In this perspective, we describe the Biology through Art project, an interdisciplinary approach to biology education that fosters creativity, engagement, and innovation through the inclusion of visual arts. Decades of research highlight the intrinsic connection between scientific practice and visual representation, underscoring drawing as a critical tool for hypothesis generation, experimental design, data visualization, and scientific communication. Yet, despite these demonstrated cognitive and academic benefits, art-based approaches remain underutilized in undergraduate biology, often due to student anxiety about drawing proficiency, instructor unfamiliarity with art pedagogy, time constraints, and challenges to scaling assignments to large classes. We discuss solutions to these barriers, and present recent examples of course assignments that enhance biology instruction through artistic expression. These assignments, developed for organismal and integrative biology courses by Biology through Art faculty, stimulate active learning, promote conceptual synthesis, and enhance scientific literacy. By presenting research-supported benefits, addressing barriers, offering adaptive curricular models, and highlighting collaborative strategies, we encourage biology educators to integrate art inclusion as a pathway to cultivate scientifically literate, creative, and engaged biology learners.
Relatives of nursing home residents are deeply involved in care relationships that extend far beyond visiting routines. However, their broader personhood is often overlooked, with existing research focusing on functional roles. This meta-synthesis aims to explore how relatives experience "being relative" within institutional long-term care, highlighting the complexity of their identity beyond institutional expectations. We conducted a qualitative meta-synthesis of 59 per-reviewed studies using Thomas and Harden's thematic synthesis approach. We systematically searched four databases (MEDLINE, CINAHL, Emcare, and PsycInfo) from inception to 17. In January 2024 and conducted citation tracking. Grounded in a social constructionist perspective, we conceptualised "being relative" as a relational identity co-constructed through everyday interactions with staff in an institutional context. Four interconnected themes characterise relatives: (i) Managing Ambiguity (navigating emotional complexity between gratitude and criticism), (ii) Fluid and Overlapping Roles (continuously shifting between advocacy, observation, and mediation), (iii) Dynamic Relationship Development (evolving connections with staff through recognition and challenge cycles), and (iv) Negotiating Care Responsibility (ongoing adaptation of involvement patterns). These themes form a cyclical model illustrating how relatives continuously navigate between institutional expectations and authentic experiences. Rather than inhabiting static roles, relatives engage in dynamic positioning processes, constantly adapting and reinterpreting their place within care settings. "Being relative" represents a dynamic process of continuous adaptation and meaning-making within institutional constraints, extending beyond functional role assignments. Our cyclical model challenges reductionist approaches and emphasises the need for person-centred care that recognises relatives as whole persons with complex identities and emotional needs. By acknowledging the person behind the institutional "mask," care facilities can improve relatives' experiences, enhance care quality for residents, and increase staff satisfaction-demonstrating the potential of truly person-centred approaches in long-term care.
The neuromuscular training is a subgroup of functional exercises. The effectiveness of the neuromuscular training substantially improves in combination with electromyography (EMG) biofeedback. The present study aimed to investigate the effect of a new model of neuromuscular training in knee osteoarthritis (KOA). This pilot, parallel randomized-clinical-trial involved 10 participants with moderate KOA, who were randomly assigned into either neuromuscular training for the gluteus maximus and gastrocnemius (pro-group = 5) or the quadriceps (against-group = 5). Muscle activity in the feedback phase of gait (EMG), pain (Visual Analog Scale [VAS] and knee injury and osteoarthritis outcome score [KOOS]-pain score), and function (average walking speed and KOOS score) were assessed at baseline, immediately after the first treatment session (except KOOS), after 10 sessions of intervention, and after a 3-month of follow-up. After the first treatment session, pain slightly (5.71%) increased in the against-group, whereas decreased by 6.45% in the Progroup; after the 10th session and 3 months, all variables in both groups improved, with a slight extra positive difference in the Pro-group. However, after 3 months, the percentage of changes in the Progroup was greater than that of the against-group. The pain intensity based on VAS (-96.8%), pain (+101.30%), and quality of life (+145.41%) scores of the KOOS questionnaire showed nearly 100% or even greater improvement in the pro-group. Retraining quadriceps and gastrocnemius and gluteus maximus using biofeedback during gait seems promising in KOA, although the Progroup apparently experienced considerably greater clinical improvement. The study provides preliminary evidence of the clinical feasibility of a novel neuromuscular training paradigm for KOA based on biofeedback during gait. This study was registered under the International Randomized Controlled Trial Number registry on November 20, 2023.
