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Lack of preformed long-chain polyunsaturated fatty acids (LCPUFA) in infant formula has been hypothesised as contributing to cognitive differences between breast-fed and formula-fed infants. Previous systematic reviews found no cognitive differences between infants fed formula with LCPUFA and those fed formula without, but focused on early developmental measures, such as Bayley Scales of Infant Development, which are poorly differentiating and not predictive of cognitive ability in childhood. This systematic review examined the effect of randomising infants to formula supplemented with LCUFA vs unsupplemented formula on cognitive function ≥ age 2.5 years. We searched Medline, Embase the Cochrane Central Register of Controlled Trials without date limit, following a pre-published protocol according to PRISMA guidelines. We conducted random effects meta-analyses in RevMan v5.4 and followed GRADE and Cochrane Guidelines to evaluate strength of evidence and potential for bias. We included 8 trial cohorts which randomised participants between 1993 and 2004 and analyse 6 previously unpublished outcomes provided by various trialists. Age at the last available cognitive test ranged from 3.3 to 16 years. The pooled mean difference in Wechsler Preschool and Primary Scale of Intelligence-Revised from four trials in term-born children showed no benefit of LCPUFA: -0.04 points (95% confidence interval -5.94 to 5.85, 95% prediction interval -14.17 to 14.25). The pooled mean difference in Wechsler Abbreviated Scale of Intelligence score from two trials in preterm-born children also showed no benefit of LCPUFA: -7.71 (95% CI -24.63 to 9.22, 95% PI -97.80 to 82.38). Overall quality of evidence was low, due to substantial heterogeneity, low rates of follow-up, and indications of selective publication. The long-term effect of LCPUFA supplementation in term and preterm-born infants on cognition is highly uncertain and includes potential for large benefit as well as large harm. Based on our findings, LCPUFA supplementation of infant formula is not recommended until further robust evidence excludes long-term harm.

Background Late preterm infants suffer from more complications and are less likely to be breastfed compared to term infants and their mothers experience higher levels of stress than mothers with term infants. The physiological or hormonal responses that influence milk ejection, milk production, and/or maternal behaviour are possible mechanisms by which maternal distress could negatively influence breastfeeding success. Maternal mood might also affect infant behaviour (feeding, sleeping, and crying) through changes in milk volume and composition, and consequently breastfeeding success and infant growth. Previous research, using relaxation therapy in 64 Malaysian first-time mothers breastfeeding their full-term infants, demonstrated that the therapy was effective in reducing maternal stress and improving infant growth. We hypothesise that expected benefits are even greater in a more vulnerable population where additional breastfeeding support is especially needed, such as in mothers of late preterm infants. Methods/design This protocol describes our randomised controlled trial that tests whether a breastfeeding meditation audio reduces maternal stress in mothers of late preterm infants in London. Home visits will be conducted at 2–3 and 6–8 weeks post-delivery. Participants will be randomised to a control group or an intervention group, where mothers will be asked to listen to a meditation tape on a daily basis while breastfeeding. The main outcomes of the intervention will be maternal stress markers and infant weight Z-score. Potential mediators will be the secondary outcomes and include breast milk macronutrient and hormone levels (ghrelin, leptin, cortisol, and adiponectin), milk volume assessed by 48-h test-weighing, and maternal engagement with the infant. Infant behaviour, including crying and sleeping, and infant appetite will be evaluated. Data about other mediators such as maternal perception of milk supply and salivary oxytocin will be collected. Discussion We hypothesise that the use of the breastfeeding meditation will reduce maternal stress and consequently improve infant growth mediated by changes in milk composition and volume and maternal behaviour. This study will allow us to understand the mother–infant factors that influence breastfeeding in late preterm infants and potentially identify a method that could improve mother, infant, and breastfeeding outcomes. Trial registration ClinicalTrials.gov, NCT03791749 . Registered 1 January 2019.

