Group Sp Research Articles

Spirulina supplementation to alleviate negative effects of lead in layer chicken.

Lead (Pb), a toxic heavy metal, is a serious concern for poultry that negatively affects their productivity and health. To combat those issues efficiently, it is necessary to include feed supplements that have rich antioxidant properties for satisfactory health and productivity. Spirulina platensis (Sp), a microalgae, is a compound that provides several health benefits for humans and animals. This study explores that supplementation of Sp in diet as well as in water reduces the burden of Pb in different tissues, improves hematology, and improves the productive performance of advanced-age laying hens. Forty birds were separated into four groups: the control (C), Spirulina (Sp), Pb, and (Pb + Sp) groups. The Pb group was given Pb acetate at a dose of 2 gm/l in water ad libitum for 4 weeks. Sp group was fed Sp at a dose of 4 gm/kg feed. The Pb + Sp group was given Pb and Sp as in the previous groups. Productive performance and hematology such as hemoglobin (Hb), packed cell volume, red blood cell, mean corpuscular volume, mean corpuscular Hb (MCH) concentration, and MCH were significantly (p < 0.05) decreased in Pb-treated groups compared to controls. The distribution of Pb concentration was highest in the bones and lowest in the gizzard. However, Sp treatment significantly (p < 0.05) increased the productive performance and the hematological parameters. Moreover, Pb concentration in different organs significantly decreased in the group treated with Sp. This study indicates that Sp can possibly be used as a natural and powerful dietary additive to mitigate heavy metal intoxication in chickens, thereby being efficient and effective for production.

Effect of Dexmedetomidine versus Propofol on Sevoflurane related Emergence Agitation in Paediatric Patients: A Randomised Clinical Study

Introduction: Postoperative Emergence Agitation (EA) is a troublesome side-effect of sevoflurane anaesthesia. Drugs like dexmedetomidine and propofol offer significant benefits in reducing the incidence and severity of sevoflurane-related postoperative EA in paediatric patients. Aim: To compare the efficacy of intravenous dexmedetomidine and propofol in reducing the incidence and severity of EA associated with sevoflurane anaesthesia in paediatric patients. Materials and Methods: A randomised clinical study was conducted on 140 patients, belonging to American Society of Anaesthesiologists Physical Status (ASA PS) classes I and II, aged between 2-6 years, undergoing infraumbilical surgery lasting more than one hour. The patients were divided into two equal groups receiving dexmedetomidine 0.3 μg/kg (Group SD) and propofol 1 mg/kg (Group SP) at the start of skin closure, administered over 10 minutes. The incidence of EA in the Post Anaesthesia Care Unit (PACU) was evaluated using the Watcha scale, and the severity of EA was assessed using the Paediatric Anaesthesia Emergence Delirium (PAED) scale. A Watcha score of 3 or 4 indicated the presence of EA, while a PAED score of ≥12 was deemed significant. Statistical analysis of the data was performed using International Business Machines (IBM) Statistical Package for Social Sciences (SPSS) version 22.0, with an Independent sample t-test for comparing normally distributed quantitative parameters, and the Chi-square test for comparing categorical outcomes between the study groups. Results: The mean age of the patients in group SD was 4.19±0.78 years, and in group SP was 4.03±0.71 years. Both study groups were found to be comparable in terms of patient characteristics such as age, sex, weight, and duration of surgery (p-value &gt;0.05). The incidence of postoperative EA, as measured by the Watcha scale, was higher in group SP compared to group SD upon arrival and up to 30 minutes in the PACU (p-value &lt;0.001). The severity of EA, assessed using the PAED score, was greater in group SP compared to group SD at 0, 5, 10,15 and 20 minutes in the PACU (p-value &lt;0.001). Conclusion: Dexmedetomidine 0.3 μg/kg was more effective than propofol 1 mg/kg in reducing the incidence and severity of EA associated with sevoflurane anaesthesia, with minimal haemodynamic effects and no clinically relevant severe adverse effects in both the groups. The significantly prolonged extubation times observed in the propofol group did not result in significantly longer stays in the PACU.

Unveiling pembrolizumab effectiveness in diverse subtypes of MSI-high endometrial cancers.