Sleep plays a crucial role in memory consolidation. In everyday educational settings, students often rapidly review studied material just before sleep, but the effect of this strategy on subsequent memory has never been investigated. Here we assessed whether briefly re-reading a studied text immediately before a retention interval spent asleep or awake affects its delayed recall. In a mixed design, 34 university students were assigned to a Sleep or a Wake group. Eight hours after studying and immediately recalling a brief text, participants either quickly re-read it (for 1 min) or not, before an approximately 8-h retention interval spent asleep or awake. Main effects of Group and Condition were found (better performance in Sleep vs. Wake and in Re-reading vs. No Re-reading conditions, respectively), as well as an interaction Group x Condition. Crucially, only participants who re-read the text before sleeping showed a net improvement in recall relative to their own initial performance, whereas performance slightly deteriorated in all other conditions. These findings extend previous work on sleep-related prose memory consolidation by showing that a brief pre-sleep review, ecologically similar to common student study habits, can boost subsequent memory beyond mere protection from forgetting. They suggest that quick reviews of studied material at bedtime may represent an effective and practical strategy for memory enhancement in real-life learning contexts.
Cereal safety is a critical public health concern, as crops are frequently compromised by mycotoxin-producing fungi, particularly those from the genus Fusarium. Although metabarcoding is a powerful tool for characterizing these fungal communities, the universal internal transcribed spacer 2 (ITS2) marker lacks the resolution required to distinguish closely related species with distinct toxigenic profiles. The objective of this work was to accurately characterize the mycobiota and specific Fusarium community structure in Spanish cereal field samples. We propose a high-resolution metabarcoding workflow within the QIIME 2 environment to optimize Fusarium identification using the translation elongation factor 1-α (TEF1) gene. We developed a TEF1 Naive Bayes classifier trained on a curated database derived from FUSARIUM-ID v.3.0, expanded with eukaryotic sequences to prevent false-positive assignments. This approach was validated through direct comparison with ITS2 in the same samples. As expected, ITS2 significantly underestimates Fusarium diversity, whereas TEF1 enables precise species-level resolution within this genus. General mycobiota analysis performed using ITS2 revealed that fungal communities are shaped primarily by geographical location rather than host cereal species. Crucially, our approach confirmed the persistence of key toxigenic species, such as F. langsethiae and F. graminearum, and revealed broader diversity through the consistent detection of species often overlooked by traditional methods, including F. equiseti, F. acuminatum, and F. culmorum. We conclude that our metabarcoding framework reveals a high Fusarium diversity in Spanish cereal grains, and this knowledge is essential for designing targeted strategies to predict and mitigate mycotoxin contamination in these crops.
Young broilers are sensitive to dietary stressors such as increased level of non-starch polysaccharide (NSP) because their intestinal morphology and function are still developing and not yet fully mature. Viscous grains such as rye and barley with high NSP content can increase digesta viscosity, impair nutrient absorption, increase gut leakage and reduce performance. This study evaluated the effect of a xylanase-β-glucanase enzymes combination (XB) and a consensus bacterial 6-phytase variant (PhyG) on gut health and growth performance in young broilers (0 to 14 d old) fed diets containing rye and barley. A randomized complete block design was used and 180 Ross 308 male chicks was assigned to 5 treatment diets with 6 replications per treatment: 1) corn-wheat-soybean meal-based positive control (PC); 2) the PC reformulated with addition of rye and barley served as negative control (NC); 3) the NC supplemented with 1,000 phytase units (FTU)/kg of phytase (NC+PhyG); 4) the NC supplemented with phytase and XB (at 100g/MT providing 1,220 XU/kg xylanase and 152 U/kg β-glucanase, NC+PhyG+XB100), and; 5) the NC supplemented with the same phytase dose but XB at double dose (NC+PhyG+XB200). All diets were fed ad libitum as a mash. Compared with the PC, the NC increased (P < 0.05) ileal and jejunal digesta viscosity, increased intestinal permeability and reduced overall weight gain, all of which were fully ameliorated (P > 0.05) by the NC+PhyG+XB200 treatment. The results indicate that combining phytase and XB is efficacious for supporting gut health and maintaining growth performance in young broilers from 0-14 d of age fed a NSP-rich diet.
