Structural Insights into the Rrp4 Subunit from the Crystal Structure of the Thermoplasma acidophilum Exosome.

The exosome multiprotein complex plays a critical role in RNA processing and degradation. This system governs the regulation of mRNA quality, degradation in the cytoplasm, the processing of short noncoding RNA, and the breakdown of RNA fragments. We determined two crystal structures of exosome components from Thermoplasma acidophilum (Taci): one with a resolution of 2.3 Å that reveals the central components (TaciRrp41 and TaciRrp42), and another with a resolution of 3.5 Å that displays the whole exosome (TaciRrp41, TaciRrp42, and TaciRrp4). The fundamental exosome structure revealed the presence of a heterodimeric complex consisting of TaciRrp41 and TaciRrp42. The structure comprises nine subunits, with TaciRrp41 and TaciRrp42 arranged in a circular configuration, while TaciRrp4 is located at the apex. The RNA degradation capabilities of the TaciRrp4:41:42 complex were verified by RNA degradation assays, consistent with prior findings in other archaeal exosomes. The resemblance between archaeal exosomes and bacterial PNPase suggests a common mechanism for RNA degradation. Despite sharing comparable topologies, the surface charge distributions of TaciRrp4 and other archaea structures are surprisingly distinct. Different RNA breakdown substrates may be responsible for this variation. These newfound structural findings enhance our comprehension of RNA processing and degradation in biological systems.

The Evolution of Phenomenology in Korean Nursing Research: A Scoping Review.

PURPOSE: Phenomenological methods are used to capture human experience, and nursing research has long attempted phenomenological approaches in many studies. This study explored the 22-year trends (2001- 2022) in phenomenological research within Korean nursing science and identified the types of journals where research is published, common phenomenological data analysis methods, phenomena of interest, and standards of rigor applied to phenomenological studies. METHODS: This scoping review followed the six stages recommended by Arksey and O'Malley's (2005) and utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR) for reporting guidance. A total of 4,354 articles acquired through systematic searches across seven search engines PubMed, CINAHL, Embase, Research Information Sharing Service (RISS), Korea Citation Index (KCI), Korea Institute of Science and Technology Information (KISTI), and Korean studies Information Service System (KISS) were reviewed. Key search terms and inclusion and exclusion criteria were used as strategies to identify relevant articles. RESULTS: In the final review, 568 Korean phenomenological studies were included. Among the phenomenology research, 50.4% of the total work was performed between 2016 and 2020, and the Colaizzi method of study was the most common (62.9%). Most researchers were published in nursing journals (55.8%). Nurses constituted the majority of participants (24.5%), followed by people living with illnesses (23.1%) and people of all ages. The primary focus included participants' experiences: the disease experience of the sick, the job-related experience of the nurses, and the learning-related experience of the nursing students. The median sample size of reviewed papers (i.e., 9) is relevant to phenomenological research saturation. The most rigorous studies applied Lincoln and Guba's criteria (54.0%). CONCLUSIONS: Advancing phenomenological research in nursing entails giving priority to diverse perspectives, rigor, and the foundational essence of phenomenology. Ensuring transparency and reliability requires reinforcing rigor through the integration of phenomenology, philosophy, and effective data analysis methods.

Evidence-Based Pain Assessment in Nonverbal Palliative Care Patients.

