Digital Eye Straining: Exploring Its Prevalence, Associated Factors, and Effects on the Quality of Life.

BACKGROUND: Digital eye strain (DES) has become a pervasive issue in contemporary society due to increased reliance on electronic devices. This study aims to comprehensively explore the symptoms, severity, and associated factors of DES, considering demographic, behavioral, and health-related variables. METHODOLOGY: A cross-sectional study was conducted among participants with diverse demographic backgrounds. A structured questionnaire collected data on participant characteristics, electronic device usage patterns, symptoms of DES, and its impact on various aspects of quality of life. Statistical analyses, including chi-square tests, were employed to assess associations and significance. RESULTS: The majority of participants reported symptoms of DES, with eye dryness, headache, and eye redness being the most prevalent. Symptom severity varied, with age, daily device usage, adherence to the 20-20-20 rule, and studying with electronic devices demonstrating statistically significant associations. Participants diagnosed with eye diseases exhibited higher symptom severity. While disagreement was common regarding DES increasing stress, a substantial proportion acknowledged its impact on productivity and attention. CONCLUSION: The current study showed that there is a significant correlation between the incidence of digital eye straining and longer screen exposure time. The findings underscore the importance of age, behavior, and ocular health in understanding and addressing DES. The results contribute to the broader discourse on digital eye health and emphasize the need for targeted interventions to alleviate the impact of DES on daily life.

Nanoliposomal Irinotecan With Fluorouracil and Leucovorin or Gemcitabine Plus Cisplatin in Advanced Cholangiocarcinoma: A Phase II Study of the AIO Hepatobiliary-YMO Cancer Groups (NIFE-AIO-YMO HEP-0315).

PURPOSE: First-line therapy options in advanced cholangiocarcinoma (CCA) are based on the ABC-02 trial regimen (gemcitabine/cisplatin [G/C]). The NIFE trial examined nanoliposomal irinotecan/fluorouracil/leucovorin (nal-IRI/FU/LV) as alternative first-line therapy in advanced CCA. METHODS: NIFE is a prospective, open-label, randomized, multicenter phase II study that aimed at detecting efficacy comparable with the standard treatment. Patients with advanced CCA were randomly assigned (1:1) to receive nal-IRI/FU/LV (arm A) or G/C (arm B). Stratification parameters were intrahepatic versus extrahepatic CCA, sex, and Eastern Cooperative Oncology Group (ECOG; 0/1). Arm A was designed as a Simon's optimal two-stage design and arm B served as a randomized control group. The primary goal was to exclude an inferior progression-free survival (PFS) at 4 months of only 40%, while assuming a rate of 60% on G/C population. RESULTS: Between 2018 and 2020, overall 91 patients were randomly assigned to receive nal-IRI/FU/LV (n = 49) or G/C (n = 42). The NIFE trial formally met its primary end point with a 4-month PFS rate of 51% in patients receiving nal-IRI/FU/LV. The median PFS was 6 months (2.4-9.6) in arm A and 6.9 months (2.5-7.9) in arm B. Median overall survival (OS) was 15.9 months (10.6-20.3) in arm A and 13.6 months (6.5-17.7) in arm B. The exploratory comparison of study arms suggested a numerical but statistically not significant advantage for nal-IRI/FU/LV (hazard ratio for PFS, 0.85 [95% CI, 0.53 to 1.38] and for OS, 0.94 [95% CI, 0.58 to 1.50]). Analysis for stratification parameters revealed no differences for sex and ECOG, but for tumor localization. The objective response rate was 24.5% with nal-IRI/FU/LV and 11.9% with G/C. No unexpected toxicities occurred. AEs related to nal-IRI/FU/LV were mainly GI and to G/C hematologic. CONCLUSION: Treatment of advanced CCA with nal-IRI/FU/LV demonstrated efficacy in first-line therapy without new safety findings and merits further validation.

Implementation and outcomes of beta-lactam allergy management protocol at a comprehensive cancer center.

