Structure, self-assembly, and properties of a truncated reflectin variant.

Naturally occurring and recombinant protein-based materials are frequently employed for the study of fundamental biological processes and are often leveraged for applications in areas as diverse as electronics, optics, bioengineering, medicine, and even fashion. Within this context, unique structural proteins known as reflectins have recently attracted substantial attention due to their key roles in the fascinating color-changing capabilities of cephalopods and their technological potential as biophotonic and bioelectronic materials. However, progress toward understanding reflectins has been hindered by their atypical aromatic and charged residue-enriched sequences, extreme sensitivities to subtle changes in environmental conditions, and well-known propensities for aggregation. Herein, we elucidate the structure of a reflectin variant at the molecular level, demonstrate a straightforward mechanical agitation-based methodology for controlling this variant's hierarchical assembly, and establish a direct correlation between the protein's structural characteristics and intrinsic optical properties. Altogether, our findings address multiple challenges associated with the development of reflectins as materials, furnish molecular-level insight into the mechanistic underpinnings of cephalopod skin cells' color-changing functionalities, and may inform new research directions across biochemistry, cellular biology, bioengineering, and optics.

Lower miR-26a levels in breastmilk affect gene expression in adipose tissue of offspring.

Breastmilk miRNAs may act as epigenetic regulators of metabolism and energy homeostasis in offspring. Here, we aimed to investigate the regulatory effects of miR-26a on adipose tissue development. First, the 3T3-L1 cell model was used to identify putative target genes for miR-26a. Then, target genes were analysed in adipose tissue of offspring from dams that supplied lower levels of breastmilk miR-26a to determine whether miR-26a milk concentration might have a long-lasting impact on adipose tissue in the progeny. In the in vitro model, both over- and under-expression of miR-26a were induced by transfecting into 3T3-L1 with miR-26a mimic and inhibitor. Array analysis was performed after induction of miR-26a to ascertain the impact on mRNA target genes and influence of differentiation status. Focusing on genes related to adipose tissue development, transfection with miR-26a mimic reduced the expression of Pten, Hmga1, Stk11, Rb1, and Adam17 in both pre- and mature adipocytes. Data mostly confirmed the results found in the animal model. After weaning, descendants of cafeteria-fed dams breastfed with lower levels of miR-26a displayed greater expression of Hmag1, Rb1, and Adam17 in retroperitoneal white adipose tissue in comparison with controls. Hence, alterations in the amount of miR-26a supplied through milk during lactation is able to alter the expression of target genes in the descendants and may affect adipose tissue development. Thus, milk miR-26a may act as an epigenetic regulator influencing early metabolic program in the progeny, which emerges as a relevant component of an optimal milk composition for correct development.

Breast Milk MicroRNAs Related to Leptin and Adiponectin Function Can Be Modulated by Maternal Diet and Influence Offspring Phenotype in Rats.

There is evidence of the role of milk components in the metabolic programming of offspring. Here, we aimed to investigate the effects of a diet during lactation on breast milk leptin, adiponectin, and related miRNAs' expression, and their impact on dams and their offspring. Dams were fed a control diet (controls) or a diet enriched with oleic acid, betaine, and leucine (TX) throughout lactation. A TX diet promoted higher leptin at lactation day (LD) five and lower adiponectin on LD15 (vs. controls) in milk, resulting in increased leptin to adiponectin (L/A) ratio throughout lactation. Moreover, TX diet reduced milk levels of miR-27a, miR-103, miR-200a, and miR-222. Concerning TX offspring, higher body fat was early observed and maintained into adult life, accompanied by higher HOMA-IR than controls at three months of age. Offspring body fat content in adulthood correlated positively with milk L/A ratio at LD15 and negatively with miRNAs modulated by the TX diet. In conclusion, maternal diet during lactation can modulate leptin and adiponectin interplay with miRNAs in milk, setting up the metabolic programming of the offspring. Better knowledge about the influence of diet on this process is necessary to promote a healthy adult life in the progeny.