BACKGROUND: Central to palliative care is the early assessment and treatment of pain, whether physical, psychosocial, or spiritual. Nonverbal palliative care patients are at risk for inadequate pain assessment leading to prolonged suffering. AIMS: The purpose of this project was to implement and evaluate an evidence-based pain assessment tool for nonverbal palliative care patients. DESIGN: The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Healthcare and the Implementation Strategies for Evidence-Based Practice Guide provided the guiding frameworks. SETTINGS: On a six-bed adult inpatient Palliative Care Unit (PCU). PARTICIPANTS/SUBJECTS: Nonverbal palliative care patients. METHODS: Evidence supported use of the Multidimensional Objective Pain Assessment Tool (MOPAT) for nonverbal patients receiving palliative care. During an eight-week pilot, nurses recorded pain assessments on a paper form and trended pain scores over a 24-hour period. Evaluation included knowledge, attitudes, and behaviors pre- and post-pilot and was subsequently used in a Precision Implementation Approach to promote adoption. RESULTS: Nurses' attitudes toward palliative care pain assessment improved in all items on the evaluation tools. Pain was assessed using MOPAT for 74% of nonverbal palliative care patients and 88% of patients had linked pain interventions to MOPAT scores. CONCLUSIONS: MOPAT is the only valid evidence-based pain assessment tool for nonverbal patients receiving palliative care. This project led to successful adoption of the MOPAT within the PCU.

Control of fibrosis with enhanced safety via asymmetric inhibition of prolyl-tRNA synthetase 1.

Prolyl-tRNA synthetase 1 (PARS1) has attracted much interest in controlling pathologic accumulation of collagen containing high amounts of proline in fibrotic diseases. However, there are concerns about its catalytic inhibition for potential adverse effects on global protein synthesis. We developed a novel compound, DWN12088, whose safety was validated by clinical phase 1 studies, and therapeutic efficacy was shown in idiopathic pulmonary fibrosis model. Structural and kinetic analyses revealed that DWN12088 binds to catalytic site of each protomer of PARS1 dimer in an asymmetric mode with different affinity, resulting in decreased responsiveness at higher doses, thereby expanding safety window. The mutations disrupting PARS1 homodimerization restored the sensitivity to DWN12088, validating negative communication between PARS1 promoters for the DWN12088 binding. Thus, this work suggests that DWN12088, an asymmetric catalytic inhibitor of PARS1 as a novel therapeutic agent against fibrosis with enhanced safety.

Factors determining the oral absorption and systemic disposition of zeaxanthin in rats: in vitro, in situ, and in vivo evaluations.

CONTEXT: Zeaxanthin is a yellow­coloured dietary carotenoid widely recognized as an essential component of the macula. It exerts blue light filtering and antioxidant activities, offering eye health and vision benefits. OBJECTIVE: This study explores the oral absorption and systemic disposition of zeaxanthin from biopharmaceutical and pharmacokinetic perspectives. MATERIALS AND METHODS: In vivo intravenous (5 and 10 mg/kg) and intraportal (5 mg/kg) pharmacokinetic studies were performed to determine intrinsic tissue­blood partition coefficient, elimination pathway, and hepatic clearance, of zeaxanthin in rats. Moreover, in vitro physicochemical property test, in situ closed loop study, in vivo oral pharmacokinetic study (20 and 100 mg/kg), and in vivo lymphatic absorption study (100 mg/kg) were conducted to investigate the gut absorption properties of zeaxanthin and assess the effects of several lipids on the lymphatic absorption of zeaxanthin in rats. RESULTS: Zeaxanthin exhibited poor solubility (≤144 ng/mL) and stability (6.0-76.9% of the initial amount remained at 24 h) in simulated gut luminal fluids. Gut absorption of zeaxanthin occurred primarily in the duodenum, but the major fraction (≥84.7%) of the dose remained unabsorbed across the entire gut tract. Considerable fractions of intravenous zeaxanthin accumulated in the liver, lung, and spleen (21.3, 11.7, and 2.0%, respectively). It was found that the liver is the major eliminating organ of zeaxanthin, accounting for 53.5-90.1% of the total clearance process (hepatic extraction ratio of 0.623). DISCUSSION AND CONCLUSIONS: To our knowledge, this is the first systematic study to report factors that determine the oral bioavailability and systemic clearance of zeaxanthin.

A Concept Analysis of Illness Intrusiveness in Chronic Disease: Application of the Hybrid Model Method.

