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Chronic idiopathic constipation (CIC) is one of the most common gastrointestinal disorders, with a global prevalence of 14%. It is commoner in women and its prevalence increases with age. There are three subtypes of CIC: dyssynergic defaecation, slow transit constipation and normal transit constipation, which is the most common subtype. Clinical assessment of the patient with constipation requires careful history taking, in order to identify any red flag symptoms that would necessitate further investigation with colonoscopy to exclude colorectal malignancy. Screening for hypercalcaemia, hypothyroidism and coeliac disease with appropriate blood tests should be considered. A digital rectal examination should be performed to assess for evidence of dyssynergic defaecation. If this is suspected, further investigation with high resolution anorectal manometry should be undertaken. Anorectal biofeedback can be offered to patients with dyssynergic defaecation as a means of correcting the associated impairment of pelvic floor, abdominal wall and rectal functioning. Lifestyle modifications, such as increasing dietary fibre, are the first step in managing other causes of CIC. If patients do not respond to these simple changes, then treatment with osmotic and stimulant laxatives should be trialled. Patients not responding to traditional laxatives should be offered treatment with prosecretory agents such as lubiprostone, linaclotide and plecanatide, or the 5-HT4 receptor agonist prucalopride, where available. If there is no response to pharmacological treatment, surgical intervention can be considered, but it is only suitable for a carefully selected subset of patients with proven slow transit constipation.

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Hypokinetic dysarthria in Parkinson disease (PD) hinders the ability to verbally communicate and interferes with activities of daily living. SPEAK OUT!® is a therapy program designed to improve functional communicative ability. In contrast to the Lee Silverman Voice Treatment program, SPEAK OUT!® promotes speaking with intent to effect loud speech. This study evaluated the efficacy of SPEAK OUT!® in persons with idiopathic PD in 3 domains: self-reported voice handicap, clinical ratings of dysarthria and prosody, and acoustic analysis of prosody.

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Diabetes is a common complication of pregnancy, and the prevalence of all types of the disease is increasing worldwide. Diabetes in pregnancy is associated with short term and long term adverse effects for mother and child. The goal of treatment of diabetes in pregnancy is to minimize maternal and fetal adverse events related to hyperglycemia. Treatment options vary by type of diabetes, from a focus on lifestyle modifications in gestational diabetes to continuous glucose monitoring and insulin pumps in pregestational diabetes. Nevertheless, given the commonality of hyperglycemia, considerable overlap exists in the treatment of different types of diabetes in pregnancy. Also, despite ongoing research on treatment of diabetes in pregnancy for decades, changes in the characteristics of the patient population have highlighted the limited effectiveness of different therapies. Specifically, despite the co-occurrence of obesity and diabetes, treatment recommendations including glycemic targets are not altered in such cases and a single optimal treatment strategy for each type of diabetes in pregnancy does not seem to exist. Rather, the approach to treating pregnant women with diabetes likely needs to be individualized to maximize the short term and long term health of mother and child. This article will review recent clinical studies to summarize established treatment strategies and introduce novel therapies for diabetes in pregnancy.

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Increasing antibiotic resistance urges for new technologies for studying microbes and antimicrobial mechanism of action. We adapted thermal proteome profiling (TPP) to probe the thermostability of Escherichia coli proteins in vivoE. coli had a more thermostable proteome than human cells, with protein thermostability depending on subcellular location-forming a high-to-low gradient from the cell surface to the cytoplasm. While subunits of protein complexes residing in one compartment melted similarly, protein complexes spanning compartments often had their subunits melting in a location-wise manner. Monitoring the E. coli meltome and proteome at different growth phases captured changes in metabolism. Cells lacking TolC, a component of multiple efflux pumps, exhibited major physiological changes, including differential thermostability and levels of its interaction partners, signaling cascades, and periplasmic quality control. Finally, we combined in vitro and in vivo TPP to identify targets of known antimicrobial drugs and to map their downstream effects. In conclusion, we demonstrate that TPP can be used in bacteria to probe protein complex architecture, metabolic pathways, and intracellular drug target engagement.

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This study was undertaken to analyze if different preparation and exposure periods of eluates from ocular prosthesis acrylic resin influence the cytotoxicity for conjunctival cells.

