Using a translanguaging framework to examine language production in a trilingual person with aphasia.

When language abilities in aphasia are assessed in clinical and research settings, the standard practice is to examine each language of a multilingual person separately. But many multilingual individuals, with and without aphasia, mix their languages regularly when they communicate with other speakers who share their languages. We applied a novel approach to scoring language production of a multilingual person with aphasia. Our aim was to discover whether the assessment outcome would differ meaningfully when we count accurate responses in only the target language of the assessment session versus when we apply a translanguaging framework, that is, count all accurate responses, regardless of the language in which they were produced. The participant is a Farsi-German-English speaking woman with chronic moderate aphasia. We examined the participant's performance on two picture-naming tasks, an answering wh-question task, and an elicited narrative task. The results demonstrated that scores in English, the participant's third-learned and least-impaired language did not differ between the two scoring methods. Performance in German, the participant's moderately impaired second language benefited from translanguaging-based scoring across the board. In Farsi, her weakest language post-CVA, the participant's scores were higher under the translanguaging-based scoring approach in some but not all of the tasks. Our findings suggest that whether a translanguaging-based scoring makes a difference in the results obtained depends on relative language abilities and on pragmatic constraints, with additional influence of the linguistic distances between the languages in question.

Study protocol to investigate the efficacy of confocal laser endomicroscopy-based selective single-elimination diet over standard fivefold elimination diet in patients with endomicroscopically proven food intolerance: app-assisted, monocentric, double-blind, randomised and controlled trial in Germany.

INTRODUCTION: Imprecise nutritional recommendations due to a lack of diagnostic test accuracy are a frequent problem for individuals with adverse reactions to foods but no precise diagnosis. Consequently, patients follow very broad and strict elimination diets to avoid uncontrolled symptoms such as diarrhoea and abdominal pain. Dietary limitations and the uncertainty of developing gastrointestinal symptoms after the inadvertent ingestion of food have been demonstrated to reduce the quality of life (QoL) of affected individuals and subsequently might increase the risk of malnutrition and intestinal dysbiosis. This trial aims to investigate the effects of a tailored diet based on the confocal laser endoscopy (CLE) examination result to limit the side effects of unspecific and broad elimination diets and to increase the patient's QoL. METHODS AND ANALYSIS: The study is designed as a prospective, double-blind, monocentric, randomised and controlled trial conducted at the University Hospital of Schleswig-Holstein, Campus Lübeck, Germany. One hundred seventy-two patients with non-IgE-related food allergies and positive CLE results will be randomised to either a tailored diet or a standard fivefold elimination diet. The primary endpoints are the difference between the end and the start of the intervention in health-related QoL and the sum score of the severity of symptoms after 12 weeks. Key secondary endpoints are changes in the severity of symptoms, further QoL measurements, self-assessed state of health and number of days with a pathologically altered stool. Microbiome diversity and metabolome of stool, urine and blood will also be investigated. Safety endpoints are body composition, body mass index and adverse events. ETHICS AND DISSEMINATION: The study protocol was accepted by the ethical committee of the University of Lübeck (AZ: 22-111) on 4 May2022. Results of the study will be published in peer-reviewed journals and presented at scientific meetings. TRIAL REGISTRATION NUMBER: German Clinical Trials Register (DRKS00029323).

A nutritional supplement based on a synbiotic combination of Bacillus subtilis DSM 32315 and L-alanyl-L-glutamine improves glucose metabolism in healthy prediabetic subjects - A real-life post-marketing study.

Introduction: Impaired glucose homeostasis is a significant risk factor for cardiometabolic diseases, whereas the efficacy of available standard therapies is limited, mainly because of poor adherence. This post-marketing study assessed the glucose-lowering potential of a synbiotic-based formulation. Methods: One hundred ninety-two participants were enrolled in a digital nutrition program with continuous glucose monitoring (CGM) and received a study product comprising Bacillus subtilis DSM 32315 and L-alanyl-L-glutamine. Participants underwent a first sensor phase without supplementation, followed by a 14-day supplementation phase without sensor, and completed by a second sensor phase while continuing supplementation. Fasting glucose levels were determined before and after supplementation by CGM. In addition, the postprandial glycemic response to an oral glucose challenge, body weight, HbA1c concentrations, and BMI was analyzed. Subgroup analyses of subjects with elevated glucose and HbA1c levels vs. normoglycemic subjects were performed. Results: Supplementation with the study product resulted in significant improvements in glucose parameters (delta values: fasting glucose -2,13% ± 8.86; iAUC0-120 -4.91% ± 78.87; HbA1c: -1.20% ± 4.72) accompanied by a significant weight reduction (-1.07 kg ± 2.30) in the study population. Subgroup analyses revealed that the improvements were mainly attributed to a prediabetic subgroup with elevated fasting glucose and HbA1c values before supplementation (delta values: fasting glucose -6.10% 4± 7.89; iAUC0-120 -6.28% ± 115.85; HbA1c -3.31% ± 4.36; weight: -1.47 kg ± 2.82). Conclusion: This study indicates that the synbiotic composition is an effective and convenient approach to counteract hyperglycemia. Further placebo-controlled studies are warranted to test its efficacy in the treatment of cardiometabolic diseases.

