Experiences and perceived benefits of remotely delivered dance/movement therapy for adult cancer patients: a multi-method program evaluation.

BACKGROUND: Dance/movement therapy (DMT) is increasingly used as a complementary treatment to address psychological and physical wellbeing. However, it is unknown how it can be leveraged in adult cancer care. This mixed methods program evaluation aimed to assess patient-reported benefits and satisfaction with the virtual DMT in an academic oncology setting. METHODS: We developed, implemented, and evaluated a 6-week virtual, synchronous DMT program aiming to improve physical health, address mental distress, and foster social connection for cancer patients. We used deidentified program evaluation data to assess impact of DMT on patient-reported outcomes and patients' satisfaction with the DMT program. Pre- and post-session data were analyzed using descriptive statistics and a paired t-test. Qualitative data were captured through semi-structured interviews and analyzed using thematic analysis. RESULTS: Results from 39 participants (mean age 64.7 ± 9.8), majority female (89.7%) with a history of breast cancer (43.6%), showed high satisfaction (100%) and unanimous program recommendation (100%). Significant improvements were noted in anxiety (- 0.42 ± 0.76, p = .009), distress (- 0.35 ± 0.80, p = .036), and sense of joy (0.73 ± 1.18, p = .004), with a non-significant trend in increased physical activity (0.38 ± 0.98, p = .057). Thematic findings indicated that DMT participation (1) facilitated engagement in physical activity for improved physical health, (2) fostered creative expression, (3) improved mental state, and (4) helped build social connections and support. CONCLUSION: Our DMT program shows promise as a component of integrative cancer care. The mixed-method evaluation provides insightful information to generate hypotheses for future RCT studies aiming to evaluate the specific effects of DMT on patient experience and outcomes.

Short-Chain Fatty Acid Production by Gut Microbiota Predicts Treatment Response in Multiple Myeloma.

PURPOSE: The gut microbiota plays important roles in health and disease. We questioned whether the gut microbiota and related metabolites are altered in monoclonal gammopathies and evaluated their potential role in multiple myeloma and its response to treatment. EXPERIMENTAL DESIGN: We used 16S rRNA sequencing to characterize and compare the gut microbiota of patients with monoclonal gammopathy of undetermined significance (n = 11), smoldering multiple myeloma (n = 9), newly diagnosed multiple myeloma (n = 11), relapsed/refractory multiple myeloma (n = 6), or with complete remission (n = 9). Short-chain fatty acids (SCFA) were quantified in serum and tested in cell lines. Relevant metabolites were validated in a second cohort of 62 patients. RESULTS: Significant differences in alpha- and beta diversity were present across the groups and both were lower in patients with relapse/refractory disease and higher in patients with complete remission after treatment. Differences were found in the abundance of several microbiota taxa across disease progression and in response to treatment. Bacteria involved in SCFA production, including Prevotella, Blautia, Weissella, and Agathobacter, were more represented in the premalignant or complete remission samples, and patients with higher levels of Agathobacter showed better overall survival. Serum levels of butyrate and propionate decreased across disease progression and butyrate was positively associated with a better response. Both metabolites had antiproliferative effects in multiple myeloma cell lines. CONCLUSIONS: We demonstrate that SCFAs metabolites and the gut microbiota associated with their production might have beneficial effects in disease evolution and response to treatment, underscoring its therapeutic potential and value as a predictor.

Test Strip Platform Spin-Off for Telomerase Activity Detection: Development of an Electrochemical Biosensor.

Telomerase overexpression has been associated directly with cancer, and the enzyme itself is recognized within the scientific community as a cancer biomarker. BIDEA's biosensing strip (BBS) is an innovative technology capable of detecting the presence of telomerase activity (TA) using electrochemical impedance spectroscopy (EIS). This BBS is an interdigital gold (GID) electrode array similar in size and handling to a portable glucose sensor. For the detection of the biomarker, BBS was modified by the immobilization of a telomere-like single strand DNA (ssDNA) on its surface. The sensor was exposed to telomerase-positive extract from commercially available cancer cells, and the EIS spectra were measured. Telomerase recognizes the sequence of this immobilized ssDNA probe on the BBS, and the reverse transcription process that occurs in cancer cells is replicated, resulting in the ssDNA probe elongation. This surface process caused by the presence of TA generates changes in the capacitive process on the electrode array microchip surface, which is followed by EIS as the sensing tool and correlated with the presence of cancer cells. The telomerases' total cell extraction protocol results demonstrate significant changes in the charge-transfer resistance (R ct) change rate after exposure to telomerase-positive extract with a detection limit of 2.94 × 104 cells/mL. Finally, a preliminary study with a small set of "blind" uterine biopsy samples suggests the feasibility of using the changes in the R ct magnitude change rate (Δ(ΔR ct/R cti)/Δt) to distinguish positive from negative endometrial adenocarcinoma samples by the presence or absence of TA.

