MSpace

MSpace is the University of Manitoba’s Institutional Repository. The purpose of MSpace is to acquire, preserve and provide access to the scholarly works of University faculty and students within an open access environment.

 

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Open Access
Allergic rhinitis
(BMC, 2024-12-27) Rosenfield, Lana; Keith, Paul K.; Quirt, Jaclyn; Small, Peter; Ellis, Anne K.
Abstract Allergic rhinitis (AR) is a common disorder that is strongly linked to asthma and conjunctivitis. Classic symptoms include nasal congestion, nasal itch, rhinorrhea and sneezing. A thorough history, physical examination and assessment of allergen sensitization are important for establishing the diagnosis of AR. Intranasal corticosteroids and second-generation antihistamines are the mainstay of treatment. Allergen immunotherapy is an effective immune-modulating treatment for use in addition to or as an alternative to pharmacologic therapy. This article provides an overview on the pathophysiology, diagnosis, and appropriate management of AR.
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Open Access
A-I-D for cascades: an application of the Behaviour Change Wheel to design a theory-based intervention for addressing prescribing cascades in primary care
(BMC, 2024-12-05) McCarthy, Lisa M.; Farrell, Barbara J.; Metge, Colleen; Jeffs, Lianne; Toenjes, Sameera; Rodriguez, M. C.
Abstract Background Prescribing cascades, which occur when a medication is used to treat the side effect of another medication, are important contributors to polypharmacy. There is an absence of studies that evaluate interventions to address them. We describe an application of the Behaviour Change Wheel (BCW) to design theory-informed interventions for addressing prescribing cascades within interprofessional primary care teams. Methods The BCW framework was applied to guide intervention development. This report describes the first seven steps. Three behaviours were developed based on data collected from two qualitative studies exploring why and how cascades occur across practice settings. A target behaviour was selected and the COM-B model was applied to identify relevant factors for interprofessional primary care teams. Relevant intervention types, policy options, and corresponding behaviour change techniques (BCTs) were identified, and intervention examples drafted. Prioritization of behaviours and intervention examples were guided by the APEASE criteria. Results The three behaviours involved supporting: (1) healthcare providers (HCPs) to ask about, investigate and manage cascades, (2) the public to ask about prescribing cascades, and (3) the public to share medication histories and experiences with HCPs. The team selected the HCP behaviour, A-I-D (ask, investigate, deprescribe), for intervention development. Psychological capability and physical opportunity were the most relevant COM-B components. Ten intervention options comprised of BCTs were developed, which are ready for further prioritization by stakeholders. These can be grouped into: provision of educational materials for use by HCPs; provision of consultation or training to support HCPs; and knowledge mobilization strategies. Through the process, the team identified that development of a practice guidance tool, which assists HCPs to investigate and manage prescribing cascades, is needed to support further intervention development. Conclusions The BCW framework guided the design of intervention examples to support primary HCPs practicing in interprofessional teams to address prescribing cascades. When identifying interventions for future consultation, creation of a practice guidance tool was prioritized as it underpins all proposed interventions for addressing prescribing cascades in practice. Further research is needed to determine what primary HCPs would need in this practice guidance tool and how it will be used in practice, to support its development.
