Dendritic cell effector mechanisms and tumor immune microenvironment infiltration define TLR8 modulation and PD-1 blockade.

The potent immunostimulatory effects of toll-like receptor 8 (TLR8) agonism in combination with PD-1 blockade have resulted in various preclinical investigations, yet the mechanism of action in humans remains unknown. To decipher the combinatory mode of action of TLR8 agonism and PD-1 blockade, we employed a unique, open-label, phase 1b pre-operative window of opportunity clinical trial ( NCT03906526 ) in head and neck squamous cell carcinoma (HNSCC) patients. Matched pre- and post-treatment tumor biopsies from the same lesion were obtained. We used single-cell RNA sequencing and custom multiplex staining to leverage the unique advantage of same-lesion longitudinal sampling. Patients receiving dual TLR8 agonism and anti-PD-1 blockade exhibited marked upregulation of innate immune effector genes and cytokines, highlighted by increased CLEC9A+ dendritic cell and CLEC7A/SYK expression. This was revealed via comparison with a previous cohort from an anti-PD-1 blockade monotherapy single-cell RNA sequencing study. Furthermore, in dual therapy patients, post-treatment mature dendritic cells increased in adjacency to CD8 + T-cells. Increased tumoral cytotoxic T-lymphocyte densities and expanded CXCL13 + CD8 + T- cell populations were observed in responders, with increased tertiary lymphoid structures (TLSs) across all three patients. This study provides key insights into the mode of action of TLR8 agonism and anti-PD-1 blockade immune targeting in HNSCC patients.

MIR124-3 and NKX6-1 hypermethylation profiles accurately predict metachronous gastric lesions in a Caucasian population.

BACKGROUND: Early gastric cancer is treated endoscopically, but patients require surveillance due to the risk of metachronous gastric lesions (MGLs). Epigenetic alterations, particularly aberrant DNA methylation in genes, such as MIR124-3, MIR34b/c, NKX6-1, EMX1, MOS and CDO1, have been identified as promising biomarkers for MGL in Asian populations. We aimed to determine whether these changes could predict MGL risk in intermediate-risk Caucasian patients. METHODS: This case-cohort study included 36 patients who developed MGL matched to 48 patients without evidence of MGL in the same time frame (controls). Multiplex quantitative methylation-specific PCR was performed using DNA extracted from the normal mucosa adjacent to the primary lesion. The overall risk of progression to MGL was assessed using Kaplan-Meier and Cox proportional hazards model analyses. RESULTS: MIR124-3, MIR34b/c and NKX6-1 were successfully analyzed in 77 samples. MIR124-3 hypermethylation was detected in individuals who developed MGL (relative quantification 78.8 vs 50.5 in controls, p = 0.014), particularly in females and Helicobacter pylori-negative patients (p = 0.021 and p = 0.0079, respectively). This finding was further associated with a significantly greater risk for MGL development (aHR = 2.31, 95% CI 1.03-5.17, p = 0.042). Similarly, NKX6-1 was found to be hypermethylated in patients with synchronous lesions (relative quantification 7.9 vs 0.0 in controls, p = 0.0026). A molecular-based methylation model incorporating both genes was significantly associated with a threefold increased risk for MGL development (aHR = 3.10, 95% CI 1.07-8.95, p = 0.037). CONCLUSIONS: This preliminary study revealed an association between MIR124-3 and NKX6-1 hypermethylation and the development of MGL in a Western population. These findings may represent a burden reduction and a greener approach to patient care.

Analysis of food supplements and sports foods consumption patterns among a sample of gym-goers in Portugal.

