with peak levels observed 4h post-exposure. The rise in endothelial and platelet-derived EVs aligns with documented responses to acute vascular injury, paralleling the effects seen with traditional cigarette and e-cigarette use. Despite HTPs being marketed as safer alternatives, our results indicate that nicotine-containing HTPs may still pose significant vascular risks. These findings contribute to the growing body of evidence cautioning against the perceived safety of HTPs and reinforce the importance of regulatory oversight and public health initiatives targeting nicotine delivery technologies. Trial Registrations: ClinicalTrials.gov ID: NCT04824495, registered 2021-01-07.

Nematicidal Potentiality of Four Marine Molluscans' Defensive Secretions From the Red Sea Against Syphacia obvelata (Nematoda: Oxyuridae) In Vitro.

The continuous requirement to substitute safe and affordable alternatives for helminth medications, as well as address the resistance of some used drug classes, introduced bioactive products derived from marine animals into the field of competition; however, almost all the previous research only focused on their impact on bacterial and protozoal infection. In the present work, we investigated the potential in vitro nematocidal effect of the aqueous extract of defense secretions for four species of marine mollusks: two cephalopods, namely the cuttlefish Sepia pharaonis and the common Octopus Octopus vulagris and two gastropods, the sea hare Aplysia argus and the sea slug Berthillina citrina, against the adult murine pinworm Syphacia obvelata. Data showed dose and time efficacy in all examined extracts. The sea slug's skin acid secretion has the highest impact, causing death in the cultivated worms, followed by the ink of the sea hare, the common octopus and the cuttlefish, where LC90 after 10 h of exposure were 250, 290, 316, and 391 µg/mL, respectively. Comparatively with the control and albendazole-treated groups, the skin acid secretion of the sea slug caused the highest levels of the antioxidant enzymes SOD, Cat and GSH-PX; however, albendazole prompted the highest level of GSH-PX enzyme in all experimental groups.

A Multicenter Retrospective Study Evaluating Distal Radial Access vs. Conventional Transradial or Transvenous Access for Endovascular Treatment of Malfunctioning Dialysis Fistulas

Background: This study aims to evaluate the feasibility, efficacy, and safety of distal transradial access (dRA) for the endovascular management of malfunctioning dialysis fistulas. This study also compares dRA with conventional access techniques, such as proximal radial and transvenous access, focusing on technical success, clinical outcomes, and vascular access site complications (VASCs). Methods: A retrospective multicenter study was conducted across four hospitals, including 292 patients treated between January 2019 and June 2024. Of these, 57 patients underwent dRA, and 235 received proximal radial or transvenous access. Key outcomes included technical success (successful completion of the procedure), clinical success (restoration of functional dialysis access), and complication rates. Data were collected on procedure times and complication profiles. Results: Technical success was achieved in 96.5% of patients undergoing dRA, compared to 98.3% in those receiving conventional access (p = 0.388). Clinical success was similar between groups (96.5% vs. 97%, p = 0.835). The overall complication rate was 10.5% for dRA and 8.5% for conventional access (p = 0.632). Cannulation time was longer for dRA (109.1 vs. 91.9 s, p &lt; 0.001), but total procedure duration was comparable between the groups. No major complications were observed in either cohort, and improved post-procedure access flow rates were recorded in all patients. Conclusions: Distal transradial access is a feasible and effective approach for the endovascular management of malfunctioning dialysis fistulas, with outcomes comparable to conventional access techniques. It provides a safe alternative, particularly for patients with complex fistulas, while maintaining a low complication profile.

