Metabolic and cellular effects of carbohydrate-based preconditioning drinks

This thesis investigates the metabolic and cellular effects of carbohydrate-based preconditioning drinks in humans. Previous studies have demonstrated that preoperative carbohydrate loading, as opposed to overnight fasting, attenuated the development of postoperative insulin resistance by up to 50% and led to clinical benefits. Preconditioning with carbohydrate-based drinks was incorporated into enhanced recovery after surgery programs. The latter included interventions that aimed to minimise ‘metabolic-stress’ and hasten recovery after major surgery. However, the cellular mechanisms underlying the adverse effects of preoperative fasting and the beneficial effects of preconditioning with carbohydrate-based drinks were hitherto unknown. In healthy volunteers, short-term fasting (up to 24 hours) reduced liver volume, depleted liver glycogen (-50%) and lipid reserves, and increased intramyocellular lipid concentrations (+23%), as measured by magnetic resonance spectroscopy. Changes in liver glycogen were partially reversed following ingestion of a carbohydrate-based drink that also contained glutamine and antioxidants (ONS, Fresenius Kabi, Germany). Fasting also led to significantly decreased blood mononuclear cell mitochondrial complex activity. In patients undergoing laparoscopic cholecystectomy, preoperative conditioning with ONS, compared to ingestion of a placebo-drink, significantly increased intraoperative liver glycogen by 50%, increased intraoperative plasma glutamine and antioxidant concentrations, led to lower expression of skeletal muscle pyruvate dehydrogenase kinase 4 mRNA and protein expression, and finally, reduced cellular oxidative stress, as indicated by a 1.5-fold lower expression of metallothionein-1A in the ONS group. Ingestion of ONS led to markedly differing hormonal and metabolic responses compared to those following a clear carbohydrate drink (preOp®, Nutricia Clinical Care, UK), with ‘blunted’ postprandial glucose and insulin responses following ONS. Supplementing preOp® with glutamine ‘blunted’ postprandial insulin and glucose responses but this was not due to differences in glucagon-like peptide-1 concentrations. Finally, the gastric emptying of these drinks was more dependent on carbohydrate content than macronutrient composition or osmolality

MINARET: A Recommendation Framework for Scientific Reviewers

International audienceWe are witnessing a continuous growth in the size of scientific communities and the number of scientific publications. This phenomenon requires a continuous effort for ensuring the quality of publications and a healthy scientific evaluation process. Peer reviewing is the de facto mechanism to assess the quality of scientific work. For journal editors, managing an efficient and effective manuscript peer review process is not a straightforward task. In particular, a main component in the journal editors' role is, for each submitted manuscript, to ensure selecting adequate reviewers who need to be: 1) Matching on their research interests with the topic of the submission, 2) Fair in their evaluation of the submission, i.e., no conflict of interest with the authors, 3) Qualified in terms of various aspects including scientific impact, previous review/authorship experience for the journal , quality of the reviews, etc. Thus, manually selecting and assessing the adequate reviewers is becoming tedious and time consuming task. We demonstrate MINARET, a recommendation framework for selecting scientific reviewers. The framework facilitates the job of journal editors for conducting an efficient and effective scientific review process. The framework exploits the valuable information available on the modern scholarly Websites (e.g., Google Scholar, ACM DL, DBLP, Publons) for identifying candidate reviewers relevant to the topic of the manuscript, filtering them (e.g. excluding those with potential conflict of interest), and ranking them based on several metrics configured by the editor (user). The framework extracts the required information for the recommendation process from the online resources on-the-fly which ensures the output recommendations to be dynamic and based on up-to-date information

Outcomes of linear-stapled versus hand-sewn gastrojejunal anastomosis in laparoscopic Roux en-Y gastric bypass