BACKGROUND: Gym-goers usually seek methods to improve performance, muscle gain, and overall health. One of the main strategies is including food supplements (FS) into their routine as aids to enhance their athletic capabilities and satisfy their nutritional needs. Thus, this study aimed to investigate and characterize the main FS and Sports Foods (SF) currently consumed, as well as the main reasons for their use and the source of advice in a group of gym-goers in the Lisbon Metropolitan Area (Portugal). METHODS: A cross-sectional study was conducted, including 303 gym-goers from Lisbon, Portugal, who were 133 women and 170 males (30.8 ± 12.9 years old). Face-to-face interviews were used by qualified researchers to gather data. RESULTS: Most of the interviewed athletes (71.95 %) took FS/SF, being men the main consumers. On average, 1.59 supplements were consumed per athlete. Logistic regression models indicated significant associations between age, gender, and motivations for gym attendance. While men and younger groups attended mainly for hypertrophy, women and older groups were focused on well-being. Protein (59.17 %) was the most used FS/SF, followed by creatine (41.28 %) and multivitamins (27.06 %). Men and younger individuals preferred protein and creatine, while older individuals focused more on specific vitamins and minerals. Women seemed to prefer L-carnitine and protein yogurts. Main sources of information included the internet, friends, and dietitians with notable gender and age-based preferences. Online stores were the main place of purchase. Monthly expenditures on FS/SF were not significantly affected by age or gender, but motivations for use had an influence. CONCLUSION: Most of the athletes interviewed took FS/SF, being men the major consumers. Protein was the principal FS/SF used, with online stores being the main place of purchase and the internet the primary source of information. Age and gender were key factors in adopted training, in the FS/SF chosen, and in the source of information selected. It is crucial that health professionals take primary responsibility for providing this guidance.

Diet composition and plastic ingestion in Poecilia reticulata from urban streams.

Fish are excellent bioindicators and can reveal the presence of plastic in the environment. Diagnosing the composition and abundance of polymers in the fish diet makes it possible to evaluate their point sources and possible trophic transfers. We aimed to use the gastrointestinal contents of Poecilia reticulata in subtropical urban streams to detect the occurrence, shape, color, size, and chemical composition of polymers. For this, the diet of 240 individuals was analyzed using the volumetric method, and the microplastics (MPs; < 5 mm) recorded were characterized using Raman spectroscopy. Individuals predominantly consumed organic detritus and aquatic macroinvertebrates, with higher proportions of Diptera. A total of 111 plastic particles (< 0.5 to 12 mm) were recorded, and a subset of 14.4% was subjected to a micro-Raman spectrometer (830 nm excitation). The occurrence of polyethylene terephthalate (PET) and polypropylene (PP) with phthalocyanine dye was recorded. Some fragments could not be identified by Raman, but they contained indigo blue dye. Poecilia reticulata had a predominantly detritivorous diet with a record of plastic consumption, reflecting environmental pollution. Our results demonstrate that individuals of P. reticulata have ingested MPs in urban streams. This reinforces the need for future studies on the relationship between the presence of MPs in fish and the level of pollution in streams, comparisons with species of different feeding habits, and the potentially harmful effects on the entire biota.

The Quality of Life of Former Portuguese Football Players.

BACKGROUND: The demands of playing professional football can have an impact on an individual's quality of life (QoL), which may remain into retirement. Given limited evidence exists regarding the QoL in former football players, this study aimed to assess QoL among Portuguese former players according to career duration, career end period, competitive level, tactical-positional status, international status, academic qualifications, serious injuries in career, and current professional football connection. METHODS: The study included 84 Portuguese former football players (48.8 ± 8.2 years old) who transitioned to retirement between 1988 and 2018. The WHOQOL-BREF questionnaire was used to assess QoL perceptions, and the Portuguese version was validated. RESULTS AND DISCUSSION: The former players have positive QoL indicators, both in general and across the four domains, namely in terms of the physical, psychological, and social relationship and environment. There were no statistically significant differences in QoL between the defined categories for career end period, competitive level, tactical-positional status, international status, and current professional football connection. Likewise, there was no significant correlation between QoL and career duration. In contrast, there were significant differences in general QoL (p < 0.023) and in the physical domain (p < 0.001) between former players with different academic qualifications. A significant correlation was found between the number of severe injuries sustained in a career and QoL in the physical domain (R = -0.300, p = 0.006). CONCLUSIONS: There are no concerning QoL results presented by former players. However, the number of severe injuries sustained during the career was associated with a lower QoL, while holding higher academic qualifications demonstrated higher general and physical QoL. Studies with larger samples should be conducted to confirm these trends.

Exploring the feasibility and implications of cranioencephalic computed tomography in HER2-positive breast cancer: A pilot study.

