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The study aimed to formulate and optimize complementary weaning flours for better antioxidants and sensory acceptability. D-optimal constrained mixture design was used to generate Eighteen formulations with a range of malted sorghum 40–60%, blanched soybean 20–30%, boiled karkade seeds 10–20%, and 10% premix (5% figl leaves, 4.5% sugar, and 0.5% salt) added in equal proportion to all formulations were evaluated. The sensory properties of the gruel made from the selected complementary flour were evaluated using untrained panellists. The result indicated that high malted sorghum supplement levels in the formula were associated with increased bioactive compounds and antioxidant capacity. The optimum values of bioactive compounds, antioxidant capacity, and functional properties of the formulated product were 51.0%, 22.0%, and 17.0% for sorghum, soybean, and karkade seeds flour with 10.0% premix, respectively. The sensory acceptability of the gruel samples evaluated from the optimized complementary flour rich in antioxidants was significantly (p

Diversity-generating retroelements (DGRs) create unparalleled levels of protein sequence variation through mutagenic retrohoming. Sequence information is transferred from an invariant template region (TR), through an RNA intermediate, to a protein-coding variable region. Selective infidelity at adenines during transfer is a hallmark of DGRs from disparate bacteria, archaea, and microbial viruses. We recapitulated selective infidelity in vitro for the prototypical Bordetella bacteriophage DGR. A complex of the DGR reverse transcriptase bRT and pentameric accessory variability determinant (Avd) protein along with DGR RNA were necessary and sufficient for synthesis of template-primed, covalently linked RNA-cDNA molecules, as observed in vivo. We identified RNA-cDNA molecules to be branched and most plausibly linked through 2'-5' phosphodiester bonds. Adenine-mutagenesis was intrinsic to the bRT-Avd complex, which displayed unprecedented promiscuity while reverse transcribing adenines of either DGR or non-DGR RNA templates. In contrast, bRT-Avd processivity was strictly dependent on the template, occurring only for the DGR RNA. This restriction was mainly due to a noncoding segment downstream of TR, which specifically bound Avd and created a privileged site for processive polymerization. Restriction to DGR RNA may protect the host genome from damage. These results define the early steps in a novel pathway for massive sequence diversification.

High-throughput short-read sequencing has revolutionized how transcriptomes are quantified and annotated. However, while Illumina short-read sequencers can be used to analyze entire transcriptomes down to the level of individual splicing events with great accuracy, they fall short of analyzing how these individual events are combined into complete RNA transcript isoforms. Because of this shortfall, long-distance information is required to complement short-read sequencing to analyze transcriptomes on the level of full-length RNA transcript isoforms. While long-read sequencing technology can provide this long-distance information, there are issues with both Pacific Biosciences (PacBio) and Oxford Nanopore Technologies (ONT) long-read sequencing technologies that prevent their widespread adoption. Briefly, PacBio sequencers produce low numbers of reads with high accuracy, while ONT sequencers produce higher numbers of reads with lower accuracy. Here, we introduce and validate a long-read ONT-based sequencing method. At the same cost, our Rolling Circle Amplification to Concatemeric Consensus (R2C2) method generates more accurate reads of full-length RNA transcript isoforms than any other available long-read sequencing method. These reads can then be used to generate isoform-level transcriptomes for both genome annotation and differential expression analysis in bulk or single-cell samples.

BackgroundIt was recently discovered that abundant and stable extracellular RNA (exRNA) species exist in bodily fluids. Saliva is an emerging biofluid for biomarker development for noninvasive detection and screening of local and systemic diseases. Use of RNA-Sequencing (RNA-Seq) to profile exRNA is rapidly growing; however, no single preparation and analysis protocol can be used for all biofluids. Specifically, RNA-Seq of saliva is particularly challenging owing to high abundance of bacterial contents and low abundance of salivary exRNA. Given the laborious procedures needed for RNA-Seq library construction, sequencing, data storage, and data analysis, saliva-specific and optimized protocols are essential.MethodsWe compared different RNA isolation methods and library construction kits for long and small RNA sequencing. The role of ribosomal RNA (rRNA) depletion also was evaluated.ResultsThe miRNeasy Micro Kit (Qiagen) showed the highest total RNA yield (70.8 ng/mL cell-free saliva) and best small RNA recovery, and the NEBNext library preparation kits resulted in the highest number of detected human genes [5649-6813 at 1 reads per kilobase RNA per million mapped (RPKM)] and small RNAs [482-696 microRNAs (miRNAs) and 190-214 other small RNAs]. The proportion of human RNA-Seq reads was much higher in rRNA-depleted saliva samples (41%) than in samples without rRNA depletion (14%). In addition, the transfer RNA (tRNA)-derived RNA fragments (tRFs), a novel class of small RNAs, were highly abundant in human saliva, specifically tRF-4 (4%) and tRF-5 (15.25%).ConclusionsOur results may help in selection of the best adapted methods of RNA isolation and small and long RNA library constructions for salivary exRNA studies.

X-linked hyper-immunoglobulin M (hyper-IgM) syndrome (XHIM) is a primary immunodeficiency due to mutations in CD40 ligand that affect immunoglobulin class-switch recombination and somatic hypermutation. The disease is amenable to gene therapy using retroviral vectors, but dysregulated gene expression results in abnormal lymphoproliferation in mouse models, highlighting the need for alternative strategies. Here, we demonstrate the ability of both the transcription activator-like effector nuclease (TALEN) and clustered regularly interspaced short palindromic repeats-associated protein 9 (CRISPR/Cas9) platforms to efficiently drive integration of a normal copy of the CD40L cDNA delivered by Adeno-Associated Virus. Site-specific insertion of the donor sequence downstream of the endogenous CD40L promoter maintained physiologic expression of CD40L while overriding all reported downstream mutations. High levels of gene modification were achieved in primary human hematopoietic stem cells (HSCs), as well as in cell lines and XHIM-patient-derived T cells. Notably, gene-corrected HSCs engrafted in immunodeficient mice at clinically relevant frequencies. These studies provide the foundation for a permanent curative therapy in XHIM.