This study clarifies the concept of illness intrusiveness in patients with a chronic disease using the hybrid model method. To clarify the dimension, attributes, and definition of illness intrusiveness in chronic disease, three phases of analysis were conducted. In the theoretical phase, a working definition was devised through a systematic review. In the fieldwork phase, individual in-depth interviews were conducted with nine participants with chronic diseases. In the final analytic phase, the results were integrated through comparison and review. There are four domains and eleven attributes of illness intrusiveness in chronic disease. The domains include physical, psychological, social/contextual, and spiritual. The physical domain consists of four attributes: pain, fatigue, physical malfunction, and change of body image. The psychological domain consists of three attributes: psychological weakness, uncertainty, and stigma. The social/contextual domain is made up of three attributes: withdrawal of role play, limit of daily life, and burden of changing health habits. Finally, the spiritual domain had one attribute: unstable spiritual state. Thus, based on the study findings, it is necessary to develop a suitable illness intrusiveness in chronic disease assessment scale to assess chronic disease patients.

Influencing Factors on Nursing Students' Learning Flow during the COVID-19 Pandemic: A Mixed Method Research.

PURPOSE: This study aimed to investigate the factors affecting nursing students' learning flow in COVID-19 pandemic situations through mixed-method research. METHOD: Of the 245 nursing students participating in the survey, 20 participated in a focus group interview. Quantitative data were analyzed using stepwise multiple regression analysis. Qualitative data were analyzed using content analysis. RESULTS: The factors affecting the learning flow of nursing students during the COVID-19 pandemic were their self-regulated learning ability (ß = .24, p = .001); learning motivation (ß = .23, p = .001); self-efficacy in clinical practice (ß = .14, p = .014); and lecture type, or a mixture of recorded and real-time video lectures (ß = .13, p = .022). As a result of the qualitative study, eight categories and 22 subcategories were derived. The eight categories are: a lack of preparation in the starting of virtual classes, adapting and growing in a new learning environment, enhancing nursing knowledge and skills through virtual clinical training, self-regulation difficulties when studying alone due to social distancing, difficulty concentrating when learning online, disadvantages of virtual learning, concerns about academic performance, and missing opportunities to enjoy college life. CONCLUSION: Students attempted to discover their own learning expertise through virtual learning while concerned that they would be unable to fully establish their competence to work as actual hospital nurses due to a lack of clinical practice. In such a learning environment, systematic support and strategies are needed to increase the learning flow of nursing students.

Field study of the indoor environments for preventing the spread of the SARS-CoV-2 in Seoul.

Despite the prolonged global spread of COVID-19, few studies have investigated the environmental influence on the spread of SARS-CoV-2 RNA with a metropolitan scale, particularly the detection of SARS-CoV-2 after disinfection at multi-use facilities. Between February 2020 and January 2021, 1,769 indoor air samples and object surfaces were tested at 231 multi-use facilities where confirmed cases were known to have occurred in Seoul, to determine whether SARS-CoV-2 RNA could be detected even after disinfection. Samples were collected by air scanner and swab pipette and detected by real-time RT-PCR. As a result, 10 (0.56%) positive samples were detected despite disinfection. The common environmental features of all 10 were surfaces that contained moisture and windowless buildings. With the aim of preventing the spread of COVID-19, from January to February 2021, we next conducted 643 preemptive tests before the outbreak of infections at 22 multi-use facilities where cluster infections were frequent. From these preemptive inspections, we obtained five (0.78%) positive results from two facilities, which enabled us to disinfect the buildings and give all the users a COVID-19 test. Based on the study purpose of finding and investigating cases of positive detection even after disinfection in the field through long-term environmental detection in a large city, our preemptive investigation results helped to prevent the spread of infectious diseases by confirming the potential existence of an asymptomatic patient.

Factors Affecting Nurses' Performance of Cancer Pain Management in a Tertiary Hospital.