Background: Breast cancer has several subtypes, including HER2-positive breast cancer, which is characterized by overexpression of human epidermal growth factor receptor 2 (HER2), aggressiveness, poor prognosis, and high risk of recurrence and metastasis. Brain metastases are a common complication of HER2-positive breast cancer, but brain imaging is not included in the initial staging of this disease. This prospective pilot study aimed to evaluate the usefulness of brain computed tomography (CT) in the initial staging of HER2-positive breast cancer. Patients and methods: Fifty-eight patients were enrolled and demographic, clinical, and breast cancer-specific data were collected after the informed consent and ethical approval were obtained. Results: A descriptive analysis was performed. The median age of the patients was 55 years, and the majority had good performance status. Brain CT scans were performed at diagnosis, and no brain metastases were detected in early-stage patients. However, brain CT identified brain metastases in one advanced-stage patient with clinical suspicion. Conclusions: This study suggests that brain CT may have limited utility in the initial staging of early HER2-positive breast cancer, while it could be a valuable tool in advanced cases. Further research is needed, including a higher number of patients to identify those with high risk, which may benefit from brain imaging.

Insights into Immune Exhaustion in Chronic Hepatitis B: A Review of Checkpoint Receptor Expression.

Hepatitis B, caused by the hepatitis B virus (HBV), often progresses to chronic infection, leading to severe complications, such as cirrhosis, liver failure, and hepatocellular carcinoma. Chronic HBV infection is characterized by a complex interplay between the virus and the host immune system, resulting in immune cell exhaustion, a phenomenon commonly observed in chronic viral infections and cancer. This state of exhaustion involves elevated levels of inhibitory molecules, cells, and cell surface receptors, as opposed to stimulatory counterparts. This review aims to elucidate the expression patterns of various co-inhibitory and co-stimulatory receptors on immune cells isolated from chronic hepatitis B (CHB) patients. By analyzing existing data, the review conducts comparisons between CHB patients and healthy adults, explores the differences between HBV-specific and total T cells in CHB patients, and examines variations between intrahepatic and peripheral immune cells in CHB patients. Understanding the mechanisms underlying immune exhaustion in CHB is crucial for developing novel immunotherapeutic approaches. This detailed analysis sheds light on the immune exhaustion observed in CHB and lays the groundwork for future combined immunotherapy strategies aimed at leveraging checkpoint receptors to restore immune function and improve clinical outcomes.

Assessing knowledge and awareness of Food and Drug Interactions among nutrition sciences students: Implications for education and clinical practice.

BACKGROUND: Chronic diseases and polymedication increase the risk of food-drug interactions (FDIs) among the population, negatively impacting health. Nutritionists, as responsible for dietary planning, have a key role in preventing these events. AIM: To assess the knowledge about FDIs among a sample of Nutrition Sciences Bachelor students. METHODS: A descriptive cross-sectional observational study was conducted, involving 44 students from the 3rd and 4th academic years of different Portuguese universities during the 2023/2024 academic year. Participants completed a self-reported questionnaire, covering general and specific FDIs knowledge, academic background, and perceptions regarding FDIs importance and training adequacy. RESULTS: Results revealed a general lack of FDIs knowledge among participants, particularly in identifying specific interactions and appropriate dietary management. While half of the students reported exposure to a subject dedicated to FDIs, only 18.18% considered the knowledge acquired sufficient. Nearly all participants (93.18%) expressed the need for further training in FDIs during their undergraduate course. Furthermore, none of the participants had received additional training or attended workshops on FDIs. Specifically, participants struggled to identify appropriate dietary choices in conjunction with certain medications. Moreover, only a minority of participants demonstrated awareness of the ideal timing for medication intake relative to food consumption. Despite these knowledge gaps, participants recognized the importance of FDIs knowledge for future clinical practice. CONCLUSION: Bridging these knowledge gaps through targeted educational interventions and interdisciplinary collaboration is essential to ensure future nutrition professionals are equipped to address the complex challenges posed by FDIs in professional practice.

Preoperative statin therapy for adults undergoing cardiac surgery.