Indigo is an ancient dye uniquely capable of producing the signature tones in blue denim; however, the dyeing process requires chemical steps that are environmentally damaging. We describe a sustainable dyeing strategy that not only circumvents the use of toxic reagents for indigo chemical synthesis but also removes the need for a reducing agent for dye solubilization. This strategy utilizes a glucose moiety as a biochemical protecting group to stabilize the reactive indigo precursor indoxyl to form indican, preventing spontaneous oxidation to crystalline indigo during microbial fermentation. Application of a β-glucosidase removes the protecting group from indican, resulting in indigo crystal formation in the cotton fibers. We identified the gene coding for the glucosyltransferase PtUGT1 from the indigo plant Polygonum tinctorium and solved the structure of PtUGT1. Heterologous expression of PtUGT1 in Escherichia coli supported high indican conversion, and biosynthesized indican was used to dye cotton swatches and a garment.

Atopic dermatitis (AD) is the most common inflammatory skin disease seen in children. It is a heterogeneous disorder, with a variety of associated manifestations and symptoms. Cases may range from mild to severe. As a result, a spectrum of prescription and nonprescription therapies may be utilized when managing this condition. This article provides an extensive overview of these therapies, with equal consideration provided to current, emerging, and alternative options used in the pediatric population. [ABSTRACT FROM AUTHOR]

Capparis ovata is a natural plant that grows widely in Turkey and its flowering buds and berry pickle are used in traditional medicine. Thus, the current study was expanded to evaluate the biochemical, pharmacological, and toxicological aspects of the Capparis ovata water extract (COWE). To determine the biochemical properties of COWE, mineral and fatty acid content, elemental analysis, flavonoid/phenolic content, radical‐scavenging capacity, and pesticide analysis were performed. Furthermore, to find out whether it had anti‐inflammatory properties, reverse transcription‐polymerase chain reaction (RT‐PCR) and nuclear factor kappa B (NF‐κB) luciferase activity tests were conducted. Whole‐genome transcriptomic profiling was carried out at a dose level of 500 mg/kg COWE to understand its pharmacological effect. Transaminases in serum were tested, and quantitative polymerase chain reaction (qPCR) was done using a custom design array that included the stress and molecular toxicology pathway to establish its toxicological qualities. As a result of the evaluations, it was observed that COWE has a high mineral and unsaturated fatty acid content, flavonoid/phenolic content, and radical‐scavenging ability. It significantly inhibited NF‐κB transcriptional activity as well as inflammatory cytokine expression in T‐lymphoblast cells. Whole‐genome transcriptomic profiling depicted that COWE modulates immune responses by upregulating natural killer cell activation, cellular response to type I interferon, B‐cell proliferation and differentiation, and Janus kinase–signal transducer and activator of transcription (JAK–STAT) pathways. Molecular Toxicology Pathfinder RT2 Profiler PCR array analysis revealed that COWE at or lower dose of 500 mg/kg/day did not cause a comparatively adverse effect. According to the findings, COWE is a rich source of nutrients and can be used as an adjunct therapy for various inflammatory diseases. [ABSTRACT FROM AUTHOR]

Accurate segmentation of lung nodules from pulmonary computed tomography (CT) slices plays a vital role in the analysis and diagnosis of lung cancer. Convolutional Neural Networks (CNNs) have achieved state-of-the-art performance in the automatic segmentation of lung nodules. However, they are still challenged by the large diversity of segmentation targets, and the small inter-class variances between the nodule and its surrounding tissues. To tackle this issue, we propose a features complementary network according to the process of clinical diagnosis, which made full use of the complementarity and facilitation among lung nodule location information, global coarse area, and edge information. Specifically, we first consider the importance of global features of nodules in segmentation and propose a cross-scale weighted high-level feature decoder module. Then, we develop a low-level feature decoder module for edge feature refinement. Finally, we construct a complementary module to make information complement and promote each other. Furthermore, we weight pixels located at the nodule edge on the loss function and add an edge supervision to the deep supervision, both of which emphasize the importance of edges in segmentation. The experimental results demonstrate that our model achieves robust pulmonary nodule segmentation and more accurate edge segmentation. [ABSTRACT FROM AUTHOR]

Noting that 2022 marked the 45th anniversary of the Additional Protocols to the 1949 Geneva Conventions – the first treaties that explicitly noted the relationship between international human rights law and international humanitarian law - this column reflects on how the relationship between these two bodies of law has developed since 1977. It demonstrates that while much progress has been made internationally towards understanding the relationship between two bodies of law, there are still obstacles to be overcome if the goal is to apply the two bodies of law in a complementary fashion and achieve the maximum protection of the human person. [ABSTRACT FROM AUTHOR]