Purpose: More than 60% of patients with advanced cancer experience pain, and uncontrolled pain reduces the quality of life. Nurses are the closest healthcare providers to the patient and are suitable for managing cancer pain using pharmacological and non-pharmacological interventions. This study aimed to identify factors affecting the performance of cancer pain management among nurses. Methods: This study was conducted among 155 participating nurses working at a tertiary hospital who had experience with cancer pain management. Data collection was performed between October 18, 2021 and October 25, 2021. Data analysis was conducted using descriptive statistics, the independent-sample t-test, one-way analysis of variance, and hierarchical regression analysis. Results: There were 110 subjects (71.0%) who had no experience of cancer pain management education. The results of regression analysis indicated that barriers included medical staff, patients, and the hospital system for cancer pain management (ß=0.28, P<0.001). The performance of cancer pain management was also affected by experience of cancer pain management training (ß=0.22, P=0.007), and cancer pain management knowledge (ß=0.21, P=0.006). The explanatory power of the variable was 16.6%. Conclusion: It is crucial to assess system-related obstacles, as well as patients and medical staff, in order to improve nurses' cancer pain management performance. A systematic approach incorporating multidisciplinary interventions from interprofessional teams is required for effective pain management. Furthermore, pain management education is required both for cancer ward nurses and nurses in other wards.

Care for critically and terminally ill patients and moral distress of physicians and nurses in tertiary hospitals in South Korea: A qualitative study.

Physicians and nurses working in acute care settings, such as tertiary hospitals, are involved in various stages of critical and terminal care, ranging from diagnosis of life-threatening diseases to care for the dying. It is well known that critical and terminal care causes moral distress to healthcare professionals. This study aimed to explore moral distress in critical and terminal care in acute hospital settings by analyzing the experiences of physicians and nurses from various departments. Semi-structured in-depth interviews were conducted in two tertiary hospitals in South Korea. The collected data were analyzed using grounded theory. A total of 22 physicians and nurses who had experienced moral difficulties regarding critical and terminal care were recruited via purposive maximum variation sampling, and 21 reported moral distress. The following points were what participants believed to be right for the patients: minimizing meaningless interventions during the terminal stage, letting patients know of their poor prognosis, saving lives, offering palliative care, and providing care with compassion. However, family dominance, hierarchy, the clinical culture of avoiding the discussion of death, lack of support for the surviving patients, and intensive workload challenged what the participants were pursuing and frustrated them. As a result, the participants experienced stress, lack of enthusiasm, guilt, depression, and skepticism. This study revealed that healthcare professionals working in tertiary hospitals in South Korea experienced moral distress when taking care of critically and terminally ill patients, in similar ways to the medical staff working in other settings. On the other hand, the present study uniquely identified that the aspects of saving lives and the necessity of palliative care were reported as those valued by healthcare professionals. This study contributes to the literature by adding data collected from two tertiary hospitals in South Korea.

(-)-Loliolide Isolated from Sargassum horneri Suppressed Oxidative Stress and Inflammation by Activating Nrf2/HO-1 Signaling in IFN-γ/TNF-α-Stimulated HaCaT Keratinocytes.

The present study evaluated the effects of (-)-loliolide isolated from Sargassum horneri (S. horneri) against oxidative stress and inflammation, and its biological mechanism in interferon (IFN)-γ/tumor necrosis factor (TNF)-α-stimulated HaCaT keratinocytes. The results showed that (-)-loliolide improved the cell viability by reducing the production of intracellular reactive oxygen species (ROS) in IFN-γ/TNF-α-stimulated HaCaT keratinocytes. In addition, (-)-loliolide effectively decreased the expression of inflammatory cytokines (interleukin (IL)-4 IL-6, IL-13, IFN-γ and TNF-α) and chemokines (CCL11 (Eotaxin), macrophage-derived chemokine (MDC), regulated on activation, normal T cell expressed and secreted (RANTES), and thymus and activation-regulated chemokine (TARC)), by downregulating the expression of epidermal-derived initial cytokines (IL-25, IL-33 and thymic stromal lymphopoietin (TSLP)). Furthermore, (-)-loliolide suppressed the activation of mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) signaling, whereas it activated nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling. Interestingly, the cytoprotective effects of (-)-loliolide against IFN-γ/TNF-α stimulation were significantly blocked upon inhibition of HO-1. Taken together, these results suggest that (-)-loliolide effectively suppressed the oxidative stress and inflammation by activating the Nrf2/HO-1 signaling in IFN-γ/TNF-α-stimulated HaCaT keratinocytes.

