Search

Postexercise hydration is fundamental to replace fluid loss from sweat. This study evaluated rehydration and gastrointestinal (GI) symptoms for each of three beverages: water (W), sports drink (SD), and skimmed, lactose-free milk (SLM) after moderate-intensity cycling in the heat. Sixteen college students completed three exercise sessions each to lose ≈2% of their body mass. They drank 150% of body mass loss of the drink assigned in randomized order; net fluid balance, diuresis, and GI symptoms were measured and followed up for 3 hr after completion of fluid intake. SLM showed higher fluid retention (∼69%) versus W (∼40%; p <.001); SD (∼56%) was not different from SLM or W (p >.05). Net fluid balance was higher for SLM (−0.26 kg) and SD (−0.42 kg) than W (−0.67 kg) after 3 hr (p <.001), resulting from a significantly lower diuresis with SLM. Reported GI disturbances were mild and showed no difference among drinks (p >.05) despite ingestion of W (1,992 ± 425 ml), SD (1,999 ± 429 ml), and SLM (1,993 ± 426 ml) in 90 min. In conclusion, SLM was more effective than W for postexercise rehydration, showing greater fluid retention for the 3-hr follow-up and presenting with low-intensity GI symptoms similar to those with W and SD. These results confirm that SLM is an effective option for hydration after exercise in the heat. [ABSTRACT FROM AUTHOR]

Purpose: Successful participation in taekwondo (TKD) requires athletes to possess quick decision-making abilities and demonstrate technical proficiency during competition. Dehydration, occurring during both training and competition, is widely recognized to have various negative effects. Methods: This study investigated the impact of different levels of dehydration on cognitive function, as measured by the Vienna Test System, and the specific performance of kicking techniques among TKD athletes. Using a randomized crossover design, 12 participants were involved in the study. Before and after 1 hour of training at 80% of maximal heart rate, participants were weighed and provided urine samples. All participants were randomly assigned to 3 different hydration conditions: the euhydrated (EUH) group had unrestricted access to fluid consumption, while the hypohydrated (HYP) and severely HYP (S-HYP) groups experienced reductions of 2.0% and 4.0% of their initial body weight, respectively. Results: The EUH group exhibited better reaction speed in reaction-time test-form S1 than the HYP and S-HYP groups. Notably, the EUH group demonstrated a significantly higher success rate in the front-side kick (EUH 98%, HYP 90%, S-HYP 88%; P <.05). However, the success rates of back roundhouse kick and free head kick were similar among the 3 statuses. Furthermore, postexercise heart rates were found to be significantly higher in the HYP and S-HYP groups compared with the EUH group. Conclusions: This study provides insight into the negative effects of dehydration on cognitive function and TKD-specific performance. It is recommended that TKD athletes maintain optimal hydration levels during training and competition to ensure optimal performance. [ABSTRACT FROM AUTHOR]

Purpose: We examined fluid intake, the relation between body mass (BM) loss and performance, and core temperature in young triathletes during a competition in tropical climate. Methods: Fluid intake and pre and post BM were measured in 35 adolescent athletes, and core temperature was measured in one female and one male. Results: Mean urine specific gravity (1.024 [0.007]) indicated that athletes were in suboptimal state of hydration upon waking. Race time was 73.2 (8.0) minutes. BM decreased by 0.6 (0.3) kg (P <.05). Fluid intake (528.5 [221.6] mL) replaced 47% of the fluid loss (1184.9 [256.4] mL) and was higher during run (11.5 [6.6] mL·min−1) compared to bike (7.3 [3.1] mL·min−1), P <.01. Loss in BM was ≥1.0% in 66% and ≥1.5% in 29% of the athletes. Males showed a moderate association between percentage loss in BM and finishing time (r = −.52), higher sweat rates (1.0 [0.3] L·h−1), and faster times (69.4 [7.5] min; P <.05). Core temperature rose to 40.1 °C in the female and 39.6 °C in the male. Conclusion: Young triathletes competing in a hot/humid climate became mildly to moderately dehydrated and hyperthermic even when water and sports drinks were available but did not show symptoms of heat illness. [ABSTRACT FROM AUTHOR]

Purpose: The primary objective was to assess the performance benefits of caffeine (CAF) supplementation in habitual users. Importantly, this investigation was designed to account for the potential confounding effects of CAF withdrawal (CAFW), which are inherent and common in previous work. Methods: Ten CAF-consuming (394 [146] mg·d−1) recreational cyclists (age 39.1 [14.9] y; maximum oxygen consumption 54.2 [6.2] mL·kg–1·min–1) completed four 10-km time trials (TTs) on a cycle ergometer. On each trial day, 8 hours before reporting to the laboratory, subjects consumed 1.5 mg·kg–1 CAF to prevent withdrawal (no withdrawal [N]) or a placebo (PLA; withdrawal [W]). Then, 1 hour prior to exercise, they received either 6 mg·kg–1 CAF or PLA. These protocols were repeated 4 times, employing all combinations of N/W and CAF/PLA. Results: CAFW did not impair TT power output (PLAW vs PLANP =.13). However, preexercise CAF only improved TT performance when compared to PLA in the W condition (CAFN vs PLAWP =.008, CAFW vs PLAWP =.04), not when W was mitigated (PLAN vs CAFNP =.33). Conclusions: These data indicate that preexercise CAF only improves recreational cycling performance when compared to bouts preceded by CAF abstinence, suggesting that habitual users may not benefit from 6 mg·kg–1 of CAF and that previous work may have overstated the value of CAF supplementation for habitual users. Future work should examine higher doses of CAF for habitual users. [ABSTRACT FROM AUTHOR]

Why you should read this article: • UK care homes are an important example of a complex environment where research is essential but faces multiple challenges in terms of rigour and methodology • This paper offers a variety of important methodological strategies to identify and address challenges that could impact findings and the ability to carry out research • It highlights the importance of taking a critical stance with all elements of the research process and illustrates the need to identify and mitigate challenges when conducting research in complex environments. Background: The evidence base for hydration practice in care homes is underdeveloped. High-quality research is therefore needed to determine what practices support older people with dementia in drinking sufficient fluid. However, methodological developments are needed to be able to do this. Aim: To highlight the methodological issues researchers encountered during a feasibility cluster, randomised controlled trial of ThinkDrink, a hydration care guide for people with dementia living in UK care homes. Discussion: This is a challenging area because of the complexity of recruitment, participation and data collection in care homes. Researchers must pay extra attention to rigour and quality in the design of their studies. There may be multiple challenges, so various strategies may be required. Conclusion: It is important that researchers continue to reflect on rigorous approaches to develop evidence in a crucial area of care, despite these challenges. Implications for practice: Researchers working in complex environments face a variety of challenges to complete methodologically rigorous research. It is important for researchers to be critical of research processes and data, to mitigate and overcome these challenges. [ABSTRACT FROM AUTHOR]

Aim: Urinary tract infections (UTIs) rank among the most prevalent infections in humans, carrying substantial implications for public health. Women experiencing recurrent UTIs are often advised to boost their fluid intake to help eliminate bacteria. In this study, we explored the impact of elevated fluid consumption during UTIs using a mouse model of pyelonephritis. Methods: UTI was induced in 8–10 w female BALB/cJ‐mice by surgically injecting Escherichia coli (O6:K13:H1) into the bladder whereafter mice were randomized to gel food (GF) or regular chow. Immune response and infection severity were determined 24‐h post‐infection. In vitro bacterial growth (OD600) was determined in urine from mice or from human volunteers. Results: Gel feeding increased urine output (1.40 ± 0.77 μL min−1, p < 0.01) and diluted the urine (668.7 ± 177 mOsmol kg−1, p < 0.0001) compared to controls on regular chow (urine output: 0.34 ± 0.27 μL min−1, osmolality: 1439 ± 473.5 mOsmol kg−1). Mice on GF had a higher risk of pyelonephritis (87.5%) and more severe infections (26.22 ± 9.88 CFU mg−1 tissue) compared to controls (43.75%; 3.87 ± 3.56 CFU mg−1, p < 0.01). Correspondingly, the growth of E. coli was markedly reduced at osmolalities above 1200 mOsmol kg−1 compared to 600 mOsmol kg−1 and GF mice had lower urine levels of uromodulin (13.70 ± 1.89 μg mL−1, p < 0.01) compared to controls (24.65 ± 2.70 μg mL−1). Conclusion: Increased water intake and urine flow in mice will markedly increase the risk of pyelonephritis. The increased risk may reflect reduced urine uromodulin combined with optimized growth conditions for E. coli. The study does not immediately support the notion that established UTIs can be eliminated by increased water intake. [ABSTRACT FROM AUTHOR]

Summary: Objectives: We aimed to validate dietary assessment methods against the gold standard, doubly labeled water (DLW), for estimating total energy intake (TEI). Methods: PubMed, Scopus, Web of Science, and Google Scholar databases were searched until May 2023. Inclusion criteria encompassed studies involving participants aged 1–18 years, employing dietary assessment methods like food records, dietary histories, food frequency questionnaire (FFQ), or 24‐h recalls estimating TEI alongside DLW to measure total energy expenditure (TEE). Data were pooled using random‐effects meta‐analysis models. Results: Thirty‐three studies were identified, with sample sizes ranging from 9 to 118 participants. Meta‐analysis of 22 studies identified underestimation of TEI (mean difference [MD] = −262.9 kcal/day [95% CI: −380.0, −145.8]; I2 = 93.55%) for food records compared with TEE estimated by DLW. Other dietary assessment methods, including food recalls (n = 9) (MD = 54.2 kcal/day [95% CI: −19.8, 128.1]; I2 = 49.62%), FFQ (n = 7) (MD = 44.5 kcal/day [95% CI: −317.8, 406.8]; I2 = 94.94%), and diet history (n = 3) (MD = −130.8 kcal/day [95% CI: −455.8, 194.1]; I2 = 77.48%), showed no significant differences in TEI compared with DLW‐estimated TEE. All studies were of high quality. Conclusion: Food records may underestimate TEI, yet additional research is needed to identify the most accurate methods for assessing children's dietary intake. [ABSTRACT FROM AUTHOR]

