Life | July 2024 - Browse Articles

11 pages, 838 KiB

Open AccessReview

From Muscle–Bone Concept to the ArthroMyoFascial Complex: A Pragmatic Anatomical Concept for Physiotherapy and Manual Therapy

by Karl Noten and Robbert van Amstel

Life 2024, 14(7), 799; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070799 (registering DOI) - 25 Jun 2024

Abstract

Background: In physiotherapy, the classic muscle–bone concept is used to translate basic and clinical anatomy. By defining the anatomical structures from superficial to deeper layers which frame the ArthroMyoFascial complex, our aim is to offer clinicians a comprehensive concept of within the muscle–bone [...] Read more.

Background: In physiotherapy, the classic muscle–bone concept is used to translate basic and clinical anatomy. By defining the anatomical structures from superficial to deeper layers which frame the ArthroMyoFascial complex, our aim is to offer clinicians a comprehensive concept of within the muscle–bone concept. Method: This study is a narrative review and ultrasound observation. Results: Based on the literature and ultrasound skeletonization, the ArthroMyoFascial complex is defined. This model clarifies fascial continuity at the joint level, describing anatomical structures from skin to deeper layers, including superficial fascia, deep fascia, myofascia including skeletal muscle fibers, and arthrofascia all connected via connective tissue linkages. This model enhances the understanding of the muscle–bone concept within the larger ArthroMyoFascial complex. Conclusion: The ArthroMyoFascial complex consists of multiple anatomical structures from superficial to deeper layers, namely the skin, superficial fascia, deep fascia, myofascia including muscle fibers, and arthrofascia, all linked within a connective tissue matrix. This model indicates that it is a force-transmitting system between the skin and the bone. This information is crucial for manual therapists, including physiotherapists, osteopaths, chiropractors, and massage therapists, as they all work with fascial tissues within the musculoskeletal domain. Understanding fascia within the muscle–bone concept enhances clinical practice, aiding in therapeutic testing, treatment, reporting, and multidisciplinary communication, which is vital for musculoskeletal and orthopedic rehabilitation. Full article

(This article belongs to the Special Issue Clinical Implications of the Fascial System)

10 pages, 401 KiB

Open AccessArticle

Analysis of Midterm Readmissions and Related Costs after Open and Endovascular Procedures for Aorto-Iliac Occlusive Disease

by Elda Chiara Colacchio, Sabrina Menara, Francesco Squizzato, Michele Piazza, Mirko Menegolo, Franco Grego and Michele Antonello

Life 2024, 14(7), 798; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070798 (registering DOI) - 25 Jun 2024

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Abstract

Background. Readmissions rates and costs were analysed over follow-up for patients who underwent open or endovascular procedures for aorto-iliac occlusive disease (AIOD). Methods. Patients who underwent aorto-bifemoral bypass (ABF) or covered kissing stent (CKS) for AIOD from May 2008 to February 2018 were [...] Read more.

Background. Readmissions rates and costs were analysed over follow-up for patients who underwent open or endovascular procedures for aorto-iliac occlusive disease (AIOD). Methods. Patients who underwent aorto-bifemoral bypass (ABF) or covered kissing stent (CKS) for AIOD from May 2008 to February 2018 were compared in terms of readmission rates, related costs expressed in EUR, freedom from generic readmission (FFGR), and freedom from readmission for surgical reasons (FFRS). Results. ABF had a readmission rate of 16% and CKS of 18% (p = 0.999). The most common cause of readmission was prosthesis limb or stent occlusion. Time to readmission was longer for ABF (35 months [²¹,²²,²³,²⁴,²⁵,²⁶,²⁷,²⁸,²⁹,³⁰,³¹,³²,³³,³⁴,³⁵,³⁶,³⁷,³⁸,³⁹,⁴⁰,⁴¹,⁴²,⁴³,⁴⁴,⁴⁵,⁴⁶,⁴⁷,⁴⁸,⁴⁹,⁵⁰,⁵¹,⁵²,⁵³,⁵⁴,⁵⁵,⁵⁶,⁵⁷,⁵⁸,⁵⁹,⁶⁰,⁶¹,⁶²,⁶³,⁶⁴,⁶⁵,⁶⁶,⁶⁷,⁶⁸,⁶⁹,⁷⁰,⁷¹,⁷²,⁷³,⁷⁴,⁷⁵,⁷⁶,⁷⁷,⁷⁸,⁷⁹,⁸⁰,⁸¹,⁸²] vs. 13.5 months [1–68.7] in the CKS group, p = 0.334). CKS group had higher cumulative re-hospitalisation, ICU stay, and reintervention costs (11569 ± 2216 SEM, 2405 ± 1125, 5264 ± 1230, respectively) and a trend for more readmissions in the first 36 months, without reaching significance. Conclusion. This study reports on a period of time exceeding ninety days. Even if not reaching significance, the CKS group presented a higher trend in readmissions till 36 months and a higher trend in readmission costs, while time-to-readmission was longer in the ABF group. Full article

(This article belongs to the Special Issue Updates in Cardiovascular Medicine: Diagnosis, Treatment and Technical Aspects: 2nd Edition)

22 pages, 1113 KiB

Open AccessArticle

Transcriptomic Analysis Reveals the Effect of Urea on Metabolism of Nannochloropsis oceanica

by Han Zhu, Zhenli Ye, Zhengru Xu and Li Wei

Life 2024, 14(7), 797; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070797 - 24 Jun 2024

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Abstract

The eukaryotic microalga Nannochloropsis oceanica represents a promising bioresource for the production of biofuels and pharmaceuticals. Urea, a crucial nutrient for the photosynthetic N. oceanica, stimulates the accumulation of substances such as lipids, which influence growth and physiology. However, the specific mechanisms [...] Read more.