Effects of (-)-Loliolide against Fine Dust Preconditioned Keratinocyte Media-Induced Dermal Fibroblast Inflammation.

At present air pollution in parts of East Asia is at an alarming level due to elevated levels of fine dust (FD). Other than pulmonary complications, FD was found to affect the pathogenesis of ROS-dependent inflammatory responses via penetrating barrier-disrupted skin, leading to degradation of extracellular matrix components through the keratinocyte-fibroblast axis. The present study discloses the evaluation of human dermal fibroblast (HDF) responses to FD preconditioned human keratinocyte media (HPM) primed without and with (-)-loliolide (HTT). HPM-FD treatment increased the ROS level in HDFs and activated mitogen-activated protein kinase-derived nuclear factor (NF)-κB inflammatory signaling pathways with a minor reduction of viability. The above events led to cell differentiation and production of matrix metalloproteinases (MMP), increasing collagenase and elastase activity despite the increase of tissue inhibitors of metalloproteinases (TIMP). Media from HTT primed keratinocytes stimulated with FD indicated ameliorated levels of MMPs, inflammatory cytokines, and chemokines in HDFs with suppressed collagenase and elastase activity. Present observations help to understand the factors that affect HDFs in the microenvironment of FD exposed keratinocytes and the therapeutic role of HTT as a suppressor of skin aging. Further studies using organotypic skin culture models could broaden the understanding of the effects of FD and the therapeutic role of HTT.

Bacterial cellulose nanofibrils-armored Pickering emulsions with limited influx of metal ions.

This study introduces a hydrophobically modified bacterial cellulose nanofibrils (BCNF)-stabilized Pickering emulsion system, which can limit the influx of metal ions through the interface. We showed that the C18 alkyl chain-grafted BCNF (C18BCNF) can readily associate to generate a resilient thin membrane at the oil-water interface regardless of the type of oil, which is essential for the production of stable emulsion drops. The viscoelasticity of C18BCNF-armored Pickering emulsion was feasibly tunable by manipulating the grafting amount of the C18 alkyl chains, as well as controlling the C18BCNF concentration. We also demonstrated that the C18BCNF membrane formed at the interface effectively entrapped metal ions through electrostatic binding with the carboxyl groups on C18BCNF, thus maintaining original UV-absorbing capability of chemical UV filter-containing emulsions. We expect that the BCNF surfactant fabricated in this study has immense potential for the development of various complex emulsion products.

Designing a Clinical Ethics Education Program for Nurses Based on the ADDIE Model.

BACKGROUND AND PURPOSE: The ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model enables educators to create programs using a systematic approach designed to meet learner's needs. The purpose of this study was to develop and evaluate a clinical ethics education program for nurses to improve their ethical confidence, ethical competence, and moral sensitivity. METHODS: The study was conducted in three steps. In the first step, a seven-session ethics program was developed using the ADDIE model. The themes of each session were as follows: (a) sharing individual ethical issues in clinical settings; (b) understanding a process involved in ethical decision-making; (c) identifying ethical issues in end-of-life care; (d) identifying ethical issues in family caregiving; (e) learning communication skills; (f) developing ethical leadership skills; and (g) reflecting to build self-awareness of the significance of practicing clinical ethics. The second step involved the delivery of the program. In the third step, using a mixed methods design, the effects of the program were evaluated through a quantitative survey administered both before and after completion of the program and focus group interviews. RESULTS: The seven-session ethics program based on the ADDIE model improved ethical confidence, ethical competence, and moral sensitivity in nurses. IMPLICATIONS FOR PRACTICE: The ADDIE model can be an effective tool in nursing education, offering an established structure for developing educational programs. In order to validate the effectiveness of the ethics program, it is necessary to conduct repeated measure studies and further studies at the institutional level.