The efficacy of pembrolizumab in patients with microsatellite instability (MSI)-high cancers has been reported; however, the differences in efficacy according to the subtypes of MSI-high endometrial cancers (ECs) remain unclear. MSI-high ECs are classified into at least 3 groups based on their molecular characteristics: MLH1 hypermethylated, Lynch-like syndrome (LLS)-associated, and Lynch syndrome (LS)-associated cancers. This study aimed to investigate whether the efficacy of pembrolizumab differs among these 3 groups, and if so, whether EPM2AIP1 immunohistochemistry (IHC), which correlates with MLH1 promoter methylation, can be used to rule out MLH1 methylation cases. This study included 12 patients with MSI-high EC who received pembrolizumab treatment. Patients were categorized into 3 groups based on MLH1 methylation analysis and the Amsterdam Criteria: MLH1 hypermethylated (sporadic [SP]), LLS-associated, and LS-associated. Patients' medical records were retrospectively reviewed, and the efficacy of treatment was evaluated based on the response rate using the Response Evaluation Criteria in Solid Tumors version 1.1. The overall response rate was 75% (3/4) in the SP group, while it was 100% including one complete response patient in the LLS-associated and the LS-associated group, respectively. The sensitivity and positive predictive value of EPM2AIP1 IHC for MLH1 methylation were 100% and 66.7%, respectively. Pembrolizumab may be more effective in LLS and LS-associated groups. EPM2AIP1 IHC was less predictive than MLH1 methylation analysis; however, it may be useful for ruling out MLH1 methylation cases due to its high sensitivity. Further studies are needed to determine whether EPM2AIP1 IHC can predict pembrolizumab efficacy.

ISOLATION AND MOLECULAR IDENTIFICATION OF AMYLOLITIC BACTERIA FROM VANNAMEI SHRIMP (LITHOPENAEUS VANNAMEI) PONDS AS PROBIOTIC AGENTS

Probiotics are bacteria that have the potential to be developed as biocontrol agents in aquaculture. Several probiotic abilities have been known such as amylum breakdown and antibacterial which are relevant to suppressing the growth of pathogens. This study aimed to isolate and identify the molecular amylolytic bacteria from vannamei shrimp aquaculture ponds with different systems as probiotic agents. The method used were a survey and random sampling technique from traditional and intensive shrimp farming. Parameters analyzed included the proportion of amylolytic bacteria, amylolytic index, and molecular identification. The results showed that the proportion of amylolytic bacteria in intensive ponds was higher than in traditional ponds. Screening based on colony morphology and the highest activity index obtained four identified bacterial isolates from the Vibrio sp, Staphylococcus sp, and Pseudoalteromonas groups with an identity value of 98.23%-99.80%. Pseudoalteromonas sp. has the highest amylotlytic content and generlly has antimicrobial activity which can be used as probiotic agents.

Elevated serum neuropeptide Y levels are associated with carotid plaque formation in Chinese adults: a cross-sectional study

BackgroundCarotid plaque (CP) formation is an important consequence of atherosclerosis and leads to significant complications. Levels of neuropeptide Y (NPY), which is a sympathetic neurotransmitter, are elevated in cardiovascular diseases. It also has important roles in inflammatory conditions. This study aimed to explore the relationship between serum NPY and CP and to study further the influence of NPY and inflammatory factors on CP.MethodsThis cross-sectional study was conducted among 300 adults who underwent a health examination at the Second Affiliated Hospital of Fujian Medical University in Fujian Province, of whom 177 were finally enrolled. The participants were divided into the CP (n = 120) and non-CP (NCP) or control (n = 57) groups according to the results of carotid artery color Doppler ultrasound. The CP group was further classified into stable plaque (SP, n = 80) and vulnerable plaque (VP, n = 40) groups based on plaque characteristics. Serum NPY and pro-inflammatory cytokine tumor necrosis factor-α (TNF-α) levels were examined. Univariate and correlation analyses were used to evaluate the correlation between serum NPY levels, pro-inflammatory cytokines, and the CP phenotype.ResultsThe serum NPY and TNF-α levels of patients in the CP group were significantly higher than those in individuals from the NCP group [ (177.30 ± 43.29) pg.mL− 1 vs. (121.53 ± 40.16)pg.mL− 1, P < 0.001; (41.94 ± 14.19) pg.mL− 1 vs.(33.54 ± 13.37)pg.mL− 1, P = 0.003]. The serum NPY levels of the patients in the VP group were significantly higher than those in patients from the SP group [(191.67 ± 39.87)ng.L− 1 vs.(170.12 ± 43.37)ng.L− 1, P = 0.01, P < 0.05]. Serum TNF-α and NPY levels were positively correlated among patients from the CP group (r = 0.184, P = 0.044). The binary logistic regression analysis showed that serum NPY and TNF-α were independent influencing factors of CP [(OR = 1.029, P < 0.001);(OR = 1.030, P = 0.023)]. The area under the ROC curve of NPY predicting the CP showed statistical significance at a value of 0.819.ConclusionTogether, elevated serum NPY levels seem to be associated with the occurrence of coronary atherosclerosis in Chinese adults.