The eukaryotic microalga Nannochloropsis oceanica represents a promising bioresource for the production of biofuels and pharmaceuticals. Urea, a crucial nutrient for the photosynthetic N. oceanica, stimulates the accumulation of substances such as lipids, which influence growth and physiology. However, the specific mechanisms by which N. oceanica responds and adapts to urea addition remain unknown. High-throughput mRNA sequencing and differential gene expression analysis under control and urea-added conditions revealed significant metabolic changes. This involved the differential expression of 2104 genes, with 1354 being upregulated and 750 downregulated, resulting in the reprogramming of crucial pathways such as carbon and nitrogen metabolism, photosynthesis, and lipid metabolism. The results specifically showed that genes associated with photosynthesis in N. oceanica were significantly downregulated, particularly those related to light-harvesting proteins. Interestingly, urea absorption and transport may depend not only on specialized transport channels such as urease but also on alternative transport channels such as the ABC transporter family and the CLC protein family. In addition, urea caused specific changes in carbon and lipid metabolism. Genes associated with the Calvin cycle and carbon concentration mechanisms were significantly upregulated. In lipid metabolism, the expression of genes associated with lipases and polyunsaturated fatty acid synthesis was highly activated. Furthermore, the expression of several genes involved in the tricarboxylic acid cycle and folate metabolism was enhanced, making important contributions to energy supply and the synthesis and modification of genes and macromolecules. Our observations indicate that N. oceanica actively and dynamically regulates the redistribution of carbon and nitrogen after urea addition, providing references for further research on the effects of urea on N. oceanica. Full article

(This article belongs to the Special Issue Lipid Metabolism, Regulation and Biosynthesis of Microalgae)

10 pages, 3203 KiB

Open AccessArticle

Hydrogen Gas Inhalation Treatment for Coronary Artery Lesions in a Kawasaki Disease Mouse Model

by Wen-Ling Shih, Tsung-Ming Yeh, Kuang-Den Chen, Steve Leu, Shih-Feng Liu, Ying-Hsien Huang and Ho-Chang Kuo

Life 2024, 14(7), 796; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070796 - 24 Jun 2024

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Abstract

Background: Kawasaki disease (KD) is a syndrome primarily affecting young children, typically under the age of five, and is characterized by the development of acute vasculitis. Through extensive research conducted on both murine and human subjects, it has been demonstrated that heightened levels [...] Read more.

Background: Kawasaki disease (KD) is a syndrome primarily affecting young children, typically under the age of five, and is characterized by the development of acute vasculitis. Through extensive research conducted on both murine and human subjects, it has been demonstrated that heightened levels of reactive oxygen species (ROS) play a pivotal role in the development of KD, especial coronary artery lesions (CALs). Hydrogen gas exhibits potent antioxidant properties that effectively regulate ROS production and the inflammatory response. Methods: We used Lactobacillus casei cell wall extract (LCWE)-induced vasculitis in mice as an animal model of KD and treated the mice with hydrogen gas inhalation. Results: We observed significant dilatation and higher Z scores in the left coronary artery (LCA) in D21 and D28 in mice after LCWE treatment compared to the control group (p < 0.001) and a significant resolution of LCA diameters (p < 0.01) and Z scores (p < 0.01) after treatment with inhaled hydrogen gas. We further demonstrated that serum IL-6 expression was higher in mice after LCWE treatment (p < 0.01) and IL-6 significantly decreased after inhaled hydrogen gas therapy (p < 0.001). Conclusion: According to our literature review, this is the first report where hydrogen gas inhalation has been demonstrated to be effective for the treatment of coronary artery dilatation in a KD murine model. Full article

(This article belongs to the Special Issue Vascular Disease: Etiologic, Diagnostic, Prognostic and Therapeutic Research—2nd Edition)

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13 pages, 6081 KiB

Open AccessArticle

Zonisamide Ameliorated the Apoptosis and Inflammation in Cerebellar Tissue of Induced Alcohol Addiction Animal Model

by Fırat Aşır, Fikri Erdemci, Zuhal Çankırı, Tuğcan Korak, Süreyya Özdemir Başaran, Özge Kaplan, Özkan Yükselmiş, Nilüfer Dönmezdil, Hayat Ayaz, Şehmus Kaplan and Selçuk Tunik

Life 2024, 14(7), 795; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070795 - 24 Jun 2024

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Abstract

This study investigated the effects of zonisamide treatment on cerebellar tissues in an experimental alcohol addiction (AA) model and its potential mechanisms of action, particularly regarding apoptotic protease activating factor-1 (APAF-1) and tumor necrosis factor-alpha (TNF-α) expression. Thirty rats were divided into three [...] Read more.

