Timing Of Intake Research Articles

Do oral contraceptives affect young women's memory? Dopamine-dependent working memory is influenced by COMT genotype, but not time of pill ingestion.

BackgroundDespite the widespread use of oral contraceptives (OCs), and the well-documented influence of estrogens, notably 17β-estradiol (E2), on cognition, research relating OCs to working memory is limited and mixed. Two factors may contribute to these mixed findings: 1) pharmacokinetics of oral contraceptives, which drive fluctuations in synthetic hormone levels; and 2) genetic polymorphisms related to dopamine degradation and working memory, which interact with E2. This research investigated whether the pharmacokinetics of oral contraceptives, in concert with the single nucleotide polymorphism (Val158Met; rs4680) of the catechol-o-methyltransferase gene (COMT), influence working memory performance.MethodsUniversity-age women taking and not taking OCs were tested for working memory and genotyped for COMT. If they were not taking OCs (n = 62), sessions occurred in the early follicular (low E2) and late follicular (high E2) phase. If they were taking OCs (n = 52), sessions occurred 1–2 hours after (high ethinyl estradiol, EE) and ~24 hours after (low EE) pill ingestion. Working memory was tested using the N-back, AX-CPT, Digit Span, and Digit Ordering Tasks. Data were analyzed using multilevel models with estrogen condition, COMT, and group as predictors, controlling for mood and practice effects.ResultsFor women taking OCs, time of pill ingestion did not influence performance. However, the subgroup with COMT val/val (low dopamine) were less accurate on 2-back lure trials than those with COMT met/met (high dopamine). For women not taking OCs, cycle phase moderated COMT’s influence on lure accuracy. When compared, women taking OCs had higher AX-CPT proactive control indices than those not taking OCs.ConclusionThese findings suggest that oral contraceptives are not detrimental for young women’s working memory and that they may increase proactive control. The more pronounced effects of COMT in women taking OCs suggests that, in women taking OCs, suppressed endogenous E2–not fluctuating EE levels–may be more relevant for working memory. Future studies are needed to differentiate effects of endogenous versus synthetic estrogens on working memory.

Feed flavour supplementation improves kinetics of intake and feeding behaviour pattern of lactating sows in a tropical climate

A total of 60 mixed parity sows were used in our study to evaluate the impact of the supplementation of a feed flavour during lactation on their feeding behaviour under tropical climatic conditions. Sows were distributed in a 2 x 2 factorial experimental design: two seasons: hot and cool; and two diets: control diet and a diet with the inclusion of a feed flavour during 24 d lactation. The average relative humidity and ambient temperature for the cool season were 23.1°C and 56.5%, respectively. The corresponding values for the hot season were 26.2ºC and 70.1%. No interaction between season and diet composition was found for all traits. Daily feed intake was affected by season (P < 0.001), whereby the feed intake was lower during the hot season than in the cool season (5.66 vs. 7.23 kg/ d). The daily ingestion time was less in the hot than in the cool season (36.8 vs. 72.3 min/ d; P < 0.01) and the ingestion time per meal was also lower in the hot compared to the cool season (5.7 vs. 7.5 min/ meal; P < 0.05). The hot season also reduced (P < 0.01) rate of daily intake when compared to the cool season (36.8 vs. 72.3 g/ min). In both seasons, the proportion of total daily feed intake was higher from 00:00 to 10:00 am. The number of meals per day was not affected (P > 0.10) by dietary flavour inclusion. The average meal size was lower (P < 0.05) in sows fed the control diet when compared with flavour fed sows. Daily feed intake was greater (P < 0.01) in the flavour diet than in the control (6.42 vs. 5.36 kg/ d). The ingestion time was affected (P < 0.05) by the flavour, whereas sows from the control had a lower ingestion (58.4 vs. 46.6 min/ d). Sows receiving flavour showed a higher (P < 0.01) nocturnal (704 vs. 583 g/ meal) and diurnal (678 vs. 582 g/ meal) feed intake when compared to control fed sows. This study confirms that the feeding behaviour of the lactating sow is affected by seasonal variations of the tropical climate. Irrespective of season, the strategic use of feed flavour improved feed consumption and performance under tropical conditions.