The profile of villous chorion vascularization in primary placental insufficiency

Introduction. Placentation and autochthonous vascularization during the early period of intrauterine development in primary placental insufficiency are important stages in the establishment of embryo-haemochorial circulation. Vascular and angiogenesis dysfunctions in the early period of gestation are essential in the development of changes in placental vascular status with severe repercussions on pregnancy outcome in the first trimester of gestation. The purpose of the work. Evaluation of vascular density by the application of the anti-CD31 antibody in the chorio-villar germinal site in short-term dysregulated pregnancies. Material and methods. 184 cases were divided into 2 groups: stagnant pregnancies (SP (L1 = 144 cases) and early spontaneous abortion (ESA) (L2 = 40 cases). Control material: pregnancies resolved at social indications/desire (A) (n = 18) distributed according to gestational term (3-5 weeks), (6-9 weeks), and (10-12weeks). The estimation of the histomorphological features was performed by applying the classical conventional method with hematoxylin-eosin (H.E.), and the immunohistochemical evaluation of the vascular density in the chorio-villar profile with the help of the endothelial marker anti-CD31. The statistical relationships between fetal conceptus assessment forms, gestational term, and age were analyzed. Results. Distribution of pregnancies by profile: (SP) – 78.2% vs (ESA) – 21.8%, with vascular disturbances attested in 100% of cases by increasing the density of avascular chorionic villi in the case of stagnant pregnancies in 75% of cases. The application of immunoexpression with anti-CD31 at the level of the stroma of the chorionic villi determined PVI with a maximum mean in the control group (91.51±0.71) vs the ESA and SP groups (82.29±12.96 and 57.47±6.53, respectively). The index of vascularization with lumen (IV/L+) and vascularization index without lumen (IV/L-) were statistically significantly different (p = 0.011) for (SP). Applying the student t-test revealed statistically significant differences for PVI in most groups, except PSD vs SP at the age of 10-12 gestation of weeks (w.g.) At the same time, there are statistically significant differences between the means of vessels with lumen within PSD and SP (t31 = 5.500, p = 0.000005), and the means of vessels without lumen registered statistically significant differences in the PSD and SP groups (t12 = 3.862, p = 0.002). Conclusions. Pregnancy evolution depends on the degree of vascularization, as well as on the quality of the vascular network.

Evolving approaches in the management of patients with subarachnoid hemorrhage from 2002 to 2022: The impact of clazosentan and treatment modalities on outcomes

