Bioactive compounds and antioxidant activity of black and green tea available in Bangladesh

People in Bangladesh are traditionally used to consume mainly black tea. However, some tea manufacturing companies are now producing green tea, though in a small scale. To create new knowledge as well as awareness about the consumption of green tea, the present study was carried out to compare the black and green tea available in Bangladesh based on their bioactive compounds and antioxidant activity. A total of eight brands of black tea and two brands of green tea were bought from the supermarkets. Total phenolics, total tannin, total flavonoids, and caffeine content were measured as bioactive compounds, and antioxidant activity was evaluated by using two different methods such as DPPH (1,1- diphenyl-2-picrylhydrazyl) radical-scavenging activity and ABTS+ radical scavenging activity of methanol extracts of black and green tea. Every bioactive compound in black and green tea was found to be significantly different (P < 0.05). The total phenolic content, on average, was measured at 242.46 mg GAE/g dry extract and 763.41 mg GAE/ g dry extract in black and green tea, respectively. Black tea contained 6.47 mg TAE/g dry extract tannin, whereas green tea had much more tannin content, 14.51 mg TAE/g dry extract, which is more than double in amount. On the other hand, the total flavonoid content was almost double in black tea (61.82 mg QE/g dry extract) compared to green tea (31.85 mg QE/g dry extract). Antioxidant activities were determined at different concentrations of tea samples. At every concentration, green tea presented higher ABTS+ and DPPH radical scavenging activity than black tea. The highest percentage of inhibition was observed at 20 ppm both in black and green tea, finding 98.50 % and 99.07 % inhibition, respectively. Overall, significantly (P < 0.05) higher amount of phenolic compounds as well as antioxidant activity were observed in green tea.

Phytochemicals from Ajwa dates pulp extract induce apoptosis in human triple-negative breast cancer by inhibiting AKT/mTOR pathway and modulating Bcl-2 family proteins

Ajwa dates (Phoenix dactylifera L.) have been described in traditional and alternative medicine to provide several health benefits, but their mechanism of apoptosis induction against human triple-negative breast cancer MDA-MB-231 cells remains to be investigated. In this study, we analyzed the phytoconstituents in ethanolic Ajwa Dates Pulp Extract (ADPE) by liquid chromatography-mass spectrometry (LC-MS) and investigated anticancer effects against MDA-MB-231 cells. LC-MS analysis revealed that ADPE contained phytocomponents belonging to classes such as carbohydrates, phenolics, flavonoids and terpenoids. MTT assay demonstrated statistically significant dose- and time-dependent inhibition of MDA-MB-231 cells with IC50 values of 17.45 and 16.67 mg/mL at 24 and 48 h, respectively. Hoechst 33342 dye and DNA fragmentation data showed apoptotic cell death while AO/PI and Annexin V-FITC data revealed cells in late apoptosis at higher doses of ADPE. More importantly, ADPE prompted reactive oxygen species (ROS) induced alterations in mitochondrial membrane potential (MMP) in ADPE treated MDA-MB-231 cells. Cell cycle analysis demonstrated that ADPE induced cell arrest in S and G2/M checkpoints. ADPE upregulated the p53, Bax and cleaved caspase-3, thereby leading to the downregulation of Bcl-2 and AKT/mTOR pathway. ADPE did not show any significant toxicity on normal human peripheral blood mononuclear cells which suggests its safe application to biological systems under study. Thus, ADPE has the potential to be used as an adjunct to the mainline of treatment against breast cancer.

Long noncoding RNAs RN7SK and GAS5 Regulate Macrophage Innate Immune Function and Polarization

Objective:

Macrophages (Mϕ) are polarized in two phenotypes: classically activated M1 phenotype and alternatively activated M2 phenotype to marginalize the pathogenic/non-pathogenic threat. Burgeoning reports are now elucidating the regulatory role of lncRNAs in various immune process. In this study, we aimed to identify the lncRNAs that mediate Mϕ function and polarization.

Methods:

CD14+ monocytes isolated from PBMCs and differentiated to M1 and M2Mϕ, using GM-CSF or M-CSF, respectively. Expression of 88 different lncRNAs was examined by RT-qPCR. Cells transfected with siRNAs targeting RN7SK, GAS5, IPW and ZFAS1 were examined for Mϕ polarization markers and innate immune functions (phagocytosis and antigen uptake/processing).