This study investigated the effects of zonisamide treatment on cerebellar tissues in an experimental alcohol addiction (AA) model and its potential mechanisms of action, particularly regarding apoptotic protease activating factor-1 (APAF-1) and tumor necrosis factor-alpha (TNF-α) expression. Thirty rats were divided into three groups: sham, ethanol (EtOH), and EtOH + zonisamide. AA was induced by administering 6 cc of EtOH orally every 8 h for 4 days. Zonisamide (100 mg/kg) was given to rats once daily before EtOH administration. Motor defects were evaluated using an open field maze. Serum TNF-α levels were measured from blood samples. Cerebellar sections were processed for histological examination and immunostained for APAF-1 and TNF-α. Protein interaction networks were constructed using Cytoscape, and functional annotations were performed with ShinyGO (version 0.80) software. The traveled area in the EtOH group was significantly reduced compared to the sham group (p = 0.0005). Rats in the EtOH + zonisamide group covered a larger area, with zonisamide treatment significantly improving locomotor ability compared to the EtOH group (p = 0.0463). Serum TNF-α levels were significantly elevated in the EtOH group compared to the sham group (p < 0.0001) and were significantly decreased in the EtOH + zonisamide group compared to the EtOH group (p = 0.0309). Regular cerebellar histological layers were observed in the sham group, while EtOH induction caused loss of cerebellar tissue integrity, neuronal degeneration, vascular dilatation and congestion, reduced myelin density, and neuropils in the EtOH group. Zonisamide treatment improved these pathologies, enhancing myelination and neuropil formation. Negative APAF-1 and TNF-α expressions were observed across cerebellar layers in the sham group. Due to EtOH toxicity, APAF-1 and TNF-α expression were upregulated in the EtOH group compared to the sham group (p < 0.001 for both). Zonisamide treatment downregulated these protein expressions in the EtOH + zonisamide group compared to the EtOH group (p < 0.001 and p = 0.0087, respectively). APAF-1 was primarily associated with AA through antifolate resistance, endopeptidases, and the interleukin-1 pathway, while TNF-α was predominantly enriched in infections and choline-binding, indicating zonisamide’s impact on immune and inflammatory pathways. In conclusion, zonisamide treatment significantly mitigated ethanol-induced cerebellar damage and inflammation in an AA model. Zonisamide improved locomotor function and reduced serum TNF-α levels, as well as APAF-1 and TNF-α expression in cerebellar tissues. These findings suggest that zonisamide exerts its protective effects by modulating immune and inflammatory pathways, thereby preserving cerebellar integrity and function. Full article

(This article belongs to the Section Pharmaceutical Science)

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27 pages, 8919 KiB

Open AccessArticle

A Case Series and Literature Review of Alveolar Echinococcosis in Kashmir, India: An Emerging Endemic Zone for Echinococcus multilocularis

by Mohammad Sultan Khuroo, Naira Sultan Khuroo and Ajaz Ahmad Rather

Life 2024, 14(7), 794; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070794 - 24 Jun 2024

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Abstract

A prospective study on 110 patients with echinococcosis at Dr. Khuroo’s Medical Clinic, Srinagar, Kashmir, India, from March 2019 to April 2024 identified 12 cases (4 males, 8 females; mean age of 46.58 ± 11.97 years) of Alveolar echinococcosis (AE). Two patients were [...] Read more.

A prospective study on 110 patients with echinococcosis at Dr. Khuroo’s Medical Clinic, Srinagar, Kashmir, India, from March 2019 to April 2024 identified 12 cases (4 males, 8 females; mean age of 46.58 ± 11.97 years) of Alveolar echinococcosis (AE). Two patients were detected through ultrasound examinations carried out for unrelated causes; one presented with features of liver abscess, and nine had pain in the right upper quadrant for a mean period of 2.2 ± 1.79 years. All had the liver as the primary organ involved, with 15 tumor masses of a mean maximum diameter of 9.22 ± 3.21 cm and volume of 426 ± 374.61 cm³. Tumors placed centrally had invaded vessels and the biliary tract in eight patients, and those placed peripherally had invaded the liver capsule and adjacent organs in nine patients. Histologic examination of liver biopsies or resected organs revealed necrotic lesions, calcifications, and granulomatous inflammation with slender, thin-walled vesicles of bizarre configuration that stained strongly eosinophilic with periodic acid Schiff. Two patients had segmental liver resections; one was treated with liver aspiration, while the other nine with advanced disease received chemotherapy with albendazole along with praziquantel. Patients showed clinical improvement on a median follow-up of 12 months (range 1 to 60 months); however, MRI T2-weighted images and ¹⁸F-FDG-PET-CECT scans in two patients showed active disease on follow-up at one and five years, respectively. A systematic review detected 146 cases of AE in India from 1980 to April 2024. Twenty cases were from foreign countries, mostly from Central Asian republics, and 118 (93.65%) of the remaining 126 Indian patients were permanent residents of Kashmir Valley. The disease affected a population of 79,197 residing in 22 villages from 5 border districts of the valley. These villages were either high in or adjacent to the Himalayan mountain range. Disease prevalence in the affected population was 146.47/10⁵ (males 131.53/10⁵ and females 163.18/10⁵) and the incidence was 12.41/10⁵/year (males 11.16/10⁵/year and females 13.81/10⁵/year). Possible causes of the emergence of AE are discussed, and future directions for research to face this challenge arebeen identified. Full article