Two independently evolved natural mutations additively deregulate TyrA enzymes and boost tyrosine production in planta.

l-Tyrosine is an essential amino acid for protein synthesis and is also used in plants to synthesize diverse natural products. Plants primarily synthesize tyrosine via TyrA arogenate dehydrogenase (TyrAa or ADH), which are typically strongly feedback inhibited by tyrosine. However, two plant lineages, Fabaceae (legumes) and Caryophyllales, have TyrA enzymes that exhibit relaxed sensitivity to tyrosine inhibition and are associated with elevated production of tyrosine-derived compounds, such as betalain pigments uniquely produced in core Caryophyllales. Although we previously showed that a single D222N substitution is primarily responsible for the deregulation of legume TyrAs, it is unknown when and how the deregulated Caryophyllales TyrA emerged. Here, through phylogeny-guided TyrA structure-function analysis, we found that functionally deregulated TyrAs evolved early in the core Caryophyllales before the origin of betalains, where the E208D amino acid substitution in the active site, which is at a different and opposite location from D222N found in legume TyrAs, played a key role in the TyrA functionalization. Unlike legumes, however, additional substitutions on non-active site residues further contributed to the deregulation of TyrAs in Caryophyllales. The introduction of a mutation analogous to E208D partially deregulated tyrosine-sensitive TyrAs, such as Arabidopsis TyrA2 (AtTyrA2). Moreover, the combined introduction of D222N and E208D additively deregulated AtTyrA2, for which the expression in Nicotiana benthamiana led to highly elevated accumulation of tyrosine in planta. The present study demonstrates that phylogeny-guided characterization of key residues underlying primary metabolic innovations can provide powerful tools to boost the production of essential plant natural products.

Sustainable Food Support during an Ultra-Endurance and Mindfulness Event: A Case Study in Spain.

The present industrial food-production system is not suitably ecological for the environment. Mindful nutrition in sport is a relevant emergent sub-discipline that could help reduce environmental degradation. This case study describes a sustainable support diet during an ultra-endurance running (UR) event called the "Indoor Everest Challenge". This UR challenge involved attaining the altitude of Mount Everest (8849 m) in a simulated way, in less than 24 h, without using ultra-processed food and without wasting plastics. During this challenge, a male athlete (34 years, weight: 78 kg, and height: 173 cm) wore a SenseWear Armband® (BodyMedia Inc., Pittsburg, PA, USA) accelerometer on his right arm to estimate energy expenditure. To supply his nutritional requirements, the athlete consumed only specially prepared homemade and organic food. All consumption was weighed and recorded in real-time; we determined nutrients using two databases: a food composition software, Dial Alce Ingenieria® (Madrid, Spain), to measure energy and macro- and micro-nutrients, and Phenol Explorer Database® (INRA Institut National de Recherche pour l'Alimentation, Paris, France) precisely to determine polyphenolic content. Most energy intake (up to 96%) came from plant foods. We found that subject consumed 15.8 g/kg-1/d-1 or 1242 g of carbohydrates (CHO), (2.4 g/kg-1/d-1) or 190 g of proteins (P), and 10,692 mL of fluid. The total energy intake (7580 kcal) showed a distribution of 65% CHO, 10% P, and 25% lipids (L). Furthermore, this sustainable diet lead to a high antioxidant intake, specifically vitamin C (1079 mg), vitamin E (57 mg), and total polyphenols (1910 mg). This sustainable approach was suitable for meeting energy, CHO, and P recommendations for UR. Physical and mental training (mindfulness) were integrated from the specific preliminary phase to the day of the challenge. The athlete completed this challenge in 18 h with a low environmental impact. This sports event had an educational component, as it awakened curiosity towards food sustainability.

Cocamidopropyl Betaine Surfactant 0.075% Solution in Physiological Serum for Hygiene Process of COVID-19 Intubated Patients.