Clinical studies have demonstrated that depression increases the risk of bone fracture and impaired bone growth. However, the mechanisms by which psychosocial stress aggravates bone properties remain to be fully elucidated. Repeated social defeat (RSD) is a murine model system that recapitulates key physiological, immunological, and behavioral alterations observed in humans exposed to repeated psychosocial stress. The objective of this study was to examine whether RSD alters bone characteristics and to explore the mechanisms underlying these effects. Twenty-four wild-type (WT) male C57BL/6N mice (6-8 weeks old) were obtained and assigned equally into control and stress groups. For the stress group, an aggressive CD-1 male mouse (12 months old) was introduced into the cage of an established cohort of three resident C57BL/6N mice for 2 h daily for 6 consecutive days. Seventeen hours after the last stress cycle, the spleen and femur were dissected. The femurs were then scanned using micro-computed tomography (micro-CT) to analyze bone volume, mineral content, morphological parameters, and growth plate thickness. Following non-destructive micro-CT scanning, the femurs were fractured to measure their strength. Biomarkers of osteoclast activity and splenomegaly were also assayed. Spleen weight and osteoclastic biomarkers were significantly higher in the stress group than in the control group (p < 0.03). The stress group also showed significantly lower values of mineral, volume, and morphology of bone than the control group (p < 0.04). These bone changes resulted in weaker femur strength compared to the control group (p < 0.01). Additionally, the growth plate was significantly thinner in the stress group (p < 0.01) and contained disordered chondrocytes. Repeated social defeat in adolescent male mice resulted in weakened bone characteristics and altered growth plate morphology. Increased biomarkers of osteoclast number and activity were observed in the stress group. These findings suggest that RSD can impair bone health and growth in mice, which may provide insight into how psychosocial stressors like bullying or low social status could similarly impact bone health in humans.
Proper positioning is widely recognized in neonatal care. Implementing evidence-based education to improve Neonatal Intensive Care Unit (NICU) nurses' competency in infant positioning performance is essential. Evidence-based educational strategies are critical to enhancing NICU nurses' competency in infant positioning. To compare the effect of face-to-face training versus mobile learning (m-learning) utilizing multimedia resources on the positioning of preterm infants among NICU nurses. This quasi-experimental pretest-posttest study employed a nonequivalent control group design, with 90 convenience-selected nurses from the NICU assigned to one of three groups: control, face-to-face training, or mobile learning (m-learning). The intervention consisted of face-to-face training (30 min plus 10-15 min of bedside training over 2 weeks) and m-learning (interactive multimedia content via WhatsApp for 2 weeks). Data were collected using the Infant Positioning Assessment Tool (IPAT) at baseline (T1), one week (T2), and one month (T3) post-intervention. Nurses' performance of infant positioning was in a "need to change" state in three groups preintervention (p > 0.05). Post-intervention, in T2, the control group remained in a "need to change" state (IPAT score = 4.71 ± 0.44), whereas both the face-to-face training group (IPAT score = 8.66 ± 0.55) and the m-learning group (IPAT score = 8.57 ± 0.40) were in an "acceptable" state. In T3, compared to T1, there was a significant difference in IPAT scores among the control, face-to-face training, and m-learning groups, respectively (IPAT scores = 4.66 ± 0.37, 6.63 ± 0.48, 7.88 ± 0.65, p < 0.001). Both intervention groups showed decline from T2, but the pattern differed markedly: all nurses in the face-to-face group (100%) returned to "need to change" status, while 40% of the m-learning group maintained acceptable performance. The m-learning group demonstrated significantly higher scores and better knowledge retention at one month follow-up compared to the face-to-face group. Face-to-face and m-learning methods significantly improved nurses' ability to position premature infants, with m-learning showing better long-term knowledge retention. These findings confirm that each approach is effective on its own, while also suggesting that their unique strengths could be combined. Therefore, we recommend future research explore the effectiveness of blended learning strategies that combine the immediate feedback and practical experience of face-to-face training with the accessibility and reinforcement of m-learning.