Summary: Background: The prevalence of childhood obesity in the U.S. has increased, likely due to decreased physical activity, increased sedentary behaviour and unhealthy diets. Little is known about the relationships between these factors and weight gain in those under the age of three. Objectives: This study aimed to understand the longitudinal associations of weight gain over 6‐month intervals with child and parent characteristics as children develop from 6 to 36 months. Methods: Mother and infant data were collected at 6‐month intervals from 6 to 36 months. Weight (kg) was the primary outcome variable, and potential explanatory variables included child and parent characteristics, physical activity, motor development, diet and sleep. Structural equation modelling was used to assess associations between explanatory variables and 6‐month weight gain. Results: Weight increased ~1 kg per 6‐month interval (p < 0.001) from 6 to 36 months. Childcare outside of the home at 12 months was associated with 0.272 kg (p = 0.002) greater weight gain at 18 months, while children's physical activity was associated with 0.228 kg (per 2 SD, p = 0.051) less weight gain during the same time period. Mother's TV and screen media use (0.102 kg per hour/day, p = 0.046) and child's intake of high‐energy beverages at 18 months (0.387 kg, p = 0.037) were both associated with greater weight gain at 24 months. Conclusion: Childcare, physical activity, screen media use and high‐energy beverage consumption might affect weight gain at different time points in early childhood. These insights can inform efforts to prevent excessive weight gain and childhood obesity effectively. [ABSTRACT FROM AUTHOR]

Objectives: Noncarious cervical lesions (NCCLs) are multifactorial and can be caused by the anatomical structure of the teeth, erosion, abrasion and abnormal occlusion. The aim of this case–control study was to explore the risk factors for NCCLs. Methods: Cone‐beam computed tomography was used to determine whether a wedge‐shaped defect existed at the cementoenamel junction. We compared 63 participants with NCCLs with 63 controls without NCCLs, matched for sex, age (±1 year) and toothbrushing‐related factors (e.g., type of bristle and brushing patterns, frequency and strength). All participants were asked to complete a questionnaire about self‐administered daily diet habits and health condition. Univariate and multivariate logistic regression analyses were conducted to determine the risk factors for NCCLs. Results: Significant variables in the univariate analysis (i.e., p <.2) included frequency of carbonated beverage consumption, sella‐nasion‐point B angle (SNB) and Frankfort‐mandibular plane angle (FMA). Multivariate logistic regression demonstrated that the consumption frequency of carbonated beverages (odds ratio [OR] = 3.147; 95% confidence interval [CI], 1.039–9.532), FMA (OR = 1.100; 95% CI, 1.004–1.204) and SNB (OR = 0.896; 95% CI, 0.813–0.988) was independent influencing factors. The area under the receiver operating characteristic curve (AUC) value of regression Model 1 (established with the frequency of carbonated beverage consumption, FMA, SNB and sleep bruxism) was 0.700 (95% CI, 0.607–0.792; p <.001), and that of regression Model 2 (established using the frequency of carbonated beverage consumption, FMA and SNB) was 0.704 (95% CI, 0.612–0.796; p <.001). Conclusions: The consumption frequency of carbonated beverages and FMA was risk factors for NCCLs; the higher the frequency of carbonated beverage consumption and FMA, the higher was the probability of NCCLs. SNB was a protective factor for NCCL occurrence; the larger the SNB, the lower was the probability of NCCL occurrence. These findings have further clarified the aetiology of NCCLs and provided clinicians with valuable insights into strategies for preventing the loss of dental tissue. [ABSTRACT FROM AUTHOR]

Background: Haemodialysis (HD) patients are reported to be at greater risk of malnourishment, and at risk of increased morbidity and mortality. However, most studies report from economically advanced countries. We therefore assessed the nutritional status and diet among HD patients attending a public university hospital in a sub-Saharan African country. Subjects: We performed nutritional assessments in HD patients attending the largest dialysis centre, in the country, collecting demographic and clinical data, dietary intake, along with anthropometric and bioimpedance body composition measurements in May 2022. Malnutrition was classified according to subjective global assessment score (SGA). Additional assessments of protein energy wasting (PEW), clinical frailty, and sarcopenia were made. Results: All 97 HD patients were recruited, mean age 44.7 ± 12.2 years, with 55 (56.7%) males. Malnutrition was present in 43.8%, PEW 20.6%, frailty 17.6% and sarcopenia 4.1%. On multivariable logistic regression higher serum albumin (adjusted odds ratio (AOR) 0.89, 95% confidence intervals (CI) 0.85-0.95, p < 0.001), creatinine (AOR 0.99, 95%CI 0.98–0.99, p < 0.001), greater mid upper arm circumference (AOR 0.89, 95%CI 0.83–0.95, p = 0.001), body cell mass (BCM) (AOR 0.79, 95%CI 0.67–0.95, p = 0.013) and employment (AOR 0.45, 95%CI 0.23–0.87, p = 0.017), were are all protective against malnourishment. Almost 75% had reduced dietary protein intake. Conclusions: Despite a younger, less co-morbid patient population, malnutrition is common in this resource poor setting. The staple diet is based on maize, a low protein foodstuff. Employment improved finances and potentially allows better nutrition. Further studies are required to determine whether additional dietary protein can reduce the prevalence of malnutrition in this population. [ABSTRACT FROM AUTHOR]

Background: Postoperative thirst is one of the most intense, common and easily ignored subjective discomforts in patients after gynecological surgery. This study aimed to investigate whether early oral hydration on demand in the postanesthesia care unit (PACU) after gynecological laparoscopy under general anesthesia can appease postoperative thirst and increase patient comfort. Methods: Participants were randomized into the intervention and control groups. Patients in the intervention group were allowed to achieve early oral hydration on demand in the PACU if they were evaluated as fully conscious, with stable vital signs, grade 5 muscle strength, and well-recovered cough and swallowing reflex. However, the total amount of water intake throughout the entire study should not exceed 0.5mL/kg. During the study, the frequency of water intake, the total amount of water intake and adverse events were accurately recorded. The control group was managed according to the routine procedures and began to drink water 2 h after anesthesia. The intensity of thirst and subjective comfort in patients were assessed using the visual analog scale (VAS) when they entered and left the PACU. Results: No statistically significant differences were identified in age, height, weight, body mass index, pre-operative fasting time, duration of surgery, intraoperative fluid intake, intraoperative blood loss, intraoperative urine volume, and thirst intensity and subjective comfort scores between the groups before intervention (P > 0.05). After intervention, the VAS score for thirst intensity in the intervention group significantly decreased (P < 0.05), and the VAS score for subjective comfort in the intervention group significantly increased (P < 0.05). No adverse events were detected in both groups during the entire study. Conclusion: Early oral hydration on demand in the PACU can safely and effectively relieve postoperative thirst in patients, and improve patient comfort after gynecological laparoscopy. Trial registration: This single-center, prospective, randomized controlled trial was registered at the Chinese Clinical Trial Center on April 27, 2023. The registration number of this study is ChiCTR2300070985. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion There is no universally accepted treatment consensus for haemorrhoids, and thus, management has been individualized all over the world. This study was conducted to assess a global view of how surgeons manage haemorrhoids.The research panel of the International Society of University Colon and Rectal Surgeons (ISUCRS) developed a voluntary, anonymous questionnaire evaluating surgeons' experience, volume and treatment approaches to haemorrhoids. The 44 multiple‐choice questionnaire was available for one month via the ISUCRS email database and the social media platforms Viber and WhatsApp.The survey was completed by 1005 surgeons from 103 countries; 931 (92.6%) were in active practice, 819 (81.5%) were between 30 and 60 years of age, and 822 (81.8%) were male. Detailed patient history (92.9%), perineal inspection (91.2%), and digital rectal examination (91.1%) were the most common assessment methods. For internal haemorrhoids, 924 (91.9%) of participants graded them I–IV, with the degree of haemorrhoids being the most important factor considered to determine the treatment approach (76.3%). The most common nonprocedural/conservative treatment consisted of increased daily fibre intake (86.9%), increased water intake (82.7%), and normalization of bowel habits/toilet training (74.4%). Conservative treatment was the first‐line treatment for symptomatic first (92.5%), second (72.4%) and third (47.3%) degree haemorrhoids; however, surgery was the first‐line treatment for symptomatic fourth degree haemorrhoids (77.6%). Rubber band ligation was the second‐line treatment in first (50.7%) and second (47.2%) degree haemorrhoids, whereas surgery was the second‐line treatment in third (82.9%) and fourth (16.7%) degree symptomatic haemorrhoids. Rubber band ligation was performed in the office by 645(64.2%) of the participants. The most common surgical procedure performed for haemorrhoids was an excisional haemorrhoidectomy for both internal (87.1%) and external (89.7%) haemorrhoids – with 716 (71.2%) of participants removing 1, 2 or 3 sectors as necessary.Although there is no global haemorrhoidal treatment consensus, there are many practice similarities among the different cultures, resources, volume and experience of surgeons around the world. With additional studies, a consensus statement could potentially be developed. [ABSTRACT FROM AUTHOR]