Results:

Our results show differential expression of seventeen lncRNAs in M2Mϕ compared to monocytes including RN7SK, GAS5, IPW and ZFAS1. Knockdown of RN7SK and GAS5 showed downregulation of M2 surface markers (CD163, CD206 or Dectin) and concomitant increase in M1 markers (MHC II or CD23). M1/M2 markers were not impacted by IPW or ZFAS1 knockdown. mRNA levels of polarization markers were not effected by RN7SK or GAS5 RNAi. We observed enhanced antigen uptake and processing both in M1/M2 Mϕ transfected with siRNA targeting GAS5 and RN7SK but not IPW and ZFAS1. In addition, knockdown of RN7SK significantly augmented labelled E.coli uptake by M1/M2 Mϕ, while no significant difference was noticed in GAS5 silenced cells.

Conclusion:

This study clearly deciphered that remarkable changes in lncRNA occur during monocyte to Mϕ differentiation, polarization and regulate integral innate functions of Mϕ. Manipulation of lncRNAs could be tested in therapeutic reversal of pro and anti-inflammatory pathologies.

Optimal NH4 + /NO3 - ratios enhance the shade tolerance of soybean seedlings under low light conditions

In the maize-soybean intercropping system, shade is the major chronic restraint that affects normal growth of soybean. Different spatial patterns of this system affect the microclimate of soybean through shading from maize plants. However, the negative impacts of shading stress can be mitigated by providing optimal ratios of different fertilizers. Therefore, to test this hypothesis, soybean plants were grown under different light conditions (normal light or shade) to evaluate the response to varying NH4 + /NO3 - ratios. Seeds of soybean (Glycine max L. cv. Nan-99-6) were grown in nutrient solution with a total concentration of 5 mM N using different NH4 + /NO3 - ratios (T0  = 0:0, T1  = 0:100, T2  = 25:75, T3  = 50:50 and T4  = 75:25) for 40 days in a greenhouse at PPFD 320.95 μmol m-2  s-1 (low light) or 967.53 μmol m-2  s-1 (normal light). Under low light, growth and photosynthesis of soybean seedlings significantly decreased as compared to normal light conditions. However, the optimal ratios of NH4 + / NO3 - improved growth and photosynthesis of soybean seedlings under both light conditions. Our results indicated that soybean seedlings supplied with optimal NH4 + /NO3 - ratios (25:75 and 50:50) have maximum biomass yield, chlorophyll pigments, leaf gas exchange, photochemical activity and root growth as compared to low and high NH4 + /NO3 - ratios (T1 and T4 ). High ratios of NH4 + /NO3 - (T4 ) resulted in reduced plant growth due to nutrient accumulation in plant tissues; therefore, we suggest that optimal ratios of NH4 + /NO3 - (T2 and T3 ) can enhance the shade tolerance of soybean seedlings.

Tracheostomy, ventilatory wean, and decannulation in COVID-19 patients

PURPOSE

COVID-19 patients requiring mechanical ventilation can overwhelm existing bed capacity. We aimed to better understand the factors that influence the trajectory of tracheostomy care in this population to facilitate capacity planning and improve outcomes.

METHODS

We conducted an observational cohort study of patients in a high-volume centre in the worst-affected region of the UK including all patients that underwent tracheostomy for COVID-19 pneumonitis ventilatory wean from 1st March 2020 to 10th May 2020. The primary outcome was time from insertion to decannulation. The analysis utilised Cox regression to account for patients that are still progressing through their tracheostomy pathway.

RESULTS

At the point of analysis, a median 21 days (IQR 15-28) post-tracheostomy and 39 days (IQR 32-45) post-intubation, 35/69 (57.4%) patients had been decannulated a median of 17 days (IQR 12-20.5) post-insertion. The overall median age was 55 (IQR 48-61) with a male-to-female ratio of 2:1. In Cox regression analysis, FiO2 at tracheostomy ≥ 0.4 (HR 1.80; 95% CI 0.89-3.60; p = 0.048) and last pre-tracheostomy peak cough flow (HR 2.27; 95% CI 1.78-4.45; p = 0.001) were independent variables associated with prolonged time to decannulation.

CONCLUSION

Higher FiO2 at tracheostomy and higher pre-tracheostomy peak cough flow are associated with increased delay in COVID-19 tracheostomy patient decannulation. These finding comprise the most comprehensive report of COVID-19 tracheostomy decannulation to date and will assist service planning for future peaks of this pandemic.