Long-acting ART (LA-ART) regimens available or in development are emerging alternatives to daily oral HIV treatment, designed to improve adherence. We explored preference heterogeneity for LA-ART among people living with HIV (PLWH) in Kenya and investigated their association with sociodemographic and psychosocial characteristics. We designed a discrete choice experiment (DCE) to elicit preferences for LA-ART attributes among 700 PLWH recruited from three clinics in Nairobi Kenya (January 2023-February 2024). Each participant answered 17 choice-tasks, each with 2 hypothetical LA-ART alternatives and current daily oral therapy. Each LA-ART profile was defined by mode (long-acting pills, injections under the skin, injections into the muscle, and implants), pain, frequency, location of treatment, pre-treatment time undetectable, pre-treatment negative reaction testing, and late-dose leeway. Participants answered demographic and psychosocial questions and provided consent to link their clinical data. We fitted a latent-class model to the DCE data, assigned class membership to each participant, and estimated a multinomial logit model to explore associations between participant characteristics and class membership. We found three classes in our DCE data and labeled them based on which hypothetical LA-ART formulation they preferred over their current daily oral therapy: LA-Implant (41% of the sample), LA-Injection-or-Oral (subcutaneous or intramuscular injection; 38%) and LA-Oral (21%) classes. All classes preferred "clinic" of over "home" for treatment location. Compared to LA-Oral participants, the other two classes had more experience with and less aversion to injections and had started ART more recently. LA-Implant participants were more likely to have housing insecurity. LA-Injection-or-Oral participants were less likely to be a female sex worker and to have a monthly income; and more likely to be a man who has sex with men or male sex worker, to have private insurance, and to have easier access to a clinic. Results provide a deeper understanding of the LA-ART preference landscape. Understanding PLWH preferences for these therapies is crucial to increasing their acceptance and uptake as regimens become available and could aid in the development of preference-informed interventions.
Androgenetic alopecia (AGA) is a common non-scarring alopecia with substantial psychosocial burden. Minoxidil and 5α-reductase inhibitors remain standards of care but require prolonged adherence and do not fully address the dermal microenvironment. To evaluate efficacy and safety of intradermal 10% glucose combined with non-cross-linked hyaluronic acid (NHA) versus NHA alone for scalp hair regrowth. In this prospective, single-center, randomized, evaluator-blinded pilot study, 40 adults with mild-to-moderate AGA (Norwood-Hamilton II-IV or Ludwig I-II) were randomized 1:1 to receive intradermal 10% glucose + NHA (Sihler G, Sihler Inc., Korea) or NHA alone. Participants underwent five sessions at 3-week intervals (weeks 0-12). This pilot study was not prospectively registered. The primary end point was change in terminal hair density (hairs/cm2) in a fixed target area from baseline to week 18. Secondary outcomes included hair shaft diameter, global photographic assessments, responder rates, and patient-reported outcomes. Thirty-eight participants completed the study (19 per group). At week 18, mean terminal hair density increased by + 19.3 ± 8.1 hairs/cm2 with glucose+NHA and by + 6.2 ± 7.5 hairs/cm2 with NHA alone (between-group difference 13.1 hairs/cm2; 95% CI 7.6-18.7; p < 0.001). Mean hair shaft diameter increased by + 12.8% ± 6.9 versus + 4.1%±6.1 (p = 0.002). Responder rates (≥ 15% density increase) were 74% versus 26% (p = 0.003). Adverse events were mild and transient; no serious events occurred. In this pilot RCT, intradermal 10% glucose combined with NHA produced greater improvements in objective and subjective hair outcomes than NHA alone, with a favorable shortterm safety profile. Larger, longer trials are warranted. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Acute Low Back Pain (LBP) commonly shows rapid symptom improvement during the early phase; however, delayed or inadequate treatment may increase the risk of recurrence and chronicity. Ultrasound-guided pharmacopuncture has demonstrated promising analgesic effects, yet the optimal needle length for deep interfascial targeting remains unclear, particularly in procedures involving the Quadratus Lumborum-Psoas-Iliocostalis (QPI) space. This study aims to compare the short-term clinical response, procedural feasibility, and safety of short versus long needles used for QPI-guided pharmacopuncture in patients with acute LBP. This prospective, multicenter, comparative observational study includes adults aged 20-65 years presenting with acute LBP within 7 days of onset. Participants undergo a single session of ultrasound-guided Polydeoxyribonucleotide (PDRN) pharmacopuncture targeting the QPI interfascial plane using either a short needle (26G × 60 mm) or a long needle (25G × 100 mm). Group assignment is based on pre-designated site-level data extraction rather than randomization. The primary outcome is the change in the Numeric Rating Scale (NRS) score immediately after treatment. Secondary outcomes include changes in lumbar range of motion (ROM), patient-reported percentage pain reduction (PRPPR), and procedural usability. Safety is monitored immediately post-procedure and again during a telephone follow-up 24-36 h later. Statistical analyses will compare between-group effects and explore potential associations with procedural characteristics. This study aims to provide preliminary feasibility evidence on whether needle length affects procedural performance and immediate analgesic response during ultrasound-guided interfascial pharmacopuncture for acute LBP. By evaluating both clinical and procedural metrics, the results may contribute to establishing standardized needle-selection criteria and support future randomized controlled trials designed to optimize deep pharmacopuncture techniques within Korean medicine primary care settings. https://cris.nih.go.kr/cris/search/detailSearch.do?seq=32507&search_page=L&search_lang=&class_yn=.