PURPOSE: Beta-lactam allergy (BLA) is associated with increased broad-spectrum antibiotic (Br-ABX) use and worse clinical outcomes. We evaluated our hospital-wide BLA protocol (BLA-P) that used following categories: intolerance, low-risk, and high-risk. METHODS: Hospitalized adult patients with listed BLA during 10/2021-12/2022 were eligible. Exclusions were critically ill, surgical, hospice or comfort care, or non-verbal patients. Assessment was counted each time a pharmacist evaluated BLA. Interventions were no further action (high-risk allergy, patient refusal, unstable clinical status), updated allergy label, or delabeled. Delabeling was done either based on antibiotic history (direct-delabeling), or via test-dose challenge for low-risk patients. Br-ABX usage was compared in the unique delabeled patients: the empiric antibiotic use 90 days post-delabeling versus pre-delabeling using McNemar test (SPSS). RESULTS: A total of 700 assessments in 631 patients were identified. 441 assessments in 377 patients (median 63 years-old, 41% male, 50% hematological cancer) met inclusion criteria. The assessments revealed 9% intolerance, 55% low-risk, 23% high-risk and 13% unknown reaction. Interventions resulted in no further action 7%, updated label 72%, and delabeling 21%. 65% of the delabeling was via direct-delabeling and 35% test-dose challenge. Among patients who received a test-dose challenge, 36/36(97%) had no documented allergic reactions, and 1/26(3%) developed a mild rash. The use of aztreonam (pre-delabeling 28% vs. post-delabeling 1.2%, p < 0.001) and meropenem (13% vs. 2.4%, p = 0.022) significantly decreased while cefepime (24% vs. 50%, p = 0.001) and piperacillin-tazobactam (3.7% vs. 22%, p < 0.001) increased after delabeling. CONCLUSION: BLA-P led to 21% delabeling, which resulted in increased preferred Br-ABX and decrease in aztreonam/meropenem use among delabeled patients.

STING orchestrates the neuronal inflammatory stress response in multiple sclerosis.

Inflammation-induced neurodegeneration is a defining feature of multiple sclerosis (MS), yet the underlying mechanisms remain unclear. By dissecting the neuronal inflammatory stress response, we discovered that neurons in MS and its mouse model induce the stimulator of interferon genes (STING). However, activation of neuronal STING requires its detachment from the stromal interaction molecule 1 (STIM1), a process triggered by glutamate excitotoxicity. This detachment initiates non-canonical STING signaling, which leads to autophagic degradation of glutathione peroxidase 4 (GPX4), essential for neuronal redox homeostasis and thereby inducing ferroptosis. Both genetic and pharmacological interventions that target STING in neurons protect against inflammation-induced neurodegeneration. Our findings position STING as a central regulator of the detrimental neuronal inflammatory stress response, integrating inflammation with glutamate signaling to cause neuronal cell death, and present it as a tractable target for treating neurodegeneration in MS.

Sex- and species-specific contribution of CD99 to T cell costimulation during multiple sclerosis.