Effect of uniconazole and nitrogen level on lodging resistance and yield potential of maize under medium and high plant density

Lodging in maize results in grain yield reduction. This experiment investigated the effects of different application rates of the growth retardant, uniconazole (UCZ), and nitrogen (N) on medium and high maize population densities on lodging resistance and yield. UCZ was applied to maize seeds at concentrations of 0 (U₀ ) and 25 (U₂₅ ) mg kg^-1 , and three different N application rates, 0 (N₀ ), 150 (N₁₅₀ ) and 225 (N₂₂₅ ) kg ha^-1 , at plant densities of 75,000 (D₁ ) and 105,000 plants ha^-1 (D₂ ). UCZ application, different N rates and plant population density affected the lodging resistance and yield attributes of maize. The diameter, plumpness, cortex penetration and bending strengths of the internodes were enhanced with UCZ and N application at medium and high plant density, where maximum values were obtained with U₂₅ N₁₅₀ D₁ . Internode length increased in the high-density population and higher N rate, whereas UCZ reduced internode length, where maximum internode length was obtained with U₀ N₂₂₅ D₂ . Plant height, centre of gravity height, ear and height above ear-bearing node were higher with the high N rate, while UCZ reduced it significantly. UCZ, N rate and plant density enhanced lignin accumulation in the third internode and ear-bearing internode, where maximum values were obtained with U₂₅ N₁₅₀ D₁ . Yield and yield attributes were also improved by UCZ, N rate and population density. Treatment with U₂₅ N₁₅₀ D₂ significantly improved grain yield of maize compared with the other treatments.

Fuzzy bipolar soft semiprime ideals in ordered semigroups

In this paper, we introduce fuzzy bipolar soft semiprimality in the structure of ordered semigroups and investigate some properties of the concept. Moreover, ordered semigroups and their some classes are characterized by means of fuzzy bipolar soft semiprimality. Finally, the Cartesian product of fuzzy bipolar soft semiprime (resp., prime) ideals over ordered semigroups is examined. Some of the ideas are supported by apt examples.

Effects of Bacillus sp. MR-1/2 and magnetite nanoparticles on yield improvement of rice by urea fertilizer under different watering regimes

AIMS

The present research aimed to examine the use of magnetite nanoparticles (MNPs) in combination with phyto-beneficial rhizobacterium (PhBR) for improvement of applied N recovery (ANR) from urea fertilizer in rice grown under deficient and optimum watering conditions.

METHODS AND RESULTS

The Bacillus sp. MR-1/2 was positive for acetylene reduction, phosphate solubilization and ACC deaminase activity at temperature ranges 35-45°C. In a pot experiment, urea, MNPs and Bacillus sp. MR-1/2 were applied either alone or in combination to rice plants grown in pots under water deficit and optimal watering conditions. Combined application of urea, MNPs and Bacillus sp. MR-1/2 increased the plant N content and ANR by 27 and 65%, respectively, over their respective control values in rice grown under optimum watering conditions, whereas these increases were 27 and 41%, respectively, in rice grown under water deficit conditions. This treatment also increased the kernel weight and plant dry matter by 36 and 60%, respectively, over control (urea alone) values in rice grown under water deficit conditions, whereas these increases were 31 and 21·8%, respectively, in rice grown under optimum watering conditions. Values of malondialdehyde (MDA) contents, ascorbate peroxidase (APX), catalase and ethylene concentration were higher in control treatment under both the watering regimes. The application of Bacillus sp. MR-1/2 either alone or in combination with MNPs and urea reduced MDA contents, APX, catalase and ethylene production in the rice plants.

CONCLUSION

The combined application of MNPs+Bacillus sp. MR-1/2 reduced the N losses from applied urea, increased N uptake and ANR in rice, decreased MDA contents, APX and catalase activity and ethylene level in rice grown under deficit and optimum water conditions.

SIGNIFICANCE AND IMPACT OF THE STUDY

The application of MNPs together with Bacillus sp. MR-1/2 may help to increase ANR and rice productivity under water deficit conditions with low cost of production.

Resistance training exercises for obese and non-obese individuals living in high-altitude regions utilizing biochemical markers-A controlled trial

Background

High-altitude disease prevalence varies according to types of exposure and the effects of hypoxic and hypobaric environments, with the result that people at high altitudes present many different physiological responses.

Aims

The research aims to analyze the effects of resistance training (RT) exercises at high altitudes on obese subjects and to explain the determinants that make obese people more susceptible to various chronic illnesses such as diabetes mellitus, hypertension, asthma, etc.

Methods

This study recruited 225 subjects living in the high-altitude region of Aseer, Saudi Arabia, and divided them into three groups. The first two groups consisted of obese people, out of which one group received RT and one did not. The third group consisted of average-weight individuals, according to their BMI, who received RT. Biochemical parameters were checked for all three groups before commencing with the RT and at the 4^th and 8^th week to measure the effects of the exercise.