This study compared the efficacy of a Panax ginseng polysaccharide (GPS) and Houttuynia cordata essential oil (HCEO) complex with antibiotics in Arbor Acres broilers. Three hundred 1-day-old broilers were randomly assigned to five groups: a blank control group (C), an antibiotic group (A), and three groups administered the GPS-HCEO complex via drinking water at 0.1 (M1), 0.3 (M2), or 0.6 mL/L (M3). Compared with Group C, FCR was significantly decreased in Groups M1, M2, and M3 during the early phase (P < 0.05). During the late phase and the overall experimental period, FCR was significantly lower in Groups A, M1, and M3 than in Group C (P < 0.05). For slaughter performance, the four treatment groups showed no significant differences in slaughter rate, semi-eviscerated rate, eviscerated rate, breast muscle rate, leg muscle rate, lean meat rate, or wing rate compared with Group C (P > 0.05), whereas Group A had a significantly lower abdominal fat rate than Group C and the three GPS-HCEO groups (P < 0.05). Serum analysis showed that IgG, IgM, IgA, IL-1, and IL-10 levels remained unchanged compared with Group C (P > 0.05), whereas serum triglyceride levels were increased in all treatment groups (P < 0.05). Antibiotic supplementation impaired duodenal morphology and reduced cecal microbial diversity, as reflected by the Simpson index, as well as the relative abundance of Firmicutes and Tenericutes. Supplementation with 0.6 mL/L GPS-HCEO complex achieved a feed conversion efficiency comparable to that of antibiotics. Unlike antibiotics, the GPS-HCEO complex improved jejunal and ileal morphology, as indicated by increased VH and V/C ratio, without disrupting the core microbial structure. It also promoted the enrichment of the beneficial genera Aerococcus and Jeotgalicoccus in the cecum. These findings suggest that the GPS-HCEO complex has potential as a feed additive for reducing antibiotic use in broiler production.
To evaluate the effect of platelet-rich plasma (PRP) on the rate of orthodontic tooth movement during maxillary canine retraction. This split-mouth controlled clinical study included 15 patients aged between 18 and 30 years requiring bilateral maxillary first premolar extractions. One side of the maxillary arch was randomly assigned as the experimental side and received a single submucosal injection of autologous PRP around the distal aspect of the canine, while the contralateral side served as the control. Mini-implants were placed bilaterally between the maxillary first and second molars and loaded with NiTi closed-coil springs delivering a retractive force of 150 g for canine retraction. Orthodontic tooth movement was evaluated using intraoral scans obtained with Trios 3 scanner at baseline (T0) and at 4-week intervals up to 16 weeks (T1-T4). The rate of canine movement was calculated using Ortho Systems Orthodontics software. Intergroup comparisons were performed using an unpaired t-test, and within-group comparisons were analyzed using one-way analysis of variance. The mean rate of canine retraction on the PRP side was 0.37 ± 0.34 mm, 0.37 ± 0.34 mm, 0.66 ± 0.46 mm, and 0.52 ± 0.44 mm across successive intervals. On the control side, the corresponding values were 0.31 ± 0.24 mm, 0.31 ± 0.24 mm, 0.23 ± 0.27 mm, and 0.38 ± 0.53 mm. A statistically significant difference was observed during the T2-T3 interval (P < 0.05). A single submucosal PRP injection may enhance canine retraction during orthodontic treatment, although the effect appears transient and time dependent.