Efficacy of dulaglutide: an evidence-based review of its potential indications

Diabetes mellitus (DM) is the biggest noncontagious epidemic in human history. This review is addressing an urgent challenge of modern healthcare - the treatment of type 2 diabetes mellitus (DM2). Key attention is paid to the prevention of the development and progression of type 2 diabetes complications and the need to manage risk factors for cardiovascular diseases (CVD), which are the leading cause of high mortality rates in people with type 2 diabetes. The clinical trials (CT) of recent decades contributed to the build-up of a solid evidence base on the effect of various antihyperglycemic drugs on the development of diabetic complications and outcomes in patients with T2DM. Also, the emergence of innovative classes of antihyperglycemic drugs have significantly expanded the potential of T2DM therapy. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of glucose-lowering drugs that affect many pathogenetic mechanisms of T2DM and have a high safety profile. Creation of extended-release forms of GLP-1 RAs is an important step in the treatment of T2DM. Dulaglutide (Trulicity) has become the first GLP-1 RA for the treatment of T2DM (2016) authorized in Russia that can be used once weekly without regard to timing of food ingestion, which contributes to high compliance with treatment. The evidence base on the efficacy and safety of dulaglutide is continuously expanding. The authors paid attention to the issues of cardiovascular safety of the administration of dulaglutide, discussed the main results of REWIND study, and brought up a problem about the expediency of an earlier initiation of primary prevention of cardiovascular events in patients with type 2 diabetes. The results of the REWIND study made it possible to recommend the inclusion of GLP-1 RAs into the therapy of patients with type 2 diabetes and cardiovascular risk factors with a view to get additional advantages in terms of life prognosis.

Pattern of Acute Organophosphorus Poisoning at a Tertiary Care Hospital of Western Maharashtra

Background: Every year, 3 million cases of pesticide, mainly O.P. poisoning, occurs all over the world. Therefore, statistics regarding O.P. poisoning in a specific region will aid in the early diagnosis and treatment of cases. The main objective of this research project is to find out the pattern of O.P. poisoning cases at the tertiary care center. Methods: We conducted a retrospective cross-sectional study, in which we analyzed data from 40 cases of O.P. poisoning, including patient information regarding gender, age, time of ingestion, type of poison, mode of poisoning, any first aid received, treatment given, duration of hospital stay and outcome of the treatment. Results: There were 16 females (40%) and 24 males (60%). The most common age group was 21 to 40 years, with 19 participants (47.50%). The majority of the participants were from the rural area, 38 cases (95%), while in 36 cases, the poisoning was suicidal (90%). 28 participants (70%) received some form of first aid. In addition, 21 of the participants received Atropine (52.50%), 13 received only gastric lavage (32.50%), 5 received both Atropine and Pralidoxime (12.50%), while one patient only received Pralidoxime (2.5%) as treatment. I.C.U. admission was required in 39 participants (97.50%), and ventilatory support was required in 2 participants (5%). Our study observed 4 deaths (10%) amongst our participants. The multivariate analysis of deaths in our study showed that specifically not receiving any first aid (p = 0.039) and requirement of the ventilator (p&lt;0.001) were seen to have a significant association with deaths in our study. Conclusion: O.P. poisoning is the commonest cause of suicidal deaths in developing countries. Creating awareness regarding O.P. poisoning and legislative action on using hazardous poisons will help reduce the deaths.

Effects of MitoQ on Central Hemodynamics, Arterial Stiffness, and Oxidative Stress In Healthy, Young Adults

