Hypoglycaemia Prevention, Awareness of Symptoms, and Treatment (HypoPAST): protocol for a 24-week hybrid type 1 randomised controlled trial of a fully online psycho-educational programme for adults with type 1 diabetes

\ua9 The Author(s) 2024. Background : Management of type 1 diabetes (T1D) requires the use of insulin, which can cause hypoglycaemia (low blood glucose levels). While most hypoglycaemic episodes can be self-treated, all episodes can be sudden, inconvenient, challenging to prevent or manage, unpleasant and/or cause unwanted attention or embarrassment. Severe hypoglycaemic episodes, requiring assistance from others for recovery, are rare but potentially dangerous. Repeated exposure to hypoglycaemia can reduce classic warning symptoms (‘awareness’), thereby increasing risk of severe episodes. Thus, fear of hypoglycaemia is common among adults with T1D and can have a negative impact on how they manage their diabetes, as well as on daily functioning, well-being and quality of life. While advances in glycaemic technologies and group-based psycho-educational programmes can reduce fear, frequency and impact of hypoglycaemia, they are not universally or freely available, nor do they fully resolve problematic hypoglycaemia or associated worries. This study aims to determine the effectiveness of a fully online, self-directed, scalable, psycho-educational intervention for reducing fear of hypoglycaemia: the Hypoglycaemia Prevention, Awareness of Symptoms, and Treatment (HypoPAST) programme. Methods: A 24-week, two-arm, parallel-group, hybrid type 1 randomised controlled trial, conducted remotely (online and telephone). Australian adults (≥ 18 years) with self-reported T1D and fear of hypoglycaemia will be recruited, and allocated at random (1:1) to HypoPAST or control (usual care). The primary outcome is the between-group difference in fear of hypoglycaemia (assessed using HFS-II Worry score) at 24 weeks. A sample size of N = 196 is required to detect a 9-point difference, with 90% power and allowing for 30% attrition. Multiple secondary outcomes include self-reported psychological, behavioural, biomedical, health economic, and process evaluation data. Data will be collected at baseline, 12 and 24 weeks using online surveys, 2-week ecological momentary assessments, website analytics and semi-structured interviews. Discussion: This study will provide evidence regarding the effectiveness, cost-effectiveness and acceptability of a novel, online psycho-educational programme: HypoPAST. Due to the fully online format, HypoPAST is expected to provide an inexpensive, convenient, accessible and scalable solution for reducing fear of hypoglycaemia among adults with T1D. Trial registration: Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12623000894695 (21 August 2023)

Gene expression imputation across multiple brain regions provides insights into schizophrenia risk

Transcriptomic imputation approaches combine eQTL reference panels with large-scale genotype data in order to test associations between disease and gene expression. These genic associations could elucidate signals in complex genome-wide association study (GWAS) loci and may disentangle the role of different tissues in disease development. We used the largest eQTL reference panel for the dorso-lateral prefrontal cortex (DLPFC) to create a set of gene expression predictors and demonstrate their utility. We applied DLPFC and 12 GTEx-brain predictors to 40,299 schizophrenia cases and 65,264 matched controls for a large transcriptomic imputation study of schizophrenia. We identified 413 genic associations across 13 brain regions. Stepwise conditioning identified 67 non-MHC genes, of which 14 did not fall within previous GWAS loci. We identified 36 significantly enriched pathways, including hexosaminidase-A deficiency, and multiple porphyric disorder pathways. We investigated developmental expression patterns among the 67 non-MHC genes and identified specific groups of pre- and postnatal expression

Integrated analysis of environmental and genetic influences on cord blood DNA methylation in new-borns

Epigenetic processes, including DNA methylation (DNAm), are among the mechanisms allowing integration of genetic and environmental factors to shape cellular function. While many studies have investigated either environmental or genetic contributions to DNAm, few have assessed their integrated effects. Here we examine the relative contributions of prenatal environmental factors and genotype on DNA methylation in neonatal blood at variably methylated regions (VMRs) in 4 independent cohorts (overall n = 2365). We use Akaike's information criterion to test which factors best explain variability of methylation in the cohort-specific VMRs: several prenatal environmental factors (E), genotypes in cis (G), or their additive (G + E) or interaction (GxE) effects. Genetic and environmental factors in combination best explain DNAm at the majority of VMRs. The CpGs best explained by either G, G + E or GxE are functionally distinct. The enrichment of genetic variants from GxE models in GWAS for complex disorders supports their importance for disease risk.</p

Trichuris suis secrete products that reduce disease severity in a multiple sclerosis model

AbstractMultiple sclerosis is a chronic inflammatory central nervous system (CNS) disease, which affects about 1 in 1000 individuals in the western world. It has been suggested that this relatively high prevalence is linked to a high level of hygiene,</jats:p

Visual assessment of the intensity of hypoglycaemia symptoms in type 1 diabetes

Visual assessment of the intensity of hypoglycaemia symptoms in type 1 diabete

Phytochemical contents, antioxidant effects, and inhibitory activities of key enzymes associated with Alzheimer's disease, ulcer, and skin disorders of Sideritis albiflora

WOS: 000524389300037PubMed ID: 31609004In this study, urease, tyrosinase, cholinesterase inhibitory, and antioxidant activities of various extracts of Sideritis albiflora and Sideritis leptoclada were determined together with the phytochemical contents. In addition, the fatty acid compositions and phenolic compounds were investigated by gas chromatography (GC), gas chromatography-mass spectrometry (GC-MS), and high performance liquid chromatography-diode array detector (HPLC-DAD). Rosmarinic acid and caffeic acid in both Sideritis species were identified as the most abundant phenolic compounds whereas palmitic acid was found as a major fatty acid. The acetone extract of S. leptoclada indicated the highest antioxidant activity in beta-carotene-linoleic acid (IC50: 17.23 +/- 0.11 mu g/ml), DPPH center dot (IC50: 28.14 +/- 0.05 mu g/ml) and ABTS(center dot+) (IC50: 15.18 +/- 0.02 mu g/ml) assays. The acetone extract of S. albiflora (A(0.50): 32.71 +/- 0.44 mu g/ml) was found as the best reductant in cupric reducing antioxidant capacity (CUPRAC) assay. Against acetylcholinesterase (AChE) and butyrylcholinesterase (BChE), only the hexane extracts of Sideritis species showed moderate inhibitory activity. Moreover, all extracts of S. albiflora and the hexane extract of S. leptoclada exhibited significantly higher urease inhibitory activity than that of thiourea. Further, in vivo activity studies on extracts and isolated constituents obtained from these species are needed to understand the activity in biological systems