Early discharge following cardiac implantable electronic device implantation: a systematic review and meta-analysis

Abstract Background As the demand for cardiac implantable electronic device (CIED) placement rises, healthcare expenses, including the post-procedure hospital stay costs, have been on the increase. This systematic review and meta-analysis were undertaken to evaluate the safety and viability of same-day discharge (SDD) following cardiac device implantations. Methods We conducted a systematic searched of PubMed, Embase and Cochrane database during November 2023 for studies comparing SDD versus discharge after overnight stay (OS) after CIED. Outcomes included all-cause mortality and complications after the procedure (lead/device dislodgment, re-hospitalization, pneumothorax, local hematoma and wound complications). Data from each study were combined using the random-effects model to calculate pooled odds ratio (OR) with 95% confidence interval (CI). Results Eleven studies, including two randomized clinical trials, were incorporated, with a total of 64,646 patients, providing 918 pooled death events (74 in SDD and 844 in OS). The meta-analysis revealed that SDD was associated with a significantly lower risk of all-cause mortality compared to OS (pooled HR 0.72; 95% CI: 0.55-0.93; I2=0%) and no difference was found regarding re-hospitalization (pooled HR 0.96; 95% CI: 0.88-1.05; I2 55%). SSD was not associated with higher lead/device dislodgement (pooled HR 0.93; 95% CI: 0.50-1.71; I2=0%), pneumothorax (pooler HR 1.04; 95% CI: 0.31-3.50; I2 0%) and wound complications (pooled HR 0.65; 95% CI 0.22-1.01; I2 0%). SSD was associated with more episodes of local hematoma (pooled HR 0.31; 95% CI 0.09-1.05; I2 0%). Conclusion Our meta-analysis suggests that SDD is associated with a decreased all-cause mortality compared to OS. Although associated with more episodes of local hematoma, SDD was not significantly different regarding lead/device dislodgment, pneumothorax, re-admissions and wound complications. SDD after CIED appears to be a safe and feasible alternative.

Exosomes derived from apical papilla stem cells improve NASH by regulating fatty acid metabolism and reducing inflammation

BackgroundApical papilla stem cells (SCAPs) exhibit significant potential for tissue repair, characterized by their anti-inflammatory and pro-angiogenic properties. Exosomes derived from stem cells have emerged as safer alternatives that retain comparable physiological functions. This study explores the therapeutic potential of exosomes sourced from SCAPs in the treatment of non-alcoholic steatohepatitis (NASH).MethodsA NASH mouse model was established through the administration of a high-fat diet (HFD), and SCAPs were subsequently isolated for experimental purposes. A cell model of NASH was established in vitro by treating hepatocellular carcinoma cells with oleic acid (OA) and palmitic acid (PA). Exosomes were isolated via differential centrifugation. The mice were treated with exosomes injected into the tail vein, and the hepatocytes were incubated with exosomes in vitro. After the experiment, physiological and biochemical markers were analyzed to assess the effects of exosomes derived from SCAPs on the progression of NASH in both NASH mouse models and NASH cell models.ResultsAfter exosomes treatment, the weight gain and liver damage induced by HFD were significantly reduced. Additionally, hepatic fat accumulation was markedly alleviated. Mechanistically, exosomes treatment promoted the expression of genes involved in hepatic fatty acid oxidation and transport, while simultaneously suppressing genes associated with fatty acid synthesis. Furthermore, the levels of serum inflammatory cytokines and the mRNA expression of inflammatory markers in liver tissue were significantly decreased. In vitro cell experiments produced similar results.

A closer look: sperm analysis and clinical outcomes of microscopic and loupe-assisted varicocele repair in male infertility due to moderate-to-severe varicocele.