(This article belongs to the Special Issue Trends in Microbiology 2024)

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Graphical abstract

9 pages, 1389 KiB

Open AccessCommunication

Self-Generated Lower Body Negative Pressure Exercise: A Low Power Countermeasure for Acute Space Missions

by Suhas Rao Velichala, Ryan D. Kassel, Victoria Ly, Donald E. Watenpaugh, Stuart M. C. Lee, Brandon R. Macias and Alan R. Hargens

Life 2024, 14(7), 793; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070793 - 24 Jun 2024

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Abstract

Microgravity in spaceflight produces headward fluid shifts which probably contribute to Spaceflight-Associated Neuro-Ocular Syndrome (SANS). Developing new methods to mitigate these shifts is crucial for preventing SANS. One possible strategy is the use of self-generated lower body negative pressure (LBNP). This study evaluates [...] Read more.

Microgravity in spaceflight produces headward fluid shifts which probably contribute to Spaceflight-Associated Neuro-Ocular Syndrome (SANS). Developing new methods to mitigate these shifts is crucial for preventing SANS. One possible strategy is the use of self-generated lower body negative pressure (LBNP). This study evaluates biological or physiological effects induced by bed rest to simulate adaptations to microgravity. Participants were tested during powered LBNP and dynamic self-generated (SELF) LBNP at 25 mmHg for 15 min. The results were compared to the physiologic responses observed in seated upright and supine positions without LBNP, which served as controls for normal gravitational effects on fluid dynamics. Eleven participants’ (five male, six female) heart rates, blood pressures, and cross-sectional areas (CSA) of left and right internal jugular veins (IJV) were monitored. Self-generated LBNP, which requires mild to moderate physical activity, significantly elevated heart rate and blood pressure (p < 0.01). Self-generated LBNP also significantly reduced right IJV CSA compared to supine position (p = 0.005), though changes on the left side were not significant (p = 0.365). While the effects of SELF and traditional LBNP on IJV CSA were largely similar, traditional LBNP significantly reduced IJV CSA on both sides. Given its low mass, volume, and power requirements, SELF LBNP is a promising countermeasure against SANS. Results from this study warrant longer-term studies of SELF LBNP under simulated spaceflight conditions. Full article

(This article belongs to the Special Issue Microgravity and Spaceflight: New Insights and Potential Defense Strategies)

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14 pages, 435 KiB

Open AccessSystematic Review

Exploring Study Design Foibles in Randomized Controlled Trials on Convalescent Plasma in Hospitalized COVID-19 Patients

by Massimo Franchini, Carlo Mengoli, Arturo Casadevall and Daniele Focosi

Life 2024, 14(7), 792; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070792 - 22 Jun 2024

Viewed by 425

Abstract

Background: Sample size estimation is an essential step in the design of randomized controlled trials (RCTs) evaluating a treatment effect. Sample size is a critical variable in determining statistical significance and, thus, it significantly influences RCTs’ success or failure. During the COVID-19 [...] Read more.

Background: Sample size estimation is an essential step in the design of randomized controlled trials (RCTs) evaluating a treatment effect. Sample size is a critical variable in determining statistical significance and, thus, it significantly influences RCTs’ success or failure. During the COVID-19 pandemic, many RCTs tested the efficacy of COVID-19 convalescent plasma (CCP) in hospitalized patients but reported different efficacies, which could be attributed to, in addition to timing and dose, inadequate sample size estimates. Methods: To assess the sample size estimation in RCTs evaluating the effect of treatment with CCP in hospitalized COVID-19 patients, we searched the medical literature between January 2020 and March 2024 through PubMed and other electronic databases, extracting information on expected size effect, statistical power, significance level, and measured efficacy. Results: A total of 32 RCTs were identified. While power and significance level were highly consistent, heterogeneity in the expected size effect was relevant. Approximately one third of the RCTs did not reach the planned sample size for various reasons, with the most important one being slow patient recruitment during the pandemic’s peaks. RCTs with a primary outcome in favor of CCP treatment had a significant lower median absolute difference in the expected size effect than unfavorable RCTs (20.0% versus 33.9%, P = 0.04). Conclusions: The analyses of sample sizes in RCTs of CCP treatment in hospitalized COVID-19 patients reveal that many underestimated the number of participants needed because of excessively high expectations on efficacy, and thus, these studies had low statistical power. This, in combination with a lower-than-planned recruitment of cases and controls, could have further negatively influenced the primary outcomes of the RCTs. Full article

(This article belongs to the Topic Multifaceted Efforts from Basic Research to Clinical Practice in Controlling COVID-19 Disease)

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13 pages, 1108 KiB

Open AccessArticle

Anti-SARS-CoV-2 Neutralizing Responses in Various Populations: Use of a Rapid Surrogate Lateral Flow Assay and Correlations with Anti-RBD Antibody Levels

by Joël Gozlan, Audrey Baron, Anders Boyd, Maud Salmona, Djeneba Fofana, Marine Minier, Audrey Gabassi, Laurence Morand-Joubert, Constance Delaugerre and Sarah Maylin

Life 2024, 14(7), 791; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070791 - 22 Jun 2024

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Abstract

Background: After the global COVID-19 crisis, understanding post-infectious immunity and vaccine efficacy remains crucial. This study aims to assess anti-SARS-CoV-2 immunity through a quantitative analysis of anti-receptor-binding domain (RBD) antibodies and rapid functional testing of the neutralizing humoral response. Methods: A retrospective analysis [...] Read more.