BACKGROUND: In laparoscopic Roux en-Y gastric bypass (LRYGB), the gastrojejunal anastomosis (GJA) may be performed using linear-stapled (LS) or completely hand-sewn (HS) techniques. No published study has compared operative and clinical outcomes following LS and HS LRYGB when performed by surgeons beyond the learning curve. This study examined outcomes of both techniques performed by two 'technique-specific' bariatric fellowship-trained surgeons. METHODS: Data on consecutive primary LRYGB undertaken in two university hospitals were prospectively collected over 28-months and included demographics, co-morbidities, postoperative morbidity, mortality, length of stay (LOS), reoperations, and excess weight loss (EWL). Data were presented as mean ± SD. RESULTS: There were 366 LRYGB studied (LS = 144 and HS = 222 patients) with 96 % 12-month follow-up. All procedures were completed laparoscopically with no anastomotic leak or mortality. The LS cohort had a lower body mass index (48.3 ± 5.0 vs 53.8 ± 7.1, P < 0.001), greater incidence of diabetes mellitus (P = 0.009) and sleep apnea (P = 0.007). The HS cohort had more patients in Obesity Surgery Mortality Risk Score classes B and C (P = 0.004 and P = 0.01), and shorter operating time (127 ± 30 vs 172 ± 30 min, P < 0.001). There were no differences in LOS, complications, or reoperations. The HS technique was associated with more GJA stenoses requiring endoscopic dilatation (7.7 vs 0 %, P < 0.001). At 12 months, EWL (%) was comparable between the two techniques (LS 71.0 ± 15.5 vs HS 66.5 ± 13.7, P = 0.09). CONCLUSIONS: When performed by 'technique-specific' surgeons, both LS and HS GJA in LRYGB may be performed safely with no significant differences in morbidity, reoperations, or EWL

Chlorpyrifos Acts as a Positive Modulator and an Agonist of N-Methyl-d-Aspartate (NMDA) Receptors: A Novel Mechanism of Chlorpyrifos-Induced Neurotoxicity

Chlorpyrifos (CPF) is a broad-spectrum organophosphate insecticide. Long-term exposure to low levels of CPF is associated with neurodevelopmental and neurodegenerative disorders. The mechanisms leading to these effects are still not fully understood. Normal NMDA receptor (NMDAR) function is essential for neuronal development and higher brain functionality, while its inappropriate stimulation results in neurological deficits. Thus, the current study aimed to investigate the role of NMDARs in CPF-induced neurotoxicity. We show that NMDARs mediate CPF-induced excitotoxicity in differentiated human fetal cortical neuronal ReNcell CX stem cells. In addition, by using two-electrode voltage clamp electrophysiology of Xenopus oocytes expressing NMDARs, we show CPF potentiation of both GluN1-1a/GluN2A (EC50 ≈ 40 nM) and GluN1-1a/GluN2B (EC50 ≈ 55 nM) receptors, as well as reductions (approximately halved) in the NMDA EC50s and direct activation by 10 μM CPF of both receptor types. In silico molecular docking validated CPF’s association with NMDARs through relatively high affinity binding (−8.82 kcal/mol) to a modulator site at the GluN1–GluN2A interface of the ligand-binding domains

Evaluation of liver function tests and risk score assessment to screen patients for significant liver disease prior to bariatric and metabolic surgery

Bariatric and metabolic surgery is associated with significant improvement in obesity-related comorbidities, but for patients with non-alcoholic fatty liver disease (NAFLD), clinical outcomes are dependent on the severity of liver disease, i.e. improvement of NAFLD in most patients but increased risks of fulminant hepatic failure and/or bleeding varices in patients with more advanced cirrhosis. Our study showed that absolute values of liver enzymes were poor indicator of risk of liver fibrosis. The use of AST/ALT ratio, Fib 4 or NAFLD scores were appropriate screening tools, with each risk score appearing to pick out a certain phenotype of patients based on age, BMI or individual values of ALT, AST or platelet count. There is lack of agreement in some cases between FIB-4 scores and NAFLD scores when ruling out patients at high risk of liver fibrosis. Meticulous screening of patients at risk of liver fibrosis is crucial in order to reduce the risk of liver-related complications following bariatric and metabolic surgery