Cellulose nanofiber-multilayered fruit peel-mimetic gelatin hydrogel microcapsules for micropackaging of bioactive ingredients.

We report a facile but robust approach to fabricate fruit peel-mimetic microcapsules (FPMCs) of which shell was structured by layering cellulose nanofibers (CNFs) with an antioxidant and a waxy compound on monodisperse gelatin microparticles using the layer-by-layer deposition. The thickness and moduli of the shell increased commonly depending on the number of CNF layers, indicating that the incorporation of CNFs made the shell layer rigid. We determined that the coating of the outermost FPMC layer with dodecane nanoemulsions softened the shell surface, thus preventing the generation of microcracks, which is essential for minimizing dehydration in the drying process. Furthermore, we also confirmed that the co-deposition of a phenolic compound, gallic acid, which is encapsulated in the polymeric micelles, with the shell layers allowed the FPMCs to exert antioxidant effects against the influx of oxygen from the atmosphere. These results highlight that our FPMC system could pave the way for the development of a micropackaging technology that enables encapsulation and stabilization of bioactive ingredients.

An Aqueous Extract from Batillus Cornutus Meat Protects Against H2O2-Mediated Cellular Damage via Up-Regulation of Nrf2/HO-1 Signal Pathway in Chang Cells.

In this study, we evaluated the protective effects of an aqueous extract from Batillus cornutus meat (BM) against cellular oxidative damage caused by hydrogen peroxide (H2O2) in human hepatocyte, Chang cells. First, we prepared an aqueous extract of BM meat (BMW) showing the highest taurine content among free amino acid contents. BMW led to high antioxidant activity showing 2,2-azino-bis(3-ethylbenzthiazoline)-6-sulfonic acid (ABTS) radical scavenging activity, good reducing power and an oxygen radical absorbance capacity (ORAC) value. Also, BMW improved cell viability that was diminished by H2O2 exposure, as it reduced the generation of intracellular reactive oxygen species (ROS) in Chang cells. In addition, BMW up-regulated the production of antioxidant enzymes, such as catalase and superoxide dismutase (SOD), compared to H2O2-treated Chang cells lacking BMW. Moreover, BMW induced the expressions of nuclear Nrf2 and cytosolic HO-1 in H2O2-treated Chang cells. Interestingly, the treatment of ZnPP, HO-1 inhibitor, abolished the improvement in cell viability and intracellular ROS generation mediated by BMW treatment. In conclusion, this study suggests that BMW protects hepatocytes against H2O2-mediated cellular oxidative damage via up-regulation of the Nrf2/HO-1 signal pathway.

Antioxidant Effects of an Alcalase Hydrolysate from Batillus cornutus Meat.

Batillus cornutus (B. cornutus) is one of the gastropoda, which are distributed along the coast of China, Japan and South Korea and northeast area. In this study, we first identified the antioxidant effects of a B. cornutus meat (BM) enzymatic hydrolysate in H2O2-treated Vero cells. First of all, we prepared an Alcalase hydrolysate from BM (BMA) and revealed a high taurine content. Also, taurine rich BMA dose-dependently increased 2,2-azino-bis(3-ethylbenzthiazoline)-6-sulfonic acid (ABTS) radical scavenging activity, reducing power and the higher oxygen radical absorbance capacity (ORAC) value. In addition, BMA significantly increased the cell viability via the down-regulation of intracellular reactive oxygen species (ROS) production, as well as the decreased formation of apoptotic bodies and sub-G1 DNA population in H2O2-treated Vero cells. Furthermore, BMA increased the expression of the anti-apoptotic molecule, Bcl-2, and decreased the expressions of Bax, p53 and cleaved PARP, all of which are pro-apoptotic molecules, in H2O2-treated Vero cells. Based on these results, this study suggests that BMA may be used as a potential protector on damage caused by oxidative stress.

Cytoprotective Effects of an Aqueous Extracts from Atrina Pectinate Meat in H2O2-Induced Oxidative Stress in a Human Hepatocyte.