Background: After the global COVID-19 crisis, understanding post-infectious immunity and vaccine efficacy remains crucial. This study aims to assess anti-SARS-CoV-2 immunity through a quantitative analysis of anti-receptor-binding domain (RBD) antibodies and rapid functional testing of the neutralizing humoral response. Methods: A retrospective analysis was conducted on samples from various cohorts, including partially vaccinated, fully vaccinated, post-COVID/no-vaccination, and post-COVID/vaccination individuals with various immune-competency statuses. The anti-RBD antibodies were measured using an automated chemiluminescence assay, while the neutralizing antibodies’ (NAbs’) activity was assessed through the lateral flow ichroma COVID-19 nAb test (LFT), a surrogate neutralization assay. Results: The analysis revealed various levels of anti-RBD antibodies and seroneutralization responses across cohorts, with the post-COVID/vaccination group demonstrating the most robust protection. A correlation between anti-RBD antibodies and seroneutralization was observed, albeit with varying strength depending on the subgroup analyzed. Longitudinal assessment following natural infection showed an initial surge followed by a decline in both measures. A cutoff of 3.0 log₁₀ BAU/mL was established to predict significant seroneutralization. Conclusions: The ichroma™ COVID-19 nAb test displayed high specificity and emerged as a valuable tool for monitoring anti-SARS-CoV-2 immunity. These findings contribute to understand the antibody response dynamics and underscore the potential of rapid tests in predicting protection against SARS-CoV-2 infection. Full article

(This article belongs to the Special Issue Vaccines in Virology: New Developments and Pathogen Response)

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11 pages, 620 KiB

Open AccessReview

A Systematic Review on the Application of Virtual Reality for Muscular Dystrophy Rehabilitation: Motor Learning Benefits

by Pawel Kiper, Sara Federico, Joanna Szczepańska-Gieracha, Patryk Szary, Adam Wrzeciono, Justyna Mazurek, Carlos Luque-Moreno, Aleksandra Kiper, Mattia Spagna, Rita Barresi and Błażej Cieślik

Life 2024, 14(7), 790; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070790 - 22 Jun 2024

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Abstract

Using virtual reality (VR) for Muscular Dystrophy (MD) rehabilitation promises to be a novel therapeutic approach, potentially enhancing motor learning, functional outcomes, and overall quality of life. This systematic review primarily aimed to provide a comprehensive summary of the current understanding regarding the [...] Read more.

Using virtual reality (VR) for Muscular Dystrophy (MD) rehabilitation promises to be a novel therapeutic approach, potentially enhancing motor learning, functional outcomes, and overall quality of life. This systematic review primarily aimed to provide a comprehensive summary of the current understanding regarding the application of VR in supporting MD rehabilitation. A systematic search was performed in PubMed, Scopus, Cochrane Library, and Web of Science to identify relevant articles. The inclusion criteria encompassed studies involving individuals diagnosed with MD who underwent VR interventions, with a primary focus on assessing functional improvement. Methodological quality of the studies was assessed by using the Physiotherapy Evidence Database (PEDro) scale. Seven studies, involving 440 individuals with Duchenne Muscular Dystrophy (DMD), were included in the review. Among these studies, six primarily explored the motor learning potential of VR, while one study investigated the impact of VR training on functional abilities. In conclusion, the qualitative synthesis supports VR-based interventions’ potential positive effects on motor learning, performance improvement, and functional outcomes in individuals with DMD. However, current usage mainly focuses on assessing the potential mechanisms’ benefits, suggesting the importance of expanding clinical adoption to harness their therapeutic potential for MD patients. Full article

(This article belongs to the Special Issue Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities)

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12 pages, 424 KiB

Open AccessArticle

Intravesical Gemcitabine and Docetaxel Therapy for BCG-Naïve Patients: A Promising Approach to Non-Muscle Invasive Bladder Cancer

by Mirko Bakula, Tvrtko Hudolin, Nikola Knezevic, Zoran Zimak, Jerko Andelic, Ilija Juric, Marija Gamulin, Milena Gnjidic and Zeljko Kastelan

Life 2024, 14(7), 789; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070789 - 22 Jun 2024

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Abstract

Bacillus Calmette-Guérin (BCG) therapy for patients with non-muscle invasive bladder cancer (NMIBC) faces limitations in efficacy and significant side effects, aggravated by a recent global shortage. In this prospective clinical study, we report the outcomes of sequential intravesical administration of gemcitabine and docetaxel [...] Read more.

Bacillus Calmette-Guérin (BCG) therapy for patients with non-muscle invasive bladder cancer (NMIBC) faces limitations in efficacy and significant side effects, aggravated by a recent global shortage. In this prospective clinical study, we report the outcomes of sequential intravesical administration of gemcitabine and docetaxel (Gem/Doce) as a first-line treatment for BCG-naïve patients with high-risk NMIBC (HR NMIBC). From October 2019 until April 2022, we enrolled 52 patients and followed the treatment protocol set forth by the University of Iowa. Follow-up assessments were conducted every 3 months. In this cohort, 25 (48.1%) patients were diagnosed with high-grade T1 (T1HG) bladder cancer, 10 (19.2%) patients had carcinoma in situ (CIS), and 17 (32.7%) patients had a combination of T1HG+CIS. The median time to first recurrence in the T1HG, CIS, and T1HG+CIS groups was 11, 10.5, and 8.8 months, respectively. The recurrence-free survival was 98.1%, 94.2%, and 80.8% at 6, 9, and 12 months, respectively. The rate of progression-free survival was 100%, 98.1%, and 92.3% at 6, 9, and 12 months, respectively. We demonstrated the safety and efficacy of Gem/Doce therapy in BCG-naïve patients with HR NMIBC during a one-year follow-up. Further research with extended follow-ups, as well as direct comparisons of Gem/Doce with other anticancer agents, is essential. Full article

(This article belongs to the Special Issue Novel and Innovative Approaches in the Management of Urological Tumors)

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12 pages, 629 KiB

Open AccessArticle

Hypoglossal Nerve Stimulation Therapy in a Belgian Cohort of Obstructive Sleep Apnea Patients

by Dorine Van Loo, Marijke Dieltjens, Sanne Engelen, Johan Verbraecken and Olivier M. Vanderveken

Life 2024, 14(7), 788; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070788 - 21 Jun 2024

Viewed by 259

Abstract

Hypoglossal nerve stimulation (HGNS) has emerged as a widespread and innovative treatment option for selected moderate-to-severe obstructive sleep apnea patients who cannot be treated effectively with traditional treatment modalities. In this observational cohort study, the objective and subjective outcomes of Belgian OSA patients [...] Read more.

Hypoglossal nerve stimulation (HGNS) has emerged as a widespread and innovative treatment option for selected moderate-to-severe obstructive sleep apnea patients who cannot be treated effectively with traditional treatment modalities. In this observational cohort study, the objective and subjective outcomes of Belgian OSA patients treated with HGNS therapy were analyzed at 6 and 12 months post-implantation. Thirty-nine patients implanted with a respiration-synchronized HGNS device at the Antwerp University Hospital were included in this study. Patients underwent baseline in-laboratory polysomnography and a follow-up sleep study 6 and 12 months post-implantation. Questionnaires on patient experience and daytime sleepiness were filled out and data on objective therapy usage were collected. All 39 patients completed the 6-month follow-up and 21 patients (54%) completed the 12-month follow-up. Median AHI decreased from 33.8 [26.1–45.0] to 10.2 [4.8;16.4] at the 6-month follow-up, and to 9.6 [4.1;16.4] at the 12-month follow-up (p < 0.001). The surgical success rate, according to the Sher₂₀ criteria, was 80% and 76% at the 6- and 12-month follow-ups, respectively. Median ESS improved from 12.0 [7.0;18.0] at baseline to 6.0 [2.5;11.0] at 6 months (p < 0.001) and to 6.5 [2.8;11.5] at 12 months (p = 0.012). Objective therapy usage was 7.4 [6.6;8.0] and 7.0 [5.9:8.2] h/night at the 6- and 12-month follow-ups, respectively. A high overall clinical effectiveness of HGNS therapy, as shown by a mean disease alleviation of 58%, was demonstrated at 12 months post-implantation. Overall, HGNS therapy using respiration-synchronized neurostimulation of the XII cranial nerve resulted in a significant improvement in both objective and subjective OSA outcomes, with a high level of patient satisfaction and high treatment adherence. Full article

(This article belongs to the Special Issue Towards Personalized Medicine for Obstructive Sleep Apnea)

12 pages, 789 KiB

Open AccessSystematic Review

Butyrate- and Beta-Hydroxybutyrate-Mediated Effects of Interventions with Pro- and Prebiotics, Fasting, and Caloric Restrictions on Depression: A Systematic Review and Meta-Analysis

by Marian Breuling, Elena Tomeva, Nevena Ivanovic and Alexander Haslberger

Life 2024, 14(7), 787; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070787 - 21 Jun 2024

Viewed by 213

Abstract

To examine the butyrate- and beta-hydroxybutyrate (BHB)-modulated effects of pre- and probiotic interventions, fasting, and caloric restriction interventions, a systematic literature review was carried out with a subsequent meta-analysis. Three pre-and probiotic intervention randomized control trials (RCTs) were included in the meta-analysis. A [...] Read more.