Genotypic and Phenotypic Structure of the Population of Phytophthora infestans in Egypt Revealed the Presence of European Genotypes

Late blight disease of potato and tomato, caused by Phytophthora infestans, results in serious losses to Egyptian and global potato and tomato production. To understand the structure and dynamics of the Egyptian population of P. infestans, 205 isolates were collected from potato and tomato plants during three growing seasons in 2010–2012. The characterization was achieved by mating-type assay, metalaxyl sensitivity assay, and virulence pattern. Additionally, genotyping of 85 Egyptian isolates and 15 reference UK isolates was performed using 12 highly informative microsatellite (SSR) markers David E. L. Cooke and five effector (RxLR) genes. Mating-type testing showed that 58% (118 of 205) of the isolates belonged to mating type A1, 35% (71 isolates) to mating type A2, and the rest 8% (16 isolates) were self-fertile. The phenotype of metalaxyl response was represented as 45% resistant, 43% sensitive, and 12% as intermediate. Structure analysis grouped the 85 identified genotypes into two main clonal lineages. The first clonal lineage comprised 21 isolates belonging to A2 mating type and 8 self-fertile isolates. This clonal lineage was identified as Blue_13 or EU_13_A2. The second main clonal lineage comprised 55 isolates and was identified as EU_23_A1. A single isolate with a novel SSR genotype that formed a distinct genetic grouping was also identified. The effector sequencing showed good correspondence with the virulence data and highlighted differences in the presence and absence of loci as well as nucleotide polymorphism that affect gene function. This study indicated a changing population of P. infestans in Egypt and discusses the findings in the context of late blight management

Microbial and Sensory Assessment of Sand Smelt Fish Burger and Finger during Frozen Storage

The current study aimed to assess the microbiological safety and sensory quality of fish burger and finger made from sand smelt fish (Atherinahepsetus) which was found unacceptable from consumers. The substitution material (soybean flour (SF) and minced boiled potatoes (MBP)) were used by different levels in this investigation to improve the sensory evaluation of produced fish products. Total bacterial count (TBC) values for burger and finger samples gradually declined till the day 45th then increased in the later period of frozen storage. Yeast and Molds growth were not detected during the frozen storage over the entire period of 90 days storage, except for zero time the score values of the quality attributes: color, taste, odor and texture, as well as overall acceptability of sand smelt fish burgers and fingers, slightly declined during frozen storage. The filling materials SF and MBP used in the production of fish products showed an observed effect in maintaining the sensory qualities of the products for 90 days of frozen storage. It can be concluded that sand smelt fish products maintained good microbial and sensory quality at the end of 90 storage period in the freezer, opening an opportunity for this good nutritious protein source to be used as a daily food

Protective role of biosynthesized silver nanoparticles synthesized using sesame oil as biocontrol approach against Erwinia amylovora causing fire blight in pears (Pyrus communis L.)