Results

Mean and standard deviations of the demographic variables: age was 34.2 ± 8.9 years, weight was 69.3 ± 8.5 kg, and height was 1.6 ± 0.06 meters. RT had a significant effect on the total levels of cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, adiponectin, interleukin-6, and testosterone. Post-hoc comparisons using the Fisher's Least Significant Difference test indicated that the mean scores between the groups differed significantly.

Conclusion

Our findings show that RT would be a useful and practical substitute to improve the health status of obese patients. It helps to decrease body fat and to improve lipid profiles and hormonal control.

Normative reference values for functional, lateral, and oblique direction reach tests in Saudi children aged six to 15 years old and psychometric properties of the oblique direction reach test

Aims

To establish normative values for functional, lateral, and Oblique Direction Reach Tests (ODRT) and to assess the validity and reliability of the ODRT in Saudi children of age 6-15 years.

Methods

Three hundred Saudi children of age 6-15 years children were recruited by using snowball sampling. Children were measured for distance reached in forward, lateral, and oblique direction on a graph paper, which was mounted on a wall/cardboard.

Results

The Mean ± SD for forward, lateral and oblique direction reach was 25.63 ± 6.95, 18.91 ± 5.66, 22.08 ± 5.98 cm respectively. The Intraclass Correlation Coefficient values of intra and inter-rater reliability of ODRT shown to be 0.94 and 0.91, respectively. Concurrent validity of ODRT with forward and lateral reach test is 0.87 and 0.84, respectively.

Conclusion

: We established the normal values for functional, lateral, and ODRT in 6-15 years of Saudi children. We found that ODRT is a valid and reliable for measuring limits of stability in oblique direction.

Cytotoxicity of Moringa oleifera fruits on human liver cancer and molecular docking analysis of bioactive constituents against caspase-3 enzyme

Moringa oleifera is an excellent source of phenolics and flavonoids comprise various pharmacological activities. The fourth widespread leading cause of the patients' death is liver cancer. This study was formulated to perform the antiproliferative activity of Moringa oleifera fruit (MOF) extract on human liver cancer HepG2 cells and computational validation of cell death. HepG2 cell line was treated with 25, 50, 75, 100, and 200 µg/ml of MOF extract for 48 hr, and antiproliferative activity was analyzed using MTT assay, nuclear condensation, annexin V-FITC/PI double stain, ROS generation, and apoptosis executioner enzyme caspase-3. MOF extract reduced the cell viability significantly (p ˂ .05) by increasing cellular apoptosis which was confirmed by annexin V-FITC/PI staining assay. In addition, MOF stimulated intracellular ROS production and subsequently induced caspase-3 activity depending upon dose. In silico analysis revealed the good binding interaction between amino acid residues of caspase-3 (PDB ID: 1GFW) protein and selected active constituents of MOF. PASS analyses of the phytoconstituents showed no violation of Lipinski's rule of five. Analysis of drug-likeness and toxicity measurement exhibited drug-like candidates with no predicted toxicity. In conclusion, this study showed the potential anticancer activity of MOF extract which may be valuable source for anticancer drug development. PRACTICAL APPLICATIONS: Moringa oleifera fruit extract induced the anti-proliferative activity against human hepatocellular carcinoma HepG2 cells through ROS-mediated apoptosis and activation of caspase-3 enzyme. Structure-based virtual screening study between bioactive components of Moringa oleifera fruits and apoptosis executioner caspase-3 enzyme has validated the anti-proliferative activity of Moringa oleifera fruit extract. Interestingly, active phytoconstituents of Moringa oleifera fruit exhibited drug-like candidates with no predicted toxicity. Thus, Moringa oleifera fruit could be used as valuable source for anticancer drug development against human liver cancer with relatively non-toxic to healthy cells.

Assessment of lymphovascular invasion in early stage endometrial carcinoma -a retrospective study

Introduction

Endometrial carcinoma is associated with several known prognostic factors. Recently, lymphovascular invasion (LVI) has gained a prominent position in the risk assessment of early endometrioid endometrial carcinoma, in identifying patients who can benefit from adjuvant radiation therapy. This study aims to assess LVI in early-stage endometrioid endometrial carcinoma accurately with emphasis on its extent /grading. We also propose a few local recommendations for improving LVI reproducibility in endometrial carcinoma to guide future studies.

Methods

The duration of this retrospective study was 2 years. Early-stage I (Ia and Ib), and grade 1 and 2 endometrioid endometrial carcinomas were included. 03 reviewers independently recorded their findings on H&E stained slides. LVI was graded as none, focal and substantial. In discordant cases, immunohistochemical stain CD 31 was used.

All the data was entered in the statistical software SPSS version 26 and analyzed for frequencies. The relationships between various histological parameters assessed and the degree of reproducibility for LVI amongst various observers were also determined.

Results

Out of a total of 70 cases of endometrioid carcinoma diagnosed on hysterectomy specimen, only 32 met our inclusion criteria. The rate of LVI positivity was 6.3 %, 34.4 %, and 37.5 % respectively for reviewers 1, 2, and 3. The degree of reproducibility in LVI assessment and LVI grading was significant amongst reviewers 2 and 3. Also, a significant association was drawn between tumor grade and LVI.

Conclusion

Despite limitations in our study we recommend including both LVI assessment and grading in routine reporting formats locally. By adding a second reviewer in LVI assessment and using CD31 in discrepant cases LVI positivity can be significantly increased.

Awake tracheal intubation with the ProVu™ video stylet: a case series

Management of the difficult airway is integral to peri-operative practice. The development of devices to simplify airway handling are changing our approach to tracheal intubation. We report a case series of three patients who underwent awake tracheal intubation with the ProVu™ video stylet (Flexicare Medical Ltd, Mountain Ash, UK). All three patients had predicted difficult airways, including: limited mouth opening secondary to radiotherapy; previous exenteration, hemi-maxillectomy and scapular free flap formation; and cervical fixation. Awake tracheal intubation was performed successfully in all three cases, with no complications reported. This is the first reported case series of the ProVu™ video stylet as an awake tracheal intubation device. The benefits and limitations of this video stylet are discussed.

D4 and D5 dopamine receptor mRNA expression in human peripheral blood lymphocytes among cooccurring opioid and amphetamine-type stimulants use disorder undergoing methadone maintenance therapy

Introduction: Opioid and amphetamine type stimulant (ATS) exert their rewarding effects by stimulating the dopaminergic system in the mesolimbic area. It has been suggested that dopamine system in peripheral blood lymphocytes reflect the central dopamine system’s activity and pathology, especially in neuropsychiatric diseases including drug addiction. The present study aimed to assess the effect of co-occurring opioid and ATS (COATS) addiction towards mRNA expression of dopamine receptors DRD4 and DRD5 in peripheral blood lymphocytes (PBLs) of drug dependent subjects (n=36) undergoing methadone maintenance therapy in comparison to control subjects (n=36). Materials and methods: Ten mL blood were obtained from the subjects followed by lymphocyte isolation, RNA extraction and reverse transcription. DRD4 and DRD5 mRNA expression in peripheral lymphocytes was assessed using real-time PCR. The DRD4 mRNA expression but not DRD5 was significantly reduced in the peripheral lymphocytes of COATS subjects. Results: Mean expression value for DRD4 was 14.0+0.24 among patients and 13.3+0.25 among control subjects. For DRD5 it was 12.87 + 0.75 among patients and 12.59 + 1.24 among controls. Conclusion: Inconclusion, co-occurring opioid and ATS addiction was associated with persistent deficiency of DRD4 but not DRD5 in PBLs. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.563-568

PPAR-gamma induced AKT3 expression increases levels of mitochondrial biogenesis driving prostate cancer

Peroxisome Proliferator-Activated Receptor Gamma (PPARG) is one of the three members of the PPAR family of transcription factors. Besides its roles in adipocyte differentiation and lipid metabolism, we recently demonstrated an association between PPARG and metastasis in prostate cancer. In this study a functional effect of PPARG on AKT serine/threonine kinase 3 (AKT3), which ultimately results in a more aggressive disease phenotype was identified. AKT3 has previously been shown to regulate PPARG co-activator 1 alpha (PGC1α) localisation and function through its action on chromosome maintenance region 1 (CRM1). AKT3 promotes PGC1α localisation to the nucleus through its inhibitory effects on CRM1, a known nuclear export protein. Collectively our results demonstrate how PPARG over-expression drives an increase in AKT3 levels, which in turn has the downstream effect of increasing PGC1α localisation within the nucleus, driving mitochondrial biogenesis. Furthermore, this increase in mitochondrial mass provides higher energetic output in the form of elevated ATP levels which may fuel the progression of the tumour cell through epithelial to mesenchymal transition (EMT) and ultimately metastasis.

Silver decorated 2D nanosheets of GO and MoS2serve as nanocatalyst for water treatment and antimicrobial applications as ascertained with molecular docking evaluation

In this work, synthesis of graphene oxide (GO) and reduced graphene oxide (rGO) was realized through a modified Hummers route. Different concentrations (5 and 10 wt%) of Ag were doped in MoS₂and rGO using a hydrothermal technique. Synthesized Ag-MoS₂and Ag-rGO were evaluated through XRD that confirmed the hexagonal structure of MoS₂along with the transformation of GO to Ag-rGO as indicated by a shift in XRD peaks while Mo-O bonding and S=O functional groups were confirmed with FTIR. Morphological information of GO and formation of MoS₂nanopetals as well as interlayer spacing were verified through FESEM and HRTEM respectively. Raman analysis was employed to probe any evidence regarding defect densities of GO. Optical properties of GO, MoS₂, Ag-rGO, and Ag-MoS₂were visualized through UV-vis and PL spectroscopy. Prepared products were employed as nanocatalysts to purify industrial wastewater. Experimental results revealed that Ag-rGO and Ag-MoS₂showed 99% and 80% response in photocatalytic activity. Besides, the nanocatalyst (Ag-MoS₂and Ag-rGO) exhibited 6.05 mm inhibition zones againstS. aureusgram positive (G+) and 3.05 mm forE. coligram negative (G-) in antibacterial activity. To rationalize biocidal mechanism of Ag-doped MoS₂NPs and Ag-rGO,in silicomolecular docking study was employed for two enzymes i.e.β-lactamase and D-alanine-D-alanine ligase B (ddlB) from cell wall biosynthetic pathway and enoyl-[acylcarrier-protein] reductase (FabI) from fatty acid biosynthetic pathway belonging toS. aureus. The present study provides evidence for the development of cost-effective, environment friendly and viable candidate for photocatalytic and antimicrobial applications.

CCL25 and CCR9 is a unique pathway that potentiates pannus formation by remodeling RA macrophages into mature osteoclasts

This study elucidates the mechanism of CCL25 and CCR9 in rheumatoid arthritis (RA). RA synovial fluid (SF) expresses elevated levels of CCL25 compared to OA SF and plasma from RA and normal. CCL25 was released into RA SF by fibroblasts (FLS) and macrophages (MΦs) stimulated with IL-1β and IL-6. CCR9 is also presented on IL-1β and IL-6 activated RA FLS and differentiated MΦs. Conversely, in RA PBMCs neither CCL25 nor CCR9 are impacted by 3-month longitudinal TNF inhibitor therapy. CCL25 amplifies RA FLS and monocyte infiltration via p38 and ERK phosphorylation. CCL25-stimulated RA FLS secrete potentiated levels of IL-8 which is disrupted by p38 and ERK inhibitors. CCL25 polarizes RA monocytes into nontraditional M1 MΦs that produce IL-8 and CCL2. Activation of p38 and ERK cascades are also responsible for the CCL25-induced M1 MΦ development. Unexpectedly, CCL25 was unable to polarize RA PBMCs into effector Th1/Th17 cells. Consistently, lymphokine like RANKL was uninvolved in CCL25-induced osteoclastogenesis; however, this manifestation was regulated by osteoclastic factors such as RANK, cathepsin K (CTSK), and TNF-α. In short, we reveal that CCL25/CCR9 manipulates RA FLS and MΦ migration and inflammatory phenotype in addition to osteoclast formation via p38 and ERK activation.

Evaluation of synchronization protocols and methods of early pregnancy diagnosis in dairy cattle

The studies aimed to evaluate the pregnancy rate (PR) for timed artificial insemination (TAI) after G7G-Ovsynch, modified G7G-Ovsynch (MG7G-Ovsynch) and Ovsynch protocols and to assess the accuracy of using pregnancy-associated glycoproteins (PAGs) and plasma progesterone (P4) in pregnancy diagnosis compared with ultrasonography (US). In study 1, Holstein cows (n = 37) were bred by TAI following the G7G-Ovsynch protocol (n = 19) or MG7G-Ovsynch (n = 18). Pregnancy was evaluated by US at days 31, 59, and 87 after breeding. The PR was not different for the G7G-Ovsynch and MG7G-Ovsynch. Blood and milk samples were collected on day 3 after insemination and then weekly through day 59 post TAI in cows diagnosed as not pregnant on day 31 and through day 87 in pregnant cows. PAGs were measured using ELISA and P4 by radioimmunoassay (RIA). In the second study, Holstein cows (n = 212) were bred by TAI following G7G-Ovsynch protocol (n = 110) or standard Ovsynch (n = 102). Cows were subjected to pregnancy diagnosis on days 30, 60, and 90. A subset (n = 15 in each group) was subjected to blood and milk samples on days 30, 45, 60, 75, and 90 to measure PAGs and P4. In study 2, PR was not significantly different between synchronization protocols on days 30, 60, and 90. Pregnancy loss averaged 15% between day 30 and day 90. The use of PAGs and P4 proved equally effective in diagnosis of pregnancy. Thus, G7G-Ovsynch was deemed the protocol of choice in postpartum cows, and PAGs assayed in milk or plasma could be used to diagnose pregnancy.