BACKGROUND: Differences in immune responses between women and men are leading to a strong sex bias in the incidence of autoimmune diseases that predominantly affect women, such as multiple sclerosis (MS). MS manifests in more than twice as many women, making sex one of the most important risk factor. However, it is incompletely understood which genes contribute to sex differences in autoimmune incidence. To address that, we conducted a gene expression analysis in female and male human spleen and identified the transmembrane protein CD99 as one of the most significantly differentially expressed genes with marked increase in men. CD99 has been reported to participate in immune cell transmigration and T cell regulation, but sex-specific implications have not been comprehensively investigated. METHODS: In this study, we conducted a gene expression analysis in female and male human spleen using the Genotype-Tissue Expression (GTEx) project dataset to identify differentially expressed genes between women and men. After successful validation on protein level of human immune cell subsets, we assessed hormonal regulation of CD99 as well as its implication on T cell regulation in primary human T cells and Jurkat T cells. In addition, we performed in vivo assays in wildtype mice and in Cd99-deficient mice to further analyze functional consequences of differential CD99 expression. RESULTS: Here, we found higher CD99 gene expression in male human spleens compared to females and confirmed this expression difference on protein level on the surface of T cells and pDCs. Androgens are likely dispensable as the cause shown by in vitro assays and ex vivo analysis of trans men samples. In cerebrospinal fluid, CD99 was higher on T cells compared to blood. Of note, male MS patients had lower CD99 levels on CD4+ T cells in the CSF, unlike controls. By contrast, both sexes had similar CD99 expression in mice and Cd99-deficient mice showed equal susceptibility to experimental autoimmune encephalomyelitis compared to wildtypes. Functionally, CD99 increased upon human T cell activation and inhibited T cell proliferation after blockade. Accordingly, CD99-deficient Jurkat T cells showed decreased cell proliferation and cluster formation, rescued by CD99 reintroduction. CONCLUSIONS: Our results demonstrate that CD99 is sex-specifically regulated in healthy individuals and MS patients and that it is involved in T cell costimulation in humans but not in mice. CD99 could potentially contribute to MS incidence and susceptibility in a sex-specific manner.

The immune system protects us from bacterial and viral infections and impacts the outcome of many diseases. Thus, understanding immunological processes is crucial to unravel pathogenic mechanisms and to develop new therapeutic treatment options. Sex is a biological variable affecting immunity and it is known that females and males differ in their immunological responses. Women mount stronger immune responses leading to more rapid control of infections and greater vaccine efficacy compared to men. However, this enhanced immune responsiveness is accompanied by female preponderance and susceptibility to autoimmune diseases like systemic lupus erythematosus, rheumatoid arthritis and multiple sclerosis (MS). MS sex ratio varies around 2:1 to 3:1 with a steadily increasing incidence in female MS patients making sex one of the top risk factors for developing MS. However, the underlying biological mechanisms including sex hormones as well as genetic and epigenetic factors and their complex interplay remain largely unknown. Here, we discovered the gene and its encoded protein CD99 to be differentially expressed between women and men with men showing increased expression on many immune cell subsets including T cells. Since T cells are key contributors to MS pathogenesis, we examined the role of CD99 on T cells of healthy individuals and MS patients. We were able to identify CD99-mediated T cell regulation, which might contribute to sex differences in MS susceptibility and incidence indicating the importance to include sex as a biological variable. Of note, these differences were not reproduced in mice showing the necessity of functional research in humans.

Natural product discovery in soil actinomycetes: unlocking their potential within an ecological context.

Natural products (NPs) produced by bacteria, particularly soil actinomycetes, often possess diverse bioactivities and play a crucial role in human health, agriculture, and biotechnology. Soil actinomycete genomes contain a vast number of predicted biosynthetic gene clusters (BGCs) yet to be exploited. Understanding the factors governing NP production in an ecological context and activating cryptic and silent BGCs in soil actinomycetes will provide researchers with a wealth of molecules with potential novel applications. Here, we highlight recent advances in NP discovery strategies employing ecology-inspired approaches and discuss the importance of understanding the environmental signals responsible for activation of NP production, particularly in a soil microbial community context, as well as the challenges that remain.

Cysteine, sodium metabisulfite, and glutathione enhance crosslinking between proteins during high moisture meat analog extrusion processing and may improve the fibrousness of the products.