The objective of this research is to investigate the potential mechanisms underlying electro-acupuncture intervention in chronic prostatitis (CP). Rats were randomly divided into five groups: a control group, a model group (suffering from CP), an electro-acupuncture group, an inhibitor group, and an activator group. One day post-modeling, electro-acupuncture intervention was conducted on the electro-acupuncture group, inhibitor group, and activator group at the acupoints “Baihuan Shu” (BL 30) and “Huiyang” (BL 35). Relevant indicators were used to evaluate the efficacy. Compared with models, the electro-acupuncture group showed significantly increased horizontal and vertical movement scores and sugar water intake, and significantly decreased prostate wet weight and prostate index. Compared with the electro-acupuncture group, the inhibitor group showed significantly increased horizontal and vertical movement scores and sugar water consumption. In contrast, for the activator group, these scores and consumption levels significantly decreased, while their prostate wet weight and prostate index increased significantly. Compared with models, the expression of TLR4 and p-NF-κB/NF-κB proteins in the prostate tissue of electro-acupuncture group was significantly lower. In terms of the inhibitor group, they also showed a decrease in TLR4 and p-NF-κB/NF-κB protein expression, whilst the activator group showed an increase. Therefore, electro-acupuncture at “Baihuan Shu” (BL 30) and “Huiyang” (BL 35) can significantly enhance movement scores, vertical movement scores, and sugar water consumption in rats with CP. Moreover, it can decrease the wet weight and index of the prostate, possibly by regulating the TLR4/NF-κB pathway. [ABSTRACT FROM AUTHOR]

Background: Oral fluid intake decreases in advanced cancer in the dying phase of illness. There is inadequate evidence to support the assessment, and management, of hydration in the dying. Bioelectrical impedance analysis (BIA) is a body composition assessment tool. BIA has the potential to inform clinal management in advanced cancer, by examining the relationships between hydration status and clinical variables. Aim: BIA was used to determine the association between hydration status, symptoms, clinical signs, quality-of-life and survival in advanced cancer, including those who are dying (i.e. in the last week of life). Materials and methods: We conducted a prospective observational study of people with advanced cancer in three centres. Advance consent methodology was used to conduct hydration assessments in the dying. Total body water was estimated using the BIA Impedance index (Height – H (m)2 /Resistance – R (Ohms)). Backward regression was used to identify factors (physical signs, symptoms, quality of life) that predicted H2/R. Participants in the last 7 days of life were further assessed with BIA to assess hydration changes, and its relationship with clinical outcomes. Results: One hundred and twenty-five people participated (males n = 74 (59.2%), females, n = 51 (40.8%)). We used backward regression analysis to describe a statistical model to predict hydration status in advanced cancer. The model demonstrated that 'less hydration' (lower H2/R) was associated with female sex (Beta = -0.39, p < 0.001), increased appetite (Beta = -0.12, p = 0.09), increased dehydration assessment scale score (dry mouth, dry axilla, sunken eyes - Beta = -0.19, p = 0.006), and increased breathlessness (Beta = -0.15, p = 0.03). 'More hydration' (higher H2/R) was associated with oedema (Beta = 0.49, p < 0.001). In dying participants (n = 18, 14.4%), hydration status (H2/R) was not significantly different compared to their baseline measurements (n = 18, M = 49.6, SD = 16.0 vs. M = 51.0, SD = 12.1; t(17) = 0.64, p = 0.53) and was not significantly associated with agitation (rs = -0.85, p = 0.74), pain (rs = 0.31, p = 0.23) or respiratory tract secretions (rs = -0.34, p = 0.19). Conclusions: This is the first study to use bioimpedance to report a model (using clinical factors) to predict hydration status in advanced cancer. Our data demonstrates the feasibility of using an advance consent method to conduct research in dying people. This method can potentially improve the evidence base (and hence, quality of care) for the dying. Future BIA research can involve hydration assessment of cancers (according to type and stage) and associated variables (e.g., stage of illness, ethnicity and gender). Further work can use BIA to identify clinically relevant outcomes for hydration studies and establish a core outcome set to evaluate how hydration affects symptoms and quality-of-life in cancer. Key message: What is already known about this topic? - Oral fluid intake decreases in people with advanced cancer, especially when they approach the dying phase of their illness. - There is inadequate evidence to support hydration assessment and decision making in the dying phase of illness. - It is important to understand which clinical factors are associated with hydration status in advanced cancer, to enable healthcare professionals, to evaluate hydration status and support clinical decision making. - Bioimpedance is a non-invasive technology, which has potential to identify clinically relevant variables for cancer hydration assessment. What this paper adds. - This is the first study to use bioimpedance to report a model (using clinical factors) to predict hydration status in advanced cancer. - The variables with combined significance for predicting hydration status were biological sex, appetite, dry mouth, dry axilla, sunken eyes, breathlessness and oedema. In the dying phase, hydration status did not significantly change compared to baseline, and hydration status was not significantly associated with survival. Implications for practice, theory or policy. - Further work can use bioimpedance to identify clinically relevant outcomes for hydration studies, to establish a core outcome set to evaluate how hydration affects symptoms and quality-of-life in cancer. [ABSTRACT FROM AUTHOR]

The article discusses the visualization of high-dimensional data in physiology research. It emphasizes the importance of clarifying the axes and units represented in diagrams to accurately interpret the data. The article introduces dimensionality reduction methods such as principal component analysis (PCA), t-Distributed Stochastic Neighbor Embedding (t-SNE), and Uniform Manifold Approximation and Projection (UMAP). It explains that t-SNE preserves local structure but not global structure, while UMAP aims to preserve both. The article concludes by highlighting the growing use of these methods in various scientific fields and the need for clear explanations when presenting high-dimensional plots. [Extracted from the article]

This study investigates the problem of low efficiency and the lack of a water supply at the Hemmat Water Intake, in Iran, where severe sediment accumulation was observed at the intake mouth. The Flow-3D software was used to simulate the flow patterns under various scenarios of hydraulic regimentation works. The considered parameters include: (i) three alternative locations of the spur dike (i.e., a spur dike placed on the opposite side of the intake inlet and aligned with the upstream edge of the intake, to be regarded as a witness spur dike; a spur dike at a distance DS of 7 m downstream of the witness spur dike, which implies a dimensionless distance DS/bi1 of 1/3, with bi1 being the intake opening width; and a spur dike at a distance of 7 m upstream of the witness spur dike with a dimensionless distance, still, of 1/3); (ii) four spur dike lengths, LS/Br, with LS being the effective spur dike length and Br the approach river width; and (iii) five spur dike deviation angles of 75, 90, 105, 120, and 135 degrees (the deviation angle is the angle between the spur dike axis and the original river-bank line from which the spur dike extends). The results showed that, with the increase in the relative spur dike length (LS/Br), the velocity of the flow entering the water intake increases by 11%. A spur deviation angle of 135 degrees increases the flow depth at the intake inlet by 9% compared to a smaller deviation angle of 75 degrees. In addition, the spur dike increases the flow shear stresses at the intake inlet by up to 50%. Overall, the main flow of the river with the highest velocity and depth, and best directed towards the water intake, occurs for the placement of the longest spur dike (i.e., LS/Br = 0.46) in front of the inlet (i.e., witness spur dike) and for a spur dike deviation angle of 135 degrees. The spur dike increases the shear stress at the intake entrance by more than five times with respect to the case of its absence. In general, the presence of a spur dike on the opposite bank and with a deviation angle in the direction of the intake inlet well directs the main flow towards the canal intake. Moreover, it reduces the possibility of sedimentation in the canal inlet by increasing the flow velocity. Therefore, the results of this study could also be useful in increasing the hydraulic efficiency of lateral intakes by reducing the sedimentation phenomena. [ABSTRACT FROM AUTHOR]

The harsh and dry conditions of desert environments have resulted in genomic adaptations, allowing for desert organisms to withstand prolonged drought, extreme temperatures, and limited food resources. Here, we present a comprehensive exploration of gene expression across five tissues (kidney, liver, lung, gastrointestinal tract, and hypothalamus) and 19 phenotypic measurements to explore the whole-organism physiological and genomic response to water deprivation in the desert-adapted cactus mouse (Peromyscus eremicus). The findings encompass the identification of differentially expressed genes and correlative analysis between phenotypes and gene expression patterns across multiple tissues. Specifically, we found robust activation of the vasopressin renin-angiotensin-aldosterone system (RAAS) pathways, whose primary function is to manage water and solute balance. Animals reduced food intake during water deprivation, and upregulation of PCK1 highlights the adaptive response to reduced oral intake via its actions aimed at maintained serum glucose levels. Even with such responses to maintain water balance, hemoconcentration still occurred, prompting a protective downregulation of genes responsible for the production of clotting factors while simultaneously enhancing angiogenesis which is thought to maintain tissue perfusion. In this study, we elucidate the complex mechanisms involved in water balance in the desert-adapted cactus mouse, P. eremicus. By prioritizing a comprehensive analysis of whole-organism physiology and multi-tissue gene expression in a simulated desert environment, we describe the complex response of regulatory processes. [ABSTRACT FROM AUTHOR]

Background: Hyoid bone is attached to the mandible, tongue, larynx, temporal bone, and cervical spine via different types of muscles or ligaments. The tongue, mandible, and hyoid system play a crucial role in swallowing function. This within subject study aimed to evaluate the impact of mandibular implant overdentures on the displacement of the hyoid bones during the swallowing process. Methods: Twenty five healthy edentulous subjects were selected for participating in the study. New complete dentures were constructed for all the participants. Subsequently two dental implants were inserted in the canine regions of the participant's mandibular arch. In order to retain the mandibular prosthesis in place, ball attachments were incorporated into the mandibular dentures to convert them into implant overdentures. Using 10 ml of thin liquid bolus, videofluoroscopy swallowing examination was performed in three different oral conditions: without complete dentures (WCD), with complete denture (CDs), and with a mandibular implant overdenture (IODs). ANOVA with Bonferroni test was used to analyze the data in order to determine how the hyoid displacement varied throughout different oral conditions. Results: Compared to complete dentures, mandibular implant overdentures showed a significant decrease (P < 0.05) in both anterior hyoid displacement and duration of hyoid maximum anterior excursion (DOHMAE). However, there was a non-significant difference (P > 0.05) between the two oral circumstances in terms of superior hyoid displacement or duration for hyoid maximum elevation (DOHME). There is no penetration or aspiration for both complete denture and implant overdenture oral conditions. Conclusion: Implant retained overdentures have a positive effect on hyoid displacement during swallowing of thin liquid bolus consistency relative to conventional complete dentures. Trial registration: Retrospectively registered (NCT06187181) 02/1/2024. [ABSTRACT FROM AUTHOR]