A Digital Therapeutic Allowing a Personalized Low-Glycemic Nutrition for the Prophylaxis of Migraine: Real World Data from Two Prospective Studies.

Migraine is a headache disorder associated with a high socioeconomic burden. The digital therapeutic sinCephalea provides an individualized low-glycemic diet based on continuous glucose measurement and is intended to provide a non-pharmacological migraine prophylaxis. We performed two prospective studies with migraine patients who used sinCephalea over a period of 16 weeks. The patients used a headache diary and recorded their migraine-related daily life impairments using the assessment tools HIT-6 and MIDAS for a pre versus post comparison. In addition, continuous glucose data of patients were compared to healthy controls. In both studies, patients reported a reduction of headache and migraine days as well as reductions in HIT-6 and MIDAS scores. More specifically, migraine days decreased by 2.40 days (95% CI [-3.37; -1.42]), HIT-6 improved by 3.17 points (95% CI [-4.63; -1.70]) and MIDAS by 13.45 points (95% CI [-22.01; -4.89]). Glucose data suggest that migraine patients have slightly increased mean glucose values compared to healthy controls, but drop into a glucose range that is below one's individual standard range before a migraine attack. In conclusion, sinCephalea is a non-pharmacological, digital migraine prophylaxis that induces a therapeutic effect within the range of pharmacological interventions.

Effect of replacing maize silage with red clover silage in the diet on milk fatty acid composition in cows.

This study aimed to evaluate the effect of replacing maize silage plus soybean meal with red clover silage (RCS) plus wheat on the fatty acid (FA) profile in the milk fat of cows. Forty-four lactating German Holstein cows were used in a 4 × 4 Latin square design with 21-d periods composed of 13 d of adaptation to diets followed by an 8-d sampling phase. Experimental diets offered as total mixed ration consisted of a constant forage-to-concentrate ratio (75:25) with target proportions of RCS to maize silage of 15:60 (RCS15), 30:45 (RCS30), 45:30 (RCS45), and 60:15 (RCS60) on a dry matter basis. Increasing the level of RCS in the diet was accompanied by a reduction of linoleic acid content in the diet and decreased linearly the proportions of linoleic acid in the milk up to 4%. Proportions of α-linolenic acid in milk increased 2-fold with RCS60 compared with RCS15, which resulted from the linear increase in α-linolenic acid intake with incremental levels of RCS. Vaccenic acid in the milk fat was reduced by 24%. Rumenic acid, a conjugated linoleic acid (cis-9,trans-11 conjugated linoleic acid) considered to be a human health promoter, was also decreased by 22%. Reduced rumenic acid in the milk fat was probably due to a reduced amount of vaccenic acid produced in the rumen and, consequently, to the low amount of vaccenic acid to be desaturated to rumenic acid in the mammary gland by Δ9-desaturase. Oleic acid was enriched in the milk fat, although the dietary concentration of oleic acid decreased. Stearic acid proportions remained constant with increasing levels of RCS. The proportions of total polyunsaturated FA were increased by 12%, and the long-chain FA proportions increased linearly with increasing levels of RCS. Myristic acid was reduced linearly, but palmitic acid remained constant. Saturated FA was reduced linearly by 2%. Branched-chain FA, which are presumed to possess anticarcinogenic properties, were reduced to a small extent only (quadratic effect). We conclude that replacing maize silage with RCS appears to alter milk FA composition by reducing linoleic acid intake and ruminal biohydrogenation. Feeding RCS represents a strategy to increase intake of α-linolenic acid in dairy cows. However, because changes in the FA profile show positive as well as negative effects, no distinct conclusions can be drawn with regard to human health benefits.