Minimally invasive dentistry has driven the development of alternative cavity preparation techniques aimed at preserving tooth structure and improving biological outcomes. Ultrasonic systems associated with chemical vapor deposition (CVD) diamond tips have emerged as a potential alternative to conventional rotary instruments; however, evidence regarding their effects on dentin surface morphology and smear layer characteristics under SEM remains limited. This study aimed to evaluate the morphological characteristics of dentin surfaces after cavity preparation using ultrasonic and conventional rotary techniques. Twenty extracted human teeth were sectioned longitudinally to obtain standardized specimens. Samples were assigned to ultrasonic preparation using CVD diamond tips or conventional rotary preparation using carbide burs at high and low speeds. After preparation, specimens were cleaned, stored in distilled water, sputter-coated, and analyzed by scanning electron microscopy (SEM). Surface morphology, smear layer presence, and dentinal tubule exposure were qualitatively assessed at different magnifications. Ultrasonic preparation resulted in consistently cleaner dentin surfaces with minimal smear layer and open dentinal tubules, whereas conventional rotary instrumentation produced irregular surfaces covered by dense smear layer and debris. Ultrasonic cavity preparation using CVD diamond tips demonstrated superior surface characteristics compared with conventional rotary techniques, supporting its potential as a minimally invasive approach that may enhance adhesion and preserve dentin-pulp integrity.
Dietary protein source is one of the primary factors influencing host nitrogen metabolism and intestinal microbiota. However, conventional diet formulations primarily focus on overall nutritional levels, overlooking the differences in amino acid release rates among various protein sources. This study investigates how different protein sources affect nitrogen metabolism and gut microbiota in finishing pigs. The corn-soybean meal diet served as the control (SBM). Fish meal and rapeseed meal isonitrogenously replaced 50% of soybean meal to formulate FM and RPM diets. Twenty-four finishing pigs (DLY; 53.40 ± 2.53 kg) were housed individually in metabolic cages, randomly assigned to three groups (n = 8), and fed for 8 weeks. Feeding the three diets had no significant effect on the growth performance of finishing pigs. Compared with SBM and FM, RPM diet significantly increased fecal nitrogen, but reduced urinary nitrogen, blood urea nitrogen and blood ammonia levels, reduced free amino acids in the small intestinal chyme and plasma, downregulated expressions of amino acid transporters, and showed slower in vitro amino acid release, collectively indicating less amino acid release into the small intestinal lumen and consequently less amino acids into the circulation. In addition, compared with the SBM and FM groups, RPM exhibited increased ileal microbial diversity, characterized by lower relative abundances of Streptococcus, Staphylococcus and higher relative abundances of Lactobacillus, Turicibacter. Additionally, microbial cell amino acids and microbial cell protein concentrations were significantly reduced in the RPM group. Correlation analysis showed that the amino acid release rate was negatively correlated with fecal nitrogen, the relative abundance of Lactobacillus and Turicibacter, while positively correlated with urinary nitrogen, blood urea nitrogen, the relative abundance of Streptococcus and Staphylococcus, microbial cell protein, and total microbial cell amino acid content. Dietary protein sources altered host nitrogen metabolism and restructured the ileal microbiota, with the rate of amino acid release appearing to be a key factor associated with these changes.
This study evaluated the outcomes of intra-articular tranexamic acid (TXA) and/or suction drainage in patients undergoing total knee arthroplasty (TKA). Following approval from the institutional review board, a prospective, randomized, and blinded clinical study was conducted in Northwest Syria, including 192 patients who underwent unilateral TKA between August 2023 and April 2025. Patients were randomly assigned to three groups: TXA with suction drainage, TXA only, or suction drainage only. Patients with coagulopathies, active infections, previous knee surgeries, or contraindications to TXA were excluded. All procedures followed a standardized surgical and postoperative protocol. Outcome measures included total and hidden blood loss (HBL), drainage volume, transfusion rate, limb swelling, and wound complications. Total blood loss was lowest in Group 2 (710 mL) compared to Group 1 (891 mL) and Group 3 (1391 mL) (P < 0.0001). No transfusions were required in Group 2, whereas 7.8% of Group 1 and 36% of Group 3 received transfusions (P < 0.0001). No wound complications occurred in Group 2. HBL and early swelling were higher in Group 2 but resolved within 6 weeks. Knee range of motion at 2 months showed no significant differences among groups (p = 0.0789). Intra-articular TXA without suction drainage appears to be the safest and most effective method to reduce perioperative blood loss in TKA. Larger multicenter studies are recommended.