To examine the butyrate- and beta-hydroxybutyrate (BHB)-modulated effects of pre- and probiotic interventions, fasting, and caloric restriction interventions, a systematic literature review was carried out with a subsequent meta-analysis. Three pre-and probiotic intervention randomized control trials (RCTs) were included in the meta-analysis. A significant increase in butyrate (standardized mean difference (SMD) [confidence interval (CI)] 0.34; [0.02–0.67]) and an improvement in depression scores (SMD [CI] 0.15, [−0.35–0.70]) through pre- and probiotic interventions were shown in the meta-analysis. The intervention duration of the included studies ranged from three days to four weeks, with the examined population being healthy adults. Butyrate was measured in either plasma or feces, and the depression score was obtained under the Swedish core affect scale, the hospital anxiety and depression scale (HADS), or the depression, anxiety, and stress scale—21 items (DASS-21). In addition to butyrate, the total SCFA concentration also seems to be positively associated with pre- and probiotic administration (SMD [CI] 0.55 [0.15–0.95]). Despite the significant short-chain fatty acid (SCFA) and butyrate concentration changes, no significant correlation between butyrate and depression or between SCFAs and depression could be shown through linear regression models. Nevertheless, the regression coefficient b1 = 1.57 (p = 0.17) for butyrate suggests a strong, positive connection between butyrate and depression. Additionally, three studies were qualitatively analyzed, examining fasting as an intervention and revealing a connection between fasting, BHB, and depression. The association between fasting, BHB, and depression or mood elevation appeared to be related to BHB concentrations, which may be due to the similar biochemical properties of BHB and butyrate. Furthermore, caloric restrictions as alternatives to fasting were proposed as potential long-term interventions. Full article

(This article belongs to the Special Issue Immunologically Relevant Aspects of Foods—Probiotics and Nutrigenomics)

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22 pages, 1416 KiB

Open AccessArticle

Combining Different Natural Plant Extracts to Stabilize the Antioxidative Activity of Dragon’s Blood

by Ying-Zhen Su and Pei-Luen Lu

Life 2024, 14(7), 786; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070786 - 21 Jun 2024

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Abstract

Dragon’s blood (血竭) is a traditional Chinese medicine known for its wound hemostasis, blood circulation, and stasis properties. Recently, it has also been utilized in cosmetics, though its antioxidant capacity remains unclear. This study aims to stabilize the bioactivity of dragon’s blood using [...] Read more.

Dragon’s blood (血竭) is a traditional Chinese medicine known for its wound hemostasis, blood circulation, and stasis properties. Recently, it has also been utilized in cosmetics, though its antioxidant capacity remains unclear. This study aims to stabilize the bioactivity of dragon’s blood using various plant extracts. We evaluated single plant extracts and their combinations to identify the conditions that maintained the antioxidant capacity of dragon’s blood the longest. Selected plants included Hibiscus sabdariffa, Clitoria ternatea, Hylocereus sp., Pandanus amaryllifolius, and Camellia sinensis. We used two sources of dragon’s blood: Daemonorops draco and Dracaena cochinchinensis. Extraction conditions were optimized and antioxidant activity was assessed using the free radical scavenging ability of 1,1-diphenyl-2-picrylhydrazyl (DPPH), total anthocyanin concentration (TAC), total polyphenol content (TPC), the free radical scavenging activity of ABTS, and a ferric reducing antioxidant power (FRAP) assay. The results showed that all plant extracts exhibited high antioxidant capacity. Clitoria ternatea had the highest DPPH scavenging ability at 93.81%, with the best combination being green tea and Daemonorops draco at 92.57%. Clitoria ternatea had the highest TPC at 9921 mg GAE/100 g, with the best combination (green tea and Dracaena cochinchinensis) at 10500 mg GAE/100 g. ABTS activity was highest for green tea at 98.3%, with the best combination (Clitoria ternatea and Daemonorops draco) at 93.29%. The FRAP assay showed that green tea had the highest electron-donating potential at 3.85 mg/mL, with the best combination (Daemonorops draco and Dracaena cochinchinensis) at 3.71 mg/mL. This study advances our understanding of the antioxidant properties of these plants and the traditional Chinese medicine dragon’s blood, enhancing the efficacy of dragon’s blood in skincare and cosmetics. Moreover, the application of these extracts could rejuvenate local agriculture, impacting the skincare, cosmetics, and sustainable agriculture sectors. Full article

(This article belongs to the Section Pharmaceutical Science)

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17 pages, 3601 KiB

Open AccessArticle

Ocimum sanctum as a Source of Quorum Sensing Inhibitors to Combat Antibiotic Resistance of Human and Aquaculture Pathogens

by Sybiya Vasantha Packiavathy Issac Abraham, Veera Ravi Arumugam, Nancy Immaculate Mary, Jeba Sweetly Dharmadhas, Rajamanikandan Sundararaj, Arul Ananth Devanesan, Ramachandran Rajamanickam, Raja Veerapandian, John Paul John Bosco and Jeyapragash Danaraj

Life 2024, 14(7), 785; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070785 - 21 Jun 2024

Viewed by 229

Abstract

Biofilms play a decisive role in the infectious process and the development of antibiotic resistance. The establishment of bacterial biofilms is regulated by a signal-mediated cell–cell communication process called “quorum sensing” (QS). The identification of quorum sensing inhibitors (QSI) to mitigate the QS [...] Read more.