PURPOSE Cardiovascular disease is characterized by blood pressure (BP) dysregulation and vascular dysfunction, secondary to vascular oxidative stress. Exogenous antioxidants mitigate vascular oxidative stress by scavenging reactive oxygen species (ROS). MitoQ, a mitochondrial specific antioxidant improves vascular function and reduces elevated arterial stiffness in older adults. However, it is unclear if MitoQ improves vascular function in healthy young adults for primary prevention purposes. Therefore, central hemodynamics, arterial stiffness, and measures of oxidative stress were assessed in healthy young adults before and after acute MitoQ (or placebo) supplementation. METHODS Eleven participants (six females, age: 26±4 years, BMI: 25±3 kg/m2, screening BP: 109±10/65±4 mmHg, Mean±SD) reported to our laboratory for two separate sessions (crossover design) and randomly assigned either a placebo or MitoQ protocol (100-160mg, depending on body mass). Sessions were separated by ≥72-hour wash out period. Laboratory measures were performed before and 45 minutes after MitoQ (or placebo) capsules were ingested. Following ≥10 minutes of quiet rest, triplicate readings of brachial (oscillometric) and aortic BP (SphygmoCor) were obtained. We assessed carotid-femoral pulse wave velocity (PWV) and augmentation index as indices of arterial stiffness. We obtained blood samples via intravenous catheter placement to assess ROS levels with electron paramagnetic resonance and plasma superoxide dismutase activity using an enzymatic assay kit. 2-way ANOVAs were performed to determine effects on treatment x time interaction. RESULTS No significant treatment x time interactions for brachial (p=0.52) and aortic (p=0.64) systolic BP readings, or brachial (p=0.34) and aortic (p=0.11) diastolic BP readings were observed. However, brachial systolic BP tended to modestly increase after capsule ingestion (placebo:114±8 to 118±9; MitoQ: 116±11 to 118±8; time: p=0.05). Carotid-femoral PWV did not change following placebo (4.3±0.7 to 4.5±0.8 m/s) or MitoQ (4.3±0.7 to 4.4±0.8 m/s) ingestion (time: p=0.35, interaction p=0.30). Augmentation index decreased from pre- to post- capsule ingestion for both placebo (14±9 to 11±8 %) and MitoQ (14±9 to 10±8 %; time: p<0.01) with no significant interaction (p=0.28). There was no significant treatment x time interaction for Blood ROS (p=0.99) concentration or plasma superoxide dismutase activity (p=0.89). CONCLUSIONS While additional data are needed to build our sample size and determine if there are racial or ethnic differences in responses, our preliminary findings suggest that acute MitoQ supplementation does not influence central hemodynamics or arterial stiffness in healthy, young adults.

Real-Life Applications and Challenges of Andexanet Alfa for Life-Threatening Bleeding and Reversal Prior to Surgery

Andexanet alfa is a targeted reversal agent for apixaban and rivaroxaban for life-threatening or uncontrolled bleeding. There are few multicenter, real world studies that also include patients with off-label use who require emergent surgery. The objective was to describe hemostatic efficacy, thrombotic events, clinical applications, pharmaceutical challenges, and mortality associated with reversing apixaban and rivaroxaban with andexanet alfa in clinical practice. Retrospective descriptive observational cohort study of andexanet alfa use at 2 academic medical centers in the United States from July 1, 2018 to September 30, 2019. Ninety patients received 91 doses of andexanet alfa including 6 for reversal prior to surgery. Effective hemostasis was achieved in 72.9% of bleeding episodes and all patients that received andexanet alfa preoperatively were deemed to have effective hemostasis. Thrombotic events occurred in 7 of 90 patients (7.7%) and 2 of these events occurred the day after administration. Incorrect high-dose andexanet alfa was given 11 times with an estimated excess expenditure of $272,250. Thirty-two of 90 (35.5%) patients died, and most deaths occurred during the initial hospitalization. Our real-world experience with andexanet alfa in bleeding patients is similar to the non-comparative trial that led to Food and Drug Administration approval, and our findings show good hemostatic efficacy in a small number of patients requiring emergent surgery. We highlight the importance of appropriate dose based on time of ingestion and factor Xa inhibitor dose. Our 2 institutions spent over a quarter of a million dollars on excess andexanet alfa in a year and a half.

Chocolate ingestion in dogs: 156 events (2015-2019).