Identification of blood cell transcriptome-based biomarkers in adulthood predictive of increased risk to develop metabolic disorders using early life intervention rat models.

Calorie restriction during gestation in rats has long-lasting adverse effects in the offspring. It induces metabolic syndrome-related alterations, which are partially reversed by leptin supplementation during lactation. We employed these conditions to identify transcript-based nutrient sensitive biomarkers in peripheral blood mononuclear cells (PBMCs) predictive of later adverse metabolic health. The best candidate was validated in humans. Transcriptome analysis of PBMCs from adult male Wistar rats of three experimental groups was performed: offspring of control dams (CON), and offspring of 20% calorie-restricted dams during gestation without (CR) and with leptin supplementation throughout lactation (CR-LEP). The expression of 401 genes was affected by gestational calorie restriction and reversed by leptin. The changes preceded metabolic syndrome-related phenotypic alterations. Of these genes, Npc1 mRNA levels were lower in CR vs CON, and normalized to CON in CR-LEP. In humans, NPC1 mRNA levels in peripheral blood cells (PBCs) were decreased in subjects with mildly impaired metabolic health compared to healthy subjects. Therefore, a set of potential transcript-based biomarkers indicative of a predisposition to metabolic syndrome-related alterations were identified, including NPC1, which was validated in humans. Low NPC1 transcript levels in PBCs are a candidate biomarker of increased risk for impaired metabolic health in humans.

Alterations in plasma acylcarnitine and amino acid profiles may indicate poor nutrition during the suckling period due to maternal intake of an unbalanced diet and may predict later metabolic dysfunction.

Plasma profiles of acylcarnitines (ACs) and amino acids (AAs) may have interest as potential biomarkers. Here we analyzed plasma AC and AA profiles in 2 rat models with different metabolic programming outcomes: offspring of dams fed a cafeteria diet during lactation (O-CAF, with a thin-outside-fat-inside phenotype) and the offspring of dams with diet-induced obesity subjected to dietary normalization before gestation [offspring of postcafeteria dams (O-PCaf), nonaltered phenotype]. The purpose was to identify early variables that might indicate a propensity for a dysmetabolic state. O-CAF rats presented higher circulating levels of most of the lipid-derived ACs and higher hepatic expression of genes related to fatty acid oxidation ( Ppara and Cpt1a) than controls [offspring of control dams (O-C)]. They also exhibited an altered plasma AA profile. These differences were not observed in O-PCaf animals. A partial least squares-discriminant analysis score plot of the metabolomics data showed a clear separation between O-CAF and O-C animals. The long-chain ACs (C18, C18:1, C18:2, C16:1, and C16DC) and the AAs glycine, alanine, isoleucine, serine, and proline are the variables mainly influencing this separation. In summary, we have identified a cluster of ACs and AAs whose alterations may indicate poor nutrition during lactation due to maternal unbalanced diet intake and predict the later dysmetabolic phenotype observed in the offspring.-Pomar, C. A., Kuda, O., Kopecky, J., Rombaldova, M., Castro, H., Picó, C., Sánchez, J., Palou, A. Alterations in plasma acylcarnitine and amino acid profiles may indicate poor nutrition during the suckling period due to maternal intake of an unbalanced diet and may predict later metabolic dysfunction.

Metabolomic approach in milk from calorie-restricted rats during lactation: a potential link to the programming of a healthy phenotype in offspring.