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Open Access
Exploring the efficacy of Transcutaneous Auricular Vagus nerve stimulation (taVNS) in modulating local and systemic inflammation in experimental models of colitis
(BMC, 2024-12-09) Hesampour, Fatemeh; Tshikudi, Diane Malu; Bernstein, Charles Noah; Ghia, Jean-Eric
Abstract Background Current inflammatory bowel disease (IBD) treatments often fail to achieve lasting remission and have adverse effects. Vagus nerve stimulation (VNS) offers a promising therapy due to its anti-inflammatory effects. Its invasive nature, however, has led to the development of non-invasive methods like transcutaneous auricular VNS (taVNS). This study assesses taVNS’s impact on acute colitis progression, inflammatory, anti-inflammatory, and apoptosis-related markers. Methods Male C57BL/6 mice (11–12 weeks) were used for dextran sulfate sodium (DSS)- and dinitrobenzene sulfonic acid (DNBS)-induced colitis studies. The administration of taVNS or no stimulation (anesthesia without stimulation) for 10 min per mouse began one day before colitis induction and continued daily until sacrifice. Ulcerative colitis (UC)-like colitis was induced by administering 5% DSS in drinking water for 5 days, after which the mice were sacrificed. Crohn’s disease (CD)-like colitis was induced through a single intrarectal injection of DNBS/ethanol, with the mice sacrificed after 3 days. Disease activity index (DAI), macroscopic evaluations, and histological damage were assessed. Colon, spleen, and blood samples were analyzed via qRT-PCR and ELISA. One-way or two-way ANOVA with Bonferroni and Šídák tests were applied. Results taVNS improved DAI, macroscopic, and histological scores in DSS colitis mice, but only partially mitigated weight loss and DAI in DNBS colitis mice. In DSS colitis, taVNS locally decreased colonic inflammation by downregulating pro-inflammatory markers (IL-1β, TNF-α, Mip1β, MMP 9, MMP 2, and Nos2) at the mRNA level and upregulating anti-inflammatory TGF-β in non-colitic conditions at both mRNA and protein levels and IL-10 mRNA levels in both non-colitic and colitic conditions. Systemically, taVNS decreased splenic TNF-α in non-colitic mice and increased serum levels of TGF-β in colitic mice and splenic levels in non-colitic and colitic mice. Effects were absent in DNBS-induced colitis. Additionally, taVNS decreased pro-apoptotic markers (Bax, Bak1, and caspase 8) in non-colitic and colitic conditions and increased the pro-survival molecule Bad in non-colitic mice. Conclusions This study demonstrates that taVNS has model-dependent local and systemic effects, reducing inflammation and apoptosis in UC-like colitis while offering protective benefits in non-colitic conditions. These findings encourage further research into underlying mechanisms and developing adjunct therapies for UC.
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Open Access
Immunoglobulin E (IgE)-mediated food allergy
(BMC, 2024-12-30) Bégin, Philippe; Waserman, Susan; Protudjer, Jennifer; Jeimy, Samira; Watson, Wade
Abstract Food allergy is defined as an adverse immunologic response to a food. Immunoglobulin E (IgE)-mediated reactions to foods are associated with a broad range of signs and symptoms that may involve any of the following body systems: the skin, gastrointestinal tract, respiratory tract, and cardiovascular system. IgE-mediated food allergy is a leading cause of anaphylaxis. Therefore, timely and appropriate diagnosis and treatment are imperative. A diagnosis of food allergy entails a careful history and diagnostic tests, which may include skin prick tests, serum-specific IgE, and oral food challenge. The goal of food allergy care is to empower patients and caregivers to manage the risk of food-allergic reactions, reduce food allergy-related anxiety, and achieve a sense of control over their condition. This can be achieved in different ways for different patients and across different life stages. This article provides an overview of the epidemiology, pathophysiology, diagnosis, and management of IgE-mediated food allergy.
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Open Access
Primary prevention of food allergy: beyond early introduction
(BMC, 2024-12-19) Chan, Edmond S.; Abrams, Elissa M.; Mack, Douglas P.; Protudjer, Jennifer; Watson, Wade
Abstract Food allergy typically begins early in life and persists as a lifelong condition. Delayed introduction of allergenic foods followed by years of hesitancy to introduce these foods early may have contributed to the increase in food allergy prevalence in recent decades. Most infant feeding guidelines focus on the importance of early introduction of allergenic foods in infants at around age 4–6 months. However, regular, ongoing ingestion of allergenic foods is also critical for the primary prevention of food allergy. Similarly, intermittent exposure to cow’s milk formula (CMF) in early infancy increases the risk of cow’s milk allergy (CMA), while regular exposure (if it is introduced) prevents it. Families hesitant to introduce allergenic foods to their infant at home (despite education) should be offered introduction in a primary care clinic. Infants who have failed primary prevention should be referred to an allergist for consideration of early infant oral immunotherapy (OIT).