To describe the clinical features and outcome of dogs after chocolate ingestion. Retrospective evaluation of clinical signs, clinical pathological findings, therapy and outcome of 156 dogs after chocolate ingestion. The concentration of methylxanthines (theobromine, caffeine) was calculated based on the type of chocolate and the amount ingested. One hundred and twelve dogs had no clinical signs. Forty-four dogs had clinical signs of chocolate intoxication. Twenty-eight of these 44 dogs ingested dark and bitter chocolate. Reasons for presentation were agitation (33), tremor (22), vomiting (21), panting (11), polyuria/polydipsia (seven) and diarrhea (two). Common clinical findings were sinus tachycardia (28), tachypnea/panting (14), hyperthermia (10) and dehydration (seven). Clinical pathological findings in 34 of 44 dogs consisted of hyperlactataemia (23), hypokalaemia (16), mild hyperglycaemia (16) and mild alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation (14). After decontamination (apomorphine, activated carbon) and symptomatic treatment (fluid therapy, esmolol, forced diuresis, sedatives), 43 of the 44 dogs survived. In dogs with potential chocolate intoxication, the type and amount of chocolate and the time of ingestion are important factors. Cardiovascular, neurological and gastrointestinal signs are the most common clinical signs. In this case series, the prognosis after decontamination and symptomatic therapy was good, with a mortality rate of less than 3%.

Increased Driving Distance to Screening Colonoscopy Negatively Affects Bowel Preparation Quality: an Observational Study.

To prepare for colonoscopy, patients must consume a bowel purgative and travel from their home to the site of their procedure. The timing of bowel purgative ingestion predicts bowel preparation quality. Currently, it is not known if driving distance impacts bowel preparation quality or adenoma detection. This study investigates the effect of driving distance on bowel preparation and adenoma detection. This is a cross-sectional retrospective analysis of outpatient screening colonoscopy procedures that were completed at an academic medical center. A total of 5089 patients who completed screening colonoscopy across 3 procedure units were analyzed. Description of bowel preparation was dichotomized to either adequate or inadequate. Patient residential addresses were converted into geographic coordinates for geospatial analysis of driving distance to their colonoscopy site. Median driving distance was 13.1 miles. Eighty-nine percent of patients had an adequate bowel preparation. The rate of adenoma detection was 37%. On multivariable logistic regression adjusting for age, sex, race, insurance, endoscopist, and site, increasing driving distance (10-mile increments) was negatively associated with adequate bowel preparation (odds ratio = 0.91; 95% confidence interval 0.85 to 0.97), while adenoma detection was positively associated with adequate bowel preparation (odds ratio = 1.53; 95% confidence interval 1.24 to 1.88) but not with driving distance (odds ratio = 1.02; 95% confidence interval 0.98 to 1.06). Driving distances of 30 miles or less were associated with adequate bowel preparation (odds ratio = 1.37; 95% confidence interval 1.09 to 1.72). Increasing driving distance to screening colonoscopy was negatively associated with adequate bowel preparation but not adenoma detection. Among an academic medical center population, the likelihood of adequate bowel preparation was highest in patients traveling 30 miles or less to their screening colonoscopy. Patient driving distance to colonoscopy is an important consideration in optimizing screening colonoscopy quality.

English

Creatine is a sports supplement with high scientific evidence on its effects on performance and with emerging health’s results, including for vegetarian athletes and older adults. The creatine type and effective doses have been well studied, presenting consistent results. However, not many studies have evaluated the ingestion timing in terms of its interaction with the creatine effects. The aim of this review is to analyze the different existing scientific literature on creatine supplementation protocols and their interaction with the timing of ingestion, in order to assess whether there is a greater effect of the ergogenic dose of creatine considered effective when It is ingested before, post workout or at another time of the day. The results of this work presented different types of protocols and doses in creatine supplementation, despite being diverse the protocols shown in the literature, the most effective consisted of a consumption of 0.3 g/kg/d for five days, followed by a consumption of 0.03 g/kg/d, thus achieving a greater reserve of PCr in skeletal muscle. Studies showed greater benefits when creatine intake was carried out in the moments close to workout due to greater blood flow, the studies pointing to significant improvements in post-workout consumption, since creatine can increase the rate of glycogen uptake in muscle and increase insulin sensitivity

The effect of ginseng supplementation on anabolic index, muscle strength, body composition, and testosterone and cortisol response to acute resistance exercise in male bodybuilders