ObjectiveThis study aimed to assess the changes in patient demographics, aneurysm characteristics, and treatment modalities for subarachnoid hemorrhage (SAH) over the past two decades. MethodsWe analyzed SAH 6,446 patients between 2002 and 2022, which was divided into three periods: 2002–2011 (FP), 2012–2021 (SP), and post-clazosentan 2022 (PC). The final cohort included 2878, 2016, and 152 patients in FP, SP, and PC groups, respectively. We examined patient demographics, surgical procedures, spasm prevention therapy, and delayed ischemic neurological deficits (DIND). ResultsThe mean age of the patients increased over the study period (64, 66, and 68 years in FP, SP, and PC groups, respectively). Clipping was the predominant method during FP (79 %); however, coiling surpassed clipping in 2022 (coiling vs. clipping, 47 % vs. 46.3 %). Before clazosentan introduction, fasudil was the primary spasm prevention treatment (>80 %); however, its use decreased (63.9 %) after clazosentan introduction. DIND varied across FP, SP, and PC groups (37.4 %, 24.2 %, and 16.7 % respectively). Age and generation were significantly associated with DIND and irreversibility. ConclusionRegarding the management of patients with SAH, shift from clipping to coiling, and the introduction of new spasm prevention treatments such as clazosentan were observed, led to a decrease in DIND.

Proprioception analysis of patients with anterior cruciate ligament reconstruction

Objectives: This study evaluates the effect of tibial stump mechanoreceptor preservation on proprioception, muscle strength, recovery and functional outcomes after arthroscopic anterior cruciate ligament surgery (ACLS). Methods: Patients undergoing ACLS between January-July 2019 were evaluated by a single surgeon. The HUMAC NORM 2 device measured patients' proprioceptive sensation and muscle strength before and after surgery; KOOS and Oxford scales were used to score patients’ functional results. The patients were divided into two groups: those who underwent stump-preserving surgery (SP group) and those who underwent conventional surgery (C group). Results: Our study evaluated 27 patients, 11 in the SP and 16 in the C groups. The two groups had no statistical difference in muscle strength, proprioception, and functional scores in the first and third postoperative months. In the sixth-month evaluation, significantly better functional scores were found in the C group. Further, the athletic function was better in patients with good proprioception recovery, regardless of the group comparison. Conclusions: Preserving the stump and mechanoreceptors on the tibial face was not determined to provide additional benefit to the patients in the first six months after surgery. Returning to sports was faster and functional scores were better in patients with good proprioception recovery.

Erector Spinae versus Surgically Placed Pain Catheters for Thoracic Outlet Decompression

Perioperative care after surgery for thoracic outlet syndrome (TOS) involves multimodal pain control. Pain catheters with bupivacaine infusion are a modality to minimize perioperative narcotic use. Our study aims to compare surgically placed pain catheters (SP) with erector spinae pain catheters (ESP) placed by the anesthesia pain service. Retrospective review of a prospectively maintained surgical TOS database identified patients undergoing transaxillary first rib resection (FRR) who had either SP or ESP placed for pain control. Patients were matched for age and gender. Data collected included demographics, operative details, and perioperative pain medication use. Narcotic pain medication doses were converted to milligram morphine equivalents (MME) for comparison between groups. Pain medications were collected for several time points: intraoperatively, for each post-operative day (POD), and for the entire hospital stay. Eighty-eight total patients were selected for comparison: 44 patients in the SP and ESP groups. Patients in each group did not differ with regards to age, BMI, gender, diagnosis, or comorbidities. There were no differences in preoperative narcotic use, preoperative pain score, or QuickDASH score. All patients underwent FRR. Concurrent cervical rib resection was performed in 6.8% SP and 6.8% ESP patients (p=1.00), pectoralis minor tenotomy in 34.1% SP and 29.5% ESP patients (p=0.65), and venogram in 31.8% SP and 31.8% ESP patients (p=1.00). Mean OR time was 90.0 minutes in SP and 105.3 minute in ESP cases (p=0.15). Mean length of stay was 1.9 days for SP and 1.8 days for ESP patients (p=0.56). There were no significant differences in intraoperative narcotics dosing in MME (SC: 22.1 vs ESP: 25.3, p=0.018). On POD 0, there were no differences in total narcotics dosing (MME) (SC: 112.0 vs ESP: 100.7, p=0.59), or in the use of acetaminophen, NSAIDS, or muscle relaxants. A similar trend in narcotics dosing was observed on POD 1 (SP: 58.6 vs ESP: 69.7, p=0.43), and POD 2 (SP: 23.5 vs ESP: 71.3, p=0.23). On POD 1, there was a higher percentage of SP patients taking NSAIDs (63.6% vs 40.9%, p=0.024), however, this difference was not observed on POD 2. There were no differences in acetaminophen or muscle relaxant use on POD 1 or 2. Total hospital stay MME was similar between groups (SC: 215.9 vs ESP: 250.9, p=0.23) CONCLUSION: Pain catheters with bupivacaine infusions are helpful adjuncts in postoperative pain control after FRR for TOS. This study compares SP to ESP, and demonstrates no difference in narcotics use between SP and ESP groups. SC should be used for pain control in facilities which do not have an anesthesia pain service available for ESP placement.