The aim of the study was to compare the clinical outcomes, sperm parameters, and complications of loupe-assisted and microscopic varicocele repair in patients with infertility due to moderate-to-severe varicocele. We included all male individuals over 18years of age who underwent inguinal varicocele repair at our center due to infertility. Subjects with azoospermia, genetic abnormalities such as Kallmann syndrome, incomplete medical records, or those lost to follow-up were excluded from the study. Patients were divided into two groups based on the magnification tool used (microscope or loupe). Follow-ups were conducted at 3months and 1year post-surgery. Sperm parameters, pregnancy rates, and surgical complications were recorded to compare the efficacy of the magnification tools. The Improvement Index for sperm parameters was calculated by dividing the difference between the post-operative and pre-operative parameters by the pre-operative parameter. An Improvement Index above 0.5 was considered a good outcome. Out of 104 patients, 58 underwent loupe-assisted and 46 underwent microscopic varicocele repair. Sperm concentration and progressive motility increased significantly in the semen analyses at three months and one year post-operation compared to pre-operative semen analyses. However, increases in sperm morphology were not statistically significant in either follow-up semen analysis. An Improvement Index greater than 0.5 (indicating a good outcome) was observed in 35.3%, 34.1%, and 15.2% of patients for sperm concentration, progressive motility, and morphology, respectively, after 3months, and 38.9%, 43.4%, and 22.4% after 1year. Nonetheless, there were no significant differences in the Improvement Index of sperm parameters between the two magnification methods. The operative duration was significantly longer with microscopic magnification (median of 70.0 [20.0] minutes vs. 45.0 [20.0] minutes) (p value < 0.001). Conversely, the pregnancy rates were 34.5% (20 patients) in the loupe-assisted group and 37.0% (17 patients) in the microscopic group, which was not significantly different (p value: 0.794). Similarly, the rate of complications was not significantly different, with 5 patients (10.9%) experiencing complications (4 hydroceles and 1 wound infection) in the microscopic group compared to 4 patients (6.9%) (3 hydroceles and 1 wound infection) in the loupe-assisted group (p value: 0.504). The current study's results indicate that the clinical outcomes, sperm parameters, and complications associated with loupe-assisted varicocele repair are comparable to those of microsurgical varicocele repair, which is considered the gold standard. We suggest conducting prospective studies to assess whether loupe-assisted varicocele repair is a safe alternative, especially in centers with limited or no access to surgical microscopes.

Arsenic in Rice: A Call to Change Feeding Substitution Practices for Pediatric Otolaryngology Patients.

Rice products are ubiquitous in the diets of American children and are often utilized to thicken feeds as part of treatments for gastroesophageal reflux disease in infants. However, a 2015 Food and Drug Administration investigation demonstrated that they contain unsafe levels of inorganic arsenic. Inorganic arsenic exposure has been linked to serious health issues including skin, lung, and bladder cancer. Smaller children are put at higher risk due to the increased arsenic-to-weight ratio compared to adults, threatening their development in multiple ways. Other thickeners offer cost-effective, safer alternatives. With this communication, we aim to raise awareness of this issue within the otolaryngology practice thereby bringing us abreast of the best practices of the pediatric and gastrointestinal medical societies who have recommended against the use of rice for thickening feeds, instead advocating for alternate natural thickening agents like wheat or oatmeal.

Bladder irrigation with tap water to reduce antibiotic use for urinary tract infections in catheter users.

To evaluate the safety and effectiveness of bladder irrigation (BI) with tap water to reduce antibiotic use for the treatment of urinary tract infections (UTIs) in patients with recurrent UTI symptoms and to assess the treatment satisfaction of BI. This prospective, observational study included patients with an indwelling catheter or performing clean intermittent catheterisation (CIC) who had recurrent UTI symptoms between July 2022 and March 2024. BI with tap water was used for the treatment of UTIs without systemic symptoms (e.g., fever, flank pain or delirium). Patients started daily irrigation at the onset of UTI symptoms and used a tapering schedule. The number of antibiotic treatments for UTIs, UTI incidence rate ratio (IRR), UTI-related hospitalisations, treatment satisfaction and quality of life (QoL) were compared between a 3-month period before and after BI with tap water. A total of 60 patients were included with a median (interquartile range) age of 64.5 (50.4-72.6) years, 66.7% were male, and 83.3% were performing CIC. Antibiotic use was decreased on average by 38.1% (IRR = 0.62; P = 0.016) and catheter-associated UTIs by 37.9% (IRR = 0.62; P = 0.005). No increase was observed in the incidence of UTIs with systemic symptoms or UTI-related hospitalisations. In addition, no differences were observed in the health-related QoL. The majority of patients were positive about the subjective effectiveness (81%), ease of use (86%) and overall satisfaction (85%) of BI with tap water. These findings emphasise the potential of BI with tap water as a promising and patient-friendly alternative for the treatment of UTIs in patients with urinary catheters. BI with tap water significantly reduces antibiotic use and UTI incidence in patients with recurrent UTIs and is a safe and patient-friendly alternative that can be easily implemented in the management of UTIs.