Protection forests are state forests that are authorized by the government to be managed, but on the other hand, indigenous peoples already exist and manage forests that are claimed as customary forest. How is the management of protection forests between the government and indigenous peoples? The purpose of this study is to examine the management of protection forests between the government and indigenous peoples and the collaboration in the management of protection forests between the two. The results showed that the management of protection forests by the government was not optimal at the site level based on the principles of protection forest management that had only been done with boundaries: only area boundaries, not blocks and plots, forest protection such as area patrols, installation of prohibition boards and appeals) and land rehabilitation (planting with woody plant species and multipurpose trees. Protected forest management by indigenous peoples has touched the site level on several aspects of protected forest management principles. Protected management activities by indigenous peoples following the principles of protected forest management are the cultivation of fruit plants, land use with dusung/traditional agroforestry cropping patterns, forest protection is prohibited from cutting trees at water sources, along riverbanks, replanting if cutting fruit trees that are not productive, utilizing non-timber forest products. The government as the planner but implementing it in the field is the indigenous people who are accompanied by the government and joint monitoring and evaluation. Protected forest management based on the principle of protected forest management is more optimally carried out in a collaborative and complementary manner between the government and indigenous peoples. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic, recurrent, and inflammatory skin disease experienced mostly in childhood. Chronicity of the disease, relapses, constant need of regular skin care causes seeking for alternative treatments. The aim of this study is to evaluate the complementary and alternative treatments (CAT) used by parents' caregivers in pediatric patients diagnosed with AD, and the association between CAT use and patient characteristics. A questionnaire questioning the sociocultural and demographic characteristics of the family, the clinical findings of the patients, their treatments and CAT applications was recorded. Eighty-three patients were included in the study. 68.7% of the patients used at least one type of CAT. Vitamins and oils were the most commonly used CAT (48.8% and 47%, respectively) and 73.3% of the patients using CAT continued normal AD treatment while using CAT. The biggest factor affecting CAT choice was the advice of the immediate circle (75%), and 40.6% of the patients stated that they benefited from the complementary therapy. CAT are widely used in AD. Physicians should know the socio-cultural structure of the region they are in, the CAT used and their side effects, and inform the families. [ABSTRACT FROM AUTHOR]

Simple Summary: Complementary and alternative medicine (CAM) therapies include a wide range of procedures and products that are often used by cancer patients to directly combat cancer and to protect normal cells from the toxic effects of conventional therapies. Most often, their use is self-prescribed based on a collection of scattered information from websites and advice from relatives or friends. In this paper, we examined the potential known benefits and harms associated with the most commonly used alternative treatments to provide a practical guide for caregivers and patients. CAM is used by about 40% of cancer patients in Western Countries, with peaks of 80% for breast cancer patients. Cancer patients use CAM to boost immune function, to control cancer symptoms and treatment-related side effects, and to improve health-related quality of life (HR-QoL) and survival. Unfortunately, self-prescription of natural remedies in cancer patients can lead to unexpected toxicities and can reduce the effectiveness of cancer therapy. Although CAM usually refers to all the "natural or organic" products/methods that are generally considered less toxic, there are concerns about drug interactions, especially in patients participating in clinical trials with experimental agents. Despite the claims of the promising and potential benefits made by prescribers, many CAMs lack clear scientific evidence of their safety and efficacy. Given the widespread use of CAM—both clearly declared and overt—in this review, we focused on the most important known data on the risk of interactions between biologics and oncology drugs with the goal of opening up CAM in accordance with the meaning of integrative medicine. [ABSTRACT FROM AUTHOR]

This paper analyses the consumption of complementary products, which by their nature are consumed or used with others to meet the needs or desires of the consumer. These products can see their link reinforced through price promotions, promotions that exert a lot of influence at the purchase time. To this purpose, a research is carried out with Spanish consumers analysing four categories of food through a survey of consumer behaviour interest. Through the results, it is highlight the importance of identifying complementarity between products, the preference for these complementarities and the planning of promotions between categories to be more effective. [ABSTRACT FROM AUTHOR]

For centuries, pharmacologic interventions have been the primary intervention for pain in intensive care patients. Opioid use has significant side effects and long-term risks including addiction and loss of life. Critical care nurses and other health care professionals can include effective nonpharmacological complementary modalities to reduce pain. Approaches discussed include guided imagery, acupuncture, music and sound therapy, cold therapy, massage, and physical and occupational therapy. Evidence-based research that examined the efficacy of these complementary methods found significant reduction in pain, trauma, length of stay, or post-intensive care syndrome in critical care patients., Competing Interests: Disclosure All authors report no commercial or financial conflicts of interest. There was no funding from any source for this publication., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Linear programming has been reported to be a good technique that can be used to develop and optimize complementary foods to curb children's malnutrition. Despite some studies using it to develop and assess the nutritional quality of linear programmed instant complementary foods based on high proteinous red-billed quelea bird meat, information on the sensory and shelf life stability of these foods is limited in the country. Objective: The objective of this study was to develop and assess the sensory properties, preference mapping and shelf life of the developed and optimized quale birds meat-based complementary flour and porridge. Methods: Four formulations; control containing birds meat only, banana mixed with meat (Banana_meat), potatoes mixed with meat (potatoes_meat) and rice mixed with meat (rice_meat) were developed by mixing with other ingredients and extruded separately using a barrel extrude to get flour. The extruded flours were assessed for shelf life and also used to develop porridge samples for sensory properties, consumer acceptance and preference mapping analyses using standard methods. Results: There were significant (p

Background: Conventional and complementary treatments are often used in rehabilitation for persons with stroke. The conventional treatment makes use of medications, physiotherapy, occupational, speech, and diet therapies, while the complementary treatment makes use of homeopathy, naturopathy, massage, and acupuncture. The structure, process, and outcomes of stroke rehabilitation using conventional or complementary treatments have not been empirically investigated in Ghana. Aims: This study aims to investigate the structure, process, and outcomes of stroke rehabilitation at the Korle Bu Teaching Hospital (KBTH) in Accra and Kwayisi Christian Herbal Clinic (KCHC) in Nankese-Ayisaa, Ghana, and to explore the experiences of persons with stroke. Methods: This study involves a mixed methods approach. This study will utilize three study designs, namely, cross-sectional, hospital-based cohort, and qualitative exploratory study designs. The objectives of the study will be achieved using three phases, namely, phase one will recruit health professionals and gather information on the structure and process of stroke rehabilitation at a conventional and complementary hospital using adapted questionnaires; phase two will determine the outcomes of stroke patients attending a conventional and complementary hospital facility at baseline, 2-, 3-, and 6-month follow-up using outcome measures based on the International Classification of Functioning, Disability and Health (ICF) model; and phase three will explore the experiences of stroke patients who use complementary or conventional treatment using an interview guide. Data analysis: IBM SPSS Statistics Version 27 will be used to analyze the data using descriptive and inferential statistics. Repeated measures of ANOVA will be used to determine the differences between variables at baseline, 2-, 3-, and 6-month post-stroke. The qualitative data will be transcribed and entered into Atlas Ti version 9.0. The data will be coded and analyzed using thematic areas that will be generated from the codes. Conclusion: The study protocol will provide a comprehensive overview of the structure, process, and outcomes of stroke rehabilitation in Ghana, incorporating both conventional and complementary treatment and rehabilitation into the stroke recovery journey. It will also inform clinical practice, with new insights on the experiences of stroke patients based on their choice of rehabilitation pathway. [ABSTRACT FROM AUTHOR]