PURPOSE: Mild/moderate maternal calorie restriction during lactation in rats has been associated with a lower predisposition to obesity and a healthier metabolic profile in adult offspring. Here, we aimed to assess the impact of maternal calorie restriction during lactation on milk composition to identify potential candidate components that could be involved in the programming effects in offspring. METHODS: An untargeted metabolomic approach in milk samples from 20%-calorie-restricted lactating (CRL) dams and their controls was performed. Levels of leptin, adiponectin, and irisin hormones in milk were also determined at lactating days 5, 10, and 15. RESULTS: Metabolomic analyses revealed a different metabolite pattern in milk between controls and CRL dams. 29 differential metabolites were tentatively identified (p < 0.05, FC > 1.5). Among them, myo-inositol, which showed greater levels in milk from CRL rats than controls, may be highlighted as one of the biologically plausible candidates that could be related to the beneficial effects of CRL in offspring. Results regarding myo-inositol were validated spectrophotometrically at days 10 and 15 of lactation, and levels in milk were correlated with maternal plasma levels. In addition, milk from CRL dams presented increased levels of adiponectin, decreased levels of irisin, and no changes in leptin levels vs controls throughout lactation. CONCLUSION: These data reveal important changes in milk composition due to calorie restriction during lactation that may be involved in the metabolic programming of the healthier phenotype of adult offspring. However, the possible contribution of the specific components is yet to be determined.

[Nutritional status and associated factors in ambulatory elderly patients]. / Estado nutricional y factores asociados en pacientes ancianos ambulatorios.

OBJECTIVE: To analyze the nutritional status (NS) of patients older than 65 years and establish their relationship with sociodemographic and health variables. DESIGN: Cross-sectional observational study in patients older than 65 years. LOCATION: 3 health centers. PARTICIPANTS: 255 patients: ambulatory (AP), in domiciliary care (DP) or institutionalized (IP). They completed the study 243 (response rate 95.3%). MAIN MEASUREMENTS: The Chang method was applied to determine the NS. Sociodemographic, anthropometric variables, dependence, mood, cognitive and analytical parameters were collected. Associations were analyzed applying chi-square and analysis of variance. The prevalence ratio (PR) for malnutrition was calculated. A multivariate model was applied (binary logistic regression). Significance was considered for p<0.05. RESULTS: The average age was 81.3 years (SD=7.4) and 72.0% were women. 48.9% were AP, 26.8% DP and 24.2% IP. 29.6% (95% CI: 23.9-35.8) presented malnutrition. Greater malnutrition was established in relation to living in a residence or requiring home help (PR=5.3), age over 85 (PR=4.9), presenting a moderate or higher dependency for basic activities of daily living (PR=3.9) and instrumental (PR=3.3), need help for mobility (PR=2.9) and present moderate/severe cognitive impairment (PR=2.1). The determinants of malnutrition in the multivariate model were older than 85 years old and being IP or DP. CONCLUSIONS: Emphasis should be placed on evaluating NS in patients older than 85 years of age who live in a residence or require home care, since they are the groups at greatest risk of malnutrition.

Validation (in Spanish) of the Mini Nutritional Assessment survey to assess the nutritional status of patients over 65 years of age.

AIM: To validate the Mini Nutritional Assessment (MNA) in a Spanish population over 65 years of age with varying degrees of independence. DESIGN: This cross-sectional validation study used the Chang nutritional assessment method as a reference test. PARTICIPANTS: 248 subjects (72.2% female), with a mean age of 81.3, completed the study. They were classified into three groups: (i) autonomous patients who were able to take part in activities outside their home; (ii) patients who require help with daily self-care; (iii) patients living in a residential health care facility. SETTING: Three health centres and three residential care homes situated in Cordoba (Spain). RESULTS: The kappa values for intra-observer and inter-observer agreement were 0.870 and 0.784, respectively. The intra-class correlation coefficient intra-observer was 0.874 and the inter-observer was 0.789. The sensitivity and specificity readings for the diagnostic accuracy of MNA were 63.2% and 72.9% in the total sample, respectively. The area under the curve was 0.726. For patients in the Group A, B and C, the sensitivity was 89.3%, 60.7% and 18.8%, and the specificity was 23.3%, 56.8% and 94.1%, respectively. CONCLUSION: The results for the reliability of the survey were excellent, and its internal consistency was acceptable. The diagnostic accuracy, as measured by the sensitivity and specificity readings, was lower than that obtained with the original survey. It can therefore be considered more suitable for a population with limited autonomy, and less appropriate for independent patients. The results may not be relevant to patients outside of the Cordova region in Spain.

miRNAs and Novel Food Compounds Related to the Browning Process.