BACKGROUND: High moisture meat analog (HMMA) products processed using extrusion have become increasingly popular in the last few years. Because the formation of disulfide bonds is believed to play a critical role in the texturization mechanism, this study aimed to understand how chemical compounds capable of reducing disulfide bonds, specifically cysteine, sodium metabisulfite, and glutathione, affect the texture and the chemical interactions between the proteins. METHOD: Wheat protein blended with cysteine, sodium metabisulfite, or glutathione at levels of 0, 0.5, 1.0, 2.5, 5.0, and 7.5 g kg-1 was extruded at three different temperatures (115, 140, and 165 °C) using a co-rotating twin-screw extruder. The feed rate (85 g min-1), the moisture content (600 g kg-1), and the screw speed (300 rpm) were kept constant. Unextruded and extruded material was subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis, polymeric protein fractionation, and sulfhydryl group/disulfide bond analysis. Extruded samples were further analyzed for their hardness and their anisotropic index. RESULTS: The inclusion of reductants significantly affected the structure of the obtained extrudates. Although reducing agents had a relatively small impact on the total amount of disulfide bonds, their action significantly enhanced crosslinking between the proteins. At select conditions, samples with high fibrousness were specifically obtained when cysteine or sodium metabisulfite was included at levels of 5.0 g kg-1. DISCUSSION: In the presence of reducing agents, it is believed that disulfide bonds are split earlier during the process without binding to them, giving the protein strands more time to unravel and align, leading to a better flow behavior and more fibrous products. © 2024 Society of Chemical Industry.

Talc and calcium carbonate inclusions in direct expanded pea starch extrudates exhibit different behavior under increasing screw speeds.

The ability to modulate direct expanded product structures improves the versatility and range of product applications. The effect of nucleating agents, namely, talc and calcium carbonate (CC), on the expansion characteristics of pea starch extrudates as impacted by screw speed was explored. Pea starch blends with increasing levels of nucleating agents (0.25%, 1%, and 2%) at 18% moisture (w.b.) were extruded across a range of screw speeds (150, 250, 350, and 450 rpm). The water absorption index, water solubility index (WSI), expansion ratio (ER), unit density, and cell count were determined to evaluate the performance of nucleating agents. The nucleating efficiency of CC, as assessed by cell count, improved with increasing screw speeds. In contrast, the nucleating efficiency of talc was influenced by inclusion levels irrespective of screw speed. ER values ranged from 2.10 to 2.88, where higher nucleating agent inclusions and screw speeds corresponded with lower ER values. Increased nucleating agents and screw speeds corresponded to higher WSI values suggesting the nucleating agents promoted starch degradation. The nucleating agents appeared to promote flow instabilities indicated upon assessment of the extrudate surface. PRACTICAL APPLICATION: This study provides helpful information on the expanded extrudate structure of pea starch as influenced by screw speed and nucleating agents. These findings may help the food industry select processing parameters and appropriate nucleating agent inclusion levels when producing new expanded products with unique textures.

Repurposing N-acetylcysteine for management of non-acetaminophen induced acute liver failure: an evidence scan from a global health perspective.

Background: The World Health Organization (WHO)'s Essential Medicines List (EML) plays an important role in advocating for access to key treatments for conditions affecting people in all geographic settings. We applied our established drug repurposing methods to one EML agent, N-acetylcysteine (NAC), to identify additional uses of relevance to the global health community beyond its existing EML indication (acetaminophen toxicity). Methods: We undertook a phenome-wide association study (PheWAS) of a variant in the glutathione synthetase (GSS) gene in approximately 35,000 patients to explore novel indications for use of NAC, which targets glutathione. We then evaluated the evidence regarding biologic plausibility, efficacy, and safety of NAC use in the new phenotype candidates. Results: PheWAS of GSS variant R418Q revealed increased risk of several phenotypes related to non-acetaminophen induced acute liver failure (ALF), indicating that NAC may represent a therapeutic option for treating this condition. Evidence review identified practice guidelines, systematic reviews, clinical trials, retrospective cohorts and case series, and case reports. This evidence suggesting benefit of NAC use in this subset of ALF patients. The safety profile of NAC in this literature was also concordant with existing evidence on safety of this agent in acetaminophen-induced ALF. Conclusions: This body of literature indicates efficacy and safety of NAC in non-acetaminophen induced ALF. Given the presence of NAC on the EML, this medication is likely to be available across a range of resource settings; promulgating its use in this novel subset of ALF can provide healthcare professionals and patients with a valuable and safe complement to supportive care for this disease.