Synbiotics, mixtures of live microbes and substrates selectively utilized by host organisms, are of considerable interest due to their ability to improve gastrointestinal health. However, formulating synbiotics remains challenging, due in part, to the absence of rational strategies to assess these products for synbiotic activities prior to clinical trials. Currently, synbiotics are formulated as either complementary or synergistic. Complementary synbiotics are made by combining probiotics and prebiotics, with each component acting independently and with the combination shown to provide a clinical health benefit. Most commercial synbiotics as well as those used in clinical trials have been of the complementary type. In contrast, synergistic synbiotics require that the added microbe is specifically stimulated or it's persistence or activity are enhanced by the cognate substrate. Although several innovative examples have been described in the past few years based on this principle, in practice, relatively few synbiotic studies have tested for synergism. In this review, selected recent examples of complementary and synergistic synbiotics and the rationale for their formulation will be described. In addition, pre-clinical experimental approaches for identifying combinations that provide a basis for satisfying the requirements for synergism will be discussed. [ABSTRACT FROM AUTHOR]

Since the commercialization of 5G, the government has actively encouraged 5G industry chain enterprises to accelerate the progress of 5G. Bundling is a popular means to expand 5G subscribers and improve 5G market coverage. Considering the characteristics of bundling, this study establishes a secondary supply chain composed of a terminal manufacturer and a telecom operator under the condition of network externality strength. In this supply chain, the product quality of the terminal manufacturer is complementary to the service quality of the telecom operator. Using Steinberg's theory, we derive the optimal value of each decision variable in a centralized mode and a decentralized mode and take profit maximization as the goal. This paper also designs a contract of bidirectional cost sharing and revenue compensation for supply chain coordination. Finally, the influence of network externality strength and a mass-additive factor on the supply chain is discussed using numerical analysis. The results show that higher network externality strength has a significant impact on product pricing, the quality of each entity and the profit of the supply chain. At the same time, the degree of complementarity between the terminal product quality and the telecommunications service quality affects whether consumers choose to buy contract products. A higher degree of complementarity promotes the market inflow into high-end consumers. [ABSTRACT FROM AUTHOR]

This paper examines how EU‐China trade affected intra‐EU trade. The estimation shows that when a country's share of trade with China increased, its share of trade with EU partners declined. This suggests that stronger trade links with China resulted in weaker trade links among EU countries. Furthermore, the "disintegration" effect of the export to China was stronger than that of import from China, meaning that the influence of China as an export destination was greater than that of China as a source of import. An extended analysis shows that the disintegration effect was most strongly felt in trade links among EU core countries, less strongly felt in trade links between EU core and periphery countries, and least strongly felt in trade links among EU periphery countries. In comparison, we find that EU import from the United States and India significantly weakened and strengthened intra‐EU trade, respectively. Estimation results using product level data demonstrate that the effects depend on the types of products we are concerned with. Whether using gross value or value added, the conclusions remain valid. [ABSTRACT FROM AUTHOR]

Joyce McSwan,1,* Jeffrey Gudin,2,* Xue-Jun Song,3 Perola Grinberg Plapler,4 Neil John Betteridge,5 Hayet Kechemir,6 Iva Igracki-Turudic,7 Gisele Pickering8 1GCPHN Persistent Pain Program, PainWISE, Gold Coast, QLD, Australia; 2Department of Anesthesiology, University of Miami, Miller School of Medicine, Miami, FL, USA; 3SUSTech Center of Pain Medicine, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of China; 4Division of Physical Medicine, Institute of Orthopedics and Traumatology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; 5Neil Betteridge Associates Ltd, London, UK; 6Consumer Healthcare Medical Affairs Department, Sanofi CHC, Paris, France; 7Consumer Healthcare Medical Affairs Department, Sanofi CHC, Frankfurt, Germany; 8Clinical Investigation Center CIC Inserm 1405, University Hospital Clermont-Ferrand, Clermont-Ferrand, France*These authors contributed equally to this workCorrespondence: Gisele PickeringClinical Investigation Center CIC Inserm 1405, University Hospital Clermont-Ferrand, rue Montalembert, CHU G Montpied, Clermont-Ferrand, 63000, FranceTel +33 4 73 17 84 16Fax +33 4 73 17 84 12Email gisele.pickering@uca.frAbstract: Traditionally, musculoskeletal pain management has focused on the use of conventional treatments to relieve pain. However, multi-modal integrative medicine including alternative/complementary treatments is becoming more widely used and integrated into treatment guidelines around the world. The uptake of this approach varies according to country, with generally a higher uptake in developed countries and in females aged more than 40 years. Integral to the concept described here, is that the body has an innate ability to self-heal, which can be optimized by the use of integrative medical strategies. Stress triggers for acute or recurring musculoskeletal pain are diverse and can range from physical to psychological. The mechanism by which the body responds to triggers and initiates the self-healing processes is complex, but five body networks or processes are thought to be integral: the nervous system, microcirculation/vasodilation, immune modulation, muscular relaxation/contraction and psychological balance. Multi-modal integrative medicine approaches include nutritional/dietary modification, postural/muscular training exercises, and cognitive behavioral mind/body techniques. This article will review the self-healing concept and provide plausible scientific evidence where available.Keywords: innate, complementary, intrinsic ability, multi-modal, acute, equilibrium