Substance P (SP) and a calcitonin‐related gene alpha (αCGRP−/−) are implicated in musculoskeletal pain perception and were shown to have different effects on the pathogenesis of osteoarthritis (OA). However, it has not been investigated, whether deficiency for SP or αCGRP impacts pain‐related behavior and well‐being as well as gait during development of experimental OA. We induced OA in the right knee of wild‐type (WT) mice and mice either deficient for SP (tachykinin 1, Tac‐1) or αCGRP (male, n = 8 per genotype) by destabilizing the medial meniscus (DMM). We monitored body weight and food and water intake as indicators of wellbeing, determined nest building and composite pain score, and performed CatWalk gait analysis over 12 weeks. Cartilage degeneration was determined by OARSI scoring. The 12‐week post‐DMM, cartilage degradation in the medial compartment was significantly reduced in Tac1−/− mice compared to the WT and to αCGRP−/− mice, coinciding with highest unloading of the operated limb in Tac1−/−. Behavioral and gait analysis revealed only minor differences between the genotypes. Paw print area was most prominently reduced in Tac1−/− over the observation period; at 12 weeks, we found a significant reduction in normalized print area in Tac1−/− compared to presurgery and to the WT at the same time‐point. Calculated weight bearing was significantly reduced only in Tac1−/−. Overall, we observed minor impact of DMM on gait and behavior in the present study. The reduced cartilage damage in the absence of SP might be in part due to reduced loading, however, the mechanism is not clear yet. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the antidiabetic activity of crude extract of Olea europaea L. (CEOE) leaves in streptozotocin induced-diabetic rats and also to determine its tannin content. Methods: Thirty (30) male, normoglycemic Wistar rats (170 - 250 g) were randomly divided into five groups of six rats each. Group 1, which served as the normal control group, received distilled water while groups 2 and 3, were administered 200 and 600 mg/kg of CEOE extract daily for 18 days, respectively. Group 4 was given glibenclamide (Glibil; 3 mg/kg) while group 5 served as the untreated diabetic control group. Diabetes was induced with a single intraperitoneal injection of streptozotocin (50 mg/kg) and rats with blood glucose levels ≥ 250 mg/dL were confirmed to be diabetic. The blood glucose concentration, water and feed intake, tannin content of CEOE as well as the weight of organs were determined. Results: The results showed that O. europea contained a large amount of tannins (806.22 ± 0.036 μg Tannic Acid Equivalent/g Extract). Administration of the extract (200 and 600 mg/kg) significantly decreased polydipsia and polyphagia, and reversed weight loss in rats with diabetes (p < 0.05 and p < 0.01, respectively) in comparison with glibenclamide. Conclusion: The antidiabetic activity of the crude extract of O. europea was higher than that observed with glibenclamide, thus validating the folkloric use of this plant in diabetes care. Further investigation of Olea europea, including thorough chemical and pharmacological studies, are required. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) is a clinical syndrome characterized by multiple metabolic disorders and is a serious global health problem. The coffee effect, acting as one of the most prevalent beverages on metabolic syndrome, is debatable. Methods: We included patients from the National Health and Nutrition Examination Survey 2003–2018 and used a comprehensive evaluation called the MetS z-score to assess the severity of metabolic syndrome. The relationship between coffee, decaffeinated coffee, tea, and MetS z-scores was explored using a weighted linear regression. We also divided the participants into metabolic and non-metabolic syndrome groups according to the NCEP/ATP III criteria for the subgroup analysis. Results: A total of 14,504 participants were included in this study. The results demonstrated that drinking more than three cups of coffee daily was significantly linked to lower MetS z-scores (p < 0.001). Daily coffee consumption was also associated with lower BMI (p = 0.02), systolic blood pressure (p < 0.001), Homeostatic Model Assessment for Insulin Resistance (p < 0.001), and triglycerides (p < 0.001), while it was positively correlated with HDL-C (p = 0.001). Participants who consumed more than three cups of coffee daily had a lower MetS z-score in the MetS (p < 0.001) and non-MetS (p = 0.04) groups. Conclusion: This research indicates that coffee consumption is linked to MetS severity. However, decaffeinated coffee and tea intake were unrelated to MetS severity. [ABSTRACT FROM AUTHOR]

Context Energy drinks (EDs) are beverages that contain ingredients that may pose a risk to consumers' cardiovascular health. But current evidence is conflicting and warrants further investigation. Objective A systematic review and meta-analysis was conducted on studies that examined the acute effects of ED consumption on systolic blood pressure (SBP), diastolic blood pressure (DBP), resting heart rate, cardiac output (CO), endothelial function, and QT/QTc interval in healthy adults. Data Sources The databases PubMed, EMBASE, Cochrane, LILACS, Web of Science, SportDiscus, and the gray literature were searched to identify randomized controlled trials (RCTs). Data Extraction Two independent evaluators screened 2014 studies and extracted relevant data from those selected for the analysis. A risk of bias assessment was also performed with the RoB 2 tool and a strength of evidence assessment was performed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Data Analysis A total of 17 RCTs were included in the meta-analysis. With regard to risk of bias, 11 studies were rated as having "some concerns" and 6 as "high risk of bias." The consumption of EDs increased SBP, DBP, and CO in different time frames. More pronounced effects were seen on SBP at 60-80 minutes (4.71 mmHg; 95% CI: 2.97–6.45; GRADE: moderate), DBP at 120 minutes (4.51 mmHg; 95% CI: 2.60–6.42; GRADE: low), and CO at 30-40 minutes after consumption (0.43 L; 95% CI: 0.08–0.77; GRADE: very low). The effects of ED consumption on resting heart rate and QT/QTc interval were not significant (P ≤ 0.05). The assessment of endothelial function effects was not performed due to the absence of any RCTs meeting the inclusion criteria. Conclusions Acute consumption of EDs increases SBP, DBP, and CO in healthy adults. However, no alterations were observed in other cardiovascular parameters. The results should be interpreted with caution due to the limited number of studies included in the analysis. Systematic Review Registration PROSPERO registration no. CRD42022295335. [ABSTRACT FROM AUTHOR]

To establish the criterion‐assessed energy and fluid requirements of female netball players, 13 adult players from a senior Netball Super League squad were assessed over 14 days in a cross‐sectional design, representing a two‐ and one‐match microcycle, respectively. Total energy expenditure (TEE) and water turnover (WT) were measured by doubly labeled water. Resting and activity energy expenditure were measured by indirect calorimetry and Actiheart, respectively. Mean 14‐day TEE was 13.46 ± 1.20 MJ day−1 (95% CI, 12.63–14.39 MJ day−1). Resting energy expenditure was 6.53 ± 0.60 MJ day−1 (95% CI, 6.17–6.89 MJ day−1). Physical activity level was 2.07 ± 0.19 arbitrary units (AU) (95% CI, 1.95–2.18 AU). Mean WT was 4.1 ± 0.9 L day−1 (95% CI, 3.6–4.7 L day−1). Match days led to significantly greater TEE than training (+2.85 ± 0.70 MJ day−1; 95% CI, +1.00– +4.70 MJ day−1; p = 0.002) and rest (+4.85 ± 0.70 MJ day−1; 95% CI, +3.13–+6.56 MJ day−1; p < 0.001) days. Matches led to significantly greater energy expenditure (+1.85 ± 1.27 MJ; 95% CI, +0.95–+2.76 MJ day−1; p = 0.001) than court‐based training sessions. There was no significant difference in TEE (+0.03 ± 0.35 MJ day−1; 95% CI, −0.74–+0.80 MJ day−1; p = 0.936) across weeks. Calibrated Actiheart 5 monitors underestimated TEE (−1.92 ± 1.21 MJ day−1). Energy and fluid turnover were greatest on match days, followed by training and rest days, with no difference across weeks. This study provides criterion‐assessed energy and fluid requirements to inform dietary guidance for female netball players. Highlights: The energy and fluid requirements of female netball players were greatest on match days, followed by training and rest days, with no difference across a one‐ or two‐match weekly microcycle. Therefore, players are encouraged to periodise their intake on a daily basis, aligning with the demands of their training and match schedule.Female netball players have in‐season energy requirements representative of a vigorously active lifestyle (physical activity level: >2.0 arbitrary units). Water turnover varied widely amongst participants (range: 62 mL fat‐free mass [FFM] day−1), while total energy requirements were more homogenous (range: 0.05 MJ FFM day−1).Calibrated Actiheart 5 monitors underestimated female netball player total energy expenditure in comparison to the doubly labelled water criterion (range: −0.38–3.84 MJ day−1). Further research is now required to investigate the validity of Actiheart for measuring team sport athlete energy expenditure. [ABSTRACT FROM AUTHOR]

The relation of exposure to arsenic in drinking water during pregnancy to the risk of preterm birth (PTB) was contradictory. This meta-analysis aimed to examine the association between drinking water arsenic and PTB. A systematic search in PubMed and Scopus was performed to achieve all relevant studies. Odds ratios (OR) and 95% confidence intervals (CI) were used to pool data using the random-effect models. Overall, 11 studies with a total sample size of 3,404,189 participants were included in the meta-analysis. Arsenic exposure through drinking water during pregnancy was related to an increased risk of PTB (OR = 1.06; 95%CI = 1.01–1.10 for highest versus lowest category of arsenic), with significant heterogeneity across the studies (I2 = 84.8%, P = 0.001). This finding was supported by cohort studies (OR = 1.05; 95%CI = 1.01–1.10). This meta-analysis proposes that higher arsenic exposure in drinking water may be a risk factor for PTB. [ABSTRACT FROM AUTHOR]

Background: The strong connection between gut microbes and human health has been confirmed by an increasing number of studies. Although probiotics have been found to relieve ulcerative colitis, the mechanism varies by the species involved. In this study, the physiological, immune and pathological factors of mice were measured and shotgun metagenomic sequencing was conducted to investigate the potential mechanisms in preventing ulcerative colitis. Results: The results demonstrated that ingestion of Lactobacillus fermentum GLF‐217 and Lactobacillus plantarum FLP‐215 significantly alleviated ulcerative colitis induced by dextran sulfate sodium (DSS), as evidenced by the increase in body weight, food intake, water intake and colon length as well as the decrease in disease activity index, histopathological score and inflammatory factor. Both strains not only improved intestinal mucosa by increasing mucin‐2 and zonula occludens‐1, but also improved the immune system response by elevating interleukin‐10 levels and decreasing the levels of interleukin‐1β, interleukin‐6, tumor necrosis factor‐α and interferon‐γ. Moreover, L. fermentum GLF‐217 and L. plantarum FLP‐215 play a role in preventing DSS‐induced colitis by regulating the structure of gut microbiota and promoting the formation of short‐chain fatty acids. Conclusions: This study may provide a reference for the prevention strategy of ulcerative colitis. © 2024 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

The association between coffee consumption and lung cancer risk remains inconsistent. To quantitatively assess this association, we conducted a meta-analysis of prospective cohort studies. We searched PubMed and Web of Science databases along with hand searches for eligible studies published up to July 2023. A total of 26 prospective studies, including 30,305 lung cancer cases and 1,795,158 participants, were included in the meta-analysis. The pooled RR for high vs. low coffee consumption was 1.30 (95% CI: 1.11–1.53) with significant heterogeneity (I2 = 72.0%, p <.001). For never smokers, however, the pooled RR was 1.18 (95% CI: 0.999–1.38) with no evidence of heterogeneity (I2 = 0.0%, p =.53). By adjustment for body mass index (BMI), there was no significant association between coffee consumption and lung cancer risk in studies that adjusted for BMI (RR = 1.06; 95% CI: 0.87–1.30) (Pdifference =.01). Further analysis of studies that adjusted for BMI in never smokers found that coffee consumption was not associated with lung cancer risk. In conclusion, the association of high coffee consumption with lung cancer risk was attenuated when the confounding effects caused by smoking and BMI were controlled. Our results, therefore, imply that coffee consumption does not seem to be a risk factor for lung cancer incidence. [ABSTRACT FROM AUTHOR]

Background: Modification of foods or liquids is commonly administered as part of dysphagia treatment. However, no consensus exists on the parameters for defining texture‐modified food for patients with dysphagia. Objectives: The aim of this study was to evaluate the effect of food/liquid material on swallowing physiology in patients with dysphagia and to discuss the optimal food choice for direct swallowing therapy. Materials and Methods: A total of 140 patients underwent a videofluoroscopic swallowing study using three test foods/liquids: 3 mL of mildly thick liquid (Thick liquid), jelly made of agar and polysaccharide [ABSTRACT FROM AUTHOR]

Objectives: To assess whether meal or water intake may affect the measurement of the ultrasound (US) attenuation coefficient (AC) imaging, a parameter that is directly related to liver fat content. Methods: The study was performed in two centers (Italy and USA). AC was obtained using the ATI algorithm implemented in the Aplio i‐series US systems (Canon Medical Systems, Japan) by one operator at each center. Measurements were performed at baseline and 5, 15, 30, 45 minutes after drinking 500 mL of water (group 1), or 30, 45, 60, 90, 120 minutes after eating a meal of about 600 kcal (group 2). Multilevel generalized estimating equations for repeated measures were used for the statistical analysis to consider the clustered nature of the data. Results: Twenty‐six individuals were enrolled: 11 (10 females; age, 43.7 ± 12.5 years) in Italy and 15 (10 females; age, 60.7 ± 6.3 years) in USA. At B‐mode US, 10 (38.5%) had liver steatosis. The baseline AC values, in decibel/centimeter/megahertz, were 0.64 (0.12) in group 1 and 0.66 (0.13) in group 2. There was not any significant difference in AC values at every time‐point after water or meal intake either in group 1 or group 2. This result did not change including sex, age, and skin‐to‐liver capsule into the models. Conclusions: The measurement of the AC, which is a biomarker of liver steatosis, does not require a fasting state and drinking water does not affect the result. [ABSTRACT FROM AUTHOR]

Aims: Renal dysfunction in patients with chronic heart failure predicts a poor prognosis. Tolvaptan has a diuretic effect in patients with chronic kidney disease and heart failure without adverse effects on renal function. We aimed to determine the effects of tolvaptan and predictors of worsening renal function in patients with heart failure. Methods and results: This post hoc analysis was a sub‐analysis of a single‐centre prospectively randomized trial on the early and short‐term tolvaptan administration. We enrolled 201 participants with decompensated heart failure between January 2014 and March 2019 (early group, n = 104; age: 79.0 ± 12.8 years; late group, n = 97; age: 80.3 ± 10.8 years). Renal ultrasonography was performed before and after the administration of tolvaptan. Urine output and oral water intake significantly increased during tolvaptan administration. The difference between water intake and urine volume increased during tolvaptan administration. Changes in body weight, blood pressure, heart rate, and estimated glomerular filtration rate (eGFR) in both groups were comparable. The changes in peak‐systolic velocity (PSV), acceleration time (AT) of the renal arteries, and resistance index were comparable. The changes in PSV and end‐diastolic velocity (EDV) of the interlobar arteries increased following tolvaptan administration (Δmax PSV: 0.0 ± 14.8 cm/s before tolvaptan vs. 5.6 ± 15.7 cm/s after tolvaptan, P = 0.002; Δmean PSV: 0.4 ± 12.3 vs. 4.9 ± 12.7 cm/s, P = 0.002; Δmax EDV: −0.2 ± 3.5 vs. 1.4 ± 4.0 cm/s, P = 0.001; Δmean EDV: −0.0 ± 3.1 vs. 1.1 ± 3.4 cm/s, P = 0.003). The renal artery AT was negatively correlated with the eGFR (Δmax AT: beta = −0.2354, P = 0.044; Δmean AT: beta = −0.2477, P = 0.035). Conclusions: Tolvaptan increased the PSV and EDV of the interlobar artery, which may mean tolvaptan increased renal blood flow. The renal artery AT may be a surrogate for worsening renal function. [ABSTRACT FROM AUTHOR]

α-Lipoic acid (LA) is an antioxidant of endogenous production, also obtained exogenously. Oxidative stress is closely associated with hypertension, which causes kidney injury and endothelial dysfunction. Here, we evaluated the cardiovascular and renal effects of LA in the two-kidney-one-clip (2K1C) hypertension model. The rats were divided into four groups: Sham surgery (Sham), the two-kidneys-one-clip (2K1C) group, and groups treated with LA for 14 days (Sham-LA and 2K1C-LA). No changes were observed in the pattern of food, water intake, and urinary volume. The left/right kidney weight LKw/RKw ratio was significantly higher in 2K1C animals. LA treatment did not reverse the increase in cardiac mass. In relation to vascular reactivity, there was an increase in the potency of phenylephrine (PHE) curve in the hypertensive animals treated with LA compared to the 2K1C group and also compared to the Sham group. Vasorelaxation induced by acetylcholine (Ach) and sodium nitroprusside (SNP) were not improved by treatment with LA. Urea and creatinine levels were not altered by the LA treatment. In conclusion, the morphological changes in the aorta and heart were not reversed; however, the treatment with LA mitigated the contraction increase induced by the 2K1C hypertension. [ABSTRACT FROM AUTHOR]

The study aimed to investigate the potential of hesperetin‐loaded chitosan nanoparticles (HSPCNPs) in alleviating hyperglycemia by modulating key enzymes in diabetic rats. Chitosan nanoparticles loaded with hesperetin were prepared using the ionic gelation method and characterized with Electron microscope (SEM), zeta potential, particle size analysis, Fourier‐transform infrared (FT‐IR), Energy dispersive spectroscopy (EDS) and Encapsulation efficiency and Loading efficiency. To induce diabetes, rats were fed a high‐fat beef tallow diet for 28 days, then given a single dose of streptozotocin (STZ) at 35 mg/kg b.w in 0.1 M citrate buffer (pH 4.0). Rats were treated with HSPCNPs at doses of 10, 20, and 40 mg/kg b.w. The analyzed parameters included body weight, food and water intake, plasma glucose and insulin, liver and skeletal muscle glycogen levels, and carbohydrate metabolism. SEM imaging revealed dimensions between 124.2 and 251.6 nm and a mean particle size of 145.0 nm. FT‐IR analysis confirmed the presence of functional groups in the chitosan nanoparticles, and the zeta potential was 35.5 mV. HSPCNP 40 mg/kg b.w significantly (p < 0.05) reduced blood glucose levels and glycosylated hemoglobin, improving body weight, food intake, and reducing water intake. In diabetic rats, enzymes for carbohydrate metabolism like fructose 1,6‐bisphosphatase, phosphoenolpyruvate carboxykinase, and glucose 6‐phosphatase are evaluated in the liver, while glucose 6 phosphate dehydrogenase and hexokinase activity were significantly lower. Additionally, plasma insulin levels increased, indicating enhanced insulin sensitivity. The results show that HSPCNPs at 40 mg/kg b.w. ameliorate hyperglycemia to provide robust protection against diabetic complications and significantly improve metabolic health. [ABSTRACT FROM AUTHOR]