Obesity prevalence is rapidly increasing worldwide. With the discovery of brown adipose tissue (BAT) in adult humans, BAT activation has emerged as a potential strategy for increasing energy expenditure. Recently, the presence of a third type of fat, referred to as beige or brite (brown in white), has been recognized to be present in certain kinds of white adipose tissue (WAT) depots. It has been suggested that WAT can undergo the process of browning in response to stimuli that induce and enhance the expression of thermogenesis: a metabolic feature typically associated with BAT. MicroRNAs (miRNAs) are small transcriptional regulators that control gene expression in a variety of tissues, including WAT and BAT. Likewise, it was shown that several food compounds could influence miRNAs associated with browning, thus, potentially contributing to the management of excessive adipose tissue accumulation (obesity) through specific nutritional and dietetic approaches. Therefore, this has created significant excitement towards the development of a promising dietary strategy to promote browning/beiging in WAT to potentially contribute to combat the growing epidemic of obesity. For this reason, we summarize the current knowledge about miRNAs and food compounds that could be applied in promoting adipose browning, as well as the cellular mechanisms involved.

Overestimation of hours dedicated to family caregiving of persons with heart failure.

AIMS: The aim of this study is to profile the family caregivers of people living with heart failure, to determine the perceived and real time devoted to daily care and to identify the factors associated with caregivers' overestimation of time dedicated to care. BACKGROUND: The time spent by family caregivers on daily care is related to overload, but there are differences between real and perceived time spent. The reason for this difference is unknown, as is its impact on the caregiver. DESIGN: Multicentre, cross-sectional study. METHODS: This study forms part of a longitudinal, multicentre, ambispective cohort investigation. The study population was composed of 478 patient-family caregiver dyads and the data were collected over 2 years from 2014 - 2016. RESULTS: The mean time perceived to be spent on daily care was 8.79 hr versus a real value of 4.41 hr. These values were positively correlated. A significant correlation was also found between the overestimation of hours spent and the age of the caregiver, the duration of the caregiving relationship and the number of people providing support and with the patient's level of dependence and self-care. CONCLUSION: The overestimation of time dedicated to care seems to be related to patients' and caregivers' characteristics, such as functional status, caregiver burden, age and cohabitation. These patterns should be considered by nurses when carrying out assessment and care planning with these patients and their caregivers.

Effects and consequences of caring for persons with heart failure: (ECCUPENIC study) a nested case-control study.

AIM: Primary: To report a research protocol to analyse the relationship between the degree of heart failure and the health-related quality of life of patients and their family caregivers. Secondary: To identify the characteristics of heart failure patients and their caregivers and the association between these characteristics and hospital admissions. Moreover, to conduct a longitudinal analysis of the relationship between patients' and that of their family caregivers. BACKGROUND: As heart failure progresses, it reduces the patient's quality of life and progressive functional deterioration requires hospital admission and the provision of healthcare resources. The availability of a family caregiver is a key element in addressing and managing this healthcare problem and some research results have associated this factor with the prognosis for heart failure. DESIGN: Multicentre cohort nested case-control study. METHODS: Exploratory analysis: Descriptive statistics, measures of central tendency and dispersion or percentages. Bivariate analysis: Using Student's t-test and chi-square test, anova and non-parametric tests. Survival analysis: Kaplan-Meier curves. Multivariate analysis: Cox's proportional hazards model. All calculations performed with an alpha level of 0·05. DISCUSSION: Lack of family support for patients with HF or greater duration of care is associated with more hospitalizations and increased depression among caregivers. Further longitudinal studies with a large population sample are required.

Enhancing hepatic fatty acid oxidation as a strategy for reversing metabolic disorders programmed by maternal undernutrition during gestation.