In the present study, we investigated the antioxidant activity of an aqueous extract from Atrina pectinate meat (APW) against H2O2-induced oxidative stress in a human hepatocyte. The extraction yield of APW was 30.01 ± 0.83% and which contained the highest taurine content among free amino acid contents. APW led to the high antioxidant activity showing 2,2-azino-bis(3-ethylbenzthiazoline)-6-sulfonic acid (ABTS) radical scavenging activity, good reducing power and oxygen radical absorbance capacity (ORAC) value. Also, the results showed that APW improved the cell viability decreased by H2O2 stimulation as well as the reduction of intracellular reactive oxygen species (ROS) generation in hepatocytes. Additionally, APW up-regulated the production of antioxidant mechanisms related enzymes such as catalase and superoxide dismutase (SOD), compared to the only H2O2-treated hepatocytes. Moreover, APW increased the expressions of nuclear Nrf2 and cytosolic HO-1 in H2O2-treated hepatocytes. Interestingly, the treatment of ZnPP, a HO-1 inhibitor abolished the cell viability and intracellular ROS generation induced by APW treatment. In conclusion, this study suggests that APW protects H2O2 induced oxidative stress via up-regulating of Nrf2/HO-1 signal pathway in hepatocytes.

Radio-Protective Effects of Loliolus beka Gray Meat Consisted of a Plentiful Taurine Against Damages Caused by Gamma Ray Irradiation.

Gamma ray irradiation causes immune suppression, in which oxidative stress reduces cell viability and damages immune cells. In the present study, we investigated whether Loliolus beka gray meat (LBM), which contains large amounts of taurine, protects against damage of murine splenocytes by oxidative stress. An aqueous extract of LBM (LBMW) was prepared, which contained plentiful levels of taurine. LBMW improved cell viability of gamma ray-irradiated murine splenocytes, an effect that was associated with significant reduction in the production of reactive oxygen species (ROS). We also showed that the production of nitric oxide (NO) and ROS in gamma ray-irradiated zebrafish embryos, as well as the death of the embryos, were diminished by LBMW. These data suggest that the consumption of taurine-rich foods, such as LBM, may be used in the protection of cells against oxidative stress.

Clinical Patterns of Continuous and Intermittent Palliative Sedation in Patients With Terminal Cancer: A Descriptive, Observational Study.

CONTEXT: Limited information is available regarding the detailed clinical patterns of palliative sedation (PS), that is, the symptom control rate, salvage medication, and the effectiveness of intermittent PS (IPS) versus continuous PS (CPS). OBJECTIVES: The primary aim was to investigate clinical outcomes of PS in a real clinical setting. METHODS: Clinical information was prospectively collected for patients who were treated according to a prescribed protocol and assessment tools in a hospice unit affiliated with a tertiary cancer center between September 2015 and March 2017. Data were analyzed retrospectively. Midazolam was used as the first medication for PS, and propofol and phenobarbital were subsequently used as salvage medications. Indications of PS, the depth of sedation, the quality of sleep, and the level of consciousness were assessed. RESULTS: A total of 306 patients were enrolled, 89 of whom (29.1%) received PS. No difference in survival time was found between patients with and without PS (median survival, 34.0 vs 25.0 days, P = 0.109). Delirium was the most common indication of PS. The symptoms of 73 (82.0%) of 89 patients with PS were relieved with midazolam. Twelve (75.0%) of 16 midazolam-failure patients responded to propofol, five of whom (31%) exhibited respiratory depression. Of the 89 patients receiving PS, 61 (68.5%) received IPS and 28 patients (31.5%) received CPS. The median survival times from PS initiation to death were six days in the IPS group and one day in the CPS group (P < 0.001). Interestingly, consciousness levels were significantly improved after IPS in the delirium group compared with those in the other group (41.7% vs 16.7%, P = 0.002). CONCLUSION: The refractory symptoms of end-of-life patients with cancer can ultimately be relieved with various medications for PS. IPS may improve the consciousness level of patients with delirium.