Issue Addressed Methods Results Conclusions So What? The study addresses the global health concern of sugar overconsumption, particularly focusing on the prevalence of sugar‐sweetened beverage consumption among young people.The study tested three different health promotion campaign concepts, designed to reduce sugar‐sweetened beverage intake and promote water consumption as a healthier alternative. A total of 402 young adults (18–29) were recruited from a university campus and an online panel. Participants were randomly assigned to view one of three campaign images: one advocating for substituting sugar‐sweetened beverages with water, and two exclusively promoting water consumption. These images were assessed through an online survey, which included questions on emotional response, salience, attitudes and intentions towards various beverages.Participants exposed to the campaign emphasising the benefits of water showed a greater intention to increase water consumption and reduce both sugar‐ and non‐sugar‐sweetened beverages compared with the other groups. There were no significant differences observed for the beverage choice task across the campaigns.The findings suggest that messaging focusing on the benefits of water holds promise in encouraging healthier beverage consumption intentions among young adults. The lack of significant differences in the beverage choice task across the campaigns indicates a need for further research to explore long‐term behaviour change effects.By highlighting the benefits of water consumption, campaigns may have the potential to positively influence beverage choices and promote healthier habits. Continued research in this area can provide valuable insights for developing more impactful interventions aimed at reducing sugar‐sweetened beverage consumption. [ABSTRACT FROM AUTHOR]

In this review, we aimed to comprehensively summarize current literature on pathophysiology, relevance, diagnosis and treatment of fluid accumulation in patients with sepsis/septic shock. Fluid accumulation syndrome (FAS) is defined as fluid accumulation (any degree, expressed as percentage from baseline body weight) with new onset organ-failure. Over the years, many studies have described the negative impact of FAS on clinically relevant outcomes. While the relationship between FAS and ICU outcomes is well described, uncertainty exists regarding its diagnosis, monitoring and treatment. A stepwise approach is suggested to prevent and treat FAS in patients with septic shock, including minimizing fluid intake (e.g., by limiting intravenous fluid administration and employing de-escalation whenever possible), limiting sodium and chloride administration, and maximizing fluid output (e.g., with diuretics, or renal replacement therapy). Current literature implies the need for a multi-tier, multi-modal approach to de-resuscitation, combining a restrictive fluid management regime with a standardized early active de-resuscitation, maintenance fluid reduction (avoiding fluid creep) and potentially using physical measures such as compression stockings. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Maintaining a healthy and diverse diet during pregnancy is crucial for maternal well-being and fetal development. The first trimester marks the beginning of vital developmental processes influenced by maternal nutritional status. Therefore, we aimed to determine dietary adequacy and diversity among first-trimester pregnant women. Methods: In this cross-sectional study, we recruited 306 first-trimester pregnant women from the antenatal clinics of Aga Khan University Hospital, Karachi (January 2020 to September 2021). Eligible women possessed smartphones (for the mHealth intervention trial) and reported no major comorbidities or medication use. Data about socio-demographic, obstetric, and dietary history were collected through interviews using a structured questionnaire. Booking weight, height, blood pressure, and haemoglobin levels were extracted from medical records. An aggregate dietary risk score (DRS) was calculated separately for quantity and quality by summing the DRS for each of the six major food groups. A score of 0 was assigned to adequate, 1.5 to intermediate, and 3 to inadequate quantity or quality categories. Data were analysed using STATA 14.0. Results: The mean ± SD for DRS quantity and quality were 10.6 ± 2.4 and 7.5 ± 2.5, respectively. Adequate dietary quantity and quality per week for starch-based food were reported by 14.4% and 21.2%, for vegetables by 0.3% and 49%, for fruits by 41.2% and 88.6%, for animal and plant protein by 19% and 0%, for milk and milk products by 1% and 37.6% and for oils and fats by 90.5% and 8.8%, respectively. Sweet and savoury snacks were eaten by 74.8% and 53.9%, respectively. Ready-made meals, carbonated beverages, packaged juices, and additional salt were consumed by 55.2%, 46.4%, 34.3%, and 7.5%, respectively. The median (IQR) water intake was 6 (4–8) glasses/day. Conclusions: During the early stages of pregnancy, women enrolled for antenatal care at an urban private tertiary care hospital report inadequate dietary intake for various food groups, except for the quantity of oils/fats and the quality of fruit consumption. Poor dietary practices underscore the need for focused and impactful dietary counselling during the initial stages of pregnancy. [ABSTRACT FROM AUTHOR]

Introduction Method Result Conclusion Heart failure (HF) is caused by functional and structural irregularity leading to impaired ejection or filling capacity of the heart. HF leads to chronic inflammatory conditions in the heart leads to weight loss, anorexia, and muscle atrophy known as cachexia. The present study was carried out to investigate the role of Ezetimibe, an NRF2 activator, in cardiac cachexia and to develop a treatment strategy for cardiac cachexia.Balb/c mice of either sex at 6–8 weeks of age were given 2 mg/kg of doxorubicin in 0.9% sodium chloride solution intraperitoneally (i.p.) for the alternate days for the first week and then once a week for the next 4 weeks. After induction of cardiac atrophy, treatment with Ezetimibe (1.5 mg/kg, p.o) was given for the next 4 weeks.In the cardiac cachectic animals, a significant decrease in body weight, food, and water intake was observed. Cardiac cachectic animals showed a significant increase in serum glucose, total cholesterol, LDL, triglyceride, VLDL, CK‐MB, LDH, and CRP levels. Cardiac atrophic index, heart weight to body weight ratios (HW/BW), right ventricular weight to heart weight ratios (RV/HW), and left ventricular weight to heart weight ratios (LV/HW), were significantly decreased in cardiac cachectic animals. The weights of the skeletal muscles such as EDL, gastrocnemius, soleus, tibialis anterior, and quadriceps muscles, and the weight of adipose tissue such as subcutaneous, visceral, perirenal, and brown adipose tissue were significantly decreased in the cardiac cachectic group relative to the normal group. Treatment with ezetimibe improves body weight, food intake, and water intake. Ezetimibe decreases serum glucose, total cholesterol, LDL, triglyceride, VLDL, CK‐MB, LDH and CRP levels. Cardiac atrophic markers such as HW/BW, RV/HW, and LV/HW were improved. The weight of skeletal muscles and adipose tissue was increased after treatment with ezetimibe.Our data showed that the NRF2 activator, Ezetimibe produces a beneficial effect on cardiac cachexia in the doxorubicin‐induced cardiac cachexia model. Ezetimibe was successful to reduce the levels of inflammatory cytokines, ameliorate the effects on cardiac muscle wasting, lipid levels, fat tissues, and skeletal muscles. [ABSTRACT FROM AUTHOR]

Simple Summary: This study explored the effects of the different dietary combinations of soyhulls and the β-mannanase enzyme on production performance, economics, egg quality, blood biochemicals, nutrient digestibility, and gut health in laying hens during the late peak production phase. Golden brown hens were fed different diets for four weeks, and the combination of 3% soyhulls and 30 mg/kg β-mannanase showed potential benefits. It improved production performance and increased egg weight, albumen weight, and height while significantly lowering total cholesterol, LDL, and VLDL levels. This combination also improved gut morphology and enhanced nutrient digestibility. Overall, the inclusion of 3% soyhulls and 30 mg/kg β-mannanase in the diet may have positive effects on production performance, nutrient digestibility, and gut health and potentially lower serum cholesterol levels in laying hens while maintaining acceptable egg quality. This study investigated the effects of the β-mannanase enzyme and soyhulls on production performance, economics, egg quality, hematology and serum biochemistry, nutrient digestibility, gut morphology, digesta viscosity, and excreta consistency in laying hens during the late peak production phase (37 to 40 weeks of age). Golden brown hens (RIR × Fayoumi; n = 200) were fed a control diet (no soyhulls or enzymes) and diets containing four combinations, i.e., 3% soyhulls with 20 mg/kg β-mannanase (D1), 3% soyhulls with 30 mg/kg β-mannanase (D2), 9% soyhulls with 20 mg/kg β-mannanase (D3), and 9% soyhulls with 30 mg/kg β-mannanase (D4), for four weeks in four replicates of 10 birds each. Overall, a significantly higher (p < 0.05) feed intake, weight gain, feed conversion ratio, and water intake were calculated in the D2 group as compared to the control and remaining combinations of soyhulls and β-mannanase. No mortality was recorded during the entire experiment. Economically, the D1 and D2 groups showed the best results as compared to the D3 and D4 groups. Egg quality parameters like egg weight, shell weight and shell thickness, yolk weight, albumen weight and height, and the Haugh unit remained unchanged (p > 0.05). Similarly, the D2 group showed significantly lower total cholesterol, LDL, and VLDL levels and enhanced gut morphology with greater villus width, height, crypt depth, and surface area across intestinal segments. Crude protein (CP), crude fiber (CF), crude fat, and ash digestibility were higher (p < 0.05) in the D1 and D2 groups compared to the control. Digesta viscosity, excreta consistency, and other egg quality parameters remained unaffected. In conclusion, the dietary inclusion of a combination of 3% soyhulls and 30 mg/kg β-mannanase may have potential benefits for laying hens by improving some production performance and egg quality indicators and economics, lowering blood cholesterol, LDL, and VLDL levels, enhancing nutrient digestibility, and improving gut morphology without affecting egg quality. [ABSTRACT FROM AUTHOR]