A Novel Enterococcus-Based Nanofertilizer Promotes Seedling Growth and Vigor in Wheat (Triticum aestivum L.).

Excessive use of chemical fertilizers poses significant environmental and health concerns. Microbial-based biofertilizers are increasingly being promoted as safe alternatives. However, they have limitations such as gaining farmers' trust, the need for technical expertise, and the variable performance of microbes in the field. The development of nanobiofertilizers as agro-stimulants and agro-protective agents for climate-smart and sustainable agriculture could overcome these limitations. In the present study, auxin-producing Enterococcus sp. SR9, based on its plant growth-promoting traits, was selected for the microbe-assisted synthesis of silver nanoparticles (AgNPs). These microbial-nanoparticles SR9AgNPs were characterized using UV/Vis spectrophotometry, scanning electron microscopy, and a size analyzer. To test the efficacy of SR9AgNPs compared to treatment with the SR9 isolate alone, the germination rates of cucumber (Cucumis sativus), tomato (Solanum lycopersicum), and wheat (Triticum aestivum L.) seeds were analyzed. The data revealed that seeds simultaneously treated with SR9AgNPs and SR9 showed better germination rates than untreated control plants. In the case of vigor, wheat showed the most positive response to the nanoparticle treatment, with a higher vigor index than the other crops analyzed. The toxicity assessment of SR9AgNPs demonstrated no apparent toxicity at a concentration of 100 ppm, resulting in the highest germination and biomass gain in wheat seedlings. This work represents the first step in the characterization of microbial-assisted SR9AgNPs and encourages future studies to extend these conclusions to other relevant crops under field conditions.

Person-centred crisis support services as alternatives to emergency departments: a systematic scoping review.

To identify, critically appraise, and synthesise the published and grey literature on person-centred crisis support services as an alternative to support in emergency departments (EDs) for people experiencing mental health crises. This scoping review explores the characteristics and outcomes of these services. A systematic scoping review was undertaken to identify publications describing person-centred crisis support services and their outcomes. Search strings were applied to multiple databases, and publications were subjected to quality appraisal. The review process was informed by The Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). Thirteen publications were included in the narrative synthesis, and these considered eight separate crisis support services. The methodological quality of the publications included was limited. Key findings were positive visitors' experiences, high rates of ED deflection, and overlaps between repeat visits, crises prevention, and hospital avoidance. Key recommendations included increasing opening hours and capacity and improving service awareness and accessibility. The available evidence suggests that person-centred crisis support services are perceived by stakeholders as safe and effective alternatives to EDs for people experiencing mental health crises, providing more timely and appropriate care while reducing ED mental health presentations. Due to the limited quality of the publications included, high-quality research is needed to better understand the model and confirm the findings reported in this review.

Measurement and health risks assessment of BTEX compounds exposure in beauty Lahijan City salons

The presence of BTEX (Benzene, Toluene, Ethylbenzene, and Xylene) compounds in beauty salons has raised concerns about potential health risks. This study aimed to measure the levels of BTEX compounds in the air of beauty salons in Lahijan, Iran and assess the associated health risks. Air samples were collected from 15 beauty salons, and the concentrations of BTEX compounds were measured according to 1501 NIOSH standard method. The results showed that the mean concentrations of benzene (20.62 µg/m3), toluene (18.3 µg/m3), ethylbenzene (38.36 µg/m3), and O and P-xylene (27.35, 23.6 µg/m3) were above the recommended levels. The indoor to outdoor ratios for benzene, toluene, ethylbenzene, O and P-xylene were 3.04, 2.36, 3.75, 4.89, and 6.54, respectively. Also, the toluene/benzene (T/B) ratio in indoor and outdoor was 20.9 and 2.68 respectively. Almost half of the technicians (49.12%) reported adverse health effects, including joint pain, itchy eyes and nose, and respiratory allergies. The IARC guideline suggests that there is a potential risk of cancer development for individuals in all salons with LCR values exceeding 10−6, but the HQ index values indicate no non-carcinogenic risk. The findings suggest that beauty salon workers and customers are at risk of developing health problems from exposure to BTEX compounds. Effective risk management strategies, such as proper ventilation, use of personal protective equipment, and substitution of harmful chemicals with safer alternatives, to minimize exposure and protect the health of salon workers and customers recommended.

