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Topic Review
Potential Effects of Fasting in SARS-CoV-2 Infection
Intermittent fasting is a potential complementary therapy to vaccination and antiviral therapies that not only impacts chronic disease risk but also has good evidence of an impact on infectious diseases such as COVID-19. Intermittent fasting should improve the immune response of and reduce acute hyperinflammation for unvaccinated people, strengthen immunity between vaccinations for vaccinated people, and prolong the length of time a vaccinated person can go before receiving a subsequent booster dose of the SARS-CoV-2 vaccine. A set of at least 10 biological mechanisms may be impacted by intermittent fasting in the human physiological response to SARS-CoV-2 that may reduce the severity of COVID-19 outcomes. For example, by boosting autophagy, fasting may aid the immune system to identify silently infected cells via increased degradation of viral proteins and through antigen presentation to natural killer cells and cytotoxic T cells. Intermittent fasting may also provide a constellation of mechanisms that empower a damaged human immune system to repair itself and to hunt down residual SARS-CoV-2 virus that is hiding from it in the context of both acute infection and post-acute sequelae of COVID-19. Furthermore, fasting adds no financial cost to a care plan and, when practiced safely, is available to most adults regardless of education, income, location, or ancestry. Clinical trials of intermittent fasting for reduction of COVID-19 severity are needed.
  • 1.9K
  • 06 Jan 2023
Topic Review
Facioscapulohumeral Muscular Dystrophy
Facioscapulohumeral muscular dystrophy (FSHD)—the worldwide third most common inherited muscular dystrophy caused by the heterozygous contraction of a 3.3 kb tandem repeat (D4Z4) on a chromosome with a 4q35 haplotype—is a progressive genetic myopathy with variable onset of symptoms, distribution of muscle weakness, and clinical severity.  A rough correlation between the phenotypic severity of FSHD and the D4Z4 repeat size has been reported, and the majority of patients with infantile FSHD obtain a very short D4Z4 repeat length (one to three copies, EcoRI size 10–14 kb), in contrast to the classical, slowly progressive, form of FSHD (15–38 kb). With the increasing identifications of case reports and the advance in genetic diagnostics, recent studies have suggested that the variant of FSHD is not a genetically separate entity but a part of the FSHD spectrum. Nevertheless, many questions about the clinical phenotype and natural history of FSHD remain unanswered, limiting evidence-based clinical management.
  • 1.9K
  • 05 Nov 2020
Topic Review
Asynchronous Environment Assessment
The emergence and global spread of COVID-19 has disrupted the traditional mechanisms of education throughout the world. Institutions of learning were caught unprepared and this jeopardised the face-to-face method of curriculum delivery and assessment. Teaching institutions have shifted to an asynchronous mode whilst attempting to preserve the principles of integrity, equity, inclusiveness, fairness, ethics, and safety. A framework of assessment that enables educators to utilise appropriate methods in measuring a student’s progress is crucial for the success of teaching and learning, especially in health education that demands high standards and comprises consistent scientific content. 
  • 1.9K
  • 30 Sep 2021
Topic Review
Gut Microbiota and Related Diseases
Dynamic interactions between gut microbiota and a host’s innate and adaptive immune systems play key roles in maintaining intestinal homeostasis and inhibiting inflammation. The gut microbiota metabolizes proteins and complex carbohydrates, synthesize vitamins, and produce an enormous number of metabolic products that can mediate cross-talk between gut epithelial and immune cells. As a defense mechanism, gut epithelial cells produce a mucosal barrier to segregate microbiota from host immune cells and reduce intestinal permeability. An impaired interaction between gut microbiota and the mucosal immune system can lead to an increased abundance of potentially pathogenic gram-negative bacteria and their associated metabolic changes, disrupting the epithelial barrier and increasing susceptibility to infections. Gut dysbiosis, or negative alterations in gut microbial composition, can also dysregulate immune responses, causing inflammation, oxidative stress, and insulin resistance. Over time, chronic dysbiosis and the translocation of bacteria and their metabolic products across the mucosal barrier may increase prevalence of type 2 diabetes, cardiovascular disease, inflammatory bowel disease, autoimmune disease, and a variety of cancers. 