Replacing maize silage plus soybean meal with red clover silage plus wheat in diets for lactating dairy cows.

The objectives of this study were to evaluate the effects of replacing maize silage plus soybean meal with red clover silage (RCS) plus wheat on feed intake, diet digestibility, N partitioning, urinary excretion of purine derivatives, and milk production in dairy cows. Forty-four lactating German Holstein cows were used in a 4 × 4 Latin square design with 21-d periods composed of a 13-d adaptation phase followed by an 8-d sampling phase. Experimental diets offered as total mixed ration consisted of a constant forage-to-concentrate ratio (75:25) with targeted proportions of RCS-to-maize silage of 15:60 (RCS15), 30:45 (RCS30), 45:30 (RCS45), and 60:15 (RCS60) on a dry matter (DM) basis. Increasing the proportion of RCS plus wheat in the diet decreased linearly the intake of DM from 22.4 to 19.8 kg/d, and of organic matter from 21.1 to 18.1 kg/d. The apparent total tract digestibility (ATTD) of DM and organic matter did not differ across diets and averaged 68.4 and 70.5%, respectively. However, ATTD of N decreased linearly from 68.5 to 63.2%, whereas ATTD of neutral detergent fiber and acid detergent fiber increased linearly from 50.4 to 59.6% and from 48.4 to 57.7%, respectively, when increasing the proportion of RCS plus wheat. Fecal N excretion increased from 31.6 (RCS15) to 37.2% (RCS60) of N intake, whereas urinary N excretion was the lowest (32.8% of N intake) with RCS45. Hence, N efficiency (milk N/N intake) decreased linearly with incremental levels of RCS plus wheat, being the lowest when feeding RCS60 (25.4%), probably due to increased nonprotein N proportion in total dietary N. Urinary excretion of purine derivatives decreased linearly from 378 to 339 mmol/d, which suggests that increasing levels of RCS plus wheat reduced the microbial crude protein flow at the duodenum. Milk yield and milk protein concentration declined linearly from 35.9 to 30.2 kg/d and from 3.20 to 3.01%, respectively, when increasing the proportion of RCS plus wheat. In conclusion, caution should be taken before introducing high levels of RCS plus wheat in diets of high-yielding dairy cows. However, RCS plus wheat can be included up to 30% of the dairy cow diet (DM basis) without a reduction in lactation performance.

[5-year course of dyslexia ­ Persistence, sex effects, performance in reading and spelling, and school-related success]. / 5-Jahres-Verlauf der LRS: Stabilität, Geschlechtseffekte, Schriftsprachniveau und Schulerfolg.

Objective: The study examines the 5-year course of children with dyslexia with regard to their sex. Furthermore, the study investigates the impact of dyslexia on the performance in reading and spelling skills and school-related success. Method: A group of 995 6- to 16-year-olds were examined at the initial assessment. Part of the initial sample was then re-examined after 43 and 63 months. The diagnosis of dyslexia was based on the double discrepancy criterion using a standard deviation of 1.5. Though they had no intellectual deficits, the children showed a considerable discrepancy between their reading or writing abilities and (1) their nonverbal intelligence and (2) the mean of their grade norm. Results: Nearly 70 % of those examined had a persisting diagnosis of dyslexia over a period of 63 months. The 5-year course was not influenced by sex. Despite average intelligence, the performance in writing and spelling of children suffering from dyslexia was one standard deviation below a control group without dyslexia with average intelligence and 0.5 standard deviations below a group of children suffering from intellectual deficits. Furthermore, the school-related success of the dyslexics was significantly lower than those of children with average intelligence. Dyslexics showed similar school-related success rates to children suffering from intellectual deficits. Conclusions: Dyslexia represents a considerable developmental risk. The adverse impact of dyslexia on school-related success supports the importance of early diagnostics and intervention. It also underlines the need for reliable and general accepted diagnostic criteria. It is important to define such criteria in light of the prevalence rates.

Michael acceptor based antiplasmodial and antitrypanosomal cysteine protease inhibitors with unusual amino acids.