The incidence of cancer is rapidly increasing among the world. Cancer mostly demand cytotoxic regiment that caused adverse events. Fatigue is the most symptom that complained by oncology patients. Nurse has obligation to relieve patient’s simptom and promote well being during the therapeutic procedure. The aim of this study was to analyse the effect of complementary and alternative therapy to reduce fatigue based on nursing perspective. Design of the study was literature review. Online searching method involved four databases including Pubmed, Sciendirect, SAGE, and Pubmed. The inclusion criteria of studies were published in free fulltext between 2012 and 2018, clinical experimental studies at least quasi experiment or RCT. The exclusion criteriawere not in adult population who received chemotherapy. The results found eight studies matched the criteria. There were two studies applied massage as body manipulation and exercise-energy based intervention such as acupressure, yoga, qigong, and taichi. Those intervention were relevant with nursing body of knowledge, well explained in the North American Nursing Diagnosis Association, Nursing Outcomes Classification, Nursing Interventions Classification (NANDA, NOC, and NIC) as standardized nursing language.

Diversity-generating retroelements (DGRs) are molecular evolution machines that facilitate microbial adaptation to environmental changes. Hypervariation occurs via a mutagenic retrotransposition process from a template repeat (TR) to a variable repeat (VR) that results in adenine-to-random nucleotide conversions. Here we show that reverse transcription of the Bordetella phage DGR is primed by an adenine residue in TR RNA and is dependent on the DGR-encoded reverse transcriptase (bRT) and accessory variability determinant (Avd ), but is VR-independent. We also find that the catalytic center of bRT plays an essential role in site-specific cleavage of TR RNA for cDNA priming. Adenine-specific mutagenesis occurs during reverse transcription and does not involve dUTP incorporation, indicating it results from bRT-catalyzed misincorporation of standard deoxyribonucleotides. In vivo assays show that this hybrid RNA-cDNA molecule is required for mutagenic transposition, revealing a unique mechanism of DNA hypervariation for microbial adaptation.

Maintaining stable intracellular pH (pHi) is essential for homeostasis, and requires the ability to both sense pH changes that may result from internal and external sources, and to regulate downstream compensatory pH pathways. Here we identified the cAMP-producing enzyme soluble adenylyl cyclase (sAC) as the first molecular pH sensor in corals. sAC protein was detected throughout coral tissues, including those involved in symbiosis and calcification. Application of a sAC-specific inhibitor caused significant and reversible pHi acidosis in isolated coral cells under both dark and light conditions, indicating sAC is essential for sensing and regulating pHi perturbations caused by respiration and photosynthesis. Furthermore, pHi regulation during external acidification was also dependent on sAC activity. Thus, sAC is a sensor and regulator of pH disturbances from both metabolic and external origin in corals. Since sAC is present in all coral cell types, and the cAMP pathway can regulate virtually every aspect of cell physiology through post-translational modifications of proteins, sAC is likely to trigger multiple homeostatic mechanisms in response to pH disturbances. This is also the first evidence that sAC modulates pHi in any non-mammalian animal. Since corals are basal metazoans, our results indicate this function is evolutionarily conserved across animals.

Early mammalian embryonic transcriptomes are dynamic throughout the process of preimplantation development. Cataloging of primate transcriptomics during early development has been accomplished in humans, but global characterization of transcripts is lacking in the rhesus macaque: a key model for human reproductive processes. We report here the systematic classification of individual macaque transcriptomes using RNA-Seq technology from the germinal vesicle stage oocyte through the blastocyst stage embryo. Major differences in gene expression were found between sequential stages, with the 4- to 8-cell stages showing the highest level of differential gene expression. Analysis of putative transcription factor binding sites also revealed a striking increase in key regulatory factors in 8-cell embryos, indicating a strong likelihood of embryonic genome activation occurring at this stage. Furthermore, clustering analyses of gene co-expression throughout this period resulted in distinct groups of transcripts significantly associated to the different embryo stages assayed. The sequence data provided here along with characterizations of major regulatory transcript groups present a comprehensive atlas of polyadenylated transcripts that serves as a useful resource for comparative studies of preimplantation development in humans and other species.

The diversity of small molecules formed via plant diterpene metabolism offers a rich source of known and potentially new biopharmaceuticals. Among these, the microtubule-destabilizing activity of pseudolaric acid B (PAB) holds promise for new anticancer agents. PAB is found, perhaps uniquely, in the coniferous tree golden larch (Pseudolarix amabilis, Pxa). Here we describe the discovery and mechanistic analysis of golden larch terpene synthase 8 (PxaTPS8), an unusual diterpene synthase (diTPS) that catalyzes the first committed step in PAB biosynthesis. Mining of the golden larch root transcriptome revealed a large TPS family, including the monofunctional class I diTPS PxaTPS8, which converts geranylgeranyl diphosphate into a previously unknown 5,7-fused bicyclic diterpene, coined "pseudolaratriene." Combined NMR and quantum chemical analysis verified the structure of pseudolaratriene, and co-occurrence with PxaTPS8 and PAB in P amabilis tissues supports the intermediacy of pseudolaratriene in PAB metabolism. Although PxaTPS8 adopts the typical three-domain structure of diTPSs, sequence phylogeny places the enzyme with two-domain TPSs of mono- and sesqui-terpene biosynthesis. Site-directed mutagenesis of PxaTPS8 revealed several catalytic residues that, together with quantum chemical calculations, suggested a substantial divergence of PxaTPS8 from other TPSs leading to a distinct carbocation-driven reaction mechanism en route to the 5,7-trans-fused bicyclic pseudolaratriene scaffold. PxaTPS8 expression in microbial and plant hosts provided proof of concept for metabolic engineering of pseudolaratriene.