BACKGROUND: Despite significant advances in surgical techniques and perioperative care, people undertaking cardiac surgery due to cardiovascular disease are more prone to the development of postoperative adverse events. Statins (5-hydroxy-3-methylglutaryl-co-enzyme A (HMG-CoA) reductase inhibitors) are well-known for their anti-inflammatory and antioxidant effects and are established for primary and secondary prevention of coronary artery disease. In addition, statins are thought to have clinical benefits in perioperative outcomes in people undergoing cardiac surgery. This review is an update of a review that was first published in 2012 and updated in 2015. OBJECTIVES: To evaluate the benefits and harms of preoperative statin therapy in adults undergoing cardiac surgery compared to standard of care or placebo. SEARCH METHODS: We performed a search of the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 9, 2023), Ovid MEDLINE (1980 to 14 September 2023), and Ovid Embase (1980 to 2023 (week 36)). We applied no language restrictions. SELECTION CRITERIA: We included all randomised controlled trials (RCTs) comparing any statin treatment before cardiac surgery, for any given duration and dose, versus no preoperative statin therapy (standard of care) or placebo. We excluded trials without a registered trial protocol and trials without approval by an institutional ethics committee. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodology. Primary outcomes were short-term mortality and major adverse cardiovascular events. Secondary outcomes were myocardial infarction, atrial fibrillation, stroke, renal failure, length of intensive care unit (ICU) stay, length of hospital stay and adverse effects related to statin therapy. We reported effect measures as risk ratios (RRs) or mean differences (MDs) with corresponding 95% confidence intervals (CIs). We used the RoB 1 tool to assess the risk of bias in included trials, and GRADE to assess the certainty of the evidence. MAIN RESULTS: We identified eight RCTs (five new to this review) including 5592 participants. Pooled analysis showed that statin treatment before surgery may result in little to no difference in the risk of postoperative short-term mortality (RR 1.36, 95% CI 0.72 to 2.59; I2 = 0%; 6 RCTs, 5260 participants; low-certainty evidence; note 2 RCTs reported 0 events in both groups so RR calculated from 4 RCTs with 5143 participants). We are very uncertain about the effect of statins on major adverse cardiovascular events (RR 0.93, 95% CI 0.77 to 1.13; 1 RCT, 2406 participants; very low-certainty evidence). Statins probably result in little to no difference in myocardial infarction (RR 0.88, 95% CI 0.73 to 1.06; I2 = 0%; 5 RCTs, 4645 participants; moderate-certainty evidence), may result in little to no difference in atrial fibrillation (RR 0.87, 95% CI 0.72 to 1.05; I2 = 60%; 8 RCTs, 5592 participants; low-certainty evidence), and may result in little to no difference in stroke (RR 1.47, 95% CI 0.90 to 2.40; I2 = 0%; 4 RCTs, 5143 participants; low-certainty evidence). We are very uncertain about the effect of statins on renal failure (RR 1.04, 95% CI 0.80 to 1.34; I2 = 57%; 4 RCTs, 4728 participants; very low-certainty evidence). Additionally, statins probably result in little to no difference in length of ICU stay (MD 1.40 hours, 95% CI -1.62 to 4.41; I2 = 43%; 3 RCTs, 4528 participants; moderate-certainty evidence) and overall hospital stay (MD -0.31 days, 95% CI -0.64 to 0.03; I2 = 84%; 5 RCTs, 4788 participants; moderate-certainty evidence). No study had any individual risk of bias domain classified as high. However, two studies were at high risk of bias overall given the classification of unclear risk of bias in three domains. AUTHORS' CONCLUSIONS: In this updated Cochrane review, we found no evidence that statin use in the perioperative period of elective cardiac surgery was associated with any clinical benefit or worsening, when compared with placebo or standard of care. Compared with placebo or standard of care, statin use probably results in little to no difference in MIs, length of ICU stay and overall hospital stay; and may make little to no difference to mortality, atrial fibrillation and stroke. We are very uncertain about the effects of statins on major harmful cardiac events and renal failure. The certainty of the evidence validating this finding varied from moderate to very low, depending on the outcome. Future trials should focus on assessing the impact of statin therapy on mortality and major adverse cardiovascular events.

Using marine mussels to assess the potential ecotoxicological effects of two different commercial microplastics.

Microplastics (MPs) in the aquatic environment pose a serious threat to biota, by being confounded with food. These effects occur in mussels which are filter-feeding organisms. Mussels from the genus Mytilus sp. were used to evaluate the ecotoxicological effects of two MPs, polypropylene (PP) and polyethylene terephthalate (PET), after 4 and 28-days. Measured individual endpoints were condition index and feeding rate; and sub-individual parameters, metabolism of phase I (CYP1A1, CYP1A2 and CYP3A4) and II (glutathione S-transferases - GSTs), and antioxidant defense (catalase - CAT). MPs decreased both condition index (CI) and feeding rate (FR). No alterations occurred in metabolic enzymes, suggesting that these MPs are not metabolized by these pathways. Furthermore, lack of alterations in GSTs and CAT activities suggests the absence of conjugation and oxidative stress. Overall, biochemical markers were not responsive, but non-enzymatic responses showed deleterious effects caused by these MPs, which may be of high ecological importance.