Impact of prebriefing on emotions in a high-fidelity simulation session: A randomized controlled study.

Medical simulation is associated with intense emotions which influence human behavior. We aim to investigate how prebriefing impacts on learners' emotions during a high-fidelity simulation (HFS) session. This is a prospective randomized controlled study. Participants were randomly allocated to receive a standardized prebriefing (SP group) versus not receiving it (NSP group). Debriefing following the «good judgment» approach, structured in reactions, understanding and summary phases, was used in both groups. In order to assess emotions, we used the circumplex model of affect applying the Affect Grid scale, which was performed prior to prebriefing, following case performance and following debriefing. Debriefing times were also assessed. A total of 128 physicians participate in the study (64 vs. 64). Following case performance, this HFS session was experienced with significantly more pleasant emotions compared to baseline, that were maintained during debriefing (p < 0.01) while alertness increased after case performance diminishing after debriefing (p < 0.01). There were no statistical significant differences between groups. In the NSP group, total debriefing (p = 0.003) and understanding phase (p = 0.002) times were significantly longer. This HFS session was experienced as pleasant with high alertness with no specific emotional impact attributable to prebriefing. Prebriefing leads to a freer flowing debriefing.

Athletic Training Students’ Mental Health Recognition and Referral Skills, Part 1: A Randomized Controlled Trial

Context The increased prevalence of mental health conditions and athletic training education’s heightened focus on behavioral and mental health necessitate an examination of teaching techniques for this material. This study explores the impact of virtual pedagogical strategies on athletic training students’ knowledge and confidence with mental health recognition and referral to help educators determine best practices for content delivery. Objective This study examined the effect of Mental Health First Aid (MHFA) training on students’ knowledge and confidence in mental health recognition and referral. The impact of group allocation (standardized patient [SP] encounters, case-based learning [CBL], and control) on these outcomes was also assessed. Design Randomized controllled trial portion from a sequential, explanatory mixed-methods design. Setting Online learning environment. Patients or Other Participants Convenience sample of 70 students (25 men, 44 women, 1 nonbinary; aged 23.38 ± 2.27 years) from Commission on Accreditation of Athletic Training Education-accredited graduate-level professional athletic training programs. Intervention(s) All participants completed MHFA training followed by either no intervention, an SP encounter, or CBL activity. Main Outcome Measure(s) Mental health recognition and referral skills as measured by an electronic knowledge assessment and self-reported confidence scale whose content validity were established by an expert panel. Results A mixed-model analysis of variance showed significant improvement from pretest to posttest for both knowledge and confidence [knowledge: F(1,67) = 70.31, P &amp;lt; .001; confidence: F(1,67) = 206.41, P &amp;lt; .001]. This relationship was similar among all 3 groups. No significant difference in knowledge or confidence was found between the control, SP, and CBL groups. Conclusions With the increased need to care for patients’ behavioral and mental health, professional athletic training programs and continuing education should consider incorporating MHFA training to improve content knowledge and confidence in skills. While no numerical difference between the groups was shown by this study, supplementation with simulation through CBL or SP encounters provides an opportunity for application specific to athletic training practice, which may help reinforce concepts and enhance clinical readiness.