Comparative In Vivo Biocompatibility of Cellulose-Derived and Synthetic Meshes in Subcutaneous Transplantation Models.

Despite the increasing interest in cellulose-derived materials in biomedical research, there remains a significant gap in comprehensive in vivo analyses of cellulosic materials obtained from various sources and processing methods. To explore durable alternatives to synthetic medical meshes, we evaluated the in vivo biocompatibility of bacterial nanocellulose, regenerated cellulose, and cellulose nanofibrils in a subcutaneous transplantation model, alongside incumbent polypropylene and polydioxanone. Notably, this study demonstrates the in vivo biocompatibility of regenerated cellulose obtained through alkali dissolution and subsequent regeneration. All cellulose-derived implants triggered the expected foreign body response in the host tissue, characterized predominantly by macrophages and foreign body giant cells. Porous materials promoted cell ingrowth and biointegration. Our results highlight the potential of bacterial nanocellulose and regenerated cellulose as safe alternatives to commercial polypropylene meshes. However, the in vivo fragmentation observed for cellulose nanofibril meshes suggests the need for measures to optimize their processing and preparation.

Applications of plant-derived extracellular vesicles in medicine.

Plant-derived extracellular vesicles (EVs) are promising therapeutic agents owing to their natural abundance, accessibility, and unique biological properties. This review provides a comprehensive exploration of the therapeutic potential of plant-derived EVs and emphasizes their anti-inflammatory, antimicrobial, and tumor-inhibitory effects. Here, we discussed the advancements in isolation and purification techniques, such as ultracentrifugation and size-exclusion chromatography, which are critical for maintaining the functional integrity of these nanovesicles. Next, we investigated the diverse administration routes of EVs and carefully weighed their respective advantages and challenges related to bioavailability and patient compliance. Moreover, we elucidated the multifaceted mechanisms of action of plant-derived EVs, including their roles in anti-inflammation, antioxidation, antitumor activity, and modulation of gut microbiota. We also discussed the impact of EVs on specific diseases such as cancer and inflammatory bowel disease, highlighting the importance of addressing current challenges related to production scalability, regulatory compliance, and immunogenicity. Finally, we proposed future research directions for optimizing EV extraction and developing targeted delivery systems. Through these efforts, we envision the seamless integration of plant-derived EVs into mainstream medicine, offering safe and potent therapeutic alternatives across various medical disciplines.

Isolated “on-pump” tricuspid valve repair through right-sided anterolateral thoracotomy by modified femoral-monocaval cannulation in patients with repeated heart intervention – a safe and effective surgical alternative

Isolated “on-pump” tricuspid valve repair through right-sided anterolateral thoracotomy by modified femoral-monocaval cannulation in patients with repeated heart intervention – a safe and effective surgical alternative

Green Alternatives for the Control of Fungal Diseases in Strawberry: In-Field Optimization of the Use of Elicitors, Botanical Extracts and Essential Oils