Changes in physical activity and sedentary behavior during the first COVID-19 pandemic- restrictions in Germany: a nationwide survey : Running head: physical activity during the COVID-19 restrictions.

BACKGROUND: The COVID-19 pandemic restrictions posed challenges to maintaining healthy lifestyles and physical well-being. During the first mobility restrictions from March to mid-July 2020, the German population was advised to stay home, except for work, exercise, and essential shopping. Our objective was to comprehensively assess the impact of these restrictions on changes in physical activity and sedentary behavior to identify the most affected groups. METHODS: Between April 30, 2020, and May 12, 2020, we distributed a COVID-19-specific questionnaire to participants of the German National Cohort (NAKO). This questionnaire gathered information about participants' physical activity and sedentary behavior currently compared to the time before the restrictions. We integrated this new data with existing information on anxiety, depressive symptoms, and physical activity. The analyses focused on sociodemographic factors, social relationships, physical health, and working conditions. RESULTS: Out of 152,421 respondents, a significant proportion reported altered physical activity and sedentary behavioral patterns due to COVID-19 restrictions. Over a third of the participants initially meeting the WHO's physical activity recommendation could no longer meet the guidelines during the restrictions. Participants reported substantial declines in sports activities (mean change (M) = -0.38; 95% CI: -.390; -.378; range from -2 to + 2) and reduced active transportation (M = -0.12; 95% CI: -.126; -.117). However, they also increased recreational physical activities (M = 0.12; 95% CI: .117; .126) while engaging in more sedentary behavior (M = 0.24; 95% CI: .240; .247) compared to pre-restriction levels. Multivariable linear and log-binomial regression models indicated that younger adults were more affected by the restrictions than older adults. The shift to remote work, self-rated health, and depressive symptoms were the factors most strongly associated with changes in all physical activity domains, including sedentary behavior, and the likelihood to continue following the physical activity guidelines. CONCLUSIONS: Mobility patterns shifted towards inactivity or low-intensity activities during the nationwide restrictions in the spring of 2020, potentially leading to considerable and lasting health risks.

Specialized biopolymers: versatile tools for microbial resilience.

Bacteria produce a wide range of specialized biopolymers that can be classified into polysaccharides, polyamides, and polyesters and are considered to fulfill storage functions. In this review, we highlight recent developments in the field linking metabolism of biopolymers to stress and signaling physiology of the producers and demonstrating that biopolymers contribute to bacterial stress resistance and shape structure and composition of microenvironments. While specialized biopolymers are currently the focus of much attention in biotechnology as innovative and biodegradable materials, our understanding about the regulation and functions of these valuable compounds for the producers, microbial communities, and our environment is still very limited. Addressing open questions about signals, mechanisms, and functions in the area of biopolymers harbors potential for exciting discoveries with high relevance for biotechnology and fundamental research.

The interaction between wheat and pea protein influences the final chemical and sensory characteristics of extruded high moisture meat analogs.

Plant-based meat analog products, including those produced by extrusion processing, have become increasingly popular. Complete comprehension of the texturization mechanism and the formation of fibrousness would help improve existing products and extend the variety of plant sources used. Therefore, this study aimed to provide improved insight into the mechanism of texturization during the processing of high-moisture meat analog (HMMA) products. Blends with different wheat and pea protein ratios (100:0, 80:20, 60:40, 40:60, 20:80, and 0:100 wheat:pea) were extruded at a screw speed of 400 rpm, two different moisture contents (50% and 55%), and a feed rate of 90 g/min using a co-rotating twin-screw extruder. Extrudates were analyzed for their texture, free sulfhydryl groups, disulfide bonds, and solubility in different extractants relative to the raw ingredient blends. In addition, a sensory analysis was conducted using the rapid and cost-effective "rate-all-that-apply" (RATA) methodology. The interplay between the two protein types had synergistic effects on the system parameters torque, pressure, and specific mechanical energy, as well as on some textural and sensory parameters. Molecular analyses were not influenced by the interplay between wheat and pea protein as the molecular analyses followed linear trends with the pea inclusion level. Analysis of protein solubility suggests that the texturization mechanism differs slightly depending on the protein type. It is suggested that the texturization of wheat protein depends highly on disulfide bonds, whereas the texturization of pea protein relies on the combination of disulfide bonds and non-covalent interactions. Additionally, RATA was found to be a valuable tool for HMMA products.