Background: Complementary and alternative medicine (CAM) is a well-known medical science that uses a variety of therapeutic strategies and approaches to effectively prevent and treat a wide range of human ailments. Determining graduating medical and health science students' knowledge, attitude, and practice regarding CAM can help in the integration of these systems into the health care system at large in a healthy manner. Therefore, this study aimed to assess the level of Knowledge, Attitude, and Practice (KAP) of CAM among the University of Gondar (UOG) graduating medical and health science students. Methods: An institutional-based cross-sectional study was conducted from June 13 to July 26, 2021, at the University of Gondar, college of medicine and health science, Gondar, Northwest Ethiopia. Descriptive statistics were calculated for baseline characteristics. Bivariate and multivariate logistic regression were used to identify the association between dependent and independent variables. Results: The study included 302 students, making the response rate 98.05%. The mean age of the participants was 23.5 ± 1.4 years. About 80(26.5%) of respondents appeared to have good knowledge. Knowledge about CAM was significantly greater among pharmacy students compared to medical students at 4.852(95% CI-1.831, 12.859). About 86% of students had a positive attitude toward CAM. This study revealed that females had 0.042 times less likely positive attitude towards CAM than male students (95%CI-0.008, 0.210). The most common CAM modality amongst all was nutritional therapy, at 35.8%. Regarding to students' overall practice, 101(33.5%) of students had good practice. pharmacy students had 2.527 times more good practice than medical students (95% CI-1.001, 6.379). Whereas, nursing students were 0.375 times less likely to have good practice than medical students (95% CI-0.141, 0.999). Conclusion: As the finding of this study indicates, despite students' positive attitudes towards CAM, their knowledge and practice are poor.

BackgroundConventional and complementary treatments are often used in rehabilitation for persons with stroke. The conventional treatment makes use of medications, physiotherapy, occupational, speech, and diet therapies, while the complementary treatment makes use of homeopathy, naturopathy, massage, and acupuncture. The structure, process, and outcomes of stroke rehabilitation using conventional or complementary treatments have not been empirically investigated in Ghana.AimsThis study aims to investigate the structure, process, and outcomes of stroke rehabilitation at the Korle Bu Teaching Hospital (KBTH) in Accra and Kwayisi Christian Herbal Clinic (KCHC) in Nankese-Ayisaa, Ghana, and to explore the experiences of persons with stroke.MethodsThis study involves a mixed methods approach. This study will utilize three study designs, namely, cross-sectional, hospital-based cohort, and qualitative exploratory study designs. The objectives of the study will be achieved using three phases, namely, phase one will recruit health professionals and gather information on the structure and process of stroke rehabilitation at a conventional and complementary hospital using adapted questionnaires; phase two will determine the outcomes of stroke patients attending a conventional and complementary hospital facility at baseline, 2-, 3-, and 6-month follow-up using outcome measures based on the International Classification of Functioning, Disability and Health (ICF) model; and phase three will explore the experiences of stroke patients who use complementary or conventional treatment using an interview guide.Data analysisIBM SPSS Statistics Version 27 will be used to analyze the data using descriptive and inferential statistics. Repeated measures of ANOVA will be used to determine the differences between variables at baseline, 2-, 3-, and 6-month post-stroke. The qualitative data will be transcribed and entered into Atlas Ti version 9.0. The data will be coded and analyzed using thematic areas that will be generated from the codes.ConclusionThe study protocol will provide a comprehensive overview of the structure, process, and outcomes of stroke rehabilitation in Ghana, incorporating both conventional and complementary treatment and rehabilitation into the stroke recovery journey. It will also inform clinical practice, with new insights on the experiences of stroke patients based on their choice of rehabilitation pathway.

Synbiotics, mixtures of live microbes and substrates selectively utilized by host organisms, are of considerable interest due to their ability to improve gastrointestinal health. However, formulating synbiotics remains challenging, due in part, to the absence of rational strategies to assess these products for synbiotic activities prior to clinical trials. Currently, synbiotics are formulated as either complementary or synergistic. Complementary synbiotics are made by combining probiotics and prebiotics, with each component acting independently and with the combination shown to provide a clinical health benefit. Most commercial synbiotics as well as those used in clinical trials have been of the complementary type. In contrast, synergistic synbiotics require that the added microbe is specifically stimulated or it’s persistence or activity are enhanced by the cognate substrate. Although several innovative examples have been described in the past few years based on this principle, in practice, relatively few synbiotic studies have tested for synergism. In this review, selected recent examples of complementary and synergistic synbiotics and the rationale for their formulation will be described. In addition, pre-clinical experimental approaches for identifying combinations that provide a basis for satisfying the requirements for synergism will be discussed.

Objectives: Cesarean sections are one of the common surgical procedures around the world. Management of cesarean section side effects, including pain, hematoma, delayed wound healing, is of particular importance in maintaining maternal health and ability to care for the baby. The tendency to use complementary medicine strategies is on the rise because of the easy treatment with low side effects. The purpose of this study was to systematically review the efficacy and safety of clinical trials performed in Iran and worldwide on the effect of complementary medicine on pain relief and wound healing after cesarean section.Methods : : PRISMA checklist was followed to prepare the report of this systematic review. The search process was carried out on databases on databases of Magiran, SID, Iran Medex, Scopus, Pub Med, Science direct, Medline and Cochrane library using keywords of cesarean, pain, wound healing, Herbal medicine, acupressure, massage, complementary medicine and their Persian equivalent and all possible combinations, from inception until February 2020. We used the Jadad scale to assess the quality of the searched articles. According to the Jadad scale, the articles with a score of at least 3 were included in the study.Results : : Finally, 28 clinical trials (with a sample size of 3,245) scored at least 3 on the Jadad scale were included into the analysis. This article reviewed 13 articles on medicinal herbs, 4 articles on massage, 1 article on reflexology, 2 articles on acupressure.Conclusion : : According to the present review, the use of medicinal herbs was the most common method of complementary medicine in pain relief and wound healing after cesarean section.