When using ventilators in the management of the coronavirus disease 2019 patient, dense and abundant mucous secretions are formed, obstructing the endotracheal tube and making its aspiration difficult. This situation is worsened if in order to minimize the risk of infection of the medical personnel, the humidifier is disconnected. This circumstance forces the tube to be removed, cleaned, or changed, increasing the workload of the intensive care unit staff. Other therapies tested until now, like mesna, acetylcysteine, or hypertonic saline solution, are valid alternatives, although they have not shown great efficacy for this specific procedure in the past. The sanitary emergency forced the collaboration between a pharmacist and an otorhinolaryngologist to develop the cocamidopropyl betaine surfactant formula, after several tests with different concentrations of the surfactant. The objective of this compounding formula was to resolve a mechanical problem and avoid reintubation due to obstruction of the ventilator tube. The cocamidopropyl betaine surfactant solution 0.075% in saline 0.9% (physiological serum) solution demonstrated to be a well-tolerated formula, using inexpensive materials, was simple to prepare, and was easy to use in clinical practice.

Novel Indices of Coronary Physiology: Do We Need Alternatives to Fractional Flow Reserve?

Fractional flow reserve is the current invasive gold standard for assessing the ischemic potential of an angiographically intermediate coronary stenosis. Procedural cost and time, the need for coronary vessel instrumentation, and the need to administer adenosine to achieve maximal hyperemia remain integral components of invasive fractional flow reserve. The number of new alternatives to fractional flow reserve has proliferated over the last ten years using techniques ranging from alternative pressure wire metrics to anatomic simulation via angiography or intravascular imaging. This review article provides a critical description of the currently available or under-development alternatives to fractional flow reserve with a special focus on the available evidence, pros, and cons for each with a view towards their clinical application in the near future for the functional assessment of coronary artery disease.

Evolution of l-DOPA 4,5-dioxygenase activity allows for recurrent specialisation to betalain pigmentation in Caryophyllales.

The evolution of l-DOPA 4,5-dioxygenase activity, encoded by the gene DODA, was a key step in the origin of betalain biosynthesis in Caryophyllales. We previously proposed that l-DOPA 4,5-dioxygenase activity evolved via a single Caryophyllales-specific neofunctionalisation event within the DODA gene lineage. However, this neofunctionalisation event has not been confirmed and the DODA gene lineage exhibits numerous gene duplication events, whose evolutionary significance is unclear. To address this, we functionally characterised 23 distinct DODA proteins for l-DOPA 4,5-dioxygenase activity, from four betalain-pigmented and five anthocyanin-pigmented species, representing key evolutionary transitions across Caryophyllales. By mapping these functional data to an updated DODA phylogeny, we then explored the evolution of l-DOPA 4,5-dioxygenase activity. We find that low l-DOPA 4,5-dioxygenase activity is distributed across the DODA gene lineage. In this context, repeated gene duplication events within the DODA gene lineage give rise to polyphyletic occurrences of elevated l-DOPA 4,5-dioxygenase activity, accompanied by convergent shifts in key functional residues and distinct genomic patterns of micro-synteny. In the context of an updated organismal phylogeny and newly inferred pigment reconstructions, we argue that repeated convergent acquisition of elevated l-DOPA 4,5-dioxygenase activity is consistent with recurrent specialisation to betalain synthesis in Caryophyllales.

Redirecting Primary Metabolism to Boost Production of Tyrosine-Derived Specialised Metabolites in Planta.

L-Tyrosine-derived specialized metabolites perform many important functions in plants, and have valuable applications in human health and nutrition. A necessary step in the overproduction of specialised tyrosine-derived metabolites in planta is the manipulation of primary metabolism to enhance the availability of tyrosine. Here, we utilise a naturally occurring de-regulated isoform of the key enzyme, arogenate dehydrogenase, to re-engineer the interface of primary and specialised metabolism, to boost the production of tyrosine-derived pigments in a heterologous plant host. Through manipulation of tyrosine availability, we report a 7-fold increase in the production of tyrosine-derived betalain pigments, with an upper range of 855 mg·kg-1·FW, which compare favourably to many in vitro and commercial sources of betalain pigments. Since the most common plant pathway for tyrosine synthesis occurs via arogenate, the de-regulated arogenate dehydrogenase isoform is a promising route for enhanced production of tyrosine-derived pharmaceuticals in diverse plant hosts.