Parasomnias and Associated Factors Among University Students: A Cross-Sectional Study in Saudi Arabia.

Background and aim Parasomnias are a group of sleep-related movements or emotions like sleepwalking, sleep talking, teeth grinding (Bruxism), nocturnal enuresis (sleep enuresis), sleep terrors (night terrors), sleep-related eating disorder (SRED), nightmare disorder, REM Sleep Behavior Disorder (RBD), and confusional arousals. Parasomnias are more common in children than in adults. This study aimed to estimate the prevalence of different parasomnias among university students in Saudi Arabia. Additionally, it aimed to study the relationship between different parasomnias and gender-associated sleep disorders, mental disorders, and other medical diseases, stress, substance use, and medications. Methods This study is a descriptive cross-sectional survey-based study. The target population for this study is university students from different regions of Saudi Arabia. Parasomnia was defined as having at least one of the 11 disorders (over the past six months). Data was collected through an online survey. The survey was distributed on different online platforms to collect data from other regions of Saudi Arabia. The study took place between August and November 2022. Results Among 1,296 participants, 934 (72.1%) were female, and 1,071 (82.6%) were aged 19-24 years. A total of 1054 (81, 3%) participants reported having at least one parasomnia disorder. The most prevalent parasomnias were sleep talking 656 (50.6%), nightmares 650 (50.2%), and confusional arousals 524 (40.4%). The least prevalent parasomnia was sleep-related eating disorder 98 (7.6%). Among participants, 580 (44.8%) had a family history of parasomnia, 439 (33.9%) were diagnosed with sleep disorders, 296 (22.8%) were diagnosed with mental illnesses, and 92 (7.1%) had other medical diseases. Conclusion Parasomnias are prevalent among university students in Saudi Arabia. Parasomnias were higher in female students and in students with a family history of parasomnia. Parasomnias in adults might be a chronic or recurrent disorder. Parasomnias are significantly associated with psychological stress, depression, and anxiety disorders.

Influence of legume-derived proteins with varying solubility on the direct expansion of corn starch during twin-screw extrusion processing.

This study analyzed the effect of the inclusion of legume-derived proteins, specifically pea and fava bean protein, with varying solubility levels on the expansion of corn starch. Three different proteins exhibiting low, medium, or high solubility were mixed with corn starch to obtain blends containing 15%, 25%, and 35% (w/w) of the protein. Extrusion was performed on a twin-screw extruder at three different screw speeds (200, 400, and 600 rpm), a moisture content of 16% (w.b.), and a die temperature of 140°C. Obtained extrudates were analyzed for their expansion, unit density, and hydration properties, namely, water solubility index (WSI) and water absorption index (WAI). Extrudates containing the protein with the highest solubility showed different patterns than those that had proteins with low or medium solubility. Expansion ratio (ER) increased from a maximum of 3.55 ± 0.24 for pure corn starch up to 5.45 ± 0.43 when incorporating 35% of the protein with medium solubility but significantly decreased down to 1.24 ± 0.08 when incorporating 35% of the most soluble protein. The influence on the system parameters, as well as on the hydration properties, was also greatest for the blends containing the protein with the highest solubility. Even though significant Pearson correlations were observed between protein solubility and ER (r = -0.579), unity density (r = 0.614), WSI (r = -0.634), torque (r = -0.612), as well as specific mechanical energy (r = -0.451), further research is needed to evaluate if the solubility is indeed the reason for certain behaviors or if other protein characteristics are more critical for expansion. PRACTICAL APPLICATION: This manuscript provides practical information on the influence of the addition of legume-derived proteins with different solubility levels on direct expansion. The obtained results may help the industry with the selection of the appropriate proteins for inclusion levels in producing high protein direct-expanded extruded food products.