Hypertension is the primary cause of mortality. Hence globally, there is a growing interest in complementing antihypertensive drugs with herbs to alleviate blood pressure among hypertensive patients. Thus, this review aimed to evaluate the effectiveness of complementing drugs with herbs on blood pressure and lipid profile outcomes, the associated factors and the types of complementary herbs alongside their consumption regimes. This review is registered in PROSPERO on the National Institute of Health Database with an ID: CRD42021270481. Using the PICOS (population, intervention, comparison, outcome, study type) mnemonic formula and search strategy, we searched (January 2010 to February 2024) five electronic databases including Pubmed, Scopus, Web of Science, CINAHL (Cumulative Index for Nursing and Allied Health Literature) and Psychology & Behavioral Sciences Collection (PBSC). The inclusion criteria of the review were that all included papers had to be randomised control trials in English among hypertensive adults who complemented antihypertensive drugs with herbs. A Cochrane risk of bias assessment as well as a meta-analysis and narrative synthesis were conducted to answer the objectives. Twenty-five randomised controlled trials involving 1996 participants from 14 countries were included. The risk of bias among included articles was assessed and presented using the Cochrane risk of bias tool and the graphs were generated. The effects of complementing antihypertensive drugs with different herb regimes on blood pressure and lipid profile outcomes were compared to those solely on antihypertensive drugs and placebo via a random model effects meta-analysis using the Revman manager. Systolic blood pressure (SBP) and triglycerides gave a significant reduction in favour of the intervention group which complemented herbs. The overall pooled systolic blood pressure showed a reduction of (SMD=0.81, 95 % CI 0.14–1.47, p < 0.02, p for heterogeneity=0.00001, I2 =97 %) while triglycerides were (SMD=0.73, 95 % CI 0.17–1.28, p < 0.01, p for heterogeneity=0.00001, I2 =85 %). However, diastolic blood pressure, total cholesterol, HDL and LDL did not exert significant outcomes. The complemented herbs with antihypertensive drugs did show improvement in overall blood pressure management in the majority of the studies compared to the placebo group. Blood pressure and lipid profiles are the health outcomes that enable access to complementing herbs in controlling high blood pressure. Some limitations of this review are attributed to performance, detection and attrition bias in a few included articles alongside the presence of a high heterogeneity overall. • Evaluate the effectiveness of complementing antihypertensive drugs with herbs • Meta-analysis revealed improvements in systolic blood pressure and triglycerides • Chinese Herbal medicine and whortleberries beneficial for high blood pressure [ABSTRACT FROM AUTHOR]

For decades, scholars have emphasized the strong relationship between tourism and heritage. Many scholars have already shown that they are an inevitable couple. Considering the significant research that confirms their connection, the relationship between heritage and tourism was not fully explored from a tourist point of view even though a heritage experience exists only through the eyes of those who look at it. Consequently, in this study, conducted in Gyeongju, South Korea, we explored the bond between heritage and tourism from the eyes of tourists. This study utilizes ethnographic approaches ranging from in-depth interviews to friendly conversations with domestic tourists. Three types of relations between tourism and heritage are proposed based on individual interpretations and narratives that articulate and confirm tourism experiences: synergistic, complementary and antagonistic. [ABSTRACT FROM AUTHOR]

In a series of four papers we determine structures whose existence is dual, in the sense of complementary, to the existence of stars or combs from the well‐known star—comb lemma for infinite graphs. Call a set U of vertices in a graph Gtough in G if only finitely many components of G−X meet U for every finite vertex set X⊆V(G). In this fourth and final paper of the series, we structurally characterise the connected graphs G in which a given vertex set U⊆V(G) is tough. Our characterisations are phrased in terms of tree‐decompositions, tangle‐distinguishing separators and tough subgraphs (a graph G is tough if its vertex set is tough in G). From the perspective of stars and combs, we thereby find structures whose existence is complementary to the existence of so‐called undominating stars. [ABSTRACT FROM AUTHOR]

In a series of four papers we determine structures whose existence is dual, in the sense of complementary, to the existence of stars or combs. Here, in the third paper of the series, we present duality theorems for a combination of stars and combs: undominated combs. We describe their complementary structures in terms of rayless trees and of tree‐decompositions. Applications include a complete characterisation, in terms of normal spanning trees, of the graphs whose rays are dominated but which have no rayless spanning tree. Only two such graphs had so far been constructed, by Seymour and Thomas and by Thomassen. As a corollary, we show that graphs with a normal spanning tree have a rayless spanning tree if and only if all their rays are dominated. [ABSTRACT FROM AUTHOR]

Context: Given the high prevalence of burdensome symptoms in palliative care (PC) and increasing use of complementary and integrative medicine (CIM) therapies, research is needed to determine how often and what types of CIM therapies providers recommend to manage symptoms in PC.Objectives: To document recommendation rates of CIM for target symptoms and assess if, CIM use varies by provider characteristics.Methods: Nationwide survey's of physicians (MD and DO), physician assistants, and nurse practitioners in PC.Results: Participants (N = 404) were mostly female (71.3%), physicians (74.9%), and cared for adults (90.4%). Providers recommended CIM an average of 6.82 times per-month (95% CI: 6.04-7.60) and used an average of 5.13 (95% CI: 4.90-5.36) out of 10 CIM modalities. Respondents recommended mind-body medicines (e.g., meditation, biofeedback) most, followed by massage, and acupuncture and/or acupressure. The most targeted symptoms included pain; followed by anxiety, mood disturbance, and distress. Recommendation frequencies for specific modality-for-symptom combinations ranged from little use (e.g., aromatherapy for constipation) to occasional use (e.g., mind-body interventions for psychiatric symptoms). Finally, recommendation rates increased as a function of pediatric practice, noninpatient practice setting, provider age, and proportion of effort spent delivering palliative care.Conclusion: To the best of our knowledge, this is the first national survey to characterize PC providers' CIM recommendation behaviors and assess specific therapies and common target symptoms. Providers recommended a broad range of CIM but do so less frequently than patients report using CIM. These findings should be of interest to any provider caring for patients with serious illness. [ABSTRACT FROM AUTHOR]