  • 1.8K
  • 23 Jan 2021
Topic Review
Herbal Medicine
Herbal medicine (also herbalism) is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. There is limited scientific evidence for the safety and efficacy of plants used in 21st century herbalism, which generally does not provide standards for purity or dosage. The scope of herbal medicine commonly includes fungal and bee products, as well as minerals, shells and certain animal parts. Herbal medicine is also called phytomedicine or phytotherapy. Paraherbalism describes alternative and pseudoscientific practices of using unrefined plant or animal extracts as unproven medicines or health-promoting agents. Paraherbalism relies on the belief that preserving various substances from a given source with less processing is safer or more effective than manufactured products, a concept for which there is no evidence.
  • 1.8K
  • 25 Nov 2022
Topic Review
Tuskegee Syphilis Experiment
The Tuskegee Study of Untreated Syphilis in the African American Male was a clinical study conducted between 1932 and 1972 by the United States Public Health Service. The purpose of this study was to observe the natural history of untreated syphilis; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States. The Public Health Service started the study in 1932 in collaboration with Tuskegee University (then the Tuskegee Institute), a historically black college in Alabama. Investigators enrolled in the study a total of 600 impoverished, African-American sharecroppers from Macon County, Alabama. Of these men, 399 had latent syphilis, with a control group of 201 men who were not infected. As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS, who disguised placebos, ineffective methods, and diagnostic procedures as treatment. The men who had syphilis were never informed of their diagnosis, despite the risk of infecting others, and the fact that the disease could lead to blindness, deafness, mental illness, heart disease, bone deterioration, collapse of the central nervous system, and death.. According to the Centers for Disease Control and Prevention, the men were told that they were being treated for "bad blood,” a colloquialism that described various conditions such as syphilis, anemia and fatigue. "Bad blood"—specifically the collection of illnesses the term included—was a leading cause of death within the southern African-American community. The men were initially told that the study was only going to last six months, but it was extended to 40 years. After funding for treatment was lost, the study was continued without informing the men that they would never be treated. None of the infected men were treated with penicillin despite the fact that by 1947, the antibiotic had become the standard treatment for syphilis. Study clinicians could have chosen to treat all syphilitic subjects and close the study, or split off a control group for testing with penicillin. Instead, they continued the study without treating any participants; they withheld treatment and information about it from the subjects. In addition, scientists prevented participants from accessing syphilis treatment programs available to other residents in the area. The study continued, under numerous Public Health Service supervisors, until 1972, when a leak to the press resulted in its termination on November 16 of that year. The victims of the study, all African-American, included numerous men who died of syphilis, 40 wives who contracted the disease and 19 children born with congenital syphilis. The 40-year Tuskegee Study of Untreated Syphilis in the African American Male study was a major violation of ethical standards. Researchers knowingly failed to treat participants appropriately after penicillin was proven to be an effective treatment for syphilis and became widely available. Moreover, participants remained ignorant of the study clinicians’ true purpose, which was to observe the natural course of untreated syphilis. The revelation in 1972 of study failures by a whistleblower, Peter Buxtun, led to major changes in U.S. law and regulation concerning the protection of participants in clinical studies. Now studies require informed consent, communication of diagnosis and accurate reporting of test results. The Tuskegee Syphilis Study, cited as "arguably the most infamous biomedical research study in U.S. history," led to the 1979 Belmont Report and to the establishment of the Office for Human Research Protections (OHRP). It also led to federal laws and regulations requiring institutional review boards for the protection of human subjects in studies involving them. The OHRP manages this responsibility within the United States Department of Health and Human Services (HHS). On May 16, 1997, President Bill Clinton formally apologized on behalf of the United States to victims of the study.
