Explore the vast range of titles available.

This paper provides evidence-based and, when appropriate, expert reviewed recommendations for long-stay residents who are prescribed texture-modified diets (TMDs), with the consideration that these residents are at high risk of worsening oropharyngeal dysphagia (OD), malnutrition, dehydration, aspiration pneumonia, and OD-associated mortality, poorer quality of life and high costs. Nestlé Health Science funded an initial virtual meeting attended by all authors, in which the unmet needs and subsequent recommendations for OD management were discussed. The opinions, results, and recommendations detailed in this paper are those of the authors, and are independent of funding sources. OD is common in nursing home (NH) residents, and is defined as the inability to initiate and perform safe swallowing. The long-stay NH resident population has specific characteristics marked by a shorter life expectancy relative to community-dwelling older adults, high prevalence of multimorbidity with a high rate of complications, dementia, frailty, disability, and often polypharmacy. As a result, OD is associated with malnutrition, dehydration, aspiration pneumonia, functional decline, and death. Complications of OD can potentially be prevented with the use of TMDs. This report presents expert opinion and evidence-informed recommendations for best practice on the nutritional management of OD. It aims to highlight the practice gaps between the evidence-based management of OD and real-world patterns, including inadequate dietary provision and insufficient staff training. In addition, the unmet need for OD screening and improvements in therapeutic diets are explored and discussed. There is currently limited empirical evidence to guide practice in OD management. Given the complex and heterogeneous population of long-stay NH residents, some ‘best practice' approaches and interventions require extensive efficacy testing before further changes in policy can be implemented.

The hydrogen economy is a concept focused on this element as a carrier of clean and cheap energy, one of the keys is the storage of this gas safely. In this sense, TiCrV-based alloys have great capacity to store hydrogen. In the present working studied the influence of the process of mechanical milling of high energy in the storage capacity of hydrogen of TiCr1.1 V0.9 alloy. The alloy was synthesized by arc fusion and manually crushed. The effects of mechanical milling were studied for periods of time of 1 hour and 3 hours at 300 revolutions per minute with a weight/weight ratio of the sample 10: 1. The x-ray diffraction analyzes revealed solid phase formation of body center cubic phase, characteristic of TiCrV base alloys, and formation of TiCr1.8H5.3 hydrides and TiH2 hydrides with orthorhombic structure and body center cubic, respectively. The hydrogen storage capacity of the TiCr1.1 V0.9 alloy decreased with the increase in grinding time. The reasons for the drop in hydrogen storage capacity are mainly two: contamination of the surface of the alloy powder and changes in the microstructure generated by the plastic deformation in the grinding process. However, an increase in absorption kinetics was observed at longer milling times because the surface area increases since the crystallite size decreases. This phenomenon can be explained by the catalytic effect produced by the decrease in the particle size of the samples. The differential scanning calorimetry analysis was able to determine that the TiCr1.8H5.3 hydride stored a greater amount of hydrogen and has a lower desorption temperature compared to the TiH2 hydride.

We previously identified niclosamide as a promising repurposed drug candidate for hepatocellular carcinoma (HCC) treatment. However, it is poorly water soluble, limiting its tissue bioavailability and clinical application. To overcome these challenges, we developed an orally bioavailable self-microemulsifying drug delivery system encapsulating niclosamide (Nic-SMEDDS). Nic-SMEDDS was synthesized and characterized for its physicochemical properties, in vivo pharmacokinetics and absorption mechanisms, and in vivo therapeutic efficacy in an orthotopic patient-derived xenograft (PDX)-HCC mouse model. Niclosamide ethanolamine salt (NEN), with superior water solubility, was used as a positive control. Nic-SMEDDS (5.6% drug load) displayed favorable physicochemical properties and drug release profiles in vitro. In vivo, Nic-SMEDDS displayed prolonged retention time and plasma release profile compared to niclosamide or NEN. Oral administration of Nic-SMEDDS to non-tumor bearing mice improved niclosamide bioavailability and C by 4.1- and 1.8-fold, respectively, compared to oral niclosamide. Cycloheximide pre-treatment blocked niclosamide absorption from orally administered Nic-SMEDDS, suggesting that its absorption was facilitated through the chylomicron pathway. Nic-SMEDDS (100 mg/kg, bid) showed greater anti-tumor efficacy compared to NEN (200 mg/kg, qd); this correlated with higher levels ( < 0.01) of niclosamide, increased caspase-3, and decreased Ki-67 in the harvested PDX tissues when Nic-SMEDDS was given. Biochemical analysis at the treatment end-point indicated that Nic-SMEDDS elevated lipid levels in treated mice. We successfully developed an orally bioavailable formulation of niclosamide, which significantly enhanced oral bioavailability and anti-tumor efficacy in an HCC PDX mouse model. Our data support its clinical translation for the treatment of solid tumors.