This study evaluated the effects of dietary arginine (Arg) on growth performance, testicular development, and apoptosis in juvenile and adult male swimming crabs (Portunus trituberculatus). Six isonitrogenous and isolipidic diets were formulated with graded Arg levels of 1.89% (control), 2.27%, 2.65%, 3.05%, 3.43%, and 3.80%, respectively. A total of 180 juvenile male crabs (initial weight: 4.35 ± 0.02 g) were randomly assigned to six treatments (three replicates of 10 crabs each) and cultured for 20 weeks. Four crabs per replicate were sampled at week 13 (juvenile stage), and the remaining six crabs per replicate were sampled at week 20 (adult stage). At the juvenile stage, compared with the control, those fed the 2.27% Arg diet exhibited significantly higher final body weight (FBW), percent weight gain (PWG), specific growth rate (SGR), and feed efficiency (FE) (P < 0.05). Conversely, the lowest growth performance was observed in the 3.80% Arg group, whereas feed intake (FI) showed an inverse trend (P < 0.001). In the hemolymph, crabs fed the 2.27% Arg diet exhibited the highest activities of endothelial nitric oxide synthase (e-NOS), superoxide dismutase (T-SOD), catalase (CAT), as well as the highest total antioxidant capacity (T-AOC), and glutathione (GSH) content, which were significantly higher than those in the control (P < 0.05). In the hepatopancreas, the relative expression of immune-related genes (mnsod, gsh-px, relish, and po) were upregulated in the 2.27% Arg group compared with control (P < 0.05). And the relative expression of genes involved in lipid synthesis (fas, dgat, acc, and fad) and lipid catabolism (cpt-1, fatp, and fabp) were significantly elevated (P < 0.05), and B-cell diameter was significantly reduced in 2.27% Arg group compared with the control (P < 0.001). At the adult stage, crabs fed 2.27% and 2.65% Arg diets showed higher gonadosomatic index, testis index and vas deferens index than those fed other diets (P < 0.05). In the hemolymph, the activities of adenylate kinase (AK) and neuronal nitric oxide synthase (n-NOS), as well as nitric oxide (NO) content, were significantly increased in the 2.65% Arg group (P < 0.05), while hemolymph ammonia content was significantly decreased compared with the control (P = 0.007). Compared with the control, testicular relative expression of genes involved in Arg metabolism (odc1, creatinase, nadh6, sms, and nnos), spermatogenesis (iag, dsx, and soxe), and protein synthesis (tor) were significantly elevated in the 2.65% Arg group (P < 0.05). Furthermore, compared with the control, 2.65% Arg enhanced anti-apoptotic gene (bcl2) relative expression, reduced BAX/BCL-2 and P-JNK/JNK ratios, decreased apoptotic cell proportion, and lowered reactive oxygen species (ROS) mean fluorescence levels in the testis (P < 0.05). In conclusion, the optimal dietary Arg requirements for juvenile and adult P. trituberculatus were estimated to be 2.04% and 2.46%, respectively. Furthermore, dietary supplementation with 2.27% Arg maximally enhanced growth and immune function in juvenile crabs, whereas 2.65% Arg could improve Arg metabolism, promote testicular development, and reduce cell apoptosis in adult male crabs.
To examine the effects of low-, moderate-, and high-intensity aerobic running on depression, anxiety, and stress among adolescents with problematic internet use (PIU). A randomized controlled design was used. A total of 120 adolescents with PIU, aged 12-15 years, were randomly assigned to a low-intensity group, a moderate-intensity group, a high-intensity group, or a control group (n = 30 per group). The intervention lasted 12 weeks. Exercise intensity was defined according to percentages of maximal heart rate (HRmax): low intensity, 40-49% HRmax; moderate intensity, 50-59% HRmax; and high intensity, 60-69% HRmax. Depression, anxiety, and stress were assessed at pretest, midtest, and posttest using the Depression Anxiety Stress Scales-21 (DASS-21). Repeated-measures mixed-effects models were fitted for each outcome, followed by Bonferroni-adjusted simple-effects analyses. Significant main effects of group and time, as well as significant group × time interactions, were observed for depression, anxiety, and stress. Compared with the control group, all three exercise conditions showed lower depression, anxiety, and stress scores at posttest. No statistically significant posttest differences were found among the three intervention groups. However, the temporal patterns of improvement differed across exercise intensities. Moderate-intensity running showed a more continuous pattern of change across the intervention period, high-intensity running showed earlier improvement, particularly at midtest, and low-intensity running also produced significant benefits, although its effects emerged later. Aerobic running can reduce depression, anxiety, and stress among adolescents with PIU. The findings suggest that intensity-related differences are better understood in terms of timing and trajectory of emotional change rather than endpoint superiority across exercise conditions. These findings provide intensity-specific evidence to inform more targeted exercise prescriptions for adolescents with PIU.