Biofilms play a decisive role in the infectious process and the development of antibiotic resistance. The establishment of bacterial biofilms is regulated by a signal-mediated cell–cell communication process called “quorum sensing” (QS). The identification of quorum sensing inhibitors (QSI) to mitigate the QS process may facilitate the development of novel treatment strategies for biofilm-based infections. In this study, the traditional medicinal plant Ocimum sanctum was screened for QS inhibitory potential. Sub-MICs of the extract significantly affected the secretion of EPS in Gram-negative human pathogens such as Escherichia coli, Pseudomonas aeruginosa PAO1, Proteus mirabilis, and Serratia marcescens, as well as aquaculture pathogens Vibrio harveyi, V. parahaemolyticus, and V. vulnificus, which render the bacteria more sensitive, leading to a loss of bacterial biomass from the substratum. The observed inhibitory activity of the O. sanctum extract might be attributed to the presence of eugenol, as evidenced through ultraviolet (UV)-visible, gas chromatography-mass spectroscopy (GC–MS), Fourier transformer infrared (FTIR) spectroscopy analyses, and computational studies. Additionally, the QSI potential of eugenol was corroborated through in vitro studies using the marker strain Chromobacterium violaceum. Full article

(This article belongs to the Special Issue Trends in Microbiology 2024)

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17 pages, 6276 KiB

Open AccessArticle

The Role of Grifola frondosa Polysaccharide in Preventing Skeletal Muscle Atrophy in Type 2 Diabetes Mellitus

by Ying She, Yun Ma, Pei Zou, Yang Peng, Yong An, Hang Chen, Peng Luo and Shaofeng Wei

Life 2024, 14(7), 784; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070784 - 21 Jun 2024

Viewed by 173

Abstract

Type 2 diabetes mellitus (T2DM) is a burgeoning public health challenge worldwide. Individuals with T2DM are at increased risk for skeletal muscle atrophy, a serious complication that significantly compromises quality of life and for which effective prevention measures are currently inadequate. Emerging evidence [...] Read more.

Type 2 diabetes mellitus (T2DM) is a burgeoning public health challenge worldwide. Individuals with T2DM are at increased risk for skeletal muscle atrophy, a serious complication that significantly compromises quality of life and for which effective prevention measures are currently inadequate. Emerging evidence indicates that systemic and local inflammation stemming from the compromised intestinal barrier is one of the crucial mechanisms contributing to skeletal muscle atrophy in T2DM patients. Notably, natural plant polysaccharides were found to be capable of enhancing intestinal barrier function and mitigating secondary inflammation in some diseases. Herein, we hypothesized that Grifola frondosa polysaccharide (GFP), one of the major plant polysaccharides, could prevent skeletal muscle atrophy in T2DM via regulating intestinal barrier function and inhibiting systemic and local inflammation. Using a well-established T2DM rat model, we demonstrated that GFP was able to not only prevent hyperglycemia and insulin resistance but also repair intestinal mucosal barrier damage and subsequent inflammation, thereby alleviating the skeletal muscle atrophy in the T2DM rat model. Additionally, the binding free energy analysis and molecular docking of monosaccharides constituting GFP were further expanded for related targets to uncover more potential mechanisms. These results provide a novel preventative and therapeutic strategy for T2DM patients. Full article

(This article belongs to the Special Issue Green Medicine: Unraveling the Medicinal Effects of Plant Extracts and Functional Foods)

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31 pages, 1077 KiB

Open AccessSystematic Review

Towards Improved XAI-Based Epidemiological Research into the Next Potential Pandemic

by Hamed Khalili and Maria A. Wimmer

Life 2024, 14(7), 783; https://0-doi-org.brum.beds.ac.uk/10.3390/life14070783 - 21 Jun 2024

Viewed by 212

Abstract

By applying AI techniques to a variety of pandemic-relevant data, artificial intelligence (AI) has substantially supported the control of the spread of the SARS-CoV-2 virus. Along with this, epidemiological machine learning studies of SARS-CoV-2 have been frequently published. While these models can be [...] Read more.

By applying AI techniques to a variety of pandemic-relevant data, artificial intelligence (AI) has substantially supported the control of the spread of the SARS-CoV-2 virus. Along with this, epidemiological machine learning studies of SARS-CoV-2 have been frequently published. While these models can be perceived as precise and policy-relevant to guide governments towards optimal containment policies, their black box nature can hamper building trust and relying confidently on the prescriptions proposed. This paper focuses on interpretable AI-based epidemiological models in the context of the recent SARS-CoV-2 pandemic. We systematically review existing studies, which jointly incorporate AI, SARS-CoV-2 epidemiology, and explainable AI approaches (XAI). First, we propose a conceptual framework by synthesizing the main methodological features of the existing AI pipelines of SARS-CoV-2. Upon the proposed conceptual framework and by analyzing the selected epidemiological studies, we reflect on current research gaps in epidemiological AI toolboxes and how to fill these gaps to generate enhanced policy support in the next potential pandemic. Full article

(This article belongs to the Special Issue COVID-19 and SARS-CoV-2 Investigations: Characteristics, Clinical Course, Prevention, Treatment and Prognosis)

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Life, Volume 14, Issue 7 (July 2024) – 17 articles

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