IntroductionMalnutrition is a highly prevalent chronic condition that contributes to higher morbidity and mortality in patients with multiple comorbidities. While positive effects of nutritional therapy in the in-hospital setting have recently been demonstrated, the benefits of long-term nutritional therapy after hospital discharge remain uncertain. Herein, we outline the design and rationale of the EFFORTII trial, the largest nutritional trial to date to assess the effects of continued nutritional support after hospital discharge in medical patients, with particular attention to key design decisions regarding nutritional strategy, patient selection criteria and study endpoints.Methods and analysisThe Effect of Continued Nutritional Support at Hospital Discharge on Mortality, Frailty, Functional Outcomes and Recovery (EFFORTII) is an investigator-initiated, non-commercial randomised controlled trial designed to evaluate whether ongoing, individualised nutritional therapy after hospital discharge—targeted to meet specific energy and protein requirements—offers a cost-effective approach to lowering mortality, minimising complications and maintaining functional status compared with standard care. Eligible participants are adult, chronically ill medical inpatients at risk of malnutrition. Patients in the intervention group receive individualised nutritional therapy delivered by an experienced dietitian through a combination of telemedicine and in-person consultations. The intervention aims to meet personalised nutritional targets, supported by a trained dietitian. Control group patients receive nutritional counselling at discharge, but no structured nutritional management during follow-up. We designed the trial as an event-driven trial with a target of 247 mortality events (primary endpoint), which will be assessed over approximately 5 years until event-driven endpoint is met. The minimum total sample size is at least 802 participants, based on the assumed treatment HR of 0.70. The main trial is enrolling patients across multiple sites in Switzerland. During the trial, additional sites in Spain joined the study, and their data will be analysed using a patient-level pooled approach.Ethics and disseminationThis study involves human participants and was first granted ethical approval by the Ethics Committee Northwest- and Central Switzerland and then by all participating local ethics committees. Written informed consent will be obtained from all participants. Findings will be disseminated in peer-reviewed journals and academic conferences.Trial registration numberNCT04926597.

IntroductionObesity is a chronic disease associated with other comorbidities, including atherogenic dyslipidemia (AD). Bariatric surgery (BS) has shown to reduce cardiovascular risk (CVR) by achieving a significant weight reduction and improving the lipid profile. Different surgical techniques may have a different effect on the lipoprotein profile.PurposeTo evaluate the lipid profile at 3 years after BS according to the surgical technique used and to determine which variables predict variation in the lipid profile at 3 years after BS.MethodsRetrospective observational study of 206 patients who underwent BS between 2010 and 2019. We analyzed the variation of lipid parameters in the 3 years of follow-up according to the surgical technique, including a group analysis of patients according to whether they had dyslipidemia and whether they were treated or untreated and determined which variables predict variation in the lipid profile at 3 years after BS.ResultsThere was a significant increase in high-density lipoprotein cholesterol (HDL-c) with sleeve gastrectomy (SG) and a significant decrease in total cholesterol (TC), LDL-cholesterol (LDL-c), non-HDL, and LDL/non-HDL with biliopancreatic diversion (BPD). Variables predicting lipid profile variation were surgical technique and pre-surgery lipoprotein level.ConclusionsMalabsorptive techniques achieve a greater decrease in TC and LDL-c throughout follow-up and could also improve residual cardiovascular risk (non-HDL and LDL/non-HDL). The type of surgical technique and the presurgery lipid profile predict variation after 3 years of BS.

Interest in obesity has grown exponentially over the last years, with the availability of highly effective new pharmacological treatment options. The increasing use of pharmacological treatment options has stimulated debates on several fundamental issues, including (1) full recognition of obesity as a disease, and (2) optimization of the diagnostic criteria of obesity and the timing for offering different treatment options. We aim at critically discussing here the similarities, discrepancies, and potential misunderstandings suggested by the European Association for the Study of Obesity (EASO) and Lancet Diabetes Endocrinology Commission statements. In particular, two aspects are discussed: (1) the BMI limitations and the necessity to include visceral fat and, more in general, body composition assessment in the diagnosis of obesity; (2) the opportunity to consider obesity always as a clinically relevant chronic disease due to its biological, psychological, and social characteristics.