Automatic Classification and Visualization of Text Data on Rare Diseases.

More than 7000 rare diseases affect over 400 million people, posing significant challenges for medical research and healthcare. The integration of precision medicine with artificial intelligence offers promising solutions. This work introduces a classifier developed to discern whether research and news articles pertain to rare or non-rare diseases. Our methodology involves extracting 709 rare disease MeSH terms from Mondo and MeSH to improve rare disease categorization. We evaluate our classifier on abstracts from PubMed/MEDLINE and an expert-annotated news dataset, which includes news articles on four selected rare neurodevelopmental disorders (NDDs)-considered the largest category of rare diseases-from a total of 16 analyzed. We achieved F1 scores of 85% for abstracts and 71% for news articles, demonstrating robustness across both datasets and highlighting the potential of integrating artificial intelligence and ontologies to improve disease classification. Although the results are promising, they also indicate the need for further refinement in managing data heterogeneity. Our classifier improves the identification and categorization of medical information, essential for advancing research, enhancing information access, influencing policy, and supporting personalized treatments. Future work will focus on expanding disease classification to distinguish between attributes such as infectious and hereditary diseases, addressing data heterogeneity, and incorporating multilingual capabilities.

What are the global patterns of microplastic ingestion by fish? A scientometric review.

The billions of tons of plastic released into the environment mostly fragment into smaller particles that reach rivers and oceans, posing toxicity risks to aquatic organisms. As fish serve as excellent environmental indicator organisms, this study aims to comprehensively review and quantify published data regarding the abundance of microplastics (MPs) ingested by fish through scientometric analysis. Systematic analysis reveals that global aquatic ecosystems are contaminated by MPs, with the characteristics of these contaminants stemming from inadequate disposal management practices. The abundance of MPs was recorded in several fish species, notably Cyprinus carpio in natural environments and Danio rerio in controlled environments. According to the surveyed studies, laboratory experiments do not accurately represent the conditions found in natural environments. The results suggest that, in natural environments, the predominant colors of MPs are blue, black, and red. Fibers emerged as the most prevalent type, with polyethylene (PE) and polypropylene (PP) being the most frequently identified chemical compositions. On the other hand, laboratory studies showed that the spheres and fragments ingested were predominantly polystyrene (PS) green, followed by the colors blue and red. This discrepancy complicates drawing accurate conclusions regarding the actual effects of plastic particles on aquatic biota. Given the enduring presence of plastic in the environment, it is imperative to consider and implement environmental monitoring for effective, long-term management.

Evaluation of bovine colostrum replacer supplementation to improve weaning transition in Holstein dairy calves.

The objective of this randomized controlled trial was to evaluate the efficacy of supplementing bovine colostrum replacer during weaning to reduce intestinal permeability and improve gain. For this experiment, 65 calves were enrolled and housed individually until 70 d of age. Calves were fed milk replacer (150 g/L) 3 times daily with 9, 10.5, 11.25, and 12 L/d offered from d 1 to 7, 8 to 14, 15 to 21, 22 to 56, respectively. Calves were weaned over 8 d from d 57 to 64, receiving a total of 7.8 L in 2 meals per day from d 57 to 60 and 3.8 L/d in 1 feeding from d 61 to 64. At d 57, calves were blocked by birth weight and randomly assigned to 1 of 2 treatments, equal in ME, which were fed once daily during weaning from d 57 to 64: control (CON; n = 31 calves): 3.8 L of milk replacer (150 g/L) fed by nipple bottle, or colostrum supplementation (COL; n = 34): a mixture of 1 L of bovine colostrum replacer (125 g/L) and 3 L of milk replacer (150 g/L) with 3.8 L of of the mixture fed by nipple bottle. Serum IgG was measured within 48 h of birth and BW was taken at d 0, 57, 60, 64, 70, 77, and 84. Starter intake and bovine respiratory disease (BRD) score were measured daily from d 50 to 70, and fecal consistency was examined daily from d 56 to 70. Serum BHB and lung consolidation were evaluated at d 57, 64, and 70, and intestinal permeability was assessed by recovery of chromium-EDTA, lactulose, and d-mannitol from plasma after oral administration at d 56 and 65. Body weight had no difference between treatment groups at the start of weaning, but COL were 2.79 kg (95% CI: 0.90-4.68) and 2.76 kg (95% CI: 0.86-4.65) heavier than CON at d 77 and 84, respectively. Additionally, COL tended to gain 100.00 g/d more than CON calves (95% CI: -10.41-207.13) from d 57 to 84. No differences were observed in any of the other variables measured. Supplementation of bovine colostrum replacer during weaning may improve weight gain, but the mechanism of action is not clear.