On Localized Self-Homotopy Groups of SU(4) and Sp(4)

On Localized Self-Homotopy Groups of SU(4) and Sp(4)

Knock-down of IGFBP2 ameliorates lung fibrosis and inflammation in rats with severe pneumonia through STAT3 pathway

Objective To observe the mechanism of IGFBP2 knock-down in improving lung fibrosis and inflammation through STAT3 pathway in rats with severe pneumonia. Materials and Methods First, SP rat model was established. Then rats were divided into the Control group, the SP group, the SP + Lv-vector shRNA group, the SP + Lv-IGFBP2 shRNA group, the SP + Lv-vector group, and the SP + Lv-IGFBP2 group. The mRNA and protein levels of IGFBP2, NOS, CD206 and Arg 1 were detected by RT-qPCR and Western blot. IHC was used to check the positive expression of IGFBP2 and MCP1. A fully automated blood gas analyzer was used to detected PaCO2, CO2 content, PaO2 and SaO2. HE and Masson staining were performed to observe the lung tissue injury and collagen deposition of rats in each group. ELISA assays were used to calculate the levels of inflammatory factors IL-1β, IL-6, TNF-α, IL-4, and IL-10. Flow cytometry was conducted to acquire the ratio of M1-type AMs and M2-type AMs. Results Compared with the Control group, IGFBP2, iNOS, CD206, and Arg1 mRNA and protein expression levels, IGFBP2 and MCP1 positive expressions, PaCO2, p-STAT3/STAT3, p-JAK2/JAK2, IL-1β, IL-6, and TNF-α levels, the number of AMs and neutrophils, the proportion of M1 type AMs and the expressions of α-SMA, Collagen-I, Collagen III, and Fibronectin were significantly increased in SP rats (p < 0.05), while PaCO2, CO2, and SaO2, IL-4 and IL-10 levels, and the proportion of M2 type AMs decreased (p < 0.05). However, the knockdown of IGFBP2 reversed the above index trends. Conclusion Knock-down of IGFBP2 ameliorated lung injury in SP rats, inhibited inflammation and pulmonary fibrosis, and promoted M2-type transformation of AMs by activating the STAT3 pathway.

Circulating metabolic signatures of rapid and slow progression to type 1 diabetes in islet autoantibody-positive children.

Appearance of multiple islet cell autoantibodies in early life is indicative of future progression to overt type 1 diabetes, however, at varying rates. Here, we aimed to study whether distinct metabolic patterns could be identified in rapid progressors (RP, disease manifestation within 18 months after the initial seroconversion to autoantibody positivity) vs. slow progressors (SP, disease manifestation at 60 months or later from the appearance of the first autoantibody). Longitudinal samples were collected from RP (n=25) and SP (n=41) groups at the ages of 3, 6, 12, 18, 24, or ≥ 36 months. We performed a comprehensive metabolomics study, analyzing both polar metabolites and lipids. The sample series included a total of 239 samples for lipidomics and 213 for polar metabolites. We observed that metabolites mediated by gut microbiome, such as those involved in tryptophan metabolism, were the main discriminators between RP and SP. The study identified specific circulating molecules and pathways, including amino acid (threonine), sugar derivatives (hexose), and quinic acid that may define rapid vs. slow progression to type 1 diabetes. However, the circulating lipidome did not appear to play a major role in differentiating between RP and SP. Our study suggests that a distinct metabolic profile is linked with the type 1 diabetes progression. The identification of specific metabolites and pathways that differentiate RP from SP may have implications for early intervention strategies to delay the development of type 1 diabetes.

3D-printed LEGO®-inspired titanium scaffolds for patient-specific regenerative medicine

Despite the recent advances in 3D-printing, it is often difficult to fabricate implants that optimally fit a defect size or shape. There are some approaches to resolve this issue, such as patient-specific implant/scaffold designs based on CT images of the patients, however, this process is labor-intensive and costly. Especially in developing countries, affordable treatment options are required, while still not excluding these patient groups from potential material and manufacturing advances. Here, a selective laser melting (SLM) 3D-printing strategy was used to fabricate a hierarchical, LEGO®-inspired Assemblable Titanium Scaffold (ATS) system, which can be manually assembled in any shape or size with ease. A surgeon can quickly create a scaffold that would fit to the defect right before the implantation during the surgery. Additionally, the direct inclusion of micro- and macroporous structures via 3D-printing, as well as a double acid-etched surface treatment (ST) in the ATS, ensure biocompatibility, sufficient nutrient flow, cell migration and enhanced osteogenesis. Three different structures were designed (non-porous:NP, semi-porous:SP, ultra-porous:UP), 3D-printed with the SLM technique and then surface treated for the ST groups. After analyzing characteristics of the ATS such as printing quality, surface roughness and interconnected porosity, mechanical testing and finite element analysis (FEA) demonstrated that individual and stacked ATS have sufficient mechanical properties to withstand loading in a physiological system. All ATS showed high cell viability, and the SP and UP groups demonstrated enhanced cell proliferation rates compared to the NP group. Furthermore, we also verified that cells were well-attached and spread on the porous structures and successful cell migration between the ATS units was seen in the case of assemblies. The UP and SP groups exhibited higher calcium deposition and RT-qPCR proved higher osteogenic gene expression compared to NP group. Finally, we demonstrate a number of possible medical applications that reveal the potential of the ATS through assembly.