Calcium channel ß3 subunit regulates ATP-dependent migration of dendritic cells.

Migratory dendritic cells (migDCs) continuously patrol tissues and are activated by injury and inflammation. Extracellular adenosine triphosphate (ATP) is released by damaged cells or actively secreted during inflammation and increases migDC motility. However, the underlying molecular mechanisms by which ATP accelerates migDC migration is not understood. Here, we show that migDCs can be distinguished from other DC subsets and immune cells by their expression of the voltage-gated calcium channel subunit ß3 (Cavß3; CACNB3), which exclusively facilitates ATP-dependent migration in vitro and during tissue damage in vivo. By contrast, CACNB3 does not regulate lipopolysaccharide-dependent migration. Mechanistically, CACNB3 regulates ATP-dependent inositol 1,4,5-trisphophate receptor-controlled calcium release from the endoplasmic reticulum. This, in turn, is required for ATP-mediated suppression of adhesion molecules, their detachment, and initiation of migDC migration. Thus, Cacnb3-deficient migDCs have an impaired migration after ATP exposure. In summary, we identified CACNB3 as a master regulator of ATP-dependent migDC migration that controls tissue-specific immunological responses during injury and inflammation.

High methoxyl pectin can improve the extrusion characteristics and increase the dietary fiber content of starch-cellulose extrudates.

Improving total dietary fiber content while maintaining the texture/expansion of extruded products is a challenge. Pectin has a dual function; it is a source of dietary fiber and it also functions as a hydrocolloid, which could improve the texture of high-fiber extruded foods. The objective of this study was to evaluate the impacts of pectin types from citrus peel on the expansion characteristics of starch-cellulose extrudates. High and low methoxyl pectin (HMP and LMP) was added to the starch-cellulose mixtures and extruded using a twin-screw extruder. The pasting properties of raw mixtures, extrusion properties, microstructure, and dietary fiber contents of the extrudates were studied. The inclusion of HMP in raw material improved the peak viscosity (629.7 ± 8.1 to 754.7 ± 80.1 mPa s) and maintained the final viscosity compared to the control (starch-cellulose mixture alone), unlike LMP. HMP relatively maintained the extrusion process parameters such as torque, back pressure, and specific mechanical energy as the control. Interestingly, the addition of 7% of HMP had a similar expansion ratio (3.41 ± 0.08 to 2.35 ± 0.06) compared to the control (3.46 ± 0.08 to 2.32 ± 0.09) under the extrusion conditions studied. The total dietary fiber content improved from 12.22 ± 0.01% to 18.26 ± 0.63% (w/w). HMP maintained the expansion characteristic of starch-cellulose extrudates and improved its total dietary fiber content relative to LMP. Adding HMP to the mixtures improved the extensibility of the melt, favoring bubble growth and expansion of the starch-cellulose extrudates. Fourier transform infrared spectroscopy data suggested that there could be intermolecular interactions between starch, cellulose, and pectin, but the nature of these interactions needs further investigation. PRACTICAL APPLICATION: The study provides practical information on the influence of the addition of high and low methoxyl pectin on starch-cellulose extrudates. The results can help the industry to produce snack products that are more nutritious but are still well accepted by the consumers.

Assessment of Public Knowledge of Hypertension Among the Saudi Population.