Effects of microplastics on key reproductive and biochemical endpoints of the freshwater microcrustacean Daphnia magna.

Human activities have directly impacted the environment, causing significant ecological imbalances. From the different contaminants resulting from human activities, plastics are of major environmental concern. Due to their high use and consequent discharge, plastics tend to accumulate in aquatic environments. There, plastics can form smaller particles (microplastics, MPs), due to fragmentation and weathering, which are more prone to interact with aquatic organisms and cause deleterious effects, including at the basis of different food webs. This study assessed the effects of two microplastics (polyethylene terephthalate, PET; and polypropylene, PP; both of common domestic use) in the freshwater cladoceran species Daphnia magna. Toxic effects were assessed by measuring reproductive traits (first brood and total number of offspring), and activities of biomarkers involved in xenobiotic metabolism (phase I: cytochrome P-450 isoenzymes CYP1A1, 1A2 and 3A4; phase II/conjugation: glutathione S-transferases; and antioxidant defense (catalase)). Both MPs showed a potential to significantly reduce reproductive parameters in D. magna. Furthermore, PET caused a significant increase in some isoenzymes of CYP450 in acutely exposed organisms, but this effect was not observed in chronically exposed animals. Similarly, the activity of the antioxidant defense (CAT) was significantly increased in acutely exposed animals, but not in chronically exposed organisms. This pattern of effects suggests a possible mechanism of long-term adaptation to the presence of the tested MPs. In conclusion, the herein tested MPs have shown the potential to induce deleterious effects on D. magna mainly observed in terms of the reproductive outcomes. Changes at the biochemical level seems transient and are not likely to occur in long term, environmentally exposed crustaceans.

Cost-effectiveness of semaglutide 2.4 mg in chronic weight management in Portugal.

BACKGROUND: Obesity and overweight are a significant public health concern. Subcutaneous semaglutide 2.4 mg injection is a glucagon-like peptide-1 (GLP-1) analogue approved by the European Medicines Agency as an adjunct to a reduced calorie diet and increased physical activity (diet and exercise, D&E) for the treatment obesity and overweight in the presence of at least one weight related comorbidity. This study aimed to assess the cost-effectiveness of semaglutide 2.4 mg in combination with D&E compared to D&E alone for the Portuguese setting. METHODS: Analysis were conducted using the Core Obesity Model (COM) version 18, a Markov state transition cohort model, to predict the health outcomes and costs of weight related complications based on changes in surrogate endpoints. Efficacy and safety data were sourced from the STEP trials (Body Mass Index, systolic blood pressure and glycemic status) from a cohort of adults aged on average 48 years with obesity (BMI ≥ 30 kg/m2) and ≥ 1 obesity-related comorbidities, over a time horizon of 40 years. Costs were estimated from the perspective of the Portuguese National Health Service. Sensitivity analyses were conducted to test the robustness of results across a range of assumptions. RESULTS: On a patient level, Semaglutide 2.4 mg in addition to D&E compared to D&E alone, improved QALYs by 0.098 and yielded higher costs by 1,325 EUR over a 40-year time horizon, with an ICER of 13,459 EUR per QALY gained and 100% probability of cost-effectiveness at the given WTP. Semaglutide 2.4 mg remained cost-effective across all different scenarios and sensitivity analysis at a WTP of 20,000 EUR per QALY. Among the subpopulations examined, Semaglutide 2.4 mg yielded ICERs of 18,459 EUR for patients with BMI ≥ 30 kg/m2 and of 22,657 EUR for patients with BMI ≥ 35 kg/m2. CONCLUSIONS: Semaglutide 2.4 mg was cost-effective compared to D&E alone for patients with obesity (BMI ≥ 30 kg/m2) and weight related comorbidities in Portugal, over a 40-year time horizon.