Erwinia amylovora, the primary cause of fire blight, is thought to be one of the most difficult crop diseases to eradicate. The study aimed to evaluate the performance of essential sesame oil (SO) and silver nanoparticle synthesized by sesame oil SO-AgNPs against E. amylovora. Using GC-MS, it was found that essential sesame oil contains the main component of the oil was sesamin, asarninin, heptane, c-Sitosterol, anethol, and trimethyl -6- ((s) - 4-methylcyclohexan – 3 – en-1-yl)) tetrahydro -2H-pyran. The diluted sesame oil (SO) was used as a reducing agent in synthesis of AgNPs in aqueous solution. By using UV-Visible spectrophotometry (UV–Vis), Dynamic Light Scattering (DLS), High Resolution Transmission Electron Microscopy (HRTEM), and Fourier Transformer InfraRed (FTIR) analysis, the produced Ag NPs were studied. The average particle size of the spherical Ag NPs was determined to be 54.98 nm using data from HRTEM and DLS. SO-Ag NPs (20 µg/ml) showed a promising antibacterial against E. amylovora, producing a 22.9 mm Zone of Inhibition (ZOI) against E. amylovora, followed by SO-Ag NPs (10 ug/ml) that gave 18.2 mm ZOI., compared to gentamicin that produced 13.2 mm ZOI. The most effective inducers were SO-Ag NPs at 10 ug/ml, which decreased the percentage of disease severity by 27.5 and increased the percentage of protection against disease infection by 68.39%. SO-Ag NPs was the most effective inducers which decreased the contents of Malonaldehyde (MDA) and H2O2 by 41.3% and 77.1%. Applying SO-Ag NPs or SO lowered the level of malondialdehyde (MDA) and hydrogen peroxide (H2O2) and improved the fruit set and yield in infected trees. We could assume that, to prevent E. amylovora fire blight disease in pears, SO-Ag NPs, SO are safe, effective, and environmentally friendly alternatives to conventional antibiotics.

Glycated albumin and glycated albumin/ glycated haemoglobin ratio decrease with increasing BMI compared to Glycated haemoglobin in Type 2 diabetes patients

Abstract: Background: Obese T2DM patients are more prone to develop accelerated complications which burdens the global health systems with undue expenditure. Glycated haemoglobin (A1c) had been settled as a gold standard glycemic indicator though it&apos;s levels must be prudently interpreted in some patients. Glycatedalbumin (GA) as an alternative, intermediate glycemic indicator is gaining much attention. Aim: assessing the correlation of each of glycated albumin and glycated haemoglobin to body mass index (BMI) in T2DM patients Hypothesis: negative correlation existsbetween BMI &amp; glycated albumin. Subjects and methods: Cross sectional study into which 62 participants-aged 25-60 years -who are T2DM on insulin were recruited at Suez Canal University hospital.None of them was smoker or known to be CLD or DKD patient, none was on regular statins, aspirin or metformin. All had normal CBC and albumin indices, they underwent thorough history taking &amp; examination. anthropometric measurements namely body mass index (BMI) were taken.They were grouped into a non-obese group with BMI &lt;25 Kg/m 2 &amp; obese group whose BMI ≥25 Kg/m 2 , each with a sample size of 31 participants. FPG,PPPG, HbA1c, CBC, serum albumin, serum insulin and GA were analyzed.insulin resistance was measured by HOMA-IR. Results: GA was insignificantly lower in obese T2DM compared to non-obese (579.3 µmol/L vs 600.0 µmol/L,p-value = 0.631), while GA/HbA1c ratio was significantly low among obese compared to non-obese. (61.1 vs 66.8, p-value= 0.040). Also GA was insignificantly lower in obese with insulin resistance (615.0 ±177.5 µmol/L) than obese with no insulin resistance (550.0±148.2 µmol/L) and also lower than non-obese with insulin resistance (637.4±153.0 µmol/L).Similarly GA/HbA1c ratio was lower in obese with &amp;without insulin resistance (mean 57.6 ±SD 12.8 &amp; mean 64.1 ±SD 9.0 respectively) compared to GA/HbA1c ratio in non-obese with &amp; without insulin resistance (mean 66.9 ±SD 11.0 &amp; mean 66.7 ±SD 9.1 respectively). Conclusion: This study showed that care to be paid while interpreting GA levels in obese T2DM as GA and GA/HbA1c ratio are lower in this population. [Iman El -Sherif, Mohamed I. Shoeir, Mohamed M. Mohey El Din Awad, Amal Fathy and Seham Ahmed. Glycated albumin and glycated albumin/ glycated haemoglobin ratio decrease with increasing BMI compared to Glycated haemoglobin in Type 2 diabetes patients

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication