The aim of this study was to assess the effects of different dietary selenium sources, selenium nanoparticle (nSe), and selenomethionine (SeMet) as feed additives on growth performance, hepatic enzymes’ activity, biochemical, mucosal immune parameters, liver histology, and appetite-related gene transcript in goldfish (Carassius auratus). At first, goldfish juveniles (n=480; mean 4.54 g) were fed dietary selenium nanoparticle at 0, 0.3, 0.6, and 0.9 mg nSe/kg diet and SeMet at 0, 0.3, 0.6, and 0.9 mg Se/kg for 9 weeks. Growth performance was evaluated using standard procedures. Blood, skin mucus, and tissue samples (liver and intestine) were collected for biochemical, mucosal immune response, histology, and ghrelin and insulin-like growth factor-I (IGF-I) gene expression. The results showed that fish fed diets fortified with 0.6 mg nSe/kg and 0.6 mg Se/kg had a significant higher weight gain, specific growth rates (SGR), and lower feed conversion ratios (FCR) than fish fed basal diets (p less then 0.05). Furthermore, dietary nSe and SeMet enhanced blood biochemical profiles especially alkaline phosphatase (ALP) (p less then 0.05) and mucosal immunity than the control group in goldfish. Moreover, the liver histological investigation showed that fish fed 0.9 mg of SeMet and nSe kg-1 diets had higher liver lesion scores such as karyolysis, lipidosis, and hyperemia while fish fed 0, 0.3, and 0.6 mg of SeMet and nSe kg-1 diets had small liver changes at 9 weeks. The study further established that inclusion of nSe and SeMet in the diet of goldfish greatly promoted ghrelin and IGF-1genes expressions (p less then 0.05). Overall, dietary nSe performs better than SeMet and basal diets. The results evoked that nSe and SeMet stimulate the growth, biochemical, and mucosal immunity in goldfish at 0.6 mg/kg.Couples who are at risk of transmitting a genetic disease to their offspring may face difficult challenges regarding reproductive decision-making. Deciding if, and how, to purse their child wish can be a demanding process. This study aims to describe the reproductive joint decision-making process of genetically at-risk couples. A qualitative study was conducted with 16 couples (N=31) at risk of transmitting a genetic disease to their offspring and who received genetic counseling. Most couples were not aware of all available reproductive options in the Netherlands. A variety of motives was reported with almost all couples expressing a preference towards a reproductive option in which the child is genetically related to both parents. Only a few couples considered other options such as the use of donor gametes, adoption, and foster parenting. All couples indicated that they had multiple conversations to reach a mutually supported reproductive decision. Several carriers reported feelings of guilt and in some couples, the woman appeared to have a greater impact in the decision-making process as she should carry a pregnancy and should undergo medical treatments. This study provides insight in the extensive decision-making process of genetically at-risk couples and the role of both partners in this process. These findings can guide the development of genetic counseling (e.g., increase awareness of available reproductive options) and decision support for these couples.Some highly challenging, seemingly „unsolvable” situations that arise in medical education could be the result of autistic traits (AT) in learners. AT exist in physicians and learners, ranging from profiles compatible with DSM-5’s criteria for autism spectrum disorder (ASD) to more subtle manifestations of ASD’s „broader phenotype.” Often associated with strengths and talents, AT may nonetheless pose significant challenges for learning, teaching, and practising medicine. Since AT remain widely under-recognized and misunderstood by educators, clinicians, and affected individuals alike, they represent a blind spot in medical education. The use of a „neurodiversity lens” to examine challenging situations may help educators consider different pedagogical approaches to address those potentially stemming from AT.This paper aims to raise awareness and understanding of AT-related difficulties in struggling medical learners. To overcome the blind spot challenge and help develop this „neurodiversity lens,” we explore different angles. Beyond any diagnostic consideration, we offer a series of contextual examples, paralleled with explanatory concepts from the field of ASD. We also underline the role of context on functional impact and describe the often ill-defined pattern of challenges encountered, as well as the fertile grounds for interpersonal misunderstandings and disrespect. We propose historical, cultural, and clinical reasons likely contributing to the blind spot. Mindful of the potential risks of prejudice associated with identifying AT-related difficulties, we underline the necessity and feasibility of conciliating diversity and dignity with accountability standards for medical competence.

Diabetes mellitus (DM) is associated with a broad range of complications, such as retinopathy, nephropathy, neuropathy, and cardiovascular disease. Therefore, predicting DM from head and neck images is a challenge for clinicians. The purpose of this study was to assess the mandibular condylar bone marrow in DM patients using computed tomography (CT) texture analysis.