Exploring the immunomodulatory properties of glucan particles in human primary cells.

The immunomodulatory properties of ß-glucans have sparked interest among various medical fields. As vaccine adjuvants, glucan particles offer additional advantages as antigen delivery systems. This study reported the immunomodulatory properties of glucan particles with different size and chemical composition. The effect of glucan microparticles (GPs) and glucan nanoparticles (Glu 130 and 355 NPs) was evaluated on human immune cells. While GPs and Glu 355 NPs demonstrated substantial interaction with Dectin-1 receptor on monocytes, Glu 130 NPs exhibited reduced activation of this receptor. This observation was substantiated by blocking Dectin-1, resulting in inhibition of reactive oxygen species production induced by GPs and Glu 355 NPs. Notably, monocyte-derived dendritic cells (moDCs) stimulated by Glu 355 NPs exhibited phenotypic and functional maturation, essential for antigen cross-presentation. The immunomodulatory efficacy was investigated using an autologous mixed lymphocyte reaction (AMLR), resulting in considerable rates of lymphocyte proliferation and an intriguing profile of cytokine and chemokine release. Our findings highlight the importance of meticulously characterizing the size and chemical composition of ß-glucan particles to draw accurate conclusions regarding their immunomodulatory activity. This in vitro model mimics the human cellular immune response, and the results obtained endorse the use of ß-glucan-based delivery systems as future vaccine adjuvants.

Volatile Organic Compounds from Offspring of Stingless Bee Sacrificed in Hygienic Behavior Test.

This study shows the profile of volatile organic compounds (VOCs) from pupae and larvae of Melipona quadrifasciata anthidioides Lepeletier subjected to three death induction techniques for hygienic behavior (HB) studies: freezing in liquid nitrogen (LN2), freezing in a freezer (FRZ) and piercing of offspring with an entomological pin (PIN). The VOCs from larvae and pupae were obtained through headspace solid-phase microextraction and characterized using gas chromatography coupled to mass spectrometry. In addition, an HB test was performed on the colonies. The main classes of VOCs were hydrocarbons, terpenes and alcohols. Multivariate analysis was applied and showed that there was a separation in the compound profiles between the different treatments. The HB test in the colonies showed that 24 hours after the application of the techniques, the bees removed more dead larvae in LN2 treatment (83.5 %), while after 48 hours more larvae were removed in the LN2 and FRZ treatments (92.3 %). When compared to pupae removal, larvae removal was significantly faster in LN2.

Balancing trade-offs: Enhanced carbon assimilation and productivity with reduced nutritional value in a well-watered C4 pasture under a warmer CO2-enriched atmosphere.

The concentration of atmospheric CO2 and temperature are pivotal components of ecosystem productivity, carbon balance, and food security. In this study, we investigated the impacts of a warmer climate (+2 °C above ambient temperature) and an atmosphere enriched with CO2 (600 ppm) on gas exchange, antioxidant enzymatic system, growth, nutritive value, and digestibility of a well-watered, managed pasture of Megathyrsus maximus, a tropical C4 forage grass, under field conditions. Elevated [CO2] (eC) improved photosynthesis and reduced stomatal conductance, resulting in increased water use efficiency and plant C content. Under eC, stem biomass production increased without a corresponding increase in leaf biomass, leading to a smaller leaf/stem ratio. Additionally, eC had negative impacts on forage nutritive value and digestibility. Elevated temperature (eT) increased photosynthetic gains, as well as stem and leaf biomass production. However, it reduced P and K concentration, forage nutritive value, and digestibility. Under the combined conditions of eC and eT (eCeT), eT completely offset the effects of eC on the leaf/stem ratio. However, eT intensified the effects of eC on photosynthesis, leaf C concentration, biomass accumulation, and nutritive value. This resulted in a forage with 12% more acid detergent fiber content and 28% more lignin. Additionally, there was a decrease of 19% in crude protein leading to a 15% decrease in forage digestibility. These changes could potentially affect animal feeding efficiency and feedback climate change, as ruminants may experience an amplification in methane emissions. Our results highlight the critical significance of conducting multifactorial field studies when evaluating plant responses to climate change variables.