BACKGROUND/AIMS: Moderate maternal calorie-restriction during gestation programmes offspring for a major propensity to develop metabolic alterations in adulthood. We aimed to assess whether increased hepatic fatty-acid oxidation (FAO), at early ages, by gene transfer of Cpt1am (active mutant of carnitine palmitoyltransferase-1a), may be a strategy for reversing metabolic disturbances associated to maternal calorie-restriction during gestation in rats. METHODS: AAV-Gfp (control) and AAV-Cpt1am vectors were administered by tail vein injection in 18-day-old control-pups and the offspring of 20% calorie-restricted rats during gestation (CR). After weaning, animals were fed with normal-fat diet. At the age of 4 months, they were moved to HF-diet and sacrificed at the age of 6 months to collect tissues. Locomotive activity, energy expenditure and blood pressure were measured. RESULTS: Under HF-diet, CR-animals showed higher HOMA-IR, adipocyte diameter and hepatic triglyceride accumulation than controls; these alterations were reverted in Cpt1am-injected animals. In liver, this treatment ameliorated inflammatory state, decreased expression of lipogenesis-related genes and partially restored the decreased expression of leptin-receptor occurring in CR-animals. Treatment also reverted the decreased energy expenditure and the increased blood pressure of CR-animals. CONCLUSION: Increasing hepatic FAO through AAV-Cpt1am injection at juvenile ages prevents some metabolic disorders associated to gestational maternal calorie-restriction.

Impact of a legislative framework on quality of end-of-life care and dying in an acute hospital in Spain.

BACKGROUND: In Andalusia, Spain, a legislative framework was put in place in 2010 to guarantee dignity in dying and quality of care in the last phase of life. AIM: The aim of this study was to determine whether health professionals have incorporated the requirements of this legislation into their clinical practice and whether there have been improvements in decision-making procedures affecting the quality of dying in hospitals. METHODS: A cross-sectional analysis was carried out in an acute hospital in Andalusia, Spain. Clinical records of patients who died in the Costa del Sol Hospital were evaluated before and after the new legislative framework was introduced. Participants were all the patients aged over 18 years (n=398) who died in 2009 (n=216) or 2011 (n=182) of oncological disease or non-oncological chronic disease. Bivariate analyses evaluated differences between the two periods and associations among the patients' characteristics and the context of care. RESULTS: Provision of information on measures to facilitate comfort and the relief of physical suffering increased from 15.7% to 22.0%, although this was not significant. There was a significant increase in the number of patients who received joint counselling in this regard from doctors and nurses, from 0% in 2009 to 7.1% in 2011. CONCLUSIONS: The minimal changes found 1 year after the implementation of the framework confirm that culture change is a lengthy, difficult task that cannot be achieved through laws alone.

The Impact of Diet on miRNA Regulation and Its Implications for Health: A Systematic Review.

The evidence suggests that diet can modulate endogenous microRNA (miRNA) expression. Changes in miRNA expression may affect metabolic processes and consequently be involved in health status and disease development. The aim of this systematic review was to summarize the evidence of the role of diet and specific food components in the regulation of miRNA expression and discuss its implications for human health and disease development. The PubMed, Embase and Web of Science databases were searched in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for relevant studies. A total of 32 interventional and 5 observational studies performed in adults and evaluating dietary modulation of miRNA expression were included. Energy- and fat-controlled diets along with plant-based foods show substantial evidence of modulating endogenous miRNA levels. Plasma, serum and peripheral blood mononuclear cells (PBMCs) are the main sources used to measure miRNAs. A total of 108 miRNAs modulated by diet were identified. We confirmed that dietary habits are closely associated with the modulation of endogenous miRNAs. Particularly, energy content and fat intake appeared to be key factors influencing miRNA levels. Furthermore, since miRNAs are involved in the regulation of several biological processes, this modulatory process may affect health status and lead to metabolic disorders.

Early Life Programming of Adipose Tissue Remodeling and Browning Capacity by Micronutrients and Bioactive Compounds as a Potential Anti-Obesity Strategy.