Stress reactivity can be different in women compared to men, which might consequently influence disease risk.Stress in women may also generate adverse physiological effects on their offspring during pregnancy or lactation. The objective of this study was to compare the effects of different relaxation interventions on physiological outcomes and perceived relaxation in healthy young women, to assist in identifying the most appropriate intervention(s) for use in a subsequent trial for mothers who deliver prematurely. A within-subject study was conducted in 17 women of reproductive age comparing five different relaxation interventions (guided-imagery meditation audio (GIM), music listening (ML), relaxation lighting (RL), GIM+RL, ML+RL), with control (silence/sitting), assigned in random order over a 3-6 week period. Subjective feelings of relaxation (10-point scale), heart rate (HR), systolic and diastolic blood pressure (SBP, DBP), and fingertip temperature (FT) were measured before and after each technique. All interventions significantly increased perceived relaxation and FT, while music also significantly reduced SBP (  < 0.05). Compared to control, HR significantly decreased following GIM (mean difference = 3.2 bpm,  < 0.05), and FT increased (mean difference = 2.2 °C,  < 0.05) and SBP decreased (mean difference = 3.3 mmHg,  < 0.01) following ML. GIM + RL followed by GIM were the most preferred interventions. Based on preference, simplicity, and the physiological and psychological effects, GIM and ML were identified as the most effective tools for reducing stress and improving relaxation. These techniques warrant further research in larger samples and other populations.

Breast milk is an unparalleled source of nutrition that is particularly beneficial to infants who are born early. Breastfeeding also involves signalling between parent and offspring through biological (breast milk) and non-biological (behavioural) pathways. Maternal stress is one modifiable variable that could influence the signals being transmitted and that could negatively affect breastfeeding success and infant growth. In this thesis, I aimed to investigate the evolutionary, physiological, psychological and behavioural aspects of mother-infant signalling during breastfeeding using an experimental design to improve outcomes among a sample of mothers and their late preterm and early term infants. Maternal stress was manipulated using a relaxation intervention to test whether the intervention would result in stress reduction and higher infant weight gain. Secondary outcomes of the intervention were also studied including infant behaviour (crying, sleeping, appetite), maternal engagement with the infant (responsiveness, attachment), maternal verbal memory, breastfeeding frequency, breast milk volume, and breast milk composition. I also explored whether maternal capital, as an indicator of maternal resources available for investment, is associated with infant outcomes, and whether the relaxation intervention modifies the relationship between these variables. Participants recruited from three hospitals in London were randomised to the intervention group (n=35), where they were asked to listen to a meditation recording while breastfeeding from 3 weeks post-delivery, or the control group (n=37) where no intervention was given. Home visits were conducted at 2-3 weeks and 6-8 weeks post-delivery where information about the mother, infant and breastfeeding was gathered. I also collected breast milk and saliva samples at both times points for macronutrient and hormone analysis. The relaxation intervention was effective in increasing infant weight gain, reducing maternal cortisol, shortening infant crying duration, improving maternal cognitive function and increasing breastfeeding frequency. Maternal capital was associated with infant, maternal and breastfeeding outcomes, and the relaxation therapy modified the relationship between these measures where it was particularly beneficial to mothers of lower maternal capital. Overall, this thesis provides evidence for improving mother-infant signalling using a simple experimental approach in an understudied population and discusses the findings from an anthropological and biological perspective.

Breastfeeding involves signaling between mother and offspring through biological (breast milk) and behavioral pathways. This study tested this by examining the effects of a relaxation intervention in an understudied infant population. Breastfeeding mothers of late preterm (340/7–366/7 weeks) and early term (370/7–386/7 weeks) infants were randomized to the relaxation group (RG, n = 35), where they were asked to listen to a meditation recording while breastfeeding from 3 weeks post-delivery, or the control group (CG, n = 37) where no intervention was given. Primary outcomes-maternal stress and infant weight-were assessed at 2–3 (baseline) and 6–8 weeks post-delivery. Secondary outcomes included infant length, infant behavior, maternal verbal memory, salivary cortisol, and breast milk composition. Infants in the RG had significantly higher change in weight-for-age Z-score compared to those in CG (effect size: 0.4; 95% CI: 0.09, 0.71; p = 0.01), and shorter crying duration [RG: 5.0 min, 0.0–120.0 vs. CG: 30.0 min, 0.0–142.0; p = 0.03]. RG mothers had greater reduction in cortisol (effect size: −0.08 ug/dL, 95% CI −0.15, −0.01; p = 0.03) and better maternal verbal learning score (effect size: 1.1 words, 95% CI 0.04, 2.1; p = 0.04) than CG mothers, but did not differ in stress scores. A simple relaxation intervention during breastfeeding could be beneficial in promoting growth of late preterm and early term infants. Further investigation of other potential biological and behavioral mediators is warranted.