Summary Aims Bodybuilders are among the athletes who are more likely to take nutritional supplements such as ginseng. The aim of this study was to investigate the effect of ginseng supplementation on anabolic index, muscle strength, body composition, and testosterone (T) and cortisol (C) response to acute resistance exercise in male bodybuilders. Methods In a pretest–posttest control group design, twenty male bodybuilders were randomly divided into two experimental (EG, n = 10) and control (CG, n = 10) groups. The assessments were carried out in three stages: pre-supplementation (Pre-S), post-supplementation (Post-S), and post-exercise (Post-Ex = after a bodybuilding exercise session as acute resistance exercise). General characteristics of subjects, muscle strength, body composition and blood levels of T and C were measured. The supplementation period was six weeks (two ginseng capsules, twice daily, times of ingestion). The CG group also consumed similar capsules containing starch. Analyses of variances with repeated measures were used to test the significance of changes of variables between three stages of the assessment. P Results Ginseng supplementation has no significant effects on C (P = 0.059), anabolic index (T/C ratio, P = 0.463), body mass index (P = 0.182), waist to hip ratio (P = 0.828), and muscle strength (bench press P = 0.684, leg press P = 0.717), while it significantly decreased T levels after acute resistance exercise (EG: Pre-S 4.87 ± 2.54, Post-S 4.80 ± 2.46, Post-Ex 4.17 ± 2.85 ng/mL, CG: Pre-S 4.15 ± 1.36, Post-S 3.73 ± 1.30, Post-Ex 4.46 ± 1.40 ng/mL, P = 0.026) in male bodybuilders. Conclusion It does not appear that six weeks ginseng supplementation simultaneously with bodybuilding exercises has an extra effect on anabolic index, muscle strength and body composition in male bodybuilders, but it does have a decreasing effect on T levels response to acute resistance exercise.

A Rest Quality Metric Using a Cluster-Based Analysis of Accelerometer Data and Correlation With Digital Medicine Ingestion Data: Algorithm Development.

BackgroundAdherence to medication regimens and patient rest are two important factors in the well-being of patients with serious mental illness. Both of these behaviors are traditionally difficult to record objectively in unsupervised populations.ObjectiveA digital medicine system that provides objective time-stamped medication ingestion records was used by patients with serious mental illness. Accelerometer data from the digital medicine system was used to assess rest quality and thus allow for investigation into correlations between rest and medication ingestion.MethodsLongest daily rest periods were identified and then evaluated using a k-means clustering algorithm and distance metric to quantify the relative quality of patient rest during these periods. This accelerometer-derived quality-of-rest metric, along with other accepted metrics of rest quality, such as duration and start time of the longest rest periods, was compared to the objective medication ingestion records. Overall medication adherence classification based on rest features was not performed due to a lack of patients with poor adherence in the sample population.ResultsExplorations of the relationship between these rest metrics and ingestion did seem to indicate that patients with poor adherence experienced relatively low quality of rest; however, patients with better adherence did not necessarily exhibit consistent rest quality. This sample did not contain sufficient patients with poor adherence to draw more robust correlations between rest quality and ingestion behavior. The correlation of temporal outliers in these rest metrics with daily outliers in ingestion time was also explored.ConclusionsThis result demonstrates the ability of digital medicine systems to quantify patient rest quality, providing a framework for further work to expand the participant population, compare these rest metrics to gold-standard sleep measurements, and correlate these digital medicine biomarkers with objective medication ingestion data.

Brain-Gut-Microbiome Interactions and Intermittent Fasting in Obesity.

The obesity epidemic and its metabolic consequences are a major public health problem both in the USA and globally. While the underlying causes are multifactorial, dysregulations within the brain–gut–microbiome (BGM) system play a central role. Normal eating behavior is coordinated by the tightly regulated balance between intestinal, extraintestinal and central homeostatic and hedonic mechanisms, resulting in stable body weight. The ubiquitous availability and marketing of inexpensive, highly palatable and calorie-dense food has played a crucial role in shifting this balance towards hedonic eating through both central (disruptions in dopaminergic signaling) and intestinal (vagal afferent function, metabolic toxemia, systemic immune activation, changes to gut microbiome and metabolome) mechanisms. The balance between homeostatic and hedonic eating behaviors is not only influenced by the amount and composition of the diet, but also by the timing and rhythmicity of food ingestion. Circadian rhythmicity affects both eating behavior and multiple gut functions, as well as the composition and interactions of the microbiome with the gut. Profound preclinical effects of intermittent fasting and time restricted eating on the gut microbiome and on host metabolism, mostly demonstrated in animal models and in a limited number of controlled human trials, have been reported. In this Review, we will discuss the effects of time-restricted eating on the BGM and review the promising effects of this eating pattern in obesity treatment.