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With rapid urbanization and increase in car ownership, ambient noise pollution resulting from diversified sources (e.g., road traffic, railway, commercial services) has become a severe environmental problem in the populated areas in China. However, research on the spatial variation of noise pollution and its potential effects on urban residents' mental health has to date been quite scarce in developing countries like China. Using a health survey conducted in Beijing in 2017, we for the first time investigated the spatial distributions of multiple noise pollution perceived by residents in Beijing, including road traffic noise, railway (or subway) noise, commercial noise, and housing renovation (or construction) noise. Our results indicate that there is geographic variability in noise pollution at the neighborhood scale, and road traffic and housing renovation/construction are the principal sources of noise pollution in Beijing. We then employed Bayesian multilevel logistic models to examine the associations between diversified noise pollution and urban residents' mental health symptoms, including anxiety, stress, fatigue, headache, and sleep disturbance, while controlling for a wide range of confounding factors such as socio-demographics, objective built environment characteristics, social environment and geographic context. The results show that perceived higher noise-pollution exposure is significantly associated with worse mental health, while physical environment variables seem to contribute little to variations in self-reported mental disorders, except for proximity to the main road. Social factors or socio-demographic attributes, such as age and income, are significant covariates of urban residents' mental health, while the social environment (i.e., community attachment) and housing satisfaction are significantly correlated with anxiety and stress. This study provides empirical evidence on the noise-health relationships in the Chinese context and sheds light on the policy implications for environmental pollution mitigation and healthy city development in China.

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The aims of the present study were to optimize the operational parameters to maximize the yield of ultrasound-assisted polysaccharide extraction from Volvariella volvacea (straw mushroom) fruiting bodies by using for the first time one-factor-at-a-time and three-level Box-Behnken factorial designs. A maximum polysaccharide yield of 8.28 ± 0.23% was obtained under the optimized conditions of ultrasound power of 175 W, extraction temperature of 57 °C, extraction time of 33 min, and the ratio of liquid to raw material of 25:1, respectively. Compared to the hot-water extraction, the ultrasound-assistance favored the extraction of polysaccharides from V. volvacea for its higher polysaccharide yield and efficiency. Further preliminary polysaccharide structural characterization indicated that ultrasound treatment affected the monosaccharide compositions and ratios, and molecular weight range of polysaccharides extracted from V. volvacea.

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The blends of Poly(propylene carbonate) (PPC) and polyester-based thermoplastic polyurethane (TPU) were melt compounded in an internal mixer. The compatibility, thermal behaviors, mechanical properties and toughening mechanism of the blends were investigated using Fourier transform infrared spectra (FTIR), tensile tests, impact tests, differential scanning calorimetry (DSC), scanning electron microscopy (SEM) and dynamic mechanical analysis technologies. FTIR and SEM examination reveal strong interfacial adhesion between PPC matrix and suspended TPU particles. Dynamic mechanical analyzer (DMA) characterize the glass transition temperature, secondary motion and low temperature properties. By the incorporation of TPU, the thermal stabilities are greatly enhanced and the mechanical properties are obviously improved for the PPC/TPU blends. Moreover, PPC/TPU blends exhibit a brittle-ductile transition with the addition of 20 wt % TPU. It is considered that the enhanced toughness results in the shear yielding occurred in both PPC matrix and TPU particles of the blends.

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Quantitative Structure Activity Relationships (QSAR or SAR) have helped scientists to establish mathematical relationships between molecular structures and their biological activities. In the present article, SAR studies have been carried out on 89 tetrahydroimidazo[4,5,1-jk][1,4]benzodiazepine (TIBO) derivatives using different classifiers, such as support vector machines, artificial neural networks, random forests, and decision trees. The goal is to propose classification models that will be able to classify TIBO compounds into two groups: high and low inhibitors of HIV-1 reverse transcriptase. Each molecular structure was encoded by 10 descriptors. To check the validity of the established models, all of them were subjected to various validation tests: internal validation, Y-randomization, and external validation. The established classification models have been successful. The correct classification rates reached 100% and 90% in the learning and test sets, respectively. Finally, molecular docking analysis was carried out to understand the interactions between reverse transcriptase enzyme and the TIBO compounds studied. Hydrophobic and hydrogen bond interactions led to the identification of active binding sites. The established models could help scientists to predict the inhibition activity of untested compounds or of novel molecules prior to their synthesis. Therefore, they could reduce the trial and error process in the design of human immunodeficiency virus (HIV) inhibitors.