Multi-modal hashing supports efficient multimedia retrieval well. However, existing methods still suffer from two problems: (1) Fixed multi-modal fusion. They collaborate the multi-modal features with fixed weights for hash learning, which cannot adaptively capture the variations of online streaming multimedia contents. (2) Binary optimization challenge. To generate binary hash codes, existing methods adopt either two-step relaxed optimization that causes significant quantization errors or direct discrete optimization that consumes considerable computation and storage cost. To address these problems, we first propose a Supervised Multi-modal Hashing with Online Query-adaption method. A self-weighted fusion strategy is designed to adaptively preserve the multi-modal features into hash codes by exploiting their complementarity. Besides, the hash codes are efficiently learned with the supervision of pair-wise semantic labels to enhance their discriminative capability while avoiding the challenging symmetric similarity matrix factorization. Further, we propose an effi- cient UnsupervisedMulti-modal Hashing with Online Query-adaption method with an adaptive multi-modal quantization strategy. The hash codes are directly learned without the reliance on the specific objective formulations. Finally, in both methods, we design a parameter-free online hashing module to adaptively capture query variations at the online retrieval stage. Experiments validate the superiority of our proposed methods. [ABSTRACT FROM AUTHOR]

INTRODUCTION It is important that the healthcare professionals who are with the mother at the moment of birth and afterwards, know and apply effective complementary treatment and supportive care methods, and also know their effects and limitations. The aim of this study is to determine the knowledge levels and attitudes of health personnel about complementary therapy and supportive care methods to be used in the management of labor pain and postpartum period. METHODS A cross-sectional study included 142 midwives/nurses and physicians working in the delivery room and maternity services of mother-friendly hospitals in Manisa, Turkey, between August 2018 and April 2019. The questionnaire consisting of 25 questions evaluated the knowledge and attitudes of the participants about complementary therapy and supportive care methods. RESULTS It was found that 30.6% of the healthcare professionals participating in the study used complementary treatment and supportive care methods in their patients. The least heard method was chiropractic (6.6%), the best-known method was hydrotherapy (water birth) (5.8%) and the most used method was massage (14.0%). It was determined that the mean total attitude score of the healthcare workers on complementary treatment and supportive care methods was 18.57 ± 5.12 (range: 8--40). It was found that the education levels of healthcare professionals (z= -2.144, p<0.05) and the institutions affect (Χ2=23.417; p<0.05) the attitude scores. CONCLUSIONS One out of every two healthcare professionals did not have information about complementary treatment and supportive care methods. Healthcare professionals mostly have positive opinions about these methods. [ABSTRACT FROM AUTHOR]

Acupuncture is an ancient system of medicine which involves introduction of specific needles in described sites into prescribed depths. A few apprehensions about this technique are the close proximity of the needles with vital structures and possible injuries. In the present paper, an attempt was made to use ultrasound which is a non invasive technique of identifying vital structures in two cases and to find out its utility. First case is of a 35-year-old male, with history of alcoholism, presented with a wrist drop, was advised electroacupuncture where the needles were placed in the centre of the muscle bulk with ultrasound guidance to elicit good motor response. Another case, a 45-year-old female patient had tennis elbow where the superficial veins and nerves were avoided before pricking on selected sites. The response was as expected and normal. The first case had satisfactory motor recovery while the second one had adequate pain relief. There was neither bleeding from any site nor any other complications. A survey scan of the puncture site can be advised before inserting acupuncture needles. Ultrasound guided acupuncture is feasible without compromising the traditions. This concept becomes easier as ultrasound and acupuncture have been conveniently handled together by anaesthesiologists.

As the cost of next-generation sequencing has decreased, library preparation costs have become a more significant proportion of the total cost, especially for high-throughput applications such as single-cell RNA profiling. Here, we have applied novel technologies to scale down reaction volumes for library preparation. Our system consisted of in vitro differentiated human embryonic stem cells representing two stages of pancreatic differentiation, for which we prepared multiple biological and technical replicates. We used the Fluidigm (San Francisco, CA) C1 single-cell Autoprep System for single-cell complementary DNA (cDNA) generation and an enzyme-based tagmentation system (Nextera XT; Illumina, San Diego, CA) with a nanoliter liquid handler (mosquito HTS; TTP Labtech, Royston, UK) for library preparation, reducing the reaction volume down to 2 µL and using as little as 20 pg of input cDNA. The resulting sequencing data were bioinformatically analyzed and correlated among the different library reaction volumes. Our results showed that decreasing the reaction volume did not interfere with the quality or the reproducibility of the sequencing data, and the transcriptional data from the scaled-down libraries allowed us to distinguish between single cells. Thus, we have developed a process to enable efficient and cost-effective high-throughput single-cell transcriptome sequencing.

Identifying "druggable" targets and their corresponding therapeutic agents are two fundamental challenges in drug discovery research. The one-bead-one-compound (OBOC) combinatorial library method has been developed to discover peptides or small molecules that bind to a specific target protein or elicit a specific cellular response. The phage display cDNA expression proteome library method has been employed to identify target proteins that interact with specific compounds. Here, we combined these two high-throughput approaches, efficiently interrogated approximately 10(13) possible molecular interactions, and identified 91 small molecule compound beads that interacted strongly with the phage library. Of 19 compounds resynthesized, 4 were cytotoxic against cancer cells; one of these compounds was found to interact with EIF5B and inhibit protein translation. As more binding pairs are confirmed and evaluated, the "library-against-library" screening approach and the resulting small molecule-protein domain interaction database may serve as a valuable tool for basic research and drug development.