Clinical presentations of suicidality in relation to medical assistance in dying.

This study explores the assessments of mental health clinicians working with suicidal patients who requested access to medical assistance in dying (MAiD). A sample of convenience completed an online questionnaire about their experiences with suicidal patients. Respondents described their encounters with 227 suicidal patients: 44 requested access to MAiD, and 183 did not. Data were analyzed using chi-squared and simple t-test to identify differences between the respondents' descriptions of the two groups. Results noted differences between patients who experience suicide ideation and request MAiD (SPM), and those who experience suicide ideation and do not (SP). Overall, the SPM group was older, more physical health concerns, chronic pain, existential distress, and less hope. Many had experienced several episodes of mental health care and medication trials, though unlike the SP group, they had a split between accessing a little care and a lot of care. They also engaged in less suicide planning, and some had no history of suicide attempts. It is important that mental health clinicians learn to differentiate between MAiD requests due to an ongoing and irremediable mental disorder, and MAiD requests in response to circumscribed psychological suffering that could be relieved via a change in circumstances and/or access to different treatment options amenable to the patient.

Impacts of florfenicol on immunity, antioxidant activity, and histopathology of Oreochromis niloticus: a potential protective effect of dietary spirulina platensis.

The misuse of antibiotics enhances the development of resistant microorganisms and decreases the efficacy of treatments. Florfenicol (FF) is one of the antibiotics approved for use in aquaculture in Egypt. Because of its extensive usage, potential negative impacts on aquatic creatures are a major concern. This motivates us to search for an appropriate neoadjuvant to work synergistically with FF and reduce adverse effects. Results from this study will contribute towards improving the understanding of the impacts of FF on Oreochromis niloticus and the possible amelioratory effects of Spirulina platensis algae (SP). O. niloticus (n = 240; 40 ± 2.5g) were fed on two diets supplemented with or without SP for 4 weeks, then divided into four treatments each in three replicates (n = 60/treatment). G1; was fed a control diet, and the other groups were fed diets supplemented with FF (10mg /kg of BW, G2), SP (2g/kg of diet, G3), or FF + SP (G4) for 10 days. Among the four groups, the SP group (G3) had the best immunostimulatory effects as observed by a significant (p < 0.05) elevation in phagocytic activity, phagocytic index, IL6, and TNF-α. The treatment with FF had significantly impacted hepatic and renal tissues, as the values of liver enzymes and creatinine demonstrated tissue deterioration and also resulted in oxidative stress, which was expressed by an increase of GPx, CAT, and SOD in (G2). Additionally, the combined FF + SP improved the hematological parameters and decreased the oxidative damage induced by FF (G4). Thus, it was clear that FF has harmful effects on O. niloticus and that SP can modulate such impacts. These data recommend the use of SP as an effective immunostimulant and a probable adjuvant to FF in O. niloticus diets to attain maximum disease resistance.