Background Hypertension is a major risk factor for cardiovascular illness and premature death and is becoming more prevalent worldwide. To promote better educational strategies regarding hypertension, it is crucial to identify the most significant knowledge gaps among the general public. This study aimed to assess the knowledge of hypertension among the general public in Saudi Arabia. Methodology A cross-sectional, questionnaire-based study was conducted in Saudi Arabia. The target population was the general public aged ≥18 in Saudi Arabia. Statistical analysis was conducted using RStudio (R version 4.1.1). Numerical data were described as mean ± standard deviation or median and interquartile range (IQR) whenever applicable. P-values <0.05 indicated statistical significance. Results A total of 1,404 respondents were collected. After exclusion, 1,399 records were analyzed in this study. More than half of the respondents were females (59.5%) aged 18-39 years (52.7%) and had a university degree (64.8%). Additionally, 46.0% were employed. Approximately one-quarter of the sample had hypertension (26.3%), while 73.3% had a family history of hypertension The median score was 16.0 (IQR = 12.0-18.0) with a minimum and a maximum of 0.0 and 22.0, respectively. Reliability testing revealed that knowledge items had a good internal consistency (Cronbach's alpha = 0.859 based on 22 knowledge items). There was no significant association between knowledge and gender and having a personal history of hypertension. However, the knowledge score differed significantly by age, educational level, employment status, and having a family history of hypertension. On the multivariate analysis, knowledge scores were independently higher among participants in the higher age categories. Moreover, having a university degree, a postgraduate degree, and a family history of hypertension were independently associated with higher knowledge scores. Conclusions This study found that the general public in Saudi Arabia had good levels of knowledge about hypertension. Being knowledgeable about hypertension not only improves adherence to treatment plans among antihypertensive patients but also aids in avoiding its occurrence and consequences among non-hypertensive patients by adopting self-care. Serial and frequent studies on this issue are recommended to gather more evidence on this topic. Ongoing hypertension education is essential to enhance knowledge to minimize the burden of this prevalent issue.

Awareness of the General Population Toward Constipation and Its Complications in the Western Region, Saudi Arabia.

Background and aim Constipation can be defined as unsatisfying defecation characterized by difficult stool passage, infrequent stools, or both. Complications include hemorrhoids, anal fissures, and prolapse of pelvic organs. Unfortunately, there needs to be more data available regarding awareness on this subject. Thus, in this study, we aim to measure the level of understanding of constipation and its complications in the western region of Saudi Arabia. Methods In this cross-sectional study, a valid and reliable questionnaire was used in data collection. In addition, SPSS (IBM Corp., Armonk, NY) was used for the analysis of collected data. Results The present study included a total of 778 participants from the general public, 75.6% of whom were female and 24.4% of whom were male. We found that 70% of participants had an overall good awareness of constipation, with significant variation in levels of awareness among different groups; levels of awareness increased with age (P-value < 0.001), higher education also positively affected the level of understanding (P-value = 0.04), and participants who reported personal experience had higher levels of awareness than participants who did not have personal experience (P-value​​​​​​​ = 0.002). There was no significant association between the level of awareness and gender or city of residence. Conclusion Much of our population was well aware of constipation and its complications, with significant variation in awareness among different age groups, educational levels, and personal experiences.

Sarcoma Patients Admitted to the Intensive Care Unit (ICU): Predictive Relevance of Common Sepsis and Performance Parameters.

Purpose: Prognosis of sarcoma patients is improving, with a better understanding of sarcomagenesis revealing novel therapeutic targets. However, aggressive chemotherapy remains an essential part of treatment, bearing the risk of severe side effects that require intensive medical treatment. Available data on the characteristics and clinical outcome of sarcoma patients admitted to intensive care units (ICU) are sparse. Patients and Methods: We performed a retrospective analysis of sarcoma patients admitted to the ICU from 2005 to 2022. Patients ≥18 years with histologically proven sarcoma were included in our study. Results: Sixty-six patients were eligible for analysis. The following characteristics had significant impact on overall survival: sex (p=0.046), tumour localization (p=0.02), therapeutic intention (p=0.02), line of chemotherapy (p<0.001), SAPS II score (p=0.03) and SOFA score (p=0.02). Conclusion: Our study confirms the predictive relevance of established sepsis and performance scores in sarcoma patients. For overall survival, common clinical characteristics are also of significant value. Further investigation is needed to optimize ICU treatment of sarcoma patients.