Due to the present industrial world, the risk of radioactivity is notably increasing. Thus, an appropriate shielding material needs to be designed to protect humans and the environment against radiation. In view of this, the present study aims to design new composites of the main matrix of bentonite–gypsum with a low-cost, abundant, and natural matrix. This main matrix was intercalated in various amounts with micro- and nanosized particles of bismuth oxide (Bi2O3) as the filler. Energy dispersive X-ray analysis (EDX) recognized the chemical composition of the prepared specimen. The morphology of the bentonite–gypsum specimen was tested using scanning electron microscopy (SEM). The SEM images showed the uniformity and porosity of a cross-section of samples. The NaI (Tl) scintillation detector was used with four radioactive sources (241Am, 137Cs, 133Ba, and 60Co) of various photon energies. Genie 2000 software was used to determine the area under the peak of the energy spectrum observed in the presence and absence of each specimen. Then, the linear and mass attenuation coefficients were obtained. After comparing the experimental results of the mass attenuation coefficient with the theoretical values from XCOM software, it was found that the experimental results were valid. The radiation shielding parameters were computed, including the mass attenuation coefficients (MAC), half-value layer (HVL), tenth-value layer (TVL), and mean free path (MFP), which are dependent on the linear attenuation coefficient. In addition, the effective atomic number and buildup factors were calculated. The results of all of these parameters provided the same conclusion, which confirms the improvement of the properties of γ-ray shielding materials using a mixture of bentonite and gypsum as the main matrix, which is much better than using bentonite alone. Moreover, bentonite mixed with gypsum is a more economical means of production. Therefore, the investigated bentonite–gypsum materials have potential uses in applications such as gamma-ray shielding materials.

Aims This study aimed to investigate whether the response to adding metformin to insulin in young adults with type 1 diabetes (T1D) differs according to weight phenotype and insulin sensitivity index. Methods A prospective pilot study was conducted over 26 weeks in which insulin plus metformin (2 g/day) was administered to 35 individuals, ranging from normal weight (NW) to overweight (OW) to obese (OB) T1D individuals, to correlate insulin sensitivity indices and other clinical variables. Results At the end of the follow-up period, all groups showed an increase in the eGDR (NW: 7.37 vs 8.16, p = 0.002; OW: 7.28 vs 8.24, p < 0.001; OB: 6.33 vs 7.52 p < 0.001). K ITT and SEARCH SCORE improved only in the OB group (2.15 vs 3.14, p < 0.001 and 5.26 vs 5.72, p = 0.007, respectively). Furthermore, HbA1c and BMI were significantly greater in the OB group (− 0.62%, p < 0.001; − 1.12 kg/m 2 , p = 0.031, respectively). Regression analysis revealed that the serum levels of triglycerides and uric acid were significantly (0.059, p = 0.013; 0.076, p = 0.001) associated with insulin sensitivity indices. Conclusions The study showed that eGDR improved independently of basal weight after metformin treatment. However, the K ITT and SEARCH indices improved only in the obese group. Triglycerides and uric acid are associated with insulin sensitivity indices. These results highlight the heterogeneity of the mechanisms underlying insulin resistance and its response to metformin in individuals with T1D.