Comparison of the antihypertensive efficacy of morning and bedtime dosing on reducing morning blood pressure surge: A protocol for systemic review and meta-analysis.

Background:It is well known that morning blood pressure surge increases the risk of myocardial events in the first several hours post-awakening. This meta-analysis was performed to compare the antihypertensive efficacy of morning and bedtime dosing on decreasing morning blood pressure surge.Methods:Articles in 4 databases about clinical trials of ingestion time of antihypertensive drugs were searched and performed a meta-analysis to evaluate the different effects on morning blood pressure and absolute blood pressure (BP) reduction from baseline of between bedtime administration (experimental group) and morning awaking administration (control group).Results:The aim of this study is to compare the antihypertensive efficacy of morning and bedtime dosing on decreasing morning blood pressure surge.Conclusions:The bedtime will provide evidence support for clinicians and patients for reducing morning blood pressure surge.Ethics and dissemination:This study does not require ethical approval.

Acute caffeine supplementation improves jumping, sprinting, and change-of-direction performance in basketball players when ingested in the morning but not evening

ABSTRACT This study compared the effects of acute caffeine supplementation (3 mg/kg) administered in the morning and evening on performance-related variables in basketball players. Eleven, national-level, adolescent male basketball players underwent field-based fitness testing on four occasions: morning (10:00) with caffeine ingestion (AMCAFF), morning (10:00) with placebo ingestion (AMPLAC), evening (21:00) with caffeine ingestion (PMCAFF), and evening (21:00) with placebo ingestion (PMPLAC). Fitness testing included of a countermovement jump without arm swing (CMJ), CMJ with arm swing (CMJAS), squat jump (SJ), Lane Agility Drill (LAD), 20-m linear sprint, and Suicide Run with (SRD) and without dribbling (SR). Data were analysed using two-way repeated measures analyses of variance and paired t-tests, with effect sizes (ES) also determined for all pairwise comparisons. Follow-up t-test comparisons revealed that AMCAFF produced small-moderate, significant (p<0.001), improvements in CMJ (ES = 0.51), CMJAS (ES = 0.40), SJ (ES = 0.51), and SR (ES = −0.45) compared to AMPLAC. AMCAFF also produced a moderate, significantly (p<0.001) faster LAD (ES = −0.61) compared to PMCAFF. PMPLAC demonstrated small-moderate, significant (p<0.05) improvements in CMJ (ES = 0.43), CMJAS (ES = 0.48), and 20-m sprint (ES = −0.63) compared to AMPLAC. In contrast, AMPLAC resulted in large, significantly (p<0.001), faster SRD (ES = −1.46) and SR (ES = −1.59) compared to PMPLAC. Given the ergogenic effects of caffeine during basketball-specific fitness tests appear to be influenced by time of ingestion, basketball practitioners should consider administering caffeine only to players in the morning to improve vertical jump, sprinting, and change-of-direction performance, with no beneficial effects observed with caffeine ingestion in the evening. Highlights The effect of caffeine supplementation on basketball-specific performance related variables were mediated by ingestion time in elite, adolescent basketball players. AMCAFF produced small-moderate improvements in vertical jump, change-of-direction, 20-m linear sprint, and repeated-sprint performance compared to AMPLAC while PMCAFF produced trivial differences in each performance-related variable compared to PMPLAC. Comparisons between ingestion times in the placebo condition revealed vertical jump height and 20-m sprint speed were impaired in the morning compared to the evening, but these time-dependent differences were eliminated when caffeine was consumed in the morning. Basketball practitioners should consider administering caffeine only to players in the morning to improve vertical jump, sprinting, and change-of-direction performance, with no beneficial effects observed with caffeine ingestion in the evening.

Maillard reaction. Pathogenic effects.