The aim of this study was to develop evidence-based recommendations for glycemic control of patients with diabetes mellitus or stress hyperglycemia who are receiving enteral nutrition (EN). A Delphi survey method using Grading Recommendations Assessment, Development and Evaluation criteria was utilized for evaluation of suitable studies. In patients with diabetes or stress hyperglycemia who were on EN support, the following results were found:1.Apply the same goals of metabolic control as applied for all diabetic patients;2.The caloric intake provided by EN should be similar to that of patients without diabetes and with the same clinical condition;3.Determine the percentage of macronutrients based on an individualized assessment of metabolic goals and comorbidities;4.Diabetes-specific EN formulas should contain low-glycemic index carbohydrates and a moderate or high percentage of monounsaturated fatty acids in relation to the total caloric value;5.Specific formulas for diabetes should contain fiber, although its presence is not a determining factor for reduction of postprandial glycemia;6.Diabetes-specific rather than standard hyperproteic formulas in mechanically ventilated patients in the intensive care unit should be used as these formulas not only improve metabolic control, they also may reduce complications from respiratory infections;7.Diabetes-specific formulas should be used for home EN;8.Insulin therapy with basal-bolus regimens should be used for hospitalized patients with hyperglycemia and enteral feeding; and9.Postpyloric route for patients with diabetic gastroparesis requiring enteral feeding is strongly recommended. Benefits of supplementation with vitamins/minerals above standard requirements remain unclear. These recommendations and suggestions regarding enteral feeding in patients with diabetes and hyperglycemia have direct clinical applicability. •The prevalence of diabetes and stress hyperglycemia in people requiring artificial nutrition support is very high and predisposes to a higher morbidity and mortality, particularly when combined with malnutrition.•In patients with diabetes or stress hyperglycemia, we suggest use of diabetic-specific formulas (especially in home enteral nutrition support) and diabetes-specific hyperproteic formulas in the case of mechanically ventilated critically ill patients rather than standard formulas.•In these patients, we suggest applying the same goals of metabolic control as for all diabetic patients.•Diabetes-specific enteral nutrition formulas should contain low-glycemic index carbohydrates and a moderate or high percentage of monounsaturated fatty acids in relation to the total caloric value and also fiber, although its presence is not a determining factor for reducing of postprandial glycemia.•We suggest insulin therapy with basal-bolus regimens for hospitalized patients with hyperglycemia and enteral feeding.

Luca Cardelli Affiliations Microsoft Research, Cambridge, United Kingdom, Department of Computer Science, University of Oxford, Oxford, United Kingdom Rosa D. Hernansaiz-Ballesteros Affiliation: Randall Division of Cell and Molecular Biophysics, King's College London, London, United Kingdom Neil Dalchau Affiliation: Microsoft Research, Cambridge, United Kingdom Attila Csikász-Nagy * E-mail: csikasznagy@gmail.com Affiliations Randall Division of Cell and Molecular Biophysics, King's College London, London, United Kingdom, Pázmány Péter Catholic University, Faculty of Information Technology and Bionics, Budapest, Hungary ORCID http://orcid.org/0000-0002-2919-5601Citation: Cardelli L, Hernansaiz-Ballesteros RD, Dalchau N, Csikász-Nagy A (2017) Efficient Switches in Biology and Computer Science. With the reduction in energy efficiency requirements, biological complexity could have neutrally increased, and, as evolution and engineers both select for dynamical effectiveness (reliability, robustness, and speed), the number of positive feedback loops could have increased in the system (three in AM versus eight in NCC on Fig 7).

Background: The accessory head of the flexor pollicis longus (AHFPL) has an oblique trajectory from medial to lateral aspect of the forearm below the flexor digitorum superficialis muscle and then joins the flexor pollicis longus muscle. When the anterior interosseous nerve (AIN) courses underneath the muscle belly of the AHFPL an entrapment neuropathy may occur, known as anterior interosseous nerve syndrome (AINS). Materials and methods: This descriptive cross-sectional study evaluated 106 fresh upper extremities. When the AHFPL was present, its fascicle was traced up to evaluate the origin site. The morphometric variables were measured using a digital micrometre (Mitutoyo, Japan). The relationship between the AHFLP and the AIN was evaluated. Results: The AHFPL was found in 34 (32.1%) of the 106 forearms. The AHFPL arose from the flexor digitorum superficialis muscle in 16 (47.1%) forearms, the medial epicondyle of the humerus in 10 (29.4%) forearms and the coronoid process of ulna in 8 (23.5%) forearms. The average total length of the AHFPL was 94.11 ± ± 10.33 mm. The AIN was located lateral to the AHFPL in 3 (8.8%) forearms, posterolateral in 7 (20.6%) forearms and posterior in 24 (70.6%) forearms. Conclusions: This study performed in a South American population sample revealed a prevalence of the AHFPL in a lower range compared to previous studies in North Americans and Asians. The AIN coursed more frequently underneath the muscle belly of AHFPL. This finding has clinical significance in the onset of the AINS and the subsequent surgical procedure for the AIN decompression.

The titanium oxide nanotubes have generated great interest in recent years because to the wide variety of applications in which they are used. The reason for this is the excellent surface properties that this material gets after of grow in the anodizing process. These properties can easily modify the electrochemical anodizing process. For this reason, we have analyzed the effect of electrolyte on the morphology and corrosion resistance of titanium oxide nanotubes grown at glycerol with 0.3% w/w ammonium fluoride and 2% v/v distilled water at 30 volts for 1 hour and ethylene glycol with 0.3% w/w ammonium fluoride and 2% v/v distilled water at 40 volts for 30 minutes. The morphology of the surfaces is observed by scanning electron microscopy. The resistance to corrosion of the samples is evaluated by potentiodynamic polarization curves in Hanks solution at 37 °C. The results of the nanotubes grew in glycerol have a length of 0.7 μm with a morphology of the bamboo type, while the nanotubes grown in ethyleneglycol they have a length of 3.3 μm and their morphology is smooth wall. Regarding the corrosion rate, it was determined that the nanotubes grown in glycerol have a higher corrosion rate. Because to these low corrosion rates it is considered that the two surfaces can be used as alternatives to modify orthopedic implant materials.