Globally, the edible insect industry is emerging due to its potential contributions to food security and environmental sustainability. Edible insects are rapidly being integrated into the development of alternative foods and new pharmaceuticals. Silkworms, known for their high protein content, are not only a potential new source of human food and animal feed but have also been traditionally used for medicinal purposes. However, conventional silkworms are difficult to ingest. To address this, we have developed a steamed and freeze-dried mature silkworm larva powder (SMSP), and it is essential to investigate its potential toxicity and food safety for further studies and applications. Therefore, this study aimed to evaluate the toxicity of SMSP. A toxicity assessment of SMSP was conducted according to OECD guidelines. An oral repeat-administration study was performed on male and female SD rats at doses of 625, 1250, and 2500 mg/kg/day for 4 and 13 weeks. No toxicological changes were observed in clinical signs, body weight, water and food intake, urine tests, hematology, clinical biochemistry, gross findings, or histopathological examination. In conclusion, the no observed adverse effect level (NOAEL) of SMSP was 2500 mg/kg/day, with no target organs identified in either sex of the rats. These results suggest that SMSP is safe, is without side effects and has potential for use as an edible ingredient and in health functional food applications. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusion This study aims to determine the awareness levels and factors affecting it, along with prevalent misconceptions about Steatotic Liver Disease (SLD) among participants with high‐risk indicators.A questionnaire with open‐ended questions was utilized. Participants were recruited from two general internal medicine outpatient clinics, focusing on those with high‐risk indicators for SLD. Data collection involved a questionnaire covering demographic information, self‐reported clinical conditions, and open‐ended questions about SLD awareness. Key focus areas included misconceptions, thematic awareness, and the relationship between awareness and educational attainment.The study involved 228 participants, predominantly female (70.4%), with an average age of 53.8 years. Only 33.7% showed a comprehensive understanding of all aspects of SLD. However, 90.4% provided some accurate information, though often limited or incomplete. Higher education and awareness of SLD risks were key predictors of better understanding. The logistic regression model, with an accuracy of 0.76 and recall of 0.84, found higher education inversely related to low awareness. Common misconceptions highlighted included the belief that polypharmacy or certain medications cause SLD, fatigue as an effect, and increased water intake as a treatment. Notably, seven patients mentioned artichoke consumption as a potential treatment.The findings highlight the gap between comprehensive and partial awareness of SLD among high‐risk individuals. Educational level and informed understanding of SLD risks are crucial for improving awareness, emphasizing the need for specialized educational efforts and risk communication to high‐risk patients. [ABSTRACT FROM AUTHOR]

Paper production is a process based on using water. Most of the industrialized countries set strict standards to protect the environment, and all industrial wastewater output must be based on such standards. Because of their economic value, recycled fibers must be separated from the effluent and returned to the system when the effluent leaves the factory. The purpose of this study was to investigate and measure the amount and costs of water consumption and the amount of fiber wastage in the controlled and uncontrolled output of the desired factory effluent. From observations of a local OCC recycling factory, the amount of water consumption and effluent output and the amount of fibers in the effluent output of this factory before pre-treatment and after pre-treatment were investigated. It was observed that if the water intake was not controlled and if pre-treatment was not used, a significant amount of fibers was thrown away along with the wastewater, which was 8,440 kg per 391 tons of production in one month based on total suspended solid. [ABSTRACT FROM AUTHOR]

Acylglycerophosphate acyltransferases (AGPATs) catalyze the de novo formation of phosphatidic acid to synthesize glycerophospholipids and triglycerides. AGPATs demonstrate unique physiological roles despite a similar biochemical function. AGPAT3 is highly expressed in the testis, kidney, and liver, with intermediate expression in adipose tissue. Loss of AGPAT3 is associated with reproductive abnormalities and visual dysfunction. However, the role of AGPAT3 in adipose tissue and whole body metabolism has not been investigated. We found that male Agpat3 knockout (KO) mice exhibited reduced body weights with decreased white and brown adipose tissue mass. Such changes were less pronounced in the female Agpat3-KO mice. Agpat3-KO mice have reduced plasma insulin growth factor 1 (IGF1) and insulin levels and diminished circulating lipid metabolites. They manifested intact glucose homeostasis and insulin sensitivity despite a lean phenotype. Agpat3-KO mice maintained an energy balance with normal food intake, energy expenditure, and physical activity, except for increased water intake. Their adaptive thermogenesis was also normal despite reduced brown adipose mass and triglyceride content. Mechanistically, Agpat3 was elevated during mouse and human adipogenesis and enriched in adipocytes. Agpat3-knockdown 3T3-L1 cells and Agpat3-deficient mouse embryonic fibroblasts (MEFs) have impaired adipogenesis in vitro. Interestingly, pioglitazone treatment rescued the adipogenic deficiency in Agpat3-deficient cells. We conclude that AGPAT3 regulates adipogenesis and adipose development. It is possible that adipogenic impairment in Agpat3-deficient cells potentially leads to reduced adipose mass. Findings from this work support the unique role of AGPAT3 in adipose tissue. NEW & NOTEWORTHY AGPAT3 deficiency results in male-specific growth retardation. It reduces adipose tissue mass but does not significantly impact glucose homeostasis or energy balance, except for influencing water intake in mice. Like AGPAT2, AGPAT3 is upregulated during adipogenesis, potentially by peroxisome proliferator-activated receptor gamma (PPARc). Loss of AGPAT3 impairs adipocyte differentiation, which could be rescued by pioglitazone. Overall, AGPAT3 plays a significant role in regulating adipose tissue mass, partially involving its influence on adipocyte differentiation. [ABSTRACT FROM AUTHOR]

To investigate the association between physical activity (PA) and the prevalence of kidney stones. A cross-section study was conducted using data from National Health and Nutrition Examination Survey 2007-2018. PA was evaluated based on the Global Physical Activity Questionnaire. Multivariable logistic regression was performed to elucidate the association between PA (patterns, intensity, duration, and frequency of moderate and vigorous PA) and the prevalence of kidney stones after adjusting for potential confounders. Stratified and interaction analyses were conducted to detect potential effect modifiers. In addition, PA was assessed using metabolic equivalent and physical volume, and followed the regression above. Water intake was obtained from the day 2 dietary recall and was included in the sensitivity analysis. A total of 34,390 participants were included in the analysis. The multivariable logistic regression revealed that individuals who engaged in moderate PA for 30-60 minutes per day had a significant inverse association with the prevalence of kidney stones in the fully adjusted model (odds ratio = 0.804, 95% confidence interval 0.700 to 0.923), while no more significant finding was observed for other PA parameters. Interaction and stratified analyses indicated no covariate modifying the association. The results above were robust in the sensitivity analysis. The duration of moderate PA (30-60 min/d) is inversely associated with the prevalence of kidney stones, while no more significant association was observed between other PA parameters (including patterns, intensity, duration, and frequency of vigorous PA, frequency of moderate PA) and kidney stones. [ABSTRACT FROM AUTHOR]

Untreated and alkali-treated Sunn hemp hessian cloth-reinforced high-density polyethylene (HDPE) composites were prepared by the compression molding method. The fabricated composites contained 40, 45, 50, 55, 60, and 65wt% fiber contents and were optimized. 55wt% fiber contents reinforced composites showed better mechanical properties. This composite was alkali treated and irradiated under gamma-ray at doses 2.5‒7.5 kGy at the rate of 6 kGy/h. The X-ray diffraction (XRD) result indicates that the crystallinity of the alkali-treated Sunn hemp-reinforced HDPE composites shows a higher value than those of untreated and irradiated composites. Better adhesion between fiber and matrix was observed from surface micrographs. Fourier-transform infrared (FTIR) spectroscopy reveals cross-linking between fiber and matrix. The water intake properties of irradiated composite show more hydrophobic nature than that of untreated and alkali-treated composites. The tensile strength of the gamma-ray irradiated composites are 20% and 33% greater than that of untreated and alkali-treated composites. Similar results are found for Young's modulus. At a certain dose of 5 kGy, the irradiated composites show improved thermal, mechanical, and structural properties than untreated and alkali-treated composites. [ABSTRACT FROM AUTHOR]

Skin tears are a major problem for patients and the health care professionals who treat them. Although opinions on their prevalence differ, it is estimated that they are encountered more frequently than pressure sores but are overlooked. Recommendations based on strong evidence were presented for the prevention and treatment of skin tears as classified by the International Skin Tear Advisory Panel. This case series includes the clinical status of 3 patients who developed skin tears while receiving care in the hospital, and the corrective and preventive practices related to skin tears. This article will contribute to raising the awareness of health care professionals in predicting, preventing, evaluating, and treating skin tears. [ABSTRACT FROM AUTHOR]

Body water homeostasis is maintained by the correct balance between water intake and water loss through urine, faeces, sweat and breath. It is known that elevated circulating levels of the antidiuretic hormone vasopressin decrease urine volume to prevent excessive water loss from the body. Vasopressin/cAMP/protein kinase A (PKA) signalling is the canonical pathway in renal collecting ducts for phosphorylating aquaporin‐2 (AQP2) water channels, which leads to the reabsorption of water from urine via AQP2. Although recent omics data have verified various downstream targets of PKA, crucial regulators that mediate PKA‐induced AQP2 phosphorylation remain unknown, mainly because vasopressin is usually used to activate PKA as a positive control. Vasopressin is extremely potent and phosphorylates various PKA substrates non‐specifically, making it difficult to narrow down the candidate mediators responsible for AQP2 phosphorylation. The intracellular localization of PKA is tightly regulated by its scaffold proteins, also known as A‐kinase anchoring proteins (AKAPs). Furthermore, each AKAP has a target domain that determines its intracellular localization, enabling the creation of a local PKA signalling network. Although vasopressin activates most PKAs independently of their intracellular localization, some chemical compounds preferentially act on PKAs localized on AQP2‐containing vesicles while simultaneously phosphorylating AQP2 and its surrounding PKA substrates. Immunoprecipitation with antibodies against phosphorylated PKA substrates followed by mass spectrometry analysis revealed that the PKA substrate in proximity to AQP2 was lipopolysaccharide‐responsive and beige‐like anchor (LRBA). Furthermore, Lrba knockout studies revealed that LRBA was required for vasopressin‐induced AQP2 phosphorylation. [ABSTRACT FROM AUTHOR]