Finding safe and reliable alternatives to fungicides is currently one of the biggest challenges in agriculture. In this regard, this experiment investigated the effectiveness of different elicitors, botanical extracts and essential oils to control grey mold (Botrytis cinerea) and powdery mildew (Podosphaera aphanis) on strawberry plants. This trial was conducted in field conditions under a plastic tunnel with strawberry plants ‘Elsanta’. A first group of strawberry plants was treated before flowering with elicitors [acibenzolar-S-Methyl–(BTH), chitosan], botanical extracts (seaweed extract, alfalfa hydrolysate) and essential oils (thyme and juniper), and grey mold incidence on flowers was evaluated (Experiment 1). Furthermore, a second group of plants was treated before (Experiment 2) and after (Experiment 3) controlled inoculation with P. aphanis. The results indicated that the incidence of flower infected by B. cinerea was reduced by approximately 50% with thyme and juniper essential oils’ applications compared to the untreated control, with no significant difference observed compared to the commercial fungicide penconazole (positive control). As a consequence, the final yield of essential-oil-treated plants was +27% higher than that of non-treated plants. No significant differences emerged for other tested products against grey mold. However, gene expression analysis showed an up-regulation (&gt;2 ÷ 5 folds as compared to control 4 days after application) of FaEDS1, FaLOX and PR gene expression (FaPR1, FaPR5, FaPR10) in leaves treated with BTH. The other natural substances tested also induced defense-related genes, albeit at a lower level than BTH. In Experiment 2, all treatments applied prior to inoculation significantly reduced the incidence and severity of powdery mildew as compared to control. At 28 days after inoculation, chitosan and thyme essential oil applications performed similarly to their positive controls (BTH and penconazole, respectively), showing a significant reduction in disease incidence (by −84 and −92%) as compared to control. Post-inoculum application of essential oils (Experiment 3) showed an efficacy similar to that of penconazole against powdery mildew. These results indicated that the tested substances could be used as alternatives to fungicides for the control of grey mold and powdery mildew in strawberry, therefore representing a valuable tool for the control of these fungal diseases under the framework of sustainable agriculture.

Exploring the Potential of Moringa Oleifera Phytochemicals as Inhibitors of Dipeptidyl Peptidase-4 (DPP-4) in Diabetes Mellitus: A Molecular Docking Approach

Abstract Diabetes mellitus (DM) is a global health concern characterized by chronic hyperglycemia due to defects in insulin secretion, insulin action, or both. Type 2 diabetes (T2DM), the most prevalent form, is largely driven by obesity and a sedentary lifestyle, contributing to over 95% of diabetes cases worldwide. The current treatment regimens for T2DM, including Dipeptidyl Peptidase-4 (DPP-4) inhibitors, aim to enhance insulin secretion but are often associated with adverse side effects. This has intensified the search for natural, safer alternatives with comparable efficacy. Moringa oleifera, a highly valued plant with an extensive history in traditional medicine, has shown promising antidiabetic properties. This research explores the potential of Moringa oleifera-derived phytochemicals as natural DPP-4 inhibitors using in-silico molecular docking techniques. The study identifies and evaluates the binding affinities of these phytochemicals to the DPP-4 enzyme, aiming to predict their inhibitory potential and minimal side effects, thereby contributing to the development of novel, safer hypoglycemic drugs. The results indicate the compounds’ potential as effective DPP-4 inhibitors with promising hypoglycemic properties. Specifically, piceatannol exhibited the highest binding affinity of -7.9 kcal/mol, whereas vanillic acid had the lowest at -5.7 kcal/mol. This study underscores the potential of Moringa oleifera as a natural, safer alternative in the development of novel anti-diabetic drugs, contributing to the growing body of research on plant-based therapeutics for diabetes management.

Nutritional evaluation of an aqueous-processed canola protein concentrate in diets of Atlantic Salmon Salmo salar at different life stages