Thymoquinone with Metformin Decreases Fasting, Post Prandial Glucose, and HbA1c in Type 2 Diabetic Patients

OBJECTIVE

Antihyperglycemic activity of Thymoquinone (TQ) was evaluated in diabetic mouse model and patients.

METHODS

TQ (50 mg/kg) was orally administered daily for 21 days in combination with metformin in diabetic mice and a reduction on blood glucose level was monitored. In human, a 90-day randomized study was carried out in 60 Type 2 Diabetes mellitus patients to evaluate safety and efficacy of TQ administration with metformin in a 3-arm study. Patients in arm 1 (T1) received 1 tablet of metformin SR 1000 mg and 1 tablet of TQ 50 mg once daily. The second arm (T2) patients received 1 tablet of metformin SR 1000 mg and 2 tablets of TQ 50 mg once daily. Patients in arm 3 (R) received 1 tablet of metformin SR 1000 mg only.

RESULTS

The diabetic mice treated with combination of TQ and metformin showed significant decrease in blood sugar compared to those treated with only metformin. In patients who completed the study, the glycated hemoglobin (HbA1c) values in T1, T2 and R decreased after 3 months from 7.2, 7.2 and 7.3 to 6.7, 6.8, and 7.1, respectively. A greater reduction in Fasting Blood Glucose and Post Prandial Blood Glucose was also observed in T1 and T2 arms compared to R.

CONCLUSION

At dose levels of 50 and 100 mg of TQ combined with a daily dose of 1000 mg Metformin demonstrated a reduction in the levels of HbA1c and blood glucose compared to the standard treatment of diabetic patients with metformin alone.

A single-blinded, multicenter, randomized controlled trial to evaluate NeuroSAFE robotic-assisted radical prostatectomy (RARP) versus standard robotic-assisted radical prostatectomy (RARP) in men with localized prostate cancer: NeuroSAFE PROOF—Trial in progress

TPS262

Background: Robot-assisted radical prostatectomy (RARP) offers cure for localised prostate cancer but is associated with considerable toxicity. Potency and urinary continence are improved when the neurovascular bundles (NVBs) are preserved during a nerve-sparing (NS) RARP. The NeuroSAFE (intra-operative frozen section examination of the neurovascular structure adjacent prostate margin) seeks to promote optimal NS to maximise the opportunity for functional recovery without jeopardising oncological safety. The NeuroSAFE technique in RP has never been evaluated against a standard of care in an randomised controlled trial. Methods: This is a pragmatic, multicentre, single-blinded randomised controlled trial (RCT) in which men are allocated in a 1:1 ratio to NeuroSAFE RARP or standard RARP. Men in the NeuroSAFE RARP arm will undergo RARP with NS guided by the NeuroSAFE technique. Men in the standard RARP arm will undergo RARP with NS guided by standard current practice (prostate cancer clinical characteristics, multi-parametric magnetic resonance imaging (mpMRI) recommendations and digital rectal examination (DRE)). Eligible men will have operable localised prostate cancer, will be opting for RARP as primary treatment and will have good baseline erectile function (EF) (as defined by an Internatinoal Index of Erectile Function (IIEF)-5 score >21). The primary outcome is the proportion of men who achieve EF recovery at 12-months according to the IIEF. Oncological safety will be ensured by the independent DMC who will routinely review proportions of men with treatment failure (adjuvant therapy or biochemical recurrence (BCR)) in each arm. A sample size of 404 is estimated required. NeuroSAFE PROOF will continue to follow participant recovery for 5 years following treatment. Key secondary outcomes include patient-reported urinary continence recovery, sexual satisfaction, quality of life, and economic analyses. NeuroSAFE PROOF will be the first RCT of frozen section in radical prostatectomy (RP) in the world. Ethics and dissemination: Ethical approval was obtained from the National Research Ethics Committee North London (17/LO/1978). Results of this study will be disseminated through national and international papers, and to study participants. Clinical trial information: NCT03317990.

healthcareCOVID: a national cross-sectional observational study identifying risk factors for developing suspected or confirmed COVID-19 in UK healthcare workers

Objective

To establish the prevalence, risk factors and implications of suspected or confirmed coronavirus disease 2019 (COVID-19) infection among healthcare workers in the United Kingdom (UK).

Design

Cross-sectional observational study.

Setting

UK-based primary and secondary care.

Participants

Healthcare workers aged ≥18 years working between 1 February and 25 May 2020.