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Open Access
Urticaria
(BMC, 2024-12-09) Ben-Shoshan, Moshe; Kanani, Amin; Kalicinsky, Chrystyna; Watson, Wade
Abstract Urticaria (hives) is a common disorder that may be associated with angioedema (swelling that occurs beneath the skin). It is generally classified as acute or chronic, and chronic urticaria is further classified as spontaneous or inducible Second-generation, non-sedating histamine type 1 (H1)-receptor antihistamines represent the mainstay of therapy for both acute and chronic urticaria. Second-line treatment for uncontrolled chronic urticaria includes omalizumab (a monoclonal anti-immunoglobulin E [IgE] antibody). In this article, we review the causes, diagnosis and management of urticaria (with or without angioedema).
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Open Access
Anaphylaxis
(BMC, 2024-12-09) Abrams, Elissa M.; Alqurashi, Waleed; Fischer, David A.; Vander Leek, Timothy K.; Ellis, Anne K.
Abstract Anaphylaxis is an acute, potentially fatal systemic hypersensitivity reaction with varied mechanisms and clinical presentations. Although prompt recognition and treatment of anaphylaxis are imperative, both patients and healthcare professionals often fail to recognize and diagnose its early signs. Clinical manifestations vary widely, however, the most common signs are cutaneous symptoms, including urticaria and angioedema. Immediate intramuscular administration of epinephrine into the anterolateral thigh is first-line therapy, and is always safe even if the diagnosis is uncertain. The mainstays of long-term management include specialist assessment, allergen avoidance measures, and the provision of an epinephrine auto-injector with an individualized anaphylaxis emergency plan. This article provides an overview of the causes, clinical features, diagnosis, and acute as well as long-term management of anaphylaxis.
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Open Access
Engaging Red River Métis families in Manitoba in the development of child health resources – findings from a qualitative study
(BMC, 2024-12-18) Knisley, Lisa; Driedger, S. Michelle; Hartling, Lisa; Chartrand, Frances; Sanguins, Julianne; Scott, Shannon D.
Abstract Background Most research that includes Red River Métis tends to be pan-Indigenous. Grouping Métis with First Nations and Inuit can diminish their unique and diverse experiences, as well as distinctions-based approaches. Taking a step toward addressing this problem, the Manitoba Métis Federation (MMF; the national government of the Red River Métis) invited researchers within the Canadian network Translating Emergency Knowledge for Kids to partner in this research, which focuses on understanding engagement strategies that can help expose Red River Métis parents to child health research opportunities and build trust and transparency amongst research partners and participants. Methods A qualitative descriptive approach underpinned by a participatory paradigm guided this study. Semi-structured interviews were conducted with 19 Red River Métis parents and Elders via Zoom or telephone. An inductive thematic analysis approach was used to explore patterns and themes across the data. Results Analysis generated four themes: (a) show me why you are here; (b) make it easier for me to take part; (c) create welcoming spaces; and (d) it should be a give and take experience. Parents emphasized the importance of kinship and personal connections, and said they want to hear about child health study opportunities from trusted organizations. They want researchers to be transparent about their research motivations and to offer multiple ways to participate to help them fit research into their busy lives. Relational approaches within the research process (e.g., creating informal/welcoming environments, gathering over food, fostering shared learning/creative opportunities) are prominent in the findings. Conclusion There is a dearth of research focused on the distinct experiences of Red River Métis families. Engaging Red River Métis parents early in the research process will help incorporate their preferences and perspectives into the design of a larger project to adapt child health resources. More training is needed to help researchers improve their abilities to engage in self-reflection, listen, recognize power relationships, and demonstrate trust and transparency in each research interaction. It is only through respectful and successful engagement that child health research can be relevant, applicable and positively impact Red River Métis children, families and communities.
