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A 38-year-old woman with history of alcohol abuse was admitted with generalized weakness, dehydration, alcoholic hepatitis, hyponatremia (serum sodium 116 mM/L), and cachexia (BMI 19 kg/m2). She developed hypoxemic respiratory failure after intravenous fluid resuscitation and required intubation and mechanical ventilation. Neurological exam revealed motor weakness, hyporeflexia, ataxia, and unsustained clonus. Neurology consultation was obtained and MRI revealed hyperintensity in the pons consistent with osmotic demyelination syndrome (1). Review of her records revealed her sodium level increased by 8 mM/L in first 6 hours of presentation, and then a slow increase of 4-6 mM/L daily to the normal range. She received nutritional support and aggressive physical therapy, and was discharged to skilled nursing facility after six weeks of hospitalization.

In order to achieve the National Greenhouse Gas Reduction Target, the government and Gyeongsangbuk-do waste sector are planning to significantly expand the waste reduction and recycling rate. Household waste in the northern part of Gyeongsangbuk-do burns household waste from 11 northern local governments at “Clear Nuri Park”, a wide-area waste treatment facility, and close properties and surveys of household waste are needed to reduce greenhouse gases generated by incineration and resource recovery facilities. Constellation analysis investigated a total of 1,110.4 kg of household waste over three seasons (spring, summer, and fall), with paper being the most common with 259.5 kg (23.4%), followed by other 256.8 kg (23.1%) > vinyl 241.6 kg (21.8%) > plastic 99 kg (8.9%). Recycling waste accounted for the largest proportion of household waste in the northern part of North Gyeongsang Province with 695.2 kg (63.0%), followed by incineration with 321.5 kg (29.2%), food logistics with 82.5 kg (7.4%), hazardous waste with 2.4 kg (0.2%), and landfill with 1.8kg (0.2%). According to the estimation of greenhouse gas generation from the incineration of household waste in the northern part of Gyeongsangbuk-do in 2022, the total greenhouse gas emission was 75,052.4tCO2eq, and Andong City was the largest with 28,217.6tCO2eq, followed by Yeongju City with 13,462.3tCO2eq and Sangju City with 7,426.1tCO2eq. Based on the amount brought into Clear Nuri Park in 2022, the total reduction of greenhouse gases was 12,012.94tCO2eq, of which Andong City had the largest reduction with 4,637.52tCO2eq reduction, followed by Yeongju City with 1,938.18tCO2eq and Sangju City with 1,133.48tCO2eq. In the case of reduction by constellation, plastics were found to be the most reduced to 11,779.7tCO2eq, followed by rubber leather 152tCO2eq, paper 59.1tCO2eq, and other household wastes 18.6tCO2eq. It is necessary to check the ratio of properties with high greenhouse gases (plastics and rubber leather) through the analysis of household waste properties by city and county.

Objective Most dengue cases are managed in an outpatient setting, where patients are advised to return to the clinic daily for monitoring. Some patients can develop severe dengue at home and fail to recognise the deterioration. An application called DengueAid was designed as a self-monitoring tool for patients to reduce delay in seeking timely treatment. This study aimed to assess the feasibility of conducting a randomised controlled trial to determine the effectiveness of the DengueAid application. Methods Dengue patients were recruited from a public health clinic in Malaysia and randomised to either use the DengueAid application plus standard care for dengue or receive only the standard care. The outcomes evaluated were the (1) feasibility of recruitment, data collection and follow-up procedures; (2) preliminary clinical outcome measures; and (3) acceptability of DengueAid. Qualitative interviews were conducted for participants in the intervention arm to assess the acceptability of DengueAid. Results Thirty-seven patients were recruited with 97% ( n = 36) retention rates. The recruitment rate was low (63% refusal rate, n = 62/99) with difficulty in data collection and follow-up due to the variable interval of care for dengue in an outpatient setting. DengueAid application was acceptable to the participants, but preliminary clinical outcomes and qualitative data suggested limited utility of the application. Unwell conditions of patients and limited access to healthcare are important factors impacting the application's utility. Conclusion The feasibility trial uncovered issues with recruitment, data collection and follow-up processes. Further research and modification to the application are needed to improve its utility and usability.

(1) Background: Adipose tissue serves as a central repository for energy storage and is an endocrine organ capable of secreting various adipokines, including leptin and adiponectin. These adipokines exert profound influences on diverse physiological processes such as insulin sensitivity, appetite regulation, lipid metabolism, energy homeostasis, and body weight. Given the integral role of adipose tissue in metabolic regulation, it is imperative to investigate the effects of varying proportions and types of dietary fats on adipocyte function. In addition, our previous study showed that P/S = 5 and MUFA = 60% appeared to be beneficial in preventing white adipose tissue accumulation by decreasing plasma insulin levels and increasing hepatic lipolytic enzyme activities involved in β-oxidation. Therefore, the objective of this study was to explore the effects of a polyunsaturated fatty acid (PUFA) to saturated fatty acid (SFA) ratio of 5 and varying levels of monounsaturated fatty acids (MUFA = 30% or 60%) on lipogenesis. (2) Methods: We cultured 3T3-L1 mouse embryo fibroblasts in Dulbecco’s modified Eagle’s medium (DMEM) containing 10% bovine calf serum until confluent. Varying ratios of palmitic acid (PA), oleic acid (OA), and linoleic acid (LA) were first bound with bovine serum albumin (BSA) before being applied to 3T3-L1 adipocytes in low doses and in high doses. (3) Results: Low doses of P/S ratio = 5, MUFA = 60% (M60) fatty acids decreased the accumulation of triglycerides in mature adipocytes by decreasing the mRNA expression of adipogenic factors, such as peroxisome proliferator-activated receptors (PPARs), lipoprotein lipase (LPL), and glucose transporter-4 (GLUT-4), while increasing lipolytic enzyme (hormone-sensitive lipase, HSL) expression when compared to high doses of P/S ratio = 5, MUFA = 60% (M60), low and high doses of P/S ratio = 5, MUFA = 30% (M30). Furthermore, the treatment of M60 in low doses also decreased the secretion of leptin and increased the secretion of adiponectin in adipocytes. (4) Conclusions: The composition of P/S = 5, MUFA = 60% fatty acid in low doses appeared to result in anti-adipogenic effects on 3T3-L1 adipocytes due to the down-regulation of adipogenic effects and the transcription factor.