The short-chain fatty acid uptake fluxes by mice on a guar gum supplemented diet associate with amelioration of major biomarkers of the metabolic syndrome

Studies with dietary supplementation of various types of fibers have shown beneficial effects on symptoms of the metabolic syndrome. Short-chain fatty acids (SCFAs), the main products of intestinal bacterial fermentation of dietary fiber, have been suggested to play a key role. Whether the concentration of SCFAs or their metabolism drives these beneficial effects is not yet clear. In this study we investigated the SCFA concentrations and in vivo host uptake fluxes in the absence or presence of the dietary fiber guar gum. C57Bl/6J mice were fed a high-fat diet supplemented with 0%, 5%, 7.5% or 10% of the fiber guar gum. To determine the effect on SCFA metabolism, C-13-labeled acetate, propionate or butyrate were infused into the cecum of mice for 6 h and the isotopic enrichment of cecal SCFAs was measured. The in vivo production, uptake and bacterial interconversion of acetate, propionate and butyrate were calculated by combining the data from the three infusion experiments in a single steady-state isotope model. Guar gum treatment decreased markers of the metabolic syndrome (body weight, adipose weight, triglycerides, glucose and insulin levels and HOMA-IR) in a dose-dependent manner. In addition, hepatic mRNA expression of genes involved in gluconeogenesis and fatty acid synthesis decreased dose-dependently by guar gum treatment. Cecal SCFA concentrations were increased compared to the control group, but no differences were observed between the different guar gum doses. Thus, no significant correlation was found between cecal SCFA concentrations and metabolic markers. In contrast, in vivo SCFA uptake fluxes by the host correlated linearly with metabolic markers. We argue that in vivo SCFA fluxes, and not concentrations, govern the protection from the metabolic syndrome by dietary fibers

Parenting a child with chronic illness as they transition into adulthood:a systematic review and thematic synthesis of parents’ experiences

Objective - To understand how parents view and experience their role as their child with a long-term physical health condition transitions to adulthood and adult healthcare services. Methods - Five databases were systematically searched for qualitative articles examining parents’ views and experiences of their child’s healthcare transition. Papers were quality assessed and thematically synthesised. Results - Thirty-two papers from six countries, spanning a 17-year period were included. Long-term conditions were diverse. Findings indicated that parents view their child’s progression toward self-care as an incremental process which they seek to facilitate through up-skilling them in self-management practices. Parental perceptions of their child’s readiness, wellness, competence and long-term condition impacted on the child’ progression to healthcare autonomy. A lack of transitional healthcare and differences between paediatric and adult services served as barriers to effective transition. Parents were required to adjust their role, responsibilities and behaviour to support their child’s growing independence. Conclusion - Parents can be key facilitators of their child’s healthcare transition, supporting them to become experts in their own condition and care. To do so, they require clarification on their role and support from service providers. Practice Implications - Interventions are needed which address the transitional care needs of parents as well as young people

Junctional Adhesion Molecule-C Mediates the Recruitment of Embryonic-Endothelial Progenitor Cells to the Perivascular Niche during Tumor Angiogenesis

The homing of Endothelial Progenitor Cells (EPCs) to tumor angiogenic sites has been described as a multistep process, involving adhesion, migration, incorporation and sprouting, for which the underlying molecular and cellular mechanisms are yet to be fully defined. Here, we studied the expression of Junctional Adhesion Molecule-C (JAM-C) by EPCs and its role in EPC homing to tumor angiogenic vessels. For this, we used mouse embryonic-Endothelial Progenitor Cells (e-EPCs), intravital multi-fluorescence microscopy techniques and the dorsal skin-fold chamber model. JAM-C was found to be expressed by e-EPCs and endothelial cells. Blocking JAM-C did not affect adhesion of e-EPCs to endothelial monolayers in vitro but, interestingly, it did reduce their adhesion to tumor endothelium in vivo. The most striking effect of JAM-C blocking was on tube formation on matrigel in vitro and the incorporation and sprouting of e-EPCs to tumor endothelium in vivo. Our results demonstrate that JAM-C mediates e-EPC recruitment to tumor angiogenic sites, i.e., coordinated homing of EPCs to the perivascular niche, where they cluster and interact with tumor blood vessels. This suggests that JAM-C plays a critical role in the process of vascular assembly and may represent a potential therapeutic target to control tumor angiogenesis

Corticosteroids for presumed pneumocystis pneumonia in patients with HIV infection

Adjunctive corticosteroids decrease mortality in patients with HIV infection who have moderate to severe hypoxemia and suspected or confirmed pneumocystis pneumonia. Corticosteroids lead to a higher incidence of herpetic lesions, but not other opportunistic conditions. (Strength of recommendation: A, based on a systematic review of randomized controlled trials [RCTs].

Recovery of algal turfs following removal

As a consequence of the increasing human footprint on the environment, marine ecosystems are rapidly transforming into new configurations dominated by early-successional and weedy life forms. Algal turfs, in particular, are emerging as a common and widespread configuration of shallow temperate and tropical reefs, and are predicted to transform reef dynamics and ecosystem services. Restoration is an increasingly used approach to mitigate these transformations, with turf removal being proposed as a tool to shift back the competitive balance and facilitate the recovery of initial species, such as forest-forming seaweeds. Yet, our practical understanding of turf recovery trajectories following removal is limited, and removal success may be hindered by strong feedback mechanisms that reinforce turf dominance once turfs are established. Here we investigate the recovery of algal turfs and their properties (mean height, turf biomass and sediment load) to experimental clearance across six turf-dominated reefs at ca. 9 m in subtropical western Australia. Turf cover, mean height, and sediment loads exhibited a rapid recovery following experimental clearing, with all experimental sites reaching pre-clearing turf conditions between 28 and 46 days. This response was mostly driven by the growth of filamentous turf species, whose cover exhibited a positive relationship with sediment load, and are well-known to rapidly recover after disturbance. Turf abundance and turf properties remained relatively constant for the remaining experimental period. Our results suggest that clearing turfs creates only a small time window for recovery of seaweed forests, which limits the effectiveness of turf clearing as a restoration tool. System-specific quantitative evidence on the recovery capacity of turfs may thus be necessary to guide restoration initiatives and develop decision support systems that account for the risks, feasibility, and costs and benefits of restoring turf-dominated systems to previous configurations.publishedVersio

The Recovery Learning Community (RLC) Outcomes Study: Perspectives of RLC Participants [English and Spanish versions]

A Spanish translation of this publication is available to download under Additional Files below. Researchers at the UMass Medical School Systems and Psychosocial Advances Research Center (SPARC) worked with peer and state mental health stakeholders to develop a mixed-methods survey to assess individuals’ personal, health, and life outcomes in relation to Recovery Learning Community participation