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Open Access
Bacteria-activated macrophage membrane coated ROS-responsive nanoparticle for targeted delivery of antibiotics to infected wounds
(BMC, 2024-12-19) Luo, Ying; Jia, Xiaoli; Wu, Xiaozhuo; Diao, Ling; Zhao, Yawei; Liu, Xing; Peng, Yi; Zhong, Wen; xing, malcolm ; Lyu, Guozhong
Abstract Bacterial infections and antibiotic resistance represent significant global public health challenges, necessitating the development of innovative antibacterial agents with targeted delivery capabilities. Our study utilized macrophages’ natural ability to recognize bacteria and the increased reactive oxygen species (ROS) at infection sites to develop a novel nanoparticle for targeted delivery and controlled release. We prepared bacteria-activated macrophage membranes triggered by Staphylococcus aureus (Sa-MMs), which showed significantly higher expression of Toll-like receptors (TLRs), compared to normal macrophage membranes (MMs). These Sa-MMs were then used to coat vancomycin-loaded amphiphilic nanoparticles with ROS responsiveness (Van-NPs), resulting in the novel targeted delivery system Sa-MM@Van-NPs. Studies both In vitro and in vivo demonstrated that biocompatible Sa-MM@Van-NPs efficiently targeted infected sites and released vancomycin to eliminate bacteria, facilitating faster wound healing. By combining targeted delivery to infected sites and ROS-responsive antibiotic release, this approach might represent a robust strategy for precise infection eradication and enhanced wound healing.
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Open Access
Effect of defatting method on the structure and function of moringa seed proteins
(2025-01-16) Olukitibi, Abisoye; Kassa, Mulualem (Food and Human Nutritional Sciences); Utioh, Alphonsus (Food and Human Nutritional Sciences); Aluko, Rotimi
The global drive for sustainable food systems highlights the potential of underutilized crops like Moringa stenopetala (MS) for their nutritional and functional properties. This study examines the impact of defatting methods on the physicochemical and functional properties of MS protein isolates prepared using alkaline isoelectric precipitation (ISO) and NaCl membrane filtration (MEM_NaCl). Protein isolates were derived from cold-pressed MS meal, both undefatted (UMGPI) and defatted using acetone (AMGPI), hexane (HMGPI), methanol (MMGPI), ethanol (EMGPI; 70%, 7EMGPI; 50%, 5EMGPI), and water (WMGPI). ISO yielded superior protein recovery (41.73 – 83.23%) and content (69.50 – 83.24%) compared to MEM_NaCl, which achieved lower recovery rates (12.96 – 63.67%) and content (28.21 – 72.83%). Thus, ISO-prepared isolates were prioritized for further analysis. UMGPI provided the highest yield, while AMGPI showed superior protein content and solubility (25 – 75%) across pH levels 3 – 9. MMGPI stood out for high amino acid values, while AMGPI exhibited the highest foaming capacity (~80%) and stability at pH 7 and 9. Protein solubility peaked at pH 3. Intrinsic fluorescence revealed weak tyrosine (303 nm) and pronounced tryptophan peaks (348 nm), with MMGPI showing the highest intensity at pH 3. 7EMGPI excelled in in vitro protein digestibility (81.32%) and oil-holding capacity (3.93 g/g). Water-holding capacity was highest in 5EMGPI (2.81 g/g). UMGPI retained the highest phenolic content (1.39 – 1.53 mg GAE/g), while WMGPI had the lowest (0.57 – 1.29 mg GAE/g). Bitterness intensities ranged from 23.34 (MMGPI) to 28.24 (AMGPI). Enzymatic hydrolysis with alcalase (ALH), flavourzyme (FLH), and pepsin + pancreatin (PPH) improved bioactivity. PPH achieved the highest protein recovery (86.23%), superoxide scavenging (25.77 – 84.55%), and metal chelation (4.64%). ALH demonstrated the highest protein content (72.16%), lowest peptide molecular weight (0.38–2.19 kDa), potent ACE inhibition (15.07 – 66.56%), and renin inhibition (24.89 – 51.68%). FLH excelled in pancreatic lipase inhibition (42.06 – 64.38%) and arginase inhibition (13.18 – 34.57%). These findings highlight the role of defatting methods in optimizing MS protein functionality, with AMGPI emerging as a promising candidate for functional foods and nutraceuticals. Enzymatic hydrolysis, particularly with alcalase, further broadens their application potential.