Certain organoleptic modifications by way of processing and cooking foods at high temperatures in dry heat, make them especially appetizing and objects of addiction. It results from Maillard reaction, or glycation, consisting of the non-enzymatic union between carbonyl groups, mainly from reducing sugars as glucose and fructose, with the amino group of proteins and nucleic acids. In addition to physical changes, also the chemical structure and function of these compounds are changed. Besides exogenous glycation generated during the cooking of foods, recently in situ glycation has been reported in the intestinal lumen during digestion, when certain non-glycated foods are combined with fructose at the time of ingestion. In addition, endogenous glycation, which correlates in the extracellular mainly with blood glucose and in the intracellular with glycolysis metabolites and fructose, is specially significant. Since the 70s, with the frequent sucrose replacement by fructose, much more reactive than glucose, the presence of glycation products in processed foods and soft drinks increased.Pathogenic effects of these compounds, also called glycotoxins, are known to contribute to oxidative stress and inflammation. This increases progression of chronic diseases, well documented in diabetes, renal insuficiency, cardiovascular disease and aging process, and are being explore d in many other chronic diseases as neurodegenerative disorders and early aging. Based on the knowledge achieved so far, measures to preserve health are described by attending ways of cooking and processing foods, besides recommendations for life habits and antioxidants dietary intakes for inhibition or antagonism on glycotoxins.

Single hair analysis: Validation of a screening method for over 150 analytes and application on documented single-dose cases.

Hair is the matrix of choice in forensic toxicology when retrospective analysis is needed. Nonetheless, due to misalignment, different growth stages and segmentation lengths of 0.5-1 cm, resolution of time is limited. By segmental analysis of single hairs, most of these factors can be compensated and resolution of time is enhanced. A method for manually segmenting single hairs in 2-mm sections and screening for 156 analytes by liquid chromatography coupled to tandem mass spectrometry has been developed and validated. The method was applied to 15 single-dose cases concerning different pharmaceuticals by analyzing 10 hairs each, sampled 1 and 2 months after ingestion in most cases. The validation showed a lower limit of quantification of ≤1.25 pg/segment for ~90% of analytes and good accuracy. Many substances could be detected in the presented cases, whereas detection of benzodiazepines and low dosed opioids remains challenging. In positive cases, characteristic peak-shaped concentration profiles across the hairs were obtained. The segment with most coinciding peak maxima can be allocated to the time of ingestion. A method for the determination of individual hair growth rate was applied and revealed a gap between expected and actual position of peak maxima. Additionally, different localization of simultaneously administered substances was observed. These findings were tried to be explained by different routes of incorporation and may contribute to current knowledge. The presented method may directly be applied to similar questions in hair analysis, and the findings are considered important for interpreting further results in single hair analysis.

Long-term use of the hybrid artificial pancreas by adjusting carbohydrate ratios and programmed basal rate: A reinforcement learning approach

Background and objectivesThe hybrid artificial pancreas regulates glucose levels in people with type 1 diabetes. It delivers (i) insulin boluses at meal times based on the meals’ carbohydrate content and the carbohydrate ratios (CRs) and (ii) insulin basal, between meals and at night, continuously modulated around individual-specific programmed basal rate. The CRs and programmed basal rate significantly vary between individuals and within the same individual with type 1 diabetes, and using suboptimal values in the hybrid artificial pancreas may degrade glucose control. We propose a reinforcement learning algorithm to adaptively optimize CRs and programmed basal rate to improve the performance of the hybrid artificial pancreas. MethodsThe proposed reinforcement learning algorithm was designed using the Q-learning approach. The algorithm learns the optimal actions (CRs and programmed basal rate) by applying them to the individual's state (previous day's glucose levels and insulin delivery) based on an exploration and exploitation trade-off. First, outcomes from our simulator were compared to those of a clinical study in 23 individuals with type 1 diabetes and have yielded similar results. Second, the learning algorithm was tested using the simulator with two scenarios. Scenario 1 has fixed meal sizes and ingestion times and scenario 2 has a more realistic eating behavior with random meal sizes, ingestion times, and carbohydrate counting errors. ResultsAfter about five weeks, the reinforcement learning algorithm improved the percentage of time spent in target range from 67% to 86.7% in scenario 1 and 65.5% to 86% in scenario 2. The percentage of time spent below 4.0 mmol/L decreased from 9% to 0.9% in scenario 1 and 9.5% to 1.1% in scenario 2. ConclusionsResults indicate that the proposed algorithm has the potential to improve glucose control in people with type 1 diabetes using the hybrid artificial pancreas. The proposed algorithm is a key in making the hybrid artificial pancreas adaptive for the long-term real life outpatient studies.