The early stages of life, especially the period from conception to two years, are crucial for shaping metabolic health and the risk of obesity in adulthood. Adipose tissue (AT) plays a crucial role in regulating energy homeostasis and metabolism, and brown AT (BAT) and the browning of white AT (WAT) are promising targets for combating weight gain. Nutritional factors during prenatal and early postnatal stages can influence the development of AT, affecting the likelihood of obesity later on. This narrative review focuses on the nutritional programming of AT features. Research conducted across various animal models with diverse interventions has provided insights into the effects of specific compounds on AT development and function, influencing the development of crucial structures and neuroendocrine circuits responsible for energy balance. The hormone leptin has been identified as an essential nutrient during lactation for healthy metabolic programming against obesity development in adults. Studies have also highlighted that maternal supplementation with polyunsaturated fatty acids (PUFAs), vitamin A, nicotinamide riboside, and polyphenols during pregnancy and lactation, as well as offspring supplementation with myo-inositol, vitamin A, nicotinamide riboside, and resveratrol during the suckling period, can impact AT features and long-term health outcomes and help understand predisposition to obesity later in life.

Shared Decision-making in Breast Cancer Reconstructive Surgery: Experience in a Leading Hospital.

Background: The paradigm of healthcare has evolved toward patient-centered approaches, where shared decision-making (SDM) plays a pivotal role. This study aimed to explore the implementation of SDM during breast cancer reconstruction consultations and assess its impact on patient satisfaction and the decision-making process as a whole. Methods: A total of 102 female patients undergoing breast reconstruction were included in a multidisciplinary breast pathology unit. A streamlined SDM model involving choice introduction, option description, and preference exploration was implemented. A validated Spanish version of the nine-item Shared Decision Making Questionnaire was used alongside a complementary questionnaire. Data analysis was carried out using electronic data capture software. Results: The nine-item Shared Decision Making Questionnaire results indicate strong agreement in presenting various options and explaining their advantages and disadvantages. Patients were less confident about their participation in decision-making. The Complementary Shared Decision Making Questionnaire highlighted high satisfaction with interview times and language clarity but areas for improvement in consultation space and therapeutic choice participation. Conclusions: Integrating SDM into breast reconstruction consultations empowers patients in the decision-making process and enhances satisfaction. Decision aids prove effective in this context, facilitating patients' comprehension and reducing decisional conflict. There are areas for improvement within the SDM strategy, and they are detectable through scales. Although challenges in information transmission and patient involvement persist, adopting an SDM model has potential benefits that warrant further investigation.

Metabolic programming of sirtuin 1 (SIRT1) expression by moderate energy restriction during gestation in rats may be related to obesity susceptibility in later life.

In rats, 20% gestational energy restriction programmes offspring for higher food intake, which in adulthood results in higher body weight in males but not in females. Here, we aimed to assess whether the effects of moderate energy restriction during gestation and the sex-related outcomes on adult body weight may be related to the metabolic programming of sirtuin expression in different tissues. For this purpose, 25-d-old offspring of control and 20% energy-restricted (ER) rats (from days 1-12 of pregnancy) were studied. Body weight and the weight of white adipose tissue (WAT) depots and liver were recorded and mRNA expression of sirtuin 1 (SIRT1) and selected genes in the WAT, liver, muscle and hypothalamus were analysed. No differences were found in body weight or the weight of WAT and liver between the control and ER animals. A similar pattern of SIRT1 mRNA expression was found in the WAT, liver and skeletal muscle of ER animals, but in a sex-dependent manner: ER males showed lower SIRT1 mRNA levels than the controls, while no differences were found in females. A sex-different pattern was also observed in the hypothalamus. ER males, but not females, also showed lower mRNA levels of adipose TAG lipase (ATGL) and uncoupling protein 2 in WAT and of sterol response element binding protein 1c and stearoyl-CoA desaturase-1 in the liver. Both sexes of ER animals showed lower mRNA levels of 5' adenosine monophosphate-activated protein kinase and ATGL in the liver. In conclusion, moderate maternal energy restriction during gestation programmes a particular, sex-dependent gene expression profile of SIRT1 in different peripheral tissues, which may be related to obesity predisposition in adulthood; therefore SIRT1 expression emerges as a potential early biomarker of obesity susceptibility.