Platycladi Semen oil ameliorates Aβ_(25-35)-induced brain injury in mice based on network pharmacology and gut microbiota

The present study aimed to investigate the protective effect and underlying mechanism of Platycladi Semen oil(SP) on Aβ_(25-35)-induced brain injury in mice to provide a theoretical basis for the clinical treatment of Alzheimer's disease(AD). Male Kunming(KM) mice were randomly divided into a control group, a model group(brain injection of Aβ_(25-35), 200 μmol·L~(-1), 0.15 μL·g~(-1)), a positive drug group(donepezil, 10 mg·kg~(-1)), and low-and high-dose SP groups(0.5 and 1 mL·kg~(-1)). Learning and memory ability, neuronal damage, levels of Aβ_(1-42)/Aβ_(1-40), p-Tau, related indicators of apoptosis and oxidative stress, and immune cells, and protein and mRNA expression related to the sphingosine kinase 1(SPHK1)/sphingosine-1-phosphate(S1P)/sphingosine-1-phosphate receptor 5(S1PR5) signaling pathway of mice in each group were determined. In addition, compounds in SP were analyzed by gas chromatography-mass spectrometry(GC-MS). The mechanism of SP against AD was investigated by network pharmacology, 16S rDNA gene sequencing for gut microbiota(GM), and molecular docking techniques. The results showed that SP could improve the learning and memory function of Aβ_(25-35)-induced mice, reduce hippocampal neuronal damage, decrease the levels of Aβ_(1-42)/Aβ_(1-40), p-Tau, and indicators related to apoptosis and oxidative stress in the brain, and maintain the homeostasis of immune cells and GM. Network pharmacology and sequencing analysis for GM showed that the therapeutic effect of SP on AD was associated with the sphingolipid signaling pathway. Meanwhile,(Z,Z,Z)-9,12,15-octadecatrienoic acid and(Z,Z)-9,12-octadecadienoic acid, the components with the highest content in SP, showed good binding activity to SPHK1 and S1PR5. Therefore, it is inferred that SP exerts anti-apoptosis and antioxidant effects by regulating GM and inhibiting SPHK1/S1P/S1PR5 pathway, thereby improving brain injury induced by Aβ_(25-35) in mice. Moreover,(Z,Z,Z)-9,12,15-octadecatrienoic acid and(Z,Z)-9,12-octadecadienoic acid may be the material basis for the anti-AD effect of SP.

A comparative study on the short-term clinical outcomes of Da Vinci SP versus Da Vinci Xi for rectal cancer surgery.

The Da Vinci SP robot system was recently introduced, but its safety and feasibility for rectal cancer compared with the currently used robot system have not been reported. This was a single-centre retrospective study. Data from patients who underwent abdominal total mesorectal excision (TME) from October 2015 to October 2022 were analysed. After propensity score matching, the short-term outcomes were compared. A total of 56 patient data were analysed. Intersphincteric resection was more common in the SP group (7 cases (25%) vs. 0 case (0%), p=0.001). The operation time was significantly shorter in SP (184 vs. 227.5min, p<0.0001), but the docking time was similar. The postoperative complications were similar. There were no differences in the postoperative pain score and length of hospital stay. The SP robotic system for abdominal TME has acceptable short-term and is safe and technically feasible.

Comparing surgical outcomes of da Vinci SP and da Vinci Xi for endometrial cancer surgical staging in a propensity score-matched study

The number of studies comparing robotic systems in endometrial cancer staging is limited. This retrospective study analyzed the medical records of 42 consecutive endometrial cancer patients, who underwent robotic staging using the da Vinci SP (SP) system, and 126 propensity score-matched patients who underwent staging using the da Vinci Xi (Xi) system. Median console and total operation times were longer in the SP group than those in the Xi group (125 vs. 77 min, p < 0.001; 225 vs. 154.5 min, p < 0.001, respectively). Notably, the median console time of the first 10 cases using SP was 184 min; it subsequently decreased to 99.5 min in the fourth 10 cases. SP had lesser postoperative hemoglobin (Hb) change (0.6 ± 0.7 g/dL vs. 1.8 ± 0.9 g/dL in Xi, p < 0.001) and lower median pain score at 6 h after surgery (2 vs. 3 in Xi, p = 0.046). Moreover, median postoperative hospital stay was shorter in the SP group (2 days) than that in the Xi group (6 days) (p < 0.001). Although SP was correlated with lower postoperative Hb change, shorter postoperative hospital stay, and lower pain score than those in Xi, it required longer operation times. Further prospective randomized studies are needed to validate the benefits of SP compared to other robotic platforms.