This study aimed to evaluate the effects of immunization with recombinant Echinococcus granulosus antigen P29 (rEg.P29) on hematological, physiological, and biochemical indicators in sheep. A total of 36 4-6-month-old female Ningxia Yanchi Tan sheep, negative for Brucella and echinococcosis antibodies by ELISA, were randomly assigned to four groups (nine sheep per group). Following primary and booster immunizations with rEg.P29, peripheral blood samples were collected at weeks 0 and 20. ELISA, automated hematology analysis, and biochemical analysis were used to assess antigen-specific antibody levels, routine blood parameters, and biochemical indicators. At week 20 post-immunization, all sheep were humanely euthanized, and liver, spleen, and kidney tissues were collected for histopathological examination. rEg.P29 significantly increased antigen-specific IgG levels at 20 weeks post-immunization compared with baseline. Hematological, biochemical, and histopathological analyses revealed no abnormal changes in blood parameters, physiological metabolism, or tissue morphology of the liver, spleen, and kidney, indicating a favorable safety profile. rEg.P29 immunization induces a robust humoral immune response without affecting hematopoietic cell homeostasis or liver and kidney function in sheep, as confirmed by hematological, biochemical, and histopathological analyses. These findings demonstrate the immunogenicity and safety of rEg.P29 and support its potential for the development of vaccines against echinococcosis.
Prediabetes is a major global health concern due to its high prevalence and strong association with obesity and increased cardiovascular risk. Most individuals with prediabetes progress to type 2 diabetes, and although lifestyle modification is recommended early, long-term adherence and scalability remain challenging. SiPore21 offers a promising solution. SiPore21 is an oral gel containing engineered mesoporous silica particles that act locally in the gut by entrapping digestive enzymes and modulating macronutrient uptake. This 12-week, randomised, double-blind, placebo-controlled, multicentre trial was conducted at 27 centres across three European countries (ClinicalTrials.gov: NCT06087822). During Oct 5, 2023 and Jul 30, 2024, 318 participants were enrolled and assessed, and 312 completed the intervention (SiPore21 n = 155; placebo n = 157). Adults aged 18-70 years with overweight or obesity (BMI > 25 to ≤40 kg/m2) and elevated HbA1c (≥42 and ≤58 mmol/mol [≥6 and ≤ 7.5%]) were eligible. Participants were randomly assigned 1:1 to SiPore21 or placebo using a web-based interactive randomisation system. SiPore21 was administered three times daily with meals for 12 weeks. The primary outcome was change in HbA1c from baseline to Week 12. Secondary outcomes included changes in body weight, lipid profiles, and other metabolic parameters. Safety and tolerability were assessed throughout. The primary analysis was performed on all participants who received at least one dose and at least one post-baseline HbA1c measurement; the safety analysis included all participants who received at least one dose. SiPore21 significantly reduced HbA1c from baseline (p = 0.0036), indicating a favourable glycaemic effect, whereas no significant reduction was observed with placebo (p = 0.0872). In a post hoc sex-stratified analysis, the HbA1c reduction vs. placebo was statistically significant in women (p = 0.019), whereas a marked placebo response in men attenuated the overall between-group difference. SiPore21 also improved body weight (p = 0.0374), fat mass (p = 0.05), and lipid measures (LDL-C; p = 0.035, total cholesterol; p = 0.0496) compared to placebo, and was associated with reduced progression from prediabetes to diabetes (p = 0.0233) and increased reversion to earlier glycaemic states (p = 0.0044). SiPore21 was safe and well tolerated, with only mild, transient gastrointestinal events and no serious adverse device effects. SiPore21 improved glycaemic control, body composition, and lipid metabolism while stabilising glycaemic status, whereas corresponding improvements were not observed in the placebo group. SiPore21 was well tolerated, with no clinically meaningful safety concerns identified. These findings support its potential as a safe and effective non-pharmacological option for prediabetes or early type 2 diabetes. Sigrid Therapeutics AB.