Background Surgery on posterior cranial fossa (PCF) and pineal region (PR) carries the risks of intraoperative trauma to the brainstem structures, blood loss, venous air embolism (VAE), cardiovascular instability, and other complications. Success in surgery, among other factors, depends on selecting the optimal patient position. Our objective was to find associations between patient positioning, incidence of intraoperative complications, neurological recovery, and the extent of surgery. Methods This observational study was conducted in two medical centers The Ohio State University Wexner Medical Center (USA) and The Burdenko Neurosurgical Institute (Russian Federation). Patients were distributed in two groups based on the surgical position sitting position (SP) or horizontal position (HP). The inclusion criteria were adult patients with space-occupying or vascular lesions requiring an open PCF or PR surgery. Perioperative variables were recorded and summarized using descriptive statistics. The post-treatment . More HP patients experienced macroglossia and increased blood loss. At 3 months, there was no difference of parameters between the two groups. Clinical Trial Registration ClinicalTrials.gov registration number NCT03364283. Copyright © 2020 Mavarez-Martinez, Israelyan, Soghomonyan, Fiorda-Diaz, Sandhu, Shimansky, Ammirati, Palettas, Lubnin and Bergese.Objectives Sub-optimal dietary protein consumption may partially underlie the age-related loss of muscle mass and function (sarcopenia). Specifically, dose, timing, source and distribution of dietary protein across the day might influence muscle anabolism in individuals from across the lifespan. Design The present study aimed to assess daily and meal-specific protein intake, protein source and protein intake pattern in 40 young (23.8 ± 4.3 years), 40 middle-aged (51.6 ± 4.1 years), and 40 old (77.4 ± 7.4 years) individuals using 3-day weighed food diaries. Results Old individuals consumed on average 83.4 ± 24.6 g of daily protein, which was significantly lower compared with young but not middle-aged individuals who consumed, respectively, 105.1 ± 43.0 g and 97.0 ± 31.1 g of daily protein (P = 0.013). No significant difference in daily protein intake was found with middle-aged individuals. Dietary protein intake pattern was uneven across meals for all groups (P less then 0.001 for all). Sources of protein consumption were similar between groups except at lunch where old individuals ingested lower quality proteins compared with middle aged and young individuals. Conclusion Although total daily protein intake was sufficient in the majority of participants, per-meal protein intake and protein distribution contend the current knowledge regarding optimal protein intakes. Increasing protein intake, especially at breakfast and lunch, could mitigate age-related muscle loss. Copyright © 2020 Smeuninx, Greig and Breen.Extracellular vesicles (EV) function in intercellular communication, and those in human milk may confer immunologic benefits to infants. Methods of EV isolation such as ultracentrifugation (UC) may not be feasible for the study of EVs in human milk due to the need for large sample volume. A technique to isolate EVs from a small volume of human milk using a precipitation reagent is described herein. Electron microscopy, nanoparticle tracking analysis, and semi-quantitative antibody array were conducted to confirm isolation of human milk EVs. Count, size, protein content, and fatty acid quantification of EVs were determined. This isolation technique yielded 8.9 x 109 (± 1.1 × 109) EV particles/mL of human milk.  https://www.selleckchem.com/products/GDC-0980-RG7422.html  The present method meets the Minimal Information for Studies of Extracellular Vesicles (MISEV) guidelines. An established EV isolation method suitable for a low volume of human milk will facilitate further research in this growing area. Copyright © 2020 Bickmore and Miklavcic.Background The ketogenic diet (KD) is a high-fat, low-carbohydrate diet that limits glucose and results in the production of ketones by the liver and their uptake as an alternative energy source by the brain. KD is an evidence-based treatment for intractable epilepsy. KD is also self-administered, with limited evidence of efficacy, for conditions including weight loss, cognitive and memory enhancement, type II diabetes, cancer, neurological and psychiatric disorders. A commonly discussed side effect of KD in media and online forums is "keto flu," a cluster of transient symptoms generally reported as occurring within the first few weeks of KD. This study aimed to characterize the pattern of symptoms, severity and time course of keto flu as related by users of online forums. Method Online forums referring to "keto flu," "keto-induction," or "keto-adaptation" in the URL were identified in Google. Passages describing personal experiences of keto flu were categorized manually with reference to pattern of symptoms,um conversations. A composite picture emerged across 101 posts describing personally experienced symptoms. User conversations were generally supportive, sharing remedies for keto flu reflecting assumptions of physiological effects of KD. Copyright © 2020 Bostock, Kirkby, Taylor and Hawrelak.Trophoblasts as the particular cells of the placenta play an important role in implantation and formation of the maternal-fetal interface. RND3 (also known as RhoE) is a unique member of the Rnd subfamily of small GTP-binding proteins. However, its function in cytotrophoblasts (CTBs) at the maternal-fetal interface is poorly understood. In the present study, we found that RND3 expression was significantly increased in trophoblasts from the villous tissues of patients with recurrent miscarriage (RM). RND3 inhibited proliferation and migration and promoted apoptosis in HTR-8/SVneo cells. Using dual-luciferase reporter and chromatin immunoprecipitation assays, we found that forkhead box D3 (FOXD3) is a key transcription factor that binds to the RND3 core promoter region and regulates RND3 expression. Here, the level of FOXD3 was upregulated in the first-trimester CTBs of patients with RM, which in turn mediated RND3 function, including inhibition of cell proliferation and migration and promotion of apoptosis. Further, we found that RND3 regulates trophoblast migration and proliferation via the RhoA-ROCK1 signaling pathway and inhibits apoptosis via ERK1/2 signaling.