Tularemia is an extremely contagious zoonotic illness resulting from infection with the intracellular bacterium Francisella tularensis . It is transmitted primarily via vector bites particularly from ticks, flies, and mosquitoes and is a severe public health threat. Because of its high virulence, low infective dose, aerosol transmissibility, and potential for mass casualties, F. tularensis is also considered a potential biological warfare agent. Despite its severity, there is presently no licensed vaccine against this pathogen. In the present work, a subtractive proteomics pipeline was implemented to identify potential antigenic targets to prepare a multi-epitope vaccine. Five vaccine constructs were generated through the combination of B-cell, HTL, and CTL epitopes with suitable adjuvants and linkers. Among these, two constructs V1 and V2 were extremely non-allergenic and antigenic. To assess immune receptor engagement, molecular docking was conducted with TLR4 and TLR5, followed by 200 ns molecular dynamics simulations. Vaccine-receptor complexes were analyzed using RMSD, RMSF, radius of gyration (Rg), Dynamic Cross-Correlation Matrix (DCCM), SASA, PCA, H-bond analysis and MMPBSA binding energy calculations, all confirming structural stability and strong binding affinity. In-silico cloning revealed a GC content of 50% and 1.0 codon adaptation index (CAI), suggesting high expression potential in E. coli . Immune simulation further supported the construct`s ability to elicit a robust and long-lasting immunity. These computational findings highlight the potential of the constructed vaccines as effective candidates against F. tularensis , though experimental substantiation is requisite.

Feline sporotrichosis due to Sporothrix brasiliensis is frequently severe and often correlated to zoonotic transmission. Feline Immunodeficiency Virus (FIV) and Feline Leukemia Virus (FeLV) cause immunodeficiency in cats; no association has been identified with critical cases of sporotrichosis. Moreover, the cytokine profile in Sporothrix-infected cats and a potential impact of retrovirus co-infections on their immunity is unknown. This study assessed immunological parameters in cats with sporotrichosis with and without FIV or FeLV co-infection. FeLV infection was detected by antigen ELISA and by provirus PCR. FIV infection was investigated through ELISA and Western blot. Cytokine transcription (IFN-γ, IL-4, IL-5, IL-6, IL-10, IL-12, TNF-α) was quantified using RT-qPCR and lymphocyte subpopulations (CD4, CD8, CD5 and CD21) were assessed by flow cytometry. Thirty cats with sporotrichosis were recruited to the study, including three FIV-positive and five FeLV-positive (progressive infection) cats. One cat with regressive FeLV infection was excluded from statistics. In comparison to retrovirus-negative cats, FIV-positive cats and FeLV-positive cats had higher IL-10 levels, FeLV-positive cats had lower IL-4 levels and FIV-positive cats had lower IL-12 levels and a lower CD4+/CD8+ ratio. Remarkably, all cats with poor general condition were FeLV (progressive infection) or FIV-positive, but the retrovirus status was not associated with the sporotrichosis treatment length or outcome. The immunological changes and the more severe clinical presentation observed in cats with retrovirus co-infections encourage future prospective studies that address the impact of these changes on prognostic determinants of feline sporotrichosis and the development of new therapy strategies that control disease spread.

Introduction Neurofibromatosis type 1 (NF1) is a genetic disorder caused by a mutation in the NF1 gene. This disease presents with various system-based manifestations, including cardiac, musculoskeletal, and neuronal issues, which have been well-studied in previous research and have prompted the development of current and emerging treatments. These treatments, mainly medications targeting specific manifestations of NF1, aim to mitigate the negative impacts of the disease on patients’ lives. NF1 is associated with an increased risk of malignancy and a significant decrease in life expectancy. In this paper, we review the current and emerging treatments for NF1 in relation to its system-based manifestations.MethodsWe conducted an extensive literature search using specific keywords through databases such as PubMed, Scopus, and Cochrane. The articles we found were compiled and subjected to strict inclusion and exclusion criteria.ResultsPharmacological advances have led to the development of products that hold promise as future treatments for NF1. Given the diverse manifestations that can affect multiple organ systems in patients with NF1, it is important to consider a variety of treatment options to achieve optimal results. However, one of the major challenges in diagnosing and treating NF1 is that patients present asymptomatically, making it necessary to rely on clinical features for diagnosis.ConclusionIn conclusion, NF1 is a complex disease with varying manifestations and a growing field of pharmacologic treatments. The information presented in this article synthesizes current knowledge and available therapies for NF1.