On-line stable isotope gas exchange reveals an inducible but leaky carbon concentrating mechanism in Nannochloropsis salina.

Carbon concentrating mechanisms (CCMs) are common among microalgae, but their regulation and even existence in some of the most promising biofuel production strains is poorly understood. This is partly because screening for new strains does not commonly include assessment of CCM function or regulation despite its fundamental role in primary carbon metabolism. In addition, the inducible nature of many microalgal CCMs means that environmental conditions should be considered when assessing CCM function and its potential impact on biofuels. In this study, we address the effect of environmental conditions by combining novel, high frequency, on-line (13)CO2 gas exchange screen with microscope-based lipid characterization to assess CCM function in Nannochloropsis salina and its interaction with lipid production. Regulation of CCM function was explored by changing the concentration of CO2 provided to continuous cultures in airlift bioreactors where cell density was kept constant across conditions by controlling the rate of media supply. Our isotopic gas exchange results were consistent with N. salina having an inducible "pump-leak" style CCM similar to that of Nannochloropsis gaditana. Though cells grew faster at high CO2 and had higher rates of net CO2 uptake, we did not observe significant differences in lipid content between conditions. Since the rate of CO2 supply was much higher for the high CO2 conditions, we calculated that growing cells bubbled with low CO2 is about 40 % more efficient for carbon capture than bubbling with high CO2. We attribute this higher efficiency to the activity of a CCM under low CO2 conditions.

Relationship between hyperglycemia, hormone disturbances, and clinical evolution in severely hyperglycemic post surgery critically ill children: an observational study.

BACKGROUND: To study hormonal changes associated with severe hyperglycemia in critically ill children and the relationship with prognosis and length of stay in intensive care. METHODS: Observational study in twenty-nine critically ill children with severe hyperglycemia defined as 2 blood glucose measurements greater than 180 mg/dL. Severity of illness was assessed using pediatric index of mortality (PIM2), pediatric risk of mortality (PRISM) score, and pediatric logistic organ dysfunction (PELOD) scales. Blood glucose, glycosuria, insulin, C-peptide, cortisol, corticotropin, insulinlike growth factor-1, growth hormone, thyrotropin, thyroxine, and treatment with insulin were recorded. ß-cell function and insulin sensitivity and resistance were determined on the basis of the homeostatic model assessment (HOMA), using blood glucose and C-peptide levels. RESULTS: The initial blood glucose level was 249 mg/dL and fell gradually to 125 mg/dL at 72 hours. Initial ß-cell function (49.2%) and insulin sensitivity (13.2%) were low. At the time of diagnosis of hyperglycemia, 50% of the patients presented insulin resistance and ß-cell dysfunction, 46% presented isolated insulin resistance, and 4% isolated ß-cell dysfunction. ß-cell function improved rapidly but insulin resistance persisted. Initial glycemia did not correlate with any other factor, and there was no relationship between glycemia and mortality. Patients who died had higher cortisol and growth hormone levels at diagnosis. Length of stay was correlated by univariate analysis, but not by multivariate analysis, with C-peptide and glycemic control at 24 hours, insulin resistance, and severity of illness scores. CONCLUSIONS: Critically ill children with severe hyperglycemia initially present decreased ß-cell function and insulin sensitivity. Nonsurvivors had higher cortisol and growth hormone levels and developed hyperglycemia later than survivors.

Dientes cariados, obturados y perdidos en pacientes con diabetes mellitus y sin ella / Decayed, missing and filled teeth in patients with and without diabetes mellitus

Se estudió a 50 pacientes con diabetes mellitus que acudieron al Centro de Atención al Diabético de Santiago de Cuba y a igual número sin esta enfermedad, atendidos en la clínica estomatológica del Hospital Provincial Docente Dr. Joaquín Castillo Duany. En el primer grupo se evaluó el control metabólico de su padecimiento, antes y después del ingreso, tomando en cuenta no solo datos clínicos, sino valores de glucemia en ayuna y posprandial después de 2 horas, mientras que el grado de afectación dental se determinó en ambos mediante el índice cariado-perdido-obturado-diente (COP-D). Se halló que este último fue menor en los integrantes del primer grupo, aunque las caries abundaron más en ellos, así como también que el grado de control metabólico no repercutió sobre el citado índice