To improve water access while working and contribute to fewer heat-related illnesses (HRI), backpack hydration systems were provided to over 200 farmworkers to use during the 2022 growing season. Acceptability of the water intake intervention was assessed among farmworkers in eastern North Carolina, USA. With a pre-established community–university partnership, the acceptability of the intervention was assessed using a cross-sectional survey. The backpack brand selected included a 3-liter water bladder and attached drinking hose. Data analysis included descriptive and correlation statistics. Among 47 male, migrant farmworkers, most (90%) reported the hydration backpack to be acceptable or completely acceptable to workplace fluid intake. Most (53%) reported using the backpack some of the time, compared to 28% who used it often. The participants reported an average of 4.8 (SD 2.2) liters of water intake from the backpack on a typical workday. Most reported the backpack improved the quantity and frequency of their water consumption. This study was an important first step in implementation of hydration backpack systems as an HRI-preventative intervention among farmworkers. Future interventional studies could assess the efficacy of the backpacks on health outcomes, including incidence of dehydration and symptoms of HRI. [ABSTRACT FROM AUTHOR]

In this study, the researchers aimed to investigate the effects of pelvic floor muscle training (PFMT) applied with telerehabilitation on urinary symptoms, quality of life, and subjective perception of improvement and satisfaction in multiple sclerosis (MS) patients having lower urinary tract symptoms. Patients were randomly divided into PFMT (n:21) and control (n:21) groups. The PFMT group received PFMT via telerehabilitation for 8 weeks and lifestyle advice, while the control group received only lifestyle advice. Although lifestyle advice alone was not effective, PFMT applied with telerehabilitation was an effective method in the management of lower urinary tract symptoms in MS patients. PFMT applied with telerehabilitation can be considered as an alternative method. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to determine the long-term effect of increasing water intake in patients with autosomal dominant polycystic kidney disease (ADPKD) on longitudinal changes in health-related quality of life (HRQoL) in the setting of a clinical trial. Methods Self-completed HRQoL (using the KDQoL-SF, v.1.3 questionnaire) was assessed annually in participants of a 3-year randomized controlled clinical trial (n  = 187), allocated (1:1) either to increase water intake to reduce urine osmolality to ≤270 mosmol/kg (implemented by dietetic coaching, self-monitoring tools, text messaging) or continue usual water intake. Results Overall, 96% and 81.8% of participants (n  = 187) completed the questionnaire at the baseline and final study visits, respectively. At baseline, the physical component summary score (PCS) and mental component summary score (MCS) were similar in the two groups (P > 0.05) and the five dimensions with the lowest scores in both groups were: energy and fatigue; general and overall health; sleep; emotional well-being; and pain. Within each group, there were no longitudinal changes over time. At the final visit, the PCS was higher in the increased water intake group (51.3 ± 7.6, mean ± standard deviation) compared to the usual water intake group 48.8 ± 9.3; P = 0.037) whereas the MCS was numerically similar. The improvement in the PCS was due to higher sub-scale values for physical functioning and pain (both P < 0.05). By multivariate analysis, only baseline PCS and height-corrected total kidney volume were associated with the final PCS (P < 0.05). Conclusion HRQoL scores remained stable over a 3 year period, and were not adversely affected by the intervention to increase water intake. Future studies should evaluate the clinical significance of the higher PCS in the increased water intake group. [ABSTRACT FROM AUTHOR]

Aim: Evidence shows that 20%–30% of patients who aspirate do so silently. Research to date has not demonstrated clear evidence to indicate which patients are at higher risk of silent aspiration. Our aim was to use univariate logistic regression analysis of retrospective case review to determine potential patterns of silent aspiration. Materials and methods: We conducted a retrospective analysis of 455 fiberoptic endoscopic evaluation of swallowing (FEES) reports. The patients were divided into four groups: G1 – neurological diseases (n = 93), G2 – head and neck surgery (n = 200), G3 – gastroenterological diseases (n = 94) and G4 – other patients (n = 68). Data included the occurrence or absence of saliva penetration or aspiration, of silent fluid/solid food penetration or aspiration, type of penetration or aspiration, occurrence of cranial nerve paresis, radiotherapy and tracheostomy. Univariate logistic regression was used to evaluate independent risk factors of silent aspiration in the study population. Three models with different independent variables were considered. Results: There is a statistically significant difference in the frequency of occurrence of silent penetration and aspiration within the groups (p < 0.001), with intraglutative being most frequent. Fluid and food penetration and aspiration correlated with saliva penetration and aspiration in all groups (p < 0.001). Cranial nerve paresis (IX and X), radiotherapy and tracheostomy correlate with saliva penetration and aspiration (p = 0.020 for cranial nerve paresis; p = 0.004 for radiotherapy; p < 0.001 for tracheostomy). One hundred and fifteen patients (45.81%) in the subgroup of patients with intraglutative aspiration had cranial nerve paresis (IX, X or IX–X). Conclusions: Patients who should be prioritised or considered to be at a higher need of instrumental swallowing evaluation are those with IX and X cranial nerve paresis, tracheostomy and those who have had radiotherapy, with saliva swallowing problems, especially after paraganglioma, thyroid and parathyroid glands and middle and posterior fossa tumour surgery. WHAT THIS PAPER ADDS: What is already known on the subject: Clinical signs of penetration or aspiration include coughing, throat clearing and voice changes, while silent penetration or aspiration patients aspirate without demonstrating any clinical symptoms. The most common consequences of silent aspiration include aspiration pneumonia, recurrent lower respiratory tract infections and respiratory failure. Additionally, malnutrition and dehydration can be indicators of silent aspiration. Patients may unknowingly reduce their oral intake and lose weight. Retrospective studies have shown that 20%–30% of patients aspirate silently (e.g. patients after stroke, acquired brain injury, head and neck cancer treatment, prolonged intubation). Clinical examination of swallowing can miss up to 50% of cases of silent aspiration. What this paper adds to existing knowledge: Currently, silent aspiration is often discussed in neurological literature, but its applications to head and neck surgery are limited. In this study, we identify head and neck surgery patients who should be prioritised or considered to be in higher need of instrumental swallowing evaluation due to a higher risk of silent aspiration. What are the potential or actual clinical implications of this work?: Post‐treatment structural changes can result in lower cranial nerve paresis (IX, X, XII) and face injury, in which vagus and glossopharyngeal nerves are injured. After tracheostomy and radiotherapy, patients with problems swallowing saliva need careful clinical examination, particularly cranial nerve examination. [ABSTRACT FROM AUTHOR]

Aspiration and pneumonia are common in people with eating, drinking and swallowing difficulties. Thickened liquids are often used as a first-line measure by speech-language pathologists and other health and social care professionals to reduce aspiration and pneumonia in people with eating, drinking and swallowing difficulties. This approach, and the relative lack of evidence of benefit, has come under increased criticism in recent years. This aim of this review is to examine alternatives—or complementary approaches—that might be considered by SLPs and other professionals treating people with eating, drinking and swallowing difficulties. We examined the current research evidence and will discuss medical factors, bolus modification approaches, rehabilitation approaches, hygiene and residue reduction interventions, physical and postural interventions, common sense strategies, and other issues to consider when using thickened liquids. We conclude that there are many options available to health and social care professionals who are supporting people with eating, drinking and swallowing difficulties, some of which have a less, equal or more supportive evidence base than thickened liquids. A broad multidisciplinary and multifactorial approach is beneficial, and more acceptable to, people with eating, drinking and swallowing difficulties. [ABSTRACT FROM AUTHOR]

Immunonutrition, which focuses on specific nutrients in breast milk and post-weaning diets, plays a crucial role in supporting infants' immune system development. This study explored the impact of maternal supplementation with Bifidobacterium breve M-16V and a combination of short-chain galacto-oligosaccharide (scGOS) and long-chain fructo-oligosaccharide (lcFOS) from pregnancy through lactation, extending into the early childhood of the offspring. The synbiotic supplementation's effects were examined at both mucosal and systemic levels. While the supplementation did not influence their overall growth, water intake, or food consumption, a trophic effect was observed in the small intestine, enhancing its weight, length, width, and microscopic structures. A gene expression analysis indicated a reduction in FcRn and Blimp1 and an increase in Zo1 and Tlr9, suggesting enhanced maturation and barrier function. Intestinal immunoglobulin (Ig) A levels remained unaffected, while cecal IgA levels decreased. The synbiotic supplementation led to an increased abundance of total bacteria and Ig-coated bacteria in the cecum. The abundance of Bifidobacterium increased in both the intestine and cecum. Short-chain fatty acid production decreased in the intestine but increased in the cecum due to the synbiotic supplementation. Systemically, the Ig profiles remained unaffected. In conclusion, maternal synbiotic supplementation during gestation, lactation, and early life is established as a new strategy to improve the maturation and functionality of the gastrointestinal barrier. Additionally, it participates in the microbiota colonization of the gut, leading to a healthier composition. [ABSTRACT FROM AUTHOR]