New peptidic Michael acceptor based cysteine protease inhibitors displaying antiparasitic activity were identified by testing a broad series of 45 compounds in total, containing Asn, Gln, or Phe. As target enzymes, falcipain-2 and -3 from P. falciparum and rhodesain from T. b. rhodesiense were used. In the case of the Asn/Gln containing compounds, the trityl-protected, diastereomeric E-configured vinylogous dipeptide esters 16 (Boc-(S)-Phg-(R/S)-vGln(Trt)-OEt) were discovered as most active inhibitors concerning both protease inhibition and antiparasitic acitivity, with inhibition constants in the submicromolar range. The compounds were shown to display time-dependent and competitive inhibition. In the case of the Phe containing compounds, the maleic acid derivatives 42 and 43 (BnO-Phe<--Mal-Phe-OBn, BnO-Phe<--Mal-Phe-Ala-OBn, Mal = maleic acid) displayed good inhibition of rhodesain as well as good antitrypanosomal activity, while the fumaric acid derived E-analogue 14 (BnO-Phe<--Fum-Phe-OBn) only displayed inhibition of the target enzymes but no antiparasitic activity. Inhibition by these Phe derivatives was shown to be time-independent and competitive.

Synthesis and evaluation of non-peptidic cysteine protease inhibitors of P. falciparum derived from etacrynic acid.

A series of etacrynic acid derivatives was synthesized and screened for their in vitro activity against Plasmodium falciparum, as well as their activity against recombinantly expressed falcipain-2 and -3. The two most active compounds of the series displayed IC(50) values of 9.0 and 18.8 microM against Plasmodia.

Screening of protease inhibitors as antiplasmodial agents. Part I: Aziridines and epoxides.

A broad protease-based and cell-based screening of protease inhibitors yielded the aziridine-2-carboxylic acid derivative 2 a and the N-acylated aziridine-2,3-dicarboxylic acid derivatives 32 a and 34 b as the most potent inhibitors of falcipain-2 and falcipain-3 (IC(50) falcipain-2: 0.079-5.4 microM, falcipain-3: 0.25-39.8 microM). As the compounds also display in vitro activity against the P. falciparum parasite in the submicromolar and low micromolar range, these compound classes are leads for new antiplasmodial falcipain inhibitors.

Aziridide-based inhibitors of cathepsin L: synthesis, inhibition activity, and docking studies.

A comprehensive screening of N-acylated aziridine (aziridide) based cysteine protease inhibitors containing either Boc-Leu-Caa (Caa=cyclic amino acid), Boc-Gly-Caa, or Boc-Phe-Ala attached to the aziridine nitrogen atom revealed Boc-(S)-Leu-(S)-Azy-(S,S)-Azi(OBn)(2) (18 a) as a highly potent cathepsin L (CL) inhibitor (K(i)=13 nM) (Azy=aziridine-2-carboxylate, Azi=aziridine-2,3-dicarboxylate). Docking studies, which also accounted for the unusual bonding situations (the flexibility and hybridization of the aziridides) predict that the inhibitor adopts a Y shape and spans across the entire active site cleft, binding into both the nonprimed and primed sites of CL.

Screening of electrophilic compounds yields an aziridinyl peptide as new active-site directed SARS-CoV main protease inhibitor.

The coronavirus main protease, M(pro), is considered a major target for drugs suitable to combat coronavirus infections including the severe acute respiratory syndrome (SARS). In this study, comprehensive HPLC- and FRET-substrate-based screenings of various electrophilic compounds were performed to identify potential M(pro) inhibitors. The data revealed that the coronaviral main protease is inhibited by aziridine- and oxirane-2-carboxylates. Among the trans-configured aziridine-2,3-dicarboxylates the Gly-Gly-containing peptide 2c was found to be the most potent inhibitor.

Dodecahedral clathrate structures and magic numbers in alkali cation microhydration clusters.

Using global geometry optimization based on our specialized version of Genetic Algorithms, we have examined the global and most important local minimum energy structures of water microsolvation clusters of potassium and cesium cations within the common TIP4P/OPLS model. Together with our earlier results on the corresponding sodium case, this work constitutes a first step towards a theoretical elucidation of "magic numbers" of solvating molecules and proposed special structures occurring in these systems. In particular, the actual role of dodecahedral cage structures is examined. Within the present model, they do not occur in sodium microsolvation, in agreement with the absence of the magic number 20 for this system. For potassium and cesium microsolvation, dodecahedral cages do occur but their actual structures are far from ideal and their importance appears to be overrated. We offer simple explanations for structural features and trends, and for magic numbers smaller than 20.