Hydrolyzed Chicken Extract (ProBeptigen®) on Cognitive Function in Healthy Middle-Aged People: A Randomized Double-Blind Trial.

Cognitive decline is an important issue of global public health. Cognitive aging might begin at middle adulthood, the period particularly vulnerable to stress in lifespan. Essence of chicken (EOC) has consistently demonstrated its beneficial effects on various cognitive domains as nutritional supplementation. This study primarily aimed to examine the cognitive enhancement effects of ProBeptigen® (previously named CMI-168), hydrolyzed peptides extracted from EOC, in healthy middle-aged people under mild stress. Ninety healthy subjects were randomly assigned into the ProBeptigen® or placebo group for eight weeks. Neurocognitive assessment, event-related potentials (ERPs), and blood tests were conducted before, during, and after the treatment. The ProBeptigen® group outperformed placebo group on Logical Memory subtests of Wechsler Memory Scale-third edition (WMS-III) and Spatial Working Memory task in the Cambridge Neuropsychological Test Automated Battery (CANTAB). The anti-inflammatory effects of ProBeptigen® in humans were also confirmed, with progressively declining high-sensitivity C-reactive protein (hs-CRP) levels. Regular dietary supplementation of ProBeptigen® is suggested to improve verbal short- and long-term memory as well as spatial working memory, and reduce inflammation in middle-aged healthy individuals with stress. The effects of ProBeptigen® on cognition warrant further investigation. (NCT03612752).

Developing a comprehensive, culturally sensitive conceptual framework of health domains in Singapore.

The increasing focus of healthcare systems worldwide on long-term care highlights the need for culturally sensitive Health-Related Quality of Life instruments to accurately capture perceived health of various populations. Such instruments require a contextualized conceptual framework of health domains, which is lacking in some socio-cultural contexts. We developed a comprehensive and culturally sensitive conceptual framework of health domains relevant to the Singaporean population. We recruited Singaporeans/ permanent residents, English/ Chinese-speaking, with/ without chronic illnesses to participate in focus group discussions (FGDs) and in-depth interviews (IDIs). We elicited health areas participants perceived to be important for them to be happy and satisfied with life. To encourage spontaneous emergence of themes, we did not specify any aspect beyond the broad domains of Physical, Mental, and Social health so as not to limit the emergence of new themes. Themes from the transcripts were distilled through open coding (two independent coders), then classified into more abstract domains (each transcript coded independently by two coders from a pool of six coders). From October 2013 to August 2014, 121 members of the general public participated in 18 FGDs and 13 IDIs (44.6% males, mean age: 53.3 years 77% Chinese, 9% Malay, 12% Indian, 63% with chronic illness) while 13 healthcare workers participated as patient-proxies in three FGDs. Thematic analysis identified 27 domains. The 15 physical domains included physical appearance, energy, physical fitness, and health and resistance to illness. The nine mental domains included emotions, self-esteem, and personal freedom. The three social domains were social contact, social relationships, and social roles. This conceptual framework reflected physical, mental, and social dimensions of well-being, suggesting that the Singapore population's views on health support the World Health Organization's definition of health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".

A systematic review and meta-analysis comparing pancreaticoduodenectomy versus limited resection for duodenal gastrointestinal stromal tumors.

PURPOSE: This study was designed to compare the clinical outcomes of patients who underwent limited resection (LR) versus pancreaticoduodenectomy (PD) for duodenal gastrointestinal stromal tumors (GISTs). METHODS: A systematic review of the literature was performed to identify studies analyzing the clinical outcomes of LR and PD for duodenal GISTs. RESULTS: Eleven studies were included, of which 7 that compared 162 patients who underwent LR versus 98 patients who underwent PD were suitable for meta-analysis. Patients who underwent PD were more likely to have tumors which were large (≥ 5 cm) [76.0 vs. 36.6 %, odds ratio (OR) 5.49, 95 % confidence interval (CI) 1.8-16.76], with high mitotic count ≥5/50 high-power field (HPF) (33.7 vs. 18.5 %, OR 2.23, 95 % CI 1.22-4.08), classified as high risk (60.3 vs. 32.0 %, OR 3.23, 95 % CI 1.65-6.34), and which were located at D2 (80.5 vs. 28.6 %, OR 10.33, 95 % CI 5.22-20.47) compared with LR. PD was associated with a higher postoperative morbidity rate than LR [48.3 vs. 20.7 %, relative risk (RR) 2.34, 95 % CI 1.61-3.42]. LR was not associated with an increased local recurrence rate, had a better DFS [hazard ratio (HR) 2.07, 95 % CI 1.07-4.01], and lower rate of distant metastasis (8.9 vs. 25.8 %, OR 0.28, 95 % CI 0.13-0.59) compared with PD. CONCLUSIONS: LR should be the procedure of choice for duodenal GIST whenever technically feasible, because it is associated with good oncologic outcomes and lower morbidity compared with PD. The oncologic outcome of GIST is more likely to be dependent on tumor biology rather that the type of surgical resection. The use of Imatinib in patients with duodenal GIST may potentially allow a proportion of patients who would otherwise require a PD to undergo LR instead.