Main outcome measures

A composite endpoint of laboratory-confirmed diagnosis of SARS-CoV-2, or self-isolation or hospitalisation due to suspected or confirmed COVID-19.

Results

Of 6,152 eligible responses, the composite endpoint was present in 1,806 (29.4%) healthcare workers, of whom 49 (0.8%) were hospitalised, 459 (7.5%) tested positive for SARS-CoV-2, and 1,776 (28.9%) reported self-isolation. Overall, between 11,870 and 21,158 days of self-isolation were required by the cohort, equalling approximately 71 to 127 working days lost per 1,000 working days. The strongest risk factor associated with the presence of the primary composite endpoint was increasing frequency of contact with suspected or confirmed COVID-19 cases without adequate personal protective equipment (PPE): 'Never' (reference), 'Rarely' (adjusted odds ratio 1.06, (95% confidence interval: [0.87-1.29])), 'Sometimes' (1.7 [1.37-2.10]), 'Often' (1.84 [1.28-2.63]), 'Always' (2.93, [1.75-5.06]). Additionally, several comorbidities (cancer, respiratory disease, and obesity); working in a 'doctors' role; using public transportation for work; regular contact with suspected or confirmed COVID-19 patients; and lack of PPE were also associated with the presence of the primary endpoint. A total of 1,382 (22.5%) healthcare workers reported lacking access to PPE items while having clinical contact with suspected or confirmed COVID-19 cases.

Conclusions

Suspected or confirmed COVID-19 was more common in healthcare workers than in the general population and is associated with significant workforce implications. Risk factors included inadequate PPE, which was reported by nearly a quarter of healthcare workers. Governments and policymakers must ensure adequate PPE is available as well as developing strategies to mitigate risk for high-risk healthcare workers during future COVID-19 waves.

A prospective, observational, cohort study of airway management of patients with COVID-19 by specialist tracheal intubation teams

PURPOSE

Because of the anticipated surge in cases requiring intensive care unit admission, the high aerosol-generating risk of tracheal intubation, and the specific requirements in coronavirus disease (COVID-19) patients, a dedicated Mobile Endotracheal Rapid Intubation Team (MERIT) was formed to ensure that a highly skilled team would be deployed to manage the airways of this cohort of patients. Here, we report our intubation team experience and activity as well as patient outcomes during the COVID-19 pandemic.

METHODS

The MERIT members followed a protocolized early tracheal intubation model. Over a seven-week period during the peak of the pandemic, prospective data were collected on MERIT activity, COVID-19 symptoms or diagnosis in the team members, and demographic, procedural, and clinical outcomes of patients.

RESULTS

We analyzed data from 150 primary tracheal intubation episodes, with 101 (67.3%) of those occurring in men, and with a mean (standard deviation) age of 55.7 (13.8) yr. Black, Asian, and minority ethnic groups accounted for 55.7% of patients. 91.3% of tracheal intubations were performed with videolaryngoscopy, and the first pass success rate was 88.0%. The 30-day survival was 69.2%, and the median [interquartile range] length of critical care stay was 11 [6-20] days and of hospital stay was 12 [7-22] days. Seven (11.1%) MERIT healthcare professionals self-isolated because of COVID-19 symptoms, with a total 41 days of clinical work lost. There was one reported incident of a breach of personal protective equipment and multiple anecdotal reports of doffing breaches.

CONCLUSION

We have shown that a highly skilled designated intubation team, following a protocolized, early tracheal intubation model may be beneficial in improving patient and staff safety, and could be considered by other institutions in future pandemic surges.

Targeting the BAF complex in advanced prostate cancer

INTRODUCTION

The BRG1/BRM associated factors (BAF) complex is a chromatin remodeling SWI/SNF which is mutated in 20% of cancers. This complex has many interchangeable subunits which may have oncogenic or tumor suppressor activity in a context-dependent manner. The BAF complex is mutated in 35-50% of metastatic prostate cancer (PC); however, its role in advanced disease is unclear. This review attempts to consolidate current knowledge of the BAF complex in PC and explore potential therapeutic approaches.

AREAS COVERED

This review covers the known roles of some BAF subunits, their alterations, and the models which best explain their mechanisms in driving PC. Following this, the authors provide their expert perspective on how this complex could be targeted in the future with a personalized medicine approach.

EXPERT OPINION

Personalized medicine would allow for patient stratification to exploit synthetic lethal strategies in targeting a mutated BAF complex as shown experimentally in other cancers. BAF dependency can also be targeted in patients stratified for other molecular markers such as BRG1 targeting in phosphatase and tensin homolog (PTEN) deficient PC.