A novel aqueous processing method was applied on canola defatted meal to produce a protein concentrate (>76 % crude protein, dry matter basis). This aqueous-processed canola protein concentrate (ACPC) was evaluated in three experiments with Atlantic salmon. The objectives were to (1) estimate the nutrient digestibility of ACPC in juvenile fish, (2) appraise its nutrient digestibility in post-smolt salmon, and (3) evaluate the long-term effect of ACPC on growth, survival, nutrient utilization, body composition, fillet pigmentation and gut histology of post-smolt salmon. In the first study, one Reference and one test diet, which was a blend of 70 % Reference and 30 % ACPC (70:30 ratio), were fed to juvenile salmon (57 ± 7 g) and feces were collected using settling columns. In the second study, post-smolt salmon (228 ± 4 g) were fed one Reference and three test diets, which consisted of three Reference to ACPC ratios: 90:10, 80:20 and 70:30. Feces were collected by manual stripping. The long-term study (168 days) was designed as a 2 × 4 full factorial analysis with two types of formula (Americas, with processed animal proteins (PAPs), and Europe, without PAPs) and four inclusion levels of ACPC (0, 10, 15, 20 %) fed to post-smolt Atlantic salmon (228 ± 5 g). Fish were bulk weighed every 28 or 56 days. Distal intestine and fillet were sampled (10 fish/tank) at the end for histological examination and color measurement, respectively. All diets (43–49 % crude protein, 18–25 % crude lipid depending on studies) were extruded and fed to apparent satiation. The apparent digestibility coefficients (ADCs) of ACPC protein in juvenile and post-smolt salmon were 89 % and ≥ 94 %, respectively. The essential amino acids ADCs in juvenile and post-smolt salmon were 83–99 % and 91–99 %, respectively. ACPC protein digestibility was not significantly affected by its inclusion level (P = 0.470). In the third experiment, growth (TGC: 0.143–0.160) and feed intake (668–780 g/fish) were not significantly affected by ACPC inclusion (P ≥ 0.10). Feed conversion ratios varied between 1.04 and 1.08. An unexpected occurrence of disease caused 1.6 % mortality over three weeks during the 24-week long-term study and survival was significantly higher in salmon fed ACPC-containing diets (P < 0.001). ACPC inclusion significantly increased fillet redness (P < 0.001) and increased villus length of distal intestine (P < 0.001). In conclusion, ACPC was a safe and nutritive protein alternative in salmon diets, regardless of inclusion level.

Clinical outcomes of peripherally inserted central catheters in patients with gastroenterological diseases: Report of a 9-year experience.

Peripherally inserted central catheters (PICCs) are safe and useful alternatives to centrally inserted central catheters (CICCs). Several studies have investigated the effectiveness and safety of PICCs; however, few have focused on their use in patients with gastroenterological diseases. In the present study, we evaluated the outcomes of patients with gastroenterological diseases who received PICCs and identified the risk factors associated with central line-associated blood stream infection (CLABSI). We retrospectively examined hospitalized patients at our institution who received PICCs between 2015 and 2023. We evaluated the data on their clinical characteristics, complications, and outcomes. Furthermore, we investigated the risk factors for CLABSIs. A total of 405 patients were included (262 men and 143 women). The median age was 71 (range, 15-94) years. The vessels were inserted in the basilic, cephalic, and brachial veins in 366 (90%), 22 (6%), and 17 (4%) patients, respectively. The median procedure time was 32 [6-149] min. The median dwell time was 16 [0-188] days. CLABSI, catheter occlusions, phlebitis, and exit-site skin infection occurred in 14 (3.5%; 1.77/1000 catheter days), 6 (1.5%; 0.76/1000 catheter days), 3 (0.7%; 0.38/1000 catheter days), and 1 (0.2%; 0.13/1000 catheter days) patients, respectively. There was no case of deep vein thrombosis or pulmonary thrombosis due to PICC placement. Multivariate analysis performed using a Cox's proportional hazard regression model revealed that patients with gastroenterological malignancies had an independently higher risk for CLABSIs (odds ratio [OR]: 3.25, 95% confidence interval [CI]: 1.05-10.05, p = 0.041) and that older age (⩾70 years) tended to be associated with CLABSIs (OR: 3.61, 95% CI: 0.98-13.32, p = 0.054). Gastroenterological malignancies and older age were associated with a higher risk of CLABSIs. Rigorous catheter management is crucial for preventing complications, particularly in vulnerable patient subgroups.