This retrospective study included 16 DM and age and sex matched 16 control patients (11 men, 5 women; mean age, 56.8 ± 14.4years; range 31-78years). Patients with Type I DM, prior history of taking bisphosphonates, osteoarthritis of the temporomandibular joint, and CT images with metal artifacts were excluded from this study. Bilateral mandibular condylar bone marrow was manually contoured on axial CT images. The presence or absence of DM is the primary predictor variable. Texture features of the region of interest was the outcome variable, that were analyzed using an open-access software, MaZda Ver.3.3. For each group, 20 features out of 279 parameters were selected with Fisher, probability of error and average correlation coefficient methods in MaZda. Bivariate statistics were computed with the Mann-Whitney U test and the P value was set at .05.

One histogram feature, 15Gy level co-occurrence matrix features, and four gray level run length matrix features showed differences between the DM patients and non-DM patients (P < 0.05).

Several texture features of the condyle demonstrated differences between the DM and non-DM patients. CT texture analysis may potentially detect DM from the condylar bone marrow.

Several texture features of the condyle demonstrated differences between the DM and non-DM patients. CT texture analysis may potentially detect DM from the condylar bone marrow.Cancer immunotherapy has been at the forefront of therapeutic interventions for many different tumor types over the last decade. While the discovery of immunotherapeutics continues to occur at an accelerated rate, their translation is often hindered by a lack of strategies to deliver them specifically into solid tumors. Accordingly, significant scientific efforts have been dedicated to understanding the underlying mechanisms that govern their delivery into tumors and the subsequent immune modulation. In this review, we aim to summarize the efforts focused on overcoming tumor-associated biological barriers and enhancing the potency of immunotherapy. We summarize the current understanding of biological barriers that limit the entry of intravascularly administered immunotherapies into the tumors, in vitro techniques developed to investigate the underlying transport processes, and delivery strategies developed to overcome the barriers. Overall, we aim to provide the reader with a framework that guides the rational development of technologies for improved solid tumor immunotherapy.Fundamental studies performed during the last decades have shown that cell fate is much more plastic than previously considered, and technologies for its manipulation are a keystone for many new tissue regeneration therapies. Transcription factors (TFs) are DNA-binding proteins that control gene expression, and they have critical roles in the control of cell fate and other cellular behavior. TF-based therapies have much medical potential, but their use as drugs depends on the development of suitable delivery technologies that can help them reach their action site inside of the cells. TFs can be used either as proteins or encoded in polynucleotides. When used in protein form, many TFs require to be associated to a cell-penetrating peptide or another transduction domain. As polynucleotides, they can be delivered either by viral carriers or by non-viral systems such as polyplexes and lipoplexes. TF-based therapies have extensively shown their potential to solve many tissue-engineering problems, including bone, cartilage and cardiac regeneration. Yet, their use has expanded beyond regenerative medicine to other prominent disease areas such as cancer therapy and immunomodulation. This review summarizes some of the delivery options for effective TF-based therapies and their current main applications.In recent years, the incidence of infected wounds is steadily increasing, and so is the clinical as well as economic interest in effective therapies. These combine reduction of pathogen load in the wound with general wound management to facilitate the healing process. The success of current therapies is challenged by harsh conditions in the wound microenvironment, chronicity, and biofilm formation, thus impeding adequate concentrations of active antimicrobials at the site of infection. Inadequate dosing accuracy of systemically and topically applied antibiotics is prone to promote development of antibiotic resistance, while in the case of antiseptics, cytotoxicity is a major problem. Advanced drug delivery systems have the potential to enable the tailor-made application of antimicrobials to the side of action, resulting in an effective treatment with negligible side effects. This review provides a comprehensive overview of the current state of treatment options for the therapy of infected wounds. In this context, a special focus is set on delivery systems for antimicrobials ranging from semi-solid and liquid formulations over wound dressings to more advanced carriers such as nano-sized particulate systems, vesicular systems, electrospun fibers, and microneedles, which are discussed regarding their potential for effective therapy of wound infections. Further, established and novel models and analytical techniques for preclinical testing are introduced and a future perspective is provided.

Studies on the association between urinary albumin to creatinine ratio (ACR) and bone mineral density (BMD) are still controversial.

This study investigated the association between ACR and BMD in the general US population.

This cross-sectional study identified 2007 individuals aged 40 or above years with complete and valid data on urinary albumin to creatinine ratio (ACR) and femoral neck, total femur and lumbar spine BMD from the National Health and Nutrition Examination Survey 2013-2014. ACR was directly measured with established methods. BMDs were measured by dual-energy X-ray absorptiometry (DXA). After adjusting for multiple covariates, we used general linear model (GLM) to compare the mean of BMD between the quartiles of ACR.

The mean age of participants in this study was 54.6 ± 11.3years; 52.6% of them were female. ACR was negatively associated with BMD at femoral neck, total femur and lumbar spine (all P < 0.05). After adjusting for covariates, higher level of ACR quartile was associated with lower femoral neck BMD (P for trend = 0.