Factors Influencing Blood Alkalosis and Other Physiological Responses, Gastrointestinal Symptoms, and Exercise Performance Following Sodium Citrate Supplementation: A Review.

This review aimed to identify factors associated with (a)physiological responses, (b)gastrointestinal (GI) symptoms, and (c)exercise performance following sodium citrate supplementation. A literature search identified 33 articles. Observations of physiological responses and GI symptoms were categorized by dose (< 500, 500, and > 500mg/kg body mass [BM]) and by timing of postingestion measurements (in minutes). Exercise performance following sodium citrate supplementation was compared with placebo using statistical significance, percentage change, and effect size. Performance observations were categorized by exercise duration (very short < 60s, short ≥ 60 and ≤ 420s, and longer > 420s) and intensity (very high > 100% VO2max and high 90-100% VO2max). Ingestion of 500mg/kg BM sodium citrate induced blood alkalosis more frequently than < 500mg/kg BM, and with similar frequency to >500mg/kg BM. The GI symptoms were minimized when a 500mg/kg BM dose was ingested in capsules rather than in solution. Significant improvements in performance following sodium citrate supplementation were reported in all observations of short-duration and very high-intensity exercise with a 500mg/kg BM dose. However, the efficacy of supplementation for short-duration, high-intensity exercise is less clear, given that only 25% of observations reported significant improvements in performance following sodium citrate supplementation. Based on the current literature, the authors recommend ingestion of 500mg/kg BM sodium citrate in capsules to induce alkalosis and minimize GI symptoms. Supplementation was of most benefit to performance of short-duration exercise of very high intensity; further investigation is required to determine the importance of ingestion duration and timing.

Endoscopic retrieval of an accidentally ingested bur during a dental procedure: a case report

BackgroundAccidental ingestion of a dental bur during the dental procedure is a rare, but a potentially serious complication. Early recognition and foreign body retrieval is essential to prevent adverse patient outcomes.Case presentationA 76-year old male patient, presented to the department with a chief complaint of sensitivity in his upper right back tooth due to attrition. After assessing the pulp status, root canal therapy was planned for the tooth. During the procedure, it was noticed that the dental bur slipped out of the hand piece and the patient had accidentally ingested it. The patient was conscious and had no trouble while breathing at the time of ingestion of the bur although he had mild cough which lasted for a short duration. The dental procedure was aborted immediately and the patient was taken to the hospital for emergency care. The presence and location of the dental bur was confirmed using chest and abdominal x-rays and it was subsequently retrieved by esophagogastroduodenoscopy (EGD) procedure under general anaesthesia on the same day as a part of the emergency procedure. The analysis of this case reaffirms the importance of the use of physical barriers such as rubber dams and gauze screens as precautionary measures to prevent such incidents from occurring.ConclusionIngestion of instruments are uncertain and hazardous complications to encounter during a dental procedure. The need for physical barrier like rubber dam is mandatory for all dental procedures. However, the dentist should be well trained to handle such medical emergencies and reassure the patient by taking them into confidence. Each incident encountered should be thoroughly documented to supply adequate guidance for treatment aspects. This would fulfil the professional responsibilities of the dentist/ clinician and may help avoid possible legal and ethical issues. This case report emphasizes on the need for the usage of physical barriers during dental procedures in order to avoid medical emergencies.

Methods of feeding colostrum and their effect on the passive immunity

Passive transport of colostral immunoglobulins is essential for calves to maintain optimal health. There are many factors that influence the absorption of immunoglobulins such as colostrum density, timing of ingestion, volume of colostrum but also the method of feeding. This study compares two manners of feeding calves – the esophageal tube feeder (n = 97) and the nipple bottle (n = 97), and their effect on the number of all absorbed immunoglobulins (IgG, IgM, IgA, IgD, and IgE). It was statistically proven that absorption of immunoglobulins is better with the nipple bottle (P&lt; 0.0001). The feeding of calves through a nipple bottle is more beneficial because the content of total protein is the higher than by the feeding through an esophageal tube feeder.