  • 1.8K
  • 07 Nov 2022
Topic Review
Adenosine Deaminase
Adenosine deaminase (ADA, EC 3.5.4.4) - the enzyme engaged in purine metabolism that irreversibly converts adenosine or 2′deoxyadenosine to inosine or 2′deoxyinosine, respectively. In human tissues, it occurs as two isoenzymes: ADA1 and ADA2. ADA1 constitutes the majority of ADA activity and it is present in virtually all tissues, while ADA2 has been found with ADA1 only in monocytes/macrophages. Both ADA isoenzymes are present in cytosolic form, soluble fraction that can be located away from the originating cell, or as ecto-enzymes binding to the cell surface by dedicated proteins. Intracellularly, ADA plays a significant role counteracting high concentrations of 2'deoxyadenosine. When intracellular ADA activity is lowered, e.g. during severe combined immunodeficiency disease (SCID), 2′deoxyadenosine accumulates and is converted to 2′-deoxyadenosine-5′-triphosphate (dATP), which inhibits ribonucleotide reductase (RNR), a crucial enzyme in DNA synthesis that follows disrupted T-cell development. Intracellular concentration of adenosine, the second substrate for ADA, is maintained inside the cell on the low level by adenosine kinase with Km value ~ 1 µM. Under conditions of low energy charge, adenosine-5′-monophosphate (AMP) that originates from adenosine-5′-triphosphate (ATP) degradation, is rapidly transformed to adenosine, which is not immediately deaminated to inosine due to high Km of ADA (25–100 µM). This results in temporary accumulation of adenosine that is vigorously exported out the cell via equilibrative nucleoside transporters (ENTs). Therefore, transmembrane adenosine transport, together with the activities of ecto-ADA and soluble ADA are important regulators of extracellular adenosine concentration. Except enzymatic function, ecto-ADA plays a significant extra-enzymatic role in the interactions between cells that expressed ADA-anchoring proteins on their surfaces. This co-stimulatory and cell-to-cell connecting actions along with its activity regulate many cellular processes related to proliferation and differentiation, which affect pathological conditions associated with cardiovascular diseases such as endothelial activation and dysfunction, inflammation, myocardial ischemia-reperfusion injury, or coagulation disorders. Since these pathologies are associated with ADA overexpression, the inhibition of its activity as well as binding to the surface proteins exhibit an attractive therapeutic potential in cardiovascular diseases.
  • 1.8K
  • 30 Oct 2020
Topic Review
Lactic Acid Fermentation on Food
The microbial and biochemical changes in different fermented foods due to the fermenting microorganisms. It has been a matter of study because it contributes to the enhancement of nutritional content in fermented foods due to various fermenting microorganisms that results in the modifications of foods ecosystems like on flavour, rheology, and shelf-life, as well as on the functional/nutritional characteristics of the foods. Fermentation technique has been used for centuries to upgrade food materials and to formulate a more acceptable product. It helps in the successful degradation of anti-nutritive compounds present in the fermented foods thus making it safe and consumable. This entry will help to know more about the potential of fermented foods to increase substantially the nutritional value of the world's most abundant food resources. The fermentation process has converted the unpalatable food materials into attractive and nutritious foods to add variety and flavour to monotonous staple dishes. It also enhances the nutritional value of foods in terms of vitamins, antioxidants, volatile compounds and minerals, etc. This entry may promote microbial and biochemical changes in fermented foods in a broad manner that helps to understand the overall beneficial effect of microorganisms on fermented foods. 
  • 1.8K
  • 13 Dec 2020
Topic Review
Gluten
From a chemical perspective, gluten has been defined as the proteinaceous mass that remains when wheat dough is washed with water and consists primarily of the prolamin and glutelin fractions of the storage proteins of wheat.
  • 1.8K
  • 24 Aug 2020
Topic Review
The Relationship between COVID-19 and Hypothalamic–Pituitary–Adrenal Axis
Coronavirus disease 2019 (COVID-19) is a highly heterogeneous disease regarding severity, vulnerability to infection due to comorbidities, and treatment approaches. The hypothalamic–pituitary–adrenal (HPA) axis has been identified as one of the most critical endocrine targets of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that might significantly impact outcomes after infection.
  • 1.8K
  • 18 Jul 2022
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